From Rights to Risks: Mental Health Implications for Pregnant Patients Following the Reversal of Roe v. Wade

Area of Science:

• Reproductive Health
• Mental Health
• Public Health Policy

Background:

• The overturn of Roe v. Wade has impacted reproductive rights and access to abortion care in the US.
• This legal shift may influence the psychological well-being of individuals seeking abortion services.
• Previous research indicates a correlation between abortion access and mental health outcomes.

Purpose of the Study:

• To evaluate the incidence and prevalence of acute stress episodes (ASE) and depressive episodes in patients undergoing non-spontaneous abortions.
• To compare these mental health outcomes across distinct time periods: pre-COVID, COVID, and post-Roe v. Wade (pRvW).
• To examine disparities in mental health outcomes among different racial groups.

Main Methods:

• Utilized the TriNetX electronic health record database across 66 US healthcare organizations.
• Assessed diagnoses for depressive episodes (ICD-10-CM=F32) and acute stress episodes (ICD-10-CM=F43.0, F43.9, F43.11).
• Employed relative risk and Chi-squared tests to compare outcomes across pre-COVID (2017-2019), COVID (2020-2022), and pRvW (2022-2024) periods, analyzing racial group differences from 2017-2024.

Main Results:

• The prevalence of both depressive and acute stress episodes showed an increasing trend over time.
• The incidence of depressive episodes was lowest during COVID and highest in the pRvW period.
• The incidence of acute stress episodes increased during the COVID and pRvW periods, with no significant statistical difference between these two.
• Depressive episode prevalence significantly increased among African American patients (p=0.0146).

Conclusions:

• The overturn of Roe v. Wade appears associated with increased incidence and prevalence of acute psychiatric diagnoses post-non-spontaneous abortion.
• Certain racial groups, particularly African Americans, experienced disproportionately higher rates of depressive episodes.
• Findings underscore the necessity for enhanced psychological support services, especially within marginalized communities affected by reproductive rights changes.