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Alana Casanova-Burgess: My name is Alana Casanova-Burgess filling in for Melissa Harris-Perry and this is The Takeaway. Looming on so many people's minds these last few months has been the future of abortion care in America, which may soon become more restrictive depending on upcoming decisions by the Supreme Court. Cases like Dobbs V Jackson Women's Health Organization, which is challenging Mississippi's new law that bans abortions after 15 weeks of pregnancy are more far-reaching than meets the eye. If the Supreme Court rules in favor of the Mississippi law, it could further erode reproductive rights across the country. What effect will that have on women who seek that care?

It's a question that has been hard to answer scientifically. Researchers can't just randomly assign outcomes to women in order to study what happens to them. A new study has found a way around that problem, The Turnaway Study led by researchers at the University of California, San Francisco found that pregnant women who were denied an abortion fared far worse in several aspects of their life. That includes educationally, financially, physically, and mentally. Here to talk with us on the long-term effects women face when denied an abortion is science and health journalist Mariana Lenharo. Mariana, thank you for joining us.

Mariana Lenharo: Thank you so much for having me.

Alana Casanova-Burgess: What are the major findings of this study?

Mariana Lenharo: This study compared women who received an abortion and women who were denied an abortion because they were too far along in their pregnancies. Those are very similar groups with the exception of one receiving the abortion and the other being denied an abortion. In terms of the socioeconomic consequences of being denied an abortion, the study found that women who were denied an abortion were much more likely to live in poverty than the ones who received an abortion, so 61% of women denied an abortion lived below US federal poverty levels in comparison to 45% of the ones who received the abortion.

They were also more likely to be unemployed, more likely to be receiving financial benefits from the temporary assistance for needy families, and they were more likely to report not having enough money for living expenses. The study also compared the credit scores of these two groups of women. They looked back a few years into their credits course and they learned that their financial circumstances were trending very similarly up until the point where they seek abortion. In that moment, women who were denied an abortion, they suffer an increase of debt in the number of negative public records like bankruptcy or eviction.

Alana Casanova-Burgess: Can you explain more about how the research was conducted? What made the study so comprehensive compared to previous research?

Mariana Lenharo: Yes. This is a very big study, so they recruited almost 1000 women in 30 abortion facilities over 21 states in the United States. As you mentioned before, it's very hard to measure the impact of abortion because you can't randomly assign an abortion or deny an abortion to have a perfect experiment. What this study did which was very clever according to the researchers that I interviewed is that they found a natural experiment. Many women are already being denied an abortion because they are too far along in their pregnancies when they go to these facilities.

What the author of this study designed was that they compared these women who were seeking an abortion and were too late in their pregnancies with women who were late in their pregnancies but they were just under the gestational limit and they received the abortion. According to many of the scientists that I interviewed, this was a very clever way to compare two groups of women who had very similar backgrounds. The only difference between them was that one received the abortion and the other didn't receive the abortion.

They followed these women for five years interviewing them six months and they asked all kinds of questions about their financial situation, education, mental health, physical health, relationships, so it's very comprehensive.

Alana Casanova-Burgess: You mentioned the credit score difference and other financial effects. What about issues stemming from physical health, what did the researchers find?

Mariana Lenharo: More women who gave birth because they were denied an abortion report fair or poor physical health, so 27% of them report fair physical health compared to 20% of the women who did receive the abortion. They found two deaths in women who were denied an abortion from causes related to pregnancy or childbirth, and in the group of women who received the abortion, there weren't any cases of deaths.

Alana Casanova-Burgess: What about mental health?

Mariana Lenharo: Abortion did not increase mental health problems like anxiety or depression, but they did find short term decline in mental health among women who were denied an abortion. Many studies before had found an association between abortion and mental health problems, but that probably comes from the fact that women seeking an abortion already have existing mental health problems which may be part of why they are seeking abortion. It's an association, but it's not a causal association. In this study, they didn't find any emerging cases of depression or anxiety due to having an abortion.

Alana Casanova-Burgess: Right now, we're at a crossroads in the US as abortion laws in some states are looking to become way more restrictive. What does the study suggest about what that would mean for women across the country?

Mariana Lenharo: The study's looking into a very specific group of women. 90% of women who seek abortion in the United States are early in their pregnancies in their first trimester. This study is looking into women who are further along in their pregnancies, so it's a specific group, but according to researchers that I interviewed, these findings of this study could suggest what may happen in the United States if abortion laws become stricter. It suggests that people who are denied an abortion may suffer from these socioeconomic problems, physical health and mental health problems that the study found if they are unable to get an abortion or to travel to a place where abortion is legal for their cases.

Alana Casanova-Burgess: That was science and health reporter Mariana Lenharo. She recently wrote about The Turnaway Study for Scientific American. Thank you so much for coming on.

Mariana Lenharo: Thank you so much for having me.

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