ADHD Symptoms and Pregnancy Risk

Two days before my college graduation, I realized I was pregnant.

I didn’t need a test to confirm it; my cycle ran regular as a clock. Nausea had kicked in, and terror rushed behind. I was a cradle Catholic. My mother and her friends spoke of pregnant girls in hushed, embarrassed tones. Some girls I knew hid their pregnancies for a full nine months, then placed their babies for adoption. Some kept their children and lived as pitiable dependents. Some were sent away to maternity homes. One was expelled from Catholic school. At age 22, I no longer considered myself religious and I knew pregnancy was not an option.

Despite my untreated ADHD, I’d earned acceptance to graduate school. A baby didn’t fit into my academic future.

I needed an abortion. And I needed it fast.

But I had $20 to my name. I had no ride to an abortion clinic — and even if I had, in that time and place, abortions cost money I didn’t have. Then (as now), pregnant girls were on their own. I couldn’t tell my friends. I couldn’t tell anyone. In my impulsive desperation, I dove headlong into Google. Even in those days, several websites told girls who’d run out of options what to do and how to do it.

[Read: Roe v. Wade Ruling May Disproportionately Impact Girls with ADHD]

The suggested solutions for ending a pregnancy were dangerous. Only impulsive girls prone to risk-taking would attempt them. I picked one and followed through. It worked. I sobbed alone in the shower with what I recognize now as labor pains. Years later, I still wonder if that monumental risk harmed me in some irreparable way.

This is what happens when women with ADHD have no access to basic reproductive care.

Last month, many Americans found themselves stripped of this essential freedom. With abortion no longer a federally protected right, several states acted immediately to prohibit it. Thirteen states have trigger laws that swiftly banned the procedure. A full 22, according to The Guttmacher Institute, have laws that could be “used to restrict the legal status of abortion.” It is now, or soon will be, impossible to access abortion care through much of the South: every Southern state except Virginia and North Carolina will ban the procedure. Fifty-eight percent of American women live in states “hostile or extremely hostile” to abortion rights.

While Roe’s repeal affects all people able to become pregnant, it’s particularly dangerous for women with ADHD. Their symptoms include inattention, impulsivity, emotional dysregulation, and low frustration tolerance; according to the DSM, these affect “work, home life, and relationships” — more so if that ADHD is left untreated. These symptoms, combined with a lack of reproductive rights, creates a dangerous stew for adults with ADHD, especially those who remain undiagnosed.

Like I was.

I was impulsive enough to turn to Google — because I couldn’t think rationally enough to plan. I was too frustrated to make another, better choice. I acted rashly. Without ADHD, I may have made a better choice.

[Read: “My Period-Tracking App Helps Me Manage My ADHD. What Do I Do Post-Roe?”]

Birth control pills must be taken every day, at roughly the same time. The Guttmacher Institute places a “typical-use” failure of the pill at seven percent; obviously, with symptoms of forgetfulness, that number rises for those with ADHD. A higher number of people with ADHD will now become pregnant on the pill — and lack access to abortion.

Moreover, many people have received their birth control at health centers, such as Planned Parenthood, that also provided abortion-care services. With those centers shut down, many Americans with ADHD will face a new barrier to accessing birth control. They may resort to condoms — a method that comes with a typical-use failure rate of 13%.

I fell into that 13%. I tried to be responsible — and faced an unplanned pregnancy regardless.

But let’s not forget that impulsivity is another common symptom of adult ADHD. Without access to hormonal birth control, potentially pregnant people with ADHD are more prone to simply roll the dice, engaging in sexual intercourse without protection (a less likely scenario if they had access to hormonal birth control). This will create more unwanted pregnancies — and without access to abortion care, many will have no choice but to carry those pregnancies to term.

Or not.

As I learned, there are many ways to induce abortion, and pregnant people with ADHD symptoms of impulsivity and low tolerance of frustration may be more likely to resort to Google, as I did. Many of those non-medical remedies are ineffective and dangerous. They could cause harm to the pregnant person or simply not work, resulting in not only a term pregnancy, but one in which a child suffers from birth defects.

Adults with ADHD who face an unplanned pregnancy and no reproductive rights are staring down serious challenges. They’re more likely to have difficulty finding and keeping jobs. In 2014, a full 75% of all abortion patients were “poor” (with an income below the federal poverty level) or “low-income” (with an income 100-199% of the federal poverty level). This level is undoubtedly higher in pregnant people with ADHD. With Roe protections repealed, more pregnant people with ADHD will find themselves poor and carrying an unwanted pregnancy.

States with abortion restrictions are less likely to have social services in place for impoverished parents, and parents with ADHD are more likely to need them. Without them, these post-Roe children are more likely to suffer the consequences of growing up poor in America: “low academic achievement, obesity, behavioral problems, and social and emotional development difficulties,” according to the American Psychological Association, along with “hunger, illness, insecurity, [and] instability.”

Moreover, children of parents with ADHD have a 50% chance of having ADHD themselves. This can lead to a vicious cycle of unwanted pregnancy and poverty that’s not easily broken.

These statistics don’t begin to touch the lived reality of a person with ADHD facing an unwanted pregnancy. Consequences spiral outward: How many pregnant people with ADHD, faced with a lack of options, will live in denial, eschewing proper prenatal care? How many people with ADHD, confronting an unwanted pregnancy, will suffer partner violence — as those with ADHD are more likely to encounter? How many children will be abused and neglected? Children of unwanted pregnancies are more likely to be maltreated, both by their mothers and fathers.

While this post-Roe world is dangerous for all potentially pregnant people, those with ADHD are in more dire straits than most. Many facets of their disorder leave them prone to unwanted pregnancy; without reproductive rights, both they and their unwanted children may struggle against tremendous odds to avoid poverty and maintain their psychological well-being. The repeal of Roe endangers every potentially pregnant person in America. For those with ADHD, that repeal is more likely to sow life-altering consequences — and more likely to continue vicious cycles of poverty and failure.

Reproductive Rights for Women with ADHD: Next Steps

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