The Turnaway Study
Awarded 2013
Large Research Grants
Diana Greene Foster, PhD
University of California, San Francisco

The majority of all abortions in developing countries are performed in unsafe or illegal conditions, the consequences of which can be severe—including infection, infertility, and death. To understand the use and sequelae of illegal abortion and the effects of access to safe abortion services, a prospective longitudinal study of women with unwanted pregnancies is needed. A prospective study is possible where abortion is legal but where a gestational limits, and other barriers to care, prevent some women seeking legal abortions from receiving them. We propose to follow these excluded women over time, and compare their health outcomes to women who receive legal abortions just under the gestational limit. We seek to adapt the successful, prospective cohort design of our ongoing study in the US, the Turnaway Study, to improve measures of the sequelae of abortion in developing countries. We propose this new research to improve understanding of how women learn about and seek illegal abortions by pursuing the following three specific aims: 1. Develop tools to measure knowledge of, access to and complications from illegal abortion following denial of legal abortion care. 2. Establish the feasibility of conducting a prospective cohort study among women seeking abortions in Tunisia, Nepal, Bangladesh and South Africa. 3. Assess the appropriateness of comparison groups and evaluate the extent of illegal abortion-seeking following denial of legal abortion services.