The Turnaway study looks at women who are “turned away” from having abortions because of missing gestational age limits versus those who are able to obtain the care they desire. This is a very important study for two reasons. One, we need to understand the true impact of limiting access to abortion. Two, many papers erroneously compare all pregnancy outcomes (desired and not desired) with abortion outcomes, but a desired pregnancy and an undesired one are potentially two very different things.
Restricting access to abortion care in such a way that it makes the procedure obsolete definitely drives some women to seek illegal or home abortions, but what happens to those women who simply go through with their undesired pregnancy?
The narrative espoused by many anti-choice politicians and even some doctors is that when a women is denied an abortion somehow magically the pregnancy will become desired and everything will be okay. However, if a government aims to deny women abortion it should care what happens to those women. And now we know we have a better understanding.
The Turnaway study is a prospective cohort and looks at women from 30 abortions facilities around the country and divides them into 3 groups: women up to 3 weeks over the facility’s gestational age limit who were denied an abortion, women presenting at a facility with a pregnancy that was within 2 weeks under the facility’s gestational age limit who obtained an abortion, and women who obtained a first trimester abortion. The study will follow women for 5 years with telephone interviews twice a year. This paper just published looks at the baseline findings and what happened at 6 months after either obtaining an abortion as desired or being denied and proceeding with an unwanted pregnancy.
Side effects were reported in both groups. Women who had abortions had cramping and bleeding and the types of side effects we expect after abortions. Women who were forced to carry their pregnancies had side effect too, things like blood transfusions, wound issues related to c-section, a fractured pelvis, retained placenta, dangerously high blood pressure (pre-eclampsia), infections, and death.
A total of 6.3% of women denied abortions had life-threatening health issues as compared with 1.1.% who had abortions close to the limit at the clinic and 0.4% having first trimester abortions.
Let’s look at those numbers again and let them sink in, 6.3% serious, life-threatening health issues because abortion was denied and 0.4% with 1st trimester access.
There are some study limitations – the biggest is that health issues were self-reported, but it’s a pretty large cohort and the response rate for such a survey is actually good so I think the results are valid. Certainly they fit in with what we know about the rate of pregnancy complications.
As this study continues we will know more about long-term health consequences and perhaps mental health issues as well. But now we have more medical proof that restricting abortion access is bad for women’s health. And unfortunately for many in our government that’s okay.
Good point, but I think the study was able to control for that. First, the incidence of health conditions was the same in all 3 groups. But even more important is the later (the within 2 weeks) abortion group – that adds a control of getting a later procedure because of some kind of health reasons.
Thanks for your comment!
Not that I don’t agree that being denied an abortion can have serious health consequences, but given the design of the study, it must first be ruled out that a propensity for health issues is a cause of missing the gestational age deadline and thus being denied an abortion.
I appreciate your advocacy and perspective. Thanks for all you do for women and for science.