February 11, 2015

Susan Horn

Policy Analyst, Licensure and Certification

Department of Health

9960 Mayland Drive, Suite 401

Richmond, VA 23233

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

Dear Ms. Horn,

Thank you for the opportunity to submit written comments in response to the State Board of Health’s (“the Board”) rulemaking process to amend the regulations for the licensure of abortion facilities.[1]

The National Abortion Federation (NAF) is the professional association of abortion providers. Our mission is to ensure safe, legal, and accessible abortion care, which promotes health and justice for women. Our member facilities care for half of the women who choose abortion in the United States and Canada each year, including women in Virginia.

NAF is the leading organization offering accredited continuing medical education to health care professionals in all aspects of abortion care. NAF has also developed the most comprehensive medical textbook on abortion, Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care, and created a range of multimedia educational materials for residency programs, medical educators, and practicing clinicians. In addition, NAF member facilities, including our members in Virginia, adhere to our evidence-based Clinical Policy Guidelines (CPGs), which set the standards for quality abortion care.[2] NAF’s CPGs establish clinical guidelines, which are developed by consensus of medical professionals, based on rigorous review of the relevant medical literature and known patient outcomes.

Abortion care is one of the safest and most commonly provided medical procedures in the United States. Serious complications are extremely rare.[3] Credit for the outstanding safety record of abortion care is attributed to the specialized care given and received in outpatient facilities, which currently provide 95% of the abortion care in the United States.[4] Even prior to the adoption of the most recent regulations for the licensure of Virginia abortion facilities, these facilities were subject to extensive state regulations, above and beyond those that applied to other outpatient facilities offering other medical procedures with a comparable safety record.

Given the safety of abortion care, NAF believes that the regulations, as currently written, are burdensome and medically-unnecessary. We commend the Department of Health (“the Department”) in its determination that it was necessary to amend the regulations during its periodic review, and the Board in its approval of a Notice of Intended Regulatory Action (NOIRA) that officially began the rulemaking process.

We hope that the Department and the Board will use this opportunity to promulgate amendments that are medically-appropriate and evidence-based. We would encourage the Department and the Board to thoroughly review the suggested amendments submitted by the Virginia Coalition to Protect Women’s Health, which include the amendments that NAF and Virginia NAF members believe are most appropriate.

We are happy to serve as a resource for you. Please contact us with any questions.

Sincerely,

Lisa M. Brown

General Counsel & Senior Policy Director

[1] 12 Va. Admin. Code §§ 5-412 et seq.

[2] National Abortion Federation, Clinical Policy Guidelines (2014), available at http://prochoice.org/wp-content/uploads/2014NAFCPGs.pdf.

[3] Facts on Induced Abortion in the United States, Guttmacher Institute, http://www.guttmacher.org/pubs/fb_induced_abortion.html (last updated Feb. 2014).

[4] Rachel K. Jones and Kathryn Kooistra, Guttmacher Institute, Abortion Incidence and Access to Services in the United States, 2008, 43 Perspectives on Sexual and Reproductive Health, no. 1, at 42 (March 2011).