Diana Greene Foster - The Turnaway Study: Ten Years, a Thousand Women, and the Consequences of Having—or Being Denied—an Abortion

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Copyright 2020 by Diana Greene Foster

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First Scribner hardcover edition June 2020

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Library of Congress Cataloging-in-Publication Data is available.

ISBN 978-1-9821-4156-1

ISBN 978-1-9821-4158-5 (ebook)

Note to Readers: Names and identifying details have been changed and first-person interviews have been condensed and edited for clarity.

To the women of the Turnaway Study

T en women sit in a clinic waiting room. They have come from as far as three hundred miles away, made many calls to find this place, and passed shouting protesters on the way in. One is a woman holding her husbands hand. Another is a college student with her boyfriend. Theres a woman on her phone, checking in with the roommate who is watching her three-year-old child. Another woman is also on the phone, telling someone where she is and what she is about to do. Theres a woman who looks miserable and sick. Two of the women are nervousworried about being judged for getting here late. Although most of the women are in their twenties, two are teenagers, each accompanied by a friend. The final woman, clearly upset by the protesters outside, is leafing through a book of journal entries written by others. One by one, they are called in to find out if they got to the clinic soon enough.

Did the time it took for these women to realize they were pregnant, to have conversations with partners or parents, to decide what to do, to gather enough money, to figure out where to go and how to get theredid it delay them until it was too late?

Will they receive an abortion, and what they hope will be a second chance?

Or will they be turned away?

Every day, all over the United States, this scene repeats itselfin a hospital in San Francisco; in a small clinic in the middle of Maine; in the only clinics in North Dakota and South Dakota; in a clinic in Texas on the border with Mexico; in a clinic in a Manhattan high-rise; in a big facility in Chicago; in Atlanta, Boston, Little Rock, Seattle, Louisville, Albuquerque, Tuscaloosa, Dallas, Pittsburgh, Tallahassee, Cleveland, Phoenix, Portland, Los Angeles, and in hundreds of other clinics and hospitals across the country. Every year, thousands of people are denied abortions because they show up too late in pregnancy.

This book is about what happens to women who come in just under a clinics deadline and receive a wanted abortion, and what happens to those who arrive at the very same clinics just a few days or weeks later in pregnancy and are turned away. It is also a book about the state of abortion access in our country and the people whose lives are affected by it.

Because politics drives abortion access in the United States, the cutoffthe point in pregnancy after which one is unable to get an abortiondepends on where you live. Over the decades since the 1973 landmark case Roe v. Wade, which allowed states to ban abortion only after viability and never if necessary to preserve maternal life or health, the Supreme Court has permitted states to impose a huge range of restrictions on abortion and what is required to get one. The bills became law in Georgia, Kentucky, Louisiana, Mississippi, and Ohio but immediately faced legal challenges that postponed their implementation. And regardless of where each state draws the line, many clinics wont terminate a pregnancy beyond the first trimester, and many more dont go all the way to their states legal limit because of a lack of trained providers, the presence of various laws restricting abortion facilities, or a desire to avoid attention from protesters and politicians.

The fact that many of the state abortion gestational limit laws have already led to lawsuits is by design. Lawmakers and anti-abortion activists have crafted these laws specifically to challenge Roe, hoping to provoke a lawsuit that will end up before a Supreme Court newly stacked in favor of allowing laws that ban abortion. In 2016, President Donald Trumps fiercely anti-abortion running mate and now vice president, Mike Pence, pledged on the campaign trail, If we appoint strict constructionists to the Supreme Court of the United States, as Donald Trump intends to do, I believe we will see Roe versus Wade consigned to the ash heap of history, where it belongs. I promise you. In their first term in office, the duo has turned that pledge into a genuine possibility. With the addition of Justices Neil Gorsuch and Brett Kavanaugh, the Supreme Court may now have enough conservative votes to reverse that 1973 precedent on abortion rightsthat is, to reject the Supreme Courts measured approach and instead allow states full discretion to ban abortion outright.

Since Roe v. Wade, abortion has dominated our political discussions in the United States. Political and legal efforts to restrict access to abortion have never been more intense than they have been in the past decade. Rhetoric and policy proposals have expanded from punishing abortion providers to imprisoning patients. Recently, 207 members of Congress signed a letter to the Supreme Court asking the justices to uphold in Louisiana a restrictive law similar to one the Court ruled unconstitutional in Texas in 2016. In other words, access to abortion is in greater jeopardy than it has been since Roe was decided more than forty-five years ago.

Many restrictions on abortion are passed with the justification that they make abortion safer, or prevent women who might experience regret and psychological harm from getting an abortion. The political debate about abortion has shifted in the last few decades. Instead of focusing on the rights of fetuses versus the rights of women, anti-abortion advocates and lawmakers have tried to reframe the abortion debate as a womens health issue, suggesting that abortion hurts women, leading to depression, anxiety, and suicidal thoughts. Where evidence is lacking, policymakers have routinely invented it. In 2007, Supreme Court justice Anthony Kennedy, writing the majority opinion upholding a ban on one abortion procedure performed later in pregnancy, seized an opportunity to weigh in on the emotional and mental state of women who have abortions. He wrote, While we find no reliable data to measure the phenomenon, it seems unexceptionable to conclude some women come to regret their choice to abort the infant life they once created and sustained. Severe depression and loss of esteem can follow. Clearly, in 2007, there was a serious need for reliable data on the consequences of abortion.