The U.S. Supreme Court ruling that overturned the landmark Roe v. Wade decision resulted in a higher prevalence of mental distress among reproductive-aged women living in states restricting abortion rights, according to new research published in JAMA Open Network.
The study aimed to examine whether the U.S. Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization had any association with mental distress among women of reproductive age. The ruling overturned Roe v. Wade, which had previously granted women the constitutional right to have an abortion. The new ruling allowed states to set their own abortion laws, including outright bans.
The American Psychological Association had previously expressed concern that eliminating the constitutional right to abortion would harm women’s mental health and exacerbate the ongoing mental health crisis in the United States. Therefore, this study sought to investigate whether the ruling had any such effects.
“Losing the constitutional right to abortion can have significant consequences,” said study author Muzhe Yang, a professor of economics at Lehigh University.
“Restricting access to safe and legal abortions can disproportionately impact women in racial/ethnic minority groups, low socioeconomic status, and medically underserved areas. These women may bear a disproportionate economic and mental health burden of having an unwanted pregnancy and its economic consequences due to the increased travel costs associated with obtaining an abortion.”
The researchers used individual-level data from the Census Bureau Household Pulse Survey, which had been previously used to study mental health. The survey contained information on respondent sociodemographics and residential state, to which the researchers matched information on the status of state abortion bans from the Guttmacher Institute and travel distance to the nearest abortion clinic from previous studies.
The researchers used a difference-in-differences model to compare changes in mental distress among women of reproductive age living in states where abortion rights were restricted after the Supreme Court decision vs. states where abortion rights continued to be protected, while accounting for confounders.
The difference-in-differences model is a statistical technique used to estimate the causal effect of a treatment or intervention, such as a policy change, by comparing the changes in outcomes over time between a treatment group (those who are exposed to the policy change) and a control group (those who are not exposed to the policy change). The model calculates the difference between the average change in outcomes for the treatment group before and after the policy change, and the average change in outcomes for the control group over the same period.
The researchers found a statistically significant higher prevalence of mental distress among women of reproductive age living in states with restricted abortion rights after the ruling. They observed a 10% increase in the prevalence of mental distress after the ruling, compared to the pre-period proportion. In contrast, there were no such associations observed among women who were older than reproductive age.
Furthermore, the researchers found that the association between the Supreme Court decision and mental distress varied by barriers to legal abortion, as proxied by state-level changes in travel distances to the nearest abortion clinics. The association was stronger in states where travel distances to the nearest abortion clinics increased after the ruling.
The study’s findings suggest that the mental health impact of restricting abortion access could extend beyond women who seek and are denied an abortion to the broader population of women who are at risk of having an unwanted pregnancy.
“Our study’s findings align with those from the Turnaway study, which showed that women who were denied an abortion due to being over the permissible gestational threshold in their state experienced higher levels of anxiety and mental health distress, relative to women who were allowed to have an abortion,” Yang told PsyPost.
“While the Turnaway study specifically highlighted the adverse mental health effects for women who actually sought and were denied an abortion, our study suggests that the mental health impact of restricting abortion access could extend beyond this subset of women to the broader population of women who are at risk of having an unwanted pregnancy and seeking an abortion, either currently or in the future.”
The new research sheds light on the psychological consequences of the Dobbs v Jackson Women’s Health Organization. But the findings include some caveats. The researchers noted that their study could not measure some important variables, such as personal beliefs and values related to abortion.
It is unclear whether individuals who highly valued legal access to abortion experienced higher levels of mental distress after the decision, or whether those who placed a low value on access to abortion experienced reduced levels of mental distress.
The study, “Mental Distress Among Female Individuals of Reproductive Age and Reported Barriers to Legal Abortion Following the US Supreme Court Decision to Overturn Roe v Wade“, was authored by Dhaval Dave, Wei Fu, and Muzhe Yang.
