Mental health conditions are excluded from some state abortion exemptions.

Mental health advocates say many states have a cruel quandary on abortion: There are exemptions for life-threatening emergencies, but psychological crises don’t count.

None of this means anything to an Arizona mother of three who committed suicide during her fourth pregnancy and says an abortion saved her life. Or to researcher Kara Zivin, who nearly died from a suicide attempt in pregnancy and whose work shows that these crises are not uncommon.

Zivin had a healthy baby, but she empathises with women facing mental health emergencies who believe terminating the pregnancy is their only option.

“People often try to separate mental health from physical health, like your brain is somehow disconnected from the rest of your body,” says Zivin, professor of psychiatry, obstetrics and gynecology and health management at the University of Michigan. he said.

Rowe v. Wade was overturned in June, which reflects the contradiction. In at least eight states that allow exemptions for life-threatening conditions, the focus is on physical health. The mental health of the mother is not covered.

Some of these exemptions are vaguely worded. Others are obvious.

Florida’s exemption covers life-threatening diseases “other than psychiatric conditions.”

Laws in Georgia, Nebraska, and West Virginia specify that medical emergencies do not include threats of suicide. A county judge’s decision that overturned the Georgia law on Tuesday is being appealed.

Some opponents of abortion say the laws are intended to protect women from faking mental illness so that doctors can terminate their pregnancies.

Patricia, who is 31, married and “your average neighborhood chick,” says her anguish was painfully real. The Phoenix woman spoke to The Associated Press on the condition that only her first name be used, citing security concerns and privacy.

She says a wave of severe depression hit her in the summer of 2018 and “broke not only my mind, but my heart and soul.” She could neither eat, nor sleep, nor take care of her three young daughters properly. Panic and suicidal thoughts bombarded him. When she found out a few weeks later that she was pregnant again, she knew she wasn’t in the shape of someone else’s mom.

At the time, her abortion was legal in Arizona. The state recently implemented an almost complete ban, although this has been temporarily paused.

Postpartum depression is well recognized – US studies suggest it affects around 1 in 8 women – but evidence suggests depression may be even more common during pregnancy.

Bleeding, heart conditions and infections preceded suicide and mental health conditions including substance abuse became the leading underlying causes of pregnancy-related deaths in 2017-19, the Centers for Disease Control and Prevention said in a September report.

Zivin co-authored a study published last year that found suicidal thoughts and behaviors were on the rise among commercially insured American individuals before, during, and after pregnancy. Rates were low, but they increased from 1 per 10,000 in 2006 to about 3 per 10,000 in 2017 among people with anxiety or depression.

Zivin didn’t consider terminating her pregnancy 10 years ago, but said she understands why a suicidal woman feels abortion is her only option. She called the limited exemption laws “unfortunate” and said the politicians who wrote them “do not appreciate or understand the burden of mental illness.”

Observers note that in 1973’s Roe v. Prior to the Wade decision legalizing abortion, a mental illness diagnosis enabled some women to have abortions and some states required psychiatrists to certify the diagnosis.

Opponents of abortion argue that many women pre-roe feigned mental illness and that psychiatrists became their accomplices.

The old laws “essentially forced psychiatrists to stretch the truth,” said Carol Joffe, professor of OB-GYN at the University of California, San Francisco.

She notes that California once required two psychiatrists to sign off on such an abortion.

“It was like everything to do with health care and pre-abortion cry. It was class based,” she said. “Most of these psychiatrists didn’t do it for free. You should have had the money.”

Laws banning mental health exceptions “show indifference to the very real mental illness that some pregnant people have” and shows “how unfair it is for politicians to make health care policy,” Joff said.

Rep. Ed Setzler, a Georgia Republican who sponsored that state’s legislation, argued that “a claim of stress or mental anguish simply does not rise to the level that the legislature was persuaded would result in the termination of the child’s life.” should. ”

Eric Johnson, president of the Alabama Pro Life Coalition, wrote that the state’s nearly total abortion ban and that the suicide exemption was included at the request of the state medical association. The narrowly crafted measure exempts only suicidal women who are diagnosed by a psychiatrist and requires that the abortion be performed in a hospital.

“If you put it there and don’t define it closely, it’s a hole big enough to drive a truck through,” he said.

The National Right to Life Committee, an anti-abortion group that lobbied for these measures, defended the restrictions.

“Mothers experiencing serious mental health problems should receive counseling and mental health care. Having an abortion will not make mental health issues less likely,” said spokeswoman Laura Echevarria.

According to the American Psychological Association, there is evidence that denial of an abortion can lead to mental distress.

Michelle Oberman, a Santa Clara University law professor and expert in reproductive health ethics, said restrictions on abortion that make no exceptions for serious mental illness are cruel and misguided.

Even if the behind these measures are targeting women who attempt to fake mental illness, the law will inevitably affect people who are actually suffering, she said.

The mindset behind these laws “doesn’t really consider what it would feel like to face patients with serious mental illness,” Oberman said. “What a mental health emergency looks like is jaw-dropping,” she said. “They are real and they are a threat to life.”

Copyright 2022 Health News Florida

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