2022 Analysis: Costs of Reproductive Health Restrictions

Access to comprehensive reproductive health care is central to women’s freedom and full participation in society. In recent decades, a rise in state efforts to limit access to reproductive health care has threatened women’s equality and put state and regional economies at risk. Between January 1st and April 29, 2021, 108 state-level abortion restrictions were enacted, the most in more than 10 years. In 2022, there were fewer abortion restrictions passed – 50 – but many were near-total or total bans, meaning women in those states can no longer access abortion there. These restrictions fall hardest on women who already face systemic obstacles accessing health care and economic opportunities: Black, Hispanic, low-income, young, and rural women, as well as LGBTQ+ individuals.

While the cost of reproductive health restrictions is most harmful to women and their families, it also has consequences for businesses and state economies. Restrictions reduce women’s participation in the workforce, which results in significant loss of wages. For businesses, restrictions on access to reproductive health care affect their ability to achieve optimal results, which then impacts state economies.

This analysis provides an estimate of the cost of reproductive health restrictions at the state level.

Please note that this analysis does not include the impact of bans that would have been observed since the Dobbs Supreme Court decision. The analysis requires a full year of labor and census data, which is not yet available for 2023 when most of the impact would have occurred. Compared to our previous analysis, our current model accounts for the economic impact of new restrictions on medication abortion, a category we had not previously modeled. In December 2022, a total of 27 states had additional restrictions on medication abortion which had further impact on the cost to state economies and women’s labor force participation.

Ending Reproductive Health Restrictions: Good for Women, Good for Business

Below you will find an interactive map.  Please navigate the map by hovering your mouse above the state you wish to learn more about.

Key Findings

StateAverage Annual Economic Loss as a % of State GDP*Total Average Annual Economic LossAverage Annual % Labor Force Loss Women 15-44Total Average Annual Labor Force Loss Women 15-44
Alabama0.90%$2,381,904,951 1.60%9,608
Alaska0.40%$251,941,285 1.30%1,197
Arizona1.00%$4,519,289,297 1.70%16,480
Arkansas1.20%$1,934,189,137 2.00%7,786
California0.30%$10,934,214,122 0.80%39,188
Colorado0.20%$1,202,817,459 0.40%3,632
Connecticut0.40%$1,403,507,109 0.80%4,065
Delaware0.40%$352,847,713 0.90%1,252
District Of Columbia0.10%$124,781,412 0.20%226
Florida0.80%$11,143,499,582 1.50%38,850
Georgia1.00%$7,756,934,100 2.00%29,545
Hawaii0.30%$311,431,790 0.70%1,208
Idaho1.10%$1,208,139,811 1.80%4,715
Illinois0.50%$5,404,904,981 0.80%13,936
Indiana1.30%$5,751,383,019 1.90%17,570
Iowa0.80%$1,782,683,983 1.10%5,230
Kansas1.00%$2,117,037,448 1.60%6,525
Kentucky1.10%$2,883,170,259 2.00%11,372
Louisiana1.00%$2,892,193,024 2.10%12,379
Maine0.40%$349,139,550 0.60%1,064
Maryland0.50%$2,363,182,649 0.90%7,608
Massachusetts0.50%$3,351,868,058 0.80%8,242
Michigan1.30%$8,134,505,377 1.90%24,722
Minnesota0.50%$2,423,433,112 0.70%6,114
Mississippi1.20%$1,624,032,006 2.20%7,793
Missouri1.40%$5,301,556,113 1.90%15,401
Montana0.70%$485,735,167 0.90%1,512
Nebraska1.10%$1,807,076,570 1.60%4,785
Nevada0.60%$1,278,811,331 1.30%5,173
New Hampshire0.40%$402,422,743 0.60%1,164
New Jersey0.40%$2,632,003,726 0.60%7,596
New Mexico0.50%$564,057,452 1.10%2,648
New York0.30%$5,647,547,105 0.70%17,527
North Carolina1.00%$7,301,199,945 2.00%27,778
North Dakota0.80%$592,839,882 1.50%1,672
Ohio0.90%$7,147,435,525 1.50%23,109
Oklahoma1.10%$2,667,007,621 2.30%11,981
Oregon0.30%$826,785,819 0.40%2,620
Pennsylvania0.90%$8,548,925,192 1.50%25,766
Rhode Island0.80%$572,506,535 0.90%1,516
South Carolina1.00%$2,995,847,675 1.80%11,505
South Dakota1.00%$671,354,489 1.50%1,897
Tennessee0.80%$3,809,082,532 1.40%13,463
Texas1.00%$23,002,230,902 2.30%93,244
Utah1.10%$2,631,931,918 2.10%10,636
Vermont0.20%$62,854,531 0.20%179
Virginia0.60%$4,086,077,720 1.10%13,386
Washington0.30%$2,293,473,626 0.70%7,295
West Virginia0.80%$755,375,307 1.50%3,115
Wisconsin1.00%$4,029,758,559 1.30%10,884
Wyoming0.40%$187,282,122 1.20%909
National0.70%$172,904,211,339 1.40%597,068

Notes: IWPR estimates using 2020-2022 Current Populations Survey Data. The number of restrictions by state are based on Guttmacher Institute’s “Overview of Abortion Laws” (May 2023). All values are reported in 2022 constant prices. *Annual Average Loss between 2020-2022 as a percentage of 2022 GDP.


Results reported in this analysis correspond to a new estimation of IWPR’s Cost of Reproductive Health Restrictions model released in 2021. As in our previous analysis, this research seeks to answer the following question: What are the costs of abortion restrictions at the state level? This model uses population-level macro analyses, pooling three years of data from January 2020 to December 2022 of US Bureau of Labor Statistics (BLS) data from the monthly Current Population Survey (CPS). All values reported are adjusted for inflation using 2022 constant prices.

The number of state-level abortion restrictions, our key independent variable, is constructed based on the Guttmacher Institute’s “Overview of Abortion Laws” (May 2023).[1] For this ordinal measure, the abortion restrictions tracked by the Guttmacher Institute were weighed equally and combined into the following IWPR broader categories:

IWPR Broad Categories Guttmacher narrow categories
1. TRAP Laws a. Must be performed by a licensed physician
b. Must be performed in a hospital if at (gestational age)
c. Second physician must participate if at (gestational age)
2. Bans of Procedures a. Prohibited except in cases of life or health endangerment if at (gestational age)
b. “Partial Birth” abortion banned
3. Public Funding Restricted a. Prohibits funding all or most medically necessary abortions
b. Funds limited to life endangerment, rape, and incest
4. Provider Can Refuse to Participate a. Any limitations to private funding
b. Private Insurance Coverage Limited
5. Provider Can Refuse to Participate a. Individual
b. Institution
6. Mandated Counseling Includes Information on: a. Breast cancer link
b. Fetal pain
c. Negative psychological effects
7. Waiting Period (18 or more hours after counseling)
8. Parental Consent Required for Minors
9. Medication restriction a. Must be provided by physician
b. Patient must have in person visit for prescription
c. Gestational age limit for provision
d. Patient must take first dose in the presence of physician
e. Mailing of abortion pills banned

1 Guttmacher Institute, “Overview of Abortion Laws.” https://www.guttmacher.org/state-policy/explore/overviewabortion-laws. IWPR analysis is based on the version available as of May 2023.

All states, including the District of Columbia (DC), were then assigned into abortion restrictions categories ranging from one to nine based on the number of abortion restrictions enacted in that state. All abortion restrictions were weighed equally in estimating the economic impacts on women’s labor force participation and earnings.

We follow our previous methodology to estimate the impact of state-level restrictions on women’s labor force participation between the ages of 15 and 44 and to evaluate the impact of state abortion restrictions on women’s earnings in this same age group and who were employed in the private sector. For an in-depth description of this methodology, please see The Costs of Reproductive Health Restrictions: An Economic Case for Ending Harmful State Policies.

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