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'Our Patients Aren’t Stupid': New Study Finds Mandatory Waiting Periods, Counseling Don’t Work as Intended

While these restrictions provide logistical and financial obstacles to obtaining an abortion, they often do not achieve the desired emotional obstacle of forcing a patient to reconsider their abortion decision.

In a new study, researchers discovered that abortion restrictions like mandatory waiting periods and forced counseling often don’t affect a patient’s certainty about having an abortion. In some cases, such sessions even increase their confidence in their decision to have an abortion.

This study took place in Utah, the first state to enact the longest waiting period before an abortion, a 72-hour wait, which is accompanied by a mandatory in-person visit to the clinic at least 24 hours before the abortion. Since Utah’s legislature passed these draconian restrictions in 2012, four other states have enacted 72-hour waiting period requirements.

These types of abortion restrictions are medically unnecessary and create additional barriers for patients seeking abortion care. “Many of our patients are hit by funding issues, confusion over the waiting period, and gestational limits .… Daily I see firsthand how these anti-choice policies are harming women and pushing them further into poverty,” Kelsea McLain, director of patient advocacy at A Woman’s Choice of Raleigh, North Carolina, told Rewire.

While these restrictions provide logistical and financial obstacles to obtaining an abortion, they often do not achieve the desired emotional obstacle of forcing a patient to reconsider their abortion decision, according to the study. Just last year, a legislator in Utah defended the 72-hour waiting period, saying it’s necessary for an irreversible medical procedure. When Utah Gov. Gary Herbert (R) signed the bill, a spokesperson said he thought it “allows a woman who’s facing that decision to fully weigh her options and the implications of that decision.”

To assess the effect of Utah’s multiple abortion restrictions, researchers surveyed 500 women who arrived at family planning clinics in Utah for their pre-abortion information visit. Three weeks later, researchers conducted phone interviews to determine the pregnancy outcome and discuss any changes in the patient’s certainty about their decision.

Overall, researchers found that the majority of participants (63 percent) said that the pre-abortion information visit did not change how certain they were about their decision to have an abortion. For patients who did report a change in certainty, almost one-third (29 percent) said the pre-abortion information visit made them more certain about their decision to have an abortion. Just like with the information visit, the vast majority (75 percent) of patients said that waiting 72 hours before having their abortion didn’t affect their certainty, and about a quarter (17 percent) said it made them more certain of their decision. The patients who reported being less certain about their abortion were mostly already conflicted about their decision when they first made the abortion appointment, according to the study’s authors.

What explains these results? Visiting the clinic before having an abortion may have a kind of demystifying effect. The researchers explained in the study that getting the chance to visit the clinic and meet the staff increased participants’ confidence in their decision. These findings suggest that these anti-abortion restrictions themselves may be inadvertently destigmatizing abortion by giving clinic staff additional opportunities to answer a patient’s questions about abortion and for patients to see the compassionate, safe atmosphere at the abortion clinic.

These results may be surprising to some, but they aren’t to researchers or abortion providers. Abortion restrictions like waiting periods and information sessions presuppose that deciding to have an abortion is somehow distinct from other decisions people make about their health care. The evidence is quite the contrary: Patients are more certain about their decision to have an abortion than people making other health-care decisions. Dr. DeShawn Taylor, owner and medical director of Desert Star Family Planning clinic in Arizona, shared that anti-abortion regulations like state-mandated information sessions don’t change minds but can cause emotional distress. “Patients have already taken the time to think about what they want to do …. For people for whom this is an emotional decision, it makes them more emotional. For people who are unemotional about it by the time they get to the office, they just look and shake their head about how stupid the laws are,” Taylor told Rewire.

And what about the small percentage of people who felt conflicted about their decision to have an abortion? The researchers suggest that abortion providers can individually encourage these patients to take more time to make their decision. In fact, most abortion providers already have a practice in place to do just that. Dr. Gabrielle Goodrick, medical director of the Camelback Family Planning clinic in Phoenix, Arizona, detailed the protocol her patients already go through to confirm that they’re confident in their decision to have an abortion: “As with any surgical or medical procedure, patients are consented to the risks and benefits of choosing to have an abortion, and offered information, and options counseling if needed. Most patients are 100 percent sure the minute they walk in,” said Goodrick.

McLain described a similar process in her North Carolina clinic, adding, “Patients are given verbal instructions to let us know at any point if we need to stop, reschedule, or cancel the process. They are able to say ‘no’ up until the moment the physician begins the procedure .… We build up trust during the appointment by being honest, sincere, and friendly so they know they can speak up for themselves.”

This study is groundbreaking in its findings yet somewhat limited in its application more broadly. Because the study took place in Utah, the researchers’ sample had a greater number of Mormons and was less racially and ethnically diverse than the rest of the U.S. population. The researchers noted that being Mormon was actually associated with becoming more certain about an abortion decision after the information session and waiting period.

McLain commented that sometimes, having to jump through hoops motivates her patients to fight anti-abortion laws: “Our patients aren’t stupid. They are women making decisions that impact their daily lives .… And when patients ask for ways to fight back, we look up their local representatives and give them all the numbers and emails they need.”

As the research and providers’ responses show, people don’t need anti-choice legislative interventions to make a decision about having an abortion. What they need is emotional, logistical, and financial support in pursuing the decision they’ve already made.