A requirement that doctors providing abortion have admitting privileges at a hospital within 30 miles has yet to take effect in Louisiana, while a legal challenge is pending.
Texas started enforcing a very similar restriction last November. Half the abortion clinics in that state immediately closed.
Dan Grossman is an OB/GYN and researcher at Ibis Reproductive Health in Oakland, California. He led a survey of Texas clinics and found the admitting privileges requirement was the main reason for the closures.
He says the stigma surrounding abortion made it difficult for physicians needing to find other doctors who already had admitting privileges to back their applications.
“Even though they often had good relationships with these physicians who in fact had referred patients to them. These physicians said, 'I just can’t be public about this. I can’t go on the record and vouch for you.'”
In other cases, hospitals wanted doctors to guarantee a certain number of admissions.
“These physicians don’t do in-patient care. So the only possible admissions they would have would be for really serious complications, which, luckily, are very very rare," Grossman said.
Nationally, about .05 percent of patients getting an abortion in the first trimester experience a complication that has to be treated in a hospital.
In the first six months after the admitting privileges requirement was enforced in Texas, there was a 2 percent uptick in the proportion of abortions performed in the second-trimester, as women had to travel farther and wait longer for care at the clinics that managed to stay open.
Grossman is keeping an eye on that.
“We know abortions performed later in pregnancy are associated with a higher risk of complications," he said.
In August, a federal judge put enforcement of the hospital admitting privileges requirement on hold in Louisiana for a month while two of the doctors fighting the rule here sought privileges. That temporary restraining order’s been extended. Briefs are due in the case Oct. 9.