Bad Freaking News, with helpful annotations

AZ Abortion Law to Take Effect After Judge's Ruling
Mon, Jul 30 2012, Reuters

Arizona's law banning abortions after 20 weeks will go forward, says U.S. District Judge James Teilborg.

The law is a change from the current system in Arizona. Under the previous law, abortions were permitted up until viability which occurs around 24 weeks. Starting Thursday, abortions after 20 weeks will not be allowed unless there is a medical emergency.

Judge Teilborg was asked to stop enforcement of a new Arizona law passed by the legislature. He declined to do so by ruling that the law is acceptable under the Constitution.

Arizona is not the first state to ban abortions around 20 weeks but it's still a tricky decision, legally speaking, for a state to ban abortions before viability. The Judge acknowledged that the Supreme Court has blocked states from implementing outright bans on abortion before viability as an unfair burden [but he says that] the Arizona law is acceptable in part because it doesn't impose much of a burden on a pregnant woman.

His reasoning is that there is relatively little time between 20 weeks and the 22-24 weeks when viability occurs,[1][2] according to Arizona Daily Star.

Part of the burden on women in pre-viability abortions is that they may not know of fetal abnormalities before that time. The evidence presented to Judge Teilborg indicated that there are few conditions that would be diagnosed after 20 weeks that could not have been diagnosed earlier.[3] As a result, banning abortions after 20 weeks would not significantly increase the burden on the woman.[4]

He did note that if a unique circumstance arose where fetal abnormality was diagnosed after the first 20 weeks, it would be appropriate to challenge Arizona's abortion law.[5][6] But until that actually happens, the typical situation will dictate the constitutionality of the law.

To uphold a restriction on abortion, the state must also show a legitimate reason for the new restriction. Teilborg was convinced that the state's respect for life[7] and concern for preventing fetal pain[8] was a sufficient concern to justify the law, reports Arizona Daily Star.

Arizona's new abortion law is not the first of its kind, although it may be the first law banning abortions after 20 weeks to be challenged in federal court, reports Reuters. The plaintiffs had not filed an appeal as of Monday.

Footnotes, placenta sandwich 08/01/12:

[1] More like 24-26 weeks; it would be ludicrous to use 22 weeks as a general theoretical threshold for viability, even in a high-tech, high-cost US hospital context.


[2] (Also, how is 4 weeks just a "little time" to be cutting off? Is it really? What did he base this on? Has he experienced a crisis pregnancy before? I'm honestly curious what makes a person decide this rather than something else. Because for every person talking about banning later abortions who calls 4 weeks "relatively little time" [as in, "I don't really understand your life, but a couple weeks' less time is not a big deal, just get to the clinic earlier"], there's another person talking about banning later abortions who calls 4 weeks "plenty of time" to find out you're pregnant, decide what you're going to do, and seek out the necessary care [as in, "I don't really understand reproductive biology, but you're already 8 weeks pregnant, what took you 8 whole weeks to get an abortion?"]. Somehow, they're both wrong.)


[3] I don't know what evidence this refers to, as there is plenty of time past 20 weeks for plenty of fetal development to go wrong, and it does.


[4] Few conditions are undetectable before 20 weeks, and "as a result" it wouldn't be burdensome to ban abortion after 20 weeks? Wow, so many people are erased in that one little phrase. Including women who are seeking later abortions for reasons other than fetal anomaly.


[5] Sad but true. Assuming this ruling isn't overturned, the last hope for people needing abortion care in Arizona is for an already-pregnant person to be adversely affected by this ban and have the means to bring their specific case to court. Of course, as in Roe v. Wade, the individual adversely affected will be well past their pregnancy by the time of the court's decision -- which sometimes results in a judge saying that the claimant is no longer affected and thus no longer has standing! Isn't this the original meaning of "Catch 22"?


[6] But also, why is it that the only person hypothesized to have standing as an adversely-affected party is a woman whose pregnancy was diagnosed with a fetal anomaly after 20 weeks? What about those who face other kinds of situations and obstacles in obtaining their abortion care before 20 weeks (see footnote [3])?


[7] Not WOMEN'S lives, silly!


[8] We don't know when a fetus is capable of experiencing pain, but it's definitely not at 20 weeks. In fact, it's not anytime before 27 weeks and it may be even later. This is the general consensus of embryologists, neonatologists, neurologists and other people knowledgeable about the development of the nervous system.

We Will Keep Our Clinics Open!

In the last year (+) several abortion clinics around the country have closed for a myriad of reasons. We often mention that a vast majority of abortion doctors are "aging out" and fewer medical students currently coming out of school are motivated to provide abortions. Several clinics have also closed after inspections by the Department of Health and Human Services or similar state agencies (DHH, DHS). Abortion provision is challenging and comes up against many blockades on many levels. 

In Fayetteville, Arkansas, the Fayetteville Women's Center closed its doors because the doctor is facing health problems. Several other doctors have become ill, died, or simply reached the age, or well beyond the age, of retirement. Dr. Eugene Glick and Dr. Tiller are two doctors who come to mind who have passed away. Of course, Dr. Tiller did not die of old age or a disease, he was murdered by anti-abortion radicals.

Several clinics have closed after DHH inspections. This is challenging because when a clinic is shut down or its license is suspended, the fairness of DHH is always in question. A few months in Montgomery, Alabama, the Beacon Women's Center had its licence suspended after a DHH inspection. More recently in Shreveport, Louisiana, the Hope Medical Group for Women was shut down after a DHH inspection. Based on a recent law signed by the Louisiana governor, any abortion clinic with any defiency at all must suspend operation immediately and the appeals process to reopen can take months -- here is an article from RH Reality Check to help give a little perspective. According to that article, the owner of Hope Medical Group is going to challenge this law in court. In the northeast, at least two doctors have had to close their doors because of problems found by DHH.

When clinics are closed because DHH finds problems, it is challenging. If DHH came into abortion clinics and advised staff on how to run better medical facilities, that would be great. For example, at my clinic we are constantly striving to improve our patient care and services. The problem is that in reality, very often  DHH inspectors walk into abortion clinics with the intent of finding something wrong. When I read a news story about a clinic being ordered to close, there is no way to know if the problems cited are problems that actually warranted (medically or otherwise) shutting the clinic down. In states like Alabama or Louisiana where the social environment is conservative, it's very possible that both the DHH inspector and the person who wrote the news article are anti-choice. Really, I guess that is possible in Anywhere, USA.

Where I work we spend day after day stressing over what DHH might try to make into an issue. We know we run a clinic that offers safe medical care. Yet instead of focusing on improving our overall patient care and services, we must worry over which piece of our policies and procedures DHH might decide to pick apart if an anti-choice inspector shows up one day.

Abortion care is under seige in this country. Roe v. Wade may never even be overturned, but folks who are in power and against abortion continue to attempt everything they can to make it as difficult as possible to seek abortion care. My boss, who has worked in abortion provision since Roe v. Wade, often mentions that liberals are not as organized as we once were. Women who are of reproductive age today were not alive or not of reproductive age during pre-Roe years. Sometimes I wonder how many hoops women will have to jump through to get a simple medical procedure before folks are ready to get back out and yell, "We will keep our clinics open, enough is enough!"