"If Something Goes Sideways with This, I'm Risking my Life": Pregnancy Experiences During the Fall of Roe v. Wade.

Abstract

Background: The Dobbs v. Jackson Supreme Court decision overturned Roe v. Wade and federal abortion protections, resulting in nearly half of U.S. states banning or significantly restricting abortion. Qualitative data are needed to understand how abortion restrictions influence pregnancy perceptions and experiences.

Objectives: This study describes pregnancy perceptions and experiences before and after Dobbs, across states with abortion restrictions and protections, and across individual-level differences in income and age.

Design and methods: We conducted in-depth interviews with people during pregnancy (n = 31, 28 pre-Dobbs) and a subset of those individuals again during the postpregnancy period (n = 14, all post-Dobbs) from October 2021 to August 2023. All interviews were recorded, transcribed, concept mapped, and coded using MAXQDA 2022. We also conducted across-group comparisons by state abortion policy, income, and age.

Results: Before Dobbs, participants described how abortion accessibility was already compromised in some states. After abortion was banned in restrictive states, participants described feeling dehumanized, criminalized, that their reproductive autonomy was constrained, and that pregnancy carried real risks to their lives. In protective states, participants were grateful they had abortion access but lacked awareness and knowledge about abortion access in other states. Participants explained that Dobbs and abortion restrictions are harming perinatal wellbeing, even for wanted pregnancies. Group comparisons demonstrated that lower income and younger people described greater impacts related to abortion availability.

Conclusion: Post-Dobbs abortion restrictions are negatively impacting the mental and physical well-being of pregnant people, even those with wanted pregnancies. Dobbs could exacerbate existing health inequities for younger and lower-income people.