Forecasts for a post‐Roe America: The effects of increased travel distance on abortions and births

Abstract

I compile novel data measuring county‐level travel distances to abortion facilities and resident abortion rates from 2009 through 2020. Using these data, I implement a difference‐in‐difference research design measuring the effects of driving distance to the nearest abortion facility on abortions and births. The results indicate large but diminishing effects: an increase from 0 to 100 miles is estimated to reduce abortion rates by 19.4% and increase birth rates by 2.2%, while the next 100 miles reduces abortions by an additional 12.8% and increases births by an additional 1.6%. Based on this evidence, I forecast the effects of post‐Roe abortion bans on abortion rates by county, state, and region. In a scenario in which total abortion bans take effect in 24 states, about one‐quarter of residents seeking abortions are predicted to become trapped by distance and about three‐quarters of those who are trapped are predicted to give birth as a result.

Comparison of No-Test Telehealth and In-Person Medication Abortion

“…Although geographic and logistical barriers have always delayed and complicated pregnant people's access to abortion, 33,34 these barriers have become increasingly problematic following the Supreme Court's June 2022 decision revoking federal protections on abortion. 35,36 Thus, expansion of telehealth and no-test or history-based models offers a safe and effective, as well as urgently needed, way to overcome at least some of the logistical and geographic barriers to accessing abortion. 37 Study findings may also be used to refute ongoing efforts to further regulate and restrict access to medication abortion, most notably in the Alliance for Hippocratic Medicine v FDA case currently before the US Supreme Court.…”

The Economics of Abortion Policy

“…Across a range of studies examining recent policy reforms these results have been found to still be relevant (Fischer et al, 2018; Lindo et al, 2020a; Myers, 2023; Venator and Fletcher, 2020, both in terms of the magnitude of the effect on access to abortion, as well as in finding the existence of substantial non-linear effects. Using novel data on the location of abortion clinics as well as state-level reforms across the entire US, Myers (2023) documents the importance of distance in both explaining abortion rates, as well as explaining birth rates. Like impacts of distance on access to abortion, impacts on birth rates are found to be non-linear.…”

“…Like impacts of distance on access to abortion, impacts on birth rates are found to be non-linear. Myers (2023) documents that increasing distance to the nearest clinic by 100 miles increases birth rates by 2.2% for the first 100 mile increase, and this figure declines t0 1.6% for the next 100 mile increase. She estimates that the costs of these changes in distance are largest for younger women, especially teens and individuals in their early 20s.…”

The impact of juvenile curfews on teenage birth rates

“…The abortion rate for the same group of women is nearly half that of the birth rate in recent years (Maddow-Zimet & Kost, 2021). The recent loss of the federal constitutional right to abortion has made abortion less accessible; existing evidence suggests that abortion care requiring travel or consent decreases abortion rates and, consequently, increases birth rates for young women by up to 5% (Jones & Pineda-Torres, 2021;Joyce, Kaestner & Ward, 2020;Myers, 2024). Even with a diminished effect on birth rates in the current era, juvenile curfews could be a useful policy tool to prevent teenage pregnancies in the post-Roe landscape.…”