The future of one of Charlottesville’s two clinics offering abortions is in the hands of state politicians, and pro-choice activists and medical professionals across the commonwealth are up in arms. Governor McDonnell quietly signed a bill last month that cracks down on building codes in abortion clinics. The piece of legislation was passed in the name of patient health and safety, but the costs of the new regulations—like widening hallways and replacing sink fixtures—could force the Charlottesville Medical Center for Women, the area’s only privately owned abortion clinic, to close, in addition to many others around the state.
“We don’t mind being regulated,” said Charlottesville Medical Center for Women director Jill Abbey. “What we do mind are regulations that are not evidence-based. There’s no question that this is not about patient safety.”
The new law, passed during a contentious 2012 legislative session, requires that abortion clinics meet the same building standards as hospitals. McDonnell described the requirements as “common sense,” and said they would ensure that the procedure “takes place in facilities that are modern, safe, and well-regulated.” The statewide building codes include specifics on hallway width, procedure room size, HVAC systems, number of parking spaces, and covered walkways.
State Board of Health Chair Bruce Edwards, a Virginia Beach EMS chief, said he and his fellow commissioners were acting within legal parameters when they signed off on the new regulations. He said his vote to implement the new law had nothing to do with politics or his own beliefs—he was just doing as he was told.
“We were advised by the attorney general’s office, which is the only legal office we can listen to by the code of Virginia,” he said. “I’m just so used to government, and I know how it works. So I took the advice of the attorney general.”
At the heart of the controversy is the law’s revoked grandfather clause. When the Virginia State Board of Health originally voted on the bill last June, it allowed existing clinics to be exempt from the new regulations. But when attorney general Ken Cuccinelli refused to sign off on the regulations, the Board voted 13-2 three months later to eliminate the grandfathering.
Now that existing clinics are facing new building codes, they’ll be forced to determine what is and is not realistically affordable.
“The cost is enormous to retrofit a building to regulations that were never meant to be used that way,” Abbey said. “Clinics are looking at what it will cost to retrofit a current building. Can you afford it? If not, can you afford a new building?”
The Charlottesville Medical Center for Women, located on Commonwealth Drive, has been providing abortions for women in the city and surrounding counties since 2004. The clinic’s doctor has been performing the procedure since 1973. But regardless of experience and regional reputation, director Jill Abbey said, the future of the practice looks bleak. Unlike the national nonprofit Planned Parenthood, with its Charlottesville location just around the corner on Hydraulic Road, the medical center is privately owned, and doesn’t have a steady flow of grant and donor funds to cover the multi-thousand-dollar renovations required by the new regulations.
Whether or not the Charlottesville Medical Center for Women will survive the changes is still up in the air, she said, and private clinics without the benefit of nonprofit funding all over the state will face the same financial challenges.
Legislators say the bill is strictly about patient safety, and not part of a political agenda. Those opposed to the new bill say the regulations are arbitrary, and a right-wing attempt to sidestep the legality of abortion by making it less accessible.
“Men in legislature are inserting themselves not only just in women’s lives, but in the exam room,” Abbey said.
Kathy Greenier, a women’s rights activist who works for the American Civil Liberties Union, said similar regulations have been set in other states, like South Carolina and Mississippi, and she wasn’t surprised to see Virginia make the move.
“It’s a tried and true tactic of anti-choice activists,” Greenier said. “What is surprising to me, though, is the complete disregard for the medical community’s judgment and experience in this process.”
Thousands of activists and medical professionals have spoken out against the bill, both at Board of Health meetings and on the bill’s online comment forum. Greenier said 177 doctors—none of whom are abortion providers—signed a letter to the board requesting respect for the doctor-patient relationship, and stating that the regulations are not necessary.
“Get out of their practice,” Greenier said. “Don’t try to push these things on them when they’re the experts.”
Edwards said the State Board of Health heard the concerns loud and clear.
“We are hearing these comments,” Edwards said. But the 3,000 e-mails he received and hours of arguments he heard against the legislation didn’t sway his vote, and he was one of 13 commissioners to vote to pass the law along last September.
“We were acting within our direction of the General Assembly, within the parameters they set for us,” he said.
McDonnell has publicly identified himself as a pro-life governor, and has consistently supported anti-abortion legislation in Virginia. But when asked about his own political affiliations, Edwards said it was irrelevant.
“I’m a patient advocate,” he said. “I want to see the safest procedures in the safest environment for anybody in that general condition.”
Edwards said he was unaware of any centers at risk of closing.
“I haven’t heard that anybody’s going to be shut down,” he said. “Speculation—I’m just not going to go there.”
Edwards said the board will receive regular updates at meetings on the licensure of Virginia’s clinics over the next three years, including any granted variances. After a 60-day public comment period beginning at the end of January, the bill will go back in front of the Board of Health for a final vote. While it’s not officially a done deal yet, Planned Parenthood Health Systems—a regional PPH affiliate—field coordinator Olivia Babis said the Virginia branches are operating under the presumption that the regulations will be permanent.
But unlike the city’s other abortion provider, Charlottesville’s Planned Parenthood clinic will likely be able to withstand the financial hit. Charlottesville has one of Virginia’s newer Planned Parenthood locations, which will only need minor renovations, like changes to the HVAC system and new sinks.
“But even those changes are very expensive and can cost thousands of dollars,” she said. “None are really simple, but some will need more construction than others.”
The construction will certainly be a financial burden, Babis said, but none of Virginia’s Planned Parenthood locations are at immediate risk of shutting down.
“We’ve been around for almost 100 years, and we’re not going anywhere,” she said. “But it’s a strain, and unprecedented.”
Charlottesville’s Planned Parenthood will likely stay afloat with the help of grants and donations. But Babis and others said there’s already a shortage of abortion clinics available to Virginia women, and the area can’t afford to lose the private centers.
According to Abbey, 85 percent of Virginia counties don’t have abortion providers, forcing women in rural counties to make long drives for appointments. If clinics like hers and its sister branches in Richmond, Roanoke, and Newport News close because they can’t afford to meet the new regulations, it will be one more barrier for Virginia women.
“People are already traveling a distance, and it’s just not good to have access so limited,” she said. “They say it’s about women’s health? It’s not good for women’s health to only have one option.”