"If I close my doors, their access is dramatically, dramatically reduced," Ayers said.
Mississippi, Wisconsin and Texas have laws similar to Alabama, but Texas is the only state where it is being enforced. Testimony in the non-jury Alabama trial in Montgomery continues through June 5. U.S. District Judge Myron Thompson will rule after that.
Proponents of the law say problems arise because traveling doctors remain in a city only a few hours and aren't around to handle complications. Lawyers from the state attorney general's office said they will present witnesses, including physicians, who will testify that having a doctor on hand to manage problems and admit a patient to the hospital will improve the quality of care.
The clinic operators say complications are rare. They said their traveling physicians wouldn't qualify for the admitting privileges because they don't live in the cities with the clinics, would not have the required number of hospital admissions, and would not be around to handle on-call duties like some hospitals require. But both acknowledged none of their traveling doctors has ever tried to get admitting privileges where the clinics are located.
Both said abortion clinic doctors are subject to frequent harassment, and they've never had physicians in the clinics' cities express interest in doing the procedures.
"I can't imagine after all this time and effort that there is one rock left unturned," Fox said.
The attorney general's staff noted that the abortion clinics in Tuscaloosa and Huntsville use local doctors with hospital privileges, and they questioned Ayers and Fox about what they have done to find physicians who would meet the law's requirements.
"I never recruited someone to move here," Ayers acknowledged under questioning.
Both operators described harassment of staff and physicians and said that makes finding employees difficult. Ayers recounted one physician the clinic used from Baltimore, Maryland, who had his picture taken outside the clinic and then had posters about him being an abortion doctor show up in his neighborhood.
The Birmingham clinic of Planned Parenthood Southeast ceased operations in January after firing two staff members for selling an abortion medication to a person in the clinic's parking lot. Fox said the clinic hopes to get approval from the state health department to reopen by next month.
The Alabama Department of Public Health reports the two clinics not threatened by the law are the state's largest, with the Tuscaloosa clinic performing 3,503 abortions in 2012 and the Huntsville clinic 1,451. The department reports the Birmingham clinic recorded 1,396 abortions in 2012, the Mobile clinic 1,275, and the Montgomery clinic 978.
Ayers said her traveling doctors are in the capital city one day per week and are paid $80 to $85 per abortion.
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