Should abortion clinics be regulated like other outpatient surgery facilities?

[B2G]

I've seen some activity by various states to push for this legislation.

On the one hand, I can see how this could be problematic for states where pro lifers are at the helm and enforce it with such overkill that some clinics would be forced to close or undergo extreme hardship.

On the other hand, if I'm going in for an abortion, I want to make damned sure they are staffed with competent, certified personnel, are enforcing strict sanitation guidelines and have the available equipment on hand and procedures in place should something go terribly wrong.

What do you think?

[PeaceNikki]

1. They already are. In fact, significantly MORE regulated than other outpatient surgical facilities.

The problem with the horrible case in PA was that those regulations were not enforced.

[B2G]

6. Actually, that's not true

It's up to each state, and not all of them are regulated the same. Many of them operate under the same regulations as a private physicians office, which is isn't nearly as stringent as an outpatient surgical facility.

[PeaceNikki]

7. Can you cite any examples of such states?

[B2G]

9. Michigan for one

And until very recently, Virginia and New Jersey.

[PeaceNikki]

16. ok, based on those examples of VERY poor TRAP laws, I would reply to your OP with an emphatic "NO!"

http://www.prochoiceamerica.org/what-is-choice/fast-facts/issues-trap.html

[Raine1967]

22. Comparing Abortion clinics to outpatient surgery is a bit disingenuous, at least here in Virginia.

Seriously. Here in Virginia, they are being held to hospital standards, and we aren't talking about health care standards, we are talking about infrastructure.

http://www.motherjones.com/politics/2011/09/virginia-abortion-building-rules (from 2011 -- as you mentioned, Virginia adopted these regulations. The Board of Health that approved this last week was largely appointed by by AG Cucinelli, also a candidate for governor.)

New regulations that require abortion providers to comply with building codes designed for hospitals could force this Planned Parenthood health center to shut its doors as soon as next year. Unveiled in August and approved by the Virginia Board of Health last week, the rules would likely be impossible to meet within the space that Planned Parenthood currently rents on the third floor of a nondescript, brown-brick office building about 10 miles from downtown Washington, DC.

To comply with the regulations, the Falls Church office would have to nearly double the width of its hallways, to five feet wide. Its pre-op rooms would have to measure at least 80 square feet, and operating rooms 250 square feet. The new rules dictate the type of HVAC system the office needs to have, the number of parking spaces, and where the bathrooms should be located.

I've been to abortion clinics -- this attack against abortion-- and those that provide services isn't about competent staff and certified personnel.

You know what can go terribly wrong? A back alley abortion because clinics are forced to shut due to ridiculous regulations.

[cthulu2016]

2. Is anyone you know of arguing for unsanitary or incompetent abortion faccilities?

[Raine1967]

24. Ken Cuccinelli and his appointed BOH members.

They are very very concerned.

[AnotherMcIntosh]

3. Who says that they are not?

[Lithos]

4. Most cases, yes

In fact, the issue is some (Red) states create impossible standards for abortion and family clinics which many well funded emergency rooms would not be able to maintain.

[Deep13]

5. New safety rules are a ruse...

...to make abortions difficult to get despite being ostensibly legal.

[La Lioness Priyanka]

13. yup.

[cali]

8. absolutely not. despite the claims of anti-choicers, abortion

is very safe in this country:

http://www.prochoice.org/about_abortion/facts/safety_of_abortion.html

these laws have nothing to do with safety and everything to do with regulating clinics out of business.

The Virginia Board of Health voted Friday to require clinics that perform abortions to meet strict, hospital-style building codes that operators say could put many of them out of business.

<snip>

http://www.washingtonpost.com/local/va-politics/va-board-adopts-strict-abortion-clinic-rules/2013/04/12/fb60d3ca-a35f-11e2-82bc-511538ae90a4_story.html

These regulations are known as TRAP laws-

What is a TRAP bill?

TRAP stands for Targeted Regulation of Abortion Providers. TRAP bills single out abortion providers for medically unnecessary, politically motivated state regulations. They can be divided into three general categories:

a measure that singles out abortion providers for medically unnecessary regulations, standards, personnel qualifications, building and/or structural requirements;
a politically motivated provision that needlessly addresses the licensing of abortion clinics and/or charges an exorbitant fee to register a clinic in the state; or
a measure that unnecessarily regulates where abortions may be provided or designates abortion clinics as ambulatory surgical centers, outpatient care centers, or hospitals without medical justification.

<snip>

Abortion is one of the safest and most commonly provided medical procedures in the United States. Fewer than 0.3% of abortion patients experience a complication requiring hospitalization.1 In the U.S., more than 90% of all abortions are provided in outpatient facilities such as doctors' offices and clinics. Credit for the outstanding safety record of abortion care is attributed to the specialized quality care given and received in these facilities. Since the legalization of abortion in 1973, the provision of abortion services in the U.S. has become a public health model for the rest of the world. There is no evidence that abortions would be safer in another setting, or that abortions are performed inadequately in outpatient facilities.

What is the impact of TRAP laws?

Enactment of this type of legislation discourages health care providers from offering abortion care and can make provision very burdensome and/or expensive for smaller providers. This exacerbates the provider shortage that already exists in the United States. In 2000, 87% of counties in the U.S. did not have a single abortion provider, and this number rose to 97% for non-metropolitan counties.3 In addition, mandated staffing requirements and qualifications that often appear in TRAP bills restrict clinicians' autonomy by tying them to a particular hospital within a certain distance of the clinic, which unnecessarily limits the ability of providers to travel to serve underrepresented populations.

<snip>

http://www.prochoice.org/about_abortion/facts/trap_laws.html

[B2G]

10. Very infomative

Thank you Cali!

[cali]

12. very welcome, B.

I think it's vital we understand what TRAP laws are and what the purpose of those laws is. It's not the personhood type legislation that will end up in front of SCOTUS, it's one of these cases. And Roe gave wide latitude to the states to regulate abortion, so I'm concerned that they could win in the Supreme Court.

[B2G]

15. I have never understood that latitude

Why it's not consistent within each state is beyond me.

But I'll read up on TRAP. Good info.

[Dawson Leery]

33. Gosnell was operating an old style, illegal clinic.

This case will be used by the anti-choice mafia to pas more TRAP laws.

[cali]

36. well, not quite

yes, the case will wrongly be used to pass more trap laws, but the clinic operated openly.

<snip>

Why wasn’t this shut down sooner?

This is partly what the grand jury set out to figure out, and their conclusion is disturbing to say the least. Multiple government agencies, hospitals, and organizations sat on information that should have shut the clinic down years earlier.

The Pennsylvania Department of Health audits hospitals and medical facilities. It approved Gosnell’s clinic in 1979. When it checked back a decade later, the report says it found numerous violations but took Gosnell at his word when he promised to fix them.

<snip>

But still, it did get complaints: from several lawyers representing women injured by Gosnell; from a doctor who hand-delivered a complaint alerting the department to the fact that several women referred to Gosnell got the same venereal disease; from the medical examiner of Delaware County informing the department that Gosnell performed an abortion on a 14-year-old girl who was 30 weeks pregnant; and when Mongar, the Bhutanese woman, died.

The Department of State, which licenses individual physicians, also ignored the alarm bells. A decade ago, a former employee reported dangerous conditions at the clinic, but the department let it drop after interviewing Gosnell offsite. Then an insurance company told the department about a 22-year-old woman who died of sepsis after Gosnell perforated her uterus. Again, and several more times, the department ignored complaints.

<snip>

http://www.thedailybeast.com/articles/2013/04/12/why-is-the-media-apologizing-about-kermit-gosnell-coverage.html

[Dawson Leery]

39. Women must have easy access to safe abortion procedures.

This "clinic", should have been shut down in the 90's.

Gosnell took advantage of women of little means in desperate situations.

[PeaceNikki]

11. I hope this thread isn't an advocacy for TRAP laws.

TRAP laws push women to providers like that monster Gosnell.

http://www.prochoice.org/policy/states/trap_laws.html

Dangers Of TRAP Bills
TRAP bills are often introduced by abortion opponents who claim that abortion is an unsafe and unregulated procedure. By implying that abortion clinics are uniquely dangerous and in need of special regulation, such bills recklessly promote an unfounded fear of abortion.

Abortion is, in fact, one of the safest medical procedures in the United States. Complications from having an abortion in the first three months of pregnancy are considerably less frequent and less serious than those associated with giving birth.

The onerous requirements imposed by TRAP bills are also unnecessary because abortion clinics are already highly regulated. Clinics are already required to comply with numerous safety requirements, including federal CLIA and OSHA requirements, as well as local building and fire codes. Additionally, to ensure the highest standards of care in abortion clinics, NAF has established Clinical Policy Guidelines, with which all NAF members comply.

By redefining and imposing unnecessary and burdensome regulations on clinics that are irrelevant to the functionality and safety of abortion practice, the passage of TRAP bills can result in clinics being closed to women seeking reproductive health care.

[La Lioness Priyanka]

14. has there been a recent spate of abortion related deaths or complications?

are we seeking a solution for a problem that does not exist?

[B2G]

17. Deaths, no

Complications? I don't know how you would even begin to research that.

[La Lioness Priyanka]

19. there would be complaints, an increase in lawsuits etc.

My point is where is your concern coming from? the recent concern around abortion is all about limiting choice.

Why did you suddenly think of this specific procedure requiring more oversight?

[cali]

25. It's researched and information can be found by googling.

http://www.google.com/webhp?hl=en&tab=nw#hl=en&sclient=psy-ab&q=abortion+complication+statistics&oq=abortion+complication+statistics&gs_l=serp.12..0j0i22i30.1121144.1127899.0.1129329.24.20.0.4.4.0.411.3571.5j9j4j1j1.20.0...0.0...1c.1.9.psy-ab.yCCD5dY9678&pbx=1&bav=on.2,or.r_qf.&fp=9852c8ad188f4e9c&biw=1240&bih=528

[PeaceNikki]

18. Yes. Anti-choicers are using the Gosnell case as their 'Sandy Hook'

ETA: I don't think the OP is an anti-choicer. We had discussions yesterday on the topic, but I think the anti-choice message of TRAP is being spread.

[La Lioness Priyanka]

20. but it's one case and one doctor?

there hasn't been a general rise in abortion related complications for women, has there?

[PeaceNikki]

21. I think not. But reproductive choice has been under attack for some time.

And this case is one they will try to use despite the primary takeaway from it is that access to safe, legal and affordable abortions allowed that monster to thrive.

[cali]

28. No. But that will happen as these cretins push abortion back into

dark alleys.

[B2G]

23. Thanks Nikki. I'm definitely pro choice

but alot of my family members are not. The Gosnell case has shaken the email tree. Just trying to fully understand all of the issues, because frankly I've never really looked at them in detail before.

[PeaceNikki]

26. I understand. Like I said, I know that this case is being used to push for TRAP

and we should all understand what the implications are and really delve into the root causes and MASSIVE failures that led to that horror.

[cali]

27. It certainly is and it greatly concerns me that they're having ANY

success on that front.

[B2G]

30. "Anti-choicers are using the Gosnell case as their 'Sandy Hook'"

Spot on.

[kestrel91316]

29. Any facility in which physicians practice medicine is already

regulated to the satisfaction of the various states' medical licensing boards. They know what they are doing. If they feel additional regulations are needed, they will create them.

Non-physician meddling busybodies don't need to pipe in with their own attempts to regulate based on religious or political bias.

[La Lioness Priyanka]

32. this.

[B2G]

31. You guys rock

Thanks for all of your responses and information. I learn to much here!

[on point]

34. Should be just like any other dr office. No reason to single them out at all

[Manifestor_of_Light]

35. The Gosnell case is a failure of the state medical board and Board of Health to regulate.

I've read the District Attorney's report on this, which is horrific.

What Gosnell did was illegal, sadistic and sick. What he did was what desperate women would resort to. He did not have trained personnel giving anesthesia. He was charged with one count of murder of an adult woman. Several women lost their uteri. He also killed viable fetuses and was charged with several counts of murder for that.

Investigators were worried about his pill selling racket, but didn't notice the filth and broken equipment and heavily drugged women bleeding on the furniture, etc. Any investigator who reported their concerns was ignored.

"Tort reform" is a scam by Republicans to ignore the real malpractice problem. The real problem is state medical boards not disciplining bad doctors. In Texas they damage children for life by not delivering them soon enough, causing hypoxia, in one case I took depositions for.

What did the doctor do? Moved out of state and kept doing malpractice.

The Gosnell case is about what happens when abortion is illegal and not regulated properly. The TRAP regulations are too much and are designed to put abortion clinics out of business.

It's the fault of the state boards and the health department. Everyone is missing the point.

[cali]

37. yes.

the state fucked up big time

[Iggo]

38. Don't be ridiculous.

[LeftInTX]

40. It will increase the cost to something like outpatient surgery

And in Texas, and many other states, I don't think Medicaid covers abortion. So, women without insurance wouldn't be able to afford abortion.