{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T23:49:59Z","timestamp":1775000999717,"version":"3.50.1"},"posted":{"date-parts":[[2026,3,11]]},"group-title":"Public and Global Health","reference-count":29,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,3,28]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>The Nepal Turnaway Study was designed to understand abortion care experiences and the longitudinal wellbeing of abortion-seekers and their families.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>The Nepal Turnaway Study is a nation-wide cohort of abortion seekers recruited from public and private facilities across all seven provinces between April 2019 and December 2020. It contains 1,832 abortion seekers followed for up to five years. Repeated measures of socioeconomic status, health and wellbeing\u2014including maternal physical and mental health and child health (under age three)\u2014were collected every six months or annually, alongside detailed pregnancy and abortion-seeking histories.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Findings to date<\/jats:title>\n                  <jats:p>Abortion seekers in this context can be recruited at health facilities (96% participation) and successfully followed for up to five years (85% retention). Nearly half (49%, n=856) of abortion seekers were initially denied their abortion, and 16% (n=275) ultimately carried the pregnancy to term and gave birth. Those who were denied were more likely to be socioeconomically disadvantaged prior to abortion seeking.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Future plans<\/jats:title>\n                  <jats:p>The Nepal Turnaway Study will be used to understand the longitudinal health and socioeconomic effects of receiving a wanted abortion in this setting. Exposure-balancing weights can be applied to ensure rigorous estimation of the effects of abortion denial on longitudinal outcomes. This cohort can also be used more broadly to examine the trajectories of women and their families in the years following abortion-seeking.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Registration<\/jats:title>\n                  <jats:p>\n                    This study has been registered at\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\">clinicaltrials.gov<\/jats:ext-link>\n                    (\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT03930576\">NCT03930576<\/jats:ext-link>\n                    )\n                  <\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.03.10.26348060","type":"posted-content","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T17:20:36Z","timestamp":1773249636000},"source":"Crossref","is-referenced-by-count":0,"title":["Cohort profile: The Nepal Turnaway Study"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3317-9516","authenticated-orcid":false,"given":"Rachel","family":"Murro","sequence":"first","affiliation":[{"name":"Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, California, United States of America"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5025-2412","authenticated-orcid":false,"given":"Sarah","family":"Raifman","sequence":"additional","affiliation":[{"name":"Advancing Standards in Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Oakland CA, United States of America"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3121-9526","authenticated-orcid":false,"given":"W John","family":"Boscardin","sequence":"additional","affiliation":[{"name":"Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, California, United States of America"},{"name":"Department of Medicine, University of California, San Francisco, California, United States of America"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2913-1480","authenticated-orcid":false,"given":"Mahesh C","family":"Puri","sequence":"additional","affiliation":[{"name":"Center for Research on Environment Health and Population Activities (CREHPA), Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunita","family":"Karki","sequence":"additional","affiliation":[{"name":"Center for Research on Environment Health and Population Activities (CREHPA), Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5748-2570","authenticated-orcid":false,"given":"Anupama Ale","family":"Magar","sequence":"additional","affiliation":[{"name":"Center for Research on Environment Health and Population Activities (CREHPA), Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dev Chandra","family":"Maharjan","sequence":"additional","affiliation":[{"name":"Center for Research on Environment Health and Population Activities (CREHPA), Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9892-249X","authenticated-orcid":false,"given":"Corinne H","family":"Rocca","sequence":"additional","affiliation":[{"name":"Advancing Standards in Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Oakland CA, United States of America"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3904-3177","authenticated-orcid":false,"given":"M Antonia","family":"Biggs","sequence":"additional","affiliation":[{"name":"Advancing Standards in Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Oakland CA, United States of America"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8711-3029","authenticated-orcid":false,"given":"Nadia G","family":"Diamond-Smith","sequence":"additional","affiliation":[{"name":"Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, California, United States of America"},{"name":"Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, United States of America"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2741-0283","authenticated-orcid":false,"given":"Diana Greene","family":"Foster","sequence":"additional","affiliation":[{"name":"Advancing Standards in Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Oakland CA, United States of 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