I'm Not Okay: Roe Overturned and Its Effects on Mental Health

I have been trying to write this piece for over a week now. Each time I open this document, with the intent to get my thoughts fully expressed, I find that I am simultaneously without words and so full of them that I cannot even know where to begin. This is not a normal blog post. Nothing about the stripping of human rights from half the nation is normal. It is unimaginable and yet it is reality.

Usually, I begin sessions with clients the same way. As they walk through the door, I ask “How are you today?” and they answer, and ask me the same question back. In the past, when the country was not on the brink of calamity, I answered “I’m good/fine, thanks!” No matter what was going on in my life, I would always say that I was fine. Why did I do this? Because therapy is about the client, and talking about myself is taking away precious time and attention from them. It has never been difficult for me to put my issues aside for my clients. Until June 24th, 2022.

 After reading that Roe v. Wade had been overturned, I opened the door to my first therapy session of the day. My client walked into my office and as she settled onto the couch she asked, “How are you?” I hesitated. I wanted to say I was “fine.” I have had days in the past when I was dealing with grief or trauma, and I had still not hesitated to say those words, “I’m okay.” On that day, I struggled. Because I was not okay. Sometimes as a therapist, you come across a situation they don’t prepare you for in graduate school. A time when you and your client are both sitting with the same exact trauma, and there is no denying that you are just as unsure as they are on how to cope. So I told her, “I’m not okay”. It was not a textbook moment, but it was a human one.

So, why am I not okay? Because abortion is mental health care. In a swift and cruel cut, people who can get pregnant were classified as second-class citizens. The trauma that occurred at the moment that those rights were taken away is incalculable. These are the first drops of rain in the upcoming torrential downpour of trauma about to occur. Trauma such as: having to give birth to your rapist’s child; being prosecuted, jailed and labeled a felon for exercising freedom to your own body; being watched and judged by “pro-life” individuals to make sure you give birth or risk being reported; young girls becoming mothers when they are children themselves; having to give up a child to the foster care system that is already overloaded and abuse-infested; risking your life and changing your body forever against your will; watching your partner die because they have an ectopic pregnancy and abortion is the only treatment; giving birth to a baby who is so severely disabled that it dies immediately after being born; being a child born to parents who do not want you and cannot afford to care for you; and so many more stories that women could literally write entire libraries of stories about how this will negatively impact their lives and wellbeing. I don’t believe there are proper words to elucidate the trauma that has just begun to unfold.

Taking a Toll on Women’s Mental Health      

Some effects are more quantifiable. For example, women who were denied access to an abortion were significantly more likely to have higher anxiety symptoms than those who did have access (Foster et al., 2015). Anxiety will increase. During the pandemic, 40% of Americans experienced symptoms of depression (CDC Household Pulse Survey, 2020). While it is simply not possible to have research conclusions of how the overturning of Roe will affect rates of depression and anxiety currently, it seems a very plausible hypothesis that when half of the country gets their human rights revoked, depressive symptoms will increase in the population. To support this, studies have shown that mothers whose pregnancies were unwanted and/or unplanned were at significantly higher risk for postpartum depression and other poor mental health outcomes (Barton, K., Redshaw, M., Quigley, M.A. et al, 2017; Herd et al, 2016).

Speaking of poor outcomes, considering that homicide is already a leading cause of death in pregnant women usually committed by their own partners (Wallace et al, 2019), it is also predictable that these rates of homicide will dramatically increase as women can no longer escape their abusers through the option of abortion. Instead, they will remain tied to them and vulnerable for the remainder of the unwanted pregnancy.

Of course, we must also be aware that the abortion restrictions will disproportionately affect POCs, minorities, LGBTQIA+ and economically disadvantaged persons. For example, according to the Kaiser Institute, in Mississippi where minority women comprised 44% of the female population, they accounted for 81% of women who received abortion care. Privileged women (generally white, upper class) will still have access to safe abortions (I'll take a moment to recognize my extreme privilege as the author, as I am a white cis gendered woman, who lives in a state that protects abortion access and also has financial means to seek one elsewhere if necessary.) This burden of impact is intentional, make no mistake. It's a way to further suppress voters who can hurt the GOP agenda. Let's make one thing clear; the ban on abortion will irrevocably harm the mental and physical health for all women across the United States but especially for POC and other minorities. There is plenty of research to support this.

Unfortunately, it doesn’t seem like the SCOTUS is done with their massacre. In the past week, SCOTUS has greatly decreased the EPA’s power to fight climate change, revoked gun restrictions laws, ruled in favor of letting a federal employee openly forcing their religion on others, and Clarence Thomas has stated his intent to revisit crucial cases that could potentially revoke gay marriage rights, make homosexuality illegal, and ban contraception.  

Channel Your Anger

All I can say is that the grief you feel is valid. The rage, the sadness, the comical irony, the avoidance, the bargaining, the numbness … it is all okay. Because quite frankly, we are not okay. Your therapist hears you and feels the same way. We care about you and sit in it with you. I grieve deeply for my clients, and future clients who will be impacted by this. I grieve and submerge myself in the chaos of emotion that everyone affected by this. I will still continue to hold space in the months and years to come for all that need it.

However, this is not a time to land on the acceptance phase in the five phases of grief. In fact, I urge you to land on anger. Anger is an emotion that occurs when boundaries have been crossed. Oh man, did they get crossed. We can still win this fight, but we all need to work together. Join protests, participate in the general work strike and sex strike being organized, boycott companies that contribute to pro-life funds, join the auntie network (r/auntie), vote, donate, and most of all take incredible care of yourself and loved ones right now. We will need mental strength in the times to come, which requires self-care.

Finally, I recommend that when someone asks you "How are you?", answer them honestly. Say "I'm not okay". Let people know how you are affected by this. Chances are they will join you in that conversation. If they don't, well, maybe it's their turn to feel uncomfortable for a change.

You don’t have to go this alone. 

*In response to the COVID-19 pandemic, we continue to offer telemental health sessions.*

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