State abortion bans may unequally affect American Indian, Alaska Native, Black women

Key takeaways:

• More American Indian or Alaska Native and Black women live in states with abortion bans vs. limited or available access.
• Fewer Asian, Hispanic, Pacific Islanders and multiracial women live in states with bans.

A greater proportion of American Indian or Alaska Native and Black women of reproductive age live in states with effective abortion bans vs. limited or available access, highlighting possible unequal impact of abortion bans, data show.

“Reduced access to reproductive health care is associated with racial and ethnic disparities in pregnancy-related morbidity and mortality in the U.S.,” Demetri Goutos, MBA, health services researcher in the department of health law, policy and management at Boston University School of Public Health, and colleagues wrote. “In 2022, the Dobbs v. Jackson Women’s Health Organization Supreme Court decision removed constitutional protections for the right to abortion. Since then, several states have restricted abortion access entirely or limited abortions to 6 weeks’ gestation or less, coinciding with the average timing of pregnancy discovery and precluding most individuals from legally accessing abortion.”

Goutos and colleagues obtained data on abortion policies from the State Abortion Policy Tracker and grouped state abortion policies into three categories. States banning abortion at any gestational age or at 6 weeks gestation were referred to as states with effective abortion bans. These states were compared with states with limited abortion access with abortion banned between 6 weeks gestation and the previous federal limit of 23 to 24 weeks gestation and states with available abortion access allowing abortion until or after fetal viability.

Using demographic data from CDC WONDER, researchers compared race and ethnicity of women of reproductive age living in states with restrictive abortion policies after Dobbs and states without.

As of November, 15 U.S. states banned abortion entirely, two banned abortion after 6 weeks gestation, 10 had limited abortion access and 24 had available abortion access. Overall, 43,778,189 women of reproductive age lived in states with effective abortion bans, and 106,258,137 lived in states with limited or available abortion access.

The proportion of American Indian or Alaska Native (0.88% vs. 0.75%), Black (18.85% vs. 11.88%) and white (55.5% vs. 54.2%) women of reproductive age were higher in states with effective abortion bans compared with states with limited or available abortion access.

Conversely, the proportions of Asian (3.86% vs. 8.24%), Hispanic (18.83% vs. 22.06%), Native Hawaiian or other Pacific Islander (0.11% vs. 0.25%) and multiracial (1.98% vs. 2.63%) women were lower in states with effective abortion bans compared with states with limited or available abortion access.

Estimating populations based on the U.S. census was a limitation to this study as it is subject to limitations of survey-based data and response reliability, according to the researchers.

“Policies improving access to the full spectrum of reproductive health care, including safe abortion, may reduce such disparities,” the researchers wrote.