Report: Abortion Restrictions Tied to Poor Health Outcomes

States that put tight restrictions on abortion generally perform worse on women’s and children’s health outcomes, according to a new report released by the Center for Reproductive Rights and Ibis Reproductive Health, both groups that support abortion rights.

The report tracked 14 types of abortion restrictions that state legislatures have implemented across the country, including requirements that a woman undergo counseling or have an ultrasound before getting an abortion. The authors then plotted each state's number of restrictions against a wellness score for women and children, based on a "broad perspective" evaluation of health outcome statistics and the number of state policies the authors deemed "supportive" of those outcomes.

States with conservative leadership, including Texas, scored slightly lower on health outcomes, were less likely to support state-funded health programs and were more likely to restrict access to abortion, the study found. This isn't unexpected: Republicans widely oppose abortion and endorse fiscal responsibility — including when it means tightening up on taxpayer-subsidized health care. 

But the report's authors say their findings mean that lawmakers who seek to limit access to abortion “cannot honestly claim to own the mantle of women’s health and safety." Texas in particular “performs poorly across indicators of women’s health, children’s health, social determinants of health and policies supportive of women’s and children’s well-being,” they added. 

Abortion opponents in the Texas Legislature say that while they vehemently oppose the procedure, that doesn't mean they aren't committed to providing access to health services for Texas women. They say abortion and women's health care are two separate issues entirely. 

“My thought has been to not have strictly family planning clinics, but to provide proper comprehensive care,” said outgoing state Sen. Bob Deuell, R-Greenville, who has worked to prevent clinics affiliated with abortion providers from getting state funds — but opposed deeper cuts to women's health programs. “These women get family planning, but they don’t get any follow-up for their other problems.”

Texas, which has implemented 12 of the 14 types of abortion restrictions tracked by the report's authors, scored in the bottom quintile of an “overall well-being” score, based on factors such as child mortality rates and the percentage of women who received cervical cancer screenings. Among the restrictions Texas has placed on abortion clinics is a 2013 law requiring them to meet the same standards as ambulatory surgical centers, including having minimum sizes for rooms and doorways and pipelines for anesthesia.

Supporters of the abortion restrictions say they protect innocent life, and that requirements like the ambulatory surgical center provision will improve women’s safety when obtaining an abortion.

State Rep. Jodie Laubenberg, R-Parker, authored the 2013 law known as House Bill 2, which enacted those requirements. Laubenberg has praised the law as a “step we've taken to protect both babies and women.”

The Center for Reproductive Rights is challenging HB 2 in federal court.

The law sparked passionate debate before its passage last summer during a special session, one that followed an 11-hour filibuster by state Sen. Wendy Davis, D-Fort Worth. The law bans most abortions after 20 weeks and requires doctors who perform abortions to obtain admitting privileges at hospitals within 30 miles.

Lawmakers had enacted sweeping cuts to family planning two years earlier, which contributed to the closure of 76 clinics around the state. The Texas Health and Human Services Commission predicted an additional 24,000 births from unintended pregnancies in 2014 and 2015 as a result of those cuts, at a cost to the state of more than $100 million.

During the 2013 legislative session, lawmakers revisited women’s health and ended up passing a financial package nearly twice as large as in the 2011 session. Their 2013 allocation for women's health programs totaled $240.1 million in the 2014-15 budget — up from $127.3 million in the two years after the cuts and $201.4 million in the two years before the cuts.

But rather than fully restoring the state’s shrunken family planning services, lawmakers put $100 million toward an expanded primary health care program, billed as covering treatment for “more comprehensive health problems.” Republican lawmakers say that program provides some of those family planning services, and that they have supported efforts to improve women's health outcomes.

“Women’s health and improving outcomes is, and always has been, a priority of mine," state Sen. Jane Nelson, Republican of Flower Mound and chairwoman of the Senate Finance Committee, said in a statement. "As we develop next session’s budget, I am closely watching the agency’s appropriation request to ensure women’s health is sufficiently funded.”

This story was produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.