Publications > Abortion

Emotions and decision rightness over five years following an abortion: An examination of decision difficulty and abortion stigma

Researchers found that the vast majority of women felt that abortion was the right decision for them after five years.

  • Rocca CH, Samari G, Foster DG, Gould H, Kimport K. Social Science & Medicine. January 2020.

Self-reported physical health of women who did and did not terminate pregnancy after seeking abortion services: a cohort study

Researchers found that the physical health of women who have a first or second trimester abortion is no worse than those who gave birth. Instead, across several measures of chronic pain and overall self-rated health, women who give birth after being denied a wanted abortion fare worse than women who receive a wanted abortion.

  • Ralph LJ, Schwarz EB, Grossman D, Foster DG. Annals of Internal Medicine. June 2019

Estimating the proportion of Medicaid-eligible pregnant women in Louisiana who do not get abortions when Medicaid does not cover abortion

This research found that about one fourth of Medicaid-eligible pregnant women give birth instead of having an abortion because Medicaid does not cover abortion. Restrictions imposed by the Hyde Amendment are an insurmountable barrier to obtaining an abortion for women.

  • Roberts SCM, Johns NE, Williams V, Wing E, Upadhyay UD. BMC Women's Health. June 2019.

Comparison of health, development, maternal bonding, and poverty among children born after denial of abortion vs after pregnancies subsequent to an abortion

The first known US study to examine the association of access to abortion with outcomes for children, observing both children born from pregnancies for which the woman was denied an abortion and children born from subsequent pregnancies to women who received an abortion.

  • Foster DG, Biggs MA, Raifman S, Gipson J, Kimport K, Rocca CH. JAMA Pediatrics. November 2018. 

Association of facility type with procedural-related morbidities and adverse events among patients undergoing induced abortions

The study looked at data from more than 50,000 abortions and found no difference in complications for abortions that were performed in ambulatory surgical centers versus office-based settings.

  • Roberts SCM, Upadhyay UD, Liu G, Kerns JL, Ba D, Beam N, Leslie DL. JAMA. June 2018.

Effect of counseling quality on anxiety, grief, and coping after second-trimester abortion for pregnancy complications

The study found that when the provider involved the woman in decision making, she was more likely to feel satisfied with her decision. Women who had shared decision making and those who felt satisfied with their decision showed less grief and post-traumatic stress.

  • Kerns JL, Mengesha B, McNamara BC, Cassidy A, Pearlson G, Kuppermann M. Contraception. June 2018. 

Identifying national availability of abortion care and distance from major US cities: systematic online research

The study found 27 states in the US that qualify as “abortion deserts”—cities where people have to travel 100 miles or more to reach an abortion clinic. There are “abortion deserts” in every region of the country except the Northeast.

  • Cartwright AF, Karunaratne M, Barr-Walker J, Johns NE, Upadhyay UD. Journal of Medical Internet Research. May 2018. 

Socioeconomic outcomes of women who receive and women who are denied wanted abortions in the United States

The paper finds that being denied a wanted abortion, compared with being able to obtain abortion care, results in significant increase in household poverty and reduction in full time employment. 

  • Foster DG, Biggs MA, Ralph L, Gerdts C, Roberts S, Glymour MM. American Journal of Public Health. March 2018. 

The impact of a parental notification requirement on Illinois minors' access to and decision-making around abortion

This study examines the impacts of the parental notification law in Illinois and shows that increased parental involvement did not increase parental support or the minor’s certainty about her decision. In fact, researchers found negative outcomes for minors in the year following the law’s enactment.

  • Ralph LJ, King E, Belusa E, Foster DG, Brindis CD, Biggs MA. Journal of Adolescent Health. March 2018.

Effectiveness and safety of early medication abortion provided in pharmacies by auxiliary nurse-midwives: A non-inferiority study in Nepal

Researchers compared women receiving medication abortion from trained auxiliary nurse-midwives at either a pharmacy or a government health facility. The study found that the care given at pharmacies was just as safe and effective as in clinics.

  • Rocca CH, Puri M, Shrestha P, Blum M, Maharjan D, Grossman D, Regmi K, Darney PD, Harper CC. PLOS One. January 2018.

A harm-reduction model of abortion counseling about misoprostol use in Peru with telephone and in-person follow-up: A cohort study

This study tested a way to guide women to safer abortion options within restrictive legal limits.

  • Grossman D, Baum SE, Andjelic D, Tatum C, Torres G, Fuentes L, Friedman J. PLOS One. January 2018.

Safety of medical abortion provided through telemedicine compared with in person

The study looked at data from Iowa patients who received a medication abortion either via telemedicine or in person. Of the nearly 20,000 patients studied, only 49 complications were reported, and there was no difference in the complication rate between women who had an in-person visit and those who received the service via telemedicine.

  • Grossman D, Grindlay K. Obstetrics and Gynecology. October 2017. 

Evaluating the impact of a mandatory pre-abortion ultrasound viewing law: A mixed methods study

This paper found that women seeking abortions overwhelmingly go through with the abortion, even when required to view the ultrasound image before the procedure.

  • Upadhyay UD, Kimport K, Belusa EKO, Johns NE, Laube DW, Roberts SCM. PLOS One. July 2017.

Women’s mental health and well-being 5 years after receiving or being denied an abortion

In this five-year longitudinal study, women who received abortions showed no greater levels of mental distress, such as depression and anxiety, than women who were denied abortions. In fact, women denied abortions experienced greater short-term distress than women who received them. 

  • Biggs MA, Upadhyay UD, McCulloch CE, Foster DG. JAMA Psychiatry. December 2016. 

Comparison of outcomes before and after Ohio's law mandating use of the FDA-Approved protocol for medication abortion: A retrospective cohort study

This research debunked an Ohio law purporting to improve women’s safety by requiring out-of-date medication abortion care, proving it actually led to worse outcomes.

  • Upadhyay UD, Johns NE, Combellick SL, Kohn JE, Keder LM, Roberts SC. PLOS Medicine. August 2016. 

The effect of abortion on having and achieving aspirational one-year plans

Women who received a wanted abortion were more likely to have and achieve aspirational goals compared to women denied an abortion.

  • Upadhyay UD, Biggs MA, Foster DG. BMC Women's Health. November 2015. 

The role of the nonpneumatic antishock garment in reducing blood loss and mortality associated with post-abortion hemorrhage

A simple tool called Lifewrap was found to reduce bleeding resulting from unsafe abortions—a substantial cause of maternal deaths worldwide.

  • Manandhar S, El Ayadi AM, Butrick E, Hosang R, Miller S. Studies in Family Planning. September 2015. 

Decision rightness and emotional responses to abortion in the United States: A longitudinal study

Women experienced decreasing emotional intensity over time, and the overwhelming majority of women felt that termination was the right decision for them over three years. Emotional support may be beneficial for women having abortions who report intended pregnancies or difficulty deciding.

  • Rocca CH, Kimport K, Roberts SCM, Gould H, Neuhaus J, Foster DG. PLOS ONE. July 2015. 

A comparison of depression and anxiety symptom trajectories between women who had an abortion and women denied one

Women who received an abortion had similar or lower levels of depression and anxiety than women denied an abortion. Our findings do not support the notion that abortion is a cause of mental health problems.

  • Foster DG, Steinberg JR, Roberts SC, Neuhaus J, Biggs MA. Psychological Medicine. January 2015.

Beyond political claims: women’s interest in and emotional response to viewing their ultrasound image in abortion care

Ultrasound viewing appears not to have a singular emotional effect. The presence of state regulation and facility policies matters for women's interest in and responses to viewing.

  • Kimport K, Weitz TA, Foster DG. Perspectives on Sexual and Reproductive Health. December 2014.

Incidence of emergency department visits and complications after abortion

Abortion complication rates are low and comparable to previously published rates, even when ED visits are included and there is no loss to follow-up.

  • Upadhyay UD, Desai S, Zlidar V, Weitz TA, Grossman D, Anderson P, Taylor D. Obstetrics & Gynecology. December 2014.

Acceptability and clinical outcomes of first- and second-trimester surgical abortion by suction aspiration in Colombia

Second-trimester surgical abortion in an outpatient primary care setting in Colombia can be provided safely, and satisfaction with these services is high.

  • DePiñeres T, Baum S, Grossman D. Contraception. September 2014.

Does abortion reduce self-esteem and life satisfaction?

Women denied an abortion initially reported lower self-esteem and life satisfaction than women who sought and obtained an abortion.

  • Biggs MA, Upadhyay UD, Steinberg J, Foster DG. Quality of Life Research. April 2014.

Buccal misoprostol plus laminaria for cervical preparation before dilation and evacuation at 21-23 weeks of gestation: a randomized controlled trial

Adjuvant buccal misoprostol results in slightly shorter dilations and evacuations (D&Es) at the cost of more side effects.

  • Drey EA, Benson LS, Sokoloff A, Steinauer JE, Roy G, Jackson RA. Contraception. April 2014.

Relationship between ultrasound viewing and proceeding to abortion

Voluntarily viewing the ultrasound image may contribute to a small proportion of women with medium or low decision certainty deciding to continue the pregnancy; such viewing does not alter decisions of the large majority of women who are certain that abortion is the right decision.

  • Gatter M, Kimport K, Foster DG, Weitz TA, Upadhyay UD. Obstetrics & Gynecology. January 2014.

Telling stories about abortion: abortion-related plots in American film and television, 1916-2013

This analysis empirically describes the number of abortion-related plotlines in American film and television.

  • Sisson G, Kimport K. Contraception. January 2014.

Understanding why women seek abortions in the US

Study findings demonstrate that the reasons women seek abortion are complex and interrelated, similar to those found in previous studies.

  • Biggs MA, Gould H, Foster DG. BMC Women’s Health. July 2013.

Effects of abortion legalization in Nepal, 2001–2010

The liberalization of abortion policy in Nepal has benefited women’s health, and likely contributes to falling maternal mortality in the country.

  • Henderson JT, Puri M, Blum M, Harper CC, Rana A, et al. PLOS ONE. May 2013.

Safety of aspiration abortion performed by nurse practitioners, certified nurse midwives, and physician assistants under a California legal waiver

Abortion complications were clinically equivalent between newly trained nurse practitioners, certified nurse midwives, and physician assistants and physicians, supporting the adoption of policies to allow these providers to perform early aspirations to expand access to abortion care.

  • Weitz TA, Taylor D, Desai S, Upadhyay UD, Battistelli MF, Waldman J, Drey EA. American Journal of Public Health. January 2013.

Denial of abortion because of provider gestational age limits in the United States

The incidence of being denied abortion will likely increase, disproportionately affecting young and poor women.

  • Upadhyay UD, Weitz TA, Jones RK, Barar RE, Foster DG. American Journal of Public Health. September 2013.

Prostaglandins for first-trimester termination

Evidence now demonstrates that more than 200 mg of mifepristone provides no additional benefit, that vaginal misoprostol is superior to oral, especially between 7 and 9 weeks' gestation, and that misoprostol may be safely self-administered at home.

  • Meckstroth KR, Darney PD. Best Practice & Research: Clinical Obstetrics & Gynaecology. October 2003.

Acceptability and feasibility of early pregnancy termination by mifepristone-misoprostol: Results of a large multicenter trial in the United States

American women found abortion with the use of mifepristone and misoprostol acceptable. Even most with unsuccessful outcomes would select the regimen again and recommend it to others. Most providers and women thought that home use of misoprostol should be available for women who prefer it.

  • Winikoff B, Ellertson C, Elul B, Sivin I, Mifepristone Clinical Trials Group. Archives of Family Medicine. July 1998.