September 16, 2013 — There is little evidence to support some Texas legislators' claim that conditions at existing abortion clinics endanger women seeking abortion care, according to a Texas Tribune review of state records, the Texas Tribune/New York Times reports. Such lawmakers successfully pushed through legislation (HB 2) imposing restrictive new regulations for clinics, arguing that there was a need to ensure safety (Aaronson, Texas Tribune/New York Times, 9/14).
Gov. Rick Perry (R) signed the antiabortion measure into law in July. It includes four abortion regulations: a ban on abortion after 20 weeks of pregnancy unless a woman's life is in danger, a requirement that abortions be performed at an ambulatory surgical center, a mandate that physicians administer medication abortion drugs in person and a requirement that physicians who perform abortions have admitting privileges at a hospital within 30 miles (Women's Health Policy Report, 7/14).
Nine of the state's 36 abortion clinics have closed since January, and another has stopped performing abortions. Two of the recently closed clinics were Planned Parenthood facilities whose last inspections showed no violations. Only six of the state's clinics meet the new law's ambulatory surgical center standards, and it is still unknown how many clinics have providers who will be able to obtain admitting privileges, according to the Times.
Review Finds Few Errors, All Administrative
For its review, the Texas Tribune examined state inspection records for the state's 36 abortion clinics in 2012. According to the review, state auditors identified only 19 regulatory violations at six non-ambulatory surgical center abortion clinics that could have endangered patient safety. In addition, none of the violations was severe enough to merit financial penalties, and the clinics' proposed corrective action plans were sufficient to protect patients, according to the Department of State Health Services.
For example, inspectors found expired or unlabeled medicines in certain clinics, as well as instances in which medical staff failed to follow proper infection control policies. Most of these administrative violations were found at a Whole Women's Health facility in Beaumont, whose correction plan has been accepted by the state. A health department spokesperson did not specify whether any of the clinics' violations were associated with patient complications, citing confidentiality rules.
The review also found that the Texas Medical Board took action against three abortion providers for solely administrative infractions that did not involve criminal practices or abortions performed late during pregnancy.
Overall, only five women have died in Texas due to abortion complications between 2000 and 2010. During that time period, Texas clinics performed 865,300 abortions, making the state's abortion-related death rate 0.58 per 100,000 abortions, compared with the national rate of 0.7.
Meanwhile, the state has levied a battery of fines against abortion clinics for violations, including a $119,000 fine against Planned Parenthood Trust of South Texas for failing to acquire adequate licensure when three of its facilities started offering medication abortion. Other fines of between $200 and $500 have been levied against clinics that failed to post their licensure numbers on their websites, misreported the fetal gestational age or failed to submit a corrective plan on schedule.
Abortion-Rights Supporters, Opponents Comment
Emily Horne -- a lobbyist for the antiabortion-rights group Texas Right to Life -- said the violations cited in 2012 could have easily endangered patients and that a "lower standard of care" could become the norm if inspectors "find these problems and do nothing about them." She said that HB 2's goal "is to improve patient safety for the woman and child," adding, "You can't advocate for more abortion that is unsafe."
Whole Women's Health CEO Amy Hagstrom Miller said the "point of [HB 2] was to make abortion inaccessible," adding, "It wasn't about safety, because there is no safety problem around abortion in Texas."
Separately, Daniel Grossman -- a principal investigator on the University of Texas-Austin's Texas Policy Evaluation Project, which is examining the policy implications of HB 2 -- said he thinks "it's very, very likely that abortion self-induction is going to go up, and that's definitely going to be bad for women's health" (Texas Tribune/New York Times, 9/14).