Document Type


Date of Degree Completion

Spring 2023

Degree Name

Master of Public Health (MPH)


Health Sciences

Committee Chair

Katarina Mucha, PhD, MPH

Second Committee Member

Casey Mace Firebaugh, PhD, MPH


Background. Early termination of a pregnancy (hereinafter referred to as an “abortion”) has been debated in the United States (U.S.) for decades, without much regard to the negative outcomes that forced pregnancies have for those assigned female at birth regarding poverty, mental health and maternal mortality. In 1973, access to safe abortions was protected so long that the procedure was done within the legal gestational period and/or was necessary for the health and safety of the patient (Blackmun, 1972). Unfortunately, in 2022, the Supreme Court took that protection away and made it legal for states to determine the reproductive rights for those assigned female at birth, (hereinafter referred to as “AFAB”) (Alito, 2022). Methods. The aim of this comparative analysis reviewed and utilized existing research in order to identify the themes expected to be causative factors for negative health outcomes from abortion restrictions. Sociodemographic data was gathered from various public domains, including, but not limited to, both states’ 2021 Census reports, their poverty, pregnancy, and maternal mortality rates, as well as their current abortion policies. Results. Results from all of the prevailing research and literature that was utilized for this study showed serious concerns regarding the negative impact that anti-abortion laws will have on increasing the risk or exacerbation of poverty, mental health disorders, and maternal mortality outcomes. Poverty. People AFAB being denied an abortion experience a significant increase in financial distress during the year that they give birth compared to their counterparts who received a wanted abortion. Unpaid debts that are 30 or more days past due more than double in size and negative events, such as evictions and bankruptcies, increase substantially (Miller et al., 2020). Mental Health. Low self-esteem, anxiety and lower life satisfaction were found to be higher for those who were denied an abortion than those who had one (Biggs et al., 2017). For those AFAB who had mental health disorders prior to becoming pregnant, were more likely to seek an abortion and, if denied, were more likely to have their mental health disorders exacerbated post-pregnancy (Steinberg et al., 2014). Maternal Mortality. Pregnancy is associated with a 14-times greater maternal mortality rate in comparison to abortion (Ginsberg & Shulman, 2021). Ninety-percent of pregnancy-related deaths in Texas in 2019 were preventable (DSHS, 2022). Conclusions. Being denied an abortion has large and persistent negative effects on someone AFAB’s financial well-being, mental health, and maternal mortality outcomes.