“It didn’t matter what the bill said...”: Divergent factors influencing legislative decision-making on restrictive abortion policy in Georgia Open Access

Abstract

Background: In 2019, nine states passed legislation to ban abortion altogether or at very early points in pregnancy. In March 2019 Georgia passed HB 481, a “heartbeat bill” that would prohibit abortion at about 6 weeks gestation. Given the prevalence of anti-abortion legislation and the public health implications of abortion restrictions, we wanted to understand how legislators made decisions on early abortion bans, like HB 481.

 

Methods: We conducted in-depth interviews with nine legislators from the Georgia House of Representatives who were present during the 2019 legislative session. In-depth Interviews were conducted in-person and over the phone, and were audio-recorded for accuracy. Recordings were transcribed verbatim and inductive codes were identified. Codes focused primarily on views of abortion in general, views of specific abortion policy, and how information about HB 481 was obtained. A thematic analysis was performed to elucidate legislators’ perspectives. 

 

Results: Legislators had clear considerations that differed by party affiliation. Democrats described concerns with HB 481 grounded in reproductive autonomy and justice. They claimed concern with the lives of pregnant persons citing the physical and emotional harm these bills cause. They questioned the medical evidence used to support HB 481 and argued that it violated the freedom to choose when to have children. Republican legislators evoked a similar harm reduction framework, but were concerned with protecting the lives of the unborn, arguing that a fetus should be considered a person once a “heartbeat” is detected and that abortion after this point is equal to killing a person. Republicans described aligning with their constituents who they believed hold the same beliefs. Although both sides presented evidence during the legislative session, participants voted according to their previously held beliefs on abortion. 

 

Conclusions: Controversial abortion legislation is commonplace, bringing with it heated debates on when life begins and how to protect it. It is important to understand the underlying motives for legislators’ decisions in order to enhance communication and improve policy outcomes related to reproductive health and rights. 

Table of Contents

ABSTRACT……………………………………………………………………………………...iv

ACKNOWLEDGMENTS………………………………………………………………………vi

CHAPTER 1: INTRODUCTION……………………………………………………………….1

1.1 Background…………………………………………………………………………..1

1.2 Purpose……………………………………………………………………………….4

1.3 Significance…………………………………………………………………………...4

CHAPTER 2: LITERATURE REVIEW………………………………………………………5

2.1 Abortion Laws………………………………………………………………………..5

2.1.1     State Restrictions………………………………………………………...6

2.1.2     Early Abortion Bans……………………………………………………..9

2.1.3     Georgia House Bill 481…………………………………………………..9

2.2 Consequences of Abortion Restrictions…………………………………………...10

2.2.1     Unsafe Abortion………………………………………………………...10

2.2.2     Economic and Social Consequences…………………………………...12

2.2.3     Abortion Myths…………………………………………………………13

2.3 Policy Making Processes……………………………………………………………14

2.3.1     Factors that Influence Legislative Decision-Making…………………15

CHAPTER 3: MANUSCRIPT…………………………………………………………………17

           Contribution of Student………………………………………………………………...17

Abstract…………………………………………………………………………………..18

Introduction……………………………………………………………………………...19

Methods………………………………………………………………………………….22

Results…………………………………………………………………………………...24

Discussion……………………………………………………………………………….33

Conclusion………………………………………………………………………………38

           Manuscript References………………………………………………………………….39

CHAPTER 4: IMPLICATIONS FOR PUBLIC HEALTH………………………………….41

           4.1 Future Research……………………………………………………………………..42

THESIS REFERENCES……………………………………………………………………….43

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Law
Keyword	abortion reproductive health public health policy legislative decision-making abortion policy
Committee Chair / Thesis Advisor	Dr. Dabney P. Evans, Emory University
Committee Members	Dr. Subasri Narasimhan, Emory University

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