There's been quite a lot of research about women's emotions immediately following an abortion. Some experience sadness, guilt and anger; others feel relief. For many, it's a mix of all of these and more. But what about in the long term?
Researchers from the University of California at San Francisco delved into this question in an analysis of 667 women recruited from 30 sites across the country as part of the Turnaway Study - a landmark body of research about how abortion affects women physically, socially, emotionally and economically.
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Starting one week after their abortions and then twice yearly after that, the women were asked about their feelings. The authors said they wondered about stigma and how the women would reflect on their decisions as time passed.
What they found was a surprise: Over time, all emotions, good and bad, faded.
"A really interesting finding is how the intensity of all emotions is so low," said Corinne Rocca, lead author of the study and a UCSF associate professor of obstetrics, gynecology and reproductive sciences.
A week after their abortions, about 51 percent of women expressed mostly positive emotions, 17 percent expressed negative emotions and 20 percent said they had none or few. As time went by, the number who felt few or no emotions rose sharply. At the five-year mark, 84 percent reported either primarily positive emotions or none at all, while 6 percent had primarily negative feelings. There was "no evidence" of new negative or positive emotions, the authors said.
Immediately after their abortions, 95 percent of those who agreed to interviews said they had made the right decision. At five years, that percentage increased to 99 percent.
Rocca was careful to point out that a woman's feelings of regret and her judgment that an abortion was the correct decision for her under the circumstances are different things: "You can feel the emotion of regret, yet feel you did what was right for you."
The study authors did not hesitate to weigh in on the political implications of their work. They wrote that their findings "challenge the rationale for state-mandated counseling protocols . . . and other policies regulating access to abortion premised on emotional harm claims (e.g. waiting periods.)."
"What this study is showing is that there is a small minority who do regret their abortions," Rocca said. "I in no way want to reduce the struggles of those who regret their abortions, but it is misguided to take away the options for everyone based on this minority."
That conclusion is unlikely to be accepted, however, by opponents of abortion rights, who have criticized the Turnaway Study for using an unrepresentative sample.
In a 2018 paper in Linacre Quarterly, the ethics journal of the Catholic Medical Association, antiabortion activist David Reardon describes how more than two-thirds of the women approached for the study refused to participate. Of those who agreed, half dropped out. Those who reported the highest rates of relief and happiness were the ones most likely to remain, he argued. Those who reported the least relief were most likely to drop out, he said.
The study sample "is clearly biased toward a subset of women who expected the least negative reactions to their abortion, experienced the least stress relative to discussing their abortions, and perhaps may even have experienced therapeutic benefits from talking about their abortions with researchers who affirmed the 'rightness' of their abortion decisions," he wrote.
The authors responded by saying that they recognize the relatively low participation rate "might elicit questions about selection bias." However, they wrote that a 38 percent response rate among women seeking a "stigmatized" health service is in line with other studies and that they have "no reason to believe women would select into the study based on how their emotions would change over five years."
Launched in 2008, the Turnaway Study's main goal is to examine two disparate groups of women - those who had abortions and those who sought to terminate their pregnancies but were "turned away" because they were past the gestational limits set by the clinics and ended up carrying to term. The average age of the women at the time of abortion was 25. Thirty-five percent were white, 32 percent black, 21 percent Latina, and the rest were other races and ethnicities. Sixty-two percent were already mothers, and the mean gestational age was 15 weeks.
Fifty articles have been published from the 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 article released Sunday in the journal Social Science & Medicine is one of the final papers from the study.