independent abortion providers

American Civil Liberties Union attorneys went to federal court Sept. 6, seeking to overturn legislation that could close the last abortion clinic in Kentucky.

EMW Women’s Surgical Center provides safe and legal abortion care in the state, but the clinic faces ongoing threats from GOP Gov. Matt Bevin.

Kentucky legislation requires that doctors who perform abortions have admitting privileges at a nearby hospital. The ACLU argues this regulation is unconstitutional, pointing to the 2016 Supreme Court ruling in Whole Woman’s Health v. Hellerstedt that struck down similar legislation in Texas.

That case was brought by Whole Woman’s Health, an independent provider in Texas. Such providers are closing at an alarming rate, according to Nikki Madsen, executive director of the Abortion Care Network. 

Independent clinics — not private physicians’ offices, hospitals or national affiliated health centers like Planned Parenthood — provide the majority of abortion care in the United States. In nine states — Arkansas, Georgia, Kentucky, Mississippi, Nevada, North Dakota, Oklahoma, West Virginia and Wyoming — independent centers are the only providers of in-clinic abortions.

The independent model dates to the years after the Supreme Court’s landmark ruling in Roe v. Wade, when feminists and physicians began opening community-based outpatient centers to provide affordable care.

About 28 percent of independent clinics have closed in the past five years, according to ACN’s “Communities Need Clinics,” a review based on data collected between June 2015 and July 2017 from every clinic in the United States that publicly discloses providing abortion care. 

ACN says 145 clinics have closed since 2012, leaving 365 clinics operating in the United States. Ten clinics closed this year, 19 in 2016, 33 in 2015, 23 in 2014, 40 in 2013 and 20 in 2012.

From the report: “When clinics close, patients are forced to travel farther, find overnight lodging, take additional time away from work and find child care, increasing both medical and personal out-of-pocket costs. Patients are also forced to wait longer to access care, may not be able to access the method of their choice and, in some cases, may not be able to obtain an abortion at all.”

Advocates for reproductive freedom and access to abortion say anti-choice lawmakers are driving the clinic closures. In the past six years, states have passed 338 laws to limit access to abortion care.

Even if the measures eventually are ruled unconstitutional — as was the case last year in Wisconsin, Alabama, Mississippi and Texas, “devastating effects have outlasted the legislation,” according to ACN. 

Twenty clinics closed in Texas before the U.S. Supreme Court ruled against HB2 in Whole Woman’s Health v. Hellerstedt. Only two clinics reopened.

Percentage of U.S. abortions by provider type

60 percent: Independent clinics

35 percent: Planned Parenthood

4 percent: Hospitals

1 percent: Physicians’ offices

Source: Abortion Care Network


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