What Abortion for "Health" Really Means

By Christopher Dodson
Executive Director
North Dakota Catholic Conference
August 2023

Readers may recall that last Spring the North Dakota Supreme Court inexplicably held that the state constitution includes a right to abortion to protect the life or “health” of the mother. The court provided no support for its opinion on health and did not explain what it meant by “health.”

The state legislature responded by enacting a new law that allows abortion when it is necessary “to prevent substantial physical impairment of a major bodily function, not including any psychological or emotional condition.” The legislature thought that if the law must include a health exception, the exception should be limited to instances where an abortion is absolutely necessary to directly treat a serious physical medical condition.

The abortion lobby, however, thinks that “health” should include not only everything that we typically consider health-related, but also familial, economic, and even geographic conditions. We know this because abortion activists have gone back to court asking for exactly that.

Here are some of the “health” reasons for abortion that the plaintiffs — who now include some North Dakota physicians — think should be constitutionally protected: back pain for which surgical treatment would have to wait until after delivery, diabetes, the inability to balance “health treatment with the demands of pregnancy and then caring for an infant,” a history of child abuse or neglect, morning sickness, and the cost and stress associated with traveling to another state for an abortion.

Of course, none of these conditions are directly treated by abortion. But that does not matter to the “abortion for any reason” crowd. In fact, the complaint argues that “health” even includes conditions that might arise after the child is born. For example, they want the court to declare a legal right to kill an unborn child if the abortionist thinks that the mother might later suffer from postpartum depression or other mental health conditions.

Indeed, the new complaint focuses a great deal on abortion for reasons of mental health. The strategy is apparent. Advocates for mental health care have made great strides when it comes to treating mental health on par with physical health. The abortion lobby is perverting that good work by trying to wedge mental health into “health” for purposes of abortion law.

While it is true that mental health — which includes substance abuse disorders — should often be treated as a physical condition, the fact remains that there does not exist any clinically diagnosable mental disorder that is medically treated by an abortion. This is not a Catholic belief. It is a medical fact.

The plaintiffs make the often-repeated claim that “mental health is the most frequent underlying cause of pregnancy-related deaths in the United States” and that “approximately 23% of pregnancy-related deaths are associated with mental health conditions . . .” But a closer look at the claim reveals that it is misleading. The claim comes from reports by thirty-six state maternal mortality review committees. The first thing to note is that “pregnancy-related” includes during pregnancy and twelve months after pregnancy. We do not know how many of those deaths occurred during pregnancy. Secondly, while it is true that the “mental health” category had more numbers than other categories in the study, the overwhelming majority of deaths were for other reasons.

All mental health deaths in the report were due to suicide or overdose due to a substance abuse disorder. Of all the deaths reported, only 8.4% were determined to be suicide, which is the main argument made in the complaint for a mental health exception. Importantly, another study by the same author notes that nearly three-quarters of people with a pregnancy-related mental health cause of death had a history of depression, and more than two-thirds had past or current substance abuse. In other words, pregnancy itself is not a risk factor for suicide or overdose. Depression or substance abuse are the risk factors. This fact is supported by a study in the Journal of the American Medical Association showing that pregnant or recently pregnant women are 50% less likely to commit suicide than all other women of childbearing age.

Some women may experience mental health disorders during pregnancy, but the baby is not the cause. Some women may have a higher possibility of suffering from postpartum depression but killing the baby beforehand is not the answer. Abortion in those circumstances is not just morally wrong, it is bad medicine. Talk therapy, medication, or both are the standard practices for treating mental health and substance abuse disorders.

Supporters of abortion and even the news media may describe the new legal action as addressing situations where a pregnant woman’s life might be in danger. This is not true. The new complaint itself reveals the abortion lobby’s real agenda — a legal right to abortion for any reason under the guise of “health.”

A copy of the new complaint and brief is at: https://ndcatholic.org/resources/2023compbrief.pdf