Another day, another visit: Impact of Arkansas’ mandatory waiting period for women seeking an abortion by demographic groups
中文摘要
26个州要求寻求堕胎的女性在接受咨询后等待18至72小时，才能完成堕胎。13个州要求咨询必须当面进行，因此至少需要前往医疗服务提供者处就诊两次。2015年4月，阿肯色州将堕胎等待期从24小时延长至48小时，更重要的是，要求女性当面接受咨询。从医学角度看并无必要的两次就诊要求，大幅增加了交通、误工、儿童照护以及前往堕胎机构时遭受污名化和骚扰等方面的成本。我们采用断点回归设计，分析阿肯色州2015年强制等待期（MWP）法律对堕胎率的即时影响。我们使用阿肯色州卫生部（DOH）提供的去标识化个体层面数据，涵盖2000年至2020年在阿肯色州实施的所有堕胎。我们的研究首次使用月度个体数据，并按种族/族裔、年龄、产次、婚姻状况和受教育程度进行分层分析。该法律生效后，全体女性的堕胎率立即下降了17%，其中非西班牙裔白人女性下降了22%，非西班牙裔黑人女性下降了14%。我们表明，该法律使有子女的未婚成年女性的堕胎率下降最多。如果罗诉韦德案被推翻，堕胎将在阿肯色州成为非法行为。鉴于堕胎率下降与强制等待期的两次就诊要求相关，随着前往最近的合法提供堕胎服务的医疗机构的距离增加，堕胎率很可能进一步下降。
Abstract
Twenty-six states require that women seeking an abortion wait between 18 and 72 h after receipt of counseling before the abortion can be completed. Thirteen states require that the counseling be given in person necessitating at least two visits to the provider. In April of 2015, Arkansas increased the waiting period for an abortion from 24 to 48 h and more significantly, required that women receive the counseling in person. The two-visit requirement, unnecessary from a medical standpoint, substantially increases the cost in terms of travel, lost work, child care, and exposure to stigma and harassment upon accessing abortion facilities. We use a regression discontinuity design to analyze the immediate effect of Arkansas’s 2015 mandatory waiting period (MWP) law on abortion rates. We use de-identified, individual-level data from the Arkansas Department of Health (DOH) on all abortions performed in Arkansas from 2000 to 2020. Our study is the first to use monthly individual data and stratify analyses by race/ethnicity, age, parity, marital status and schooling. Abortion rates fell 17 percent among all women, but 22 percent among white non-Hispanics and 14 percent among black non-Hispanics immediately after the law went into effect. We show that the law decreased abortion rates the most among unmarried adults with children. If Roe v. Wade is overturned, abortion will become illegal in Arkansas. Given the decline in abortion rates associated the MWP’s two-visit requirement, abortion rates will likely fall further as travel distance to the nearest legal provider increases.