The Association Between Economic Outcomes and Abortion: A Scoping Review

Background: Abortion access is not just an issue of autonomy, but an economic issue as well. Evidence of the intersectionality of abortion health care and economics has endured due to the financial cascading effects a denial of an abortion, or the inability to access an abortion, has on one’s personal, professional, and economic upward mobility. A change in recent policies impacting access to abortion warrants an updated synthesis examining the relationships between economic outcomes and abortion access for people of reproductive age in the United States (U.S.). Aim: This scoping review summarizes evidence pertaining to the association between economic outcomes--such as individual and family income, poverty, and subjective poverty—and abortion access to identify gaps which future research studies could address. Methods: Arksey and O’Malley’s (2005) scoping review methodological framework was used to conduct a comprehensive literature search of four electronic databases for peer reviewed articles from 1967-2024. The long timeframe provided a full landscape of research regarding the association of economics and abortion access in the U.S., aiding in answering the research questions of this scoping study. Duplicates were removed and results were screened at the title and abstract level before the full text analysis. English-language articles were included if they addressed abortion, if participants were women of reproductive age (15-44 years) in the U.S., and if they examined financial outcomes including individual income, family income, poverty, subjective poverty, or upward mobility. Publications were excluded if they did not address abortion. Results: 2,412 titles and abstracts were screened. Nine studies were included in this scoping review which showed both positive and negative associations between abortion access and different economic indicators such as individual income (n = 6), subjective poverty (n = 8), poverty (n = 6) and family/household income (n = 7). Discussion: Prior to seeking an abortion, the financial characteristics are often similar for women of reproductive age. However, women denied an abortion experience higher financial distress due to lack of employment, a decrease in personal income, and an increase in subjective poverty. This contributes to lower household income and possibly increases the percentage of living below the federal poverty level (FPL) compared to women who receive a wanted abortion and were similar socioeconomically at the time of seeking an abortion.