Current state of abortion access

Before June 2022, two Supreme Court rulings determined the landscape of abortion access in the U.S: Roe vs. Wade (1973) and Planned Parenthood v. Casey (1992). Together, these rulings established that the state must balance the autonomy and privacy of the pregnant person against the life of the fetus, prioritizing the pregnant person’s privacy and autonomy in earlier stages of pregnancy (before fetus viability) and fetal health in later stages of pregnancy (after fetus viability). Although these rulings effectively protected the right to access abortion in early stages of pregnancy, states were still permitted to pass legislation governing abortion access in a variety of ways. Many state laws were passed with the stated intention of protecting the pregnant person (e.g., requirements for abortion providers to have admitting privileges in a nearby hospital) while simultaneously increasing the difficulty of accessing abortion. In 2022, Dobbs v. Jackson Women’s Health Organization overturned Supreme Court precedent, finding no constitutionally protected right to abortion access at any point during pregnancy. This ruling allowed states to further restrict abortion access, including bans that allow abortion only in exceptional cases (e.g., rape, incest, threats to the life of the pregnant person).

Currently, 14 states have bans on abortion (with select exceptions, notably Wyoming and North Dakota’s bans are currently enjoined), seven states have restrictive bans (e.g., bans on abortions after 6, 12, or 18 weeks), and five states along with Puerto Rico allow access but do not explicitly protect abortion access. On the other hand, 24 states and the District of Columbia have codified the right to abortion access through various legal mechanisms. At the federal level, the Hyde Amendment (and other similar amendments that govern spending) bars federal funds (e.g., Medicaid, federal prison funding, military funding, federal worker health plans) from being spent on abortion except in the case of rape, incest, or serious parental injury.

Potential restriction of abortion access

We focus our discussion on three significant mechanisms that may further restrict access to abortion depending on the degree to which they are enforced or enacted. First, regulations surrounding the provision of abortion services and supplies may have varied implications depending on executive and judicial interpretation. For example, the Comstock Act, passed in 1873, criminalized the distribution of “obscene” materials through the mail including information regarding abortifacients (Cohen et al., Reference Cohen, Adashi and Ziegler2023). Although the Comstock Act has not been enforced in the context of abortion since Roe v. Wade, after the Dobbs ruling it is once again enforceable (Kurtzleben, Reference Kurtzleben2024). Thus, even without new legislation, the Comstock Act could be used to prevent the shipping of medication or supplies used for abortion procedures.

Second, regulations that further limit federal funding for abortion access may restrict access for select populations. Specifically, there has been a push to expand the Hyde Amendment (Exec. Order No. 14182, 2025) and to pass similar laws that eliminate all federal funding for entities that provide abortions (e.g., U.S. Congress, 2025a; U.S. Congress, 2025b). Such an expansion would additionally restrict access to abortion and other less controversial care like birth control for those not directly dependent on federal funding for their healthcare.

Finally, many states, through laws, constitutional amendments, and judicial rulings, have granted personhood to fertilized embryos (e.g., Alabama Constitution Section 36.06). For example, the Supreme Court of Louisiana’s designation of embryonic juridical personhood has consequently criminalized many steps inherent to in vitro fertilization (IVF) treatment. If these policies are expanded nationwide through either national legislation (i.e., HR 722 “Life at Conception Act” 2025) or federal courts, it could limit access to reproductive care nationwide.

Impacts for I-O psychology

In combination with abortion-restrictive state legislation, these three mechanisms of restriction could re-define the landscape in escalating ways. We evaluate the impacts of these potential shifts by groups of stakeholders, focusing on organizations, employees, and healthcare providers. We then discuss implications for I-O psychologists relevant to each population.

Impacts on organization

The legal and logistical barriers to accessing abortion imposed by state laws, coupled with potential federal restrictions, have significant consequences for organizations. Restrictive policies shape workforce mobility, employee retention, and employer decision making regarding benefits and compliance. Below, we outline key implications for organizations in these highly regulated environments.

Employer policies

Organizations may face external pressures from consumers, investors, employees, and advocacy groups regarding their stance on reproductive rights. For example, in the wake of the Dobbs decision, some companies began reimbursing travel for out-of-state abortion care or expanding reproductive healthcare benefits (Goldberg & Cheung, Reference Goldberg and Cheung2022). However, these policies introduce potential legal, ethical, and practical complexities, depending on further restrictions. For example, state governments could penalize employers who facilitate abortion access (e.g., through aiding-and-abetting laws coupled with embryonic juridical personhood), or federal funds may be withheld from companies that facilitate abortion access for employees. Further, companies that take a public position on abortion access—whether supportive or restrictive—may experience reputational consequences affecting brand perception, customer loyalty, and employee satisfaction. Consequently, some employers are rolling back previous benefits supporting employee abortion access, including the Pentagon’s shift away from funding travel for abortion coverage for service members and dependents (Kube, Reference Kube2025). Conversely, organizations that remain silent may be criticized by stakeholders who expect corporate leaders to address social and political issues that affect the workforce. Organizations must therefore navigate a shifting landscape in which their benefits offerings may conflict with state or federal regulations and stakeholder preferences, requiring careful legal review and strategic policy development.

Beyond direct supports for abortion access, organizations play a role in both alleviating and aggravating the financial well-being of workers by providing (or restricting) resources and opportunities (Soundararajan et al., Reference Soundararajan, Sahasranamam, Rogerson, Bapuji, Spence and Shaw2025). Resources supporting working families may become more critical and take new forms as restrictions around abortion access increase. For example, programs allowing pathways for low-wage or part-time workers to flexibly gain skills and advancement opportunities while also caring for dependents may be critical to breaking employment-related poverty cycles facilitated by abortion restriction. Additionally, livable wages, healthcare benefits, mental health benefits, education benefits, and flexible work arrangements may help uplift workers disproportionately affected by economic threats due to restricted abortion access.

I-O practitioners can aid organizations in evaluating their benefits packages as tools for employee attraction and retention. An understanding of talent pool development, employee compensation, and the work–family interface will become critical. I-O researchers must better understand how workplace benefits signal organizational values and relate to employee attitudes, and how family systems make decisions about employment of individual members.

Employer practices

Beyond formal policies, organizational practices are likely to be further impacted by abortion access restrictions. For example, organizations operating in highly regulated states may struggle with talent retention and recruitment of workers valuing reproductive healthcare access. Research on talent migration suggests that professionals—especially those with specialized skills and higher levels of education—may seek employment in states with stronger reproductive rights protections (Mahoney et al., Reference Mahoney, Dundar, Bahn, Rogers and Doorley2025). Employers in restrictive states may therefore face challenges attracting top talent, particularly among younger workers, women, and people who may need reproductive healthcare in the future. Retention concerns may also be salient for existing employees. Organizations that do not provide sufficient healthcare benefits or flexible work arrangements to accommodate employees in restrictive states may see increased turnover, particularly among employees able to relocate. This highlights the need for organizational practices designed to support this portion of the workforce to achieve organizational goals.

Idiosyncratic arrangements may become the main—if not the only—means of finding time and money to access abortion care among workers. Low-wage workers, in particular, have limited access to formal healthcare (U.S. Bureau of Labor Statistics, 2020) and flexibility benefits (Kossek & Lautsch, 2018) through their employers. Consequently, low-wage workers may be particularly likely to rely on informal arrangements with supervisors and coworkers to find the time and money to access abortion care. Such informal arrangements are not guaranteed and can foster inequity in access to such support (Casper et al., Reference Casper, Hyde, Smith, Amirkamali and Wayne2025). Lack of informal support can have negative consequences for the well-being of workers and their families (e.g., French et al., Reference French, Agars and Arvan2024). We anticipate informal supports will be even more closely tied to well-being outcomes, providing a critical doorway (or barrier) for accessing abortion in a timely and cost-effective manner. Moreover, in workplaces where abortion remains a stigmatized topic, individuals may be less likely to disclose their reproductive healthcare needs, leading to decreased social support and potential workplace isolation.

I-O practitioners will need to become facile in helping organizations navigate and support the need for idiosyncratic arrangements when company-wide policies and benefits are not feasible or available. Researchers should identify best practices in how and when to disclose, support, and navigate interpersonal and institutional politics when facilitating employee access to reproductive care.

Impacts on workers

For vulnerable workers (those in highly regulated states, those living near or below the poverty line), abortion access is already constrained, often requiring extensive travel, legal navigation, and financial costs. Enforcing the Comstock Act to block the distribution of medication abortion would eliminate one of the most accessible options for abortion care (Nadworny, Reference Nadworny2024). For low-income workers this could severely reduce access as in-clinic visits are more expensive (Bartels, Reference Bartels2024), and for those in restrictive states, this would nearly eliminate access altogether. Similarly, if organizations that largely serve populations through Title X provisions (e.g., Planned Parenthood) no longer receive funding from the federal government due to Hyde amendment style policies, access to abortion for many may become so impractical as to “deprive poor and minority women of the constitutional rightFootnote ² to choose abortion” (Thurgood Marshall; Harris v. McRae, 1980).

Psychological outcomes

The resulting inability to terminate a pregnancy could have profound physical and psychological effects, as being denied an abortion is associated with higher risks of pregnancy-related complications, worsened long-term health outcomes, and elevated levels of stress and anxiety (Biggs et al., Reference Biggs, Upadhyay, McCulloch and Foster2017; Ralph et al., Reference Ralph, Schwarz, Grossman and Foster2019). Similarly, employees who seek abortion care—especially those required to travel out of state—may experience anxiety about workplace repercussions, particularly if employers hold anti-abortion stances or if state laws criminalize abortion-related assistance. Compounded with existing stressors and strains (e.g., job insecurity, illness; Patterson et al., Reference Patterson, Watson, Baker, Sinclair and Jones2024), difficulty or inability to access abortion may exacerbate existing mental and physical illness disparities, translating into greater absenteeism, more use of sick leave, heightened work-related stress, and turnover (e.g., Carlson et al., Reference Carlson, Grzywacz, Ferguson, Hunter, Clinch and Arcury2011).

These legal changes may even impact employees who don’t need abortion care. For example, employees with differing views on abortion access may experience conflicts in team dynamics due to increased workplace polarization, reflecting patterns of incivility due to political differences in the workplace (Miner et al., Reference Miner, Costa, He and Wooderson2021). Additionally, organizations that don’t acknowledge the impact of restrictive policies may be perceived as unsupportive or misaligned with employee values. Research suggests that workplace climates that do not actively support reproductive health can contribute to lower employee engagement, reduced psychological safety, and increased turnover intentions (Bergman et al., Reference Bergman, Gaskins, Allen, Cheung, Hebl, King and Zelin2023). Together, the political and legal climate may influence workplace culture, creating greater stress, tension, or fear among employees.

I-O practitioners will need to navigate the impact of distress and anxiety on the work experience, as well as the effects of employee political discussions at work. Similarly, they should work to counsel decision makers on the impact that CEO activism may have on employee attitudes such as job commitment, dependent upon the ideology of the employees (e.g., Wowak et al., Reference Wowak, Busenbark and Hambrick2022). I-O researchers need to understand the relationship between the tenuous access workers have to abortion care and their work-related well-being. Similarly, further research into the role of political ideology in workplace dynamics is critical. Last, both I-O practitioners and researchers need to consider vulnerable populations (e.g., low-income workers) who may be most impacted by these legal changes but are often overlooked by our field (Gloss et al., Reference Gloss, Carr, Reichman, Abdul-Nasiru and Oestereich2017).

Career outcomes

Economic viability, educational attainment, and maintaining employment were among the top reasons women sought an abortion (Finer et al., Reference Finer, Frohwirth, Dauphinee, Singh and Moore2005). Further, research suggests abortion restriction is associated with lower educational attainment and economic stability (Everett & Taylor, Reference Everett and Taylor2024), and that being denied an abortion is associated with future financial distress (e.g., unpaid debt size, evictions, and bankruptcies; Miller et al., Reference Miller, Wherry and Foster2023) and unemployment (Foster et al., Reference Foster, Biggs, Ralph, Gerdts, Roberts and Glymour2022). Unemployment and underemployment are associated with numerous psychological and physical costs for workers and their families, including distress, anxiety, lower self-worth, divorce, and abuse (Thompson & Dahling, 2019). Moreover, it can be difficult to re-enter the workforce after a period of unemployment.

Workplace engagement may be disrupted due to the physical and emotional demands of an unplanned pregnancy, particularly if employees do not receive adequate family leave or workplace accommodations. Career advancement opportunities may also be affected, as women facing limited abortion access experience lessened career mobility (Bahn et al., Reference Bahn, Kugler, Mahoney and McGrew2020). Further, employees carrying unwanted pregnancies who must take extended leave or who are forced to shift career priorities due to caregiving responsibilities may face slowed professional growth, wage stagnation, and reduced access to leadership roles. Thus, further restrictions on abortion access can directly threaten the economic stability of workers and their families, a particularly salient threat among those already living near the poverty line or in restrictive states.

I-O practitioners must work to expand their toolkits to better understand career outcomes for employees and methods of selection, recruitment, and retention that take into consideration pregnancy-related gaps in employment. Researchers must work toward understanding the career and economic impacts of abortion access not only for employees but for entire family systems.

Healthcare profession

Healthcare professionals will likely face special challenges with further restricted abortion access. Obstetrician-gynecologists (OB-GYNs) in restrictive states encounter mounting legal uncertainty when treating high-risk pregnancies, ectopic pregnancies, miscarriages, or even prescribing certain forms of contraception (Guttmacher Institute, 2024b). This legal ambiguity creates ethical dilemmas and jeopardizes patient care. A recent survey (Manatt Health, 2024) revealed that 76% of Texas OB-GYNs felt unable to follow best practices and evidence-based medicine, with 60% reporting fear of legal repercussions for doing so. Compounding these concerns, nearly one-third (29%) of OB-GYNs admitted to lacking a clear understanding of their state’s abortion laws, further eroding their confidence in providing care.

Beyond OB-GYNs, healthcare providers in primary care, emergency medicine, and pediatrics may also find themselves treating patients who need abortion care, either due to personal choice or to preserve their lives. The potential enforcement of the Comstock Act adds another layer of legal risk, as healthcare providers prescribing abortion medications via mail-order pharmacies could face prosecution, even when practicing in states where abortion is legally protected.

This shifting legal landscape may discourage entry into careers in reproductive health specialties and encourage practicing physicians to transition to less legally fraught specialties or geographic regions. Indeed, Hulsman et al. (Reference Hulsman, Bradley, Caldwell, Christman, Rusk and Shanks2023) found that 52.2% of medical students reported being less likely to specialize in OB-GYN due to abortion restrictions. Following the Dobbs decision, states with more restrictive policies have struggled to recruit and retain OB-GYNs (Weiner, Reference Weiner2023), particularly in rural areas already experiencing OB-GYN shortages. Alarmingly, 35% of U.S. counties had no OB-GYN even before Dobbs (March of Dimes, 2024). As abortion restrictions further deter new OB-GYNs, access to critical reproductive healthcare—including cervical cancer screenings, contraception, and sexually transmitted infection testing—may also diminish. Further, healthcare organizations that rely on Title X funding and provide abortion care would be in jeopardy should Hyde-style legislation pass, limiting healthcare access for the vulnerable populations more likely to access any medical care via these organizations (Carson, Reference Carson2018; U.S. Bureau of Labor Statistics, 2020).

In short, the increasingly precarious legal environment for OB-GYNs and other healthcare workers threatens to create a human capital crisis. With healthcare professionals already facing high burnout rates due to the COVID-19 pandemic (Restauri & Sheridan, Reference Restauri and Sheridan2020), the added stress of legal uncertainty may drive further attrition. Further, the possible moral injury of not being able to provide appropriate care may also lead to distress (e.g., Riedel et al., Reference Riedel, Kreh, Kulcar, Lieber and Juen2022), which has been linked to turnover intentions and actual turnover (Podsakoff et al., Reference Podsakoff, LePine and LePine2007), raising serious concerns for workforce stability.

I-O practitioners working with healthcare organizations, particularly in reproductive health, may need to facilitate the adoption of new organizational strategies to support healthcare workers, such as initiatives to reduce burnout (e.g., De Simone et al., Reference De Simone, Vargas and Servillo2021). I-O researchers must work to better understand the psychological, social, and professional impacts of being prevented from providing care one thinks is appropriate, or altogether.