This piece is published in collaboration with Echoing Ida, a Forward Together project.

With clinics closing left and right because of anti-abortion legislation, access to safe abortion care is dwindling in the United States. This is having significant ramifications across the country, particularly for women in abusive relationships, new research suggests.

The “Turnaway Study” is a five-year project through which researchers are observing the physical, mental, and socioeconomic impact on women of continuing an unintended pregnancy that they sought to terminate. The researchers are then comparing that data with data from women who were able to have an abortion. Released around the time of Domestic Violence Awareness Month by Advancing New Standards in Reproductive Health (ANSIRH), the results from the fourth year of the study assesses the importance of access to abortion clinics for women experiencing violence at the hands of an intimate partner. Interviewing women on either side of the line at which the clinics in the study would no longer perform abortions (often 20 weeks’ gestation), the researchers tracked women’s health and life outcomes, including mental health, economic status, and occurrences of intimate partner violence (IPV).

Women who have experienced violence by an intimate partner have a greater likelihood of experiencing unintended pregnancy and seeking an abortion. (A 2013 analysis of 15 global cities found that a reduction in a city’s incidents of intimate partner violence by 50 percent can reduce unintended pregnancy rates by up to 18 percent in that city.) In this new study, ANSIRH researchers found that women experiencing intimate partner violence, and who were unable to get the abortion they were seeking, were less likely to be able to escape their abusive relationship. “[W]e found that the incidents of domestic violence by the man involved in the pregnancy declined among women who had the abortion but stayed steady when she carried the pregnancy to term,” wrote Dr. Diana Greene Foster, principal investigator of the study. “This indicates that being unable to have the abortion tethered women to violent men, while women who have the abortion were more able to escape abusive relationships.”

Getting out of a dangerous relationship can also have an impact on a survivor’s health. Women in abusive situations can have negative health outcomes, including physical injuries, depression, post-traumatic stress disorder, and sexually transmitted infections. Abuse during pregnancy also leads to preterm delivery, low birth weight, and neonatal death, not to mention the effect that violence has on children in a relationship: Over 60 percent of people seeking abortions are already parents, and violence in the home can lead to physical and emotional abuse of those children as well.

For many survivors of abuse, accessing abortion care is key to saving our lives. This is especially true for Black women: While Black women make up only 8 percent of the U.S. population, we make up 22 percent of homicides resulting from domestic violence; that’s three times the rate for white women.

As the Turnaway Study also finds, the ability to leave violent relationships is key to helping women escape the cycle of poverty. Roughly 80 percent of the study’s participants stated that they did not have enough money to pay for their basic living needs when seeking an abortion. The research found that those who were seeking, and subsequently denied, an abortion were three times as likely to be living below the federal poverty level two years later.

The women interviewed as part of the study provide a glimpse into how these findings affect people’s lives. When asked why she wanted an abortion, Gloria (a pseudonym) responded, “Because my significant other wasn’t the person I thought he was. I became afraid of him and knew I didn’t want to spend the next 18 years dealing with the type of behavior he displays.”

Gloria’s words rang true to me. I connected deeply with her words because I’ve thought them myself.

When I was a teen I had a partner who was, at times, verbally abusive. He made threats that he would have his family members physically attack me if I “acted out.” Because his abuse didn’t leave me with bruises, I thought it was part of a deep love that sometimes hurts. His threats were peppered with whispers of love and plans for the future. Mistakenly I thought we’d be able to work it out. It wasn’t until he punched a wall next to my head, resulting in a boxer’s fracture and a cast, that I realized I should start planning my exit strategy. When I found out that I was pregnant, at 19, I knew I had to get out. I couldn’t put a child through the stress and violence I experienced.

Having an abortion was one of the ways I was able to leave the relationship and make changes in my life. It was the best decision for me. I will never apologize for that.

With the prevalence of abuse in relationships, my story is common.

Stigma and shame about abusive relationships and seeking an abortion keep so many people isolated, unsupported by loved ones, and without resources to help them heal. When sexism and racism are combined to hurt one body, as they are for Black women and other women of color, the effects are even more numerous and cut even deeper. Gender and sexuality are racialized, and women of color are less likely to be seen as “victims” when the world portrays them as “jezebels” or undeserving of shielding from abusers. Fewer government programs, nonprofits, counselors, and other IPV resources are equipped to support women of color at the cross-section of multiple layered identities.

As state legislators work hard to restrict access to safe abortion care, they are closing doors in the face of survivors of abuse looking for an escape route.

We should trust people seeking an abortion to make the best decision for themselves, their families, and their lives. We  should be working together to increase access to support systems, not putting up ideological barriers. Because every day there is a woman like me in a clinic asking for an abortion: a woman without visible bruises or scars, but who confidently knows that making this appointment is step one in her escape plan.