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Exclusive research provided to The 19th shows that almost all of the abortions in Utah were done in clinics, which will soon no longer be able to perform the procedure.
Last week, Utah Gov. Spencer Cox signed a law banning abortions from being provided in specialized clinics. Under the law, Utah will stop renewing or issuing licenses to abortion clinics starting May 2. As of January 2024, licenses will be outlawed in the state.
Abortion is still legal in Utah up to 18 weeks of pregnancy. Defenders of the law, House Bill 467 — which could go into effect as early as May 3 — say it is not a total ban on abortion because hospitals would still be able to perform them. But research shared exclusively with The 19th by the the Guttmacher Institute, a nonpartisan research and policy organization focused on reproductive and sexual health, shows that in 2020 — the most recent year for which there is available data — 99 percent of all abortions in Utah took place in clinics, with only 1 percent happening in hospitals.
Elizabeth Nash, principal policy associate for state issues at Guttmacher, told The 19th that this new legislation out of Utah is “the ultimate TRAP bill, the ultimate form of clinic regulation.” This new law continues the 50-year-long tradition, since Roe v. Wade became law of the land, in which anti-abortion lawmakers have introduced measures to regulate abortion clinics to the point of necessary closure, she said.
“This was never about any public health or medical reason — these laws were always designed to make it impossible to keep clinic doors open and this is the ultimate expression of that,” Nash said.
Saying hospitals are a viable alternative to clinics “is just not realistic,“ Nash said. “Typically, if an abortion is provided at a hospital it is usually because there is something really seriously wrong medically, either with the pregnant person’s health or with the developing fetus. There has to be a real medical reason to use a hospital for abortion because it is a hospital.”
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She stressed that a hospital setting by necessity requires a certain level of care and resources for any kind of procedure — something mismatched with what is needed for the typical abortion, which can be easily provided through telehealth or a provider’s office.
“You can’t just show up at a hospital and say, ‘I’m ready for this care now — when can you pencil me in?’ This isn’t how care is provided in hospitals,” Nash said.
Nash also explained that when it comes to Utah’s new law, the move didn’t occur in a vacuum. The state had passed a 2020 trigger ban against abortion, set to go into effect with the overturning of Roe v. Wade last June, but that law was quickly challenged and placed under injunction. As Utah’s appeal over the trigger ban continues to work its way through the court system, lawmakers who are opposed to abortion access in the state have sought an alternate means of creating an effective ban, this time focusing on clinics.
Karrie Galloway, the CEO and president of Planned Parenthood Association of Utah (PPAU), said when it comes to providers and patients both, “the key word is frustration.” PPAU currently has three clinics in the state that are licensed to provide abortion care; come May, barring any immediate legal action, that will no longer be the case.
“What they have done by moving all abortion to hospitals is create an unrealistic system of health care,” she said.
Galloway added that when the bill eliminating this licensing provision, and thus banning in-clinic care, was being debated on the floor of the legislature, Democrats attempted to argue for exceptions based on religious beliefs and for those with mental health conditions requiring medications that are incompatible with a developing fetus. Those proposals were struck down. The new law, Galloway said, “is not taking into consideration a pluralistic society that has health care needs … It is confusing and it is frustrating, and all of the possible pregnancies in Utah now need to be addressed with some kind of comprehensive health care plan.”
This latest news out of Utah is yet another iteration of the “year of experimentation with legislation on abortion” that Nash said has come in the wake of Roe’s overturn. “We are now seeing legislation introduced that is different from before and this is one example of that. I have never seen a state rollback and repeal their requirement for abortion in this way by limiting it only to hospitals.”
Nash said she anticipates legislatures in other states keeping a close eye on what happens next in Utah. This kind of law “gives them an out by saying, ‘Well, we’re not banning abortion, we’re just putting it in hospitals.’” She added that anti-abortion lawmakers often emphasize concern for patient safety as a reason for pressing for abortion to be taken out of clinics and moved solely to hospitals, despite a large body of research showing that it is a procedure that can be safely provided in a clinic setting or through telehealth.
Because of the abortion access landscape surrounding the state, people in Utah are about to find themselves in a situation very similar to that of those seeking abortion care in Texas because of the geographic isolation, Nash said.
“This is effectively an abortion ban, and people will have to leave the state to access abortion or access it online,” she said.
Nash describes the region in which Utah is situated as “pretty dire” when it comes to abortion access generally. The closest state with readily available abortion access will be either Colorado or New Mexico.
“You are looking at long journeys ahead if someone is going to leave the state, and those journeys come at a cost, both financial and emotional,” Nash said. “You have to pull together all of those funds to travel and have to take time away from your family and support network and you may not feel comfortable disclosing why you are taking time away. There is a heavy burden there and that is what people face when they have to leave their states for abortion care.”