On June 24, 2022, the Supreme Court overturned its decision in Roe v. Wade, which established a constitutional right to abortion. As many as 28 states are now expected to ban or restrict abortion. Many women from these states will seek an abortion in another state or access a “medical abortion” but many others, less able to travel or get a prescription for the abortion pill in a timely fashion, will end up carrying an unintended pregnancy to term.
As we document in this brief, the states expected to restrict or ban abortion rank among the worst in the country for the well-being of their children, in part because they spend the least to support them. As a result, in the wake of the Court’s decision, inequality of opportunity will almost surely increase. Children born in states where abortion is restricted are already disadvantaged compared to other children and unless these same states match their interest in saving fetal lives with increased investment after the children are born, their future prospects will be seriously compromised.
A post-Roe America
In thirteen trigger states, abortions are now illegal or will be illegal within 30 days – these states are Arkansas, Idaho, Kentucky, Louisiana, Mississippi, Missouri, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, Utah, and Wyoming. While some of these states have exceptions for cases of rape or incest, a majority of them only recognize an exception to the ban if the woman seeking an abortion is at risk of death. Up to an additional 15 states are likely to attempt a ban or further restrict abortion access following the Roe decision.
There are a number of states that already have laws in place to protect abortion rights. These states are Washington, Oregon, California, Nevada, Colorado, Illinois, New York, New Jersey, Maryland, Vermont, Massachusetts, Connecticut, Delaware, Maine, Rhode Island, and Hawaii.
However, the states that ensure abortion access are outnumbered by those that have banned or are likely to ban or restrict abortion. Without Roe, these restrictions will leave nearly half of women living in a state with no or restricted abortion access. According to an estimate by a team of economists, roughly 100,000 women in the first year following the Roe decision will be unable to access a legal abortion provider. Some will miscarry and some may obtain an illegal abortion. In the end, about 75,000 women who would have had an abortion are likely going to give birth over the next year, according to an estimate by Caitlin Knowles Myers.
How will children’s lives be affected?
Women who seek abortions are more likely to be living below the poverty line, to already have children, and to be experiencing a disruptive life event, like a job loss or breakup of a relationship, which are not ideal circumstances for caring for a child. One famous study showed that women who sought an abortion but were denied one fared worse when compared to a similar group that terminated their pregnancy. Adverse consequences for these women included financial hardships, health complications, and other deleterious effects, such as the need to remain in an abusive relationship or raise a child alone, which are likely to affect their child’s well-being.
Should abortion restrictions lead to more unplanned births in a post-Roe world, we can expect worse outcomes for children and families in those states.
The unplanned pregnancy rate is higher in states expected to ban or restrict abortion. Should abortion restrictions lead to more unplanned births in a post-Roe world, we can expect worse outcomes for these children and their families. For example, Sawhill and Venator estimate that if all currently mistimed births were instead aligned with the timing preferred by their mothers, as reported by their mothers in a government survey after the birth of the child, the children’s college graduation rates would have increased by eight percentage points and their lifetime incomes by around $52,000.
Do states likely to restrict abortion have a good pro-family track record?
Most people who are pro-life presumably want the best for children and the families raising them after the child is born. However, the states expected to restrict or ban abortion rank among the worst in the country in terms of child well-being and public spending that supports children.
To measure state support of children, we ranked states based on a combined index that takes into account two important factors: the overall well-being of children and the total spending per child in each state. The child well-being component of our index was developed by the Annie E. Casey Foundation Kids Count Data Center and is comprised of 16 indicators of economic, educational, health, and community well-being, including the share of children in poverty, reading and math proficiency, low birth weight, and teen births, among others. State expenditures per child come from the Urban Institute’s State Spending on Kids Dataset, which includes comprehensive spending on children in the areas of economic support, education, health, and community/infrastructure (e.g., parks and libraries). Together, these rankings give us a good idea of how children are faring in each state and how much the state is investing to support them.
Based on these rankings, we find that the 10 most child-friendly states also have some of the most liberal abortion policies. These states are Vermont, Massachusetts, Connecticut, Wyoming, New York, Maine, New Jersey, Minnesota, Rhode Island, and Pennsylvania. Of these 10 child-friendly states, only one has a trigger ban in place, while the other nine do not have any laws that would ban or restrict abortion following a Roe reversal. Most of the child-friendly states protect abortion in their state law, state constitutions, and have created expanded access to abortion care. Additionally, most of the states at the top of our ranking make abortions available up to viability, which is typically considered to be 24 weeks. After that, a number of these states have exceptions past viability for a medical emergency that would threaten a woman’s life. In Vermont, which is at the top of our ranking, abortion is legal at all stages of pregnancy and there are no legal barriers that would make it more difficult for women to obtain an abortion, such as waiting periods or mandatory parental consent.
The states where children are more likely to be born into the worst circumstances, and are receiving the least support after birth, also tend to be the ones that are restricting a women’s right to choose.
Conversely, the states where children are more likely to be born into the worst circumstances, and are receiving the least support after birth, also tend to be the ones that are restricting a women’s right to choose. The bottom 10 states in our ranking are: Missouri, Idaho, Florida, South Dakota, Tennessee, Arizona, Oklahoma, Georgia, Nevada, and Texas. Of these states, six currently have a trigger ban in place that would go into effect following the Roe decision. Three additional states have restricted abortion to the first six weeks of pregnancy (Georgia) or the first 15 weeks (Arizona and Florida).
These states rank lower on our index because they have higher rates of child poverty, more children living in a single parent family, and worse educational outcomes for young children; and they spend relatively little per child, which undoubtedly contributes to these worse outcomes. Collectively, the bottom 10 states only spend 60 percent of the amount that the top 10 states spend per child. One notable difference in spending is due to whether or not a state chose to expand Medicaid. Half of the states in our bottom 10 list did not adopt Medicaid expansion.
Abortion has been a contentious topic. People on both sides feel passionately about the issue. One objective of the recent Supreme Court ruling is to return this difficult decision to the states, thereby allowing a more varied local response in keeping with the divergence of public opinion.
But one clear result of the decision will be to expose America’s children to even more unequal childhoods and lifetime opportunities than currently exist – unless those who support the Supreme Court’s recent decision advocate for stronger social policies at the state and federal level to make sure that the welfare of children is supported not just before, but also after, birth.
 To create a combined ranking, we took the simple average of the state rankings based on child well-being and total expenditures on children per child.
 See the full Annie E. Casey Foundation Kids Count report for more information on the child well-being index: https://www.aecf.org/resources/2021-kids-count-data-book
 Our rank presented here uses the state by state spending on children dataset, which includes total state and federal spending on children per child in 2016. We also ranked the states based on state-only and mixed federal and state expenditures (eliminating the federal programs) and found a similar trend. Details available from the authors on rankings upon request.
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