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.