Contrary to some news reports, a new bill introduced in Louisiana is unlikely to create a state database of all women who have taken emergency contraception—but reproductive rights experts are more concerned that the bill could close three out of Louisiana’s five abortion clinics using regulations similar to those that have shuttered more than one-third of clinics in Texas.
Amy Irvin, a founding board member of the New Orleans Abortion Fund, told RH Reality Check that if the proposed bill, HB 388, becomes law, two clinics in New Orleans and one clinic in Baton Rouge would likely close, leaving open only one clinic in Shreveport and one in nearby Bossier City. That would mean that only women who live in the northwest corner of the state would have access to a nearby clinic. The Shreveport clinic would also have reduced capacity because only one of its two doctors who provide abortion care has the admitting privileges with a local hospital required by the proposed law. And the doctor who does have those privileges in Bossier City could no longer travel to perform abortions at one of the New Orleans clinics, as he currently does, because the law would mandate that the admitting privileges be within 30 miles of the clinic where the abortion is performed.
Lack of hospital admitting privileges was the reason so many Texas clinics closed, and reproductive health advocates say that admitting privileges are unnecessary and burdensome for many reasons. Hospitals have to accept all patients in an emergency no matter the circumstances, and so an extra agreement with an abortion provider is redundant. Many hospitals also require a minimum number of patient referrals before they will grant admitting privileges, and because abortion is an incredibly safe procedure and serious complications are rare, most abortion providers can’t meet those minimum numbers. Moreover, many hospitals simply don’t want to grant admitting privileges to physicians who provide abortions because abortion is such a politicized issue. The hospitals “don’t want that stigma,” Irvin said. “They don’t want other patients to know that.”
But the lion’s share of media attention thus far has been on something other than potential clinic closures. After Louisiana blogger Lamar White, Jr. claimed that a state representative had proposed a “state database of women who take the morning-after pill,” Jezebel ran with the idea in a headline reading “Sorry, But A Plan B Database Won’t Keep People From Having Sex.” The story discussed why shaming techniques like a “Scarlet Ledger” of women who have had an abortion or taken emergency contraception, which HB 388 could supposedly make possible, won’t deter women from having sex or from having abortions. Less sensationally, Salon reported that the measure would “keep a state database of people who have had medication abortions.”
There are several problems with these claims, Amanda Allen, state legislative counsel at the Center for Reproductive Rights, told RH Reality Check in an interview.
First of all, Louisiana already collects detailed records about both surgical and medication abortion. Information must be sent to the state’s health department about every procedure, at which point identifying information is stripped out, and the data is aggregated into a report on general abortion trends. While the existing reporting requirements for doctors are “onerous,” Allen said, nothing about this new law would change them. Even Louisiana Right to Life, which worked on the legislation with sponsor Katrina Jackson (D-Monroe), said only that the bill would “clarify” the existing law.
“There’s not going to be anything new created here, because the Department of Health already collects this information,” Allen said. “This is part of why politicians should not be legislating medicine, because it’s completely unnecessary.”
But the fears about Plan B databases come from language in the bill that changes the definition of a “first trimester” abortion from one that is “six to fourteen weeks” to one that is “up to fourteen weeks.” Because many anti-choice advocates claim—inaccurately—that emergency contraception can cause a very early abortion, the fear is that the law could be interpreted to include emergency contraception in the aforementioned onerous reporting requirements.
But, Allen said, the bill doesn’t change the state’s definition of abortion, which is not written in a way that would affect emergency contraception. And HB 388 amends two different parts of the Louisiana code—one about the reporting requirements, and one about licensing requirements for abortion clinics—but the “up to fourteen weeks” language only appears in the licensing section. So not only would that definition not affect reporting requirements, it doesn’t even appear to have much of a purpose.
Allen said she “can’t think of any practical implications” for clinics in changing the definition of “first trimester” in this way. “Any clinic currently providing a first-trimester surgical abortion is going to be required to comply with the licensing scheme already.”
Allen said the bill would also not impose any new restrictions on medication abortion like 24-hour waiting periods, contrary to what The Times-Picayune reported. The waiting period, an ultrasound requirement, and biased “counseling” are already required for both medication and surgical abortions.
The proposed admitting privileges requirement, however, would be new, and would pose “a direct threat to women’s safety because it will close safe and reputable abortion providers who are unable to meet the requirements,” Allen said. And she said a new provision requiring licensure for doctors who perform at least five abortions a year, rather than five abortions a month, could also be “problematic” and “a backdoor attempt to end abortion access in private physicians’ offices.”
White, the blogger, wrote a follow-up post on Wednesday acknowledging that he was being “purposefully alarmist” about what the bill could do, because he wanted it to be “scrutinized thoroughly” and because he thought, “perhaps cynically,” that people would be more outraged about the idea of a Plan B database than by clinic closures. But he also said he thought his alarmism on Plan B was justified, partly because the Bioethics Defense Fund, which helped write the bill, has published reports falsely calling emergency contraception an abortifacient.
“I want to raise the alarm because [the bill] could close facilities just like it did in Texas—and because there is a longer-term agenda going on here,” White told RH Reality Check. “I’m happy to be an alarmist about this. It’s OK to me if [regulating emergency contraception] is not right now what they’re intending to do, because I do think this is part of the longer term agenda.”