Abortion Restrictions and Violence Against Women and Girls 15-44 in Missouri, 2012-2023

Abstract

Abortion restrictions in the United States continue to threaten the health equity and bodily autonomy of those who can become pregnant, increasing risk for violent victimization. Research is needed to understand how abortion restrictions contribute to the normalization of violence against women and girls. This study used multiple interrupted time series analyses to examine the immediate and sustained effects of abortion restrictions on violence against women and girls aged 15-44 within Missouri from 2012 through 2023. Missouri passed and enforced three abortion restrictions between 2014 and 2019, and in 2022, enforced a trigger law following the Dobbs decision that banned access to abortion in the state. We used homicide data from the Supplementary Homicide Reports Multiply-Imputed Database and calculated bimonthly homicide rates for the target population. Interruptions were based on the bimonthly period within which Missouri began enforcement of each abortion restriction. We assessed effect modification by race of the victim, weapon used, victim-offender relationship, and gender of offender. Three out of the four abortion restrictions enforced in Missouri between 2012 through 2023 are associated with immediate increases to the homicide rate among women and girls, with minimal sustained trend changes in the months following. Homicides by male offenders and firearms were also observed to immediately increase following abortion restriction enforcement. Immediate increases in homicide rates were highest among Black women and girls, relative to White women and girls. These findings highlight how abortion restrictions undermine gender health equity and contribute to violence against women and girls.