Admitting Priviledges

Anti-choice folks cried foul when their motives for requiring doctors who provide abortions to obtain admitting privileges at local hospitals were labeled politically motivated. My what a difference six months makes.

For instance, Executive Director for Wisconsin Right to Life, Barbara Lyons stated: "The 5th Circuit decision matters because the admitting privileges provision is essential to protect a woman’s health. With no admitting privileges, a woman suffering complications from her abortion is placed in an ambulance and taken to a hospital where no one knows her, her medical records are not available, and she is left to explain why she is there."

With that dramatic descriptive imagery one could be led to believe that abortion clinics ship off the few patients with complications to some unknown place under a shroud of secrecy and shame. I can even picture the ambulance pulling up and a patient emerging on a stretcher, eyes down cast, blood pooling around her gurney and being interrogated by medical professionals who apparently have no idea how to recognize or handle abortion complications. Barbara Lyons would have you believe that without admitting privileges doctors are unable to admit patients with complications leaving women vulnerable and helpless should their surgery go awry.

Anti-women Governor Rick Perry signed legislation in Texas requiring clinics to have at least one doctor with admitting privileges to a hospital within 30 miles (the bill is referred to as HB 2). Upon this action the supporters of reproductive rights knew immediately what forces were at work. Hospital admitting privileges can be granted or denied without any logical reasoning behind the decisions. Some hospitals even have a requirement that Doctors must admit a certain amount of patients once granted the admitting privileges in order to keep them. If you understand how abortion services work you might note immediately that abortion providers often work on a part time basis with clinics and do not admit many patients to local hospitals. In fact, at a recent conference I heard an abortion provider declare that if you are admitting more than one patient per year to the hospital due to complications arising from abortion procedures that you are not a very good provider. Due to safety concerns in certain hostile states, doctors are actually flown in to clinics located in places where an abortion provider would likely face harassment and threats of violence should they reside in the community. If a doctor only goes to a clinic once a week, how likely are they to be granted admitting privileges by the local hospital? Not very. To recap, hospital admitting privileges can be granted or denied for any reason. Hospitals are not required to explain why or why not they choose to grant admitting privileges to some doctors and not to others. Legislation requiring abortion clinics to have doctors with admitting privileges is a ploy to close down clinics and absolutely places undue burdens on the women who lose access to clinics because of this policy. It's been about five months since these new requirements took effect and they have caused the closure of about a third of all abortion clinics in Texas.


Here are some facts:

1. Surgical abortions are safer then giving birth and complications are rare. According to the Guttmacher Institute when performed under proper medical conditions by trained personnel in a hygienic setting, abortion is an extremely safe procedure. Fewer than 1% of all U.S. abortion patients experience a major complication and the risk of death associated with abortion is 10 times as low as that associated with childbirth.


2. Under a 1986 federal law known as EMTALA, hospitals are required to provide, admit and treat anyone who needs emergency care. This requirement includes pregnant women who need a life-saving abortion, are in labor, or are suffering the effects of a botched abortion. Hospitals cannot refuse to treat a women with abortion complications just because her abortion provider did not have a prior "relationship" with the hospital which is all admitting privileges mean anyway.


Furthermore, as Barbara Lyons laments that women will be stranded at hospitals where "no one knows her" and "her medical records are not available," the most pressing question I have is how would that change if a doctor had admitting privileges? The quality of care given to these women should not depend on whether or not anyone at the hospital knows her or not. That sentiment is so far from the point that I am surprised she takes herself seriously. In fact, how long a women has to wait and how far she has e to travel for abortion services is directly related to her care. When Texas decided to require this arbitrary admitting privilege regulation it is placing politics so far above the care of women it is baffling that anyone fails to see the thinly veiled attempt at closing clinics in the name of protecting women.

In fact proponents of the admitting privilege legislation stated that hospitals would not be able to discriminate against abortion providers seeking admitting privileges as many opponents claimed. They stated that the law was only intended to make abortion safer for women and any one who thought otherwise didn't truly care about women's health. Take a look at this articlefrom last Fall. Granted it comes from the extreme "lifenews.com", but even still that goes to further to prove the point that admitting privileges are being used to close clinics, not to make them safer. In the instance of the horrible case of Kermit Gosnell especially, I am hard pressed to see how any admitting privileges would have changed this sick and disturbed individual who is the exception and not the rule when it comes to abortion providers. This article also brings up other controversial issues that aren't explained in much depth either but what I want to highlight is the flawed logic used by the writer and how misleading it is. "Admitting privileges should not be a problem for a good physician to come by," says the author, "the criteria hospitals examine when deciding whether or not to grant admitting privileges to a local physician tend to be board certifications, malpractice history and reported complications, level of experience and expertise, and validation of educational credentials. Bottom line: If a doctor cannot get admitting privileges, then maybe women should be protected from receiving any medical treatment (or mistreatment) from him or her." So it IS about women's health and safety right? Not just a ploy to close clinics...if physicians are granted admitting privileges based on all of the described criteria above than there should be no problem for legitimate providers to gain them. Right? Well, no...

Doctor with over 40 years experience has difficulties gaining admitting privileges.

In addition, it was revealed last week that University General Hospital of Dallas revoked admitting privileges which had been granted to two doctors and specifically stated that it was because these doctors provided abortions. The hospital stated:

"It has come to our attention that you perform 'voluntary interruption of pregnancies' as a regular part of your medical practice. As a matter of policy, UGHD does not perform these procedures due to the fact that obstetric procedures are not within UGHD's scope of services and that UGHD does not have the capacity to treat complications that may arise from voluntary interruption of pregnancies."
NATION NOW

A judge has already issued a temporary injunction against the revocation as both doctors have sued the state of Texas citing a law that prohibits discrimination based on a physicians decision to provide abortion services or not. The law was brought up by supporters of HB 2 as a reason why hospitals would not be allowed to refuse admitting privileges solely on the basis of whether they performed abortions or not. In the lifenews.com article our author claims, "admitting privileges should not be hard for a good physician to come by," so why are they? Could it be because they have little to do with protecting women and a lot to do with hindering abortion access for women?

Texas is not the only state that has used admitting privileges legislation to try to close down clinics. Wisconsin and Mississippi are at various stages of enacting and retrying the controversial admitting privileges requirement. Alabama has passed a similar law that would close down three of the five abortion clinics in the State. The constitutionality of that law is being challenged and a federal judge decided to send the case to trial on May 19th which will determine whether or not the law will take effect in yet another state.

"It really is about the health care of women," Alabama State Senator Scott Beason asserted.

Really? Forgive me if I remain skeptical.