Occupational Therapy for Abortion in the Aftermath of Dobbs v. Jackson Women’s Health | Overturning Roe v. Wade

AOTA Statement in Response to Dobbs v. Jackson Women’s Health

The AOTA president, Alyson Stover MOT, JD, OTR/L, BCP, released a statement on July 1st on the AOTA webpage under the category of its mission and vision.

It took a while (in my opinion) for this to be released, considering when all of the other professional health associations released them on the same days, if not only a few days later.

I will be discussing what happened with these statements in my latest podcast episode with my co-host, who is a nurse, in response to the APTA, ANA, ASHA, and APA.

Let me know what you think of the AOTA statement in the voicemail line or by writing to me.

Abortion Access by State

Kaiser Family Foundation has a useful page on abortion in the US by state including the status of access by state. Visit the website for the most up-to-date status.

OT Practice: Theory and Framework Components to Consider

  • PEO: environment and where one lives now has a large impact on their access to health, medications, and services.
  • MOHO: habits, roles, routines
  • Mental health: fear, anxiety, depression, PTSD, grief and bereavement
  • ADLs – sexual activity participation, safe sex
  • IADLs – family planning, child rearing, finances, medications
  • Work – taking days off, paid leave, FMLA
  • Education – potential disruption due to earlier child care responsibilities
  • Leisure – poor balance due to childcare and work demands
  • Sleep – loss of sleep and poor sleep participation
  • Health management – education, management of chronic conditions due to lack of access to Rx

Consequences and Research on the 2022 Abortion Ban

Abortion bans could affect care for miscarriage and infertility (JAMA)

One point this article[1]Rubin R. How Abortion Bans Could Affect Care for Miscarriage and Infertility. JAMA. 2022;328(4):318–320. doi:10.1001/jama.2022.11488 brought up was that of miscarriage and how spontaneous abortions can be difficult to distinguish from induced abortions. While this is mainly a medical topic, there are issues and practice implications in the domain of occupational therapy such as mental health for managing complicated grief disorders, resuming occupational therapy roles, and the ADLs of sex and family planning. It also falls in the occupation of health management as it pertains to the care of one’s body, medications, and symptom management.

Ripple Effect on Men and the Family (Opinion)

One insight that I gained was the ripple effect that the bans on abortion can have on those related to women surrounding pregnancies such as husbands, children, grandparents, and so on. According to NPR, one in five men have been involved in an abortion. I wonder now in the aftermath of Roe v. Wade, if this number will go up. What I am expecting is an increased awareness of other family members and more involvement with family planning issues now. This will likely depend on demographic factors, socioeconomic factors, culture, religion, and so on.

With this then, is there a role for occupational therapists in addressing the rest of the family and abortion? I would say yes, as occupational therapy practitioners often work with the family to provide family-centered care. There, of course, could be disagreements among partners, but speaking in terms of societal impacts, it is hypothesized that young men could become dads much earlier than they’re prepared for, depending on if abortion is banned where they lived or not.[2]NPR. (2022). The end of Roe v. Wade has huge economic implications for male partners, too. Retrieved from https://www.npr.org/2022/06/27/1107715589/abortion-access-impact-on-men

This will likely be detrimental to those from lower economic status and backgrounds who will then have fewer opportunities to pursue higher education due to having to enter the workforce earlier than before.

Time will tell what our role is for these families affected by abortion decisions. But as OTs work with the occupation of education and work, this is well within our scope of practice in theory. In practice, it is likely not.

Occupational therapy practitioners should now be familiar with abortion medications (Opinion)

Confusing laws. Uncharted territory. Unclear research on side effects of some drugs related to induced abortions. Some women with chronic conditions are now treated like criminals at the pharmacy.

Now patients may now face ethical dilemmas and limited access to health interventions as they may even be forced off of certain medications to treat other conditions such as methotrexate for lupus as they may unintentionally induce abortion.[3]Tanner, L. (2022). AP News: Abortion laws spark profound changes in other medical care. Retrieved from: … Reference List

Examples of conditions fall in the autoimmune diseases category including for Crohn’s disease.

Do occupational therapists play a role and benefit from being familiar with such drugs? Will it benefit patients if OTPs are familiar with which drugs may affect pregnancy? While this role predominantly falls on physicians and pharmacists, I still say yes, as it pertains to one’s bodily autonomy, their right to know, and the ethical principle of justice. Women who stop taking these medications may have worsening symptoms requiring alternative nonpharmacological methods for management, and this is where OT may come in. This may spark more interventions under OT for conditions that have long been around but managed mainly by pharmacology.

Sadly, we are going back in time for medicine, my friends.

My hopes from our OT associations, educators, and researchers

  • Clear standards and protocols for navigating this new frontier.
  • Outlined scope of practice for specific practices in occupational therapy related to abortion.
  • New screens and assessments for risk factors, symptoms, and outcomes related to the abortion ban.
  • Advocacy for OT in relevant areas of practice for abortion.
  • More research (mental health, physical health, newborn health) and a building body of evidence to continue to advocate for the relevance of OT in the future healthcare system and society.
  • Continuing education content to keep OT practitioners up to date on the laws and best practices.

References

References
1 Rubin R. How Abortion Bans Could Affect Care for Miscarriage and Infertility. JAMA. 2022;328(4):318–320. doi:10.1001/jama.2022.11488
2 NPR. (2022). The end of Roe v. Wade has huge economic implications for male partners, too. Retrieved from https://www.npr.org/2022/06/27/1107715589/abortion-access-impact-on-men
3 Tanner, L. (2022). AP News: Abortion laws spark profound changes in other medical care. Retrieved from: https://apnews.com/article/abortion-science-health-medication-lupus-e4042947e4cc0c45e38837d394199033
Jeff is a licensed occupational therapist and lead content creator for OT Dude. He covers all things occupational therapy as well as other topics including healthcare, wellness, mental health, technology, science, sociology, and philosophy. Buy me a Coffee on Venmo.