Background Popular support for access to abortion and contraceptive services is often based on the idea that they will help women determine the trajectory of their life course. This study examined whether receiving versus being denied an abortion affects aspirational life goal setting and attainment 5 years later.

Methods We compared women who sought and were denied an abortion because they were 3 weeks beyond the gestational limit (‘Parenting-Turnaways’) to those who received an abortion in the first trimester (‘First-Trimesters’); received an abortion within 2 weeks of the facility’s gestational limit (‘Near-Limits’); and sought an abortion, were turned away and received an abortion elsewhere or placed their baby for adoption (‘Non-Parenting-Turnaways’). We used mixed effects logistic regression analyses to estimate the odds of setting an aspirational plan and to estimate the odds of both setting and achieving an aspirational 5-year plan.

Results At 1 week post abortion-seeking, 791 women reported 1864 5-year plans, most of which were aspirational (n=1692, 91%). Parenting-Turnaways had lower odds of setting an aspirational 5-year plan than Near-Limits (OR 0.36, 95% CI 0.18 to 0.73). There were no differences by group in achieving aspirational 5-year plans among those who had them.

Conclusions Soon after abortion-seeking, women denied a wanted abortion were less optimistic about their long-term futures than women who received a wanted abortion. Abortion access can help women set positive long-term goals.