Restrictive abortion policy climate is associated with increased depression symptoms among women in the United States: Findings from a 25-year longitudinal study
Year: 2026
Type: article
Abstract: Purpose: To examine associations between state-level abortion restrictiveness and depression among female participants in a large, US sample surveyed from 1990 to 2015. Methods: Eligible participants were female respondents in the Monitoring the Future panel study followed from adolescence into adulthood (N = 19,881 female respondents with 50,995 unique observations). Depression symptoms were assessed using a four-item index. State-level restrictive abortion policy climate was quantified using an annual index of 18 policies, standardized across states and years. We modeled associations using log-binomial multilevel models, adjusting for individual (e.g., race/ethnicity, age, urbanicity) and state-level (e.g., unemployment, income inequality, political and legislative composition, demographic composition, gender wage gap) confounders. We conducted tests to assess robustness of findings, including using a negative control outcome (motor vehicle crashes), alternative populations (male respondents), and subgroup tests by religiosity. Results: A one-standard deviation increase in state abortion restrictiveness (equivalent to approximately 4 more restrictive laws) was associated with a 7% increase in depression symptoms among females (adjusted risk ratio [RR] = 1.07, 95% confidence interval [CI]: 1.02-1.11). As hypothesized, associations among our alternative sample were not statistically significant (males, RR = 1.03, 95% CI 0.99-1.08, though estimates did not statistically differ by sex) as were associations with our negative control outcome (motor vehicle crashes). As hypothesized, associations were most pronounced among female respondents reporting low religiosity (RR = 1.08, 95% CI: 1.01-1.15), and not significant among those reporting high religiosity. Conclusion: Restrictive abortion policies are associated with higher depression symptoms among women. Legal protections for reproductive health care may benefit mental health.
Source: SSM - Mental Health
Institutions: Columbia University, University of Michigan, Emory University
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,540
Funders: Center for Reproductive Health Research in the Southeast, Emory University, National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism, National Heart, Lung, and Blood Institute, National Institute of Mental Health, National Institute on Drug Abuse, NHLBI Division of Intramural Research
OpenAlex ID: W7130849885