State abortion policy, geographic access to abortion providers and changing family formation

Fam Plann Perspect. 1998 Nov-Dec;30(6):281-7.


Context: One of the goals in cutting welfare payments and setting time limits on welfare receipt is the reduction of out-of-wedlock childbearing among poor women. Yet such changes may increase the demand for abortion at the same time that access to abortion has decreased, throwing into doubt the potential effect of these changes on the proportion of women who are heading families.

Methods: State and county fixed-effects models were used to estimate the effects of factors influencing abortion availability--geographic access, parental notification requirements and Medicaid funding restrictions--on the county-level proportion of women heading households.

Results: The decline in geographic access to abortion providers during the 1980s accounted for a small but significant portion of the rise in the percentage of women heading families (about 2%). Restrictions on Medicaid funding for abortion accounted for about half of the increase in female headship among blacks, while new state parental notification requirements contributed modestly to the rise in the proportion of white women heading single-parent families.

Conclusions: Welfare reform legislation and attempts to reduce the availability of abortion services in the United States appear to be working at cross-purposes. Cutbacks in access to abortion may have contributed modestly to the increase in the proportion of women heading households.

PIP: This study examined whether new barriers to abortion access are likely to contribute to increased female headship in the US. State and country fixed effects models are estimated for the impact of geographic access to abortion providers, notification requirements, parental consent, and Medicaid funding restrictions. Data were obtained from county records from summary tape files of the 1980 and 1990 censuses; abortion provider information from the Alan Guttmacher Institute; and physicians active in OB-GYN patient care data from the Bureau of Health Professionals Area Resource File. Pooled data amounted to 6132 observations for 3066 counties. The data included nonmarital births without a marriage and marital births followed by separation or divorce. Sensitivity analysis accounted for local divorce rates. Fixed effects controls accounted for unobserved variables. Population-weighted descriptive statistics are provided for dependent and key independent variables. Abortion provider declines ranged from 13% to 19%. Findings indicate that declines in geographic access accounted for a small, but significant, decline in increased female headship. About 50% of the increase among Black female headship was accounted for by restrictions on Medicaid funding. A modest amount of the rise in White female headship was due to state parent notification requirements. The difference in the estimated impact of abortion providers in the state and county specific models supported findings of Kane and Staiger. Sensitivity models did not alter the effects of access to abortion providers and physicians. Findings suggest conflicting or competing public policy goals.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Abortion, Legal / statistics & numerical data*
  • Abortion, Legal / trends
  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Family Characteristics*
  • Female
  • Health Services Accessibility*
  • Humans
  • Pregnancy
  • Public Policy*
  • Regression Analysis
  • Social Welfare / legislation & jurisprudence
  • United States