Awareness of state-level abortion policy climates among young adult Black women: Examining agreement between state classifications and participant perceptions

Awareness of state-level abortion policy is critical to reproductive care access, particularly among young adult Black women (YABW) who are anticipated to be greatly impacted by the US Supreme Court's overturning of abortion protections.

This study assessed YABW's perceptions of the abortion policy climate in their state and the accuracy of these ratings against policy-driven classifications of state-level abortion climates.

YABW (N = 483, 18-22 years) participated in an online sexual and reproductive health survey in 2023. We leveraged Guttmacher Institute's state classifications of abortion policy and participants rated their state's abortion policy climate from restrictive to protective. Agreement between participants' ratings and the state classifications was evaluated with Cohen's kappa; bias among participants' rating was assessed with chi-square goodness of fit test. Logistic regression was used to identify participant characteristics associated with participant bias.

Compared to state classifications, participants rated fewer states as restrictive and twice as many states as mixed; a third perceived states as less restrictive than classified. Those rating their state as more protective than classified lived in rural communities (aOR = 6.77) or the South (aOR = 12.52) and were sexually active (aOR = 3.97). Those rating their state as more restrictive than the classification were wealthier (aOR = 1.67), lived in the Northeast (aOR = 2.86), and did not complete high school (aOR = .18).

A substantial proportion of YABW inaccurately assessed the restrictiveness of their states' abortion climates, which has implications for their reproductive decision making.