Impacts of Targeted Regulation of Abortion Providers

Regulations designed to restrict abortion access have proliferated over the past decade. Targeted regulation of abortion providers (TRAP) laws often subject providers to more stringent requirements than what is standard for other clinicians and impose restrictions beyond those necessary to protect patients. Following the U.S. Supreme Court’s decisions in Roe v. Wade and Planned Parenthood of Southeastern Pennsylvania v. Casey, many states moved to limit abortion by regulating access to clinics rather than banning the procedure outright. Examples of such laws include North Carolina’s clinic humidity specifications, Louisiana’s procedure room size requirements, and Alabama’s prohibition of abortion clinics located within 2,000 feet of a school. Proponents of TRAP laws often cite patient safety and health when enacting these regulations. However, according to the American College of Obstetricians and Gynecologists, abortion is safe in areas where it is legal. Indeed, fewer than 0.3 percent of U.S. patients undergoing the procedure experience complications requiring hospitalization. Critics argue that these regulations are aimed at shutting down providers in an attempt to chip away at abortion access—not to protect patients. Opponents argue that requirements under TRAP laws can be unnecessarily burdensome or nearly impossible to fulfill. For example, TRAP laws often require abortion providers to pay licensing fees and maintain minimum physical dimensions of rooms and corridors, requirements that may be cost-prohibitive and arbitrary. The public health impacts of TRAP laws have been shown to disproportionately affect people of color and lower socioeconomic status. Clinic closures across the country have resulted in longer wait periods and travel times, which place additional strain on patients in rural areas. Logistical requirements that do not improve patient safety—such as 24-hour waiting periods, mandatory ultrasounds and counseling, and informed consent laws—require patients to make multiple, sometimes costly trips to clinics. For uninsured patients, delays can increase the overall cost of the procedure and present an additional barrier to accessing quality care. This week’s Saturday Seminar summarizes a selection of expert research on the history of TRAP laws and their effect on abortion access and services