June 17, 2024

When states restrict access to reproductive care, women’s suicide rates rise, study finds

The increasing number of state-level restrictions on reproductive care, including abortion, has been repeatedly 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 results suggest that when states restrict access to abortion, suicide rates among women of reproductive age who live there 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 behaviour. Environmental stressors may include a number of interpersonal or health-related difficulties and macro-level factors such as economic conditions and media portrayal of suicide.

In the United States, abortion and reproductive care are divisive issues, and states have enacted numerous restrictions. The ever-changing legislation and media coverage of these issues may have implications for the mental health of women of reproductive age. Previous studies have examined the association between obtaining an abortion and adverse mental health outcomes but have provided conflicting evidence. In addition, research has found that women who were denied an abortion due to gestational limitations experienced higher levels of stress and anxiety compared to those who received an abortion.

For their study, Jonathan Zandberg and his colleagues relied on state-level data from the National System of Vital Statistics 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 with state-level access to reproductive care, 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 adjustment for state-level sociodemographic factors such as poverty, education, and race/ethnicity.

The research team acknowledged that there were some limitations to their study. First, the study relied on state-level data, which does not accurately reflect individual-level experiences. Second, the study lacked individual-level data on the proportion of suicides that occurred specifically 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 for women’s mental health and well-being. The study highlights the need for policy makers to consider the potential consequences of restrictive reproductive care policies.

The research team acknowledged that their findings also highlight the need for more research into the mental health impacts of restrictive reproductive care policies. Future research could explore the mechanisms by which restrictive policies may impact on 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,” wrote Jonathan Zandberg, Rebecca Waller, Elina Visoki, and Ran Barzilay.

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