UCSF: UCSF Turnaway Study Shows Impact of Abortion Access on Well-Being

A groundbreaking study conducted by UC San Francisco reveals the long-term adverse effects of unwanted pregnancy on people’s lives, pointing to widespread challenges that will result from the US Supreme Court ruling to overturn the constitutional right to an abortion.

UCSF’s landmark Turnaway Study found that more than 95 percent of people who chose to have abortions reported that it was the right decision for them, when interviewed over the next five years. There was also no evidence of mental health problems among study participants following an abortion. However, those who were unable to have abortions because they were past the gestational limit suffered from adverse effects such as serious physical and mental health challenges, economic hardship, lack of support and insecurity.

The debate about abortion rarely focuses on what happens to the pregnant person.

DIANA GREENE FOSTER, PHD

The study also found that those who sought and received an abortion were more financially stable, set more ambitious life goals, raised children under more stable conditions, and were more likely to have a wanted child later.

“This study has been really important,” said Diana Greene Foster, PhD, a professor in the Department of Obstetrics, Gynecology & Reproductive Sciences who led the study. “It provided the evidence that was missing on the consequences of abortion access for people’s health and well-being.”

Foster, a demographer and the director of research at UCSF’s Advancing New Standards in Reproductive Health (ANSIRH) program, added that despite more than 50 scientific papers published because of the study, her own award-winning book on the study, and the study forming the basis of legal briefs at the Supreme Court and elsewhere, the national conversation remains stuck on ideological and political considerations.

“The debate about abortion rarely focuses on what happens to the pregnant person,” she said. “It’s framed as an abstract moral question in which everyone else weighs in without considering why someone would be in the circumstances where they want an abortion – and what happens to them and their lives when they can’t get one.”

Study Shows Better Outcomes with Abortion Access
In the Turnaway Study, researchers followed 1,000 women from 30 centers around the country for five years – some a few days under a clinic’s gestational limit, and therefore able to receive an abortion, and some who were a few days over the limit and therefore were denied from getting an abortion.

Among those who were denied an abortion, the study found that individuals reported more life-threatening complications from the end of pregnancy, such as eclampsia and infections. Over the longer term, those who were denied an abortion and subsequently gave birth reported worse health and greater chronic pain compared to those who were able to terminate their pregnancy.

The study also found negative effects on the children born from unwanted pregnancies, including poorer maternal bonding and economic insecurity. These parents were also more likely to raise the child alone, without the support of family members or partners, and were more likely to stay in contact with an abusive partner.

In addition, individuals who were not able to access abortion were three times more likely to be unemployed than those who were able to access one. They had four times greater odds of living below the federal poverty line, were more likely to report not being able to afford basic living needs, and were more likely to be enrolled in food assistance or other public safety-net programs such as Temporary Assistance for Needy Families.

Foster said her goal in conducting the Turnaway Study was to provide much-needed data on the consequences of abortion for people’s wellbeing. She notes that her earlier research on contraception, which led to birth control being more widely adopted, has undoubtedly helped prevent many abortions.

“My agenda going in was to figure out whether abortion causes mental health harm and the ways in which getting it or not getting it would affect people’s well-being,” Foster said.

Yet, she noted, “after the Turnaway Study, it’s hard to be neutral on the topic of a person’s right to choose abortion, because it’s so clearly associated with better outcomes for families and for children.”