More about Maryland’s Draft Abortion Clinic Regulations

By Dave Andrusko

Abortionist Steven Brigham

On Monday we discussed the draft abortion clinic regulations formulated by the Maryland Department of Health and Mental Hygiene. Today we’ve revisit this development based on more information.

It is universally agreed (as the Baltimore Sun wrote Sunday on its blog) that the “regulations were issued in response to a high-profile incident last fall when a woman was critically injured at an Elkton clinic run by Steven C. Brigham, a man who did not have a license to practice medicine in Maryland. His unorthodox approach involved initiating abortions in New Jersey and instructing patients to drive to Maryland where he completed the surgery.”

Maryland abortion clinics have never been inspected (not all are even licensed by the state) because they fall outside of the definition of an “ambulatory care facility.” There were attempts in the last legislative session to hold abortion clinics to these same standards as an ambulatory care facility.

An April 1 story explained that “Bills requiring higher safety standards at abortion clinics were shelved after state health department officials promised to craft new regulations to govern the clinics,” according to the Maryland Gazette’s Jeff Newman. Those were the draft regulations produced last Friday.

An Associated Press (AP) story yesterday read as if were largely a press release from the Health Department. On the one hand, the statement issued by the Department defended itself (the state’s regulated abortion the same way it has other “medical procedures”—e.g., a licensed physician is required). But on the other hand, “The department is moving forward to strengthen oversight in light of rare cases of physicians who violated the standard of care with surgical abortions.” (More about that below.)

This produced, the statement concluded,  draft regulations that “reflect the right balance of preserving both safety and access.”

The draft abortion clinic regulations hardly go overboard in the direction of safety. Abortion clinics would be required to have a license from the state. To handle emergencies a  staff member would have to be available 24 hours a day. Only appropriately trained staff and licensed health care providers could administer anesthetics.

And “A surgical abortion facility also would have to have a procedure to transfer patients to a hospital when care is needed beyond the capabilities of the facility,” according to the AP. In other words when a woman is in serious trouble following an abortion, there has to be a protocol in place to get  her to a hospital!

These are not in response to imaginary, what-if problems. According to the AP

A review of the board’s public orders from 1991 found that five physicians had been disciplined for violating the standards of care for surgical abortions, the department said. Women died or were seriously injured in each case, according to the disciplinary records. Women were harmed by improper administration or monitoring of general anesthesia under the care of three of the five physicians, the department said.

As we discussed Monday, Brigham has had his license pulled, suspended, or relinquished in a total of five states. Brigham has been the subject of investigations for botched abortions and other violations in New York, Pennsylvania, Georgia, Florida, and California.

New Jersey law requires abortions over 14 weeks to be done in a hospital or ambulatory care facility. Brigham’s clinic is not licensed as such a facility, and he lacks both hospital admitting privileges and obstetrical training in the state.

New Jersey Deputy Attorney General Jeri Warhaftig told the New Jersey Board of Medical Examiners last year that in the most recent cases Brigham did not merely dilate the women’s cervixes in New Jersey and then bring them to Maryland for the actual abortion. He also gave the women drugs that caused “fetal demise,” putting them at “points of no return beyond which an abortion cannot be discontinued,” Warhaftig said, according to the Star-Ledger.

Since New Jersey law requires abortions over 14 weeks to be done in a hospital or ambulatory care facility, and Brigham’s Voorhees clinic is not licensed as such, the abortions he began there violated state law and put the women at risk of serious injury, according to the attorney general’s office. The board agreed, stating that “his continued practice presents a clear and imminent danger,” the Star-Ledger reported.

In a typical incident, after Brigham “administered a drug that killed the fetus” at his Voorhees, New Jersey, clinic, the pregnant woman was told to drive to Elkton, Maryland, the next day, where the now-dead baby was dismembered and removed, according to the Associated Press. Brigham did not have a Maryland license.

After the scheme was discovered, investigators searched the Elkton clinic, “where a chest freezer held about 35 late-term fetuses,” the Courier-Post reported.

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