What Studies Show: Impact of Abortion Regulations

Posted on March 22, 2022 By

The upcoming Dobbs v. Jackson case in the U.S. Supreme Court, which may overturn or curtail Roe v. Wade, calls for educating about this question: What do we know about what restrictions do?


The edited excerpts below are from Peace Psychology Perspectives on Abortion, Chapter 15, The Psychological and Social Impact of Legal Regulations.



by Rachel MacNair


Different states (U.S. and Mexican) had regulations in effect one year but not the previous year. Some impact one group more than another; for example, parental consent laws only matter to minors. Therefore, this could be analyzed as a natural experiment.


Women Who Ask and Are Turned Down

When abortions were primarily illegal and societal pressures for legalization were mounting, one method of easing restrictions allowed women to apply to a committee for permission to abort a pregnancy. A 1988 book reporting research from this condition is Born Unwanted: Development Effects of Denied Abortion.

How would the children compare with the children from accepted pregnancies? The answer is complicated, but the author’s summary includes:

Inspection of the data reveals that the difference is not so much in UP [unwanted pregnancy] children failing more often, but rather in being substantially underrepresented among the students graded above average, very good, or outstanding . . . the UP children consistently appeared worse, primarily due to underrepresentation in the above-average categories. (p. 88)

To re-iterate: “the UP subjects are not so much overrepresented on the extremely negative indicators as they are underrepresented on the positive ones” (p. 124).

Those of the “abortion-as-violence” position, however, argue that if abortion is killing a human being, doing so to avoid being underrepresented among the above average seems rather draconian. (The headline in Sisterlife, then newsletter of Feminists for Life: Prof Repulsed by Working Class; Recommends Elimination. Not Clear Who Will Repair His Mercedes.)


In the United States, after the 1973 Supreme Court decision Roe v. Wade suddenly legalized abortion in all 50 states, the Medicaid program for funding medical services to low- income people included abortion. Then in 1976 a legislative provision, the Hyde Amendment, restricted Medicaid funding to only cases of rape, incest, and preventing the death of the pregnant woman. These being rare, in many states funding was immediately severed, while other states continued. This provided a natural experiment.

The Guttmacher Institute reported that in states without funding, the abortion rate was 1.6 times higher for Medicaid-eligible women than for women of higher income. The fact that it is greater than one to one suggests poverty plays a role in abortion decisions. However, the rate in states with funding is 3.9 times higher for women on Medicaid.

Yet childbirths in the states without funding either stayed the same or were also reduced. The missing abortions were not entirely replaced by women continuing pregnancies, but by couples taking more care about becoming pregnant.

Distance of Facilities

An early study showed counties further away from the abortion clinics of Atlanta had lower abortion-to-live birth ratios than those nearer. A more recent study in Texas using 1993 data found the probability of a pregnant woman choosing abortion appeared quite sensitive to availability variables; women in counties further away from clinics had a lower rate than those near.

Parental Involvement

See the topic page on this at Peace and Life Referendums: What Studies Show for Parental Involvement for Abortions Performed on Minors.       

Outright Legal Ban

The restrictions covered here will only prevent abortions in women whose desire to have an abortion is sufficiently ambivalent, or if the added inconvenience of procuring abortion puts the inconvenience of using a condom in a better light. Pregnant women who are determined to have an abortion will find funding, drive extra distances, tolerate information and waiting periods, and forge ahead. Only an outright legal ban makes abortion essentially unavailable. Even then, determined women will travel to where they are not banned or have them surreptitiously.

Two countries that have instituted legal bans after a period of fairly free availability are Poland in 1993 and Nicaragua in 2006. In both, the abortion rate went down (inasmuch as it was reported since it was banned), the maternal mortality rate went down, and indicators of maternal health went up.

However, there were simultaneous dramatic occurrences in both – a transition out of communism in Poland, and an assertive women’s health-care campaign by the Nicaraguan government.

In the opposite direction, abortion legalization in South Africa, Ethiopia, and Nepal was also accompanied by better maternal health outcomes, and likely for similar reasons.

Mexico had a “natural experiment” as abortion was legalized in some of its 32 states but not others. One 2015 study tested whether there was an association with maternal mortality (from both aborted and continued pregnancies) after controlling for other variables such as clean water. Over ten years, they found states with less permissive laws had lower maternal mortality than states with more permissive laws. However, there were independent associations with female literacy, skilled attendance at birth, low birth weight, clean water, sanitation, and intimate partner violence, which in a regression accounted for most of the variance in maternal mortality. Authors conclude: “Although less permissive states exhibited consistently lower maternal mortality rates, this finding was not explained by abortion legislation itself. Rather, these differences were explained by other independent factors, which appeared to have a more favorable distribution in these states.”  The question of why less permissive abortion laws were associated with these other measures of benefit was beyond the scope of the study.



For our posts on similar topics, see: 

Why the Hyde Amendment Helps Low-Income Women

Abortion Facilitates Sex Abuse: Documentation

Should Abortions be Illegal?

Who the Law Targets

“The Daily Show” Doesn’t Do Its Homework


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