Unreliable Turnaway Abortion Study Violated Women's Privacy Rights, New Report
October 29, 2024 (Pensacola, FL)
A prominent study cited in abortion rights lawsuits is based on the unethical use of personal identifying information, according to a new peer reviewed report.
In addition, the report catalogues numerous ways the Turnaway Study has violated the accepted standards for reporting scientific results. The report is authored by David Reardon, director of the Elliot Institute and the author of over 40 peer reviewed studies examining the harms of unwanted abortions on women.
Background of Turnaway Study
Data for the Turnaway Study was collected by ANSIRH, a department at the University of California San Francisco dedicated to advancing abortion access both domestically and abroad. The Susan Thompson Buffett Foundation, which has provided over $4 billion dollars to advance Malthusian population control efforts is the department’s largest benefactor.
Over fifty papers have been published based on the Turnaway Study data collected with the help of thirty clinics.
Most recently, in an effort to prove that women who are denied abortions suffer economic harms, ANSIRH provided the personally identifying information of the participants to Experian to retrieve their credit history data, including a summary of court appearances.
Credit History Data Retrieved Without Permission
Based on ANSIRH’s published reports, Reardon’s study was able to document that the study participants were never informed that their credit records would be pulled or examined, much less asked for permission to do so. His queries to Turnaway Study authors to provide any evidence to the contrary were rebuffed.
“Retrieving credit history data without the knowledge or consent of study participants is a clear and grave violation of research ethics,” said Reardon. “It is even worse that this was done using the names and addresses of women who had immediately dropped out of the study.”
Over 170 women who had told abortion clinic workers that they were willing to be interviewed by ANSIRH later refused to participate in the first interview. Several hundred more dropped out before subsequent interviews.
“It is simply wrong to assume that a study participant’s consent to be interviewed includes tacit permission to access their credit histories and court records—especially eight years after they had already withdrawn from the study—without ever informing them of this intent,” said Reardon.
Non-Random, Non-Representative Sample
Reardon’s critique also charges that the Turnaway Study papers are deficient in that they rely on a non-random and non-representative sample of abortion clinic patients. Not all abortion patients were invited to participate. And of the non-random group invited, only 31% participated. Of these, over half dropped out before the end of the study.
The resulting self-censure bias was highlighted in another investigation authored by Reardon. It replicated the Turnaway Study’s own decision satisfaction question in a random national survey. That study revealed that the 31% who agreed to take part in the Turnaway Study were very dissimilar to the 67% of women in the national sample who reported the highest levels of pressure to abort and the most negative outcomes. Conversely, the Turnaway Study sample was most like the 33% of women in the national sample who faced the least pressures to abort and the fewest negative outcomes.
In short, the Turnaway Study does not equally represent all the types of women who have abortions.
Adulterated Grouping Further Diminishes the Value of Turnaway Study Analyses
Theoretically, the Turnaway Study is intended to find differences between women who have had abortions and women who were turned away by abortion clinics due to state laws banning abortion after fetal viability, the turnaway group.
But in in most Turnaway Study reports, ANSIRH fails to distinguish between the 160 women who gave birth and the 50 women who went on to get abortions at another abortion clinic. In addition, hidden in the details of another ANSIRH report is the fact that 40% of women in the turnaway group had histories of prior abortions.
“If we want to understand the differences between having an abortion and not having an abortion, much less being denied abortions, you need to properly separate these groups of women before you analyze the differences,” Reardon said. “ANSRIH could and should have done this. But they didn’t. Instead, they deliberately mix women with a history of prior abortions, and women who even went on to get abortions elsewhere, into their so called ‘turnaway group.’ This means their two groups overlap. In their abortion group, 100% have had abortions. In their turnaway group, over 40% of women had abortions. This completely obscures a researcher’s ability to observe any differences between having and not having an abortion.”
Reardon believes ANSIRH deliberately introduced these methodological inconsistencies in order to shift their results in a manner that would allow them to be interpreted in a way that advances ANSIRH’s own ideological mission.
STROBE Reporting Standards Routinely Violated by ANSIRH
The guidelines for publishing research results are described by STROBE (STrengthening the Reporting of OBservational studies in Epidemiology).
STROBE instructs authors to carefully “give a cautious overall interpretation of results considering objectives, limitations, multiplicity of analyses, results from similar studies, and other relevant evidence.”
According to Reardon, ANSIRH’s studies often ignore this standard. Specifically, in the Turnaway Study credit history analysis, the researchers found that there were actually very few statistically significant differences in credit history between their abortion and turnaway groups. The few differences that were found were related to delinquent debt and credit scores. Specifically, the average past-due debt of women in the turnaway group rose from $938 in the years prior to their pregnancy to $1750 afterwards (an $812 difference). Additionally, in the five years after seeking an abortion, the average credit score of the turnaway group was 550 compared to 558 for the abortion group.
Using ANSIRH’s published statistics, Reardon calculated what epidemiologists call the Cohen’s d measure of effect size for each of the very few statistically significant differences. In every case, based on the standard conventions for interpreting degrees of effect, each difference should have been described as a “very small effect.”
Despite these statistical findings, ANSIRH redefined these very small differences as “large.” Indeed, their conclusions asserted that their study had proven that there is “strong evidence that being denied an abortion had large effects on markers of financial distress” (emphasis added). According to Reardon, this conclusion exaggerated effect size, ignored the fact that most of the credit history comparisons were not significantly different, and falsely recharacterized a small $812 increase in average debt load as “financial distress.”
Reardon argues that ANSIRH’s framing of their conclusion in this way is a clear violation of STROBE guidelines. In addition, he argues that ANSIRH’s own data, when fully considered, directly contradicts their dire conclusion. Specifically, when women in both groups were asked if they had a “lack of enough money,” there was no significant differences between the two groups. Therefore, according to their own self-assessments, neither group was experiencing higher rates of “financial distress.”
Most importantly, according to Reardon, hidden in other ANSIRH reports is the fact that almost all the women who gave birth in the turnaway group reported they were glad they had not had abortions. They did not bemoan being “denied” abortions. Instead, in light of his own research on the high prevalence of unwanted abortions, Reardon believes it is most likely that the birthing women in ANSIRH’s turnaway group would most likely describe their experiences as having been spared rather than denied abortions. If that is so, the average increase of $812 in household debt was most likely accepted as a small price to pay for having an unplanned but very welcomed child.
Reardon Calls for Retraction or Revision of Turnaway Study
“The unethical use of personal identifying information from human subjects, which in this case was used to obtain credit and court case data without the permission of the study’s subjects, is grounds for retraction,” Reardon said.
“Moreover, ANSIRH researchers should be required to revise their published conclusions in all of their other studies according to STROBE guidelines. They need to retract their exaggerated conclusions. Given their non-random, non-representative convenience sample, they should be required to emphasize that their results should not be used to draw any conclusions applicable to the general population of women. They are only useful for pre-testing hypotheses worthy of additional investigations. Claiming anything more than that is political posturing. Women deserve better.”
Online version of this news release.
References
Reardon DC. Turnaway Study Report Unethically Violated Participants’ Privacy and Misleads Public with a Non-Representative Sample, Selective Reporting, and Overstated Conclusions. Issues Law Med. 2024 Fall;39(2):140-169. doi: 10.70257/TWGF1217. PMID: 39446261.
Reardon DC, Rafferty KA, Longbons T. The Effects of Abortion Decision Rightness and Decision Type on Women’s Satisfaction and Mental Health. Cureus. 2023 May 11;15(5):e38882. doi: 10.7759/cureus.38882. PMID: 37303450; PMCID: PMC10257365.
