A woman’s decision to get an abortion is not an easy one. Unintended pregnancies can lead to emotional distress, and eventually take a toll on a woman’s mental health, but in some cases, an abortion could ease the agony. New research from the University of California, San Francisco suggests denying women abortions, not the procedure itself, increases the risk of depression and anxiety.

In the United States, there are 35 states that currently require women who seek abortions to receive counseling about the alleged negative emotional effects they may experience. These mandatory waiting periods, between counseling and the procedure, range from 18 hours to 72 hours, and vary state by state. For example, in Florida, state law requires the physician to be “physically present in the same room” as the patient when providing the state-mandated counseling.

Women are forced to take two trips to an abortion provider on separate days, which can be physically and financially taxing, especially for low-income women. This also delays the care a woman needs. Pro-life advocates say these waiting period laws give women enough time to decide whether or not they really want an abortion. However, previous research has found most women experience waiting periods as an obstacle, not as an aid.

“There are policies and decisions being made with this assumption that abortion harms women’s mental health,” said M. Antonia Biggs, study author and a social psychologist researcher at UCSF, TIME reported.

“We found that the women who were denied abortions had more anxiety, lower self esteem, and less life satisfaction compared to women who [obtained them initially],” she added.

In the new study, published in JAMA Psychiatry, part of an ongoing trial called the Turnaway Study, Biggs and her colleagues followed 956 women from 21 states who sought an abortion. The women were interviewed a total of 11 times, including once a week after seeking an abortion, and again every six months for five years. This data was used to compare the outcomes of those who successfully aborted with those who showed up at the clinic past the gestational limits and were turned away.

The Turnaway study found most women seeking an abortion had higher than usual rates of anxiety and low self-esteem. This isn’t surprising since an unintended pregnancy, in itself, is a stress event for any woman. However, women who were denied an abortion reported more anxiety, lower self-esteem, and less life satisfaction. Both groups of women, those who had abortions and those who were turned away, saw a decrease of these symptoms over time. Within six months to a year, women who were turned away saw their anxiety levels drop toward the lower levels experienced by women who got abortions. For all of the women, symptoms of depression dropped over time.

The significantly higher levels of stress among the women denied an abortion may be due to a number of factors, such as trying to obtain the procedure, to the social stresses of an unplanned pregnancy. The researchers did find a link between experiencing negative mental health outcomes and a previous history of mental health conditions, or traumatic life experiences.

Although researchers cannot confirm what influences a woman’s emotional response to abortion, it does suggest lax abortion laws could protect a woman’s mental health.

After all, women should trust their own instincts of what they want to do with their body.