North Dakota Leads Race To The Bottom For Women's Health

North Dakota's only abortion clinic is in danger of being shut down because its patient safety record is too good.

In a race for bragging rights to be the first state in the nation to end abortion services, North Dakota's Governor Jack Dalrymple signed three extreme abortion restrictions this week, less than 24 hours after they landed on his desk. One of them is likely to close the state's only abortion provider, the Red River Women's Clinic. These are the bills:

  • HB 1305: Banning abortions for reasons of sex-selection or genetic anomalies.
  • HB 1456: Banning abortions from the point at which a heartbeat can be detected.
  • SB 2305: Requiring abortion providers to have hospital admitting privileges.

The first two are unlikely to have much effect beyond wasting North Dakota taxpayers' money on lawsuits defending them. Neither is likely to pass constitutional muster, though they contribute to the constant re-litigation of women's basic rights and grab headlines away from the restrictions that most effectively eliminate abortion access.

The last bill, SB 2305, though it sounds the most innocuous, is a Targeted Regulation of Abortion Providers (TRAP) bill, designed intentionally to close the state's last clinic. Though proposed as a patient safety measure, Red River is likely to fall short because they have an excellent safety record and local hospitals require doctors to meet a 10 patient per year referral minimum to gain admitting privileges.

“I’ve had one time that I’ve had to admit a patient in the last ten years,” Red River's director, Tammi Kromenaker explained. "I would never employ a doctor who had to admit ten patients a year. That would mean they were a terrible doctor.”

Again, the Red River Women's Clinic is likely to be shut down because it's too safe a medical facility to get hospital admitting privileges.

SB 2305 is not flashy. It's not pushing back the Roe v. Wade threshold. It's not redefining citizenship to include fertilized eggs or treating miscarriages as a criminal offense.

Yet if SB 2305 holds, it will end abortion care in North Dakota under the flag of women's safety. Nearly all of the TRAP laws proposed across multiple states are described as safety regulations, in spite of the fact that abortion, especially first trimester abortion, is safer than giving birth. Other low-profile, but highly effective, abortion restrictions include mandatory waiting periods and counseling sessions. Bills that force women to wait, like restrictions intended to close clinics, all have the effect of not only making abortion more costly and time-consuming, but less safe. When women have to travel or take more days off work, this tends to push abortion later in a pregnancy, even though procedural risks gradually increase over time.

Nor is it a coincidence how many of these bills sound the same or have the same rationale. Many of them are taken from blueprint legislation written by an anti-abortion legislative mill, Americans United for Life, a group making concerted national efforts to both bring court challenges to abortion rights and make the procedure effectively impossible to obtain for millions of women.

Once again, anti-abortion activists and legislators have succeeded best not through their jaw-dropping proposals to declare a fertilized egg a person, but by sliding boring technicalities into bills whose details don't make for great headlines. They've gotten really good at this game.

Longtime blogger Natasha Chart is the campaign director at RH Reality Check.

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