The hits on reproductive rights keep coming: On Wednesday, the Ohio Legislature passed the strictest abortion law in the country. It bans abortions from the moment a fetal heartbeat can be detected, which usually occurs just six weeks into a pregnancy. (It’s not too late to ask Governor John Kasich veto it, though.)
Also this week, the Texas Department of State Health Services just updated the “fact” guide it insists women must before they can terminate a pregnancy. The new version of “A Woman’s Right to Know” links abortion and breast cancer, and makes other spurious claims that have been debunked by multiple studies.
Roe v. Wade, has been under constant threat since it became law in 1973, but in the last few years, it’s gotten significantly worse: More abortion restrictions have been passed between 2011 and 2015 than in the past 40 years. (231 of them, to be exact, 411 in the first quarter of this year alone.)
Below, we’re sharing eight of the unnecessary, demeaning and downright absurd things American women are forced to do before they can terminate an unwanted pregnancy. If Trump and his Health and Human Services nominee Tom Price have their way, we’ll likely see even more added to this list.
Get her parents’ permission.Getty Images
The Supreme Court ruled in 1979 that a woman’s parents can’t have absolute veto power over her right to an abortion. But 38 states now require women under the age of 18 to get parental consent for the procedure.
While some states only require consent from one parent, others require it from both — or require that both parents be notified. Five states (Oklahoma, Texas, Utah, Virginia, and Wyoming) require that both parents be notified and provide consent prior to an abortion.
In some states, teens who can’t get parental permission—like, say, their parents aren’t around or they’d face abuse or homelessness if their parents found out they’re pregnant—must get permission from a judge. The process is often described as overwhelming and humiliating, and it ultimately leaves women at the mercy of a judge’s personal biases.
3. Receive “counseling.”Getty Images
In all, 38 states require women to receive mandatory “counseling” prior to getting an abortion. Five states (Indiana, Louisiana, Mississippi, Utah, and Wisconsin) require it be done in person. While some of the counseling prepares people for the actual procedure, many states use it as an opportunity to talk patients out of it.
Some states require doctors to tell patients about fetal development and the gestational age of their fetus; some force doctors to provide dubious information about a fetus’ ability to “feel pain. Indiana, Kansas, Missouri, Oklahoma, and North and South Dakota require doctors to convey the unscientific belief that “personhood begins at conception.”
Look at images of a fetus.Getty Images
Many states now require women to have ultrasounds and look at an image of their fetus before terminating a pregnancy. Louisiana, Texas, and Wisconsin also requireabortion providers to “describe” the ultrasound to patients.
Ten other states just require that patients be offered the opportunity to view their ultrasound images.
Pay for the procedure out-of-pocket.Getty Images
Endure arbitrary waiting periods.
Almost half of all states require some kind of mandatory waiting period between an abortion consultation and the actual procedure. Most are 24 hours, but Missouri, North Carolina, Oklahoma, South Dakota, and Utah have all mandated 72-hour waiting periods.MANDEL NGAN/AFP/Getty Images
These laws often force patients to make two separate trips to a clinic—which means taking more time off work, enduring more transportation costs, and often facing more harassment from anti-choice protestors outside clinics.
Follow unnecessary procedures.Getty Images
The development of mifepristone, also known as RU-486 or the “abortion pill,” has allowed many women to terminate a pregnancy without an invasive procedure or clinic appointment. In fact, RU-486 was used for 23% of all abortions in 2011.
Mifepristone is a prescription drug, but it’s not available at pharmacies—it must be administered from a doctor’s office. This year, the FDA updated its guidelines to allow it to be administered by a physician’s assistant or nurse, and to let providers in rural areas offer it via telemedicine. The FDA also approved the use of the drug for an additional three weeks of gestational age.
But many states have yet to update their regulations and still require a doctor to be present when the medication is taken. Three states still follow the outdated FDA guidelines and prohibit the use of mifepristone past the ninth week.
Drive a long way.Getty Images
Abortion clinics have been closing at an unprecedented rate in recent years, due to regulations made to be so complex they can’t reasonably stay open. Patients seeking abortions can have to drive hundreds of miles, arrange for overnight stays, and take time off work just to receive a routine medical procedure.
Listen to outright lies.Getty Images
“A Woman’s Right to Know,” given to all women in Texas seeking to end a pregnancy, declares there’s a link between breast cancer and abortions (false), and warns that women who end their pregnancies may become infertile (false).
It also claims having an abortion can make you suicidal (You guessed it: false).
Unfortunately, Texas isn’t the only state that gives patients information chosen by legislators, not doctors: In all, 38 states have some form of “informed consent” law, and often women are given inaccurate or outdated information aimed at discouraging abortion.
In some cases, doctors who are forced to make such statements will tell patients, “The state requires me to say this. It’s not actually true.”