Investigations Abortion

From Alaska to Alabama, Investigation Shows False Testimony Formed Basis for Abortion Restrictions

Sofia Resnick

Why are states continuing to pass abortion restrictions based partly on erroneous theories that abortion harms women? And why are state attorneys general calling as expert witnesses some of the very people who proffered these spurious notions to state legislatures in the first place?

To view the full False Witnesses gallery, click here.

In October 2012, Alaska Superior Court Judge John Suddock wrote a 65-page decision affirming a state mandate that at least one parent be notified before a woman under 18 can obtain an abortion. But from the get-go, and throughout the decision, Suddock deflated anti-abortion advocates’ loudest claim: that abortion is unsafe for women.

“Hospitalizations during pregnancy occur 15 percent of the time, but are vanishingly rare for abortions,” he wrote. Further down, he added, “Modern abortion is an extraordinarily safe procedure.”

On the question of whether abortion causes mental illness—critical to the abortion-harms-women narrative—Suddock dismissed that one, too.

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“Mental illness is a constellation of subjective and objective signs and symptoms ultimately causing individual distress,” he wrote. “The illness may have genetic origins or derive from life experiences. Since the 1980’s, the majority consensus of American psychiatry is that abortion does not cause mental illness.”

Despite the court’s agreement with plaintiffs that the law in question “advances no compelling state interest in the health of minor women,” the court upheld the bulk of the law, arguing that it promotes “family involvement in a young woman’s pregnancy decision” by “the least restrictive means available.” (Plaintiffs appealed the decision, and the case is pending before the Alaska Supreme Court.)

But the court’s upfront dismissal of common but unfounded claims that abortion is a generally unsafe procedure prompts the question: Why are states continuing to pass abortion restrictions based partly on erroneous theories that abortion harms women?

And why are state attorneys general calling as expert witnesses some of the very people who proffered these spurious notions to state legislatures in the first place?

In the last few years, state legislatures have been passing abortion restrictions largely based on unfounded theories that abortion is a dangerous procedure that significantly increases women’s risk of developing breast cancer and mental health disorders, among other claims. Rewire recently profiled several of the medical professionals and researchers who routinely peddle these largely unsupported theories, first before state legislators and then later before state and federal judges, on the taxpayers’ dime. Those profiled in our False Witnesses series have collectively received at least $657,000 from state attorneys general to help them defend abortion restrictions that, in some cases, they helped enact.

In some cases, these False Witnesses have had a clear impact on the formation of state laws.

In North Dakota, for example, the state Senate Judiciary Committee’s hearing minutes included opinions from Dr. James C. Anderson and Dr. John M. Thorp, Jr. in defense of a law that requires physicians who perform abortions in North Dakota to be licensed in that state and to obtain admitting privileges at a local hospital. (The lawsuit involving this statute was settled earlier this year.) Anderson and Thorp are routinely called by state attorneys general to deliver expert witness reports supporting these types of laws—laws that are deemed medically unnecessary by major medical organizations such as the American College of Obstetricians and Gynecologists (ACOG) and the American Medical Association. Last year both groups submitted a friend-of-the-court brief opposing a Texas anti-abortion law, wherein they asserted there is “simply no medical basis to impose a local admitting privileges requirement on abortion providers.”

Yet, as Rewire’s reporting shows, these experts’ reliability has been seriously undermined. Anderson is a family medicine emergency room physician in Richmond, Virginia, and Thorp is an obstetrician-gynecologist and a professor of obstetrics and gynecology at the University of North Carolina-Chapel Hill School of Medicine. Both are outspoken in their anti-choice views and have testified in recent years in support of various laws limiting access to abortion care. Both also have been criticized by federal judges for relying on assumptions that reflect unsupported biases against abortion. Also cited in the minutes from North Dakota’s Senate Judiciary Committee, for example, is questionable research claiming abortion causes mental illness authored by Bowling Green State University family studies professor Priscilla K. Coleman and Vincent M. Rue, an anti-abortion activist and independent legal consultant who helps state attorneys general coordinate expert witnesses to testify in favor of laws that restrict abortion.

North Dakota’s attorney general later paid Anderson, Thorp, Coleman, and Rue (through his firm, Rue & Stanford-Rue PA), as well as longtime anti-choice advocate and OB-GYN Dr. Donna J. Harrison, to help defend various laws in state and federal court, including the aforementioned admitting privileges law, between 2011 and 2014.

Georgia State University law professor Eric J. Segall told Rewire that the recent proliferation of dubious evidence being used in court to defend abortion restrictions is “problematic.”

Segall, who teaches constitutional law and the federal courts, said he believes this trend in getting anti-choice doctors and researchers to testify to abortion’s supposedly widespread health risks stems from the Supreme Court’s 1990 decision in Planned Parenthood v. Casey.

“Once the Casey decision changed the law from basically no restrictions were allowed before viability to only restrictions that cause an undue burden would be unconstitutional prior to viability, there’s been an attempt for there to be a cottage industry of experts to testify [in favor of anti-abortion legislation],” Segall said. “I think the anti-choice side will do virtually anything they can to stop abortions.”

South Dakota is another state that has relied on the testimony of some of the False Witnesses identified in our series to help pass abortion restrictions. In 2005, former state Rep. Roger Hunt (R-Brandon)—who outspokenly opposes abortion—sponsored a bill that created a legislative task force to study abortion. The task force included lawmakers, anti-abortion activists, abortion-rights supporters, and supposedly neutral members. But the majority of those on the task force openly opposed abortion rights, and the resulting report presented by the task force to the governor reflected the majority’s unsupported anti-abortion stance.

Citing oral and written presentations from False Witnesses such as Joel L. Brind, Dr. Byron C. Calhoun, Coleman, David C. Reardon, and Rue, the task force asserted that abortion was harmful to women’s physical and mental health. The final report referenced Coleman’s testimony in its unfounded claim that when a woman has an abortion her ability to reason and understand is diminished. “When a decision involves a violation of one’s conscience, regression in cognitive functioning enables women to cope with the decision,” the report reads. Based on statements collected by an anti-abortion organization and directors of so-called crisis pregnancy centers, the task force also concluded that abortion is “inherently coercive.”

Ultimately, the task force concluded, “to fully protect the rights, interests, and health of the mother and the life of her unborn child, a ban on abortions is required.”

Lawmakers, including Hunt, relied on this report to pass two abortion bans (both overturned) and a law that created a 72-hour waiting period for women seeking abortions (not including holidays and weekends) and that required women seeking abortion to first receive counseling related to coercion at crisis pregnancy centers that advocate against abortion (this counseling requirement is stilled wrapped in litigation; the rest of the law has been enacted).

Other abortion restrictions, seemingly copied by state after state (some with the help of groups such as Americans United for Life and the National Right to Life Committee, which produce model legislation seeking abortion restrictions and bans), are inevitably challenged by abortion providers and medical professionals in the state and then defended in court by some of the same so-called experts whose false testimony first supported their passage. Anderson and Thorp, for example, have testified in multiple states, including Alabama, Mississippi, North Dakota, Texas, and Wisconsin, arguing that abortion providers should have to obtain admitting privileges at a local hospital because it ensures women’s safety for what they say is an inherently dangerous procedure. These laws passed despite opposition from mainstream medical associations like ACOG and the American Medical Association.

To be sure, for many other state abortion restrictions, the specific testimonies or research papers that swayed lawmakers to sponsor or vote for specific laws are difficult to pinpoint. In our False Witnesses series, we documented several instances where these medical experts’ testimonies or research papers likely helped influence the passage of anti-choice laws. For example, Coleman’s work was cited in a sweeping Arizona law that included a host of restrictions; University of St. Thomas law professor Teresa S. Collett testified before legislatures in Idaho and Nebraska in support of 20-week abortion bans; and a statement from Calhoun was presented to West Virginia lawmakers debating a 20-week abortion ban that was later vetoed by the governor.

Easier to identify is where experts have helped defend these laws once they are challenged.

After Texas enacted last year’s omnibus HB 2—which bans abortion at 20 weeks, requires that abortion clinics be transformed into ambulatory surgical centers, requires abortion providers to obtain admitting privileges at local hospitals, and places new restrictions on medication abortions—the attorney general hired some of the aforementioned expert witnesses to help defend the law in an ongoing lawsuit. According to records from the Texas Comptroller of Public Accounts, the state has so far paid Rue’s firm more than $59,000 to consult with expert witness selection and reports and has paid Anderson and Thorp at least $24,000 and $26,000, respectively, for their work as expert witnesses. (In August, U.S. District Judge Lee Yeakel condemned the state’s apparent efforts to obscure Rue’s level of involvement in the case. Yeakel also argued that Rue’s involvement in shaping testimonies undermined the reliability of the state’s experts’ opinions.)

Judges Grow Impatient With Use of Shoddy Evidence

Yeakel and Alaska’s Suddock are not the only judges to dismiss questionable evidence presented in recent abortion-related lawsuits.

In a December 2013 opinion, Appeals Court Judge Richard Posner challenged the arguments presented by the state’s witnesses in defense of a Wisconsin law requiring abortion providers to obtain admitting privileges at local hospitals. He noted, for example, that “there is no evidence that women who have complications from an abortion recover more quickly or more completely or with less pain or discomfort if their physician has admitting privileges at the hospital to which the patient is taken for treatment of the complications,” despite the state’s assertion to the contrary. He also pointed out that “[n]o documentation of medical need” for the admitting privileges requirement was presented to the Wisconsin legislature when the law was introduced.

Another federal judge, District Court Judge Myron H. Thompson, in an October 2014 supplemental opinion concerning a constitutional challenge to an Alabama admitting privileges law, explained why he discounted certain testimony from Anderson and Thorp. In Anderson’s case, Thompson wrote that the court “was struck by the flimsiness of Anderson’s basis for reliance on [Vincent] Rue and by his failure to obtain basic information about the affiliations, credentials, or employment of the consultant whose report he submitted as his own.” Regarding Thorp, Thompson wrote that the North Carolina-based OB-GYN “displayed a disturbing apathy toward the accuracy of his testimony” and that “choices that he made in developing his estimates [of abortion complications] seemed to be driven more by a bias against abortion and a desire to inflate complication rates than by a true desire to reach an accurate estimate of the dangerousness of abortion procedures.”

The judge additionally called out Thorp for hypocrisy in his assertion that doctors who perform abortions should provide “continuity of care” to their patients.

“[E]ven though the procedures he performs at his own office may, like abortion, in extremely rare cases cause complications that require post-procedure hysterectomy or laparatomy, he himself does not maintain staff privileges at a local hospital that would allow him to perform gynecological surgery for his patients,” Thompson wrote of Thorp.

Eric Segall told Rewire that he has never seen as much resistance as he has of late from lower court judges toward the use of shoddy evidence in defense of what he believes are politically motivated but medically unnecessary abortion restrictions.

“With the recent spate of decisions by lower court judges in Alabama, by Judge Posner in Wisconsin, by the lower court judge in Texas, I think we’re seeing judicial hostility towards the lack of real evidence supporting both the admitting privileges laws and the abortion-clinics-have-to-be-mini-hospital laws that I’ve not experienced in my career following the Supreme Court,” Segall said.

Segall, who supports abortion rights, said it is noteworthy that various lower court judges—including Posner, who was appointed by President Ronald Reagan to the U.S. Court of Appeals for the Seventh Circuit—are growing tired of what they’re seeing as unsupported, biased notions masquerading as scientific fact.

“This whole thing is a charade,” Segall said. “Admitting privileges laws don’t help women’s health, yet lawyers are saying that it does, legislators are saying that it does, and judges are very impatient with that dishonesty. There’s no evidence. So, I think that’s the hostility; I don’t think it’s an abortion-specific thing, certainly not for Judge Posner. I think it’s, ‘Why are states and lawyers for the states trying to put one over on us?’”

Visit Rewire Data to learn about connections between the False Witnesses we profiled and recently passed abortion restrictions.

Sharona Coutts contributed to this report.

Analysis Politics

The 2016 Republican Platform Is Riddled With Conservative Abortion Myths

Ally Boguhn

Anti-choice activists and leaders have embraced the Republican platform, which relies on a series of falsehoods about reproductive health care.

Republicans voted to ratify their 2016 platform this week, codifying what many deem one of the most extreme platforms ever accepted by the party.

“Platforms are traditionally written by and for the party faithful and largely ignored by everyone else,” wrote the New York Times‘ editorial board Monday. “But this year, the Republicans are putting out an agenda that demands notice.”

“It is as though, rather than trying to reconcile Mr. Trump’s heretical views with conservative orthodoxy, the writers of the platform simply opted to go with the most extreme version of every position,” it continued. “Tailored to Mr. Trump’s impulsive bluster, this document lays bare just how much the G.O.P. is driven by a regressive, extremist inner core.”

Tucked away in the 66-page document accepted by Republicans as their official guide to “the Party’s principles and policies” are countless resolutions that seem to back up the Times‘ assertion that the platform is “the most extreme” ever put forth by the party, including: rolling back marriage equalitydeclaring pornography a “public health crisis”; and codifying the Hyde Amendment to permanently block federal funding for abortion.

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Anti-choice activists and leaders have embraced the platform, which the Susan B. Anthony List deemed the “Most Pro-life Platform Ever” in a press release upon the GOP’s Monday vote at the convention. “The Republican platform has always been strong when it comes to protecting unborn children, their mothers, and the conscience rights of pro-life Americans,” said the organization’s president, Marjorie Dannenfelser, in a statement. “The platform ratified today takes that stand from good to great.”  

Operation Rescue, an organization known for its radical tactics and links to violence, similarly declared the platform a “victory,” noting its inclusion of so-called personhood language, which could ban abortion and many forms of contraception. “We are celebrating today on the streets of Cleveland. We got everything we have asked for in the party platform,” said Troy Newman, president of Operation Rescue, in a statement posted to the group’s website.

But what stands out most in the Republicans’ document is the series of falsehoods and myths relied upon to push their conservative agenda. Here are just a few of the most egregious pieces of misinformation about abortion to be found within the pages of the 2016 platform:

Myth #1: Planned Parenthood Profits From Fetal Tissue Donations

Featured in multiple sections of the Republican platform is the tired and repeatedly debunked claim that Planned Parenthood profits from fetal tissue donations. In the subsection on “protecting human life,” the platform says:

We oppose the use of public funds to perform or promote abortion or to fund organizations, like Planned Parenthood, so long as they provide or refer for elective abortions or sell fetal body parts rather than provide healthcare. We urge all states and Congress to make it a crime to acquire, transfer, or sell fetal tissues from elective abortions for research, and we call on Congress to enact a ban on any sale of fetal body parts. In the meantime, we call on Congress to ban the practice of misleading women on so-called fetal harvesting consent forms, a fact revealed by a 2015 investigation. We will not fund or subsidize healthcare that includes abortion coverage.

Later in the document, under a section titled “Preserving Medicare and Medicaid,” the platform again asserts that abortion providers are selling “the body parts of aborted children”—presumably again referring to the controversy surrounding Planned Parenthood:

We respect the states’ authority and flexibility to exclude abortion providers from federal programs such as Medicaid and other healthcare and family planning programs so long as they continue to perform or refer for elective abortions or sell the body parts of aborted children.

The platform appears to reference the widely discredited videos produced by anti-choice organization Center for Medical Progress (CMP) as part of its smear campaign against Planned Parenthood. The videos were deceptively edited, as Rewire has extensively reported. CMP’s leader David Daleiden is currently under federal indictment for tampering with government documents in connection with obtaining the footage. Republicans have nonetheless steadfastly clung to the group’s claims in an effort to block access to reproductive health care.

Since CMP began releasing its videos last year, 13 state and three congressional inquiries into allegations based on the videos have turned up no evidence of wrongdoing on behalf of Planned Parenthood.

Dawn Laguens, executive vice president of Planned Parenthood Action Fund—which has endorsed Hillary Clinton—called the Republicans’ inclusion of CMP’s allegation in their platform “despicable” in a statement to the Huffington Post. “This isn’t just an attack on Planned Parenthood health centers,” said Laguens. “It’s an attack on the millions of patients who rely on Planned Parenthood each year for basic health care. It’s an attack on the brave doctors and nurses who have been facing down violent rhetoric and threats just to provide people with cancer screenings, birth control, and well-woman exams.”

Myth #2: The Supreme Court Struck Down “Commonsense” Laws About “Basic Health and Safety” in Whole Woman’s Health v. Hellerstedt

In the section focusing on the party’s opposition to abortion, the GOP’s platform also reaffirms their commitment to targeted regulation of abortion providers (TRAP) laws. According to the platform:

We salute the many states that now protect women and girls through laws requiring informed consent, parental consent, waiting periods, and clinic regulation. We condemn the Supreme Court’s activist decision in Whole Woman’s Health v. Hellerstedt striking down commonsense Texas laws providing for basic health and safety standards in abortion clinics.

The idea that TRAP laws, such as those struck down by the recent Supreme Court decision in Whole Woman’s Health, are solely for protecting women and keeping them safe is just as common among conservatives as it is false. However, as Rewire explained when Paul Ryan agreed with a nearly identical claim last week about Texas’ clinic regulations, “the provisions of the law in question were not about keeping anybody safe”:

As Justice Stephen Breyer noted in the opinion declaring them unconstitutional, “When directly asked at oral argument whether Texas knew of a single instance in which the new requirement would have helped even one woman obtain better treatment, Texas admitted that there was no evidence in the record of such a case.”

All the provisions actually did, according to Breyer on behalf of the Court majority, was put “a substantial obstacle in the path of women seeking a previability abortion,” and “constitute an undue burden on abortion access.”

Myth #3: 20-Week Abortion Bans Are Justified By “Current Medical Research” Suggesting That Is When a Fetus Can Feel Pain

The platform went on to point to Republicans’ Pain-Capable Unborn Child Protection Act, a piece of anti-choice legislation already passed in several states that, if approved in Congress, would create a federal ban on abortion after 20 weeks based on junk science claiming fetuses can feel pain at that point in pregnancy:

Over a dozen states have passed Pain-Capable Unborn Child Protection Acts prohibiting abortion after twenty weeks, the point at which current medical research shows that unborn babies can feel excruciating pain during abortions, and we call on Congress to enact the federal version.

Major medical groups and experts, however, agree that a fetus has not developed to the point where it can feel pain until the third trimester. According to a 2013 letter from the American Congress of Obstetricians and Gynecologists, “A rigorous 2005 scientific review of evidence published in the Journal of the American Medical Association (JAMA) concluded that fetal perception of pain is unlikely before the third trimester,” which begins around the 28th week of pregnancy. A 2010 review of the scientific evidence on the issue conducted by the British Royal College of Obstetricians and Gynaecologists similarly found “that the fetus cannot experience pain in any sense prior” to 24 weeks’ gestation.

Doctors who testify otherwise often have a history of anti-choice activism. For example, a letter read aloud during a debate over West Virginia’s ultimately failed 20-week abortion ban was drafted by Dr. Byron Calhoun, who was caught lying about the number of abortion-related complications he saw in Charleston.

Myth #4: Abortion “Endangers the Health and Well-being of Women”

In an apparent effort to criticize the Affordable Care Act for promoting “the notion of abortion as healthcare,” the platform baselessly claimed that abortion “endangers the health and well-being” of those who receive care:

Through Obamacare, the current Administration has promoted the notion of abortion as healthcare. We, however, affirm the dignity of women by protecting the sanctity of human life. Numerous studies have shown that abortion endangers the health and well-being of women, and we stand firmly against it.

Scientific evidence overwhelmingly supports the conclusion that abortion is safe. Research shows that a first-trimester abortion carries less than 0.05 percent risk of major complications, according to the Guttmacher Institute, and “pose[s] virtually no long-term risk of problems such as infertility, ectopic pregnancy, spontaneous abortion (miscarriage) or birth defect, and little or no risk of preterm or low-birth-weight deliveries.”

There is similarly no evidence to back up the GOP’s claim that abortion endangers the well-being of women. A 2008 study from the American Psychological Association’s Task Force on Mental Health and Abortion, an expansive analysis on current research regarding the issue, found that while those who have an abortion may experience a variety of feelings, “no evidence sufficient to support the claim that an observed association between abortion history and mental health was caused by the abortion per se, as opposed to other factors.”

As is the case for many of the anti-abortion myths perpetuated within the platform, many of the so-called experts who claim there is a link between abortion and mental illness are discredited anti-choice activists.

Myth #5: Mifepristone, a Drug Used for Medical Abortions, Is “Dangerous”

Both anti-choice activists and conservative Republicans have been vocal opponents of the Food and Drug Administration (FDA’s) March update to the regulations for mifepristone, a drug also known as Mifeprex and RU-486 that is used in medication abortions. However, in this year’s platform, the GOP goes a step further to claim that both the drug and its general approval by the FDA are “dangerous”:

We believe the FDA’s approval of Mifeprex, a dangerous abortifacient formerly known as RU-486, threatens women’s health, as does the agency’s endorsement of over-the-counter sales of powerful contraceptives without a physician’s recommendation. We support cutting federal and state funding for entities that endanger women’s health by performing abortions in a manner inconsistent with federal or state law.

Studies, however, have overwhelmingly found mifepristone to be safe. In fact, the Association of Reproductive Health Professionals says mifepristone “is safer than acetaminophen,” aspirin, and Viagra. When the FDA conducted a 2011 post-market study of those who have used the drug since it was approved by the agency, they found that more than 1.5 million women in the U.S. had used it to end a pregnancy, only 2,200 of whom had experienced an “adverse event” after.

The platform also appears to reference the FDA’s approval of making emergency contraception such as Plan B available over the counter, claiming that it too is a threat to women’s health. However, studies show that emergency contraception is safe and effective at preventing pregnancy. According to the World Health Organization, side effects are “uncommon and generally mild.”

News Abortion

Leading Anti-Choice ‘Expert’ Suggests Women Turn to Crisis Pregnancy Centers to Cope With Abortion Restrictions

Ally Boguhn

Though crisis pregnancy centers often lie to women to persuade them not get an abortion, Priscilla Coleman suggested that people dealing with the additional financial and geographical barriers imposed by waiting periods turn to those organizations for help.

A leading anti-choice “expert” suggested during an interview with Rewire at the National Right to Life Convention last week that women should turn to crisis pregnancy centers to cope with the barriers to abortion care, including obstacles she helped create.

Priscilla Coleman, one of the “False Witnesses” previously featured on Rewire for her egregious falsehoods about the supposed link between abortion and mental health, said that the “scientific information” she provides in her speaking engagements and through her nonprofit, the World Expert Consortium for Abortion Research and Education (WECARE), has helped get anti-choice bills passed in states, particularly South Dakota.

Though her work has been widely discredited by the scientific and medical community, Coleman has nonetheless frequently appeared as an “expert witness” in trials and hearings. As Coleman told Rewire, she is “not a medical doctor” but has nonetheless “been really involved for ten years now with South Dakota” and its anti-choice legislation. This included the South Dakota Informed Consent Law (HB 1166), and what she deemed to be an “anti-coercion bill,” seemingly referring to HB 1217, which requires that a woman seeking an abortion wait 72 hours and visit a crisis pregnancy center prior to the abortion.

Coleman acknowledged that the anti-choice laws in the state such as the waiting period had created barriers to care, as “women have to … get a hotel, you know, or find a way back” to clinics.

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“And that’s the complaint on the other side, that it’s making access more difficult,” Coleman went on, “but as all the data out there is showing the long-term effects of abortion, spending three more days to make the decision is in the women’s best interest, no matter what side you’re on.”

When pressed to respond to those who note that anti-choice restrictions make accessing abortion more difficult, Coleman replied that she “would just say that it’s worth a three-day hotel room and … if you’re going to pay for an abortion, allow an extra couple hundred dollars … to take some time because it has lifetime implications.”

Coleman, however, struggled to account for how one might come up with that money.

“Well, they’re somehow coming up with the money for the abortion,” said Coleman. “I’m not familiar enough with fees and things, but my understanding is that most women, no matter how poor they are, still have to pay for the procedure. Is that correct?”

Though crisis pregnancy centers often lie to women to persuade them not get an abortion, Coleman suggested that those dealing with the additional financial and geographical barriers imposed by waiting periods turn to those organizations for help.

“I’m sure that if they contacted crisis pregnancy centers … women could find a place to stay for a couple of days,” said Coleman. “I’m sure that many people affiliated with those centers would be happy to house the women in their own home if there is a room for them.”

The other anti-choice law Coleman connected herself with, HB 1166, uses the same falsehoods she claims her research supports. South Dakota’s so-called informed consent law requires doctors to receive consent prior to performing an abortion, and mandates that physicians provide those seeking care with written information that, among other things, falsely claims there is a connection between abortion and both “depression and related psychological distress” and “increased risk of suicide ideation and suicide.”

Coleman “served as an expert in South Dakota” after Planned Parenthood affiliates challenged the legislation, according to WECARE’s website.

As the Guttmacher Institute explains, all states already require patients consent prior to receiving medical care, and materials provided by the states that require mandated abortion counseling often offer “information that is irrelevant or misleading.”