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The microeconomics of abortion: a scoping review and analysis of the economic consequences for abortion care-seekers

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  • Coast, Ernestina
  • Lattof, Samantha R.
  • Rodgers, Yana Van Der Meulen
  • Moore, Brittany
  • Poss, Cheri

Abstract

Background: The economic consequences of abortion care and abortion policies for individuals occur directly and indirectly. We lack synthesis of the economic costs, impacts, benefit or value of abortion care at the micro-level (i.e., individuals and households). This scoping review examines the microeconomic costs, benefits and consequences of abortion care and policies. Methods and findings: Searches were conducted in eight electronic databases and applied inclusion/exclusion criteria using the PRISMA extension for Scoping Reviews. For inclusion, studies must have examined at least one of the following outcomes: costs, impacts, benefits, and value of abortion care or abortion policies. Quantitative and qualitative data were extracted for descriptive statistics and thematic analysis. Of the 230 included microeconomic studies, costs are the most frequently reported microeconomic outcome (n = 180), followed by impacts (n = 84), benefits (n = 39), and values (n = 26). Individual-level costs of abortion-related care have implications for the timing and type of care sought, globally. In contexts requiring multiple referrals or follow-up visits, these costs are multiplied. The ways in which people pay for abortion-related costs are diverse. The intersection between micro-level costs and delay(s) to abortion-related care is substantial. Individuals forego other costs and expenditures, or are pushed further into debt and/or poverty, in order to fund abortion-related care. The evidence base on the economic impacts of policy or law change is from high-income countries, dominated by studies from the United States. Conclusions: Delays underpinned by economic factors can thwart care-seeking, affect the type of care sought, and impact the gestational age at which care is sought or reached. The evidence base includes little evidence on the micro-level costs for adolescents. Specific sub-groups of abortion care-seekers (transgendered and/or disabled people) are absent from the evidence and it is likely that they may experience higher direct and indirect costs because they may experience greater barriers to abortion care.

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  • Coast, Ernestina & Lattof, Samantha R. & Rodgers, Yana Van Der Meulen & Moore, Brittany & Poss, Cheri, 2021. "The microeconomics of abortion: a scoping review and analysis of the economic consequences for abortion care-seekers," LSE Research Online Documents on Economics 110747, London School of Economics and Political Science, LSE Library.
    • Handle: RePEc:ehl:lserod:110747
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    1. Samantha R Lattof & Ernestina Coast & Yana van der Meulen Rodgers & Brittany Moore & Cheri Poss, 2020. "The mesoeconomics of abortion: A scoping review and analysis of the economic effects of abortion on health systems," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-25, November.
    2. Yana van der Meulen Rodgers & Ernestina Coast & Samantha R Lattof & Cheri Poss & Brittany Moore, 2021. "The macroeconomics of abortion: A scoping review and analysis of the costs and outcomes," PLOS ONE, Public Library of Science, vol. 16(5), pages 1-18, May.
    3. Gallo, Maria F. & Nghia, Nguyen C., 2007. "Real life is different: A qualitative study of why women delay abortion until the second trimester in Vietnam," Social Science & Medicine, Elsevier, vol. 64(9), pages 1812-1822, May.
    4. Thaddeus, Sereen & Maine, Deborah, 1994. "Too far to walk: Maternal mortality in context," Social Science & Medicine, Elsevier, vol. 38(8), pages 1091-1110, April.
    5. Brittany Moore & Cheri Poss & Ernestina Coast & Samantha R Lattof & Yana van der Meulen Rodgers, 2021. "The economics of abortion and its links with stigma: A secondary analysis from a scoping review on the economics of abortion," PLOS ONE, Public Library of Science, vol. 16(2), pages 1-19, February.
    6. Coast, Ernestina & Murray, Susan F., 2016. "“These things are dangerous”: Understanding induced abortion trajectories in urban Zambia," Social Science & Medicine, Elsevier, vol. 153(C), pages 201-209.
    7. Upadhyay, U.D. & Weitz, T.A. & Jones, R.K. & Barar, R.E. & Foster, D.G., 2014. "Denial of abortion because of provider gestational age limits in the United States," American Journal of Public Health, American Public Health Association, vol. 104(9), pages 1687-1694.
    8. Douglas Almond & Lena Edlund & Kevin Milligan, 2013. "Son Preference and the Persistence of Culture: Evidence from South and East Asian Immigrants to Canada," Population and Development Review, The Population Council, Inc., vol. 39(1), pages 75-95, March.
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    10. Leone, Tiziana & Coast, Ernestina & Parmar, Divya & Vwalika, Bellington, 2016. "The individual level cost of pregnancy termination in Zambia: a comparison of safe and unsafe abortion," LSE Research Online Documents on Economics 64716, London School of Economics and Political Science, LSE Library.
    11. Izugbara, Chimaraoke O. & Egesa, Carolyne & Okelo, Rispah, 2015. "‘High profile health facilities can add to your trouble’: Women, stigma and un/safe abortion in Kenya," Social Science & Medicine, Elsevier, vol. 141(C), pages 9-18.
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    1. Brittany Moore & Yana van der Meulen Rodgers & Ernestina Coast & Samantha R Lattof & Cheri Poss, 2021. "History and scientific background on the economics of abortion," PLOS ONE, Public Library of Science, vol. 16(9), pages 1-9, September.
    2. Samantha R Lattof & Ernestina Coast & Yana van der Meulen Rodgers & Brittany Moore & Cheri Poss, 2020. "The mesoeconomics of abortion: A scoping review and analysis of the economic effects of abortion on health systems," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-25, November.

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    JEL classification:

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