Abstract
Objectives
In this paper, we estimate the average effect of two common TRAP (targeted regulation
of abortion providers) laws on abortion rates using a novel longitudinal database
of state-level policy shifts.
Study design
We merged several sources of policy, abortion, and sociodemographic data from 1991–2014.
We used a difference-in-differences design to control for time-fixed state-level characteristics
and common factors affecting abortion trends across all states, as well as measured
time-varying state-level factors that may impact TRAP enforcement and abortion rates.
We used generalized linear models with cluster-robust standard errors to obtain our
estimates.
Results
Enforcement of ambulatory surgical center (ASC) laws reduced the abortion rate by
1.25 abortions per 1000 women aged 15–44 (95% CI: −3.39, .89), and admitting privilege
laws increased the abortion rate by .57 abortions per 1000 women aged 15–44 (95% CI:
−.68, 1.83), but neither effect was statistically distinguishable from zero. Our findings
were robust to the inclusion of covariates and various sensitivity analyses.
Conclusion
Our results suggest that ASC and admitting privilege laws did not, on average, lead
to a meaningful change in abortion rates.
Implications
US abortion rates are currently at record lows, but our findings suggest that TRAP
laws are not a meaningful driver of this trend. However, this does not mean that these
laws are without consequence in a particular state (or a given year). Researchers
should assess the average long-run impact of TRAP laws on other outcomes in the future.
Keywords
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Article Info
Publication History
Published online: June 13, 2019
Accepted:
June 4,
2019
Received in revised form:
May 31,
2019
Received:
February 10,
2019
Footnotes
☆Competing interests: None declared.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
