On April 28th, the Fifth Circuit Court of Appeals will hear a case that could determine the future of legal abortion in Mississippi. At issue is a bill that requires doctors at Jackson Women’s Health Organization (JWHO), the state’s sole abortion clinic, to have admitting privileges at an area hospital.
Gov. Phil Bryant (R), who has made no secret of his desire to make Mississippi an abortion-free state, signed the bill into law in 2012. JWHO and the Center for Reproductive Rights (CRR) filed a suit challenging the bill’s constitutionality, and in April 2013 a district court granted a preliminary injunction against the law. Now the Fifth Circuit will decide whether to uphold the district court’s decision to grant the injunction, which would mean that the block would stay in place and the clinic would stay open while the litigation continues; or whether to reverse the decision, in which case the law will take effect and the clinic will close.
‘Last week I spoke with Julie Rikelman, litigation director at CRR, about this case and what it could mean for reproductive rights well beyond Mississippi’s borders. “
I think the most important thing to understand about these admitting privileges laws is that they’re not being proposed or pushed by doctors or the medical establishment, they’re being pushed by anti-choice politicians,” Rikelman said. “And actually the major medical groups in the country oppose these laws, because they know that they do nothing to help women’s health and safety. The American Medical Association and the American College of Obstetricians and Gynecologists is on the record saying that these laws do not promote women’s health and by shutting down access to legal abortion they will actually harm women’s health.”
A reason that major medical organizations oppose such restrictions, Rikelman explained, is because “hospitals give admitting privileges based on a variety of criteria that have absolutely nothing to do with how good a doctor is or isn’t. For instance, some hospitals only give admitting privileges to doctors who bring in a lot of surgeries to the hospitals, who bring in a lot of cases. Because abortion is so safe, [abortion providers] don’t bring a lot of cases to the hospital, and just for that reason alone the hospital may conclude that it doesn’t make sense for them economically to give that doctor privileges.” Of course, hospitals may be influenced by other factors, as Rikelman points out. “In Mississippi in particular, we now know from the record that the local hospitals in Jackson either refused to consider the doctors’ applications for privileges at all or denied them simply because they provide abortions. It had absolutely nothing to do with their qualifications. So the notion that the hospitals will be acting as a credential check on the doctors is just false.”
It’s not surprising that Jackson Women’s Health Organization, the only abortion clinic operating in an extremely anti-choice state, is subject to a high level of scrutiny. “The clinic already meets all of the safety requirements [of] major medical organizations and even the state of Mississippi, before it passed this law,” Rikelman observes. “The clinic is probably one of the most frequently inspected medical practices in the state, and it was inspected several times right before this law went into effect. The Department of Health in Mississippi found that it met all applicable regulations.” The clinic also has a transfer agreement in place, so that in the unlikely event that a patient does need hospital care, that can happen as quickly as possible.
“Mississippi [legislators] were surprisingly honest abut the fact that it was their goal to shut down the last clinic and they thought that this law would do it,” Rikelman said. “It’s important to understand that even in other states, even if it’s not quite as extreme and even if the politicians are less honest, that’s what these laws are about. They’re about shutting down clinics, they’re not about women’s health or safety.”
In an effort to safeguard reproductive rights, last fall a group of Democratic legislators in both the House and Senate introduced the Women’s Health Protection Act. Designed to ensure that women have the right to legal abortion regardless of what state they live in, the Act would prohibit states from passing laws that create barriers to access. Admitting privileges laws would fall under that category, as would measures that require women to have ultrasounds and require clinics to meet unnecessary building standards, among other TRAP (targeted regulation of abortion providers) laws.
The fate of the Act remains to be seen, as does the Fifth Circuit’s ruling. But just as passage of the Act would send a strong message of support for women’s autonomy and privacy, a reversal of the lower court’s decision would have a chilling effect — not just in Mississippi, but nationwide.
“The decisions that [the Fifth Circuit] makes are obviously considered by other federal courts of appeals in other parts of the country,” Rikelman says. “If it decides that this law is constitutional, what it means is that states can now effectively ban abortion within their borders, and that will exactly be the situation before Roe when the Supreme Court came in and said no, the state does not have the power to ban abortion. It will be returning us to a pre-1973 time.”
Sarah Erdreich is the author of Generation Roe: Inside the Future of the Pro-Choice Movement. She lives in Washington, D.C. with her family.