According to one of the most comprehensive studies on abortion, the vast majority of women who were denied an abortion ended up poorer, sicker and in precarious conditions.
On June 24, the United States Supreme Court overturned the decision in Roe v. Wade, which protects access to abortion in the United States.
Dr. Diana Greene Foster is baffled; she misunderstands why, before invalidating Roe v. Wade, the United States Supreme Court did not consider studies that show the multiple negative impacts associated with denying access to abortion.
It's a real nightmare. It is a total disregard for the well-being of women, men, families, children. Ideology takes precedence over their well-being, says this professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the University of California, San Francisco and research director at Advancing New Standards in Reproductive Health (ANSIRH).
She and hundreds of researchers have submitted briefs to the Court in the hope that the judgment will be based on the evidence.
She knows this evidence very well, since she is the author of one of the largest studies on the subject, the Turnaway Study.
Dr. Foster also argued, in an opinion piece published in the journal Science just over a month before the judgment of the Supreme Court does not fall, so that the decision of the judges is guided by evidence and not by ideologies and preconceived ideas.
Dr. Diana Foster Greene led the Turnaway Study, which showed that refusing an abortion had more harmful consequences for women and families than abortion.
As a researcher, I believe science should not be done in an ivory tower, away from people. […] Science is clearly relevant in deciding the controversial issues of our time, including access to abortion. In fact, science is especially essential right now. The highest court in the United States must not ignore it, she wrote.
In Canada, experts like Martha Paynter, a nurse who has just published a book on the issue of abortion in Canada, misunderstand why studies like Dr. Foster's have not been considered by the Supreme Court.
This is problematic when a court makes judgments about physical or mental health issues. Judges aren't clinicians, doctors, says this nurse and board chair of Wellness Within, a nonprofit reproductive justice organization.
Abortion harms women and is dangerous. These are claims made by those who wish to restrict access to abortion.
To confirm or refute these impressions and perceptions, Dr Foster and about forty colleagues wanted to test these assumptions.
In 2007, Dr. Foster and her team undertook the Turnaway study to determine the long-term impact on the lives of women who had to carry an unwanted pregnancy to term.
Prior to this study, there was little quality research on the physical and social consequences of unwanted pregnancies.
For example, explains Dr. Foster, several studies have compared the experiences of two very different groups: either women who have had an abortion and women who have carried a pregnancy to term without having considered having an abortion.
< p class="e-p">In the case of the Turnaway Study, more than 1,000 women who attempted to obtain an abortion at approximately 30 clinics across the United States participated in the study. A portion of participants obtained an abortion; the other was refused.
Of the 1000 participants:
- about 60% already had a child;
- half of them were in their twenties;
- three quarters of them were already living below the poverty line;
- about 40% said they were not financially stable to have a child;
- 36% said the timing was not right;
- 31% cited relationship problems;
- 30% said they wanted to take better care of their other children.
Participants were followed every six months for over five years; more than 8000 interviews were done. These exhaustive data have led to the publication of more than fifty studies in scientific journals.
The Turnaway study clearly demonstrated that carrying an unwanted pregnancy to term because of being denied an abortion has significant consequences for women’s physical and mental health.
“If we had just listened to what these women were telling us about their reasons for having an abortion, we would have seen the consequences of refusing.
— Dr. Diana Greene Foster, University of California, San Francisco
In fact, the list of negative consequences is very long.
The vast majority of women who were refused an abortion ended up poorer, sicker and in precarious conditions.
Women who were unable to have an abortion were four times more likely to live below the federal poverty level, not have enough money for basic needs, and be unemployed; they had poorer credit ratings; they were more likely to have gone bankrupt or been evicted from a home.
On a physical level, they were more prone to suffer from hypertension and chronic pain and to suffer serious complications at the end of their pregnancy, such as eclampsia.
Two women who could not have an abortion died during childbirth. No woman who obtained an abortion died.
Those who were unable to obtain an abortion suffered more from low self-esteem and anxiety.
What's more, the health and well-being of children and the entire family were also negatively affected.
These women were more likely to be with a violent partner; to be a single mother.
About 90% of women who were unable to obtain an abortion kept their child. But as the study shows, it is not without consequences.
Several people said they had difficulty bonding with the child. In fact, children whose mothers were denied abortions were more likely to have language, gross and fine motor problems.
Finally, the researchers observed that people who have an abortion later in pregnancy experience the same consequences as people who have an abortion earlier.
The Turnaway study lists numerous health impacts on women who were denied an abortion.
By limiting access to abortion, women are exposed to poverty, comments Martha Paynter. Since poverty is one of the determinants of health, we can expect her to suffer health consequences. One cannot deny a person's right to make decisions about their health and expect there to be no health impacts.
The study also reveals that women who consider terminating their pregnancies take the decision seriously.
“Over 95% of people who get an abortion say it was the right decision. »
— Dr. Diana Greene Foster, University of California, San Francisco
After five years, less than 15% of women say they feel sad about their abortion. Two out of three women felt little or no emotion about their decision. The most frequently reported feeling was relief. Women were also more likely to have a wanted pregnancy later.
Moreover, these findings were cited by the Constitutional Court of Chile in a judgment that allowed the decriminalization of abortion.
Dr. Foster now fears that it will be the most vulnerable American women who will bear the brunt of this decision: minors, immigrants, people living in poverty, people with chronic illnesses, people incarcerated.
An analysis of the New York Timesestimates that nearly 34 million women of childbearing age in 28 states may no longer have access to abortion. The Guttmacher Institute estimates that there will be approximately 100,000 fewer legal abortions per year after the ruling is overturned.
This judgment will force the pregnancy of 11-year-olds, 12-year-olds, 13-year-olds. It's barbaric, worries Martha Paynter.
Dr. Foster is also concerned that women who experience a miscarriage will not have access to the treatments necessary to complete the expulsion of the embryo.
The two women also fear more deaths among women.
“We know that women will die because of this decision.
Dr. Foster believes there will be deaths in particular among women who risk alternative and unsafe methods of abortion – such as buying drugs online. For some it will be fine, for others it could be fatal.
Then, as the Turnaway study shows, women who will have to carry their unwanted pregnancy to term will suffer long-term consequences on their physical and mental health.
Martha Paynter's book, Abortion to Abolition: Reproductive Health and Justice in Canada, was published the day after the US Supreme Court ruling.
Martha Paynter points out that the United States has an astronomically high maternal mortality rate. The United States does not help women take care of their health and well-being, she laments.
Dr. prohibiting abortion are among the states with the highest infant mortality rates.
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For a few weeks, even before the Supreme Court's decision, Dr. Foster's team had been busy undertaking a new study.
The team will follow women with unwanted pregnancies just before and just after the termination of abortion rights in the United States.
We want to study the last people who had access to abortion in their state and women who had appointments that were suddenly canceled. Who will be able to get care elsewhere? At what price? Who will receive hazardous care? Who will carry her pregnancy to term?
The researcher does not know if the women will agree to participate, considering the difficult context. Some women may be reluctant to talk to us, especially if they use illegal methods to obtain an abortion, she says, noting that her team is considering ways to anonymize the data to protect it.
Meanwhile, Dr. Foster struggles to be optimistic. She clings to the hope that states, which are now responsible for prohibiting, limiting or allowing abortion on their territory, will take the science into consideration.