Monday, July 1, 2019

Are there health consequences to being "turned away" for an abortion?




One of the arguments against women having abortions promulgated by anti-abortion activists is that the procedure causes women to have poorer health than those who choose to carry a pregnancy to term.  Actually, the opposite is true according to The Turnaway Study, a prospective, longitudinal study comparing the mental, physical and socioeconomic consequences for women who either terminated a pregnancy in the first or second trimester (n= 705) or were "turned away" and forced to carry an unwanted pregnancy to term (n=231).   Study subjects recruited from ~ 30 abortion clinics across the U.S. between 2008-2010 were interviewed by phone every 6 months over a 5-year period.  They were asked about their physical, mental, and emotional health, relationship status, contraceptive use, education, employment status, economic situation, social support and family relationships.
The study did NOT find that having an abortion had detrimental effects on women’s health.  Instead, the investigators discovered that there were serious consequences for those DENIED the procedure:
  • 4-fold greater odds of living below the federal poverty level
  • More likely to experience eclampsia and death
  • More likely to suffer from anxiety and loss of self-esteem in the short term
  • More likely to stay with an abusive partner

In fact, of those who underwent an abortion, 95% reported that it was the right decision for them 5 years following the procedure. 

Although most of the published literature has found no adverse mental health outcomes following abortion, the few that have compared the mental well-being of women who underwent abortion with those who carried to term or with the general population of women.  These studies failed to take into account differences between women who chose to continue a pregnancy versus those whose circumstances led them to terminate one – namely poverty, lack of social support, intimate partner violence, rape, lack of education and pre-existing mental health issues.  The decision to have an abortion depends on each individual woman’s circumstances and is a poignant example of the social determinants of health.  Before we jump to conclusions or render judgment, maybe we need to put ourselves in another person’s shoes.

Judith Wolf, MD    Associate Director, WHEP

Stotland NL.  Update on Reproductive Rights and Women’s Health. Med Clin N Am 103 (2019) 751-766