Journal Article

Racial and ethnic abortion disparities following Georgia’s 22-week gestational age limit

Introduction
Georgia's 2012 House Bill 954 (HB954) prohibiting abortions after 22 weeks from last menstrual period (LMP) has been associated with a significant decrease in abortions after 22 weeks. However, the policy's effects by race or ethnicity remain unexplored. We investigated whether changes in abortion numbers and ratios (per 1,000 live births) in Georgia after HB954 varied by race or ethnicity.

Methods
Using Georgia Department of Public Health induced terminations of pregnancy data from 2007 to 2017, we examined changes in number of abortions and abortion ratios (per 1,000 live births) by race and ethnicity following HB954 implementation.

Results
After full implementation of HB954 in 2015, the number of abortions and abortion ratios at or after 22 weeks (from last menstrual period) decreased among White (b_Number = –261.83, p < .001; b_Ratio = –3.31, p < .001), Black (b_Number = –416.17, p < .001; b_Ratio = –8.84, p < .001), non-Hispanic (b_Number = –667.00, p = .001; b_Ratio = –5.82, p < .001), and Hispanic (b_Number = –56.25, p = .002; b_Ratio = –2.44, p = .002) people. However, the ratio of abortions before 22 weeks increased for Black people (b_LessThan22Weeks = 44.06, p = .028) and remained stable for White (b_LessThan22Weeks = –6.78, p = .433), Hispanic (b_LessThan22Weeks = 21.27, p = .212), and non-Hispanic people (b_LessThan22Weeks = 26.93, p = .172).

Conclusion
The full implementation of HB954 had differential effects by race/ethnicity and gestational age. Although abortion at 22 weeks or more decreased for all groups, abortion at less than 22 weeks increased among Black people. Additional research should elucidate the possible causes, consequences, and reactions to differential effects of abortion restrictions by race and ethnicity.