Impact of Abortion Denial on Susceptibility of the Resulting Infant to Lifelong Health Issues
Creators: name: Freeman, Ava
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2023
Subjects: Maternal stress
Abortion
Health outcomes
Fetal development
Unwanted pregnancy
HPA-axis

description: As of April, 2023, increasingly restrictive abortion bans are being implemented across the United States, at a time in which unintended and unwanted pregnancies account for over half of all pregnancies each year. Existing research has previously established independent associations between abortion denial, unintended/unwanted pregnancy and maternal stress, as well as prenatal stress exposure of the fetus and dysregulation of the fetal hypothalamic-pituitary-adrenal (HPA) axis with adverse health outcomes. This review originally aimed to collect and analyze the existing body of knowledge about the impact of maternal stress which stems from abortion denial and subsequent unintended/unwanted pregnancy on programming of the fetal HPA axis and subsequent health outcomes across the life course. However, after an extensive literature search for studies exploring the aforementioned association, it was concluded that there are no studies that investigate the exact pathway hypothesized, and very few studies that investigate the association between abortion denial and unwanted pregnancy with long term health outcomes. Thus, the aim of this paper was pivoted to review the sparse existing literature and identify an area of research that necessitates further development given the current sociopolitical environment which threatens to endanger the lives and well-being of women and children alike. Investigation into this connection is motivated by the need to expand the current understanding of one of the many adverse impacts of diminished access to abortion care, as a way to promote safe and equitable access to abortion. Additionally, the present paper presents a theoretical framework of this hypothesized causal pathway, as well as proposes a prospective, longitudinal pilot research study that could be used to examine this connection. From the studies reviewed, it is clear that there is a considerable amount of knowledge that exists on all of the aforementioned factors, and connections between subsequent variables (e.g., abortion denial, unintended or unwanted pregnancy, and maternal stress; maternal stress and fetal HPA axis programming; dysregulation of the HPA axis and adverse psychological and physiological health outcomes) are evident. However, there remains a lack of studies that directly investigate the pathway between abortion denial and adverse health outcomes later in life, through dysregulation of the fetal HPA axis. Future research should investigate this possible pathway, and strive to develop a better understanding of the interplay of stressors, including those derived from abortion denial and the succeeding pregnancy, as well as those specific to women of color, of low socioeconomic status, and of diverse gender identities. Such research will assist in the eventual achievement of true health equity and reproductive justice.