It seems counterintuitive: why would obstetrician-gynecologists oppose laws that purport to improve the safety of women?  

Because too often, these efforts provide no benefit to patients and instead are intended to restrict access to abortion, all under the guise of protecting women’s health.  

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One egregious example comes from Texas, where legislators passed regulations forcing outpatient abortion clinics to meet the same building standards as mini-hospitals known as ambulatory surgical centers (ASCs) and requiring physicians performing abortions to obtain admitting privileges at a local hospital. On March 2, the Supreme Court will hear arguments on this issue, with the justices evaluating whether, by making it harder for women to access safe abortion,  these laws would unduly burden women’s constitutional rights. 

As an ob-gyn, I believe wholeheartedly that they do. It is clear that not only would women’s rights be burdened, but their health and safety would be harmed; rather than improving patient safety, this law would worsen it. Here’s why. 

By imposing unnecessary, expensive and at times, impossible, standards on abortion clinics and providers, these regulations would result in the closure of more than 75 percent of the abortion clinics in Texas. In an already large state, this will create significant barriers to Texas women getting safe, legal abortions, and it will ultimately make abortion less safe – quite the opposite of the law’s claimed intent. 

Let’s address the pretext upon which these restrictions are grounded: neither the admitting privilege requirement nor the facilities rules will improve patient outcomes. Abortion is already one of the safest medical procedures performed, with a lower complication rate than many other outpatient procedures that are not subject to similarly stringent regulations.  

There is no medical need to perform abortions in a hospital-like ASC, which would require current abortion clinics to undergo costly upgrades unrelated to typical abortion care, for example widening of hallways. This is especially unnecessary for medication abortion, which involves women ingesting pills. 

The law also requires that abortion providers maintain admitting privileges at hospitals, but this is also out-of-step with modern medical practice. In an exceedingly rare instance of a patient requiring urgent care after an abortion, any hospital’s emergency physicians would treat her, regardless of the admitting privileges status of her abortion provider. 

Importantly, admitting privileges are not necessarily an indication of a physician’s competency. Instead, hospitals can deny admitting privileges for many reasons that do not impact the quality, empathetic care that a woman receives. For example, a hospital may require a physician to admit a certain number of patients each year, but a physician focusing on providing safe reproductive care would never meet that threshold.

 

Moreover, too often politics play a role in privileging decisions.  In Mississippi for example, physicians at the state’s only abortion clinic were rejected out of hand -- two hospitals wouldn’t even accept applications from the clinic’s doctors, while others rejected them solely because they perform abortions. 

The ulterior motives behind these laws are apparent: the burdens they impose have already led to the shuttering of half of the abortion clinics in the state. As a result, many women are forced to significantly delay the procedure, actually leading to more abortions later in pregnancy. 

As a result, some women could turn to illegal or self-induced abortions or face the mental and physical health risks of being forced, due to circumstance, to carry unwanted pregnancies to term.  The risks in all of these situations far outweigh the nonexistent health benefits the law purports to create, and forcing a woman to remain pregnant against her wishes is just plain cruel.

These tactics reveal not only a disregard for women, but for the importance of the doctor-patient relationship. Doctors want to provide care for their patients when and where they need it.  No doctor wants his or her patients to have to jump through hoops to get needed care. 

If their true intent is to protect women’s health, policymakers will listen to the medical experts across the country who are united in opposition to this law. As an ob-gyn, I hope that a majority of Supreme Court justices will do the same.

Make no mistake – chipping away at the Constitutional right to abortion is an intentional attack on women.

DeFrancesco is president of the American College of Obstetricians and Gynecologists.