Inside Mississippi's last abortion clinic

Last week, California expanded access to abortion across the state by allowing nurse practitioners, midwives and physician assistants to conduct a common type of the procedure. This goes against the tide in much of the country, where measures restricting access to abortion have come in a flurry over the last three years.

Twenty-six states now mandate waiting periods before an abortion, 17 require the woman undergo counseling and in seven states, providers must have admitting privileges at a local hospital, according to a tally by the Guttmacher Institute, a reproductive rights research organization.

Mississippi passed its admitting privileges law in 2012, but no abortion doctor in the state had so far been able to attain it. The state’s only surviving abortion clinic would have had to close its doors, if a doctor hadn’t taken the state to court.

Last summer, America Tonight visited the Jackson Women's Health Organization in Jackson, Miss. In Lori Jane Gliha’s report, Dr. Willie Parker explains what keeps him going every day, and why he was driven to legal action.

“Some told us that providing abortion care was not consistent with the hospital mission,” Parker told American Tonight. “Some just didn’t reply to our request. And some, based on the application process, told us we weren’t eligible and they halted the process. That was about 13 hospitals.”

Parker filed for immediate court action after the law was passed, and a judge temporarily blocked its enforcement to give Parker and other doctors time to come into compliance. Judges in three of the other seven states with these laws have also granted injunctions, and more than a dozen groups, including Planned Parenthood and the American Civil Liberties Union, sued Texas last month to block the provision, part of a bundle of restrictions passed over the summer.

Anti-abortion activists say the admitting privileges requirement is important for women’s health. Supporters of abortion claim it has nothing to do with women’s well-being, and everything to do with shutting down clinics. They call the law a Targeted Regulation of Abortion, or more commonly, a TRAP.

“Our goal is to end all abortion. So if the clinic closes then yes, that is going to always be something that will be better for women’s health,” Terri Herring, the president of the Pro-Life America Network, a Mississippi-based advocacy group, told America Tonight. “Because in no way shape or form do we believe that abortion is good for women’s health. You’re looking at physical scars and emotional scars that last a lifetime.”

TRAP laws are different from the measures anti-abortion activists pushed in the 1990s, like partial-birth abortion bans, mandatory counseling and waiting periods for abortion-seekers. They tend not to drum up a big emotional reaction or moralistic defense. They’re complicated. And they’re boring.

Requirements for the square-footage of procedure rooms, parking lot sizes and clinic ventilation systems aren’t “sexy,” explains Elizabeth Nash, the state issues manager at the Guttmacher Institute. But since finding new medical space can be incredibly difficult, and remodelling can be incredibly expensive, the measures are incredibly effective. And since 2010, they’ve come in a flurry.

When it comes to abortion clinics, 12 states specify corridor width, 12 states specify the size of procedure rooms and nine states demand that they’re within a certain distance from a hospital, according to the Guttmacher Institute.

“I think it’s pretty clear that if you want to close down clinics,” says Nash, “one of the best ways to do that is to make it impossible to keep them open.”

It can be difficult for abortion providers to get admitting privileges at a hospital. Hospitals generally grant those rights to doctors who can serve them in some way, through emergency rotations, or simply admitting a certain number of patients a year. And abortion doctors rarely need to admit a patient to the hospital ever. A religiously-affiliated hospital may also simply disagree with abortion, and choose to exercise that veto power.

Whether or not an abortion provider has admitting privileges has no impact on patient care, Nash points out, since if there were an emergency, that patient would be admitted to the hospital regardless of what licenses the doctor carried in her pocket.

“None. It has none,” Nash says about the impact of the law, “except that it’s really hard to get.”