Does being denied an abortion have long-term physical health consequences?

Although the impact of abortions on mental and short-term health has been examined a great deal, there has not been a lot of focus on the long-term health consequences of giving birth compared with having an abortion. A recent study, appearing in the Annals of Internal Medicine, chronicled the physical health of women 5 years after they either received or were denied abortion services.

Data for the cohort study were from the Turnaway Study, which followed women who sought but did not necessarily receive abortions at US clinics between January 2008 and December 2010. Participants rated their current overall physical health on a semiannual basis for 5 years following a baseline interview.

The average age of the 558 participants was 25 years. One-third (33%) were white, one-third (32%) were African American, one-fifth (22%) were Hispanic, and 13% were from other racial/ethnic groups. Eighty percent of participants were unmarried and one-third were living below the federal poverty level. One-fifth (19%) reported that their prepregnancy health was fair or poor.

Women who gave birth were younger (mean age 23.4 years) than those who obtained a second-trimester abortion (mean age 24.5 years) and those who obtained first-trimester abortions (mean age 26.0 years). Furthermore, women who had a first-trimester abortion were more likely to report a history of prepregnancy depression or anxiety than women who obtained a second-trimester abortion or gave birth (32% vs 21% and 21%, respectively). Prepregnancy obesity also differed by group: women who had a first-trimester abortion were more likely to be obese (30%) than women who had a second-trimester abortion or gave birth (16% and 16%, respectively).

Although there were no significant differences between women who had a first- and second-trimester abortions in longitudinal models comparing self-rated health, chronic pain, or obesity, there were several differences between women who gave birth and those who had an abortion. Women who had a first-trimester abortion had reduced odds of being in fair or poor health over 5 years (aOR 0.87 [95% CI, 0.77 to 0.98]). On the other hand, women who gave birth showed an increase in fair or poor health over that period (aOR 1.23 [95% CI 1.01 to 1.51]).

A similar trajectory was seen in regard to women with chronic pain. Women who had a first-trimester abortion reported a decrease in headaches or migraines (aOR 0.80 [95% CI 0.68 to 0.94] and women who gave birth reported increased head pain over time (aOR 1.29 [95% CI1.01 to 1.65]). Women who reported chronic joint pain and who gave birth reported an increase in pain over time compared with women who had a second-trimester abortion. Trajectories for chronic abdominal pain, back pain, pelvic pain, other pain, and obesity did not differ between women who gave birth and those who had an abortion.