Running head: THREATS POSED BY UNWANTED PREGNANCY



Running head: THREATS POSED BY UNWANTED PREGNANCY

Threats to a Woman’s Psychological Well-being Posed by Unwanted Pregnancies

Lisa Kim, Olivia Olsen & Kristin Brenner

University of Oregon

Table of Contents

Page

I. Introduction ...................................................................................................................... 3

II. Arguments

A. Legal Issues.......................................................................................................... 5

B. Science Issues and Social Science

1. Abortions in cases of rape and physical harm.............................................. 7

3. Psychological impact of abortion ................................................................9

4. Abortion and teenage pregnancy ............................................................... 11

III. Conclusion .................................................................................................................... 14 IV. References .....................................................................................................................16

Introduction

Unwanted pregnancies can pose severe threats to a woman’s mental health, therefore this psychological danger posed by the pregnancy to a woman must also be considered for a law to pass in the Constitution. Abortion is the oldest and historically the most common method for controlling fertility, and a woman’s right to control what she does to her body. It has been used in all societies, and has been a method to terminate unwanted pregnancies. If abortions are not taken into account in relation to mental health there is the possibility of previous methods finding their way back into our society which include harmful methods of abortion. Although abortions have always been very common, it is not so common to find research that explores the processes of decision making and the various experiences of the women who are faced with abortion (Alex & Hammarstrom, 2004).

An unintended pregnancy most often defined as a pregnancy that is not timed properly (earlier than planned) or is unwanted. Mental health is defined in the Random House dictionary as the psychological state of someone who is functioning at a satisfactory level of emotional and behavioral adjustment. Going through with an unwanted pregnancy and the status of a woman’s mental health degenerating are strongly correlated. Carrying a child when the woman does not have the desire to can have negative health, social and psychological consequences on a woman. Health problems lead to greater chances for developing illnesses and death not only to the mother but also the child (Russo, 2002). In the context of abortion, the word ‘health’ has been analyzed and defined broadly. Health encompasses both mental and general health conditions because the body is interconnected.

In the case of Doe v. Bolton, “health” is suggested to encompass the spectrum of a person’s well-being as a whole. It not only deals with psychological health, but also physical, emotional, familiar [health] and the age of the woman. In the case of Roe v Wade, Jane Roe suggested that her decision to abort a baby was her right, and that her right to personal privacy were protected by the First, Fourth, Fifth, Ninth, Fourteenth Amendments (Roe v Wade, 2005).

Not only is the notion of mental health a large part in reproductive rights, it is also an issue that is greatly affected by these rights and the decisions that pertain directly to them. Clearly one’s mental health must be critically evaluated when even considering an abortion. Not only does there need to be evaluation or pre-screening of whether or not one is capable of making that decision by a professional, but there also needs to be a realization that the final decision to abort is not an easy one and can elicit many emotions such as anger, helplessness, guilt, regret, and emptiness. It is imperative before this procedure is done that a woman must be counseled (Reardon, 2003) and made aware the risks and emotional effects one may experience afterwards so she may be better educated in making her decision. The fact is no one can tell a woman what is right or wrong for her, her decision must be entirely her own because in the end good or bad the outcome affects her and her alone. It must be completely independent of what others think such as pro life activists, family, friends, and peers which can be emotionally trying especially since relationships may be severed or destroyed by the decision. Women make the decision to have an abortion everyday. The fact is that nearly half of the pregnancies that occur each year are unintended, and nearly half of these unintended pregnancies end in induced abortions. Although this is a decision that most women generally want to avoid making, nearly half of American women have had at least one abortion (“The new civil war,” 1998). Many reasons can cause a woman to reach this decision as a conclusion to give her some mental sanity and for her overall health and well being mentally and physically. Especially in cases where an unwanted pregnancy is the result of rape or any violence towards women, incestuous acts, cases of depression result from the unwanted pregnancy, and in times of economic distress where raising a child in this situation would not be beneficial to either party.

Legal Issues

Ever since Roe v Wade was settled in 1973 that legalized abortion, the laws regarding abortion have consistently been challenged. When Roe v Wade was put into effect it stated that a state’s decision to regulate or ban abortion after a fetus becomes viable is subject to exception when “ the life or health of the mother is at stake.” (Roe v Wade, 2005) However, the definition of health has consistently been loosely defined. In the 1973 case of Doe v Bolton, the term health was defined as encompassing “the entire spectrum of well being” including “physical, emotional, psychological, familial, and the woman’s age. The case of Doe v Bolton also argued that medical judgement could be made to give a woman an abortion on the grounds of physical, emotional, and psychological well being as they are factors that are all relevant to a person’s health.

In 1971 the case of the United States v Vuitch was brought to the supreme court challenging a District of Columbia statute that criminalized abortions “unless the same were done as necessary for the preservation of the mothers life or health.” A doctor had recently been indicted under that statute, but the D.C. district court dismissed the charges on the grounds that the “word health is not defined and in fact remains so vague in its interpretation and the practice under the act that there is no indication whether it includes varying degrees of mental as well as physical health”. When the court decided to uphold the statute, they interpreted the meaning of health to include a variety of factors. Writing for the majority, Justice Black stated that “ certainly this construction accords with the general usage an modern understanding of the word health, which includes psychological as well as physical well being (US v Vuitch, 1971).

In 1995 a bill banning partial birth abortions was passed in Ohio, the bill gave exceptions to the law only when necessary to prevent the death of the pregnant woman or a serious risk of substantial and irreversible impairment of major bodily function on the pregnant woman. The was found to be invalid because it failed to cover impairment of mental health. Judge Walter Rice when hearing the case relied on the case of Doe v Bolton to hold that “ a state may not constitutionally limit the provision of abortions only to those situations in which a pregnant woman’s physical health is threatened, because it this impermissibly limits the physicians discretion to determine what measures are necessary to preserve her health. The court cited the case of an extremely deformed baby or one conceived out of rape or incest as examples of when an abortion might be necessary on the grounds of the mothers mental health.

Other cases regulating abortion have also had exceptions regarding the mothers health. In the 1992 case of Casey v Planned Parenthood, when the court replaced the trimester system with a distinction made at viability regarding partial birth abortions, the law stated that after viability states “may proscribe abortions as long as they provide an exception for the life and health of the mother.” In addition, in the case of Harris v MacRae the Supreme court stated that the case of Roe v Wade, that Roe emphasized the fact that the “woman’s decision carries with it significant personal health implications- both physical and psychological.” Roe also stated that even after fetal viability a state may not prohibit abortions necessary to preserve the life or health of the mother.

More recently in the 2003 case of Carhart v Ashcroft, declared the partial birth abortion at of 2003 unconstitutional because it failed to include any exception to the prohibition on abortion procedures where it is necessary in appropriate medical judgements for the preservation of the .... health of the mother. Thus the act prohibits physicians from providing the best medica; care for their patients needs. It also bans physicians from providing the safest abortion possible for their patient. Plaintiffs in the case argue that the act contains only a limited exception for the woman’s life, it provides that it is prohibitions do not apply to a partial birth abortion that is necessary to save the life of “ a woman whose life is endangered by a physical disorder, physical illness, or physical injury including a life endangering physical condition caused by or arising from the pregnancy itself. The act also does not contain an exception for abortions necessary to save the life of a woman whose life is endangered by a mental disorder , illness or injury.

The Abortion Act was passed in the year 1967 and then in 1990 it was amended. It states that an abortion can be done in a legal manner if two or more doctors comply that 1) The mental and physical health of the woman, or existing children will suffer if the pregnancy continues or 2) The child, if it is born, will be seriously physically or mentally handicapped. The Abortion Act, especially the first section has always been interpreted in different ways by opposing sides. However, the mental health of a woman is written in the Abortion Act which suggests its severity when considering an abortion or continuing an unwanted pregnancy.

Abortion in Cases of Rape and Physical Harm

The common argument from anti abortion activists is that women end up in situations because of their own choices and actions. However, this is not true for victims of rape or incest. A woman that is raped is a victim of a serious violent crime. Approximately, 1 in 8 women are victimized by forcible rape each year. Of these rapes 5% are estimated to result in unwanted pregnancy, which translates to about 50,000 a year. (Russo & Denious, 1998) Not only do female rape victims of these rape experience lifelong physical and emotional scarring from the actual rape themselves, but also with the decision of what to do with the unwanted pregnancies as a result. This poses another aspect of how one’s mental health can be affected by their reproductive rights but also the potential abuses relating to them as well. In this case, if a woman is not allowed to have an abortion then the child that is conceived will most likely become a constant reminder of the experience, and many also do not have the economic funds and resources to bring up a child in their circumstances. For many women, the feelings of powerlessness, loss of control, and dissociation they feel from rape is compensated in a way by exercising their personal rights about their own body when it comes to making the decision whether or not to abort the child they are burdened with. (Russo & Denious, 1998) Previous cases have stated that a baby conceived of rape or incest as examples of when an abortion might be justified on the grounds of mental health.

A correlation has been found that women who are in violent relationships are likely to be abused during their pregnancy contributing to an increased number of stillbirths and miscarriages. In a large population based study across four states (Alaska, Maine, Oklahoma, and West Virginia) of 12,612 mothers found that 43% of women sampled had an unintended pregnancy (Gazimararian et al, 1995) and of the women who reported that they had been physically abused during the 12 months before their delivery 70% reported having an unintended pregnancy. Given these findings it is imperative to see how bringing a child into the world in this emotionally unstable and violent setting could have distinguishable consequences. Situations such as an unstable relationship with a partner are included in what might be considered an issue of not sound mental health. The emotional unavailability to raise a child due to a situations such as domestic violence are causes of psychological stress, and some abortions have been granted purely on grounds related to stress. This suggests that the mental health status of the mother carries over to affect others, such as the child and the child’s mental health, which can be influenced by his acceptability into the world.

Psychological Impact of Abortion

Many anti abortion activists argue that allowing a woman to have an abortion will cause more psychological problems, than relieve any pre- existing issues. However, this argument is weak as well designed studies have shown that the risk of psychological harm is low. Studies have found that post abortion rates of distress and dysfunction are lower than pre abortion rates. In the cases of unwanted pregnancy, it has been shown that if an abortion is desired and denied, the denial of the abortion can have a negative psychological effects on the woman.

As long as the screening and counseling aspect as mentioned above is not neglected, the majority of women after receiving an abortion have been found to be satisfied with their decision. In a study conducted by Russo and Pope in 1993 of 249 married abortion patients, only 5% reported dissatisfaction with their decision suggesting that the counseling and screening process was effective. Scientists have found when the abortion is conducted in the first trimester of the pregnancy, it is not found to have severe or long lasting negative effects (“The new civil war,” 1998). Despite the fact that up to 50% of abortion patients experience feelings of guilt, anger, or regret with the decision research suggests these feelings occur before the procedure or only comprise a short term consequence thereafter (Adler et al, 1990). This suggests that the mental health of a woman is restored after the abortion for the long term. These negative immediate emotions are normal because abortion is a mentally and emotionally trying experience in itself and reactions to it are emotionally charged. Researchers have found that most women feel a sense of relief and “emotional washout” after the procedure, in part because their heightened anxiety beforehand was so great. It is essential to note that these reactions are more probable if the pregnancy was unintended and unwanted. If this is the case then feelings of happiness and satisfaction will increase over time (Adler, 1992). Some have argued that abortion can have a positive effect on a woman’s psyche. Psychological benefits gained from abortion in thee women include a sense of personal empowerment, and a smaller family size.

In Alex and Hammarstrom’s (2003) study of a woman’s experience in connection with induced abortion, pregnancy brought on signs of psychological and mental degeneration such as mild depression and sadness, when the women had doubts of having the ability to provide for the baby in the future, especially as a single parent who was (prior to the pregnancy) dependent upon someone else for financial support. The researchers that performed this study described the emotional trauma experienced by women who have little to no support during their unwanted pregnancy. It suggests that from time to time the feelings of a woman not wanting to be pregnant is in large part, a result of their partners not wanted a child (Alex & Hammarstrom, 2004). Pregnancies were unwanted by the women also due to recollections of their childhood. The women had grown up in broken homes, where parents had gone through a rough divorce, and where fathers were alcoholics (which was associated with many of the negative childhood memories). The women felt depressed as their current situation almost exactly resembled their childhood. Women in these situations were depressed thinking about their past, and the future of their child. Feelings of depression were fostered by the constant loneliness and desertion they felt from their unsupportive partner. The combination of depression and lack of support, bringing the women farther from comfort, increased low self-esteem and brought on continuous doubts of being able to bring the child anything positive in it’s life. Shameful feelings of their current situation in this chain of psychological stress of the mother continued through pregnancy and after the child was born (Alex, Hammarstrom, 2004).

Abortion and Teenage Pregnancy

The adverse consequences of a teenager’s inability to control their pregnancy can be particularly severe in some cases (Russo & David, 2002). Teens who are pregnant as well as teens who have recently gone through a rough or unwanted pregnancy are three times more likely to be victims of homicide when compared to their peers who have not experienced pregnancy. The rate of homicide was in fact nearly double in all women who were pregnant, which suggests some link between the two (Krulewich, Roberts, Thompson, 2003). In Sopher’s (1999) study of adolescents, she suggests that a large portion of the population who are seeking to terminate their unwanted pregnancies are teenagers, because it conflicted with their daily life (more than for adult women). Dropping out of school was a result of feelings of shame, guilt, and inability to cope. Dropping out of school left teens with a sense of lost hope for the future, constant worries for how they would find a job to support themselves and the baby. The pregnancies were unplanned and unwanted. Pregnancy has detrimental affects on adolescents, such as overwhelming psychological stress, and depression also found in older women. However, different from older women, adolescents feel a sense of inability to handle the situation. They deal with ridicule from peers, nervous breakdowns, rejection from peer groups, and from family more often than adult women (Sopher, 1999). Furthermore, many adolescents think that a pregnancy means the end of their future career, because of the bigger issues such as poverty and health complications that now face them. Abortion may avoid negative health consequences, especially for teenage mothers. Unintended and unwanted childbearing can have negative health consequences including greater chances for illness for both the mother and the child (Russo & David, 2002). Older women on the other hand feel a sense of hopelessness when they become pregnant. They feel that they are no longer able to, nor prepared to go through with the obligations that motherhood presents to them. Often times it interferes with work situations as well, which can be a big issue when the woman’s income is the only income she has. Other concerns have to do with the ideal public perception of what accounts for good conditions in raising a child, and what the ideal image of a mother is. Older women who have grown children and were not planning another child usually do not fit this ideal image (Sihvo, Bajos, Kaminski, 2003).

As stated in the Adler, Ozer, and Tschann study in 2003, a lasting concern for adolescents is the parental consent forms that they have to face, which is occasionally required when the mother-to-be is younger than 16 years old. This is because people under 16 are still thought of as children and are believed to not have decision making skills compared to that of an adult (Soper, 1999). However, studies have shown differences in self report responses among teenage girls who have become pregnant. The researchers found that teens would be hesitant to tell their parents or even go to a facility altogether, because if the facility found out their age then they would be obligated by law to inform the parents. In the 2003 study of Adler, Ozer & Tschann, another problem found in relation to parental notification, was that “young women with serious concerns about the consequences of notifying their parents may pursue other avenues to obtain abortions. As a result, some adolescents subject themselves to risk of injury and death by seeking an illegal abortion” It was also found in the same study, that adolescents who voluntarily told their parents about their unwanted pregnancy had adverse consequences that followed as well. The young women did not personally put themselves at risk of injury or death, but experienced parents “making them have an abortion, physical violence, and being forced to leave home” (Adler, Ozer, & Tschann, 2003). These findings suggest that some adolescents (especially those with strict parents) would rather put themselves at high risk than tell their parents about their unintended pregnancy. On the contrary, these findings also suggest that when parents are told voluntarily by their children, they may not be of any support, but rather enhance the psychological trauma experienced by the adolescent.

In addition to these worries carried by the adolescent, when the relationship between the parent and the child are not ideal a possibility exists that the parents will pressure the pregnant adolescent to make a decision that is against their will. In the case of incest, the father of the pregnant adolescent may be the same person signing the consent form, which would be horrible for the already traumatized teen to go through. This would also grant the person responsible for the psychological trauma experienced more power over the choice of her future role as a parent. This would result in leaving the adolescent to feel a loss in control over all decisions affecting her own body, freedom, and future.

Conclusion

When looking at the various cases that have decided against allowing abortions only when the mothers physical health is in danger, it is reason to stand behind the argument that mental health conditions should be included in allowing abortions. By looking at the Random House dictionary definition of the word health, it is defined as “the condition of being sound in body, mind , and spirit”. If the law limits the definition of health to only physical health the law is limiting physicians to give their patients the best treatment that they find necessary. Also, by placing more limits on the woman’s and physician’s right to choose the best possible treatment, the law is limiting their right to privacy. With this definition, health is defined in both terms of body and mind, and laws surrounding the availability of abortion should be as well.

A woman’s right to choose an abortion arises fundamentally from the right to privacy, as Roe claimed in her case of Roe v Wade. The studies featured in this paper clearly suggest how abortion is in many ways the last resort for women, even amidst suffering through many mentally trying times. To claim that a woman’s mental health need not be considered in relation to abortion is not even a stance taken from pro-lifers, who agree and acknowledge that a woman’s mental health is affected in the process of decision making that occurs before an abortion or unwanted pregnancy (Reardon, 2003). If the right of women to choose an abortion based on mental health is denied, then women may go through with abortion on their own using methods unsafe and outdated for our time. In this case, there would be many more deaths (than unborn children) that occur as a result of both mothers and fetuses dying. Denying abortion of unwanted pregnancies will also lead to many psychological damage of mothers that carry through pregnancy and last well after the baby is born. Mothers may have regrets trying to raise their children whom they did not intend to have, because carrying a baby to term that was unwanted are linked with child abuse, divorce, poverty, and juvenile delinquency (Russo, 2002). Many women who will raise their child as a result of rape or other another form of violence will be living with a constant reminder of the incident.

It is especially difficult to define mental health in relation to unwanted pregnancies and abortions because of individual differences. However it’s complexity is not alarming, and the inability for people to categorize it, stems from the issues related to abortion being a moral, religious, legal, political, health and human rights issue (Reardon, 2003).

References

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