This opinion article was written by Rebecca Griffin, Communications Specialist at the Bixby Center for Global Reproductive Health. For more like this, see our health and wellbeing newsfeed.
The future of abortion access in the United States feels more uncertain than ever.
The Supreme Court no longer has its tenuous majority for abortion rights, and that shift has emboldened anti-abortion activists and lawmakers. According to the Center for Reproductive Rights, twenty-one states are at high risk of losing abortion access if Roe v. Wade were overturned.
But already today there are women in the US who experience firsthand what a world without abortion access is like.
Legality on paper is not the same as having access to abortion providers, the money needed to pay for one, access to child care for the kids you already have while you travel for an appointment (60% of women who have abortions in the US are already mothers) and enough money to cover transportation costs.
Twenty-seven large cities in the US are “abortion deserts” where someone would have to travel more than 100 miles each way to obtain an abortion.
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Six states have only one abortion clinic, and many of those are under constant threat from hostile governments.
As policymakers engage with this public health crisis, it’s critical to understand how abortion actually impacts people’s lives. The Turnaway Study, from Advancing New Standards in Reproductive Health at the UCSF Bixby Center for Global Reproductive Health, gives us vital new information about the actual lives of women.
In this groundbreaking study we followed women for 5 years to understand what happens to people who get an abortion compared to those who want one but are turned away. The data from this study is indispensable for ensuring that policy on abortion is grounded in evidence and women’s lived experiences.
The foundation of many abortion restrictions is supposed concern for women’s health and well-being. This concern has no grounding in evidence, but its influence is broad.
It has led to harmful policies such as waiting periods as long as 72 hours before a person can have an abortion or mandatory counseling laws that require doctors to share unproven claims about abortion causing mental health problems. The Turnaway Study shows that these myths don’t hold up to scrutiny. Here are the facts:
- Abortion does not increase women’s risk of having suicidal thoughts or the chance of developing post-traumatic stress disorder, depression, anxiety, low self-esteem or lower life satisfaction.
- Abortion does not increase women’s use of alcohol, tobacco or drugs.
- 95% of women said abortion was the right decision for them.
- Women who received a wanted abortion were more likely to have a positive outlook on the future and achieve aspirational life plans within 1 year.
The Turnaway Study found that most women give multiple reasons for seeking abortion, including finances, timing, issues with a partner and the need to focus on their other children.
Policies that introduce barriers to abortion harm children
As one 19-year-old woman said about her reasons for seeking an abortion: ”I already have one baby, money wise, my relationship with the father of my first baby, relationship with my mom, school.”
Most women who sought an abortion after 20 weeks were delayed initially because they didn’t realize they were pregnant. Once they’re delayed, financial and logistical barriers push them even later in pregnancy.
Unsurprisingly, women are very good at understanding their own circumstances and what continuing an unwanted pregnancy will mean in their lives. The Turnaway Study shows how their concerns play out.
Policies that harm women
The Turnaway research team estimates that more than 4,000 women are denied an abortion in the US each year due to facilities’ gestational limits. As more states pass bans, thousands more could be impacted. Based on the study, we know that:
- Women who are denied an abortion have almost 4 times greater odds of a household income below the federal poverty level and 3 times greater odds of being unemployed. There was an increased likelihood that women didn’t have enough money to pay for basic family necessities like food, housing, and transportation if they were denied an abortion.
- Women who are unable to terminate unwanted pregnancies were more likely to stay in contact with violent partners, putting them and their children at greater risk.
- Continuing an unwanted pregnancy and giving birth is associated with more serious health problems than abortion. Across several measures of chronic pain and overall self-rated health, women who gave birth after being denied a wanted abortion fare worse than women who receive a wanted abortion.
We also know policies that introduce barriers to abortion harm children.
Existing children of women denied abortions were more than 3 times more likely to live in households below the federal poverty level and they were less likely to achieve developmental milestones than the existing children of women who received abortions.
Being unable to terminate an unwanted pregnancy also results in poorer bonding with the new child compared to being able to wait to have a more intended pregnancy after an abortion.
The onus on policymakers
Blocking or repealing restrictions on abortion is the bare minimum policymakers can do.
To put these findings into practice in a way that improves people’s lives, governments must work to make abortion affordable and accessible. That includes policies like:
- Passing laws that affirm the right to abortion
- Requiring private and public insurance coverage for abortion
- Growing the abortion provider workforce by supporting training and allowing advanced-practice clinicians to perform abortions
- Providing medication abortion via telemedicine
The evidence is clear. Abortion is necessary healthcare and no person who wants one should be denied. Policymakers at every level of government must use their power to ensure abortion access for all. — Rebecca Griffin