The Supreme Court Just Blocked an Abortion-Restriction Law in Louisiana. What’s the Science Behind the Law?

Studies show that, in most cases, laws requiring doctors to have admitting privileges at a nearby hospital are not necessary for the health and safety of women getting abortions.
Protesters gathered at the Fifth Circuit Court of Appeals in New Orleans on October 5th, 2018, to denounce a decision that upheld a Louisiana law requiring abortion doctors to have admitting privileges at nearby hospitals. They also protested the nomination of Justice Brett Kavanaugh to the Supreme Court one day before he was sworn into office.

The Supreme Court on Thursday blocked a law that opponents argued would have made it unfairly difficult for women in Louisiana to obtain abortions. The law requires that abortion doctors have admitting privileges at a nearby hospital. Proponents of admitting privilege laws in general argue that they help ensure women get quality care when they have an abortion. Opponents say they’re unnecessary and create an “undue burden” to abortion access, which is protected by law.

What does the research suggest about these laws? Are they needed to make abortions safe? I previously reported on the evidence in 2015, when the Supreme Court was preparing to look at an admitting privileges law in Texas, which the court ultimately struck down. Below is what I found then, with updated numbers where they’re available:

[S]tudies show that, for the vast majority of the time, [admitting privilege laws] are not necessary for the health and safety of women getting abortions.

In 2015, about 89 percent of clinic-based abortions performed in the U.S. were either medical abortions—where the patient takes pills, usually a combination of mifepristone and misoprostol—or first-trimester, surgical abortions.* These types of abortions are generally very safe.

One recent review found that only one-half of one percent of first-trimester, aspiration abortions (a popular type of surgical abortion) had complications serious enough that the woman had to visit a hospital. Laws like Texas’ are “unlikely to improve the safety” of such abortions, that study’s authors concluded. Meanwhile, the complication rate of mifepristone is 0.02 percent.

About nine percent of abortions in the U.S. are surgical abortions performed after the first trimester. These later abortions are riskier; the risk of death grows “exponentially” with each passing week. In 2014, the latest year for which such data is available, six women are known to have died from complications of legal abortions in the U.S.* Pregnancy in the U.S. is comparatively much more dangerous, however: About 700 Americans die every year from complications of pregnancy and childbirth.*

So what may happen if Louisiana’s admitting privileges law goes into effect? The answer may make the difference to whether this policy survives its legal challenge. In Texas, admitting privileges, plus another abortion-restricting law, led to the closure of more than half of that state’s abortion clinics, as NPR reported in 2015. In Louisiana, those challenging the admitting privileges law argue that it would lead three of the state’s four abortion providers to stop performing abortions and that having only one abortion doctor in the state is an undue burden. In a dissent, Supreme Court Justice Brett Kavanaugh wrote that it was unclear whether those three doctors would really be unable to obtain admitting privileges.

The case isn’t finished yet, and the Supreme Court will likely hear a challenge to it later this year, the New York Times reports.

*These sentences have been updated to reflect the latest data.

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