Access to early, comprehensive, and high-quality prenatal care improves maternal and child health. In the wake of abortion bans, decreased access to reproductive health care and legal complexities around miscarriage management could create challenges to accessing prenatal care. This could disproportionately affect populations of pregnant people whose access to care is already constrained by multiple systems of oppression, including people from racially and ethnically minoritized groups, who have low-income and are covered by Medicaid, or who live in rural areas.

We hypothesize that abortion bans are causing delays in prenatal care initiation and fewer visits, particularly for populations that face additional structural barriers to accessing care. We will test these hypotheses through a secondary data analysis of data from the National Center for Health Statistics Restricted-Use Birth Certificate records and the Pregnancy Risk Assessment Monitoring System (PRAMS). These datasets contain standard measures of prenatal care initiation, visits, and self-reported access to care, as well as the pregnant person’s race and ethnicity, type of insurance, and rurality of residence. We will use a rigorous empirical approach that compares how these outcomes changed following the Dobbs v Jackson Women’s Health Organization Supreme Court decision in states that implemented total abortion bans compared to states that did not ban abortion. We will then conduct stratified analyses by patient demographics to understand how these results varied across groups. Our results will provide the first population-level evidence on how abortion bans have affected prenatal care, overall and among populations already facing structural barriers to care.