The Persistent Health Effects of Abortion Denial

The Persistent Health Effects of Abortion Denial

Juliana Londoño Vélez (University of California, Los Angeles (UCLA))

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ABSTRACT:

This paper estimates the causal effects of abortion denial on women's mental, physical, and reproductive health using comprehensive longitudinal administrative health records from Colombia. We exploit the country’s tutela system—which allows women to petition judges for abortion care—and random assignment of cases to judges with differing propensities to deny abortion requests. Abortion denial reduces the probability of obtaining a recorded induced abortion by 50 percentage points (p.p.), yet fewer than half of prevented abortions translate into additional births. It causes large and persistent adverse effects on mental health. In the quarter of denial, mental-health diagnoses increase by 26 p.p. and psychotropic medication use by 7 p.p.; both effects remain clinically meaningful three years later. Abortion denial also has large, persistent effects on physical and reproductive health, including persistent reproductive infections and morbidity, increased emergency department visits and hospitalizations, and higher mortality. Effects are substantially larger among women denied later in pregnancy, indicating that health costs increase sharply with gestational age. The evidence is consistent with lasting reproductive-health deterioration, including persistent infections and serious complications in subsequent pregnancies. Lastly, sharp bounds indicate that persistent physical health effects are largely attributable to women whose pregnancies do not result in a recorded live birth (e.g., because they obtain abortions outside the formal health system), rather than to additional births induced by denial. Overall, abortion denial has large, persistent, and clinically meaningful consequences for women's health.

BIO:

Juliana Londoño Vélez is an Associate Professor of Economics at the University of California, Los Angeles (UCLA), and a Co-editor of the Journal of Public Economics. She is a 2026 Sloan Research Fellow in Economics and a Faculty Research Fellow at the National Bureau of Economic Research. Juliana is an applied microeconomist studying how tax and social policies can reduce poverty and inequality and promote upward mobility. Her work has been published in leading economics journals, including The Quarterly Journal of Economics, Journal of Political Economy, and Review of Economic Studies.