Platt I S, Zivin K, Xiaosong Z, Tilea A, Miller E, Widner A, Courant A, Hall S V, Schroeder A, Dalton V K
Department of Health Policy and Management, The George Washington University Milken Institute School of Public Health, Washington, DC, United States.
Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, United States.
Front Reprod Health. 2025 Aug 29;7:1553493. doi: 10.3389/frph.2025.1553493. eCollection 2025.
Prior research found that suicidality increased among commercially insured birthing people between 2006 and 2017. The 2022 decision overturned and made obtaining an abortion more difficult across the United States, which may have negative mental health effects among commercially insured birthing people.
We conducted a cross-sectional analysis using mixed-effects logistic regression models to quantify the relationship between state-level abortion restrictions and a diagnosis of suicidality or self-harm in the 12 months before or after delivery among individuals with employer-sponsored health insurance in the United States who delivered between 2010 and 2020.
Of the 610,177 deliveries in our final analytic cohort, birthing people residing in states with high abortion restrictiveness were younger (12.8% of birthing people were ages 15-24 compared to 7.8% in low restriction states) and more likely to be Black (10.4% compared to 6.1%). Birthing people living in states with high abortion restrictiveness were more likely to experience suicidality than birthing people living in states with low abortion restrictiveness [odds ratio (OR): 1.5; 95% CI: 1.2, 1.8; = 0.0012]. When controlling for age, state abortion restrictiveness was not significantly associated with suicidality [adjusted odds ratio (adjOR): 1.2; 95% CI: 1.0, 1.4; = 0.0603], and birthing people ages 15-24 were substantially more likely than birthing people ages 35-44 to experience suicidality (adjOR: 7.3; 95% CI: 6.5, 8.2; < 0.001).
In the years prior to the decision, commercially insured birthing people in states with high abortion restrictiveness experienced a growing mental health crisis, when compared to those in low restriction states. These differences are associated with differences in demographic characteristics, such as age and race. As researchers continue to monitor health outcomes related to the recent enactment of the most severe category of restriction (e.g., bans), these findings remain crucial to recognize and account for in further studies.
先前的研究发现，2006年至2017年间，参加商业保险的分娩者的自杀倾向有所增加。2022年的一项裁决被推翻，在美国各地，堕胎变得更加困难，这可能会对参加商业保险的分娩者的心理健康产生负面影响。
我们进行了一项横断面分析，使用混合效应逻辑回归模型来量化美国2010年至2020年间分娩的、拥有雇主赞助医疗保险的个体在分娩前或分娩后12个月内，州一级堕胎限制与自杀倾向或自我伤害诊断之间的关系。
在我们最终的分析队列中的610177例分娩中，居住在堕胎限制高的州的分娩者更年轻（15至24岁的分娩者占12.8%，而在低限制州为7.8%），且更有可能是黑人（分别为10.4%和6.1%）。与居住在堕胎限制低的州的分娩者相比，居住在堕胎限制高的州的分娩者更有可能出现自杀倾向[比值比（OR）：1.5；95%置信区间：1.2，1.8；P = 0.0012]。在控制年龄后，州堕胎限制与自杀倾向无显著关联[调整后比值比（adjOR）：1.2；95%置信区间：1.0，1.4；P = 0.0603]，15至24岁的分娩者比35至44岁的分娩者出现自杀倾向的可能性要大得多（adjOR：7.3；95%置信区间：6.5，8.2；P < 0.001）。
在该裁决之前的几年里，与堕胎限制低的州相比，堕胎限制高的州中参加商业保险的分娩者经历了日益严重的心理健康危机。这些差异与年龄和种族等人口特征的差异有关。随着研究人员继续监测与最近颁布的最严格限制类别（如禁令）相关的健康结果，这些发现对于进一步的研究而言，认识到并加以考虑仍然至关重要。
