The Impact of a Restrictive Abortion Policy on Newborns’ Health

Gábor Hajdu, MTA-ELTE Peripato Comparative Social Dynamics Research Group
Tamás Hajdu, Institute of Economics, Research Centre for Economic and Regional Studies of the Hungarian Academy of Sciences

In this research, we examine the consequences of the restrictive Hungarian abortion policy introduced in 1974. Following the law change that restricted the access to legally permissible abortions the number of induced abortions decreased by 70 000, whereas the number of live births increased by 30 000 between 1973 and 1974. We analyze the impacts of the law change on the health at birth indicators of the affected children.

Using large-scale, individual-level administrative datasets of the Hungarian Central Statistical Office (the registry of live births, the registry of induced abortions, the registry of infant mortality) we estimate the effects by comparing children born just before and after the law change. In other words, we rely on data of children born within a short timespan around the law change. In this way, we are able to rule out the effect of other (unobservable) time trends and other potential behavioral responses to the law change, and we can draw causal inference. Using socio-economic background variables of the parents that are available in the live birth database (e.g. education, occupation, age, the pregnancy history of the mother), we can control for a composition effect as well. Beside the simple difference strategy described above, we also rely on a difference-in-difference strategy and placebo regressions.

Since most of the evidence on the impact of the access to abortion on health in early life comes from the USA, this study adds to the literature by studying the effects for a country outside the United States. In a wider perspective, our research is also related to the literature on the impact of the access to contraceptive technologies.


From January 1, 1974, new abortion rules were introduced in Hungary that was justified as it is intended to protect the health of the women, but the implicit goal was to reduce the high number of abortions and to increase the fertility. The new regime restricted the access to legally permissible abortions, and had dramatic impacts immediately. The number of induced abortions decreased from 169 650 to 102 022 between 1973 and 1974. At the same time, the number of live birth increased by 30 000 births.

There are three main mechanisms through which a restrictive abortion policy might affect the health outcomes of children. (i) There is an increase in the number unwanted children, and this unwantedness might have negative impacts on the child. (ii) The composition of women giving birth might change. (iii) A negative crowding effect might emerge due to changes in cohort size.

In this research, we examine the effects of the restrictive abortion policy on the health of the newborns. Using the complete registry data of the Hungarian live births, we examine the health of newborns born before and after the law change (e.g. birth weight, birth length, week of delivery, APGAR score). We also investigate how infant mortality, neonatal mortality and postneonatal mortality are affected by the change in the abortion law.

We estimate the effect of the law change by comparing children born just before and after the law change, i.e. we will rely on data of children born within a reasonably short timespan around the law change. This strategy makes us able to minimize the effect of other (unobservable) time trends and other potential behavioral responses to the law change and provides the opportunity to draw causal inference. Using socio-economic background variables of the parents that are available in the live birth database (e.g. education, occupation, age, the pregnancy history of the mother), we can (at least partially) control for composition effect as well.

Beside the simple difference strategy described above, we also rely on a difference-in-difference strategy and placebo regressions. If we will use data from a time span that is less than one year, i.e. we compare children born in the second part of 1974 with children born in the first part of 1974, with the simple difference we might observe an effect that reflects only the effect of seasonality. If restriction of the abortion law had a significant effect, the difference between children born in the second part of 1974 (i.e. who born after the new law came into full effect) and children born in the second part of 1973 should be significant, but we should not observe significant difference between children born in the first part of 1974 and children born in the first part of 1973 (i.e. between children born before the new law came into full effect). Consequently, the difference between the two differences should be significant.

As an alternative approach to the difference-in-difference strategy and as a robustness test we also use “placebo treatment” models. In this exercise, we assume that the law change was not introduced in 1974, but in other random years (e.g. 1976). Then, we follow the very same identification strategy discussed earlier. In these models, we do not expect to observe significant differences between children born before and after the “law change”. If we observe non-zero associations, then the causal interpretation of our other results might be false.

Since most of the evidence on the impact of the access to abortion on health in early life comes from the USA, this study adds to the literature by studying the effects for a country outside the United States. In a wider perspective, our research is also related to the literature on the impact of the access to contraceptive technologies.

Presented in Session 1161: Health, Wellbeing, and Morbidity