When Partial Liberalization Saves Lives: The Impact of Colombia's 2006 Abortion Reform on Neonatal Health

This paper examines the effects of abortion liberalization on newborn health outcomes in a middle-income country context. We exploit Colombia’s 2006 Constitutional Court ruling (C-355), which partially decriminalized abortion in three circumstances: risk to the mother’s health, fetal inviability, and pregnancies resulting from sexual violence, as a quasi-natural experiment. Using a difference-in-differences design with administrative data on all live births, we estimate the causal impact of this reform on key neonatal health indicators, including birth weight, gestational age, and APGAR scores. We find that the partial liberalization led to significant improvements in newborn health, particularly among younger and socially vulnerable mothers. The results suggest that expanded legal access to abortion reduced the incidence of high-risk pregnancies and improved the composition of births, consistent with maternal selection mechanisms observed in the United States and other high-income settings. These effects are robust to alternative specifications and concentrated in areas with greater hospital availability, indicating that institutional capacity mediated the reform’s health benefits. Our findings contribute to the global evidence that liberalizing abortion laws can improve both maternal and neonatal health, even when reforms are partial and implemented within constrained health systems. They highlight that legal access, combined with adequate service delivery, can yield measurable population-level gains in newborn survival and equity in reproductive health.