Amid lawsuits on Ohio abortion laws, researchers study impacts on care

An OB-GYN patient examination chair. (Getty images.)

Researchers from several Ohio universities have found that state laws that regulate abortion services are “harmful” to patients and make it harder for those patients to receive proper care.

Members of the Ohio Policy Evaluation Network, a group made up of researchers from The Ohio State University, the University of Cincinnati, and Case Western Reserve University, analyzed the impacts of state laws like the 24-hour waiting period and in-person appointment requirements for abortion services in a recently published white paper.

“These laws make it harder for patients to experience timely, safe and routine health care and result in distressing challenges for abortion seekers,” the research states.

When it comes to the requirement that patients wait 24 hours before having an abortion, the study showed that “24 hours is almost never just 24 hours, as waiting period and two-appointment requirements significantly delay abortion care.”

“While one rationale for waiting periods is to provide pregnant people with more time to consider their options, evidence from OPEN studies found that for some abortion seekers, the opposite is true,” researchers stated.

Using data collected from more than 1,300 survey participants, patient chart reviews, and interviews, researchers found that between 2014 and 2018, only 6% of abortion patients were able to have an abortion 24 hours after the first appointment. About 48% of the state’s abortion patients waited a week or more after their initial appointment.

Ohio’s Attorney General, Dave Yost, touched on criticism that the waiting period usually ended up causing further delays in care as part of a response to an active lawsuit against the regulation, among others.

From Yost’s perspective, though the 24-hour waiting period is the requirement, the fact that it takes longer for patients to receive care is not the state’s fault, but the fault of the providers and patients.

“But the fact that patients often wait longer than 24 hours is not because of the law, but rather is attributable to several factors outside of the state’s control,” Yost stated in court documents submitted as part of a Hamilton County lawsuit challenging the law.

The laws are being challenged now that Ohio has an amendment to its constitution, approved by 57% of voters last November, that establishes the right to abortion and reproductive care for all Ohioans.

The research done by OPEN concluded that “the waiting period and the two-appointment requirements were often what drove the long delay between the first and second appointments.”

“In some cases, abortion seekers had to delay care to secure funding for their abortion, including the increased expenses resulting from two trips or two days of lost pay, further exacerbating their challenges,” the white paper stated. “Delays threaten patient safety: although abortion is very safe, risk increases with length of gestation.”

Interviews with patients showed “psychosocial burdens” when it came to the required minimum of two in-person appointments, including multiple interactions with anti-abortion rights protesters outside clinics.

Those interviewed by researchers “described having taken time to consider whether abortion was right for them before seeking care,” and many made an appointment “only after they made up their mind.”

“Once they had decided to terminate a pregnancy, most described wanting to secure their abortion care quickly so they could move on with their lives,” according to the study.

The regulations that caused them to wait to receive abortion care “delayed emotional resolution,” the patients stated.

Survey participants for the study were Ohio residents who had sought abortion services in the state between 2020 and 2021. Of those, almost 30% said the two-appointment requirement “was a challenge to navigate.”

Most likely challenges reported in the study were financial issues, scheduling difficulties, trouble locating a clinic, and privacy concerns.

The expenses necessary to seek out care not just once, but twice “place an inequitable economic burden on abortion seekers,” researchers found.

The laws that require these waiting periods and in-person appointments are also in conflict with medical evidence, according to the study.

Because of gestational limits in regulations over the years, such as the six-week abortion ban instituted in 2019 (which is currently held up in court), patients and physicians were concerned about feeling “rushed to make health care decisions” when those gestational limits combined with waiting periods and appointment requirements.

Medical professionals quoted in the study said they are “forced to impose the state’s non-evidence based timeline on patients in ways that pressure patients.”

“Overall, the challenges Ohio’s waiting period and two-appointment requirements create result in lasting burdens, especially economic hardship for those seeking abortion care,” the study concluded.

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