State-level GOP lawmakers are ready to unleash a new crop of medically unnecessary proposals to force people to wait a day or two—or three—before they receive abortion care.

Mandatory waiting periods are among the most common restrictions that have been pushed by abortion rights foes and approved by legislatures in recent years. Already in 2018, Republicans in New Jersey, New Hampshire, and Colorado have introduced forced waiting period bills.

Reproductive rights advocates told Rewire that waiting periods are arbitrary restrictions that are medically unnecessary, create financial barriers, and constitute an undue burden for access to abortion. The continued GOP push for waiting period laws comes after a major legal setback for anti-choice legislators backing such measures. 

A Florida judge on January 9 permanently blocked a state law that forces a pregnant person to complete a 24-hour waiting period before having an abortion. The law forces a pregnant person seeking abortion care to make an extra trip to the physician in order to listen to state-mandated counseling prior to obtaining the abortion.

Circuit Judge Terry Lewis wrote in the decision that no other state law “subjects no other medical procedure, including those that pose greater health risks than abortion, to a mandatory delay,” and declared the law unconstitutional. “A law that forces a patient to delay medical care to the detriment of her health cannot be the least restrictive means of furthering any compelling state interest,” Lewis wrote.

The lawsuit was filed in 2015 by the Center for Reproductive Rights, the American Civil Liberties Union (ACLU), and the ACLU of Florida on behalf of Bread and Roses Women’s Health Center in Gainesville.

Autumn Katz, senior staff attorney at the Center for Reproductive Rights, said in a statement that it is “cruel and unconstitutional” for the state to force pregnant people to delay care for reasons that are medically unnecessary.

“Women know what’s best for their lives and futures and don’t need politicians getting in the way of their health care decisions,” Katz said.

Florida Republican Gov. Rick Scott’s spokesperson Lauren Schenone told Reuters that the governor’s office is “reviewing the ruling,” and did not comment on whether the ruling will be appealed to the state supreme court.

Scott signed the bill into law in June 2015. When the bill was passed by the GOP-controlled state legislature, proponents of the law claimed it was intended to empower women.

“If all this bill does is have one woman—just one—after some time of reflection, after some time of thought say, ‘I’m going to make the decision to have this baby’ … I will consider that be a huge success,” said state Sen. Anitere Flores (R-Miami).

Similar justifications have been echoed by lawmakers and activists in other states.

Twenty-seven states require a pregnant person to wait a specified amount of time prior to obtaining an abortion, according to the Guttmacher Institute. There are 18 states that require 24-hour waiting periods, three states that require 48-hour waiting periods, and five states that require 72-hour waiting periods.

Elizabeth Nash, senior state issues manager at the Guttmacher Institute, told Rewire that in the years following the landmark Roe v. Wade U.S. Supreme Court decision, legislators in several states passed laws mandating 24-hour waiting periods for abortion.

“In 2010, we had a real change in the state legislative level, and started to see states enact 72-hour and 48-hour waiting periods,” Nash said. “Often times they were combined with the in-person counseling requirement, and that’s really a difficult combination of requirements to meet from both a patient and provider perspective.”

There have been dozens of bills introduced by state lawmakers in recent years to either create waiting periods or increase the length of time required for waiting periods.

Utah’s GOP-majority legislature in 2012 became the first state to enact a law that required pregnant people complete a 72-hour waiting period before having an abortion.

Lawmakers and anti-choice activists who supported the law said those seeking abortion care should be required to compete a waiting period to allow time to “fully understand and think about the consequences of that choice.”

Dr. Leah Torres, a Utah-based physician and OB/GYN who provides abortion and reproductive health care, told Rewire that her patients are often surprised when she informs them that they will have to wait three days to have the common medical procedure. 

“They often either didn’t know about it or thought it was 24 hours,” Torres said. “Either way, they’re willing to do whatever it takes to have the abortion they need, though they feel judged by the state and explain that they’ve ‘known for more than three days’ that they’ve wanted an abortion.”

Research that studied the law’s impact found that the 72-hour forced waiting period did not dissuade the vast majority of pregnant people seeking abortion care, and only made it more difficult and expensive to obtain the procedure. 

Torres said that there are other consequences caused by the forcing pregnant people to delay abortion care.

“Pregnancies don’t stop growing and the three extra days will push them into having higher risks with the procedure, including no longer having the option of a medical abortion and being forced to have a surgical procedure,” Torres said. “Cost increases in this situation, and other situations such as going from 14 weeks and five days to 15 weeks and one day.”

Studies of waiting periods in other states have found similar impacts. In Arizona, most pregnant people “reported one or more financial or logistical challenges in obtaining abortion care” due to the state’s 24-hour waiting period, according to a study published in Women’s Health Issues.

“Unnecessary risk increase along with unnecessary cost increase is all that is really accomplished with any waiting period,” Torres said. “People don’t need the state to force them to think about their family-making plans, people already do that naturally.”

Nash said that waiting periods only serve to make it “much more difficult” to both provide and access abortion care. “The idea that a reflection period is necessary for them is really out of step with reality, and there’s no medical literature that says this is medically necessary,” Nash said.

Laws that restrict access to abortion have a disproportionate impact on low-income communities and communities of color, and waiting periods can create a significant financial burden for pregnant people seeking abortion care.

“From the patient perspective you have to go to the facility twice, and you have to do it within at least 48 hours or 72 hours later,” Nash said. “That is very difficult for many patients, because it requires all of the logistics to fall into place—be it child care, or travel, or work schedule.”

Mississippi is one of a handful of states with one abortion clinic, and in addition to a 24-hour waiting period there are a number of other legal restrictions to access to abortion care.  

Laurie Bertram Roberts is the co-founder of the Mississippi Reproductive Freedom Fund (MRFF), an organization that provides financial assistance and practical support for pregnant people in the state seeking abortion care. MRFF receives an average of 70 calls per week from pregnant people seeking assistance, and Roberts said that around 80 percent of the people who call are Black women, and that practically every caller has a low income. 

“There’s far more that we can’t fund than we do fund; the need far outweighs the demand,” Bertram Roberts said. “This week we’ve gotten about 40 calls, and we’ll only be able to provide two of them with direct funding and we’ll only be able to help four of them with practical support.”

“For many callers, state-mandated waiting periods multiply other barriers they have,” Bertram Roberts said. “If child care, travel, or getting off work or school is a barrier, now it’s times two. This can often delay their care not by days, but weeks, even months as they get money and arrangements together.”

Bertram Roberts said that many callers are often confused as to why laws mandating waiting periods exist, feel insulted and ask why lawmakers would do this to them. “All I can say is they believe you should have to stay pregnant,” Bertram Roberts said.