Why independent abortion clinics are suffering the most under The Hyde Amendment

In this country, and under this administration, the notion of universal healthcare (let alone abortion access) is as comical as watching Trump deliver a coronavirus briefing. Especially when you have conservatives trying to dismantle decades of reproductive progress. Case and point: The Hyde Amendment.

For those uninformed, or simply unaffected, The Hyde Amendment is a legislative term restricting federal dollars to pay for abortion, except under circumstances of incest, rape or to save a woman's life. There are many individuals who suffer under these terms, mostly independent clinics located in the South, including Alabama, Mississippi and Tennessee. For these clinics, providing abortion care to patients is becoming a challenge.

"In any business, if you're smaller you tend to have a smaller budget and less leeway in your budget to adjust to downturn," said Katy Leopard, director of external affairs at CHOICES - Memphis Center for Reproductive Health. "You're more vulnerable to legislative issues that might come down the pipeline. From things that make abortion harder to things that make it more expensive. It is much harder for smaller clinics to absorb those costs."

Because clinics in battleground states don't receive federal or government funding for abortion, they're having to do more with less. For example, the majority of smaller clinics don't own their buildings and only have part-time staff working during the day. Then there's the added stress of having limited capacity, which is the reality for Leopard and her team, who serve patients out of only two exam rooms. When you see 25-30 abortions patients per day, as Leopard does, being understaffed can prove problematic.

In addition to having limited space and being understaffed, smaller clinics also rely on private funding or often turn to The National Abortion Federation. However, when you reside in a Red state such as Tennessee, crowdfunding for an abortion clinic can be extremely difficult. Primarily when abortion is such a stigmatized topic among residents.

As of 2019, 29 states were considered hostile toward abortion­­ rights, according to data collected by Guttmacher. Only 14 states were considered supportive, with seven states falling somewhere in between. When you consider the fact one in four women will have an abortion by the age of 45, you would think legislators would want to make abortion more accessible. However, that's very unlikely when you have conservative officials continuously opposed to abortion care.

But the Hyde Amendment isn't the only barrier abortion clinics have to face. There's also hospital admitting privileges laws, which state any doctor providing abortions must have hospital admitting privileges. At first, this might not sound like a huge deal. However, the majority of hospitals in Memphis are baptist hospitals, methodists hospitals or religiously affiliated hospitals. With that being the case, it can be tough getting a doctor admitting privileges if somebody on the hospital board is an anti-abortion or anti-choice advocate... which is often the case.

"Getting hospital admitting privileges is not as easy as it sounds and it's also not medically necessary," Leopard explains. "During my ten years at CHOICES, there were times we had to go round and round with a hospital about getting privileges for our doctor, or we ended up hiring a new doctor, who already had admitting privileges. This just made it more difficult for our clinic"

In addition to the admitting privileges law, there's also the ambulatory surgical center regulation that requires a certificate of need within the state of Tennessee. It also requires hallways and exam rooms be a certain width and size, with laboratories operating on specific hours and performing certain tasks. Leopard explains these additional restrictions only add more stress to her job and are "completely unnecessary for an abortion clinic."

At the end of the day, healthcare shouldn't be an impossible luxury meant for those fortunate enough to afford it. It should be a universal concept. It also shouldn't be a tiresome maze, for both patients and providers to navigate. But when you have an administration keen on reforming the U.S. back to patriarchally traditional standards, where does reproductive justice fall on that scale?

For Leopard, the solution is simple.

"My short answer is to always elect different people, but the underlying issue there is educating voters," she said. "Educating voters is what we need to do, but part of that is not allowing abortion to continue to be this dirty, horrible thing that's all by itself in a corner."

I couldn't have said it better myself.