Here’s What It Really Means To Be Denied An Abortion

With the 49th anniversary of landmark abortion rights case Roe v. Wade approaching on Jan. 22, reproductive rights are more crucial — and more endangered — than ever. As Roe continues buckling under the weight of numerous abortion restrictions across the United States, the consequences are more than just political: They’re a matter of life and death.

Diana Greene Foster, Ph.D., professor at the Bixby Center for Global Reproductive Health at USCF, knows this. In June 2020, Foster published The Turnaway Study, a book detailing her team’s research on women who were denied abortions and forced to carry unwanted pregnancies to term. The research first began under Advancing New Standards in Reproductive Health (ANSIRH) in 2008, with Foster leading the team. “Two women ... died after childbirth because they were denied an abortion,” Foster says, citing some of the stories from the study that have stuck with her. She points out that it’s in stark contrast to the “risk” of a legal abortion: “We had no abortion-related deaths [during the study], and two childbirth-related deaths,” she says.

For almost 50 years, the Supreme Court’s landmark 1973 decision in Roe v. Wade has been the baseline for reproductive rights. An entire generation — several generations, really — have grown up with the understanding that they have the right to end an unwanted pregnancy, and that their bodies are their own. But Foster’s research shows how tenuous that right is in a year when more than 100 restrictions on abortion were passed around the United States, and what’s really at risk if that right is inaccessible.

Being denied an abortion, Foster highlights, “has serious ramifications.” Many of the women included in Foster’s study not only faced increased financial issues after giving birth, but also physical issues: complications from delivery, chronic head and joint pain, hypertension, depression, and anxiety, and women who were in abusive relationships became tethered to their toxic partners after giving birth. “It’s not abstract. We understand who is affected,” she emphasizes: low-income communities; individuals who live in highly restrictive “hostile” states; and young people who face additional legal barriers, like needing consent from a parent or guardian to obtain abortion care.

The study, conducted with a team of researchers, followed more than 1,100 women who were too far along in gestation to get an abortion in their state and were forced to carry unwanted pregnancies to term. Per abortion rights think tank the Guttmacher Institute, as of 2022 44 states ban abortion at certain points in gestation, some as early as six weeks. Foster notes that historically, there’s been a gap in research on abortion denial, partly because other studies have compared people who access abortion with people who carry wanted pregnancies to term. That misses the point, according to Foster: “You can't compare somebody who's in the position of being pregnant against their will to someone who has a planned pregnancy,” she says. “Those are not the same experiences.” Instead, researchers in the Turnaway Study compared people who had abortions to people who were denied abortions, and while researchers were initially searching for differences in mental health, their findings highlighted that being denied an abortion also had major impacts on people’s physical, social, and economic well-being.

“If you ask people, ‘Why do [you] want an abortion?’ they give you reasons that entirely demonstrate what the consequences are when they don't get one,” Foster says. “People say, ‘I can't afford to have a baby,’ and we see [them] become poorer when they're unable to get an abortion. They say they want to take care of their existing kids, [and] we see their existing kids do worse if they're not able to get an abortion. They say their relationship isn't good enough to support a child or another child, and we see relationships dissolve.”

The numbers bear it out: The study found women who were forced to carry unwanted pregnancies to term were four times more likely to be living below the federal poverty line after giving birth than those who had received wanted abortions. Furthermore, existing children of women who were denied abortions also fared worse, as they were over six times more likely to live in a household “in which their mother reported not having enough money to pay for food, housing, and transportation.”

This is not just a political question. This is a very common personal experience.

Foster emphasizes how there’s one very important aspect about abortion care that the U.S. government still doesn’t seem to understand: Pregnant people are often discussed as abstract concepts by policymakers in Washington, but their lives are not political game pieces. “This is not just a political question. This is a very common personal experience with [complexities],” she states. “Everybody [should] make their own decision about when they're ready to have a child.”

Foster’s work has already made multiple appearances in prominent Supreme Court cases surrounding reproductive rights, including several briefs about the real-world impact of abortion restriction. “[The study] has had this effect in legal circles, to provide some scientific evidence where otherwise it's [an] ideological debate,” she says.

Crucial in those legal circles is the Supreme Court case Dobbs v. Jackson Women’s Health Organization case, which will determine whether or not state laws that ban abortions pre-viability are unconstitutional. On Dec. 1, 2021, the Supreme Court heard oral arguments in the case, and a decision is expected in or before June of this year. If the Mississippi law at the center of the case is upheld, states will have free rein to restrict abortion to the point where it is effectively banned, meaning abortion will become de facto illegal in large swaths of the country.

“It's very likely that Dobbs will [end] a constitutionally protected right to abortion, and as a result, in many states it will become much harder to get an abortion,” says Foster. According to the Guttmacher Institute, 26 states are considered “certain or likely” to ban abortion in the absence of Roe. “Being denied an abortion makes poor women poorer,” she adds. “This is not a decision the Supreme Court should be [making] for people. It's something people need to do for themselves.”

When it comes to advice for individuals struggling to obtain abortion access in their state, Foster recommends several online resources that allow patients to receive abortion care through telehealth, such as ineedana.com and the Euki app. These sites allow patients to access medication abortion, which can be used to end a pregnancy of up to 10 weeks. Most of all, however, she encourages people to believe in themselves.

“Persevere, whether that's deciding to have a baby before you thought you were ready, but you want to, or deciding to have an abortion,” Foster says. “You can trust your own decision-making.”