Study: Mandatory waiting periods for abortion increase intimate partner violence

A study published in December in the Journal of Health Economics by UW-Madison researchers finds that state-mandated waiting periods for abortion are associated with increases in intimate partner violence against women of reproductive age.

Intimate partner violence is a common crime, affecting about one-third of U.S. women in their lifetimes. A major public health issue and a violation of human rights, intimate partner violence has high personal, social, and economic costs.

Since the U.S. Supreme Court’s Dobbs decision overturned the federal right to abortion, many states have restricted abortion access even further. The study authors say the findings “underscore the complexity” of restrictive abortion laws’ effects on public health and welfare. They highlight the urgent need for policies based on a full understanding of the laws’ effects.

Christine Durrance, a UW-Madison professor of public affairs, led the research in collaboration with La Follette School of Public Affairs faculty Yang Wang and Barbara Wolfe.

The work is one of several research projects the UW Collaborative for Reproductive Equity (CORE) launched in 2023 to monitor and document access to reproductive healthcare post-Dobbs. Durrance serves as CORE’s Research Hub co-advisor.

The researchers find that the implementation of two-trip mandatory waiting periods for abortion is associated with a 15 percent increase in intimate partner violence.

Mandatory waiting periods are a common state-level abortion restriction. They require a person seeking an abortion to wait anywhere from 18 to 72 hours after an initial counseling appointment (and, in some states, a mandatory ultrasound) before the abortion procedure.

In 22 U.S. states, this counseling information can be provided by mail, phone, fax, or online. Thirteen other U.S. states, including Wisconsin, require in-person counseling. These “two-trip” waiting periods necessitate two clinic visits due to the wait between counseling and the abortion.

The researchers focused on the effects of two-trip mandatory waiting periods, finding that the implementation of such policies is associated with a 15 percent increase in intimate partner violence, mainly driven by assault.

State abortion policies often conflict with best clinical practice. Previous research shows that mandatory waiting periods, especially those needing two clinic visits, are medically unnecessary, can significantly raise the costs of accessing abortion care, and reduce abortion access overall. They also increase second-trimester abortions, which carry greater medical risks and costs.

The study authors say the findings “underscore the complexity” of restrictive abortion laws’ effects on public health and welfare.

The researchers suggest that delayed or denied abortion care due to mandatory waiting periods appear likely to raise the risk of intimate partner violence. Increased violence may stem from family stress, strained finances, poor physical or mental health, and shifting household power dynamics. The researchers find that, in higher-poverty areas, mandatory waiting periods are more strongly associated with more intimate partner violence.

The findings highlight an even wider effect of restrictive abortion laws than previous research has identified. Such restrictions harm society and health, beyond their immediate impact on reproductive healthcare.

The authors suggest that policymakers should comprehensively assess abortion policy after Dobbs, direct limited resources to protect vulnerable populations, and create effective policies to prevent intimate partner violence.

“The correlation between these restrictive policies and intimate partner violence highlights the necessity for a comprehensive approach to reproductive health legislation that takes into account its potential to exacerbate disparities and public health crises,” the researchers conclude. “As the nation grapples with the consequences of Dobbs, this research provides valuable insights into the intricate web of outcomes tied to reproductive health policies.”

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