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The effect of receiving versus being denied an abortion on making and achieving aspirational 5-year life plans
  1. Molly A McCarthy1,
  2. Ushma Upadhyay2,
  3. Lauren Ralph2,
  4. M Antonia Biggs2,
  5. Diana Greene Foster3
  1. 1 Department of Health Promotion, University of Nebraska Medical Center, Omaha, Nebraska, USA
  2. 2 University of California San Francisco (UCSF), San Francisco, California, USA
  3. 3 Advancing New Standards in Reproductive Health (ANSIRH), UCSF, Oakland, California, USA
  1. Correspondence to Dr Molly A McCarthy, Department of Occupational Therapy, Creighton University, Omaha, NE 68178-0170, USA; mollymccarthy{at}


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.

  • abortion
  • goal-setting
  • long-term goals
  • aspirational plans
  • life goals
  • unintended pregnancy

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  • Contributors DGF conceptualised, designed and supervised this study. MAM, UU and DGF conducted statistical analyses, with support from LR and MAB. MAM drafted the manuscript. All the authors revised the manuscript critically for important intellectual content, and all the authors approved the final version and agree to be accountable for all aspects of the work.

  • Funding This study was funded by grants from the Wallace Alexander Gerbode Foundation, the David and Lucile Packard Foundation (Project Grant A126385), the William and Flora Hewett Foundation (Institutional Grant A117053) and an anonymous foundation (Project Grant A108127).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.