Science says women are quite certain about having an abortion

“Our findings challenge the argument that women are particularly conflicted about having an abortion.”

CREDIT: iStock
CREDIT: iStock

Women who decide to get abortions are just as confident about their decision as people making other kinds of health care decisions, groundbreaking research from the University of California’s Advancing New Standards in Reproductive Health (ANSRH) shows.

“Women are certain about their decision to have an abortion when they present for care,” Lauren Ralph, an epidemiologist at ANSRH and the study’s lead author, told ThinkProgress.

These findings directly refute the argument that women are particularly conflicted about having abortions — an assumption that has led to the proliferation of GOP-sponsored laws requiring ultrasounds, additional counseling visits, and extended waiting periods intended to help women make a difficult decision.

“Our findings challenge the argument that women are particularly conflicted about having an abortion.”

To gauge women’s certainty, researchers used the Decisional Conflict Scale, which Ralph described as the “gold standard for assessing an individual’s certainty about a health care decision.”


They surveyed 500 women at four Utah locations, asking them to complete the scale before meeting with the provider, and then followed up with the women three weeks later to see if they had actually had an abortion.

“Overall, women scored very low on the scale, which is indicative of high certainty,” said Ralph. “Women who were more certain were also more likely to have had an abortion at the followup.” Eighty-nine percent of the surveyed women received abortions.

Because the Decisional Conflict Scale is a standard measure, the researchers were also able to compare their results to other studies of health care decisions. Women, they found, were as certain or even more certain about their decision to seek an abortion as men and women were about the decision to get reconstructive knee surgery, undergo prenatal testing in pregnancy, and move forward with treatment for colorectal and breast cancer.

“Our finding directly challenges the narrative that decision making on abortion is somehow exceptional compared to other health care decisions and requires additional protection, such as state laws that mandate waiting periods or targeted counseling, and whose stated purpose is to prevent women from making an unconsidered decision,” said Ralph.

Proponents of these laws, which mandate pre-abortion counseling and a set waiting period before patients are allowed to proceed with an abortion, say they are necessary to make sure pregnant women have enough time to make a serious decision.

“Women are certain about their decision to have an abortion when they present for care.”

But these kind of restrictions aren’t imposed on any any other type of medical procedure — even ones that can be medically fraught, like choosing how aggressively to treat cancer, and about which people who were surveyed actually were more uncertain than the women deciding on abortions.


And this new study, which is the first to use the rigorous and scientifically validated measure of certainty, is just one more piece of evidence that the rationale behind these laws isn’t backed up by the facts.

Previous research has shown that nearly 90 percent of women report they’re “highly confident” about having an abortion when they first seek out a clinic. Studies have also shown that even when women have mixed emotions after ending a pregnancy, they don’t regret their abortion and overwhelmingly say they made the right choice.

And instead of helping women make their decisions, these laws actually pose an additional burden. Extended waiting periods typically require patients to make multiple trips to an abortion clinic, requiring transportation and time off work. Reproductive rights advocates say this poses a particularly untenable burden for low-income women, making abortion care unnecessarily difficult or pricing them out completely.

There’s research to back this position. One study examining Texas’ 24-hour period, for example, found that the policy could cause “excessive hardship,” and nearly half of the respondents reported spending an average of $146 in extra transportation and childcare costs because of the second trip. And a recent study of Utah’s 72-hour waiting period found that two-thirds of women reported that the wait affected them negatively, including lost wages, transportation costs, and having to tell someone they wouldn’t have normally told about their abortion.

Nonetheless, such laws, pushed through by Republican-dominated state legislatures across the country, are increasingly popular. Thirty-five states mandate counseling before an abortion, and many of these mandate what that counseling must contain — from information about fetal development to requiring that women be told life begins at conception. Twenty-seven states mandate a waiting period, which range from 24 to 72 hours.