The Obscure Legal Fights That Could Wipe Out The Country’s Abortion Clinics


This week, abortion rights are up for debate in both Alabama and Wisconsin. Both states are currently engaged in legal challenges against similar laws that require abortion providers to obtain admitting privileges from local hospitals — essentially, an unnecessary business arrangement linking clinics and hospitals.

It’s complicated legislation that may not immediately raise alarm about the state of reproductive rights. But the outcomes of these two trials could actually have huge implications for women’s ability to continue exercising their right to choose.

Admitting privilege requirements are one of the tactics that fall under the anti-choice strategy known as the Targeted Regulated of Abortion Providers, or TRAP. They’re specifically designed to cut off women’s access to abortion by forcing clinics out of business. Since TRAP laws appear to be dry and bureaucratic on the surface — dealing with hospital privileges and building codes — they’ve been extremely politically successful. It’s easy for them to slip under the radar while more obviously egregious types of abortion restrictions, like harsh bans, capture the headlines. After all, doesn’t regulating clinics to make them safer seem like a good idea?

In reality, abortion is already one of the safest medical procedures in the country, and there’s no evidence that clinics or providers need more regulation. But TRAP laws have spread across the country anyway. According to the Guttmacher Institute, 27 states now over-regulate abortion providers with policies that go beyond the scope of what’s medically necessary to keep patients safe. And eight states, including Alabama and Wisconsin, have passed laws requiring abortion doctors to have admitting privileges with local hospitals.

The medical professionals in those states don’t mince words about how catastrophic TRAP laws can be. During the trial proceeding in Alabama, abortion providers testified that they will have to end their services if the TRAP law is allowed to take effect, since it’s impossible for them to comply with the law. Local hospitals won’t give them admitting privileges because the staff there are too wary to be affiliated with abortion.

“They did not want a relationship with Planned Parenthood at all,” one Alabama provider said in reference to the University of Alabama School of Medicine, which has indicated that it will not renew its partnerships with doctors at the women’s health organization. “They did not want the political controversies that come with having a relationship with Planned Parenthood.”

On Tuesday, abortion providers in Wisconsin testified that the requirement will lead clinics to close, forcing women to travel farther for their care and contributing to long delays at the state’s remaining reproductive health facilities. Once that happens, some women won’t be able to afford to make a long trip to the nearest clinic.

“It will definitely hurt the women in Wisconsin who are often the most vulnerable,” Planned Parenthood of Wisconsin’s medical director, Dr. Kathy King, testified.

These predictions aren’t without precedent. An identical TRAP law took effect in Texas this past fall. Since then, multiple clinics have been forced out of business, and some doctors have lost their licenses because they can’t get admitting privileges. That’s left hundreds of miles of the Lone Star State without access to a single abortion facility — and the state’s most vulnerable residents are paying the price.

Nonetheless, states continue to pass TRAP laws. This month, Louisiana and Oklahoma became the latest states to approve admitting privileges laws identical to the one that’s wreaking havoc on Texas women’s access to reproductive health care. Eventually, the issue will likely end up before the Supreme Court.

Particularly if Alabama is allowed to enforce its TRAP law, it will have devastating consequences for the women who live in the South, an area where abortion restrictions are rapidly advancing and the number of clinics are dwindling. There are about 8.6 million women of reproductive age living in Oklahoma, Texas, Louisiana, Mississippi, and Alabama — but if the TRAP laws that have been approved in those states are allowed to take effect, there will be just 12 abortion clinics left in that entire region. In large swaths of the country, women will be forced to travel hundreds of miles to get to the nearest clinic, a barrier that will be too difficult for some of them to overcome.

“Let me be clear: This law was designed by politicians, not doctors, with the single-minded goal of shutting down women’s health care centers and ending access to safe, legal abortion,” Louise Melling, the deputy legal director of the American Civil Liberties Union, said in reference to Alabama’s TRAP law when the trial first began. “Opponents are waging a stealth war on abortion with these medically unnecessary regulations, and women and families are paying the price.”

And as women’s access to abortion clinics hangs in the balance, largely dependent on legal challenges that have escaped most of the country’s notice, the stealth war is gaining ground.