There was a prominent pro-life win last week when the Supreme Court upheld an Arkansas law requiring providers of chemical abortions to have a transfer agreement with a hospital. This law puts women’s safety first, and it may end up closing two abortion clinics in the state.
However, Planned Parenthood is not happy about this ruling. In fact, abortion providers in Texas, Alabama, Mississippi, and many other states publicly advocate against laws requiring their facilities to have transfer agreements or their doctors to have admitting privileges with local hospitals.
Their reasoning? Abortion is a common surgery with a low incidence of post-procedure complications, and emergency rooms must see and treat all patients who come. Therefore, requiring admitting privileges of abortion doctors or transfer agreements of abortion facilities is a high-cost, low-benefit requirement which only leads to less access to safe abortion, which is unconstitutional according to Roe v Wade.
Hospital transfer agreements are a contract between a healthcare facility (usually one which provides surgical procedures) and a hospital emergency room. The agreement outlines what will happen before, during, and after the transfer of a patient in case of an emergency. In the event of an emergency, some of the benefits afforded by a transfer agreement are:
- Medical and treatment records will be given to the hospital to ensure the best care for each specific patient
- Insurance information will be provided to the hospital
- A patient’s personal belongings will be delivered to the hospital with them
- A patient’s emergency contact will be notified
- The hospital will prioritize admitting and caring for the patient
It is highly beneficial to the patient in the emergency situation to be coming from a facility with a transfer agreement with a hospital. The patient will be seen more promptly and the hospital will be provided with medical history upon or shortly after admission. This means the patient has a better chance of receiving appropriate, personalized care in a timely manner to safeguard their life and health.
Additionally, patients will not have to worry about notifying their emergency contacts, providing insurance information, or remembering to grab all their personal belongings to take with them because the facility transferring them has committed to doing all of it for them. Search online for tips on choosing an ambulatory surgical center and you will find no matter the procedure, the common advice is to make sure there is a transfer agreement in place or ask if your surgeon has admitting privileges.
All ambulatory surgical centers (ASCs) must have transfer agreements with hospitals, even ones which provide surgeries with little risk of complication, such as cataract removal. An abortion provider in Toledo, Ohio only recently got its ASC licensure re-approved after a long legal battle due to it not being able to renew a transfer agreement with a local hospital along with other violations of the ASC rules for licensure.
Not all abortion providers are ASCs, though, and many do not want to be held to the same high standards of safety. However, in 2003, the American College of Surgeons, together with the American Society of Anesthesiologists, put forth 10 core principles it urged all states to consider when regulating office-based surgical procedures (not just ASCs).
Core Principle #4 states, ”Physicians performing office-based surgery must have admitting privileges at a nearby hospital, a transfer agreement with another physician who has admitting privileges at a nearby hospital, or maintain an emergency transfer agreement with a nearby hospital.” Even oral surgeons performing wisdom teeth removal in non-hospital settings are encouraged to do so only when they have admitting privileges at a hospital.
All surgical procedures have different rates of complication. Research on the health and safety outcomes of patients receiving surgery at facilities which have hospital transfer agreements versus facilities which do not is still in the "exploratory stage."
Nevertheless, transfer agreements with hospitals confer a large enough benefit and guarantee enough of a safety net that the American College of Surgeons declared the need for a transfer agreement regardless of surgical procedure being performed.
Pro-lifers know every life is precious. It may seem contrary to the pro-life position to make abortion clinics safer for abortion-minded women. Requiring transfer agreements from abortion facilities to hospitals does not negate the fact innocent humans are killed in the act of elective abortion, but if we can save one woman’s life by advocating for best-practice safety regulations of all abortion facilities, then we will.
And for the people who proclaim access to safe, legal abortion is a constitutional right — they should also be advocating for regulations which increase safety and health outcomes in cases of emergency, and regulations which follow policies set forth by evidence and experts.