The increasing number of state-level restrictions on reproductive care, including abortion, have repeatedly been linked to adverse mental health outcomes among women. A new study published in JAMA Psychiatry aimed to investigate the association between access to reproductive care and suicide rates among women of reproductive age in the United States. The findings indicate that when states restrict access to abortion, the suicide rates of reproductive-age women living there tends to increase.
Suicide is one of the three leading causes of death in young women, and previous research has found that biological and psychological factors, along with environmental stressors, contribute to suicidal behavior. Environmental stressors can include several interpersonal or health-related difficulties and macro-level factors like economic conditions and media representations of suicide.
In the United States, abortion and reproductive care are divisive issues, and states have enacted numerous restrictions. The constantly changing legislation and media coverage of these issues have potential implications for the mental health of reproductive-aged women. Previous studies have examined the association between receiving an abortion and adverse mental health outcomes but have produced conflicting evidence. Additionally, research has found that women who were denied an abortion due to gestational limits experienced higher stress and anxiety compared to those who received an abortion.
For their study, Jonathan Zandberg and colleagues relied on state-level data from the National Vital Statistics System and the Guttmacher Institute. The study included all 50 states and the District of Columbia, covering 2000 to 2016. The primary outcome measure was the age-adjusted suicide rate among women of reproductive age (15-44 years) per 100,000 population. These suicide rates were compared to state-level access to reproductive care, which was measured using the Guttmacher Institute’s Abortion Policy in the United States dataset. The dataset includes information on state-level restrictions on abortion, such as waiting periods, mandatory counseling, and parental consent laws.
The study found that state-level restrictions on reproductive care were associated with higher suicide rates among women of reproductive age. Specifically, states with more restrictive abortion policies had higher suicide rates among women of reproductive age than those with less restrictive policies. The association remained significant after adjusting for state-level sociodemographic factors like poverty, education, and race/ethnicity.
The research team acknowledged that there were some limitations to their study. Firstly the study relied on state-level data, which may not accurately reflect individual-level experiences. Second, the study did not have individual-level data on the proportion of suicides that specifically occurred among pregnant women.
The study’s findings have important implications for public health and policy. The study suggests that state-level restrictions on reproductive care may have unintended consequences on women’s mental health and well-being. The study highlights the need for policymakers to consider restrictive reproductive care policies’ potential mental health impacts.
The research team recognized that their findings also highlight the need for further research on the mental health impacts of restrictive reproductive care policies. Future research could explore the mechanisms through which restrictive policies may impact women’s mental health and potential interventions to mitigate these impacts.
The study, “Association between state-level access to reproductive care and suicide rates among women of reproductive age in the United States,” was authored by Jonathan Zandberg, Rebecca Waller, Elina Visoki, and Ran Barzilay.