Feeling anxious about the end of Roe v. Wade? Experts discuss mental health implications

The reversal of the most significant reproductive rights ruling in U.S. history has left Roe v. Wade supporters to grapple with what's next.

The majority of Americans support legal abortions at least most of the time, repeated polls have shown, with 61% saying that abortion should be legal in most or all cases, according to a recent survey by the Pew Research Center.

Since Friday, eight states have banned abortion and about a dozen more are considering following suit.

Many anxiety-inducing questions remain, including not only how accessible abortion will remain outside of blue states but also what civil rights precedent the Supreme Court could strike down next.

The Times spoke to three people who specialize in mental health care and its relation to abortion about ways to process the news of the Supreme Court's decision in Dobbs v. Jackson Women's Health Organization and what the mental health impacts may be. Their written responses are organized below, edited for brevity.

• Rachel Dyer, board chair for Exhale Pro-Voice, a nonprofit organization that provides after-abortion support.
• Cynthia Cerrato, holistic marriage and family therapist in L.A. County who specializes in treating maternal mental health issues, among other things.
• Claudia Parada, an associate marriage and family therapist who specializes in treating multiple components of people's identities, including race, sexuality and decisions around parenting.

Q: What should people understand about the mental health fallout after the overturn of Roe v. Wade?

Dyer: "We know from scientific research that facing barriers when seeking abortions, like needing to travel to another state, delaying care to save up for the abortion itself (as well as child care, a hotel, food, gas, taking time off work), is associated with greater emotional distress. With the overturn of Roe v. Wade, we can expect this sort of emotional distress to impact more people more significantly, as states now have the power to pass laws making abortions illegal."

"Again, we know from scientific research that if you need an abortion and are unable to access one, your mental health will suffer as well as your physical, relational and financial health."

"Lastly, the literal existence of this Dobbs decision is emotionally harmful as it perpetuates abortion stigma. We know that abortions themselves do not cause emotional distress; abortion stigma does, and that stigma, at the level of our institutions and government, is only going to get worse. This will harm not only the emotional well-being of people who will need abortions in the future, but people who have already had abortions, too."

Cerrato: "What I'd like for the community to understand about the mental health fallout of this decision are the natural responses and feelings that we will experience. Normalizing and validating these feelings and behaviors will be vital to our collective healing process during this time."

"The first thing that I feel most will experience is fear. Fear of what is next. For example, I've already heard individuals concerned about if same-sex marriage is next to be overturned. Anger and a tremendous amount of anxiety are other feelings that most of us will experience as a result of our uncertain future."

"I worry that most of us share a common sentiment, including myself, which is a feeling that a historical regression awaits us."

Parada: "The impact of this decision will touch the lives of every generation in this lifetime and many generations to come.

"The long-term adverse effects of the internalization of this message is that women and people with uteruses may believe that they don't deserve to have that freedom of choice or power. As a Latinx woman, I see this internalization with older women in my family that believe we should not have the right to choose how and when we birth because they have been conditioned to trust the 'experts' to dictate what's best for their health in all areas—mentally, emotionally, physically, spiritually."

Q: What kinds of challenges and experiences have you been hearing from your patients before and after the overturn?

Dyer: "[At Exhale Pro-Voice], we have seen a significant increase in our text-line utilization since Sept. 1, 2021, when Texas SB8 went into effect [effectively banning abortions after about the sixth week of pregnancy]. We saw another uptick in December 2021, after the Dobbs v. Jackson Women's Health Organization oral arguments."

"I'm writing this just hours after the Dobbs decision was passed down, so I cannot say exactly what people reaching out to our text line have said, but we anticipate greater impacts of stigma, such as secret-keeping and isolation out of fear of judgment and ostracization; greater stress associated with access to abortions, including fear of legal repercussions; and general heightened distress because of the overturn of Roe v. Wade."

Cerrato: "The challenges and experiences that my clients have been experiencing before and after the overturn of Roe v. Wade are the same feelings that they have been feeling these last two to three years. These are feelings of hopelessness and a sense of despair."

"Most of my clients have a shared common 'coping' mechanism that, while we know isn't healthy, is protective to a certain extent. That coping mechanism is feeling a sense of numbness, feeling like they're dissociating from all of the recent traumatic events that we've experienced individually and collectively (COVID, the Uvalde mass shooting in Texas, etc.)."

"Most of my clients have also expressed a feeling of rage mixed up with helplessness. Rage at the impact of white supremacy and a patriarchal society on our communities and helplessness, feeling like there's nothing they can do to change our current climate. Most of my clients are also experiencing a sense of 'Are we ever going to get a break?'"

Parada: "It's not normal to have power and autonomy taken from you and your body. Many folks have felt dissociated, at a loss and overwhelmed. Especially because many workplaces aren't creating safe spaces to discuss the impact of this decision and often people are asked to continue with their lives, business as usual."

Q: What are some ways to healthily process the news of the Supreme Court's decision to overturn Roe v. Wade?

Dyer: "Processing the news that Roe v. Wade was overturned is going to look differently for everyone. First, I would encourage folks to slow down or pause, and check in with themselves. What are they feeling? What are they needing? Have they had enough water today? Have they been scrolling through their Twitter feeds for hours, reading news and hot takes? Being gentle with yourself, meeting your basic needs and doing things that bring you joy are essential."

Cerrato: "Finding a safe space, such as a therapist, a community group or wellness collective, seeking spiritual guidance, engaging in rituals and healthy activities are great ways of processing the news of the overturn of Roe v. Wade. It's important to also point out that processing doesn't always have to be verbal. Spending time in nature is always medicinal, as well as movement. Not only is it grounding but also increases our serotonin level which helps increase hope. Moments of silence are also a healthy practice that increases our capacity to be able to hold space for our feelings and thoughts."

"Most of all, what I'd like for the community to remember is that in order to remain hopeful and active in creating change, we must continue to center and prioritize our joy even amidst an uncertain chaotic world."

Parada: "Healthy coping techniques should not and do not serve the purpose of adjusting the individual to a broken system. There are many histories of resilience, resistance and power among our communities of women, trans and nonbinary people, Black, Indigenous and people of color that have generations of wisdoms of the body and we need to remember to lean into one another for whole person care. Even when the reality is bleak, we have knowledge of healing in our history and in our community."

Q: How do you approach or talk about this topic with family members who have opposing views?

Dyer: "Talking about abortions with friends and family who may hold opposing views carries different risks for different people. First, I would ask people to reflect on the difference between feeling uncomfortable and feeling unsafe. Many of us conflate the two, and that stops us from having conversations that are uncomfortable but are generally safe."

"Of course, if you are a young person, living with people who hold these opposing views, or have some other circumstances where your safety could be impacted, you might make different decisions."