When I left for college decades ago, I carried with me a bag of birth-control pills. In graduate school, I got the first of many IUDs. Throughout my educational career, I had the privilege of knowing that even if these contraceptive measures failed, I could have an abortion. Although there were many stressors in my young life — I was diagnosed with bipolar disorder my senior year of college — fear of forced pregnancy was not one of them.
That is no longer the case for college students today.
Let’s be clear: Abortion is a higher-ed issue. Most abortions in the U.S. are provided to women in their 20s, according to the latest data from the Centers for Disease Control and Prevention. Women aged 20 to 24 accounted for 28 percent of abortions, while those aged 25 to 29 accounted for 29 percent. (Because the CDC only tracks cisgender women, the numbers for this age group are likely higher when trans and nonbinary people are taken into account.)
Abortion makes it possible for students to pursue, and complete, higher education. Research has shown that the “most common reason” young people drop out of college is unplanned pregnancy. This is especially true for those at community colleges: A majority of community college students who become parents while enrolled will leave college without a degree. “Accessible abortion is a catalyst for college completion,” writes Ilana Horwitz, a sociologist at Tulane University “Without it, the dropout crisis might only deepen.”
The fear of forced pregnancy is now hitting our entire student population, even in states where abortion is currently legal. The Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization has changed the fabric of our society. This is not an overstatement.
We must reckon with our students’ fear and do what we can to assuage it.
Our students are already struggling under the weight of the Covid-19 pandemic. They are turning in shoddy work and missing class. In the classroom, we see disconnection, exhaustion, and defeat. For some, the trials are temporary. But mental-health struggles can be life-threatening. Last year, my own campus — the University of North Carolina at Chapel Hill — suffered several suicides and attempted suicides. Many students are already navigating college life in a fog of grief and anxiety.
With Dobbs, those burdens have become even heavier.
It is unclear at this point how abortion rights will shake out around the country. But we can be certain that many if not most U.S. states will severely restrict the procedure. According to Reuters, 22 states are poised to ban abortion in the coming weeks and months.
The decision has unsettled students’ understanding of their sexual freedom at a time in their lives when many are first exploring their sexuality. Even in states where abortion is not fully banned, confusion over what is permitted will leave students unsure about what to do if a condom breaks or they forget to take a pill.
The politicians and activists who support Dobbs may hope that young people will have less sex, but that position is absurd. Punitive deterrents do not prevent impulsive actions. The threat of forced pregnancy will not change the behavior of people who have lousy impulse control, ready access to alcohol, and overblown feelings of invincibility — in other words, our students. Their risky behavior is biologically grounded: The parts of the brain that manage decision making do not fully develop until the mid-20s.
The mental-health consequences of attending college in a state with limited or no abortion access can be devastating. How do we know? Because we can study the history of past abortion restrictions and the mental-health fallout they caused.
As the American Psychological Association puts it: “Rigorous, long-term psychological research demonstrates clearly that people who are denied abortions are more likely to experience higher levels of anxiety, lower life satisfaction and lower self-esteem compared with those who are able to obtain abortions.” Some of that research focuses on the deleterious mental-health effects of specific abortion restrictions such as required ultrasound viewing, waiting times, or misleading information about the risks of abortion. Other research suggests that logistical challenges — like difficulty making an appointment or traveling to an abortion clinic — exacerbate stress, anxiety, and depression.
Abortion bans target — intentionally or not — our society’s most vulnerable people. States in which abortion bans are imminent, Reuters reports, “generally have higher proportions of women who lack health insurance or are impoverished — or both.” Even while Roe stood, people of color and poor people had much more limited access to abortion and contraception. Post-Dobbs, those inequities will be exacerbated.
Our students of color, first-generation students, and students from lower socioeconomic backgrounds will be hit with new strains and stresses. They will frequently have fewer resources at their disposal if they need contraception and abortions themselves, and they may also suffer secondhand as their families struggle under new anti-abortion regimes.
Many students are already navigating college life in a fog of grief and anxiety. With Dobbs, those burdens have become even heavier.
The bans will be particularly cruel to victims of campus rape, who may be forced to carry unwanted pregnancies. This is, in a word, abhorrent. Although some states that ban abortions include “rape exceptions,” these exceptions are notoriously difficult to use. In many cases, Politico reported recently, it will be easier for patients who seek to terminate a pregnancy resulting from rape or incest to travel out of state than to “clear the hurdles associated with obtaining [an abortion] legally in their home state.”
For example, in Utah, a rape victim must file a police report in order to begin to make use of the exception. Yet most rape victims never go to the police — I didn’t when I was raped in college — and victims have good reasons not to.
Rape victims already suffer post-traumatic stress disorder at rates higher than combat veterans, at 30 percent (versus 20 percent). That statistic means a large number of our students are walking around with a severe psychiatric disability for which they very likely receive no accommodation. The mental trauma campus rape victims suffer can cause their grades to suffer or even push them to drop out of college.
As an expert on mental health in higher education, I have frequently heard the refrain from college employees (in particular from professors) that “we aren’t therapists.” But student mental health has always been part of our duty, no matter how much some holler otherwise. We are often the first line of defense against our students’ suffering.
So what can higher-ed workers do to alleviate the mental burden of Dobbs?
First, take stock of the situation: You are not a therapist, it is true. (Unless you are a therapist, in which case, excellent.) But you will have students who need your support, and you should want them to feel comfortable coming to you. If you are a teacher, put a line on your syllabus noting that students can approach you for help and referrals. You don’t need to be their treasured confidante. Just don’t be a standoffish jerk.
You should also note on your syllabus that you are a mandatory reporter under Title IX, and you should be sure that both you and your students understand what that entails. For example, if a student tells you that they were sexually assaulted and need abortion help, you might, depending on your role, be required to report the assault to your college’s Title IX office.
When students do come to you, your task is to get them the help they need, even if you can’t directly provide it. Research the mental-health resources on your campus so that you are ready to make referrals immediately. Prepare a draft email outlining how to access mental-health services on campus. When you need it, you’ll be glad to have it at hand. And consider taking a mental-health training course offered by your institution — many have them now in light of Covid — so you’re better prepared to handle these situations.
When a student is in crisis in your office, don’t be afraid to ask hard questions. Perhaps most importantly, if you suspect a student might be contemplating suicide, ask them directly, “Are you thinking about suicide?” Experts agree that asking about suicide does not increase the likelihood that a person will die by suicide. They also agree that a person is likely to answer this question honestly. And don’t just suggest that a distressed student contact campus counseling. Ask if you can call counseling together, right in your office, and help them make an appointment.
Consider asking your students for ideas. For example, the editorial board of Syracuse University’s Daily Orange suggested that the institution tweak its First-Year Seminar curriculum to include sexual-health education and “inform students of the reproductive health-care resources available to students at SU.” Such education can reduce uncertainty and alleviate some of the fear that Dobbs has created.
We can also anticipate the unintended pregnancies that will occur because of Dobbs and make space for them. Institutions can create campus day-care centers and child-care funds. Professors can take familial responsibilities into account when advising their students. Even if students never need to use these accommodations, their very existence will help alleviate fear and anxiety.
We cannot change the Dobbs decision, nor can we lift the systemic mental-health burden it has placed on our students. But we can witness our students’ suffering rather than ignore it. And we can help them navigate the new legal landscape with clarity and resolve.
