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US Abortion Bans and Fertility.
Suzanne O Bell1, Alexander M Franks2, David Arbour3
1Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
JAMA
|February 13, 2025
Summary
Abortion bans are linked to increased birth rates, especially among disadvantaged groups. These policies disproportionately affect marginalized communities, highlighting significant population-level impacts.
Area of Science:
- Reproductive Health
- Health Policy
- Demography
Background:
- Abortion bans may increase births among individuals facing barriers to care.
- Population-level effects and disparate impacts of abortion bans remain unclear.
Purpose of the Study:
- To assess how abortion bans affect fertility rates across different states and subpopulations in the US.
- To examine the heterogeneity in the association between abortion bans and fertility changes.
Main Methods:
- Utilized birth certificate and US Census Bureau data (2012-2023) for all 50 states and DC.
- Employed a Bayesian panel data model to analyze fertility changes associated with complete or 6-week abortion bans.
- Estimated changes in fertility rates by age, race/ethnicity, marital status, education, and insurance payer.
Main Results:
- States with abortion bans saw an estimated 1.70% increase in fertility rates, totaling over 22,000 excess births.
- Disproportionate increases were observed in racially minoritized, unmarried, younger (under 35), Medicaid-enrolled, and less educated populations.
- Variations in race/ethnicity and education levels across states significantly contributed to the observed fertility rate changes.
Conclusions:
- Fertility rates were higher in states with abortion bans than expected, particularly among structurally disadvantaged subpopulations.
- The findings underscore the unequal impacts of abortion bans on diverse demographic groups.
- These results are particularly relevant for states with poorer maternal and child health outcomes.
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