RE: Rulemaking Process to Amend Regulations for the Licensure of Abortion Facilities

Physicians for Reproductive Health (Physicians) is a doctor-led national advocacy organization that uses evidence-based medicine to promote sound reproductive health policies. Our members include physicians of all specialties from across the country, including Virginia. Physicians unites the medical community and concerned supporters. Together, we work to improve access to comprehensive reproductive health care, including contraception and abortion, especially to meet the health care needs of economically disadvantaged patients. We write to express our support for Department of Health’s decision to amend the regulations governing abortion providers and urge the Department of Health and Board of Health to promulgate regulations grounded in evidence-based medicine.

When it is legal and accessible, abortion has an excellent safety record. Abortion is one of the safest medical procedures in the United States. The vast majority of abortions—88 percent—take place in the first trimester. During this period, the risk of major complications is very small, ranging from less than 0.05 to 0.2 percent.[1],[2] As a pregnancy advances, the medical risks with abortion increase gradually. Because risks do increase, it is crucial that women seeking abortion have prompt access, free of politically motivated restrictions.

These enviable safety statistics illustrate that there is no legitimate medical reason to single out abortion for more stringent regulations than those imposed on other procedures in outpatient medical settings. When the state regulates abortion, it is critical that it does so in a way that both ensures patient safety and preserves access. A state should never impose unjustified regulations in an attempt to prevent women from obtaining an abortion.

Without question, legal abortion in the United States has improved women’s health outcomes. From 1958-1967, prior to Roe v. Wade, at least 3,400 women died from abortion procedures, almost all of which were illegal.[3] For each death suffered from unsafe abortion, many other women had illegal abortions in circumstances that were degrading and led to dangerous complications. The number of deaths dropped to nearly zero after abortion was legalized, as the medical community had predicted. We have long known that legal, accessible abortion means safe abortion. Virginians do not want to see legal abortion disappear in the state through politically motivated attacks.

We are deeply concerned that the original regulations approved by the Department of Health are not based in medicine and do not advance the interests of patients. We worry that without amending these regulations to reflect sound reproductive health policy, their effect will be to discourage providers from offering abortion care in Virginia. In the past few years, the state of Virginia has already hindered women seeking abortion by mandating scripted information, imposing an unnecessary waiting period, and requiring the display of an ultrasound image. 

We know that people have complicated feelings when it comes to abortion, but we believe that we can all agree that women should have access to the health care that they need. When abortion is not accessible, it becomes less safe. We also know that women who have abortions come from all walks of life. Every woman is unique and every situation is different. No matter the circumstances, the Virginia physicians in our network are dedicated to providing the women and families of this state with quality and compassionate health care.

We call on the Department of Health and the Board of Health to enact regulations that are evidence-based and medically appropriate.

Submitted by:

Jennifer Blasdell

Senior Director, Public Policy

Physicians for Reproductive Health

[1] Weitz TA et al. Safety of aspiration abortion performed by nurse practitioners, certified nurse midwives, and physician assistants under a California legal waiver. American Journal of Public Health, 2013, 103(3):454–461.

[2] Upadhyay UD et al. Incidence of emergency department visits and complications after abortion. Obstetrics & Gynecology. Published online December 8, 2014; DOI: 10.1097/AOG.0000000000000603.

[3] Stanley Henshaw, Unintended pregnancy and abortion in the USA: Epidemiology and public health impact, Management of Unintended and Abnormal Pregnancy at 33 (2009).