Frequently Asked Questions & Answers
Does this bill limit women's access to abortions?
No. It only defines when it is negligent for the physician to fail to screen for coercion or risk factors . . . information the doctor needs in order to give her informed medical advice. If the doctor fails to provide adequate screening, the woman may hold the abortion provider subsequently accountable in civil court. Conversely, as long as abortion doctors provide women with adequate screening and informed advice, they will not face any additional liability risk. (Fact Sheets)
What is the position of mental health professionals on pre-abortion screening?
On March 14, 2008, the British Royal Academy of Psychiatrists issued an official statement endorsing the importance of pre-abortion screening for risk factors:
Healthcare professionals who assess or refer women who are requesting an abortion should assess for mental disorder and for risk factors that may be associated with its subsequent development. If a mental disorder or risk factors are identified, there should be a clearly identified care pathway whereby the mental health needs of the woman and her significant others may be met.1
A special report prepared for the American Psychological Association on abortion and mental health, the APA task force identified over fifteen risk factors, including perceived pressure from others, a history of mental health problems, feelings of commitment to the pregnancy, ambivalence over the decision, and low self-esteem.2A
Sylvia Stengle, executive director of the National Abortion Federation, told the Wall Street Journal that at least one in five abortion patients are at psychological risk from abortion due to prior philosophical and moral beliefs contrary to abortion. Stengle stated that "It's a very worrisome subset of our patients. Sometimes, ethically, a provider has to say, 'If you think you are doing something wrong, I don't want to help you do that.'"2B
Dr. Nada Stotland, former board member of Physicians for Reproductive Choice and Health (PRHC) and former president of the American Psychiatric Association, insists that mental illness after abortion is rare. Despite her strong pro-choice convictions, however, Stotland recommends pre-abortion decision counseling and screening, including questions associated with an elevated risk of negative reactions after an abortion, such as questions regarding abandonment by partner, negative moral beliefs about abortion, history of domestic violence, et cetera.3 (Fact Sheet)
Does this bill prohibit an abortion if there is evidence of coercion or any other risk factor?
No. It does not outlaw any abortions or impose any criminal penalties on any abortions. In all cases, physicians are free to act as they see fit. They may even ignore the standard of care for screening, if they so choose. But if they do ignore this standard for screening, it is likely that sooner or later injured patients will hold them properly accountable for this negligent screening and counseling.
In every case, the judgment of how to proceed is left to the woman in consultation with her physician. Also unchanged is the right of the physician to refuse to do an abortion if it is not in the best interests of the patient--which is the doctor's right under current law.
Assume, for example, the case of a teenager with a history of depression and suicide attempts. Moreover, she would really love to have the baby but is facing such an abusive situation that she believes, "I have no choice." Even though she insists she doesn't want to do it, she simply "must have the abortion" or the abusive person will make her "pay for it."
In such a case, the doctor has the right (and some might argue the duty) to refuse to do the abortion and instead insist on her obtaining intervention counseling, and perhaps legal help. Such a refusal might be motivated by the concern that performing an unwanted abortion would be an act of aiding and abetting her abuser. Or the doctor may conclude that an abortion is contraindicated for this particular patient because an unwanted abortion may put her at higher risk of suicide.
This law does not dictate what the doctor must do in this or any other circumstance. If he determines that is in the best interests of his patient, he is free to proceed with the abortion. The law only provides that it is an act of medical negligence not to develop an informed opinion....and gives women the opportunity to hold their abortion doctors accountable for in civil court if they fail to give proper screening and counseling.
What prompted this initiative?
In the late 1980's, Feminists for Life of America first began to identify obstacles in the law which prevented women from being able to hold abortion providers properly accountable for coerced and unsafe abortions. Unfortunately, their proposals to improve right to redress laws regarding abortion malpractice were not acted upon at that time.
Renewed interest in this proposal, however, has been sparked by the increasing body of evidence which indicates that as many as 64 percent of women having abortions feel pressured, coerced or forced into unwanted abortions.4
In addition, it has come to light that many abortion providers have abandoned the pre-abortion screening and/or are ignoring risk factors for post-abortion complications which have been statistically validated in peer reviewed journal.5
This initiative was developed to empower women to hold abortion provides properly and fully accountable for negligent screening and counseling.
Isn't the problem of coerced abortions a private problem within families and relationships?
Yes. But when a woman is considering abortion in consultation with her doctor, it is no longer private. There is now an opportunity for her health care provider to help her, and if necessary, to intervene and help her escape the pressures she may face to undergo an unwanted abortion.
It would only take a few minutes for abortion counselors to inquire of a pregnant women: "Is someone else encouraging you to have this abortion? Do you want this abortion to satisfy your own needs or are you looking to do this to please someone else? Are you feeling pressured to have this abortion by any other person? Do you feel any attachment to this pregnancy or any desire to keep it?"
These questions could save countless women from unwanted abortions.
These questions can lead to referrals to family and intervention counseling, or shelters from abuse, which could help hundreds of thousands of women avoid unwanted abortions.
But today, abortion providers are free to ignore these questions. And sadly, to save time during patient intake, most do.
The sad reality is that many abortion providers simply do abortions on request, no questions asked. Whenever they fail to screen for coercion or other risk factors, they are neglecting their obligation to their patients and missing the opportunity to help women in the ways they want and deserve.
The Prevention of Coerced and Unsafe Abortions Act simply defines that it is an act of medical negligence not to make at least a good faith effort to screen for evidence of coercion. It further provides that only the woman can hold the abortion provider accountable for any failure to do proper screening.
This act does not interfere with the private decision of a woman and her doctor. But it does allow women to better hold doctors accountable for providing adequate screening and counseling.
Why then has Planned Parenthood characterized this as a ban?
This is good consumer protection law. It simply requires abortion doctors to act like all other doctors by doing proper screening so they can give informed and reasonable medical recommendations to their patients.
The only people who can oppose this legislation are those who care more about protecting the abortion industry than protecting women.
Would screening be expensive?
Proper screening need not be expensive.
Pre-abortion screening was first recommended in a 1973 study published in the Planned Parenthood's Family Planning Perspectives. The authors of that study concluded that low self-esteem, low contraception knowledge, high alienation, and delay in seeking abortion were related to subsequent psychopathology and other negative symptoms. They concluded that computer scored "screening procedures to identify such patients could easily and inexpensively be instituted by hospitals and private physicians" at a cost of less than a dollar each.6
Where can I learn more about coerced abortions.
We suggest going to www.unfairchoice.info where you will find many more materials regarding the problem of coerced and unsafe abortions.
Where can I learn more about the reasons why this legislation is necessary.
We recommend reading Abortion decisions and the duty to screen: clinical, ethical, and legal implications of predictive risk factors of post-abortion maladjustment, which is comprehensive law review article on the subject.
You should also read the following affidavits:
1. Royal College of Psychiatrists. Position Statement on Women’s Mental Health in Relation to Induced Abortion. 14th March 2008.
2A. Brenda Major, et al. Report of the APA Task Force on Mental Health and Abortion. see especially pages 11 and 92.
2B. Woo, J., "Abortion Doctor's Patients Broaden Suits," Wall Street Journal, Oct 28, 1994, B12:1.
3. Christine Lehmann. Psychiatrists Can Play Critical Role in Pregnancy Decisions. Psychiatric News, July 4, 2003. 38(13):8.
4. Rue VM, et al. "Induced abortion and traumatic stress: A preliminary comparison of American and Russian women." Med Sci Monit, 2004 10(10): SR5-16 and also Forced Abortions in America.
5. Reardon DC. Abortion decisions and the duty to screen: clinical, ethical, and legal implications of predictive risk factors of post-abortion maladjustment. Journal of Contemporary Health Law and Policy 2003 Winter;20(1):33-114
6. Robert Athanasiou et al., Psychiatric Sequelae to Term Birth and Induced Early and Late Abortion: a Longitudinal Study Family Planning Perspectives 5:227-31 (1973). The authors advised that screening for risk factors would be beneficial to patients without adding exorbitant costs: “The short form of the MMPI, for example, can be administered in 45 minutes and scored by a nurse in 10 minutes; interpretation is actuarial. The attitude scales used here can be administered and scored in about 15 minutes. For large populations, the MMPI can be computer scored and analyzed at a cost of about 85 cents per patient.” at 231 as a footnote.