When Missouri Governor Mike Parson signed a bill in May effectively outlawing abortion in the state, he proclaimed it would "protect women's health." That idea has been a staple of anti-choice legislation in recent years, often used to justify increasingly draconian rules regarding when and where—or even whether—a woman has access to abortion.
As these laws work their way through the courts, it's worth investigating this talking point. Setting aside debates about when life begins, does terminating a pregnancy present long-term health risks for the mother?
A new study that tracked a group of women for five years after they either had or were denied the procedure finds that the answer is no.
"Although some argue that abortion is detrimental to women's health, the study data indicates that physical health is no worse in women who sought and underwent abortion than in women who were denied abortion," writes a research team led by Lauren Ralph of the University of California–San Francisco. "Rather, differences emerged suggesting worse health among those who gave birth."
The researchers analyzed data from the Turnaway Study, which comprises women who sought, but did not always receive, an abortion at one of 30 clinics in the United States in 2008, 2009, and 2010. Participants gave detailed medical histories when they agreed to take part in the program; they then provided semiannual reports on their health via telephone interviews for the following five years.
The research, published in the Annals of Internal Medicine, featured 874 women: 328 who obtained a first-trimester abortion, 383 who obtained a second-trimester abortion, and 163 who were denied the procedure because they were too far along to have it according to the clinic's guidelines. All members of the latter group ultimately gave birth.
At each interview, participants rated their current overall physical health on a five-point scale from "very good" to "very poor." They also reported whether they were dealing with chronic pain, and described any other health problems they were suffering.
After taking into account a variety of factors that could affect health, including race, education, and economic hardship, the researchers found two clear patterns.
"There were no significant differences in self-rated health, chronic pain, or obesity between women who had a first-trimester abortion and those who had a second-trimester abortion," they report. "However, there were several significant differences in trajectory between women who had an abortion and those who gave birth."
Five years after having or being denied an abortion, "27 percent of women who gave birth reported fair or poor health, compared with 20 percent and 21 percent of those who had a first- or second-trimester abortion, respectively."
More specifically, the researchers found that, "[after] five years, 23 percent of women who gave birth reported chronic headaches or migraines." Among those who'd had abortions, that figure was 17 to 18 percent. Similarly, those who'd given birth were significantly more likely to report chronic joint pain than those who had not.
In an accompanying editorial, Lisa Harris and Vanessa Dalton of the University of Michigan Department of Obstetrics and Gynecology argue that these results are important "because they come from the first large, prospective study of abortion outcomes that has the right comparison group: Women with an unwanted pregnancy [who] gave birth when abortion was denied."
"The research consistently found that women who ended their pregnancies fared as well [as] or better than women who gave birth," the two M.D.s write. These findings confirm that "birth always carries more risk for morbidity and mortality than abortion."
"Through the lens of this study," they conclude, "health exceptions to abortion bans would apply ... well, always."