Abortion Clinic Opens Amidst Ohio's Heightened Regulatory Environment

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Dr. David Burkons says he always wanted to open his own small clinic, a place that could be personable with minimum wait times.

After 18 months of inspections, rejections and eventually approval, Burkons began doing surgical abortions last week. Burkons was doing medical abortions, which uses a drug regimen, in his Cuyahoga Falls clinic last year.

On a recent Friday aftenoon, the steady stream of women who visit Burkons' clinic are there for medical abortions, which is a 2 -dose drug regimen.

One brunette, 30-something woman has arrived for her second round, Burkons asks if she has had any bleeding or cramping.

The woman, who is 6 weeks pregnant, doesn't want her name used. She explains that, yes, there has been "a little bit of cramping and just a little bit of spotting." 

Burkons assures her this is normal, then he opens a small desk drawer and hands her two pills. 

"These are the misoprostol pills," he says. 

Since the landmark Roe v. Wade Supreme Court decision in the 1970s, Ohio has been a trendsetter in restricting abortions. 

"For decades, Ohio has been a state where abortion restrictions are considered the norm, in that the legislature takes up abortion restrictions routinely," says Elizabeth Nash, state issues manager for the Guttmacher Institute, a non-profit that supports abortion rights. "They have adopted nearly every restriction that exists and in some cases you see new twists to restrictions that only Ohio has, such as the transfer agreement that can only be with a private hospital."

Mike Gonidakis leads the Ohio Right To Life coalition and is a leading force behind this movement and explains the trend by saying that big bills, that propose stopping abortion rarely work. Instead, another approach seems to be winning in Ohio and other states.

"They're called Hail Mary passes for a reason," Gonidakis says. "We believe in an incremental approach to both the legislative side as well as the changing hearts and minds."

Ohio's abortion laws on how to administer RU-486, which is the two-dose pill regimen, are one example of the incremental approach. The state requires more visits than medically necessary and caps use at 7 weeks, as compared with 9 in many other states. 

Another law that exemplifies this incremental approach is the state's transfer agreement rule which requires clinics to have an agreement with a nearby non-public hospital in case of an emergency. Law experts say it is similar to the admitting privilege case the U.S. Supreme Court may consider out of Texas in the fall.

Jessie Hill is a constitutional law professor at Case Western Reserve University and a board member of Cleveland abortion clinic, Preterm. She says the various provisions have largely gone under the public radar for years.

"It's hard for people to see how any one of these things in isolation impacts abortion access but when they add up, they can really constitute a major burden," Hill says. 

Lee Strang is a conservative-leaning constitutional law professor at the University of Toledo. He says the strategy's success is because of a long-term nationwide strategy that - so-far - has withstood legal scrutiny. 

"At some point in the mid to late 70s, pro-life people recognized that they were in for the long haul and instead of trying to overturn Roe at least immediately, they tried to incrementally undermine Roe through the judicial appointment process and then through state and federal statutory restrictions on abortion," he says.

In 2013 alone, 22 states including Ohio enacted 70 provisions restricting access to abortion, according to the Guttmacher Institute.

When Dr. David Burkons opened for surgical abortions last week, there was pent up demand. He did 16 in three days, including on Sunday.

Burkons says the state's regulatory environment has caused that demand. 

"Nobody grows up saying, you know, I’m planning on having an abortion," Burkons says. "And, they think it will never happen to me, I’m too smart for that. Or whatever. And they just assume if it does happen, someone will be here."

About half of the state's abortion clinics have closed since 2010. Including Burkons' clinic, there are 9 left.

Story by Sarah Jane Tribble

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