Fifty articles have been published from [Turnaway Study] data, including many headline grabbers, such as the finding that women unable to obtain abortions had a higher probability of living in poverty, and another that showed no difference in mental-health issues, such as depression and suicidal thoughts, between those who received abortions and those who were denied the procedure.The Washington Post
Analysis of Turnaway Study data resulted in 50 scientific publications examining physical and mental health, socioeconomic status, employment, educational attainment, relationship status, contraceptive use and emotions about pregnancy and abortion. Descriptions and links to all these publications are listed here or you can download the list in our printable PDF.
Why do women seek abortions?
The most common reasons for seeking an abortion are not being able to afford to have a child, the pregnancy coming at the wrong time in life, and the man involved not being a suitable partner/parent. Alcohol, tobacco and drug use can also be a factor.
- Biggs MA, Gould H, Foster DG. Understanding why women seek abortions in the US. July 2013. BMC Women’s Health, 13:29.
- Chibber KS, Biggs MA, Roberts SCM, Foster DG. The role of intimate partners in women’s reasons for seeking abortion. January 2014. Women’s Health Issues, 24(1):e131–e138.
- Roberts SC, Avalos LA, Sinkford D, Foster DG. Alcohol, tobacco and drug use as reasons for abortion. November 2012. Alcohol and Alcoholism, 47(6):640-648
Who is denied abortion and why?
Even before most 20-week bans were implemented, more than 4,000 women per year were denied wanted abortions due to gestational limits. Women who seek later abortions are often slowed down by not realizing they were pregnant, followed by logistical barriers to getting an abortion.
- Upadhyay UD, Weitz TA, Jones RK, Barar RE, Foster DG. Denial of abortion because of provider gestational age limits in the United States. September 2014. American Journal of Public Health, 104(9):1687-1694.
- Foster DG, Dobkin LM, Upadhyay UD. Denial of abortion care due to gestational age limits. January 2013. Contraception, 87(1):3-5.
- Foster DG, Kimport K. Who seeks abortions at or after 20 weeks? December 2013. Perspectives on Sexual and Reproductive Health, 45(4):210-218.
How were participants recruited?
Recruiting from 30 facilities over three years, the Turnaway Study relied on a variety of recruitment strategies to increase participation in the study. These strategies are discussed in this publication.
- Dobkin L, Gould H, Barar R, Weiss E, Foster DG. Implementing a prospective study of women seeking abortion in the United States: The challenges of recruitment prior to informed consent. January 2014. Women’s Health Issues, 24(1):e115–e123.
What are women’s experiences paying for abortion, viewing ultrasounds, and seeing protesters?
The Turnaway Study examined women’s feeling around abortion counseling, ultrasound viewing, the impact of clinic protestors on decision making, and the challenges women faced to cover the costs of abortion — many of whom did not have access to public or private insurance.
- Kimport K, Weitz TA, Foster DG. Beyond political claims: Women’s interest in and emotional response to viewing their ultrasound image in abortion care. December 2014. Perspectives on Sexual and Reproductive Health, 46(4):185-191.
- Roberts SCM, Gould H, Kimport K, Weitz TA, Foster DG. Out-of-pocket costs and insurance coverage for abortion in the United States. March 2014. Women’s Health Issues, 24(2):e211–e218.
- Foster DG, Kimport K, Gould H, Roberts SC, Weitz TA. Effect of abortion protesters on women’s emotional response to abortion. January 2013. Contraception, 87(1):81-87.
- Gould H, Foster DG, Perrucci AC, Barar RE, Roberts SC. Predictors of abortion counseling receipt and helpfulness in the United States. July 2013. Women’s Health Issues, 23(4):e249-e255.
- Gould H, Perrucci A, Barar R, Sinkford D, Foster DG. Patient education and emotional support practices in abortion care facilities in the United States. July 2012. Women’s Health Issues, 22(4):e359-e364.
What are the effects of having or being denied abortion on mental health and wellbeing?
The Turnaway Study examined the effects of receiving or being denied abortion on women’s mental health (anxiety, depression, post-traumatic stress, and suicidal ideation) and well-being (self-esteem, life satisfaction, stress and social support).
- Biggs MA, Upadhyay U, McCulloch CE, Foster DG. Women’s mental health and well-being five years after receiving or being denied an abortion: A prospective, longitudinal cohort study. February 2017. JAMA Psychology, 74(2):169-178.
- Biggs MA, Brown K, Foster DG. Perceived abortion stigma and psychological well-being over five years after receiving or being denied an abortion. January 2020. Plos One, https://doi.org/10.1371/journal.pone.0226417.
- Biggs MA, Gould H, Barar RE, Foster DG. Five-year suicidal ideation trajectories among women receiving versus being denied an abortion. May 2018. American Journal of Psychiatry, https://doi.org/10.1176/appi.ajp.2018.18010091.
- Biggs MA, Rowland B, McCulloch CE, Foster DG. Does abortion increase women’s risk for post-traumatic stress? Findings from a prospective longitudinal cohort study. February 2016. BMJ Open, 6(2):e009698.
- Biggs MA, Neuhaus J, Foster DG. Mental health diagnoses 3 years after receiving or being denied an abortion in the United States. December 2015. American Journal of Public Health, 105(12):2557-2563.
- Foster DG, Roberts S, Steinberg J, Neuhaus J, Biggs MA. A comparison of depression and anxiety symptom trajectories between women who had an abortion and women denied one. July 2015. Psychological Medicine, 45(10):2073-2082.
- Biggs MA, Upadhyay UD, Steinberg JR, Foster DG. Does abortion reduce self-esteem and life satisfaction? November 2014. Quality of Life Research, 23(9):2505-2513.
- Harris LF, Roberts SCM, Biggs MA, Rocca CH, Foster DG. Perceived stress and emotional social support among women who are denied or receive abortions in the United States: a prospective cohort study. June 2014. BMC Women’s Health, 14:76.
How are women’s emotions affected and how do they feel about their decisions?
Women experience a mix of positive and negative emotions after an abortion, with relief predominating, and the intensity of all emotions diminishes over time. The Turnaway Study also found that over 95% of women consistently felt abortion was the right decision for them over the duration of the study.
- Rocca CH, Samari G, Foster DG, Gould H, Kimport K. Emotions and decision rightness over five years following an abortion: An examination of decision difficulty and abortion stigma. January 2020. Social Science & Medicine, 248:112704.
- Rocca CH, Kimport K, Roberts SCM, Gould H, Neuhaus J, Foster DG. Decision rightness and emotional responses to abortion in the United States: a longitudinal study. July 2015. PLOS ONE, 10(7):e0128832.
- Rocca C, Kimport K, Gould H, Foster DG. Women’s emotions one week after receiving or being denied an abortion in the United States. September 2013. Perspectives on Sexual and Reproductive Health, 45(3):122–131.
How does abortion impact substance use?
The Turnaway Study found that women who are denied abortions and carry the pregnancy to term reduce/cease some, but not all, substance use, while women who have abortions tend to continue substance use patterns from before their abortions.
- Roberts SCM, Foster DG, Gould, H, Biggs, MA. Changes in alcohol, tobacco, and drug use over five years after receiving versus being denied a pregnancy termination. March 2018. Journal of Studies on Alcohol and Drugs, 79(2):293–301.
- Roberts SC, Subbaraman MS, Delucchi KL, Wilsnack SC, Foster DG. Moderators and mediators of the relationship between receiving versus being denied a pregnancy termination and subsequent binge drinking. February 2016. Drug and Alcohol Dependence, 159:117-124.
- Roberts SCM, Ralph L, Wilsnack SC, Foster DG. Which women are missed by primary health-care based interventions for alcohol and drug use? April 2016. Addictive Behaviors, 55:32-37.
- Roberts SCM, Foster DG. Receiving versus being denied an abortion and subsequent tobacco use. March 2015. Maternal and Child Health Journal, 19(3):438-446.
- Roberts SCM. Delucchi K, Wilsnack S, Foster DGF. Receiving versus being denied a pregnancy termination and subsequent alcohol use: A longitudinal study. July 2015. Alcohol and Alcoholism, 50(4):477-484.
- Roberts SC, Rocca CH, Foster DG. Receiving versus being denied an abortion and subsequent drug use. January 2014. Drug and Alcohol Dependence, 134:63-70.
- Roberts, S. C., S. C. Wilsnack, et al. Alcohol use before and during unwanted pregnancy. November 2014. Alcoholism, Clinical & Experimental Research, 38(11):2844-2852.
Do women who are seeking abortion consider adoption?
Considering adoption and placing a child for adoption is rare, even when abortion is no longer an option. This paper describes the experiences of the women who make that choice.
- Sisson G, Ralph L, Gould H, Foster DG. Adoption decision making among women seeking abortion. March 2017. Women’s Health Issues, 27(2):136-144.
How does being denied abortion affect physical health?
Women giving birth after being denied an abortion experience more potentially life-threatening complications such as preeclampsia and postpartum hemorrhage. They also report more chronic pain and rate their overall health as worse. Two women in this study who were denied abortion died due to maternal, or pregnancy-related, causes.
- Ralph LJ, Schwarz EB, Grossman D, Foster DG. Self-reported physical health of women who did and did not terminate pregnancy after seeking abortion services: A cohort study. August 2019. Annals of Internal Medicine, 171(4):238-247.
- Gerdts C, Dobkin L, Foster DG, Schwarz EB. Side Effects, Physical health consequences, and mortality associated with abortion and birth after an unwanted pregnancy. January 2015. Women’s Health Issues, 26(1):55-59.
What are the socioeconomic consequences of having or being denied abortion?
The Turnaway Study showed that being denied a wanted abortion results in economic insecurity for women and their families, and they have increased odds of falling below the Federal Poverty Level. They experienced more debt, lower credit scores and worse financial security for years after the pregnancy.
- Miller S, Wherry LR, Foster DG. The economic consequences of being denied an abortion. January 2020. Working Paper 26662, National Bureau of Economic Research.
- Foster DG, Ralph LJ, Biggs MA, Gerdts C, Roberts SCM, Glymour MA. Socioeconomic outcomes of women who receive and women who are denied wanted abortions. March 2018. American Journal of Public Health, 108(3):407-413.
- Miller S, Wherry LR, Foster DG. What happens after an abortion denial? A Review of Results from the Turnaway Study. January 2020. AEA Papers and Proceedings, 110:1-6.
How does being denied an abortion affect romantic relationships?
Women who receive wanted abortions are more likely to describe themselves as being in very good relationships years later compared to women who are denied an abortion. Women who were denied abortion were more likely to continue to be exposed to violence.
- Upadhyay U, Foster DG, Gould H, Biggs MA. Effects of abortion on women’s intimate relationships: Findings from a prospective 5-year longitudinal cohort study. Under review.
- Mauldon J, Foster DG, Roberts SCM. Effect of abortion vs. carrying to term on a woman’s relationship with the man involved in the pregnancy. March 2015. Perspectives on Sexual and Reproductive Health, 47(1):11-18.
- Roberts SCM, Biggs MA, Chibber KS, Gould H, Rocca CH, Foster DG. Risk of violence from the man involved in the pregnancy after receiving or being denied an abortion. September 2014. BMC Medicine, 12:144.
Do women’s attitudes toward abortion rights and morality change after having an abortion?
Nearly all women in the Turnaway Study who sought abortions reported that they support abortion being legal in some or all situations, yet 20% also believed abortion is morally wrong. Most women who participated in the study supported abortion rights, but support was slightly higher from women who received abortions.
- Woodruff K, Biggs MA, Gould H, Foster DG. Attitudes toward abortion after receiving vs. being denied an abortion in the USA. December 2018. Sexuality Research and Social Policy, 15(4):452-463.
How does having or being denied abortion impact life plans and educational attainment?
Women who receive abortions have six times higher odds of having positive one-year plans and are more likely to achieve them. Women who are denied abortions are neither more nor less likely to graduate or drop out of school than women who receive abortions, but they are less likely to obtain college degrees.
- Upadhyay U, Biggs MA, Foster DG. The effect of abortion on having and achieving aspirational one-year plans. November 2015. BMC Women’s Health, 15:102.
- Ralph LJ, Mauldon J, Biggs MA, Foster DG. A prospective cohort study of the effect of receiving versus being denied an abortion on educational attainment. November 2019. Womens Health Issues, 29(6):455-464.
- McCarthy M, Upadhyay UD, Ralph L, Biggs MA, Foster DG. The effect of receiving versus being denied an abortion on having and achieving aspirational five-year plans. BMJ Sexual & Reproductive Health, In press.
How does having or being denied abortion affect contraceptive use and subsequent pregnancies?
The Turnaway Study found that women who receive an abortion are more likely to have an intended pregnancy within the next five years compared to women who are denied, and they are slightly more likely to use contraception.
- Aztlan EA, Foster DG, Upadhyay U. Subsequent unintended pregnancy among US women who receive or are denied a wanted abortion. January 2018. Journal of Midwifery and Women’s Health, 63(1):45-52.
- Moseson H, Foster DG, Upadhyay U, Vittinghoff E, Rocca C. Contraceptive use over five years after receipt or denial of abortion services. March 2018. Perspectives on Sexual and Reproductive Health, 50(1):7-14.
- Upadhyay UD, Aztlan-James EA, Rocca CH, Foster DG. Intended pregnancy after receiving vs. being denied a wanted abortion. September 2018. Contraception, 99(1):42-47.
What is the effect of having or being denied abortion on women’s existing and future children?
The Turnaway Study demonstrated that, when women have control over the timing of having children, existing and subsequent children benefit. Children born later to women who are able to get an abortion experience more economic security and better maternal bonding than the children born because a woman was denied an abortion.
- Foster DG, Biggs MA, Raifman S, Gipson JD, Kimport K, Rocca CH. Comparison of health, development, maternal bonding, and poverty among children born after denial of abortion vs after pregnancies subsequent to an abortion. September 2018. JAMA Pediatrics, 172(11):1053-1060.
- Foster DG, Raifman SE, Gipson JD, Rocca CH, Biggs MA. Effects of carrying an unwanted pregnancy to term on women’s existing children. October 2018. The Journal of Pediatrics, 205:183-189.e1
Does being denied abortion affect how pregnancy intentions are reported?
As time passed after seeking an abortion, women’s perceptions of whether their pregnancy had been intended or unintended changed. Those who were denied abortions and gave birth tended to report their pregnancy as more intended. These papers show how hard it is to measure whether pregnancies are intended, unintended, or some of both.
- Ralph LJ, Foster DG, Rocca CH. Comparing prospective versus retrospective reports of pregnancy intention in a longitudinal cohort of U.S. women. March 2020. Perspectives on Sexual and Reproductive Health, https://doi.org/10.1363/psrh.12134.
- Rocca CH, Wilson MR, Jeon M, Foster DG. Stability of retrospective pregnancy intention reporting among women with unwanted pregnancies in the United States. June 2019. Maternal and Child Health Journal, 23:1547-1555.