The reasons women have abortions are not simple and thus can be difficult to study and/or categorize. That’s one reason why the two most recent previous studies on abortion reasons, from the Guttmacher Institute, date from 2005 and 1988.
Now, though, the same team from University of California, San Francisco (UCSF) that brought us the “Turnaway” study, has used the same data set to lay out the reasons the nearly one thousand women in their study had abortions. While their data set included more women with advanced pregnancies and reasons did not always fit into clear categories, the results are revealing nonetheless.
The article, “Understanding why women seek abortions in the U.S.,” was published in the July 5, 2013, edition of BMC Women’s Health and can be freely accessed.
As noted above the authors, M. Antonia Biggs, Heather Gould, and Diana Greene Foster, all participated in the “Turnaway” study. They are part of the Advancing New Standards in Reproductive Health (ANSIR) project at the Bixby Center for Global Reproductive Health at the University of California, San Francisco (UCSF), the notorious abortion research center from the west coast.
Biggs and her fellow researchers began the “Turnaway” study in 2008. They were specifically looking to contrast the consequences of those who received abortions versus those who were “denied” abortions. Women were “denied” either because available abortionists were not trained or facilities were not equipped to handle those women presenting at those particular gestations, or because state law, for some reason, prohibited abortions at a particular stage.
We discussed this study in a five-part series National Right to Life News Today ran back in January. (Part Five, with links to four previous articles, can be found here.)
The UCSF team took data from the same set of 956 women, 273 who received first trimester abortions, 452 who obtained abortions just under the gestational limits, and 231 who sought but did not receive abortions. They asked them two open ended questions: the first about why they sought an abortion, and, second, what their main was reason behind the request. (Two women out of the 956 in the study did not answer questions on the reasons for their abortions.)
The findings are both illuminating and ambiguous. Women rarely gave a single reason and often gave additional, maybe even different reasons when pressed as to their main reason. Researchers attempted to gather these into basic themes or categories, but some of these were harder to categorize than others.
For example, one 19 year old gave the following list: “I already have one baby, money wise, my relationship with the father of my first baby, relationship with my mom, school.” Another woman, 27 years old, said “My relationship is newer and we wanted to wait. I don’t have a job, I have some debt, I want to finish school and I honestly am not in the physical shape that would want to be to start out a pregnancy.”
These cover the gamut–financial, relationship, school, and, in the way that some count it, even maternal health.
Essentially, the study authors decided just to identify certain general themes and then count every time a woman gave a response in this category. The authors seem to have abandoned the effort to identify a woman’s primary reason for abortion, as that data is not listed anywhere. Thus the best one can do with this data is to simply see how often women offered a particular rationale.
Researchers found 40% of these women mentioning something financial, 36% in some way discussing the bad “timing” of the pregnancy, 31% raising a partner issue, 29% speaking of “other children,” 20% talking of the child somehow interfering with future opportunities.
Less than 20% mentioned something about not being emotionally or mentally prepared (19%), health related reasons (12%), wanting a better life than she could provide (12%), not being independent or mature enough (7%), influence of family or friends, and not wanting to have a baby or to place a baby up for adoption (4%). 
These do not add to 100%, of course, because women tended to give more than one reason. And some other important qualifications need to be made to give a proper analysis
Looking more carefully at the data
These responses reflect a women’s self-reported subjective assessment, not some independent analysis of her situation. As such, it is a good guide to her perceptions (or at least to her beliefs about what others will consider an acceptable justification). But they do not necessarily tell us the facts about her circumstances.
For example, though we know from demographic data reported by the authors that 45% of women participating in the survey were receiving public assistance and that a considerable portion (40%) were not able to indicate that they had “enough money in the past month to meet basic needs,” we do not know what these women’s precise income was or what mix of public and private resources were available in their communities.
Would they have arrived at the same conclusion if someone had sat down with them, looked at the sort of resources available to them, and given them the sort of budget planning advice and assistance that is available at many local pregnancy care centers?
Finances are an issue for many a young couple starting out, and it is common to wonder or even worry as to exactly how one can “afford” a baby. Some circumstances are admittedly more dire than others, but it is remarkable how that year after year, decade after decade, century after century, people, some with larger families, find ways to give birth to all their children and care for them.
How much these women were aware of or considered taking advantage of these resources is unknown 
Twelve percent is a higher figure than we are accustomed to seeing citing “health” reasons, but a few caveats are needed here as well. To start with, this study group includes more women with advanced pregnancies than would be found in a general sample of aborting women. This could mean a slightly higher likelihood of physical issues (though researchers specifically excluded any women seeking abortions for “fetal anomaly” from their sample and concluded, in contrast to some other previous studies, that gestational age was not a factor here). But a bigger issue, again, is that these are subjective reports of concerns about possible health problems with the mother or the unborn child, not medical determinations of any particular risk.
Data and interviews bear this out. Almost half of the 12% reported were attributed to concerns that the woman had about the impact of her own tobacco, alcohol, or drug use on the health of her child or on her ability to care for the child. One woman said, “because I had been doing drinking and the medication I’m on for bipolar is known to cause birth defects and we decided it’s akin to child abuse if you know you’re bringing your child into the world with a higher risk for things.” There is no indication that this mother or any of the other patients giving these answers had medical tests showing any problem with the child, or were told by a doctor that having a child posed any threat to the mother’s health.
Other issues like “timing” are amorphous and hard to analyze. About 34 points of the 36% raising this issue said they simply weren’t “ready,” that it wasn’t the “right time.” Discussions involving timing often bled into other more tangible issues related to finances, school, or work schedules. Sometimes this was simply expressed in terms of emotional stress. Two percent expressed concerns about being “too old.”
Women often mentioned concerns about already born children when talking about timing or finances and nearly one in three (29%) mentioned this concern about other children overall. Though the sample here in this study is somewhat different in composition, the percentage of women reporting already having or caring for at least one child (62%) is similar to national figures on abortion patients having previously given birth obtained by Guttmacher and the U.S. Centers for Disease Control.
How much would change if partners were supportive and encouraging and women felt they would have help raising another child (women said 8% of partners were “not supportive,” 6% of partners did not want baby, 3% were abusive). No indication, again, of whether women knew of or had access to other support in their wider communities.
One thing useful that the study does is to match reasons with demographics. Perhaps not surprisingly, younger women seeking abortion were more likely to report concerns about immaturity, a lack of independence, or the child interfering with future plans. Younger women also more frequently mentioned the influence of family or friends either in pressuring to have an abortion or as people from whom they trying to keep their pregnancies secret by aborting.
African American women were more likely to report problems with their partner but less likely to report being emotionally or mentally unprepared to raise a child at the time. Women who were separated, divorced, or widowed were more also likely to report partner issues.
Women who were employed were half as likely to report a health related reason, while those who had a history of depression or an anxiety diagnosis were more than three times more likely to mention health.
It is not clear why, but women with more than a high school education were more likely to express concerns about not being financially prepared and to want to abort because they said they desired a better life for the child than the mother felt she could provide.
Some women (4%) simply admitted they wanted abortions because they didn’t want a baby or didn’t want any children and/or wouldn’t consider adoption. More than two thirds (68%) of the women saying this had never born a child. A handful of women sought abortions because of legal issues they were going through (3 women) or because of fear of giving birth (2 women).
Some of what we learned
Though it is not brought out in any detailed analysis here, it is worth noting that despite what appears to be a general resolve to abort among women in the study, data on the same women in the turnaway study show that, even as little as one week later, more than a third of the women (35%) were no longer convinced that abortion was the outcome they wanted. How many more shared that view once the child was born is not addressed here or in that earlier paper.
Identifying one single approach that will address every woman’s concerns and change her mind is difficult, given the multiplicity of the reasons and rationales given by women for seeking abortion. Some will be benefited by being connected to better support systems, while others need practical economic assistance. Anything making men more responsible for the children they father will go a long way towards helping many of these women care for their children.
Yet abortion’s legality and the implied social sanction that comes with it is clearly a major part of the cultural machinery that forces these cruel choices on women, that lets men off the hook, that leaves women to care for households of children all alone, and that makes society less accommodating to the demands of motherhood. Collectively such factors may conspire to force many of these women to consider an option that goes totally against their nurturing natures and pit the needs of one or more of their children against another.
If we believe the survey, most of the women seeking to abort here did so, not because they were triumphantly exercising their “power to choose,” but because they felt like–given the circumstances–they had no other realistic choice. Abortion forces on them a cruel, violent, destructive option that does little to solve their basic social or economic problems, problems, which may, in part, themselves be a consequence of Roe’s forced cultural transformation.
Those women would find better options and more respect for their rights and responsibilities as women and mothers with abortion off the table.