(Mis)Informed decision-making: How U.S. healthcare providers use science to influence pregnancy options counseling

The language and authority of science have become central to the U.S. abortion debate. Although the pro-choice movement has traditionally positioned itself as defenders of scientific consensus, pro-life activists have increasingly leveraged scientific claims to advance their policy goals. As a result, scientific expertise now plays a pivotal role in the moral and political struggle over abortion, reshaping the foundations of abortion and pregnancy care. Although previous studies have focused on abortion discourse and scientific claim-making through the macro lens of state politics, legislation, and social movements, this study investigates how these dynamics manifest in the intimate setting of patient-provider interactions. Through in-depth interviews with 54 U.S. healthcare providers, this study explores how providers share scientific expertise during pregnancy options counseling, and how their approaches differ based on their personal attitudes toward abortion. Despite stark differences in the content of the information shared, pro-choice- and pro-life-leaning providers reported using similar strategies to communicate scientific evidence, including deliberating choosing language (e.g., “baby” versus “fetus”) and selectively citing studies to explain abortion's physical and mental health effects. Although both groups claimed to prioritize neutrality and transparency, they also reported using tailored approaches to make their scientific expertise more compelling, credible, and accessible to their patients. Existing clinical guidelines advocate for providers to prioritize scientifically accurate, evidence-based counseling. This study demonstrates how, in practice, providers make value-laden judgments that shape how “informed” decision-making is defined.