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Women Denied Abortions May Endure Long-term Health Consequences

Being denied an abortion can endanger a woman’s health in the short-term, but now, research suggests she may continue to suffer years after childbirth.

In a new study by UC San Francisco researchers, women who were denied abortions reported higher rates of joint pain, persistent headaches and migraines, and poorer overall health five years later, compared to women able to obtain abortions.

“The findings from the study are particularly relevant today, as they highlight some of the consequences if we continue to restrict women’s access to a wanted abortion,” said Lauren Ralph, MPH, PhD, an assistant professor of obstetrics, gynecology and reproductive sciences and first author of the paper published June 11 in the Annals of Internal Medicine.

When seeking an abortion, over 1 in 20 women cite concerns about their personal health as a deciding factor. As states move to limit access to the procedure, more and more women’s fears may be realized. Proponents of the restrictive policies argue that abortions pose more danger to women than carrying an unwanted pregnancy to term, but the research simply doesn’t back these claims.

It suggests the opposite.

“When looking at long-term health effects, we found that having an abortion is not detrimental to a women’s health but being denied access to a wanted abortion likely is,” said Ralph. Overall, the differences were small – women who had abortions, whether in the first- or second-trimester, maintained similar health to those who did not. Yet when differences in health were observed, they were consistently in the direction of worse health among those who gave birth.

The researchers tracked the health of over 870 participants in the nationwide Turnaway Study, the first major longitudinal study examining the physical and social consequences for women who have been denied wanted abortions. The women had all sought abortions between 2008 and 2010, but over 160 were turned away because they exceeded their clinic’s gestational limits. Twice a year for five years, the researchers interviewed each participant about their overall health, chronic conditions and pain.

Over time, women who had given birth were more likely to rate their overall health as “fair” or “poor,” instead of “good” or “very good,” than those who had abortions. At five years, 27 percent of women who gave birth rated their health fair or poor, as compared to 20 and 21 percent of those who had first- or second-trimester abortions, respectively.

Women who had given birth also reported increasing rates of chronic joint pain and headaches – 15 and 23 percent by end of the five-year study period – compared to women who had first-trimester abortions (12 and 18 percent) and second-trimester abortions (8 and 17 percent).

Parsing the dangers of childbirth and abortion has been difficult because women in good health are more likely to choose to continue a pregnancy – a pattern known as the “healthy mother effect,” which underestimates the relative risks of childbirth. The Turnaway Study is among the first to focus on women with unwanted pregnancies, providing a unique opportunity to examine the true risks of childbirth and abortion.