Thank you for the opportunity to comment on this NOIRA. May I suggest that during your process you start anew instead of amending something that was defective since 2011. Start anew to recognize the un-constitutionality of regulations that do not provide significant medical benefit to patients nor incorporate flexibility to embrace evolving advances in medicine. Promulgate guidelines and minimum standards for all medical offices and providers that may not already be addressed in existing codes and regulations. Promulgate guidelines and regulations that only increase, not decrease, access to healthcare and confirm that the doctor/patient relationship is to be protected.

In Virginia, there is not, and never has been, a public health emergency in abortioncare, nor an evidence-based medical justification for regulating abortioncare facilities like hospitals. Until 2011, abortion providers and their practices were regulated like other physician groups and their practices. In 2011, let’s call it like it is, under the guise of women’s health and safety, politicians singled out only abortioncare providers and pro-choice gynecology practices for onerous and unnecessary restrictions and regulations. Why? To make obtaining their abortion so difficult that patients would continue an unplanned pregnancy?  Now here we are again debating regulations that apply only to abortion services. Though Virginians may never agree about abortioncare we all agree that citizens are entitled to their doctor - patient relationship. If Virginia’s Department of Health truly wanted to implement its Virginia Plan For Well Being (2016 – 2020) that honors the VDH Mission, the Board of Health would provide best practice guidelines and licensure that applies equally to every medical practice in the Commonwealth to assure that access to healthcare is increased throughout the Commonwealth.

I commend and share the VDH’s commitment to public health, your Mission “To protect the health and promote the well-being of all people in Virginia, your Vision “To become the healthiest state in the nation” by celebrating its Core Values “Our (VDH) culture values service, equity and making data-informed decisions” by utilizing five goals, three of your goals I reiterate here:

However promulgating hospital-based regulations on a doctor’s office that provides abortions and on no other healthcare providers or no other medical services does nothing to promote health and wellness nor does it serve Virginia Department of Health’s mission. This is especially disturbing because the vast majority of Virginians support a woman’s right to access safe and legal abortioncare. That unwavering support puts us in step with the rest of our country and acknowledges that the Constitution protects a woman’s right to seek legal healthcare. 

None of these overlapping and restrictive regulations being considered do anything to improve women’s health.  As someone who works every day with women impacted by these restrictions, I can tell you that these burdens are more than a mere inconvenience. For many women – especially those living in poverty, in rural communities or communities of color – these burdens can mean the difference between accessing essential care and being relegated to the status of disenfranchised citizens. For these women, the guaranteed protections of the law now exist on paper only. One in four Virginia women will have an abortion in her lifetime. That choice is a moral and spiritual decision, as well as a medical decision between a woman and her doctor. There is no room in that intimate and personal decision-making space for politicians and their artificial laws presuming to know better. Yet they continue to force their way into the conversation, stripping women of autonomy in defiance of their fundamental rights. We cannot create a just and equal society if we do not acknowledge that women are moral agents capable of making decisions about their life and family. 

As the founder and director of Falls Church Healthcare Center, a Virginia reproductive health care provider since 2002, I can tell you that promulgating restrictive regulations will have nothing to do with improving our patient’s care. To me it is clear that the 2012 regulations existed only to create barriers between a woman and her constitutionally guaranteed right to access abortioncare; barriers that make it harder for health centers like mine to provide essential health care. As someone who works every day for the women impacted by these non-data-based restrictions, I can tell you that these burdens are more than mere inconveniences which increase the cost of healthcare. They are insulting, dehumanizing and often devastating for the women forced to endure them. 

Over the last four decades Virginia built a complex web of anti-abortion restrictions that were insulting to doctors and harmful to women. During this time the number of medical offices and clinics in the state providing abortioncare has declined by around 42 percent. Don’t let the regulations you are considering reaffirm Virginia’s decades-long campaign of legislative and regulatory bullying, essentially telling women you must suffer unnecessary burdens, endure insults to your dignity and intelligence, and scale ever-larger barricades in order to get the care you need. For too many Virginians, these laws – and the regulations that mirror them - act as a de facto ban on that right.

Thank you again for the opportunity to comment on this NOIRA through the TownHall. May I suggest that during your process you start anew instead of trying to amend something that was defective from the beginning. Start anew to recognize the un-constitutionality of regulations that do not provide significant medical benefit to patients nor incorporate flexibility to embrace evolving advances in medicine. Promulgate guidelines and minimum standards for all medical offices and providers that may not already be addressed in existing codes and regulations. Promulgate guidelines and regulations that only increase, not decrease, access to healthcare and confirm that the doctor/patient relationship is to be protected.