Five Years After Abortion, Nearly All Women Say It Was the Right Decision, Study Finds

Five years after having an abortion, over 95 percent of the women in a landmark UC San Francisco study said it was the right decision for them.

The findings, published Sunday, Jan. 12, 2020, in Social Science & Medicine, come as many states are requiring waiting periods and counseling for women seeking abortions, based on the assumption that they may regret having them.

But the researchers at UCSF’s Advancing New Standards in Reproductive Health (ANSIRH) found no evidence that women began to regret their decisions as years passed. On the contrary, the women reported that both their positive and negative feelings about the abortion diminished over time. At five years, the overwhelming majority (84 percent) had either positive feelings, or none at all. 

This debunks the idea that most women suffer emotionally from having an abortion.

“Even if they had difficulty making the decision initially, or if they felt their community would not approve, our research shows that the overwhelming majority of women who obtain abortions continue to believe it was the right decision,” said Corinne Rocca, PhD, MPH, associate professor in the UCSF Department of Obstetrics, Gynecology and Reproductive Sciences, and first author of the study. “This debunks the idea that most women suffer emotionally from having an abortion.”

The researchers analyzed data from the Turnaway Study, a five-year effort to understand the health and socioeconomic consequences for nearly 1,000 women who sought abortions in 21 states around the country. The analysis included 667 participants who had abortions at the start of the study. The women were surveyed a week after they sought care and every six months thereafter, for a total of 11 times. 

While women did not report regretting their decision, many did struggle initially to make it. Just over half said the decision to terminate their pregnancy was very difficult (27 percent) or somewhat difficult (27 percent), while the rest (46 percent) said it was not difficult. About 70 percent also reported feeling they would be stigmatized by their communities if people knew they had sought an abortion, with 29 percent reporting low levels and 31 percent reporting high levels of community stigma.

Those who struggled with their decisions or felt stigmatized were more likely to experience sadness, guilt and anger shortly after obtaining the abortion. Over time, however, the number of women reporting these negative emotions declined dramatically, particularly in the first year after their abortion. This was also true for those who initially struggled with their decision. 

And relief was the most prominent emotion reported by all groups at the end of the study – just as it was at every time point in the study.

"This research goes further than previous studies, in that it follows women for longer, and was conducted on a larger sample from many different clinics throughout the U.S.,” said Julia Steinberg, PhD, an assistant professor in the department of family science at the University of Maryland, College Park, who wrote an accompanying commentary on the study in Social Science & Medicine. “It shows that women remain certain in their decision to get an abortion over time. These results clearly disprove claims that regret is likely after abortion.” 

Authors: Corinne Rocca, PhD, MPH, Diana Foster, PhD, Heather Gould, MPH, and Katrina Kimport, PhD, of UCSF; and Goleen Samari, PhD, MPH, of Columbia University’s Mailman School of Public Health.

Funding: The study was supported by research or institutional grants from the Wallace Alexander Gerbode Foundation, the David and Lucile Packard Foundation, the William and Flora Hewlett Foundation, and an anonymous foundation. 

Disclosures: The researchers had no competing interests to disclose.

About ANSIRH: Advancing New Standards in Reproductive Health (ANSIRH), based at the University of California, San Francisco, conducts rigorous scientific research on complex issues related to reproductive health in the United States and internationally. ANSIRH provides much-needed evidence for active policy debates and legal battles around reproductive health issues. Please visit www.ansirh.org.

About UCSF: The University of California, San Francisco (UCSF) is exclusively focused on the health sciences and is dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. UCSF Health, which serves as UCSF’s primary academic medical center, includes top-ranked specialty hospitals and other clinical programs, and has affiliations throughout the Bay Area.