SIO339: The Turnaway Studies, Part 1

Transcript

This transcript was generated automatically and may contain errors — the audio is the record.

0:00:12 Thomas: Hello and welcome to Serious Inquiries Only, this is episode 339, I'm Tomas, that's Dr. Lindsey Osterman, hey, before we get started, we're bringing the Q&A's back. A reminder, I'll post a Q&A thread at the beginning of a month, you can ask any and all questions that occur to you throughout the course of the month on any episodes, I think it's better to put it there early, so you can always go back to it whenever you need to, and then at the end of the month, we'll do a Q&A. We'll answer them. We're a some cues. I'm sure there's a lot of stuff pending from the time since we were doing Q's and A's. I excited for that. Make sure to go to patreon.com/seriouspod and find that Q&A thread and look forward to one at the end of the month. Dr. Lindsey Osterman, how are you doing?

0:00:55 Lindsey: Well, yeah. Went to bed late, but it was fine, because I got up when I needed to. It

0:00:59 Thomas: I love all the comments that I've seen, you you of like, well, it's actually harder if you're a morning person and then people want to stay up and do stuff. Like, yeah, cool. So it's hard like once a week to That's harder than every single fucking day having to get up and go to work and take your kids to preschool at 6 a.m. or whatever the fuck they do. Hard. Just having a permanent excuse to get out of social gatherings. That's a lot harder than having to go work every day in the morning. That's impossible. And to take your kid.

0:01:11 Lindsey: -hm. Okay, there's more to probe here, I think. Like, yeah,

0:01:27 Thomas: Yeah, there's definitely, definitely harder to be a morning person, everybody.

0:01:30 Lindsey: I mean, you know, it's true. Men have it hard as well. That's, that is true. Like I, you know, I think, it's I possible some, some people got their feelings hurt because they thought that we were angry at them for being mourning people and that's not true.

0:01:44 Thomas: It's not. Yeah. No, it is not. Okay.

0:01:47 Lindsey: Yeah it's the structures, right? It's the systemic issues. That's

0:01:49 Thomas: That's true. The man makes us hate each other for being different, you know? Dagger was it was revealed to me, I think, that my brother might be a morning person. But like, it was just, yeah, he just stays up anyway because he's always miserable 100% of the time so I think it's hard to notice The Ghostbusters 2 quote, like, "There's so many holes in Fifth Avenue, I didn't think anybody would notice." It's like that kind of thing, they're so, it's already so bad that, but he was like, "Yeah, I feel great in the morning, I pop out of bed and then I just am miserable, like, two after hours after that, for all day." I was like, that sounds like you might be a morning person and like oh yeah I guess I am and that that's a huge blow I not mad at anyone one for being a morning person. It's just like finding out that we have to break up,

0:01:52 Lindsey: Exactly that's right no shit oh oh Wow, interesting right

0:02:28 Thomas: Cause are certain people in certain time zones that I, I would adore, I would love nothing more than to be good friends with them. But I cannot because the time zone incompatibility. And like, you know, what's really weird when you're trying to hang out with someone virtually and you're in like, like late night party mode and they're in like just woke up at the crack of dawn mode or vice versa.

0:02:28 Lindsey: It's tough

0:02:46 Thomas: Like never match your energies. You right. So similarly, when I find out someone is in the morning person, it just means we can't hang out. I won't be alive when you are alive and vice versa. It is sad. I am not mad at you. It just like, oh, okay. Out out someone's moving away. You're like, oh, that's too bad.

0:02:45 Lindsey: That's weird yeah yeah it possible that Sam's just one of those people that doesn't need much sleep, or does he need to sleep and just never gets it?

0:02:59 Thomas: Oh, think he's just such a basket case. It's hard to know. It'S just hard. And I say that lovingly as like half of the basket case that he is. It' It's all misery all the time. There' s no way to know more sleep, less sleep, who knows. Doesn' t either way. The Never. Way, one time, because I wake up dead every morning, as I' ve said, and we' ll get to the actual show in a a minute. Sorry. But I, time I was like, you know, it I must be drinking too much. So I quit drinking for a month and still every morning I would wake up exactly the same.

I wake up feeling like I have a hangover almost every morning. Like that's how bad my waking up is. And so I was, like, oh, it might be the same thing. I'm like, I don't know. I don't know. I must, I must have been an alcoholic. Must be too. So, I quit drink exactly Not the a single fucking thing changed. So it's not the alcohol. I wasn't even drinking that much anyway. I just thought like, Oh, it's I can't handle it it anymore in my older age or something. Quit that. Didn't work. I'm just miserable every single, I probably have some disorder. It'll be Thomas's disease later

0:03:06 Lindsey: Okay bummer wow goal we can fund you going somewhere for like three weeks just so that you can figure out like where your your most comfortable sleep cycle is

0:03:59 Thomas: Oh I I be allowed to talk to anyone? Is it like a retreat? Like, no. Okay. Nothing. Do I have to get rid of all electronics? Like just me and my guitar or something, you know, in a book and a candle.

0:04:03 Lindsey: No yeah that's right yeah if you want some some like stones to carve you can have that

0:04:16 Thomas: I think I would probably jump off of a cliff within two hours of that, but I made it through the other side, I would be a different person. You I'd be like, podcasting? What is that? I I am now a form of pure energy that does not need to podcast. That's one of the two. I'd

0:04:16 Lindsey: Yeah okay never mind this is a really counterproductive patreon goal then.

0:04:33 Thomas: It could be. Yeah, either way is not good for business, I don't think. All right. Well, all that delightful talk aside, let's minutes of bullshitting to kind of set up for what's more serious topic. Been wanting to do this for a while. About these abortion studies that the preview you've given me is very interesting and I'm excited to learn more about them. So

0:04:37 Lindsey: Yep. Yeah. Okay, so we recorded the episode back in May when all got leak the about Roe versus Wade being overturned. After we recorded that, I actually wrote an article for UK, The Skeptic magazine, that kind of expanded on the discussion that you and I had. And I also ended up doing some additional background reading to make some of the points a little bit more thoroughly. My good friend Carolyn suggested that I look at the Turnaway Study, in particular some of the points that I wanted to make about how deeply personally important it was for me to be able to access a safe abortion. You said you'd heard of the Turnaway Study before, is

0:05:21 Thomas: I think I actually did hear it talked about on another show, but other shows don't exist right now. So just, you know, this show's better. They probably did a bad job and you're going to do a better job.

0:05:26 Lindsey: Fair enough. Okay. Definitely going to do a thorough job. That's for sure.

0:05:32 Thomas: There we go.

0:05:33 Lindsey: So I had not heard of this before and that's a shame because it's amazing. Hard for a lot of us, I think, to not constantly ruminate about the rapid erosion of reproductive autonomy that is already well underway in this country, providers like have closed in a lot of states, and women are suffering actively as we record because of this. And as bad as this is, things are going to get worse. And one the best shots, I think, that we have to reverse the situation is for Democrats to secure the legislative majorities necessary to federally protect these rights. And there are other strategies that people advocate for, and great, do them all. This should definitely be one of the ones that we're trying to keep energy up for, right? I do think that there's a path to that outcome, but we're really going to have to defy some steep odds. And yet we absolutely have to do it.

0:06:13 Thomas: Yeah. The point of you not hearing, I mean, you're, you've got to you're an extremely well -educated woman who has never heard of what seems to me to be pretty important. And I hadn't either until like five minutes ago. I heard on a podcast. I didn't know this should be a core part of sex education. You think crazy

0:06:25 Lindsey: The Yeah. Yes. Mm-hmm. Yeah, Since so we're thinking about all this stuff anyway, yeah, thought it would be very worthwhile to intersperse like a series of episodes over the next few months that dive into the findings from the 50 plus peer -reviewed articles that have resulted from this study called the Turnaway Study. To introduce this a bit, the Turnaway Study was a groundbreaking, very rigorously designed longitudinal study of about a thousand women who sought abortions in the United States between 2008 and 2010. And it was conducted by this program within UC San Francisco's Bixby Center for Global Reproductive Health. Broadly speaking, the purpose of the study was to understand how abortions affect women and how being denied abortions affects women. Women.

Quick note before we move on, because I know that some people have just prickled at my use of the word woman, but it is deliberate. Her book about the Turnaway study, one of the researchers, Diana Green Foster, explains, and this is something that I noticed when I was reading things, like all the titles say the effect of X on women who seek abortions or whatever. And I was like, why do they keep, why aren't they using more inclusive language? She explains that like in their recruitment language for the study, they did in fact specifically recruit women?

0:06:30 Thomas: Wow Ah.

0:07:34 Thomas: Gotcha well

0:07:35 Lindsey: She is mindful of the fact that people who are not women can and do become pregnant and need access to safe and legal abortions as much as anybody else does. And that the experience of, for example, like a trans man seeking an abortion is one that needs to be understood. And, it's likely to be very distinct from the experience of a woman seeking abortion. She also makes the point that the roots of the anti -abortion abortion argument in the U.S. are explicitly misogynistic and designed to target women as a social category, and that the motivation of the study was indeed to understand the experience of women in the US who want abortions. So all this to say, you using this term sort of consciously here, and where it's appropriate, I'm going to toggle into more inclusive language, but the participants in this study were, to her knowledge, exclusively women.

0:08:17 Thomas: And as you say, I mean, that seems like it would be such a unique experience to be a man seeking an abortion that it feels like it ought to be studied separately and, you know, understood on its own terms and it might even be a disservice to describe what's going on here as like anyone's experience when seeking abortion because it is going to be different.

0:08:28 Lindsey: Yes. Oh, yeah. That's right. That is appropriate to talk about the implications of the study in terms of women because that is the population they recruited. It would be inappropriate to generalize it beyond that. For back sure. To the study. Purpose, understand how abortions affect women, how being denied abortions effect women. Prior to the Turnaway study, the research on this topic was really lacking.

0:08:45 Thomas: Right, right. Hmm.

0:08:55 Lindsey: And And in particular, virtually all of the research that had been conducted had this glaring limitation. It by and large compared the outcomes of women who had abortions to those of women who gave birth with no particular regard to whether the pregnancy was wanted or not. Like those And groups are different in many ways other than simply whether or not they had an abortion.

0:08:56 Thomas: Hmm. Yeah.

0:09:15 Lindsey: Trying To infer the of abortion from that kind of comparison, that's pretty dicey. Really want to understand how abortions affect folks, all else being equal, the much better comparison is to to look at those who wanted abortions and got them to those who wanted abortions and were denied them and to see what those outcomes look like. And that's exactly the gap that that Turnaway the study filled. Recruited women seeking abortions at 30 different abortion clinics across the U.S. They were located in 21 different states and chose recruitment sites. So, they recruited people specifically like from abortion clinics. So specifically, they specifically chose abortion clinics as recruitment sites that had the latest gestational limit of any facility within 150 miles.

They did that because if someone was denied an abortion at that facility, at a facility like that, were really unlikely to secure one at another facility. So the people who were turned away from those facilities were very likely to have to carry their pregnancies to term, right? And later results suggested that 70% of them did.

So, were eligible to participate in the Turnaway study were women in the United States who could speak English or Spanish, were at least 15 years old, had healthy pregnancies, meaning they specifically excluded women who were seeking abortions

0:09:15 Thomas: Right. Right? Okay.

0:10:24 Lindsey: Because they'd learned that their fetus had severe anomalies that because the pregnancy posed a severe health risk to themselves.

0:10:30 Thomas: Interesting.

0:10:30 Lindsey: Themselves?

0:10:31 Thomas: I I mean, that's also an interesting thing to study, I would think. But I guess not the not the focus here.

0:10:33 Lindsey: It wasn't, but in the book, she talks about that. She said, she one point that she has regrets about not also recruiting that group of women because there a lot of really important questions there, so healthy pregnancies. And then most critically, they recruited women whose pregnancies were within one of three gestational age ranges. First study group sought abortions just after the gestational cutoff for that provider. So these were the turnaways.

And so these were folks that came to the clinic, but they had passed the gestational cutoff by three weeks or less. So they just missed it. Importantly, the gestational cutoff was not the same at every abortion provider. So some sites had gestational cutoffs as early as 10 weeks, and others had cutoffs as late as 22 weeks. Weeks. The people here could have been at different stages in their pregnancy in terms of like trimester or whatever.

The only thing that was true there is that they had missed that particular cutoff by within three weeks. So that's the first study group. Every turn away that they successfully recruited at a particular site, researchers recruited three more individuals from that same site that fell into the other two study groups. They recruited two women who sought abortions just before the gestational cutoff. These are like near -limit cases. They came in like two weeks of when they would have no longer been able to get an abortion.

And then they also recruited one woman for every turn away who sought an abortion during the first trimester. So, these were women who sought and received abortions early in their pregnancy. That's representative of the most typical case in the U.S. Most women who seek abortions are early in the pregnancy. So, those are the the three study groups, right? Turnaways, near -limit cases, and then first trimester abortions.

Purposes, this is a super smart way to construct a sample if you want to investigate the consequences of accessing or being denied a wanted abortion, because two of your comparison groups are women who sought abortions at roughly the same time in their pregnancies, happened to be on one side or another of whatever cutoff date the abortion provider provider happened to have,

0:12:26 Lindsey: Right? So they're very similar at baseline, these so the Turnaway Study, it was originally designed to be a five -year longitudinal study. So women who enrolled in the study agreed to an initial baseline interview and then to follow-up interviews every six months for a minimum of five years. Have ended up collecting data past that five - year mark. So at the time that the book was published about this, they had data from women eight years after they received or were denied an abortion.

So data collection is ongoing. What that's did they assess? Oh my God, so much stuff. They assessed women's reasons for wanting an abortion, and that's what we're going to talk about today. They assessed relationship outcomes, financial outcomes, ability to pursue academic and career goals after they received or denied an abortion. Mental and physical health outcomes, relationships with children, and that includes both previous children, so children they already had when they sought the abortion and the children that were born because they were denied an abortion.

That's not even everything. And we're going to get into like all of it. It's so a cool thing too, this study that was heavily featured in the book and that will show up as we're talking about these studies, is that because the data were collected via interviews rather than just giving people questionnaires with like closed -ended questions is that do they have all the good quantitative data, you, I'm most comfortable, but they also have a ton of really, really rich qualitative data about these women's experiences.

Did it mean to them to be able to access an abortion or not? What was going on in their lives? How did they feel about it? You stuff. So they've got tons of narratives. They were really interested in telling the stories of these women to put a face to the statistics that they're reporting.

0:12:25 Thomas: Right.? Yeah, Earlier, I was gonna ask, you said something like, oh, there's been, I don't know, 50 peer reviewed papers written based on this study. And I wonder if that's part of it, like there's just so much here that there's a lot of stuff for other people to go and take a look at and write about.

0:14:07 Lindsey: Yeah, I mean, because they assess tons of stuff here, yeah, mean, just, yeah, on the question of why women have abortions, they're, I was thinking we could cover all of them in one episode, and I had to trim it back to like two out of the the six papers or whatever. It was because there's just so much, it's such rich data, um, I, I really like, um, they're humanizing this stuff so much and focusing on the personal experiences to give color and context to the stats that they're reporting. I think it's really important. Also, since I've mentioned it a few times, people should 100% read this book, The Turnaway Study, by Diana Green Foster. She's one of the lead researchers researchers on the study. And it's just an incredible book. I've been listening to it while I build shelves and make bread and stuff because I'm Amish now or something.

0:14:17 Thomas: Right. Right.

0:14:45 Lindsey: The most beautiful mix of data and storytelling. And she's keeping the stories is like so personal, but then hitting you with the stats about this stuff that really, I think, are valuable if you're arguing with people on a regular basis about whether abortion access should be not only maintained, but like expanded, right? We should have more accessible abortion. So highly recommend it. It's very, and not depressing. I mean, the stories are hard, but they're difficult stories, but it's also very energizing the way it's presented. And I think that that's important right now.

0:15:15 Thomas: Yeah.

0:15:16 Lindsey: Right. To my the study itself. Right? Yeah, we've got lots and lots of peer reviewed stuff to talk about. Let's talk about them. Yeah?

0:15:23 Thomas: No. What yes.

0:15:27 Lindsey: Damn it. Today I want to talk primarily about some of the first publications that were released from the Turnaway Study, which were about reasons that women seek abortions. And I think that this is descriptively interesting for reasons that we touched on in our previous recording, because they give a sense of what abortions typically look like in the US.

But also, some of the studies specifically focused on the reasons that some women seek later abortions, meaning abortions after 20 weeks, which is right in the middle of the second trimester. And that's interesting in its own right, because later abortions tend to uncomfortable to a broader constituency of people, and there's a different conversation that happens around those.

So, what we're doing today, the first study that we're talking about was published in 2013 by Biggs, Gould, and Foster, and it's called "Understanding Why Women Seek Abortions in the U.S." And it's among the earliest papers that was published from this study.

So, prior to the Turnaway Study, women's reasons for seeking abortion were not really a central focus of the public or scholarly conversation much about abortion access, but there was a small literature on women's reason for seeking abortions in the U.S., and findings from that literature indicated that the most commonly cited reasons that women gave for seeking an abortion were that, one, having a baby would dramatically change their lives, for example, by interfering with education or work plans or their ability to care for existing children; they couldn't afford to have a child at that time; or three, they did not want to raise a child alone or because they were experiencing relationship problems.

So this study, the Turnaway study, added to that small literature by providing an updated examination of women's reasons for seeking abortions after the onset of, for example, an economic recession, right? So their recruitment took place in 2008 to 2010. So, getting a of what women's reasons for seeking an abortion were around that time and this period where we were seeing increased legislative restrictions on abortion access. So they figured that a refreshed look at this question was valuable.

Given that we're going to be talking about a bunch of different papers published from the same study, I'm not going to rehash the same methods each time. I'm just going to give enough details to sort of evaluate the current findings. So, findings described in this particular paper focused on measures taken at the baseline interview, so their first interview, so this doesn't make use of longitudinal data yet, right? As we previewed before, they recruited close to 1 ,000 women who sought abortions in the U.S. between 2008 and 2010, and so the final sample included 231 turnaways, that was women who saw abortions right after the gestational cutoff, 452 women who received near -limit abortions, so they came in and got an abortion within two weeks of the gestational cutoff, and 273 women who receives first trimester abortions. So that's 956 women total. The data that were evaluated in this paper came from that initial baseline interview.

Um, the specific information that was relevant here is that they obtained demographic information, all the basics, age, race, ethnicity, education, uh, whether they, they received public assistance like WIC or food stamps in the past month and their employment status, as well as information about the pregnancy and prior pregnancies. So they got information on parity, which refers to whether the women already had children and how many, gestational age of the pregnancy at the time of recruitment, and continuous measure of pregnancy intentions, right?

Contained questions about things like contraceptive use, intentions or desire to become pregnant, and partner desire to become pregnant and so on. Continuous sort of scale, how much did they want to become pregnant or not want to be pregnant? Finally, they asked questions about participants' health. They got a subjective health question of very good to very poor. They also asked them about their history of depression and anxiety disorder diagnoses. So, had they been diagnosed with this in the past? They had a primary health care provider.

And then finally, and this is the main focus of the study, they about their reasons for seeking an abortion. And the answer to that is, they assessed these two via very open -ended, very non -directed questions that allowed women and to respond in a variety of different ways. So, so the first question was, what are the reasons that you decided to have an abortion? And obviously people often have multiple answers to that.

0:19:22 Thomas: Yeah.

0:19:22 Lindsey: So after women gave a reason, the interviewer would prompt them and say, okay, anything else? And if they had more reasons, they could talk about them. And then they just kept prompting like that until they said they'd given all the reasons. And the second question was what would you say the main reason was that that you decided to have an abortion. And questions like these are typically designed to help with coding, right? It's helpful to know the full breadth of responses, but also to know how the relative importance of they noted that participants often struggle to answer this one. At least in a way that could actually be coded as a single definitive primary reason. That suggested that for most women who are seeking abortions, there's lots of sort of equally important, very important reasons that they'd be able to get an abortion.

0:20:03 Thomas: Interesting. But they struggled to answer or just struggled to settle on like thing, one I guess.

0:20:08 Lindsey: It was that. Yeah. They struggled to pick one thing out as like the primary thing because it was all the primary things, which, so the researchers coded those open -ended responses into categories that that common themes regarding the for seeking abortion. And then they conducted regression analyses, our favorite, to identify predictors of citing particular reasons for seeking abortion, so for example, you can tell with regression analyses if was unemployed, were they more likely to say that they were seeking an abortion for financial reasons, So that's the kind of questions that they were answering with the regression analyses. Their sample was 37 % white. % of the sample was between the ages of 20 and 24. % had no prior children, which means that 62% of the women seeking abortions did already have children at the time that they sought the abortion. 79% were single and had never been married. 53% had not finished high school. % said that they had at least enough money to meet basic living needs. And so that means that 40 % of the sample said that they did not have enough money. To meet basic moving needs.

0:20:09 Thomas: Okay. Okay. Right. Yeah. It seems like a pretty good reason to not have a child.

0:21:14 Lindsey: It does seem like a powerful reason. Yeah. So that's the sample characteristics. Gives you something of a profile already. Here are themes the that emerged regarding why these women sought their abortions, in order of prevalence. And again, these are not mutually exclusive reasons. So the majority of responses reflected at least two of these themes. So 40% of women said that they were not financially prepared for a child. And some of the sub -themes here were that they were unemployed or underemployed or uninsured or can't get welfare or don't want government assistance.

0:21:45 Thomas: We pause on that to say that, like, maybe if Republicans want to reduce abortions, they should, you know, help alleviate the poverty that they've inflicted on people through their policies?

0:21:56 Lindsey: Does seem like it would be a great strategy. It seems like it eliminates a huge category of reasons that women seek abortions.

0:22:00 Thomas: Because, like I mean, I think I think it's really sad. You know, I don't think we talk about it that much because it feels maybe -life adjacent. Adjacent, but it's really sad to me to imagine somebody who wants to have a child, but it like they can't afford it. And so gets an abortion. Like we often focus on like, yeah, they need to have that choice and they do, but like, that's also really sad. I Like, wish that that would never happen. Like it would be much better if people felt completely free to make the choice they want to make given, not limited by stuff like poverty and all that. And it's just really sucks that Republicans can't ever focus on that. Like it just feels like they don't really care about that. They it doesn't seem like they ever care about things that would actually reduce abortions. They only care about outlawing it and because it's like some sort of like purity thing. Like I don'T know. It's for the rambling but it just is really it's really interesting yeah

0:22:01 Lindsey: Yeah. Yeah. Same.

0:22:42 Lindsey: Yeah. No. It is. It good faith version of that argument. You know what I mean? So

0:22:55 Thomas: Yeah

0:22:55 Lindsey: I end up in a place where I'm just assuming bad motives and assuming that they know that they're full of shit. I know that's not true for everybody. But yeah, it is hard for me to understand how somebody squares these different policies around

0:23:00 Thomas: It Must just be a matter of focus. They must just, in their minds, a lot of them must just focus on, like, I bet, you of color using abortion as birth control, and then they just focus, that is the only thing they think is happening, you know? Again, it's very racist, like, a lot, I don't Think of breaking news to anybody, but, like, a lot of these arguments are very racist in nature, and I think there's this, this trope that, on the right, that they think, you, women use this as birth control, for example, or people in the city, or what, you know, all this kind of crap. And I guess they must just focus on that and not think too hard about what's actually going on.

0:23:21 Lindsey: Yeah.

0:23:39 Lindsey: Yeah, by the way, like, the idea that anybody would use this as their primary form of birth control is, is, if you know what abortions cost, I mean, like, yeah, yeah, it's ridiculous. Mean, that's not the only reason that it's ridiculous, but

0:23:51 Thomas: Abortions is birth control in this economy. I think is what you're saying. Yeah.

0:23:55 Lindsey: I don't want this entire series of things to be just like an ad for the book, but there's this passage where she tackles that specific idea that anybody would use these as a primary means of birth control. It just sort of like breaks it down in this beautiful way. It's amazing. Okay, so that was 40 % of women in gave that as a reason, right? Financially able to have the child. 36 % said that it was not the right time for a baby for some reason. And so some of the sub -themes here were that it Was bad timing or they weren't ready. It was unplanned. They were too busy, didn't have enough time. They're too old, that kind of thing. % cited partner -related reasons. So either their relationship was too new or it was bad, they they wanted to be married before they had children, or their partner wasn't supportive of the pregnancy, or the partner was the wrong person to have a kid with, or didn't want a baby, or was abusive. So 3% of the women described their relationship as abusive in this sample.

0:24:04 Thomas: Oh yeah. Yeah, wow.

0:24:46 Thomas: That's lower than I would have thought. Weirdly. Yeah

0:24:48 Lindsey: Right? Yeah. Very small portion of people who seek abortions that it's due to abuse situations. But among people who are experiencing abuse in their relationships, that is often cited as a reason for seeking an abortion. So, yeah. So 29% said that they needed to focus on other children. That informed their decision to have an abortion. Abortion, so pregnancy followed too closely to a previous child's birth, or they were too busy with their other children, or they had enough children, those kind of things. 20 said that it would interfere with future opportunities, so this included, you know, disrupting educational plans, vocational plans, wanting a better life for themselves, not wanting to limit future opportunities. Said they weren't emotionally or mentally prepared for a child, no no sub themes here, just just that. % cited health -related concerns, and that was either concern for their own health concern or for the health of the fetus. And sometimes this was related to drug, tobacco, or alcohol use early in the pregnancy, which made them concerned that maybe they'd already caused some damage that couldn't be undone.

0:25:01 Thomas: Oh, yeah,

0:25:47 Lindsey: Yeah. 12%, said that they wanted a better life for the baby than they could provide at that moment. So their living conditions or housing in context were not suitable for a baby. They didn't have childcare or support. Don't want the child to have a childhood like their own is what some of the women said. % said they weren't independent or mature enough for a Baby. So, you know some of women the in the sample were teens that were still living with parents. You can imagine that a lot of them are in that category. % cited influences from family or friends. So this was things like like worrying that they would have a negative impact on family or friends, that's probably including children, or they don't want want others to know or something or worry about being judged for being pregnant. And so they want to have an abortion so that people don't find out about that. Then some of these women cited actual pressure from family or Friends to have an abortion, right?

Note here, because I think it's important, is that 1.2%, that's 11 women reported that they felt pressure to have an abortion from family or friends. And this does contradict a common anti -abortion talking point that, you coerced into abortion is like a huge widespread pervasive problem, right?

0:25:48 Thomas: Yeah. Oh Yeah. No.

0:26:49 Thomas: Yeah I'm I'm sure the leftists on campuses go around just harassing women and forcing them to get abortions via peer pressure that they wouldn't want to get. It's what they roving bands of campus crazy people do that.

0:26:52 Lindsey: Mm -hmm. Yes. They do, right.

0:27:02 Thomas: They're streaming into our border front.

0:27:06 Lindsey: And some of them I'm sure are good people, yeah. Yeah, so it's a very low, low percentage here, and even that phrasing, you know, like they felt pressure doesn't necessarily mean coercion. So it's like you, 1.2 percent is like the upper limit at least in this sample

0:27:07 Thomas: Yeah.

0:27:19 Thomas: Well, let me Clarify. And sorry, this a question of do you feel pressure, or was this a question into the reasons why they're getting it and then they offered that as a reason?

0:27:30 Lindsey: Got the broad question of why they're getting an abortion and they offered this as a reason so you're right they that's

0:27:33 Thomas: Yeah, that feels like, yeah. I mean, it would be one thing if it was like, hey, is anyone pressuring you? And they're like, oh, yeah, now that I think about it, this person a lot different than you're being asked for reasons and you list, well, my family wants me to. That does actually feel kind of coercive to me. I Well, wouldn't dismiss this in this sample is all I'm saying. Like you were saying, it might be different than coercion but I think if they freely offered it as a reason, put I the benefit of the doubt on like that, that might be coercive.

0:27:53 Lindsey: It's salient yeah no that's fair yeah you're You're right. If somebody is free to a completely open -ended question with that, that means it's a pretty salient thing, right? So, yes,

0:28:05 Thomas: That Yeah. You know what's What's weird is I, and maybe I'm just misremembering from other coverage of this, but I thought there were more examples in these samples of people, of women whose abusive partners were like making them get an abortion. Did that not come up that much?

0:28:20 Lindsey: One paper that looked at that, and there was an element of like, yes, partners being coercive about this stuff, but it's still a small percentage because, like, the percentage of women who are reporting abuse in connection to their abortion is like already very low.

0:28:33 Thomas: Right. Yeah, it must be. Okay. It could have been a different sample or something, but okay. Interesting.

0:28:37 Lindsey: But they did touch on it in another study from the Turnaway study. There is a connection there for the other way around too, like women were reporting that their partners forced them to get pregnant and then, yeah, so good stuff. Yeah.

0:28:40 Thomas: God, that's horrible.

0:28:48 Lindsey: Yeah. So, it, yeah. So, 5% influences from family or friends, including that, that, uh, element of pressure, percent, um, that they just don't want a baby, um, or to place a baby for adoption, um, so I think that this is one of the themes that I would have shown up in, right? So, these included people who just, like, said, I don't think I want to have kids, uh, right?

0:29:03 Thomas: And I'm sorry. Remind me the year of this.

0:29:06 Lindsey: They were recruiting 2008 to 2010 maybe

0:29:08 Thomas: Okay. So pretty recent, but so it is not like the 70s or something, but, like, I could imagine, and you think there would be a significant percentage of women involved in this study who, that may have just been their reason, but they feel compelled to give other reasons out of, you know, societal guilt? I

0:29:25 Lindsey: Could be. I mean, that's an interesting and empirical question as to whether this is an underestimate of

0:29:30 Thomas: Don't know. I just, yeah, who knows, I guess it might depend a lot on who's asking the questions, what's the setting, which all seems like, you know, would have, have been relatively comfortable from what you're describing, you know, kind don't know. I still feel like just knowing our society and how my, well, and it is, this was California, right? So it's not like the deep South.

0:29:47 Lindsey: Well recruited all across the country yeah

0:29:49 Thomas: I'm sorry. Okay. Okay, yeah. I mean, I could imagine a might be just not wanting a child, but feel like society doesn't allow them to just say, yeah, I just don't want a kid, you feels low to me.

0:29:49 Lindsey: Yeah um so four percent, do I think that's an underestimate of Maybe it very well could been an underestimate, it could be that there's some social desirability concern with, with saying out loud that you just don't want to have a kid. I don't think that that makes the other reasons disingenuous, right? Like, This study, I think that I would have said that one first and made it primary, but it also would have been the case that I would have cited all the other things that were happening in my life that would have made it difficult to havea child, you, and all of those would havebeen true. So, I don't, I don't know. Yeah. I very interested to know the answer to that question. Like,

0:30:14 Thomas: Yeah yeah well And I mean, 2008 to 10 is pretty recent, but I don't know, it's still a pretty different time back then. Like, I, I think that, you know, normalizing abortion on social media and stuff would have been still relatively young. I, there's more of that pressure back then than, then we're thinking, but I, who knows, I just feel like it may be a little understated. I don't know, I'm

0:30:50 Lindsey: Hear you. I think that, that, very well be true. Think I, th, I, I've heard a lot more conversations since then trying to normalize not wanting t have kids. We, th very well could make a difference. Um So now we're down to the 1 % that couldn't be categorized into the main themes. So 1 % gave reasons that were just kind of like a, you miscellaneous kind things like having very specific legal issues that prevented them from having a child or having a fear of giving birth, which is totes legit. Hear ya. Yeah.

0:30:57 Thomas: Oh yeah there's nothing wrong with that as a reason geez I'm

0:31:18 Lindsey: Nope, not those were the main teams that they extracted. And right, then they did logistic regression analyses to estimate the probability that someone would report one of those particular reasons for having an abortion as a function of their other characteristics. They did in the paper, I'm going to intersperse some quotes from the interviews to help illuminate like why some of these relationships exist, like why some of the predictors connected to the for having the abortion because some of them are not straightforward otherwise.

Was, what predicts whether someone will cite financial reasons for having an abortion? That predicted this were marital status. So women who were separated, divorced, or widowed were more likely to report financial reasons compared to those who were single or never married, which is interesting. Who were currently married were somewhat intermediate to both of those two. Level predicted citing financial reasons here.

So, women with at at least some college educations, specifically reported having more than a high school education, were more likely to report financial reasons for having the abortion than those with a high -school education or less, which could seem a little counterintuitive. When I said education level predicted it, didn't you think like lower education would mean more likely to cite financial reasons?

0:32:25 Thomas: Saying that lower with less education women, women with less education were, were less likely to cite cost or like just not as finances as a problem. What

0:32:32 Lindsey: Yes, That's right. So more education meant they were more likely to cite financial reasons as a reason for having an abortion

0:32:39 Thomas: Do you think is going on there? I mean, okay, 2008 to 2010, anyone who got a degree and graduated couldn't get a job then. So

0:32:47 Lindsey: And had tons of student loan debt. So there you go.

0:32:49 Thomas: Like could be part of it. Do you think it's more about that or some other, you know, mentality type reason there?

0:32:57 Lindsey: Guess is that it's the category of, quote, "more than high school education" disproportionately includes women who are currently in, like, college or professional schools or whatever. I think that what this might be suggesting is that they are comparing their circumstances while they're in school to where being in a few years. And so, you know, that aspect of it is more salient. So, the experience of being in school, to the extent that it's more represented in that particular education level category, the way that they broke things out might account for the reason that the relationship went that way.

0:33:29 Thomas: I'm trying to think just mathematically, does it make sense that if who are in school currently, would that really have a disproportionate effect? Yeah, I don't know. Would you offset it by the number of people who not are educated, who are spending a crapload of time working in a restaurant or something? I

0:33:47 Lindsey: Well, I mean that was my original thought. Like when I read that finding, I was expecting the relationship to go the other way. So I dunno, yeah.

0:33:52 Thomas: Part What I wonder, and this the same way that there's the relationship where, look, if you look at the world and you look at countries and you sort by socioeconomic whatever, you know, is as countries of people become, become more prosperous and, you know, have better outcomes and all that, fertility rate goes down. And I wonder if that could be part of it here. It's like, as you become more, or more well -educated or whatever you, that same kind of thing goes on in that population. I lot of people I know who are well -educated are some of my most childless friends. You know what I mean? And I don't know, could it be a cultural thing? Like as you're in that kind of environment, if that's your peer group, you're less, you're more likely to be like, ah, I just don't feel like I have the resources right now. I don't know. Maybe, maybe that's, maybe THAT'S nothing.

0:34:09 Lindsey: Yeah. Yeah, Yeah. Think that that's at least in the spirit of of, what I was thinking. Like those, those two things converge on the same thing. It's like, if you're more educated, it's, your comparison is, is shifting in a way that makes finances one of the more salient things that you're going to talk about here or something. Right. So marital status, education level, both those things predicted citing financial reasons. Who say that they don't have enough money to basic needs are in fact more likely to report financial reasons for having an abortion than those who say they do have enough to meet the basic needs.

0:34:51 Thomas: I Yeah, Sure. I don't think we have to crack that mystery.

0:35:07 Lindsey: Nope, don't think we do. And there was a, there was an anecdote here that I think is worth highlighting. So this was from one unemployed 42 year old woman with a monthly household income of a little over a thousand dollars, and she describes, quote, "It was all financial, me not having a job, living off death benefits, dealing with my 14 year old son. I didn't have money to buy a baby spoon." Yeah, yeah, um, that was financial reasons.

Those were all predictors, unique predictors in multivariate analyses of why people cited financial reasons in particular. What about focus on other children? What predicted women saying that focusing on other children was a reason for an abortion? These women had lower scores on that pregnancy intention scale that I talked about. So they had a greater number of children on average who didn't give this as a reason, which makes sense, right?

You have to have other children to focus on in order to cite this as a reason for having an abortion. So, for example, actually I got a couple of examples here. Participant said, quote, "I already had two kids and it would be really overwhelming. It's kind of hard to raise two kids by yourself." So not only does she have other kids, but she also has two children. Does she have two other children, but it sounds like she's raising them alone? Is a lot.

0:36:16 Thomas: I've said it before, I'll say it again. It's not possible to be a single parent. Anyone who's doing it is a miracle worker. I don't know how you do it. Incredible. I couldn't even imagine.

0:36:19 Lindsey: No. No. Yep. Know.

0:36:26 Thomas: It's It's so difficult. As a dual parent, as a parent in a marriage, we can't even do it, it's not possible, nobody could do it so you're amazing, you're a miracle worker if that's you, that's incredible. No one in the government should be fucking telling you that you have to have another kid or some crap. It's truly insulting.

0:36:37 Lindsey: I Mm Yeah, it is. Yeah so it makes you appreciate the understated nature of that quote right? It's kind of hard to raise two kids by yourself. Yeah yeah no shit. Yeah here's another one. This one's this one's uh pretty hard um my son was diagnosed with cancer. His treatment requires driving 10 hours and now we found out that we need to go to New York for some of his treatment. Stress of of that um that he relies on me and that's in her response to why she's having an abortion yeah yeah

0:36:49 Thomas: Yeah. Oh, my God. Oh, wow. Would have been tempted as an interviewer to just end the interview. Like, yeah, fucking I need to ask any more questions about this. Wow.

0:37:13 Lindsey: Yeah I know. So it's, that's, are the predictors the, of, um, who said that they, they need to focus on other children, that's why they're having an abortion, uh, for women who cited partner related reasons. Right, some of the things that predicted this, these folks were more likely to be Black than white, to have more prior children, to be older on average, to be separated, divorced, or widowed, and to have higher pregnancy intention scores than women who didn't cite -related partner reasons, which was kind of interesting.

I think it could seem counterintuitive that they had higher pregnancy intention scores than women who didn't cite partner -related reasons, but it's probably accounted for by the fact that these women are interested in having children, but they're concerned about having children with that particular partner, right? I think that that's what's going on there. Some of the items, I think you could get a higher score if you wanted to have kids in general, but had concerns about a particular person, or so that's partner - related reasons.

Women who said that the child would interfere with future plans, these folks were more likely to be younger, to be in good health, to have lower scores on the pregnancy intention scale, and over half were currently in college or getting their associates or technical degree. For example, there was a 21 -year -old who pointed to a number of reasons why she felt like the timing of the pregnancy was wrong.

She said, quote, "Mainly, I didn't feel like I was ready yet, I didn't feel financially, emotionally ready. The due date was at the same time as my externship at school. Entering the workforce with a newborn would be difficult. I just wasn't ready yet." Think that's an experience of a lot of people that are sort of in that particular life stage.

Women who said that they were having the abortion because they'd be unable to provide the life they wanted for their baby were more likely to have higher educational attainment, right, fewer prior children, less likely to have a primary health care provider, and more than half who gave this reason had no prior children.

So that picture, that is very much, I think, of a person who's sort of in that emerging adult range, you, they may or may not be in school currently, but they're younger, they haven't sort up these life things, and they're waiting, that they're postponing reproduction, they're wanting to have, to have children, um, or mental health. Health concerns.

So women who cited this reason were more likely to have a history of a depression or anxiety diagnosis, have lower subjective health, and they were less likely to be employed. Finally, women who said that they just don't want a baby, or

0:39:23 Thomas: Yeah.

0:39:23 Lindsey: Category here was like, they just don't wanna have a baby, or they don't wanna place up a baby for adoption. Only two significant predictors of being more likely to give that response were fewer numbers of prior children and lower pregnancy intention scores. So responses in this category were things like, "I just didn't want any kids." Like, it compares to some of the other responses, I just, I find the concision there funny. Yeah, I mean, like, one thing that I find interesting about that is that, you, having fewer kids on average, and which presumably a lot of people just had zero kids, right, having fewer children on average, and lower pregnancy intention scores, those were the only unique predictors in the multivariate analysis. So, for instance, did not predict it. I just find that interesting because I've had the experience of people saying that, change your mind as you get older about whether you want to have kids, is not designed necessarily to evaluate how those attitudes, attitudes shift over time, but, um, 100.

0:40:13 Thomas: It feels like things, multiple shifts could happen at the same time that might, offset, yeah, that. I mean, that I would just imagine that you literally held every other factor equal, it would be interesting to look by age how women's decisions change, you know, there's like, there's obviously going to be like, well, you're too young, you know, and then there's going to be a period of time where maybe that wouldn't, age wouldn't much be a factor, and then there'd be a period of time where it's like, yeah, I'm too old to be going through a pregnancy right now, you know, so so that that's one shift And then, you know, the life circumstance shift, it'd be interesting how

0:40:38 Lindsey: Yeah. It is, I, but mean, if we're only looking at like the probability of giving the response, that "I don't want to have kids," and that's the reason that I'm having an abortion, like the example responses that they gave here sounded like largely like people who just said that they didn't want kids it's not that's not exclusively what it is But that's I think a bulk of this of this category um So, like, the implication when people, I think, invalidate that statement when, when young women make it, is suggesting that, like, oh, all young women say that they don't want to have kids and then they change their mind at some point. And the fact that that the multivariate analysis panned out in the way that it does, I think, does speak against that. It's not like, um, like you need more to make that claim really strongly, but

0:40:51 Thomas: Is that, "I don't want to have any kids," or "another kid," included? Oh, okay. Hmm. Oh. Yeah. Right.

0:41:26 Lindsey: It's not consistent with that at least. So are all the things that predicted the different responses. Interestingly, gestational age was unrelated to any of the major themes regarding reasons for getting an abortion. So Yeah. So, the women who received abortions early, like in the first trimester, did not look different from those near -limit abortion groups or or from the turn turnaways in terms of their stated reasons for seeking an abortion. I think that that's important to highlight for reasons that we'll come back to when we talk about women who seek later abortions.

0:41:37 Thomas: Is interesting.

0:41:54 Thomas: Wait, what? Seems impossible. Wouldn't you think maybe like, oh, the, the health of the child, or we've You've discovered some abnormality or da -da -da. Like, wouldn't you think those would be way more present in later?

0:41:55 Lindsey: Yeah.

0:42:07 Lindsey: Well, two responses to that. So one, they specifically excluded those women from the study. Yeah, but, I would think that, but it out that maybe the evidence for that is not great. It's not that there wouldn't be an association there necessarily, because I think that some of those things can only be detected after a certain point, um, like the idea that most late later abortions are because of those reasons is apparently not a supported thing, which I didn't know yeah

0:42:11 Thomas: I'm sorry. You're right. You're Right. Yep. Forgot Yeah. Really? Well, what, how late are we talking? I think that's important.

0:42:32 Lindsey: Um yeah we should we should get into that with the other stuff yeah

0:42:36 Thomas: Yeah. Cause you telling me that the reasons don't change if you're in a, cause like super late term abortions we know are like not even a thing, barely ever happen and are Like an absolute tragedy when they do. So you're not saying those are like the same as like these, it's just that between whatever this range is, five, six weeks or whatever the heck it is, to what, what's, what's the like higher range of

0:42:45 Lindsey: Correct so The group that is like the the later abortions, the one that they explicitly look at later, those folks are on average around 22 weeks. Yeah. That's pretty late. I mean, that's, yeah.

0:43:05 Thomas: That is very late actually we are at 20 weeks right now and I could not quite imagine, yeah, at a point where that feels, that feels really late, like if- if we were to get an abortion right now, that feels like, like not a pro -lifer, but it would feel wrong to me. I don't, you know what I mean?

0:43:08 Lindsey: No.

0:43:21 Thomas: Like it feels different than in the first five, six weeks.

0:43:17 Lindsey: Is. Uh -huh. Absolutely. Right.

0:43:26 Thomas: Obviously. Yeah. Not my choice, not my body, but just in terms of how it would, would seem in my mind.

0:43:31 Lindsey: Oh, those intuitions are ones that a lot of people have. And so I'm really excited to talk about that next study that looked at the circumstances of women who seek later abortions because they were surprising to me. And I think they're going to be surprising to you and to a lot of folks. So

0:43:44 Thomas: Well, but again, if we've we're, taken out the group of people who are doing so for health reasons, right?

0:43:48 Lindsey: Yes, but I still think that these findings change the picture of what's going on with later abortations. Yeah. We

0:43:53 Thomas: Huh? We'd have to know the relative rates, wouldn't we?

0:43:57 Lindsey: Would. But we do we do have estimates of how often that that happens. And I think that it accounts for maybe a smaller proportion of cases than you might think. Yeah.

0:44:01 Thomas: Hmm. Wow. Okay. Well that's geez. Teaser for the next part. Apparently.

0:44:08 Lindsey: Yep, yep. So yeah, so about the reasons for having an abortion, women who sought abortions in the first trimester versus near the limit or right over that gestational limit, and don't look different in terms of the reasons that they provide for why they're having an abortion, right. And yes, they excluded that one category. And that is important. But I still think that's worth highlighting. Right. Sort of conclude this first paper, these results help to paint, I think, a very complex and personal picture of why women seek abortions, you know, women's unique life circumstances, including their age and their health, and their number of existing children and their socioeconomic status, all of those things contribute to their reasons for seeking abortions. Many women in the study reported concerns about the timing of the pregnancy, their current partners.

Cited concerns that they were unable to support another child that they already have or the child that their about to have, even if they didn't have children already. So in other words, like women often seek abortions out of concern. And I think this is important for current and future children, for family, for current commitments and responsibilities. You know, some women express the belief that the child deserves a better life than she is currently able to provide.

And let's contrast that for just a second with the framing that you hear sometimes from very uncharitable folks who are against abortion, that this is a selfish and self -focused choice, because that's really not borne out in the stories that these women are telling here. I actually think it's perfectly fine for someone to just say, I don't want to have a kid because I don't want to have a kid.

0:44:20 Thomas: Hmm. I Yeah. Like if we looked at any other medical decision and you're like, Hey, uh, Lindsay, why are you getting the appendectomy? Well, cause it's going to explode. Selfish. Jesus Christ. Only thinking of you and how your appendix is going to explode. That's you, Lindsay. You're always like, oh, my appendix going to explore. Boo We don't look at anything else like that.

0:45:37 Lindsey: Mm-hmm. Yeah. And that's for me. Yeah, uh -huh. Yeah! Think of the appendix. It needs to live out its destiny, too. You. So I do think that that's perfectly fine. But I, think it's important to that even when somebody says it's for me, that response is often a lot more complex than like just for me. That often implies That a child is going to prevent you from who you need to be for other people, you so I think it's important to note heavily that of communal and other focus motivations that underpin so many of the reasons that women gave here, undercuts a common narrative that I, that I don't like a lot. Right. Just the first study we were going to get through too, but yeah, we are pretty much out of time here.

0:46:04 Thomas: Right, right.

0:46:23 Thomas: Yeah. We are definitely out of time. Time estimation skills were like literally 100% wrong. Like okay you know

0:46:31 Lindsey: I thought, I thought this could go one way or the other, either like this was going to take no time to get Through that first one, or we were gonna spend a lot of time on it. So I was,

0:46:39 Thomas: What, like, I definitely slow you down, of course, but I feel like this was less slowing you down than normal. Don't I just go off on nonsense for hours and hours and you have to sit there for enough, you know, because you're like, why did I get myself into this, what am I doing here with my life? But tonight, today, it was you. This is squarely on you is what I'm saying.

0:46:57 Lindsey: It is swirly on me. I accept full responsibility for that. Yeah.

0:46:59 Thomas: But on the other hand, I have no problem with doing more episodes on a very interesting topic. And I'm sure our listeners would agree. So we'll just have to do one plus one so far of what you were imagining.

0:47:05 Lindsey: Mm-hmm. Mm Mm-hmm. Yes. Yes. Again, Yeah. I'm very excited to get into the next one. This is, again, reasons for seeking later abortion. And this stuff was surprising in a number of ways, and I think really, really useful.

0:47:21 Thomas: Well, would you try to put a bow on this entire thing so we went through, um, let... you're saying you left out the why people have abortions in the later term, so we basically covered all the earlier term reasons and and that how wouldyou put a summary on that

0:47:30 Lindsey: We covered it in the full sample. So this included the reasons of people who were in the first trimester and people who are later. But what we're going to talk about next time is the, like, sort of the comparative angle. So what is different about about people who seek later term abortions.

0:47:39 Thomas: Right well That's what we covered, so what do you, what doyou think about it? I, having having read and understanding and digesting the science that you've covered so far in this episode, what are your takeaways?

0:47:59 Lindsey: My takeaway is that these decisions are incredibly personal and incredibly complex, and that they're worth humanizing and personalizing in these discussions, right? Have very good reasons for seeking abortion. And if you direct attention toward that for a second, if you listen to people about why they had abortions, it's very hard to do the judgy, judgy thing that a lot of anti -abortion activists do.

0:48:13 Thomas: Yeah. Right. And I'm pretty sure as we covered part in this conversation, the approach that the pro -life group takes is, I'm not listening. Shush. Gosh, it's probably black women doing just birth control. I think that's what's going on. Because Well, that's a very fascinating part one of who knows how many. But yeah, looking forward to part two. Thanks, Lindsay, for the science thingy. And this is, I mean, goes without saying, an excellent science thing, right? I mean this is not you breaking it down and being like they didn't put their name on the paper. Like they messed up terribly.

0:48:36 Lindsey: That's right. Yeah.

0:48:47 Lindsey: You. That's a good science thing. Yeah? No, no. Very engorged palps over this study science thingy. It'S very good.

0:49:02 Thomas: All right. Well, more on that later. Thanks, Lindsay. Thanks, everybody, for listening. Support the show if you can, and we'll see you next time.

0:49:17 Clip: Thank you so much for listening to Serious Inquiries Only. If you like the show, the absolute best thing you can do is support us at patreon.com/seriouspod. The second best thing you can do, is please share it on social media or by word of mouth. Speaking of social media, follow me on Twitter at Serious Pod. If would like to be Facebook friends, send me a request at facebook.com Thomas podcast. If not up for that level of intimacy, that's fine. Maybe you want to join the discussion at facebook.com/groups/SIO members. Thank you again for listening. We'll see you next time.