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Federal judge issues preliminary injunction against Ark. medication abortion restrictions

A federal judge on Monday issued a preliminary injunction that blocks the enforcement of an Arkansas law (Act 577) that restricts physicians' ability to provide medication abortion, the AP/Sacramento Bee reports.

Under the order, the state is barred from enforcing the law while U.S. District Judge Kristine Baker considers a legal challenge filed against the requirements (DeMillo, AP/Sacramento Bee, 3/14). According to Arkansas Online, Arkansas Attorney General Leslie Rutledge (R) is expected to appeal Baker's latest decision to the 8th U.S. Circuit Court of Appeals (Satter, Arkansas Online, 3/15).

Law details

The law, which was scheduled to take effect Jan. 1, requires that medication abortion drugs be prescribed in accordance with guidelines and dosage limits that were set by FDA when the drugs were initially approved. The FDA protocol is no longer current and goes against common medical practice.

Specifically, the law requires providers to administer a dose higher than what is commonly prescribed. In addition, under the law, medication abortions cannot be administered past seven weeks of pregnancy, rather than the nine-week limit that is used in practice.

The law also stipulates that only physicians can provide medication abortion drugs to patients. It requires such physicians to have a contract with another physician who has agreed to handle any complications. The second physician must have admitting and gynecological/surgical privileges at a nearby hospital that can handle such cases.

Providers found in violation of the requirements could be charged with a Class A misdemeanor and face civil penalties and disciplinary action.

Legal background

In December 2015, Planned Parenthood of the Heartland (PPH) filed a lawsuit challenging the law's admitting privileges provision and requirement that providers administering medication abortion adhere to the outdated FDA standards.

PPH operates two clinics in Arkansas, both of which only offer medication abortion. The complaint states that the only other provider in the state, Little Rock Family Planning Services, will discontinue medication abortion and offer only surgical abortion if the law is not blocked. The complaint noted that if the Planned Parenthood clinic in Fayetteville closes, Arkansas women would "lose access to a safe, early method of abortion using medications alone." A woman seeking abortion care would have to drive three hours to Little Rock Family Planning Services.

On Dec. 31, 2015, Baker issued a temporary restraining order that blocked for 14 days the enforcement of the two contested provisions. In January, she extended the order through March 14 (Women's Health Policy Report, 1/12).

Baker's order

In the preliminary injunction, Baker conveyed skepticism about the state's claim that the law's restrictions would benefit women, the AP/Bee reports (AP/Sacramento Bee, 3/14).

Baker stated, "Based on the record before the court at this stage of the proceeding, the court is persuaded that the standard of care under Arkansas law likely equates to what [the plaintiffs], as well as abortion providers across the county, use today as the evidence-based method for medication abortion, not the (FDA-approved) regimen" (Lyon, Arkansas News Bureau/Southwest Times Record, 3/15). She noted that the law does not include exemptions for cases of rape, incest and life endangerment to the pregnant woman (AP/Sacramento Bee, 3/15).

Further, Baker challenged the value of the law's admitting privileges provision. She wrote, "Given the record evidence presented at this stage, the court is skeptical about any benefit conferred by this provision. Instead, this court at this stage and on the record before it tends to agree with the district judge who considered a similar restriction in Wisconsin [Act 37] and determined that the contracted physician requirement was a 'solution in search of a problem'" (Arkansas News Bureau/Southwest Times Record, 3/15).

Moreover, Baker noted that, if only one clinic were to remain open under the law, the "inability to travel to the sole remaining clinic in the state will lead some women to take desperate measures, such as attempting to self-abort or seeking care from unsafe providers, which would further put their health at risk." She wrote, "At this stage of the proceedings, the Court finds that the threat of irreparable harm to [the plaintiffs], and the public interest, outweighs the immediate interests and potential injuries to the state" (AP/Sacramento Bree, 3/14).

According to Arkansas Online, Baker has allowed the case to proceed as a facial challenge to the law, meaning that the order applies not only to the plaintiffs but to any abortion provider or woman in the state who would be affected by the law. The state had sought for the case to be considered a challenge to the law "as-applied," which would have meant that the order applied only to the plaintiffs (Arkansas Online, 3/15).

Comments

Suzanna de Baca, PPH president and CEO, said, "We're pleased that today's decision allows women in Arkansas to, at least for time being, continue to access safe, legal abortion care at Planned Parenthood" (Arkansas News Bureau/Southwest Times Record, 3/15).

Stephanie Ho, a PPH physician and plaintiff in the case, said, "It's a relief to know that as this case proceeds I can continue to provide the highest quality of health care to a woman who comes to Planned Parenthood for safe and legal abortion care." She added, "No one should get inferior, outdated and less effective care from their physician" (AP/Sacramento Bee, 3/14).