The association of federal Medicaid abortion funding restrictions with adverse obstetric outcomes among United States Medicaid recipients

Objective: We examine the association of the Hyde Amendment with obstetrical outcomes in a national Medicaid population. Study design: We conducted a national study of Medicaid-funded abortions to determine the association of restrictions on adolescent, preterm, low-birth weight, and short interpregnancy interval births using administrative data. Results: States that restricted coverage for abortion had a higher median rate of adolescent (10.2%; vs 7.4%; p-value < 0.001), preterm (11.4%; vs 10.1%; p < 0.001), short interpregnancy interval, (13.0% vs 9.6%; p < 0.001), and low birth weight births (10.2% vs 8.7%; p = 0.003) than states where Medicaid provided comprehensive coverage. Conclusions: Restricting federal funds for abortion is associated with adverse outcomes. Implications: When Medicaid does not provide comprehensive coverage for abortion care, few abortions are provided and higher rates of adverse obstetrical outcomes are noted.