Any day now, the state of Mississippi is expected to send inspectors in to see if Jackson Women’s Health Organization, the only abortion clinic in the state, is violating the new law that requires abortions to be performed by a board certified OB/Gyn with admitting privileges to a local hospital.
The results of the inspection will not be a surprise. The clinic owner has already stated that all doctors were turned down for admitting privileges and that they will not be able to comply. The inspection will be the starting point for the state to revoke the clinic’s license, a process that will require letters of intention to be sent, a 30-day wait before an appeals hearing can occur, and administrative processes to be completed and then, of course, the blessing of the court, which will eventually be brought in to resolve whether or not closing the clinic altogether is a violation of undue burden on the women of Mississippi.
The state will argue no, and their explanation paints a detailed portrait of what life was like in abortion-hostile states before Roe became law, and where the anti-choice movement hopes the state will eventually be again if Roe is overturned.
According to a recent motion to dismiss the injunction and allow the law to go fully into effect, closing JWHO wouldn’t be an undue burden of women in Mississippi seeking abortions because there would still be doctors who provide abortions in private care.
[A]lthough Plaintiffs repeatedly assert that JWHO is “the sole provider of abortion services in the State of Mississippi” (Motion at 2) and that HB 1390 “will make abortion unavailable in Mississippi” (Id.), that is simply not so. JWHO may be the only Level 1 “Abortion Clinic” licensed under Title 41 in Mississippi, but the State does not apply its regulations to facilities providing less than ten abortions a month. MISS. CODE ANN. § 41-75-1(f) (definition of “abortion facility”). Thus, abortion remains available in private physicians’ offices and at hospitals that offer the procedure.23
There are a number of alarming reasons why private physicians taking over terminating pregnancies is simply not an equitable solution for potential patients, and would go even further to segregate the already growing class divide when it comes to access to full health care in the state.
According to the Associated Press, 2,297 abortions were performed in the state in 2010, 2,251 of these at JWHO. For private doctors to take over this number of terminations and do it within the state’s “less than 10 a month” guidelines would require that at least 20 new OB/Gyns add pregnancy terminations to their practices. This at a time when much of the country—especially Mississippi—is already experiencing a crisis in available, practicing OBs.
Even if that number of doctors could be recruited, numerous problems remain. How do women without primary care doctors, or even worse without any insurance at all, manage to find a doctor who could perform one? What happens when a doctor has performed up to his or her limit for the month and sees a patient in need? Even if she isn’t running close to the legal limit for an abortion, it still creates a system of unnecessary waiting and more potential detrimental health affects than a (moderately) more accessible system allows.
In fact, the state argues that these requirements are necessary as a means to protect the woman’s health, yet their own law would actually increase their risk of injury if their experts are to be believed. The state says:
Contrary to Plaintiffs’ assertions, termination of pregnancy is not a benign medical procedure. In some cases, serious complications, even life-threatening ones, arise and necessitate optimal and evidence-based treatment….Given the frequency of short-term complications from abortion (2-10%), follow-up medical care is often needed on an urgent basis to treat infection, bleeding, or organ damage. If recognized and attended to promptly, long-term consequences can be minimized. Often, though, abortion procedures are performed in freestanding clinics during weekday hours and complications are managed in urgent care centers or emergency departments after hours or on weekends.
The state does not address how pregnancy terminations being performed by private doctors in private offices, which would also be likely to occur during regular weekday hours, would be any different, especially since the doctors performing those abortions would not be required to have admitting privileges under the law. As Center for Reproductive Rights’ President Nancy Northup explained back in July:
“If they [the state] feel that every doctor in the state of Mississippi should have admitting privileges in a hospital, OK. Pass that broad law that will apply to all doctors in the state. If they think all OB-GYNs in the state should have admitting privileges to the hospitals, that’s another thing.”
Clearly, the state doesn’t want all OB’s to be required to have admitting privileges, especially in the face of a shortage of providers. What they want is a specific way to eliminate as many abortions as possible, and are using legislation targeting what they dub “itinerant” surgeons.
Dr. Thorp concludes that “H.B. 1390 is medically necessary to prevent itinerant surgeons like Dr. Parker from being allowed to abandon his patients if complications arise and emergency follow-up intervention is necessary. Mississippi women expect and deserve to receive responsible medical services which conform to accepted standards of care in medicine, not substandard care offered by itinerant surgeons who lack both board certification and hospital privileges.”
(Note: the use of “both” is deliberate, as the doctors are already board certified.)
If Dr. Thorp’s statement sounds familiar, you may recognize it from Phyllis Schlafly, although her problem with “itinerant surgeons” was that by allowing other hospital staff to perform follow-up in the event of a complication, that makes a taxpayer who helps fund the hospital through his or her taxes complicit in the act of an abortion.
The state of Mississipi’s rationale for revoking the injunction is as unsupported and misleading as is their TRAP law in the first place, something that is unsurprising once you learn that Operation Rescue was involved in the development and drafting of the bill. The justifications provided in the 35-page report that assert the bill protects women who terminate their pregnancy shows that by making a requirement that applies only to the clinic and encouraging women to go to private doctors instead who do not need to use the same safety standards, the law does no such thing. In fact, by setting more roadblocks and a limit to the number of procedures those seeking terminations will receive them even later, something that could increase the possibility for medical complications.
What the law would do if enforced, however, is make abortion accessible only to women with insurance, good connections to a doctor who can do a termination, and money to pay for a more expensive private office or hospital procedure.
In other words, it takes them right back to where they were before Roe v. Wade was decided. Just as they intend it to.