The U.S. Supreme Court has agreed to hear its first abortion case since 2007, when it upheld the federal ban on partial-birth abortion. Regardless of how the court ultimately rules, abortion is at a crossroads in America. At issue is whether what happens to a woman once she goes behind the closed doors of an abortion clinic matters, whether the veneer of the Constitution will protect medically substandard abortion facilities, and whether the abortion industry will be permitted to keep profits high by keeping standards low.

Women will be front and center in the case. As a result of the Supreme Court’s commandeering of the abortion issue in Roe v. Wade, it alone defines states’ ability to protect maternal health. In Whole Woman’s Health v. Cole, the abortion industry is challenging a Texas requirement that abortion clinics comply with medically appropriate health and safety standards.

Importantly, states set medical standards for surgical facilities in consultation with medical authorities so that, in the event of an emergency, precious time won’t be lost. A plan will be in place for emergency medical care and to avoid disasters. What is shocking about the current status of the under-regulated Wild West of the American abortion industry is that abortion facilities, where anesthesia is administered and invasive surgeries are performed, have largely avoided the comprehensive health and safety standards that professional medical facilities comply with every day.

Abortion: The Medical Red-Light District

While “historic” is a word that can be overused, it certainly applies here. The impact of the court’s ruling will sweep more broadly than Texas. Currently, 29 states prescribe health and safety standards for abortion facilities, and 15 states require abortionists to maintain hospital admitting privileges or a written patient transfer agreement with a physician who maintains such privileges. Importantly, these protective, women-centered laws have been enacted over the last two decades in direct response to the abortion industry’s increasingly deplorable safety record.

Legal abortion clinics across the country continue to offer dangerous ‘back alley abortions.’

The reality of abortion in America is truly disturbing. A far cry from what was promised by the activist Supreme Court in Roe, legal abortion clinics across the country continue to offer dangerous “back alley abortions.” Over just the last six years, more than 170 abortion providers in 30 states have faced investigations, criminal charges, administrative complaints, and civil lawsuits or have been cited for violating state laws governing the provision of abortion.

Abortion industry profits continue to trump both maternal health and compliance with the law, as demonstrated by Planned Parenthood’s trafficking of the broken bodies of aborted infants and the abortion industry’s ongoing and desperate efforts to avoid both accountability and meaningful oversight.

The sobering reality that abortion operates in the “red light district” of medicine must guide the court’s ultimate decision in the case. If the court instead adopts the abortion industry’s argument that easy access to an abortion clinic trumps all concerns about health and safety, there will be far-reaching and catastrophic consequences for American women who are routinely victimized by an abortion industry that cannot be counted on to police itself.

If an organized, profit-centered, politically well-connected abortion industry triumphs by convincing the court that it should not be required to comply with the same patient-centered standards that are commonly applied to other outpatient surgical facilities, dangerous, substandard abortion clinics will proliferate. “Circuit rider” abortionists who travel into town for the day perform abortions on women they have not previously met or counselled, and leave others to deal with the inevitable post-abortive complications will continue to be the norm in an industry that prioritizes mere access to abortion over women’s health and safety.

To Protect Women, Abortion Needs Oversight

State legislators seeking to protect women from an increasingly predatory abortion industry will be effectively thwarted. Instead, renegade abortion clinics will have been given a preemptive “veto” over commonsense regulations that they decide to ignore.

Abortion clinics will have been given carte blanche to operate outside medical norms and immune from following the best medical practices.

Unlike legitimate medical practices operating under appropriate regulatory oversight, abortion clinics will have been given carte blanche to operate outside medical norms and immune from following the best medical practices, such as high standards of cleanliness and sanitation, comprehensive pre-procedure medical evaluations, advance preparation for medical emergencies, and adequate credentialing of providers.

Alternatively, if the court gives appropriate deference to a state legislature’s determination that abortion providers must be held to medically appropriate health and safety standards and upholds the Texas law, women would receive better and more competent care. There would also be a significant reduction in the more than 26,000 women that the abortion industry conservatively estimates suffer abortion-related complications each year. The high-quality, women-centered standards at the heart of the Texas law will result in fewer complications, fewer hospitalizations, and fewer women’s deaths from abortion.

To rule in favor of the abortion industry, the court will have to ignore an increasingly dismal health and safety record and the dangers faced by every woman who walks through the doors of an abortion clinic. To rule in favor of women’s health and safety, however, the justices will simply have to remember what was decided more than 40 years ago in Roe: a state’s legitimate interest in regulating abortion “obviously extends at least to [regulating] the performing physician and his staff, to the facilities involved, to the availability of after-care, and to adequate provision for any complication or emergency that may arise.”