Editor's note: This article was updated on June 24 to reflect the Supreme Court’s decision to reverse Roe v. Wade. And the info here applies to all people seeking abortions, but we sometimes use the words “women” and “maternal health” in this guide.
There’s no ‘standard’ abortion patient. Rather, deciding to end a pregnancy is an individual decision that can hinge on a number of considerations including health, finances, relationships, and life plans. And now seems like the right time to take a closer look at why women decide to get abortions, after the Supreme Court overturned Roe v. Wade, leaving abortion access up to the states to decide.
Abortion is “a lot more common than people realize because it’s not talked about all the time,” Dr. Marta Perez, OB-GYN and assistant professor at WashU School of Medicine, told theSkimm. “A lot of people say ‘Abortion isn’t for me, I would never get an abortion,’ which is totally fine. And everyone’s allowed to make that choice. But we shouldn’t apply our scenario onto other people.”
The fact is many people decide to get abortions. One in four women will have an abortion by age 45, according to the Guttmacher Institute, a sexual and reproductive health policy and research org. So we talked through some of the reasons for ending a pregnancy — the obvious and less so — with Dr. Perez.
Someone might consider getting an abortion when…
Their pregnancy is life-threatening.
“Pregnancy itself is risky,” said Dr. Perez. That’s certainly the case in the US, where maternal mortality rates are much higher than in other developed countries. And where women of color, in particular, can face barriers to getting quality care (see: systemic racism in health care). Being pregnant, even under favorable circumstances, puts a lot of demands on many different systems in the body. So carrying a baby to term can be especially challenging for someone with a preexisting condition like diabetes or heart disease. Dangerous conditions that could require abortion health care services include: preeclampsia, ectopic pregnancies, and miscarriage.
They’re worried about their mental health.
“We already know that being pregnant and postpartum are high-risk times for mental health conditions,” Dr. Perez said. Postpartum depression impacts one in seven moms. And even those are “conservative” estimates, according to Dr. Perez. “I would say it’s probably even higher than that, because it’s something that goes undiagnosed.” Thing to know: The Turnaway Study, which looked at the long-term consequences of going through with an unwanted pregnancy, found that women who had abortions were less likely than those denied the procedure to experience anxiety and low self-esteem later on.
They can’t pay for childcare and/or don’t have paid family leave.
Only a quarter of US workers have access to paid family leave, because the US is still the only industrialized country without a paid family leave policy. At the same time, studies show that taking fewer than 12 weeks off to care for a baby has been associated with worse long-term mental health for mothers. And child care can cost more than $13K in the first year alone. Juggling those costs, while losing wages when taking off from work to recover from childbirth — might not be manageable. ‘I can’t afford a baby now’ was a major reason for abortions, according to some studies. And no, adoption is not always a reasonable alternative to abortion.
They’re faced with fetal anomalies.
Knowing that the pregnancy may not result in a healthy baby can be a primary factor in someone’s decision to get an abortion, Dr. Perez said. A prospective parent might be worried about their child’s quality of life and potential physical suffering, whether the baby tests positive for an inherited disorder or a debilitating genetic condition. In a Guttmacher Institute study, 8% of US women surveyed said fetal health concerns had a major role in their abortion decisions.
Their contraception method failed, and they don’t want kids.
Birth control doesn’t work 100% of the time. And experts say that abortion is largely not — and shouldn’t be — treated as a form of birth control. But it can fail. In Guttmacher surveys, half of US abortion patients reported that they'd used contraception in the same month that they became pregnant. More data, fwiw: The CDC found that six in 10 women who got an abortion in 2019 hadn’t gotten one before.
They’re not ready to be a mother yet.
More than 50% of abortion patients get the procedure due to timing and decisions around family size, according to the Guttmacher Institute. In surveys, women cite “educational goals” as a reason to delay having children so that they’re better positioned economically before becoming mothers. Of note: A small study suggests that children born to mothers who were denied abortions could have worse health and development outcomes compared to those born to women who earlier received an abortion.
They’re already a mother.
According to Guttmacher research, more than half of abortion patients had at least one previous birth. And the Turnaway Study found that denying women a wanted abortion could have negative consequences for her existing children. Read: Those kids had lower child development scores than the kids of mothers who received a wanted abortion at some point.
They don’t have a supportive relationship or family.
'Not wanting to be a single mother' is a factor for about half of US women who want an abortion. We don’t need to tell you that raising a child solo can create more pressure and stress for a parent. But it can also add extra challenges for her child, this study suggests. Another data point: According to the Turnaway Study, women denied abortions are more likely to stay tethered to abusive partners.
They’ve experienced rape or incest.
About 1% of women who get abortions were pregnant through rape, and less than half a percent of abortion patients were pregnant through incest, according to Guttmacher surveys. So those aren’t common reasons to end a pregnancy, but they’re reasons that were once widely accepted as abortion exceptions. Now, more and more bills banning abortions are leaving out those exceptions.
As Dr. Perez put it, “Giving birth and carrying a pregnancy is not something that’s simple, straightforward, and just an isolated nine-month event in someone’s life.” And the decision around getting an abortion is not a simple, monolithic one, either. So when reproductive rights are debated, it’s important to remember that the decisions behind getting an abortion are personal, complex, and valid.
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