Laws that require counseling and waiting periods before abortion, but that allow counseling to be delivered over the Internet, by phone or by mail, appear to have little impact on birth and abortion rates. Yet, according to a new Guttmacher Paper analyzing the relevant literature, these laws may postpone the timing of some abortions. These findings imply that counseling requirements do not cause women to change their minds about having an abortion, and that waiting period requirements do not impose significant barriers to abortion services.

Currently, 24 states require women to wait, usually for 24 hours, between an initial counseling session and the abortion procedure. The laws in seven of these states require in-person counseling at least 18–24 hours prior to the procedure. Multiple studies of such a law in Mississippi have found that the requirement was associated with a decline in the state’s abortion rates, an increase in the number of residents going out of state for an abortion, and delays in accessing abortion services. These findings suggest that an in-person counseling requirement places an additional burden on some women by forcing them to take more time off from work, arrange child care or stay away from home overnight when the distance to the clinic is great.

"When we looked at the laws across the board, we found little impact," said the lead author of the new report, Theodore Joyce. "But the Mississippi studies consistently found that an in-person counseling requirement was associated with fewer abortions overall, but more abortions obtained out-of-state and more second-trimester procedures. In other words, some women had to travel greater distances, and as a result, they decided not to have the procedure or to have it later in pregnancy, when the procedure is less safe and more expensive."

Research from other Guttmacher studies has shown that poor and low-income women—who have the highest unintended pregnancy and abortion rates—are also those most affected by abortion restrictions. Disadvantaged women who have trouble raising the funds for their abortion frequently take up to three weeks longer than better-off women to obtain an abortion and have the greatest difficulties taking time off from work, getting child care and affording the travel costs to obtain the procedure. A requirement of multiple in-person visits imposes even more barriers, which disproportionately affect the most vulnerable women.

According to previous Guttmacher research, abortion providers report that almost all women obtaining abortions are sure of their decision to terminate their pregnancy before they have even picked up the phone to make an appointment. While it is important to ensure that women have the information they need to make an informed decision, the evidence suggests that mandated counseling serves only to delay women’s access to a procedure they have already chosen, rather than to inform their decision making.

"Requiring women to make two trips to obtain an abortion is unnecessary," says Guttmacher Paper coauthor Lawrence Finer. "These laws are intended primarily to block abortion access, and the most disadvantaged women, who already have trouble accessing services, are disproportionately affected."

Click here for the full report "The Impact of State Mandatory Counseling and Waiting Period Laws on Abortion: A Literature Review," by Theodore J. Joyce of Baruch College, Stanley K. Henshaw and Lawrence B. Finer of the Guttmacher Institute, and Amanda Dennis and Kelly Blanchard of Ibis Reproductive Health.

For more information on mandatory counseling and waiting periods, click here: State Policies in Brief: Mandatory Counseling and Waiting Periods for Abortion.