Womens Health Issues 2017 Apr 5. pii: S1049-3867(16)30269-9.:

Do 72-hour waiting periods and two-visit requirements for abortion affect women's certainty? A prospective cohort study

Roberts SC, Belusa E, Turok DK, Combellick S and Ralph L


Purpose: This paper examines how Utah's two-visit requirement and 72-hour waiting period influence women's certainty about their decision to have an abortion.

Procedures: This study uses data from a prospective cohort study of 500 women who presented at an abortion information visit at four Utah family planning facilities. At the information visit, participants completed a baseline survey; 3 weeks later, they completed telephone interviews that assessed their pregnancy outcome, change in certainty, and factors affecting changes in certainty.

Main findings: Overall, 63% reported no change in certainty owing to the information visit and 74% reported no change in certainty owing to the waiting period. Changes in certainty were primarily in the direction of increased certainty, with more women reporting an increase (29%) than a decrease (8%) in certainty owing to the visit and more women reporting an increase (17%) than a decrease (8%) owing to waiting. Changes in certainty in either direction were concentrated among the minority (8%) who were conflicted about their decision at baseline. Learning about the procedure, meeting staff, and discovering that the facility was a safe medical environment were main contributors to increased certainty.

Conclusions: Most women were certain of their decision to have an abortion when they presented for their abortion information visit and their certainty remained unchanged despite the information visit and 72-hour waiting period. Changes in certainty were largely concentrated in the minority of women who expressed uncertainty about their decision before the beginning of the information visit. Thus, individualized counseling for the minority who are conflicted when they first present for care seems more appropriate than universal requirements.

Comment: This study confirmed what most of us already knew: if a woman comes for an abortion and she is determined, then she will still be determined after 48 or 72 hours. In those cases one should go ahead with the abortion at that time. If she seems uncertain during the first visit, then it is worthwhile to have a counseling conversation with her. (HMV)