Abstract
We examine the impact of progressive and regressive abortion legislation on women's health in Mexico. Following a 2007 reform in the Federal District of Mexico which decriminalised and subsidised early-term elective abortion, multiple other Mexican states increased sanctions on illegal abortion. We observe that the original legalisation resulted in a sharp decline in maternal morbidity, particularly morbidity due to haemorrhage early in pregnancy. We observe small or null impacts on women's health from increasing sanctions on illegal abortion. These results quantify the considerable improvements in non-mortal health outcomes flowing from legal access to abortion.
Highlights
Appeals to women’s health are frequently made when debating the merits of abortion legislation
By the best available estimates, 13% of all maternal deaths are due to complications surrounding clandestine and unsafe abortion, with these numbers being much higher in certain settings (World Health Organization, 2011)
We consider the impact of abortion reform on haemorrhage in early pregnancy. This is classified as haemorrhage prior to 20 weeks of gestation, and is coded from ICD-10 code O20. We focus on this outcome given that haemorrhage is one of the two most common complications of unsafe abortion (World Health Organization, 2018; Gerdts et al, 2013), and given the widespread use of misoprostol as an abortifacient agent in clandestine abortions prior to the ILE reform in Mexico DF
Summary
Appeals to women’s health are frequently made when debating the merits of abortion legislation. We focus on a period in which considerable within-country reform of abortion policy was undertaken, with both a sweeping legalisation in the Federal District of the country (Mexico DF), and increasing sanctions on (illegal) abortion in other regions of the country In this context, we are able to determine to what extent change in abortion laws, absent other major contraceptive revolutions, impact health indicators for the population of affected women. The highest estimated rate of unsafe abortion is found in the Latin America and Caribbean region where each year an estimated 4.2 million unsafe induced abortions are carried out, accounting for 12% of all maternal deaths in the region (World Health Organization, 2011) This region exhibits some of the world’s most conservative laws on abortion (United Nations, 2014). Abortion restrictions are at the center of recent global governance efforts made by the US government when the so called Mexico City Policy (the Global Gag Rule) was reinstated under the Trump administration in 2017 (Starrs, 2017)
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