Residents of Toledo, Ohio received good news Monday night, after the last abortion clinic in the city was able to sign an agreement with a local hospital that would allow it to keep its doors open.

The news came just hours after activists held a rally and press conference outside ProMedica Toledo hospital Monday afternoon. Reproductive rights activists had also phoned the hospital chain ProMedica more than 500 times since Friday, when the Ohio Supreme Court first delivered the devastating news to Toledo’s last abortion clinic, Capital Care: that the clinic will have to close or make a transfer agreement with a local hospital.

Activists demanded that ProMedica partner with Capital Care of Toledo to treat patients should abortion complications arise. Had the hospital network declined, Capital Care would have shuttered and Toledo residents would have had to travel upwards of 50 miles across state lines to Ann Arbor, Michigan for abortion services.

“Entering into this agreement aligns with ProMedica’s mission and values, including our focus on being a health system dedicated to the well-being of northwest Ohio and our belief that no one is beyond the reach of life-saving health care,” wrote ProMedica spokesman Tedra White in a statement. “Furthermore, we believe that all individuals should have access to the best care in their neighborhoods.”


Last week, the Ohio Supreme Court upheld a 2014 state order requiring Capital Care to close because the clinic lacked a state-mandated transfer agreement with a local hospital. The idea is, in the event that a patient experiences serious complications, they’d be transferred to the hospital. This requirement was part of a 2013 ominous abortion budget bill packaged as “protecting women’s health.” In reality, however, the law is unnecessarily cumbersome, as federal law already mandates that hospitals accept any patient who comes in for ambulatory care. Moreover, abortions are safe procedures, with complications occurring at a rate of less than 0.5 percent.

State officials, so far, have been successful in what anti-choice activists call the “incremental strategy” to end access to safe and legal abortion. In Ohio, 19 repressive reproductive health measures have become law since Gov. John Kasich (R) took office in 2011. Capital Care’s closure would have left only seven abortion clinics open statewide, down from 16 in 2011.

These efforts are targeted. Capital Care had a transfer agreement with the University of Toledo Medical Center prior to the 2013 restrictive abortion law, but was unable to renew it because the provision also banned agreements with statewide public institutions. The clinic went five months without a transfer agreement before the University of Michigan Health System hospital in Ann Arbor agreed to partner. The Ohio Department of Health in 2014 revoked the license because a patient would have to travel more than 30 miles for care.

“The deck has been stacked against this clinic,” said Kellie Copeland of NARAL Pro-Choice Ohio. “The Department of Health should be being utilized as a government agency to ensure that all ambulatory facilities provide the best care possible. Instead [it’s] being utilized as an agent for Kasich to close clinics.”


Former state health department bureau chief Roy Croy echoed Copeland’s remarks in an Op-ed for the Columbus Dispatch, in which he called the transfer agreement issue a “red herring.”

“The transfer-agreement rule was tailor made for many in the General Assembly and those who are intent on faith-based law and rule-making,” Croy wrote.

Activists called and wrote to ProMedica repeatedly, with the understanding that anti-choice groups are also making their case to the private hospital chain.

“To be quite honest, my heart hurts,” University of Toledo student Addison told ThinkProgress. She asked ThinkProgress not use her last name for fear of retribution. Addison left many messages with ProMedica’s secretarial staff, demanding ProMedica partner with Capital Care.

Addison said she had an abortion as a minor because she was not ready to have children yet. She recognizes she was privileged enough to have financial and emotional support for the procedure. But for many low-income women and non-binary individuals seeking abortion, Capital Care’s closure would have exacerbated an already difficult decision, she said. Not only will they have to think about travel time, women and gender minorities will have to request time off work and look for child care. In 2014, the majority of people who sought abortion services had children already.

Feminist icon Gloria Steinem also wrote to Toledo’s private hospital ProMedica, asking them to accept Capital Care’s required transfer agreement. She also wrote to St. Luke’s Hospital, another hospital that could partner with Capital Care. (ProMedica and St. Luke’s hospital share the same board of directors so the decision would have been inherently the same.)


“We must not allow a political regulatory scheme to close Toledo’s remaining abortion clinic,” Steinem said. “Its absence would not diminish the number of abortions but would increase the injury and death of women in my home city and state. Democracy begins with each person’s control of his or her own body. Without reproductive freedom, there is no democracy for American women.”

To many activists, Ohio’s law places undue burdens, or obstacles, for individuals seeking abortion — which was presumably found unconstitutional three years ago. The Supreme Court overturned a stringent Texas law on clinics and doctors in 2016 because the burdens outweighed the benefits.

“The way the dominoes fell in Texas were a lot more visible and happened much more quickly than they did in Ohio,” Copeland told ThinkProgress.

Red states have continued to pass restrictive abortion laws, and 2018 will be no different. Federal courts are often the last line of defense for reproductive rights activists, but for Capital Care, it was a hospital chain.

This story has been updated to include ProMedica’s decision to partner with Capital Care.