Utah abortion clinics could be banned from operating under a law signed into law by the state’s Republican governor, sparking a wave of confusion among clinics, hospitals and prospective patients in the highly conservative state.

Hospital and clinic administrators have no publicly detailed plans to adapt to the new rules, adding a layer of uncertainty on top of fears that if clinics close, patients may not be able to access care at hospitals due to staffing and cost considerations.

The law signed by Gov. Spencer Cox on Wednesday will take effect May 3, when abortion clinics will no longer be able to apply for a license. It institutes a full ban on January 1, 2024. Both Planned Parenthood

Association Assn.

of Utah and the Utah Hospital

Association Assn.

declined to detail how the increasingly difficult legal landscape for providers in Utah will affect access to abortion.

In addition to banning abortion clinics from operating, the law also clarifies the definition of abortion to address liability concerns about how exceptions are framed in state law, a provision Cox called a compromise.

On Thursday, the governor dismissed critics who equated restricting clinics with a de facto ban on abortion and said the law provided clarity for hospitals offering emergency abortions in the event of threats to maternal health and rape or incest reported to authorities. reported.

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This bill clarifies that so that those abortions can continue. They will continue in a hospital environment, but there is nothing stopping them from continuing, he said at a news conference.

The turmoil reflects developments in Republican strongholds in the United States that have taken shape since the U.S. Supreme Court’s Roe v. Wade, changed the legal landscape and sparked a series of lawsuits in at least 21 states.

Lawmakers in Utah have previously said the law would protect the innocent and the unborn,” adding that they don’t think the state needs the clinics after the Supreme Court overturned the constitutional right to abortion.

While Planned Parenthood previously warned that the law could dramatically hinder its ability to perform abortions, Jason Stevenson, the association’s lobbyist, said Wednesday it would examine the wording of other provisions of the law that could allow clinics to apply for new permits to perform hospital equivalent. Services.

Based on Planned Parenthood’s interpretation, he said in an interview, clinics will no longer be able to perform abortions under their current licenses. However, they plan to continue to provide the majority of their services, such as sexually transmitted diseases and cancer screenings and pregnancy tests. Stevenson said they are closely reviewing the law’s licensing options, but would not say whether the clinics will apply at this time.

Utah’s Department of Health and Human Services didn’t immediately respond to questions about how it would introduce the law, but lawmakers have said Planned Parenthood and other clinics can apply for various licenses under the law.

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Jill Victory, a Utah Hospital spokesperson

Association Assn.

said in an email it was too early to comment on whether hospitals could soon be the only abortion providers in Utah, noting that they all “have to decide how they want to proceed.”

If clinics stop offering abortions, experts are concerned. Hospitals’ relatively higher health care costs and a nationwide staff shortage will make it harder to get legal abortions in Utah, even though the law doesn’t explicitly restrict those seeking them in the state where they legally stay up to 18 weeks.

Dr Carole Joffe, professor at the University of California, San Francisco, who has written on the social effects of reproduction

healthcare

, said de-licensing clinics would change the way abortions have been performed for decades. Historically, patients with low-complicated pregnancies have usually had abortions in outpatient clinics, which on average can perform them at a lower cost.

Everything in a hospital is more expensive than in a clinic. If you’re doing an abortion in a hospital, you need more staff, she said, pointing to hospitals with teams of anesthesiologists, doctors and surgeons who have provided them with emergency scenarios in the past.

Another challenge facing already overburdened hospitals is staffing. Especially in states where anti-abortion timing is strong, many doctors or nurses in hospitals may not want to give them, Joffe said.

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You need to draw from a pool that may or may not be sympathetic to abortion, as opposed to a clinic where you won’t work unless you’re committed to abortion as part of

healthcare

said Joffe.

Abortion advocates say confusion stems from unclear language about the withdrawal process. The law prohibits clinics from obtaining new licenses after May 2 and sets a full ban on January 1, 2024. Proponents, however, are concerned about a separate provision in the 1,446-rule bill that, under state law, requires abortions to be performed only in hospitals. executed. .

Clinic-focused legislation has also raised questions about what types of facilities are best equipped to provide specialized care to patients, regardless of their socioeconomic status or location.

If clinics stop offering abortions as early as May or as late as next year, it could divert thousands of patients to hospitals and force administrators to devise new elective abortion policies. To do so would require them to expand their services beyond the emergency procedures they previously provided, raising questions about the impact of the shift on capacity, staffing, waiting lists and costs. About 2,800 abortions were performed in Utah last year.

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The Utah Hospital

Association Assn.

said no hospitals in the state performed elective abortions last year.

The new restrictions will most likely affect those seeking to terminate pregnancies through medication, which is responsible for the majority of abortions in Utah and the United States. Abortion medication is approved up to 10 weeks gestation, usually prescribed in clinics, and since a pandemic-era rule change by the FDA, it is increasingly being offered through telemedicine.

The new law takes on additional significance amid legal limbo surrounding other abortion laws signed into law in Utah.

Last year’s Supreme Court ruling led to two previously passed laws: a ban on abortion after 18 weeks in 2019 and a ban on abortions in 2020 regardless of trimester, with several exceptions, including cases of risk to maternal health and rape or incest reported to the police. Planned Parenthood

Association Assn.

of Utah sued over the 2020 ban, and in July a state court delayed its implementation until legal issues could be resolved. The 18-week ban has since become de facto law.

Abortion access advocates have decried this year’s ban on the clinic as a backdoor that anti-abortion lawmakers are using to restrict access while courts deliberate. If abortions were restricted to the exceptional circumstances regardless of trimester, closures would have less far-reaching consequences for patients seeking elective abortion up to 18 weeks gestation.