Reduced Access Lowers Abortion Rates

December 02, 1997

University Park, Pa. -- Restrictive state policies and the lack of medical providers have effectively decreased the rate of abortions in the United States, according to researchers.

"Abortion rates are generally higher along the West and East coasts, where states tend to place fewer conditions on an abortion and offer an abundance of providers compared to less populated regions," says Dr. Stephen A. Matthews, research associate with the Population Research Institute at Penn State and adjunct assistant professor of geography.

"The most common restrictions on abortion are Medicaid funding limits, 24-hour waiting periods, mandatory counseling and parental consent requirements for minors," Matthews notes. "From a pragmatic standpoint, these restrictions have made a difference in abortion rates. Calculations indicate that decreased access, due largely to restrictions, accounted for 24-30 percent of the 5 percent decline in abortion rates between 1988 and 1992."

"Conversely, birthrates go up where the costs of contraception are higher due to reduced access to providers of contraceptive methods and advice such as obstetrician-gynecologists and family planning services," says Dr. Mark O. Wilhelm, assistant professor of economics at Penn State.

Matthews, Wilhelm and David Ribar, assistant professor of economics at George Washington University, are authors of the paper, "The Effects of Economic Conditions and Access to Reproductive Health Services on State Abortion Rates and Birthrates," which appeared in the journal Family Planning Perspectives.

For the period 1988-92, the Alan Guttmacher Institute documented substantial declines in both the incidence and availability of abortions in the United States. Nationwide the abortion rate fell by 5 percent, from 27.3 abortions per 1,000 women to 25.9 per 1,000. At the same time, the proportion of women living in counties with an abortion provider fell from 71 to 69 percent, and the number of providers per 100,000 women fell from 4.4 to 4.0.

"In 1973, the year of Roe vs. Wade, 15 counties in Pennsylvania had abortion providers. By 1977, this number had risen to 32 counties, but by the early 1990s it was back down to 16," says Matthews.

A 1992 Alan Guttmacher Institute (AGI) paper reported that, during the late 1980s, 83 percent of U.S. counties and 20 percent of urban areas had no licensed physicians or service providers who dealt with abortion cases. As a result, in the U.S. Mid-Atlantic region, 18 percent of the women seeking information about an abortion had to drive between 50 and 100 miles. Another 9 percent drove 100 miles or more, Matthews adds.

"Our results make clear that policies that either expressly or indirectly reduce women's access to abortion services decrease their use of the procedure," says Wilhelm.

"The Supreme Court has generally held regulations to be invalid if they place substantial obstacles in the path of a woman desiring or considering an abortion," he notes. "The contentious issue of whether policies go too far in restricting access is being resolved by the Court under its standard of `undue burden.' "

"While the Court has applied its test one restriction at a time, our findings suggest that the 'undue burden' standard should be broadened to consider availability of abortion providers in certain geographical regions," says Matthews.

The study uses 1978-88 data combined from more than a dozen sources including the Alan Guttmacher Institute (AGI), Current Population Survey (CPS) and the U.S. Bureau of the Census.


EDITORS: Dr. Matthews can be reached at (814) 863-9721 (office) or at by email; Dr. Wilhelm is at (814) 863-7416 or at by email; and Dr. Ribar is at (202) 994-7608 or at by email.

Penn State

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