When Carol Kling walked into an abortion facility 13 years ago, she knew almost nothing about the procedure and absolutely nothing about what it would do to her years later. Pre-abortion counseling meant a nurse handed her a pill and a glass of water. "I got more counseling and information for getting a tooth pulled," Kling said.

After she swallowed the pill, the nurse walked away: "I was sitting in a room with other women in gowns. I felt like herded cattle. I didn't even see the doctor."

In an attempt to help women understand abortion's long-term physical and emotional ramifications, pro-life advocates have lobbied state legislatures to adopt "informed consent" regulations. The laws require abortion providers to give women complete information before the procedure. Informed consent laws have become a target for abortion advocates, who claim they put unnecessary burdens on women's rights and violate abortionists' free speech rights.

But on July 24, the 8th U.S. Circuit Court of Appeals upheld a provision in South Dakota's informed-consent law that requires abortion providers to advise women of the suicide risk associated with the procedure. The court ruled that the law does not place an "undue burden on abortion rights" or violate constitutional protections for free speech. Planned Parenthood originally challenged the law in 2006.

Leslee Unruh, director of the Alpha Center, a crisis pregnancy center in Sioux Falls, S.D., helped get the legislation passed. She knew post-abortive women who had committed suicide and others who had tried. She understood their emotional wreckage because she was a post abortive woman who wanted to forgive herself, but couldn't: "You carry an empty crib in your heart forever."

Unruh was at the court hearing and saw women testify about the psychological wounds they suffered because of their abortion. One woman told Unruh her job was at stake if she testified, but she drove through a blizzard and slept in her car to get to the court anyway. Unruh later learned the woman lost her job.

"That spoke volumes to me of the pain and how she wanted to make things right for other women," Unruh said.

Academic studies from the British Journal of Psychiatry, the British Medical Journal, and Finnish researcher Mika Gissler bolstered the women's testimony and confirmed the abortion-suicide connection. According to Gissler's 1997 study, women who get an abortion are seven times more likely to commit suicide. They also are 60 percent more likely to die of natural causes and 14 times more likely to die from homicide.

Kling now serves as a counselor at Rachel's Vineyard, a Christian retreat in South Dakota for individuals who have experienced or witnessed an abortion. She's seen the scars of abortion first hand. "It's a psychological killer," she said, explaining how women often turn to drugs, alcohol, or self-harm as methods of coping. Many others, she said, get into abusive relationships. Some take their own lives.

Kling said she lived in denial about her abortion for 13 years until coming to Rachel's Vineyard, where she finally faced what she had chosen and learned about God's mercy. Many women don't find help for years. Kling recalled a story about one woman who had suppressed the story of her abortion for 56 years before finding Rachel's Vineyard. During the next two days, she was able to name, grieve, and attend a memorial service for her unborn child.

"On Sunday, you could almost see rays of light coming out of her face," Kling said, laughing.

Thirty-one other states have informed-consent laws, but the scope of information that doctors must provide varies from state to state. South Dakota is the only state to include a suicide-risk advisory.

In 1992, the Supreme Court ruled in Planned Parenthood v. Casey that states have an interest in protecting maternal health and that informed consent is in line with that interest. But the content of those laws is still under debate. Planned Parenthood continues to fight the laws, saying they place an unconstitutional barrier in front of a woman seeking an abortion.

"If Planned Parenthood truly cared about the well-being of women, it would not try to prevent them from being informed of the well-documented risk of suicide that accompanies abortion," said Steven H. Aden, senior counsel at Alliance Defending Freedom (ADF). In 2010, Aden filed a friend-of-the-court brief in the case on behalf of several pro-family groups.

Many women considering an abortion are under enormous pressure and emotionally incapable of rationally processing information, Kling said. But that doesn't mean they don't want information about risks. In 2006, the Journal of Medical Ethics did a study that revealed that 95 percent of women considering an abortion want to be informed of all risks and 69 percent want to be informed of an alternative.

"If they have information and are in a state of mind where they can process it, they'll see what's going on," Kling said. Even if they go ahead with the abortion, the information can still help them understand the emotional turmoil they experience afterwards.