Division of Adolescent Medicine, University of Rochester, Rochester, New York 14642, USA.
J Adolesc Health. 2010 Aug;47(2):160-7. doi: 10.1016/j.jadohealth.2010.01.003. Epub 2010 Mar 20.
Legislation that restricts abortion access decreases abortion. It is less well understood whether these statutes affect unintended birth. Given recent increases in teen pregnancy and birth, we examined the relationship between legislation that restricts abortion access and unintended births among adolescent women.
Using 2000-2005 Pregnancy Risk Assessment Monitoring System data, we examined the relationship between adolescent pregnancy intention and policies affecting abortion access: mandatory waiting periods, parental involvement laws, and Medicaid funding restrictions. Logistic regression controlled for individual characteristics, state-level factors, geographic regions, and time trends. Subgroup analyses were done for racial, ethnic, and insurance groups.
In our multivariate model, minors in states with mandatory waiting periods were more than two times as likely to report an unintended birth, with even higher risk among blacks, Hispanics, and teens receiving Medicaid. Medicaid funding restrictions were associated with higher rates of unwanted birth among black teens. Parental involvement laws were associated with a trend toward more unwanted births in white minors and fewer in Hispanic minors.
Mandatory waiting periods are associated with higher rates of unintended birth in teens, and funding restrictions may especially affect black adolescents. Policies limiting access to abortion appear to affect the outcomes of unintended teen pregnancy. Subsequent research should clarify the magnitude of such effects, and lead to policy changes that successfully reduce unintended teen births.
限制堕胎获取途径的立法会减少堕胎数量。但这些法规是否会影响非意愿生育,人们对此的理解还不够充分。鉴于青少年怀孕和生育人数近期有所增加,我们研究了限制堕胎获取途径的立法与青少年女性非意愿生育之间的关系。
利用 2000-2005 年妊娠风险评估监测系统数据,我们研究了青少年妊娠意图与影响堕胎获取途径的政策之间的关系:强制等待期、父母参与法和医疗补助资金限制。逻辑回归控制了个体特征、州级因素、地理区域和时间趋势。对不同种族、民族和保险群体进行了亚组分析。
在我们的多变量模型中,处于有强制等待期的州的未成年人报告非意愿生育的可能性是两倍多,其中黑人和西班牙裔以及接受医疗补助的青少年风险更高。医疗补助资金限制与黑人青少年非意愿生育的更高比率相关。父母参与法与白人未成年人非意愿生育的比率呈上升趋势,而西班牙裔未成年人的非意愿生育比率则呈下降趋势。
强制等待期与青少年非意愿生育的比率升高有关,资金限制可能尤其会影响黑人青少年。限制堕胎获取途径的政策似乎会影响非意愿性青少年怀孕的结果。后续研究应明确此类影响的程度,并促使政策发生变化,成功降低非意愿性青少年生育。