Targeted regulation of abortion providers (TRAP) legislation: Missed opportunities for pro-choice communities to combat abortion stigma

Objective: Half of US states have enacted Targeted Regulation of Abortion Providers (TRAP) laws. We examined the role abortion stigma played in the introduction, debate, and passage of recent TRAP laws in Michigan (HB5711) and Virginia (SB 924). Methods: We conducted qualitative analysis of bills as introduced and ultimately passed; pro-choice and anti-abortion responses to them; and media coverage of the legislation. We identified themes using an iterative process and coded documents using Dedoose, a mixed methods web-based program. Results: Proponents of restrictive abortion bills in both states claimed the regulations were necessary to ensure patient safety. However, they do not apply to other medical or surgical procedures conducted in similar outpatient settings. Specifically, they suggested that abortion providers become more dangerous the more procedures they do and are incapable of providing the necessary institutional infrastructure to safely provide abortions. This stereotypes providers as lacking clinical judgment and accountability. Pro-choice oppositional arguments focused on the laws' potential to restrict access to abortion and cited data on the safety of abortion procedures, but did not address the skill or legitimacy of abortion providers. Discussion: Legislators and anti-choice advocates relied on stigmatizing and delegitimizing stereotypes of abortion providers to justify TRAP laws. In combating these bills, the pro-choice community did not challenge these stereotypes. Instead, most counterarguments focused on issues of access and women's rights. A sound pro-choice strategy should include challenging abortion provider stigma head-on. This may prove effective in influencing legislators and public opinion, while simultaneously supporting the abortion-providing workforce.