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Women denied abortions report worse long term physical health

Women who were denied abortions and gave birth reported worse health after 5 years than those who sought and received an abortion, according to study results published in the Annals of Internal Medicine.

“Unwanted pregnancy is common in the United States and worldwide, and abortion and childbirth after unwanted pregnancy can affect women's health,” Lauren J. Ralph, PhD, of Advancing New Standards in Reproductive Health at the Bixby Center for Global Reproductive Health at the University of California, San Francisco, and colleagues wrote. “The immediate physical health complications of childbirth and abortion indicate a higher risk to continuing a pregnancy to term than having an abortion.”

Researchers noted that compared with those who received abortions, women who gave birth experienced more adverse outcomes and had a 14-fold higher risk for death.

The Turnaway study was a 5-year prospective cohort study of the long-term physical health of women who sought abortion but may or may not have received one. Women included in the study sought an abortion at one of 30 participating clinics in the U.S. between January 2008 and December 2010, were at least 15 years of age and had no fetal anomalies.

Researchers called participants approximately 8 days after enrollment to collect baseline data and semiannually for 5 years to collect self-reported information about physical health. Participants were grouped based on whether they received a first-trimester abortion (< 13 weeks), second trimester abortion (> 13 weeks), or gave birth. Outcome measures included chronic pain and obesity.

A total of 874 participants were included in the study results. Of those, 328 received a rst-trimester abortion, 383 received a second-trimester abortion, and 163 gave birth. Researchers found no significant difference in self-reported health and chronic pain in women who received first or second trimester abortions.

Among women who gave birth, 27% (95% CI, 21-34) reported fair or poor health at 5 years compared with 20% (95% CI, 16-24) of women who had first trimester abortions and 21% (95% CI, 18-25) of women who had second trimester abortions.

Women who gave birth had similar levels of obesity and chronic pain but experienced more chronic headaches or migraines and joint pain. Among participants who gave birth, 9.2% reported gestational hypertension.

There was no significant difference in maternal mortality among those who gave birth and those who received an abortion.

“This research consistently found that women who ended their pregnancies fared as well as or better than women who gave birth,” Lisa H. Harris, MD, PhD, and Vanessa Dalton, MD, MPH, of the University of Michigan, wrote in an editorial accompanying the study. “These are important findings given that some antiabortion activists and lawmakers justify abortion restrictions with claims that they protect women’s health and well-being.”

“Ralph and colleagues’ study is a call to recognize that reproductive health is just health,” Harris and Dalton said. – by Erin Michael

Disclosures: Dalton reports personal fees from Bayer; grants from AHRQ, the Blue Cross Blue Shield Foundation, the National Institute for Reproductive Health and NCI outside of the submitted work. Harris reported grants from an anonymous foundation, the Bissell Family Foundation, the Fellowship in Family Planning and the Society of Family Planning; non-financial support from Greenwall Foundation; personal fees from Fellowship in Family Planning; other potential conflicts of interest from the American Association for the History of Medicine, the American College of Obstetricians and Gynecologists, the American Society for Bioethics and Humanities, the American Society for Reproductive Medicine, Physicians for Reproductive Health Medicine and Planned Parenthood of Michigan outside the related work. Ralph reports no relevant financial disclosures.