{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:31:38Z","timestamp":1787023898504,"version":"build-2736575974"},"reference-count":12,"publisher":"American Public Health Association","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"abstract":"<jats:p>Objectives. To investigate the association between state gestational age limit abortion laws, which restrict abortions after a specific point in pregnancy, and severe maternal morbidity (SMM) hospitalization rates in the United States.<\/jats:p>\n                  <jats:p>Methods. We used a difference-in-differences approach and hospitalizations data measured annually at the state level from 2010 to 2022 for 47 states. All models included state covariates and state and year fixed effects, which provided plausibly causal estimates of the effect of gestational age limits on SMM rates.<\/jats:p>\n                  <jats:p>Results. Any law that prohibited abortion on the basis of gestational age increased SMM rates by 7.67 (95% confidence interval [CI]\u2009=\u20091.55, 13.80) per 10\u2009000 patients. This was equal to a 10.5% increase in SMM rates compared with baseline levels. The effects were driven by older patients, hospitalizations paid for by public payers, safety net hospitals, and patients living in low-income communities. Conversely, increasing the gestational age limit by 1 week (expanding abortion access) reduced the SMM rate by 0.28 (95% CI\u2009=\u2009\u22120.568, 0.002) per 10\u2009000 patients.<\/jats:p>\n                  <jats:p>Conclusions. Restricting access to abortion care increases the risk of SMM, particularly among older women and those of lower socioeconomic status. ( Am J Public Health. Published online ahead of print October 23, 2025:e1\u2013e4. https:\/\/doi.org\/10.2105\/AJPH.2025.308291 )<\/jats:p>","DOI":"10.2105\/ajph.2025.308291","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T19:59:08Z","timestamp":1761249548000},"page":"e1-e4","source":"Crossref","is-referenced-by-count":1,"title":["The Association Between State Gestational Age Limit Abortion Laws and Severe Maternal Morbidity: United States, 2010\u20132022"],"prefix":"10.2105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3220-1993","authenticated-orcid":false,"given":"Nicole","family":"Siegal","sequence":"first","affiliation":[{"name":"Nicole Siegal is a postdoctoral fellow at the O\u2019Neill School of Public and Environmental Affairs, Indiana University, Bloomington. Aparna Soni is an associate professor in the Department of Health Policy & Management, Fairbanks School of Public Health, Indiana University, Indianapolis."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0737-485X","authenticated-orcid":false,"given":"Aparna","family":"Soni","sequence":"additional","affiliation":[{"name":"Nicole Siegal is a postdoctoral fellow at the O\u2019Neill School of Public and Environmental Affairs, Indiana University, Bloomington. Aparna Soni is an associate professor in the Department of Health Policy & Management, Fairbanks School of Public Health, Indiana University, Indianapolis."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"844","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"p_1","unstructured":"American College of Obstetricians and Gynecologists. Periviable birth. October 2017. Available at: https:\/\/www.acog.org\/-\/media\/project\/acog\/acogorg\/ clinical\/files\/obstetric-care-consensus\/articles\/2017\/ 10\/periviable-birth.pdf. Accessed October 8, 2025."},{"key":"p_2","unstructured":"Guttmacher Institute. Abortion in the United States. April 2025. Available at: https:\/\/www. guttmacher.org\/fact-sheet\/induced-abortionunited-states?gad_source=1&gclid=Cj0KCQjw 05i4BhDiARIsAB_2wfCkbwqijBBp6H_PZz-piU2Ry 4t0G-lpoDLG39gP0aalv9AyshjAE2gaAvv7EALw_ wcB. Accessed October 8, 2025."},{"key":"p_3","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2007.127530"},{"key":"p_4","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2021.05.022"},{"key":"p_5","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2019.09.012"},{"key":"p_6","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17113773"},{"key":"p_7","doi-asserted-by":"crossref","unstructured":"Miller S, Wherry L, Foster DG. The economic consequences of being denied an abortion. National Bureau of Economic Research working paper 26662. January 2020. Available at: https:\/\/www. nber.org\/papers\/w26662. Accessed October 8, 2025.","DOI":"10.3386\/w26662"},{"key":"p_8","doi-asserted-by":"publisher","DOI":"10.3368\/jhr.55.4.1217-9254R3"},{"key":"p_9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2021.102533"},{"key":"p_10","doi-asserted-by":"crossref","unstructured":"Fischer S, Royer H, White C. The impacts of reduced access to abortion and family planning services on abortion, births, and contraceptive purchases. National Bureau of Economic Research working paper 23634. July 2017. Available at: https:\/\/www.nber.org\/papers\/w23634. Accessed October 8, 2025.","DOI":"10.3386\/w23634"},{"key":"p_11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0275656"},{"key":"p_12","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.17641"}],"container-title":["American Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ajph.aphapublications.org\/doi\/pdf\/10.2105\/AJPH.2025.308291","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T19:59:10Z","timestamp":1761249550000},"score":1,"resource":{"primary":{"URL":"https:\/\/ajph.aphapublications.org\/doi\/full\/10.2105\/AJPH.2025.308291"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,23]]},"references-count":12,"alternative-id":["10.2105\/AJPH.2025.308291"],"URL":"https:\/\/doi.org\/10.2105\/ajph.2025.308291","relation":{},"ISSN":["0090-0036","1541-0048"],"issn-type":[{"value":"0090-0036","type":"print"},{"value":"1541-0048","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,23]]}}}