Texas is the Latest to Enact Rules Aimed at Shutting Down Abortion Providers: Solutions in Search of a Problem
July 18, 2013
This year will see the second-highest number of state-level abortion restrictions ever. Prominent among restrictions so far in 2013 are so-called targeted regulation of abortion providers (TRAP) requirements, a regulatory thicket designed not to benefit patients but to make it impossible for many providers to come into compliance. While not a new tactic, the scope of some of these new TRAP laws is unprecedented, as is the blunt focus by antiabortion state legislators on driving abortion providers out of business.
As is often the case with other efforts to make abortion care more difficult to access, the reasons offered in support of specific TRAP requirements-which are usually marketed under the guise of protecting women’s health-do not stand up to close scrutiny:
At the most general level, TRAP requirements are a solution in search of a problem. Abortion care in the United States is already very safe, and fewer than 0.3% of all abortion patients experience complications that require hospitalization. The risk of dying from a legal abortion in the first trimester-when almost nine in 10 abortions are performed-is no more than four in a million (see Safety of Abortion here).
Requiring a connection to a local hospital
TRAP requirements often mandate that abortion facilities or their clinicians have connections to a local hospital (such as admitting privileges or transfer agreements) that are at best unwarranted and at worst simply impossible for clinics to obtain. Such links are not necessary for patient safety, since hospitals are already required by federal law to provide emergency care to those who need it, including abortion patients in the unlikely event they experience complications (see Mandating Links to Hospitals here). Two recent examples underscore that these links are unnecessary and serve only to force abortion providers out of business:
Texas: In response to the requirement that abortion providers obtain hospital admitting privileges, the Texas Hospital Association (THA), which represents 85% of the state’s hospitals, issued a statement that reaffirms its commitment to “high-quality care” and declares that “a requirement that physicians who perform one particular outpatient procedure, abortion, be privileged at a hospital is not the appropriate way to accomplish these goals.” The statement further elaborates that ‘[t]housands of physicians operate clinics and provide services in those clinics but do not have hospital admitting privileges” and that any woman who experiences complications “will appropriately be treated by the physician staffing the emergency room when she presents there.”
Ohio: In this case, the law itself refutes the claim that it is meant to protect patient safety. Ohio has long required abortion providers to have an agreement (itself unnecessary) with a hospital allowing them to transfer patients needing emergency care. However, in June, Ohio adopted a new provision prohibiting public hospitals in the state from entering into these transfer agreements. If taken at face value that transfer agreements are needed to protect patient safety, then the new Ohio provision would serve only to harm patient safety (in fact, Ohio should incentivize or even require hospitals to enter into transfer agreements). Instead, the new provision is clearly aimed at making it impossible for some providers to come into compliance.
Please click here to read the full report: http://www.guttmacher.org/media/inthenews/2013/07/18/index.html
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