At issue are two provisions–that abortion clinics meet the same building standards as ambulatory surgical centers (ASCs) and that abortionists have admitting privileges at a nearby hospital for situations of medical emergencies.
Outpatient Surgery Standards
Ambulatory Surgery Center (ASC) requirements are applied to facilities that perform invasive outpatient surgeries. Ambulatory Surgery Center standards ensure that these facilities have a sterile environment and proper sanitation; an adequate number of trained and qualified staffers; and the ability to address medical emergencies, emergency access, and basic fire prevention and safety.
Before passing H.B. 2, legislators received testimony from a number of medical professionals on the necessity of applying these commonsense standards to abortion facilities. Many of those testimonies are detailed in an amicus brief submitted in Whole Woman’s Health on behalf of a bipartisan, bicameral group of 121 Texas legislators.
The Association of American Physicians and Surgeons, whose membership includes thousands of physicians working in a variety of medical specialties, also wrote an amicus brief in Whole Woman’s Health, affirming that “Texas is on solid medical ground.” They write:
[It is] beyond dispute that it is reasonable to require outpatient abortion facilities to abide by ASC regulations. After all, it is common ground that abortion in most cases involves a surgical procedure, that abortions occur in large numbers in outpatient settings, and that abortion (including medication abortion) presents medical risks that ASC regulations seek to prevent, mitigate, or remedy.
The Association of American Physicians and Surgeons continues:
ASC regulations target precisely the kinds of potential complications involved in outpatient abortion. … ASC regulations require more than just a sterile surgical environment. They broadly address any number of additional safety issues—such as infection control, patient supervision, anesthesia standards, and emergency protocols—that are directly relevant to the well-being of abortion patients.
Since an estimated 200 women a year will be hospitalized in Texas following an abortion, it is also reasonable for policymakers to require physicians performing abortions to have admitting privileges at nearby hospitals.
Hospital admitting privileges generally means that a physician has the qualifications and good standing in the medical community to admit and provide care for a patient at that hospital. Experts testifying in favor of H.B. 2 explained that admitting privileges can help ensure greater continuity of care in the event of an emergency, increase communication between the abortion doctor and hospital staff, and act as a check on the general quality of doctors practicing medicine.
The Association of American Physicians and Surgeons brief continues:
[C]redentialing and privileging enhance both the safety of patients and the integrity of the medical profession. The process ensures that ‘[p]ractitioners have privileges that correspond to the care, treatment and services needed by individual patients.’ It maximizes a physician’s ability to communicate with other physicians and coordinate all necessary care for the benefit of the patient. At the same time, the process allows ‘an overview of each applicant’s licensure, education, training, current competence, and physical ability to discharge patient care responsibilities.’
Again, the Association of American Physicians and Surgeons summarizes: “Put simply, an outpatient surgical provider with the ability to admit his patients to a hospital is more likely to be a physician with the experience, integrity and ability to provide his patients with the care they need, especially in the event of unforeseen emergencies.”