Biased Counseling Requirements Undermine Women's Choice

The abortion laws of a number of countries, including Germany and Italy, require that a pregnant woman be provided with counseling prior to undergoing an abortion.¹ Such counseling is often intended to discourage women from having abortions. At these sessions, women may receive information about the risks of abortion, sources of support for married and unmarried mothers, adoption, and ways to get help with social problems resulting from pregnancy.

Mandatory counseling requirements undermine a woman's autonomy in decision-making about matters significantly affecting her life and health.

• Patients have a right to neutral counseling prior to undergoing any medical procedure. However, counseling that is intended to discourage a woman from having an abortion provides a skewed picture of the options available to her.
• Where voluntary counseling is offered to the pregnant woman, information about the risks of abortion should be accompanied by information about the risks to women's health posed by pregnancy and childbirth.
• Biased counseling amounts to interference in the personal deliberations of women facing unwanted pregnancy.

Waiting Periods Second-Guess Women and Put Them at Risk

Counseling requirements are usually accompanied by waiting periods. After undergoing counseling, women may have to wait several days before being permitted to undergo an abortion. In Belgium, for example, the waiting period is six days.² During this period, women are expected to reflect upon their decision and consider their various options.

Waiting period requirements demean women and make abortion more difficult to access.

• Underlying waiting period requirements is the prejudiced assumption that women will not engage in solemn reflection and reasoned decision-making without prompting by the state.
• In a country in which a woman has only a limited period in which to discover that she is pregnant and meet all of the requirements imposed upon her for obtaining an abortion, a lengthy waiting period significantly impairs a woman's ability to access the procedure.
• Waiting periods adversely affect women who must travel long distances to counseling and medical facilities. Such women may not have the resources to pay for accommodations for the period during which they are expected to reflect upon their decisions.

Consent and Notification Requirements Deny Women Freedom to Decide

A significant number of countries, including Japan and Turkey, require a married woman seeking an abortion to obtain the consent of her spouse.³ Numerous countries, including France and India, require girls under a certain age to notify or obtain the consent of a parent before accessing the procedure.⁴ Some countries require abortion providers to obtain approval from other doctors or professionals prior to performing an abortion.

These consent and notification requirements significantly interfere in a pregnant woman's decision-making process.

• Not only do these requirements create a procedural hurdle that makes abortion more difficult to access, they might deter a woman or adolescent from seeking the procedure through legal means. They may therefore cause women to be exposed to the risks of clandestine abortion procedures.
• Requiring providers to seek approval from other physicians makes abortion more difficult to obtain. In addition, this requirement implies that abortion is a suspect procedure, requiring extra scrutiny. There is a danger that approval requirements may serve to stigmatize the practice, thus discouraging practitioners from providing the procedure. This could result in a shortage of providers and a decline in the quality of services.

Fetal Age Limits Restrict Choice and Threaten Health

Most countries that permit abortion without restriction as to reason place limits on the period during which the procedure may be accessed without a specific showing of cause. Fetal age limits for abortion on request range from eight weeks in Guyana to fetal viability in the United States and the Netherlands.⁵ Most countries set the limit at 12 to 14 weeks.⁶ Nations that permit abortion with few restrictions until a particular gestational age may allow the procedure after that point, but only under limited circumstances, such as risk to the woman's life or health or the probability of fetal impairment.

Fetal age restrictions limit women's choice and may put their health at risk.

• Abortions at late stages of pregnancy are rare and are generally only sought under extreme circumstances. But regardless of the stage of pregnancy, governments may not force a woman to carry a pregnancy to term if she is unwilling or unable. At no point may a woman's body be appropriated by the state for the physically intrusive and emotionally intense process of giving life to another human being.
• Because women face greater danger when they undergo unsafe abortion at later stages of pregnancy, governments should ensure that qualified providers are available to meet the needs of women who wish to terminate pregnancy at advanced stages.

Selective Funding Interferes with Decision-Making

Abortion is a medical procedure and it should be funded as are other medical procedures. Governments that pick and choose the circumstances under which they will fund abortions interfere with women's choices.

• Selective funding sends the message that some abortions are justified while others are not - despite the fact that they might all be legal.
• If a government chooses not to fund all procedures that are not "medically necessary," distribution of financial assistance should be based on neutral criteria, such as a woman's income.

Extensive Restrictions on Medical Facilities and Personnel Compromise Abortion Safety

The laws of many countries restrict access to abortion by specifying the types of medical facilities in which abortions may be performed and the categories of health providers that may perform the procedure. In South Africa, for example, abortion services may be provided only in government hospitals or other authorized health care facilities.⁹

Limiting the personnel and facilities authorized to perform abortion restricts women's access to safe abortion.

• Extensive restrictions on the personnel and facilities authorized to perform first-trimester abortions may result in a shortage of providers, particularly in countries that lack an adequate medical infrastructure.
• In certain countries, some types of early abortion can be performed by non-physicians in a range of medical facilities.

Restrictions on Abortion Advertising Deny Women the Power to Choose

A number of countries with fairly liberal abortion laws, such as France and Greece, restrict advertising of the procedure.¹⁰ In countries that place minimal restrictions on abortion itself, these limits on advertising often do not restrict information directed at medical professionals.

Women's right to safe and legal abortion includes the right to information about the availability of abortion services.

• Restrictions on advertising may prevent women from obtaining much needed information about the availability of abortion services, thus denying them the opportunity to make informed choices.
• Governments that prohibit commercial advertising of medical procedures must take extra steps to ensure that information is provided to women about the availability of abortion.

Endnotes