Quantifying the impact of targeted regulation of abortion provider laws on US abortion rates: a multi-state assessment

Abstract

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.

Publication
Contraception
Sam Harper
Sam Harper
Associate Professor of Epidemiology

My research interests include impact evaluation, reproducible research, and social epidemiology.

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