Implementing the mental health indication to help ensure access to safe abortion

This paper recommends implementation of the mental health indication for legal abortion to help reduce high rates of death and injury from unsafe abortion. Legal abortion to preserve a women's mental health is explicitly recognized in the laws of 23 countries. However, the law is implemented in different countries in varied ways, giving rise to a range of access to safe abortion among countries with similar laws. In this paper, I propose the enactment of guidelines for implementing the mental health indication to improve access to safe abortion. Such guidelines should enable providers to consider a woman's social and economic circumstances in determining the risk of pregnancy to her mental health. This approach is supported by global health authorities and psychological research. I also present empirical and legal support for the notion that abortion can lead to favorable mental health outcomes, as is implicit in the mental health indication.