The dangerous trend of state lawmakers prioritizing politics over women’s health care has now led to “bad medicine” laws in 37 states, according to a report the National Partnership for Women & Families released today. These laws undermine health care by mandating burdensome, medically unnecessary requirements that are not aligned with evidence or patients’ needs.

The second edition of “Bad Medicine: How a Political Agenda is Undermining Women’s Health Care,” updated from 2014, looks at five categories of bad medicine abortion restrictions: ultrasound requirements, biased counseling laws, mandatory delays, medication abortion restrictions and targeted regulation of abortion providers (TRAP laws). It finds that just 13 states have not passed these harmful laws. Thirty-seven states have passed at least one of these types of restrictions, and 17 states have passed all five: Alabama, Arizona, Arkansas, Indiana, Kansas, Louisiana, Michigan, Mississippi, Missouri, Nebraska, North Carolina, North Dakota, Ohio, Oklahoma, South Dakota, Texas and Wisconsin. The study released today looks at measures passed by the end of 2015; the 2014 edition of “Bad Medicine” examined measures passed as of June 1, 2014. (Some of these restrictions have been enjoined by the courts; see the full report for details.)

“Bad medicine laws disregard evidence-based medical practices, usurp the medical judgment of doctors and other health care providers, and ignore patients’ needs and preferences,” said Debra L. Ness, president of the National Partnership. “These laws fly in the face of national efforts to transform our health care system into one that delivers high-quality, patient- and family-centered care. It’s past time we take politics out of the exam room. State lawmakers must reject these outrageous restrictions and do all they can to ensure that women can access the high-quality, evidence-based health care they deserve.”

The new “Bad Medicine” report breaks down the five categories of abortion restrictions by state, with detailed maps. Specific findings include:

Biased Counseling Laws: Twenty-nine states have passed measures that undermine informed consent by requiring health care providers to give or offer patients information about abortion care that is inaccurate, biased or irrelevant. Since the 2014 edition of “Bad Medicine,” Arizona and Arkansas have added a new category of biased counseling laws that require health care providers to tell patients that medication abortion may be reversible – a medically unproven claim. 

Ultrasound Requirements: Twenty-five states regulate ultrasound by abortion providers in various ways, from requiring health care providers to offer or give women information about how they can get an ultrasound, to requiring providers to display the ultrasound image and describe it to a woman seeking abortion care, even if she objects. In those instances, the only way for a woman to avoid viewing an ultrasound may be to cover her eyes and ears – an egregious violation of medical standards. 

Mandatory Delays: Thirty-one states now have mandatory delay laws (Florida has joined the list since 2014). In the past two years, several states have intensified their medically unnecessary delays. Three states (Missouri, North Carolina and Oklahoma) lengthened the mandatory delay period from 24 hours to 72 hours, forcing women to wait even longer for the health care they need. Arkansas and Tennessee now also require that patients make two trips to a clinic before obtaining abortion care. Since research for this report was completed at the end of 2015, Kentucky has also passed such a law, which will take effect in July.

Medication Abortion Restrictions: Three additional medication abortion restrictions were enacted since 2014, bringing the total to 20 states that have passed measures that prevent providers from administering medication abortion in accordance with evidence-based standards of care.

Targeted Regulation of Abortion Providers (TRAP Laws): The second edition of “Bad Medicine” analyzes TRAP laws, which impose onerous and medically unnecessary requirements on abortion providers and clinics, often forcing clinics to close and driving trusted and experienced health care providers out of practice. Twenty-eight states have these laws, which include requirements that clinics meet specifications comparable to ambulatory surgical centers (ASCs); that providers have admitting privileges or alternative arrangements; and/or that providers have transfer agreements with nearby hospitals. On Wednesday morning, March 2, the U.S. Supreme Court will hear arguments on Texas’ TRAP law, HB 2, which includes both an ASC requirement and an admitting privileges requirement.

“The abortion restrictions we cover in this report are part of a calculated strategy designed to deny women the ability to make their own personal health care decisions,” said Sarah Lipton-Lubet, director of reproductive health policy and programs at the National Partnership. “When lawmakers play politics with women’s health, women and families suffer. It must stop.”

In 2015, the National Partnership and a coalition of environmental, gun safety and medical organizations released “Politics in the Exam Room: A Growing Threat,” which analyzes how politics are interfering with the professional and ethical standards of health care in treatment for toxic chemical exposures, gun violence prevention and women’s reproductive health. Visit www.BadMedicine.org to read that report and “Bad Medicine.”