Hickey: Proposed abortion regulations endanger women

It’s been a bad few months for reproductive rights.

On Oct. 13, the House of Representatives… It’s been a bad few months for reproductive rights.

On Oct. 13, the House of Representatives passed the “Protect Life Act” — sneer quotes intentional — a bill which not only bars women from purchasing insurance plans that cover abortion under the Affordable Care Act, but also allows doctors the option of denying lifesaving care to a pregnant woman if providing said care could harm the fetus she’s carrying. As if that weren’t enough, the Pennsylvania House of Representatives is expected to vote on Senate Bill 732, which would require freestanding abortion clinics in Pennsylvania to comply with Ambulatory Surgical Facilities guidelines — an insidiously reasonable-sounding measure that would close down every freestanding abortion clinic in Pennsylvania for extended periods of time and double the cost of the procedure.

SB 732 is being billed as the state government’s response to the horrors unearthed in the illegal Philadelphia abortion clinic of Dr. Kermit Gosnell. Gosnell is charged with the murder of 41-year-old Karnamaya Mongar, who died from an overdose of anesthesia allegedly applied by an unlicensed assistant, and seven infants whose spines Gosnell, again allegedly, severed with scissors after they were born alive.

But despite what proponents of this measure would have you believe, pro-choice advocates who oppose the bill don’t want abortion to be unregulated, and they don’t think what happened in Dr. Gosnell’s clinic was OK — not even close.

We are, however, aware of a few facts.

Fact 1: Abortion providers in Pennsylvania already comply with up to four different sets of guidelines, and all the facilities currently in operation have been praised for their high standards of safety and care.

Fact 2: Facilities that perform other minor surgeries such as oral surgery, foot surgery and laser eye surgery are not required to comply with ASF guidelines.

Fact 3: ASF guidelines are cumbersome, expensive and largely irrelevant to patient safety in abortion cases. SB 732 would require freestanding abortion clinics to as much as quadruple the size of their operating rooms and install hospital-grade elevators capable of lifting a small car, with no proven safety gains to justify these expensive measures. Some clinics would have to relocate to comply with additional zoning requirements. And although every licensed clinic has a registered nurse present when abortions are being performed, SB 732 would require that an RN be in attendance “at all hours when patients are present.” This means that all abortion care facilities, many of which only perform abortions one or two days per week, would have to hire an RN to oversee the regular gynecological exams, STD testing and birth-control consultations that constitute more than 90 percent of the services they provide.

Fact 4: Because no public funds can be used for abortion, the cost of hiring a full-time RN and installing a hospital-grade elevator cannot be reimbursed by Medicaid.

Fact 5: SB 732 would likely force every freestanding abortion clinic in Pennsylvania to shut down until it redesigned its facilities; in other states, this has taken over a year. Because they can’t bill Medicaid, the surviving clinics would have to increase the cost of an abortion by up to $1000. Milder versions of SB 732 have permanently closed all but four of the previously safe-certified abortion clinics in Texas and forced the only outpatient provider in Mississippi to turn away between 600 and 700 women in the 18 months it took to redesign the facility.

Fact 6: When safe abortion is illegal, unaffordable or difficult to access, women desperate to end their pregnancies sometimes take matters into their own hands. And these women often die. The National Organization for Women website has a page listing the names and biographies of some women — largely impoverished women of color — who died from botched at-home abortions. They undertook measures themselves either because the procedure was outlawed or because they couldn’t afford to go to a clinic.

But there’s one important woman they don’t list.

Karnamaya Mongar, Gosnell’s adult victim, was a refugee from Nepal. Like most of his patients, she was a poor immigrant woman with limited access to real healthcare — a woman with few alternatives. In other words, Gosnell’s “Women’s Medical Society” is what people turn to when you make it difficult for women who want abortions to get them legally … which is exactly what the Pennsylvania Senate is doing, in the name of Karnamaya Mongar.

Here’s another fact: During three inspections under Gov. Bob Casey’s term, Gosnell’s clinic was deemed seriously flawed, yet no move was ever made to shut him down. A doctor at the Children’s Hospital of Philadelphia even hand-delivered a complaint about his practice to the Pennsylvania Department of Health, and still nothing was done. Gosnell’s illegal operation wasn’t allowed to continue because abortion regulations weren’t strict enough; it was allowed to continue because the Department didn’t enforce existing laws. And if you think that fact is unrelated to the majority of Gosnell’s clientele being penniless immigrant women … well, that makes one of us.

If you want to keep women safe, enforce the laws on the books and avoid new restrictions that could shut down safe and legally operating clinics. If you still support SB 732, that’s your right —  but please don’t say it’s because you’re concerned about women’s health.