Mr. Eric Bodin

Director, Virginia Department of Health

Office of Licensure and Certification

9960 Mayland Drive, Suite 401

Henrico, VA 23233

July 31, 2014

Re: Review of final regulations (12 Va. Admin. Code §§ 5-412 et seq.)

Dear Mr. Bodin:

Physicians for Reproductive Health is a doctor-led national advocacy organization that uses evidence-based medicine to promote sound reproductive health policies. We work to make quality reproductive health services an integral part of medicine. We support access to comprehensive reproductive health care services for all women. We believe that politics and ideology should not enter into the doctor-patient relationship and we oppose medically unjustified regulations that serve only to hinder access to safe and legal abortion.

On behalf of Physicians for Reproductive Health, I write to you today in response to the State Department of Health’s (Department) request for public comment regarding whether 12 Va. Admin. Code §§ 5-412 et seq. (“the final adopted regulations”) should be repealed, amended, or retained in their current form. For reasons set forth below, I urge you to repeal the regulations, as they are not based on medical or scientific evidence and threaten the health and safety of women in Virginia seeking safe, legal abortion care.

As physicians, patient safety is our top priority. Abortion is a safe medical procedure with an outstanding safety record. Approximately 90 percent of all abortions in this country occur early in pregnancy in outpatient health centers.[1]  Both medication and surgical abortion are very safe procedures.[2]  Risk of death from either medication or surgical abortion is over 20 times less than for childbirth.[3] Rates of infection and serious complications following a medication or surgical abortion are also extremely low.[4] Further, of women having abortions before 13 weeks, 97% report no complications; 2.5% have minor complications that can be handled at the medical office or clinic; and less than 0.5% have more serious complications that require surgical intervention and/or hospitalization.[5]

Regulations governing abortion practice should be rooted in evidence-based medicine, serve legitimate health interests, and not impede access to abortion care.  We are deeply troubled that the final proposed regulations create unreasonable obstacles for health care providers trying to provide safe abortion care. When abortion becomes less accessible, it becomes less safe. Women may delay their care as they locate a provider, travel greater distances, or even seek the services of an unlicensed provider.[6]

In 2008, 85% of Virginia counties had no abortion provider and 54% of women in Virginia lived in those counties.[7]  While on paper Virginian women have the right to safe, legal abortion, in reality there are few facilities that provide this essential care. Virginia women should not bear the heavy burden of regulations that have no medical benefit or basis. We ask that you repeal these regulations and initiate a process that ensures that any future regulations will improve patient safety and not hinder access to abortion. Thank you for the opportunity to submit these comments.

Sincerely,

Nancy L. Stanwood, MD, MPH

Board Chair, Physicians for Reproductive Health