Being denied a wanted abortion may have detrimental health effects in the long term

1. The authors of this prospective cohort study found that women who were denied a wanted abortion were found to have higher rates of chronic headaches and migraines.

2. There were no significant differences observed in reports of overall health or chronic pain among women who received a first-trimester absorption compared to a second-trimester abortion.

Evidence Rating Level: 2 (Good)

Study Rundown: The authors of this study evaluated the long-term health effects of women with unwanted pregnancies who sought out an abortion and were denied, compared to women who gave birth. The paper built on existing literature which found that women who gave birth after being denied an abortion reported various pregnancy complications compared to women who had abortions. Specifically, this study assessed the physical health of women five years after seeking out abortion services and compared it to the health of those women that were denied. The authors found that being denied a wanted abortion may be associated with detrimental health effects in the long term such as chronic headaches and migraines. Such findings do not provide any evidence of negative health consequences for women who have an abortion, but rather highlight the potential health effects of those who are denied this procedure. This study had several limitations. Of note, the outcome measures were self-reported and therefore may have been subject to recall bias. Further, the authors acknowledged that 41% of participants were lost to follow-up at 5 years.

Click to read the study in Annals of Internal Medicine

Relevant Reading: Long-term physical health consequences of abortion in Taiwan, 2000 to 2013: A nationwide retrospective cohort study

In-Depth [prospective cohort study]: The authors conducted this prospective cohort study using the Turnaway Study data, which is a 5-year prospect cohort of women who sought abortions at U.S. clinics between January 2008 and December 2010. Study outcomes were self-reported and included chronic pain, asthma, gestational and nongestational hypertension and diabetes, in addition to other measures. A total of 1132 women seeking abortion were consented for the study and 874 were included in the final analysis. The average age of the subjects was 25 years and 80% were unmarried. There were 33% White, 32% African American, 22% Hispanic and 13% women from unknown/other racial and ethnic groups. The authors found that women who had a first trimester abortion had reduced odds of being in fair or poor health at the 5 year follow up (adjusted OR, 0.87 [95% CI, 0.77 to 0.98]). These results were compared with women who sought an abortion but ended up giving birth. They were found to have increased odds of being in fair or poor health at 5 years (adjusted OR 1.23 [CI, 1.01 to 1.51]). Furthermore, the authors also found that women who gave birth had higher rates of chronic headaches and chronic joint pain. There were no differences in mortality between the two groups of women.

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