Alignment of state-level policies and public attitudes towards abortion legality and government restrictions on abortion in the United States

Background: Contextual factors can shape public opinion towards abortion. We investigated the association be-tween the state-level abortion legislative climate and individual attitudes towards abortion legality and gov-ernment restrictions of abortion access in the United States. Methods: Data come from the 2020 Cooperative Congressional Election Study (n = 61,000). Using multivariable logistic regression with generalized estimating equations, we explored whether state-level abortion policy cli-mates (based on the Guttmacher Institute's 2020 rating of state abortion policies) were associated with indi-vidual attitudes (1) towards abortion legality, and (2) towards government restriction of abortion access, controlling for individual socio-demographic factors. Results: Eighty-eight percent of participants supported the legality of abortion in some or all circumstances. Conversely, 30% of the sample opposed all federal government restrictions on abortion. More than 60% of the sample lived in highly abortion-restrictive states. Participants living in states with a more supportive abortion legislative climate were more likely to support the legality of abortion in some or all circumstances (AOR = 1.07, (95% CI 1.05, 1.09). Participants in states with more supportive abortion policies were more likely to oppose federal governmental restrictions (AOR = 1.03, 95% CI 1.02, 1.04). Low religiosity, higher educational attain-ment, and politically liberal views were associated with increased support for abortion legality and increased opposition to government restrictions on abortion. Conclusions: State-level abortion policy contexts were positively associated with public attitudes towards abor-tion. While attitudes towards abortion legality are favorable across the country; there is also strong support at least one type of government restriction on abortion access. Results highlight a disconnect between multifaceted public attitudes towards abortion and polarized state contexts, suggesting that policymaking on abortion rep-resents a higher level of polarization than exists at the individual level. Policymakers and legislators should more carefully consider the desires of the public when designing abortion legislation.