The Turnaway Study (“the Study”) is a study conducted by the research team at ANSIRH (Advancing New Standards in Reproductive Health), led by demographer Diana Greene Foster. The Study examines (1) women who obtained abortions and (2) women who sought abortions at clinics but were turned away because they were past the clinics’ gestational limits. Researchers interviewed women for up to five years after they had either aborted or were denied abortion and compared their outcomes.
The Study has been the basis of dozens of peer-reviewed publications, as well as hundreds of news stories and opinion pieces. However, some of the Study’s findings receive a great deal more attention than others.
The Turnaway Study’s Known Findings
Women who abort believe it was the right decision for them.
The Turnaway Study is perhaps best known for its finding that women who get abortions do not regret them. Published in Social Science & Medicine in 2020, Foster et al explain that five years after aborting, 99% of women said, given the situation, the decision to have an abortion was right for them. The researchers found no evidence of emerging negative emotions or abortion decision regret over those five years.
These findings have been covered extensively by media outlets such as CNN, Los Angeles Times, Reuters, and New York Times. The narrative the public has come to understand is that abortion does not harm women.
In contrast, the Turnaway Study also has findings frequently cited as evidence that abortion denial does cause lasting harm.
Women denied abortion have worse financial outcomes
First, the Study found that women denied abortion experienced more financial problems than women who aborted. In a 2018 article in the American Journal of Public Health, Foster and her colleagues conclude “Women denied abortion were more likely than were women who received an abortion to experience economic hardship and insecurity lasting years.” In a 2023 American Economic Journal paper examining a different set of economic metrics, Foster et al similarly found “Women who were denied an abortion experience a large increase in financial distress that is sustained for several years.”
Women denied abortion struggle more to bond to their children.
Second, the Study found that women who give birth after being denied abortion are more likely to report poor maternal bonding. In a 2018 JAMA Pediatrics article, Foster and colleagues explain they administered the Postpartum Bonding Questionnaire to study participants and found that, compared to women who aborted and birthed other children later, women denied abortion were more likely to say they felt trapped as a mother or resented their babies.
Abortion advocates frequently cite these results when arguing that denying women abortion causes significant harm.
Almost without exception, when journalists, legislators, and abortion proponents reference the Turnaway Study, they do so to discuss the above findings to argue either that abortion does not harm women or that abortion denial does. They rarely, if ever, acknowledge the Turnaway Study findings that directly undermine these popular pro-abortion narratives.
The Turnaway Study’s Overlooked Findings
Women denied abortion say they no longer wish they’d aborted.
According to the Turnaway Study, of the women who gave birth after being denied an abortion, 96% said they no longer wished they’d aborted.
This statistic is derived from a 2021 Social Science and Medicine article. I say “derived from” because the researchers do not frame this finding in terms of who no longer wishes they’d aborted, but instead in terms of who continues to wish they had. Here is how they explain it:
One week after being denied the abortion, 59% of participants answered “yes” and 6% responded “don’t know” when asked if they still wished they could have had the abortion … These proportions declined to 11% “yes” and 1% “don’t know” by the first interview after the birth of the baby. When combining “yes” and “don’t know” responses in the logistic models, 65% gave these responses one week after abortion denial … This proportion declined sharply to 12% by the first interview after the birth of the baby (adjusted OR = 0.37 per month, 95% CI: 0.30, 0.47), and then leveled off, with 7% reporting that they still wished they could have had the abortion (or didn’t know) around the child’s first birthday and 4% at five years.
So five years after abortion denial, when asked if they still wished they could have had the abortion, 4% of women responded “yes” or “don’t know”–meaning 96% responded “no.”
The article also explains that “subsequent positive life events and bonding with the child also led to positive retrospective evaluations of the denial” and “shifts in participants’ feelings from negative to positive occurred in parallel with growing bonds with the baby.” Or, as one Turnaway Study interviewee explained it:
I bring down tears sometimes when I see him, I’m like, oh my God, how could it pass my head to have an abortion, and now I have a lovely son, you know, that I adore so much, that I love so much, you know?
In the book “The Turnaway Study,” the chapter on mental health further concludes “There are no long-term differences between women who receive and women who are denied an abortion in depression, anxiety, PTSD, self-esteem, life satisfaction, drug abuse, or alcohol abuse.”
In other words, despite abortion advocates claims of the lasting harms of abortion denial, the Turnaway Study itself found that (1) the overwhelming majority of women who gave birth after being denied an abortion said they no longer wished they’d aborted, and (2) women who aborted and women who were denied abortion had the same long-term life satisfaction.
Study proponents minimize this finding.
ANSIRH downplays these findings. The findings aren’t mentioned on ANSIRH’s website about the Turnaway Study, discussed in their summary of Turnaway Study publications, or referenced in their fact sheet about the effects of abortion denial. In contrast with the Study’s more popular results, the finding that women who give birth say they no longer wished they’d aborted is rarely even hinted at, much less the focus of media coverage.
So it was striking when New York Times columnist Ross Douthat referenced the finding in an op-ed. It was also striking when Turnaway Study researcher Diana Greene Foster felt compelled to write a letter to the editor objecting. Her framing is instructive (emphasis added):
As Mr. Douthat notes, we found that most women denied abortions eventually reconcile themselves to parenting. But Mr. Douthat glosses over the most important findings from the study.
Foster interprets women no longer wishing they’d aborted (including explicitly citing their love for their children) as “reconciling themselves to parenting,” and she believes that this result is relatively unimportant compared to other findings.
Contrast the way Turnaway Study researchers describe women who don’t regret aborting with women who don’t regret being denied abortion: they characterize the former as normal, expected, and healthy (the article title includes the phrase “decision rightness”), but pathologize the latter in terms of coping with involuntary life events (the article title talks about “contextualizing”).
There is nothing in the actual survey questions to justify this framing. Instead the assumptions appear to arise from the researchers’ own preconceived ideas about abortion, fetal personhood, and the relative importance of our economic struggles compared to our relationships with our children.
Women denied abortion experience increased economic hardship–at first.
Another element of the Turnaway Study infrequently mentioned is the finding that greater economic hardship for women denied abortion (compared to women who aborted) decreased over time and often disappeared entirely. In other words, women who aborted and women who were denied abortions ultimately had very similar financial situations.
The American Journal of Public Health publication by Foster and colleagues focused on economic metrics of employment, receipt of government assistance, and income. They found that, six months after either abortion or abortion denial, women denied abortion were more likely to be unemployed; receiving WIC, food stamps, or TANF; and living in households with income below the Federal Poverty Level. However, over time many of these metrics converged. By the end of the study period, both women who aborted and women denied abortion had similar household incomes, personal incomes, and levels of employment.
The American Economic Journal publication focused on economic metrics of debt, credit scores, and credit available. Here Foster et al reported even fewer differences, and what differences they did measure were shorter lived. In fact, at no point during the study period were there statistically significant differences between women who aborted and women denied abortion in terms of their access to credit or their ability to borrow money. Markers of financial distress (for example, debt sent to collection agencies or low credit scores) were worse initially for women denied abortion, but converged three years into the study. By the end of the study period, none of the metrics examined in this paper were statistically significantly different between the two groups.
It would be interesting to also compare the economic outcomes of (1) women who gave birth after abortion denial to (2) women who gave birth after unintended pregnancies for which they did not seek abortion to begin with. However that comparison was beyond the scope of the Study.
As it stands, the Study comes to the unsurprising conclusion that, at least initially, having children is more expensive than not having children. It’s perhaps more surprising that the Study found these differences in financial wellbeing converge as soon as they do.
Women denied abortion emotionally bond normally to their babies.
The Turnaway Study finds poorer maternal bonding for women who give birth after abortion denial (compared to women who abort and have other children later). It also finds that the vast majority of women denied abortion emotionally bond to their children normally. In a 2018 article published in JAMA Pediatrics, researchers reported that 97% of women who aborted and had children later bonded normally to their subsequent babies–as did 91% of women who gave birth after abortion denial.
Notably, this survey was conducted when the children were 18 months old. Recall that, from the time of the child’s first birthday until five years after the abortion denial, the same group of women became increasingly likely to report they no longer wished they’d aborted. It’s plausible they would similarly be more likely to report normal emotional bonding as time went on.
Meanwhile, the article regarding children’s wellbeing also found that “perinatal and child health outcomes were not different” between the two groups of children, and there was “no clear pattern of delayed child development.” Compared to children born subsequently to women who had aborted, children born to women denied abortion were equally likely to be breastfed, and no more likely to be born prematurely, be admitted to NICUs, have low birth weight, or have physical disabilities. The two groups of children were equally likely to reach developmental milestones for fine motor skills, self-help skills, social emotional skills, and receptive and expressive language.
Full Findings Paint a Different Picture
The Turnaway Study is known for finding that women who abort view the abortion as the right decision for them, and when women are denied abortion they struggle more with finances and bonding to their children. However the study also found that economic differences diminished or disappeared over time, at least 90% of women denied abortion bonded normally to their babies, and nearly all women who gave birth after abortion said they no longer wished they’d aborted.
These findings combined paint a more complex picture than abortion as liberation and abortion denial as subjugation. According to the Turnaway Study, whether women abort or are denied abortion, they overwhelmingly report positive retrospective evaluation of their situations. Their economic outcomes improve over time, and they raise and love their children.