Policy Matters| Volume 27, ISSUE 2, P129-135, March 2017

State-Mandated (Mis)Information and Women's Endorsement of Common Abortion Myths

Published:January 25, 2017DOI:



      The extent that state-mandated informed consent scripts affect women's knowledge about abortion is unknown. We examine women's endorsement of common abortion myths before and after receiving state-mandated information that included accurate and inaccurate statements about abortion.


      In Utah, women presenting for an abortion information visit completed baseline surveys (n = 494) and follow-up interviews 3 weeks later (n = 309). Women answered five items about abortion risks, indicating which of two statements was closer to the truth (as established by prior research) or responding “don't know.” We developed a continuous myth endorsement scale (range, 0–1) and, using multivariable regression models, examined predictors of myth endorsement at baseline and change in myth endorsement from baseline to follow-up.


      At baseline, many women reported not knowing about abortion risks (range, 36%–70% across myths). Women who were younger, non-White, and had previously given birth but not had a prior abortion reported higher myth endorsement at baseline. Overall, myth endorsement decreased after the information visit (0.37–0.31; p < .001). However, endorsement of the myth that was included in the state script—describing inaccurate risks of depression and anxiety—increased at follow-up (0.47–0.52; p < .05).


      Lack of knowledge about the effects of abortion is common. Knowledge of information that was accurately presented or not referenced in state-mandated scripts increased. In contrast, inaccurate information was associated with decreases in women's knowledge about abortion, violating accepted principles of informed consent. State policies that require or result in the provision of inaccurate information should be reconsidered.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Women's Health Issues
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • AMA Council on Ethical and Judicial Affairs
        Code of Medical Ethics of the American Medical Association.
        American Medical Association, Chicago2016
        • Baker A.
        Abortion and options counseling: A comprehensive reference.
        Hope Clinic for Women, Granite City, IL1995
        • Beral V.
        • Bull D.
        • Doll R.
        • Peto R.
        • Reeves G.
        • Collaborative Group on Hormonal Factors in Breast, C
        Breast cancer and abortion: collaborative reanalysis of data from 53 epidemiological studies, including 83?000 women with breast cancer from 16 countries.
        Lancet. 2004; 363: 1007-1016
        • Bessett D.
        • Gerdts C.
        • Littman L.L.
        • Kavanaugh M.L.
        • Norris A.
        Does state-level context matter for individuals' knowledge about abortion, legality and health? Challenging the 'red states v. blue states' hypothesis.
        Culture, Health & Sexuality. 2015; 17: 733-746
        • Biggs M.A.
        • Upadhyay U.D.
        • McCulloch C.E.
        • Foster D.G.
        Women’s mental health and well-being 5 years after receiving or being denied an abortion: A prospective, longitudinal cohort study.
        JAMA Psychiatry. 2016;
        • Bryant A.G.
        • Levi E.E.
        Abortion misinformation from crisis pregnancy centers in North Carolina.
        Contraception. 2012; 86: 752-756
        • Daniels C.R.
        • Ferguson J.
        • Howard G.
        • Roberti A.
        Informed or misinformed consent? Abortion policy in the United States.
        Journal of Health Politics, Policy and Law. 2016; 41: 181-209
        • Dennis A.
        • Manski R.
        • Blanchard K.
        Does Medicaid coverage matter? A qualitative multi-state study of abortion affordability for low-income women.
        Journal of Health Care for the Poor and Underserved. 2014; 25: 1571-1585
        • di Mauro D.
        • Joffe C.
        The religious right and the reshaping of sexual policy: An examination of reproductive rights and sexuality education.
        Sexuality Research & Social Policy. 2007; 4: 67-92
        • Foster D.G.
        • Gould H.
        • Taylor J.
        • Weitz T.A.
        Attitudes and decision making among women seeking abortions at one U.S. clinic.
        Perspectives on Sexual and Reproductive Health. 2012; 44: 117-124
        • Foster D.G.
        • Steinberg J.R.
        • Roberts S.C.
        • Neuhaus J.
        • Biggs M.A.
        A comparison of depression and anxiety symptom trajectories between women who had an abortion and women denied one.
        Psychological Medicine. 2015; 45: 2073-2082
        • Gatter M.
        • Kimport K.
        • Foster D.G.
        • Weitz T.A.
        • Upadhyay U.D.
        Relationship between ultrasound viewing and proceeding to abortion.
        Obstetrics & Gynecology. 2014; 123: 81-87
        • Gerdts C.
        • Fuentes L.
        • Grossman D.
        • White K.
        • Keefe-Oates B.
        • Baum S.E.
        • Potter J.E.
        Impact of clinic closures on women obtaining abortion services after implementation of a restrictive law in Texas.
        American Journal of Public Health. 2016; 106: 857-864
        • Gould H.
        • Perrucci A.
        • Barar R.
        • Sinkford D.
        • Foster D.G.
        Patient education and emotional support practices in abortion care facilities in the United States.
        Womens Health Issues. 2012; 22: e359-e364
        • Guttmacher Institute
        Counseling and waiting periods for abortion.
        (New York: Author. Available:) (Accessed: December 1, 2016)
        • Hogue C.J.
        Impact of abortion on subsequent fecundity.
        Clinics in Obstetrics and Gynaecology. 1986; 13: 95-103
        • Jerman J.
        • Jones R.K.
        • Onda T.
        Characteristics of U.S. abortion patients in 2014 and changes since 2008.
        Guttmacher Institute, New York2016
        • Kavanaugh M.L.
        • Bessett D.
        • Littman L.L.
        • Norris A.
        Connecting knowledge about abortion and sexual and reproductive health to belief about abortion restrictions: findings from an online survey.
        Womens Health Issues. 2013; 23: e239-e247
        • Lazzarini Z.
        South Dakota's abortion script–threatening the physician-patient relationship.
        New England Journal of Medicine. 2008; 359: 2189-2191
        • Littman L.L.
        • Jacobs A.
        • Negron R.
        • Shochet T.
        • Gold M.
        • Cremer M.
        Beliefs about abortion risks in women returning to the clinic after their abortions: A pilot study.
        Contraception. 2014; 90: 19-22
        • Major B.
        • Appelbaum M.
        • Beckman L.
        • Dutton M.A.
        • Russo N.F.
        • West C.
        Abortion and mental health: Evaluating the evidence.
        American Psychologist. 2009; 64: 863-890
        • Mariner W.K.
        • Annas G.J.
        Informed consent and the First Amendment.
        New England Journal of Medicine. 2015; 372: 1285-1287
        • Ott M.A.
        • Santelli J.S.
        Abstinence and abstinence-only education.
        Current Opinion in Obstetrics & Gynecology. 2007; 19: 446-452
        • Paul M.
        • Lichtenberg S.
        • Borgatta L.
        • Grimes D.
        • Stubblefield P.
        • Creinin M.
        Management of unintended and abnormal pregnancy: Comprehensive abortion care.
        Wiley-Blackwell, Hoboken, NJ2009
        • Perrucci A.
        Decision assessment and counseling in abortion care: Philosophy and practice.
        Rowman & Littlefield, New York2012
        • Ralph L.J.
        • Foster D.G.
        • Kimport K.
        • Turok D.
        • Roberts S.C.
        Measuring decisional certainty among women seeking abortion.
        Contraception. 2016; ([Epub ahead of print])
        • Raymond E.G.
        • Grimes D.A.
        The comparative safety of legal induced abortion and childbirth in the United States.
        Obstetrics & Gynecology. 2012; 119: 215-219
        • Richardson C.T.
        • Nash E.
        Misinformed consent: The medical accuracy of state-developed abortion counseling materials.
        (Available:) (Accessed: December 1, 2016)
        • Roberts S.C.
        • Turok D.K.
        • Belusa E.
        • Combellick S.
        • Upadhyay U.D.
        Utah's 72-hour waiting period for abortion: Experiences among a clinic-based sample of women.
        Perspectives on Sexual and Reproductive Health. 2016; 48: 179-187
        • Rocca C.H.
        • Kimport K.
        • Gould H.
        • Foster D.G.
        Women's emotions one week after receiving or being denied an abortion in the United States.
        Perspectives on Sexual and Reproductive Health. 2013; 45: 122-131
        • Sanders J.N.
        • Conway H.
        • Jacobson J.
        • Torres L.
        • Turok D.K.
        The longest wait: Examining the impact of Utah's 72-hour waiting period for abortion.
        Womens Health Issues. 2016; 26: 483-487
        • Sisson G.
        • Kimport K.
        Telling stories about abortion: abortion-related plots in American film and television, 1916–2013.
        Contraception. 2014; 89: 413-418
        • Smith M.R.
        Informed Consent laws: Protecting a woman's right to know.
        (Available:) (Accessed: December 1, 2016)
        • StataCorp
        Stata/SE 14.1.
        Author, College Station, TX2015
        • U.S. House of Representatives Committee on Government Reform
        The content of federally funded abstinence-only education programs.
        Author, Washington, DC2004
        • Upadhyay U.D.
        • Desai S.
        • Zlidar V.
        • Weitz T.A.
        • Grossman D.
        • Anderson P.
        • Taylor D.
        Incidence of emergency department visits and complications after abortion.
        Obstetrics & Gynecology. 2015; 125: 175-183
        • Utah Department of Health
        Information about the developing embryo and fetus, about abortion, and about abortion alternatives.
        (Available:) (Accessed: December 1, 2016)
        • Vandewalker I.
        Abortion and informed consent: How biases counseling laws mandate violations of medical ethics.
        Michigan Journal of Gender and Law. 2012; 19
        • Vox
        What Americans think about abortion.
        (Available:) (Accessed: December 1, 2016)
        • Wiebe E.R.
        • Littman L.
        • Kaczorowski J.
        • Moshier E.L.
        Misperceptions about the risks of abortion in women presenting for abortion.
        Journal of Obstetrics and Gynaecology Canada. 2014; 36: 223-230


      Nancy F. Berglas, DrPH, is a public health social scientist at Advancing New Standards in Reproductive Health at the University of California, San Francisco.


      Heather Gould, MPH, is a research manager for several studies at Advancing New Standards in Reproductive Health, at the University of California, San Francisco.


      David K. Turok, MD, MPH, is an Associate Professor in the Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah.


      Jessica N. Sanders, PhD, MSPH, is Director of Family Planning Research in the Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah.


      Alissa C. Perrucci, PhD, MPH, is a clinical psychologist and Counseling & Administrative Manager at the Women's Options Center at Zuckerberg San Francisco General Hospital and Trauma Center.


      Sarah C.M. Roberts, DrPH, is an Associate Professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences and a public health social scientist at Advancing New Standards in Reproductive Health, both at the University of California, San Francisco.