Abstract
The authors sought to determine whether and how occupational therapy practice is being affected by the 2022 overturning of Roe v. Wade and subsequent abortion-related restrictions as well as what resources practitioners might need to address clients’ needs.
In the United States, the abortion rate in 2020 was 25%, meaning that one in four pregnant people ages 15–44 yr would be expected to have an abortion by age 45 if the abortion rate remained stable (Jones, 2024). Legal access to abortion was protected at the federal level by the 1973 U.S. Supreme Court Roe v. Wade decision. However, in 2022 the Supreme Court returned the ability to restrict abortion to states through its decision in the Dobbs, State Health Office of the Mississippi Department of Health, et al. v. Jackson Women’s Health Organization et al. (hereinafter Dobbs) case. The issue of abortion is contentious. However, most medical professional societies recognize abortion as a safe, essential component of health care and object to the loss of autonomy in health care decision making that the Dobbs decision represents; these include the American Medical Association (Resnick, 2022), the American Academy of Nursing (2022), the American Academy of Pediatrics (2022), the American College of Obstetricians and Gynecologists (2022), the American College of Surgeons (2022), and the American Physical Therapy Association (Herr, 2022).
The members of the American Occupational Therapy Association (AOTA) are not united in their viewpoint on abortion and abortion access and on whether the Dobbs decision will have implications for occupational therapy practitioners. In summer 2022, in the wake of the Dobbs decision, then–AOTA President Alyson Stover released a statement that acknowledged that the Dobbs decision would “change how we practice occupational therapy, while heightening the experiences of occupational and social injustices” (Stover, 2022b). Stover’s statement inspired a number of diverse responses that are still visible on a Facebook page as of September, 2024 (Facebook, 2022). Some members criticized the statement as too weak, arguing that AOTA’s failure to take a firm stance on the harmful effects of the Dobbs decision on reproductive justice and bodily autonomy represents a neglect of occupational therapy values—justice, autonomy, and beneficence (Facebook, 2022). However, some members commented that because occupational therapy practitioners do not provide abortion care, and because some AOTA members were celebrating the Dobbs decision, the lack of a more strident statement from AOTA was prudent and appropriate.
One occupational therapy professional entity articulated a clear, concise viewpoint on the ways in which the Dobbs decision had direct implications for occupational therapy practitioners: the Indiana Occupational Therapy Association (IOTA, 2022). In July 2022, IOTA released a statement on reproductive health care legislation that argued that there were four ways in which the Dobbs decision would affect occupational therapy practice: With abortion restrictions in place, there will likely be more children and birthing parents seeking occupational therapy services that involve early intervention, outpatient services, pre- and postnatal care, and mental health care—including for grief over the deaths of parents, partners, family and community members, and friends who will die or experience hardship as a result of clandestine abortions or unplanned parenthood. Sexual activity is an activity of daily living, and AOTA has affirmed that sexual activity is within occupational therapy’s scope of practice (Stover, 2022b). Obtaining reproductive health care and abortion services is a health management occupation, and consumers’ loss of ability to manage this aspect of their health care needs is associated with a number of issues, including mental health problems, remaining in abusive relationships (Roberts et al., 2014), a loss of autonomy, and pelvic health issues, and has implications for role transitions and role loss (IOTA, 2022). Abortion restrictions are directly related to two of the Core Values in AOTA’s (2020a) Code of Ethics: (1) Freedom (i.e., the right to exercise autonomy and self-direction) and (2) Justice (i.e., ensuring that people can live a satisfactory life regardless of age, gender identity, sexual orientation, race, religion, origin, socioeconomic status, degree of ability, or any other status or attributes; IOTA, 2022).
There is little argument that access to abortion care in the United States has a profound impact on what people who can become pregnant can do (i.e., their occupations), how they feel, and medical risks that they take. In part, evidence for this accrued during the century between 1873 and 1973, when access to abortion was limited by the federal Comstock Act of 1873 (Pub. L. 42-438), and it was up to individual states to choose whether abortion was legal (Bergman et al., 2023). During that era, in states where abortion was illegal some people with unwanted pregnancies sought clandestine abortions or attempted to terminate their own pregnancies by inserting knitting needles, coat hangers, bicycle spokes, and ballpoint pens into their uterus, while others swallowed turpentine, laundry bleach, or acid (Polgar & Fried, 1976). Hundreds of pregnant people died each year (Kessler, 2019). Those who were unable to end their pregnancies either became parents—or, in a minority of cases (∼9%)—chose adoption (Sisson et al., 2017).
Between 1973 and 2022, abortion was once again a protected right at the national level because of the U.S. Supreme Court Roe v. Wade decision. As a result, we now know that when abortion access is available people who can become pregnant are far more likely to be able to participate in the workforce (Foster et al., 2022), increase their educational attainment (Angrist & Evans, 1996), move into higher paid occupations (Bahn et al., 2020), and develop aspirational 5-yr plans related to careers (McCarthy et al., 2020). Evidence suggests that people who are denied abortions may also be more likely to remain with abusive partners (Roberts et al., 2014) and to experience serious pregnancy complications, poorer long-term health; chronic pain; mental health problems, such as suicidality; higher stress; lower self-esteem; and lower life satisfaction than people who are able to obtain abortions (Kaufman et al., 2022; Rocca et al., 2020; Zandberg et al., 2023). These consequences disproportionately affect marginalized people, including racially and ethnically minoritized individuals, low-income people, people living in rural areas, undocumented people, immigrants, and people who do not speak English (Kheyfets et al., 2023).
In December 2022, AOTA formed the Post-Dobbs Task Force to “identify potential concerns affecting occupational therapy after the Supreme Court’s decision in ‘Dobbs v. Jackson Women’s Health Organization’” (AOTA, 2023a, p.1) and to “identify areas within occupational therapy’s scope of practice that may be directly/indirectly affected, limited, and/or impaired due to the Dobbs decision” (AOTA, 2023b, p. 1). The task force reviewed published literature and AOTA resources, read the Facebook thread previously referenced (Facebook, 2022), perused CommunOT comments on the Dobbs decision, conducted an in-person “Conversations That Matter” session at the AOTA INSPIRE 2023 Annual Conference and Expo, and examined the work of other professional associations (AOTA Post-Dobbs Task Force, 2023). The task force noted that there were too few peer-reviewed published papers on the topic of abortion access and occupational therapy practice; as a result, the authors were inspired to conduct the present study, in which we addressed the following research question: “In what ways has the Dobbs decision affected occupational therapy practice—if at all—in states that subsequently changed their abortion laws?”
Method
The first two authors (Darya Nemati and Delaney McKee) conducted 15 semistructured interviews with occupational therapy practitioners currently practicing in states where there have been legislative changes to abortion access since the June 2022 Dobbs decision. Interviews took place between May 2023 and September 2023. Although the authors had planned to conduct 30 interviews, data saturation—the point at which no new themes emerged—was reached after 15 interviews (Hennink & Kaiser, 2022; Moustakas, 1994). All research procedures were reviewed by the Boston University institutional review board and granted an exemption determination.
Study Participants and Recruitment
Study participants were recruited in three ways. First, information about the research opportunity was disseminated via social media and at the 2023 “Conversations That Matter” session organized by the AOTA Post-Dobbs Task Force. Second, the executive directors of state occupational therapy associations were asked to send messages to their networks to advertise the research opportunity. Third, the authors directly messaged occupational therapy practitioners in their personal networks, and occupational therapy practitioners with whom they were connected on LinkedIn, to ask them to disseminate information about the research opportunity.
Eligible participants included occupational therapy practitioners licensed and practicing in the following 22 states: Alaska, Alabama, Arizona, Florida, Georgia, Idaho, Indiana, Kentucky, Louisiana, Michigan, Missouri, North Carolina, North Dakota, Nebraska, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, and Wisconsin. Inclusion criteria included being age ≥18 yr, having access to a phone or computer to use Zoom for the interview, having a valid email address to receive an e-gift card as remuneration, and speaking English. Potential participants were screened for research eligibility via email. Once eligibility was confirmed, participants received a copy of the consent form, and an interview was scheduled.
The 15 participants in this sample were all licensed occupational therapy practitioners (100%), and all were female (100%; Table 1 lists the demographic characteristics). They ranged in age from 27 to 69 yr (M = 41.5, SD = 11.9). Approximately three-fourths of the sample identified as White (73%), 13% identified as Black or African American, 7% identified as Asian, and 7% identified as Hispanic or Latinx. The practice settings in which they worked varied. Approximately one-third worked in a hospital or rehabilitation facility (27%), approximately one-third worked in academia (27%), 20% worked with a pediatric population, 13% worked at pelvic floor therapy private practices, and 13% worked in community-based settings (Table 1).
Participant Demographics
Interview Procedures
Participants were offered the option to participate in the Zoom interviews either with or without the camera on. Each interview lasted approximately 30 min. All participants were asked the same nine open-ended questions about the effects of the Dobbs decision (i.e., abortion restriction laws) on occupational therapy practice and about their needs as occupational therapy practitioners living in states where access to abortion is restricted. Example questions included the following: Can you identify areas within occupational therapy’s scope of practice that may be directly/indirectly affected, limited, and/or impaired due to the recent changes in abortion access and abortion-related restrictions? If so, can you please share a concrete story that illustrates that? What kinds of readings, handouts, webinars, trainings, or other materials in this area do you think would be helpful to you that AOTA could provide?
Because the voiceprint of an audio file can be considered personally identifying, and because there are costs involved in sending audio files to transcription services, interviews were not audio recorded for two reasons: (1) to protect participant privacy and (2) to save transcription costs. Instead, each interview involved two authors. One author asked the interview questions, and the other typed the participant’s response in real time. Each participant received a $25 e-gift card via email after the interview.
Data Analysis
We used an interpretive epistemological perspective (Merriam & Tisdell, 2016). To improve the transparency of the coding frame and how it was applied to these data, and therefore the rigor of the content-based analysis approach (O’Connor et al., 2020), each transcript was coded independently by the two authors who conducted the interviews (Nemati and McKee). The authors used an inductive coding approach, meaning that we developed codes from the content of the data rather than from preconceived categories or themes (Saldaña, 2016). The authors used a phased approach to consensus coding. First, an initial code list was developed. Second, they each applied the initial codes to three transcripts each. Third, they met and discussed the coding frame and made choices to refine and streamline it. During this step, Nemati and McKee used reflexivity (i.e., reflected on and discussed with one another their own perspectives, values, and assumptions with respect to how those might be influencing interpretation of data). Fourth, they recoded the first three interviews with the new coding frame and coded the remaining 12 interviews independently.
Again, as the research team proceeded through the coding procedures they engaged in a reflective process (i.e., reflexivity) and considered how their own positionality could shape how they made meaning from the data (Olmos-Vega et al., 2023). For example, the authors had conversations about the fact that our own viewpoints in favor of abortion access may have encouraged more disclosures from participants about clients’ problems with access to abortion and may have influenced how we understood participant comments about their clients’ abortion-access challenges. Miles and Huberman (1994) suggested that 80% agreement on 95% of codes is an acceptable level of interrater consistency. In our case, coders had an initial agreement percentage of 88% on 100% of codes across the 15 transcripts. Discrepancies were discussed and consensus-coded. All three authors met to discuss the final coded transcripts and identify major themes. Illustrative quotations from each of the major themes were selected by the two coders. The research team took several steps to ensure the integrity and trustworthiness of the data collection, storage, and analysis process. First, we kept careful track of the decisions we made about the steps of our research, choices about codes, and rationales for selecting certain quotes to present as illustrative (i.e., we kept an audit trail; Rodgers & Cowles, 1993). Second, through team conversations, we arrived at a consensus on themes, data coding, and the selection of illustrative quotes (Carter et al., 2014). Third, throughout the research process we reflected on our positionality and the implications for data collection, interpretation, and presentation (Dowling, 2006).
Results
Theme 1: Abortion Restriction Laws Are Affecting Some Occupational Therapy Clients’ Mental Health
Participants shared their observations about the ways in which changes in abortion laws in their states appeared to have affected the mental health of clients in their practice settings; specifically, they described clients who had displayed anxiety, fear, and depression and reported that this was because they had been denied access to abortion subsequent to state-specific restrictions and experienced stress about being unable to travel to get abortion care because of inadequate financial resources. The participants talked about feeling personal distress from seeing their clients’ stress and wanting to do more to support their clients’ mental health related to abortion care access. For example, one occupational therapy practitioner with 15 yr of experience who provided maternal mental health services, and who recently started working in a rural community health setting in a southern state, said “My primary role is mental health, specifically maternal mental health. There’s been an increase in postpartum depression because there are no [abortion care] options.”
Another participant, who worked in an inpatient psychiatric setting, shared a specific story of a client who had been admitted on an involuntary hold and was simultaneously dealing with the trauma of an unplanned pregnancy: She was very concerned about getting out because she’s pregnant. . . . She wanted to go to Planned Parenthood but was concerned about [a state law] restricting what she could do. She didn’t have social or economic resources, according to her, and she was worried about how this could impact her and her unborn child.
This participant went on to share that these concerns had all come to light during an occupational therapy group. When asked about how her role in providing services to this client may have been affected, she stated,
I still provide the same services; however, it is more challenging. We teach clients about cognitive restructuring or stress management, but nothing is going to change [the fact] that she has this limitation now and she can’t leave the facility. . . . I wouldn’t want to make a recommendation [to her] based on this being the law right now.
Pelvic floor therapists in the sample also reported that they had encountered the implications of these new restrictions on the mental health of their clients. One therapist described observing the physical manifestation of clients’ stress and anxiety related to abortion access: “I have had people relate their pain to pelvic pain and lack of perceived access. They are so stressed about getting pregnant that they develop pelvic tension during sex.”
Theme 2: Clients Are Discussing Reproductive Health With Occupational Therapy Practitioners Across a Variety of Settings
Participants who worked in schools, pelvic floor therapy settings, and community-based settings said they had encountered the effects of abortion restrictions in their work within occupational therapy’s scope of practice specifically related to reproductive health. A pelvic floor therapist in a midwestern state shared that she no longer recommends to clients that they use a particular app for tracking their menstrual cycle, out of fear of how the information could be used: Even in the case of cycle tracking, I always used to recommend the [menstruation-tracking] app because I loved it, but now I don’t. I removed all my information from it, too, because you could potentially be subpoenaed [for] that info if you were to get pregnant and have an abortion.
Another pelvic floor therapist shared her experience with seeing an increase in clients presenting with pelvic pain, which she attributed to the Dobbs decision: I have seen an uptick in things like pelvic pain, difficulty with patients having painful sex, constipation, diarrhea, mental health [issues], abdominal pain, anxiety, and depression. I have seen people get super-obsessed with having several forms of birth control to prevent pregnancy and clients who still feel like it’s not enough. . . . There has been a huge increase in pelvic floor tension that I have seen among clients since the Dobbs decision.
A participant working in a school-based setting shared how she has had to shift her approach to focus on reproductive health and safety with the parents of students with whom she works: I think I’ve just been more aware of my need to provide information to [the] parents or guardians of some of my students and to work with them on preventative measures as far as pregnancy goes. . . . I provide a resource to them, and I feel like it’s a pretty neutral resource, not opinionated. It’s a decision-making tool that parents can use; they can sit with child, if [the child is] cognitively able, or the parent can do it for them. It goes through options of birth control pills or IUD, or do you want to not do anything. . . . It just made me more aware of the real need to provide information to parents.
Theme 3: Occupational Therapy Practitioners Are Using Clinical Judgment and Their Personal Beliefs to Support Clients Affected by Abortion Restrictions
Given that there is no specific guidance from AOTA or state-based occupational therapy organizations on how to approach abortion care and clients’ related needs, which can include mental health and reproductive health care, participants said they had been using their own clinical judgment, personal views, and therapeutic use of self to provide services to clients who may be affected by abortion restrictions in those states. One occupational therapy practitioner stated the following: When you’re a therapist, people will tell you things that they wouldn’t tell others, in-depth conversations to understand people, where they come from, what is going on in their lives. . . I think we should protect humans, and I believe preborn humans should be protected, and that results in a lot of discussion, mother is the mother, and that person needs attention, the baby is also a baby, and that person has their individual DNA and has rights. And so, I have those conversations with my clients just as I would have those conversations with anybody; I have religious reasoning and scientific reasoning.
Another participant turned to the Occupational Therapy Practice Framework: Domain and Process (OTPF–4; AOTA, 2020b) for guidance: I’ve really been digging into the [OTPF–4] and judication for services within my notes. I work for a very conservative Christian university…, but that’s a whole different situation. It’s really just made me dig in and get refamiliarized with my practice, letting the [OTPF–4] really drive what I do.
One participant told us how she has adapted her approach to accommodate new client needs after the Dobbs decision: I have started working with other medical providers and trying to collect information. If the pamphlet is in the office, they can take it or not take it: This is your closest women’s health provider, this is online pharmacy, this is where you can go to more information.
It was not uncommon for participants to share that they felt that they could not provide the client-centered services that they typically would because of uncertainty and fear. Occupational therapy practitioners across the country are not sure of the repercussions they may face if they provide resources or recommendations to clients seeking abortion in states where it has been restricted. I personally was concerned about even giving people resources as to where to get an abortion in [midwestern state]. I was worried that I would have ramifications. I would say maybe for a month [I was worried because of] fear [due to] Republican marketing [i.e., messaging]. I’m usually so transparent and open with my clients, and everything and I was a little blocked out for a month.
Theme 4: Occupational Therapy Practitioners Are Seeking Guidance and Evidence-Based Resources to Best Support Clients
We asked interviewees to share what resources they have seen related to providing occupational therapy in the context of changing federal and state laws related to abortion and what kinds of resources they are seeking. Practitioners reported the need for resources to provide to clients that address region- and state-specific abortion restriction guidelines, increased mental health intervention training, and reproductive health. Participants said they are looking to AOTA and state occupational therapy organizations to provide guidance. One focused on the need for mental health resources: [We need] anything that would encompass psychosocial intervention [or] treatment, [or] mental health training regardless of what setting you work in. [There are] other settings where this could be helpful, even in physical dysfunction [i.e., training in mental health in physical rehabilitation settings is needed as well]. As [occupational therapy practitioners] we provide psychosocial services, and now more than ever there’s a need for mental health trainings if issues come up regardless of setting and practice.
Another participant expressed the need for increased training opportunities within the reproductive health sector: I don’t know that there’s actually any [continuing education courses (CEs)], but I would be very open. Last year, I did take a CE related to sex, what is our role within sex but not specific to reproductive freedoms. If there was a CE like that, I would certainly take it.
An occupational therapy practitioner working in a school setting shared similar sentiments and said she had already taken it upon herself to seek out the information she feels is necessary to know given the current legislation in her state and the needs of her clients: I feel like I needed to educate myself since access is cut off here, and where can they go, and who can they talk to. So, now I have the information ready, but I have not had the instance come up yet, but I am prepared if it does. I consider that my professional responsibility to provide that info. . . . It would be helpful to have more resources on reproductive health, like links to resources on reproductive health.
Occupational therapy practitioners on both sides of the political debate on abortion mentioned wanting information from a trustworthy organization that provides scientific facts for occupational therapy practitioners. One provided specific examples of what this may look like: Region-specific fact or resource sheets to provide people with the hard facts. A lot of what we’re running into is false information. . . . [We need] a resource explaining how the embryo/fetus is disposed of properly, what a fetal heartbeat is versus fetal pole heartbeat.
Discussion
In this qualitative study, we investigated current occupational therapy practice and the needs of occupational therapy practitioners related to the legislative changes on abortion access after the Supreme Court Dobbs decision of June 2022. One theme that emerged from the interviews with the occupational therapy practitioners in our sample is that they had observed impacts of the changed legislation on their clients’ mental health. Although some occupational therapy practitioners feel uniquely positioned to address clients’ mental health needs, there is a lack of resources available for those who are encountering abortion and abortion-related needs among their clients. It is important to note that the OTPF–4 specifies that it is within occupational therapy’s scope of practice to address reproductive health, sex, and intimacy with clients—and access to abortion services fits squarely within those topics.
Our research also revealed that occupational therapy practitioners have experienced powerful instances when clients have raised challenges related to mental health implications of the Dobbs decision, unfavorable pregnancy outcomes (i.e., fetal demise, sepsis, polydrug-addicted newborns, and detrimental cardiac implications for birthing people), poor health outcomes as a result of unsafe abortion, and increased pain from increased pelvic tension caused by restrictions to abortion access. These stories underscore the importance of providing occupational therapy practitioners with clear guidance on what they can say and do to support clients who are seeking information about access to abortion care and who seek mental health support when they experience a lack of access to abortion care. At present, it is difficult for occupational therapy practitioners to find training, best practices, and other resource-related information that would support them help clients who have abortion services–related questions, needs, or problems.
Our findings are in line with IOTA’s (2022) suggestion that clients’ loss of ability to manage this aspect of their reproductive health care may be associated with mental health problems. IOTA also suggested that lack of access to abortion services can result in pelvic health issues, and data from our participants support that contention.
Our research is also consistent with reports from other health professions, such as social work, that have found that professionals in the field are now facing “complex ethical decisions about whether and how best to serve individuals who face reproductive health decisions and seek reproductive health services” (Reamer, 2023, pp. 7–8). The occupational therapy practitioners interviewed in this study reported seeking similar guidelines and feeling uncertain about the legal and ethical implications of providing services under the current legislative changes in their state. Data from our study are also consistent with the argument made by the American Physical Therapy Association and the Academy of Pelvic Health Physical Therapy that although physical therapists are not performing or directly assisting with abortion as a medical procedure, the profession is still part of the health care system, and physical therapists are providers prenatal and postpartum care (Academy of Pelvic Health Physical Therapy, 2022; Herr, 2022).
Our findings that some clients have been asking occupational therapy practitioners for information about reproductive health information, including about abortion, suggest that it would be beneficial for occupational therapy practitioners to consider themselves part of the system of care that supports reproductive health and that this is therefore within their scope of practice. Similarly, a recent qualitative study of obstetrics and gynecology professionals found that they are anticipating “a rise in ethical dilemmas when standard of care is law-based and not patient centered” (Grimes et al., 2023, p. 346). In keeping with that prior study, our findings demonstrate that occupational therapy practitioners have encountered situations in practice where they felt unable to provide appropriate care in the context of abortion for fear of legal repercussions, emphasizing a shared concern for ethical practice within occupational therapy.
The occupational therapy practitioners we interviewed provided a rationale for why they felt that providing reproductive health information to clients, including about access to abortion when that information is requested, was within their scope of practice. They referred to the AOTA Code of Ethics, including the Core Value of Justice and the Principles of Autonomy and Nonmaleficence, as well as our values as a client-centered profession and the duty to provide the services that clients are currently seeking and that are within occupational therapy’s scope of practice. As a result, occupational therapy practitioners are now seeking guidance from AOTA or state-based organizations on how to continue providing ethical and client-centered practice within the parameters of abortion restrictions in certain states.
These findings are consistent with the discussions and research taking place within allied health communities, including social work, physical therapy, pelvic floor therapy, and obstetrics–gynecology (Grimes et al., 2023; Herr, 2022; Reamer, 2023). Our findings underscore the importance of the work that is already being done in these fields to recognize the impact that abortion restrictions have had on professionals practicing in certain states and demonstrate the need for similar guidance and research in the field of occupational therapy. A fundamental next step will be to develop resources that can be used to provide client-centered and evidence-based occupational therapy practice that aligns with AOTA’s current Code of Ethics for practitioners in states that have restrictions on abortion.
There are at least three limitations to this study. First, the research was conducted within 1 yr of most Dobbs-related legislative changes. As more time goes by, the ways in which a lack of access to abortion is affecting clients, and therefore occupational therapy practitioners, may become more apparent. In addition, some states (e.g., Virginia, New Hampshire, New Mexico) have not yet determined whether their state constitution protects legal access to abortion, meaning they may be added to the list of states that restrict abortion and will thus need to be included in further research. Second, the sample size was small and lacked diversity with respect to gender, race, and ethnicity. Although there was more racial and ethnic diversity in our sample than in the current occupational therapy profession in the United States, the homogeneity of the occupational therapy workforce in terms of these parameters is a limitation of the profession that thus has implications for the diversity of research samples that are drawn from it. Third, the interviews were not audio recorded. We used an approach that involved one interviewer and one real-time note-taker. A possible limitation of this is that some participant sentiments were not captured. However, research suggests that audio-recorded transcripts and interview scripts written directly after the interview, using notes taken during the interview, produce data with a level of quality that is comparable to that of recording (Rutakumwa et al., 2020), and our procedure was to write the interview transcript in real time, not after the interview was over. As such, we have confidence that our notes were sufficiently detailed.
Implications for Occupational Therapy Practice and Research
The results of this study have several implications for occupational therapy research and practice: ▪ Occupational therapy practitioners have a range of viewpoints about legislative changes that restrict access to abortion. However, all occupational therapy practitioners will benefit from guidance and evidence-based resources that enable them to give accurate information to clients and support client health. ▪ There is presently too little information available to occupational therapy practitioners about how they can support clients who are seeking reproductive health options or what repercussions they may face for providing particular resources in some states. Some occupational therapy practitioners hope that AOTA and state occupational therapy organizations will provide guidance. Continuing education classes were specifically requested. ▪ Research that investigates how frequently occupational therapy practitioners are asked to provide reproductive health information and support to clients is needed, as is research that identifies effective practices for supporting clients who request reproductive health support.
Conclusion
Occupational therapy practitioners in the United States are being asked questions about abortion, abortion access, and reproductive health by clients. Practitioners working in acute care/hospital, pediatric, pelvic health, maternal health, and mental health settings require support to navigate new policies in their states related to abortion access. Their personal viewpoints about abortion notwithstanding, the majority of the occupational therapy practitioners in our sample stated that they had observed that some of their occupational therapy clients have experienced anxiety, depression, and stress because of changes in abortion access. Therefore, resources about abortion access and abortion care are needed to help guide their practice.