States with more abortion restrictions tend to score worse when it comes to health outcomes for women and children and have fewer policies to support those populations, according to a new study from a research center and a legal advocacy organization that seek to improve abortion access.

On average, the 26 states with more than 10 abortion restrictions had poorer health scores for women than the 24 other states, the report by Ibis Reproductive Health and the Center for Reproductive Rights found.

Massachusetts was one of the states with fewer abortion restrictions and more supportive policies compared to the national average.

(Courtesy Ibis Reproductive Health)

I spoke with Terri-Ann Thompson, one of the authors of the report and an associate at Ibis, which is based in Cambridge. Our conversation, lightly edited, follows.

How would you summarize your findings?

We have developed a report that is a snapshot of time and energy being spent on two different categories of policies: policies that have a harmful impact on women, and policies that are known to support women and families. We were curious to see whether the numbers of policies in place for abortions and women and children's health actually reflected anecdotal messaging from anti-abortion legislators that abortion restrictions were actually being enacted to protect the health and well-being of women, their pregnancies and their children.

What we actually found, however, is a challenge to the claim of politicians who have passed abortion restrictions under the guise of protecting women's health and safety. The report shows that many of the states that have the highest numbers of restrictions for abortions actually have dramatically fewer policies that would truly address the challenges women and families face.

What are some examples of supportive policies?

States were scored on a scale of 0 to 24 to reflect the total number of possible supportive policies. Some examples of supportive policies are: expanded Medicaid under the Affordable Care Act; expanded family and medical leave beyond the [Family Medical Leave Act]: mandated sex education; maternal mortality review board established; contraceptive parity laws in place.

What might explain this correlation you found?

I think in states where it is harder for women to make choices about their pregnancy and to have a safe abortion, there are fewer policies in place that could support women and their children before and after pregnancy.

We know that policies such as increased Medicaid eligibility limits for pregnant women have been shown to increase health care coverage of pregnant women and reduce infant mortality and low birth weight. So if these policies are not in place, then we don't see the resulting benefits for women and for children's health outcomes. That's why I think we see a correlation.

I noticed that this report was first published in 2014. What has stayed the same, and what has changed in the 2017 report?

One of the things that we noticed between the 2014 and 2017 report is that the correlation hasn't changed. So we're still seeing the same association that states with the highest number of abortion restrictions tend to have the worst women and children's health outcomes and the fewest supportive policies that would advance the health and well being of families.

Unlike the 2014 report, in 2017 we see a divide with states falling either within the 0-7 abortion restriction category or the 10-14 restrictions category. In the cases where states have passed 10 or more of the restrictions included in the analysis, those account for a disproportionately large number of the nearly 400 abortion restrictions politicians have passed since 2010. Also in 2017, five versus three states had the maximum number of abortion restrictions enacted.

(Courtesy Ibis Reproductive Health)

What are the implications of the report on policy?

I do think it has implications for policymakers, and certainly how we envision this report being used is as a tool for advocates. We hope that armed with this information and these numbers, they will be able to push for more supportive health policies and to push policy makers to truly prioritize women and children's health rather than enacting more punitive laws around reproductive health.

What were your findings specifically about Massachusetts?

What we see in the case of Massachusetts is that supportive policies actually outnumber the abortion restrictions passed in the state. It has six abortion restrictions and 15 supportive policies.

There are many factors I would say that are involved in the enactment of abortion restrictions that were shown to be harmful to women and families. And while this report can’t say why these six factors were passed in Massachusetts, what it does show is that the state has put some supportive policies in place to bolster women's and children's health.

In fact, what we see in the rest of the report is that Massachusetts holds some of the higher scores on women's health indicators, scoring 10 out of 15. On children's health, it scores 9 out of 15, and even on social determinants, it scored 6 out of 10, with the highest score being 9. So Massachusetts is actually doing well in terms of those indicators.

Why are these findings important? What do you hope people will learn after reading the report?

I think what we would like people to leave with is two things: One is that if indeed abortion restrictions are being applied, enacted and passed in order to protect women's and children's health, we would expect to see corresponding policies that could support women who would then carry a pregnancy to term. But that’s not what we’re seeing.

Second, why it matters is that in many states, there are already disparities in reproductive and other health areas. And when you add another layer of many abortion restrictions and fewer supportive policies, the result is actually women being placed at further disadvantage for good health. So in a context where health outcomes are flailing for women and children, adding more restrictions and having fewer supportive policies actually just makes the situation worse.