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Unwanted disclosure of abortion decision may harm people’s mental health

People seeking an abortion in the United States are likely selective in terms of who they wish to involve in the abortion decision. In order to overcome obstacles accessing needed care, they may be forced to disclose the abortion decision and involve someone who is unsupportive. With Roe v. Wade overturned, more people will face financial and logistical barriers to abortion care, forcing them to turn to people who may be unsupportive of their decision. Our new findings suggest that these situations are associated with experiencing more negative mental health symptoms.

Key Findings

Over one-quarter (27%) of participants told someone they would have preferred not to tell about their abortion decision.
Unwanted abortion disclosure was mostly due to obstacles getting to the appointment, like time to appointment (46%), travel distance (33%), and finding money to pay for the procedure and other costs (32%).
Unwanted abortion disclosure was associated with involving someone who did not support the abortion decision.
Unwanted abortion disclosure and involving someone who does not support the decision were associated with more symptoms of depression, anxiety, and stress.

Study Design

The Burden Study is a cross-sectional survey of people seeking abortion services and is designed to assess the logistical and psychosocial barriers people face when trying to access this care. From January to June 2019, we surveyed people presenting for abortion at four clinics in California, New Mexico, and Illinois regarding their experiences accessing abortion. Participants could respond “Yes” or “No” to the question, “In order to get to the clinic for your appointment today, did you have to tell anyone that you would have preferred not to tell, that you were considering ending this pregnancy?”


Logistical burdens, such as travel distance and costs accessing abortion, can reduce privacy and autonomy during the decision-making process. Additionally, involving someone who is not supportive of the decision may lead to more symptoms of depression, anxiety, and stress for the abortion patient. While social support during the abortion decision can be beneficial for people in need of financial and emotional support, so that they can overcome increased barriers accessing abortion care, involving someone who is unsupportive may be harmful.

The article, Unwanted abortion disclosure and social support in the abortion decision and mental health symptoms: A cross-sectional survey, is available in Contraception.