PRB

As abortion access is increasingly restricted in the United States, states with abortion bans continue to rank among the worst for child well-being across several indicators, according to a new PRB analysis. In addition, the number of abortions performed nationally increased between 2020 and 2023 despite more states banning abortion.

After the U.S. Supreme Court overturned Roe v. Wade in June 2022, PRB evaluated child well-being in the 13 states that had enacted abortion bans by August 3, 2022, including nine with near total bans and four with bans after six weeks of pregnancy.¹ These 13 states ranked among the worst for overall child well-being in 2022, based on data collected in the years prior to 2022.²

As of October 2024, 17 states have banned abortion—13 with near total bans and four with six-week bans—while the legality and availability of abortion have become key issues among voters.³ With post-ban data now available, PRB examined trends in births and abortions at the national and state level, and reassessed child well-being in the states with abortion bans.

The latest data reveal surprising trends in the number of births and abortions in 2023, the first full year following the Supreme Court’s decision. Despite more states enacting bans, the number of births in the United States was nearly 2% lower in 2023 than in 2022—3,596,017 compared with 3,667,758.⁴ Among the states with existing bans, 14 also experienced a decline in births between 2022 and 2023, while one remained the same (South Dakota) and two saw increases (Idaho and Tennessee).

In addition, the estimated total number of clinician-provided abortions in the United States was 11% higher in 2023 than in 2020—1,032,560 compared with 930,160.⁵ Among the 17 states with current bans, abortion estimates for 2023 are only available for the four states with six-week bans. Between 2020 and 2023, the number of abortions declined by 23% in Georgia but increased by 11% in Florida, 16% in Iowa, and 83% in South Carolina.⁶

To reassess child well-being in the states with current abortion bans, we used the latest data on the child poverty rate, the share of births with low birth weight, the share of children living in households with food insecurity, and the overall child well-being rank from the 2024 KIDS COUNT Data Book (Table 1).

Table 1. Births, Abortions, and Child Well-Being in States With Abortion Bans

Notes: The listed states currently ban all abortion in most cases except for the states of Florida, Georgia, Iowa, and South Carolina which have abortion bans after six weeks of pregnancy. The category of “Overall Rank in Child Well-Being, 2024,” provides an overall rank across indicators of economic well-being, education, health, and family and community from the 2024 KIDS COUNT Data Book.
Sources: Annie E. Casey Foundation, 2024 KIDS COUNT Data Book, June 10, 2024 and KIDS COUNT Data Center; Guttmacher Institute, Interactive Map: Abortion Policies and Access in the United States and Monthly Abortion Provision Study; and Centers For Disease Control and Prevention, CDC Wonder: Natality, 2016-2023 expanded.

Experiencing poverty in childhood has been shown to have lifelong consequences for health and earnings in adulthood.⁷ But nine of the 10 U.S. states with the highest child poverty rates are states that currently ban abortion. In the 17 states with abortion bans, the percentage of children living in poverty ranges from 11% in Idaho to 25% in Louisiana, according to the latest data. Only five of the states with bans—Idaho, Iowa, Missouri, Indiana, and South Dakota—have child poverty rates below the national average of 16%. In nearly half of the states with bans, one-fifth or more of children live in families with incomes below the federal poverty level.⁸

Low birth weight (less than 5.5 pounds) is a leading cause of infant mortality and puts babies at higher risk of long-term health and developmental problems.⁹ But in 11 of the 17 states banning abortion, the share of all births with low birth weight exceeds the national average (8.6%). Only four of these states—Idaho, Indiana, Iowa, and South Dakota—have a share of births with low birth weight below the national average. In fact, in five of the states with abortion bans, at least one in 10 births had low birth weight.

Ongoing inflation and stubbornly high food prices are also key issues among voters. High food prices can contribute to food insecurity—another important measure of child well-being that is not included in the KIDS COUNT overall ranking.

Lack of sufficient nutritional food—especially at young ages—puts children at higher risk for health problems and difficulties with learning in school.¹⁰ But 11 of the 15 states with the highest levels of food insecurity among children ban abortion, according to data from the Census Bureau’s Current Population Survey Food Security Supplement for 2021-2023 (Table 1).¹¹ In the states with abortion bans, the share of children living in households with food insecurity in the previous 12 months ranged from a low of 14% in Tennessee to a high of 24% in Texas. More than one-fifth of children experienced food insecurity in the previous 12 months in Arkansas, Georgia, Kentucky, Oklahoma, and Texas.

The Annie E. Casey Foundation’s 2024 KIDS COUNT Data Book looks at 16 key measures of child well-being for 2022 and provides each state’s overall rank for child well-being. The overall rank provides a summary measure of how each state is doing across four different domains of child well-being—economic, education, health, and family and community (Table 1).

Eight of the states with current abortion bans rank among the 12 worst states nationwide for overall child well-being. Only two states that ban abortion—Idaho and Iowa—rank among the top 20 states for overall child well-being, and Iowa is the only state with a current ban that ranks in the top 10. While these 17 states may indeed be pro-birth, this evidence suggests the majority are not equally pro-child.

With the low levels of child well-being in 14 of these 17 states today, what are the potential implications of a future increase in births in these states due to lack of access to abortion? Prior research has found that women who seek abortions are disproportionately poor and low-income, so more babies could be born into families living in poverty.¹² This could lead to an increase in both the child poverty rate and the number of at-risk children in general in these states—especially the longer abortion bans remain in place.

These key measures of child well-being and other recent research indicate that the states with bans are not investing sufficient resources to support their at-risk children—before or after banning abortion. States with abortion bans provide less support for vulnerable children and their families in terms of health care, food assistance, and cash benefits.¹³ If policymakers and pro-life advocates in these states continue to focus their resources primarily on anti-abortion efforts, they will continue to fail in meeting the needs of thousands of vulnerable children who require additional support to thrive.