THE IMPACT OF PROVIDER AVAILABILITY ON ABORTION DEMAND

I. INTRODUCTION In the 1973 case of Roe V. Wade, the U.S. Surpreme Court ruled that states cannot prohibit a woman from having an abortion during the first trimester of pregnancy; a state can regulate abortions in the second trimester, but a state can only prohibit abortions during the third trimester of pregnancy. While the Court's decision does not mandate the provision of abortion services, it does allow for the availability of abortion providers to vary within a state. Since that landmark decision, which effectively broadened abortion availability in the United States, the debate has focused largely on how sensitive abortion demand is to the legal availability of abortion services. Variations in the availability of abortion providers impact the demand for abortions in several ways. (i) Greater geographical availability of abortion providers reduces the travel cost associated with acquiring an abortion. If demand is sensitive to changes in the full cost of abortion services, then more availability will increase the quantify of legal abortions demanded. (ii) The availability of abortion providers could signal social approval for the abortion decision, lowering the psychic cost of terminating an unwanted pregnancy. (iii) Provider availability creates a potential moral hazard problem: Knowing that abortion services are available produces an incentive for individuals to be less careful in using contraception to avoid unwanted pregnancies. In each of these cases, greater availability of abortion providers induces individuals to increase their consumption of abortion services. Furthermore, variations in provider availability may alter an individual's implicit consumption of abortion services relative to contraception, although the explicit consumption of abortion services occurs only after a pregnancy. Therefore, pregnancy rates also may reveal any effect of variations in provider availability on abortion demand. Empirical research has been limited in assessing the direct impact of variations in the local availability of abortion services on abortion demand as well as on pregnancy rates. Dayek and Smith (1976) measure the economic value of Roe v. Wade by estimating a travel-cost demand function for abortions in New York, a state with liberal abortion statutes prior to Roe v. Wade. The national liberalization of abortion providers following Roe v. Wade eliminated the need for out-of-state women to obtain a legal abortion in New York, reducing the necessary travel cost of having an abortion. Using their travel-cost demand estimates, one can predict the gain in consumer surplus resulting from greater availability of providers in other states. Over a 10 year period prior to Roe v. Wade, estimates of the foregone benefits of liberalized abortion statues are between $12 million and $30 million. Medoff (1988) estimates the demand for abortions in U.S. states as a function of the dollar cost of abortion services and other socioeconomic factors impacting demand. Demand is shown to be responsive to changes in the dollar east of provider services. However, these data do not allow for testing the effect of variations in provider availability on abortion demand. Gohmann and Ohsfeldt (1992) estimate the demand for abortions using pooled data on U.S. states. They include a statelevel variable to index provider availability, which proves to be insignificant determinant of both abortion and pregnancy rates. Powell-Griner and Trent (1987) find that women residing in metropolitan areas tend to have more abortions than do those in rural areas. One may attribute this finding to the greater availability of abortion services in metropolitan areas. This paper applies a model of fertility control in order to estimate directly the responsiveness of abortion demand to county-level variations in the travel-cost component of the full cost of abortion services. Data on the availability of abortion providers in the 254 counties in Texas, 235 of which were without an abortion provider as of 1992, provide a unique opportunity to approximate the travel cost of abortion services far Texas residents. …