The Association Between State Gestational Age Limit Abortion Laws and Severe Maternal Morbidity: United States, 2010-2022.

Abstract

<b>Objectives.</b> To investigate the association between state gestational age limit abortion laws, which restrict abortions after a specific point in pregnancy, and severe maternal morbidity (SMM) hospitalization rates in the United States. <b>Methods.</b> We used a difference-in-differences approach and hospitalizations data measured annually at the state level from 2010 to 2022 for 47 states. All models included state covariates and state and year fixed effects, which provided plausibly causal estimates of the effect of gestational age limits on SMM rates. <b>Results.</b> Any law that prohibited abortion on the basis of gestational age increased SMM rates by 7.67 (95% confidence interval [CI] = 1.55, 13.80) per 10 000 patients. This was equal to a 10.5% increase in SMM rates compared with baseline levels. The effects were driven by older patients, hospitalizations paid for by public payers, safety net hospitals, and patients living in low-income communities. Conversely, increasing the gestational age limit by 1 week (expanding abortion access) reduced the SMM rate by 0.28 (95% CI = -0.568, 0.002) per 10 000 patients. <b>Conclusions.</b> Restricting access to abortion care increases the risk of SMM, particularly among older women and those of lower socioeconomic status. (<i>Am J Public Health</i>. 2026;116(3):341-344. https://doi.org/10.2105/AJPH.2025.308291).