Urban Wire Research Shows Access to Legal Abortion Improves Women’s Lives
Emily M. Johnston
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Abortion rights activists participate in a Bans Off Our Bodies rally at the U.S. Supreme Court on May 14, 2022 in Washington, DC.

The leaked draft US Supreme Court opinion in Dobbs v. Jackson Women’s Health Organization would immediately restrict legal abortion access by overturning the court’s 1973 Roe v. Wade decision, which recognized the constitutional right to abortion.

Though abortion has been debated in US politics for decades, the evidence is clear: access to legal abortion improves women’s lives (PDF).

In 2016 and 2018, the Urban Institute fielded the Survey of Family Planning and Women’s Lives (PDF) and conducted follow-up interviews with survey participants to understand their experiences with unplanned pregnancy, birth, and abortion. Findings from this work provide insights about how substantial new restrictions on abortion access would affect women’s lives.

(Note: In this post, we use the term “women” to align with the data sources referenced, but we acknowledge not all people who seek abortion identify as women.)

The vast majority of women think an unplanned birth would negatively affect a woman’s life

More than 8 in 10 women surveyed in 2016 said an unplanned birth would negatively affect a woman’s life, with more than half of women reporting a negative outcome for at least four of seven aspects of their lives. Most—close to 2 in 3—worried about negative effects on a woman’s education, followed by concerns about her income, mental health, and job.

Numerous studies confirm these perceptions—access to legal abortion improves women’s economic and social lives, and being denied an abortion creates economic hardship and financial insecurity for women and their children.

Bar graph showing the perceived effects of an unplanned birth on 7 aspects of women’s lives among women ages 18 to 44, 2016

Women perceive access to abortion as more difficult in states with restrictive abortion policies

Since Roe, states have enacted more than 1,000 laws or regulations restricting access to abortion, including gestational limits, waiting periods, mandated preabortion counseling, and prohibitions on the use of state funds.

About 4 in 10 women surveyed in 2018 believed access to procedural abortion was easy, but 3 in 10 believed it was difficult, with medication abortion perceived as somewhat easier to access than procedural abortion. For both types, women in states with more restrictive abortion policies were more likely to perceive abortion access as difficult.

Though difficulty may reflect a range of factors—finding a provider, cost, time, travel, logistics, and emotional costs—these findings suggest abortion restrictions fuel women’s perceptions that access is difficult.

Women believe “everyone should have their own choice”

In follow-up interviews, women emphasized the importance of having choices when deciding whether to continue or terminate an unplanned pregnancy and described their decisions as highly personal and dependent on many factors.

Nearly all interviewees in 2016 expected they would carry an unplanned pregnancy to term and raise the child, yet about one-third interviewed in 2018 reported they had an abortion when faced with an unplanned pregnancy. Women in both groups worried an unplanned pregnancy would have adverse impacts on their finances, income, education, and career, as well as on their physical health and emotional well-being.

Most 2018 interviewees, all of whom had experienced an unplanned pregnancy, were not immediately aware of their pregnancy, and some did not make the decision to continue or terminate their pregnancy until two or more months into their pregnancy. Women thought it was important to be able to make their own decisions with enough time to consider their options before deciding.

Everyone should have their own choice. That is the whole thing with our beautiful country, where we have our own choice and options and freedom.… Nobody knows nobody’s situation, and nobody can tell anybody what to do.
36 years old at the time of the interview in 2018; terminated most recent unplanned pregnancy

Abortion access improves women’s overall and economic well-being

Summarized in an amicus brief (PDF) filed by more than 150 economists, research shows access to abortion improves women’s economic well-being. The Turnaway Study found women who received an abortion were less likely than those denied an abortion to experience financial hardship, receive public assistance, live in poverty, or report poor or fair health. If Roe is overturned, a lack of legal abortion access will cause women’s overall and economic well-being to suffer.

Abortion restrictions would disproportionately harm Black women

Women of color stand to lose the most. Already, abortion restrictions in the US disproportionately harm people of color, who are more likely to lack access to comprehensive reproductive health care. Multiple amicus briefs filed in support of Jackson Women’s Health Organization highlight the distinct harms abortion restriction would have on Black women in particular, who already face racial and socioeconomic barriers to reproductive autonomy.

Abortion access would be immediately restricted, with negative impacts on women’s well-being

As of May 17, 2022, 22 states have laws that could be used to restrict legal abortion in the absence of Roe, including 13 states with “trigger laws” that would effectively ban abortion—laws that would take effect automatically if the protections of Roe are removed.

Currently, abortion is still legal in all 50 states and DC, and local abortion funds and other organizations are working to help people maintain access to abortion. In Texas, where abortions after about six weeks are banned, women access abortion by traveling out of state or ordering abortion medication online.

However, if Roe v. Wade is overturned, millions of women would face greater barriers to legal abortion access, including traveling farther to find an abortion provider. For those unable to get an abortion, evidence shows continuing an unwanted pregnancy will lead to more pregnancy-related deaths, adverse mental and physical health outcomes (PDF) for women, and adverse social and economic outcomes (PDF) for women and their families.

Research Areas Health and health care
Tags Health equity Health care laws and regulations Family planning Maternal, child, and reproductive health Sexual and reproductive health Women and girls
Policy Centers Health Policy Center
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