Navigating the Overturning of Roe v. Wade in Integrated Behavioral Health

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By A. Alban Foulser, MA, and Rachel J. Ammirati, Ph.D., on behalf of the Atlanta Behavioral Health Advocates

The overturning of Roe v. Wade has resulted in major changes to state laws regarding abortion access. As laws continue to change and medical clinics stop providing abortions, behavioral health professionals will be asked to respond to a wide range of patient concerns related to family planning and local policies (Biggs et al., 2017), including problem-solving and managing distressing emotions. Behavioral health professionals working in primary care and similar medical settings are especially likely to encounter these concerns, yet may have only a brief amount of time in which to address patients’ needs. Additionally, patients in primary care may have limited access to medical professionals with specific expertise related to abortion (Dorner et al., 2015). Because the provision of informational resources is a common intervention strategy used in stepped integrated care models (Maragakis & O’Donohue, 2018), behavioral health professionals in these settings must be informed and have resources readily available. Moreover, they must be thoughtful about their scope of practice limits and potential ethical issues likely to arise in abortion-related behavioral health consultation and intervention. With the goal of supporting our busy integrated behavioral health colleagues’ need to know about informational resources relevant to family planning-related concerns, we have compiled a list of such resources that we hope our colleagues and their patients will find helpful.

Issues Related to Family Planning Options

Patient concerns related to the Supreme Court decision will vary widely. Previous research has demonstrated that people forced to travel to access an abortion in the United States face a range of barriers, including logistical difficulties due to travel, difficulty navigating the healthcare system, limited options for clinics providing abortion, financial concerns, and restrictions at the state or clinic level (Jerman et al., 2017). Patients who are pregnant or considering becoming pregnant may therefore consult behavioral health providers about their options, including seeking information about the current status of abortion access in their area, clinics providing abortions, and resources for financial or logistical support.

Directing patients to well-known family planning organizations such as Planned Parenthood is one way to assist with answering many patient questions related to these topics. However, behavioral health professionals may be wary of discussing these topics with patients due to concerns about legal implications. Of note, the American Psychological Association has published an FAQ page addressing legal concerns that psychologists may have when discussing issues related to abortion.

Additionally, many non-behavioral health-focused organizations have created resources for professionals and patients alike that include similar information. For example, to support pregnant people considering various courses of action, the American College of Obstetricians and Gynecologists has an informative webpage about the possible options of raising the baby, placing the baby for adoption, and having an abortion. The U.S. Department of Veterans Affairs also has an informative website on reproductive health with additional resources for Veterans. For patients seeking information on the current status of abortion access in their area, interactive maps managed by the Guttmacher Institute and the Center for Reproductive Rights provide clear and regularly updated information about abortion access in each state. Additionally, to counter misinformation that has recently been spread on social media platforms, the National Capital Poison Center provides accurate information about herbal abortifacients (products used to facilitate abortions) and cautions that their use can be toxic.

Issues Related to Emotional Reactions

Additionally, the overturning of Roe v. Wade will lead to strong emotional reactions for many patients. Previous research from the Turnaway Study (Foster, 2020) has demonstrated that patients experience a wide range of positive and negative emotions in the week following being denied an abortion (Rocca et al., 2021; Rocca et al, 2013).

However, negative emotional reactions are not limited to pregnant people being denied an abortion. For example, CBS News published the results of their poll on reactions to the Supreme Court decision, which found that respondents who disapproved of the Supreme Court decision reported feeling primarily upset, angry, and scared. Behavioral health professionals can expect to see patients seeking support for strong emotional reactions due to the impact on their own or loved ones’ pregnancies and access to abortion, as well as distress related to their personal sociopolitical views, and disagreements in their relationships, family, or culture. All-Options is an organization that provides free emotional support for experiences with pregnancy, parenting, abortion, and adoption through a peer support talk line as well as a faith-based talk line.

For some patients, managing strong negative emotional reactions to the overturning of Roe v. Wade may include channeling these emotions into advocacy and activism (Earnshaw et al., 2016; Kleres & Wettergren, 2017). In these cases, behavioral health providers may consider directing patients to organizations such as Sister Song, Planned Parenthood, and the Latina Institute. In addition, the American Psychological Association has created a comprehensive page on issues related to abortion, which includes news and resources related to advocacy. Indeed, previous research suggests that coping with negative emotions through activism can lead to a greater sense of individual and social well-being (Earnshaw et al., 2016; MacDonnell et al., 2017).

Final Thoughts

The overturning of Roe v. Wade will continue to have a broad impact on the behavioral health of many individuals, and behavioral health providers working in primary care and other medical settings are likely to field many questions related to this historic decision. Although this list of resources is far from exhaustive, we intentionally kept this list brief in order to support the needs of busy integrated behavioral health providers. We hope this will provide a useful starting point for behavioral health professionals and their patients in medical settings as they navigate the multifaceted impact of the overturning of Roe v. Wade.