Abortion

Indiana Right to Life Seeks to Eliminate Access to Safe, Early Medication Abortion

The group is claiming that a Lafayette clinic is violating law by providing medication abortions without licensing their clinic as a surgical abortion center.

Photo: Think Progress.

Anti-choicers have been honing in over the past few years on early medication abortions—which take place by or before 8 weeks of pregnancy—seeing the protocol as a threat to their plan to make abortion physically and financially inaccessible. RU-486, a medication that safely induces abortion up to the ninth week of pregnancy, enables a woman to access abortion in privacy and without the immediate presence of a doctor. The availablity of RU-486 has expanded access to early safe abortion across the country at the same time that legislatures have become increasingly hostile to reproductive rights.

Efforts by right-wing controlled legislatures to limit the use of the drug run the gamut from forcing doctors to use outdated FDA protocols that add increased expense, mandating onerous and unnecessary counseling procedures, or forcing doctors to be physically present at the time of the abortion and for all additional follow up visits, in order to ensure that options like telemed abortions cannot be arranged for those who live too far from a clinic with a doctor on staff. Now, Indiana Right to Life, the state’s largest anti-choice organization, has a new attack.

It is accusing the Lafayette Planned Parenthood of conducting abortions without a license.

Lafayette Planned Parenthood has has a setup unlike any other clinic in the state. It is the only reproductive health care center that offers RU 486 but does not perform surgical abortions. As such, it doesn’t qualify as an abortion center according to the official definition in state law, which refers specifically to “a freestanding entity that performs surgical abortion procedures.”

Because it does not meet the qualifications of a surgical abortion center, Lafayette Planned Parenthood isn’t required to have the same kind of license required by other clinics. It’s this fact that has Indiana Right to Life so upset.

“Women who visit this Planned Parenthood office deserve to find a facility that meets the state requirements for health and safety required of all other Indiana abortion clinics,” Indiana Right to Life Legislative Director Sue Swayze told the Indy Star

The group has filed complaint with the state board of health, hoping to instigate an investigation into the clinic. If the Lafayette clinic is not found to be breaking any laws, then IRTL says their next step would be to change the laws themselves.

“We filed a request with the Attorney General’s Office to find out what’s really happening here and what’s lawful and what’s not,” Swayze told WLFI News, adding that if they don’t need a license then that would be “something she and others want to work on getting changed,” according to the news report.

Are the licensing requirements for admitting privileges to a local hospital even necessary? Not at all, Planned Parenthood Indiana President and CEO Betty Cockrum told Rewire. Passing laws requiring admitting privileges where they are not necessary is a favorite tactic of anti-choice groups seeking to limit access to safe, legal abortion, all wrapped up in the guise of “patient safety.” And a requirement for admitting privileges has absolutely no relationship to the safety of abortion procedures.

“You’re in Southern Indiana, the Old National Highway, US 40, south of US 40 there is one clinic, it’s in Bloomington and it’s one of ours,” Cockrum explained. “Let’s just assume there is an unfortunate outcome. You live in Evansville. You drive to Bloomington, you have your procedure, you drive back home and you have a concern. How much good does it do that the doctor that performs the procedure in Bloomington has admitting privileges in Bloomington when you are three hours away in Evansville?”

With a medication abortion, admitting privileges make even less sense as a means of keeping patients safe, as the abortion isn’t even performed in the clinic. But according to another offshoot anti-choice group in Indiana, not only will they demand that the Lafayette clinic obtain admitting privileges and licensing, but they also seek to require that all medication abortion procedures follow and outdated FDA protocol.

“There are serious adverse reactions to RU-486,” Connie Basham, of Tippecanoe County Right to Life claimed in an interview with JC Online.  “FDA regulations require patients to return to the doctor three days after receiving the first pill, then 14 days later to evaluate their condition. The FDA requires the drug to be administered under the supervision of a physician in a licensed facility, and the dispensing physician must have admitting privileges at a local hospital. Is there a qualified physician on-site at the facility?”

Anti-choice tactics have all but eliminated medication abortion in Ohio. And a ban on off-label use in Oklahoma has been blocked in the courts.

Cockrum believes efforts by anti-choice Indiana groups are just another attempt to use bogus claims of “patient safety” to reduce access to safe abortion care. “At this point, if there is a restriction that has passed somewhere else that hasn’t come up in our legislature yet, I just assume someone is about to propose it.”

The question then is what sort of law they hope to propose. An FDA-only law such as Ohio’s, which would mandate providing women with three times as much of the drug as scientific evidence deems medically necessary, tripling the cost of a medication abortion? An “evaluation first” law such as was passed in Wisconsin, which also creates a potential felony if a woman didn’t meet with her original provider after the abortion was completed for a follow up appointment, a law which forced all entities to stop offering medication abortions out of fear of criminal prosecution? Or a Super-TRAP bill like one that actually failed in Missouri, requiring that doctors who prescribe for medication abortions have admitting privileges, meet patients 24 hours in advance, and have at least $1 million in malpractice insurance to boot?

Whichever approach is taken, it won’t be about patient safety. That would be a lie says Sue Ellen Braunlin of Indiana Religious Coalition in Support of Reproductive Justice.

“We have watched what [Indiana Right to Life] has done in the last two legislative sessions, and it has just been horrifying. They bring out people to testify and they are all emotional-based testimony. There was not one single medical or expert testimony in support of a single thing that they have brought up in the last two years.”

“Medical abortion is safer than aspirin, Tylenol and Viagra,” said Braunlin, an anesthesiologist, said in an interview last week. “They are setting it up for a TRAP law that they have tried to put through in previous sessions. Last year they tried to require that the dose used was exactly the dose required. In this case some physicians did get involved and say ‘This is three times more than what is required,’ and that did get dropped. But we knew they were going to try again.”

There has been no response so far from the Indiana Department of Health regarding whether or not it deems there is any merit to Indiana Right to Life’s complaint that the Lafayette clinic is “practicing medicine without a license.”  But whether or not IRTL gets an answer, you can expect them to ask more questions—and offer more “solutions”—once the state legislature meets again.