It’s Official: Abortion is More Regulated Than Any Other Health Care Service

A new study published in the American Journal of Public Health confirmed what many reproductive rights advocates have long known: abortion is more regulated and legislated than any other health care service.

The study, conducted by researchers at the University of California, San Francisco (UCSF), analyzed facility standards and office-based surgery regulations in all 50 states, looking specifically at the disparities in the way abortion facilities are regulated in comparison to other medical facilities. Those researchers found that laws around abortion facilities are “more numerous, expansive and burdensome than laws regulating facilities that provide other medical procedures.”

A 2014 study from UCSF found that only a quarter of one percent of all surgical abortions result in major complications. You are quite literally 40 times more likely to die from having a colonoscopy than an abortion, and 90 times more likely to die giving birth than having the procedure. And yet, between 2011 and 2016, a quarter of all of the more than 1,000 restrictions limiting abortion access since Roe v. Wade were signed into law. That’s because, far too often, regulations on abortion often have nothing to do with women’s health and safety—and everything to do with politics and lawmakers’ personal disapproval of the procedure.

Most common among these are TRAP laws—short for the targeted regulation of abortion providers. Their purpose is to shut down abortion facilities by placing medically unnecessary requirements on them, many of which are too expensive or burdensome for abortion providers operating on limiting funding to be able to meet. Some of these requirements include requiring providers have nearby hospital admitting privileges, mandating hallway dimensions for abortion clinics and requiring clinics to have contracts with local ambulance companies.

In the years between 2013, when the omnibus abortion bill HB 2 was signed into law in Texas, and 2016, when the Supreme Court struck it down, more than half of the state’s 41 abortion clinics were shut down and could no longer offer abortion services to the states millions of women of reproductive age. HB 2 set off a wave of TRAP laws across the country, however, which remain in place—and many clinics that shutter under these laws never open again, even if the laws are repealed or struck down.

The consequences for the last five years lawmakers spent hyper-policing of women’s access to crucial health care have been steep—pregnancy and birth-related deaths in the U.S. have been on the rise, disproportionately so in states with more stringent abortion laws. And extraneous and politically-motivated regulations placed on women’s health clinics don’t just burden and endanger women’s health—they also reinforce existing unfair stigma around the procedure and those who provide it, endangering the lives of abortion providers and their staff as well as abortion advocates.

There are myriad health care services less safe and with higher complication risks than abortion, offered in facilities that don’t have to meet any of these requirements. TRAP laws and others like them are predicated on the false premise that abortion is dangerous—and that women will somehow wind up in ambulances being rushed to nearby hospitals or carried in stretchers in the hallways of abortion clinics, for making decisions about their own bodies.  But with the highest maternal death rates in the industrialized world and credible studies showing a correlation between depression and anxiety and being denied abortion access, it’s become increasingly clear that laws restricting abortion access achieve quite the opposite.

It could take years for women to regain access to the myriad abortion clinics shut down by TRAP laws across the country, and it could take even more time for society to eventually consider abortion as safe—if not safer—than any other medical procedure. But a strong first step would be for the general public—and plenty of lawmakers among them—to listen to medical experts.



Kylie Cheung writes about reproductive and survivor justice, and is the author of Survivor Injustice: State-Sanctioned Abuse, Domestic Violence, and the Fight for Bodily Autonomy, available Aug. 15.