LIMITS OF PUBLIC POLICY TO CHANGE INDIVIDUALS’ CONSIDERATION OF ABORTION IN THE US SOUTHWEST

Abstract

Objectives

We aimed to understand abortion decision making and the extent to which unsupportive social/economic policies might contribute to people having abortions who might otherwise choose childbearing

Methods

As part of a longitudinal cohort study in the US Southwest, we prospectively followed 2,015 participants aged 15-34 years, recruited between 2019-2022 from 23 healthcare facilities, for one year until incident pregnancy (n=382) and through pregnancy decision-making. Participants having abortions reported the circumstances under which they might have decided to continue the pregnancy and raise the child.

Results

Among the 95 people who had an abortion, only 15% said nothing would have led them to decide to carry the pregnancy to term. About 71% indicated at least one circumstance related to social/economic status. For instance, 58% might have chosen to give birth if they had more money, of whom 1 in 5 said they would need less than $5,000. Housing was a major consideration, with 47% of women reconsidering abortion if they had their own or a better place to live. However, the vast majority (90%) also indicated circumstances that are immutable to social/economic policy such as if they were older (39%), finished with school (28%), married (27%), in better health (26%), or if their other children did not need their attention (21%). Only one participant exclusively indicated circumstances that could be addressed with economic policies, such as housing, childcare, and financial support.

Conclusions

Results suggest that more supportive social/economic policies could help improve reproductive autonomy but would unlikely significantly reduce need for abortion.