Being denied an abortion could be more traumatic than getting one

Women who receive abortions experience less short-term anxiety and low self-esteem than women who are denied them, according to a new study. This is consistent with previous findings that the vast majority of women who receive abortions feel relief. And it’s another nail in the coffin of the tired misconception that women who terminate their pregnancies are psychologically damaged by the experience.

In the United States, 35 states require a waiting period and counseling before a woman can terminate her pregnancy. In nine of those states, women are required to receive information about the supposed long-term psychological consequences of getting an abortion, such as post-traumatic stress disorder and depression. But a new study published today in the journal JAMA Psychiatry reveals that those warnings aren’t actually based on scientific evidence.

It’s another nail in the coffin of the tired misconception that abortions hurt women

Until recently, there hasn’t been a lot of data about how the decision to terminate a pregnancy affects a woman’s mental and emotional wellbeing. That hasn’t stopped lawmakers from speculating, though. “While we find no reliable data to measure the phenomenon, it seems unexceptionable to conclude some women come to regret their choice to abort,” Supreme Court Justice Anthony Kennedy wrote in the opinion for the abortion case Gonzales v. Carhart. He continued, “Severe depression and loss of esteem can follow.” The myth that an abortion can cause this lasting psychological harm has been used to justify laws in some states that require women to view their ultrasounds and wait 24 hours before getting an abortion, to make extra sure they want it.

It’s true — women can experience regret in the week following an abortion. But recent studies have also shown that the vast majority of women who receive abortions — including the ones feeling regret — also feel relief, and think that they made the right decision.

“[There’s] this narrative that abortion hurts women,” says Diana Foster, a professor studying reproductive health at the University of California, San Francisco and the senior investigator on the study. “But there’s not much evidence supporting it. So we wanted to look at what the effects of abortion are.”

“It’s an area that’s under-researched yet controversial.”

Today’s study is part of the Turnaway Study, a five-year study that tracks the effects of abortion on women who receive one versus women who are turned away for being too late in their pregnancy. Foster and her colleagues at the University of California, San Francisco assessed the mental health of nearly 1,000 women who sought abortions in 21 different states.

The researchers interviewed the women in the first week after they sought an abortion, and then twice a year for the following five years. They found that women who were denied abortions actually experienced more anxiety and lower self-esteem in the short term than women who received them. Over time, both groups of women — those who received and those who were denied abortions — went on to have comparable levels of depression, anxiety, and self-esteem. So being denied a wanted abortion might be worse for a woman’s mental health than letting her get one, the study authors concluded.

The findings are important, in part because there have been so few studies exploring the psychological effects of abortions on women, says Emily Dossett, a reproductive psychiatrist who was not involved in this research. “Just like most issues in women’s mental health it’s an area that’s under researched yet controversial,” she says. But the more data we have, the more able we are to have rational conversations about abortions, she adds.

Today’s results fall right into line with previous results published from the Turnaway Study. One paper looking into why women seek abortions found that the reasons vary: some women don’t have enough money; others have an unsupportive or abusive partner, or a partner who does not want a baby; others say they need to focus on their other children, and that they’re not emotionally or mentally ready. So it comes as no surprise that women who are successful at terminating their unwanted pregnancies benefit from it, researchers say.

Women who get the abortions they want experience less short-term anxiety and low self-esteem

Another Turnaway Study paper showed that that women who are either allowed to get abortions, or who are turned away but do not end up parenting the baby, are more likely to achieve their goals for the coming year than women who are turned away and go on to parent the child. Plus, carrying a pregnancy to term and giving birth can have health consequences — having a legal abortion is actually statistically safer for a woman. In fact, an analysis of data collected by the Centers for Disease Control and Prevention found women who carry a pregnancy to term are 14 times more at risk of dying than women who receive legal abortions.

Despite today’s findings — and the larger body of evidence on the benefits of allowing women to receive the medical procedure they want — some states are trying to make it harder than ever for women get them.

In Ohio, the state legislature passed a so-called “heartbeat” bill that would have banned abortions at six weeks, which is before many women even know they’re pregnant. (Calling it a “heartbeat” bill is actually misleading because the little ball of cells that is a six-week-old fetus doesn’t really have a heart yet, just a thickening with cardiac activity.) Governor John Kasich eventually vetoed the bill, but signed into law a ban on abortions after 20 weeks. Other states have placed onerous restrictions on abortion providers that could essentially run them out of business, making it increasingly difficult for women to access necessary medical care.

All these laws shows how little lawmakers consider the science and women’s well being, Dossett says. Foster agrees: “I would like the debate about abortions to take into account women’s experiences more,” she says. “For there to be data, and for women who’ve had abortions to be able to have a role.”