As a group of physicians specializing in psychiatry and women’s mental health, we call attention to the violation of women’s rights inherent in the Texas ban on abortion after six weeks. This law, as well as the copycat just-proposed bill in Florida if enacted, will have significant and long-lasting consequences beyond the effect it has on any woman with an unwanted or traumatic pregnancy.

This unethical law is fraught with negative consequences.

1) It increases the risk of psychiatric illness, which, in turn, will worsen infant and child outcomes in many cases.

2) It places a “bounty” on physicians and other medical professionals who are following evidence-based standards of medical care.

3) It disregards the traumatic reasons for abortive services (e.g., incest, rape).

4) It criminalizes women who resolve traumatic pregnancies though abortion and criminalizes their families.

5) It violates patient and family autonomy in making medical decisions.

6) It inappropriately inserts the legal system into the private lives of Texas women, their loved ones, and anyone willing to offer support in a time of need.

7) It further exacerbates systemic patterns of discrimination based on race, gender, and socioeconomic situation, as these negative consequences will be disproportionately borne by women who are unable to afford travel to a state in which abortion services are available.

Being forced to carry an unwanted pregnancy to term increases the risk of depression in pregnancy and after birth (perinatal depression), which in turn worsens infant and child outcomes. Perinatal depression is associated with adverse outcomes that have long-term consequences. It is associated with pregnancy complications, including preterm birth, low birth weight, and gestational diabetes. It is also associated with consequences for the child, including lower IQ, slower language development, and an increased risk of subsequent psychiatric illness. It is also associated with an increased risk of suicide. Suicide is a leading cause of death in the first year after delivery. Maternal suicide leaves newborns without a mother.

This law is completely at odds with current standards of care. It intends to force the continuation of traumatic pregnancies, including those resulting from rape and incest, regardless of the consequences.  It will also result in the deaths of women who resort to illegal or self-induced abortion due to desperation and lack of access to simple, safe, early pregnancy termination.

Encouraging plaintiffs to sue anyone involved in abortion services or support of women obtaining them, by offering a cash reward, will only serve to degrade and harm the fabric of Texas society. Doing so will increase polarization and mistrust within families and communities, worsen health disparities and access to medical care, and clog the courts with frivolous “bounty” cases.

An American Psychiatric Association position statement states, “Freedom to act to interrupt pregnancy must be considered a mental health imperative with major social and mental health implications.” Laws such as those in Texas set a dangerous precedent and will have far-reaching adverse consequences for women, their children, and their communities. It is time for repeal.