Utah Law TRAPs Providers; 72-Hour Waiting Period (Almost) an Afterthought

Posted on 5.23.2012 by Amy

I contacted the Mountain View Women’s Clinic in Salt Lake City because I wanted to hear about Utah’s new 72-hour waiting period for abortion, which went into effect earlier this month.

But Dr. Bill Adams, the clinic’s owner and provider, had other things on his mind. In the months before Utah made history with the longest waiting period in the country, Dr. Adams was thinking about doorknobs.

Rules about doorknobs -- along with bathroom fans, electrical wiring, cleaning supply storage, and a host of other things -- were threatening his survival.

Utah has a new Targeted Regulation of Abortion Providers (TRAP) law, adding to similar laws in Virginia and dozens of other states. TRAP laws impose a range of onerous regulations that are silently imperiling abortion clinics.* This year alone, TRAP bills have been introduced in 14 states, according to the Guttmacher Institute.

The new rules went into effect in Utah last month. Adams explains:

“We got about 17 pages in rules and regulations we’re supposed to comply with, a lot of it infrastructure. They wanted our exam rooms to be a certain size; we had to add lighting, fire protection, emergency exits and all this stuff that we never worried about before.”

Adams had to install a bar in the bathroom (“so my 20-year-old patients can pull themselves off the toilet”) and set aside a locked room with a ventilation fan for cleaning supplies. He had to install a separate switch in the bathroom so the fan and light would turn on separately. And he had to switch to a lever-style doorknob on his bathroom door.

On top of thousands of dollars in renovations, Adams has paid nearly $2,700 for fees and licensing to the Health Department; they charge $550 when they visit the clinic to check compliance.

Most pressingly for Adams, he is now required to have admitting privileges at a nearby hospital. The hospital across the street where he had privileges for 25 years was bought by an anti-choice company. And several years ago, Adams cancelled his malpractice insurance, reasoning that since the state had taken over the informed consent process (the main reason doctors are sued), he no longer needed it. But canceling his insurance meant losing his hospital privileges.

Adams has applied for privileges at another hospital. If it doesn’t get them, he’ll have to close.

Then Utah would have only three abortion clinics.

The TRAP laws are ostensibly about safety. But a campaign website for Carl Wimmer, the former Utah state legislator who introduced the bill, makes no mention of safety. It’s clear the law is about ending abortion:

“Life is a God-given right protected by the Constitution, and it is the responsibility of the federal government to defend both the born and unborn. Carl has championed legislation imposing tough restrictions on abortion clinics to protect the rights of the unborn. He passed legislation that removed a loop-hole that held women harmless if they intentionally kill their unborn child outside of a lawful abortion, increased inspections on abortion clinics, and passed laws requiring doctors to both inform mothers of a baby’s ability to feel pain and to perform ultrasounds before such procedures can take place.” (emphasis added)

It’s not that Adams isn’t concerned about the waiting period, but he says it’s too early to tell exactly what the effect will be. Of course it’s a burden for his patients, some of whom travel five or six hours from parts of Wyoming or Idaho, because his prices are lower, he says. Women who are eight weeks pregnant and want a medication abortion rather than a surgical one might cross the eligibility threshold over those three days and be forced to have surgery.

I ask Adams whether it has ever been this bad before, at least in terms legal restrictions on abortion. According to the Guttmacher Institute, in the first three months of 2012, legislators in 45 states introduced 944 provisions related to reproductive health and rights. That’s more than 10 per day, if you include weekends. He says:

“No. Anti-abortionists didn’t wise up law-wise until the last few years. When I first got out they were burning clinics and assassinating abortionists, and I guess they got too much backlash from that so that’s when they started going to the legislatures and introducing all these laws, and they’ve been a lot more effective doing that than killing us.”

I ask him why it’s worth it, given the ostracism he faces. I mean he lives in UTAH, home of the 72-hour waiting period, where permission from both parents is required if a minor wants an abortion.

Adams tells me about how he began his medical residency before abortion was legal.

“In those probably six or eight months in my first-year residency, before abortion became legal in D.C., I was on call every third night, and I don’t think a night went by that I didn’t admit at least one patient who had an illegal abortion...These women were septic, they’d always come in with a fever and an infection...So I know what illegal abortion is like and I’d hate to see it return.”

In the email he sends responding to my request for an interview, Dr. Adams warns me that he might get angry and swear a lot. But during our phone interview, he is exceptionally polite and calm. He tells me that abortion is a dirty word and women don’t talk about it. They don’t share the stories that might help them preserve the right for others. He sounds eerily resigned as he tells me: “I’m afraid they’ll lose it.”

*In related news, a clinic in Alabama recently closed after the Department of Public Health found 76 “violations,” 10 of which reportedly related to the legibility of the doctor’s handwriting.