At least Iowa state Sen. Jake Chapman didn’t try to disguise his motivation for proposing to make abortion a hate crime against the unborn this spring. The Republican made it clear he prioritizes fetuses over pregnant women.
The same can’t be said for the Texas lawmakers and governor who enacted some of the most stringent abortion restrictions in the country under the guise of protecting women’s health. In last week’s 5-to-3 ruling striking down those restrictions, the U.S. Supreme Court said they constitute an undue burden on a woman’s constitutionally protected right to terminate a pregnancy.
Justices Stephen G. Breyer, who wrote the majority opinion, and Ruth Bader Ginsburg, who wrote a concurring one, did a fine job of calling those lawmakers’ bluffs. The Washington Post described the ruling as a break from “a steady decay of abortion rights since 1973’s landmark Roe v. Wade decision.” Pro-choice and anti-abortion forces agreed on one thing: The ruling will make it harder for states to pass new restrictions on abortion.
Passed in 2013, the Texas law had required all abortion doctors to have admitting privileges at hospitals within 30 miles, and abortion clinics to have hospital-level surgical operating rooms that met spacing requirements such as: At least 240 square feet of floor space; a minimum of 14 feet between cabinets, counters, and shelves; pre-op and post-op rooms with one-way traffic patterns, and prescribed corridor widths. It called for advanced heating and ventilation systems and contained piping and plumbing specifications.
Those are ridiculous requirements. Statistically, abortion is a safe procedure. Between 2001 and 2012, there were only five related deaths in Texas, a ratio of one death in 120,000 to 144,000 abortions. Childbirth is 14 times as likely to cause a woman’s death, yet surgical centers are not even required for midwife-attended births. Death from a colonoscopy is 10 times as likely, and from liposuction, 28 times as likely, according to statistics cited in the ruling. Neither requires a surgical center.
With 22 of Texas’ 41 abortion clinics already closed because of the law, and only nine expected to survive if it were upheld, the remaining facilities could hardly worry about comfortable cabinet spacing. Some already are so crammed, waiting patients have to sit on the floor, according to the lead plaintiff, Whole Women’s Health. Those most affected are young, low-income and rural women and women of color.
Acknowledging the state’s interest in the safety of all medical procedures, Breyer wrote the Texas law’s requirements promoted no such thing. The federal district court had cited peer-reviewed studies showing complications from first-trimester abortion at under one-quarter of 1 percent, and less than half a percent for second-trimester abortions. In fact, because it’s so safe, it’s difficult for many abortion doctors to get hospital admitting privileges, Breyer wrote: “In a word, doctors would be unable to maintain admitting privileges or obtain those privileges for the future, because the fact that abortions are so safe meant that providers were unlikely to have any patients to admit.”
When patients do suffer complications, they tend to be in the days afterward, when they would have left the facility, according to expert testimony he referenced.
Calling it “beyond rational belief” that the Texas law could protect women’s health, Ginsburg wrote, “When a state severely limits access to safe and legal procedures, women in desperate circumstances may resort to unlicensed rogue practitioners … at great risk to their health and safety.”
None of this may matter to those whose only goal is to cut back on abortion access, whether for conscience or political calculation. Certainly one can empathize with those who genuinely believe abortion is the taking of a human life. But abortion has been ruled a constitutional right, and constructing medical regulations to make it less accessible is unethical and dishonest. Unable to win on constitutionality, opponents have chipped away at access, and 26 states now have laws targeting doctors and clinics. In 2011-2012, states passed 92 laws interfering with women’s reproductive health choices.
The district court ruling cited by Breyer found that between Nov. 1, 2012, and May 1, 2014, the number of women of reproductive age living more than 50 miles from a clinic doubled to more than 1.6 million, while those living more than 100 miles away grew 150 percent, to 1 million. In Dallas-Fort Worth, where nearly one-third of abortion seeking women now go, they have to wait 16 days on average, some up to 23, according to plaintiffs. They say delays there and in Austin will cause a big increase in second-trimester abortions.
On MSNBC last Monday, former Texas state Sen. Wendy Davis, who staged a filibuster over the law, predicted “an unwinding” of more than 300 laws restricting abortion access as a result of the ruling. The leader of an Iowa anti-abortion group also predicted the ruling will hurt abortion-restriction efforts there.
I suggested after the 2012 elections, when abortion foes suffered multiple defeats at the polls, that abortion as a political wedge issue had outlived its value. A majority of Americans support abortion rights. Democrats had seized the momentum from Republicans, building a narrative about a war on women.
This doesn’t mean abortion opponents should go quietly. Iowa’s abortion rate declined 40 percent in the seven years ending in 2014 because of greater access to pregnancy-prevention techniques. All sides should now work to make them even less necessary by promoting comprehensive sex education, birth control accessibility and greater life choices. Now that would be something to celebrate.
Rekha Basu: email@example.com