How many abortions did the post-Roe bans prevent?
The first data on births since Roe v. Wade was overturned shows how many abortion bans have had their intended effect: Births increased in every state with a ban, an analysis of the data shows.
Comparing birth statistics in states before and after the bans expired, researchers estimate that the laws caused about 32,000 annual births based on the first six months of 2023, a relatively small increase that was in line with general expectations.
So far, studies have shown that many women in states with bans have ended their pregnancies anyway by traveling to other states or ordering pills online. What they have not been able to demonstrate is how many women did so and continued their pregnancies. The new analysis, published as a working paper by the Institute of Labor Economics on Friday, found that in the first six months of the year, between a fifth and a quarter of women living in states with a ban – who might otherwise be on were looking for an abortion – didn’t get one.
“The importance of our results is that when you take away access, it can affect fertility,” said Daniel Dench, an economist at Georgia Tech and author of the paper with Mayra Pineda-Torres of Georgia Tech and Caitlin Myers of Middlebury College. “If you make it more difficult, women can’t always leave the state to have an abortion.”
Overall, data indicate that the number of legal abortions nationwide has remained stable or increased slightly since the Supreme Court’s Dobbs decision, despite abortion bans in what are now fourteen states. This is likely due to new clinics opening in states where it is legal, and the emergence of new ways to order abortion pills online, expanding access for both women who have traveled to those states and those who lived there.
“This is an inequality story,” Professor Myers said. “Most people are leaving banned states one way or another, and more and more people in protected states are having abortions. And at the same time, this shows something that these data cannot show: there is a significant minority of people in banned states who do fall into the trap.”
The researchers used birth data, by age and race, from the Centers for Disease Control and Prevention from 2005 through June 2023. They used a statistical method that compared states with similar trends in births before the Dobbs decision to estimate how much a ban changed the expected birth rate. This increased their certainty that the change was due to the policy and not other factors.
They found that births increased by an average of 2.3 percent in states with bans compared to states where abortion remained legal.
The analysis found that the increased births were disproportionately among women in their 20s and among black and Hispanic women, which researchers said could be because these groups tend to be poorer, making it harder to travel. They are also the demographic groups that are more likely to have abortions.
Dr. Alison Norris, who studies reproductive health at Ohio State and was not involved in the study, said she was not surprised that births were increasing, especially among these groups. She noted that before Dobbs, access to abortion was already limited in many states, so “any amount of change we see will in some ways be an underestimate of the challenges people face.”
The largest increases in births occurred in states where women had to travel the farthest to reach an abortion clinic. Texas, where the average driving distance to the nearest abortion clinic was 450 miles, saw a 5.1 percent increase in births, compared to states that had not implemented bans but had similar trends before Dobbs. Mississippi, where it increased 240 miles, saw a 4.4 percent increase.
In states where there was less change in driving distance to the nearest clinic, there was a smaller relative change in the number of births. For example, Missouri had only one clinic, in St. Louis. When it closed, the average driving distance to the nearest clinic increased only two miles, because clinics along the Illinois border already served Missouri residents. The number of births there increased by only 0.4 percent.
There was also evidence that online abortion pills, ordered from overseas suppliers, played a role in some states. The three states where the increase in births was smaller than researchers predicted based on travel distances — Arkansas, Oklahoma and Louisiana — also saw big increases in orders for abortion drugs from the largest overseas provider, according to an analysis by those orders.
“The insinuation of much reporting on such data points is that it is a bad thing if more children are welcomed in states with better laws than in states that expedite abortion,” said Kristan Hawkins, president of Students for Life. of America, in an email. “It is a triumph that pro-life policies result in saving lives.”
The data on births is preliminary: a fuller account of Dobbs’ effect on the fertility rate, including county-level data, won’t be available for another year. The researchers cannot be sure that the increase in births is attributed to women who wanted abortions but were unable to obtain them, but the timing and consistency of the results suggest this.
The researchers said these trends may change as more birth data becomes available. The women who gave birth in the first half of the year would have already been pregnant when the abortion ban came into effect, or they became pregnant shortly afterwards. Since the dates ended, new restrictions on abortion have come into effect in some places, and access has expanded in others.
The number of births could decrease. New shield laws The goal is to legally protect providers who send abortion pills to states with bans, and people could change their sex and contraception behavior in response to a ban. Or the number of births could increase as more states restrict abortion; some of this may depend on the outcome of a case to restrict the shipment of one of the two abortion pills.
“The abortion landscape continues to evolve,” says Professor Pineda-Torres. “People adapt, providers adapt, laws adapt.”