Many are so demanding that clinics cannot comply. On Monday, a judge halted a Mississippi law that would have shut down the state’s only abortion facility.
Maryland adopted regulations last year requiring abortion clinics to be specially licensed and inspected, in response to a widely publicized botched abortion in Elkton. The state last month suspended the licenses of three clinics, which have since been reinstated. Virginia approved rules this month requiring abortion clinics to adhere to hospital-like standards, leading at least one clinic to decide to close. The District does annual visits to abortion clinics as part of routine health inspections.
Abortion rights advocates say that they support regulations and inspections for abortion clinics but that providers should not be singled out for special scrutiny. They say abortions are generally safe. According to the Centers for Disease Control and Prevention, 10 women died after having abortions in 2010, the most recent year for which CDC has data. By comparison, 793 people died in bicycle accidents that year.
Abortion rights advocates say that many of the rules adopted in the states are not meant to promote abortion safety but to shut down clinics.
David Grimes, former head of the CDC’s abortion surveillance branch, said clinics like Gosnell’s were commonplace before Roe v. Wade, the court case that legalized abortion. Today, the problem of substandard clinics is so small that the branch, which investigated problem clinics, no longer exists, he said.
“The legalization of abortion stands out as a public health triumph,” he said. “Over 1,000 women died every year from illegal abortion in the 1940s. Now it’s less than a handful a year. That’s the story, not one aberrant doctor in Philadelphia.”
But critics say the Gosnell case shows what can happen without close oversight.
The grand jury that indicted Gosnell also excoriated several oversight agencies for failing to crack down on his clinic. In the grand jurors’ 2011 report, they called the failure a “complete regulatory collapse.”
The report details how the Pennsylvania Department of Health issued approval for Gosnell to open the clinic in 1979. The next site review came a decade later, and while numerous violations already were apparent, “Gosnell got a pass when he promised to fix them,” the report states.
The same report found that the Pennsylvania Department of State also could have put a stop to Gosnell. Nearly a decade before his arrest, the report states, a former employee presented the Pennsylvania Board of Medicine with a complaint “that laid out the whole scope of his operation,” from unsterile conditions to underage patients to over-prescribing of pain pills.
Soon after, the department received another report about a woman who died of sepsis after Gosnell perforated her uterus. In addition, a city health department worker who came to the clinic as part of a vaccination program reported appalling conditions. But her reports “went into a black hole,” jurors found.
“Bureaucratic inertia is not exactly news. We understand that. But we think this was something more,” the grand jury wrote. “We think the reason no one acted is because the women in question were poor and of color, because the victims were infants without identities, and because the subject was the political football of abortion.”