Women’s Health
The impact of targeted regulation of abortion provider laws on birth rates among minors in the U.S. Kaya Van Roost* Kaya Van Roost Nichole Austin Alissa Koski
Background–In the decades preceding Dobbs, many states were tightening access to abortion through supply-side abortion restrictions, including targeted regulation of abortion provider (TRAP) laws. Evidence on the impact of TRAP laws on abortion provision is mixed, and no study has investigated effects among subgroups, such as minors. TRAP laws may add to the difficulties that minors face in accessing abortion, increasing their likelihood of carrying pregnancies to term. Given the well-known negative consequences of early childbearing, understanding the impact of these laws on minors is crucial. We quantified the impact of two types of TRAP laws–ambulatory surgical center (ASC) and admitting privilege laws–on birth rates among girls aged 15-17.
Data & methods–We identified treated states that enforced a TRAP law between 2000 and 2022 through a comprehensive database of the laws. We used CDC birth data and census population information to calculate birth rates. We compared changes in birth rates post-TRAP law enforcement among treated states to the same changes in untreated states using the Calloway and Sant’Anna difference-in-differences method for contexts with variations in treatment timing.
Results–The mean birth rate in states that later enforced an ASC or admitting privilege law was 24 and 21 per 1000 girls aged 15-17, respectively, in pre-treatment years. The enforcement of an ASC law led to a 14% increase in the birth rate (0.14, 95% CI: 0.073, 0.20), while admitting privilege laws increased birth rates by 12% (0.12, 95% CI: 0.050, 0.19) on average across post-enforcement years.
Discussion–As the restriction of abortion intensifies post-Dobbs, it will be critical to consider the effects on minors, who face additional barriers to accessing abortion and for whom giving birth carries unique risks. Our results show that prior, less restrictive regulation of abortion through TRAP laws led to small increases in birth rates among girls aged 15-17.
