{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T14:53:59Z","timestamp":1787669639092,"version":"build-2736575974"},"reference-count":56,"publisher":"Duke University Press","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>An increasingly hostile policy climate has reshaped abortion access in the United States. Recent literature has studied the effects of restrictive abortion policies on reproductive health outcomes. This study is the first to investigate the association between state-level abortion policy hostility and the pregnancy intentions of women with a pregnancy resulting in live birth. Data are from the Pregnancy Risk Assessment Monitoring System survey, merged with a state-level legislative database from 2012\u20132018 and other state-level controls. Cross-sectional results reveal that a one-unit increase in abortion policy hostility is associated with a relative risk (odds) of having a live birth resulting from an unintended versus intended pregnancy that is 1.02 times as high (RRR = 1.02, 95% confidence interval = 1.01, 1.03). This result corresponds to a 13% increase in the predicted probability of having a live birth resulting from an unintended pregnancy between a zero-hostility and a maximum-hostility state. Models stratified by demographic and socioeconomic characteristics reveal that the association between abortion policy hostility and live birth resulting from an unintended pregnancy is particularly robust among women in younger, less educated, Medicaid, uninsured, and rural populations.<\/jats:p>","DOI":"10.1215\/00703370-10952575","type":"journal-article","created":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T07:36:58Z","timestamp":1694158618000},"page":"1469-1491","source":"Crossref","is-referenced-by-count":11,"title":["State-Level Abortion Policy Hostility and Unplanned Births in the Pre-<i>Dobbs<\/i> Era"],"prefix":"10.1215","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9134-6570","authenticated-orcid":true,"given":"Julia C. P.","family":"Eddelbuettel","sequence":"first","affiliation":[{"name":"Department of Policy Analysis and Management, Brooks School of Public Policy, Cornell University, Ithaca, NY, USA"},{"name":"Ph.D. Program in Health Policy, Harvard University, Cambridge, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5287-8398","authenticated-orcid":true,"given":"Sharon","family":"Sassler","sequence":"additional","affiliation":[{"name":"Department of Policy Analysis and Management, Brooks School of Public Policy, Cornell University, Ithaca, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"73","published-online":{"date-parts":[[2023,10,1]]},"reference":[{"key":"2023100213321153800_dem10952575C1","doi-asserted-by":"crossref","unstructured":"Aiken\n              A. R. A.\n            \n          , StarlingJ. E., ScottJ. G., & GompertsR. (2022). Association of Texas Senate Bill 8 with requests for self-managed medication abortion. JAMA Network Open, 5, e221122. https:\/\/doi.org\/10.1001\/jamanetworkopen.2022.1122","DOI":"10.1001\/jamanetworkopen.2022.1122"},{"key":"2023100213321153800_dem10952575C2","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1136\/bmjsrh-2017-101866","article-title":"Assessing the impact of TRAP laws on abortion and women's health in the USA: A systematic review","volume":"44","author":"Austin","year":"2018","journal-title":"BMJ Sexual & Reproductive Health"},{"key":"2023100213321153800_dem10952575C3","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1111\/1475-6773.13185","article-title":"Constructing a longitudinal database of targeted regulation of abortion providers laws","volume":"54","author":"Austin","year":"2019","journal-title":"Health Services Research"},{"key":"2023100213321153800_dem10952575C4","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/j.contraception.2019.06.003","article-title":"Quantifying the impact of targeted regulation of abortion provider laws on U.S. abortion rates: A multi-state assessment","volume":"100","author":"Austin","year":"2019","journal-title":"Contraception"},{"key":"2023100213321153800_dem10952575C5","doi-asserted-by":"crossref","first-page":"e007151","DOI":"10.1136\/bmjgh-2021-007151","article-title":"Country-specific estimates of unintended pregnancy and abortion incidence: A global comparative analysis of levels in 2015\u20132019","volume":"7","author":"Bearak","year":"2022","journal-title":"BMJ Global Health"},{"key":"2023100213321153800_dem10952575C6","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1001\/jamapsychiatry.2016.3478","article-title":"Women's mental health and well-being 5 years after receiving or being denied an abortion: A prospective, longitudinal cohort study","volume":"74","author":"Biggs","year":"2017","journal-title":"JAMA Psychiatry"},{"key":"2023100213321153800_dem10952575C7","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.whi.2020.11.005","article-title":"Impact of state-level reproductive health legislation on access to and use of reproductive health services and reproductive health outcomes: A systematic scoping review in the Affordable Care Act era","volume":"31","author":"Bossick","year":"2021","journal-title":"Women's Health Issues"},{"key":"2023100213321153800_dem10952575C8","doi-asserted-by":"crossref","unstructured":"Brown\n              B. P.\n            \n          , HebertL. E., GilliamM., & KaestnerR. (2020). Association of highly restrictive state abortion policies with abortion rates, 2000\u20132014. JAMA Network Open, 3, e2024610. https:\/\/doi.org\/10.1001\/jamanetworkopen.2020.24610","DOI":"10.1001\/jamanetworkopen.2020.24610"},{"key":"2023100213321153800_dem10952575C9","unstructured":"Centers for Disease Control and Prevention. (2023, March28). PRAMS. Retrieved from https:\/\/www.cdc.gov\/prams\/index.htm"},{"key":"2023100213321153800_dem10952575C10","unstructured":"Dobbs v. Jackson Women's Health Organization, 19 U.S. 1392 (2022). 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(2020, January22). Targeted regulation of abortion providers (TRAP) laws. 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State abortion policy landscape: From hostile to supportive. Guttmacher Institute. Retrieved from https:\/\/www.guttmacher.org\/article\/2019\/08\/state-abortion-policy-landscape-hostile-supportive"},{"key":"2023100213321153800_dem10952575C37","unstructured":"Nash\n              E.\n            \n           (2021, October4). For the first time ever, U.S. states enacted more than 100 abortion restrictions in a single year. Guttmacher Institute. Retrieved from https:\/\/www.guttmacher.org\/article\/2021\/10\/first-time-ever-us-states-enacted-more-100-abortion-restrictions-single-year"},{"key":"2023100213321153800_dem10952575C38","first-page":"41","article-title":"The U.S. abortion rate continues to drop: Once again, state abortion restrictions are not the main driver","volume":"22","author":"Nash","year":"2019","journal-title":"Guttmacher Policy Review"},{"key":"2023100213321153800_dem10952575C39","unstructured":"National Center for Health Statistics. (2019, November8). Key statistics from the National Survey of Family Growth\u2014I listing. Centers for Disease Control and Prevention. Retrieved from https:\/\/www.cdc.gov\/nchs\/nsfg\/key_statistics\/i.htm"},{"key":"2023100213321153800_dem10952575C40","unstructured":"Pew Research Center. (2014). Pew Research Center 2014 U.S. Religious Landscape Study. 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(2015). Unintended pregnancy and the changing demography of American women, 1987\u20132008. Demographic Research, 33, 1257\u20131270. https:\/\/doi.org\/10.4054\/DemRes.2015.33.45","DOI":"10.4054\/DemRes.2015.33.45"},{"key":"2023100213321153800_dem10952575C51","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.contraception.2012.07.016","article-title":"Burden of unintended pregnancy in the United States: Potential savings with increased use of long-acting reversible contraception","volume":"87","author":"Trussell","year":"2013","journal-title":"Contraception"},{"key":"2023100213321153800_dem10952575C52","doi-asserted-by":"crossref","unstructured":"Upadhyay\n              U. D.\n            \n          , McCookA. A., BennettA. H., CartwrightA. F., & RobertsS. C. M. (2021). State abortion policies and Medicaid coverage of abortion are associated with pregnancy outcomes among individuals seeking abortion recruited using Google Ads: A national cohort study. 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