June
27, 2016 the Supreme Court delivered a resounding and badly needed
victory for reproductive health and rights. In doing so, it also
restored scientific facts to their rightful place in American
jurisprudence and in the legislative decision-making that has for too
long threatened the health and wellbeing of women and their families.
Over the past five years, conservative lawmakers have replaced facts,
evidence, and medical expertise with their own convenient “truths”
fabricated to erode abortion access in the name of protecting women’s
health. Put plainly, the Court’s decision calls B.S. on those claims
and sets the record straight on the safety of abortion and the danger
of anti-choice legislation.
At question in Whole Woman’s Health were
two components of Texas’s HB2—the omnibus abortion bill that Wendy
Davis infamously filibustered in 2013—that closed more than half of
Texas’s 40 abortion clinics. Those components required abortion
providers to have admitting privileges at a hospital within 30 minutes
of their practice and that abortion clinics meet the standards of
ambulatory surgical centers (essentially full-scale emergency rooms).
The Court determined, contrary to the arguments of Texas lawmakers and
the Fifth Circuit Court of Appeals that originally upheld the law, that
these requirements did not pose any benefit to women’s health, and in
fact undermined it.
As
lawmakers across the country have relentlessly sought to regulate
abortion in recent years, they have peddled false narratives about the
danger of the procedure. But the Court’s decision finally silenced
those narratives, using incontrovertible scientific data to illustrate
the safety of abortion and the medically unnecessary and potentially
deleterious nature of anti-choice legislation. The decision puts to
rest many of the inaccuracies that have served as the bedrock of the
anti-choice movement in recent years.
Some of these debunked claims include:
Abortion is dangerous. Wrong! It’s actually quite safe, as major medical organizations like
the American Congress of Obstetricians and Gynecologists and the
American Medical Association have repeated ad nauseam. The majority
cited the incredibly low complication rates for abortion (one-quarter
of 1 percent for those occurring in the first trimester and less than
one-half of 1 percent for much-rarer second trimester procedures) and
argued the procedure is in fact so safe that “there was no significant
health-related problem that the law needed to help cure.” Boom. What
more is there to say, really?
It is in the best interest of women’s health for physicians to have admitting privileges at nearby hospitals. To
the contrary, the Court found that the “admitting-privileges
requirement places a ‘substantial obstacle in the path of a woman’s
choice,’” and that there is no evidence to suggest that “compared to
prior law (which required a ‘working arrangement’ with a doctor with
admitting privileges), the new law advanced Texas’ legitimate interest
in protecting women’s health.” The Court went on to point out that it
would be nearly impossible for abortion providers to meet this HB2
requirement because hospitals often only grant admitting privileges to
physicians who admit a certain number of patients a year. However, “the
fact that abortions are so safe meant that providers were unlikely to
have any patients to admit.”
To optimize women’s health, abortions should be performed in settings akin to emergency rooms. Actually,
that’s nonsense too. Given abortion’s safety record, the Court
determined there is no health benefit for abortion clinics to meet such
standards, and requiring them to do so would reduce the number of
providers, cause a strain on the remaining clinics, and detract from
the quality of care available for remaining patients. It also pointed
out the irony that similar regulations are not applied to medical
procedures that have far higher rates of complication, illustrating the
purely ideological nature of HB2 and similar laws. Some highlights:
- “The record contains evidence indicating
that abortions taking place in an abortion facility are safe—indeed,
safer than numerous procedures that take place outside hospitals and to
which Texas does not apply its surgical-center requirements.”
- “Nationwide,
childbirth is 14 times more likely than abortion to result in death,
but Texas law allows a midwife to oversee childbirth in the patient’s
own home.”
- “Colonoscopy, a
procedure that typically takes place outside a hospital (or surgical
center) setting, has a mortality rate 10 times higher than abortion.”
- “The mortality rate for liposuction, another outpatient procedure, is 28 times higher than the mortality rate for abortion.”
We can’t really be sure that clinics closed because of anti-choice requirements. Um, yes, we can. During oral arguments,
Justice Alito (who joined the dissent in yesterday’s 5–3 opinion),
suggested the closing of 20 clinics in the wake of HB2 might in fact
have nothing to do with the law’s onerous requirements. He said there
was “very little specific evidence in the record in this case with
respect to why any particular clinic closed.” The majority had no time
for this line of questioning. “In our view, the record contains
sufficient evidence that the admitting-privileges requirement led to
the closure of half of Texas’ clinics, or thereabouts. Those closures
meant fewer doctors, longer waiting times, and increased crowding.”
Patients wouldn’t really be left without care. Obviously,
they would. Advocates have long argued that if HB2 were fully
implemented, the remaining providers would not be able to meet the
increased demand of patients. Texas insisted the remaining providers
(which would have been roughly eight for the second most populous state
in the country) could simply increase capacity to meet the need. But
the Court highlighted evidence that, should HB2 be allowed to stand,
the remaining clinics would face a five-fold increase in abortions
(60,000 to 70,000 annually, up from 14,000). “Common sense suggests
that, more often than not, a physical facility that satisfies a certain
physical demand will not be able to meet five times that demand without
expanding or otherwise incurring significant costs.” The Court
determined:
More
fundamentally, in the face of no threat to women’s health Texas seeks
to force women to travel long distances to get abortions in
crammed-to-capacity superfacilities. Patients seeking these services
are less likely to get the kind of individualized attention, serious
conversation, and emotional support that doctors at less taxed
facilities may have offered. Healthcare facilities and medical
professionals are not fungible commodities.
The
Supreme Court protected the right of women and families to make their
own choices. And it did so by reminding us that facts are real. Science
is real. Evidence is real. And it can’t be willfully ignored or
tarnished or fabricated to advance anti-choice ideology that erodes the
constitutional right to reproductive health care.
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