One of the issues still to be decided by the North Carolina Legislature before it adjourns is whether to approve new rules that Republicans say would make abortion safer.
Democrats say abortions in the state are already very safe, and that the new provisions would lead to clinics closing.
Senate Bill 353 would give the Department of Health and Human Services the authority to come up with rules to regulate clinics providing abortions. An earlier measure passed in the Senate would require clinics to have the same standards as ambulatory surgery centers. That would have shut down all but one in the state.
The debate over the new rules has led to weeks of protests and arrests, and national media attention.
One man who's been caught up in it all is Dr. John Baker. His clinic, the Baker Clinic for Women in Durham, used to provide abortions. It was shut down earlier this month by the North Carolina Department of Health and Human Services, over the way it handled a routine blood test. Baker said he plans to reopen as soon as the state will allow him to, and that he's already fixed the problem.
The Baker Clinic’s closing became one more bit of evidence for some North Carolina legislators that more guidelines are needed to ensure safe abortions.
“Well, in just the past few months we’ve had two abortion clinics shut down in North Carolina by the Department of Health and Human Services," said State Senator Warren Daniel. He's one of the sponsors of some of the new rules. "One a couple weeks ago was in Durham. According to the department these clinics presented an imminent danger to the health safety and welfare of their patients.”
Dr. Baker disagrees with Daniel, and says the rules that shut down his clinic down aren’t specific to abortion providers. They’re rules any doctor’s office doing blood tests has to follow.
“Well, It has nothing to do with the current rules, nor does it have anything to do with the current legislation." said Baker. "At all. Period. Nothing.”
Baker says the fact that his clinic was shut down under current guidelines means no new rules are needed.
These two men are talking about the same event. The same violation is in question. But they have formed very different conclusions about the safety of abortions in North Carolina.
Who's right depends on who you ask.
“I know that there are problems." says Jacqueline Bonk, who's pushed hard for the new guidelines. "Because I’ve heard about them. I've heard people tell me face to face what their specific problems are. And I believe them.”
Bonk is the director of the Catholic Diocese of Raleigh's Pro-Life Office, and she says in her work, she’s seen and talked to many women who experienced unsafe abortions and dealt with complications like infection, bleeding, and infertility.
But more than twenty years have passed since the last reported abortion-related death in North Carolina. And Bonk couldn't point to specific examples of severe complications.
She says there's a reason for that: women's shame about their abortions leads to under-reporting.
“I can’t give you those statistics because people don’t report them, and we don’t have them in charts," Bonk said. "But I know they occur."
When asked what provisions of the new rules will increase safety, and how, Bonk could only point to one provision: the one requiring a doctor be present for an entire abortion procedure.
When asked if there are any examples of complications arising because a doctor left mid-procedure, Bonk said, "I’ve never heard of a specific story about that.”
When State Senator Daniel was asked the same question, he couldn’t point to an example either.
Dr. David Grimes did have an answer to the question. He’s a fierce opponent of these new rules, and an OB-GYN who’s been speaking on behalf of the American Congress of Obstetricians and Gynecologists on this issue. He used to head up abortion surveillance for the Centers For Disease Control. He says this new rule requiring doctors be present for the entire procedure is unnecessary.
“Saying that there must be a physician present in the facility when a woman swallows a pill? Well if we really believe that women are that incompetent, then we probably should have a woman come to a clinic everyday to take her birth control pill," said Grimes. "Because we can’t trust women. It’s just nonsense. It suggests that doctor’s are going out to play golf in the middle of an operation. That's not the case.”
Grimes says abortions are very, very safe.
“The risk of death from legal abortion across North Carolina, and indeed across the US is a little less than one in 100,000 events or procedures," he said. "In contrast the risk of death from an injection of penicillin is 2 per 100,000. In the United States today, having an abortion is safer than getting an injection of penicillin.”
The American Academy of Pediatrics, American Academy of Family Physicians, American Congress of Obstetricians and Gynecologists, the American College of Surgeons and the American college of Physicians have all spoken out against rules like those now being considered in North Carolina.
But for State Senator Daniel it’s not about what people see now; he’s worried about what could happen in the future:
“It's sort of the same thing as the school shooting in Connecticut," said Daniel. "You try to make policy changes before that happens in your state, and that’s what we’re trying to do here.”
The North Carolina Department of Health and Human Services refused an interview request, but in an email, Ricky Diaz, a spokesman for the department, did answer some questions. Diaz wrote that the biggest impediment his department faces in ensuring safe abortions is staffing. There are only 10 full time HHS staff surveying the hundreds of facilities that provide abortions across the state. Diaz says that means the medical components of abortion clinics are only inspected every three to five years.
His email also pointed out that abortion guidelines in North Carolina haven’t been updated since 1995.
But any update may have to wait. The House and Senate passed two different versions of new rules. And with legislative leaders vowing to adjourn this week, time is running out for a compromise.