They’re frequently identified as “Women’s Health and Safety” laws, but a growing number of laws regulating abortion providers are more accurately called TRAP laws — Targeted Regulation of Abortion Providers. They’re aimed at stopping abortion by making them logistically impossible — shutting down clinics — rather than flat-out illegal. You can generally recognize a TRAP law when it purports to make a basic medical procedure safer by browbeating or delaying a woman into not having it at all.
Mandatory delays, ultrasounds, “informed consent” lectures, and medication restrictions strike out at abortion by hitting women directly. They place unnecessary delays in the middle of a time-sensitive procedure. They cause women stress and affect their emotional well-being. They cost money, travel time, and lost wages. And they impose on that most crucial of relationships between doctor and patient, forcing doctors to perform unnecessary medical procedures and provide misleading information to interfere with a woman’s ability to make choices about her own health care. They go against recommendations of the AMA and the ACOG, and they do it in the name of protecting the very women they’re harming. If you’re the kind of person who believes in evil, these restrictions are arguably the most evil of TRAP laws.
A recent report by the National Partnership for Women & Families, aptly titled Bad Medicine, looks at laws that “undermine the high-quality, patient-centered care that health care providers and advocates strive to achieve.”
Ultrasounds. Twenty-four states currently have laws requiring doctors to offer, perform, or perform and describe, or perform and describe and force the viewing of an ultrasound to a woman seeking an abortion, whether she wants one or not. (Four states call for transvaginal ultrasound at certain early points in the pregnancy, requiring that the transducer be inserted into the woman’s vagina.) In five states, the ultrasound must be followed by a 24-hour waiting period. The intent of these requirements is to make abortion as physically and emotionally taxing as possible to place a barrier between a woman and the medical procedure she wants and/or needs.
Waiting periods. Thirty states have a mandatory delay, ranging from one to three business days, between the woman’s initial consultation with her doctor and the abortion procedure itself. This is particularly arduous for women who have to travel a considerable distance to have an abortion — in Texas, for instance, which is now down to fewer than ten clinics for the entire state — and won’t be able to take time off from work, make the lengthy trip twice, and/or afford to stay in a hotel overnight (or for several nights). This isn’t unintentional. The purpose of the waiting period is to give women time to become uncertain of a decision they had been certain about, and to make them unable to make the return trip to undergo the procedure.
Mandatory, inaccurate counseling. Eleven states require an additional counseling appointment, purportedly to help women be comfortable and secure in whatever choice they make. In reality, though, a study by the Guttmacher Institute indicates that 87 percent of women are highly confident in their decision without counseling. The counseling isn’t to make women secure in their choice; it’s to make them question it. And it’s designed to do that by lying — 28 states require doctors to provide, in the name of “informed consent,” information to women that is medically inaccurate at best. Women are told about the (medically disproven) link between abortion and breast cancer, the (fictitious) “post-abortion syndrome,” and a fetus’s (mythological) ability to feel pain at 20 weeks’ gestation, among others.
Restrictions on medical abortions. Eighteen states have passed restrictions on how providers can administer medical abortions — abortions requiring just a couple of pills rather than an outpatient surgical procedure. They are frequently easier, less traumatic, and medically preferable for some women, which is why laws have to be passed to stop them. These include a requirement for physicians to follow an outdated protocol from 2000 for timing and dosage of the drugs, rather than more up-to-date protocols grounded in evidence-based standards and the judgment of the doctor who’s actually in contact with the actual patient. They also prohibit telemedicine — consultation with a trained, licensed physician via videoconferencing, for instance — which can make health care accessible to women in underserved and rural areas. When it’s applied to fields like obstetrics, gynecology, and primary care, it’s considered a fantastic advancement in health care quality and safety; when it’s applied to abortion, it’s suddenly a threat to women’s health and safety.
The American Medical Association, the American College of Physicians, and the American College of Obstetrics and Gynecologists have all recognized that some or all of these restrictions are politically motivated and guaranteed to block, not protect, a woman’s access to safe, accurate, evidence-based, up-to-date, ethical, compassionately delivered health care. Yet currently, 29 states have at least one of these restrictions in force, and 15 states have all four. In the name of women’s health and safety.