Two Texas doctors—Lamar Robinson and Jasbir Ahluwalia—had their admitting privileges reinstated last week at the University General Hospital in Dallas (UGHD). Their privileges were revoked in late March for performing legal abortions at clinics independent of the hospital.
Texas’s House Bill 2 (HB2) took effect in November 2013, requiring that abortion providers have admitting privileges within 30 miles of the clinic. Subsequently, Robinson, owner of Abortion Advantage, and Ahluwalia, medical director of Routh Street Women’s Clinic, were granted admitting privileges at UGHD in December 2013 and January 2014, respectively.
The two received identical letters on March 31 informing them of their loss of privileges because the hospital allegedly “does not have the capacity to treat complications that may arise from voluntary interruption of pregnancies” and because “performing these procedures is disruptive to the business and reputation of UGHD”. In April, Robinson and Ahluwalia filed a lawsuit, claiming UGHD had violated the Texas Occupations Code and engaged in other discriminatory practices. Section 103.002(b) of the Occupations Code states,
A hospital or health care facility may not discriminate against a physician, nurse, staff member or employee because of the person’s willingness to participate in an abortion procedure at another facility.
Robinson and Ahluwalia argued that the sudden revocation of their privileges after practicing for multiple months was a direct result of the hospital’s fear of anti-choice protestors. The lawsuit claims that the hospital caved on the eve of a threatened April 1 protest that was to demand the immediate revocation of Dr. Robinson’s admitting privileges.
Anti-choice protestors nationwide have become increasingly disruptive and vocal— protesting outside hospitals and inundating healthcare institutions with calls, emails and letters. Acknowledging a woman’s right to “access critical health services without fearing for their safety,” New Hampshire Gov. Maggie Hassan recently approved a law that would mandate 25-feet buffer zones around abortion clinics in her state.
The reinstatement of Robinson and Ahluwalia’s admitting privileges also sends a strong message that protestors will not be a barrier to providing quality healthcare to women.
But these two victories follow a tide of problematic anti-choice legislation. In recent years, TRAP laws—or the Targeted Regulation of Abortion Providers—have led to the closure of clinics around the nation. TRAP restrictions include requiring clinics to meet surgical center standards, in addition to requiring unnecessary hospital admitting privileges. In Texas, 14 of the state’s 36 clinics have closed due to a failure to meet these new requirements, forcing many women to travel large distances to receive treatment, reported Eesha Pandit at In These Times.
One woman in Texas traveled seven hours to reach an abortion clinic in Houston, Pandit wrote. She had to sleep in a bus station because she did not have the money for a hotel room, but when she went to her appointment the next morning she learned she would have to attempt to find enough funding to stay, or travel back-and-forth to Houston for at least three more visits before she could have her abortion. Due to HB2, clinics must observe a 24-hour waiting period between counseling a patient and administering the abortion. Additionally, the two doses of medication required for the abortion must be taken at separate visits. Finally, the patient must return to the clinic for a follow-up visit after two weeks.
Such laws overwhelmingly hurt lower-income women and women of color. Forty-two percent of women seeking abortions live below the federal poverty line. With abortions already costing, on average, $450, adding travel, accommodation, child care and the opportunity cost of missing work makes abortions in Texas for lower-income women increasingly difficult. Unfortunately, if denied an abortion, these women face the reality that two years down the road, their probability of living below the federal poverty line triples.
Abortions are generally safe procedures—the Center for Disease Control and Prevention estimates that around 1 in 100,000 women die from receiving an abortion. However, the chances of experiencing complications rise sharply the longer a woman waits before receiving an abortion, and with the recent closure of abortion clinics, many women are faced with longer and longer waiting times. In Wisconsin, Planned Parenthood is reporting 2- to 3-week wait periods for women seeking abortions. This wait period could increase to 8 to 10 weeks if more clinics close. Currently, a clinic in Dallas is so overwhelmed that women seeking abortions could wait up to 6 weeks before seeing a doctor.
“One could make a joke here about planning ahead for your unplanned pregnancy,” a Texas medical provider wrote.
The Supreme Court’s 1992 ruling in Planned Parenthood v. Casey stated that laws that served as obstacles for women seeking abortions “impose an undue burden on the right.” In light of these recent laws, it’s time to reconsider what exactly qualifies as “an undue burden.” Hopefully courts continue to prevent hospitals from pandering to extremists, and if not, then at least listen to the words of Dr. Serdar Bulun, chair of Northwestern University’s department of obstetrics and gynecology. Dr. Bulun was chosen as the impartial expert in a trial over Wisconsin’s admitting privileges law and testified before a federal judge in late May:
I think it is an unacceptable experiment to see if you decrease access [to abortion clinics] and see if more women die … Should we do any experiment for this? I don’t think so.
Photo of University General Hospital of Dallas Courtesy of University General Hospital of Dallas.