I'd like to start by telling you the story of two women born early
in the 20th century. They lived on different coasts,
they had different religious backgrounds and they were in different stages of life when each experienced
an unwanted pregnancy. Sally was newly married
at the start of the Great Depression. She and her husband decided they couldn't afford
to start a family yet, but abortion was illegal in New York City, and so she traveled to Puerto Rico
to get an illegal abortion. Dorothy had recently graduated
from high school when she became pregnant
by a much older golf instructor. Her conservative parents shunned her and she had to go away to a Salvation Army home
for unwed mothers, where she gave birth
and placed the child for adoption. These women were my grandmothers, and they're part of the reason
I became a demographer and professor studying the causes and consequences
of unintended pregnancy. For years, people have alleged
that abortion harms women. The idea that abortion causes
mental health harm in particular has been used to justify laws
that ban abortion or try and dissuade people
from choosing it. This came to a head in 2007, when Supreme Court Justice Anthony Kennedy allowed restrictions on abortion to stand because, as he said,
"While we find no reliable data to measure the phenomenon, it seems unexceptionable to conclude that 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." "No reliable data"? Those are words a demographer lives for. (Laughter) We began data collection
the very next year. (Applause) (Cheers) To study the outcomes
for people who get abortions, you need a comparison group, ideally people who want an abortion
and can't get them, because they would be
in exactly the same circumstances, but one group gets the abortion
and the other group doesn't. My research team
at the University of California, San Francisco, went to 30 abortion facilities
across the country, each one selected because it was distant enough
from other clinics that if someone were too far along
in pregnancy for that clinic, there was very few
other places they could go. At each site, we focused
on recruiting two groups of people, women who were just under the limit
and got their abortions, and women who showed up
a little bit too late in pregnancy and were turned away. I called it the Turnaway Study, and the study design was a success. In analyzing the data, we see those two groups
were the same at the start. Women who received
and women who were denied abortions had similar mental health, physical health
and socioeconomic well-being at the time they sought an abortion. We followed almost a thousand women, calling them every six months
for five years, using scientifically validated questions
to measure their physical health, their mental health
and their families' well-being. And we can see that although
they started the same, those two groups, their lives diverged in ways
that could be directly attributed to whether they got their abortion
or were turned away. And it didn't work out the way that Kennedy had
"unexceptionably" concluded. (Laughter) In fact, we found
no mental health harm from abortion. Instead, we saw higher anxiety,
lower self-esteem, lower life satisfaction for the people
who were denied the abortion. But this difference didn't last. Over time, the two groups looked the same, not because both groups were doing poorly
in terms of mental health. In fact, symptoms of depression
and anxiety improved for both groups over time. But the two groups diverged
in other important ways. We find worse physical health for women who carried the pregnancy to term and gave birth. Consistent with the vast
medical literature, we see that childbirth is associated
with greater risks than abortion, including hemorrhage, eclampsia, and even death. And the differences in physical health
don't end at the time of childbirth. For years later, we saw
higher chronic pain, more hypertension and overall worse physical health
for women who were denied the abortion and gave birth. We also find large
socioeconomic differences, where women who are denied abortions face more hardships
than women who receive abortions. We find an increase in public assistance, but it's not enough to make up
for a loss of full-time employment. Women, often raising children alone, end up falling below
the federal poverty level. Working with economists, I was able to show that those who received
and those who were denied abortions were similar economically for years
before the year of the unwanted pregnancy, but for years after, we see more debt,
lower credit scores and a greater chance
of eviction and bankruptcy for people who were turned away. And one other area
of difference I'll mention. We see differences in the chance that women set and achieve
aspirational plans for their future. This includes things like breaking ties
with abusive partners, finding high quality
romantic relationships, getting advanced educational degrees, financially supporting
their older children and even differences in the chance
of having an intended pregnancy later. The results of my study consistently show that when there is a difference, those who were able
to get their wanted abortion did better than those who weren't. This may come as a surprise to people who don't think
about why women get abortions. Women often give many reasons: housing and financial circumstances, their relationship with the man
involved in the pregnancy, their need to take care
of existing children. More than half of those
seeking abortions nationally are already parenting at least one child. All of the areas
women were concerned about -- finances, children,
relationships, life aspirations -- were the areas
in which we see differences. In the experiences
of those denied abortions, we see all their concerns
playing out exactly as they anticipated when they were deciding
whether to have an abortion. Their concerns were justified. Over the five years we followed them, we see that over 95 percent
of those who received their abortion said it was the right decision for them. Very few of those people who gave birth decided to place a child for adoption. Less than 10 percent. So there's another example of a Supreme Court justice
making an assumption that turned out to be wrong. You may remember Amy Coney Barrett, in deliberating on ending 50 years
of abortion rights in our country, suggested that women could
drop their babies off at fire stations. We find that once people
have taken the risk and made the monumental sacrifice
of giving birth to a child, most people decide to parent that child. Adoption is not an easy choice. And in fact, the women
who placed children for adoption were the most likely to say that they were having difficulty
coping with their experience. It's not news to me that some people
think abortion is wrong, but when someone's in the circumstance
where they are pregnant and they cannot support a child
and take care of their existing children or make a decent life for themself, they're trying to make a decision that is right for their life
and their family. As the abortion provider
Dr. George Tiller used to say before his murder in 2009: Trust women. (Applause) Access to safe, legal abortion
is important for all of us. Unintended pregnancy
is very common in my family, in all of our families, across our country,
in red states and blue states, and across the globe. I've worked with scientists
in Tunisia, Colombia, South Africa, Bangladesh and Nepal to study the experiences of people
who are pregnant when they aren't ready. And we see these same concerns
about wanting to have children under the right circumstances. Access to abortion is universally, fundamentally important
to the well-being of families. (Applause) The overwhelming international trend
is towards liberalizing abortion laws and not, like the United States,
of imposing new restrictions. Until the United States
rejoins the rest of the world, there is a lot we can do
to support pregnant people, whether they do or do not
want to carry that pregnancy to term. We need much more generous
and less punitive supports for low-income families, like income supports, extended periods of health care coverage, child care and parental leave, so nobody decides to end
an otherwise wanted pregnancy for economic reasons alone. But when someone's in the position
where they don't have the circumstances where they want to raise a child and they want to end their pregnancy, they need the information
and resources to do so safely. Since the 2022
Supreme Court Dobbs decision that overturned Roe and ended federal protections
for abortion rights, we see that people who are experiencing
an unwanted pregnancy are determined. People have strong motivation because they understand the consequences
of carrying an unwanted pregnancy to term. People who have the resources
to circumvent their state law by traveling or ordering
medication abortion pills online, do. Now with large swaths
of the Southern United States and Midwest without a single legal abortion clinic, women who can travel hundreds of miles to get an abortion out of state. People without the emotional and financial
and social resources to travel -- that includes minors and immigrants and people whose travel is restricted
because of their own health or the law -- will experience all the hardships
we've documented in the Turnaway Study. The importance
of control over childbearing is also shown in the stories
of my grandmothers. My father's mother, Sally, got her abortion in Puerto Rico
and went on with her life, which included
having three children later, when her financial footing
was more secure. She was warm and funny
and a wonderful mom. My -- (Applause) My other grandmother, who gave birth, she experienced severe
complications from childbirth, both physical and emotional. After placing my mother for adoption, she struggled to find
strong romantic relationships and she never did get
to have more children, although she desperately wanted to. My mother found her when I was 12, and she and I became very close. She was my nearest relative
when I went off to college at UC Berkeley and she even came to visit me when I was in graduate
school at Princeton. And I was the one by her side,
holding her hand, when she died many years later. (Applause) What I think about her experience
is that her life took a detour when she got pregnant as a teenager and she never found a way
to get back on the track she wanted. The experiences of my grandmothers
are consistent with the Turnaway Study, and also show us what to expect
in this post-Dobbs world. What we know is that being able to make one's own decision
about childbearing without government interference is crucial for the economic
well-being of families and allows people to pursue
personal and educational goals, including having wanted children later. Access to abortion is about control over one's body, life and destiny. Thank you. (Applause and cheers)
