Unwilling to Disclose? Privacy and Pregnancy in Post-Roe America

• In Event: Public Policy Attitudes

Abstract

On June 24, 2022, the Supreme Court overturned Roe v. Wade and, with it, the right to abortion in the United States. Following this landmark decision, a number of states swiftly and even automatically banned abortion with very limited exceptions. The Dobbs decision has dramatically limited access to abortion at every stage of pregnancy in many US states (e.g., Rader et al. 2022). This uncertain and restrictive policy environment has created the conditions for a chilling effect on doctor-patient relationships and women’s willingness to disclose their pregnancy status, as patients and doctors have been prosecuted for accessing and providing access to abortion and law enforcement officials have used patients’ personal data against them (Human Rights Watch 2023). This project analyzes large-scale survey data to examine changes in women's willingness to disclose pregnancy status before and after the Dobbs decision, as well as across states with more or less restrictive legal environments. We theorize that women, especially those who live in states with more severe abortion restrictions, may have become wary of sharing their pregnancy status--on confidential surveys as well as with health care providers--in response to the Dobbs decision. This could have critical implications for the tenor of women’s relationships with their health care providers and the nature of women’s health. A chilling effect on disclosure could also have wide-ranging implications for the validity of scientific research across medical and social-scientific fields that relies on survey-based disclosures of pregnancy status.

In this paper, we analyze data from a health survey that was in the field pre- and post-Dobbs (the CDC’s Behavioral Risk Factor Surveillance System) and a mixed-mode public opinion survey (the 2022 Collaborative Midterm Survey) to investigate the following research questions: (1) Before and after the Dobbs decision, did the willingness of women aged 18-49 to disclose their pregnancy status change and, if so, did these effects differ across state legal environments? (2) In the post-Roe period, to what extent do differences in women’s willingness to disclose their pregnancy status depend on state residency and individual-level factors like partisanship and socioeconomic status? We employ a difference-in-differences approach to address these questions. We supplement these analyses with a descriptive analysis of Google Trends pre- and post-Dobbs leak in May 2022 and pre- and post-Dobbs decision in June 2022 to examine changes in keyword search frequency over time and across states and regions.

Findings from our analyses will speak to the potentially chilling effect on pregnancy disclosure that the Dobbs decision may have had across the country.

Authors

• Cindy D. Kam, Vanderbilt University

• Colette Marcellin, Vanderbilt University