In this paper, we estimate the impacts of abortion clinic closures on access to clinics in terms of distance and congestion, abortion rates, and birth rates. Between 2010 and 2017, Wisconsin passed three laws regulating abortion providers and two of five abortion clinics closed in Wisconsin, increasing the distance to the nearest clinic to 55 miles on average and to over 100 miles in the most affected counties. We use a difference‐in‐differences design to estimate the effect of changes in travel distance on births and abortions, using within‐county variation across time in distance to identify the effect. We find that a 100‐mile increase in distance to the nearest clinic is associated with 30.7 percent fewer abortions and 3.2 percent more births. We see no significant effect of increased congestion at remaining clinics on abortion rates. Interacting the legislative changes with distance, we find that the effects of distance on abortion are approximately 1.33 time stronger in the presence of laws requiring multiple physician visits to obtain an abortion. Our results suggest that even small numbers of clinic closures can result in significant restrictions to abortion access of similar magnitude to those seen in Texas where a greater number of clinics ceased operations.

中文翻译：

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德克萨斯州以外的不适当负担：威斯康星州流产诊所关闭，出生和流产的分析

在本文中，我们从距离和交通拥挤，堕胎率和出生率方面评估了人工流产诊所关闭对门诊的影响。在2010年至2017年之间，威斯康星州通过了三部规范堕胎提供者的法律，并且在威斯康星州关闭了五家堕胎诊所中的两家，将到最近诊所的距离平均增加到55英里，在受影响最严重的县中增加到100英里。我们使用差异差异设计来估计出行距离变化对出生和堕胎的影响，并使用跨时间的县内变化来确定影响。我们发现，到最近诊所的距离增加100英里，流产减少30.7％，分娩增加3.2％。我们认为，剩余诊所的拥挤程度增加对流产率没有显着影响。与距离相关的立法变化相互影响，我们发现，在存在需要多次医生就诊以获得流产的法律的情况下，距离对流产的影响要强大约1.33倍。我们的结果表明，即使关闭诊所的数量很少，也可能导致对流产通路的重大限制，其程度与德克萨斯州更多的诊所停止运营的情况相似。