P045 - EXPLORING US STATE ABORTION POLICY TRAJECTORIES FROM 1970 TO 2014 USING SEQUENCE ANALYSIS

• Published in: Contraception (Stoneham) Vol. 127
• Main Authors: Koenig, LR, Pacca, L, Hamad, R, Vable, A
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-11-2023
• ISSN: 0010-7824; 1879-0518
• DOI: 10.1016/j.contraception.2023.110212

The national abortion landscape changed dramatically in 2022 when the Dobbs v Jackson Women’s Health Organization decision led to abortion care being banned in at least 13 states. Even before Dobbs, state abortion restrictions had been implemented for decades. We characterized US states’ abortion policy trajectories from 1970 to 2014.
We examined state policy data from all US states from 1970 to 2014. We calculated an index of abortion policy permissiveness, reflecting the total number of protective abortion policies minus the number of restrictive abortion policies each year in each state. We used sequence analysis to measure similarities between state abortion policy trajectories across the study period, and clustering to identify states with similar policy trajectories.
State abortion policies were largely moderate or protective from the 1970s to the 1990s and became more restrictive in some states starting in the mid-1990s. We identified four distinct clusters of abortion policy trajectories: 1) moderate to restrictive, 2) protective to restrictive, 3) recent restrictions beginning in the mid-2000s, and 4) consistently protective. Moderate to restrictive states, protective to restrictive states, and states that implemented recent restrictions were predominantly located in the South and Midwest. Consistently protective states were most likely to be on the East and West coasts.
Even prior to the Dobbs decision, abortion restrictions intensified in many US states, especially between the 1990s and 2014. Abortion policies have become increasingly polarized over time such that reproductive autonomy is increasingly curtailed and determined by state of residence. Sequence and cluster analysis is a promising analytic strategy to characterize longitudinal trends in reproductive health policy.