The Doula Project, cofounded in 2007 as The Abortion Doula Project by Mary Mahoney, Lauren Mitchell, and Miriam Zoila Perez, is a nonprofit organization of full-spectrum doulas based in New York City, New York, and is one of the first organizations to provide free full-spectrum doula care to pregnant people. Full-spectrum doulas provide non-medical physical, emotional, and informational support to pregnant people through a wide range of pregnancy experiences, including birth, miscarriage, stillbirth, fetal anomalies, and abortion. Since 2007, The Doula Project has trained doulas to provide emotional and informational comfort to those experiencing fetal loss in support of its goal to create a society in which all pregnant people have access to care and support for both their emotional and physical, regardless of their pregnancy outcome.

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 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.

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.

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.

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.

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.