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Health & Science

New Abortion Laws Switch Focus From Women to Doctors

Texas is one of 26 states that have passed the controversial “TRAP” laws


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Texas is one of 26 states that have passed the controversial “TRAP” laws

A federal judge in Austin will issue a decision in the next few days about whether abortion clinics in Texas must become outpatient surgery centers. The Texas law is part of a national trend, in which state legislatures regulate the doctor and his or her office instead of the woman seeking an abortion.

The laws are collectively known as TRAP laws for "Targeted Regulation of Abortion Providers."

"They do just that," said Rochelle Tafolla, a spokeswoman for Planned Parenthood Gulf Coast in Houston. "They ‘trap' providers into very tight, medically unnecessary restrictions."

The Texas law that passed in 2013 requires doctors who do abortions to get admitting privileges at a hospital within 30 miles. Many clinics, especially rural ones, found it difficult to comply with that rule by the November deadline. The number of Texas abortion clinics dropped from 41 to 20.

Now the law's final rule requires the doctor's office to meet all the standards of an ambulatory surgical center — an array of rules that govern hallway widths, the presence of showers and lockers, HVAC specifications, and other construction codes that can cost millions of dollars to implement. The rule goes into effect on Labor Day, unless federal Judge Lee Yeakel of the Western district in Austin issues an injunction to stop it.

Tafolla said only eight clinics in Texas will meet the newest requirement, and they're all in the major cities: two are in Houston (including Planned Parenthood Gulf Cost), two in San Antonio, two in Dallas, and one each in Fort Worth and Austin.

Women in East Texas, the Rio Grande Valley, and west of San Antonio will have to drive hundreds of miles for multiple visits, because a 2011 law put in place a 24-hour waiting period following a mandatory ultrasound, plus follow-up visits for women using the abortion pill.

"So it isn't as simple as saying ‘Oh, there's that one place in Houston, there's that one place in Austin or Dallas.' There simply isn't enough capacity, there aren't enough physicians," Tafolla said.

The Guttmacher Institute, a research organization that studies reproductive rights, says TRAP laws really took off in 2010. Twenty-six states now have them.

Pro-life groups say the new laws make abortion safer and therefore protect women.

But the American College of Obstetricians and Gynecologists say the effect is precisely the opposite.

"So what those laws do is they limit women's access and expose women to increased risk by not enabling them to have a procedure near where they live," said Dr. Hal Lawrence, the group's CEO.

Lawrence said low-income women can't afford to travel, and may try to self-induce an abortion or carry an unwanted pregnancy to term. He added that other outpatient procedures, such as colonoscopy, carry a fatality risk that is 40 times greater than first-trimester abortion, yet colonoscopy does not receive the same unwarranted scrutiny from lawmakers.

Tafolla said legislators are passing TRAP laws because laws targeting demand for abortion didn't work. Demand-focused laws include mandatory ultrasounds, a requirement that the patient listen to the fetal heartbeat, and waiting periods before abortions. Those techniques try to get women to change their minds, Tafolla said, but they don't work.

"They have thought about this," Tafolla said. "This is an important, private, personal, complex decision they have made."

"Now the focus is on the providers," she added. "They thought they could reduce abortion by focusing on women and shaming them. Now they're focusing on the providers and doing everything they can to shut them down. So there will be no provider for women."

Observers expect Judge Yeakel to issue a decision by Friday, but if he stops the surgery center rule, Attorney General Greg Abbott could quickly appeal to reinstate it.



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