Study Ties Abortion Restrictions to 'Significant' Jump in Suicide Rates for Young Women
With abortion currently inaccessible in over a quarter of U.S. states, peer-reviewed research published Wednesday highlights the impact of cutting off care, revealing that restricted access is linked to increased suicide risk in young women.
Published in the
journal JAMA Psychiatry, the analysis of targeted regulation of
abortion providers (TRAP) laws was conducted by four experts at the Children's
Hospital of Philadelphia (CHOP) and the University of Pennsylvania (Penn).
"Stress is a key
contributor to mental health burden and a major driver of increased suicide
risk," said study
co-author Ran Barzilay, a child-adolescent psychiatrist and neuroscientist at
CHOP and Penn's Perelman School of Medicine, in a statement.
"We found that
this particular stressor—restriction to abortion—affects women of a specific
age in a specific cause of death, which is suicide," added Barzilay.
"That's the 10,000-foot view."
While the study is based on state-level data from 1974 to 2016, it was unveiled at a time of heightened fear about abortion access—just six months after the U.S. Supreme Court reversed Roe v. Wade with Dobbs v. Jackson Women's Health Organization.
Since that June 24
ruling, "trigger" bans have taken effect and anti-choice state
legislators have escalated efforts to restrict abortion, blocking millions of
people capable of becoming pregnant from seeking care close to home.
"Abortion is
currently unavailable in 14 states, and courts have temporarily blocked
enforcement of bans in eight others as of December 12, 2022," according to a
Guttmacher Institute review from last week.
During the years
examined by the Penn-CHOP researchers, 21 states enforced at least one TRAP
law.
"We constructed
three indices that measure access to reproductive care by looking at the
enforcement of state-level legislation," explained lead author Jonathan
Zandberg of Penn's Wharton School. "Every time a state enforced a law that
was related to reproductive care, we incorporated it into the index."
After examining
suicide rates before and after the laws took effect, and comparing them to
rates elsewhere and broad trends, the researchers found that
"comparatively, women who experienced the shock of this type of
restrictive legislation had a significant increase in suicide rate,"
Zandberg said.
The publication notes
that during the period studied, annual rates of death by suicide were 1.4-25.6
per 100,000 women of reproductive age—the researchers focused on those
20-34—and 2.7-33.2 per 100,000 women of postreproductive age, or 45-64.
For reproductive-aged
women, the average suicide death rate when no TRAP laws were enforced was 5.5
per 100,000, and enforcement of such a law was associated with a 5.81% higher
annual rate—a trend that was not detected among older women.
A statement from the
university points out that the researchers "examined another common cause
of death, motor vehicle death rates, and saw no effect. Controlling for
potential confounders like the economy and political climate did not change the
results."
While acknowledging
the limitations of their findings, the researchers also stressed how rigorious
their methods were.
"This association
is robust—and it has nothing to do with politics," said Barzilay.
"It's all backed by the data."
Co-author Rebecca
Waller of Penn's Department of Psychology stressed that "we're looking at
the connection between summary data about causes of death at the state level
and policy and politics over many decades."
"Yet, every death
represents an individual moment of tragedy," she said. "So, there's
clearly an awful lot more that we need to understand about what these findings
mean for individual suicide risk."
"Whatever your
view is on all of this, it's all over the news. It's everywhere," Waller
added. "The women internalizing the stories they hear are the ones who
these restrictions will affect the most."
The new findings
illustrate just one way abortion restrictions endanger the lives of people
capable of pregnancy.
Research released
earlier this month by the Commonwealth Fund shows that
"compared to states where abortion is accessible, states that have banned,
are planning to ban, or have otherwise restricted abortion have fewer maternity
care providers; more maternity care 'deserts'; higher rates of maternal
mortality and infant death, especially among women of color; higher overall
death rates for women of reproductive age; and greater racial inequities across
their healthcare systems."
That report argues
that in partnership with residents and insurance and medical providers, state
leaders can enhance the lives of patients by fighting for more and higher
quality maternity care personnel and facilities as well as "by adopting
the Affordable Care Act's Medicaid eligibility expansion for low-income adults
and extending Medicaid postpartum coverage to one year."
"Increased
federal funding for reproductive healthcare, family planning, maternity care,
and care delivery system transformations also could mitigate the impact of
the Dobbs decision and state abortion bans on people's
lives," the publication adds. "State, congressional, and executive
branch actions are all needed to protect the health of women and birthing
people and ensure optimal and equitable outcomes for mothers and infants."
The 988 Suicide &
Crisis Lifeline—which offers 24/7, free, and confidential support—can be
reached by calling or texting 988, or through chat at 988lifeline.org.