1:29pm

Thu March 28, 2013
U.S.

Pennsylvania Tightens Abortion Rules Following Clinic Deaths

Originally published on Thu March 28, 2013 4:38 pm

A Philadelphia doctor who performed abortions is on trial for murder. Kermit Gosnell, 72, is accused in the deaths of a female patient and seven babies who the prosecutor says were born alive. District Attorney R. Seth Williams laid out the case in disturbing detail in a grand jury report last year.

When authorities raided Gosnell's clinic in 2010 they found squalid conditions: blood on the floor, the stench of urine and a flea-infested cat wandering through the facility.

In court, Gosnell's attorney said his client is unfairly being held to standards one might expect at the Mayo Clinic. A jury will decide Gosnell's fate, but what is clear now is that state regulators were not doing their job.

"Unfortunately and tragically in Pennsylvania, facilities were going uninspected for years," says Maria Gallagher, a lobbyist with the Pennsylvania Pro-Life Federation. Gosnell's clinic went 17 years without an inspection, according to prosecutors.

"As for Dr. Gosnell's case, there were admitted failures in oversight at the department," says Aimee Tysarczyk, press secretary for Pennsylvania's Department of Health. But now the agency is inspecting abortion clinics regularly and making sure they meet state standards.

In 2011, the Gosnell case was mentioned frequently as Pennsylvania's General Assembly passed a law that put stricter requirements on abortion clinics. Now most clinics in the state are held to the same standards as outpatient surgery centers. That means abortion clinics must have doors and elevators that can accommodate a stretcher in case something goes wrong.

For some clinics, such as Planned Parenthood of Southeastern Pennsylvania, that meant expensive remodeling.

"Overall the cost was about $450,000 to get two of our facilities into compliance," says CEO Dayle Steinberg. The nonprofit had to install hands-free sinks. Tile floors were torn out and replaced with seamless floors that are easier to clean. The clinic's heating and air-conditioning system was upgraded and a new room was built to house sterilization equipment.

Steinberg says her organization already had a low rate of complications — less than one-tenth of 1 percent. She contends Pennsylvania's new requirements did nothing to improve services for women at her clinics.

"They were thinly disguised as improving patient safety, when really it was about increasing the cost for abortion providers — hoping that some of them wouldn't be able to afford it," Steinberg says.

The author of the legislation that put the tougher regulations in place disputes that.

"This is all about patient safety," says state Rep. Matt Baker. "We made it clear that we weren't going to arbitrarily and capriciously shut down abortion clinics."

Abortion opponents were not the only ones supporting Baker's legislation. State Rep. Margo Davidson says her 22-year-old cousin, Semika Shaw, died of sepsis and infection after an abortion at Gosnell's clinic. Davidson delivered an emotional speech on the Statehouse floor in 2011.

Dedicating her vote to Shaw, Davidson said she hopes the law will safeguard the health of women seeking abortions, "so that never again will a woman walk into a licensed health care facility in the state of Pennsylvania and be butchered, as she was."

Now that the law is in effect there are five fewer abortion clinics in Pennsylvania, though it's unclear whether the stricter regulations were the only reason they closed. That leaves 17 other providers in the state. Backers of the law say now if a woman enters a clinic in a poor neighborhood — or a rich one — she can be assured it is meeting a basic standard of care.

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Transcript

ROBERT SIEGEL, HOST:

From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.

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And I'm Audie Cornish.

In Philadelphia, a doctor who performed abortions is on trial for murder. Kermit Gosnell is accused in the deaths of a female patient and seven babies that prosecutors say were born alive. When authorities raided Gosnell's clinic in 2010, they found squalid conditions.

As NPR's Jeff Brady reports, the case has led to changes in how abortion clinics are regulated in Pennsylvania.

JEFF BRADY, BYLINE: The Kermit Gosnell story is about more than abortion, it's also about class and race. For nearly four decades, Doctor Gosnell offered services to a mostly poor and African-American population in West Philadelphia. When authorities raided Gosnell's clinic three years back, they said there was blood on the floor, a stench of urine in the air and a flea-infested cat wandering through the facility.

In court, Gosnell's attorney says his client is unfairly being held to standards one might expect at the Mayo Clinic. A jury will decide Gosnell's fate. But what is clear now, is that state regulators were not doing their job. Maria Gallagher is a lobbyist with the Pennsylvania Pro-Life Federation.

MARIA GALLAGHER: Unfortunately and tragically, in Pennsylvania, facilities were going uninspected for years.

BRADY: Gosnell's clinic went 17 years without an inspection, according to prosecutors. Pennsylvania's Department of Health says that was a mistake. The agency now regularly inspects all abortion clinics.

The state legislature also passed a law requiring most clinics be held to a higher standard, the same as outpatient surgery centers. For some clinics, that required expensive remodeling.

(SOUNDBITE OF BEEP)

BRADY: At Planned Parenthood in downtown Philadelphia, CEO Dayle Steinberg swipes her security badge to get past a heavy wood door.

(SOUNDBITE OF DOOR CLOSING)

BRADY: We're headed back to a room where abortions are performed so Steinberg can point out some of the retrofits. She says the tile floor had to be torn out and replaced with a smooth one that's easier to clean.

DAYLE STEINBERG: It's also a special grade linoleum that's quite costly

BRADY: Steinberg says the heating and air conditioning were upgraded. A new room was built just to house sterilization equipment.

STEINBERG: We had to replace the sinks in here to be hands-free sinks.

BRADY: Oh, so they have pedals on the bottom there.

STEINBERG: They have pedals on the bottom, correct.

BRADY: The price tag for two clinics: $450,000. Steinberg says this facility already had a low rate of complications - less than one-tenth of 1 percent. She contends Pennsylvania's new requirements did nothing to improve services for women here.

STEINBERG: They were thinly disguised as improving patient safety, when really it was about increasing the cost for abortion providers; hoping that some of them wouldn't be able to afford it.

BRADY: State Representative Matt Baker is the author of the law that put the tougher regulations in place. While Baker opposes abortion rights, he says limiting access was not the intent.

STATE REPRESENTATIVE MATT BAKER: We made it clear that we weren't going to arbitrarily and capriciously shut down abortion clinics.

BRADY: And abortion opponents were not the only ones supporting stricter regulations. State Representative Margo Davidson says her 22-year-old cousin died of sepsis and infection after an abortion at Gosnell's clinic. Davidson delivered an emotional speech on the State House floor.

STATE REPRESENTATIVE MARGO DAVIDSON: I honor her memory by voting yes on this legislation.

BRADY: Davidson says she hopes the law will safeguard the health of women seeking abortions.

DAVIDSON: So that never again will a woman walk into a licensed health care facility, in the State of Pennsylvania, and be butchered as she was.

BRADY: With the law in place, there are five fewer abortion clinics in Pennsylvania, though it's not clear the stricter regulations were the only reason they closed. That leaves 17 other providers in the state. Backers of the law say now if a woman enters a clinic in a poor neighborhood or a rich one, she can be assured it's meeting a basic standard of care.

Jeff Brady, NPR News, Philadelphia. Transcript provided by NPR, Copyright NPR.