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States Providing Inaccurate Clinical Information Before Abortion

Zolot, Joan PA

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AJN, American Journal of Nursing: June 2016 - Volume 116 - Issue 6 - p 15
doi: 10.1097/01.NAJ.0000484213.02361.6c
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U.S. map illustrating the percentages of fetal development booklet inaccuracies by state. Image courtesy of Amanda M. Roberti via the Informed Consent Project (

Many U.S. states have an informed-consent statute requiring providers of abortions to give women seeking abortions a state-authored packet before they undergo the procedure.

Such packets detail alternatives to abortion; risks associated with abortion, pregnancy, and childbirth; and information on embryonic and fetal development—the latter making up the bulk of the information. Case law has determined that such laws are constitutional, provided that the scientific information in the packets is accurate and not misleading. Sixty-six percent of women seeking abortions live in states with such laws, so the question of whether the information the states provide is accurate is more than academic.

According to the first-ever systematic analysis of these mate-rials, however, nearly a third of the information about fetal development provided to women in state-authored informed-consent materials is medically inaccurate.

Researchers at Rutgers University recruited seven human anatomy experts who specialize in embryonic and fetal development to evaluate the accuracy of the development-related content in materials from the 23 states that made them publicly available. The specialists consolidated similar statements from the packets and rated each according to how “truthful” and how “nonmisleading” it was. To be considered “medically accurate,” a statement had to be deemed both truthful and nonmisleading.

Although 69% of statements were deemed medically accurate, 31% were “medically inaccurate.” For instance, the statement that at week 4 of pregnancy “brain activity can be recorded” is untrue. Many of the inaccurate statements overstated or “accelerated” function or development of body systems or parts. Other medically inaccurate statements described “baby-like” behaviors, such as crying, blinking, or hiccupping, at stages of development when they aren't seen. Further, of statements about development during the first trimester of pregnancy, 45% were medically inaccurate, which is notable because the majority of abortions are sought during the first trimester. In comparison, 29% of statements related to the second trimester and 13% related to the third were inaccurate.

The study authors express concern because providers are being forced by states to give medically inaccurate information to patients—information that patients assume is accurate and that may influence the decision to have an abortion.

The 1992 Supreme Court decision supporting states’ rights to pass these laws insisted that consent be “thoughtful and informed” and achieved as a result of “objective, nonjudgmental… accurate scientific information.” Providing inaccurate information, the authors maintain, violates not only the principle of the decision but patients’ rights.

The Informed Consent Project provides a state-by-state map illustrating the accuracy of state-mandated materials. See—Joan Zolot, PA


Daniels CR, et al. J Health Polit Policy Law 2016 41 2 181–209
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