Restrictions on Medicaid Funding of Abortion: Effects on Birth Weight and Pregnancy Resolutions

Abstract

This study uses individual data from the 1980-89 National Longitudinal Survey of Youth (NLSY) and state and county level data on Medicaid funding for abortion and access to abortion services and prenatal care from the Alan Guttmacher Institute. The NLSY sample overrepresents the poor and African-Americans. This study estimates the probability that a pregnancy is carried to term and the effects of restrictions on Medicaid funding of abortion on birth weight and low birth weight. Reduced form models are used in the analysis. The analytical framework is based on models developed by Grossman and Joyce. Four models are used in the analyses. Findings indicate that restrictive laws had no significant effect on birth weight. The number of abortion providers was associated with significantly higher birth weights particularly among African-American women and low income women. The example of the effects among African American births of a 13 ounce gain revealed a decline in low birth weight from 11% to 4%. Other community measures with a statistically significant impact were the number of hospitals with prenatal care services in a county and the percentage of births to unmarried women which reduced birth weight by 14 ounces among low income women. Higher birth weight was associated with higher income the presence of a partner maternal height and maternal educational status. Lower birth weight was associated with being African-American and smoking during pregnancy. Southern African-American women and Southern low income women had higher birth weights. Results confirm that laws restricting Medicaid funding increased the probability that a pregnancy was carried to term particularly among some groups. Restrictive laws had little effect on birth weight or the incidence of low birth weight. Restrictive laws and enjoined laws had the same effect among White and high income women when the number of abortion providers was controlled for. Underreporting due to stigma is attributed to the finding that Medicaid funding had an effect on birth probabilities among high income women.