Should a woman undergoing an abortion be guaranteed the same basic medical safety as a man undergoing a vasectomy? Should both facilities – the abortion clinic and the outpatient surgical center – be required to follow medically endorsed standards for competence and cleanliness?
To most Americans, the answers to these questions are self-evident, but these are exactly the questions before the Supreme Court as it decides its most consequential abortion case in decades. In Whole Woman’s Health v. Hellerstedt, a profit-motivated abortion industry has challenged a 2013 Texas law requiring it to comply with health and safety standards that are enforced against other outpatient facilities performing invasive surgical procedures, as well as mandating that increasingly itinerant abortion providers maintain admitting privileges at local hospitals to facilitate emergency care and the treatment of post-abortive complications.
This much-anticipated ruling will determine whether the nation’s abortion clinics can continue to enjoy high profit margins while keeping patient care standards low. At stake for American women is whether the abortion industry will be required to live up to their claims about concern for and attention to women’s health by actually prioritizing the protection of women’s safety.
The reality of abortion practice in American is at odds with abortion proponents’ repeated assurances that legalized abortion ensures and protects maternal health. Over just the last six years, Americans United for Life has documented that nearly 200 abortion providers in states across the nation have faced investigations or been cited for violating state laws and medical regulations governing the provision of abortion.
For example, in April, a Virginia abortion clinic was shut down after investigators issued a 52-page deficiency report which included evidence that a staff member assisted in an abortion after unclogging a toilet but before changing scrubs or properly cleaning her hands, that an abortionist saved a blood-smeared surgical gown for future use rather than putting it into the laundry, and that surgical equipment was smeared with “foreign material” and dried yellow and brown “splatter.”
Similarly, in late 2015, an Atlanta television station reviewed inspection reports for all of Georgia’s licensed abortion clinics. The investigation uncovered multiple and repeated health and safety violations including unsterilized equipment, expired medications including the use of iodine swaps that had expired 10 years ago, a vent in a biohazard room taped off with cardboard, stirrups wrapped in duct tape, and soiled linens in procedure rooms.
Today’s legal abortion clinics are the “back alleys” that abortion advocates shamelessly invoke whenever anyone challenges their unrestricted and unregulated abortion-on-demand ideology. In direct response to this disturbing reality, a majority of states have prescribed health and safety standards for facilities performing abortions. If the Supreme Court finds in favor of the Texas law, more states will certainly follow suit and women will be better protected from the negative medical consequences of abortion and from the abortion industry’s callous operation of substandard abortion “profit centers.”
To uphold the Texas law, the Court simply needs to affirm what it said in Roe v. Wade: a state’s legitimate interest in regulating abortion “obviously extends at least to [regulating] the performing physician and his staff, to the facilities involved, to the availability of after-care, and to adequate provision for any complication or emergency that may arise.”
Conversely, to rule in favor of the profit-centered abortion industry, the Court will have to affirmatively decide that women seeking abortions are not entitled to the protections of the same patient-centered standards that are routinely applied to other surgical facilities. Dangerous abortion clinics will proliferate, and efforts by state officials to address the growing public health crisis of substandard abortion care will be frustrated.
A growing body of research illustrates that abortion harms women. Abortion providers routinely claim that 2.5 percent of women who have first-trimester abortions “undergo minor complications,” while fewer than 0.3 percent experience complications requiring hospitalization. Even taking these conservative estimates at face value and using the latest abortion statistics from the Guttmacher Institute (for 2011), that would mean, across the U.S., 26,500 women experienced complications and approximately 3,180 women required post-abortion hospitalization in 2011. These numbers are obviously not insignificant, and instead reveal a serious public health concern. These women deserve the medical protections offered by the Texas law including access to the best post-surgical and emergency care.
The Supreme Court holds the future of both American women and the increasingly predatory abortion industry in its hands. Whether the Court sides with proven health and safety requirements designed to protect women from substandard abortion providers and practices or endorses the abortion industry’s profit-maximizing scheme of ignoring medical standards that it is either unable or unwilling to meet, its ruling in Hellerstedt will be far-reaching and historic.