Women are sure about their abortion decisions, and felt less conflicted than those deciding on knee surgery, according to a first-of-its-kind study out Thursday.
The research, published in the journal Contraception, upends a widely held belief in the anti-choice movement that women feel conflicted about abortion care and need state-assisted intervention, including forced waiting periods and mandatory counseling.
“I think this finding challenges the narrative that decision making on abortion is somehow exceptional and requires additional protection,” Lauren J. Ralph, epidemiologist with the University of California San Francisco (UCSF) research group Advancing New Standards in Reproductive Health, said in a phone interview with Rewire.
Ralph, the lead author of the study, continued, “Women are certain of their decision when they present for abortion care.”
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Researchers from UCSF and the University of Utah surveyed 500 English- and Spanish-speaking women seeking abortion care at four Utah clinics between October 2013 and April 2014. About 70 percent of the respondents were white, and nearly half identified as religious.
The authors found that women felt about the same or a bit more certainty about their abortion care decision than those making decisions such as taking antidepressants while pregnant, undergoing prenatal tests after infertility, and choosing a mastectomy after a breast cancer diagnosis. Respondents were more sure about receiving abortion care than those seeking reconstructive knee surgery.
The team was the first to measure respondents’ levels of uncertainty with a survey tool, the Decisional Conflict Scale, considered by researchers to be the “gold standard.” Doing so allowed the scientists to compare women’s certainty about abortion care to health-care decisions explored in previous research.
“Since most women are certain of their decision, there’s not evidence from our study that women would benefit from additional counseling visits, having to wait up to 72 hours before receiving care, or viewing ultrasounds,” Ralph told Rewire.
Eighteen states force pregnant people to wait up to 24 hours for abortion care, three states require a 48-hour delay, and six states impose a 72-hour wait, according to recent data from the Journal of the American Medical Association.
“I think those laws rest on the notion that women are fundamentally undecided,” Ralph told Rewire.
Prior research has also found that most women are certain about ending their pregnancies, as the authors note. Research published this year on Utah’s 72-hour forced waiting period found the delay didn’t change most women’s minds; it just made abortion care more costly and difficult to obtain.
The authors explored the role of abortion myths in patients’ decision making by asking respondents to rate whether they believed a series of statements. The statements were both inaccurate—”abortion causes breast cancer”—and factual—”abortion does not cause breast cancer.”
Ralph told Rewire that women who believed the myths were more likely to be conflicted in their decision, but still had “high levels of certainty” about their choice to end their pregnancy.
The findings, Ralph said, underscore the need for accurate abortion care information.
Many states force abortion providers to tell myths to pregnant people. Five states tell patients that abortion care increases the risk of breast cancer, six claim that a fetus is a person, and 12 say abortion care causes fetal pain, as the Journal of the American Medical Association recently noted.