When women are denied an abortion, their children fare worse than peers

What will happen if Americans lose the constitutional right to abortion? Not all women who need an abortion would find a way to get one. Many would carry the unwanted pregnancy to term and give birth.

The discourse around abortion tends to focus on women and generally fails to consider how being denied an abortion affects the children a pregnant woman already has and those she may have in the future. The research is clear: Restricting access to abortion doesn’t just harm women — it harms their children as well.

For the past decade, I have been leading the nationwide Turnaway Study at the University of California, San Francisco. My colleagues and I have followed more than 200 women who were denied abortions because they showed up at abortion facilities too late in pregnancy. More than two-thirds of these women carried the unwanted pregnancy to term and gave birth. Our study shows that denying a woman a wanted abortion has a negative impact on her life and the lives of her children.

More than half of women who seek abortions are already mothers. There are three sets of children whose lives may be affected by whether a woman receives or is denied an abortion:

• the child or children a woman already has when seeking an abortion
• the child born from an unwanted pregnancy
• the child or children born from a pregnancy after an abortion

By comparing the outcomes of children of women who were denied abortions to those of more than 400 women who received abortions, we have been able to see the impact of abortion on women’s existing and future children.

Our latest research, published in the Journal of Pediatrics, shows what happens to women’s existing children. Consistent with mothers’ concerns that raising a new child would limit their ability to care for their existing children, we found significantly worse socioeconomic outcomes for children whose mothers were denied abortions than those who received them: a greater chance of living below the poverty level (72 percent compared to 55 percent) or living in a household without enough money to cover food, housing, and transportation (87 percent compared to 70 percent).

We also saw a small but significant reduction in achieving developmental milestones among children whose mothers were denied abortions compared to those who received them, possibly related to the increased financial strain on the family.

Among women who seek an abortion but are denied it, more than 90 percent choose to keep and raise the child rather than place it for adoption. What is life like for these children? We compared children born after their mothers were denied abortions to the next children born to women who received abortions. Writing in JAMA Pediatrics, we showed that children born to women who were denied abortions fared worse. They were more likely to live in households where there wasn’t enough money to pay for basic living expenses. Women are also much more likely to report poor maternal bonding — feeling trapped as a mother, resenting their baby, or longing for the “old days” before they had the baby — with the child born after abortion denial than with the next child born following a wanted abortion.

One explanation for these differences is that pregnancies after an abortion are much more likely to be intended than those for which an abortion was sought. As we wrote in the journal Contraception, women who received a wanted abortion were more likely to have an intended pregnancy in the next five years than women who carried an unwanted pregnancy to term. In other words, being able to access abortion gives women the opportunity to have a child later with the right partner, at the right time.

A woman in the Midwest who had an abortion six months after the birth of her first child and who had another baby five years after her abortion told us, “It would have been probably the worst thing for that child to come into this world because it would have never had the support it needed. I wasn’t mentally stable for that child. I do have a 1-year-old now and I am able to support myself, able to support my kids, and know the timing is right. Financially, now, it all makes sense. … But, to have two [children] 12 months apart without that abortion, there’s just no way I would be where I am right now if I would have kept that child.”

Whether to have an abortion can be a difficult decision to make. The fetus could develop into a unique person that would never get another chance to be born. A woman must also consider her own life goals, which may include taking care of her existing children, and the chance to have children under better circumstances when she can better take care of herself and a new baby.

The decision is a complicated balancing of responsibilities and opportunities that must be weighed by each woman, not made by politicians or Supreme Court justices. If a woman wants an abortion and cannot get one — a likely outcome for many if abortion becomes even more restricted than it already is — she will face diminished opportunities to achieve other life goals, gain secure financial footing, and have a child she can cherish and support.

Diana Greene Foster, Ph.D., is the director of research at Advancing New Standards in Reproductive Health, a collaborative research group at the University of California, San Francisco’s Bixby Center for Global Reproductive Health.