State health officials are implementing new rules that will limit the use of an abortion drug in Arizona and could actually make the procedure more expensive.
Formally published Monday — the precursor to enforcement — the rules are what's left of a 2012 law which also sought to ban abortions at 20 weeks. While that part was struck down by federal courts, the rest remain on the books and, with the rules, can be put into effect.
Monday's move comes as abortion foes are proposing yet another regulation, this one allowing the state Department of Health Services to make unannounced inspections of abortion clinics and add criminal penalties to existing laws for helping minors to get an abortion without parental consent.
Rep. Debbie Lesko, R-Peoria, said Monday such unannounced inspections are necessary to protect the health of women seeking to terminate pregnancies. But Jodi Liggett, spokeswoman for Planned Parenthood Arizona, said her organization fears what's in HB 2284 will not only mean unnecessary interference in abortion clinic operations but could endanger the privacy of women who don't want their identities revealed.
It could be the rules, which will take effect April 1, that would have the most immediate implications.
Among the new requirements:
- doctors who perform abortions must have admitting privileges at a hospital within 30 miles;
- all abortion clinics must have ultrasound equipment;
- nurses must be present on site for monitoring and care after abortion if a doctor is not available;
- clinics must report any time a patient be transported by ambulance.
The most far-reaching, though, could be the rules on the use of mifepristone, the abortion-inducing drug better known as RU-486.
That 2012 law now being implemented says that any medication used to induce an abortion must be administered “in compliance with the protocol authorized by the U.S. Food and Drug Administration and that is outlined in the final printing labeling instructions for that medication, drug or substance.”
In the case of RU-486, that means only through the seventh week of pregnancy, but Planned Parenthood advertises that it uses it into the ninth week.
Taking that out of the arsenal means a woman at that stage of pregnancy would have to undergo a more complicated and expensive surgical procedure.
Cathi Herrod, president of the anti-abortion Center for Arizona Policy, said the restriction is justified.
“The Food and Drug Administration underwent a lengthy evaluation process before they approved the drug for use as an abortion medication,” she said. “Women deserve to have the highest standard of safety used when they're taking abortion medication.”
The issue, however, is even more complex than that.
Cynde Cerf, spokeswoman for Planned Parenthood Arizona, said those FDA protocols actually call for a higher dosage of RU-486 than is now being used. That means not only giving a higher dosage to women than some believe is medically necessary — by a factor of three — but also increases the cost of terminating a pregnancy.
Herrod, who was instrumental in crafting the 2012 legislation and this requirement, said the state — and doctors — should not second-guess the FDA.
“They did an extensive analysis,” she said. “If there was a need to change the FDA protocol, then that's up to the FDA to do, not up to an individual abortion provider who has a vested interest in providing abortion medication to women.”
Herrod, who is on record as wanting to outlaw all abortions, said the restriction is not a back-door attempt to make the procedure more expensive and therefore out of reach of more women. She acknowledged, though, there is nothing illegal — at least in federal law — about doctors using a drug for a purpose or at a dosage that is different than what a manufacturer recommends. In fact, even Arizona law does not preclude such “off-label” use for any other drug.
Lesko said her new clinic inspection measure is designed to plug a loophole in the law.
“All other health care institutions, hospitals, clinics, if there's a complaint filed, or even if there's not a complaint filed, they can do an unannounced inspection,” she said. “It is only the abortion clinics that are different.”
If the measure is approved, though, a lawsuit is virtually certain.
A federal judge blocked a similar measure approved by lawmakers in 2004. Liggett said that is because the judge concluded abortion clinics are different than other health facilities because of the “enhanced level of privacy” sought by individuals who terminate a pregnancy.
Herrod, however, said the 2004 law was blocked because Arizona did not have a comprehensive scheme for regulating abortion clinics at the time. She said all the rules that have been adopted since then now give the state a basis for unannounced inspections.