Friday, December 30, 2022

Abortion Restrictions May Increase Risk of Suicide Among Women

Restricted access to abortion care may be associated with increased risk of suicide among women of reproductive age, according to a study published this week in JAMA Psychiatry.

“Abortion and access to reproductive care represent divisive issues in the United States, with staggering health consequences for women,” wrote Jonathan Zandberg, Ph.D., of the Wharton School of the University of Pennsylvania and colleagues. “Since 1970, states have enacted more than 1,300 abortion restrictions, including efforts to prohibit abortion after [six] weeks of gestational age. The dynamic nature of this legislation and its extensive media coverage have implications for the mental health of reproductive-aged women.”

Zandberg and colleagues analyzed laws in U.S. states that targeted abortion providers between 1974 (the first full year in which abortions were legal) and 2016 (the last full year when the data were available). They looked at laws that subject clinicians who provide abortions to the same regulations as ambulatory surgical centers; require those clinicians to have admitting privileges at nearby hospitals; and require facilities to have a written agreement with a nearby hospital in case of emergencies. These are known as Targeted Regulation of Abortion Providers (TRAP) laws.

The researchers used the Centers for Disease Control and Prevention’s Wide-ranging Online Data for Epidemiological Research (WONDER) database to determine state-level suicide rates. They specifically looked at how restrictions on reproductive care were related to suicide deaths among women of reproductive age (aged 20 to 34) compared with suicide deaths in women of post-reproductive age (aged 45 to 64). Further, to test the specificity of the findings on suicide, they also tested associations between restricted access to abortion and death rates due to motor vehicle crashes among women, another leading cause of death.

Twenty-one states enforced at least one TRAP law between 1974 and 2016. Enforcement of a TRAP law was associated with higher suicide rates among reproductive-aged women, but not among women of post-reproductive age. Specifically, enforcement of a TRAP law was associated with a 5.81% higher suicide rate among women of reproductive age compared with pre-enforcement years. Enforcement of TRAP laws were not associated with death rates due to motor vehicle crashes.

“[A]ccess to reproductive care may represent a potentially modifiable population-level suicide risk factor for reproductive-aged women,” the authors concluded. “The results may have important implications for clinicians and policymakers in the United States.”

For related information, see the Psychiatric News article “Experts Share Advice for Post-Roe World: ‘We Have to Be Proactive’.”

(Image: iStock/VioletaStoimenova)

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