Access To Abortion Contributes To A More Positive Life Outlook

Simply having the treatment option available for those who can get pregnant increases positivity and the ability to make and achieve goals.

BREAKING: Abortion access is awesome!

It’s good for you as an individual and it’s good for society as a whole — simply having the treatment option available for those who can get pregnant increases positivity and the ability to make and achieve goals.

This may sound like common sense, but we just endured a news cycle where Senate Republicans voted overwhelmingly to defund Planned Parenthood, despite an existing ban on federal money funding abortion. Considering this bill won’t ever be signed by the president anyway, this was clearly a political move from the Department of Redundancy designed to make it extra clear just how much conservatives don’t want their money to be abortion-adjacent.

That redundancy in itself showcases how fixated half of our elected officials remain on legislating against what should be a settled issue: abortion is healthcare that has existed as long as pregnancy, and any ZIP code or income-level requirement for access is an undue burden. Pair the purposely contentious political climate with a stigma that persists despite abortion’s mainstream support, and an important new study from Advancing New Standards in Reproductive Health (ANSIRH) titled “The effect of abortion on having and achieving aspirational one-year plans” is clearly worth celebrating.

“I hope this study contributes scientific evidence to discussions about the role of abortion in women’s lives,” said Ushma D. Upadhyay, PhD, MPH, an assistant professor at the University of California, San Francisco, and lead author on the study.

“Popular support for abortion is often based on a desire for women to have access to life opportunities. Until now, we have had little evidence to support this premise. It is important that we understand the effects of abortion, so that policies are made with a true understanding of the impact of abortion access on women’s health and social and economic well being.”

ANSIRH researchers conducted this first-of-its-kind examination into exactly how abortion affects people’s ability to achieve personal goals through the use of a “turnaway” model. For the longitudinal study, researchers collaborated with 30 abortion facilities across the U.S., interviewing over 1,000 people — some who had been able to access abortions and some who had been “turned away” from the abortion they needed, usually for being over a state’s gestational limit. They inquired about the respondents’ lives in general to get a sense of their overall goals and how their need to access abortion care fit into the year after they either received the procedure or being turned away.

Per ANSIRH, the “major aim of the study is to describe the mental health, physical health, and socioeconomic consequences of receiving an abortion compared to carrying an unwanted pregnancy to term.”

“Social science researchers who study abortion know that women have abortions for a wide range of reasons, which are often related to achieving their personal life goals. In the Turnaway Study, we wanted to see whether having an abortion influences those goals,” Upadhyay told The Establishment.

A crucial aspect of Upadhyay’s team’s research was their use of open-ended questions. The research team asked participants, “How do you think your life will be different one year from now?” and allowed participants to answer freely, without having to use a predetermined list of reasons or goals for seeking treatment. Respondents could answer without being subject to suggestion or influence, a model which allowed for a wide variety of responses that more closely resemble real people’s lives and experiences.

This is important as, when talking about their medical history, not everyone is comfortable including whether or not they’ve had an abortion — and not all of those who have will offer reasons for needing the procedure. Unfortunately, it can be hard to tell whether or not medical personnel will be supportive, or even just indifferent.

“I don’t ask my patients more about the abortions they [list in their medical histories] due to fear of being perceived as judging them,” said Dr. Leah Torres, a Salt Lake City-based OB-GYN specializing in reproductive health:

“The only reason for having an abortion that matters is: ‘I don’t want to be pregnant.’ That said . . . sometimes patients just volunteer a reason why such as, ‘I’m in school right now and can’t finish if I have a baby.’ In a nutshell, this study confirms many of the reasons I hear from people who have abortions.”

“We thought it was important to consider the range of goals women had for themselves — not those prescribed by society,” added Upadhyay. “While many women had educational and employment-related goals, many had personal, psychological, and physical goals, such as wanting to be happier, to be less stressed, or to be healthier.”

They found that women who’d had an abortion envisioned more optimistic plans for their immediate futures than those who were denied the care they needed and knew they’d likely have to carry their pregnancy to term. Those who were turned away mentioned childrearing plans, but typically no relationship or employment goals; their future considerations were more likely to be neutral or negative.

They found that women who’d had an abortion envisioned more optimistic plans for their immediate futures than those who were denied the care they needed and knew they’d likely have to carry their pregnancy to term.

Those who received an abortion and were not subjected to the strain and life alteration of denied care stated plans and dreams like:

“Give a good life to my kids.”

“I hope that I will be back in school.”

“Hopefully I’ll be opening my own business.”

“I’ll probably be in a different country, hopefully Australia.”

“I’m hoping to take better care of myself.”

“I’ll be married.” And also, “I hope to be divorced.”

“I just want to be happy.”

While unintended pregnancy can happen to anyone, rates are highest among groups that already have several strikes against them for achieving life goals: youth (ages 18–24), people of color, and the poor. They are also the people most likely to be Medicaid patients — a group that carries one in four unintended pregnancies to term against their will. Accounting for the factors that enter into someone’s decision about whether or not to carry an unintended pregnancy to term — poverty, social support, and education for example — is why the turnaway is both unique and valuable.

“Our study compares two groups of women — all of whom had unintended pregnancies and sought abortion,” explained Upadhyay. “Comparing two groups that sought an abortion evens the playing field and allows us to see what the effect of receiving or being denied a wanted abortion is on women’s lives.”

Torres sees the effects of barriers to abortion care in her practice and in her work as an educator and activist:

“My patients may have to travel 500 miles, take three or four days off of work, find childcare for those days because of the 72-hour waiting period, while hopefully not losing their jobs. Many have to navigate not only their primary doctor — who may be judgmental and who may not even know how to refer her for an abortion, but then possibly see another doctor because the first doesn’t know thing one about abortion laws in Utah. Many physicians are unfamiliar with the laws because they don’t perform abortions due to those laws or personal beliefs. Or both.”

The restrictive laws on gestational limits — which can be as early as 10 weeks in some states — were the singular reason cited by turnaway study participants for why they were unable to access a needed abortion.

“Women are delayed in seeking abortion for many reasons; the most common is not realizing they are pregnant,” said Upadhyay. “But there are also many logistical and financial barriers to getting an abortion in the U.S. and sometimes those barriers prevent women from getting to the clinic in time.”

Upadhyay’s 2008 study “Denial of Abortion Because of Provider Gestational Age Limits in the United States” found that 4,000 people ran into the wall of clinic or state-imposed gestational limits. She conjectures that the number is higher now — a safe assumption considering the 282 new abortion restrictions that passed since 2011.

Torres noted as well that the waiting periods and gestational limits don’t just result in some people being turned away from needed procedures; they also drastically increase cost, which can also lead to patients carrying to term.

“The 72-hour delay can double the price of the abortion, making the cost a barrier,” said Torres.

“If someone is 12 weeks and five days [along], by the time their ‘waiting period’ is over, the price of the procedure has increased by $200 [or more], which may be cost-prohibitive. If she is 14 weeks and five days at her initial appointment, the price doubles in three days’ time from $600 to $1,200.”

As a doctor who provides the full scope of reproductive health care, including prenatal and delivery, Torres has seen scenarios far worse than increased cost and travel hurdles.

“One of the few women who died giving birth during my career was a woman who had at least three other children, wanted an abortion, and couldn’t get one,” said Torres. “She then died in childbirth, which meant her children went to foster care because she was a recent immigrant with no other family. Such a tragic story.”

Like so many providers who are speaking out against condescending, harmful, and even life-threatening abortion restrictions, Torres longs for a day where care is left to patients and their physicians:

“Do not tell me someone needs to wait 72 hours ‘for their own good’ [as politicians often claim when passing abortion restrictions] when waiting that long could mean life and death. Pregnant people will take three days if they need three days. They don’t need a politician to order them to. If a doctor thinks someone isn’t sure in their decision, we ask them to come back when they are ready.”

Torres hopes that a study like ANSIRH’s can help advocates achieve their political goals in order to strengthen access to abortion care, saying:

“It should push the effort to overturn laws that restrict abortion access if we as a nation care anything about the people responsible for furthering humanity and bearing our children. Other countries prosper economically when people have access to abortion care and can plan their families. Planned pregnancies are the healthiest pregnancies. And families thrive! When we value women and protect their health and well-being — supporting them in achieving their life goals — we all win: from public health to the national and global economies.”

Upadhyay touched on another reason why valuing women could be an overall societal good when asked if anything in the turnaway study results were unexpected.

“I was surprised to find that the vast majority of women had positive life plans,” she said. “Women are resilient and most women had positive visions for their future, including those who were recently denied an abortion.”

Next up for Upadhyay is to see how the half who were unable to achieve their goals within a year fare over five years to determine if the study’s long-term results match the short-term findings. But for this study, the results are clear: “Ensuring women can have a wanted abortion enables them to maintain a positive future outlook and achieve their aspirational life plans.”