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Could Restrictions to the 'Supply Side' Lead to Fewer Abortions?

"Services will be readily available in coastal blue states, whereas women in the country's vast middle will have to travel large distances for access."

Abortion opponents have tried several tactics to try and get women considering abortion to reconsider. An article in The New England Journal of Medicine is saying these tactics have not been very effective.

Theodore Joyce with the National Bureau of Economic Research writes, tactics targeting the "supply side" -- the doctors, nurses, clinicians and others who are associated with providing abortions -- to prevent abortions from happening has had some success.

Joyce cites examples of states that have passed legislation that restricts abortion service providers and states that if this trend continues on a state-by-state basis, women would likely have to travel father to find a clinic to administer an abortion, which would be an added deterrent.

Examples Joyce includes are the following:

  • The Kansas Department of Health and Environment passed new regulations that require abortion clinics to meet certain facility stipulations, such as a required square footage for procedure rooms and janitorial closets. Joyce notes that three Kansas clinics were temporarily granted an injunction to continue operations after two physicians filed a lawsuit.
  • The Texas's Woman's Right to Know Act, which includes both demand and supply side components, requires abortions of fetuses 16 weeks or older to take place in a hospital or "ambulatory surgical center," which have requirements for staffing and facility specifications. Joyce writes that when this act went into effect in 2004, the closest ambulatory surgical center meeting the new requirements went from 33 miles away to 252 miles.
  • Missouri and Virginia, in recent years, enacted statutes  that an abortion facility performing five or more first-trimester abortions in a month would need to meet restrictions; Missouri also includes clinics that perform at least one abortion after 12 weeks of gestation. Virginia's statute is set to go in effect in 2012 after being signed by the governor and Missouri's statute was put on hold due to "economic impact."
  • Arizona now has a law that physicians must administer both surgical and medical (use of a pill) abortions, resulting in three clinics closing.

Joyce states that if similar restrictions continue to crop up in states, visualizing the states performing services on a map will look like much like the blue/red states associated with political parties:

Services will be readily available in coastal blue states, whereas women in the country's vast middle will have to travel large distances for access. To illustrate the importance of travel distance as a determinant of whether a woman obtains an abortion, consider abortion rates just before Roe v. Wade. In 1971–1972, abortion was effectively legal in five states: Alaska, California, Hawaii, New York, and Washington. In 1971–1972, there were 27,793 abortions performed in New York in residents of Illinois, an annual rate of 5.9 abortions per 1,000 female Illinois residents 15 to 44 years of age — but the rate of abortions performed in New York in Connecticut residents was almost twice as high, 10.3 per 1,000, and the rate among New Jersey residents was more than 2.5 times as high, 15.2 per 1,000.

Joyce writes that he believes that making abortions more difficult to receive based on restrictions to clinics will revive the unsafe abortions being conduction pre-Roe vs. Wade and advocates for prevention of unwanted pregnancies to reduce abortion rates.


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