Counseling and Waiting Period Requirements for Abortion

Many states require patients to receive counseling before getting an abortion, whether it be a procedural or a medication abortion. In most of those states, patients must also wait for a specified period of time after receiving counseling before they can get their abortion. Some states with waiting periods also require in-person counseling, which necessitates two in-person visits: the first for counseling and the second for the abortion. Requiring that counseling take place in person, rather than via mail, fax, internet or phone, may be a barrier to receiving care at all, especially for people who must travel long distances to reach a provider, take time off from work, or secure childcare or lodging. These dual requirements can increase costs and complicate scheduling, jeopardizing people’s ability to get the abortion care they need.

Waiting periods for abortion are medically unnecessary. They are required for almost no other medical procedure, and they do not make abortion care safer. Instead, they aim to deter people from getting an abortion or to compel them to reconsider a decision that the vast majority are already certain of by the time they contact a clinic.

Mandated counseling is also medically unnecessary because every state already requires that patients provide informed consent before undergoing medical treatment, meaning that patients must be given adequate and appropriate information about a procedure in order to understand and agree to it. However, abortion counseling requirements often undermine informed consent by making providers share information that is irrelevant or misleading. For example, some state counseling materials about abortion risks include misinformation about breast cancer or future fertility. Other states include misleading information on fetal pain that is neither necessary for care nor relevant at the gestational durations when most abortions take place. Many states include information in their counseling materials that is meant to promote childbirth, such as information about alternatives to abortion and requirements for paternal support.

Mandated counseling content and method of delivery vary by state and are marked accordingly in the tables below. Most information is conveyed verbally and through written materials, though certain topics require only one method of delivery. The tables also indicate which states supply content—including misinformation—in written materials, even though their laws do not require counseling on those topics. Details on each state’s requirements can be found in the statutes listed in the attached citation chart.

Highlights
  • 26 states require patients to receive counseling before an abortion is performed.
    • 24 states require a waiting period between receiving counseling and the abortion (Table 1).
    • 15 states require in-person counseling, necessitating two trips before receiving the abortion.
    • 9 states require providers to share misinformation about medication abortion (Table 2).
  • All 13 states with total abortion bans also require counseling and waiting periods. In these states, the policies are generally not enforced.
Current Policy Status Table

Table 1. Counseling Topics and Waiting Period Requirements for Abortion

JurisdictionWaiting period (hours)Two tripsDescription of procedureAbortion cannot be coercedFetal developmentFetal painFetus considered a person
Alabama (total ban)48 XXX  
Alaska  X *X (written)* 
Arizona24XXX (verbal, signage)X  
Arkansas (total ban)72XXX (written, signage)X* 
Florida24XX (verbal) X (written)  
Georgia24      
Idaho (total ban)24 X (written) X (written)   
Indiana (total ban)18XX XX 
Iowa24XX (verbal)    
Kentucky (total ban)24XX (verbal) X  
Louisiana (total ban)72XXX (written, signage)XX 
Mississippi (total ban)24X  X  
Missouri (total ban)72XXX (written)XX (written)X (written)
Nebraska24 X (written) X  
North Carolina72XX (written)X   
North Dakota24 X (written)XX X (verbal)
Ohio  X X  
Oklahoma (total ban)72 X (written)  XX (verbal if >20 weeks, written) X (written)
Pennsylvania24 XX (written)X  
South Carolina24 X X  
South Dakota (total ban)72X†  X 
Tennessee (total ban)48XX (verbal)X (verbal, signage)X  
Texas (total ban)24X*** 
Utah72XXX (written)XX 
West Virginia (total ban)24 X (written) X  
Wisconsin24 (2 if reported incest)XXXX  
TOTAL (26)2415 22122354

Notes: Table includes only those jurisdictions with current policies relevant to this topic. Fetus considered a person topic refers to statutes that include the text: “Abortion shall terminate the life of a whole, separate, unique, living human being.” States with total abortion bans are labeled; counseling and waiting period provisions in those states are technically in effect but are enforceable only when an abortion is allowed under an exception to the total ban. For accuracy, the table generally reflects the wording of state statutes.

*Counseling on this topic is not statutorily required but information, and misinformation, is nonetheless included in the state’s written materials. 

†South Dakota requires pregnant people to visit an anti-abortion center, referred to as a pregnancy help center, for counseling in addition to the clinic-based counseling mandated before receiving abortion care.

 

Table 2. Counseling Topics and Waiting Period Requirements for Abortion (cont.)

JurisdictionMisinformation on medication abortionAbortion risksPregnancy / childbirth risksAlternatives, assistance and paternal supportBasis for waiver or exemption
Alabama (total ban) XX (written)Xmedical emergency
Alaska XX (written)X (written)medical emergency, sexual assault, sexual abuse of a minor, incest
ArizonaX (written)XXXmedical emergency
Arkansas (total ban)XXX (verbal)X (paternal waived in cases of rape or incest)medical emergency
Florida X (verbal)X (verbal) alternatives and assistance (written)life endangerment
Georgia X (verbal)X (verbal)assistance and paternal (verbal); assistance and adoption (written)*medical emergency†
Idaho (total ban)X (written)X (written)*alternatives and assistance (written)medical emergency
Indiana (total ban) XXX (paternal waived in cases of rape)medical emergency†
Iowa X alternatives (verbal), alternatives and assistance (written)medical emergency†
Kentucky (total ban)XX (verbal)X (verbal)medical emergency
Louisiana (total ban)X (written)X (verbal, written*)X (verbal, website)X (paternal waived in cases of rape)medical emergency
Mississippi (total ban) XXXmedical emergency
Missouri (total ban) X alternatives (verbal), all three (written)medical emergency
NebraskaXXXassistance and paternal support (verbal), assistance (written)medical emergency
North Carolina XXall three (verbal), alternatives and assistance (written)medical emergency†
North Dakota XXXmedical emergency
Ohio X (verbal)X (verbal)X (written)medical emergency
Oklahoma (total ban) XXXmedical emergency†
Pennsylvania XXXmedical emergency
South Carolina XX (written)X (written)medical emergency
South Dakota (total ban)XX (verbal)Xassistance and paternal support (verbal), all three (written)medical emergency
Tennessee (total ban) X (verbal)X (verbal)assistance (verbal)medical emergency
Texas (total ban) XXXmedical emergency
UtahXXXX (written)medical emergency, lethal fetal anomaly, rape, incest, people under 14
West Virginia (total ban)XXXall three (verbal), assistance (written)medical emergency†
Wisconsin XXXmedical emergency, reported sexual assault
TOTAL (26)926232626

Notes: Table includes only those jurisdictions with current policies relevant to this topic. Alternatives, assistance and paternal support topic refers to mandated provision of information on alternatives to abortion (e.g., adoption, practical support for those choosing to give birth), information about state or private resources for parenting and pregnant people, and information about how fathers are required to provide material support for their children under state law. States with total abortion bans are labeled; counseling and waiting period provisions in those states are technically in effect but are enforceable only when an abortion is allowed under an exception to the total ban. For accuracy, the table generally reflects the wording of state statutes.

*Counseling on this topic is not statutorily required but information, and misinformation, is nonetheless included in the state’s written materials.

†Medical emergency exception does not include mental or emotional conditions or self-harm. Iowa does not include psychological, emotional or familial conditions or age.


Source URL: https://www.guttmacher.org/state-policy/explore/counseling-and-waiting-periods-abortion