Joe Riehl of West Toledo holds a sign during a January prayer vigil outside the Capital Care Clinic on West Sylvania, now Toledo’s only abortion clinic.
When a person calls the telephone number for the former Toledo abortion clinic Center for Choice or tries to access the Web site, he or she is redirected to the Northland Family Planning Centers that operate three abortion clinics in the Detroit area.
Renee Chilean, executive director of Northland, bought the old Center for Choice telephone number and Web site address when she heard the abortion clinic was being shut down by the Ohio Health Department last June.
Center for Choice closed after local hospitals declined to enter into a transfer agreement with it. Ohio law requires a pact for the transfer of patients needing emergency treatment.
Ms. Chilean said she began to notice women coming from Ohio to the Michigan clinics about two years ago when Ohio law changed and banned abortions after 22 weeks.
In Michigan, abortions are still available up to 24 weeks.
But a new influx of Toledo women to Northland’s Westland site, which is located off I-275, started about October, and she attributes the change to the closing of the Center for Choice.
Ms. Chilean said a huge increase in patients have been coming from Toledo and other parts of Ohio, about 30 to 50 a month.
“We added a physician and more patient days to accommodate the influx,” she said. “We are doing everything we can to never turn a woman away when she is feeling desperate.”
Ms. Chilean said she believes women in the Toledo area who wish to have an abortion will become even more desperate — and the numbers making the trip to Michigan will increase — if the final abortion clinic in the city, Capital Care Network, is also shut down.
Capital Care is facing the prospect of having its license revoked by the Ohio Health Department, but owner Terry Hubbard is fighting to keep the clinic open.
An administrative hearing on the issue has been scheduled for Wednesday in Columbus.
The U.S. Supreme Court affirmed the legality of abortion some 41 years ago in the historic 1973 Roe vs. Wade decision. The moral questions about abortion, however, never have been settled.
Many public opinion polls show the majority of people still support a woman’s right to have an abortion, but most polls show people strongly support some restrictions on the procedure.
In Ohio, Michigan, and several other states, anti-abortion rights organizations, sensing a shift in the public mood, have seized the opportunity to work with conservative politicians to slowly pass laws that do not challenge the legality of abortion but make it difficult or nearly impossible for abortion clinics to operate.
“Abortion is not illegal in Ohio, but we can regulate and restrict it, and that’s what we are doing,” said Mike Gonidakis, president of Ohio Right to Life.
“What’s going on in Ohio and Michigan mirrors the country,” said Elizabeth Nash, state issues manager of the Guttmacher Institute, a pro-choice think tank. Since 2011, states have passed a wave of abortion restrictions — 205 in three years, she said.
“The [pro-life advocates] have been very smart. They have chipped away at abortion rights and have been smart in naming these bills about protecting women. There is nothing in these laws about protecting women. They are simply trying to make it more difficult for these clinics to stay open,” Ms. Chilean said.
At issue in Ohio is a law passed in June as part of the state’s two-year budget. Ambulatory surgical facilities, including abortion clinics, must have a transfer agreement with a hospital that will accept patients who develop complications. The new regulation prohibits abortion clinics from forming a patient-transfer agreement with a taxpayer-funded public hospital.
Ohio is the first state in the country to pass such a restrictive law, Ms. Nash said. The law forced abortion clinics to look to private hospitals for patient-transfer agreements. But many private hospitals won’t enter into agreements with abortion clinics.
For Capital Care, the law left it without any transfer agreement, after the University of Toledo Medical Center, the former Medical College of Ohio, let its agreement with the clinic expire on July 31. The last-ditch hope for Capital Care is to be granted an exception by the health department.
Ms. Hubbard said she is prepared to fight to keep Capital Care open, and she recently hired a new lawyer to help her in the effort.
No matter the outcome of the state license revocation hearing later this month, the case could drag on for several months or years because Ms. Hubbard has the option of appealing the decision through the court system.
The law has had a devastating effect on clinics in Ohio, said abortion-rights activist Kellie Copeland. Ohio had 14 abortion clinics at the start of 2013. There are now 11 after three — Center for Choice in Toledo and clinics in Cleveland and Akron — closed last year, said Ms. Copeland, executive director of NARAL Pro-Choice Ohio.
Ms. Copeland contends the actions to revoke licenses from clinics is about ideology, not patient safety. She said the complication rate at abortion clinics was very small in Ohio, less than a 10th of a percent, before the transfer-agreement law was passed.
“It was clear that it was targeted at clinics in Toledo and Cincinnati where clinics had transfer agreements with public hospitals,” Ms. Copeland said. “Politics has no place in the Ohio Department of Health. This is disturbing.”
Mr. Gonidakis said Gov. John Kasich and the state legislature closed a loophole that has allowed state-funded medical institutions, such as UTMC, to get around laws that have been on the books for years that prohibit the use of taxpayer dollars for abortions.
Federal courts have ruled that transfer-agreement laws are constitutional, and the newly approved Ohio law is keeping public hospitals from using back-door channels to support abortion, he said.
Ms. Copeland is concerned about the remaining abortion clinics in Ohio.
“I don’t feel like any clinic is safe, but four are in their cross hairs: Capital Care, one in Dayton, and two in Cincinnati. The other seven at the moment have transfer agreements with private hospitals,” she said.
Abortion clinics in Michigan are also facing a wave of new restrictions from state lawmakers, Ms. Nash said. Michigan also has a transfer-agreement law, but unlike Ohio, the state does not prohibit public institutions from entering into pacts with abortion clinics.
Ms. Nash said that when pro-life groups find a particular tactic works in one state, it doesn’t take long for other states to adopt similar measures.
According to the Guttmacher Institute, Michigan had 30 abortion clinics in 2011. That number has dwindled to 17, according to information provided by the Michigan Department of Licensing and Regulatory Affairs.
One longtime pro-choice advocate in Toledo is not optimistic about the outcome for Capital Care.
“They have won, for now,” said Carol Dunn, one of the former owners of Center for Choice.
Ms. Dunn said the anti-abortion advocates “don’t quit. That’s why they have been successful.”
Fonda Luersman, who recruits volunteers for prayer vigils and sidewalk counseling outside of Capital Care Clinic for the Catholic Charities organization, agrees that anti-abortion rights groups have gained momentum.
Ms. Luersman said she has seen a change in the public’s attitude since she first became active in the movement in the 1980s.
“I believe we are winning. I think 87 abortion centers closed in 2013 all over the country, but we have more to go, and we are not going to stop until we have completely won,” she said.
According to the Gallup organization, the number of people who consider themselves pro-choice has shrunk from 56 percent in 1996 to 47 percent in 2013. Conversely, those who self-identify as pro-life rose from 37 percent to 46 percent of the public during that same time period.
Ms. Luersman recruits about 12 to 20 people through the Catholic parishes or by word of mouth to be present outside of Capital Care clinic on West Sylvania Avenue at least one day each week. They will continue to be there until the clinic is shut down, she said.
“We are out there to offer prayer to women and men who are coming, and we offer alternatives to abortion,” Ms. Luersman said.
Ms. Luersman said she is aware that the public has a negative image of people who protest outside of clinics. She also concedes that in the past some protesters used aggressive tactics, such as yelling at women walking into clinics and holding graphic photos of fetuses on signs.
Part of her goal is to change the image of the protesters and make them less threatening to the women and men who are arriving at the clinics.
“We are more approachable when we don’t hold signs,” Ms. Luersman said. “We smile and we say, ‘Good morning, I have some important information for you.’ I tell them that at 3 weeks your baby has a heartbeat, and I tell them that their baby can feel things. I tell them that God made their baby and has a plan for their baby and that we care about them and want to help them.”
Ms. Luersman believes that if Capital Care closes its doors, it will force women to rethink the decision to have an abortion. If it’s more inconvenient to get to a clinic out of town, she feels the local abortion rate will decrease.
“If abortion is not available, I think women will have their babies and think about it before they become sexually active,” she said.
Ms. Dunn does not agree.
She believes women who have means will still have the option of getting an abortion if Capital Care closes by going to other states where clinics still operate. She is most concerned about poor women and the lack of choices they will face if there is no local clinic.
“I think they will need more money for foster homes for these children. If they have a car and money, they can go out of town. A lot of these people don’t have two nickels to rub together,” she said.
Ms. Chilean agrees that these laws affect poor women more than middle and upper-class women.
“So many women in poverty don’t have cars and rely on taking a bus to get here,” she said. They also must have money to stay overnight in a hotel to comply with Michigan abortion laws, she said.
Ms. Copeland is concerned that women who cannot get to a clinic will try to find other illegal ways to have an abortion.
“When you take away access, it does not make abortion go away. It makes them potentially dangerous,” she said.
Mr. Gonidakis believes those who talk of women taking matters into their own hands are trying to use scare tactics to get the public to support abortion clinics.
“That is such a common talking point — back-alley abortions. It’s a stale argument,” he said.
However, Ms. Chilean said she already has seen evidence of woman turning to her clinic after they tried to obtain abortion drugs illegally, sometimes over the Internet, and finding themselves in trouble when the drugs don’t work or if they don’t take them correctly.
“I think if these laws continue to be passed, we are going to see women dying, harmed, or sick, and this is a crime. We have women tell us they have gone to these [Web] sites and they used this pill and nothing happened. They call anonymously and tell us this, because they know self-abortion is illegal so there is a danger in what they did,” Ms. Chilean said.
Contact Marlene Harris-Taylor Marlene Harris-Taylor at: email@example.com or 419-724-6091.
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