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Why is the Industry Building Big Abortion Clinics Just Across State Borders?

by | Oct 14, 2020

By Randall K. O’Bannon, Ph.D. NRL Director of Education & Research

Laws have been passed. Clinics have closed. Abortions have dropped to levels not seen since the earliest days of Roe. This does not mean the abortion industry has gone into hibernation. Far from it.

In response they are building new, gigantic, high volume mega-clinics to attract and serve new customers. And they are not shy about acknowledging that they’re doing it in locations where they can pick up business from states with more protective legislation.

On October 11, 2019, reporter Erin Heger wrote a piece for Rewire.News, an online news publisher for the abortion industry, titled “The Strategy Behind Where to Build Abortion Clinics.”

The opening line brazenly makes the strategy plain: “The bifurcation of abortion access in the United States means more clinics should be built on the border of states with onerous anti-choice restrictions, advocates say.” In other words, some states have been successful in passing pro-life legislation, such as parental involvement, right to know, fetal pain legislation, clinic regulation, etc., while other states have shored up their abortion bona fides by defending or even funding late abortion.

The abortion industry thinks that building big clinics in abortion-friendly states just across the state line from a state that actively protects mothers and their unborn children, is a good idea.

Heger uses the example of a giant new mega-clinic just built in Fairview Heights, Illinois, just across the border from St. Louis, Missouri as just the latest illustration of the principle.

A Tale of Two Neighboring States

Missouri is one of the states with the most protective legislation. They have had parental involvement laws since 1990 and right to know (informed consent) legislation in effect since 2006. There is a 72 hour waiting period. Viability testing is required for babies aborted after 20 weeks.

Recent laws include bans on abortion for genetic disability, sex selection, or race. Chemical abortions [“medication abortions”] managed remotely by web-cam are not allowed. Basic clinic safety regulations were passed, along with requirements that abortionists have admitting privileges at a local hospital.

Critically, no public funds or facilities are to be used for abortion except in cases of rape, incest, or when necessary to save the mother’s life. Missouri is one of the states which has fought to make abortion promoting and performing entities such as Planned Parenthood ineligible for Medicaid funding.

Illinois, on the other hand, mandated taxpayer funding of abortion for poor women through Medicaid in 2017. Earlier this year the state passed legislation to “protect and expand abortion access,” including gutting previous parental involvement legislation.

These differences were explicitly part of the decision to build the new mega-clinic in Fairview Heights. “We specifically chose Illinois because we know the policies in that state have made Illinois an oasis for access to the entire spectrum of reproductive health services,” Yamelsie Rodriguez, the president and CEO of Planned Parenthood of the St. Louis Region and Southwest Missouri (PPSLR&SWMO) told Rewire.

Building a Behemoth

The new clinic, an 18,000 square foot facility, is supposed to be ready to serve as many as 11,000 patients a year. It replaces a smaller Planned Parenthood clinic which provided chemical abortion and other services to more than 5,000 in 2018.

Planned Parenthood currently operates one abortion clinic in Missouri, just across the river in St. Louis. That clinic performs surgical abortions up to 21 weeks and six days (Missouri law allows up to 22 weeks), a clinic, CBS News reports, which is “fighting to keep its license” (10/2/19).

As it has with mega clinics built before, this clinic was built in secret, under a shell company, to avoid protesters or problems with contractors or vendors. (See NRL News Today)

The Fairview Heights clinic took over a previous medical building, performing some $7 million in renovations over the past year to get it ready for its new clientele.

Full information on the set up and layout is not yet available, but PPSLR&SWMO plans to open this clinic later this month and intends to offer both surgical and chemical abortions.

While some of the hype is certainly a part of Planned Parenthood’s usual publicity campaign, a chart appearing in the Belleville News-Democrat from the Illinois Department of Public Health show the number of abortion to out of state residents jumping from about 3,000 in 2014 to 5,500 in 2017.

PPSLR&SWMO clearly means to target women in the eastern side of Missouri, where its last functioning abortion clinic is located in the state, but also aims to attract potential patients in other states close to southern Illinois.

“Planned Parenthood of the St. Louis Region and Southwest Missouri has been looking to expand and protect access to comprehensive reproductive health care not just in Missouri, where we know abortion access hangs on by a thread, but in the Midwest region, where we have states like Arkansas and Kentucky increasing restrictions to limit women’s access to these services,” Rodriguez told Rewire.

A Sadly Familiar Tactic

While this is the latest clinic aiming for a multi-state clientele to be publicized, it is hardly the first. One of Denver’s notorious abortion mega-clinics is located just off of I-70, a major Midwest artery. Colorado, which Rewire identifies as “one of seven states that doesn’t restrict abortions,” is supposed to have provided abortions to women from 34 states in 2018.

For years, Planned Parenthood’s DC clinics have served women coming in from Virginia. Women living in western Missouri have always been able to visit Planned Parenthood’s abortion mega-clinic in Overland Park, Kansas.

Teens from the Philadelphia area who wanted to get around Pennsylvania’s parental involvement law could always go to the high volume abortion clinic in Cherry Hill, NJ. Women from Arkansas could travel to newly refurbished abortion mega-centers in Memphis, TN.

Women in West Texas, where abortion advocates decried all the clinic closures due to state regulations, always had the Hill Top Women’s’ Reproductive Clinic just across the border in Sunland Park, New Mexico.

Many Reasons for Mega-Clinics

It has been clear for some time that there are multiple rationales behind the building of abortion mega-clinics. The most obvious – more volume, more money – is a major reason and not to be dismissed. But it is not the only one.

The glitz and glamour of a bright, shiny new facility with designer hues and colors attracts a lot of publicity, making sure potential new customers hear a lot about the new location and its services.

The expense of building the new clinic is often offset, at least in part, by the closing of smaller unprofitable store front facilities and the laying off of that staff. (Sometimes those smaller clinics are maintained with skeleton staff to serve as satellite offices where abortion pills are dispensed and monitored by an abortionist on a webcam back at the big city mega-center.)

The claim that these are needed to address a broader “unmet need” for general reproductive healthcare does not hold water. No state has clamped down on the provision or reimbursement of birth control, STD treatment, or cancer screenings. Clinics wishing to offer these services in Missouri or any other state, can continue to do so, as long as they aren’t performing abortions and expecting the state to continue backing the group.

Planned Parenthood, the nation’s largest abortion performer and the builder of many of the country’s abortion mega-clinics, is one of those who often complains about the impact of abortion laws on their other non-abortion business. It is important to remember that PPFA has managed to keep its abortion business steady over the last decade or so while closing other non-abortion performing clinics. During that time, though, it has cut back on birth control, cancer screens, and overall clients (by more than a third, more than two-thirds, and about a fifth, respectively).

Clearly, expanding the abortion business matters more to them than keeping those other clinics open for those other services.

In addition, formerly itinerant abortionists can eliminate long travel days, stay home and work in better equipped facilities in larger cities where they can be largely anonymous, if not welcomed. The infrequent traffic of women that showed up a few days a week in a smaller rural or suburban clinic can now provide a hefty supplement to the steady stream clients from the inner city.

What the Rewire article on the latest mega-clinic shows is in addition to all these other factors, the industry sees their location and construction as strategic. Not just to get a big building and major employer so entrenched in a community that it cannot be easily removed, not just to locate in an area of high visibility and traffic; not just to be in heavily populated area with good utilities, hospitals (for complications and ready labor force), and public services, but to be in an area where they can pick up clients from other states where there are fewer clinics and more protections for unborn children.

Will It Work?

Some women will cross state lines, lured by the long list of false promises by the industry that abortion will solve their relationship problems, preserve their career options, make their lives easier or better, involve little or no physical, psychological, or social risks.

Some of the abortions lost in one state will be picked up by a border clinic in another.

But the laws the industry fears and tries to elude do save lives, and (in their more candid moments) they say so. Emily Shugerman, writing in the Daily Beast earlier this year, said that a study showed that “After nearly half of Texas’s abortion clinics shut down in 2014, several women told researchers they were forced to wait until their second trimester to have an abortion, or never obtained the abortion at all.”

That, to the abortion industry, is a tragic failure, a cause for alarm, a reason to build more of these giant mega-clinics in sympathetic border states. But when the alert pro-lifer sees that these laws meant that some women “never obtained the abortion at all,” they know that means there are children’s lives that laws like these have saved.

Falling demand for abortion overall is another reason why so many clinics have closed and unless these new mega-clinics attract a lot of new customers, they too will fail in their larger objective.

Categories: Abortion Clinic
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