The Changing Abortion Policy Landscape and Sexual Risk-Taking Behaviors Among Adolescents

Abstract

 In June 2022, the US Supreme Court Dobbs decision removed the right to abortion care, leading to state laws restricting or banning abortion. In years prior, narrower state abortion restrictions proliferated, such as parental notification laws for minors. Studies have assessed effects of these policies on birth outcomes, but limited attention has been paid to sexual risk-taking behaviors, particularly among adolescents, who face heightened risks for unplanned pregnancies and unique barriers to contraception and abortion services. Risks of unintended pregnancy may lead to declines in sexual risk behaviors among youth in the context of abortion restrictions. Alternately, youth may show limited behavioral changes, given imbalances in brain development which lead to more impulsive behavioral choices. To address these hypotheses, this quasi-experimental study evaluates how state abortion policies (e.g., parental notification, abortion bans) affect adolescents’ sexual risk-taking behaviors (number of partners, contraceptive use). We merge data on state abortion policies from 1999 through 2025 with repeated cross-sectional Youth Risk Behavior Surveys (N~ 1,700,000). We estimate logistic regression models using a difference-in-differences framework, including abortion policy indicators, youth demographics, state covariates, and state and year fixed effects to assess how state abortion restrictions affect youth sexual risk behaviors, followed by assessment of variation over demographic strata (age, sex, race). Findings will have implications for public health policies, reproductive health care, and sex education policies across the US.