Abortion providers in the United States are subject to strict evidence-based regulations (such as state licensing requirements, federal workplace safety requirements, association requirements and medical ethics) created specifically to ensure patient safety. However, nearly half of states have imposed additional regulations, targeted specifically at abortion clinics that go beyond what is necessary to ensure patient safety. These laws are referred to as targeted regulation of abortion providers, or TRAP laws, and their primary purpose is to limit access to abortion.
Most TRAP laws apply a state’s standards for ambulatory surgical centers (ASCs) to abortion clinics, even though surgical centers tend to provide riskier, more invasive procedures and use higher levels of sedation. In some cases, TRAP laws also extend to physicians’ offices where abortions are performed and even to sites where only medication abortion is administered. TRAP regulations often include minimum measurements for room size and corridor width—requirements that may necessitate relocation or costly changes to a clinic’s physical layout and structure. Some regulations also mandate that clinicians performing abortions have admitting privileges at a local hospital, even though complications from abortion that require hospital admission are rare, so abortion providers are unlikely to meet minimum annual patient admissions that some hospitals require. TRAP requirements set standards that are intended to be difficult, if not impossible, for providers to meet. Instead of improving patient care, these laws endanger patients by reducing the total number of abortion facilities that are able to stay open under these financial and administrative constraints, thus making safe services harder to obtain.
In June 2016, the U.S. Supreme Court struck down two of the most burdensome TRAP laws, which had been enacted in Texas; the regulations required physicians who provide abortions to establish official relationships with local hospitals and required abortion facilities to meet the state’s standards for ASCs. Both of these requirements were unnecessary to ensure patient safety and did little to improve patient care. In Whole Woman’s Health v. Hellerstedt, the Supreme Court did not find any evidence to support the need for these requirements and concluded that the restrictions created an undue burden for women seeking abortion services. While the decision in Whole Woman’s Health does not automatically nullify all TRAP requirements, it has paved the way to challenge other states’ TRAP laws.