THE IMPACT OF MISSISSIPPIS MANDATORY DELAY LAW ON ABORTIONS AND BIRTHS

Context.-Beginning August 8, 1992, a woman in the state of Mississippi had to wait 24 hours after in-person receipt of state-mandated inform ation regarding abortion and birth complications, fetal development, a nd alternatives to abortion before an abortion could be performed. Obj ective.-To analyze the effect of the law on the abortion and birth rat es of Mississippi residents. Design.-A retrospective analysis of abort ion and birth rates before and after the law in Mississippi as contras ted with abortion and birth rates in 2 comparison states, Georgia and South Carolina. Neither Georgia nor South Carolina enforced a mandator y delay law, but both states began enforcement of parental notificatio n statutes during the study period, Patients.-Female residents of repr oductive age in Mississippi, Georgia, and South Carolina between 1989 and 1994. Main Outcome Measures.-We compared birth rates, abortion rat es, the per centage of late abortions, and the percentage of abortions performed outside the state of residence for all women and then by ag e and race before and after August 1992 among women of Mississippi, Ge orgia, and South Carolina. Results.-We found that rate ratios (RRs) of resident abortion rates (rate after law implementation/rate before la w implementation) declined 12% more in Mississippi than in South Carol ina (95% confidence interval [CI], 8%-15%) and 14% more in Mississippi than in Georgia (95% CI, 10%-17%) in the 12 months after the law went into effect, Rate ratios for white adults declined 22% more in Missis sippi than in South Carolina (95% CI, 17%-27%) and 20% more in Mississ ippi than in Georgia (95% CI, 15%-25%). Changes among nonwhite adults and white teens were more modest but also statistically significant (P <.05). For all women, RRs of the percentage of abortions performed aft er 12 weeks' gestation increased 39% more in Mississippi than in eithe r South Carolina or Georgia (P<.05); the increase in the percentage of abortions after 12 weeks' gestation was observed for white and nonwhi te adults (P<.05). We also show that the percentage of abortions perfo rmed out of state increased 42% more among women in Mississippi relati ve to women in South Carolina after the law (95% CI, 34%-50%). Conclus ion.-The timing of the decline in abortion rates in Mississippi, the l ack of similar declines in comparison states, the rise in percentage o f late abortions and abortions performed out of state and the apparent completeness of abortion reports suggest that Mississippi's mandatory delay statute was responsible for a decline in abortion rates and an increase in abortions performed later in pregnancy among residents of Mississippi, The effect of delay laws in other states will likely depe nd on whether statutes require 2 separate visits to the abortion provi der tie, clinics, hospitals, or physicians' offices where abortions ar e performed) and the availability of abortion services.