The "Turnaways": What happens to women denied abortions?

[Direckshun]

Based on a two year longitudinal study (the study will continue for years).

Women who are forced to carry the pregnancy to term are:

• Statistically more likely to wind up unemployed.
• More likely to end up on public assistance.
• More likely to end up below the poverty line.
• More likely to stay in abusive relationships.
• Experiencing far more stress.
• More likely to experience physical health complications from giving birth than they are in any kind of abortion.

However:

• They are not more likely to become drug users.
• Or feel increased anxiety or depression over time.
• There is also no evidence of an increase in mental health disorder.
• There is no evidence of increased chronic health conditions.

If you have an opinion on abortion, and I think we all do, I think you basically have a responsibility to read through this. It's an easy read and very informative -- especially if you're a man who will never, ever have to make this decision yourself.

http://io9.com/5958187/what-happens-...dy-to-find-out

What happens to women denied abortions? This is the first scientific study to find out.
Annalee Newitz

Abortion is a hotly debated and poorly studied medical procedure. There are a few studies of dubious validity that connect abortion to mental illness and drug use. Politicians have used these studies to justify greater limitations on women seeking abortion in the United States.

There has been no sustained effort to study what happens to women who want abortions but can't get them due to restrictive rules. Until now. These women are called turnaways. A new longitudinal study reveals what happens to their economic position, health, and relationship status after seeking an abortion and being denied it.

Public health researchers with the UC San Francisco group Advancing New Standards in Reproductive Health (ANSIRH) used data from 956 women who sought abortions at 30 different abortion clinics around the U.S. 182 of them were turned away. The researchers, led by Diana Greene Foster, followed and did intensive interviews with these women, who ran the gamut of abortion experiences. Some obtained abortions easily, for some it was a struggle to get them, and some were denied abortions because their pregnancies had lasted a few days beyond the gestational limits of their local clinics. Two weeks ago, the research group presented what they'd learned after two years of the planned five-year, longitudinal "Turnaway Study" at the recent American Public Health Association conference in San Francisco.

Here's the short version of what they discovered, from a post they made on the Global Turnaway Study Facebook page:

We have found that there are no mental health consequences of abortion compared to carrying an unwanted pregnancy to term. There are other interesting findings: even later abortion is safer than childbirth and women who carried an unwanted pregnancy to term are three times more likely than women who receive an abortion to be below the poverty level two years later.

Below, you can find the longer, more complex version of the story. I spoke with Foster about the groups' preliminary findings.

Poverty

The women in the Turnaway Study were in comparable economic positions at the time they sought abortions. 45% were on public assistance and two-thirds had household incomes below the federal poverty level. One of the main reasons women cite for wanting to abort is money, and based on the outcomes for the turnaways, it seems they are right.

Most of the women who were denied an abortion, 86%, were living with their babies a year later. Only 11% had put them up for adoption. Also a year later, they were far more likely to be on public assistance — 76% of the turnaways were on the dole, as opposed to 44% of those who got abortions. 67% percent of the turnaways were below the poverty line (vs. 56% of the women who got abortions), and only 48% had a full time job (vs. 58% of the women who got abortions).

When a woman is denied the abortion she wants, she is statistically more likely to wind up unemployed, on public assistance, and below the poverty line. Another conclusion we could draw is that denying women abortions places more burden on the state because of these new mothers' increased reliance on public assistance programs.

Violence and Drug Use

In the Turnaway Study, the researchers could find no statistically significant differences in drug use between women who get abortions and women who don't. There appears to be no correlation between abortion and increased drug use. One interesting bit of data they did find was that drug users who couldn't get abortions were more likely to give their babies up for adoption.

Unfortunately, when it comes to domestic violence, being denied an abortion makes a really big difference. Turnaways were more likely to stay in a relationship with an abusive partner than women who got abortions. A year after being denied an abortion, 7% reported an incident of domestic violence in the last six months. 3% of women who received abortions reported domestic violence in the same time period. Foster emphasized that this wasn't because the turnaways were more likely to get into abusive relationships. It was simply that getting abortions allowed women to get out of such relationships more easily. So it's likely that these numbers actually reflect a dropoff in domestic violence for women who get abortions, rather than a rise among turnaways.

This pattern of violence is also part of a larger pattern that shows turnaways are more likely to remain connected to the fathers of their children. Obviously, this isn't always a good thing, as the violence statistics reveal. But even in the vast majority of cases where violence isn't involved, Foster noted that these men aren't living with the turnaways. The researchers asked women about cohabiting with partners, and found that men were no more likely to live with a turnaway who'd borne their children than they were to live with a woman who had an abortion. "The man doesn't stick around just because you have the baby — that's the crude way of putting it," Foster said.

Emotions

One of the biggest concerns about abortion is that it causes emotional problems that lead to clinical depression. The Turnaway Study looked at that question from two angles: how did turnaways and women who got abortions feel; and did they become clinically depressed. "It's important to remember that how you feel is a separate question from whether you have a mental health problem," Foster said. We'll look at women's emotions here, and discuss mental health in the next section.

As the researchers said at the American Public Health Association Meeting, "One week after seeking abortion, 97% of women who obtained an abortion felt that abortion was the right decision; 65% of turnaways still wished they had been able to obtain an abortion." Also one week after being denied an abortion, turnaways told the researchers that they had more feelings of anxiety than the women who had abortions. Women who had abortions overwhelming reported feeling relieved (90%), though many also felt sad and guilty afterwards. All of these feelings faded naturally over time in both groups, however. A year later, there were no differences in anxiety or depression between the two groups.

In other words, the Turnaway Study found no indication that there were lasting, harmful negative emotions associated with getting an abortion. The only emotional difference between the two groups at one year was that the turnaways were more stressed. They were more likely to say that they felt like they had more to do than they could get done.

None of this translated into clinical depression. "Abortion and depression don't seem directly linked," Foster said. "We'll continue to follow these women for five years, though. So we might find something else down the line."

Physical and Mental Health

The Turnaway Study found no indication that abortion could be linked with increased mental health disorders. There were no statistical differences between turnaways and women who had abortions when it came to developing clinical depression.

But turnaways did face a greater health risk from giving birth. Even late stage abortions are safer than giving birth. The researchers said at the APHA meeting:

We find physical health complications are more common and severe following birth (38% experience limited activity, average 10 days) compared to abortion (24% limited activity, average 2.7 days). There were no severe complications after abortion; after birth complications included seizure, fractured pelvis, infection and hemorrhage. We find no differences in chronic health conditions at 1 week or one year after seeking abortion.

If you look at all this data together, a new picture emerges of abortion and how the state might want to handle it. To prevent women from having to rely on public assistance, abortions should be made more widely available. In addition, there is strong evidence that making abortions available will allow women to be healthier, with brighter economic outlooks. By turning women away when they seek abortions, we risk keeping both women and their children in poverty — and, possibly, in harm's way from domestic violence.

Learn more about these studies from the abstracts of the American Public Health Association panels here and here.

[patteeu]

Originally Posted by banyon

There's this recent story too for people who think there should be no exception for health of the mother:

I think almost everyone would be willing to allow an exception for the life of the mother. The reason people don't want exceptions for the health of the mother is the same reason anyone who wants medical marijuana in California can get it. As soon as you give that inch, someone will take a mile.

[banyon]

Originally Posted by patteeu

I think almost everyone would be willing to allow an exception for the life of the mother. The reason people don't want exceptions for the health of the mother is the same reason anyone who wants medical marijuana in California can get it. As soon as you give that inch, someone will take a mile.

First off, in Ireland there is no exception period, and I assume your "almost everyone" means this country.

More relevantly though, it is possible to construe the "for the healh of the mother" too narrowly as well, as in the linked story. In hindsight it became about her life, but that was only after the complications went irreversibly out of control. Health can become life pretty quickly in a hospital.

I don't disagree that there may be cases on the other fringe, but isnt this the side to err on?

[stevieray]

those poor women, having to make someone else accountable for their actions...it only costs their "oppressors" their lives.

[patteeu]

Originally Posted by banyon

First off, in Ireland there is no exception period, and I assume your "almost everyone" means this country.

Yes, I'm talking about this country.

Originally Posted by banyon

More relevantly though, it is possible to construe the "for the healh of the mother" too narrowly as well, as in the linked story. In hindsight it became about her life, but that was only after the complications went irreversibly out of control. Health can become life pretty quickly in a hospital.

I don't disagree that there may be cases on the other fringe, but isnt this the side to err on?

For someone who considers an unborn child to be a fully formed life worthy of protection, the side to err on is the side that you don't kill the baby. An abortion means that the baby dies for sure. Not having an abortion means the child and mother may both survive.

The linked case is a case where the mother's life was in jeopardy whether the doctors recognized it in advance or not. In theory, an abortion would have been possible in a jurisdiction with an exception for the life of the mother. Even if that wouldn't have worked out in this case because her doctor didn't recognize that her life was in danger, that doesn't mean the rule is the problem. We rely on doctors' expertise and judgment when it comes to these things in all areas of medicine, not just abortion. Sometimes they get it wrong.

[King_Chief_Fan]

Originally Posted by blaise

If you oppose abortion I would assume it's because you're of the opinion that it's ending a human life. I'm not sure why risk of economic hardship would cause you to change that thinking.

you are correct

lack of abortions doen't cause economic hardship
the decisions people make cause economic hardship

a study of women who had abortions and the constant agony/guilt over that would be interesting

rubbish to think that because a person did not get an abortion they were driven to new hardships they didn't have before the pregnancy.

[BucEyedPea]

The health of the mother? That includes her mental health it's written so broadly. By that I mean she is in despair about being pregnant.

[King_Chief_Fan]

Originally Posted by BucEyedPea

The health of the mother? That includes her mental health it's written so broadly. By that I mean she is in despair about being pregnant.

ok, so let's murder the child inside to rid her of her despair? Not making sense

[patteeu]

Originally Posted by King_Chief_Fan

ok, so let's murder the child inside to rid her of her despair? Not making sense

You're misunderstanding her. She's being critical of "health of the mother" exceptions.

[BucEyedPea]

Originally Posted by patteeu

You're misunderstanding her. She's being critical of "health of the mother" exceptions.

Precisely.

[VAChief]

Originally Posted by stevieray

those poor women, having to make someone else accountable for their actions...it only costs their "oppressors" their lives.

This is definitely a sad topic, and it certainly isn't black and white for most of us. What I don't hear a lot about in these discussions however is burden of responsibility for the men. It would seem that their lives should be comparably interrupted as well. They made the same choice.

[King_Chief_Fan]

Originally Posted by BucEyedPea

Precisely.

sorry BEP...sometimes you confuse me

[Radar Chief]

Originally Posted by VAChief

This is definitely a sad topic, and it certainly isn't black and white for most of us. What I don't hear a lot about in these discussions however is burden of responsibility for the men. It would seem that their lives should be comparably interrupted as well. They made the same choice.

Are you under the mistaken impression that they aren’t already?

[vailpass]

Originally Posted by VAChief

This is definitely a sad topic, and it certainly isn't black and white for most of us. What I don't hear a lot about in these discussions however is burden of responsibility for the men. It would seem that their lives should be comparably interrupted as well. They made the same choice.

The sperm donors don't factor in on a large percentage; and of those that do a large percentage are relieved.
The percentage of mutual, conscientious abortion decisions is relatively small because those couples that take the time and consult their conscience usually do not opt for abortion.

[patteeu]

Originally Posted by VAChief

This is definitely a sad topic, and it certainly isn't black and white for most of us. What I don't hear a lot about in these discussions however is burden of responsibility for the men. It would seem that their lives should be comparably interrupted as well. They made the same choice.

It's fair to point out that the man is just as responsible for this as the woman (although I tell my girls that it's up to them to protect themselves from irresponsible men and I think all girls should view it that way).

But, the man's life is frequently interrupted for 18 years if the woman decides to keep the baby and look to him for child support. He gets no voice in whether the child lives or dies, whether the child is given up to a better home or becomes a victim of an irresponsible parent, etc. I have no more sympathy for him than I have for her, but both have their lives impacted when they get themselves into a situation like this through their joint irresponsibility.

[Brock]

Originally Posted by patteeu

But, the man's life is frequently interrupted for 18 years if the woman decides to keep the baby and look to him for child support. He gets no voice in whether the child lives or dies, whether the child is given up to a better home or becomes a victim of an irresponsible parent, etc.

Do you think a man should be able to force a woman to have an abortion because he doesn't want to pay child support? Or force her to sign a waiver of child support when she refuses to abort it?