How feasible are mobile abortion clinics?

June 15, 2009 12:13 PM

How feasible are mobile abortion clinics?

A little while ago, Dr. George Tiller, one of the last providers of late-term abortions was shot and killed. I, like many people, reflected on the insanity of that.

I read a few articles and discovered that for a long time, pro-life demonstrators would gather outside of his clinic and rally. It struck me that the kind of high emotion at these rallies contributed to an atmosphere were a single killer would feel justified to act on what they were all thinking.

I read another article that talked about how now that Dr. Tiller's clinic is shutting down, and protesters didn't have a target anymore, that many of them were left out of sorts, unsure where to direct their anger, what to do with their Sunday afternoons.

So I thought, well, if the clinic is a focal point, what if we remove it?
What if we have mobile abortion clinics?

They would be in plain white vans, so that they would be hard to target. Those seeking abortions can meet them without throngs of protesters attempting to dissuade them. They can likely travel to more far-flung rural regions where there may not be an abortion clinic close by.

A quick google search brought me to this article, which suggested to me that it might be possible on a purely utilitarian level, but knowing China's history of human rights abuses, I wasn't sure how comfortable or humane these vans would be. I was hoping that someone who was familiar with abortion services would be able to reflect on the feasability, the pros and the cons of such a service on wheels.

posted by Sully to human relations (15 answers total)

Can't speak to the medical safety and so on for such vehicles, but I doubt they could effectively dodge determined abortion opponents. Once the word got out, they'd just follow the vans as they made their rounds.
posted by notyou at 12:18 PM on June 15, 2009

It is certainly possible; there are mobile CT scanners, MRI scanners, and lithotripsy units, among others. On the other hand, security could be more difficult and many states have regulations for abortion providers that are more stringent than for other medical service providers and these might not be possible to satisfy in a mobile setting.
posted by TedW at 12:20 PM on June 15, 2009

No idea about the medical issues involved, but as a practical matter- if someone needing an abortion could find the van, someone wishing to target the van can find it too.
posted by nat at 12:20 PM on June 15, 2009

I don't know about vans, but Women on Waves have been using boats.
posted by HFSH at 12:20 PM on June 15, 2009

I'm with notyou and nat on this... It's harder to defend a moving van than a stationary building. It's also easier for a nutjob to destroy the whole operation by rear ending a van than by plowing into a building. It's medically possible though, sure.
posted by telegraph at 12:21 PM on June 15, 2009

Don't know if it would be feasible in terms of adequate space; patients require a recovery room after an abortion for a minimum of 30-60 mins., particularly if there has been sedation and anasthesia involved. It's not like you just get up off the table and walk out immediately after the procedure, like you do with a CT scan.
posted by scody at 12:25 PM on June 15, 2009

Agreed on the difficulty of protection. It also sends a message that increases the preception of dander on behalf of the patient, which is the opposite of what you want.
posted by Ironmouth at 12:42 PM on June 15, 2009

Somehow, the idea/image of an "abortion wagon" prowling through towns would seem to play right into the hands of the opponents.
posted by Thorzdad at 1:00 PM on June 15, 2009 [1 favorite]

You may also want to research regulation of abortion facilities. In many US states, there are very strict regulations about where abortions can be performed, with the law stipulating everything from proximity to a hospital to the width of the clinic doorways. Most states and countries have strict regulation of facilities for even noncontroversial medical procedures, and when something like abortion is involved, opponents use that regulatory power to make creating new facilities as difficult as possible. Given that level of scrutiny, I highly doubt that an RV would pass the inspections necessary to be allowed to open for business.
posted by decathecting at 1:21 PM on June 15, 2009 [1 favorite]

It would probably be most feasible for initial consultations, especially since so many states have 24 hour waiting periods. And for writing prescriptions for medical abortions. I don't think it would be too safe to perform a surgical abortion in a van unless you were parked in an enclosed area where someone couldn't just ram you. I'm also guessing the amount of slashed tires and vandalism would make it pretty impractical. It's not a bad idea though, but I think most abortion doctors need the sort of security that one a fixed facility can really provide. I'm guessing the pro lifers would also do things like track license plate numbers etc, so the van would likely be identified pretty easily even if there were no markings on it.
posted by whoaali at 1:25 PM on June 15, 2009 [2 favorites]

I don't know about vans, but Women on Waves have been using boats.

I think the idea behind Women on Waves is a little different -- they come to a point JUST offshore and outside the mainland's jurisdiction, so they are not legally bound by that particular country's laws, and people come out to meet them. They're actually stationary when they provide service.
posted by EmpressCallipygos at 1:57 PM on June 15, 2009

I once lived in a town where this dude was molesting kids in his van. The only thing people knew was that he had a dark colored van with a ladder on it.

I cannot tell you how many times I saw kids (and crazy-ass adults) pelting vans with eggs simply because it "kinda" matched that description. It really was nuts.

I know this idea of yours is to root out the craziness...but seriously...it wouldn't do that.

AND...

although the procedure MAY be without complications and be VERY outpatient...there can be some complications, and you really want a full staff inside of an operating room.
posted by hal_c_on at 2:02 PM on June 15, 2009 [1 favorite]

It might be feasible in a practical (physical) sense, but in a legal sense it's not very feasible. When I lived in Kansas, one of the ways that they made abortion illegal in a de facto sense was to create restrictions on where abortions could be performed that were so difficult to meet that many just gave up. Planned Parenthood offers many fine (and genuine) statistics about the safety of abortion relative to other common procedures, such as having your tonsils removed. (From a perspective of risk, have an abortion instead!)

The State of Kansas made anyone who wanted to provide abortions meet so many ridiculous and unnecessary standards having nothing to do with real safety or hygiene (decathecting hints at this when he mentions the required width of doorways), and many of these things were *designed* to be exceedingly expensive. These were for "the safety of women," despite riskier operations with much much much higher rates of complications and actual deaths having no such burdens places upon them.

I'd hate to think what it would cost to have a mobile abortion clinic that could meet such standards - it'd probably be cheaper to build a "fixed" place and cover airfare and taxi bills to get women to the clinic.
posted by Dee Xtrovert at 3:31 PM on June 15, 2009 [1 favorite]

So I thought, well, if the clinic is a focal point, what if we remove it?

You aren't removing the clinic, you are making it less secure in a mobile format. I think it would be more effective to protect abortion rights if the abortions were available everywhere. If a small town had as many abortion clinics as it has gas stations the protesters would not have enough people to protest all locations every day in any great number. It is also why I think abortions should be available at ALL hospitals. It is not a hugely complicated procedure and the protesters would soon loss public sympathy for protesting the local hospital daily, restricting access, blocking ambulances and yelling "You are killing your baby" to middle-aged women going for their yearly breast exam when the hospital in reality only provides one or two abortions a month. Normalise abortions as every other legal medical procedure is treated.
posted by saucysault at 5:49 PM on June 15, 2009 [3 favorites]

So, your van, is it picking women up from their homes? Their places of work? Some open, unprotectable public place?

Your sentiment is admirable, but a van is much harder to protect and much harder to destigmatise than a building where they also hand out birth control and do other medical work.
posted by Jilder at 9:23 PM on June 15, 2009