Abortion opponents have gained significant ground over the past several years, as harsh anti-choice laws have swept the nation and dozens of clinics have been forced to close their doors. One of the primary reasons that anti-choice activists have been so successful is because they have effectively framed these state-level restrictions in terms of “women’s health and safety,” claiming that abortion clinics need to be better regulated to ensure that women are getting the best quality care.
But the individuals who spend their lives working to protect women’s health — the doctors who specialize in reproductive issues — see right through that claim.
Dr. Serdar Bulun, the chair of Northwestern University’s department of obstetrics and gynecology, testified before a federal judge last week about an abortion restriction in Wisconsin that’s purportedly about keeping women safer. Bulun was chosen by the judge as the “impartial expert” to comment on the state law, which requires abortion doctors to obtain admitting privileges from local hospitals, as it’s up for debate in court. And the doctor didn’t have many good things to say.
“I think it is an unacceptable experiment to see if you decrease access [to abortion clinics] and see if more women die,” Bulun testifed, after he was asked if Wisconsin’s new law could increase maternal mortality. “It is not acceptable. It is not ethical. People will resort to illegal abortions. Should we do any experiment for this? I don’t think so.”
Bulun’s comments speak to the fundamental contradiction at the heart of admitting privileges requirements, which are rapidly spreading across the country (just last month, Oklahoma and Louisiana became the latest states to approve this particular abortion restriction). Even though they’re framed in terms of ensuring that women are safe, these laws actually do the direct opposite when they’re put into practice.
Admitting privilege laws essentially create a bureaucratic maze that’s too difficult for abortion providers to navigate, since hospitals frequently refuse to grant privileges to doctors who work in abortion clinics. Many hospitals want to avoid pressure from anti-choice activists, and are therefore wary to be publicly associated with abortion. And admitting privileges are actually a business arrangement, based on how much money a hospital can make from the patients transferred to them by an outside doctor. Since abortion is such a safe medical procedure, and hardly any abortion patients ever have serious complications that require hospital care, it just doesn’t make much financial sense for hospitals to enter into these partnerships with abortion doctors.
So in that context, it’s not hard to understand what happens after a state passes an admitting privileges law. Abortion providers attempt to get privileges, many of them ultimately fail, and the doctors without privileges are forced to stop practicing. Then clinics start to shut down.
That’s exactly what’s happening in Texas, where an admitting privileges law took effect last fall — hundreds of miles of the state is now left without a single abortion clinic, and desperate women are resorting to buying illegal abortion-inducing drugs on the black market. Even aside from the Lone Star State, admitting privilege requirements are particularly taking hold in the South, where millions of women of reproductive age may lose access to nearby clinics.
“Admitting privileges may not be advantageous for the patient,” Dr. Serdar Bulun concluded.
He’s hardly the first medical professional to point out that admitting privileges don’t have anything to do with women’s safety. When other states have considered similar admitting privilege requirements, doctors located there have been quick to speak out against them. The nation’s leading group of OB-GYNs, the American Congress of Obstetricians and Gynecologists (ACOG), opposes these laws because they don’t have any basis in best medical practice. So does the Texas Hospital Association.
In fact, after Texas’ law took effect, ACOG issued an open letter to lawmakers imploring them to stop passing anti-choice measures like this that interfere in the doctor-patient relationship. “While we can agree to disagree about abortion on ideological grounds, we must draw a hard line against insidious legislation that threatens women’s health,” the group’s president wrote on behalf of its 58,000 members.
Nonetheless, doctors’ opinions don’t necessarily dissuade the lawmakers and judges who make the final decisions about abortion restrictions. Despite medical professionals’ repeated objections to admitting privilege laws, these laws continue to gain political traction. Depending on how the legal challenge in Wisconsin ends up — as well as similar lawsuits in Alabama and Mississippi — this issue could be headed all the way to the Supreme Court.