Why Are Abortion Clinics Closing?

Toledo, Ohio's last abortion clinic, Capital Care Network, stopped performing surgical abortions in its facility earlier this month.  According to the Toledo Blade, the clinic now will offer only medication abortions up to nine weeks and six days of gestation. Ed Sitter of the Greater Toledo Right to Life celebrated the change and told The Blade that about two-thirds of abortions at the clinic had been surgical.

"No more babies will be torn apart within their mother's womb here in Toledo," he said. 

Ohio Right to Life Vice President Stephanie Ranade Krider told The Blade, "While this facility will undoubtedly continue to profit off of women seeking chemical abortions, with over 1,300 abortions in Lucas County in 2017, the loss of their surgical license will save many lives."  

Six of the nine remaining Ohio abortion clinics continue to offer surgical abortions. 

So what led to the change at Capital Care Network's abortion clinic in Toledo? According to The Blade, the abortion facility had been in a legal battle since 2013 because of difficulty in complying with Ohio's regulation that required the clinic to have a transfer agreement with a local hospital in case a clinic patient had complications from the abortion procedure. 

The Blade also reports Legal Director of Ohio's branch of the American Civil Liberties Union, Fred Levenson, blamed those regulations for bringing about the end of surgical abortions in Toledo. "While we are fighting for reproductive justice – and largely winning – in the federal courts, what we see today in Toledo is how Ohio's years and years of repressive legislation continues to take its toll on clinics across the state." 

Over the last 25, regulations like waiting periods, pre-abortion counseling mandates, bans on partial-birth abortion procedures, and required ultrasounds have had an effect on abortion clinics across the country, upping operation costs and aggravation.  

A report by Jessica Arons on the American Civil Liberties Union website laments the possibility that abortion clinics could disappear, largely due to state regulations and restrictions, without the Supreme Court even touching the Roe vs. Wade decision that wiped out state abortion laws, and effectively legalized abortion nationwide in 1973. 

"Ever since Roe was decided in 1973," Arons writes, "state legislatures have been chipping away at abortion access, passing more than 1,100 restrictions."

Most difficult for abortion facilities are the state regulations that require higher safety standards. The abortion industry has dubbed these requirements "TRAP" laws,  which stands for Targeted Regulations of Abortion Providers. These laws require abortion providers to have admitting privileges at local hospitals or require clinics to meet the standards of ambulatory surgical centers. Something the laws' supporters say are needed safety measures, but abortion supporters say are unnecessary because abortion is so safe. That's what happened in Toledo, and those kinds of laws are in effect in states across the country, particularly those with pro-life legislatures.

Aron's report for the ACLU cites several states where the number of abortion clinics is dwindling largely due to regulatory laws:

"1992, Arkansas had eight abortion facilities. By 2014, it had four abortion facilities, three of which were clinics. Today the number of clinics remains at three. And, depending on how a federal appeals court rules in a pending case, it could soon have only one. 

"In 1992, Kentucky had nine abortion facilities. By 2014, it had three abortion facilities and two clinics. Today it has one clinic. The state has tried to use TRAP laws to shut down the single remaining clinic, but litigation has thus far blocked it from doing so.

"Louisiana had 17 abortion facilities in 1992. By 2014, it had five abortion facilities, all of which were clinics. Today it has three. And, due to a recent court ruling, it may soon only have one. 

"In 1992, Mississippi had eight abortion facilities. By 2014, it had two abortion facilities and one clinic. Today it has one. 

"In 1992, Missouri had 12 abortion facilities. By 2014, it had two abortion facilities and one clinic. Last year it had one clinic – until a federal district court decision that allowed a second clinic to offer abortion services again. But now it has gone back down to one after a federal appeals court let two measures take effect in September.  

"In 1992, Ohio had 45 abortion clinics. By 2014, it had 17 abortion facilities and 12 clinics. Today it has 10 clinics."

A study released last week by the Guttmacher Institute, the research arm of  Planned Parenthood, found that abortion rates are the lowest they've been since Roe vs. Wade made abortion legal nationwide in 1973. But the study, reported in USA Today, says that decrease has little to do with state abortion clinic regulations, saying  57 percent of the decline in the number of abortions nationwide happened in the 18 states and the District of Columbia that did not adopt any abortion restrictions. The study says, instead, improvements in contraceptive use, a decline in pregnancy rates, and increases in the use of the abortion pill are the reason for the decline.

The same study still reports from 2011 to 2017,  "the South had a net decline of 50 clinics – 25 in Texas alone – and the Midwest had a net decline of 33 clinics, including nine each in Iowa, Michigan, and Ohio. The West lost a net of seven clinics. By contrast, the Northeast added a net 59 clinics, mostly in New Jersey and New York."

If this study's findings are true, and state abortion regulations and restrictions have no effect on the abortion rate, and therefore, their bottom line, then Planned Parenthood and other abortion providers may have found a way to cut their costs: stop litigation against state laws that regulate their industry.