Women's Reproductive Rights Policies and Adverse Birth Outcomes: A State-Level Analysis to Assess the Role of Race and Nativity Status

Sudhinaraset, May; Vilda, Dovile; Gipson, Jessica D.; Bornstein, Marta; Wallace, Maeve

doi:10.1016/j.amepre.2020.07.025

Cited by 18 publications

(22 citation statements)

References 49 publications

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“… 4 , 66–68 Others note the need to understand the intersection of race, nativity, and immigration status in health research, 4 , 102 , 105 , 106 and emerging research describes the salience of this intersection for maternal and infant health outcomes. 107–109 …”

Section: Resultsmentioning

confidence: 99%

Incorporating Measures of Structural Racism into Population Studies of Reproductive Health in the United States: A Narrative Review

et al. 2021

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Purpose: Black women in the United States face poor outcomes across reproductive health measures—from pregnancy outcomes to gynecologic cancers. Racial health inequities are attributable to systemic racism, but few population studies of reproductive health outcomes integrate upstream measures of systemic racism, and those who do are limited to maternal and infant health outcomes. Advances in understanding and intervening on the pathway from racism to reproductive health outcomes are limited by a paucity of methodological guidance toward this end. We aim to fill this gap by identifying quantitative measures of systemic racism that are salient across reproductive health outcomes. Methods: We conducted a review of literature from 2000 to 2019 to identify studies that use quantitative measures of exposure to systemic racism in population reproductive health studies. We analyzed the catalog of literature to identify cohesive domains and measures that integrate data across domains. For each domain, we contextualize its use within population health research, describe metrics currently in use, and present opportunities for their application to reproductive health research. Results: We identified four domains of systemic racism that may affect reproductive health outcomes: (1) civil rights laws and legal racial discrimination, (2) residential segregation and housing discrimination, (3) police violence, and (4) mass incarceration. Multiple quantitative measures are available for each domain. In addition, a multidimensional measure exists and additional domains of systemic racism are salient for future development into distinct measures. Conclusion: There are quantitative measures of systemic racism available for incorporation into population studies of reproductive health that investigate hypotheses, including and beyond those related to maternal and infant health. There are also promising areas for future measure development, such as the child welfare system and intersectionality. Incorporating such measures is critical for appropriate assessment of and intervention in racial inequities in reproductive health outcomes.

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Section: Resultsmentioning

confidence: 99%

Incorporating Measures of Structural Racism into Population Studies of Reproductive Health in the United States: A Narrative Review

et al. 2021

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“…A national analysis by Coles et al revealed that Black teenagers living in states with Medicaid funding restrictions were four times more likely to experience an unintended birth [ 69 ]. Lastly, Sudhinaraset and colleagues found that LBW risk was 8% lower among Black women living in states with the least restrictive reproductive rights policies, compared to counterparts living in the most restrictive states [ 53 ].…”

Section: Discussionmentioning

confidence: 99%

“…A handful of studies have demonstrated that restrictive abortion policies (or other policies governing reproductive rights) are associated with decreased access to abortion care for people of color and those with lower SES [ 67 , 68 ] and increased risks of unintended teen births [ 69 ] and low birthweight among Black women [ 53 ]. Given the landscape of racial/ethnic and socioeconomic inequities in birth outcomes in the U.S. [ 70 – 86 ], policies restricting access to abortion have the potential to exacerbate adverse birth outcomes, as well as inequities in said outcomes, for people of color and those with lower SES.…”

Section: Introductionmentioning

confidence: 99%

Racial/ethnic and educational inequities in restrictive abortion policy variation and adverse birth outcomes in the United States

Redd

Rice

Aswani

et al. 2021

BMC Health Serv Res

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Background To examine racial/ethnic and educational inequities in the relationship between state-level restrictive abortion policies and adverse birth outcomes from 2005 to 2015 in the United States. Methods Using a state-level abortion restrictiveness index comprised of 18 restrictive abortion policies, we conducted a retrospective longitudinal analysis examining whether race/ethnicity and education level moderated the relationship between the restrictiveness index and individual-level probabilities of preterm birth (PTB) and low birthweight (LBW). Data were obtained from the 2005–2015 National Center for Health Statistics Period Linked Live Birth-Infant Death Files and analyzed with linear probability models adjusted for individual- and state-level characteristics and state and year fixed-effects. Results Among 2,250,000 live births, 269,253 (12.0%) were PTBs and 182,960 (8.1%) were LBW. On average, states had approximately seven restrictive abortion policies enacted from 2005 to 2015. Black individuals experienced increased probability of PTB with additional exposure to restrictive abortion policies compared to non-Black individuals. Similarly, those with less than a college degree experienced increased probability of LBW with additional exposure to restrictive abortion policies compared to college graduates. For all analyses, inequities worsened as state environments grew increasingly restrictive. Conclusion Findings demonstrate that Black individuals at all educational levels and those with fewer years of education disproportionately experienced adverse birth outcomes associated with restrictive abortion policies. Restrictive abortion policies may compound existing racial/ethnic, socioeconomic, and intersecting racial/ethnic and socioeconomic perinatal and infant health inequities.

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“…We controlled for individual-and time-varying state-level demographic, economic, political, and policy characteristics that the structural determinants of health framework and existing literature suggest may be associated with either adverse birth outcomes or state policymaking decisions (Austin & Harper, 2019;Bitler & Zavodny, 2001;Blank, George, & London, 1996;Crear-Perry et al, 2021;Hawkins et al, 2020;Levine, Trainor, & Zimmerman, 1996;Medoff, 2012;New, 2011;Oakley, 2003;Pabayo et al, 2020;Sen, Wingate, & Kirby, 2012;Sudhinaraset, Vilda, Gipson, Bornstein, & Wallace, 2020;Wallace et al, 2017). At the individual level, we controlled for pregnant parent sociodemographic characteristics (i.e., age, race, ethnicity, education level, marital status) and health risk factors (i.e., number of births and prenatal care visits, diabetes, chronic hypertension, pregnancy-associated hypertension, and eclampsia) and infant characteristics (i.e., sex and plurality) using data from the Period Linked Birth-Infant Death files.…”

Section: Covariatesmentioning

confidence: 99%

Variation in Restrictive Abortion Policies and Adverse Birth Outcomes in the United States from 2005 to 2015

Redd

Hall

Aswani

et al. 2022

Women's Health Issues

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Women's Reproductive Rights Policies and Adverse Birth Outcomes: A State-Level Analysis to Assess the Role of Race and Nativity Status

Cited by 18 publications

References 49 publications

Incorporating Measures of Structural Racism into Population Studies of Reproductive Health in the United States: A Narrative Review

Incorporating Measures of Structural Racism into Population Studies of Reproductive Health in the United States: A Narrative Review

Racial/ethnic and educational inequities in restrictive abortion policy variation and adverse birth outcomes in the United States

Variation in Restrictive Abortion Policies and Adverse Birth Outcomes in the United States from 2005 to 2015

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