I am writing as a licensed architect, a member of the American Institute of Architects and a tenured Associate Professor at Syracuse University’s School of Architecture. One of my areas of expertise focuses on the impact of legislation on abortion clinics and has been published in my book, Contested Spaces: Abortion Clinics, Women’s Shelters and Hospitals (2013).

I am supportive of the Board’s recent vote to amend the design and construction requirements directly targeting abortion clinics. These design and construction codes were originally created to protect the life and safety of those who occupy buildings, including all building scales and all building types.  Design and construction codes are meant to ensure such issues as egress requirements, occupancy loads, wall construction to prevent the spread of fire, minimum room sizes and pertinent concerns for the welfare of building occupants to name just a few.

For many years, legislatures, health departments and building code departments across this country have been substantially changing design and construction requirements explicitly for abortion clinics. Most of these changes do not, in any way, improve the life and safety standards for the people using these facilities. These new requirements are not medically necessary or appropriate for the healthcare and reproductive services that abortion clinics provide. There are other medical facilities that perform far more invasive procedures, even requiring sedation, that are not held to the same level of building code requirements. Several that come to mind include dental and plastic surgery facilities, birthing centers, and places performing colonoscopies. I would like to specifically address the two code items that are currently under re-consideration with your department.

Physical space requirements

Abortion services are non-invasive procedures typically performed in office-based facilities and have been done so for decades. There has never been medical need for a surgical facility for first-trimester abortion care. The standards for care do not meet ambulatory requirements or a hospital-like setting for such procedures. Design and construction changes such as the enlargement of hallways and door widths, the addition of public bathrooms and drinking fountains, the addition of large janitorial closets, the construction of advanced ventilation systems and the increase in parking space requirements do not address the life or safety concerns of a clinic – precisely why building codes are written and followed. These changes would require, in many cases, a moderate to major renovation of a clinic that would not improve the healthcare being provided to their patients.

Regulation Mandate Compliance with Every Portion of the Hospital Code

As was discussed above, abortion procedures, whether surgical or medical, do not require hospital-like settings. Abortion facilities do not medically require the same types of space sizes, additional storage and janitorial requirements, parking spaces, public amenities, fire ratings or ventilation needs. It is absolutely unnecessary to require facilities providing abortion to adhere to the same design and construction code requirements as hospitals. The life and safety concerns of an abortion clinic are vastly different from those of a hospital where a hospital provides a wide array of far more complicated scopes of care. Building codes reflect this through the different types of codes for different types of building uses. From a design and construction code perspective, abortion clinic spatial uses are not the same nor should be equated to hospital code requirements, or regulated similarly to the surgical requirements hospitals must adhere to.

The design and construction requirements for abortion clinics should be the same requirements used for medical offices. These cover the life and safety standards appropriate for the level of care being provided.  I hope my letter is helpful in the deliberations for the upcoming NOIRA stage amended regulation changes the Board of Health will be undergoing. If I can be of further assistance, please do not hesitate to contact me.

Most respectfully,

Lori A. Brown