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Best of SA 2013: 4/24/2013
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Texas Abortion Providers Fear They May Not Survive New Regulations



Dr. Lester Minto at his clinic in Harlingen, which provides preventative care as well as abortions

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Protestors outside of Reproductive Services of Harlingen

“To this day, only five of us have been able to find the resources to build an ASC,” she said. “And that took eight years.”

House bill author Rep. Jodie Laubenberg (R-Parker) answered a series of questions during the special session debate about her legislation with the ostensible claim that, “the bill is about the health and safety of women,” and Senate author Glenn Hegar (R-Katy) similarly reiterated the measures are meant to “increase the quality of the care” for women, yet neither legislator could provide evidence of how it would actually benefit safety. The argument was further tested when a Texas Department of State Health Services representative pointed out during a committee hearing that abortion clinics are inspected once a year, while ASCs are reviewed once every three to up to six years, meaning that the ASC requirement could reduce oversight of abortion clinics.

While reproductive rights advocates have drawn much attention to the ASC requirement, set to take effect in September 2014, clinics first face an equally complex challenge slated for implementation 90 days after the end of the second called session, which closed July 30. Under HB2, by this November all abortion physicians must obtain admitting privileges at a hospital within 30 miles of where the procedure is performed. Purportedly intended to make sure women have access to a hospital in case of an abortion-related emergency, health care leaders say the bill’s intent seeks to solve a problem that doesn’t exist and only creates another obstacle for abortion doctors.

One such opponent is the Texas Hospital Association, which lobbied against the legislation. During an early July House committee hearing, THA attorney Stacy Wilson testified that it would be unlikely that a non-abortion serving hospital (in other words, the majority of hospitals) would grant admitting privileges to an abortion doctor. Credentialing doctors who perform outpatient services is expensive and time-consuming for hospitals. Moreover, the system in place has worked effectively; today hospitals won’t turn away a woman suffering complications irrespective of admitting privileges.

Those difficulties aren’t common to begin with. According to the Guttmacher Institute, less than 0.5 percent of women obtaining legal abortions experience a complication and the risk of death associated with the procedure is roughly one-tenth of that with childbirth. In Texas, five abortion-related deaths have been reported since 2000, according to the Department of State Health Services. The last documented death occurred in 2008.

Minto’s experience reflects those statistics—he’s admitted one patient every 10 years over the past three decades.

Adding to the obstacle, hospitals may also fear aligning themselves with abortion providers after a conservative-led rule enacted earlier this year excluded abortion providers from a Medicaid-based health program. “It puts hospitals in a pickle—they know if they don’t give abortion doctors privileges, abortion centers will shut down,” said Hagstrom Miller. “But at the same time, if they do give privileges, are they going to be barred from accepting Medicaid?”

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