July 13, 2013

Texas abortion clinics fear closures, patient backlogs

Texas passes requirements for abortions that appear to conflict with the 1973 Supreme Court decision.

By RAMIT PLUSHNICK-MASTI/The Associated Press

HOUSTON - Dr. Howard Novick winces as he recalls treating two and three women a week for infections and complications from botched abortions. It was the early 1970s, before the procedure was legalized, and the experience persuaded him to devote his life to this area of medicine.

Howard Novick
click image to enlarge

Dr. Howard Novick says he would have to come up with up to $1.5 million to upgrade his Houston abortion clinic if new restrictions become law.

The Associated Press

WHAT THE NEW RESTRICTIONS MEAN

AUSTIN, Texas - Texas lawmakers passed new abortion restrictions that will make the state one of the toughest places in the country to get an abortion.

THE BILL

The bill includes four restrictions on when, where and how a woman may obtain an abortion. The first provision requires doctors who perform abortions to have admitting privileges at a hospital within 30 miles of the clinic. Another bans abortions after 20 weeks unless the health of the woman is in immediate danger. If a woman wants to induce an abortion by taking a pill, the state will require her to take the pills in the presence of a doctor at a certified abortion facility. Lastly, all abortions must take place in an ambulatory surgical center.

THE EFFECT

According to the Texas Department of State Health Services, 72,500 abortions are performed in Texas annually. Currently, only five out of 42 abortion clinics in Texas qualify as ambulatory surgical centers, and there is some question whether the others can ever meet the infrastructure requirements such as hallway-width and ventilation standards. Most doctors do not have admitting privileges at a hospital, and it's unclear how many have such privileges at the remaining clinics in Houston, Dallas, San Antonio and Austin. If more surgical centers do not offer abortions, the remaining five would need to perform on average 43.5 a day to meet current demand.

-- The Associated Press

Now, more than 40 years later, new abortion restrictions passed by the Texas Legislature could force Novick to close the Houston abortion clinic he opened in 1980 because, he says, he does not have $1 million to $1.5 million to convert his run-of-the-mill medical office into a fully loaded surgical center with wide corridors and sophisticated air-flow systems.

"I have saved some women's lives. They are so grateful we're here for them and nonjudgmental," Novick said. "I really feel a kinship for this."

The legislation, passed early Saturday after weeks of mass protests, allows abortions only in surgical centers, requires doctors who perform them to have admitting privileges at nearby hospitals, dictates when abortion pills are taken and bans abortions after 20 weeks unless the woman's life is in imminent danger.

Abortion-rights advocates argue the costs associated with converting clinics into surgical centers are so high they will force more than 35 clinics to close, possibly leaving only a handful of facilities across the vast state. In rural areas such as the farthest reaches of West Texas or the Rio Grande Valley, that could put the closest facility 300 or more miles away.

The law could also create a backlog so great in the remaining clinics that women seeking abortions will miss the 20-week deadline, said Amy Hagstrom Miller, president and CEO of Whole Woman's Health, a company that runs five clinics in Texas.

Abortion opponents insist, however, that the new rules are designed to guarantee the best health care.

"All we're asking for is better surgical care for women seeking these procedures," said Christine Melchor, executive director of the Houston Coalition for Life.

Lt. Gov. David Dewhurst posted on Twitter a link to a map of facilities that would be affected and implied that any shutdowns would be an added benefit.

Texas already has stringent abortion laws. Two years ago, the Legislature passed a rule requiring women to get a vaginal ultrasound and a full explanation from the treating physician 24 hours before an abortion. Opponents of that rule say it adds travel costs to the expense of the procedure, and in some cases means women have to stay overnight.

For Melissa Bradshaw, all of it seems absurd. She spent the past year going through a bitter divorce and readjusting her children to a new life. An unplanned pregnancy was the last straw. So after heart-wrenching deliberation, she decided to terminate the pregnancy, calling Novick's AAA Concerned Women's Center in Houston just as Texas lawmakers held an angry debate over the new restrictions.

"Your mind is made up when you pick up the phone to call ... nobody feels good about it," Bradshaw said, noting the desperation that women or teenage girls often feel.

COURT CHALLENGE AHEAD

The new requirements may not survive a court challenge. They conflict with the 1973 U.S. Supreme Court ruling that established a woman's right to get an abortion until her fetus could viably survive outside the womb at about 22 to 24 weeks of pregnancy.

Federal courts have already struck down parts of similar laws in other states.

(Continued on page 2)

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