The Impact of TRAP Laws on the Supply of Maternal Healthcare Providers.

Abstract

This paper examines the impact of Targeted Regulation of Abortion Providers (TRAP) laws on the supply and composition of maternal healthcare providers, particularly obstetrician-gynecologists (OB/GYNs). We exploit the staggered enactment of TRAP laws across U.S. states from 2010 to 2021 using a propensity score matching and stacked difference-in-differences approach. Our analytic sample includes physician-, county- and state-level measures of OB/GYN supply, newly graduated OB/GYNs, medical school and residency program applicants, nurse practitioners (NPs) and physician assistants (PAs) who practice women's healthcare, as well as advanced practice nurse midwives. TRAP law enactment is associated with a statistically significant reduction of 2.09 in OB/GYN supply per 100,000 females aged 15-44 (6.6% relative to the baseline). This decline is particularly pronounced among OB/GYNs aged 55-64. For OB/GYNs under 34, the estimates suggest a decline but this finding should be interpreted cautiously given pre-trends. TRAP laws also are associated with a reduction in the supply of newly graduated OB/GYNs from lower-ranked medical schools. We find no evidence that NPs, PAs, or midwives substitute for the decline in OB/GYNs. Mechanism analyses provide suggestive evidence that the supply contraction operates through exit rather than relocation. These findings highlight unintended consequences of abortion restrictions on broader maternal healthcare provision.