An increasingly hostile policy climate has reshaped abortion access in the United States. Recent literature has studied the effects of restrictive abortion policies on reproductive health outcomes. This study is the first to investigate the association between state-level abortion policy hostility and the pregnancy intentions of women with a pregnancy resulting in live birth. Data are from the Pregnancy Risk Assessment Monitoring System survey, merged with a state-level legislative database from 2012–2018 and other state-level controls. Cross-sectional results reveal that a one-unit increase in abortion policy hostility is associated with a relative risk (odds) of having a live birth resulting from an unintended versus intended pregnancy that is 1.02 times as high (RRR = 1.02, 95% confidence interval = 1.01, 1.03). This result corresponds to a 13% increase in the predicted probability of having a live birth resulting from an unintended pregnancy between a zero-hostility and a maximum-hostility state. Models stratified by demographic and socioeconomic characteristics reveal that the association between abortion policy hostility and live birth resulting from an unintended pregnancy is particularly robust among women in younger, less educated, Medicaid, uninsured, and rural populations.

中文翻译：

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前多布斯时代州级堕胎政策的敌意和计划外生育

日益敌对的政策环境重塑了美国的堕胎准入。最近的文献研究了限制性堕胎政策对生殖健康结果的影响。这项研究首次调查了州级堕胎政策的敌意与怀孕妇女的怀孕意图之间的关系。数据来自妊娠风险评估监测系统调查，并与 2012-2018 年州级立法数据库和其他州级控制措施合并。横断面结果显示，堕胎政策敌意每增加一个单位，意外怀孕导致活产的相对风险（几率）是预期怀孕的 1.02 倍（RRR = 1.02，95% 置信度）间隔 = 1.01, 1.03)。这一结果相当于在零敌意状态和最大敌意状态之间因意外怀孕而导致活产的预测概率增加了 13%。按人口和社会经济特征分层的模型显示，堕胎政策敌意与意外怀孕导致的活产之间的关联在年轻、受教育程度较低、享受医疗补助、未参保和农村人口的女性中尤其明显。