The Supreme Court will soon hear arguments in a Louisiana case that will be avidly followed by both sides of the abortion divide. June Medical Services v. Russo will test whether a state can require abortion providers to have admitting privileges at a nearby hospital. The clinic will argue that women are perfectly safe without this precaution. Louisiana, on the other hand, will argue that the requirement is a common-sense health and safety regulation to protect mothers’ lives. Who is right?
One amicus brief supporting the state – signed by 207 members of Congress – makes a compelling case that women seeking abortions in Louisiana clinics will find themselves in dangerous hands, and that ensuring their safety is a legitimate legislative priority. It provides an important backdrop to the case by documenting years of shocking health and safety violations at June Medical and the two other abortion clinics involved in the suit. It also documents a long history of serious professional disciplinary actions against Louisiana abortionists.
Surgical abortion is an invasive procedure, and like any other surgery, requires sterile technique, close patient monitoring, and a high level of competency on the part of practitioners to keep dangerous, even life-threatening complications at bay. Dirty surgical instruments, expired and/or inadequate medications, untrained staff, scanty documentation – these and other failures of basic patient care are unacceptable in any surgical facility. Sadly, they were found over and over during state inspections of Louisiana‘s abortion clinics. Again and again, the clinics were cited for failure to properly sterilize and decontaminate instruments – instruments used to enter the mothers’ vaginas and uteruses – as well as the use of dirty needles and the re-use of single-use instruments.
It appears that substandard care has been the norm for women getting abortions at the Louisiana clinics. Besides unsanitary conditions, missing or expired medications were a common occurrence. The lack of emergency IV fluids led to severe complications in one case. The state documented the clinics’ failure to properly monitor sedated patients in addition to many instances of inaccurate and faulty documentation and reporting. Most damningly, the clinics failed to inform the state of the abuse of children. In upholding the Louisiana law, the Fifth Circuit decried this “horrifying…protection of rapists.”
Of course, substandard care is what one might expect when the supervising physicians have long histories of disciplinary actions against them for unethical and unprofessional behavior. The court brief draws heavily on the Fifth Circuit Court’s opinion, which went into great detail describing the deplorable records of the abortionists at the clinics in question. “Incompetent”, “neglectful”, and “non-compliant” – doctor after doctor lost their admitting privileges in Louisiana hospitals after inappropriate treatments resulted in the death or disability of their patients, both mothers and children. While employed at one of the clinics, one Doctor Whitmore, “used instruments that were rusty, cracked, and unsterile…” After one late-term abortion in which he perforated the patient’s uterus, “the patient continued to have moderate bleeding but the ambulance was not called for nearly three hours.”
Louisiana’s law requires physicians who perform abortions to have hospital privileges for two important reasons. First, admitting privileges act as a seal of approval and weed out dangerous practitioners with red flags on their records. This is crucial when the state’s abortion clinics have shown themselves incapable of (or uninterested in) hiring competent physicians to perform outpatient surgeries on vulnerable women. Second, a patient with a serious complication will be admitted to the hospital by the doctor who knows exactly what went wrong, ensuring that continuity of care will be preserved. It’s important to note that by requiring admitting privileges for abortion providers, the state of Louisiana isn’t singling them out for special treatment. Rather, the state seeks to bring them “into the same set of standards that apply to physicians providing similar types of services [in other ambulatory surgical centers.]" The guiding principle is this: Louisiana women going in for an abortion ought to be at least as safe as women going in for liposuction.
The clinics suing Louisiana claim that the state’s law will put the them out of business and harm the women they serve. The truth is that if these abortion facilities had a shred of compassion for the women they claim to be helping, they would only employ doctors who could easily meet Louisiana’s basic requirement. And, if they can’t run a safe and clean ambulatory surgical center, they should be out of business.
Dr. Grazie Pozo Christie is a Policy Advisor for The Catholic Association.