In its decision to overturn Roe v. Wade — which means abortion may now be banned in almost half the country — the Supreme Court made a catastrophic decision. As someone who studies the effects of access to abortion, I can say that denying someone a wanted abortion causes real, lasting harm to them and their families.
I led the Turnaway Study, a nationwide study of what happens to women when they receive or are denied an abortion. Over a decade, my colleagues and I interviewed nearly 1,000 women who sought abortions from 30 facilities around the country. Based on these findings, we know not having control over the timing and circumstances of birth changes the whole trajectory of that person's life, making it harder, and for those who are already struggling, even worse.
Consider, first, the economic impact. Many people seeking abortions are already experiencing financial hardship. Given the rising costs of raising a child in the United States, it is perhaps no surprise that we found that women who received abortion care were more likely to be employed and more likely to be able to pay for basic living needs such as food, housing and transportation than women who were denied abortions. They were also less likely to have household incomes below the federal poverty line years later, be evicted, or declare bankruptcy.
As one woman profiled in our study told researchers: "It is very, very difficult to find a job when you're pregnant, to keep a job when you're pregnant, and to find or maintain a job with a baby." Being denied a wanted abortion and having a child, she said, "sent my life completely off the rails."
By contrast, another woman profiled in the study told our research team that if she hadn't been able to raise funds for her abortion, "I might not be here today, or my kids might be in foster care."
The majority of women seeking abortion care are already parents—and many are trying to do what's best for their kids. Children of mothers who are able to obtain abortions are less likely to live in poverty and more likely to achieve developmental milestones. This extends to future children too: Women who are able to receive wanted abortions are more likely to have an intended pregnancy under better circumstances later.
We know not having control over the timing and circumstances of birth changes the whole trajectory of that person's life, making it harder, and for those who are already struggling, even worse.
While it has long been argued that having an abortion places people at risk of psychological harm, we found that being denied an abortion — not receiving one — was associated with short-term elevated levels of anxiety, stress, and low self-esteem. People with a history of mental health conditions, trauma and abuse, and those who felt people close to them looked down upon them for seeking an abortion, were at greatest risk of experiencing adverse psychological outcomes post-abortion seeking.
For those turned away from abortion, many women faced life-threatening complications as their pregnancy developed. Two women in the study died as a consequence of being denied an abortion and going on to give birth. The medical literature shows that people are 14 times more likely to die from childbirth than from abortion. The maternal mortality and morbidity crisis in the United States means that women, especially Black and American Indian women, face the risk of serious pregnancy complications. The greater physical health risk doesn't end at childbirth. We found that those forced to continue with their pregnancy reported more chronic head and joint pain and worse overall health for years after.
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One of the most important things I learned from the Turnaway Study is that people are thoughtful about their decision to end an unwanted pregnancy. They understand their current responsibilities and aspirations. The outcomes we found for women who were denied an abortion closely reflect the reasons women gave for not wanting to carry a pregnancy to term in the first place. They foresaw the consequences of having a child when they were not emotionally or financially ready, when they were not in a healthy relationship, and when they were struggling to take care of their existing children. Five years after obtaining care, 95% of those who did have an abortion said that it had been the right decision for them.
The United States was founded on principles of economic freedom and personal fulfillment, as embodied in the "life, liberty and pursuit of happiness" phrase in the Declaration of Independence. Roe was a step toward realizing this vision. Now that the Supreme Court has stripped people of the right to make their own decisions about their bodies, their children and their families, the harms to women and their families we found in the Turnaway Study will be multiplied manyfold. We will see a future in America that betrays the principles and progress of its past.
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