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Association Between State Abortion Restrictiveness and Perinatal Depression.

Stephanie V Hall1,2, Andrea Pangori3,2, Faelan Jacobson Davies3,2

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Journal of Women'S Health (2002)
|June 11, 2025
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Restrictive abortion policies are linked to higher rates of perinatal depression in women, even when pregnancy is intended. These policies may negatively impact maternal mental health by limiting access to care.

Keywords:
PRAMSabortionperinatal depressionreproductive health care

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Area of Science:

  • Reproductive Health
  • Maternal Mental Health
  • Public Health Policy

Background:

  • Abortion services are essential for reproductive healthcare.
  • Barriers to reproductive health services can negatively impact mental health.
  • State-level abortion policies vary significantly, potentially affecting maternal well-being.

Purpose of the Study:

  • To investigate the association between restrictive state-level abortion policies and the risk of perinatal depression.
  • To examine this association separately for women with intended and unintended pregnancies.

Main Methods:

  • Cross-sectional analysis of Pregnancy Risk Assessment and Monitoring System surveillance data.
  • Measurement of state abortion policy restrictiveness using the Guttmacher Abortion Policy Hostility Index.
  • Assessment of perinatal depression via self-reported diagnosis or the Patient Health Questionnaire.

Main Results:

  • Women in states with highly restrictive abortion policies had 1.23 times greater odds of perinatal depression.
  • Women with unintended pregnancies showed a higher probability of perinatal depression in both restrictive and less restrictive states.
  • The association between restrictive policies and perinatal depression persisted regardless of pregnancy intent.

Conclusions:

  • Restrictive state abortion policies are associated with increased perinatal depression risk.
  • Abortion restrictions may directly impede access to care or indirectly signal inadequate support services.
  • Maternal mental health outcomes must be considered in the development of reproductive health policies.