Horatio Robinson Storer was a surgeon and anti-abortion activist in the 1800s who worked in the field of women’s reproductive health and led the Physicians’ Crusade Against Abortion in the US. Historians credit Storer as being one of the first physicians to distinguish gynecology, the study of diseases affecting women and their reproductive health, as a separate subject from obstetrics, the study of pregnancy and childbirth. Storer was one of the first physicians to successfully perform a Caesarian section, or the removal of the fetus through a surgical incision, followed by the removal of the woman’s uterus, a procedure which would later be known as Porro’s operation. Storer was also an anti-abortion activist who believed that public attitudes toward abortion were too relaxed and that the laws did not effectively punish what he deemed to be the criminal act of abortion. Historians credit Storer with leading the Physicians’ Crusade Against Abortion, which they consider largely responsible for the increase in laws criminalizing abortion in the late 1800s.

In 2003, the Texas state legislature passed the Woman’s Right to Know Act, hereafter the Act, as Chapter 171 of the state’s Health and Safety Code. The Act sets requirements that physicians must follow during the informed consent process for abortion, or a medical procedure to terminate pregnancy, in Texas. Lawmakers amended the Act and added several additional regulations that restrict access to abortion in 2011, 2013, 2015, and 2017. For instance, the Act requires that physicians perform abortions after sixteen weeks of pregnancy in ambulatory surgical centers or hospitals and states that physicians must perform an ultrasound to view images, called sonograms, of a developing fetus inside a woman’s uterus before a woman may receive an abortion. The Act further requires practitioners and clinics to offer state-developed informational materials to women who seek an abortion. The Act placed several restrictions on abortion care in Texas, making it more difficult for women to access safe and legal abortion care, which opponents have challenged in courts.

In January 2014, Mary Gatter and colleagues published “Relationship between Ultrasound Viewing and Proceeding to Abortion” in Obstetrics and Gynecology hereafter “Ultrasound Viewing.” As of 2021, ten states require women to undergo an ultrasound before they may consent to having an abortion. Self-described pro-life organizations assert that viewing an image of the fetus will dissuade women from having an abortion. The authors reviewed women’s medical records from over fifteen thousand visits to one abortion provider in 2011.The authors determined viewing an ultrasound image did not change the minds of women who were already highly certain that abortion was the right decision, challenging the idea that mandatory ultrasound viewing has any effect on women’s decision to have an abortion.

The North Carolina state legislature passed The Woman’s Right to Know Act in 2011, which places several restrictions on abortion care in the state. The Woman’s Right to Know Act, or the Act, imposes informed consent requirements that physicians must fulfill before performing an abortion as well as a twenty-four hour waiting period between counseling and the procedure for people seeking abortion, with exceptions for cases of medical emergency. Then-governor of North Carolina Beverly Perdue initially vetoed House Bill 854, which contained the Act, but the state legislature overrode her veto to pass the bill. In response to a lawsuit that the American Civil Liberties Union, or ACLU, and other organizations filed in 2011, a US district court judge blocked the law’s ultrasound mandate from going into effect and a later court case determined that the mandate was illegal. With the passage of the Act in North Carolina, the state passed several abortion regulations and mandated that abortion providers must inform women of specific details about their pregnancy before performing the abortion procedure.

The objective of this project was to determine the importance of informed consent laws to achieving the larger goal of dismantling the right to abortion. I found that informed consent counseling materials in most states contain a full timeline of fetal development, along with information about the risks of abortion, the risks of childbirth, and alternatives to abortion. In addition, informed consent laws for abortion are based on model legislation called the “Women’s Right to Know Act” developed by Americans United for Life (AUL). AUL calls itself the legal architect of the pro-life movement and works to pass laws at the state level that incrementally restrict abortion access so that it gradually becomes more difficult to exercise the right to abortion established by Roe v. Wade.

In 2019, Americans United for Life, hereafter AUL, published a model legislation, called the Women’s Right to Know Act, in their annual publication Defending Life. The goal of the model legislation, which AUL annually updates, is to help state governments enact enhanced informed consent laws for abortion. The Women’s Right to Know Act requires physicians to provide specific information to women before they may consent to having an abortion. It also suggests that individual US state governments to develop informational materials about abortion and pregnancy that healthcare providers must give to women before they receive an abortion. As of 2020, twenty-eight states have enacted informed consent laws for abortion that resemble the Women’s Right to Know Act. In a larger effort to dismantle legal access to abortion, the AUL’s Women’s Right to Know Act encourages individual states to restrict access to abortion to protect, what the organization calls, the unborn child.

In Stuart v. Camnitz, the United States Court of Appeals for the Fourth Circuit affirmed the decision of a North Carolina District Court that declared a controversial ultrasound mandate for abortions unconstitutional in 2014. The ultrasound mandate was a part of the Woman’s Right to Know Act introduced in North Carolina in 2011, which placed several restrictions on abortion care providers in the state. If enforced, the ultrasound mandate would have required physicians to perform an ultrasound on every patient before an abortion and simultaneously describe the resulting image of the fetus regardless of whether the woman wanted to hear the description. The District Court ruled the mandate an unconstitutional violation of physicians’ free speech rights. The Fourth Circuit Court’s decision to affirm the District Court’s ruling established that the state could not compel healthcare providers to recite what the court called state ideology to patients against their medical judgment, which broke with precedent set by prior rulings by the Fifth and Eighth Circuit Courts in similar cases.

As of 2021, twenty-eight US states have informed consent laws for abortion, which is a medical procedure to terminate pregnancy, often called Women’s Right to Know laws. Those laws often require the state government to develop informational materials that healthcare providers must give to women before an abortion. Informational materials generally include information about the process of fetal development, accompanied by illustrations or pictures, risks and effects of abortion, and alternatives to abortion. Supporters of informed consent laws for abortion argue that such information is important for women to make a decision to have an abortion. Individual states author and distribute those informational materials, which are a primary source of information for people who seek an abortion. Medical expert and abortion rights activists have criticized the materials for providing inaccurate information, making misleading statements, and using coercive language to discourage women from choosing abortion.

In 2013, Cynthia Daniels and a team of researchers at Rutgers University in New Brunswick, New Jersey, founded the Informed Consent Project. Daniels and the researchers assessed the medical accuracy of information within state-authored informational materials for abortion. States give those materials to women who want an abortion, but using their research, the Informed Consent Project found some information from those materials to be inaccurate, misleading, and coercive. The Informed Consent Project gathered a panel of researchers and medical specialists to review the information about embryological and fetal development from twenty-three states’ informational materials. They found that approximately one-third of that information was inaccurate. The work of the Informed Consent Project challenges abortion-specific informed consent laws, highlighting medical inaccuracies in state-authored informational materials as evidence that women’s consent to abortion may be based on false or misleading statements.