They’re frequently identified as “Women’s Health and Safety” laws, but a growing number of laws regulating abortion providers are more accurately called TRAP laws — Targeted Regulation of Abortion Providers. They’re aimed at stopping abortion by making them logistically impossible — shutting down clinics — rather than flat-out illegal. You can generally recognize a TRAP law when the regulations treat a procedure that’s generally less hazardous than a tooth extraction as if it were more dangerous than a limb reattachment.
Last week, we looked at hospital admitting privileges, used to set unreachable and unnecessary standards that keep abortion providers from being able to practice. Another favorite restriction is unreasonable requirements for the medical facility itself, holding it to standards that have little impact on keeping women safe and, ultimately, plenty of impact on keeping them pregnant.
The laws generally require that abortion clinics, even those that only provide first-trimester and/or medical abortions, meet (or exceed) standards for ambulatory surgical centers — relatively sophisticated facilities designed for a range of outpatient surgical procedures. The National Abortion Federation points out that “[a]ll health care facilities, including abortion providers, are required to comply with a variety of federal and state regulations,” including the Clinical Laboratory Improvements Amendments, HIPAA, and OSHA requirements. State and federal requirements, as a matter of course, include infection control measures, emergency equipment, staffing, and patient transfer to hospitals. These abortion providers aren’t exactly performing procedures in gas station bathrooms. (Yet.)
Code requirements have included:
Wider doorways and hallways. Virginia’s 2011 law, which reclassified abortion clinics as hospitals, required doors wide enough to admit a professional gurney with four-man running team — for a procedure that very rarely results in an ER visit at all, much less one on a gurney.
Higher ceilings. Missouri’s 2007 law dictates, among other requirements, 9-foot ceilings and ceiling-mounted surgical lights in procedure rooms — even if nothing more invasive than a sonogram will be taking place there.
More bathrooms. Kansas’s 2011 law that ultimately closed all but two clinics in the state dictated more bathrooms, as well as
Larger waiting areas and
Larger janitorial closets, both of which obviously have plenty to do with women’s health and safety.
Procedures that are often performed in facilities that aren’t held to ACS standards include superficial liposuction (complication rate of 8.6 percent), wisdom tooth extraction (2 percent), and laparoscopic hernia repair (10 percent). In contrast, fewer than 0.5 percent of abortions result in complications that require additional procedures or hospitalization.
Currently, 28 states have laws holding abortion clinics to unreasonable standards for facilities. These include Pennsylvania’s 2012 law, which requires that abortion providers comply with pediatric care requirements; Texas’s 2013 law, which requires that abortions take place in a surgical facility; and Alabama’s 2013 law that recently closed down one of the state’s four remaining abortion providers.