Kari White, Gracia Sierra, Brooke Whitfield, Kristina Tocce, Samuel L. Dickman, Vinita Goyal
Objectives. To compare changes in the number of facility-based abortions among Texas residents in different age groups following the state’s 2021 law prohibiting abortion after detection of embryonic cardiac activity. Methods. We obtained data from Texas and 6 surrounding states on Texas residents’ age at abortion from state vital statistics and data provided directly by out-of-state abortion facilities. Using negative binomial regression, we estimated the percentage change in abortions before (September 2020–May 2021) and after (September 2021–May 2022) the law went into effect. Results. After the law’s implementation, total (in-state and out-of-state) facility-based abortions decreased by 26.1% (95% confidence interval [CI] = −32.7%, −18.8%) among Texans younger than 18 years, by 19.6% (95% CI = −21.4%, −17.7%) among young adult Texans aged 18 to 24 years, and by 17.0% (95% CI = −19.1%, −14.8%) among Texans aged 25 to 29 years. Conclusions. Texas’s law disproportionately affected access to facility-based abortion care among Texans aged 24 years and younger. Public Health Implications. State laws prohibiting abortions in early pregnancy disproportionately affect young people’s reproductive autonomy, likely by compounding long-standing financial and logistical barriers to facility-based care. ( Am J Public Health. Published online ahead of print November 13, 2025:e1–e4. https://doi.org/10.2105/AJPH.2025.308289 )