# Impact of reproductive health restrictions on women's mental health

> **NIH NIH R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2024 · $741,819

## Abstract

Suicide represents a leading cause of maternal morbidity, with up to one in five maternal deaths in the United
States resulting from suicide or overdose. Suicidal ideation and self-harm (suicidality) in the peripartum period
are nearly 30 times more common than suicide death, and suicidality has steadily increased in the US. Perinatal
mood and anxiety disorders (PMAD) affects at least one in five birthing individuals and often underlie suicidal
behaviors. Although mental health (MH) conditions predispose individuals for suicidality, environmental
influences, including health or economic stressors, may precipitate suicidal behavior. For instance, among
delivering women, an unintended or unwanted pregnancy represents a strong risk factor for both PMAD and
suicidal behavior. Macro-level stressors, such as restrictive state policies on marriage, divorce and reproductive
health services also increase suicide rates. But it remains unknown how state policies impact PMAD and MH
related maternal morbidity specifically. Restricted access to reproductive health services will disproportionately
affect subgroups of delivering individuals (low-income, geographically remote, or racial/ethnic groups) who are
already at risk for PMAD and its consequences because they are less able to overcome barriers. Consequently,
these policies may exacerbate existing disparities in maternal MH outcomes. The overarching goal of our
work seeks to characterize the consequences of restricting reproductive health service access on population
health. In this proposal, we will leverage the natural experiment created by the enactment of reproductive health
service restrictions on maternal health outcomes. We will assess the relationship between state policies and
PMAD rates (Aim 1), maternal morbidity (suicidality) (Aim 2), and mental health service utilization (Aim 3). We
will examine these relationships among Medicaid and commercially insured women within and across states with
and without state policies that restrict access to reproductive health services. This study directly responds to
NIMH High-Priority Areas for Research on Women’s Mental Health during the Perinatal Period (NOT-MH-
21-270), namely: research on perinatal depression and suicidal ideation and behaviors; research on perinatal
MH disorders in relation to engagement in medical care and clinical outcomes; research that identifies mutable
factors that impact utilization and outcomes, including disparities, which may serve as targets in future perinatal
MH care service delivery intervention development. It also addresses the Implementing a Maternal health and
PRegnancy Outcomes Vision for Everyone (IMPROVE) initiative, which supports research on reducing
preventable causes of maternal deaths and improving health before, during, and after delivery.

## Key facts

- **NIH application ID:** 10798721
- **Project number:** 1R01MH132937-01A1
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** VANESSA K. DALTON
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $741,819
- **Award type:** 1
- **Project period:** 2024-03-01 → 2028-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10798721

## Citation

> US National Institutes of Health, RePORTER application 10798721, Impact of reproductive health restrictions on women's mental health (1R01MH132937-01A1). Retrieved via AI Analytics 2026-06-01 from https://api.ai-analytics.org/grant/nih/10798721. Licensed CC0.

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