Informed Consent for Elective Abortion: A Policy Analysis for North Carolina
Creators: name: Pemberton, Lily K.
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2008

description: Abortion is a divisive issue. People on both the pro-life and pro-choice sides of the debate hold strong beliefs about the morality of abortion and how available it should be to women with unintended pregnancies. Its controversy not withstanding, it is an extremely common occurrence. More than a million women had an abortion in 2005, and estimates suggest that one in four women in America will have an abortion in her lifetime. Therefore, abortion services are a significant component of women's health care. The informed consent process for elective abortion is an important element in the quality of medical care women receive. The purpose of pre-procedural counseling is to help the woman make an informed decision and to provide her with emotional support if it is needed. This process should inform the woman of the risks, benefits and alternatives to the procedure, and the risks and benefits of the alternatives. Shared decision making requires that the consent procedure should also allow time for the woman to ask questions and provide a medium for the woman and her physician to discuss her values and beliefs in an effort to make the best decision for her. The prevalence of abortion, and the imperative to provide high quality care combine to make the informed consent process a matter of public health. The political and social tensions surrounding abortion have engendered numerous regulations on the provision of abortion services. This paper focuses on regulation of the informed consent process for elective abortion. Supporters of proposed regulations argue that the regulations help women by ensuring that they are given the information that they need to make informed decisions, and time to think over their decisions. Two bills currently before the NC legislature, the Woman's Right to Know Bill and the Ultrasound Before an Abortion Bill, would mandate additional requirements for the informed consent process for elective abortion. This paper is an analysis of the content of these bills, with evaluations of the risks of abortion stated in the materials, and of the implications of the regulations for women's health. The paper progresses through a history of abortion politics and social attitudes towards abortion; a discussion of the intention of informed consent and the ethical principles it was designed to uphold; a review of the evidence for the harms of abortion to women's health, focusing on the psychiatric health consequences of abortion; and a presentation and discussion of data from a series of elite interviews. The paper concludes with policy recommendations. The research and analysis indicate that the content and requirements of the two proposed bills violate the principles of the informed consent process, and could have a negative effect on women's health by causing unnecessary delays in obtaining an abortion. The informed consent process for elective abortion should help women, contributing to high quality of care and helping them make informed decisions. The two bills analyzed here are counterproductive to those two women's health goals. Countering these legislative attempts can be achieved through public education about the safety of abortion and the current practices of informed consent for elective abortion.