Living in an abortion ban state is bad for mental health
Worsened anxiety and depression is a predictable (and costly) effect of abortion bans.
The false idea that getting an abortion makes women irreparably depressed and anxious, that it causes a deep psychic wound, has for decades been used by anti-abortion activists to support abortion restrictions.
But the argument is entirely based on anecdotes, personal beliefs, and vibes. No good science has demonstrated this link.
That’s not because nobody’s tried to answer the question of what the mental health impacts of abortion are on the women who obtain them. It’s because the answer to that question, over and over again, is: none. In study after study, researchers have consistently shown that getting an abortion does not cause mental health problems.
What does reliably worsen women’s mental health, however, is banning or restricting abortion access.
A wealth of research has shown that when people are forced to carry unwanted pregnancies, it negatively impacts their physical health and finances — and mental health. In a survey conducted before the US Supreme Court overturned the constitutional right to abortion, women living in states with more abortion restrictions had higher rates of mental distress. In another study, states enforcing abortion restrictions between 1974 and 2016 had higher suicide rates in women of childbearing age in particular.
But when the court decided to overturn Roe v. Wade in 2022, it wasn’t making a decision grounded in science.
Now we’re more than a year and a half into living with the consequences. And when it comes to women’s mental health, the fallout is following the exact pattern scientists predicted.
Research shows the thing we thought was true is, in fact, true
In a study published last month, researchers at Johns Hopkins University found that people living in states that banned abortion in the immediate wake of the Court’s decision have worse symptoms of anxiety and depression than those who live in states without bans.
Using data gathered as part of US Census Household Pulse surveys, the researchers looked at respondents’ self-reported anxiety and depression scores from about six months before and six months after the Court overturned the constitutional right to abortion. They compared scores on a scale of zero to 12 among people in states with and without trigger bans, abortion restrictions that went into effect as soon as the Supreme Court issued its ruling.
What they found was, frankly, predictable: Before the Court’s decision, anxiety and depression scores were already higher in trigger states — a population-wide average of 3.5 compared with 3.3 in non-trigger states. After the decision, that difference widened significantly, largely due to changes in the mental health of women 18 to 45, what the authors defined as childbearing age. Among this subgroup, anxiety and depression scores subtly ticked up in those living in trigger states (from 4.62 to 4.76) — and dropped in those living in non-trigger states (from 4.57 to 4.49). There was no similar effect in older women, nor in men.
These differences were small but statistically meaningful, especially since they sampled the entire population, not just women considering an abortion. Moreover, they were consistent across trigger states, whether their policies and political battles around abortion had been high- or low-profile. Even when the researchers omitted data from states with particularly severe restrictions on women’s reproductive health (looking at you, Texas), the results held up.
It’s notable that the different levels of mental distress across states after Roe was overturned weren’t just a consequence of worsened anxiety and depression in states with trigger bans. Also contributing: an improvement in these symptoms in states without these bans. We can’t tell from the study exactly why that is, but it seems plausible that women living in states that protect their right to access necessary health care simply feel some relief.
Americans don’t need more mental health stressors right now
In bird’s-eye-view studies like this, it can be hard to pick apart the nuances behind a finding. For example, it’s possible other social or cultural factors are more likely to disproportionately affect women in trigger states — like variability in gender equity, interpartner violence, abortion stigma, and mental health care access.
Still, it should set off our alarm bells when high-quality research finds a causal relationship between big societal shifts and worsening depression and anxiety on a population-wide level.
People who sense limitations to their personal freedom and autonomy feel a sense of “violation and powerlessness,” says Benjamin Thornburg, a health economics PhD student who led the study. It stands to reason that the opposite of that, a sense of freedom and autonomy, would improve people’s overall mental health.
Anxiety and depression rates are reaching record highs and are especially pronounced among young adults, and suicide deaths are ticking up. At the same time, Americans are living in an age of broadly unmet mental health care needs: 160 million Americans live in areas with provider shortages and insurance denials, and only one-third of people diagnosed with a behavioral health condition get the care they need.
Policymakers need to understand “there could be an increase in the need for mental health services in states where these bans have happened,” says Thornburg.
But it’s not at all clear they do.
This story appeared originally in Today, Explained, Vox’s flagship daily newsletter. Sign up here for future editions.
USC rides 6-game win streak to No. 7 in AP poll
Six straight wins by USC have bumped the Trojans up to No. 7 in the Associated Press women's basketball poll, while South Carolina is still the unanimous No. 1.
USC swept Oregon and then-No. 11 Oregon State over the weekend. The Trojans moved into a tie for second place in the Pac-12 Conference, two games behind Stanford. They host Colorado and Utah this weekend.
The six teams in front of USC didn't change, with South Carolina leading the way, as it has since the regular season began. The Gamecocks received all 35 votes from a national media panel. South Carolina was tested in both its games last week, rallying to beat Tennessee and Georgia. Coach Dawn Staley's team trailed at halftime at home against Georgia on Sunday before winning by 14 points.
Ohio State was right behind South Carolina, marking the first time in seven weeks that a No. 2 team held its place for two consecutive polls. No. 3 Stanford, Iowa, Texas and NC State followed the Buckeyes.
Virginia Tech climbed four spots to eighth after beating Duke and Louisville. The Hokies have won nine in a row and sit in first place in the Atlantic Coast Conference, a game in front of Syracuse.
Oregon State moved up to ninth despite the loss to USC after beating then-No. 9 UCLA.
Kansas State fell three places to No. 10, while Colorado and UCLA also dropped three places.
GAME OF THE WEEK
With the NCAA career scoring record in the rearview mirror, Caitlin Clark leads Iowa into Indiana for a key Big Ten Conference matchup. Iowa is tied for second, a game behind Ohio State. The Hawkeyes beat the Hoosiers by 27 points at home last month. Expect Thursday's rematch to be a bit more competitive.
EXCITEMENT OUT WEST
It was an exciting weekend in the Pac-12 Conference, with Oregon State topping UCLA on a shot at the buzzer as well as Utah beating Colorado in the last second as well. The conference is still tops in the poll, with five teams in the first 12 and six ranked in the Top 25 overall.
The ACC and Big 12 are next with five teams each. The Big 12 has three teams and the Big East and SEC each have two. The Ivy and West Coast each have one.
The NCAA had its first reveal last Thursday of the top 16 teams at that point. South Carolina, Ohio State, Stanford and Colorado were the 1-seeds. The Buffaloes went on to lose after that. The next reveal will be Feb. 29.
IVY LEAGUE SHOWDOWN
No. 25 Princeton has won 15 straight games and sits a game in front of Columba in the Ivy League standings. The Tigers won the first meeting last month, and the two teams play in New York on Saturday with first place in the conference on the line. They shared the regular-season title last year, the first in Columbia's history.
Justice Alito is mad that George W. Bush was too woke
In a dissenting opinion, Alito takes a potshot at Bush’s signature racial justice program.
The Supreme Court announced on Tuesday that it will not hear Coalition for TJ v. Fairfax County School Board, a lawsuit attacking a school admissions program that was considered a cutting-edge conservative idea a quarter century ago — and whose most prominent champion was Republican former President George W. Bush.
Two justices dissented, with Justice Samuel Alito writing an angry opinion attacking a school admissions policy that closely mirrors Bush’s signature racial justice program.
In the late 1990s, when Bush was governor of Texas, he signed legislation creating that state’s “top 10 percent” law for university admissions. As the name implies, Bush’s law guaranteed that Texas high school students who graduated in the top 10 percent of their class would be admitted to state-run universities. The program is still in effect, although the state’s flagship school, the University of Texas at Austin, only accepts the top 6 percent or so of students due to increased applications.
Bush proudly touted this program as a way to racially diversify Texas universities and as alternative to race-conscious admissions programs that Republicans have long disdained (programs that were recently declared illegal by the Supreme Court’s GOP-appointed majority). As Bush said in 2000 while campaigning for the presidency, top 10 percent-style programs “affect the pool of applicants of minority students available for higher ed in a positive way.”
What sets Bush’s program apart from the Harvard and University of North Carolina affirmative action programs that were recently invalidated by the Court is that it does not consider the race of applicants. Under Harvard’s system, race could be used as a kind of tiebreaker to determine which of several exceptionally qualified applicants should be offered one of the very limited slots in Harvard’s freshman class. Under Bush’s program, by contrast, students are mechanically admitted based on their class ranking.
Nevertheless, as Bush made perfectly clear many times, the purpose of this program was to achieve some degree of racial diversity in Texas’s public universities. It did so by leveraging the fact that many American communities remain racially segregated, which causes Black and Latino students to cluster in certain public high schools.
The Coalition for TJ case involved the Thomas Jefferson High School for Science and Technology (“TJ”), a public magnet school in northern Virginia known for outstanding STEM instruction.
Until a few years ago, TJ used standardized tests to identify “semifinalists” for admissions, and admitted students were selected from these semifinalists based on their test scores, teacher recommendations, GPAs, and writing assignments applicants were required to complete.
In late 2020, however, TJ changed its admission process to use a program similar to Bush’s system. Under TJ’s new system, the top 1.5 percent of students from middle schools eligible to send students to TJ are automatically admitted. The school then admits an additional 100 students based on other factors, such as GPA and whether the student comes from a middle school that has historically sent few students to TJ.
Like Bush’s plan in Texas, this new admissions process does not take explicit account of race — indeed, TJ officials who screen applicants are not told each student’s race, gender, or name. However, also like Bush’s plan, there is considerable evidence that it was adopted in order to racially diversify the school. Among other things, the chair of the school board that adopted the new admissions program said it “needed to be explicit in how we are going to address the underrepresentation” of Black and Latino students at TJ.
The question presented by the Coalition for TJ case, in other words, was whether a school may adopt admissions standards that don’t consider race, but that officials choose specifically because they know they will increase racial diversity at that school. As Alito notes in his opinion, the Supreme Court’s precedents ordinarily do not allow states to enact policies that were created for the “purpose” of giving an advantage to a particular racial group, even if they operate in a racially neutral way.
That said, before the Supreme Court’s decision last year in the Harvard case, selective schools were allowed to take some limited account of race for the purpose of diversifying their student body. Harvard suggests that these sorts of programs are no longer allowed, but the Court’s decision to turn away the Coalition for TJ case is also a sign that most of the Court may still tolerate some attempts to racially diversify schools — so long as they use methods previously approved by Republicans.
Notably, only Justice Clarence Thomas joined Alito’s Coalition for TJ opinion. Justice Neil Gorsuch, who often forms a three-justice MAGA coalition with Thomas and Alito, did not.
In any event, the Court’s decision not to hear the case is evidence that a majority of the justices may tolerate top 10 percent-style programs, but it does not guarantee that they will. The Court could still agree to hear a similar case in the future — and it could potentially strike down Bush’s program when that happens.
Should the Supreme Court rule that schools may not have such programs, it would be an extraordinary blow to diversity on campus that would stretch far beyond TJ. Top 10 percent-style programs now exist in several state university systems, including Texas and California — the two largest states.
A decision against these programs, moreover, would show just how much the Republican Party has radicalized on the issue of race in the last two decades. Such a decision would almost certainly be joined only by Republican appointees to the Court, much like the Court’s decisions striking down Harvard and UNC’s policies.
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