This review begins with a detailed focus on the Turnaway Study, which addresses associations among early abortion, later abortion, and denied abortion relative to various outcomes including mental health indicators. The Turnaway Study was comprised of 516 women; however, an exact percentage of the population is not discernable due to missing information. Extrapolating from what is known reveals a likely low of 0.32% to a maximum of 3.18% of participants sampled from the available the pool. Motivation for conducting the Turnaway Study, methodological deficiencies (sampling issues and others), and bias are specifically addressed. Despite serious departures from accepted scientific practices, journals in psychology and medicine have published dozens of articles generated from the study's data. The high volume of one-sided publications has stifled dialogue on potential adverse psychological consequences of this common procedure. Following a critical analysis of the Turnaway Study, an overview of the strongest studies on abortion and mental health is offered. This comprehensive literature comprised of numerous large-scale studies from across the globe has been largely overlooked by scientists and the public, while the Turnaway Study dominates the media, information provided to women, and legal challenges involving abortion restrictions. In the final section of this article, literature reviews by professional organizations are considered, demonstrating that the biased science characterizing the Turnaway Study is aligned with a pervasive and systemic phenomenon wherein deriving reliable and valid results via careful attention to methodology and scrutiny by the scientific community have been supplanted by politics.
"Comte argued long ago that the basis for the success of science was experience and observation. We now know that that is only part of the story, albeit an important part. Nevertheless, we can use this argument to remember that the basis for our trust in science is, in fact, experience and observation - not of empirical reality, but of science itself . It is what Comte argued long ago: that just as we can only understand the natural world by observing it, so we can only understand the social world by observing it. When we observe scientists, we find that they have developed a variety of practices for vetting knowledge - for identifying problems in their theories and experiments and attempting to correct them. While these practices are fallible, we have substantial empirical evidence that they do detect error and in-sufficiency. They stimulate scientists to reconsider their views and, as warranted by evidence, to change them. This is what constitutes progress in science." ( Oreskes, 2021 , p. 64).
The Turnaway Study explored responses of women (including minors) who obtained or were denied abortions around the gestational limit of clinics throughout the United States ( Turnaway Study Operating Procedures Manual, 2016 ). The authors also included women who had first trimester abortions for comparison purposes ( Turnaway Study Operating Procedures Manual, 2016 ). More specifically, the authors recruited participants with three distinct profiles: (1) women whose pregnancies were dated between one day and three weeks after clinic gestational limits and were therefore unable to secure an abortion; (2) women whose pregnancies were between one day to two weeks shy of the clinic gestational limit and had an abortion; and finally, (3) women who had a first trimester abortion ( Turnaway Study Operating Procedures Manual, 2016 ). Most of the participants in the Turnaway Group (68%) gave birth; 32% had abortions at another location or had a miscarriage or stillbirth ( Miller et al., 2020 ). According to Miller et al. (2020 ), the investigators checked for eligibility and then relayed information about a phone interview that would transpire at 6-month intervals over five years. Topics included aspects of women's mental and physical health, background characteristics, and questions on the health and development of participants' children ( Turnaway Study Operating Procedures Manual, 2016 ). Baseline interviews occurred approximately 1 week after having or being denied an abortion ( Turnaway Study Operating Procedures Manual, 2016 ).
In January 2022, Kaiser Health News[1] interviewed Turnaway Study principal investigator, Foster, reporting, ''Data from the Turnaway Study has resulted in the publication of more than 50 peer-reviewed studies, and the answer to nearly all the questions asked, said Foster, is that the women who got abortions fared better in respect to economics and health, including their mental health, compared with those who did not have abortions.'' In an article in the December 2021 issue of Scientific American,[2] a sociology professor, Amanda Stevenson was quoted as saying, "It's impossible to overstate how scholarly the design of the study is."
The purpose of this review article is to step back from the far-reaching and laudatory comments in major media and popular press that have described the study as ''debunking most anti-abortion arguments'' (New Yorker, 7-7-20[3]), proving ''restricting abortion harms women'' (Ms. Magazine, 6-30-20[4]), and as "landmark" [Scientific American (see footnote 2)] to examine what can be gleaned from the study's inception to efforts to answer the question replete with political ramifications, does abortion place women at risk for mental health problems?
Following a detailed analysis of the Turnaway Study, an overview of the strongest studies available world-wide related to abortion and mental health is provided. This comprehensive literature has been largely ignored as the Turnaway Study dominates the media, information provided to women, and legal challenges involving abortion restrictions. In the final section of this article, literature reviews by professional organizations are addressed to illustrate that the biased science characterizing the Turnaway Study is aligned with a pervasive and systemic phenomenon wherein scientific principles have been held captive by a political agenda that has no room for vetting knowledge and skeptical scientists.
In 2016, Martin observed that Warren Buffett had provided a minimum of $88,000,000 to the University of California San Francisco's (UCSF) reproductive health research institute, with the funds supporting researchers with outspoken political agendas.
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