Forty years ago, the US Supreme Court decided in Roe v. Wade that states could not ban first-trimester abortions. Wonkblog’s Sarah Kliff takes a look at what’s been happening since; her charts document the decline in the number of US abortion providers from the mid-1970s to early 2000s (holding steady since then); an increase in state abortion restrictions, with 92 enacted in 2011 alone; and an increase in the proportion of abortion patients who are low-income and minority. Perhaps most surprising to those of us already aware of these trends is the result of a recent survey: only 44% of Americans under 30 knew the Roe decision was about abortion.

How does the legality — and equally importantly, the accessibility — of abortion affect women’s health? Two recent studies are worth highlighting. In her post today, Kliff summarizes findings from a Guttmacher Institute study published in The Lancet last year. The authors looked at abortions worldwide, and concluded:

We found that abortions continue to occur in measurable numbers in all regions of the world, regardless of the status of abortion laws. Unintended pregnancies occur in all societies, and some women who are determined to avoid an unplanned birth will resort to unsafe abortions if safe abortion is not readily available, some will suffer complications as a result, and some will die. Measures to reduce the incidence of unintended pregnancy and unsafe abortion—including improving access to family planning services and the effectiveness of contraceptive use, and ensuring access to safe abortion services and post-abortion care—are crucial steps toward achieving the MDGs [Millennium Development Goals].

In other words, tighter abortion laws don’t necessarily mean fewer abortions – just fewer safe abortions. But not every woman who’s denied an abortion by a provider will end up getting one elsewhere. The Advancing New Standards in Reproductive Health research group at University of California San Francisco is conducting a prospective longitudinal study to describe “the mental health, physical health, and socioeconomic consequences of receiving an abortion compared to carrying an unwanted pregnancy to term.” From 2008 to 2010, they recruited over 1,000 women who sought abortions at 30 abortion facilities around the US. Some of those women were under the clinics’ gestational limits and received abortions, while others were past the gestational limits and, having been denied abortions on that basis (i.e., turned away), carried their pregnancies to term. The Turnaway Study is still conducting participant interviews, which occur every six months for five years.

It’s important to note that this study is still ongoing, and results have not yet been published in peer-reviewed publications. But Turnaway Study researchers did present at the 2012 American Public Health Association annual meeting (abstracts here and here), and i09’s Annalee Newitz wrote about their findings so far, including the following:

Unfortunately, when it comes to domestic violence, being denied an abortion makes a really big difference. Turnaways were more likely to stay in a relationship with an abusive partner than women who got abortions. A year after being denied an abortion, 7% reported an incident of domestic violence in the last six months. 3% of women who received abortions reported domestic violence in the same time period. [Study leader Diana Greene] Foster emphasized that this wasn’t because the turnaways were more likely to get into abusive relationships. It was simply that getting abortions allowed women to get out of such relationships more easily. So it’s likely that these numbers actually reflect a dropoff in domestic violence for women who get abortions, rather than a rise among turnaways.

This pattern of violence is also part of a larger pattern that shows turnaways are more likely to remain connected to the fathers of their children. Obviously, this isn’t always a good thing, as the violence statistics reveal. But even in the vast majority of cases where violence isn’t involved, Foster noted that these men aren’t living with the turnaways. The researchers asked women about cohabiting with partners, and found that men were no more likely to live with a turnaway who’d borne their children than they were to live with a woman who had an abortion. “The man doesn’t stick around just because you have the baby — that’s the crude way of putting it,” Foster said.

…The Turnaway Study found no indication that abortion could be linked with increased mental health disorders. There were no statistical differences between turnaways and women who had abortions when it came to developing clinical depression.

But turnaways did face a greater health risk from giving birth. Even late stage abortions are safer than giving birth.

The Supreme Court has the final word on whether laws are constitutional; researchers have the ongoing task of documenting how laws affect public health. These and many other studies give strong evidence that when women have more control over whether and when to have children, women enjoy better health.

Comments

  1. #1 R.L. Schaefer
    ca.
    January 22, 2013

    A SAD, TWISTED CHOICE

    I note that whenever an individual, who does not believe in the right to life, refers to the unborn they use the words ; zygotes, fetus or simply “a clump of cells”. But you know, I have never heard expectant mothers saying things like; “My clump of cells is a girl.” or, “My zygote is due in 8 months.” , nor do they say, “I feel my fetus kicking.” These days, it seems it is the “wanting” of us that now defines our worth as humans. The “wanting” of us is what defines our humanity and provides us a soul.

    These invisible, “unwanted lives” need to be depersonalized by the irresponsible. The unborn within the womb denied their humanity for the lack of “wanting” – disposable and worthless – simply garbage to be thrown into the sewer.

    The baby becomes a “Choice” when it is unwanted by the selfish. It is transformed into a “personal decision” by the vote hungry politician and a burdensome “inconvenience” to the self-absorbed student or career minded professional. It is defined as “women’s health issue” or a “reproductive right” by the careless, thoughtless hedonist.

    I guess reality is sometimes just too painful to face head on – better to avert our eyes – speak in euphemisms, and close our minds to the slaughter in the womb. After all, it’s not a life – it’s just a “choice”.

    • #2 Liz Borkowski
      January 23, 2013

      What the research is showing is that abortion *is* an issue of women’s health. And there are many advocates for legal, accessible abortion who are troubled by the procedure and would far rather see unwanted pregnancies prevented in the first place through contraception. The question is whether to prioritize the future potential life of a fetus (to use the medically appropriate term) over the existing life and health of a pregnant women — and, often, the children she already has.

      I do hope that all of those who are opposed to abortion are working to increase access to reliable contraceptives and to ensure that all pregnant women can get what they need to care for themselves and their families both during pregnancy and after the child is born. Until we have paid pregnancy, parental, and sick leave, as well as heavily subsidized childcare and a stronger social safety net, carrying a pregnancy to term generally means a great deal of missed work, and in this country that usually translates to missed income.

  2. #3 elspi
    January 22, 2013

    They call them a clump of cells because they are a clump of cells. If it doesn’t have a mind, a memory or the ability to feel pain, then it isn’t a human being. (ps, this doesn’t happen until at least 3-6 months AFTER birth)

    People think of a fetus as a child exactly because they are counting their chickens before they hatch (literally).

  3. #4 R.L. Schaefer
    January 23, 2013

    When two humans engage in sex “human life” is often the result – not tadpoles, hummingbirds or saber toothed cats. Now, if this human life has been created by irresponsible, hedonists, they often consider this “life” unwanted. Then they decide that 9 months of “inconvenience” is too.. well inconvenient, so they decide to destroy the life in the womb.

    97% of all abortions are done for the cause of convenience after irresponsible sex, and have NOTHING to do with “women’s health issues”.



    However, the law recognizes the unborn as a living human and all states have statutes that protect “wanted” babies as human and recognize the killing of babies in the womb as murder if done by anyone other than the baby’s mother or her abortionist. 

    This situation logically reduces our humanity to the “wanting” of us. If the unborn are wanted by their mothers they are a “baby” or even “my little girl”. If they are inconvenient they they are reduced to the level of a cancerous “clump of cells” or subhuman “fetus”.

    Human life being defined on the basis of the “wanting” of us, by another, bodes ill for the handicapped, elderly, unproductive, sick or “unusual” among us.



    Science, logic, reason – objective truth – cry out that every member of the human family possesses an inherent and profound dignity – a right to life – regardless of the stage of development, size, sex, age, handicap, race or how little someone “wants” us.

  4. #5 Liz Borkowski
    January 24, 2013

    Where does that 97% figure come from? This 2004 survey from the Guttmacher Institute has a far more nuanced list of responses from US women explaining why they had abortions. I find it especially sad that the percentage of women who responded that they couldn’t afford a baby right now rose from 69% in 1987 to 73% in 2004.

    A description of pregnancy and childbirth as merely “inconvenient” ignores the health risks that go along with these conditions. Worldwide, a woman dies every minute from complications related to pregnancy or childbirth, and 20 more suffer injury, infection, or disease. The statistics are less alarming in the US and other developed countries, but the risk is far from zero.

    A woman with a physically undemanding job, paid sick and parental leave, a flexible schedule, and good transportation might find it merely “inconvenient” to deal with the doctor visits, morning sickness, exhaustion, and other things that come with pregnancy. But a woman whos’ on her feet working 40+ hours under a rigid schedule with no paid time off will find it very difficult to do what she needs to have a healthy pregnancy and birth.

    I have no problem with women referring to fetuses as “my baby” or “my little girl” and avoiding terminology about “wanting” babies. I’d love to see greater respect for life throughout the human life span. But I don’t think banning abortion is the right way to achieve that. How about improving economic and employment conditions so it’s no longer the case that 73% of women who have abortions do so because they can’t afford a baby?

  5. […] 40 years after Roe v. Wade, what new research tells us about abortion and women’s health (scienceblogs.com) […]

  6. #7 HMMM
    January 25, 2013

    @R.L.

    “Science, logic, reason – objective truth – cry out that every member of the human family possesses an inherent and profound dignity – a right to life – regardless of the stage of development, size, sex, age, handicap, race or how little someone “wants” us.”

    Fo real? I assume you are anti-war, anti- death penalty and anti-terrorism AND responses to terrorism then.

    Also, none of those things say humans have a right to life, you say it. There isnt anything wrong with saying people have a right to life, but neither science nor all of those other things proclaim that.

    Also, when abortions are legal, fewer people die (mothers+babies). It follows that more humans get to enjoy what you call their “right to live” when abortions are legal.

  7. #8 Mark
    January 25, 2013

    Wow RL. You just have that argument in the bag, ready to go whenever you see an abortion post. I consider that trolling really, especially considering none of those words were used above.

    I’ll repeat my standard reply to you as you post this ad nauseum all over the internet. We call them those things because (1) it’s the appropriate medical terminology (2) many of us, for very good reasons, don’t believe personhood begins anywhere near conception.

    Your constant nattering over this point, not even relevant to the discussion above, just shows you’re trolling. You’re unwillingness to accept that other people have different definitions of personhood shows you’re unreasonable. And you’re characterization of the opposition as just hedonistic, child-killing monsters is unhelpful, contributes nothing to the debate, and just demonstrates you’re a buffoon.

  8. #9 Mark
    January 25, 2013

    However, the law recognizes the unborn as a living human and all states have statutes that protect “wanted” babies as human and recognize the killing of babies in the womb as murder if done by anyone other than the baby’s mother or her abortionist.

    Also RL, I’ve pointed this out to you before, this is not accurate. A minority of states protect a fetus in this fashion. Many have a viability clause. So in the majority of the states, the laws recognize the same limits as abortion providers. Quit repeating this tired, wrong argument.

  9. #10 Robert Szasz
    January 28, 2013

    It shouldn’t have to be said by now but bodily autonomy is the fundamental right. A government that can force a woman to carry a pregnancy to term can do anything, to anyone.

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