Saturday, April 13

How Many Abortions Did the Post-Roe Bans Prevent?

The first data on births since Roe v. Wade was overturned shows how much abortion bans have had their intended effect: Births increased in every state with a ban, an analysis of the data shows.

By comparing birth statistics in states before and after the bans passed, researchers estimated that the laws caused around 32,000 annual births, based on the first six months of 2023, a relatively small increase that was in line with overall expectations.

Until now, studies have shown that many women in states with bans have ended their pregnancies anyway, by traveling to other states or ordering pills online. What they have been unable to show is how many women have not done so, and carried their pregnancies to term. The new analysis, published Friday as a working paper by the Institute of Labor Economics, found that in the first six months of the year, between one-fifth and one-fourth of women living in states with bans — who may have otherwise sought an abortion — did not get one.

“The importance of our results is when you take away access, it can affect fertility,” said Daniel Dench, an economist at Georgia Tech and an author of the paper with Mayra Pineda-Torres of Georgia Tech and Caitlin Myers of Middlebury College. “When you make it harder, women can’t always get out of states to obtain abortion.”

Overall, data suggests that the number of legal abortions nationwide has stayed steady or slightly increased since the Supreme Court’s Dobbs decision, despite abortion bans in what are now 14 states. This is probably because of new clinics that opened in states where it is legal, and the emergence of new ways to order abortion pills online, expanding access for both women who traveled to those states and those who lived there.

“This is an inequality story,” Professor Myers said. “Most people are getting out of ban states, one way or another, and more people in protected states are getting abortions. And at the same time, this shows something those data cannot show: There’s a significant minority of people in ban states that do get trapped.”

The researchers used birth data, by age and race, from the Centers for Disease Control and Prevention from 2005 through June 2023. They used a statistical method that compared states with similar trends in births before the Dobbs decision to estimate how much a ban changed the expected birthrate. This increased their certainty that the change was because of the policy and not other factors.

They found that births increased 2.3 percent, on average, in states with bans relative to states where abortion remained legal.

The analysis showed that the increased births were disproportionately among women in their 20s and Black and Hispanic women, which researchers said could be because these groups tend to be poorer, making it harder to travel. They are also the demographic groups that have tended to be more likely to seek abortions.

Dr. Alison Norris, who studies reproductive health at Ohio State and was not involved in the study, said she was not surprised to see births increasing, particularly among those groups. She noted that before Dobbs, abortion access was already limited in many states, so “any measure of change that we see will in some ways be an underestimate of the challenges that people experience.”

The biggest increases in births were in states where women had to travel the farthest to reach an abortion clinic. Texas, where the average increase in driving distance to the nearest abortion clinic was 453 miles, had a 5.1 percent increase in births, relative to states that did not pass a ban but had similar trends before Dobbs. Mississippi, where it increased 240 miles, had a 4.4 percent increase.

In states where there was less of a change in driving distance to the nearest clinic, there was a smaller relative change in births. Missouri, for instance, had only one clinic, in St. Louis. When it closed, the average driving distance to the nearest clinic increased only two miles, because clinics along the Illinois border were already serving Missourians. Births there increased just 0.4 percent.

There was also evidence that online abortion pills ordered from overseas vendors played a role in some states. The three states in which the increases in births were less than the researchers had predicted based on travel distances — Arkansas, Oklahoma and Louisiana — also had large increases in orders for medication abortions from the largest overseas provider, according to an analysis of those orders.

“The insinuation of a lot of coverage of such data points is that it’s a bad thing for there to be more children welcomed in states with better laws than in states that fast-track abortion,” said Kristan Hawkins, the president of Students for Life of America, in an email. “It’s a triumph that pro-life policies result in lives saved.”

The data on births is preliminary: A fuller accounting of the effect of Dobbs on the fertility rate, including county-level data, will not be available for another year. The researchers can’t be certain that the increase in births is attributed to women who wanted abortions but couldn’t get them, but the timing and consistency of the results suggest so.

The researchers said these trends could change as more birth data becomes available. The women giving birth in the first half of the year would have already been pregnant when abortion bans began, or they became pregnant soon after. Since the data ended, there have been new restrictions on abortion in some places, and access has expanded in others.

Births could decline. New shield laws aim to legally protect providers who mail abortion pills to states with bans, and people might be changing their behaviors around sex and contraception in response to bans. Or births could increase as more states restrict abortion; some of this may depend on the outcome of a case to restrict the mailing of one of the two abortion pills.

“The abortion landscape continues evolving,” Professor Pineda-Torres said. “People are adjusting, providers are adjusting, laws are adjusting.”