The lawyers for Planned Parenthood Great Plains and the state of Arkansas returned to federal Judge Kristine Baker’s court today to again hash out the state’s 2015 law that would require doctors who provide medication abortion to contract with ob-gyns with hospital admitting privileges. Baker issued a temporary injunction order against the law last week; Planned Parenthood is asking for a permanent injunction until trial. If that seems familiar, it’s because there has been a previous TRO and preliminary injunction granted in the case by Baker. But the 8th Circuit Court of Appeals overturned her injunction, saying the district court had not provided numbers to show that a “large fraction of women seeking medication abortions” would be unduly burdened by the state law, the U.S. Supreme Court declined to hear Planned Parenthood’s appeal and the law went into effect for 18 days, between May 29 and June 18, when the parties returned to Baker’s court seeking a TRO.

The problem with the law is that it’s based on the fallacies that medication abortion is a dangerous procedure and that the only way for a woman to get proper care if she has complications would be to have a card showing that her abortion provider has a contract with a physician with admitting privileges to a hospital somewhere. Armed with that card, according to the law’s theory, she could go to an emergency department and theoretically get better care.  … If she lived near the hospital where the doctor had admitting privileges, if the doctor was on call, and if the hospital’s ED staff was not trained well enough to handle the complications. Laws like Arkansas’s are called TRAP laws (Targeted Regulation of Abortion Providers) and despite the stated intent of the law, its real goal is simply to make it hard on women to exercise their right to abortion.


The state disputes Planned Parenthood’s case that it cannot find a doctor who’ll contract with its two clinics in Fayetteville in Little Rock, which provide medication abortion only, and that even if they can’t get backup, women who live in Northwest Arkansas would suffer no burden by having to drive to Little Rock — twice — to obtain a surgical abortion.

The state first attacked the conclusion reached by Dr. Colleen Heflin of Syracuse University that provides the necessary numbers for the 8th Circuit to ponder: Heflin, basing her work on a study done in Texas after that state closed half its clinics with a law nearly identical to Little Rock, said the lack of access to medication abortion in Northwest Arkansas would deny the right to abortion to 235 women, applying the Texas model to Arkansas abortion figures from 2017. 


The state also grilled Dr. Stephanie Ho of the Fayetteville clinic and Lori Williams, APRN, of Little Rock Family Planning Services, the state’s only surgical abortion provider and which also provides medication abortion, on their attempts to find doctors who would contract with them. If Heflin’s study is the strongest part of the state’s case (that is, if you agree that denying medication abortion to 100 percent of women who want one is not significant), the doctor contracting clause is the weakest. Planned Parenthood staff called many doctors in 2016 and both Planned Parenthood and LR Family Planning followed up with letters to all  licensed ob-gyns in the state seeking physicians to provide backup. Little Rock Family Planning made an offer in the ballpark of $150,000 to doctors, according to Williams, who testified today under subpoena from the state. Ho testified to her own inability to get hospital admitting privileges because of her practice and articles critical of her on the internet. Williams testified to the daily protests outside Little Rock Family Planning Services that she and staff must endure — including shouts and cursing and lies about the credentials of the doctors within — and the threats made against her and Dr. Tom Tvedton in the form of letters to neighbors calling them child murderers. Tvedton is one of three part-time abortion providers in the clinic; the other two live out of state, because LR Family Planning can’t find Arkansas doctors who’ll provide abortions.

Is there anyone who doesn’t believe Planned Parenthood and the LR clinic were unable to find an Arkansas physician willing to say, sure, I’ll put up with the stigma and alienation of contracting with an abortion provider? Is there anyone who isn’t aware of the dangers abortion providers and their staffs face?

And though it did not come up exactly, how would one doctor’s admitting privileges help women across the state of Arkansas anyway?

The hearing will continue Friday to accommodate a witness who will only be available that day.