What effects do pro-life laws really have?

A common criticism of pro-life advocates and legislation by pro-choice advocates is that they do not believe that restrictions on abortion will really have any effect on the number of abortions performed anyway.

Now, certainly making abortion illegal will not stop all abortions. Laws are rarely if ever followed 100% of the time, and there are always going to be those that are willing to break the law. We do however have a mountain and a half of evidence on this subject showing that imposing greater restrictions on abortion and making it harder to access does significantly decrease the number of abortions performed.

As there are many types of pro-life laws, and the effects of these restrictions can vary significantly, I’m going to break down different laws into a number of categories here and go over them individually for the sake of being thorough.

While one could argue that this is not directly a restriction on abortion, lets begin with analyzing the issue of public funding for abortions, and the effects of pro-life laws that withhold such funding.

This is an issue that has gained a lot of attention as of late with the overwhelming support of Democrat leadership to expand such funding, but something that may surprise some people is that a lot of abortions are actually publicly funded. As it stands, states are already directly spending tens of millions of dollars on over 180,000 abortion procedures every single year, making up a substantial portion of our countries overall abortions.(1)

While sometimes research on abortion is lacking, in this case, we have a lot of good info on what exactly this funding does, and what happens when it’s withheld.

Studies in the Journal of Health Economics and Population Research and Policy Review have found that approximately one-third of pregnancies that would have resulted in an abortion had state funds been available are instead carried to term when that funding is not provided. In the short term, funding changes can increase births, especially when policy is inconsistent, but over the longer run people may exercise greater care in contraception usage when funding is unavailable.(2)(3)

Indeed, research in the Journal of Health Economics on the effects of this funding and the results of restricting it for example found that not only do medicaid funding restrictions result in a significant reduction in the number of abortions preformed, but that overall births either remain static or decrease as well, despite the drops in abortion, indicating that when abortion is less financially accessible, paid for on the dime of the taxpayer, people may take greater steps to avoid pregnancy.(4)

Likewise, reviews by the Guttmacher Institute on the effects of restrictions on medicaid and public funding of abortions demonstrate that, when public funding for abortion is unavailable, approximately one-fourth of women who would have Medicaid-funded abortions instead give birth, and argue that a lack of funding does not seem to result in illegal abortions occurring.(5)

The real kicker though is that the negative effects of public funding for abortion may go well beyond needlessly increasing abortion. Research from the American Journal of Public Health on public funding of abortion and it’s effects on the health of women found that not only does restricting public funding for abortion not result in more complications resulting from illegal abortion, but that it significantly decreases both the number and proportion of publicly funded hospitalizations as a result of legal abortions. The researchers argue that this is a result of not only fewer numbers of abortions occurring in general, but more specifically the declines in late term procedures that carry even greater risks of complications.(6)

There’s a lot more research on this subject out there, but in short, not only have restrictions on the public funding of abortion been shown to reduce the number of abortions preformed, but they likely decrease unwanted pregnancies as well, and quite possibly result in safer conditions for women all around.

Let’s look at another aspect of pro-life laws which impact abortion access, which is abortion provider availability.

While it is often argued that a woman seeking an abortion will go to almost any lengths to obtain one, as we’ve seen with funding restrictions, even just the absence of taxpayer dollars is often enough to dissuade countless women from undergoing abortions. So what happens when abortions aren’t readily accessible due to things like distance, and a lack of accessible providers?

Well, research Family Planning Perspectives and Contemporary Economic Policy have demonstrated that longer travel distances and reduced access to abortion clinics significantly reduce both abortion rates and pregnancy rates. Again, when abortion is not easily accessible, people often work harder to avoid unwanted pregnancies.(7)(8)

The degree to which distance reduces abortion is significant, but estimates vary. Some research on the effects of more facilities closing in states for example has shown that a 100-mile increase in distance to the nearest abortion facility can decrease abortions by between 10% and 25%, and can result in increases in birth rates of 2% to 4%.(9)(10)

Other research however has demonstrated that a mere 25-mile increase in distance can result in a similar 10% decrease in overall abortions, and has significant effects for women initially living within a 200-mile radius of a clinic. Clinic congestion is also likely a large factor in the case of such decreases.(11)

Supply side laws that reduce the provision of abortion are perhaps among the most effective methods of decreasing abortions. Indeed, research from the Guttmacher Institute indicate that decreased access alone likely accounted for around a quarter of the observed decline in abortion rates between 1988 and 1992. The efficacy of these laws is one of the reasons why a lot of pro-life legislation tends to be centered around abortion providers first.(12)

But what about laws that focus more on the mother in particular? For example, how do parental involvement laws affect minors?

The impact of these sorts of laws is quite large. As research from the American Journal of Public Health demonstrates, not only do they tend to reduce abortion rates, but they are extremely effective at facilitating pregnancy avoidance, with birth rates continuing to decline even as these laws drove significant dives in abortion rates.(13)

This trend is shown across the body of research on the subject. Parental involvement laws are shown often to have such a significant effect on pregnancy avoidance that often birth rates remain static even as abortion rates plummet. Generally, it seems that these decreases in unintended pregnancies are driven by increased use of contraception, which is more carefully used when abortion is less of an option.(14)(15)

The scale of the effect of these laws upon abortion is pretty significant, with evidence indicating that parental involvement laws decrease minors’ demand for abortion by between 13% and 25%. States with such parental involvement laws typically see an abortion rate that is about a quarter lower than it is in states without such laws, though some may be going out of state to obtain abortions instead.(16)(17)

The evidence on policies such as waiting periods and counseling is somewhat mixed. Many studies have shown them to be modestly effective at reducing abortions, though they may result in some abortions being performed later in pregnancy, with evidence from Mississippi for example indicating that these laws drove large declines in the abortion rate. Some research in other countries even partially credits the introduction of mandatory abortion counseling with subsequently observed declines in the abortion rate of nearly 30%. Other studies however have indicated that their effect is not statistically significant when compared to parental involvement laws or medicaid funding restrictions.(18)(19)(20)

Alongside public funding restrictions and parental involvement laws, properly designed informed consent laws likewise result in significant declines in both the abortion rate and the abortion ratio, as do many other types of state-level anti-abortion legislation.(21)(22)

As one might assume, we generally see that the stricter the law is, the larger the decrease in abortions and pregnancies is. Evidence from Europe for example demonstrates that even just modest restrictions on abortion reduce abortion rates by around 25%, and also reduce pregnancy rates by as much as 10%, with little net effect on births. Extremely strict laws have an even larger effect on pregnancies though, causing declines in pregnancy rates of 27% to 45%, but decreases in pregnancy rates here are often eclipsed by even more significant decreases in the number of abortions.(23)

In short, pro-life laws have been shown to be extremely efficacious at achieving their primary goal, reducing abortion rates, often decrease unintended pregnancies, and rarely seem to lead to illegal abortions occurring.

Beyond just abortion and unwanted pregnancies however, some will raise further questions about the direct and indirect effects of pro-life laws on other issues.

One worry for example is the issue of what effect pro-life laws have on maternal deaths, whether connected to illegal abortions or not. Thankfully though, we do have some evidence that allows us to examine the veracity of such concerns.

Studies on abortion and maternal mortality have generally found that the legality of abortion does not seem to have a drastic effect on the maternal mortality ratio at all. Rather maternal mortality is generally determined by the quality of maternal health care, not by the legal status of abortion.(24)

In other cases, the relationship between abortion and maternal deaths is brazenly contrary to the popular narrative around this subject. Research on Chile for example demonstrates that after banning abortion in 1989 without any exception, even in cases where the mother’s life is at risk, the maternal mortality ratio decreased over 58%, falling from 40.8 to 16.9 per 100,000 live births, and the abortion mortality ratio likewise dropped by over 96%.(25)

Indeed, as a direct comparison, less permissive areas often tend to exhibit consistently lower maternal mortality rates than areas with more lax abortion laws. Abortion restriction is generally associated with negative impacts on maternal and abortion deaths, though again this is often related to other independent factors, like, again, higher quality maternal healthcare or skilled attendance at birth.(26)

Another issue frequently raised is the theory that abortion and it’s availability decrease crime, and the concern that prohibiting abortion may lead to increases in criminal activity as a result of those more likely to be potential criminals not being aborted.(27)

Extensive research has been done on this subject however, and there is very little evidence to indicate that abortion decreases crime at all. The theory generally does not fit the available evidence, and even when such an effect can seem superficially plausible, observed associations tends to break down when any real scrutiny is applied.(28)(29)(30)(31)(32)(33)(34)

What little research there is that purports to demonstrate a link between abortion and crime has widely been shown to be inaccurate by many different scholars. The papers and studies that make these claims that abortion decreases crime have generally been filled with severe flaws, errors, and holes in their research, inaccuracies that, when accounted for, can change the results of the research significantly.(35)(36)(37)(38)

Indeed, there are studies that have actually shown that abortion may increase crime rates rather than decreasing it at all. Research has shown that legalizing abortion can increase out-of-wedlock births and single parent families, contrary to what we might assume, and in doing so can drastically increase crime rates. Some evidence indicates that the legalization of abortion in the United States alone may have increased murders by over 7%, and have likely resulted in multi-billion dollar increases in annual victimization costs.(39)(40)(41)

Volumes could be and have been filled going over the ins and outs of the infinite minutia of factors that abortion laws can influence. In general however, arguments that these laws are ineffective or that they produce negative side effects in other areas tend to be inaccurate and out of line with evidence available on this subject.

Regardless of our opinions on abortion in general, I hope we can put to rest these arguments over the efficacy of laws against abortion, and work harder to ensure that we are not making inaccurate claims when we voice our concerns about the potential side effects of these kinds of restrictions.

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Sources

1. Public Funding for Family Planning, Sterilization and Abortion Services, FY 1980 – 2010 Guttmacher Institute, March 2012. Adam Sonfield; Rachel Benson Gold.
2. The effects of short-term variation in abortion funding on pregnancy outcomes Journal of Health Economics, Vol. 18, No. 2, 1999. Philip J. Cook; Allan M. Parnell; Michael J. Moore; Deanna Pagnini.
3. Effects on pregnancy outcomes of changes in the North Carolina State Abortion Fund Population Research and Policy Review, Vol. 21, No. 4, 2002. S. Philip Morgan; Allan M. Parnell.
4. The effect of Medicaid abortion funding restrictions on abortions, pregnancies and births Journal of Health Economics, Vol. 15, No. 5, 1996. Phillip B. Levine; Amy B. Trainor; David J. Zimmerman.
5. Restrictions on Medicaid Funding for Abortions: A Literature Review Guttmacher Institute, June 2009. Stanley K. Henshaw; Theodore J. Joyce; Amanda Dennis; Lawrence B. Finer; Kelly Blanchard.
6. Effects of restricted public funding for legal abortions: a second look. (Full Text) American Journal of Public Health, Vol. 71, No. 1, 1981. R M Selik; W Cates Jr; C W Tyler Jr.
7. Abortion Utilization: Does Travel Distance Matter? Family Planning Perspectives, Vol. 8, No. 6, 1976. James D. Shelton; Edward A. Brann; Kenneth F. Schulz.
8. The impact of provider availability on abortion demand Contemporary Economic Policy, Vol. 14, No. 2, 1996. Robert W. Brown; R. Todd Jewell.
9. Abortion Facility Closings and Abortion Rates in Texas (Full Text) INQUIRY: The Journal of Health Care Organization, Provision, and Financing, Vol. 54, 2017. Troy Quast; Fidel Gonzalez; Robert Ziemba.
10. The Impact of Supply-Side Abortion Regulation Policies in Texas Baylor University, Honors thesis, December 2016. Andrea Schlosser.
11. How Far Is Too Far? New Evidence on Abortion Clinic Closures, Access, and Abortions (Full Text) National Bureau of Economic Research, Working Paper No. 23366, 2017. Jason Lindo; Caitlin Myers; Andrea Schlosser; Scott Cunningham.
12. The Effects of Economic Conditions And Access to Reproductive Health Services On State Abortion Rates and Birthrates (Full Text) Family Planning Perspectives, Vol. 29, 1997. Stephen Matthews; David Ribar; Mark Wilhelm.
13. Impact of the Minnesota Parental Notification Law on abortion and birth. (Full Text) American Journal of Public Health, Vol. 81, No. 3, 1991. J L Rogers; R F Boruch; G B Stoms; D DeMoya.
14. Parental involvement laws and fertility behavior Journal of Health Economics, Vol. 22, No. 5, 2003. Phillip B Levine.
15. Do parental involvement laws reduce adolescent abortion rates? Contemporary Economic Policy, Vol. 12, No. 2, 1994. Robert L. Ohsfeldt; Stephan F. Gohmann.
16. The Impact of State Abortion Restrictions on Minors' Demand for Abortions The Journal of Human Resources, Vol. 31, No. 1, 1996. Deborah Haas-Wilson.
17. The Economic Impact of State Restrictions on Abortion: Parental Consent and Notification Laws and Medicaid Funding Restrictions (Full Text) Journal of Policy Analysis and Management, Vol. 12, No. 3, Summer 1993. Deborah Haas-Wilson.
18. Abortion Trends in Singapore: A 25-Year Review Journal of Pediatric and Adolescent Gynecology, Vol. 9, No. 1, February 1996. K. Singh; F.Y. Fai; R.N.V. Prasad; S.S. Ratnam.
19. The Impact of Mississippi's Mandatory Delay Law on Abortions and Births JAMA, Vol. 278, No. 8, August 27, 1997. Theodore Joyce; Stanley K. Henshaw; Julia DeClerque Skatrud.
20. Price, Restrictions and Abortion Demand Journal of Family and Economic Issues, Vol. 28, No. 4, 2007. Marshall H. Medoff.
21. Analyzing the Effect of Anti-Abortion U.S. State Legislation in the Post-Casey Era State Politics & Policy Quarterly, Vol. 11, No. 1, 2011. Michael J. New.
22. Analyzing the Impact of U.S. Antiabortion Legislation in the Post-Casey Era: A Reassessment State Politics & Policy Quarterly, Vol. 14, No. 3, 2014. Michael J. New.
23. Abortion Policy and Fertility Outcomes: The Eastern European Experience The Journal of Law and Economics, Vol. 47, No. 1, 2004. Phillip B. Levine; Douglas Staiger.
24. Women's Education Level, Maternal Health Facilities, Abortion Legislation and Maternal Deaths: A Natural Experiment in Chile from 1957 to 2007 (Full Text) PLoS ONE, Vol. 7, No. 5, 2012. Elard Koch; John Thorp; Miguel Bravo; Sebastián Gatica; Camila X. Romero; Hernán Aguilera; Ivonne Ahlers.
25. Impact of Reproductive Laws on Maternal Mortality: The Chilean Natural Experiment (Full Text) The Linacre Quarterly, Vol. 80, No. 2, 2013. Elard Koch.
26. Abortion legislation, maternal healthcare, fertility, female literacy, sanitation, violence against women and maternal deaths: a natural experiment in 32 Mexican states (Full Text) BMJ Open, Vol. 5, No. 2, 2015. Elard Koch; Monique Chireau; Fernando Pliego; Joseph Stanford; Sebastian Haddad; Byron Calhoun; Paula Aracena; Miguel Bravo; Sebastián Gatica; John Thorp.
27. Abortion and Crime The Lifeguard Initiative, March 25, 2020. William Lawyer.
28. Did Legalized Abortion Lower Crime? National Bureau of Economic Research, Working Paper No. 8319, 2001. Ted Joyce.
29. Further Tests of Abortion and Crime (Full Text) National Bureau of Economic Research, Working Paper No. 10564, 2004. Ted Joyce.
30. A Simple Test of Abortion and Crime Review of Economics and Statistics, Vol. 91, No. 1, 2009. Ted Joyce.
31. The Abortion–Crime Link: Evidence from England and Wales Economica, Vol. 75, No. 297, 2008. Leo H. Kahane; David Paton; Rob Simmons.
32. After the Epidemic: Recent Trends in Youth Violence in the United States National Bureau of Economic Research, Working Paper No. 8571, 2001. Philip Cook; John Laub.
33. What Do Economists Know About Crime? National Bureau of Economic Research, Working Paper No. 13759, 2008. Angela Dills; Jeffrey Miron; Garrett Summers.
34. [Abortion and crime] Medicina nei secoli, Vol. 23, No. 3, 2011. Guido Citoni.
35. The Impact of Legalized Abortion on Crime: Comment Quarterly Journal of Economics, Vol. 123, No. 1, 2008. Christopher L. Foote; Christopher F. Goetz.
36. Further Tests of Abortion and Crime: A Response to Donohue and Levitt (2001,2004, 2006) National Bureau of Economic Research, Working Paper No. 12607, 2006. Theodore Joyce.
37. Testing Economic Hypotheses with State-Level Data: A Comment on Donohue and Levitt SSRN, 2005. Christopher L. Foote; Christopher F. Goetz.
38. Abortion and Crime: A Review National Bureau of Economic Research, Working Paper No. 15098, 2009. Theodore Joyce.
39. An analysis of out-of-wedlock births in the United States Brookings Policy Brief Series, August 1, 1996. George A. Akerlof; Janet L. Yellen.
40. Abortion and Crime: Unwanted Children and Out-of-Wedlock Births John M. Olin Center for Studies in Law, Economics, and Public Policy Working Papers, No. 254, May 2001. John R. Lott, Jr.; John Whitley.
41. Abortion and crime: unwanted children and out‐of‐wedlock births Economic Inquiry, Vol. 45, No. 2, 2007. John R. Lott Jr; John Whitley.