If the state’s two abortion bans don’t survive, anti-abortion lawmakers at least want more regulations on the industry. 

That’s according to the sponsor of House Bill 148 – Regulation of surgical abortions, Rep. Martha Lawley (R-Worland).

“As long as abortion remains legal, we have a responsibility to protect the health and the safety of women getting abortions,” she said Monday. 

Lawmakers passed two abortion bans last year, and a “trigger ban” the year before that. The 9th District Court in Teton County stalled implementation of all three, pending a decision over whether the two active bans violate the state constitution. 

This bill, on the other hand, would put more regulations on clinics providing at least three first-trimester procedural abortions in a month, or at least one second-trimester or third-trimester procedural abortion in a year. 

“That [qualification] was actually asked for by pro-life OB-GYNs that said look, there’s going to be situations where a doctor may find themselves in an emergency situation, and have to — for the life of the mother or some emergent situation — need to perform an abortion,” Lawley said.  

While the bill calls for a regulation of “surgical abortions,” the American College of Obstetricians and Gynecologists states that because abortions, themselves, don’t involve surgery, a more accurate clinical term is “procedural abortion.”

In Wyoming, the only facility that advertises that it offers elective procedural abortions is Wellspring Health Access in Casper. It opened last April. 

The bill would require “surgical abortion facilities” like Wellspring to be licensed as ambulatory surgical centers. Doctors performing procedural abortions there would also need to have admitting privileges at a hospital not more than 10 miles away.

That means a $500 annual fee for the license, regular inspections from the Wyoming Department of Health and convincing a nearby hospital to grant these doctors admitting privileges. Violations would be considered misdemeanors, costing up to $1,000.

It could also dole out felonies to doctors who perform procedural abortions without a license to practice in Wyoming — something that’s already considered illegal. 

House Bill 148 passed the House Judiciary Committee 7-2 and passed first reading Wednesday on the House floor.

During Thursday’s House floor discussion, Majority Floor Leader Chip Neiman (R-Hulett) added a new amendment to the bill, effectively reviving House Bill 137 – Chemical abortions-ultrasound requirement, which died last Friday.

Neiman’s amendment would require a physician or pharmacist to make sure a pregnant woman receives an ultrasound at least 48 hours before she gets medications to induce abortion or gets a procedural abortion. 

The legislation says it’s to “determine the gestational age of the unborn child, to determine the location of the pregnancy, to verify a viable intrauterine pregnancy and to provide the pregnant woman the opportunity to view the active ultrasound of the unborn child and hear the heartbeat of the unborn child if the heartbeat is audible.”

That amendment was added with a 50-12 vote on the House floor.

Need for regulations debated

This bill is meant to protect women, Lawley said.

It’s something many proponents agreed with during the committee hearing Monday.

“When a woman is injured in such a business and needs to go to the hospital, what are the protocols?” questioned Ross Schriftman, a president of the Natrona County chapter of Wyoming Right to Life and member of the Jewish Pro-life Foundation. “The state has a responsibility to protect the safety of women who will seek an abortion, and to protect the public from additional costs.”

However, detractors noted that mortality rates for legal abortions have been notably low, with fewer than 0.5 deaths per 100,000 people in recent years.

“Colonoscopies have a much higher rate of mortality,” Rep. Karlee Provenza (D-Laramie) said during the hearing. “So are we going to start providing the same statutes for men who get colonoscopies?”

Rep. Sarah Penn (R-Lander), while supportive of the bill, also noted the low mortality rates. Women getting procedural abortions already have connections with the health care field, said Penn, who is a nurse practitioner in Fremont County. 

“[The women] are already under a process of close monitoring and evaluation, and if they begin to experience hemorrhage or other issues that could be complications of an abortion, then they already have contact with a surgeon, with a facility and things like that,” she said. “And so that’s what this [bill] further looks to strengthen and bolster.”

Meanwhile, sponsor Lawley stated: “Mortality is an important issue, but to say that that’s the standard on which we would regulate health and safety in the medical world, that seems honestly preposterous to me.”

Testimony from people like Dr. Rene Hinkle — a self-proclaimed lifetime Republican and plaintiff in the case against Wyoming abortion bans — said these proposed regulations show a bias against abortion as a form of health care and against women in general.

“It talks about needing a hospital privilege within 10 miles,” said Hinkle, a long-time OB-GYN physician in Cheyenne. “That is more strict than any surgical center is doing in the state right now. The state requires 50 miles for somebody to have surgical privileges.”

The American College of Obstetricians and Gynecologists has also called for a stop to regulations that aren’t necessary, stating, “Although abortion is extremely safe, it is often targeted for medically unnecessary, arbitrary requirements that restrict the ability of patients to access abortion care.”

That organization specifically lists both ultrasound requirements and facility requirements — which it calls Targeted Regulation of Abortion Provider (TRAP) laws — among the medically unnecessary regulations inhibiting abortion access.

Beyond that, both Hinkle and Wellspring’s president Julie Burkhart noted what they perceived was hypocrisy between this law and last year’s abortion ban, House Bill 152 – Life is a Human Right Act. 

That act, which HB 148 would yield to, states that abortion is not health care.

“There is a grave contradiction here,” Burkhart said. “A bill that states that abortion is not health care, and a bill before us now which purports to regulate the exact thing that the Legislature deems nonexistent.”

The argument over whether abortion is health care is a key part of the legal fight against Wyoming’s abortion bans because the state constitution guarantees residents “the right to make his or her own health care decisions,” limited only by “reasonable and necessary restrictions” from the Legislature. 

Rep. Rachel Rodriguez-Williams (R-Cody) brought an amendment to the bill on the House floor that specifies that the measure doesn’t give individuals the right to an abortion nor does it “recognize or define abortion as a health care” under the state constitution. Rodriguez-Williams was the primary sponsor of the state’s broader abortion ban. 

House Bill 148 isn’t about safety at all, Hinkle argued, and is instead a “copy-cat” law that’s similar to legislation broached in more than a dozen other states.

“This is not from Wyoming,” she said. “This is not because these things are happening in the state of Wyoming.”

Challenges and risks

Hurdles presented by this legislation are onerous, according to Burkart, who testified Monday via Zoom. That includes the requirement of hospital admitting privileges, she said. 

“The admitting privileges requirement, for example, is particularly problematic because it places a physician’s ability to serve his or her patients at the mercy of hospitals which may, out of anti-abortion bias or fear of backlash or terrorism, rarely grant admitting privileges to abortion providers,” she said. 

Meanwhile, Hinkle said there are already regulations for transferring patients to the hospital from a clinic, and many doctors doing procedures in her surgical center don’t even have admitting privileges.

“All clinics that do procedures, all abortion clinics in the state, all abortion clinics down in Colorado, have procedures in place for when there is a complication and a patient needs to be transferred emergently, which is very rarely,” she said. 

Wellspring already has “thorough emergency protocols,” according to Burkhart, and “the ability to transfer a patient promptly to a hospital for emergency care if necessary.” That clinic is less than half a mile down the street from Banner Health’s Wyoming Medical Center. 

Some argued it would be far more dangerous for women if this bill passed — resulting in even more restricted abortion access — than if it went into place. Desperate women could turn to YouTube, Google or illegal abortion providers, Hinkle said. 

“Those risks are huge because of bleeding, injury to the uterus, and infection: sepsis, which is a blood infection that can lead to death,” she said. 

“Let’s be honest about what we’re doing here,” Rep. Provenza said. “This bill is attempting to regulate reproductive health care to the point that it is inaccessible entirely. The result of that will mean that people in desperate situations will either travel … or they will be forced to take matters into their own hands, which is incredibly more dangerous and will kill women.”

Several opponents of the bill noted their history in Wyoming and Republican politics, like Cheyenne resident Barbara Kloth. For her, this bill is “fundamentally un-Wyoming.”

“Voting no on this bill does not mean that you agree with or support abortion care,” she said. “There is no medical necessity for this bill … And voting no means you are being a responsible Wyoming citizen who agrees with the core tenant of our state that we reject unnecessary governmental restrictions.”

Sublette County resident Bill Winney spoke in favor of the bill. He was in the Navy, he said, where there were rules against pregnant women being on ships underway for their own safety.

“I sat down with my head doctor and I said ‘Okay, what’s the rationale behind this requirement?’” he said. In response, the doctor told him, “There are some complications to pregnancies that can take a woman’s life in minutes to an hour or so.”

To that end, though, Hinkle said giving birth is far more dangerous and deadly for mothers than having an abortion.

Ultimately, Rep. Ken Chestek (D-Laramie) was one of the two representatives in the House Judiciary Committee who voted against the bill, alongside Provenza. For him, he was worried this wouldn’t just affect women seeking abortions, but women across the state.

“We’ve already seen throughout the state a number of OB-GYN clinics shut down, and criminalizing the practice of medicine — as this bill does — will only accelerate that trend,” he said. 

A recent WyoFile investigation highlighted the issue of delivery deserts in Wyoming and the state’s already limited number of OB-GYNs. Meanwhile, a study in Idaho recently found that the state lost 22% of its OB-GYNs since Roe v. Wade fell and the state enacted its own abortion ban. 

This article was originally published by WyoFile and is republished here with permission. WyoFile is an independent nonprofit news organization focused on Wyoming people, places and policy.