Some women, especially women of means, will find ways around the State’s assertion of power. Others—those without money or child care or the ability to take time off from work—will not be so fortunate.
Justices Stephen Breyer, Sonia Sotomayor, and Elena Kagan, dissenting opinion, Dobbs v. Jackson Women’s Health Organization
On June 24, 2022, in its decision in Dobbs v. Jackson Women’s Health Organization, the U.S. Supreme Court overturned Roe v. Wade and the nearly 50 years of precedent that protected the right to abortion. In addition to securing the right to access a critical health service, Roe positively affected women’s labor force participation and educational attainment, significantly bolstering the ability of women and families, along with state and local economies, to thrive. That progress is now at risk.
While the denial of the right to an abortion has nationwide consequences, the effects on women and families’ economic security will be particularly devastating in the 27 states that have at least one abortion ban on the books.1 Many of these states already have some of the worst economic and health outcomes for women and families across the country. For example, of these states:
- None guarantee paid family and medical leave.
- Eighteen have gender wage gaps above the national average.
- Twenty-two have poverty rates for women above the national average.
- Seventeen have poverty rates for children above the national average.
- Nineteen have not extended Medicaid coverage to 12 months postpartum.
- Only four legally require insurers to cover an extended supply of contraceptives.
Without robust federal and state action to strengthen the nation’s social safety net and advance policies to help working families,2 women, and other people who can become pregnant, facing unintended parenthood in those states are likely to fall even further through the cracks—with downstream effects on their children, communities, and local and state economies. It is therefore imperative that, in the absence of Roe, federal and state governments use every mechanism available to them to protect women’s access to abortion care. While this is certainly not a replacement for abortion access, the current moment should serve as a catalyst for the passage of long-overdue legislation and policies that can safeguard women and families’ economic security.
The connection between abortion legalization and women’s advancement
Roe v. Wade and access to reproductive health care, including abortion, helped lead to increased labor force participation. It enabled many women to finish school. That increased their earning potential. It allowed women to plan and balance their families and careers.
Secretary of the Treasury Janet Yellen
Abortion legalization under Roe was integral to women’s advancement in the United States. During a recent Senate Banking Committee hearing, Secretary of the Treasury Janet Yellen stated that “Roe v. Wade and access to reproductive health care, including abortion, helped lead to increased labor force participation. It enabled many women to finish school. That increased their earning potential. It allowed women to plan and balance their families and careers.”3
Research confirms the positive effects of abortion legalization on a range of economic indicators, including labor force participation, educational attainment, earnings, and child poverty—with particularly notable gains for Black women.4 Moreover, when women are denied access to abortion, it can negatively affect their economic security and that of their families, and state and local economies can suffer significant financial losses.5
Increases in labor force participation, educational attainment, and earnings under abortion legalization
Following the Supreme Court’s decision in Roe in 1973, women experienced a significant increase in labor force participation. (see Figure 1) The largest gains occurred in the decade and a half following Roe, during which women’s labor force participation grew at the fastest rate on record, including faster than during the 15 years prior to the Supreme Court’s decision. Equally important, the Roe framework helped to sustain these higher rates of labor force participation for the generations of women who followed.
Women’s educational attainment also grew under Roe.6 One study found that access to abortion for women facing early, undesired pregnancies increased the probability of their entering college by 41 percent and completing college by 71 percent.7 These positive effects were particularly pronounced for Black women experiencing early pregnancies: Access to abortion increased their probability of entering college by up to 200 percent.8
Abortion legalization has also boosted women’s earnings: Women whose abortion care allowed them to delay an unplanned start to parenthood by one year saw an 11 percent increase in hourly wages later on in their careers.9 Given that many women are their families’ sole or primary breadwinner,10 and that access to abortion has had positive impacts on women’s economic security overall, it is unsurprising that abortion legalization also lowered the chances of a child living in poverty.11 One 1997 study found that the so-called marginal child who was not born due to abortion access—and who would have been born absent abortion legalization—would have been 40 percent more likely than the average U.S. child at the time to live in poverty.12
Harms to women and families’ economic security under abortion bans
Research makes clear that when women do not have access to abortion care, they are more likely to suffer financially. Led by an interdisciplinary team, the Turnaway Study tracked two groups of women: one composed of those who had received abortion care, and the other composed of women who had been denied care.13 The study determined that women who were forced to carry a pregnancy to term experienced a wide range of negative financial consequences, including lower credit scores, increased debt, and more negative public financial records such as bankruptcies and evictions.14 In addition to the impact on women themselves, the study showed that these restrictions are associated with worse child developmental outcomes and a greater likelihood of child poverty.15
Additional studies have found that laws restricting access to abortion widened the gender pay gap for women of childbearing age by pushing them out of the labor force and into lower-paying jobs.16 In fact, one study found that abortion restrictions led to a drop of between 5 percent and 6.5 percent in average monthly salaries of women of childbearing age compared with the rest of the population.17 These decreases only compound the harms of the already unacceptable gender wage gap that hobbles women’s earnings and long-term wealth.18 In 2020, women overall were paid just 73 cents for every dollar men earned.19 Disparities were even greater for many women of color when compared with white, non-Hispanic men:20 Black women were paid just 58 cents, and Latina women were paid just 49 cents.21
Harms to state and local economies under abortion bans
The Institute for Women’s Policy Research found in 2021 that restrictive abortion laws cost state and local economies $105 billion annually by reducing labor force participation and earnings levels while also increasing time off and turnover among women ages 15 to 44 years old.22 The reasons behind these costs are clear: When women lack access to necessary benefits and support to balance work and family—such as paid family and medical leave and workplace flexibility—and face increased caregiving responsibilities, they are forced to cut back on work hours or leave the workforce entirely. Such costs will only worsen in a post-Roe world as abortion is banned in many more states.
State and local economies in states with abortion bans will also stand to lose even more money in a post-Roe world, as some employers will relocate to states with abortion protections to attract and retain top talent and fulfill their public pledges of diversity and inclusion. For example, after Indiana Gov. Eric Holcomb (R) signed the state’s near-total abortion ban into law in August 2022, the pharmaceutical company Eli Lilly—one of Indiana’s largest employers—issued a statement saying that it “will be forced to plan for more employment growth out of [its] home state.”23 State officials will harm women living in states with abortion bans, particularly those without means, who will face fewer job opportunities in their home state if they are unable or do not want to move when their employers understandably might relocate to another state.
States with at least one abortion ban on the books are already difficult places for women and families to thrive
To date, 27 states have at least one abortion ban on the books. In some cases, the statutory language is so extreme that it does not even allow for exceptions in cases of rape, incest, or health endangerment.24 Because of their inadequate workplace protections and policy supports, these states were already overwhelmingly difficult places for women and families to thrive before the Supreme Court overturned Roe. Now, these bans are sure to have a broader national impact, as patients will be forced to travel to states where abortion is still legal, driving up wait times and stretching capacity thin at clinics that are already overburdened.
Some of the worst economic outcomes for women and families
While there are some outliers, states that have at least one abortion ban on the books—predominantly in the Midwest and southern United States—have some of the worst economic outcomes for women and families, with many women of color facing the greatest burdens. (see Figure 3)
Federal inaction on strengthening the nation’s social infrastructure
A lack of federal action to strengthen the nation’s social infrastructure has long left women who are facing undesired pregnancies especially vulnerable to economic hardship. For instance, the United States is one of just six countries—and the only industrialized nation—that does not have a national paid leave policy;25 only a little more than half of workers have access to unpaid leave under federal law.26 Similarly, there are no federal laws mandating paid sick days or requiring employers to provide reasonable workplace accommodations for pregnant workers.27 Even the current federal minimum wage—a meager $7.25 per hour—has not increased since 2009.28 In addition, despite decadeslong attempts to improve access to affordable high-quality health care, too many people still struggle to access health services. Finally, the United States is in the midst of a child care crisis, which is the result of years of underinvestment, unsustainable costs to families, and numerous child care deserts—areas where there are too few child care slots for the number of children who need care—placing families under even more financial pressure.29
Eighteen of these states with at least one abortion ban have gender wage gaps above the national average. For example, Wyoming, which in 2019 had a gender wage gap of $21,676—the largest gap of any U.S. state—is actively seeking to institute a ban on abortion at any point in pregnancy with only narrow exceptions.30 (see Figure 3)
Similarly, 22 of these states have poverty rates for women, and 17 have poverty rates for children, above the national averages—12.6 percent and 16.1 percent, respectively—and 19 of these states have a rate of female-headed households living in poverty above the national average of 34.4 percent. In Mississippi, the state from which Dobbs originated, almost 28 percent of children and nearly 48 percent of female-headed households lived below the federal poverty level in 2019.
These economic outcomes reflect inadequate workplace protections as well as limited social safety nets and health care access. Not one of these 27 states guarantees paid family and medical leave; 17 do not have minimum wages beyond the federal minimum wage; 17 do not have laws requiring reasonable accommodations for pregnant workers; and 11 are among the 12 states that have still not expanded their Medicaid programs since the Affordable Care Act was passed in 2010. In fact, 14 of the states banning abortion access are among the 19 states with uninsured rates above the national average (10.5 percent).31
Relatively poor reproductive and maternal health outcomes
In addition to having adverse economic outcomes for women and families, many of these states also have relatively poor reproductive and maternal health outcomes largely due to a lack of access to high-quality care. For example, only four states that have at least one abortion ban on the books—Michigan, Nebraska, South Carolina, and West Virginia—legally require insurers to cover an extended supply of contraceptives.32 Moreover, as noted above, states hostile to abortion also have some of the highest rates of uninsured and comprise the majority of those still refusing to expand Medicaid.
Maternal mortality in the United States
While abortion legalization had a significant impact on women of color’s maternal mortality rates,33 it is important to acknowledge that the promise of Roe remained illusory for many women, particularly those living in states bent on restricting access even before the Dobbs decision. And, despite progress under Roe, the U.S. maternal mortality rate remains unacceptably high—indeed, the rate has only continued to increase since 2000 and eclipses that of other high-income countries.34 Moreover, Black women continue to bear the brunt of this burden, as they are three times more likely to die from pregnancy-related complications than non-Hispanic white women.35
Because, among other things, abortion bans force people to continue pregnancies even when there are significant health concerns that would make abortion care the safer option, there will likely be increases in maternal mortality due to people pursuing unsafe abortion care or experiencing fatal pregnancy-related complications. Researchers have found that a total abortion ban could increase the number of maternal deaths by 24 percent, with the greatest impact on Black women, at 39 percent.36 Similarly, a recent study determined that states with a greater number of abortion restrictions have around a 7 percent increase in total maternal mortality compared with states that have fewer abortion restrictions, with physician licensure requirements and Medicaid coverage restrictions having the largest effect.37
More specifically, access to quality maternity care is significantly restricted in many states that have at least one abortion ban on the books. Even for people who are insured, coverage of reproductive and maternal health can still vary depending on how a state regulates private and public insurance plans, given loose standards at the federal level. For example, there is still no special enrollment period for pregnancy for federal and some state marketplace plans, nor are there federal minimum coverage standards for maternity benefits, such as prenatal and postpartum care, mental health services, and breastfeeding counseling and equipment.38
In addition, as of August 2022, 19 of these states have not permanently extended Medicaid postpartum coverage from around 60 days to 12 months postpartum, as permitted under the American Rescue Plan Act of 2021. Three of these states—Texas, Missouri, and Wisconsin—only pursued extended coverage for specific populations and/or for a shorter time period.39 Women of color will be especially affected by states not extending Medicaid postpartum coverage, as they are more likely to experience pregnancy-related complications and to be uninsured or not covered by Medicaid.40
State leaders banning abortion are not interested in improving economic and health policies that support women and the children these women already have—revealing, at best, a willful ignorance of the real-life effects of abortion bans and, at worst, a deliberate attack on gender equality and women’s progress.
These trends make clear that state leaders banning abortion are not interested in improving economic and health policies that support women and the children these women already have—revealing, at best, a willful ignorance of the real-life effects of abortion bans and, at worst, a deliberate attack on gender equality and women’s progress.
Steps forward for the federal and state governments
State abortion bans are unequivocally harmful to women and families’ economic security as well as state and local economies. In states pursuing these bans, these effects will be particularly pronounced for women of color, especially Black women who have experienced strong increases in economic power linked to abortion access. To blunt these harms, legislative and administrative action will be critical.
With respect to abortion, policymakers must work to secure a federal statutory right to an abortion that codifies the promise of Roe, such as the Women’s Health Protection Act.41 In the interim, state and federal officials should use every legislative and administrative tool to expand abortion access by, among other measures:
- Ensuring broad access to early medication abortion through the mail, as is approved by the U.S. Food and Drug Administration
- Shielding from prosecution people who assist those seeking abortion or who themselves cross state lines to receive care
- Protecting the safety and privacy of individuals
- Ensuring that those who qualify for exceptions to abortion bans can get the care they need, while recognizing that all people deserve access to abortion
At the same time, federal and state policymakers must also fight to strengthen workplace protections and social safety nets—while acknowledging that these supports, as critical as they are to women’s overall economic security, do not eliminate the need for abortion care or erase the deep harms abortion bans impose on women. With this in mind, policymakers must pursue legislation that guarantees universal paid family and medical leave, paid sick days, a livable minimum wage, reasonable accommodations for pregnant workers, comprehensive health care for all, and high-quality affordable child care.
The Supreme Court’s decision to deny women the constitutional right to abortion will negatively affect women and families’ economic security, particularly for those living in the 27 states that have at least one abortion ban on the books. The decision will also hurt state and local economies as more women will be forced to reduce labor force participation and increase their time off, and as some employers choose to move to states with abortion protections to attract and retain top talent and fulfill their public pledges of diversity and inclusion. The federal and state governments must take legislative and administrative action to mitigate these harms and preserve access to abortion care.
The authors would like to thank Maggie Jo Buchanan, Elyssa Spitzer, Tracy Weitz, Beth Almeida, Molly Weston Williamson, Rose Khattar, Hailey Gibbs, Maureen Coffey, and Olivia Smith for their assistance with this report.