Home Contact Register Subscribe to the Beacon Login

Wednesday, January 30, 2013



This proposed legislation should be supported by all who put the health and wellbeing of women who are patients seeking elective termination of a pregnancy above all else.

The safety of abortion is touted by it’s advocates using statistics and terms indicating infrequency of problems. The number of procedures does, though, result in significant incidents of harm to actual human beings as a result of procedures executed by itinerate physicians.

This is a preemptive measure intended to avoid as much as is practicable unintended consequences of itinerate surgery.

Medical Privileges is a BIG DEAL for both physicians and the hospitals extending such privileges. The process has significant correlation with risk management and legal exposure. It is undertaken very, very thoroughly. For a REASON.

A more rigorous vetting of itinerant physicians by hospitals done by their professional peers WILL improve the care of women patients and thus the outcomes of their surgery or medically induced termination.

The constitutionality of a state’s duty to protect it’s citizens by establishing pre-emptive measures in general, and in this manner itinerate physician scrutiny specifically, is well established in case law.

Abortion practitioners and academics concur that establishment of medical privileges will result in improved outcomes following elective pregnancy termination.



Red River Women’s Clinic Website


It can take anywhere from about a day to 3-4 weeks from the time a woman takes the first medication until the medical abortion is completed.  The length of time depends in part on the medications taken and when the misoprostol is used.  The majority of women who take mifepristone will abort within four hours of using misoprostol.  About 95% of women will have a complete abortion within a week. 

Possible Complications:  About 95-98% of women will have a successful medical abortion.  Complications are rare.  However, a small percentage of women (approximately 0.5-2%) will need a suction aspiration (similar to a surgical abortion) because of heavy or prolonged bleeding.  Rarely, in approximately 0.1-0.2% of cases, a blood transfusion might be required to treat very heavy bleeding. 

In about 1% of cases or fewer, the medications do not work and the embryo continues to grow. In these cases, a suction procedure (surgical abortion) must be done to empty the uterus and complete the abortion.  Deciding to continue the pregnancy to term is not an option after taking the first medication because the medications can cause birth defects in the pregnancy.



• Medication abortion accounted for 17% of all nonhospital abortions, and about one-quarter of abortions before nine weeks’ gestation, in 2008.

• Fewer than 0.3% of abortion patients experience a complication that requires hospitalization.


North Dakota Abortion Numbers and Statistical Probabilities by Year

2011    2010    2009    2008    2007    2006    2005    2004    2003    2002

1,247   1,291   1,290   1,386   1,235   1,298   1,231   1,357   1,354   1,219 = 9 yr total = 12,3908

12,908 X 0.003  38.24 (9 year estimate) or  4.3 per year requiring hospitalization

How many are complicated but do not require hospitalization?

Medical termination does not work…who finishes in the case of critical need?

What about the conscience of medical professionals that would have to complete the procedure should there be horrific problems as a result of an abortion?

A Google search of the two words “Ambulance Abortion” will yield insightful results.



 “Itinerant surgery is defined in this inspection as the practice by a physician (normally residing in another city) of traveling to small rural hospitals to perform surgery. The surgeon tpically is not available for follow-up care, having traveled to another rural hospital or returned to his or her home base all in the same day. The American College of Surgeons will and have excluded physicians from fellowship for performing itinerate surgery”. United States Department of Human Services, Office of Inspector General report (1988).

The American College of Surgeons has long condemned the practice of "itinerant surgery," where doctors operate on patients and leave follow-up care to a family physician. But it has refrained from issuing guidelines on locum tenens. Paul Collicott, a director of the ACS, says it's "a necessary part of surgical practice today," given the overall shortage in the field. He says it's the responsibility of each temporary surgeon to make sure patients are handed off to another surgeon for postoperative care.” - Wall Street Journal, January 13, 2009

“I pledge myself to pursue the practice of surgery with honesty and to place the welfare and rights of my patient above all else.  I promise to deal with each patient as I would wish to be dealt with if I were in the patient’s position, and I will set my fees commensurate with the services rendered.  I will take no part in any arrangement, such as fee splitting or itinerant surgery, which induces referral or treatment for reason other than the patient’s best welfare”. Portion of the Fellowship Pledge – American College of Surgeons, International Fellowship Requirements



Termination of pregnancy is not a benign medical procedure. In some cases, serious complications, even life-threatening ones, arise and necessitate optimal and evidence-based treatment.

According to John Thorp, Jr., an abortion provider who is the author of a leading abortion textbook and who is as well as a physician is a professor of obstetrics and gynecology at the University of North Carolina (Chapel Hill) School of Medicine:

“there are few surgical procedures given so little attention and so underrated in its potential hazard as abortion.”

W.M. Hern, in ABORTION PRACTICE 101 (1990):

“Serious complications can only be evaluated in full service hospitals and often occur after regular business hours. Given the frequency of short-term complications from abortion (2-10%), follow-up medical care is often needed on an urgent basis to treat infection, bleeding, or organ damage. If recognized and attended to promptly, long-term consequences can be minimized. Often, though, abortion procedures are performed in freestanding clinics during weekday hours and complications are managed in urgent care centers or emergency departments after hours or on weekends.”

Dr. Thorp also asserts that:

“When the [abortion] provider is an ob-gyn and has admitting and treating privileges at a local hospital, he or she is more likely to effectively manage patient complications by providing continuity of care and decrease the likelihood of medical errors.”

Nationally, 73% of emergency departments report inadequate on-call coverage by specialist physicians, including obstetricians/gynecologists who are particularly difficult to secure. According to O’Malley, A., Draper, D. & Felland, L. in their publication Hospital Emergency On-Call Coverage: Is There a Doctor in the House?


Code of Professional Conduct


E. Postoperative Care 

The responsibility for the patient's postoperative care rests primarily with the operating surgeon. The emergence of critical care specialists has provided important support in the management of patients with complicated systemic problems. It is important, however, that the operating surgeon maintain a critical role in directing the care of the patient. When the patient's postoperative course necessitates the involvement of other specialists, it may be necessary to transfer the primary responsibility for the patient's care to another physician. In such cases, the operating surgeon continues to be involved in the care of the patient until surgical issues have resolved. Except in unusual circumstances, it is unethical for a surgeon to relinquish the responsibility for the postoperative surgical care to any other physician who is not qualified to provide similar surgical care. 

F. Continuity of Care of the Surgical Patient

The surgeon will ensure appropriate continuity of care of the surgical patient. An ethical surgeon should not perform elective surgery at a distance from the usual location where he or she operates without personal determination of the diagnosis and of the adequacy of preoperative preparation. Postoperative care should be rendered by the operating surgeon unless it is delegated to another physician who is as well qualified to continue this essential aspect of total surgical care.

It is recognized that for many operations performed in an ambulatory setting, the pattern of the patient's postoperative visits to the surgeon may vary considerably; it is, however, the responsibility of the operating surgeon to establish communication to maintain proper continuity of care. 



An entire legal specialty field

William and Mary Law Review [Vol.  29:609

A  hospital with  a respected staff and a reputation  for  high-quality care  will  be  attractive  to skilled physicians,  who  want access  to the  broad  patient  base  and  desire  the  prestige  of membership  on the  hospital  staff.

Staff privileges  are  one  of the most  important  assets  of a physician's  practice.

Although specific  procedures for review  of staff privilege  applications may  differ  at various  hospitals, some  general  similarities  exist. Several  groups  within the  hospital structure  participate  in the process  of  considering  an  application  for  privileges.  The  medical staff plays  a significant  role  in that process  by  evaluating the  professional  capabilities  of the applicant. The physicians  on the hospital's  credentialing  committee  investigate  the  applicant's  background  to  determine  the  extent  of  his  past  medical  training  and performance,  whether  he  is  licensed  and  board  certified,  whether he  carries  malpractice  insurance,  and  any  other  information  that they believe is relevant. The  committee may report to the staff as  a whole,  to  its  executive  committee,  or  directly  to  the  governing board.  The  board  is responsible  for making  the  final  decision,  although  many  boards  may  give  great weight  to  the findings  of the committee. If the decision  is unfavorable  to the physician,  the hospital  generally  provides  an  internal  procedure  for  appeal  and review.


Burdensome V. Life-Impacting Consequences

Abortionist Dr. Thorp acknowledges that “[a]ll competent physicians endure the ‘burdensome’ nature of applying for hospital privileges for the safety and well-being of their patients.”

Dr. James Anderson, a board-certified emergency medicine physician who serves as clinical professor at the Medical College of Virginia, opines regarding requiring physicians associated with abortion clinics to have hospital privileges, “s consistent with the time-honored practice of requiring training and credentialing of physicians who are making decisions and doing procedures that have life-impacting consequences. If a physician cannot obtain privileges for the specific requested procedures at his or her local hospital, then in my expert opinion, the physician is not qualified to do the surgical procedures that have life-changing or life-threatening impact.”


Constitutionality of Proposed SB 2305

This proposed law would likely prove to be of no unconstitutional purpose. As Casey held, a regulation serves a “valid purpose” if it is “not designed to strike at the right [to abortion] itself” and furthers the State’s “legitimate interests…in protecting the health of the woman and the life of the fetus that may become a child.” 505 U.S. at 846.


Simopolous v. Virginia, 462 U.S. 506, 511 (1983) affirms that “[t]he State has a legitimate interest in seeing to it that abortion, like any other medical procedure, is performed under circumstances that insure maximum safety for the patient”.


Simopoulos, 462 U.S. at 516 affirms that , “In view of its interest in protecting the health of its citizens, the State necessarily has considerable discretion in determining standards for the licensing of medical facilities”.


Greenville Women's Clinic v. Bryant, 222 F.3d 157, 172 (4th Cir.2000), cert. denied, 531 U.S. 1191 (2001) (“Greenville I”), held that a “valid purpose” was served by a regulation requiring abortion clinics to be associated with a physician who has admitting privileges at a local hospital.

Gonzales, supra, 550 U.S. at 163 (“The Court has given state and federal legislatures wide discretion in areas where there is medical and scientific uncertainty.”); id., at 157


Washington v. Glucksberg, 521 U.S. 702, 731 (1997) (“[t]here can be no doubt that the government ‘has an interest in protecting the integrity and ethics of the medical profession’”).


The Supreme Court has upheld health-related abortion-clinic rules that merely “may be helpful” and “can be useful.” Planned Parenthood of Central Mo. v. Danforth, 428 U.S. 52, 80, 81 (1976).


Two federal circuit courts have expressly found that “admitting privileges at local hospitals and referral arrangements with local experts” are “so obviously beneficial to patients” undergoing abortions as to easily withstand a facial constitutional challenge alleging them to be undue burdens.

Greenville Women's Clinic v. Commissioner, South Carolina Dept. of Health and 317 F.3d 357, 363 (4th Cir. 2002) (“Greenville II); Women’s Health Ctr. of West County, Inc. v. Webster, 871 F.2d 1377, 1382 (8th Cir. 1989).


Accord Tucson Woman's Clinic v. Eden, 379 F.3d 531, 547 (9th Cir. 2004) (holding that Arizona statute requiring only abortionists who performed a certain number of abortions per month to obtain admitting privileges did not violate equal protection because it was rationally related to achieving a legitimate end).




Click here to email your elected representatives.


Planned Parenthood Attempt to Hide 4th Abortion Emergency since Thanksgiving 2012 in St. Louis


During the hearing of SB 2305 on January 29, 2013,

Tammi Kromenaker, director of North Dakota’s only abortion clinic, the Red River Women’s Clinic in Fargo stated that, “Abortion care is one of the safest medical procedures in the United States,”

It CAN happen here!

North Dakota can have the highest standards and protect women at risk.

Steve Cates on January 30, 2013 at 06:27 pm
Page 1 of 1        

Post a Comment


Upload Image    

Remember my personal information

Notify me of follow-up comments?