Posted by: bridget | 28 August 2007

So Much for Safe, Legal, and Rare

A federal judge in Missouri issued an injunction to bar the state from implementing a law which would categorise abortion clinics (i.e. clinics which perform second- or third-trimester abortions, or more than five first-trimester abortions per year) as outpatient surgical centers. The clinics would be subject to health, safety, and building codes associated with those centers.

Planned Parenthood brought suit, claiming that such regulations would require them to cease operations while renovating their facilities. (Such is generally the point of health and safety laws: persons are required to cease unsafe practices until such a time when said practices can be performed in a safe manner.) Planned Parenthood claims that these regulations are “medically unnecessary” for the performance of surgical abortions. (Note, however, that the regulations are applicable to all outpatient surgical facilities; they are not designed to hamper abortionists.)

Planned Parenthood also claimed that, as HB-1055 does not distinguish between medical and surgical abortions, the law should not require non-surgical clinics which dispense RU-486 to be treated as surgical clinics.

“Of all the establishments that dispense medication (e.g. doctor’s offices, pharmacies), why is it only those that dispense medication for the purpose of inducing an abortion that must be prepared to perform surgery?” [Federal District Judge Ortrie] Smith asked.

Medical abortions have severe side effects that are unlike those seen with painkillers, blood pressure medications, or other pharmaceuticals. A medical abortion causes bleeding which is more severe than with a surgical abortion; 5% of women require follow-up care to remove tissue (which, if left in the uterus, can cause infection and infertility); and 2% of women haemorrhage severely enough to require surgical intervention (See, here). Up to 10% of women who have medical abortions need surgery afterwards (See, here).

As the pills in question are substitutes for a surgical procedure (which, in turn, is akin to a miscarriage), it should not be surprising that the side effects would be akin to those for the surgical procedure. Slightly more patients who have surgical abortions are prescribed antibiotics; however, dizziness, abdominal pain, and nausea are more common and more severe with medical abortions (See, here and here). Given the risks surrounding medical abortions, the Missouri legislature has a compelling state interest in protecting the health of the women who use RU-486.

Many pro-choice groups state that they want abortion to be safe, legal, and rare. Of course, that which is entirely safe, entirely legal, accessible, and nominally useful will never be rare. Now, it appears as if they do not even want abortion to be safe: they do not want to ensure that this “medical procedure” takes place in minimally-equipped hospitals. In Roe v. Wade, Justice Blackmun stated that:

The State has a legitimate interest in seeing to it that abortion, like any other medical procedure, is performed under circumstances that insure maximum safety for the patient. This interest obviously extends at least to the performing physician and his staff, to the facilities involved, to the availability of after-care, and to adequate provision for any complication or emergency that might arise.

Furthermore, he cited the American Public Health Association’s recommendations on abortion:

For pregnancies in the first trimester, abortion in the hospital with or without overnight stay “is probably the safest practice.” An abortion in an extramural facility, however, is an acceptable alternative “provided arrangements exist in advance to admit patients promptly if unforeseen complications develop.”

Planned Parenthood’s opposition of the Missouri regulation goes so far as to undercut Roe: it does not even want women to experience the safest possible abortion, but rather, the most accessible abortion. (Oddly, Planned Parenthood argued in Gonzales v. Carhart that a woman has a constitutional right to the safest possible abortion procedure.  See pg. 47.)  It does not want to spend $600,000 to update its facilities to be in line with other outpatient surgical facilities; rather, it would prefer to not make provisions for the nearly 10% of women who experience complications from medical abortions and the unknown number of women with complications from surgical abortions.



  1. What a joke! Of course the media will give them a pass and not point out the substandard conditions and the “safe” myth.

  2. Excellent post.

    I knew that Missouri was working to pass these safety standards, but I also knew Planned Parenthood was going to run to the Federal courthouse at their first opportunity. Radical pro-choicers are such hypocrites.

  3. Neil,

    What kills me is that these are the same people who argued for the highest levels of health protection to women back in November (Gonzales v. Carhart oral arguments).


    Thank you. :)

    If you are really concerned with women’s health and well-being (and think that the fetus is worthless), why not update your facilities to fully accomodate women? The side effects of these procedures can be life-threatening. For some reason (well, convenience), RU-486 is not taken under the supervision of a doctor. Women are sent home to miscarry, which is completely counter-intuitive.

    What cracks me up is that the same people who think that women are too fragile to find themselves another pharmacy are the ones who set up a situation whereby a woman who has a complication as a result of a medical procedure (induced miscarriage, whether by pharmaceutical or surgery) cannot return to the original facility for treatment.

    Under their own articulated standard, Planned Parenthood’s clinics should be unconstitutional….

  4. yes, well, Planned Parenthood has a lot of inconsistencies. Like their curious tendency to claim that anyone who opposes them is against “choice,” and yet you don’t hear them screaming in rage for the rights of women in China who are forced to abort every baby after their first, and furthermore, are often forced to abort every baby that is a girl. You’d think they’d be for those women’s rights…

    guess not.

    btw, living in Missouri, it’s kind of sweet knowing that this is one of the states where PP regularly gets beaten up upon. They gave us an F grade. I love it.

  5. Sweet. I’m in Virginia now, which also gets an “F.” California gets an “A” (sadly), and Massachusetts gets a C+ or something. It’s the only test a state should want to fail.

    Perhaps the National Right to Life Committee could grade the states on both fetal and maternal protection. (Maternal protection would be things like coercive abortion prevention acts, resources for pregnant and parenting students, a plethora of adoption laws, and (I doubt any state has this) laws which require men as well as women to pay for the costs of labour and delivery.) Let’s grade people on something humane.

  6. Great post, Bridget.

    You know what really annoys me about all this? It’s so unfair. I know that sounds whiny, and it is, but I can’t help it right now! I mean, of all the issues in the world, this playing field is so unbalanced. Pro-life organizations and legislators don’t seem to be entitled to the same constitutional rights that pro-aborts are. We don’t receive the same treatment in the courts, we don’t receive the same treatment in the media, in the legislatures, anywhere. I’m sick of it! I’m sick of not being able to debate and address this issue like any other issue our government deals with.

    Seriously, this legislation is as harmless to abortion providers as it can possibly get. It’s not outlawing abortion, it’s not restricting abortion, it’s just treating abortion like any other surgical procedure. And we can’t even get that to stick. Bah.

    Okay… forgive my completely incoherent rant. I’m just frustrated!

  7. Thanks, Tieki.

    Rant away. It irks me, too, that no one is really nailing PP to the wall on this one. It should be a no-brainer: why do they not want to meet the same standards that other outpatient surgical facilities meet? Apparently, it’s wrong, because it violates the sacred cow of abortion: complete, unfettered access. Who cares if you haemorrhage to death afterwards, so long as PP doesn’t have to spend $600,000 of it’s $900 million budget (yes, 0.067%) to upgrade those facilities?

    It does make me wonder how many people would be anti-abortion if we got a fair shot in the media. If the country really saw the relentless exploitation of women (not to mention the slaughter of children), there would be chaos.

    After Gonzales, you would have thought that the Supreme Court ordered women into rape rooms. What actually happened was that it upheld the constitutionality of a ban on a really barbaric practice. Miss Open Minded and Tolerant told me that it was problematic because it “chips away at abortion rights.” We can’t reasonably restrict infanticide; we can’t even ask that women receive abortions in a healthy manner. The hypocrisy of the people who don’t want women to get “unsafe, back alley” abortions is amazing. No, don’t go into the back alleys – come to PP, where you can get the same (low) standard of care!

  8. “The hypocrisy of the people who don’t want women to get “unsafe, back alley” abortions is amazing. No, don’t go into the back alleys – come to PP, where you can get the same (low) standard of care!”

    Yes but remember, that back alley guy is only in it for the money, while PP stands for principle. I can’t think what principle that is right now, but I am sure there is one. If I were cyncial, I would paraphrase the commercial for Don’s guns; “I don’t want to make money folks, I just love to sell guns.”

    Tieki – If that is an incoherent rant, then I guess I am just naturally incoherent.

  9. Having read the entire order issued by the Judge, I think one can see between the lines and realize that he will probably uphold the statute as to clinics that perform surgery. As for the clinics that perform medical abortions (as opposed to surgical abortions), the state may yet demonstrate a need for surgical requirements to be imposed on them, too. The case is just in the early stages.

  10. “The clinics would be subject to health, safety, and building codes associated with those centers.”

    Why should they be kept from performing unsafe but legal abortions? That is just so anti-abortion of you.

  11. Why should they be kept from performing unsafe but legal abortions? That is just so anti-abortion of you.

    Thank you! :)

    SST – the principle of “choice.” At its core, it is really one which denies biological reality: women get pregnant from sex, while men do not. I’ve seen the insane proposition that abortion is acceptable, as it helps a woman to control birth (i.e. it is birth control); it is the method by which she takes responsibility for her actions.

    Tiberius: Yes, this is the early stages of litigation. Nevertheless, the injunction is wrong; Roe demonstrates that the state interest in abortion is not for its own sake, but as a medical health issue. While I do hope that this litigation comes out in a certain way, I am frankly sickened that PP brought suit in the first place.

  12. We were able to accomplish some health and safety regulations in Louisiana after an undercover media operation showed photos of rusty instruments and other hygienic nightmares in a local abortion facility.

  13. Ugh. This is truly ridiculous. Abortion doctors are the only doctors liberals won’t sue or regulate.

  14. PatHMV,

    Sounds like the undercover sting operations where they found out that PP does not report statutory rape.


    I just had a vision of liberals mistakenly suing PP, thinking them to be OB-GYNs. Then I woke up. :(

  15. PatHMV,

    Sounds like the undercover sting operations where they found out that PP does not report statutory rape.


    I just had a vision of liberals mistakenly suing PP, thinking them to be OB-GYNs. Then I woke up. :(

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