- The Washington Times - Sunday, April 22, 2018

For 38 years, EMW Women’s Surgical Center has been performing abortions in Louisville, Kentucky.

It’s now the last abortion provider in the state, and it’s fighting to keep its doors open and to prevent Kentucky from becoming the first state in the nation without an abortion option.

The administration of Gov. Matt Bevin, a Republican, said last year that EMW doesn’t have valid transfer agreements with an ambulance service and hospital. State law requires transfer agreements in case a procedure goes wrong.

A judge has delayed the clinic’s closure.

In Mississippi, Jackson Women’s Health Organization is the only abortion clinic still open. It, too, is battling a series of state laws that it says makes it difficult to give women a place where they can terminate their pregnancies.

West Virginia, South Dakota and North Dakota are other states with just a single abortion clinic.

For pro-life advocates, it sounds like victory. They say clinics that can’t abide by health and safety laws should be shut down.

Pro-choice activists say the laws are too extreme and are less about safety than about eliminating opportunities for women to obtain abortions.

“They do this by passing laws that force clinics to close by subjecting them — and no other type of similar health care provider — to medically unnecessary restrictions,” said Brigitte Amiri, deputy director with the American Civil Liberties Union’s Reproductive Freedom Project. “This is precisely what is happening in Kentucky. The real goal, of course, is to ban abortion in these states.”

Reproductive rights lawyers are challenging the state laws, saying they are burdensome and amount to backdoor bans on abortion.

The key question, they say, is how far a woman should be required to travel to exercise her right under the 1973 Roe v. Wade decision to terminate her pregnancy.

Jackson Women’s Health says some clients in Mississippi travel more than 600 miles and have to stay overnight to comply with the state’s requirements, such as a 24-hour waiting period and an in-person consultation the day before the procedure.

“Women are now forced to make two trips to get the care they need with all the costs that entails,” said Diane Derzis, the clinic’s owner. “These laws are designed for one purpose only, and that is to put us out of business.”

The state’s lawmakers haven’t been shy about their intentions.

Gov. Phil Bryant, a Republican, said in 2015, “Rest assured that I am as committed as ever to ending abortion in Mississippi.”

Lila Rose, president of the pro-life organization Live Action, applauded Mr. Bryant and Mr. Bevin, saying all states should try to become abortion-free.

“Their business model is killing children for profit, and many facilities operate above the law and refuse to comply with state regulations designed to protect women. These facilities put profiting off of abortions over the safety of their clients,” said Ms. Rose.

But Kaylie Hanson Long, communications director for NARAL Pro-Choice America, said making abortion difficult to obtain won’t cut the number of abortions but will increase the rates of injuries and deaths among women seeking them.

“A GOP governor might think having zero abortion providers in his or her state is a badge of honor, but in reality that would make him or her not only out of step in their state but also responsible for endangering women and families,” said Ms. Long.

According to the Centers for Disease Control and Prevention, 652,639 abortions were performed in the U.S. in 2014. It was the lowest number in a 10-year period, suggesting abortions are on the decline. It’s unclear if that is the result of a decrease in the number of facilities or an increase in contraceptive access.

Lois Shepherd, a law professor at University of Virginia, said the legal issue with having only one abortion clinic in a state is whether the government is enacting laws to make it more difficult for women to have access to abortions.

She said restrictions have been growing for 25 years.

The Supreme Court struck back in 2016 by ruling against a Texas law that required each physician providing abortions to have admitting privileges at a hospital not more than 30 miles away and required each clinic to have wide hallways and follow other building guidelines for surgical centers.

The number of abortion facilities in Texas would have decreased from roughly 40 to 20 clinics if the laws had been upheld.

The 5-3 decision said states can’t enforce regulations that, when put together, create undue burdens on women who seek abortions.

But the ruling didn’t stop Kentucky and Mississippi from enacting a number of pro-life measures.

“Eventually, it’s just too hard and I do think we are seeing that. It’s gotten to a tipping point in a way, which is exactly what the people who pass these laws — that was their intent — it hasn’t been hidden,” said Ms. Shepherd.

In Wyoming, only one clinic advertises abortion services. But Brent Blue, director of Emerge-A-Care, disputes that it’s the only option.

“We’re the only provider in state that acknowledges we do terminations. I’ve heard that there are two others in our county that do medical abortions,” he told Vice News last year.

Arkansas may also join the list of states with one provider, depending on the outcome of a lawsuit challenging the state’s ban on medication abortions. Three clinics are operating in Arkansas, but only one provides surgical abortions. The other two strictly provide medication abortions, according to CQ magazine.

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