Skip to main content

The decline in abortion clinics

As one might suspect, there has been a rather dramatic decline in the number of abortion clinics nationwide in the past few years.

Pro-life activists attribute this decline to three things (the first two, I think, having a real and concrete impact):
  1. State legislatures passing "TRAP" laws (targeted regulation of abortion providers) that require unnecessary and expensive changes to abortion clinics, which the clinics cannot afford. TRAP laws also sometimes require clinic doctors to have admitting privileges at a local hospital, which local hospitals refuse to provide. 
  2. State legislatures "defunding" family planning clinics (that also perform abortions) by passing laws ensuring that no state money goes to places that perform abortions. 
  3. Prayer vigils and other forms of direct action at clinics themselves, like the 40 Days for Life campaign. 
Because abortion services in the United States are so heavily dependent on the clinic system, attacking clinics legally and financially is a sound strategy for making abortion effectively illegal in the United States.

The clinic system in the United States exists largely because of increased demand from women for legal and safe abortion access after Roe v. Wade and Dow v. Bolton were decided in 1973. At that time, hospitals were seen as lacking the capacity and will to handle increased demand for abortion; in addition, many hospitals in the pre-Roe and Doe era had cumbersome approval procedures. Individual OB/GYNs have been performing abortions as part of their private practices (legally and illegally) for a long time, but were not seen as possessing sufficient capacity. In addition, at least in the ones run by feminists, clinics focused specifically on reproductive health were to provide abortions and information about it in an enlightened and sensitive way.

In order for access to abortion services to be maintained or increased, one or more things has to happen:
  1. TRAP laws must be declared unconstitutional under the doctrine of the "undue burden" of Casey v. Planned Parenthood. Everyone is aware of the true motivation of TRAP laws, which is to shut down clinics without attacking the right of abortion directly. 
  2. Abortion services must be offered in non-clinic settings, such as private OB/GYN practices or hospitals. This would be difficult to do, for a host of reasons (that can be the topic of a separate post). That being noted, embedding abortion services within a larger network of other medical services and providers would make TRAP laws and defunding efforts almost impossible. 
  3. Early-stage abortion (which comprises 85-90% of all abortions in the U.S.) can be provided through medical abortion (i.e., abortion caused by taking one or more drugs). Medical abortion could be provided by private OB/GYNs, or by existing clinics but remotely (the drugs are provided locally after a video conference with a consulting physician, who could be several hundred miles away). Note that pro-life activists, alarmed over the access benefits of medical abortion, have been legislating against it as well. 
Links:

Article in The Huffington Post (August 26, 2013): Anti-Abortion Laws Take Dramatic Toll on Clinics Nationwide

Feature on RH Reality Check that contains documents from state agencies describing how the state currently regulates abortion providers: State of Abortion

Article in The Daily Beast (January 22, 2013): The Geography of Abortion Access
Labels:

Comments

Post a Comment

Popular posts from this blog

Medically necessary abortions: The battle of the experts

Apparently, Representative Joe Walsh is not entirely alone! The assertion that an abortion is never medically necessary has been floating around in the pro-life universe for at least a little while. We are now witnessing a battle of the experts. One the one side is Joe Walsh and friends. Walsh himself released a pdf document with quotations from several doctors-- including some historically prominent pro-choice doctors, like Alan Guttmacher-- making the 'never medically necessary' claim seem quite reasonable. Also on Walsh's side are several doctors  who particpated in a recent "International Symposium on Maternal Health" in Dublin. Ireland, despite a European Court of Human Rights ruling in 1992 , has a total ban on abortion. Irish pro-lifers want the country's politicians to resist pressure to implement even a life exception, so the question of medical necessity is directly relevant there. The "Dublin Declaration," released after the S...
3 comments
Read more

A Catholic EU health commissioner

The European Union Parliament approved a controversial choice for their top health official: The European Parliament backed a devout Catholic as EU health commissioner on Wednesday, brushing off critics who fear the Maltese politician could row back on EU policies on stem cell research, abortion and gay rights. Greens, Liberals and Socialists in the European Parliament had said they would vote against Tonio Borg, a former foreign and justice minister in Malta, saying his beliefs could influence EU policy. As commissioner, Borg's remit would include access to healthcare and contraception and the control of sexually transmitted diseases. Borg, who was in Malta on the day of the vote according to an EU Commission official, told EU lawmakers before the vote that his personal views wou...
Post a Comment
Read more

Four ways the presidential election could change reproductive politics

Setting aside all of the claims and counterclaims of the candidates and all related white noise, there are four concrete ways that the 2012 presidential election could cause policy changes on abortion, contraception, and family planning. If Barack Obama is reelected, little will change. If Mitt Romney is elected, I predict the following: The contraceptive mandate, issued by the Department of Health and Human Services, would be withdrawn.  Barriers to defunding Planned Parenthood could be removed. As it is now, federal courts are stopping the complete defunding of the organization (i.e., withdrawing all federal funding) due to their interpretation of federal legislative language. With Romney as president, that language could be modified (assuming the changes could get past a Democratic Senate). The composition of the federal judiciary, particularly the United States Supreme Court, would be modified through appointments. If, say, Stephen Breyer or Ruth Bader Goldberg retired, ...
Post a Comment
Read more