Georgia law eliminates abortion option for most women, with disproportionate access

In July 2022, a Georgia law limiting abortion to early pregnancy was put into effect and will eliminate abortion access for most women and disproportionately harm Black, younger and lower socioeconomic individuals, data suggest.

“Georgia has long served as an abortion access hub in the Southeast. House Bill 481, which reduced the legal limit for abortions from 22 weeks to approximately 6 weeks from last menstrual period, severely restricted access to abortion in Georgia and across the region,” Sara K. Redd, PhD, MSPH, assistant professor in the department of behavioral, social and health education sciences and director of research translation with the Center for Reproductive Health Research in the Southeast at Emory University Rollins School of Public Health, and colleagues wrote. “However, to date, no study has examined the anticipated impact of enactment of HB481 on abortion access in the state.”

This repeated cross-sectional analysis, published in JAMA Network Open, included 360,972 reported abortions in Georgia identified from the 2007 to 2017 Georgia Department of Public Health’s Induced Termination of Pregnancy files. Researchers estimated future effects of this law on abortion care in Georgia, with a focus on the last 2 years of data from 2016 and 2017.

From 2007 to 2017, researchers observed a mean of 32,816 abortions per year in Georgia. The proportion of abortions performed at less than 6 weeks’ gestation increased from 5.3% in 2008 to 12.1% in 2017 (P < .001), and the proportion of abortions performed at 6 weeks or later declined from 94.7% in 2008 to 87.9% in 2017 (P = .01).

Using estimates from 2016 to 2017, researchers suggest that only 3,854 of those abortions (11.6%) in Georgia would likely meet eligibility requirements for abortion care under this new law. In addition, this law will lead to fewer abortions obtained by Black patients compared with white patients (9.6% vs. 16.2%), patients younger than 20 years compared with those aged 40 years and older (9.1% vs. 15%) and patients with less than a high school diploma compared with those with a high school diploma or those with some college (9.2% vs. 9.6% and 13.5%, respectively).

“Our findings carry ominous implications for maternal mortality and morbidity in Georgia, a state with one of the highest maternal mortality rates in the nation and where Black women are over twice as likely to die from pregnancy-related complications compared with White women,” the researchers wrote. “With HB481’s increased restrictions on abortion in Georgia, these outcomes will likely worsen, particularly given Georgia’s severe obstetric care shortage where roughly half of counties lack an obstetrician. ... Together, these findings and context encapsulate the significant physical and emotional toll pregnant people face under HB481.”