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How the Right to Legal Abortion Changed the Arc of All Women’s Lives

Prochoice demonstrators during the March for Women's Lives rally organized by NOW Washington DC April 5 1992.

I’ve never had an abortion. In this, I am like most American women. A frequently quoted statistic from a recent study by the Guttmacher Institute, which reports that one in four women will have an abortion before the age of forty-five, may strike you as high, but it means that a large majority of women never need to end a pregnancy. (Indeed, the abortion rate has been declining for decades, although it’s disputed how much of that decrease is due to better birth control, and wider use of it, and how much to restrictions that have made abortions much harder to get.) Now that the Supreme Court seems likely to overturn Roe v. Wade sometime in the next few years—Alabama has passed a near-total ban on abortion, and Ohio, Georgia, Kentucky, Mississippi, and Missouri have passed “heartbeat” bills that, in effect, ban abortion later than six weeks of pregnancy, and any of these laws, or similar ones, could prove the catalyst—I wonder if women who have never needed to undergo the procedure, and perhaps believe that they never will, realize the many ways that the legal right to abortion has undergirded their lives.

Legal abortion means that the law recognizes a woman as a person. It says that she belongs to herself. Most obviously, it means that a woman has a safe recourse if she becomes pregnant as a result of being raped. (Believe it or not, in some states, the law allows a rapist to sue for custody or visitation rights.) It means that doctors no longer need to deny treatment to pregnant women with certain serious conditions—cancer, heart disease, kidney disease—until after they’ve given birth, by which time their health may have deteriorated irretrievably. And it means that non-Catholic hospitals can treat a woman promptly if she is having a miscarriage. (If she goes to a Catholic hospital, she may have to wait until the embryo or fetus dies. In one hospital, in Ireland, such a delay led to the death of a woman named Savita Halappanavar, who contracted septicemia. Her case spurred a movement to repeal that country’s constitutional amendment banning abortion.)

The legalization of abortion, though, has had broader and more subtle effects than limiting damage in these grave but relatively uncommon scenarios. The revolutionary advances made in the social status of American women during the nineteen-seventies are generally attributed to the availability of oral contraception, which came on the market in 1960. But, according to a 2017 study by the economist Caitlin Knowles Myers, “The Power of Abortion Policy: Re-Examining the Effects of Young Women’s Access to Reproductive Control,” published in the Journal of Political Economy , the effects of the Pill were offset by the fact that more teens and women were having sex, and so birth-control failure affected more people. Complicating the conventional wisdom that oral contraception made sex risk-free for all, the Pill was also not easy for many women to get. Restrictive laws in some states barred it for unmarried women and for women under the age of twenty-one. The Roe decision, in 1973, afforded thousands upon thousands of teen-agers a chance to avoid early marriage and motherhood. Myers writes, “Policies governing access to the pill had little if any effect on the average probabilities of marrying and giving birth at a young age. In contrast, policy environments in which abortion was legal and readily accessible by young women are estimated to have caused a 34 percent reduction in first births, a 19 percent reduction in first marriages, and a 63 percent reduction in ‘shotgun marriages’ prior to age 19.”

Access to legal abortion, whether as a backup to birth control or not, meant that women, like men, could have a sexual life without risking their future. A woman could plan her life without having to consider that it could be derailed by a single sperm. She could dream bigger dreams. Under the old rules, inculcated from girlhood, if a woman got pregnant at a young age, she married her boyfriend; and, expecting early marriage and kids, she wouldn’t have invested too heavily in her education in any case, and she would have chosen work that she could drop in and out of as family demands required.

In 1970, the average age of first-time American mothers was younger than twenty-two. Today, more women postpone marriage until they are ready for it. (Early marriages are notoriously unstable, so, if you’re glad that the divorce rate is down, you can, in part, thank Roe.) Women can also postpone childbearing until they are prepared for it, which takes some serious doing in a country that lacks paid parental leave and affordable childcare, and where discrimination against pregnant women and mothers is still widespread. For all the hand-wringing about lower birth rates, most women— eighty-six per cent of them —still become mothers. They just do it later, and have fewer children.

Most women don’t enter fields that require years of graduate-school education, but all women have benefitted from having larger numbers of women in those fields. It was female lawyers, for example, who brought cases that opened up good blue-collar jobs to women. Without more women obtaining law degrees, would men still be shaping all our legislation? Without the large numbers of women who have entered the medical professions, would psychiatrists still be telling women that they suffered from penis envy and were masochistic by nature? Would women still routinely undergo unnecessary hysterectomies? Without increased numbers of women in academia, and without the new field of women’s studies, would children still be taught, as I was, that, a hundred years ago this month, Woodrow Wilson “gave” women the vote? There has been a revolution in every field, and the women in those fields have led it.

It is frequently pointed out that the states passing abortion restrictions and bans are states where women’s status remains particularly low. Take Alabama. According to one study , by almost every index—pay, workforce participation, percentage of single mothers living in poverty, mortality due to conditions such as heart disease and stroke—the state scores among the worst for women. Children don’t fare much better: according to U.S. News rankings , Alabama is the worst state for education. It also has one of the nation’s highest rates of infant mortality (only half the counties have even one ob-gyn), and it has refused to expand Medicaid, either through the Affordable Care Act or on its own. Only four women sit in Alabama’s thirty-five-member State Senate, and none of them voted for the ban. Maybe that’s why an amendment to the bill proposed by State Senator Linda Coleman-Madison was voted down. It would have provided prenatal care and medical care for a woman and child in cases where the new law prevents the woman from obtaining an abortion. Interestingly, the law allows in-vitro fertilization, a procedure that often results in the discarding of fertilized eggs. As Clyde Chambliss, the bill’s chief sponsor in the state senate, put it, “The egg in the lab doesn’t apply. It’s not in a woman. She’s not pregnant.” In other words, life only begins at conception if there’s a woman’s body to control.

Indifference to women and children isn’t an oversight. This is why calls for better sex education and wider access to birth control are non-starters, even though they have helped lower the rate of unwanted pregnancies, which is the cause of abortion. The point isn’t to prevent unwanted pregnancy. (States with strong anti-abortion laws have some of the highest rates of teen pregnancy in the country; Alabama is among them.) The point is to roll back modernity for women.

So, if women who have never had an abortion, and don’t expect to, think that the new restrictions and bans won’t affect them, they are wrong. The new laws will fall most heavily on poor women, disproportionately on women of color, who have the highest abortion rates and will be hard-pressed to travel to distant clinics.

But without legal, accessible abortion, the assumptions that have shaped all women’s lives in the past few decades—including that they, not a torn condom or a missed pill or a rapist, will decide what happens to their bodies and their futures—will change. Women and their daughters will have a harder time, and there will be plenty of people who will say that they were foolish to think that it could be otherwise.

The Messiness of Reproduction and the Dishonesty of Anti-Abortion Propaganda

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Fact sheets /
Six out of 10 unintended pregnancies end in induced abortion.
Abortion is a common health intervention. It is very safe when carried out using a method recommended by WHO, appropriate to the pregnancy duration and by someone with the necessary skills.
However, around 45% of abortions are unsafe.
Unsafe abortion is an important preventable cause of maternal deaths and morbidities. It can lead to physical and mental health complications and social and financial burdens for women, communities and health systems.
Lack of access to safe, timely, affordable and respectful abortion care is a critical public health and human rights issue.

Around 73 million induced abortions take place worldwide each year. Six out of 10 (61%) of all unintended pregnancies, and 3 out of 10 (29%) of all pregnancies, end in induced abortion (1) .

Comprehensive abortion care is included in the list of essential health care services published by WHO in 2020. Abortion is a simple health care intervention that can be safely and effectively managed by a wide range of health workers using medication or a surgical procedure. In the first 12 weeks of pregnancy, a medical abortion can also be safely self-managed by the pregnant person outside of a health care facility (e.g. at home), in whole or in part. This requires that the woman has access to accurate information, quality medicines and support from a trained health worker (if she needs or wants it during the process).

Comprehensive abortion care includes the provision of information, abortion management and post-abortion care. It encompasses care related to miscarriage (spontaneous abortion and missed abortion), induced abortion (the deliberate interruption of an ongoing pregnancy by medical or surgical means), incomplete abortion as well as intrauterine fetal demise.

The information in this fact sheet focuses on care related to induced abortion.

Scope of the problem

When carried out using a method recommended by WHO appropriate to the pregnancy duration, and by someone with the necessary skills, abortion is a safe health care intervention (5).

However, when people with unintended pregnancies face barriers to attaining safe, timely, affordable, geographically reachable, respectful and non-discriminatory abortion care, they often resort to unsafe abortion. 1

Global estimates from 2010–2014 demonstrate that 45% of all induced abortions are unsafe. Of all unsafe abortions, one third were performed under the least safe conditions, i.e. by untrained persons using dangerous and invasive methods. More than half of all these unsafe abortions occurred in Asia, most of them in south and central Asia. In Latin American and Africa, the majority (approximately 3 out of 4) of all abortions were unsafe. In Africa, nearly half of all abortions occurred under the least safe circumstances (3) .

Consequences of inaccessible quality abortion care

Lack of access to safe, affordable, timely and respectful abortion care, and the stigma associated with abortion, pose risks to women’s physical and mental well-being throughout the life-course.

Inaccessibility of quality abortion care risks violating a range of human rights of women and girls, including the right to life; the right to the highest attainable standard of physical and mental health; the right to benefit from scientific progress and its realization; the right to decide freely and responsibly on the number, spacing and timing of children; and the right to be free from torture, cruel, inhuman and degrading treatment and punishment.

One review from 2003–12, found that 4.7-13% of maternal deaths were linked to abortive pregnancy outcomes (4) but noted that maternal deaths due to abortion, and more specifically unsafe abortion, are often misclassified and underreported given the stigma.

Deaths from safe abortion are negligible, <1/100 000 (5). On the other hand, in regions where unsafe abortions are common, the death rates are high, at > 200/100 000 abortions. Estimates from 2012 indicate that in developing countries alone, 7 million women per year were treated in hospital facilities for complications of unsafe abortion (6) .

Physical health risks associated with unsafe abortion include:

incomplete abortion (failure to remove or expel all pregnancy tissue from the uterus);
haemorrhage (heavy bleeding);
uterine perforation (caused when the uterus is pierced by a sharp object); and
damage to the genital tract and internal organs as a consequence of inserting dangerous objects into the vagina or anus.

Restrictive abortion regulation can cause distress and stigma, and risk constituting a violation of human rights of women and girls, including the right to privacy and the right to non-discrimination and equality, while also imposing financial burdens on women and girls. Regulations that force women to travel to attain legal care, or require mandatory counselling or waiting periods, lead to loss of income and other financial costs, and can make abortion inaccessible to women with low resources (6,8) .

Estimates from 2006 show that complications of unsafe abortions cost health systems in developing countries US$ 553 million per year for post-abortion treatments. In addition, households experienced US$ 922 million in loss of income due to long-term disability related to unsafe abortion (10) . Countries and health systems could make substantial monetary savings by providing greater access to modern contraception and quality induced abortion (8,9) .

Expanding quality abortion care

Evidence shows that restricting access to abortions does not reduce the number of abortions (1) ; however, it does affect whether the abortions that women and girls attain are safe and dignified. The proportion of unsafe abortions are significantly higher in countries with highly restrictive abortion laws than in countries with less restrictive laws (2) .

Barriers to accessing safe and respectful abortion include high costs, stigma for those seeking abortions and health care workers, and the refusal of health workers to provide an abortion based on personal conscience or religious belief. Access is further impeded by restrictive laws and requirements that are not medically justified, including criminalization of abortion, mandatory waiting periods, provision of biased information or counselling, third-party authorization and restrictions regarding the type of health care providers or facilities that can provide abortion services.

Multiple actions are needed at the legal, health system and community levels so that everyone who needs abortion care has access to it. The three cornerstones of an enabling environment for quality comprehensive abortion care are:

respect for human rights, including a supportive framework of law and policy;
the availability and accessibility of information; and
a supportive, universally accessible, affordable and well functioning health system.

A well-functioning health system implies many factors, including:

evidence-based policies;
universal health coverage;
the reliable supply of quality, affordable medical products and equipment;
that an adequate number of health workers, of different types, provide abortion care at a reachable distance to patients;
the delivery of abortion care through a variety of approaches, e.g. care in health facilities, digital interventions and self-care approaches, allowing for choices depending on the values and preferences of the pregnant person, available resources, and the national and local context;
that health workers are trained to provide safe and respectful abortion care, to support informed decision-making and to interpret laws and policies regulating abortion;
that health workers are supported and protected from stigma; and
provision of contraception to prevent unintended pregnancies.

Availability and accessibility of information implies:

provision of evidence-based comprehensive sexuality education; and
accurate, non-biased and evidence-based information on abortion and contraceptive methods.

WHO response

WHO provides global technical and policy guidance on the use of contraception to prevent unintended pregnancy, provision of information on abortion care, abortion management (including miscarriage, induced abortion, incomplete abortion and fetal death) and post-abortion care. In 2022, WHO published an updated, consolidated guideline on abortion care, including all WHO recommendations and best practice statements across three domains essential to the provision of abortion care: law and policy, clinical services and service delivery.

WHO also maintains the Global Abortion Policies Database . This interactive online database contains comprehensive information on the abortion laws, policies, health standards and guidelines for all countries.

Upon request, WHO provides technical support to countries to adapt sexual and reproductive health guidelines to specific contexts and strengthen national policies and programmes related to contraception and safe abortion care. A quality abortion care monitoring and evaluation framework is also in development.

WHO is a cosponsor of the HRP (UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction) , which carries out research on clinical care, abortion regulation, abortion stigma, as well as implementation research on community and health systems approaches to quality abortion care. It also monitors the global burden of unsafe abortion and its consequences.

1 An “unsafe abortion” is defined as a procedure for terminating a pregnancy performed by persons lacking the necessary information or skills or in an environment not in conformity with minimal medical standards, or both. The persons, skills and medical standards considered safe in the provision of abortion are different for medical and surgical abortion and by pregnancy duration. In using this definition, what is considered ‘safe’ or unsafe needs to be interpreted in line with the most current WHO technical and policy guidance (2).

(1) Bearak J, Popinchalk A, Ganatra B, Moller A-B, Tunçalp Ö, Beavin C et al. Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990–2019. Lancet Glob Health. 2020 Sep; 8(9):e1152-e1161. doi: 10.1016/S2214-109X(20)30315-6.

(2) Ganatra B, Tunçalp Ö, Johnston H, Johnson BR, Gülmezoglu A, Temmerman M. From concept to measurement: Operationalizing WHO's definition of unsafe abortion. Bull World Health Organ 2014;92:155; 10.2471/BLT.14.136333.

(3) Ganatra B, Gerdts C, Rossier C, Johnson Jr B R, Tuncalp Ö, Assifi A et al. Global, regional, and subregional classification of abortions by safety, 2010–14: estimates from a Bayesian hierarchical model. The Lancet. 2017 Sep.

(4) Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014 Jun; 2(6):e323-33.

(5) Raymond EG, Grimes DA. The comparative safety of legal induced abortion and childbirth in the United States. Obstet Gynecol. 2012 Feb;119(2 Pt 1):215-9. doi: 10.1097/AOG.0b013e31823fe923. PMID: 22270271.

(6) Singh S, Maddow-Zimet I. Facility-based treatment for medical complications resulting from unsafe pregnancy termination in the developing world, 2012: a review of evidence from 26 countries. BJOG 2015; published online Aug 19. DOI:10.1111/1471-0528.13552.

(7) Coast E, Lattof SR, Meulen Rodgers YV, Moore B, Poss C. The microeconomics of abortion: A scoping review and analysis of the economic consequences for abortion care-seekers. PLoS One. 2021 Jun 9;16(6):e0252005. doi: 10.1371/journal.pone.0252005. PMID: 34106927; PMCID: PMC8189560.

(8) Lattof SR, Coast E, Rodgers YVM, Moore B, Poss C. The mesoeconomics of abortion: A scoping review and analysis of the economic effects of abortion on health systems. PLoS One. 2020 Nov 4;15(11):e0237227. doi: 10.1371/journal.pone.0237227. PMID: 33147223; PMCID: PMC7641432.

(9) Rodgers YVM, Coast E, Lattof SR, Poss C, Moore B. The macroeconomics of abortion: A scoping review and analysis of the costs and outcomes. PLoS One. 2021 May 6;16(5):e0250692. doi: 10.1371/journal.pone.0250692. PMID: 33956826; PMCID: PMC8101771.

(10). Vlassoff et al. Economic impact of unsafe abortion-related morbidity and mortality: evidence and estimation challenges. Brighton, Institute of Development Studies, 2008 (IDS Research Reports 59).

Abortion care guideline
Classification of abortions by safety: article in The Lancet
Quality of care
Maintaining essential health services during the COVID-19 outbreak
Sexual and reproductive health and research including the Special Programme HRP

Global Abortion Policies Database

What can economic research tell us about the effect of abortion access on women’s lives?

Subscribe to the center for economic security and opportunity newsletter, caitlin knowles myers and caitlin knowles myers john g. mccullough professor of economics; co-director, middlebury initiative for data and digital methods - middlebury college morgan welch morgan welch senior research assistant & project coordinator - center on children and families, economic studies, brookings institution.

November 30, 2021

21 min read

On September 20, 2021, a group of 154 distinguished economists and researchers filed an amicus brief to the Supreme Court of the United States in advance of the Mississippi case, Dobbs v. Jackson Women’s Health Organization . For a full review of the evidence that shows how causal inference tools have been used to measure the effects of abortion access in the U.S., read the brief here .

Introduction

Dobbs v. Jackson Women’s Health Organization considers the constitutionality of a 2018 Mississippi law that prohibits women from accessing abortions after 15 weeks of pregnancy. This case is widely expected to determine the fate of Roe v. Wade as Mississippi is directly challenging the precedent set by the Supreme Court’s decisions in Roe , which protects abortion access before fetal viability (typically between 24 and 28 weeks of pregnancy). On December 1, 2021, the Supreme Court will hear oral arguments in Dobbs v. Jackson . In asking the Court to overturn Roe , the state of Mississippi offers reassurances that “there is simply no causal link between the availability of abortion and the capacity of women to act in society” 1 and hence no reason to believe that abortion access has shaped “the ability of women to participate equally in the economic and social life of the Nation” 2 as the Court had previously held.

While the debate over abortion often centers on largely intractable subjective questions of ethics and morality, in this instance the Court is being asked to consider an objective question about the causal effects of abortion access on the lives of women and their families. The field of economics affords insights into these objective questions through the application of sophisticated methodological approaches that can be used to isolate and measure the causal effects of abortion access on reproductive, social, and economic outcomes for women and their families.

Separating Correlation from Causation: The “Credibility Revolution” in Economics

To measure the causal effect of abortion on women’s lives, one must differentiate its effects from those of other forces, such as economic opportunity, social mores, the availability of contraception. Powerful statistical methodologies in the causal inference toolbox have made it possible for economists to do just that, moving beyond the maxim “correlation isn’t necessarily causation” and applying the scientific method to figure out when it is.

This year’s decision by the Economic Sciences Prize Committee recognized the contributions 3 of economists David Card, Joshua Angrist, and Guido Imbens, awarding them the Nobel Prize for their pathbreaking work developing and applying the tools of causal inference in a movement dubbed “the credibility revolution” (Angrist and Pischke, 2010). The gold standard for establishing such credibility is a well-executed randomized controlled trial – an experiment conducted in the lab or field in which treatment is randomly assigned. When economists can feasibly and ethically implement such experiments, they do. However, in the social world, this opportunity is often not available. For instance, one cannot feasibly or ethically randomly assign abortion access to some individuals but not others. Faced with this obstacle, economists turn to “natural” or “quasi” experimental methods, ones in which they are able to credibly argue that treatment is as good as randomly assigned.

The Effects of Abortion Access on Women’s Reproductive, Economic, and Social Lives

Evidence of the effects of abortion legalization.

The history of abortion legalization in the United States affords both a canonical and salient example of a natural experiment. While Roe v. Wade legalized abortion in most of the country in 1973, five states—Alaska, California, Hawaii, New York, and Washington—and the District of Columbia repealed their abortion bans several years in advance of Roe . Using a methodology known as “difference-in-difference estimation,” researchers compared changes in outcomes in these “repeal states” when they lifted abortion bans to changes in outcomes in the rest of the country. They also compared changes in outcomes in the rest of the country in 1973 when Roe legalized abortion to changes in outcomes in the repeal states where abortion already was legal. This difference-in-differences methodology allows the states where abortion access is not changing to serve as a counterfactual or “control” group that accounts for other forces that were impacting fertility and women’s lives in the Roe era.

Among the first to employ this approach was a team of economists (Levine, Staiger, Kane, and Zimmerman, 1999) who estimated that the legalization of abortion in repeal states led to a 4% to 11% decline in births in those states relative to the rest of the country. Levine and his co-authors found that these fertility effects were particularly large for teens and women of color, who experienced birth rate reductions that were nearly three times greater than the overall population as a result of abortion legalization. Multiple research teams have replicated the essential finding that abortion legalization substantially impacted American fertility while extending the analysis to consider other outcomes. 4 For example, Myers (2017) found that abortion legalization reduced the number of women who became teen mothers by 34% and the number who became teen brides by 20%, and again observed effects that were even larger for Black teens. Farin, Hoehn-Velasco, and Pesko (2021) found that abortion legalization reduced maternal mortality among Black women by 30-40%, with little impact on white women, offering the explanation that where abortion was illegal, Black women were less likely to be able to access safe abortions by traveling to other states or countries or by obtaining a clandestine abortion from a trusted health care provider.

The ripple effects of abortion access on the lives of women and their families

This research, which clearly demonstrates the causal relationship between abortion access and first-order demographic and health outcomes, laid the foundation for researchers to measure further ripple effects through the lives of women and their families. Multiple teams of authors have extended the difference-in-differences research designs to study educational and labor market outcomes, finding that abortion legalization increased women’s education, labor force participation, occupational prestige, and earnings and that all these effects were particularly large for Black women (Angrist and Evans, 1996; Kalist, 2004; Lindo, Pineda-Torres, Pritchard, and Tajali, 2020; Jones, 2021).

Additionally, research shows that abortion access has not only had profound effects on women’s economic and social lives but has also impacted the circumstances into which children are born. Researchers using difference-in-differences research designs have found that abortion legalization reduced the number of children who were unwanted (Bitler and Zavodny, 2002a, reduced cases of child neglect and abuse (Bitler and Zavodny, 2002b; 2004), reduced the number of children who lived in poverty (Gruber, Levine, and Staiger, 1999), and improved long-run outcomes of an entire generation of children by increasing the likelihood of attending college and reducing the likelihood of living in poverty and receiving public assistance (Ananat, Gruber, Levine, and Staiger, 2009).

Access to abortion continues to be important to women’s lives

The research cited above relies on variation in abortion access from the 1970s, and much has changed in terms of both reproductive technologies and women’s lives. Recent research shows, however, that even with the social, economic, and legal shifts that have occurred over the last few decades and even with expanded access to contraception, abortion access remains relevant to women’s reproductive lives. Today, nearly half of pregnancies are unintended (Finer and Zolna, 2016). About 6% of young women (ages 15-34) experience an unintended pregnancy each year (Finer, Lindberg, and Desai, 2018), and about 1.4% of women of childbearing age obtain an abortion each year (Jones, Witwer, and Jerman, 2019). At these rates, approximately one in four women will receive an abortion in their reproductive lifetimes. The fact is clear: women continue to rely on abortion access to determine their reproductive lives.

But what about their economic and social lives? While women have made great progress in terms of their educational attainment, career trajectories, and role in society, mothers face a variety of challenges and penalties that are not adequately addressed by public policy. Following the birth of a child, it’s well documented that working mothers face a “motherhood wage penalty,” which entails lower wages than women who did not have a child (Waldfogel, 1998; Anderson, Binder, and Krause, 2002; Kelven et al., 2019). Maternity leave may combat this penalty as it allows women to return to their jobs following the birth of a child – encouraging them to remain attached to the labor force (Rossin-Slater, 2017). However, as of this writing, the U.S. only offers up to 12 weeks of unpaid leave through the FMLA, which extends coverage to less than 60% of all workers. 5 And even if a mother is able to return to work, childcare in the U.S. is costly and often inaccessible for many. Families with infants can be expected to pay around $11,000 a year for childcare and subsidies are only available for 1 in 6 children that are eligible under the federal program. 6 Without a federal paid leave policy and access to affordable childcare, the U.S. lacks the infrastructure to adequately support mothers, and especially working mothers – making the prospect of motherhood financially unworkable for some.

This is relevant when considering that the women who seek abortions tend to be low-income mothers experiencing disruptive life events. In the most recent survey of abortion patients conducted by the Guttmacher Institute, 97% are adults, 49% are living below the poverty line, 59% already have children, and 55% are experiencing a disruptive life event such as losing a job, breaking up with a partner, or falling behind on rent (Jones and Jerman, 2017a and 2017b). It is not a stretch to imagine that access to abortion could be pivotal to these women’s financial lives, and recent evidence from “The Turnaway Study” 7 provides empirical support for this supposition. In this study, an interdisciplinary team of researchers follows two groups of women who were typically seeking abortions in the second trimester: one group that arrived at abortion clinics and learned they were just over the gestational age threshold for abortions and were “turned away” and a second that was just under the threshold and were provided an abortion. Miller, Wherry, and Foster (2020) match individuals in both groups to their Experian credit reports and observe that in the months leading up to the moment they sought an abortion, financial outcomes for both groups were trending similarly. At the moment one group is turned away from a wanted abortion, however, they began to experience substantial financial distress, exhibiting a 78% increase in past-due debt and an 81% increase in public records related to bankruptcies, evictions, and court judgments.

If Roe were overturned, the number of women experiencing substantial obstacles to obtaining an abortion would dramatically increase.

If Roe were overturned, the number of women experiencing substantial obstacles to obtaining an abortion would dramatically increase. Twelve states have enacted “trigger bans” designed to outlaw abortion in the immediate aftermath of a Roe reversal, while an additional 10 are considered highly likely to quickly enact new bans. 8 These bans would shutter abortion facilities across a wide swath of the American south and midwest, dramatically increasing travel distances and the logistical costs of obtaining an abortion. Economics research predicts what is likely to happen next. Multiple teams of economists have exploited natural experiments arising from mandatory waiting periods (Joyce and Kaestner, 2001; Lindo and Pineda-Torres, 2021; Myers, 2021) and provider closures (Quast, Gonzalez, and Ziemba, 2017; Fischer, Royer, and White, 2018; Lindo, Myers, Schlosser, and Cunningham, 2020; Venator and Fletcher, 2021; Myers, 2021). All have found that increases in travel distances prevent large numbers of women seeking abortions from reaching a provider and that most of these women give birth as a result. For instance, Lindo and co-authors (2020) exploit a natural experiment arising from the sudden closure of half of Texas’s abortion clinics in 2013 and find that an increase in travel distance from 0 to 100 miles results in a 25.8% decrease in abortions. Myers, Jones, and Upadhyay (2019) use these results to envision a post- Roe United States, forecasting that if Roe is overturned and the expected states begin to ban abortions, approximately 1/3 of women living in affected regions would be unable to reach an abortion provider, amounting to roughly 100,000 women in the first year alone.

Restricting, or outright eliminating, abortion access by overturning Roe v. Wade would diminish women’s personal and economic lives, as well as the lives of their families.

Whether one’s stance on abortion access is driven by deeply held views on women’s bodily autonomy or when life begins, the decades of research using rigorous methods is clear: there is a causal link between access to abortion and whether, when, and under what circumstances women become mothers, with ripple effects throughout their lives. Access affects their education, earnings, careers, and the subsequent life outcomes for their children. In the state’s argument, Mississippi rejects the causal link between access to abortion and societal outcomes established by economists and states that the availability of abortion isn’t relevant to women’s full participation in society. Economists provide clear evidence that overturning Roe would prevent large numbers of women experiencing unintended pregnancies—many of whom are low-income and financially vulnerable mothers—from obtaining desired abortions. Restricting, or outright eliminating, that access by overturning Roe v. Wade would diminish women’s personal and economic lives, as well as the lives of their families.

Caitlin Knowles Myers did not receive financial support from any firm or person for this article. She has received financial compensation from Planned Parenthood Federation of America and the Center for Reproductive Rights for serving as an expert witness in litigation involving abortion regulations. She has not and will not receive financial compensation for her role in the amicus brief described here. Other than the aforementioned, she has not received financial support from any firm or person with a financial or political interest in this article. Caitlin Knowles Myers is not currently an officer, director, or board member of any organization with a financial or political interest in this article.

Abboud, Ali, 2019. “The Impact of Early Fertility Shocks on Women’s Fertility and Labor Market Outcomes.” Available from SSRN: https://ssrn.com/abstract=3512913

Anderson, Deborah J., Binder, Melissa, and Kate Krause, 2002. “The motherhood wage penalty: Which mothers pay it and why?” The American Economic Review 92(2). Retrieved from https://www.aeaweb.org/articles?id=10.1257/000282802320191606

Ananat, Elizabeth Oltmans, Gruber, Jonathan, Levine, Phillip and Douglas Staiger, 2009. “Abortion and Selection.” The Review of Economic Statistics 91(1). Retrieved from https://direct.mit.edu/rest/article-abstract/91/1/124/57736/Abortion-and-Selection?redirectedFrom=fulltext .

Angrist, Joshua D., and Alan B. Krueger, 1999. “Does Compulsory School Attendance Affect Schooling and Earnings?” The Quarterly Journal of Economics 106(4). Retrieved from https://doi.org/10.2307/2937954 .

Angrist, Joshua D., and William N. Evans, 1996. “Schooling and Labor Market Consequences of the 1970 State Abortion Reforms.” National Bureau of Economic Research Working Paper 5406. Retrieved from https://www.nber.org/papers/w5406 .

Angrist, Joshua D., and Jörn-Steffen Pischke, 2010. “The Credibility Revolution in Empirical Economics: How Better Research Design Is Taking the Con out of Econometrics.” Journal of Economic Perspectives 24(2). Retrieved from https://www.aeaweb.org/articles?id=10.1257/jep.24.2.3

Bailey, Martha J., Hoynes, Hilary W., Rossin-Slater, Maya and Reed Walker, 2020. “Is the Social Safety Net a Long-Term Investment? Large-Scale Evidence from the Food Stamps Program” National Bureau of Economic Research Working Paper 26942 , Retrieved from https://www.nber.org/papers/w26942

Bitler, Marianne, and Madeline Zavodny, 2002a. “Did Abortion Legalization Reduce the Number of Unwanted Children? Evidence from Adoptions.” Perspectives on Sexual and Reproductive Health, 34 (1): 25-33. Retrieved from https://www.jstor.org/stable/3030229?origin=JSTOR-pdf

Bitler, Marianne, and Madeline Zavodny, 2002b. “Child Abuse and Abortion Availability.” American Economic Review , 92 (2): 363-367. Retrieved from https://www.aeaweb.org/articles?id=10.1257/000282802320191624

Bitler, Marianne, and Madeline Zavodny, 2004. “Child Maltreatment, Abortion Availability, and Economic Conditions.” Review of Economics of the Household 2: 119-141. Retrieved from https://doi.org/10.1023/B:REHO.0000031610.36468.0e

Farin, Sherajum Monira, Hoehn-Velasco, Lauren, and Michael Pesko, 2021. “The Impact of Legal Abortion on Maternal Health: Looking to the Past to Inform the Present.” Retrieved from SSRN: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3913899

Finer, Lawrence B., and Mia R. Zolna, 2016. “Declines in Unintended Pregnancy in the United States, 2008–2011” New England Journal of Medicine 374. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26962904/

Finer, Lawrence B., Lindberg, Laura, D., and Sheila Desai. “A prospective measure of unintended pregnancy in the United States.” Contraception 98(6). Retrieved from https://pubmed.ncbi.nlm.nih.gov/29879398/

Fischer, Stefanie, Royer, Heather, and Corey White, 2017. “The Impacts of Reduced Access to Abortion and Family Planning Services on Abortion, Births, and Contraceptive Purchases.” National Bureau of Economic Research Working Paper 23634 . Retrieved from https://www.nber.org/papers/w23634

Gruber, Jonathan, Levine, Phillip, and Douglas Staiger, 1999. “Abortion Legalization and Child Living Circumstances: Who Is the ‘Marginal Child’?” Quarterly Journal of Economics 114. Retrieved from https://doi.org/10.1162/003355399556007

Guldi, Melanie, 2008. “Fertility effects of abortion and birth control pill access for minors.” Demography 45 . Retrieved from https://doi.org/10.1353/dem.0.0026

Hoynes, Hilary, Schanzenbach, Diane Whitmore, and Douglas Almond, 2016. “Long-Run Impacts of Childhood Access to the Safety Net.” American Economic Review 106(4). Retrieved from https://www.aeaweb.org/articles?id=10.1257/aer.20130375

Jones, Kelly, 2021. “At a Crossroads: The Impact of Abortion Access on Future Economic Outcomes.” American University Working Paper . Retrieved from https://doi.org/10.17606/0Q51-0R11 .

Jones, Rachel K., Witwer, Elizabeth, Jerman, Jenna, September 18, 2018. “Abortion Incidence and Service Availability in the United States, 2017.” Guttmacher Institute. Retrieved from https://www.guttmacher.org/sites/ default/files/report_pdf/abortion-inciden ce-service-availability-us-2017.

Jones Rachel K., and Janna Jerman, 2017a. ”Population group abortion rates and lifetime incidence of abortion: United States, 2008–2014.” American Journal of Public Health 107 (12). Retrieved from https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2017.304042

Jones, Rachel K. and Jenna Jerman, 2017b. “Characteristics and Circumstances of U.S. Women Who Obtain Very Early and Second-Trimester Abortions.” PLoS One . Retrieved from https://pubmed.ncbi.nlm.nih.gov/28121999/

Joyce, Ted, and Robert Kaestner, 2001. “The Impact of Mandatory Waiting Periods and Parental Consent Laws on the Timing of Abortion and State of Occurrence among Adolescents in Mississippi and South Carolina.” Journal of Policy Analysis and Management 20(2) . Retrieved from https://www.jstor.org/stable/3325799 .

Kalist, David E., 2004. “Abortion and Female Labor Force Participation: Evidence Prior to Roe v. Wade.” Journal of Labor Research 25 (3) .

Keiser, David, and Joseph Shapiro, 2019. “Consequences of the Clean Water Act and the Demand for Water Quality.” The Quarterly Journal of Economics 134 (1).

Kleven, Henrik, Landais, Camille, Posch, Johanna, Steinhauer, Andreas, and Josef Zweimuleler, 2019. “Child Penalties Across Countries: Evidence and Explanations.” AEA Papers and Proceedings 109. Retrieved from https://www.aeaweb.org/articles?id=10.1257/pandp.20191078/

Levine, Phillip, Staiger, Douglas, Kane, Thomas, and David Zimmerman, 1999. “Roe v. Wade and American Fertility.” American Journal Of Public Health 89(2) . Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1508542/

Lindo, Jason M., Myers, Caitlin Knowles, Schlosser, Andrea, and Scott Cunningham, 2020. “How Far Is Too Far? New Evidence on Abortion Clinic Closures, Access, and Abortions” Journal of Human Resources 55. Retrieved from http://jhr.uwpress.org/content/55/4/1137.refs

Lindo, Jason M., Pineda-Torres, Mayra, Pritchard, David, and Hedieh Tajali, 2020. “Legal Access to Reproductive Control Technology, Women’s Education, and Earnings Approaching Retirement.” AEA Papers and Proceedings 110. Retrieved from https://www.aeaweb.org/articles?id=10.1257/pandp.20201108

Lindo, Jason M., and Mayra Pineda-Torres, 2021. “New Evidence on the Effects of Mandatory Waiting Periods for Abortion.” J ournal of Health Econ omics. Retrieved from https://pubmed.ncbi.nlm.nih.gov/34607119/

Miguel, Edward, Satyanath, Shanker, and Ernest Sergenti, 2004. “Economic Shocks and Civil Conflict: An Instrumental Variables Approach.” Journal of Political Economy 112(4). Retrieved from https://www.jstor.org/stable/10.1086/421174

Miller, Sarah, Wherry, Laura R., and Diana Greene Foster, 2020. “The Economic Consequences of Being Denied an Abortion.” National Bureau of Economic Research, Working Paper 26662 . Retrieved from https://www.nber.org/papers/w26662 .

Myers, Caitlin Knowles, 2017. “The Power of Abortion Policy: Reexamining the Effects of Young Women’s Access to Reproductive Control” Journal of Political Economy 125(6) . Retrieved from https://doi.org/10.1086/694293 .

Myers, Caitlin Knowles, Jones, Rachel, and Ushma Upadhyay, 2019. “Predicted changes in abortion access and incidence in a post-Roe world.” Contraception 100(5). Retrieved from https://pubmed.ncbi.nlm.nih.gov/31376381/

Myers, Caitlin Knowles, 2021. “Cooling off or Burdened? The Effects of Mandatory Waiting Periods on Abortions and Births.” IZA Institute of Labor Economics No. 14434. Retrieved from https://www.iza.org/publications/dp/14434/cooling-off-or-burdened-the-effects-of-mandatory-waiting-periods-on-abortions-and-births

Quast, Troy, Gonzalez, Fidel, and Robert Ziemba, 2017. “Abortion Facility Closings and Abortion Rates in Texas.” Inquiry: A Journal of Medical Care Organization, Provision and Financing 54 . Retrieved from https://journals.sagepub.com/doi/full/10.1177/0046958017700944

Rossin-Slater, Maya, 2017. “Maternity and Family Leave Policy.” National Bureau of Economic Research Working Paper 23069. Retrieved from https://www.nber.org/papers/w23069

Venator, Joanna, and Jason Fletcher, 2020. “Undue Burden Beyond Texas: An Analysis of Abortion Clinic Closures, Births, and Abortions in Wisconsin.” Journal of Policy Analysis and Management 40(3). Retrieved from https://doi.org/10.1002/pam.22263

Waldfogel, Jane, 1998. “The family gap for young women in the United States and Britain: Can maternity leave make a difference?” Journal of Labor Economics 16(3).

Thomas E. Dobbs v. Jackson Women’s Health Organization. On Writ of Certiorari to the United States Court of Appeals for the Fifth Circuit, Brief in Support of Petitioners, No. 19-1392.
Thomas E. Dobbs v. Jackson Women’s Health Organization. On Writ of Certiorari to the United States Court of Appeals for the Fifth Circuit, Brief for Petitioners, No. 19-139, Retrieved from https://www.supremecourt.gov/DocketPDF/19/19-1392/184703/20210722161332385_19-1392BriefForPetitioners.pdf
The Nobel Prize. 2021. “Press release: The Prize in Economic Sciences 202.” Retrieved from https://www.nobelprize.org/prizes/economic-sciences/2021/press-release/
See Angrist and Evans (1996), Gruber et al. (1999), Ananat et al. (2009), Guldi (2008), Myers (2017), Abboud (2019), Jones (2021).
Brown, Scott, Herr, Jane, Roy, Radha , and Jacob Alex Klerman, July 2020. “Employee and Worksite Perspectives of the FMLA Who Is Eligible?” U.S. Department of Labor. Retrieved from https://www.dol.gov/sites/dolgov/files/OASP/evaluation/pdf/WHD_FMLA2018PB1WhoIsEligible_StudyBrief_Aug2020.pdf
Whitehurst, Grover J., April 19, 2018. “What is the market price of daycare and preschool?” Brookings Institution. Retrieved from https://www.brookings.edu/research/what-is-the-market-price-of-daycare-and-preschool/; Chien, Nina, 2021. “Factsheet: Estimates of Child Care Eligibility & Receipt for Fiscal Year 2018.” U.S. Department of Health and Human Services. Retrieved from https://aspe.hhs.gov/sites/default/files/20 21-08/cy-2018-child-care-subsidy-eligibility.pdf
Advancing New Standards in Reproductive Health (NSIRH). “The Turnaway Study.” Retrieved from https://www.ansirh.org/research/ongoing/turnaway-study.
Center for Reproductive Rights, 2021. “What If Roe Fell?” Retrieved from https://maps.reproductiverights.org/what-if-roe-fell

Economic Studies

Center for Economic Security and Opportunity

August 21, 2024

Russell Wheeler

Elaine Kamarck, Jordan Muchnick

August 20, 2024

Abortion, the medical or surgical termination of a pregnancy, is one of the oldest, most common, and most controversial medical procedures.

Research shows people who are denied abortions are more likely to experience higher levels of anxiety, lower life satisfaction, and lower self-esteem compared with those who are able to obtain abortions.

Adapted from the Encyclopedia of Psychology

Resources from APA

U.S. Food and Drug Administration v. Alliance for Hippocratic Medicine, et al.

Involves a challenge to the U.S. Food and Drug Administration’s approval of mifepristone used for medication abortion based in part on allegations by the Alliance for Hippocratic Medicine that medication abortion causes women physical and mental health harms.

Policymakers are taking aim at women and LGBTQ+ individuals

Alarming policy trends are affecting people’s mental health, but psychologists are fighting back.

woman of color having a conversation with a medical professional

Abortion bans cause outsized harm for people of color

Increasing restrictions on reproductive care inflict a significant physical and mental burden that ripples across generations—especially for people of color.

woman checking at-home pregnancy kit results

APA Resolution on Confidentiality and Reproductive Health

Ethical standards related to patient confidentiality are significant when psychologists are faced with ethical conflicts with a law requiring the disclosure of confidential information regarding sexual and reproductive health.

More resources about abortion

Ethics and psychology practice

Frequently asked questions regarding ethical issues related to the Supreme Court decision overturning Roe v. Wade

This FAQ provides initial thoughts about ethical issues confronting psychologists following the overturning of Roe v. Wade in June 2022 and the elimination of abortion as a constitutionally-protected right.

Frequently asked questions about abortion laws and psychology practice

Since the U.S. Supreme Court issued its decision to overturn Roe v. Wade , many states have proposed, enacted, or resurrected a range of laws to either prohibit, significantly restrict, or protect reproductive rights and health care.

What APA is doing

Women’s health and civil rights

APA Services advocates for federal funding for women’s health care, improving mental health, preventing violence against women, supporting equity for women, and ending gender disparities and discrimination.

statue of blind justice in front of American flag

Five ways you can get involved in the reproductive health effort

Check out these resources on how to get involved in state-level advocacy efforts related to reproductive health.

APA policies and resolutions

APA’s Resolution on Abortion adopted in 1969 establishes that termination of pregnancy is the civil right of the pregnant woman, to be handled as are other medical and surgical procedures in consultation with her physician. Subsequent APA policies adopted in 1980, 1989, 1992, and 2022 affirmed a woman’s right to reproductive choice and negated assertions regarding adverse psychological effects of abortion.

APA Resolution Affirming and Building on APA’s History of Support for Reproductive Rights

APA urges local, state, and federal policymakers to safeguard the reproductive rights of all women and implement reforms to address oppressive policies.

Abortion resolutions

Read APA’s 1969 resolution and subsequent policies affirming the right to reproductive choice.

Amicus briefs

APA has filed multiple amicus briefs in legal challenges to abortion.

MKB Management Corp. v. Burdick

Planned Parenthood et al. v. Mike Rounds et al.

Planned Parenthood of SE Pennsylvania v. Casey

Ohio v. Akron Center for Reproductive Health Inc.

Bowen v. Kendrick

Webster v. Reproductive Health Services

Hartigan v. Zbaraz

Hodgson v. State of Minnesota

Thornburgh v. American College of Obstetricians and Gynecologists

Akron v. Akron Center for Reproductive Health Inc.

Harris v. McRae

Abortion and mental health

Women who are denied an abortion are more likely to initially experience higher levels of anxiety, lower life satisfaction, and lower self-esteem compared with women who received an abortion.
Unwanted pregnancy has been associated with deficits to the subsequent child’s cognitive, emotional, and social processes.
The number of unsafe abortions is likely to increase when policies limit access to reproductive health care.
There is a strong relationship between unwanted pregnancy and interpersonal violence.
Laws restricting access to safe, legal abortion are harmful to low-income women, women of color, and sexual and gender minorities, as well as those who live in rural or medically underserved areas.
A woman’s ability to control when and if she has a child is frequently linked to her socioeconomic standing and earning power.
Experiencing unwanted pregnancies appears to be strongly associated with poor mental health effects for women later in life.

Read more from the Report of the APA Task Force on Mental Health and Abortion (PDF, 606KB)

APA Offices

Women’s Health and Civil Rights Advocacy APA Services advocates for federal funding for women’s health care, improving mental health, preventing violence against women, supporting equity for women, and ending gender disparities and discrimination.

Women’s Programs Office The Women’s Programs Office works to improve the status, health and well-being of women psychologists and consumers of psychological services

The negative health implications of restricting abortion access

December 13, 2021— Ana Langer is professor of the practice of public health and coordinator of the Women and Health Initiative at Harvard T.H. Chan School of Public Health.

Q: Roe v. Wade may soon be overturned by the Supreme Court, while at the same time other countries are loosening restrictions around abortion rights. What are your thoughts on the current climate around this issue?

A: The trend over the past several decades is clear: Safe and legal abortion has become more widely accessible to women globally, with nearly 50 countries including Mexico, Argentina, New Zealand, Thailand, and Ireland liberalizing their abortion laws. During the same period, however, a few countries have made abortion more restricted or totally illegal, including El Salvador, Nicaragua, and Poland.

In the U.S., legal frameworks are increasingly limiting access to abortion. Even while Roe is in place, many people are currently unable to receive abortion care.

If the Supreme Court were to limit or overturn Roe, abortion would remain legal in 21 states and could immediately be prohibited in 24 states and three territories. Millions of people would be forced to travel to receive legal abortion care, something that would be impossible for many due to a range of financial and logistical reasons.

This situation does not surprise me because of the deep polarization that characterizes public views on abortion, and the growing power and relentless efforts of anti-choice groups. Furthermore, it does not surprise me because of the important gender gap that exists in this country, which is to a great extent due to the lack of strong and consistent policies and legal frameworks to support women in their efforts to better integrate their reproductive and professional roles and responsibilities.

The U.S. legalized abortion nearly 50 years ago, at a time when it was legally restricted in many countries around the world, setting an important international precedent and example. It disappoints me to see that while important progress has been made towards equality in other culturally polarized areas such as same-sex marriage, women’s right to terminate an unwanted or mistimed pregnancy is now severely threatened.

Q: How do laws that restrict abortion access impact women’s health?

A: Restricting women’s access to safe and legal abortion services has important negative health implications. We’ve seen that these laws do not result in fewer abortions. Instead, they compel women to risk their lives and health by seeking out unsafe abortion care.

According to the World Health Organization, 23,000 women die from unsafe abortions each year and tens of thousands more experience significant health complications globally. A recent study estimated that banning abortion in the U.S. would lead to a 21% increase in the number of pregnancy-related deaths overall and a 33% increase among Black women, simply because staying pregnant is more dangerous than having an abortion. Increased deaths due to unsafe abortions or attempted abortions would be in addition to these estimates.

If the current trend in the U.S. persists, “back alley” abortions will be the last resource for women with no access to safe and legal services, and the horrific consequences of such abortions will become a major cause of death and severe health complications for some of the most vulnerable women in this country.

The legal status of abortion also defines whether girls will be able to complete their educations and whether women will be able to participate in the workforce, and in public and political life.

Improving social safety net programs for women reduces gender gaps and improves girls’ and women’s health and chances to fulfill their potential, and could help reduce the number of abortions over time. Women who are better educated, have better access to comprehensive reproductive health care , and are employed and fairly remunerated will be better positioned to avoid a mistimed and unwanted pregnancy, hence the need for termination will become less common.

Q: Should abortion be considered a human right?

A: Numerous international and regional human rights treaties and national-level constitutions around the world protect the right to safe and legal abortion as a fundamental human right. Access to safe abortion is included in a constellation of rights, including the rights to life, liberty, privacy, equality and non-discrimination, and freedom from cruel, inhuman, and degrading treatment. Human rights bodies have repeatedly condemned restrictive abortion laws as being incompatible with human rights norms.

While a supportive legal framework for abortion care is critical, it is not enough to ensure access for everyone who seeks the service. For universal access to become a reality, policies that cover the cost of abortion care and its integration into the health care system, in addition to societal measures that destigmatize the procedure, are needed.

— Amy Roeder

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Reproductive rights in America

7 persistent claims about abortion, fact-checked.

Jaclyn Diaz

Koko Nakajima

Nick Underwood

Anti-abortion demonstrators watch as abortion rights protestors chant in front of the U.S. Supreme Court in Washington, D.C., on May 5. Jim Watson/AFP via Getty Images hide caption

Anti-abortion demonstrators watch as abortion rights protestors chant in front of the U.S. Supreme Court in Washington, D.C., on May 5.

Since the Supreme Court's 1973 Roe v. Wade decision ruled that women have a constitutional right to end their pregnancies, proponents and opponents of abortion rights have worked to own the conversation over the issue.

In 2019, the Centers for Disease Control and Prevention reported that 629,898 legal induced abortions were reported across the United States.

Lingering claims circulate about abortion, including about the safety of it, who gets abortions and even who supports or opposes access to abortion.

Below, seven popular claims surrounding abortion get fact-checked.

According to the Pew Research Center's polls , 37% of Americans want abortion illegal in all or most cases.

But an even bigger fraction — around 6 in 10 Americans — think abortion should be legal in all or most cases.

Current abortion rates are lower than what they were in 1973 and are now less than half what they were at their peak in the early 1980s, according to the Guttmacher Institute , a reproductive health research organization that supports abortion rights.

In 2017, pregnancy rates for females age 24 or below hit their lowest recorded levels, reflecting a long-term decline in pregnancy rates among females 24 or below.

Overall, in 2017, pregnancy rates for females of reproductive age hit their lowest recorded levels, with 87 pregnancies per 1,000 females ages 15 to 44, according to the Guttmacher Institute.

The annual number of deaths related to legal induced abortion has fluctuated from year to year since 1973, according to the CDC.

An analysis of data from 2013 to 2018 showed the national case-fatality rate for legal induced abortion was 0.41 deaths per 100,000 legal induced abortions, lower than in the previous five years.

The World Health Organization said people obtaining unsafe abortions are at a higher risk of death. Annually, 4.7% to 13.2% "of maternal deaths can be attributed to unsafe abortion," the WHO said. In developing regions of the world, there are 220 deaths per 100,000 unsafe abortions.

Trans and nonbinary people have undergone abortions as well.

The Guttmacher Institute estimates in 2017 an estimated 462 to 530 transgender or nonbinary individuals in the U.S. had abortions. That same year, the CDC said, 609,095 total abortions were carried out in the country.

The Abortion Out Loud campaign has collected stories from thousands of people who have had an abortion. Included are stories from trans and nonbinary people who have had an abortion — such as Jae, who spoke their experience.

"Most abortions in 2019 took place early in gestation," according to the CDC . Nearly 93% of abortions were performed at less than 13 weeks' gestation.

Abortion pills, which can typically be used up to 10 weeks into a pregnancy, made up 54% of abortions in 2020. These pills were the primary choice in the U.S. for the first time since the Food and Drug Administration approved the abortion drug mifepristone more than 20 years ago.

State legislatures have been moving to adopt 20-week abortion bans, with abortion opponents claiming fetuses can feel pain at that point. Roughly a third of states have implemented an abortion ban around 20 weeks .

But this contradicts widely accepted medical research from 2005. This study , published in the Journal of the American Medical Association , concluded that a fetus is not capable of experiencing pain until somewhere between 29 or 30 weeks.

Researchers wrote that fetal awareness of pain requires "functional thalamocortical connections." Those thalamocortical fibers begin appearing between 23 and 30 weeks' gestational age, but the capacity for pain perception comes later.

The argument against abortion has frequently been based on religion.

Data shows that the majority of people who get an abortion have some sort of religious affiliation, according to the most recent Guttmacher Institute data , from 2014.

The Pew Research Center also shows that attitudes on whether abortion should be legal vary among evangelical Protestants, mainline Protestants and Catholics.

Here's what could happen now that the Supreme Court has overturned Roe v. Wade

Roe v. Wade and the future of reproductive rights in America

Here's what could happen now that roe v. wade is overturned.

Supreme Court
Roe v. Wade

DNC Final Night

Here’s how the right to abortion is also an economic issue

This story was originally published by The 19th on May 4, 2022.

Correction: When this article was first published it mistakenly stated the incorrect author. The article has been updated to include the correct author. We regret the error.

In a leaked draft opinion that would overturn Roe v. Wade, Supreme Court Justice Samuel Alito argued that pregnant people don’t actually need access to abortion to ensure economic mobility — they already have it.

According to the opinion, which was published by Politico Monday night , “unmarried pregnant women” — Alito does not include all pregnant people in his opinion — now have access to pregnancy discrimination protections, “guaranteed” medical leave “in many cases,” and medical costs that are “covered by insurance or government assistance.”

READ MORE: Black and Hispanic people have the most to lose if Roe is overturned

Those “modern developments” contradict the position held by many economists and abortion rights advocates for decades, Alito wrote. In his opinion — which Chief Justice John Roberts confirmed was a genuine draft, but said was not the official decision of the court — Alito concludes that it’s not up to the Supreme Court to assess “the effect of the abortion right on society and in particular on the lives of women.”

But his argument doesn’t account for the significant limitations of the protections he lists and the persisting truth that the United States holds some of the worst records in the world in terms of pregnancy and birth-related workplace benefits, experts say. Some of the elements Alito describes in the opinion are still a work in progress. In other cases, they are leaving out some of the most vulnerable Americans.

The overarching argument Alito appears to be making is that the country has made strides since 1973, when Roe v. Wade went into effect, guaranteeing abortion rights up until fetal viability. Alito suggests that progress nullifies the connection between abortion access and economic justice. But experts on child care, paid leave and economics said his argument fails to capture how the protections codified into law in the past five decades are still not sufficient. The reasoning is also at odds with another stance held by some self-described anti-abortion feminists, who feel that access to abortion has stymied the development of robust policies to support pregnant people and families.

In terms of pregnancy discrimination, a bill with bipartisan support recently passed the U.S. House and is now being considered by the Senate to fortify workplace protections for pregnant people. But that bill was introduced precisely because significant loopholes still exist, even though Congress passed the Pregnancy Discrimination Act in 1978.

On what Alito characterizes as “guaranteed” family leave, the only workers who have anything close to guaranteed leave are the top 10 percent of earners in the country, 95 percent of whom have access to family leave that is unpaid, according to the Bureau of Labor Statistics. Only 36 percent of those highest earners also have paid family leave, and those numbers drop dramatically for the lowest paid workers, most of them women of color: 79 percent got unpaid family leave and only 5 percent had paid family leave in 2020.

Medical costs for birth are also still high, even with insurance coverage: about $4,300 on average for vaginal deliveries in 2015 and $5,200 for cesarean births, according to a wide-ranging study of more than 600,000 women in the United States between 2008 and 2015 who had health care insurance through their employer.

“The premise is false,” said Julie Kashen, a senior fellow and director for women’s economic justice at the Century Foundation, a progressive think tank. “Even if we had access to paid family leave and child care and insurance coverage for pregnancy and childbirth — even if we had all those things in place, which we do not, the need to have the right to abortion continues to exist.”

The United States ranks near the bottom of the list among advanced countries on how much it invests in child care, and it is one of only seven nations that has no national paid leave policy. Health care costs are so high in the United States, including for childbirth and pregnancy, that more than a third of American women reported skipping needed medical care, the highest rate among eleven high-income countries, according to a study by the Commonwealth Fund, a foundation providing health care research on vulnerable communities. (The study did not look at trans or nonbinary people.)

Abortion access and economic security have long been proven to have deep connections. A landmark study that followed two groups of women over 10 years — one group that wanted an abortion and got one and one that wanted one but did not get the procedure — found that those who were denied an abortion by a clinic because they were too late in their pregnancies sank deeper into poverty as a result.

The study, which did not look at outcomes for trans or gender diverse people, pinpointed the lack of abortion access as the turning point in the women’s economic trajectories, in part because there was little policy support federally and in their workplaces to help them raise their children without facing financial hardship.

The past two pandemic years have crystallized how little support there is for pregnant people and parents — so little, in fact, that women left the labor force in unprecedented numbers at the start of the COVID-19 crisis because of lack of access to paid leave and child care. In the wake of that exodus, policies to pass federal paid leave and free pre-Kindergarten got as close to becoming a political reality as they ever have in this country.

And yet, they have not passed.

Those who are most affected by the absence of those protections are the same group that will be affected by the lack of access to abortion: women and people of color.

“One of the things we have to remember is this narrative about abortion and who has access to abortion — we cannot forget that this is a race and class issue,” said Leng Leng Chancey, the executive director of 9to5, a national organization advocating for economic security for women of color.

WATCH: How Congress could wield its power to affect abortion law nationally

If Roe is ultimately overturned, as the draft opinion suggests it will be, the decision on how to restrict abortion will be left up to states . Most of the states that have already passed abortion restrictions are in the South and Midwest, the same places that have higher concentrations of low-wage workers . It is those workers, the majority of them women of color, who will face the most significant barriers to abortion, who may not be able to travel to other states to undergo the procedure and who may not even have the time off from work or financial wiggle room to consider that option.

Chancey said that when she was pregnant with her first child, she earned $7.25 an hour working at a university and was spending $150 a week on child care. They had a cesarean birth and were back at work less than 8 weeks after the surgery.

“I was afraid to lose my job — who can access [unpaid family leave]? Nobody that’s working a minimum wage job, because you have to put food on the table,” they said.

Low-income people of color often can’t afford to be out of work without pay for extended periods of time, but they are also more likely to be single parents and caregivers.

“We live in a nation that penalizes caregivers and caregiving responsibilities,” said Josephine Kalipeni, the executive director of Family Values @ Work, a national network of state and local coalitions working to pass workplace policies including paid family leave. When she had an abortion while in college, part of the decision was driven by the fact that she was the eldest of six children, expected to be a caregiver for her parents and while completing her education.

Kalipeni said she was working three jobs at the time, struggling to pay off her tuition at the end of each semester.

“I had to think and really weigh the cost knowing that my parents would not have an inheritance to pass down to me in the future, that my financial wellness was as connected to theirs as their own independent finances were, and now to think about disrupting my education, incurring the costs of having a child and having a child in the United States? There was absolutely no way I could financially or emotionally have a child,” Kalipeni said.

If Roe is overturned, groups like hers will only be emboldened to fight more for the policies Alito suggests are already in the books, she said.

“It ramps up our work in its definitive terms, but I also think it ramps up our responsibility to talk about reimagining a democracy and an economy that works for all of us,” she said. “It becomes a uniting moment.”

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What a Supreme Court ruling ending Roe v. Wade would mean for reproductive rights

Health May 03

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Voters in arizona and montana can decide on constitutional right to abortion.

Associated Press

FILE - Protesters join thousands marching around the Arizona Capitol in Phoenix, protesting the U.S. Supreme Court's decision to overturn Roe v. Wade, June 24, 2022. (AP Photo/Ross D. Franklin, File)

PHOENIX – Voters in Arizona and Montana will be able to decide in November whether they want to protect the right to an abortion in their state constitutions.

The Arizona Supreme Court ruled Tuesday that a 200-word summary that abortion advocates used to collect signatures for a ballot measure is valid, clearing the way for the issue to remain on the ballot.

Medical providers say Indiana's near-total abortion ban changed how they discuss birth control

A packet of medication with some pills removed.

Since Indiana's near-total abortion ban went into effect more than a year ago, some reproductive health care providers said they’ve had to adjust the conversations they have with patients about birth control.

Some Indiana health providers said the few, narrow exceptions under the state's near-total ban make it difficult to access care, which they said makes knowing which contraceptive options are available is even more important.

Dr. Tracey Wilkinson is the project lead for the Path4You program, which provides free contraception across the state.

Wilkinson said people tend to only become aware of barriers to care when they, or someone they know, tries to access it. Some of her patients don’t know that abortion access has been severely limited in Indiana.

“Despite all of the news coverage and focus around that abortion ban, we still have a lot of members in our community that weren't aware,” Wilkinson said. “The more that we talk about it and the more that we remind people, the better it is just so that awareness is out there.”

READ MORE: Providers, patients work to navigate access to care in near-total abortion ban's first year

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Wilkinson said patients need to understand the state’s abortion ban in order to make informed decisions.

“The added part that I bring into my counseling is that abortion is now banned in our state, so while you're thinking of various options when it comes to pregnancy prevention, please, keep in mind that abortion is no longer legal in our state,” Wilkinson said.

Wilkinson’s appointments now include helping people understand the different types of care they can still access.

“This is no longer a discussion that can be put off for the next visit or is only applied to certain patients or certain gender patients,” Wilkinson said. “It's really, kind of, every moment is crucial.”

The Path4You program launched in 2021 – about a year before Indiana lawmakers passed the state's near-total ban – and has helped more than 2,000 patients. Wilkinson said the providers expected access was easier for short-acting contraceptive options, like oral birth control. But she said they found a lot of patients needed help finding both short- and long-acting options.

“It just really speaks to the barriers to access — to just birth control — that we have,” Wilkinson said. “It doesn't matter what you are trying to get, all of it is hard. And we don't make it easy as a state.”

However since the near-total ban took effect in 2023 , Wilkinson said more people are choosing long-acting reversible options compared to before.

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Abortion funds say they need more money as florida's law fuels demand for help.

Bree Wallace works for the Tampa Bay Abortion Fund. The group uses donations to help people pay for abortion care in Florida, but has increasingly had to help people travel out-of-state for care since the state began restricting access to the procedure.

Whether scrambling to get patients abortions before six weeks or helping them to clinics in other states, the groups say a lot more help is needed since the restrictions went into effect.

Getting an abortion can cost hundreds, if not thousands of dollars, especially if travel is involved. Support groups, called abortion funds, can help people pay for care, but demand for that help has soared since Florida's law banning most abortions after six weeks started in May.

Advocates like Bree Wallace with the Tampa Bay Abortion Fund say the organizations need more money to keep up.

Wallace typically spends her days glued to her laptop messaging back-and-forth with pregnant clients who need her help getting abortion care –- and fast, if they want to comply with Florida’s law.

Abortion rights posters cover the walls of the small office Wallace set up in her Tampa home. Boxes of tampons and pads are piled across the room – she gives them out in the community. But her day job is with the fund, as its only full-time employee.

One afternoon in July, a woman reached out through text message from the waiting room of an abortion clinic. She couldn’t pay for her appointment.

Within minutes, Wallace committed to help. All the woman had to do was share her first name and last initial. She could move forward with her appointment and the clinic would charge the fund for the balance: $490.

“It can be pretty hefty for people,” said Wallace, 27, the fund’s director of case management.

Many people struggle to afford abortions

Abortions in Florida usually cost $600 to $800 during the first trimester, depending on a number of factors, including whether the patient gets a surgical or medication abortion. Part of that cost covers a mandatory in-person consultation and ultrasound the state requires patients to get at least 24 hours before their abortion.

There’s been a long-standing ban on using federal funds for abortion, so Medicaid doesn’t cover it unless states choose to spend their own money to pay for the service. Florida does not allow that and also bans Affordable Care Act plans from covering abortion, so many patients have to pay out of pocket, which is more difficult for those with low incomes.

If women do realize they're pregnant within six weeks, they often have just days to act if they want an abortion. That can be a hard enough decision to make so quickly, said Wallace, and money adds more stress.

“Especially with six weeks right now, you're kind of working against time, you don't even have time to even get that money,” she said.

Abortions have declined in Florida since the law was enacted, but thousands are still being performed each month. State data released on July 1 and Aug. 1 show more than 4,000 abortions were reported during each of the previous months.

Some patients who could have saved their own money for appointments if they had more tim, now need the fund’s help, said Wallace.

Costly trips out of state are becoming more common

Many people don't even realize they're pregnant by six weeks. Since most nearby states also ban abortion, women have to travel to places like Washington, D.C., or Illinois to get care if they're further along.

Between last-minute airfare and hotel stays, Wallace says it can easily cost another $1,000.

“But, of course, there's also taking off work, that can be hard for a lot of people, finding child care,” she added. “Sometimes this is the first time people have ever been on a plane, ever left Florida, so it's really a whole new experience for them, and it can be really confusing and stressful.”

Some Floridians, like thousands of other Americans living in states with abortion restrictions, are opting to get abortion pills through the mail from health professionals who can prescribe them online. It’s considered safe and effective, particularly in the first trimester, but Florida bans telehealth abortions. Criminal penalties don’t apply to patients, but abortion funds face legal risks, said Wallace, so they don’t provide any assistance for clients interested in pursuing this method beyond sharing information. All they can legally do for people past six weeks, she said, is help get them out of the state.

But overall need has been so great that Just 12 days into July, the Tampa Bay Abortion Fund had to pause paying for travel costs for the month to prioritize people needing appointments in Florida.

The group relies on donations and grants, and had set a $50,000-per-month budget to avoid running out of money. They spent that much in about two weeks.

Leadership is having tough conversations about the future, Wallace said.

“I think money is always going to be an issue, unfortunately,” she said. “We're still spending a lot, and with funding cuts, are really getting hit harder than that.”

National group says it has to cut back on aid

The cuts Wallace referred to involve the National Abortion Federation . It's a professional association for abortion providers that also runs the largest patient assistance fund for abortion in the U.S., known as the National Abortion Hotline.

Previously, the federation would cover 50 percent of the appointment cost for patients who qualify for aid based on income and household size. But as of July 1, that’s down to 30 percent.

Local funds say the change puts a burden on them to fill the gap.

“It has been hurting us quite a bit with budget,” said Wallace.

The Tampa Bay Abortion Fund spent more than $100,000 last month helping patients access care, double what it budgeted, said Bree Wallace, director of case management.

The decision to reduce subsidy rates was "incredibly heartbreaking and painful," said federation president Brittany Fonteno, adding that demand for help around the country has been "overwhelming."

During the first half of this year, the hotline was spending more than $6 million a month on abortion appointments and another $200,000 on travel, said Fonteno. Even more people needed help with out-of-state care after Florida's restrictions went into effect.

"If we had kept pace with our previous level of spending, we would have run out of funds by the fall," Fonteno said.

The Tampa Bay Abortion Fund co-authored an op-ed published in The Nation this month that criticizes large reproductive rights organizations like the National Abortion Federation for focusing too much of their resources on advocacy rather than patient care. More than 30 local abortion funds around the U.S. signed on to the piece.

In a follow-up statement the federation shared with WUSF via email, Fonteno said her team “deeply understands” local funds’ frustrations.

“We know these funding changes come at a difficult time and we are so grateful for the collective commitment from our members and local funds to ensure as many people can access abortion care as possible,” she said. “Sadly, our country has a broken health care system where people are forced to rely on donations to cover the cost of essential care.

Balancing helping people now with surviving in the future

Both local and national funds say they haven’t been getting as many donations as they did when Roe v. Wade was first overturned by the Supreme Court in June 2022.

Many funds can only cover a portion of a client’s abortion cost, even if that woman can’t pay anything herself. Some have to pause services when they reach their spending limits, often toward the end of each month.

That can be the most challenging time to hear from patients, said Amber Pugh, a care coordinator with the National Abortion Hotline who works with Floridians.

“It's very difficult to hear the desperation in people that they just want to get the health care that they need,” Pugh said. “We will always do our best, but sometimes we can't help everyone.”

Funds work closely together, said Pugh, and often chip in money to support each other, particularly for complex cases.

“As difficult as these bans and these restrictions are ... our communities are still out here taking care of each other,” Pugh said. “We're doing what we can, and I think that's really powerful.”

A woman who was 11 weeks pregnant relied on that community on the July afternoon Bree Wallace was working from her home. This client needed help getting to D.C. for an abortion. The Tampa Bay Abortion Fund could pay for the appointment but had already paused travel support.

Wallace tapped the national hotline, and an hour later learned they could cover the flight and hotel.

"So I'm happy about that, happy that the travel is all covered, now this person is all good," she said with a smile before moving on to the next case that demanded her attention.

The Tampa Bay Abortion Fund ended up spending more than $100,000 dollars in July, double their budget for the month. That helped 232 people get abortions — including one woman who texted this to Wallace:

“ 'Thank you,' with a million exclamation points,” Wallace read. " 'Thank you so much' – with even more exclamation points. 'I appreciate you for what you do, you just helped me more than you know.' "

A proposed constitutional amendment would expand abortion rights in Florida if it passes in November, but Wallace isn’t counting on it. The measure requires 60 percent approval to pass, and even if it does, the state has already said it anticipates legal challenges to resolve “uncertainties” related to implementing it.

Besides, Wallace said, if abortion becomes available in Florida until viability again, which is around 24 weeks, the fund will likely still work to help people in states that still have bans come to Florida for care.

Wallace knows the fund could run out of money if donations don't replenish their reserves. But with so much need right now, she said it's a chance they'll have to take.

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Impact of abortion law reforms on women’s health services and outcomes: a systematic review protocol

Foluso ishola.

Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Purvis Hall 1020 Pine Avenue West, Montreal, Quebec H3A 1A2 Canada

U. Vivian Ukah

Arijit nandi, associated data.

A country’s abortion law is a key component in determining the enabling environment for safe abortion. While restrictive abortion laws still prevail in most low- and middle-income countries (LMICs), many countries have reformed their abortion laws, with the majority of them moving away from an absolute ban. However, the implications of these reforms on women’s access to and use of health services, as well as their health outcomes, is uncertain. First, there are methodological challenges to the evaluation of abortion laws, since these changes are not exogenous. Second, extant evaluations may be limited in terms of their generalizability, given variation in reforms across the abortion legality spectrum and differences in levels of implementation and enforcement cross-nationally. This systematic review aims to address this gap. Our aim is to systematically collect, evaluate, and synthesize empirical research evidence concerning the impact of abortion law reforms on women’s health services and outcomes in LMICs.

We will conduct a systematic review of the peer-reviewed literature on changes in abortion laws and women’s health services and outcomes in LMICs. We will search Medline, Embase, CINAHL, and Web of Science databases, as well as grey literature and reference lists of included studies for further relevant literature. As our goal is to draw inference on the impact of abortion law reforms, we will include quasi-experimental studies examining the impact of change in abortion laws on at least one of our outcomes of interest. We will assess the methodological quality of studies using the quasi-experimental study designs series checklist. Due to anticipated heterogeneity in policy changes, outcomes, and study designs, we will synthesize results through a narrative description.

This review will systematically appraise and synthesize the research evidence on the impact of abortion law reforms on women’s health services and outcomes in LMICs. We will examine the effect of legislative reforms and investigate the conditions that might contribute to heterogeneous effects, including whether specific groups of women are differentially affected by abortion law reforms. We will discuss gaps and future directions for research. Findings from this review could provide evidence on emerging strategies to influence policy reforms, implement abortion services and scale up accessibility.

Systematic review registration

PROSPERO CRD42019126927

Supplementary Information

The online version contains supplementary material available at 10.1186/s13643-021-01739-w.

An estimated 25·1 million unsafe abortions occur each year, with 97% of these in developing countries [ 1 – 3 ]. Despite its frequency, unsafe abortion remains a major global public health challenge [ 4 , 5 ]. According to the World health Organization (WHO), nearly 8% of maternal deaths were attributed to unsafe abortion, with the majority of these occurring in developing countries [ 5 , 6 ]. Approximately 7 million women are admitted to hospitals every year due to complications from unsafe abortion such as hemorrhage, infections, septic shock, uterine and intestinal perforation, and peritonitis [ 7 – 9 ]. These often result in long-term effects such as infertility and chronic reproductive tract infections. The annual cost of treating major complications from unsafe abortion is estimated at US$ 232 million each year in developing countries [ 10 , 11 ]. The negative consequences on children’s health, well-being, and development have also been documented. Unsafe abortion increases risk of poor birth outcomes, neonatal and infant mortality [ 12 , 13 ]. Additionally, women who lack access to safe and legal abortion are often forced to continue with unwanted pregnancies, and may not seek prenatal care [ 14 ], which might increase risks of child morbidity and mortality.

Access to safe abortion services is often limited due to a wide range of barriers. Collectively, these barriers contribute to the staggering number of deaths and disabilities seen annually as a result of unsafe abortion, which are disproportionately felt in developing countries [ 15 – 17 ]. A recent systematic review on the barriers to abortion access in low- and middle-income countries (LMICs) implicated the following factors: restrictive abortion laws, lack of knowledge about abortion law or locations that provide abortion, high cost of services, judgmental provider attitudes, scarcity of facilities and medical equipment, poor training and shortage of staff, stigma on social and religious grounds, and lack of decision making power [ 17 ].

An important factor regulating access to abortion is abortion law [ 17 – 19 ]. Although abortion is a medical procedure, its legal status in many countries has been incorporated in penal codes which specify grounds in which abortion is permitted. These include prohibition in all circumstances, to save the woman’s life, to preserve the woman’s health, in cases of rape, incest, fetal impairment, for economic or social reasons, and on request with no requirement for justification [ 18 – 20 ].

Although abortion laws in different countries are usually compared based on the grounds under which legal abortions are allowed, these comparisons rarely take into account components of the legal framework that may have strongly restrictive implications, such as regulation of facilities that are authorized to provide abortions, mandatory waiting periods, reporting requirements in cases of rape, limited choice in terms of the method of abortion, and requirements for third-party authorizations [ 19 , 21 , 22 ]. For example, the Zambian Termination of Pregnancy Act permits abortion on socio-economic grounds. It is considered liberal, as it permits legal abortions for more indications than most countries in Sub-Saharan Africa; however, abortions must only be provided in registered hospitals, and three medical doctors—one of whom must be a specialist—must provide signatures to allow the procedure to take place [ 22 ]. Given the critical shortage of doctors in Zambia [ 23 ], this is in fact a major restriction that is only captured by a thorough analysis of the conditions under which abortion services are provided.

Additionally, abortion laws may exist outside the penal codes in some countries, where they are supplemented by health legislation and regulations such as public health statutes, reproductive health acts, court decisions, medical ethic codes, practice guidelines, and general health acts [ 18 , 19 , 24 ]. The diversity of regulatory documents may lead to conflicting directives about the grounds under which abortion is lawful [ 19 ]. For example, in Kenya and Uganda, standards and guidelines on the reduction of morbidity and mortality due to unsafe abortion supported by the constitution was contradictory to the penal code, leaving room for an ambiguous interpretation of the legal environment [ 25 ].

Regulations restricting the range of abortion methods from which women can choose, including medication abortion in particular, may also affect abortion access [ 26 , 27 ]. A literature review contextualizing medication abortion in seven African countries reported that incidence of medication abortion is low despite being a safe, effective, and low-cost abortion method, likely due to legal restrictions on access to the medications [ 27 ].

Over the past two decades, many LMICs have reformed their abortion laws [ 3 , 28 ]. Most have expanded the grounds on which abortion may be performed legally, while very few have restricted access. Countries like Uruguay, South Africa, and Portugal have amended their laws to allow abortion on request in the first trimester of pregnancy [ 29 , 30 ]. Conversely, in Nicaragua, a law to ban all abortion without any exception was introduced in 2006 [ 31 ].

Progressive reforms are expected to lead to improvements in women’s access to safe abortion and health outcomes, including reductions in the death and disabilities that accompany unsafe abortion, and reductions in stigma over the longer term [ 17 , 29 , 32 ]. However, abortion law reforms may yield different outcomes even in countries that experience similar reforms, as the legislative processes that are associated with changing abortion laws take place in highly distinct political, economic, religious, and social contexts [ 28 , 33 ]. This variation may contribute to abortion law reforms having different effects with respect to the health services and outcomes that they are hypothesized to influence [ 17 , 29 ].

Extant empirical literature has examined changes in abortion-related morbidity and mortality, contraceptive usage, fertility, and other health-related outcomes following reforms to abortion laws [ 34 – 37 ]. For example, a study in Mexico reported that a policy that decriminalized and subsidized early-term elective abortion led to substantial reductions in maternal morbidity and that this was particularly strong among vulnerable populations such as young and socioeconomically disadvantaged women [ 38 ].

To the best of our knowledge, however, the growing literature on the impact of abortion law reforms on women’s health services and outcomes has not been systematically reviewed. A study by Benson et al. evaluated evidence on the impact of abortion policy reforms on maternal death in three countries, Romania, South Africa, and Bangladesh, where reforms were immediately followed by strategies to implement abortion services, scale up accessibility, and establish complementary reproductive and maternal health services [ 39 ]. The three countries highlighted in this paper provided unique insights into implementation and practical application following law reforms, in spite of limited resources. However, the review focused only on a selection of countries that have enacted similar reforms and it is unclear if its conclusions are more widely generalizable.

Accordingly, the primary objective of this review is to summarize studies that have estimated the causal effect of a change in abortion law on women’s health services and outcomes. Additionally, we aim to examine heterogeneity in the impacts of abortion reforms, including variation across specific population sub-groups and contexts (e.g., due to variations in the intensity of enforcement and service delivery). Through this review, we aim to offer a higher-level view of the impact of abortion law reforms in LMICs, beyond what can be gained from any individual study, and to thereby highlight patterns in the evidence across studies, gaps in current research, and to identify promising programs and strategies that could be adapted and applied more broadly to increase access to safe abortion services.

The review protocol has been reported using Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) guidelines [ 40 ] (Additional file 1 ). It was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database CRD42019126927.

Eligibility criteria

Types of studies.

This review will consider quasi-experimental studies which aim to estimate the causal effect of a change in a specific law or reform and an outcome, but in which participants (in this case jurisdictions, whether countries, states/provinces, or smaller units) are not randomly assigned to treatment conditions [ 41 ]. Eligible designs include the following:

Pretest-posttest designs where the outcome is compared before and after the reform, as well as nonequivalent groups designs, such as pretest-posttest design that includes a comparison group, also known as a controlled before and after (CBA) designs.
Interrupted time series (ITS) designs where the trend of an outcome after an abortion law reform is compared to a counterfactual (i.e., trends in the outcome in the post-intervention period had the jurisdiction not enacted the reform) based on the pre-intervention trends and/or a control group [ 42 , 43 ].
Differences-in-differences (DD) designs, which compare the before vs. after change in an outcome in jurisdictions that experienced an abortion law reform to the corresponding change in the places that did not experience such a change, under the assumption of parallel trends [ 44 , 45 ].
Synthetic controls (SC) approaches, which use a weighted combination of control units that did not experience the intervention, selected to match the treated unit in its pre-intervention outcome trend, to proxy the counterfactual scenario [ 46 , 47 ].
Regression discontinuity (RD) designs, which in the case of eligibility for abortion services being determined by the value of a continuous random variable, such as age or income, would compare the distributions of post-intervention outcomes for those just above and below the threshold [ 48 ].

There is heterogeneity in the terminology and definitions used to describe quasi-experimental designs, but we will do our best to categorize studies into the above groups based on their designs, identification strategies, and assumptions.

Our focus is on quasi-experimental research because we are interested in studies evaluating the effect of population-level interventions (i.e., abortion law reform) with a design that permits inference regarding the causal effect of abortion legislation, which is not possible from other types of observational designs such as cross-sectional studies, cohort studies or case-control studies that lack an identification strategy for addressing sources of unmeasured confounding (e.g., secular trends in outcomes). We are not excluding randomized studies such as randomized controlled trials, cluster randomized trials, or stepped-wedge cluster-randomized trials; however, we do not expect to identify any relevant randomized studies given that abortion policy is unlikely to be randomly assigned. Since our objective is to provide a summary of empirical studies reporting primary research, reviews/meta-analyses, qualitative studies, editorials, letters, book reviews, correspondence, and case reports/studies will also be excluded.

Our population of interest includes women of reproductive age (15–49 years) residing in LMICs, as the policy exposure of interest applies primarily to women who have a demand for sexual and reproductive health services including abortion.

Intervention

The intervention in this study refers to a change in abortion law or policy, either from a restrictive policy to a non-restrictive or less restrictive one, or vice versa. This can, for example, include a change from abortion prohibition in all circumstances to abortion permissible in other circumstances, such as to save the woman’s life, to preserve the woman’s health, in cases of rape, incest, fetal impairment, for economic or social reasons, or on request with no requirement for justification. It can also include the abolition of existing abortion policies or the introduction of new policies including those occurring outside the penal code, which also have legal standing, such as:

National constitutions;
Supreme court decisions, as well as higher court decisions;
Customary or religious law, such as interpretations of Muslim law;
Medical ethical codes; and
Regulatory standards and guidelines governing the provision of abortion.

We will also consider national and sub-national reforms, although we anticipate that most reforms will operate at the national level.

The comparison group represents the counterfactual scenario, specifically the level and/or trend of a particular post-intervention outcome in the treated jurisdiction that experienced an abortion law reform had it, counter to the fact, not experienced this specific intervention. Comparison groups will vary depending on the type of quasi-experimental design. These may include outcome trends after abortion reform in the same country, as in the case of an interrupted time series design without a control group, or corresponding trends in countries that did not experience a change in abortion law, as in the case of the difference-in-differences design.

Outcome measures

Primary outcomes.

Access to abortion services: There is no consensus on how to measure access but we will use the following indicators, based on the relevant literature [ 49 ]: [ 1 ] the availability of trained staff to provide care, [ 2 ] facilities are geographically accessible such as distance to providers, [ 3 ] essential equipment, supplies and medications, [ 4 ] services provided regardless of woman’s ability to pay, [ 5 ] all aspects of abortion care are explained to women, [ 6 ] whether staff offer respectful care, [ 7 ] if staff work to ensure privacy, [ 8 ] if high-quality, supportive counseling is provided, [ 9 ] if services are offered in a timely manner, and [ 10 ] if women have the opportunity to express concerns, ask questions, and receive answers.
Use of abortion services refers to induced pregnancy termination, including medication abortion and number of women treated for abortion-related complications.

Secondary outcomes

Current use of any method of contraception refers to women of reproductive age currently using any method contraceptive method.
Future use of contraception refers to women of reproductive age who are not currently using contraception but intend to do so in the future.
Demand for family planning refers to women of reproductive age who are currently using, or whose sexual partner is currently using, at least one contraceptive method.
Unmet need for family planning refers to women of reproductive age who want to stop or delay childbearing but are not using any method of contraception.
Fertility rate refers to the average number of children born to women of childbearing age.
Neonatal morbidity and mortality refer to disability or death of newborn babies within the first 28 days of life.
Maternal morbidity and mortality refer to disability or death due to complications from pregnancy or childbirth.

There will be no language, date, or year restrictions on studies included in this systematic review.

Studies have to be conducted in a low- and middle-income country. We will use the country classification specified in the World Bank Data Catalogue to identify LMICs (Additional file 2 ).

Search methods

We will perform searches for eligible peer-reviewed studies in the following electronic databases.

Ovid MEDLINE(R) (from 1946 to present)
Embase Classic+Embase on OvidSP (from 1947 to present)
CINAHL (1973 to present); and
Web of Science (1900 to present)

The reference list of included studies will be hand searched for additional potentially relevant citations. Additionally, a grey literature search for reports or working papers will be done with the help of Google and Social Science Research Network (SSRN).

Search strategy

A search strategy, based on the eligibility criteria and combining subject indexing terms (i.e., MeSH) and free-text search terms in the title and abstract fields, will be developed for each electronic database. The search strategy will combine terms related to the interventions of interest (i.e., abortion law/policy), etiology (i.e., impact/effect), and context (i.e., LMICs) and will be developed with the help of a subject matter librarian. We opted not to specify outcomes in the search strategy in order to maximize the sensitivity of our search. See Additional file 3 for a draft of our search strategy.

Data collection and analysis

Data management.

Search results from all databases will be imported into Endnote reference manager software (Version X9, Clarivate Analytics) where duplicate records will be identified and excluded using a systematic, rigorous, and reproducible method that utilizes a sequential combination of fields including author, year, title, journal, and pages. Rayyan systematic review software will be used to manage records throughout the review [ 50 ].

Selection process

Two review authors will screen titles and abstracts and apply the eligibility criteria to select studies for full-text review. Reference lists of any relevant articles identified will be screened to ensure no primary research studies are missed. Studies in a language different from English will be translated by collaborators who are fluent in the particular language. If no such expertise is identified, we will use Google Translate [ 51 ]. Full text versions of potentially relevant articles will be retrieved and assessed for inclusion based on study eligibility criteria. Discrepancies will be resolved by consensus or will involve a third reviewer as an arbitrator. The selection of studies, as well as reasons for exclusions of potentially eligible studies, will be described using a PRISMA flow chart.

Data extraction

Data extraction will be independently undertaken by two authors. At the conclusion of data extraction, these two authors will meet with the third author to resolve any discrepancies. A piloted standardized extraction form will be used to extract the following information: authors, date of publication, country of study, aim of study, policy reform year, type of policy reform, data source (surveys, medical records), years compared (before and after the reform), comparators (over time or between groups), participant characteristics (age, socioeconomic status), primary and secondary outcomes, evaluation design, methods used for statistical analysis (regression), estimates reported (means, rates, proportion), information to assess risk of bias (sensitivity analyses), sources of funding, and any potential conflicts of interest.

Risk of bias and quality assessment

Two independent reviewers with content and methodological expertise in methods for policy evaluation will assess the methodological quality of included studies using the quasi-experimental study designs series risk of bias checklist [ 52 ]. This checklist provides a list of criteria for grading the quality of quasi-experimental studies that relate directly to the intrinsic strength of the studies in inferring causality. These include [ 1 ] relevant comparison, [ 2 ] number of times outcome assessments were available, [ 3 ] intervention effect estimated by changes over time for the same or different groups, [ 4 ] control of confounding, [ 5 ] how groups of individuals or clusters were formed (time or location differences), and [ 6 ] assessment of outcome variables. Each of the following domains will be assigned a “yes,” “no,” or “possibly” bias classification. Any discrepancies will be resolved by consensus or a third reviewer with expertise in review methodology if required.

Confidence in cumulative evidence

The strength of the body of evidence will be assessed using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system [ 53 ].

Data synthesis

We anticipate that risk of bias and heterogeneity in the studies included may preclude the use of meta-analyses to describe pooled effects. This may necessitate the presentation of our main findings through a narrative description. We will synthesize the findings from the included articles according to the following key headings:

Information on the differential aspects of the abortion policy reforms.
Information on the types of study design used to assess the impact of policy reforms.
Information on main effects of abortion law reforms on primary and secondary outcomes of interest.
Information on heterogeneity in the results that might be due to differences in study designs, individual-level characteristics, and contextual factors.

Potential meta-analysis

If outcomes are reported consistently across studies, we will construct forest plots and synthesize effect estimates using meta-analysis. Statistical heterogeneity will be assessed using the I 2 test where I 2 values over 50% indicate moderate to high heterogeneity [ 54 ]. If studies are sufficiently homogenous, we will use fixed effects. However, if there is evidence of heterogeneity, a random effects model will be adopted. Summary measures, including risk ratios or differences or prevalence ratios or differences will be calculated, along with 95% confidence intervals (CI).

Analysis of subgroups

If there are sufficient numbers of included studies, we will perform sub-group analyses according to type of policy reform, geographical location and type of participant characteristics such as age groups, socioeconomic status, urban/rural status, education, or marital status to examine the evidence for heterogeneous effects of abortion laws.

Sensitivity analysis

Sensitivity analyses will be conducted if there are major differences in quality of the included articles to explore the influence of risk of bias on effect estimates.

Meta-biases

If available, studies will be compared to protocols and registers to identify potential reporting bias within studies. If appropriate and there are a sufficient number of studies included, funnel plots will be generated to determine potential publication bias.

This systematic review will synthesize current evidence on the impact of abortion law reforms on women’s health. It aims to identify which legislative reforms are effective, for which population sub-groups, and under which conditions.

Potential limitations may include the low quality of included studies as a result of suboptimal study design, invalid assumptions, lack of sensitivity analysis, imprecision of estimates, variability in results, missing data, and poor outcome measurements. Our review may also include a limited number of articles because we opted to focus on evidence from quasi-experimental study design due to the causal nature of the research question under review. Nonetheless, we will synthesize the literature, provide a critical evaluation of the quality of the evidence and discuss the potential effects of any limitations to our overall conclusions. Protocol amendments will be recorded and dated using the registration for this review on PROSPERO. We will also describe any amendments in our final manuscript.

Synthesizing available evidence on the impact of abortion law reforms represents an important step towards building our knowledge base regarding how abortion law reforms affect women’s health services and health outcomes; we will provide evidence on emerging strategies to influence policy reforms, implement abortion services, and scale up accessibility. This review will be of interest to service providers, policy makers and researchers seeking to improve women’s access to safe abortion around the world.

Acknowledgements

We thank Genevieve Gore, Liaison Librarian at McGill University, for her assistance with refining the research question, keywords, and Mesh terms for the preliminary search strategy.

Abbreviations

CINAHL	Cumulative index to nursing and allied health literature
EMBASE	Excerpta medica database
LMICs	Low- and middle-income countries
PRISMA-P	Preferred reporting items for systematic review and meta-analysis protocols
PROSPERO	International prospective register of systematic reviews

Authors’ contributions

FI and AN conceived and designed the protocol. FI drafted the manuscript. FI, UVU, and AN revised the manuscript and approved its final version.

The authors acknowledge funding from the Fonds de recherche du Quebec – Santé (FRQS) PhD doctoral awards and Canadian Institutes of Health Research (CIHR) Operating Grant, “Examining the impact of social policies on health equity” (ROH-115209).

Declarations

Not applicable

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Contributor Information

Foluso Ishola, Email: [email protected] .

U. Vivian Ukah, Email: [email protected] .

Arijit Nandi, Email: [email protected] .

Health | Costs and desperation are up, donations are…

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Health | election results: florida primary and central florida races, health | costs and desperation are up, donations are running low as more florida women travel for abortion services.

Darlington Medical Associates, a 10-minute drive from the island’s airport, is experiencing the impact of Florida’s six-week abortion ban.

“We are the only clinic in Puerto Rico and the Caribbean that provides abortion service up to 24 weeks,” says Johana Molina, social worker/office manager for Darlington Medical Associates. “After Roe v. Wade was overturned, our travel patients increased a lot, but after May 1, when the six-week ban went into effect, we started to receive many more patients from Florida.”

Several times a day, Molina fields phone calls from patient navigators and organizations in Florida called abortion funds, scrambling to help women secure appointments.

“A lot of organizations send women here because it’s cheaper, it’s more friendly,” Molina says.

Florida was once a safe haven for abortion care, even in the year after the Supreme Court’s Dobbs decision that overturned Roe v. Wade. But nearly half of the country has abortion restrictions in place now, and as of May 1, Florida has one of the most limiting — a six-week ban and a 24-hour waiting period between a consent visit and a procedure.

Florida abortion providers say a regular part of their daily routine has become turning away patients too far along in pregnancy to get care in the state and connecting them to resources to travel to end their pregnancies.

In the two months after Florida’s ban went into effect, the state saw a 575% increase in people looking to travel out of state for abortions, according to National Abortion Federation data . Florida women join thousands of others nationwide each month from states with bans or restrictions, desperate for appointments at the same overburdened clinics in less restrictive states like Virginia, Illinois, and North Carolina.

Darlington Medical Associates in Puerto Rico sees more patients from Florida after the 6-week abortion ban went into effect. (Courtesy of Darlington Medical Associates)

In 2023, more than 166,000 U.S. abortion patients traveled to other states to obtain care, double the number who did so in 2020 before multiple state abortion bans went into effect, according to the Guttmacher Institute, a sexual and reproductive health and rights organization.

The demand has created a ripple effect: The cost of abortion care is rising, wait times for out-of-state appointments are longer, and organizations that pitch in to help cover travel costs must divvy their funding among more women.

“Last year, we were able to help with 50% of appointment costs for eligible clients, and now that’s dropped to 30%,” says Kamila Przytuła, executive director of Women’s Emergency Network in Miami. “We have had to cap our support per person at $1,000 max. So now we partner with other funds in our state. One will pay for hotel costs, another for child care or airfare, and another for clinic services. There’s a collective effort in pooling resources.”

How the scramble plays out

Often, abortion seekers can’t afford to pay the travel costs themselves, barely scraping up enough to pay for the actual procedure. An estimated 73% of abortion seekers in 2022 had incomes under the poverty line, according to a recent Guttmacher Institute study.

When her birth control method failed, Marie, a fast-food worker, emptied her bank account and then borrowed from a friend to get an abortion. But by the time she collected the $600 fee, she arrived at a Broward abortion clinic too late. A sonogram showed she had surpassed her sixth week of pregnancy by just a few days.

Already struggling to keep her job and take community college classes, she would need to travel to a state where the legal limits extend beyond Florida’s six-week limit, lose a day’s pay and incur travel costs. “I can’t pay for that,” she told a clinic assistant.

The South Florida Sun Sentinel is identifying Marie by only her first name to protect her.

Five Florida-based organizations — and a few national funds — have jumped in to help women like Marie afford travel. They pay for plane tickets, gas money, meals and hotel costs, rides to and from the airport or bus station, and child care when a mother travels. Getting each woman’s costs covered takes much more coordination and cooperation among organizations than it did just a year ago.

State and national abortion funds received an initial outpouring of donations after the Dobbs decision ended federal abortion rights, but contributions have since tapered off while demand is at an all-time high.

“There is not a single organization that’s not strained for resources because of how massive the need is in Florida,” Przytuła said.

Florida women are travelling to Darlington Medical Associates in San Juan, Puerto Rico, for abortion care. (Photo Courtesy of Darlington Medical Associates)

The increasing price of an abortion

Meanwhile, the finances of abortion services have become increasingly complicated: The price of an abortion and the risk for complications rise by trimester and number of weeks of pregnancy. With so many people traveling hundreds or thousands of miles to seek abortion care, it can take a week or more to get an appointment at an out-of-state clinic, which means pregnancies may progress to a more advanced stage and the cost balloons further. The total cost to travel for an abortion could be as high as $20,000 for someone in the third trimester.

“Every clinic has its own price structure,” says Elizabeth Londono, a patient navigator for Planned Parenthood of South, East and North Florida . “Some are much more expensive than others.”

The rising cost of airfare, hotel stays, and meals must be considered, too. The Brigid Alliance , which provides logistical support to people seeking abortion care, estimates that the average cost of traveling for care has increased 41% since the first half of 2022, when it was just over $1,000.

At the same time, the price of surgical and medication abortions in Florida, particularly at independent clinics, also has increased as they struggle to pay their bills and stay open. Most Florida clinics charge on average $700 to $800, up from $500. A smaller clinic in West Palm Beach now charges $1,100. “That’s a big financial ask on such a short timeline,” notes McKenna Kelley with the Tampa Bay Abortion Fund .

Shock, frustration, anger, desperation: The real-life toll of Florida’s six-week abortion ban

The barriers are more than money

In the rural and urban areas of Florida, the challenges to getting an abortion are more than just monetary. Life circumstances often put women in a difficult position as they contemplate options.

At a Miami abortion clinic recently, a doctor told Maria that her ultrasound showed she was seven weeks, two days into her pregnancy.

“You are going to need to leave Florida if you want to end the pregnancy,” the doctor explains in Spanish.

Nicaraguan-born, Maria replies that she has no family in the U.S. She has two children, 7 and 14, and lives with a friend. Two months ago, she lost her job. She tells the doctor she is upset and scared. “I need to make this go away as soon as possible,” she says.

The Sun Sentinel agreed to Maria’s request to withhold her last name.

Later that day, Maria spoke with a patient navigator and learned about the lengthy wait list for appointments at out-of-state clinics. The navigator said she would work on getting Maria an appointment in North Carolina and making travel arrangements, setting in motion the same scramble going on in nearly half the states in the country.

Some women are waiting up to four weeks for an appointment, says Serra Sippel, interim executive director of The Brigid Alliance , a national organization that helps more than 130 clients a month with travel costs for abortion care. “Delayed care is a serious impact of bans.”

It’s that scramble that has led more Floridians to Puerto Rico. Molina at Darlington Medical Associates said her clinic has become a draw for Florida women, particularly Spanish-speaking ones. It is one of four clinics on the island and the only one that offers services in the second trimester. Molina said Florida women often travel roundtrip to her clinic on the same day.

“Yesterday, we received three patients from Florida,” Molina says. “One was very anxious because she had just started a new job and thought she could lose her job if she missed work. She was desperate to return to Florida, and we counseled her that we strongly recommended that she stay one night after her procedure, but some people can’t take so much time off.”

Molina said Darlington also draws cruise workers who previously may have gone to a Florida clinic while in port. They typically make a telemedicine appointment and then pick up the abortion medication at Darlington when their ship docks in the Puerto Rico port.

Inside Darlington Medical Associates, an abortion clinic in San Juan, Puerto Rico, where Florida women are traveling to for abortion care.

The fear of travel

In Palm Beach County, Jessica Hatem, executive director of Emergency Medical Assistance, says some of her clients have never flown before or even left the state and are anxious about it.

That makes Puerto Rico an appealing option, Hatem says: “A direct flight is key so there is not a second airport to navigate. Puerto Rico is only two hours away, and there is no layover,”

Hatem said the amount of coordination required is staggering. “These women don’t work jobs that give paid time off. They don’t have childcare … It’s much more than just the financial piece,” she says.

When thousands of flights were canceled or delayed last month because of a global tech outage, Przytuła worked the phones at the Women’s Emergency Network.

A fear-stricken yet desperate South Florida woman choosing to travel for abortion care had boarded a plane for the first time in her life. Her child care, rideshare, and hotel costs were covered by abortion fund organizations that serve Florida women. The pooled monies were enough for a one-night hotel stay, not two or three. Stuck in Atlanta on a layover, the woman repeatedly asked Pryztula: “Who’s going to stay with my kids?”

Pryztula urged the woman to stay calm, assuring her she was working to get the woman back to Florida. It took her four days to get home.

The woman’s plight illustrates the challenge of requiring women to travel for health care, Prztula said. “If one thing goes wrong for these women, it can create a negative domino effect.”

Pills by phone?

In lieu of travel, some Florida women opt for telemedicine appointments with out-of-state doctors who will prescribe and mail abortion pills. Others will turn to online vendors. Taking pills at home is medically safe, but legally risky in Florida, which explicitly bans abortion by telemedicine.

In November, Floridians will weigh in on whether to amend the state constitution to protect abortion rights, a measure that requires 60% voter approval . If approved, women would have the right to an abortion in Florida up until viability, which is about 24 weeks.

“Fewer people would need to leave the state,” Hatem says. “It would be much less disruption to their lives.”

South Florida Sun Sentinel health reporter Cindy Goodman can be reached at [email protected].

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Pro-Choice Does Not Mean Pro-Abortion: An Argument for Abortion Rights Featuring the Rev. Carlton Veazey

Since the Supreme Court’s historic 1973 decision in Roe v. Wade , the issue of a woman’s right to an abortion has fostered one of the most contentious moral and political debates in America. Opponents of abortion rights argue that life begins at conception – making abortion tantamount to homicide. Abortion rights advocates, in contrast, maintain that women have a right to decide what happens to their bodies – sometimes without any restrictions.

To explore the case for abortion rights, the Pew Forum turns to the Rev. Carlton W. Veazey, who for more than a decade has been president of the Religious Coalition for Reproductive Choice. Based in Washington, D.C., the coalition advocates for reproductive choice and religious freedom on behalf of about 40 religious groups and organizations. Prior to joining the coalition, Veazey spent 33 years as a pastor at Zion Baptist Church in Washington, D.C.

A counterargument explaining the case against abortion rights is made by the Rev. J. Daniel Mindling, professor of moral theology at Mount St. Mary’s Seminary.

Featuring: The Rev. Carlton W. Veazey, President, Religious Coalition for Reproductive Choice

Interviewer: David Masci, Senior Research Fellow, Pew Forum on Religion & Public Life

Question & Answer

Can you explain how your Christian faith informs your views in support of abortion rights?

I grew up in a Christian home. My father was a Baptist minister for many years in Memphis, Tenn. One of the things that he instilled in me – I used to hear it so much – was free will, free will, free will. It was ingrained in me that you have the ability to make choices. You have the ability to decide what you want to do. You are responsible for your decisions, but God has given you that responsibility, that option to make decisions.

I had firsthand experience of seeing black women and poor women being disproportionately impacted by the fact that they had no choices about an unintended pregnancy, even if it would damage their health or cause great hardship in their family. And I remember some of them being maimed in back-alley abortions; some of them died. There was no legal choice before Roe v. Wade .

But in this day and time, we have a clearer understanding that men and women are moral agents and equipped to make decisions about even the most difficult and complex matters. We must ensure a woman can determine when and whether to have children according to her own conscience and religious beliefs and without governmental interference or coercion. We must also ensure that women have the resources to have a healthy, safe pregnancy, if that is their decision, and that women and families have the resources to raise a child with security.

The right to choose has changed and expanded over the years since Roe v. Wade . We now speak of reproductive justice – and that includes comprehensive sex education, family planning and contraception, adequate medical care, a safe environment, the ability to continue a pregnancy and the resources that make that choice possible. That is my moral framework.

You talk about free will, and as a Christian you believe in free will. But you also said that God gave us free will and gave us the opportunity to make right and wrong choices. Why do you believe that abortion can, at least in some instances, be the right choice?

Dan Maguire, a former Jesuit priest and professor of moral theology and ethics at Marquette University, says that to have a child can be a sacred choice, but to not have a child can also be a sacred choice.

And these choices revolve around circumstances and issues – like whether a person is old enough to care for a child or whether a woman already has more children than she can care for. Also, remember that medical circumstances are the reason many women have an abortion – for example, if they are having chemotherapy for cancer or have a life-threatening chronic illness – and most later-term abortions occur because of fetal abnormalities that will result in stillbirth or the death of the child. These are difficult decisions; they’re moral decisions, sometimes requiring a woman to decide if she will risk her life for a pregnancy.

Abortion is a very serious decision and each decision depends on circumstances. That’s why I tell people: I am not pro-abortion, I am pro-choice. And that’s an important distinction.

You’ve talked about the right of a woman to make a choice. Does the fetus have any rights?

First, let me say that the religious, pro-choice position is based on respect for human life, including potential life and existing life.

But I do not believe that life as we know it starts at conception. I am troubled by the implications of a fetus having legal rights because that could pit the fetus against the woman carrying the fetus; for example, if the woman needed a medical procedure, the law could require the fetus to be considered separately and equally.

From a religious perspective, it’s more important to consider the moral issues involved in making a decision about abortion. Also, it’s important to remember that religious traditions have very different ideas about the status of the fetus. Roman Catholic doctrine regards a fertilized egg as a human being. Judaism holds that life begins with the first breath.

What about at the very end of a woman’s pregnancy? Does a fetus acquire rights after the point of viability, when it can survive outside the womb? Or let me ask it another way: Assuming a woman is healthy and her fetus is healthy, should the woman be able to terminate her pregnancy until the end of her pregnancy?

There’s an assumption that a woman would end a viable pregnancy carelessly or without a reason. The facts don’t bear this out. Most abortions are performed in the first 12 weeks of pregnancy. Late abortions are virtually always performed for the most serious medical and health reasons, including saving the woman’s life.

But what if such a case came before you? If you were that woman’s pastor, what would you say?

I would talk to her in a helpful, positive, respectful way and help her discuss what was troubling her. I would suggest alternatives such as adoption.

Let me shift gears a little bit. Many Americans have said they favor a compromise, or reaching a middle-ground policy, on abortion. Do you sympathize with this desire and do you think that both sides should compromise to end this rancorous debate?

I have been to more middle-ground and common-ground meetings than I can remember and I’ve never been to one where we walked out with any decision.

That being said, I think that we all should agree that abortion should be rare. How do we do that? We do that by providing comprehensive sex education in schools and in religious congregations and by ensuring that there is accurate information about contraception and that contraception is available. Unfortunately, the U.S. Congress has not been willing to pass a bill to fund comprehensive sex education, but they are willing to put a lot of money into failed and harmful abstinence-only programs that often rely on scare tactics and inaccurate information.

Former Surgeon General David Satcher has shown that abstinence-only programs do not work and that we should provide young people with the information to protect themselves. Education that stresses abstinence and provides accurate information about contraception will reduce the abortion rate. That is the ground that I stand on. I would say that here is a way we can work together to reduce the need for abortions.

Abortion has become central to what many people call the “culture wars.” Some consider it to be the most contentious moral issue in America today. Why do many Catholics, evangelical Christians and other people of faith disagree with you?

I was raised to respect differing views so the rigid views against abortion are hard for me to understand. I will often tell someone on the other side, “I respect you. I may disagree with your theological perspective, but I respect your views. But I think it’s totally arrogant for you to tell me that I need to believe what you believe.” It’s not that I think we should not try to win each other over. But we have to respect people’s different religious beliefs.

But what about people who believe that life begins at conception and that terminating a pregnancy is murder? For them, it may not just be about respecting or tolerating each other’s viewpoints; they believe this is an issue of life or death. What do you say to people who make that kind of argument?

I would say that they have a right to their beliefs, as do I. I would try to explain that my views are grounded in my religion, as are theirs. I believe that we must ensure that women are treated with dignity and respect and that women are able to follow the dictates of their conscience – and that includes their reproductive decisions. Ultimately, it is the government’s responsibility to ensure that women have the ability to make decisions of conscience and have access to reproductive health services.

Some in the anti-abortion camp contend that the existence of legalized abortion is a sign of the self-centeredness and selfishness of our age. Is there any validity to this view?

Although abortion is a very difficult decision, it can be the most responsible decision a person can make when faced with an unintended pregnancy or a pregnancy that will have serious health consequences.

Depending on the circumstances, it might be selfish to bring a child into the world. You know, a lot of people say, “You must bring this child into the world.” They are 100 percent supportive while the child is in the womb. As soon as the child is born, they abort the child in other ways. They abort a child through lack of health care, lack of education, lack of housing, and through poverty, which can drive a child into drugs or the criminal justice system.

So is it selfish to bring children into the world and not care for them? I think the other side can be very selfish by neglecting the children we have already. For all practical purposes, children whom we are neglecting are being aborted.

This transcript has been edited for clarity, spelling and grammar.

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Legalized Abortion and the Public Health: Report of a Study (1975)

Chapter: summary and conclusions.

Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

SUMMARY AND CONCLUSIONS The legal status of abortion in the United States became a heightened national issue with the January 1973 rulings by the Supreme Court that severely limited states' rights to control the procedure. The Court's decisions on the historic cases of Roe v. Wade and Doe v. Bolton precluded any state interference with the doctor-patient decision on abortion during the first trimester (three months) of pregnancy. During the second trimester, a state could intervene only to the extent of insisting on safe medical practices "reasonably related to maternal health." And for approximately the final trimester of a pregnancyâwhat the Court called "the state subsequent to viability" of a fetusâa state could forbid abortion unless medical judgment found it necessary "for the preservation of the life or health of the mother." The rulings crystallized opposition to abortion, led to the intro- duction of national and state legislation to curtail or prohibit it, and generated political pressures for a national debate on the issue. Against this background of concerns about abortion, the Institute of Medicine in 1974 called together a committee to review the existing evidence on the relationship between legalized abortion and the health of the public. The study group was asked to examine the medical risks to women who obtained legal abortions, and to document changes in the risks as legal abortion became more available. Although there have been other publications on particular relationships between abortion and health, the Institute's study is an attempt to enlist scholars, researchers, health practitioners, and concerned lay persons in a more comprehensive analysis of the available medical information on the subject. Ethical issues of abortion are not discussed in this analysis, nor are questions concerning the fetus in abortion. The study group recog- nizes that this approach implies an ethical position with which some may disagree. The emphasis of the study is on the health effects of abortion, not on the alternatives to abortion.

Abortion legislation and practices are important factors in the relationship between abortion and health status. In order to examine legislation and court decisions that have affected the availability of legal abortion in the U.S., the study group classified the laws and practices into three categories: restrictive conditions, under which abortion is prohibited or permitted only to save the pregnant woman's life; moderately restrictive conditions, under which abortion is per- mitted with approval by several physicians, in a wider range of circumstances to preserve the woman's physical or mental health, prevent the birth of a child with severe genetic or congenital defects, or terminate a pregnancy caused by rape or incest; and non-restrictive conditions, under which abortion essentially is available according to the terms of the Supreme Court ruling. Before 1967, all abortion laws in the United States could be classified as restrictive. Easing of restrictions began in 1967 with Colorado, and soon thereafter 12 other states also adopted moderately restrictive legislation to expand the conditions under which therapeutic abortion could be obtained. In 1970, four states (Alaska, Hawaii, New York, and Washington) removed nearly all legal controls on abortion. Non-restrictive conditions have theoretically existed throughout all fifty states since January 22, 1973, the date of the Supreme Court decision. There is evidence that substantial numbers of illegal abortions were obtained in the U.S. when restrictive laws were in force. Although some of the illegal abortions were performed covertly by physicians in medical settings, many were conducted in unsanitary surroundings by unskilled operators or were self-induced. In this report, "illegal abortion" generally refers to those performed by a non-physician or the woman herself. The medical risks associated with the last two types of illegal abortions are patently greater than with the first. A recent analysis of data from the first year of New York's non- restrictive abortion legislation indicates that approximately 70 percent of the abortions obtained legally in New York City would otherwise have been obtained illegally. Replacement of legal for illegal abortions also is reflected in the substantial decline in the number of reported complications and deaths due to other-than-legal abortions since non- restrictive practices began to be implemented in the United States. The number of all known abortion-related deaths declined from 128 in 1970 to 47 in 1973; those deaths specifically attributed to other-than-legal abortions (i.e., both illegal and spontaneous) dropped from 111 to 25 during the same period, with much of that decline attributed to a reduced incidence of illegal abortions. Increased use of effective con- traception may also have played a role in the decline of abortion-related deaths. Methods most frequently used in the United States to induce abortion during the first trimester of pregnancy are suction (vacuum aspiration) or dilatation and curettage (D&C). Abortions in the second trimester are usually performed by replacing part of the amniotic fluid that surrounds

the fetus with a concentrated salt solution (saline abortion), which usually induces labor 24 to 48 hours later. Other second trimester methods are hysterotomy, a surgical entry into the uterus; hysterectomy, which is the removal of the uterus; and, recently, the injection into the uterine cavity of a prostaglandin, a substance that causes muscular contractions that expel the fetus. Statistics on legal abortion are collected for the U.S. government by the Center for Disease Control. CDC's most recent nationwide data are for 1973, the year of the Supreme Court decision. Some of those figures are: â The 615,800 legal abortions reported in 1973 were an increase of approximately 29,000 over the number reported in 1972. These probably are underestimates of the actual number of abortions performed because some states have not yet developed adequate abortion reporting systems. â The abortion ratio (number of abortions per 1,000 live births) increased from 180 in 1972 to 195 in 1973. â More than four out of five abortions were performed in the first trimester, most often by suction or D&C. â Approximately 25 percent of the reported 1973 abortions were obtained outside the woman's home state. In 1972, before the Supreme Court decision, 44 percent of the reported abortions had been obtained outside the home state of the patient, primarily in New York and the District of Columbia. â Approximately one-third of the women obtaining abortions were less than 20 years old, another third were between 20 and 25, and the remaining third over 25 years of age. â In all states where data were available, about 25 percent of the women obtaining abortions were married. â White women obtained 68 percent of all reported abortions, but non-white women had abortion ratios about one-third greater than white women. In 1972, non-white women had abortion rates (abortions per 1,000 women of reproductive age) about twice those of whites in three states from which data were available to analyze. A national survey of hospitals, clinics, and physicians conducted in 1974 by The Alan Guttmacher Institute furnished data on the number of abortions performed in the U.S. during 1973, itemized by state and type of provider. A total of 745,400 abortions were reported in the survey, a figure higher than the 615,800 abortions reported in 1973 to CDC. The Guttmacher Institute obtains its data from providers of health services, while CDC gets most of its data from state health departments.

Risks of medical complications associated with legal abortions are difficult to evaluate because of problems of definition and subjective physician judgment. Available information from 66 centers is provided by the Joint Program for the Study of Abortion, undertaken by The Population Council in 1970-1971. The JPSA study surveyed almost 73,000 legal abortions. It used a restricted definition of major complications, which included unintended major surgery, one or more blood transfusions, three or more days of fever, and several other categories involving prolonged illness or permanent impairment. Although this study also collected data on minor complica- tions, such as one day of fever post-operatively, the data on major com- plications are probably more significant. The major complication rates published by the JPSA study and summarized below relate to women who had abortions in local facilities and from whom follow-up information was obtained. â Complications in women not obtaining concurrent sterilization and with no pre-existing medical problems (e.g., diabetes, heart disease, or gynecological problems) occurred 0.6 times per 100 abortions in the first trimester and 2.1 per 100 in the second trimester. â Complications in women not obtaining concurrent sterilization, but having pre-existing problems, occurred 2.0 times per 100 in the first trimester and 6.7 in the second. â Complications in women obtaining concurrent sterilization and not having pre-existing problems occurred 7.2 times per 100 in the first trimester and 8.0 in the second. â Women with both concurrent sterilization and pre-existing problems experienced complications approximately 17 times per 100 abortions regardless of trimester. The relatively high complication rates associated with sterilization in the JPSA study would probably be lower today because new sterilization techniques require minimal surgery and carry lower rates of complications. The frequency of medical complications due to illegal abortions cannot be calculated precisely, but the trend in these complications can be estimated from the number of hospital admissions due to septic and incomplete abortionâtwo adverse consequences of the illegal procedure.

The number of such admissions in New York City's municipal hospitals declined from 6,524 in 1969 to 3,253 in 1973; most restrictions on legal abortion in New York City were lifted in July of 1970. In Los Angeles, the number of reported hospital admissions for septic abortions declined from 559 in 1969 to 119 in 1971. Other factors, such as an increased use of effective contraception and a decreasing rate of unwanted pregnancies may have contributed to these declines, but it is probable that the introduction of less restrictive abortion legislation was a major factor. There has not been enough experience with legal abortion in the U.S. for conclusions to be drawn about long-term complications, particularly for women obtaining repeated legal abortions. Some studies from abroad suggest that long-term complications may include prematurity, miscarriage, or ectopic pregnancies in future pregnancies, or infertility. But research findings from countries having long experience with legal abortion are inconsistent among studies and the relevance of these data to the U.S. is not known; methods of abortion, medical services, and socio-economic characteristics vary from one country to another. Risks of maternal death associated with legal abortion are lowâ1.7 deaths per 100,000 first trimester procedures in 1972 and 1973âand less than the risks associated with illegal abortion, full-term pregnancy, and most surgical procedures. The 1973 mortality rate for a full-term pregnancy was 14 deaths per 100,000 live vaginal deliveries; the 1969 rate for cesarean sections was 111 deaths per 100,000 deliveries. For second trimester abortions, the combined 1972-73 mortality ratio was 12.2 deaths per 100,000 abortions. (For comparison, the surgical removal of the tonsils and adenoids had a mortality risk of five deaths per 100,000 operations in 1969). When the mortality risk of legal abortion is examined by length of gestation it becomes apparent that the mortality risks increase not only from the first to the second trimester, but also by each week of ges- tation. For example, during 1972-73, the mortality ratio for legal abortions performed at eight weeks or less was 0.5, and for those performed between nine and 10 weeks was 1.7 deaths per 100,000 legal abortions. At 11 to 12 weeks the mortality ratio increased to 4.2 deaths, and by 16 to 20 weeks, the ratio was more than 17 deaths per 100,000 abortions. Hysterotomy and hysterectomy, methods performed infrequently in both trimesters, had a combined mortality ratio of 61.3 deaths per 100,000 procedures. Some data on the mortality associated with illegal abortion are avail- lable from the National Center for Health Statistics (NCHS) and from CDC. In 1961 there were 320 abortion-related deaths reported in the U.S., most of them presumed by the medical profession to be from illegal abortion. By 1973, total reported deaths had declined to 47, of which 16 were specifi- cally attributed to illegal abortions. There has been a steady decline in the mortality rates (number of deaths per 100,000 women aged 15-44) associated with other-than-legal abortion for both white and non-white women, but in 1973 the mortality rate for non-white women (0.29) was almost ten times greater than that reported for white women (0.03).

Psychological effects of legal abortion are difficult to evaluate for reasons that include lack of information on pre-abortion psychological status, ambiguous terminology, and the absence of standardized measurements. The cumulative evidence in recent years indicates that although it may be a stressful experience, abortion is not associated with any detectable increase in the incidence of mental illness. The depression or guilt feelings reported by some women following abortion are generally described as mild and temporary. This experience, however, does not necessarily apply to women with a previous history of psychiatric illness; for them, abortion may be followed by continued or aggravated mental illness. The JPSA survey led to an estimate of the incidence of post-abortion psychosis ranging from 0.2 to 0.4 per 1,000 legal abortions. This is lower than the post-partum psychosis rate of one to two per 1,000 deliveries in the United States. Psychological factors also bear on whether a woman obtains a first or second-trimester abortion. Two studies in particular suggest that women who delay abortion into the later period may have more feelings of ambiva- lence, denial of the pregnancy, or objection on religious grounds, than those obtaining abortions in the first trimester. It is also apparent, however, that some second-trimester abortions result from procedural delays, difficulties in obtaining a pregnancy test, locating appropriate counseling, or arranging and financing the procedure. Diagnosis of severe defects of a fetus well before birth has greatly advanced in the past decade. Developments in the techniques of amniocen- tesis and cell culture have enabled a number of genetic defects and other congenital disorders to be detected in the second trimester of pregnancy. Prenatal diagnosis and the opportunity to terminate an affected pregnancy by a legal abortion may help many women who would have refrained from becoming pregnant or might have given birth to an abnormal child, to bear children unaffected by the disease they fear. Abortion, with or with- out prenatal diagnosis, also can be used in instances where there is reasonable risk that the fetus may be affected by birth defects from non-genetic causes, such as those caused by exposure of the woman to rubella virus infection or x-rays, or by her ingestion of drugs known to damage the fetus. Almost 60 inherited metabolic disorders, such as Tay-Sachs disease, potentially can be diagnosed before birth. More than 20 of these diseases already have been diagnosed with reasonaable accuracy by means of amniocentesis and other procedures. The techniques also can be used to identify a fetus with abnormal chromosomes, as in Down's syndrome (mongolism), and to discriminate between male and female fetuses, which in such diseases as hemophilia would allow determination of whether the fetus was at risk of being affected or simply at risk of being a hereditary carrier of the disorder.

In North America, amniocentesis was performed in more than 6,000 second-trimester pregnancies between 1967 and 1974. The diagnostic accuracy was close to 100 percent and complication rates were about two percent. Less than 10 percent of the diagnoses disclosed an affected fetus, meaning that the great majority of parents at risk averted an unnecessary abortion and were able to carry an unaffected child to term. There are many limitations to the use of prenatal diagnosis, especially for mass screening purposes. Amniocentesis is a fairly expensive procedure, and relatively few medical personnel are qualified to administer it and carry out the necessary diagnostic tests. Only a small number of genetic disorders can now be identified by means of amniocentesis and many couples still have no way to determine whether or not they are to be the parents of a child with genetic defects. Nevertheless, the avail- ability of a legal abortion expands the options available to a woman who faces a known risk of having an affected child. Abortion as a substitute for contraception is one possibility raised by the adoption of non-restrictive abortion laws. Limited data do not allow definitive conclusions, but they suggest that the introduction of non-restrictive abortion laws in the U.S. has not lead to any documented decline in demand for contraceptive services. Among women who sought abortion and who had previously not used contraception or had used it poorly, there is some evidence that they may have begun to practice contraception because contraceptives were made available to them at the time of their abortion. The health aspects of this issue bear on the higher mortality and mor- bidity associated with abortion as compared with contraceptive use, and on the possibility that if women rely on abortion rather than contraception they may have repeated abortions, for which the risk of long-term compli- cations is not known. The incidence of repeated legal abortions is little known because legal abortion has only been widely available in the U.S. for a few years. Data from New York City indicate that during the first two years of non-restrictive laws 2.45 percent of the abortions obtained by residents were repeat procedures. If those two years are divided into six-month periods, repeated legal abortions as a percent of the total rose from 0.01 percent in the first period to 6.02 percent in the last. Part of this increase is attributable to a statistical fact: the longer non-restrictive laws are in effect, the greater the number of women eligible to have repeated legal abortions. Perhaps, too, the reporting system has improved. In any case, some low incidence of repeated abortions is to be expected because none of the current contraceptive methods is completely failureproof, nor are they likely to be used with maximum care on all occasions.

8 A recent study has suggested that one additional factor contributing to the incidence of repeated abortions is that abortion facilities may not routinely provide contraceptive services at the time of the procedure. This is of concern because of recent evidence that ovulation usually oc- curs within five weeks and perhaps as early as 10 days after an abortion. The conclusions of the study group: â Many women will seek to terminate an unwanted pregnancy by abortion whether it is legal or not. Although the mortality and morbidity . associated with illegal abortion cannot be fully measured, they are clearly greater than the risks associated with legal abortion. Evidence suggests that legislation and practices that permit women to obtain abortions in proper medical surroundings will lead to fewer deaths and a lower rate of medical complications than restrictive legislation and practices. ââ¢ The substantial differences between the mortality and morbidity associated with legal abortion in the first and second trimesters suggest that laws, medical practices, and educational programs should enable and encourage women who have chosen abortion to obtain it in the first three months of pregnancy. â More research is needed on the consequences of abortion on health status. Of highest priority are investigations of long-term medical complications, particularly after multiple abortions the effects of abortion and denied abortion on the mental health and social welfare of individuals and families the factors of motivation, behavior, and access associated with contraceptive use and the choice of abortion.

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COMMENTS

How Abortion Changed the Arc of Women's Lives
Legal abortion means that the law recognizes a woman as a person. It says that she belongs to herself. Most obviously, it means that a woman has a safe recourse if she becomes pregnant as a result ...
The facts about abortion and mental health
The Turnaway Study, a landmark analysis of abortion from Advancing New Standards in Reproductive Health (ANSIRH) at the University of California, San Francisco, served to debunk the belief that people who get abortions experience deep regret, grief, or even posttraumatic stress disorder. Instead, the most commonly felt emotion is relief (Rocca, C. H., et al., Social Science & Medicine, Vol ...
Abortion
Abortion is a common health intervention. It is very safe when carried out using a method recommended by WHO, appropriate to the pregnancy duration and by someone with the necessary skills. However, around 45% of abortions are unsafe. Unsafe abortion is an important preventable cause of maternal deaths and morbidities.
The abortion and mental health controversy: A comprehensive literature
Introduction. In 1992, the Journal of Social Issues dedicated an entire issue to the psychological effects of induced abortion. In an overview of the contributors' papers, the editor, Dr Gregory Wilmoth, concluded, There is now virtually no disagreement among researchers that some women experience negative psychological reactions postabortion.
What can economic research tell us about the effect of abortion access
This research demonstrates that abortion access does, in fact, profoundly affect women's lives by determining whether, when, and under what circumstances they become mothers, outcomes which then ...
Abortion Care in the United States
Abortion services are a vital component of reproductive health care. Since the Supreme Court's 2022 ruling in Dobbs v.Jackson Women's Health Organization, access to abortion services has been increasingly restricted in the United States. Jung and colleagues review current practice and evidence on medication abortion, procedural abortion, and associated reproductive health care, as well as ...
Abortion as a moral good
Abortion access is also essential to gender justice. Women have long been subjected to legal and social discrimination on the basis of their biological capacity for pregnancy. Today, the relatively new medical technologies of safe, effective contraception and abortion allow women to escape pregnancy's physical and social impact, and to come ...
What the data says about abortion in the U.S.
Guttmacher says that in 2020 there were 14.4 abortions in the U.S. per 1,000 women ages 15 to 44. Its data shows that the rate of abortions among women has generally been declining in the U.S. since 1981, when it reported there were 29.3 abortions per 1,000 women in that age range.
Key facts about abortion views in the U.S.
Women (66%) are more likely than men (57%) to say abortion should be legal in most or all cases, according to the survey conducted after the court's ruling. More than half of U.S. adults - including 60% of women and 51% of men - said in March that women should have a greater say than men in setting abortion policy.
Access to safe abortion is a fundamental human right
Abortion is a common medical or surgical intervention used to terminate pregnancy. Although a controversial and widely debated topic, approximately 73 million induced abortions occur worldwide each year, with 29% of all pregnancies and over 60% of unintended pregnancies ending in abortion. Abortions are considered safe if they are carried out using a method recommended by WHO, appropriate to ...
2. Social and moral considerations on abortion
Social and moral considerations on abortion. Relatively few Americans view the morality of abortion in stark terms: Overall, just 7% of all U.S. adults say abortion is morally acceptable in all cases, and 13% say it is morally wrong in all cases. A third say that abortion is morally wrong in most cases, while about a quarter (24%) say it is ...
Abortion
Abortion. Abortion, the medical or surgical termination of a pregnancy, is one of the oldest, most common, and most controversial medical procedures. Research shows people who are denied abortions are more likely to experience higher levels of anxiety, lower life satisfaction, and lower self-esteem compared with those who are able to obtain ...
The negative health implications of restricting abortion access
A recent study estimated that banning abortion in the U.S. would lead to a 21% increase in the number of pregnancy-related deaths overall and a 33% increase among Black women, simply because staying pregnant is more dangerous than having an abortion. Increased deaths due to unsafe abortions or attempted abortions would be in addition to these ...
Long-Term Health Effects
Much of the research on abortion's long-term effects has been conducted outside the United States, and a substantial volume of literature is based on abortion care in countries where such factors as socioeconomic conditions, culture, population health, health care resources, and/or the health care system are markedly different from those in the ...
A research on abortion: ethics, legislation and socio-medical outcomes
The analysis of abortion by means of medical and social documents. Abortion means a pregnancy interruption "before the fetus is viable" [] or "before the fetus is able to live independently in the extrauterine environment, usually before the 20 th week of pregnancy" [].]. "Clinical miscarriage is both a common and distressing complication of early pregnancy with many etiological ...
7 persistent claims about abortion, fact-checked : NPR
Below, seven popular claims surrounding abortion get fact-checked. According to the Pew Research Center's polls, 37% of Americans want abortion illegal in all or most cases. But an even bigger ...
Here's how the right to abortion is also an economic issue
The overarching argument Alito appears to be making is that the country has made strides since 1973, when Roe v. Wade went into effect, guaranteeing abortion rights up until fetal viability. Alito ...
Pros and Cons of Abortion: 6 Things to Consider
Pregnancy and childbirth can also trigger mental health conditions, including perinatal depression, gender dysphoria, and post-traumatic stress disorder (PTSD). Abortion does not seem to trigger ...
Three Women Testify to the Effects of State Abortion Bans
Public support for abortion rights has increased since the Supreme Court ruling in 2022, which was made possible by Mr. Trump's appointment of three justices, and for which Mr. Trump has taken ...
The Safety and Quality of Abortion Care in the United States
Physical health effects The committee identified high-quality research on numerous outcomes of interest and concludes that having an abortion does not increase a woman's risk of secondary infertility, pregnancy-related hypertensive disorders, abnormal placentation (after a D&E abortion), preterm birth, or breast cancer. Although rare, the ...
Voters in Arizona and Montana can decide on constitutional right to
Voters in Arizona and Montana will be able to decide whether they want to protect the right to an abortion in their state constitutions. ... 50 warnings and 103 advisories in effect for 33 regions ...
Medical providers say Indiana's near-total abortion ban changed how
Since Indiana's near-total abortion ban went into effect more than a year ago, some reproductive health care providers said they've had to adjust the conversations they have with patients about birth control. Some Indiana health providers said the few, narrow exceptions under the state's near-total ban make it difficult to access care, which ...
Abortion funds say they need more money as Florida's law fuels demand
Getting an abortion can cost hundreds, if not thousands of dollars, especially if travel is involved. Support groups, called abortion funds, can help people pay for care, but demand for that help has soared since Florida's law banning most abortions after six weeks started in May.. Advocates like Bree Wallace with the Tampa Bay Abortion Fund say the organizations need more money to keep up.
Impact of abortion law reforms on women's health services and outcomes
Our focus is on quasi-experimental research because we are interested in studies evaluating the effect of population-level interventions (i.e., abortion law reform) with a design that permits inference regarding the causal effect of abortion legislation, which is not possible from other types of observational designs such as cross-sectional ...
Costs up, desperation grows as abortion travel funding shrink
In 2023, more than 166,000 U.S. abortion patients traveled to other states to obtain care, double the number who did so in 2020 before multiple state abortion bans went into effect, according to ...
Competing framings of abortion in the Northern Ireland Assembly and
Her research focuses on abortion policy. She has written extensively on this subject; she is the co-author of the book Reimagining Global Abortion Politics (2018) and, with Emma Campbell, co-edited the two-volume collection Decriminalizing Abortion in Northern Ireland (2022). She was research advisor to Alliance for Choice during 2008-2023 ...
Pro-Choice Does Not Mean Pro-Abortion: An Argument for Abortion Rights
Since the Supreme Court's historic 1973 decision in Roe v. Wade, the issue of a woman's right to an abortion has fostered one of the most contentious moral and political debates in America.Opponents of abortion rights argue that life begins at conception - making abortion tantamount to homicide.
Fact-checking night 4 of the Democratic National Convention
The papers published by the two banks suggest corporations contributed to the inflation Americans have experienced in recent years; however, their pricing actions weren't the primary driver of ...
5 Takeaways From the Democratic Convention
She warned that the policies could have a devastating effect on reproductive health, leading to a nationwide abortion ban and further restrictions to women's health care.
Legalized Abortion and the Public Health: Report of a Study
Psychological effects of legal abortion are difficult to evaluate for reasons that include lack of information on pre-abortion psychological status, ambiguous terminology, and the absence of standardized measurements. The cumulative evidence in recent years indicates that although it may be a stressful experience, abortion is not associated ...