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Quantifying the impact of targeted regulation of abortion provider laws on US abortion rates: a multi-state
1Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
Objectives:
In this paper, we estimate the average effect of two common TRAP (targeted regulation of abortion providers) laws on abortion rates using a novel longitudinal database of state-level policy shifts.
Study Design:
We merged several sources of policy, abortion, and sociodemographic data from 1991-2014. We used a difference-in-differences design to control for time-fixed state-level characteristics and common factors affecting abortion trends across all states, as well as measured time-varying state-level factors that may impact TRAP enforcement and abortion rates. We used generalized linear models with cluster-robust standard errors to obtain our estimates.
Results:
Enforcement of ambulatory surgical center (ASC) laws reduced the abortion rate by 1.25 abortions per 1000 women aged 15-44 (95% CI: -3.39, .89), and admitting privilege laws increased the abortion rate by .57 abortions per 1000 women aged 15-44 (95% CI: -.68, 1.83), but neither effect was statistically distinguishable from zero. Our findings were robust to the inclusion of covariates and various sensitivity analyses.
Conclusion:
Our results suggest that ASC and admitting privilege laws did not, on average, lead to a meaningful change in abortion rates.
Implications:
US abortion rates are currently at record lows, but our findings suggest that TRAP laws are not a meaningful driver of this trend. However, this does not mean that these laws are without consequence in a particular state (or a given year). Researchers should assess the average long-run impact of TRAP laws on other outcomes in the future.
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