Abstract
Objectives
To understand how having or being denied an abortion affects the likelihood of trying
to become pregnant, overall pregnancy rates, and the rate and timing of an intended
pregnancy in the future.
Study design
The Turnaway Study is a prospective cohort study of women who received or were denied
a wanted abortion. Women were recruited from one of 30 US abortion facilities. We
examined subsequent intended pregnancy among those who presented just under the facility's
gestational limit and received an abortion (Near-Limit Abortion Group, n=413) and those who presented for abortion just beyond the facility's gestational
limit, were denied an abortion and went on to parent the child (Parenting Turnaways,
n=146). First, we modeled the probability of trying to become pregnant using multivariable
mixed-effects logistic regression. We then used Cox proportional-hazards models to
compare overall pregnancy rates and intended pregnancy rates over 5 years.
Results
Parenting Turnaways had lower predicted probabilities of reporting trying to become
pregnant in the first 1.5 years after birth/abortion than the Near-Limit Abortion
Group. They also had lower pregnancy rates overall [40.4 per 100 woman-years vs. 53.5
per 100 woman-years, adjusted hazards ratio (aHR)=0.69, 95% confidence interval (CI):
0.54–0.89]. The 5-year intended pregnancy rate was low among both groups, but compared to the Near-Limit Abortion
Group, Parenting Turnaways had a lower intended pregnancy rate (2.2 per 100 woman-years
vs. 7.5 per 100 woman-years, aHR=0.29, 95% CI: 0.10–0.85).
Conclusion
Being able to obtain a wanted abortion may enable women to have an intended pregnancy
later.
Implications
Ensuring that women can obtain an abortion for an unwanted pregnancy may enable them
to have a subsequent pregnancy when they are ready to have a baby.
Keywords
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Article info
Publication history
Published online: September 20, 2018
Accepted:
September 16,
2018
Received in revised form:
September 14,
2018
Received:
February 12,
2018
Identification
Copyright
© 2018 Published by Elsevier Inc.
