NEWS

Abortion clinic owner mulls Supreme Court case impact

Mollie Bryant
The Clarion-Ledger

The fate of Mississippi’s lone abortion provider hangs in the balance of the first Supreme Court case in decades to address restrictions on abortion clinics.

The Supreme Court announced this month that it will rule whether Texas’ restrictions on clinics should be struck down because they place an “undue burden” on women seeking abortions. Texas and Mississippi both passed laws in recent years requiring doctors who provide abortions to have admitting privileges at nearby hospitals. Texas’ law goes a step further, requiring clinics to meet the same standards as outpatient surgery centers.

“The bill was not about continuity of care. It was about putting us out of business,” said Diane Derzis, owner of Jackson Women’s Health Organization, the state’s only abortion clinic. “They’ve passed other laws over the years, and we have been able to jump through the hoops and do what the law requires until this one.”

While supporters of the measures argue their intent is to improve health outcomes for women, critics have said they place women’s access to abortion at risk, a claim bolstered by the near closure of Mississippi’s last clinic.

The Supreme Court last addressed these issues in 1992, when justices upheld women’s right to abortions but allowed states to impose restrictions that aren’t an undue burden on women. Kathryn Kolbert, director of Athena Center for Leadership Studies at Barnard College, served as the attorney for Planned Parenthood of Southeastern Pennsylvania during that case.

“People proposing these laws don’t want anything short of banning all abortion,” she said. “That’s the point.”

Although Mississippi’s law has been framed as an effort to improve women’s health, the American Medical Association and American College of Obstetricians and Gynecologists oppose admitting privileges requirements for doctors who provide abortion.

“There is no medical justification, because abortion is one of the safest medical procedures in America,” said Tiseme Zegeye, attorney for the Center for Reproductive Rights. “It’s more safe than labor or getting a shot of penicillin.”

In 2010, 10 women died from complications related to legally induced abortions in the United States, according to the most recent data available from the Centers for Disease Control and Prevention. To compare, about 650 women in the U.S. die from pregnancy and childbirth-related complications each year, according to the CDC.

However, concerns remain for Alliance Defending Freedom attorney Steven Aden.

“With virtually any outpatient procedure … chances are good the doctor has admitting privileges,” he said. “It’s the standard of practice. Only with regard to abortion is the argument made there should be some kind of special exception, but that’s bad health care, and it does no service to women in Texas and Mississippi who are seeking abortions and need to be protected by the same health and safety practices that apply to medical care.”

OB/GYN Dr. Freda Bush supports the admitting privileges requirement and also believes Mississippi should require clinics to meet the same standards as outpatient surgery centers, one of Texas’ regulations that Supreme Court justices will address. Whether these laws affect clinics’ ability to stay open isn’t the issue at hand for her.

“I am not as concerned about the closing of the clinic as I am about the care for the woman,” she said. “I think our first responsibility should be to the patient. She comes there looking for help. You certainly don’t want to injure her.”

Bush worries that if doctors lack admitting privileges, their patients are left to “fend for themselves” after an abortion.

“When they go to the ER, sometimes women are embarrassed to say they got an abortion or they don’t understand the procedure that was done, and the receiving physician is handicapped … so we lose precious time trying to evaluate and investigate,” she said.

However, complications from abortions are rare — under 1 percent, studies show.

But abortion rights advocates worry that lack of access to the procedure would lead to an increased number of women attempting to terminate their pregnancies at home using teas, drugs, abdominal trauma or other methods.

“Although the state might be trying to say they are acting in the best health interest of women, we can easily see through that. (Clinics closing) is exactly what it would do if it went into effect,” Zegeye said. “If the admitting privileges law did go into effect, it would be absolutely devastating to women in Mississippi. They would have nowhere to turn.”

Mississippi’s only clinic would have faced closure without an injunction from the law, and since Texas’ restrictions were passed in 2013, the number of clinics in the state have dropped from 46 to 18.

When Gov. Phil Bryant signed Mississippi’s bill into law, he issued a statement that said, “I believe that all human life is precious, and as governor, I will work to ensure that the lives of the born and unborn are protected in Mississippi.”

Bryant didn’t agree to an interview for this story but provided a written statement that said, “This measure is designed to protect the health and safety of women who undergo this potentially dangerous procedure, and physicians who provide abortions should be held to the same standards as physicians who perform other outpatient procedures.”

After Mississippi lawmakers passed the admitting privileges mandate in 2012, Jackson Women’s Health Organization, which has one physician with admitting privileges, applied for privileges for its remaining doctors. But no hospital within a 30-minute drive from the clinic would grant them privileges. Derzis said some of the hospitals stated during their rejections that they weren’t willing to be associated with abortion.

Last year, the 5th U.S. Circuit Court of Appeals upheld an injunction against the law that has allowed the clinic to continue practicing without additional admitting privileges. However, the injunction only applies to Jackson Women’s Health Organization, so for another clinic to open, it must meet the regulation.

“We’re confident that the Supreme Court will apply more than 40 years of precedent, saying our Constitution protects the fundamental right (to abortion),” Zegeye said. “In the alternative, if the courts did uphold the restrictions … the results would be absolutely devastating. Then more states would be able to pass sham laws, states with numerous restrictions would be able to pass even more restrictions, and the burden would fall more heavily on poor women, minority women and immigrant women.”

Derzis also expressed concerns that limited access to abortion would fall heavily on low-income and minority women.

“Women with money have always had access to abortion. The ones who haven’t are women who are poor and women of color,” she said. “(Without a clinic), women are self-aborting, forced to continue pregnancies they don’t want, in a state where teen pregnancy and infant mortality are the highest, and everyone who claims to have support for fetuses has absolutely no concern for the children after they’re born.”

If clinics can’t keep up with the regulations and are forced to close, Aden would view the situation as “reasonable and the general application of medical standards.”

“Let the market take care of that demand,” he said. “Furthermore, women can and do drive an hour or two to obtain an abortion.”

However, abortion access advocates like Kolbert argue out-of-state travel for the procedure would be an undue burden for women, in violation of the Supreme Court’s ruling from the 1990s.

“If you permit a state to say, ‘We don’t have to do it on our ground, because women can go to Texas or Alabama,’ — if every state said that, we’d be back where we were before Roe, when women had to travel cross country to a state that would perform abortions,” she said.

Contact Mollie Bryant at (601) 961-7251 or mbryant2@gannett.com. Follow @MollieEBryant on Twitter.

The Jackson Women's Health Organization is the state's sole abortion clinic.