- - Tuesday, March 1, 2016


The ability of our society to enact reasonable health regulations protecting women seeking abortions is once again at issue. Numerous abortion clinics in Texas have run afoul of Texas law HB 2 and must close unless the Supreme Court decides the case Women’s Whole Health v. Hellerstedt in their favor this week. The Texas law has several provisions, but the ones at issue in this case are the requirements that physicians have admitting privileges at a nearby hospital, and that the clinics comply with the same building codes as ambulatory surgical centers.

Supporters of the law will argue that women deserve safe medical standards regardless of where they live, and regardless of their socioeconomic position. The two clinics named in this suit argue that getting their facilities up to standard outpatient surgical code is too costly, and hospital privileges are just too hard for their physicians to obtain. They also purport to be concerned about women having to travel further from home to obtain the procedure at clinics whose standards are already up to par.

If I were a physician who was unable to appreciate and value the humanity of the developing child, and could be comfortable performing abortions, I would still be heartily ashamed to find my clinic’s lawyer before the Supreme Court arguing that I should be able to perform a surgical abortion and not be held to the same standards as a doctor who performs a colonoscopy in a surgical ambulatory center.

A surgical abortion is just that: surgical. It’s a complicated procedure, requiring the opening of the cervix — a part of the body that is designed to stay firmly closed except for the few hours a woman will spend in labor during her lifetime. It requires the insertion of forceps or suction canula into the uterus, to remove the fetus and placenta. Risks include hemorrhage, uterine perforation, cervical laceration, and retained placenta. Conscious sedation or general anesthesia are used to combat the considerable pain, and they have inherent risks themselves.

A standard-level abortion facility, nothing fancy, like the ones Planned Parenthood runs in other parts of Texas, naturally comply with the building standards of ambulatory surgical centers — because they are basic and reasonable. They include wide hallways that can accommodate a gurney that is being rushed to a waiting ambulance, and a ramp down to the parking lot. They also include paved walkways and roads about the building, abundant nearby parking, and accommodations for handicapped patients.

The clinics arguing before the court would have to retrofit their facilities to put in these standard amenities. And this costs money. What they are proposing is that their patients should receive substandard care so that their profit margin will be higher.

As far as the admitting privileges requirement, this is also a reasonable regulation for a facility that performs surgical procedures. A doctor needs to be able to admit a patient who’s had a life-threatening complication to a hospital and then treat her and follow her himself. The doctor knows exactly the procedure he performed and the medical history of the patient. These are facts that would allow for timely diagnosis and effective treatment — and knowledge that might save a woman’s life. When the performing physician does not have admitting privileges, the emergency room doctors can only rely on the woman’s understanding of what was done to her. That’s not good medicine.

When abortion was legalized across the country in 1973, many good-hearted people breathed a sigh of relief. They were concerned about the “back-alley abortionist,” who preyed on seduced and abandoned women resorting to a grim solution. Legal abortion was going to fix that because abortion would be held to the same medical standards as other procedures. Now, in an ironic reversal driven by greed, the back-alley abortionists work comfortably on Main Street — and fights shamelessly for the right to deliver less-than-adequate care to the women who trust them.

Grazie Pozo Christie specializes in radiology in the Miami area and serves on the advisory board for the Catholic Association.

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