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An Update on Tennessee’s HB 3808, Another Legislative Attempt to Limit Access to Abortion

April 8, 2012

HB 3808, the so-called “Life Defense Act,” would have threatened the safety of women and abortion providers by releasing identifying information and potentially making them targets for anti-abortion extremists. The bill has since been amended and passed in the House, and is currently on the Senate Judiciary Committee calendar for the coming week, April 10. Tennessee folks, write your state Senators now.

The bill was amended by removing the requirements related to collecting and releasing information on the women getting abortions and their providers. However, it has the following, problematic provisions as passed:

(1) A physician may not perform an abortion unless the physician has
admitting privileges at a hospital licensed under title 68 that is located:
(A) In the county in which the abortion is performed; or
(B) In a county adjacent to the county in which the abortion is
performed

Admitting privileges bills have been introduced across the country as a means of restricting abortion access. As is often the case with bills intended to restrict abortion access, the typical claim is that it’s needed for women’s safety. The frequency of such complications and mortality with early abortions (the majority of them), is extremely low, and is much lower now that Roe is in effect and the procedure is legal. No compelling evidence is available that women in Tennessee are suffering medical harm because of the status of individual abortion providers and their hospital admitting status.

When a need for emergency hospital care arises, there are two ways to get admitted to get that care – 1) your provider has admitting privileges to a certain hospital and checks you in that way, and individually continues your care; 2) you go through the emergency department. Nothing about the potential complications of abortion requires the specific abortion provider to be the one to follow up, or to be able to admit you directly to a specific hospital.

Like many ob/gyn complications, it is normal practice for women to follow up via the closest emergency department – if you have an ectopic pregnancy, complication of a home birth, or other abnormal vaginal bleeding, you go to the emergency department, and they and their associated hospitals should either have the expertise to treat you, or the ability to stabilize you until they can transfer you to a more advanced hospital. In none of these cases is the expertise of a single, identified-in-advance provider necessary in order for a woman to receive appropriate medical care.

Additionally, other “ambulatory surgical centers” in Tennessee are not required to have their providers individually have admitting privileges. They have to have a “transfer agreement” in place with a hospital, meaning that the clinic has a general agreement in place with a local hospital that they may send patients there. This is different from requiring individual providers to have admitting privileges, in that it puts a plan in place for any transfers between the clinic and the hospital, without having to set arrangements for every possible provider.

It’s particularly notable that Tennessee abortion clinics are now being held to a higher standard than outpatient surgery facilities, because one recent approach to trying to restrict abortion has been to try to implement the standards for ambulatory surgical centers, that may not be appropriate or necessary for the type of care provided at abortion clinics. These are called TRAP laws (Targeted Regulation of Abortion Providers), and that HB 3808 meets the characteristics of a TRAP law is another tip-off that it’s about abortion restriction, not women’s health.

In some parts of the country, there are no providers so one from another state flies in on certain days to provide this legal medical service to women. It is very unusual for a hospital to grant admitting privileges to a provider who is based out-of-state. HB 3808, then, is partially meant to keep women in Tennessee from having access to an abortion provider who might come in from elsewhere if the state succeeds in reducing our access to this degree. An example of the effect is happening right now – in Mississippi, where only one clinic in the whole state provides abortion, a similar hospital admitting law may cause that clinic to shut down completely.

As Representative Gary Odom observed:

“I think it’s intended to do one thing and one thing only, and that is to place another requirement on a physician that makes it more difficult for a woman to seek out the services that they want that are legal in the state of Tennessee.”

It’s clear what this is about, and it’s not about women’s safety. As Representative Jeanne Richardson concluded:

We have made it painfully clear to the women and men in Tennessee who is in charge of women’s bodies and their health care decisions, and the decisions ultimately about their lives

Tip: it’s not the women themselves, according to the Tennessee state legislature.

See Also:
Tennesee House Passes Bill Requiring Admitting Privileges for Doctors Who Perform Abortions – Robin Marty at RH Reality Check.
Red State Round Up: Tennessee – at Trust Women
Thanks to both national sites for bringing attention to this bill.

Another update: I previously sent an open letter on the bill to all of the House Health and Human Resources Committee members and officers, including my own Representative, Mary Pruitt. I also sent it to my Senator, Douglas Henry, who could be expected to support the bill. I did not get a response from any of them, including my own representatives.

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9 Comments leave one →
  1. April 9, 2012 6:45 am

    My theory is that once this in place they’re going to try and bar women from going to the emergency room for abortion complications.

    • April 9, 2012 7:35 am

      I could see them trying, but I think federal EMTALA laws would overrule anything they’d try to do from a “conscience,” or “people who are against abortion shouldn’t have to treat the (very rare) complications” perspective. But since when does our legislature care about what they can actually accomplish? Ugh.

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