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Abortion certainty does not increase in states with mandated waiting periods

More than half of U.S. states require patients to wait 18 to 72 hours after mandated counseling before having an abortion, supposedly to aid decision-making for those uncertain about their decision. But this study finds that living in a state with a waiting period or in-person two-visit requirement is not associated with increased decision certainty.

Key Findings

For patients searching for abortion information online, living in a state with mandatory waiting period laws, two-visit requirements, or both was not associated with higher levels of decision certainty when compared to those living in states with no such restrictions.
These results suggest that these state restrictions by themselves likely did not have their intended effect of increasing decision certainty in a population of individuals considering abortion.
Those who had obtained abortions by the follow-up survey four weeks later had the most stable levels of decision certainty over time.
Those who had decided to continue their pregnancies also had high levels of decision certainty.
Those still seeking abortions were the only group for whom decision certainty had decreased over four weeks—possibly reflecting delayed decision-making as a result of lower initial decision certainty or other barriers to obtaining care.

Study Design

Researchers used data from 750 participants in the Google Ads Abortion Access Study, which showed individuals an ad for a survey in the search results of key terms such as “abortion clinic near me.” Eligible individuals completed the survey, including questions on sociodemographic characteristics, pregnancy history, gestation of the current pregnancy, and decision certainty. Four weeks later, each participant received an email or text message invitation with a link to report their pregnancy status and other details in a follow-up survey.

It is important to note that this study did not capture possible harms of mandatory waiting periods and two-visit requirements. For instance, these restrictions can make the process of obtaining abortion care more difficult by requiring patients to arrange travel, child care, or time off work.

“Whether or not people ultimately choose to have an abortion, restrictions that impose additional visits or waiting periods have no benefits in terms of making people more certain about their decisions.”

The study, Abortion waiting periods and decision certainty among people searching online for abortion care, is available in Obstetrics and Gynecology.

Additional Resources