State Abortion Policy Knowledge and Opinions Among Young Adults in North Carolina

Knowledge of state-level abortion policies may impact an individual's ability to obtain abortion care. We assessed knowledge and opinions about state abortion policies among young adults in North Carolina following the implementation of new abortion restrictions.

This was a cross-sectional online survey of individuals ages 18-24 living in North Carolina, recruited via social media from July to October 2024. The primary outcome was high knowledge of state abortion policy (6 or more correct answers on 11 policy knowledge questions). We generated descriptive statistics and evaluated the associations between respondent characteristics and high knowledge.

Of 217 participants, 80% were cis women and 49% were current students. Overall, 79% identified abortion as legal in North Carolina, but only 45% had high abortion policy knowledge. More than one-half identified exceptions allowing abortion after 12 weeks in cases of threat to maternal life (62% correct) or rape (52% correct); fewer had knowledge of waiting periods (45% correct), ultrasound examination requirements (43% correct), or exceptions for life-limiting fetal anomalies (47% correct). Individuals reporting household use of public nutrition benefits were more likely to have high knowledge compared with those not receiving nutrition benefits (adjusted odds ratio, 2.18; 95% confidence interval [1.10, 4.35]). High policy knowledge was not associated with personal views about abortion morality or opinions about state abortion law, but was associated with knowledge about abortion safety (p = .002). More than one-half of the participants (60%) believed abortion is extremely or somewhat difficult to obtain in North Carolina, and 62% disapproved of the new restrictions.

Young adults in this study sample had limited knowledge about the specifics of state abortion policy, highlighting a need to educate the public about policies impacting reproductive health care.