08/14/2008

By KEN KUSMER  / Associated Press

Abortion foes frustrated at the state level are turning to counties to win legislation requiring doctors who perform the procedure to have admitting privileges at local hospitals.

The Vanderburgh County commissioners in Evansville quietly passed such an ordinance last week, and activists are seeking a similar ordinance in Allen County, home to the Fort Wayne Women's Health Organization abortion clinic. Backers say such measures protect patient safety, but abortion providers say they restrict women's access to the procedure.

Local measures mark a shift in strategy for anti-abortion activists, who during the past two legislative sessions watched the state Senate — but not the Indiana House of Representatives — pass bills that would require doctors who perform abortions to have privileges at a local hospital. Measures must pass both chambers to become law.

"We continually hit that roadblock in the House," said Mike Fichter, president and chief executive of Indiana Right to Life. "We're taking the different approach of talking to counties."

At first glance, the Vanderburgh ordinance might seem inconsequential, since the Ohio River county has no abortion clinics. Indiana has nine in all, but none south of Bloomington. They provided 10,224 abortions in 2005, the last year for which the Indiana State Department of Health has statistics.

However, Fichter called the passage of the Vanderburgh ordinance, apparently the first of its kind in Indiana, a victory because it makes it harder to establish an abortion clinic in an area of the state that doesn't have one. Some doctors providing abortions in Indiana travel among several clinics that are many miles apart and might not have local hospital admitting privileges.

Right to Life has targeted other "priority counties," Fichter said without identifying them.

Abortion rights advocate Betty Cockrum, the president and chief executive of Planned Parenthood of Indiana, called the Vanderburgh County action unnecessary because the county has no abortion clinics. Planned Parenthood operates abortion clinics in Indianapolis, Merrillville and Bloomington.

Cockrum said the rate of post-procedure complications from abortions was less than half that for full-term births.

"Putting new barriers in place and creating new hardships is not the answer," she said.

The Vanderburgh County Board of Commissioners on Aug. 5 unanimously approved the "abortion provider patient safety" ordinance on its first and final reading.

The measure states a doctor cannot perform an abortion in Vanderburgh County without having admitting privileges in that county or an adjacent county. The doctor also must tell the patient where she can receive follow-up care if complications arise.

The ordinance is similar to legislation that passed the Republican-controlled state Senate but died in the Democrat-held Indiana House the past two legislative sessions.

One of its sponsors, Sen. Patricia Miller, R-Indianapolis, has asked legislative staff to draft a similar measure to be introduced in the 2009 session.

"This is all about patient care," Miller said.

Dr. Geoff Cly, a Fort Wayne obstetrician who testified in support of the legislation earlier this year, is behind the Allen County action. He went before the Board of Commissioners there Aug. 8 to ask for an ordinance in the interest of public safety.

Cly said he has treated two women who suffered life-threatening complications including bleeding, infection and fever after having incomplete abortions at the Fort Wayne clinic. One of the women ended up having a hysterectomy, the removal of her uterus.

"This is not to stop or limit abortions. It's about protecting the patients who make the choice to have one," Cly said.

If abortion providers have hospital admitting privileges, they are subject to peer reviews that look closely at post-procedure complications and remove privileges if necessary, said Cly, who sits on a committee that oversees patient safety at Fort Wayne's Dupont Hospital.

Allen County Commissioner Nelson Peters said he asked attorneys to draft language for an ordinance so the board can look more closely at the issue. He said he has discussed it informally with doctors.

"They say it would be an appropriate step toward improving the quality of care in Allen County," Peters said.

The Indiana State Medical Association did not take a position when the matter was before the General Assembly, spokeswoman Adele Lash said.

Dr. George Klopfer, who said he has performed abortions for 35 years, including more than 20 at the Fort Wayne Women's Health Organization clinic, said Cly's request amounts to a personal attack on him. He predicted a court battle if Allen County passes an ordinance.

"I've never lost a patient yet. Am I perfect? No. Is Dr. Cly perfect? No," said Klopfer, who also performs abortions in South Bend and Gary.

The last woman to die due to legal abortion in Indiana died in 1979, state health department records show.

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On the Net:

Indiana Right to Life: http://www.indianalife.org

Planned Parenthood of Indiana: http://www.ppin.org