A judge heard a full day of testimony Wednesday about the effects that an abortion-restricting state law is expected to have on abortion-seeking women in Arkansas.
When the hearing resumes Friday, U.S. District Judge Kristine Baker will hear still more testimony on the issue in an effort to decide by 5 p.m. Monday, when a temporary restraining order expires, whether to continue blocking the state from enforcing the law by issuing a preliminary injunction.
The law, Act 577 of 2015, effectively eliminates medication abortion in Arkansas by requiring doctors who perform the procedure to first undertake what they say is an impossible task: obtain a signed contract with another physician who has admitting and obstetrical/gynecological privileges at a hospital. The second doctor would have to agree to handle any complications arising from a pill-induced abortion, and that doctor's name and contact information would be given to patients.
Planned Parenthood, which operates one clinic each in Little Rock and Fayetteville, both of which perform only the pill-induced type of abortion, filed a lawsuit over the law in late 2015, saying it was designed to put the organization out of the abortion business and restrict the number of abortions performed statewide.
The clinics say they have been unable to find any physician with the required privileges who is willing to be a contract physician because, even though a few physicians have voiced support for a woman's right to an abortion, the hospitals and clinics they are affiliated with prevent them from associating with abortion doctors.
The private practices and hospitals have that policy to avoid the heated abortion controversy that draws protesters and threats, the clinics say.
While state legislators touted the law as a way to protect women and ensure they receive continuity of care after such a two-step abortion procedure, Planned Parenthood says complications are rare. It also says the law is unnecessary because clinics already have adequate procedures in place to ensure continuity of care, and that hospital emergency rooms are equipped to handle the extremely rare situations in which medication abortion patients must be hospitalized.
Medication-induced abortion consists of taking one pill administered by a doctor and then, 24 to 48 hours later, taking a second pill at home, to complete the process. The only other abortion option available is surgical, which in Arkansas is available only at the Little Rock Family Planning Services clinic.
Surgical abortions can be performed in Arkansas through the 21st week of pregnancy, as determined by a woman's last menstrual period. Little Rock Family Planning Services performs medication abortions through nine weeks' gestation, and Planned Parenthood performs medication abortions up to the 10th week of pregnancy, according to testimony Wednesday.
Although Baker has heard arguments and testimony in the case before, an injunction she imposed in March 2016 was dissolved by the 8th U.S. Circuit Court of Appeals in St. Louis. The appellate judges directed Baker to obtain more specifics on the number of women the law would affect and whether the burdens it imposes on those women are so severe that they outweigh the law's benefits and the state's interest in regulating abortion.
Colleen Heflin, a Syracuse University professor who is an expert witness for Planned Parenthood, spent Wednesday morning defending her calculations that the increased travel distances the law would impose on Arkansas abortion-seeking women living outside Little Rock would cause abortion rates to decrease statewide by 15 percent to 40 percent, depending on which county each woman had to travel to obtain a surgical abortion.
She has also said that the elimination of abortion services in Fayetteville would prevent 235 women who otherwise would have had abortion from obtaining one.
An expert for the state, mathematics professor Tumulesh K.S. Solanky, has criticized Heflin's report, declaring it mathematically incorrect, and has said Heflin relied on a study that hasn't been peer-reviewed. But Heflin said she relied on "the most rigorous, recent study available," and that "Dr. Solanky sort of misunderstands."
She testified that most women in Arkansas who seek abortions are poor, and that any unexpected expense, such as having to travel from the state's far corners to Little Rock, "can be the tipping point that causes them to lose their job," which in return prevents them from paying rent, and can "result in catastrophe for the household."
Baker also heard testimony Wednesday from Dr. Stephanie Ho, who provides abortions at Planned Parenthood's Fayetteville clinic alongside two other doctors and is a plaintiff in the case; and from Lori Williams, director of Little Rock Family Planning Services. They described their repeated futile efforts to find a physician willing to contract with them as the law requires.
"What it means to be an abortion provider is well-known in the medical community," Williams testified. She said there are protesters outside her clinic nearly every day who regularly scream at her, and that an anti-abortion group once mailed letters including her picture to 800 of her neighbors, describing her as being complicit in killing children.
She said protesters have targeted her home and that of the clinic's local physician. The other two live out of state, she said.
She said the law's impact on her clinic would "present significant challenges" by adding about 800 patients annually, which would require the hiring of another doctor to perform abortions.
Williams, who is a nurse practitioner, and Ho testified that they weren't aware of any private physicians in Arkansas who perform abortions. Both women also said that in years of performing abortions, they have never referred a patient to an emergency room because it has never been necessary.
Metro on 06/28/2018