Brian Lyman

Montgomery Advertiser

A federal judge Monday morning ruled that a portion of a 2013 Alabama law requiring doctors at abortion clinics to have admitting privileges at a local hospitals posed an undue burden on women's abortion rights, and was unconstitutional.

In a 172-page opinion, U.S. District Judge Myron Thompson wrote that the law would effectively close three abortion clinics in the state, forcing women seeking abortions, most of whom are impoverished, to travel long distances to obtain the services.

"A significant number of the women would be prevented from obtaining an abortion; others would be delayed in obtaining abortions, exposing them to greater risks of complications; and even the women who are able to obtain abortions would suffer significant harms in terms of time, financial cost, and invasion of privacy," Thompson wrote.

Montgomery-based Reproductive Health Services and Planned Parenthood Southeast, which operates clinics in Birmingham and Mobile, sued to block the admitting privileges requirement last year, saying their doctors would be unable to meet it.

Before granting admitting privileges, hospitals usually require doctors to establish local residency and guarantee that they will admit a certain volume of patients each year. At a trial in May and June, doctors who worked at the three clinics said they did not live in Alabama, due to professional considerations and fears of harassment. Plaintiffs also stressed the safety of abortion procedures, noting studies that show the rate of complications from abortion is lower than many routine medical procedures.

Supporters of the law, which Gov. Robert Bentley signed into law in April, 2013, said it would protect women's health and ensure adequate access to care, arguments the Alabama attorney general's office made in defending the law in a bench trial that took place in May and June.

However, Thompson said the state's case was "weak, at best."

"Indeed, the court is convinced that, if this requirement would not, in the face of all the evidence in the record, constitute an impermissible undue burden, then almost no regulation, short of those imposing an outright prohibition on abortion, would," he wrote.

Alabama Attorney General Luther Strange said Monday morning his office would appeal. A similar Mississippi law was struck down by a federal appeals court last week, and the issue could be headed to the U.S. Supreme Court.

Republicans criticized the decision. In a statement, Bentley said the ruling "significantly diminishes the important protections" of the law. House Speaker Mike Hubbard, R-Auburn, said the decision was "a hurdle in the continued race to ensure that women who choose to have an abortion are being provided care in the healthiest and safest environment possible."

A 2013 study in the American Journal of Public Health said the risk of complications in a first-trimester abortion was less than one-tenth of one percent. According to the Centers for Disease Control, the mortality rate for abortion procedures was 0.67 per 100,000 procedures between 2003 and 2009.By comparison, the CDC said the pregnancy-related mortality ratio was 15.8 per 100,000 live births between 2006 and 2009.

Plaintiffs were understandably cheered. "As the judge noted today, the justifications offered for this law are weak at best," Louise Melling, deputy legal director of the ACLU, said in a statement. The ACLU represented Reproductive Health Services in the lawsuit. "Politicians, not doctors, crafted this law for the sole purpose of shutting down women's health care centers and preventing women from getting safe, legal abortions."

"Cecile Richards, president of the Planned Parenthood Federation of America, said the ruling would "ensure that women in Alabama will have access to safe, legal abortion."

In writing that the closings could be a burden on women, Thompson cited testimony that 70 percent of Planned Parenthood's patients were at or below the poverty line, while 60 percent of the patients at Montgomery's clinic were on some form of financial assistance.

"For these women, going to another city to procure an abortion is particularly expensive and difficult," he wrote. "Poor women are less likely to own their own cars and are instead dependent on public transportation, asking friends and relatives for rides, or borrowing cars; they are less likely to have internet access; many already have children, but are unlikely to have regular sources of child care; and they are more likely to work on an hourly basis with an inflexible schedule and without any paid time off or to receive public benefits which require regular attendance at meetings or classes."

Toward the end of his opinion, Thompson suggested that abortion rights should be viewed in the same light as gun rights, in that both are individual rights that cannot be exercised without the assistance of someone else -- a doctor in the case of abortion, a gun and ammunition supplier in the case of gun rights.

According to the plaintiffs in the case, the abortion law would have left only two abortion clinics open in the state -- at the time, one in Tuscaloosa and, at the time of the trial, one in Huntsville. The judge suggested parties consider a state law that would impose a requirement that only two gun shops in the state could meet.

"The defenders of this law would be called upon to do a heck of a lot of explaining--and rightly so in the face of an effect so severe," Thompson wrote. "Similarly, in this case, so long as the Supreme Court continues to recognize a constitutional right to choose to terminate a pregnancy, any regulation that would, in effect, restrict the exercise of that right to only Huntsville and Tuscaloosa should be subject to the same skepticism."

Thompson stopped short of offering relief on the requirement, saying he wanted more "input" on final relief. A temporary restraining order on the law will remain in effect until the issues are resolved.

The law also requires clinics to be built up to ambulatory standards and makes it a felony for anyone but a doctor to perform an abortion. Those portions of the law were not challenged in the lawsuit.