Almost half the United States is ready to outlaw abortion now that the Supreme Court has overruled Roe v. Wade. But many of those states are not willing to give new babies and their families the educational, medical, or financial support they need to lead a healthy life. That could leave tens of thousands of future children unnecessarily disadvantaged and living in poverty.
The precise effect on new births from the 22 states set to enact broad abortion bans now that Roe v. Wade is overturned is impossible to predict. But public health experts like Diana Greene Foster — the lead researcher on the Turnaway Study, an enormous survey project that tracked the long-term effects of receiving or being denied an abortion — expect a meaningful increase in the number of women with an unwanted pregnancy who nevertheless give birth. Middlebury College economics professor Caitlin Knowles Myers anticipates as many as 75,000 people who want an abortion but can’t get one will end up giving birth in the first year after Roe is overturned.
Those births will predominately be in the states with the most draconian post-Roe abortion restrictions. And with a few exceptions, those 22 states rank in the bottom half of states in the comprehensive support they provide to children and their families, according to the State-by-State Spending on Kids Dataset compiled by Brown University’s Margot Jackson and her colleagues. The disparities can be enormous: Vermont spends three times as much money on education, health care, and other economic support for children as Utah.
Should the Supreme Court remove federal abortion protections, “there’s really no reason to think those patterns would change,” Jackson told me before the Court’s abortion decision. “The potential consequences, the very likely consequences, would be a pretty substantial widening of the stark and striking inequalities that already exist in social support available to mothers and children.”
Families will be adding a new child in states that have made it harder for them to afford food and housing. More children could end up living in poverty, their households struggling to pay for bare necessities. Research suggests their parents will be less likely to purchase items that help with the child’s development, and they may struggle to hit early milestones compared to their peers in other states.
The children born in these circumstances will start life a few steps behind, all because their political leaders strove to ban abortion without offering support to the children who would be born if their aims were achieved.
People often get abortions because they worry about the economics
Ultimately, abortion bans may mean more babies are born to people uncertain of their ability to take care of them, in states that refuse to provide for them. As documented in the Turnaway Study, women often cite their finances or wanting to take care of the children they already have when explaining why they’d want an abortion.
“Most women seeking abortions are already experiencing financial hardships,” Foster writes in her 2020 book. Specifically, about half of the 1,000 women who participated in the Turnaway Study were living in poverty, a number consistent with national averages of women terminating a pregnancy. Three-fourths of the women in the study said they already didn’t have enough money for food, housing, and transportation.
According to the Turnaway Study’s surveys, 40 percent of women who were seeking an abortion said they were not financially prepared, and 29 percent said they needed to focus on the children they already have. Another 20 percent said that having a baby would interfere with their own future opportunities, and 12 percent said they could not provide the kind of life that they would want for their baby. (The participants could give more than one answer and most did.)
A parent’s ability to provide for their child is, in part, dependent on where they live. The State Spending on Kids Dataset has collected state fiscal records on everything from K-12 education and higher ed to child tax credits to food stamps and cash assistance. Urban Institute scholars took that information and found these enormous disparities in how much different states spend in total to support a child and their family.
Some of these disparities likely reflect the differences in cost of living; generally, it costs more money to subsist in a blue state on the coast than in a red state in the interior. But some of it is a matter of ideology, with the correlation between a less generous welfare state and more abortion restrictions being strong.
In a 2018 essay, Yale law professor Reva Siegel laid out a number of ways in which that pattern held. For example, none of the 10 most anti-abortion states have passed their own family leave policies; eight of the 10 most permissive states had. Only one of the 10 most restrictive states had enacted protections for pregnant workers. Most did not require that contraception be covered by private health insurance.
“States with the most abortion restrictions tend to have implemented fewer policies known to support women’s and children’s well-being,” concludes a 2017 overview from the Center for Reproductive Rights and Ibis Reproductive Health. Siegel argues in her review that this discord reveals that these states are more interested in restricting a woman’s reproductive choices than in protecting children’s well-being.
It’s not just how much money a state spends on a family’s welfare but how the money is spent that matters, Jackson told me. Broadly speaking, more progressive states tend to put their spending to direct assistance — “sending families a check” — while more conservative states expend their dollars for specific services, such as pregnancy prevention or marriage promotion. The first is more effective in keeping families out of poverty than the second. One 2019 paper published in Socio-Economic Review by Columbia University’s Zachary Parolin found that states instituting policies that prioritize discouraging lone motherhood over providing cash assistance had impoverished about 250,000 Black children yearly.
Republican-led states are also more likely to close off access to welfare by restricting eligibility, such as through so-called family caps, which deny families that are already enrolled in the Temporary Assistance for Needy Families program any additional assistance if they have another child. According to the Center on Budget and Policy Priorities, 12 states, largely concentrated in the South, still have such laws on the books.
A weak safety net can hurt a family’s finances and a child’s development
When people denied an abortion end up giving birth, their fears about their financial ability to raise a child tend to come true. “We find that the reasons women give for wanting an abortion strongly predict the consequences they experience when they are denied that abortion,” Foster wrote.
The Turnaway Study looked at women’s economic well-being six months after they either received an abortion or were denied one. Researchers found that 61 percent of those who were turned away were living in poverty compared to 45 percent of those who received an abortion. The first group was significantly more likely to be poor over the next four years.
The welfare the women unable to access abortions did receive helped ameliorate the loss of income and educational opportunities; the study found no meaningful difference in income for the women who got an abortion versus the women who gave birth. But because the latter was raising at least one more child than the former, they were still more likely to be living in poverty.
Being denied abortion led to a $1,750 increase in past-due bills, the study found. The incidences of bad financial events — evictions, bankruptcies, court judgments on unpaid bills — increased by 81 percent for the women who were turned away.
The children of a mother who was denied abortion were more likely to live in poverty, more likely to live in a household that receives public assistance, and more likely to live with adults who say they can not afford food, housing, and transportation.
Those are national trends, across more than 30 states. But other research suggests that children born in states with less generous safety nets will face disadvantages compared to their peers in more generous states, when you look at the benefits conferred by stronger financial and social support.
One study co-authored by Jackson found that lower-income families in states with generous public assistance spend more money on things that are likely to help improve their child’s development, such as clothing, toys, games, arts and crafts, and books. A forthcoming study utilizing the same state-level data showed that more social spending — on both health care and non-health care programs — is associated with fewer babies being born with low birth weights and fewer preterm births among mothers with less than a high school education.
Is banning abortion really about protecting children’s well-being?
It’s common for anti-abortion advocates to argue that eliminating abortion protects the lives of children. But without increases in their welfare spending, many states set to revoke abortion rights will create harmful conditions for children, limiting their access to necessities like food, and the opportunities created by education.
And that puts the real motivations of the anti-abortion crusade in doubt.
“It is conventional to assume that states restrict women’s access to abortion out of an interest in protecting new life,” Siegel points out in her 2018 law review. “If this is in fact the concern that animates abortion restrictions, these values ought to guide policies outside as well as inside the abortion context.”
If states want to protect young lives, Siegel notes, they could have enacted policies such as family leave or could even expand contraception access, limiting the number of abortions without also limiting a person’s reproductive choices.
But that’s not what these states do. Instead, they restrict abortion access and limit the public assistance available to new parents and babies. In an amicus brief for Dobbs v. Jackson Women’s Health Organization, the Mississippi case that has now overturned Roe v. Woe, Siegel and her co-authors Serena Mayeri and Melissa Murray argue states’ legal arguments in favor of their abortion bans should only hold weight if they are willing to support a child who is born out of an unwanted pregnancy that can’t be terminated:
Mississippi could provide care and support for individuals who wish: to avoid pregnancy, to bear children who will not languish in poverty, to preserve their own or their children’s health, or to safeguard their ability to provide for existing children. Instead, Mississippi chooses to prevent women from making the most intimate, consequential decisions for themselves and to coerce women into giving birth under dangerous, demeaning conditions.
The state’s abortion ban, Siegel and her co-authors argued, “thus functions more as a tool of control than as an expression of care for Mississippi’s women and children.” But such arguments had no purchase at the Supreme Court.
Instead, the states that are least capable of supporting any uptick in births are on the brink of outlawing abortion. Families and children will pay the price.
Update, June 24, 10:53 am: This story has been updated based on the Supreme Court’s decision overturning Roe v. Wade. Click here for all Vox’s latest coverage of this decision and its implications for reproductive health in the US.