{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T15:51:55Z","timestamp":1781797915836,"version":"3.54.5"},"reference-count":29,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi260537-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>\n                      Maternal mental health disorders are among the leading causes of maternal morbidity and mortality. In the US, the 2022 Supreme Court decision in\n                      <jats:italic toggle=\"yes\">Dobbs v. Jackson Women\u2019s Health Organization<\/jats:italic>\n                      and ensuing state-level abortion restrictions have raised concerns that such policies may worsen maternal health and mental health outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260537-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the association of the implementation of Texas Senate Bill 8 (SB8) abortion law, which banned abortions after embryonic cardiac activity in September 2021, with maternal mental health outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260537-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This repeated cross-sectional study used a difference-in-differences (DiD) design with pooled data from the 2016 to 2023 National Survey of Children\u2019s Health. The nationally representative sample included US mothers aged 18 to 49 years who lived with at least 1 child aged 0 to 17 years. Data were analyzed from April to October 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260537-7\">\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Mothers residing in Texas represented the treatment group, and mothers in states without abortion bans (Alaska, Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Kansas, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Washington, and Wyoming) served as the control group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260537-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>The primary outcome was mothers\u2019 self-reported fair or poor mental and emotional health. Logistic regression models, adjusted for child-, mother-, and household-level characteristics, were used to estimate changes in the probability of mental health outcomes for mothers coinciding with SB8 implementation. Similar models were estimated with maternal physical health and fathers\u2019 mental health as outcomes for sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260537-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The sample included 4323 mothers in Texas (47.2% [95% CI, 45.1%-49.4%] aged 30-39 years) and 152\u202f573 mothers in nonban states (47.1% [95% CI, 46.4%-47.7%] aged 30-39 years). Compared with mothers in nonban states, those in Texas experienced a statistically significant increase in the likelihood of reporting fair or poor mental health following SB8\u2019s implementation (DiD estimate, 2.52 percentage points; 95% CI, 0.02-5.01 percentage points). The largest increases were observed among mothers of children with public insurance (DiD estimate, 7.06 percentage points; 95% CI, 0.83-13.29 percentage points). No significant outcomes were observed for mothers\u2019 physical health outcomes or fathers\u2019 mental health in the sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260537-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>\n                      In this repeated cross-sectional study, the implementation of an abortion ban in Texas was associated with a worsening of maternal mental health among reproductive-age mothers relative to mothers in states without such bans. These results underscore the association of abortion restrictions with maternal mental health and highlight the need to strengthen support in the post-\n                      <jats:italic toggle=\"yes\">Dobbs<\/jats:italic>\n                      policy environment.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.19396","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T15:00:32Z","timestamp":1781794832000},"page":"e2619396","source":"Crossref","is-referenced-by-count":0,"title":["The Texas Abortion Ban and Maternal Mental Health"],"prefix":"10.1001","volume":"9","author":[{"given":"Mir M.","family":"Ali","sequence":"first","affiliation":[{"name":"University of Maryland, College Park"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa L.","family":"Burnett","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan H.","family":"Cantor","sequence":"additional","affiliation":[{"name":"RAND, Santa Monica, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie","family":"Song","sequence":"additional","affiliation":[{"name":"Harvard T. H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"issue":"1","key":"zoi260537r2","doi-asserted-by":"publisher","first-page":"29","DOI":"10.21106\/ijma.444","article-title":"Trends and social inequalities in maternal mortality in the United States, 1969-2018.","volume":"10","author":"Singh","year":"2021","journal-title":"Int J MCH AIDS"},{"issue":"7","key":"zoi260537r3","doi-asserted-by":"publisher","first-page":"857","DOI":"10.1001\/jamainternmed.2025.1260","article-title":"Trends and disparities in maternal self-reported mental and physical health.","volume":"185","author":"Daw","year":"2025","journal-title":"JAMA Intern Med"},{"issue":"5","key":"zoi260537r5","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1001\/jamainternmed.2024.8149","article-title":"Post-Dobbs decision changes in obstetrics and gynecology clinical workforce in states with abortion restrictions.","volume":"185","author":"Zhu","year":"2025","journal-title":"JAMA Intern Med"},{"issue":"4","key":"zoi260537r6","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.1608","article-title":"Obstetrician and gynecologist physicians\u2019 practice locations before and after the Dobbs decision.","volume":"8","author":"Staiger","year":"2025","journal-title":"JAMA Netw Open"},{"issue":"4","key":"zoi260537r7","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1001\/jama.2023.25599","article-title":"Anxiety and depression symptoms after the Dobbs abortion decision.","volume":"331","author":"Thornburg","year":"2024","journal-title":"JAMA"},{"issue":"3","key":"zoi260537r8","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.4509","article-title":"Mental distress among female individuals of reproductive age and reported barriers to legal abortion following the US supreme court decision to overturn Roe v Wade.","volume":"6","author":"Dave","year":"2023","journal-title":"JAMA Netw Open"},{"issue":"2","key":"zoi260537r11","doi-asserted-by":"publisher","first-page":"60","DOI":"10.18502\/jfrh.v14i2.4354","article-title":"The economic burden of abortion and its complication treatment cares: a systematic review.","volume":"14","author":"Soleimani Movahed","year":"2020","journal-title":"J Family Reprod Health"},{"issue":"10","key":"zoi260537r12","doi-asserted-by":"publisher","first-page":"1025","DOI":"10.1001\/jamapsychiatry.2025.1376","article-title":"US abortion restrictions and the neuropsychiatric health of pregnant individuals and families.","volume":"82","author":"Osborne","year":"2025","journal-title":"JAMA Psychiatry"},{"issue":"12","key":"zoi260537r13","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1007\/s11920-024-01557-6","article-title":"Abortion and mental health and wellbeing: a contemporary review of the literature.","volume":"26","author":"Masten","year":"2024","journal-title":"Curr Psychiatry Rep"},{"issue":"15","key":"zoi260537r14","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.1001\/jama.2024.28517","article-title":"US abortion bans and infant mortality.","volume":"333","author":"Gemmill","year":"2025","journal-title":"JAMA"},{"issue":"1","key":"zoi260537r15","doi-asserted-by":"publisher","first-page":"86","DOI":"10.36469\/001c.129633","article-title":"The effect of Dobbs v. Jackson Women\u2019s Health Organization on diagnosis of postpartum depression.","volume":"12","author":"Baser","year":"2025","journal-title":"J Health Econ Outcomes Res"},{"issue":"5","key":"zoi260537r16","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.9576","article-title":"Mental distress among females following 2021 abortion restrictions in Texas.","volume":"8","author":"Lee","year":"2025","journal-title":"JAMA Netw Open"},{"issue":"2","key":"zoi260537r17","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1111\/coep.12678","article-title":"Self-reported mental health and the Dobbs decision: variation by state abortion laws.","volume":"43","author":"Collins","year":"2025","journal-title":"Contemp Econ Policy"},{"issue":"6","key":"zoi260537r18","doi-asserted-by":"publisher","first-page":"2019","DOI":"10.1215\/00703370-9585908","article-title":"The pregnancy-related mortality impact of a total abortion ban in the United States: a research note on increased deaths due to remaining pregnant.","volume":"58","author":"Stevenson","year":"2021","journal-title":"Demography"},{"issue":"2","key":"zoi260537r20","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1515\/jci-2014-0039","article-title":"Propensity score analysis with survey weighted Data.","volume":"3","author":"Ridgeway","year":"2015","journal-title":"J Causal Inference"},{"issue":"4","key":"zoi260537r23","first-page":"681","article-title":"The structure and content of family practice: current status and future trends.","volume":"15","author":"Rosenblatt","year":"1982","journal-title":"J Fam Pract"},{"issue":"2","key":"zoi260537r25","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/j.contraception.2013.10.012","article-title":"The public health threat of anti-abortion legislation.","volume":"89","author":"Grossman","year":"2014","journal-title":"Contraception"},{"issue":"2","key":"zoi260537r26","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1215\/03616878-8802186","article-title":"Affordable but Inaccessible? 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