Types of abortion restrictions in the United States

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Abortion restrictions in the United States are laws intended or resulting in restricting the availability or practice of abortions in the United States. Though the Supreme Court in Roe v. Wade recognized a legal right for a woman in the United States to get an abortion, and Planned Parenthood v. Casey invalidated certain restrictions that create an undue burden on women seeking abortions, these cases permit states to make certain restrictions in the guise of regulation of the practice, but which they argue do not create an “undue burden”. Some state laws that impact on the availability of abortions have been upheld. Regulations imposed by individual states that have impacted on the availability of abortions, particularly in the 2010s,[1] include requiring a woman seeking an abortion to view an ultrasound, requiring abortion providers to have admitting privileges at nearby hospitals, and long waiting periods after the first consultation with the abortion provider.[2]

Nevertheless, abortion remains legal in all U.S. states, and every state has at least one abortion clinic.[3][4]

Laws targeting abortion clinics[edit]

This map shows 60-mile access to abortion providers in Texas

Some states impose regulations that apply only to abortion clinics, sometimes called TRAP (targeted regulation of abortion providers) laws, which according to Mother Jones and The New Republic impose standards that may be arbitrary or difficult to implement and are aimed at closing abortion clinics. For example, some laws require abortion clinics to meet the same standards as ambulatory surgical centers, which entail renovations that are prohibitively expensive for some clinics.

Other regulations require doctors performing abortions to have admitting privileges at a nearby hospital.[5] Some hospitals refuse admitting privileges to doctors who perform abortions.[6][7] Critics of admitting privileges laws and other TRAP laws include the American College of Obstetricians and Gynecologists, the American Public Health Association, and the American Medical Association, which have argued that such laws are medically unnecessary and that abortion is already very safe in the United States.[8][9]

From 2011, the crimes of Kermit Gosnell, a physician who ran an abortion clinic in Philadelphia, spurred federal and state bills to more strictly regulate abortion facilities. Opponents of the restrictions questioned whether stricter regulations would have deterred Gosnell, who was alleged to be knowingly in violation of existing regulations.[7]

Supporters of Texas Senate Bill 5, which included requirements for abortion clinics to meet ambulatory surgical center regulations and for abortion clinic doctors to have hospital admitting privileges, said the bill improved health care for women and babies. Opponents of the bill said it created unnecessary regulations for the purpose of reducing access to abortions. At the time of the bill's signing into law in 2013, five of the state's forty-two abortion clinics met the law's requirements. Courts had blocked enforcement of similar laws in some other states, pending lawsuits challenging their constitutionality.[10] A federal district judge determined this law to be unconstitutional, finding that the admitting privileges requirement placed an undue burden on a person seeking to have an abortion;[11] however, this decision was reversed by the Fifth Circuit Court of Appeals, resulting in the immediate closure of all but seven abortion clinics in the state, all of these in urban areas.[12] For females in the Big Bend area, the nearest clinic can be as far as 300 miles away.[13]

Following the passage of a 2013 Wisconsin law requiring abortion providers to have admitting privileges at a nearby hospital, three Catholic hospital systems in the state intended to deny admitting privileges to abortion providers. Wisconsin's attorney general said this intent violated the Church Amendment of 1973, which prohibits hospitals receiving federal funds from discriminating against a doctor on the basis of whether the doctor provides abortions.[14]

In Maryland, according to The New York Times, something "rare in this era of polarized abortion politics" occurred when laws that significantly tightened the licensing and inspection of abortion clinics were supported by those on both sides of the abortion issue.[15]

Laws targeting methods of practice[edit]

On November 4, 2013, the U.S. Supreme Court declined to hear an appeal by the state of Oklahoma to the overturning, on constitutional grounds, of a bill intended to ban the practice of terminations of early pregnancies via medications.[16]

Mandatory ultrasounds[edit]

As of March 2012, 20 states require women seeking an abortion to have an ultrasound before being allowed to have the procedure. Mandatory transvaginal ultrasounds have been particularly controversial.[17] In Texas, for instance, even if previous ultrasounds had indicated severe congenital defects, a woman seeking an abortion was required under a 2012 law to have another ultrasound done, "administered by her abortion doctor, and [she had to] listen to a state-mandated description of the fetus she was about to abort", though state-issued guidelines later eliminated the ultrasound requirement if the fetus had an "irreversible medical condition".[18]

On November 12, 2013, the U.S. Supreme Court declined to hear an appeal by the state of Oklahoma to the overturning of a bill that mandated compulsory ultrasound examinations.[19]

Waiting periods[edit]

Some states require that a person seeking an abortion wait for a period of one to six days, variously, after visiting the provider for the first time and before having the abortion. The state of South Dakota requires that the patient obtain mandatory counseling from an anti-abortion crisis pregnancy center during this time frame.[20]

Fetal heartbeat bills[edit]

This type of legislation requires either that a woman be required to listen to her fetus's heartbeat should she attempt to obtain an abortion,[21] or, more rigidly, that abortion become illegal as soon as a heartbeat can be detected, which is sometimes as early as six weeks.

Physician scripts[edit]

In some states, a doctor who is asked to perform an abortion is required to read a prepared script to the patient in order to secure informed consent. These scripts may include medically inaccurate information intended to persuade the patient not to have an abortion, such as the claim that the abortion will increase the risk of breast cancer or of psychological problems, which are not supported by mainstream medical organizations or scientific consensus.[18][22] As of July 2013, 12 states require that women be given information on the ability of a fetus to feel pain.[23] In Planned Parenthood v. Rounds, the Eighth Circuit Court of Appeals ruled that a South Dakota law requiring doctors to give patients false or misleading information about the suicide risk in women who have abortions was not unconstitutional.[24]


A 1997 Louisiana law creates a civil cause of action for abortion-related damages, including damage to the unborn, for up to ten years after the abortion. The same law also bars the state's Patient's Compensation Fund, which limits malpractice liability for participating physicians, from insuring against abortion-related claims.[25][26] An attorney for the Center for Reproductive Rights, which opposes the law, said the law is an attempt to drive abortion providers out of practice, and that every completed abortion imposes strict liability under the law because abortion necessarily involves damage to the unborn.[27]


As of 2010, 46 of 50 states and the District of Columbia had either mandatory or voluntary reporting of abortion statistics. According to an associate of the Guttmacher Institute, reporting requirements were generally "benign" and treated confidentially, but the requirements in some states have become more intrusive.[28]

A 2009 Oklahoma law, overturned by a federal court in 2010, would have required doctors to report information from a 37-question form about every woman receiving an abortion to the state health department for publication in an online registry.[28] A lawyer for the Center for Reproductive Rights, a co-plaintiff in the lawsuit challenging the law, said the law would have made public potentially identifying details about women, and was intended to dissuade women from seeking abortions.[29] Todd Lamb, who sponsored the law as a state senator, called it "essential in protecting the sanctity of life" and "pro-life".[28]

See also[edit]


  1. ^ Connor, Tracy (January 21, 2013). "40 years after Roe v. Wade, more states restricting abortion". NBCNews.com.
  2. ^ Kliff, Sarah (January 31, 2013). "All states except Oregon now limit abortion access".
  3. ^ "Using Abortion Pills for Safe Abortion in the USA. Self-Managed Abortion; Safe and Supported (SASS). — Women Help Women Consultation". Consult.womenhelp.org. 2017-01-12. Retrieved 2017-07-21.
  4. ^ Politics (2017-02-10). "Here's how many abortion clinics are in each state". Business Insider. Retrieved 2017-07-21.
  5. ^ "Abortion, Hospital Admitting Privileges, and Whole Woman's Health v. Cole" (PDF). Retrieved October 1, 2015.
  6. ^ Sheppard, Kate (June 27, 2011). "Abortion Foes' Latest Backdoor Ban". Mother Jones.
  7. ^ a b Caplan-Bricker, Nora (May 1, 2013). "The Kermit Gosnell Effect". The New Republic.
  8. ^ Grossman, Daniel; Baum, Sarah; Fuentes, Liza; White, Kari; Hopkins, Kristine; Stevenson, Amanda; Potter, Joseph E. (November 2014). "Change in abortion services after implementation of a restrictive law in Texas". Contraception. 90 (5): 496–501. doi:10.1016/j.contraception.2014.07.006. PMC 4179978. PMID 25128413.
  9. ^ "Opposition to Requirements for Hospital Admitting Privileges and Transfer Agreements for Abortion Providers". APHA Policy Statement. Retrieved 14 March 2016.
  10. ^ "Texas Gov. Perry Signs Abortion Restrictions Into Law". Wall Street Journal. Associated Press. July 18, 2013. Retrieved October 7, 2013.
  11. ^ Tomlinson, Chris (October 28, 2013). "Federal judge: Texas abortion limits unconstitutional". AP.
  12. ^ Welch, William A. (October 3, 2014). "Appeals court lets Texas enforce law that restricts abortions". USA Today.
  13. ^ Weber, Paul J. (October 2, 2014). "Fewer Texas abortion providers after court ruling". AP.
  14. ^ Ahmed, Akbar (August 7, 2013). "Hospitals can't deny admitting privileges to abortion doctors, AG says". Milwaukee Journal Sentinel. Retrieved October 4, 2013.
  15. ^ [1]
  16. ^ Court lets stand an Oklahoma ruling that a state abortion law is unconstitutional', Washington Post, Juliet Eilperin, 12 November 2013. Retrieved 13 November 2013.
  17. ^ Sheppard, Kate (March 5, 2012). "Mandatory Transvaginal Ultrasounds: Coming Soon to a State Near You". Mother Jones.
  18. ^ a b "'We Have No Choice': A Story Of The Texas Sonogram Law". NPR. January 22, 2013.
  19. ^ Court lets stand an Oklahoma ruling that a state abortion law is unconstitutional', Washington Post, Juliet Eilperin, 12 November 2013. Retrieved 12 November 2013.
  20. ^ "South Dakota governor signs extended abortion wait period law". Reuters. March 8, 2013.
  21. ^ See, for example, The Next Abortion Battleground: Fetal Heartbeats
  22. ^ Lazzarini, Zita (November 20, 2008). "South Dakota's Abortion Script — Threatening the Physician–Patient Relationship". New England Journal of Medicine. 359 (21): 2189–91. doi:10.1056/NEJMp0806742. PMID 19020321.
  23. ^ "State Policies in Brief: An Overview of Abortion Laws" (PDF). Guttmacher Institute. Retrieved 2 July 2013.
  24. ^ Can the Government Require Doctors to Provide Misleading Information to Patients Seeking Abortions?
  25. ^ Cassens Weiss, Debra (September 6, 2013). "5th Circuit finds no undue burden in law curbing liability protection for abortion providers". ABA Journal. Retrieved October 8, 2013.
  26. ^ Catalanello, Rebecca (September 5, 2013). "Abortion providers challenging Louisiana law suffer setback at 5th Circuit". Times-Picayune. Retrieved October 8, 2013.
  27. ^ Mcconnaughey, Janet (March 29, 2012). "Judge forbids La to enforce abortion liability law". Deseret News. Associated Press. Retrieved October 8, 2013.
  28. ^ a b c Donaldson James, Susan (February 19, 2010). "Okla. Strikes Down Law That Would Have 'Undressed' Women". ABC News. Retrieved October 8, 2013.
  29. ^ "Oklahoma abortion law to force women to list personal details online". Daily Telegraph. October 19, 2009. Retrieved October 8, 2013.