Abortion is one of the most common surgical procedures in the United States, and one of the central political issues of our time. Yet in spite of this, there is surprisingly little solid social science research on many of the important social, psychological, and economic consequences of abortion outcomes. Having good research on abortion is important, because research findings are often used to justify abortion policy and law.
For example, in the Supreme Court’s 2007 Carhart case, which upheld a ban on so-called “partial birth abortion,” Justice Anthony Kennedy’s decision infamously invoked the paternalistic notion that protecting women from possible negative consequences of their own decision to abort justified abortion restrictions. In the Carhart opinion, Kennedy was influenced by junk social science studies by anti-abortion advocates claiming that women who have abortions suffer from a “post-abortion syndrome” characterized by regret and severe mental health issues. There is no scientific evidence that post-abortion syndrome exists, but that didn’t stop Kennedy from basing his decision on its alleged effects anyway.
One extremely important question Kennedy didn’t give much thought to is the other side of the question: that is, what happens to women who seek abortions but are denied them. For reasons of both ideology and feasibility, this issue had not been studied much — until now, that is. Researchers at the University of California in San Francisco are currently conducting a major longitudinal study of just this question. Known as the Turnaway Study, this project is examining “the mental health, physical health and socioeconomic outcomes of receiving an abortion compared to carrying an unwanted pregnancy to term.” The findings thus far suggest that women who are denied abortions fare significantly less well than those who are able to obtain them.
I’ll discuss those findings later, but first I wanted to describe the study’s methodology. Working with first and second trimester abortion clinics, researchers recruited about 1,000 participants who fell into these three groups:
women whose gestational age was one day to three weeks over the gestational limit and who were turned away from the clinic without receiving an abortion; women whose gestational age was one day to two weeks under the clinic’s gestational limit and who received an abortion; and women who received a medical or surgical abortion in the first trimester of pregnancy.
The women were interviewed by phone every six months, for a period of five years. They were questioned about subjects including their physical and mental health, educational attainment, financial and employment status, family life, and, for women who carried their pregnancies to term, their parenting issues and children’s well-being. The researchers have recently begun to release the preliminary findings, which have not yet been published. They presented them at a recent meeting of the American Public Health Association. Here are some of the highlights:
— Most women (86%) who carried their pregnancy to term kept their baby; 11% gave the baby up for adoption.
— Being denied an abortion appears to have impoverished women and had a negative effect on their employment status. Researchers say that at the beginning of the study, there weren’t any economic differences between those who got an abortion and those who were denied one.
However, after a year, “[W]omen denied abortion were more likely to be receiving public assistance (76% vs. 44%) and have household income below the FPL [Federal Poverty Level] (67% vs. 56%) than women who received an abortion. The proportion of women denied an abortion who were working full time was lower than among women who received an abortion (48% vs. 58%).”
— Anti-abortion advocates often claim that women who abort are more likely to develop drug problems. However, the study suggests that that is not the case; abortion did not increase the risk of drug use.
— One year later, those denied an abortion were significantly more likely to have experienced domestic violence in the past six months and significantly less likely to rate their relationship with their child’s father as good or very good. At the study’s baseline, there were no differences in these areas between the two groups.
Some cautionary notes about these findings: first, they are not the final results. Second, they have not yet been published in a peer-reviewed journal, so it’s possible they may not past muster scientifically.
Third, as is the case with every social science study, it is not necessarily clear whether the outcomes are the result of causation or correlation. The study’s methodology appears to be sound; the sample size is large, and according to researchers, there were no notable observed differences between the control group (those who got an abortion) vs. the experimental group (those who didn’t). Nevertheless, there is reason to wonder whether there were in fact significant unobserved differences between the two groups. Women who are unable to organize themselves to get an abortion before it’s too late may be suffering from more financial or emotional problems than those who get one in time.
It’s also possible that they may feel more ambivalent about their decision to abort in the first place. If any of these differences exist at the outset, then the worse outcomes for the women who were denied abortion could be due to those pre-existing factors, and not the denial of abortion in and of itself. There are statistical techniques that researchers can use to control for observed and unobserved differences, but in the end separating correlation from causation is always a thorny issue. You can never know what would have happened to the turned away women in a counterfactual universe where they were able to get the abortions they needed.
Those caveats aside, the study may well prove to be the largest and best study of its kind we get, and its findings appear to be valid and reliable. In that light, the results are illuminating, and alarming. The women who were denied abortions fared significantly less well on virtually all fronts. One of the most basic and most powerful tenets of feminism is that, contra Justice Kennedy’s insulting paternalism, women themselves are the best judge of what is good for them. These study findings strongly support that conclusion; women who received abortions did much better than those who were denied abortions against their will. This suggests that if the women had received the abortions they sought, they would have fared better as well. Trusting women is not only common sense, it makes excellent public policy sense as well.