This month, the JAMA Psychiatry published the latest findings from the abortion-turnaway study. This study compares health outcomes between various groups of women: The first group obtained first-trimester abortions; the second group, which obtained later-term abortions; and the third group, which sought abortions, but was unable to obtain them because of gestational-age limits.
The media spin is that abortion does not significantly increase the risk of adverse psychological outcomes. The findings have been uncritically cited and touted by a number of mainstream media outlets including the New York Times, Slate, Time, and the Los Angeles Times.
Comparing health outcomes between these groups of women is a unique and novel approach methodologically. Under the right circumstances, such a study could reveal potentially important insights about the health impact of abortion. Unfortunately, the study is being carried out a team of researchers affiliated with the Bixby Center for Global Reproductive Health at the University of California, San Francisco. This is a research center known for its very strong support of legal abortion. As such, the authors seem primarily interested in using their findings to discredit both informed-consent laws and limits on late-term abortions.
The researchers began by interviewing a group of women who sought abortions between 2008 and 2010 and then conducted follow-up interviews at six-month intervals. The first results were released in late 2012. Media coverage of the first set of findings indicated that women who were denied abortions were more likely to be suffering from both stress and economic hardship than women who obtained abortions. However, the results were unsurprising. Women seeking late-term abortions likely do so because of some unexpected developments in either their relationship or their financial situation. Additionally, raising a child after personal turmoil is likely to cause stress and economic hardship. Finally, these early results came from an academic conference paper — which had not gone through the peer-review process.
These new findings about mental health appear in a reputable peer-reviewed journal. However, while the media has touted the findings that abortion does not pose significant health risks, they have overlooked some of the study’s methodological shortcomings. For instance, as time went on, the number of participants who participated in follow-up interviews significantly declined. Of the 956 women who completed the first interview, only 58 percent were interviewed five years later. It seems likely that those women who encountered personal or psychological problems would be more likely than others to drop out of the study. Furthermore, even though the authors present the aggregate numbers of women who dropped out of the study, it does not provide a breakdown of dropouts by cohort. It is possible that women who obtained abortions might have been more likely to discontinue participation than those who did not.
Interestingly, the study provides good evidence that women who obtain later-term abortions are likely to suffer psychologically. Women who obtained late-term abortions were statistically more likely to experience symptoms of depression and anxiety than women who obtained abortions in the first trimester. In fact, many prominent public-health studies present statistically strong evidence that late-term abortions pose various health risks. This would include the famous Danish study on the link between abortion and breast cancer, which appeared in the New England Journal of Medicine in 1997. Of course, these findings receive scant coverage from the mainstream media.