Mental health and pregnancy outcomes after being denied an abortion due to the Dobbs v Jackson Supreme Court decision

In order to effectively and efficiently help individuals access desired abortions, we must understand whether and how mental health (anxiety and depressive symptoms) is associated with various pregnancy outcomes after having been denied an abortion. According to theories of depression, mental health problems such as depression or anxiety disorders may interfere with pursuing an abortion. According to stress and coping theory, situational anxiety or depressive symptoms may motivate individuals to pursue an abortion. In addition, in order to promote mental health around being denied an abortion in this new post-Roe context, we must understand how mental health changes from the time of being denied to 2 years later and whether these changes vary by pregnancy outcome. The long-term goal of this research is to help women access desired abortions and promote mental health in women seeking abortions in states with no or very limited abortion access. The primary objectives of this research are to examine whether mental health influences pregnancy outcomes after one’s abortion appointment is cancelled (Aim 1) and to investigate whether anxiety and depressive symptom trajectories vary by pregnancy outcome after having one’s abortion visit cancelled (Aim 2). To carry out these aims, Julia Steinberg will collaborate with Dr. Diana Greene Foster at the University of California, San Francisco on a study she is leading to examine what happens to women whose abortion visits are cancelled due to the Dobbs v Jackson decision. Participants will be recruited when they are notified they can no longer have their scheduled abortion at the clinic because of the Dobbs decision. Those who enroll will complete a self-administered survey online. Enrolled participants will be followed for two years and asked to complete self-administered online surveys every two months. Participants will be asked about what they are doing or did with their pregnancy in the first and subsequent surveys. Anxiety and depressive symptoms at the time of each survey will be assessed with the validated, Patient Health Questionnaire, 4-item measure. Past depression and anxiety disorders will be assessed at the first survey. The various pregnancy outcomes examined here include: having an abortion in another state, self-managing abortion with medication, self-inducing by means other than medication, and carrying to term. They will conduct multinomial logistic regression and mixed effects linear regression and binomial logistic regression analyses to carry out the first and second aims, respectively. Results from this study will inform an R-series grant examining how mental health influences attainment of one’s reproductive goals, or how mental health of reproductive-aged women and men is affected by curtailing reproductive rights. Findings will be crucial for helping women access desired abortions and promoting mental health in the post-Roe era.