Two North Texas doctors have filed suit against a Dallas hospital that told them it had revoked their admitting privileges because they provide legal abortion care.
Federal and state laws prevent hospitals from discriminating against doctors who perform abortions.
Doctors Lamar Robinson and Jasbir Ahluwalia received identical letters, dated March 31, from the CEO of the University General Hospital of Dallas (UGHD), who wrote that because the doctors performed legal abortion procedures at locations wholly separate from the hospital, the doctors were engaging in “disruptive behavior,” in violation of the hospital’s bylaws.
The two doctors’ “practice of voluntary interruption of pregnancies,” wrote hospital CEO Charles Schuetz, “creates significant exposure and damages to UGHD’s reputation within the community.”
Appreciate our work?
Vote now! And help Rewire earn a bigger grant from CREDO:
For now, a Dallas County judge has temporarily granted a restraining order that forces the hospital to reinstate the doctors’ privileges until the case can receive a full hearing, which has been scheduled for April 30.
During debate over HB 2, reproductive rights supporters predicted that hospitals would refuse to grant privileges to abortion providers out of fear of retaliation from anti-choice protesters; in subsequent court challenges to the law, the State of Texas argued that because federal and state laws prevent hospitals from discriminating against abortion providers, doctors who provide abortions would have plenty of legal recourse in the unlikely event they were denied privileges.
Now, Robinson and Ahluwalia are suing on precisely those anti-discrimination statutes, alleging that UGHD revoked their privileges not only because they are abortion providers, but at the behest of anti-choice activists who threatened the hospital with negative publicity if it continued to employ the doctors.
Opponents of reproductive rights in Texas have been developing templates for anti-abortion activists to follow in hopes of convincing hospitals to revoke abortion providers’ admitting privileges, including contacting hospital boards and advising those who seek to get doctors de-credentialed that “you will want to inform the CEO of your plans to hold a prayer vigil outside of their hospital.”
In court documents, the doctors allege that anti-choice protesters had threatened to picket UGHD on April 1, leading to the hospital’s decision to revoke the doctors’ privileges:
On information and belief, activists opposed to abortion contacted the hospital and demanded that it revoke Dr. Robinson’s admitting privileges and sever any relationship with physicians who provide abortion. On information and belief, the hospital was threatened with an April 1, 2014 protest outside its Dallas facility if it refused to give into the activists’ demands. The day before the threatened protest, March 31, 2014, UGHD did exactly what the protestors had demanded.
UGHD’s Schuetz, a Republican political donor who lives in Houston, claims in his March 31 letter that the hospital does not provide gynecology services and “does not have the capacity to treat complications that may arise from voluntary interruption of pregnancies.”
Calls and emails to UGHD were not immediately returned, but the hospital’s website says it provides a “full array of services” and “the ultimate in modern medical treatment.” Both Robinson and Ahluwalia say they were admitted specifically to provide gynecological services such as the “identification and treatment of abscesses, cysts and cancers.”
In the March 31 letter, Schuetz also writes that “it has come to [UGHD’s] attention” that doctors Robinson and Ahluwalia perform legal abortion procedures, implying that the hospital was previously unaware it had granted privileges to two abortion providers.
Both Robinson and Ahluwalia say they were clear about their off-site abortion services when UGHD granted their admitting privileges in December and January, respectively. Dr. Robinson even says in court documents that he applied directly to perform “certain second-trimester surgical abortion procedures.”
Doctors Robinson and Ahluwalia were not the only abortion providers who went to court this week to fight for revoked admitting privileges. Lawyers for an El Paso abortion provider appeared in federal court in Austin on Wednesday after their client found that her hospital admitting privileges had been revoked without warning or explanation, causing the city’s Reproductive Services clinic to stop seeing patients on April 11, canceling 30 appointments.
Below, read the March 31 letter that UGHD sent to Robinson and Ahluwalia, calling their abortion practices damaging to the hospital’s “reputation.”
The providers seeking money include Planned Parenthood of Wisconsin, Inc., Planned Parenthood Federation of America, and Milwaukee Women's Medical Services, which conducts business as Affiliated Medical Services.
Abortion providers serving Wisconsin residents could recoup nearly $1.8 million in legal fees they amassed while fighting an anti-choice law that was first blocked in 2013. However, spokespeople for the State of Wisconsin have raised the possibility of an undisclosed settlement.
In a U.S. District Court filing dated July 28, the providers requested an award of “attorneys’ fees, costs and expenses” that could be recouped under the Civil Rights Attorneys’ Fee Awards Act of 1976. On Wednesday in response, Wisconsin Attorney General Brad Schimel asked the court to extend the due date for the state to respond from August 18 to September 1. The request was granted, according to court documents.
“The parties are currently discussing settlement of the plaintiffs’ motion. An extension of the briefing schedule would allow the parties the opportunity to explore the possibility of a settlement of this issue,” Schimel said in the court filing.
The providers seeking money include Planned Parenthood of Wisconsin, Inc., Planned Parenthood Federation of America, and Milwaukee Women’s Medical Services, which conducts business as Affiliated Medical Services. The sum requested includes $1.7 million in attorneys’ fees, $44,253 in billable costs and $22,545 in out-of-pocket expenses, according to the court filing.
Appreciate our work?
Vote now! And help Rewire earn a bigger grant from CREDO:
The providers amassed the fees fighting Wisconsin Act 37 of 2013, a Republican-initiated law that required doctors to have hospital admitting privileges within 30 miles of the location where an abortion was to be performed.
U.S. District Judge William Conley of the Western District of Wisconsin blocked the law’s enforcement soon after Republican Gov. Scott Walker signed it in 2013.
The state attorney general twice appealed to the Seventh Circuit U.S. Court of Appeals, which affirmed the lower court’s decision both times; the U.S. Supreme Court also declined to take the case a day after overturning a similar provision in Whole Woman’s Health v. Hellerstedt.
In a Court of Appeals opinion issued in November 2015, the court said there was no evidence that “transfer agreements provide inferior protection to the health of women undergoing abortion compared to admitting privileges.” The opinion concluded by saying the unconstitutional statute was burdensome and curtailed citizens’ constitutional right to an abortion.
“The statute may not be irrational, yet may still impose an undue burden—a burden excessive in relation to the aims of the statute and the benefits likely to be conferred by it— and if so it is unconstitutional,” the court said.
If not blocked, the law would have forced pregnant people in various parts of the state to travel at least an extra 200 miles round trip to access legal abortion, according to a previous Rewire report.
Johnny Koremenos, a spokesperson for Schimel, had indicated in statements to the Journal Sentineland the Wisconsin State Journal earlier this month that the state would fight the charges for legal fees. He said Schimel would challenge the providers’ request “to ensure that the state is not paying more than it should be for those fees,” according to local news reports.
Koremenos did not respond to Rewire’s request for comment.
Ismael Ozanne, the district attorney for Dane County, was also named as a defendant in the providers’ lawsuit, along with several state medical examining board members.
Planned Parenthood of Wisconsin spokeswoman Iris Riis told Rewire the money Planned Parenthood is seeking in this case is only a recoup of the legal fees already spent fighting the unconstitutional admitting privileges law.
“There would not be any leftover money to allocate to services or any fund. It would just cover what was already spent. Governor Walker’s administration appealed multiple definitive rulings, wasting countless taxpayer dollars in the process. That action also drove up our legal costs,” Riis said.
Riis said the plaintiffs do not know when Conley will issue the ruling that will determine whether Schimel will have to compensate them for legal fees.
Andrew Wiseman, a deputy clerk in the U.S. District Court, Western District of Wisconsin, told Rewire the court could not offer a prediction about the date of Conley’s ruling.
Affiliated Medical Services, which operates a clinic in Milwaukee, is being represented by the American Civil Liberties Union of Wisconsin, while private attorneys are representing Planned Parenthood.
A Texas GOP lawmaker has teamed up with an anti-choice organization to raise awareness about the supposed prevalence of forced or coerced abortion, which critics say is “wildly divorced from reality.”
Rep. Molly White (R-Belton) during a press conference at the state capitol on July 13 announced an effort to raise awareness among public officials and law enforcement that forced abortion is illegal in Texas.
White said in a statement that she is proud to work alongside The Justice Foundation (TJF), an anti-choice group, in its efforts to tell law enforcement officers about their role in intervening when a pregnant person is being forced to terminate a pregnancy.
“Because the law against forced abortions in Texas is not well known, The Justice Foundation is offering free training to police departments and child protective service offices throughout the State on the subject of forced abortion,” White said.
Appreciate our work?
Vote now! And help Rewire earn a bigger grant from CREDO:
White was joined at the press conference by Allan Parker, the president of The Justice Foundation, a “Christian faith-based organization” that represents clients in lawsuits related to conservative political causes.
Parker told Rewire that by partnering with White and anti-choice crisis pregnancy centers (CPCs), TJF hopes to reach a wider audience.
“We will partner with anyone interested in stopping forced abortions,” Parker said. “That’s why we’re expanding it to police, social workers, and in the fall we’re going to do school counselors.”
White only has a few months remaining in office, after being defeated in a closely contested Republican primary election in March. She leaves office after serving one term in the state GOP-dominated legislature, but her short time there was marked by controversy.
During the Texas Muslim Capitol Day, she directed her staff to “ask representatives from the Muslim community to renounce Islamic terrorist groups and publicly announce allegiance to America and our laws.”
Heather Busby, executive director of NARAL Pro-Choice Texas, said in an email to Rewire that White’s education initiative overstates the prevalence of coerced abortion. “Molly White’s so-called ‘forced abortion’ campaign is yet another example that shows she is wildly divorced from reality,” Busby said.
There is limited data on the how often people are forced or coerced to end a pregnancy, but Parker alleges that the majority of those who have abortions may be forced or coerced.
‘Extremely common but hidden’
“I would say that they are extremely common but hidden,” Parker said. “I would would say coerced or forced abortion range from 25 percent to 60 percent. But, it’s a little hard be to accurate at this point with our data.”
Parker said that if “a very conservative 10 percent” of the about 60,000 abortions that occur per year in Texas were due to coercion, that would mean there are about 6,000 women per year in the state that are forced to have an abortion. Parker believes that percentage is much higher.
“I believe the number is closer to 50 percent, in my opinion,” Parker said.
Busby said that White used “flawed research” to lobby for legislation aimed at preventing coerced abortions in Texas.
“Since she filed her bogus coerced abortion bill—which did not pass—last year, she has repeatedly cited flawed research and now is partnering with the Justice Foundation, an organization known to disseminate misinformation and shameful materials to crisis pregnancy centers,” Busby said.
White also sponsored HB 1648, which would have required a law enforcement officer to notify the Department of Family and Protective Services if they received information indicating that a person has coerced, forced, or attempted to coerce a pregnant minor to have or seek abortion care.
The bill was met by skepticism by both Republican lawmakers and anti-choice activists.
State affairs committee chairman Rep. Byron Cook (R-Corsicana) told White during a committee hearing the bill needed to be revised, reported the Texas Tribune.
“This committee has passed out a number of landmark pieces of legislation in this area, and the one thing I think we’ve learned is they have to be extremely well-crafted,” Cook said. “My suggestion is that you get some real legal folks to help engage on this, so if you can keep this moving forward you can potentially have the success others have had.”
‘Very small piece of the puzzle of a much larger problem’
White testified before the state affairs committee that there is a connection between women who are victims of domestic or sexual violence and women who are coerced to have an abortion. “Pregnant women are most frequently victims of domestic violence,” White said. “Their partners often threaten violence and abuse if the woman continues her pregnancy.”
There is research that suggests a connection between coerced abortion and domestic and sexual violence.
Dr. Elizabeth Miller, associate professor of pediatrics at the University of Pittsburgh, told the American Independent that coerced abortion cannot be removed from the discussion of reproductive coercion.
“Coerced abortion is a very small piece of the puzzle of a much larger problem, which is violence against women and the impact it has on her health,” Miller said. “To focus on the minutia of coerced abortion really takes away from the really broad problem of domestic violence.”
A 2010 study co-authored by Miller surveyed about 1,300 men and found that 33 percent reported having been involved in a pregnancy that ended in abortion; 8 percent reported having at one point sought to prevent a female partner from seeking abortion care; and 4 percent reported having “sought to compel” a female partner to seek an abortion.
Another study co-authored by Miller in 2010 found that among the 1,300 young women surveyed at reproductive health clinics in Northern California, about one in five said they had experienced pregnancy coercion; 15 percent of the survey respondents said they had experienced birth control sabotage.
‘Tactic to intimidate and coerce women into not choosing to have an abortion’
TJF’s so-called Center Against Forced Abortions claims to provide legal resources to pregnant people who are being forced or coerced into terminating a pregnancy. The website includes several documents available as “resources.”
One of the documents, a letter addressed to “father of your child in the womb,” states that that “you may not force, coerce, or unduly pressure the mother of your child in the womb to have an abortion,” and that you could face “criminal charge of fetal homicide.”
The letter states that any attempt to “force, unduly pressure, or coerce” a women to have an abortion could be subject to civil and criminal charges, including prosecution under the Federal Unborn Victims of Violence Act.
The document cites the 2007 case Lawrence v. State as an example of how one could be prosecuted under Texas law.
“What anti-choice activists are doing here is really egregious,” said Jessica Mason Pieklo, Rewire’s vice president of Law and the Courts. “They are using a case where a man intentionally shot his pregnant girlfriend and was charged with murder for both her death and the death of the fetus as an example of reproductive coercion. That’s not reproductive coercion. That is extreme domestic violence.”
“To use a horrific case of domestic violence that resulted in a woman’s murder as cover for yet another anti-abortion restriction is the very definition of callousness,” Mason Pieklo added.
Parker said a patient might go to a “pregnancy resource center,” fill out the document, and staff will “send that to all the abortionists in the area that they can find out about. Often that will stop an abortion. That’s about 98 percent successful, I would say.”
Reproductive rights advocates contend that the document is intended to mislead pregnant people into believing they have signed away their legal rights to abortion care.
Abortion providers around the country who are familiar with the document said it has been used for years to deceive and intimidate patients and providers by threatening them with legal action should they go through with obtaining or providing an abortion.
Vicki Saporta, president and CEO of the National Abortion Federation, previously told Rewire that abortion providers from across the country have reported receiving the forms.
“It’s just another tactic to intimidate and coerce women into not choosing to have an abortion—tricking women into thinking they have signed this and discouraging them from going through with their initial decision and inclination,” Saporta said.
Busby said that the types of tactics used by TFJ and other anti-choice organizations are a form of coercion.
“Everyone deserves to make decisions about abortion free of coercion, including not being coerced by crisis pregnancy centers,” Busby said. “Anyone’s decision to have an abortion should be free of shame and stigma, which crisis pregnancy centers and groups like the Justice Foundation perpetuate.”
“Law enforcement would be well advised to seek their own legal advice, rather than rely on this so-called ‘training,” Busby said.