The fight over abortion has erupted once again — this time during efforts to contain COVID-19.
Last week, Ohio Attorney General David Yost sent letters to three Ohio abortion clinics — and a urology clinic — requesting that they follow a state directive to cease performing “non-essential” surgeries because of the COVID-19 pandemic, according to the Columbus Dispatch; Yost sent the letters after the state health department received complaints alleging that the directive was not being followed. Essential surgeries are defined as those cases in which there is a threat to the patient’s life if a particular surgery or procedure is not performed; a threat of permanent dysfunction of an extremity or organ system; a risk of metastasis or progression of staging; or a risk of rapidly worsening to severe symptoms.
The state health department said it is investigating the complaints, although it was unclear whether that would be done collectively or on a case-by-case basis, and whether the department will consider all abortions to be non-essential.
Meanwhile, in Texas, Gov. Greg Abbott (R) issued an order on Sunday barring non-essential surgeries in his state; that order includes “any type of abortion that is not medically necessary to preserve the life or health of the mother,” Texas Attorney General Ken Paxton said in a statement on Monday, adding that failure to comply could mean penalties of up to $1,000 or 180 days of jail time. “Those who violate the governor’s order will be met with the full force of the law.”
Abortion clinics in Ohio said they planned to remain open. “Planned Parenthood’s top priority is ensuring that every person can continue accessing essential health care, including abortion,” Iris Harvey and Kersha Deibel, president and CEO of Planned Parenthood of Greater Ohio and Planned Parenthood Southwest Ohio Region, respectively, said in a statement. “Abortion is an essential, time-sensitive medical procedure.” Under the state’s order, “Planned Parenthood can still continue providing essential procedures, including surgical abortion, and our health centers continue to offer other healthcare services that our patients depend on,” they said.
Three Planned Parenthood clinics in Texas issued a more carefully worded statement. “The priority of all Planned Parenthood health centers in Texas is the health and safety of our patients and staff, and ensuring that Texans can access essential health care, including abortion,” wrote Ken Lambrecht, Melaney Linton, and Jeffrey Hons, who each run one of the clinics. “As recognized by medical experts, abortion is a time-sensitive medical procedure. A delay of 30 days, or even less, can make abortion completely inaccessible.” The clinics said they are “carefully reviewing” Abbott’s order and are “conserving needed health care resources and committed to protecting the health and safety of our patients and staff.”
Several pro-life medical organizations representing 30,000 physicians, including the American Association of Pro-Life Obstetricians & Gynecologists, the Christian Medical & Dental Associations, the American College of Pediatricians, the Catholic Medical Association, and the Association of American Physicians & Surgeons, spoke up in support of efforts to bar abortion procedures. “Elective abortion is …ELECTIVE,” they said in a statement. “That means by definition there is no medical reason to perform the abortion.”
“If a mother’s life is endangered by any pregnancy at any time, ob.gyns [sic] will be available at hospitals to separate the mother and her fetus at any gestational age, in a place where the mother’s immediate life threatening medical needs can be met, and where the needs of a human being taken from the womb can also be met,” the groups said. They added, however, that “there will rarely be cases where the fetus must be separated from his/her mother prior to the ability of the fetus to survive. Regardless of the ability of the fetus to survive the separation, ob.gyns will separate the mother and her fetus in order to save her life.”
But the American College of Obstetricians and Gynecologists, along with the American Society for Reproductive Medicine, the Society for Maternal-Fetal Medicine, and several other reproductive health groups disagreed. “To the extent that hospital systems or ambulatory surgical facilities are categorizing procedures that can be delayed during the COVID-19 pandemic, abortion should not be categorized as such a procedure,” the groups said in a statement. “Abortion is an essential component of comprehensive health care. It is also a time-sensitive service for which a delay of several weeks, or in some cases days, may increase the risks or potentially make it completely inaccessible. The consequences of being unable to obtain an abortion profoundly impact a person’s life, health, and well-being.”
ACOG president Ted Anderson, MD, PhD, said in a separate statement to MedPage Today, “Medically unnecessary regulations that are barriers to patient care that many states have put in place over the past decade should be rescinded or relaxed, especially during this time. Forcing a patient to continue pregnancy can pose threats to the safety and health of the patient.”
In contrast to Ohio and Texas, a few other states do regard abortion as an essential procedure, according to U.S. News & World Report. In Michigan, pro-choice advocates say Gov. Gretchen Whitmer’s (D) executive order temporarily halting elective procedures doesn’t include abortions, and the same holds true in North Carolina under Gov. Roy Cooper (D), a state health department spokeswoman said.