Abortion under siege in Ohio

OBTAINING A safe and legal abortion may soon become much more difficult for women in northwestern Ohio. Pressure from the misnamed anti-choice group Ohio Right to Life (sic) has resulted in the University of Toledo Medical Center (UTMC) terminating transfer agreements with the region's only two abortion clinics in a move that puts the future of these clinics--and the women who depend on them--at risk.

Under state law, most abortion clinics qualify as an "ambulatory surgical facility"--meaning that in order to legally function they must have a transfer agreement with a full-service medical facility to provide care should complications arise that cannot be treated on-site. Although any hospital that seeks to keep its nonprofit status must accept all patients in need of emergency care, without a transfer agreement in place, these clinics may have to close their doors.

In 2012, the Ohio Department of Health issued a $25,000 fine against Capital Care Network, formerly known as the Toledo Women's Center, and threatened to revoke its license for failing to have such an agreement. In August, Capital Care signed a transfer agreement with UTMC, but the trouble was only beginning.

In late March, Ohio Right to Life went on the offensive. In a press release, executive director Rev. John Coats said:

The only reason Capital Care exists is because of the publicly funded University of Toledo. Without this transfer agreement, this abortion clinic could not legally operate in Ohio. This violates the conscience rights of Ohio taxpayers as well as pro-life faculty, staff and students. Ohio law clearly prohibits state tax dollars from paying for abortion, and it is against the law for publicly funded hospitals to perform non-therapeutic abortions. Yet the University of Toledo circumvented our pro-life laws and the spirit of our public policy by entering into this transfer agreement.

IN REALITY, it is Ohio Right to Life that is seeking to circumvent the law. Abortion is legal in the U.S., but anti-choice groups and politicians are finding their way around that by imposing new legislation designed to make abortion too difficult, costly or traumatizing to be a viable option.

In North Dakota and Mississippi, regulations requiring that doctors who perform abortions must have admitting privileges to an area hospital can effectively shut down the one remaining clinic each state still has. No area hospitals are willing to grant such privileges to abortion doctors, likely due to the intense pressure from highly organized anti-choice groups.

North Dakota will vote on the so-called "Personhood Amendment" in 2014, which seeks to have the state constitution altered to define life as beginning at conception, outlawing all abortion regardless of circumstances--including rape, incest or medical necessity--and even making some forms of birth control illegal.

The Guttmacher Institute recently released an overview of laws curtailing abortion rights at a state level, and the situation for millions of women is grim.

Twenty-six states require a specified waiting period, typically 24 hours, between receiving counseling and having the actual procedure performed. Waiting periods, like many other restrictions on reproductive health care, disproportionately affect women of color and poor and working-class women, who often cannot afford to miss work, find childcare, and pay for hotel, travel, and fees.

There are 17 states that mandate some form of counseling before an abortion, such as the alleged link between abortion and breast cancer, the ability of a fetus to feel pain or long-term mental health repercussions for women. In 46 states, individual health care providers can refuse to participate in an abortion.

Examining the assault on reproductive rights on a national scale, the strategy of anti-abortion groups becomes clear. According to an NBC News/Wall Street Journal poll, 70 percent of Americans think that Roe v. Wade should not be overturned. Anti-choice groups feel they cannot win the war yet, so their focus is on the individual battles--intimidating state legislators, hospitals and universities so that while abortion is technically still legal, it is also practically impossible.

UTMC DOES not now provide--nor has it ever provided--abortion services. Having an agreement to treat patients who suffer from complications during medical procedures is not the same as performing those procedures.

Despite this rather obvious fact, UTMC caved to right-wing pressure almost immediately and announced that it will not renew its transfer agreement with Capital Care Network, which is set to expire July 31, and has also terminated negotiations with Center for Choice, another area abortion clinic. The letters notifying both clinics of the termination had no explanation for the decision from University of Toledo President Lloyd Jacobs.

If the anti-choice lobby has its way, this could become state law. In a press conference with Ohio Right to Life on the UTMC campus, state Rep. Lynn Wachtmann spoke about drafting more explicit legislation. "I will be introducing legislation as soon as I can craft it to make sure that under Ohio law these kinds of agreements with public entities such as the University of Toledo are indeed illegal," Wachtmann said.

The group is claiming that a medical transfer agreement with a publicly funded hospital is already a violation of the law, while lobbying to make it an actual feature of the law. While this type of subterfuge is nothing new for the anti-choice lobby, it is increasingly becoming more dangerous for women seeking reproductive health care.

Anita Rios, president of the Toledo chapter of the National Organization for Women, spoke frankly about her fears for the health and safety of women in the region should abortion services become unavailable. "When I had my first abortion, it was before Roe v. Wade. At the time, there were no clinics in Ohio, and I didn't know what to do," Rios explained. "My parents had a home with a low roof. I thought maybe if I could jump from that roof, it wouldn't be enough to kill me, but it would hurt me, and hopefully end that pregnancy."

Luckily for Rios, someone helped her locate a clinic in Ann Arbor, Mich., about 45 minutes away, provided her with transportation and paid for the procedure. She continued:

I was going to do the abortion myself. I wondered what I would have to do to have a miscarriage. I raise money for women to get abortions because I've been in those shoes, and somebody stepped up and helped me. They will not ever put an end to abortion. A woman who has an unwanted pregnancy will take action. My biggest fear is that women will hurt themselves.

Capital Care Network and Center for Choice are the only abortion providers in Toledo. If these clinics cannot secure new transfer agreements and soon, they will close. As of 2008, 91 percent of Ohio counties had no abortion provider, and 55 percent of all women in Ohio live in these counties.

Clinics in Toledo serve patients from nearby rural communities like Defiance and Napoleon, as well as women from as far away as Dayton and Fort Wayne, Ind. While there are clinics that handle first-trimester abortion in cities like Akron and Lima, second-trimester abortions are limited to a few select locations in Toledo, Cleveland, Cincinnati and Columbus.

Lucas County, where Toledo is located, has one of the worst rates of poverty in the entire state, with almost 20 percent of the population living below the poverty line. The closing of the city's only abortion clinics will devastate women seeking reproductive health care in the region. As Anita Rios explained:

Many women in Toledo take the bus to their clinic. I'd estimate around 50 percent of women seeking abortions qualify for aid from the National Abortion Fund, so we have a situation where women who are on the margins of being able to provide food for themselves and their families will also have to face the tremendous hardship of finding abortion services, paying for two separate trips [due to Ohio's mandated 24-hour waiting period], and all the expense that comes with it."

Within 12 hours of the announcement by UTMC, activists in Toledo were already meeting and emailing to coordinate a response and defend reproductive rights in our community. The stakes are high--abortion rights are being threatened not only within our city, but around the country.

As we're reminded every election cycle, "As Ohio goes, so goes the nation." This is one policy that women across the nation cannot afford. We will fight for safe, free and legal abortion on demand and without apology. Anything less puts the lives of women at risk.