Presentation (CTI)

OBJECTIVES: The US Supreme Court's June 24, 2022, decision in Dobbs v. Jackson Women’s Health Organization overturned Roe v. Wade and triggered significant changes in state abortion laws. Subsequently, 14 states implemented near-total or total abortion bans, and 7 others established gestational limits ranging from 6 to 18 weeks. The impact of abortion access restrictions in trigger versus non-trigger states post-Dobbs on post-partum depression (PPD) diagnosis rates among women with low socioeconomic status (SES) was examined and compared.
METHODS: A retrospective cohort study of the Kythera Labs Medicaid population from January 2019 to December 2024 was conducted. Two distinct analytic samples of women who resided in lower-SES areas, as determined by the Area Deprivation Index, were created corresponding to the periods before and after Dobbs in June 2022. The study population comprised women aged 12 to 55 years who experienced a pregnancy resulting in a live birth or stillbirth between January 2019 and December 2024 (study period). The initial pregnancy diagnosis date was designated as the index date. Women whose pregnancy concluded between January 2020 and June 2021 were assigned to the pre-Dobbs cohort, and those with pregnancy dates between June 2022 and December 2023 constituted the post-Dobbs cohort. The difference-in-difference model was employed for risk adjustment.
RESULTS: The study sample comprised 54,224 individuals who resided in low-SES areas in the pre-Dobbs period, 20,136 in trigger states and 13,881 in non-trigger states. The post-Dobbs sample included 20,207 individuals, of whom 12,924 resided in trigger states and 7,283 in non-trigger states. PPD diagnosis rate increased in trigger states post-Dobbs (β=0.0904, p=.001).
CONCLUSIONS: Significant differences in PPD diagnosis rates were found between trigger and non-trigger states among women who resided in lower-SES areas following Dobbs.