6-Week Abortion Bans Could Limit Care Access for 90% of People in Need

Georgia’s abortion ban would restrict care access for nearly 90 percent of those seeking an abortion in the state, with the biggest impacts being on Black people, young people, and those with lower socioeconomic status, according to figures from the Emory University Rollins School of Public Health.

The abortion law in question, HB481, is the result of a trigger ban that went into effect after the Supreme Court overturned Roe v. Wade in the Hobbs v. Jackson Women’s Health case in June 2022. HB481 states that individuals may not receive an abortion after embryonic cardiac activity can be detected.

That means individuals would have to access an abortion before six weeks’ gestation time; experts have said many individuals do not even know they are pregnant before that point.

“Restrictive abortion policies are structural determinants that dictate who can access health care, and via what means,” the researchers wrote in JAMA Network Open. “Laws like HB481 that ban abortion early in pregnancy are a favored political tactic by antiabortion legislators and advocates; these laws fundamentally strip individuals of their reproductive bodily autonomy and cause harm at any stage in pregnancy.”

These laws seriously impede patient access to care, the researchers added. In an assessment of all abortions conducted in the state between 2007 and 2017, the researchers concluded that the law could mean only around one in 10 people who need an abortion would be able to get one. In other words, the law is very restrictive based on previous patterns of abortion care access.

The researchers reviewed data about the 360,972 reported abortions that happened in Georgia between 2007 and 2017 and assessed whether they would meet the eligibility criteria set up as part of HB481.

All said, only 3,854, or 12 percent, of the abortions would have met the criteria set up under the six-week abortion ban. That means nearly 90 percent of those seeking abortion care would not have been allowed to get one if HB481 had been in effect during the study period. That trend could indicate that abortion care access is unattainable for nearly 90 percent of cases now, the researchers said.

Abortion care access is dismally low for anyone seeking care under HB481, the researchers said, but it is egregiously bad for those who are traditionally underserved by the medical industry. When looking at Black patients only, 9.6 percent of abortions were eligible under the 6-week abortion ban; that compares to 16.2 percent among White patients.

The health disparities continue when stratifying by age. For patients younger than age 20, only 9.1 percent of abortions are eligible under HB481; 15 percent of those over age 40 are eligible.

And when looking at education, care access becomes more limited under the abortion ban. Around 9 percent of abortions among those with less than a high school education would be eligible, followed by 9.6 percent of those with a high school diploma, and 13.5 percent of those with some college.

“These findings support and extend the existing evidence on unjust social and health consequences of restrictive abortion policies,” the researchers wrote. “Undoubtedly, individuals at the intersection of these identities (eg, young Black people, young people with fewer years of education) are at the highest risk for experiencing compounded disproportionate effects of HB481 by way of multiple, simultaneous forms of oppression via racism and White supremacy, classism, and ageism.”

These findings carry with them serious implications, the researchers said. For one, a six-week abortion ban could mean many individuals need to travel out of state to get the medical care that they want and need. But because the bans disproportionately impact people of color, younger people, and those with less educational attainment, being able to fund and coordinate that travel may mean they go without care.

Additionally, these findings come amidst a backdrop of poor maternal health equity in the US. December 2022 figures from The Commonwealth Fund found that the US continues to have the worst maternal mortality rate in the developed world, a problem that may become worse as more people carry pregnancies against their wishes but limited additional resources to ensure good outcomes.

“With HB481’s increased restrictions on abortion in Georgia, these outcomes will likely worsen, particularly given Georgia’s severe obstetric care shortage where roughly half of counties lack an obstetrician,” the Emory researchers said.

Indeed, a separate study from The Commonwealth Fund found that the states with the staunchest abortion restrictions were also more likely to be maternity care deserts. This means that individuals living in these states have less access to maternity care providers.

The Emory University researchers said these findings indicate a need for better public policy to protect the health of birthing people in the state. That should include expanded access to abortion, but in the wake of HB481, the researchers also recommended expanded Medicaid coverage, mandated paid parental leave, better health education including sexual health, funding of local abortion funds, and protecting of clinicians and others involved in abortion care.