Women are consistently reminded that a woman's right to an abortion in the United States is something that is perpetually under fire. Whether it's the March for Life or the hundreds of bills that threaten the right to choose, for many women, the attacks can feel constant. And even though though a woman's right to an abortion was guaranteed under Roe v. Wade exactly 45 years ago, Targeted Regulation of Abortion Providers (TRAP) laws prevent women's abortion access across the entire country today.
According to the Center for Reproductive Rights, TRAP laws are those which "... single out the medical practices of doctors who provide abortions and impose on them requirements that are different and more burdensome than those imposed on other medical practices." This increases the likelihood that a clinic will close and diminishes the number of doctors who are able to serve as abortion providers. TRAP laws are designed to make abortion nearly impossible to access, even though it is a constitutionally protected right.
As the Guttmacher Institute reported earlier this year, there are now TRAP laws in 27 states. Many of these laws require abortion facilities to have medically unnecessary admitting privileges at local hospitals and/or require them to meet the licensing requirements for ambulatory surgical centers. A variety of states even go so far as to specify the sizes of the procedure rooms and hallways in the facilities in which abortions can take place.
The following are detailed examples from several states that illustrate these types of TRAP law restrictions, epitomizing why these laws have made abortion access so challenging for so many women in America.
Louisiana's Size & Segregation Rules
As NARAL ProChoice America reported, Louisiana has imposed procedure room size requirements as part of its TRAP laws:
Without reference to medical necessity, outpatient abortion facilities are allowed to provide surgical abortion services only in segregated procedure rooms removed from general traffic that are a minimum of 120 square feet, exclusive of vestibule, toilets, or closets.
Louisiana's Doctor Restriction
In Louisiana, abortion providers must "be board certified or eligible in obstetrics and gynecology," vastly limiting the pool of physicians who are able to perform the procedure.
Alabama's School Rule
According to NARAL ProChoice America, Alabama's TRAP requirement that abortion providers must be ambulatory surgical centers includes very specific mandates, including the requisite that the facility cannot be within 2,000 feet of a public school:
Each abortion provider shall be classified as 'ambulatory health care occupancy' – a type of ambulatory surgical center. This classification includes certain physical-plant requirements, such as submission of architectural drawings and plans, as well as sprinkler system plans and other materials necessary to show compliance ... Additionally, an abortion clinic may not get a new license or renew an existing license if the facility is within 2,000 feet of a K-8 public school.
Ohio's Transfer Agreements
Ohio TRAP laws mandate that abortion clinics must have transfer agreements with "local" hospitals. The law is stringent in that "local" requirement — the state is trying to force the only abortion provider in Toledo to close, because it deemed that its transfer agreement with the University of Michigan Health System (which is approximately 50 miles away) did not meet its requirements.
The clinic made the agreement with Michigan after the University of Toledo Medical Center declined to renew its transfer agreement with the abortion provider — a decision made because Ohio law prohibits state public hospitals from entering into transfer agreements with abortion providers.
Toledo's abortion provider is appealing the closure decision with Ohio's Supreme Court.
Indiana's Provider Classification
Indiana law specifies that any health care provider who offers abortion services to five or more women a year, including medication-only abortion, must be classified as an abortion clinic — a classification which then subjects it to further stringent TRAP law requirements.
Indiana's Neonatal Unit Guideline
In addition to requiring all abortion services to be performed in a hospital or ambulatory outpatient surgical center, Indiana law also mandates that abortion after 20 weeks are performed in "hospital[s] equipped with extensive neonatal units."
Texas' Human Trafficking Class
In Texas, abortion facilities have to adhere to "dozens of administrative and professional-qualification requirements" that are not required of other health care facilities.
A particularly egregious example includes the requirement that all abortion facility personnel, including volunteers, must "take a four-hour human-trafficking class," even though other health care facilities "where human-trafficking survivors are likely to present themselves" are not subject to this requirement.
North Carolina's Humidity Specifications
According to NARAL ProChoice America, North Carolina's TRAP laws set some absurdly stringent requirements for abortion clinics, including the following:
- A clinic must include at least 18 individual physical components, including its own laboratory and a 'nourishment station' for 'serving meals or in-between meal snacks' ...
- The air temperature must be maintained between 75 and 80 degrees in patient recovery rooms and between 70 and 76 degrees in procedure rooms with humidity between 50 and 60 percent, and the ventilation system must change air flow six time an hour for certain rooms in the facility and 10 times per hour for others ...
North Carolina's Ultrasound Images
In North Carolina, all abortion clinics are "subject to annual inspection by the state's Department of Health and Human Services" and the results of these inspections must be published online.
Moreover, physicians who provide abortion services to women after 16 weeks gestation are required to submit ultrasound images as well as other statistics to the Department of Health and Human Services.
North Carolina's Registered Nurse Requirement
In North Carolina, a "registered nurse with experience in "post-operative or post-partum care" must be on duty in an abortion clinic at all times, even if "nursing services are not being performed," or if "physicians and/or other medical personnel are present."
And North Carolina's Groundskeeping Guidelines
North Carolina's TRAP laws also set very specific requirements regarding grounds upkeep of abortion clinics and the temperature of patient rooms. According to NARAL Pro Choice America, the state's laws mandate that "'All outside areas, grounds and/or adjacent buildings shall be kept free of rubbish, grass, and weeds…;' garbage cans stored outside must be cleaned immediately after being emptied; and air temperature must be maintained at between 72 and 76 degrees in 'patient areas.'"
These are just a few of the many examples of TRAP laws designed to limit women's abortion access. TRAP laws are pervasive throughout the country and have profoundly affected American women's ability to access safe, quality, affordable, abortion care for years.
