New Wave of Laws Seeks to Shut Down Abortion Providers

Targeted Regulation of Abortion Providers (TRAP) Requirements Are a Cynical Ploy to Make Abortion Care Less Accessible

Laws that single out abortion providers by imposing irrelevant and onerous regulations are not good-faith efforts to make an already-safe procedure safer, but instead aim to make abortion care less accessible, according to a new analysis by Guttmacher policy experts Rachel Benson Gold and Elizabeth Nash. The authors trace how opponents of abortion rights are employing a state-level strategy to not only make it burdensome for women to obtain an abortion, but also block clinics from providing abortions in the first place.

"In many states, antiabortion legislators have mostly exhausted legal means to badger women into not seeking an abortion, for instance, by requiring multiple in-person visits or mandating biased counseling and medically unnecessary ultrasound exams," says Rachel Benson Gold, Guttmacher's director of policy analysis. "A wave of laws is now bluntly focused on driving providers out of business via a thicket of regulations designed not to benefit patients but, as some of their proponents admit openly, to make it impossible for many providers to come into compliance."

TRAP laws or regulations are now in place in 27 states, where 60% of women of reproductive age live. Some of these provisions require that:

  • abortion facilities or their clinicians have unnecessary and burdensome connections to a local hospital (21 states). As the analysis details, such links to hospitals do little to add to long-standing patient safeguards while effectively granting hospitals veto power over whether an abortion clinic can exist;
  • abortion facilities meet standards for ambulatory surgical centers (26 states), even though the latter provide procedures that are more invasive and risky than abortion. Twelve states specify the size of procedure rooms and the same number specify hallway widths, often giving a minimum width well in excess of what is actually needed to transport a patient in case of an emergency; or that
  • facilities that provide only medication abortion adhere to the same standards as those that also provide surgical abortion care (18 states).

"Examining the details of these TRAP requirements, which are usually marketed under the guise of protecting women's health, exposes how little they have do with patient safety," says Elizabeth Nash, Guttmacher's state issues manager. "For instance, in Virginia, new rules not only mandate larger-than-necessary dimensions for procedure rooms and corridors, but also specify requirements for the ventilation system, parking lot and covered entrances."

The authors further refute the stated rationale for singling out abortion providers via TRAP requirements, noting that abortion is an extremely safe medical procedure. Less than 0.3% of U.S. abortion patients experience a complication that requires hospitalization and the risk of dying from a legal abortion in the first trimester—when almost nine in 10 abortions are performed—is no more than four in a million.

"TRAP laws are a solution in search of a problem, a cynical ploy to advance an agenda that seeks to make it more and more difficult for women to obtain an abortion, with the ultimate goal of eliminating U.S. women's access to safe and legal abortion," says Gold. "It's especially unfortunate that the horrible crimes committed by Kermit Gosnell in Philadelphia have helped fuel the latest wave of these laws. Gosnell was able to prey on low-income women seeking abortions not because of inadequate regulation, but because Pennsylvania authorities failed to enforce the regulations already on the books."

Read the full analysis here:

"TRAP Laws Gain Political Traction While Abortion Clinics—and the Women They Serve—Pay the Price," by Rachel Benson Gold and Elizabeth Nash

For more information:

State Center: Overview of TRAP Laws

State Center: State Policies in Brief

Fact Sheet: Induced Abortion in the United States

Video: Abortion in the United States

Analysis: Medication Abortion Restrictions Burden Women and Providers

Also in this issue of Guttmacher Policy Review:

"A Tribute to Cory L. Richards, Editor of the Guttmacher Policy Review, 1998–2013

"Still True: Abortion Does Not Increase Women's Risk of Mental Health Problems," by Susan A. Cohen;

"Vigilance Needed to Make Health Reform Work for 'Essential Community Providers'," by Adam Sonfield;

For the Record, "Obama Administration Yields to the Courts and the Evidence, Allows Emergency Contraception to Be Sold Without Restrictions"

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