Down to it's last abortion clinic and facing a legal battle with anti-choice Governor Matt Bevin on the federal level on Wednesday, Kentucky could potentially become the first state to have no licensed clinics performing abortions in the United States, NPR reports.
The final clinic is the EMW Women's Surgical Center located in downtown Louisville. They're currently at odds with a state law that calls for the clinic to work with local hospitals and ambulance service for patients in case of emergency, as NBC News reported. While EMW stated that they have had a longstanding relationship of that kind with a local hospital, they added that they were told by Bevin's administration earlier this year that those prior agreements weren't enough.
Representatives from the clinic called the move "blatantly unconstitutional" and are seeking an injunction to keep the clinic from being forced to close — and, if they fail, they predict what could dire circumstances for the women of Kentucky who are already struggling to have affordable, accessible healthcare.
"Kentucky women would be left without access to a critical and constitutionally protected medical procedure," EMW representatives told NBC News.
— ACLU of Kentucky (@ACLUofKY) July 22, 2017
Moves like this from the Kentucky Governor's office are what are frequently knowns as Targed Regulation of Abortion Providers or TRAP laws. Simply put, they are laws or restrictions that are put soley on doctors who provide abortions that aren't implemented for other sorts of procedures — including more invasive ones.
In 2014, the American Congress of Obstetricians and Gynecologists (ACOG) wrote that these state regulations create obstacles for underserved women and are frequently established "under the guise of promoting patient safety, single out abortion from other outpatient procedures and impose medically unnecessary requirements designed to reduce access to abortion."
ACOG also writes that abortion is an overwhelmingly safe procedure and that these regulations are often misleading about that fact:
"Although abortion is legal in the United States, it has become increasingly marginalized from mainstream medical care. It is often the only essential health care service not offered by a woman’s usual health care provider and within a woman’s usual health care system," according to ACOG. "Where abortion is legal, it is extremely safe. The risk of death associated with childbirth is approximately 14 times higher than that with abortion. In the United States, 88% of abortions occur within the first trimester, when abortion is safest. Serious complications from abortions at all gestational ages are rare."
EMW's attorney Donald L. Cox told NBC News that the state's moves are "absolutely just another attempt to ban abortion in Kentucky.”
— Andrew Villegas (@ReporterAndrew) July 29, 2017
Amanda Stamper, a spokesperson for Gov. Bevin, told the Associated Press that the Governor stood by the requirements, stating that "essentially all health care facilities in Kentucky are required to have such agreements, and it is telling that the abortion industry believes that it alone should be exempt."
Supporters of the clinic, however, are desperate to see it remain open. As the last remaining surgical center to provide the service in the state, women from across the state seeking abortions (a legal, constitutionally protected procedure) are required to drive to that single location (at times taking hours to get there.) And, as reproductive health research group the Guttmacher Institute notes, the state already has restrictions in place requiring people seeking abortion to wait 24-hours and receive state-mandated counseling before having their procedure (which can be particularly damning for low-income people and mothers who might need to take time off work or arrange for childcare or travel).
TL;DR: Even with this lone clinic in the state, people seeking abortions are already facing some serious barriers toward safe and affordable care that these latest requirements would only exacerbate.
Citing last year's Supreme Court decision in Whole Women's Health vs. Hellerstedt that ruled against states putting an undue burden on on abortion access, Dr. Ernest Marshall, one of EMW's founders, set forth two possibilities for the future of the procedure in his state: "Will we build on the momentum of last year's Supreme Court decision upholding abortion rights? Or will Kentucky be the harbinger of a future where the right to abortion only exists if you live in the right zip code?"