Abortion curbs unsafe for women
The Fifth Circuit Court decision upholding a state law regarding abortion ignores the consensus of medical experts that Texas’ thinly veiled attempt to restrict access to abortion interferes with the practice of medicine and accepted standards of care. That’s why OB-GYNs are disappointed in this decision, which is simply not the right one for American women.
Under the guise of protecting women’s health and safety, abortion restrictions like the ones upheld by the court actually jeopardize women’s well-being. Moreover, this decision says politicians can limit women’s access to safe and legal abortion care under false pretenses.
Specifically, the law requires abortions in Texas to be performed in ambulatory surgery centers (i.e. mini-hospitals) and makes physicians providing abortion care obtain admitting privileges at local hospitals. These are not the common-sense approaches that they may seem, however. They improperly over-regulate medical care, do not improve patient safety and, most importantly, interfere with the doctor-patient relationship — setting burdensome standards that many providers and clinics cannot meet.
Abortion is one of the safest medical procedures performed in the United States, and neither of these restrictions would make it any safer. Nationally, the risk of death resulting from abortion is exceptionally low, at much less than 1 percent. In Texas, the rate is even lower.
This impressive safety record has been accomplished with most abortions performed in physicians’ offices and outpatient clinics.
Ambulatory surgical centers, or ASCs, are essentially mini-hospitals; abortion procedures simply do not require this. This is because most abortions are very simple procedures that do not require the extensive external sterility precautions and other operating room requirements needed for more invasive procedures.
Moreover, other procedures that are less safe than abortion are permitted in non-ASC settings. Colonoscopies, for example, are not required by law to be performed in ASCs in Texas, even though they have greater mortality rates.
There is simply no medical need to require abortion facilities to meet higher standards than similar or riskier outpatient procedures.
Perhaps even more absurdly, the Texas law requires medication abortion to be administered in such a hospital-like environment, despite the fact that women are only ingesting pills.
The law also requires that abortion providers maintain admitting privileges at hospitals near where the abortion is performed, but this is out of step with current models of medical practice. In modern medicine, the same doctor often does not provide both outpatient and hospital-based care to a patient. Instead, hospitals employ expert physicians who are trained to respond to any medical emergency. Whether an abortion provider has admitting privileges at a local hospital has nothing to do with the care that the patient receives.
Further, admitting privileges are not necessarily an indication of a physician’s clinical competency. Hospitals award or deny admitting privileges for many reasons unrelated to clinical competency — reasons that do not impact the quality empathetic care that a woman receives.
Since this law was passed, approximately half of the abortion clinics in Texas have been forced to close. It is likely that with this decision, even fewer clinics will remain to serve Texan women in need of safe abortion care.
Evidence shows that when the average distance to the nearest provider of abortion services for women is significantly increased — which for some women in Texas could amount to hundreds of miles — access to abortion services is delayed or eliminated entirely.
Even though abortion is safe — and legal — the risk of complications increases during pregnancy, and since the passage of the law, early access to abortion has become bottlenecked. Reports of women procuring abortion-inducing drugs over the Internet, in Mexico or on the black market also have proliferated.
OB-GYNs are dedicated to medical care of the highest quality, but this law offers no health benefit for women.
Health care regulations must be grounded in sound science, medical evidence and quality care — not personal bias.
The cynical use of the state’s regulatory system to undermine women’s rights, integrity and safety is wholly unconstitutional and is just plain wrong.