Denying Women Abortions Can Hurt Their Health For Years

Anti-abortion lawmakers claim it's risky, health-wise. But a new study finds more evidence that's not the case.
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Anti-abortion legislators around the country have been passing restrictions in the name of women’s health for years, and on Friday, the Supreme Court overturned Roe v. Wade to remove legal protection of abortion rights.

But a major longitudinal study shows that women who are denied abortions — and go on to have a baby — have worse health outcomes years later than women who receive an abortion.

The latest findings from the Turnaway Study, conducted by researchers at the University of California, San Francisco, compared the health of roughly 330 women who had an abortion during their first trimester with 380 who had an abortion during their second trimester and just over 160 who tried to get an abortion but who were turned away. The latter women were denied access to the procedure because they were over their clinic’s gestational limits. 

Five years after the women either had an abortion or were denied one, they answered questions about their overall health, as well as specific concerns like chronic pain, headaches and hypertension. 

The women who were able to get an abortion generally rated their health about the same whether the procedure took place during the first or second trimester. 

But the women who were denied an abortion and went on to have a baby fared worse.

Some 27% said their health was “fair” or “poor,” compared to 20% of women who had a first-trimester abortion and 21% who had a second-trimester abortion. 

They also reported more headaches and joint pain, although all three groups had similar rates of other types of chronic pain and obesity. 

“The argument that abortion is harmful to women’s health is certainly not supported by the data,” Dr. Lauren Ralph, author of the study and an epidemiologist with the university’s Advancing New Standards In Reproductive Health project, told HuffPost.

“Instead, we consistently found that when differences did emerge, women who were denied abortions and gave birth fared worse,” she said.

The new findings do not establish cause and effect, so it is unclear exactly why women who were denied an abortion reported worse health outcomes years later. Ralph said that in some cases, childbirth could have exacerbated existing health problems the women already had. Pregnancy and childbirth can also cause long-term health issues such as joint pain. 

But that is likely not the full picture.

“There is this complex relationship between health, socioeconomic status and stress,” Ralph said. “I would guess there are a number of factors.”

The vast majority of American states prohibit abortion after a certain point in pregnancy. Roughly half have laws setting that ban as early as 13 to 24 weeks — roughly the second trimester ― often based on the unscientific claim that a fetus can feel pain around 22 weeks.

And some states have begun restricting abortion at much earlier stages of pregnancy, like the recent surge in bans on abortion at six or eight weeks gestation. None of those laws are currently in effect, and many are facing legal challenges.

The Turnaway Study tracked nearly 1,000 women overall, recruited at 30 abortion clinics across 21 states, between 2008 and 2015. The study team spoke with them on the phone one week after they either had or were denied an abortion, and then semi-annually for five years. 

Previously, researchers using that same dataset found that women who got an abortion had no long-term adverse mental health effects. Women who were turned away, however, reported greater anxiety and lower life satisfaction and self-esteem soon after they were told they couldn’t have an abortion. 

Medical organizations like the American College of Obstetricians and Gynecologists emphasize that access to abortion is an integral part of women’s health care. 

“Where abortion is legal, it is extremely safe,” the college said in a 2014 committee opinion calling for increased abortion access. “The risk of death associated with childbirth is approximately 14 times higher than that with abortion.”

Before You Go

Myths About Abortion That Need To Be Busted
MYTH: Abortion is dangerous.(01 of08)
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REALITY: Over 99.75 percent of abortions do not cause major medical problems.Less than one-quarter of 1 percent of abortions performed in the United States lead to major health complications, according to a 2014 study from the University of California, San Francisco, that tracked 55,000 women for six weeks after their abortions. The researchers note that this makes an abortion statistically about as risky as a colonoscopy.If that fact seems surprising, consider how American pop culture misrepresents the risks of abortion: Nine percent of film and television characters who have abortions die as a direct result of the procedure, according to another 2014 study from UCSF. (credit:Getty Images)
2. MYTH: Medical abortions -- those performed using pills -- are still fringe.(02 of08)
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REALITY: About one in five abortions are medical abortions.The Centers for Disease Control and Prevention found that 19 percent of abortions in 2011 were medical abortions and that 28.5 percent of those took place in the first nine weeks of pregnancy. The Guttmacher Institute also found that medical abortions increased substantially from 2008 to 2011, meaning more women have ended their pregnancies with this alternative to surgery.

3. MYTH: Women who get abortions will regret it, and are more likely to suffer mental health issues.
(03 of08)
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REALITY: Most women will not regret their decision, and are no more likely to experience mental health problems than women who carry an unplanned pregnancy to term.While many women experience mixed emotions after an abortion, 95 percent of women who have abortions ultimately feel they have made the right decision, according to an August 2013 study from UCSF. "Experiencing negative emotions postabortion is different from believing that abortion was not the right decision," the researchers explained. Furthermore, while unplanned pregnancies often cause emotional stress, there is no evidence to suggest that women who choose to terminate their pregnancies will be more likely to suffer from mental health issues, according to a 2008 report from the American Psychological Association that investigated all relevant medical studies published since 1989.The APA found that past studies claiming abortion causes depression and other mental health problems consistently failed to account for other risk factors, particularly a woman's medical history. The APA accounted for these factors and found that, among women who have an unplanned pregnancy, those who have abortions are no more likely to experience mental health problems than those who carry the pregnancy to term.
4. MYTH: Fetuses experience pain during abortions.(04 of08)
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REALITY: Fetuses cannot feel pain until at least the 24th week of pregnancy. Experts ranging from Britain’s Royal College of Obstetricians and Gynaecologists to the American Congress of Obstetricians and Gynecologists agree with that timeline. In fact, research from UCSF found that fetuses can't perceive pain before 29 or 30 weeks of development.Then why have so many states banned abortions after 20 weeks of pregnancy? Perhaps misrepresentation of research is partly to blame: Many of the researchers most frequently cited by pro-life politicians told The New York Times that their research does not prove anything about fetal pain.
5. MYTH: The majority of Americans don't think abortion should be legal.(05 of08)
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REALITY: Most Americans support a woman's right to choose.According to a Gallup poll from 2014, 78 percent of Americans think abortion should be legal in some or all circumstances. (Fifty percent said "some circumstances," while 28 percent said all.) What's more, in 2012, Gallup found that 61 percent of Americans think abortions that take place during the first trimester of pregnancy should be legal. (Nine out of 10 abortions in the U.S. do take place during that time period, according to Guttmacher.) (credit:Getty )
7. MYTH: Most American women have easy access to abortions.(06 of08)
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REALITY: Women face a growing number of barriers to accessing abortions.More than 57 percent of American women live in states that are hostile or extremely hostile to abortion rights, according to the Guttmacher Institute. That represents a marked increase from 2000, when 31 percent of American women lived in such states. In 2011, 89 percent of counties in America had no abortion clinics. This is no accident: Across the U.S., lawmakers have enacted 231 new abortion restrictions over the past four years, according to a Guttmacher analysis from January 2015. As a result, many women have to travel great distances to reach an abortion clinic, where they may face 24-hour wait periods. These barriers particularly affect women living in rural areas and low-income women, who often can't afford to take time off work and pay for gas and a hotel room. Other laws force women to go through potentially distressing procedures, such as viewing their own ultrasound photos, in order to move forward with an abortion.
9. MYTH: Women would never have abortions if they knew what it was like to have a child.(07 of08)
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REALITY: Most women who have abortions are already mothers.Sixty-one percent of women who had abortions in 2008 were mothers, and 34 percent had two or more children, according to the Guttmacher Institute. That number only increased after the 2009 financial downturn. The National Abortion Federation told Slate that between 2008 and 2011, 72 percent of women seeking abortions were already mothers. A study from Guttmacher found that mothers typically have abortions to protect the children they already have; they simply cannot afford to raise another child. (credit:Getty Images)
10. MYTH: It is dangerous to perform abortions in clinics that do not meet the same standards as ambulatory surgical clinics. (08 of08)
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REALITY: Requiring abortion clinics to meet these standards does little to improve patient safety and forces many to shut down.Currently, 22 states require abortion clinics to meet a set of restrictive and often arbitrary standards, dictating that they be close to hospitals and that their hallways and closets meet certain measurements. Clinics often need to undergo expensive renovations in order to comply, and leading doctors' groups say the laws do little to improve patient safety.What's more, 11 states now require that doctors at abortion clinics obtain admitting privileges at a nearby hospital, but many hospitals flat-out refuse to grant these privileges. As a result, hospitals essentially have the power to shut down nearby clinics. (credit:Getty Images)

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