Targeted Regulation of Abortion Providers (TRAP)
Alabama imposes extra restrictions on abortion providers, despite the fact that all health-care providers already must comply with a variety of federal and state regulations governing health, safety, building and fire codes, and zoning requirements.
Restrictions on Where Abortion Services May Be Provided
Alabama places medically unnecessary restrictions on where abortion services may be provided.
Any health-care facility that provides 30 or more abortion procedures per month during any two months of the calendar year, or that provides "advertising" that it provides abortion care by some public means such as newspaper, telephone directory, magazine, or electronic media must comply with a uniquely imposed licensure scheme not required of other medical providers. Ala. Admin. Code. r. 420-5-1-.01(2)(b), -.01(3), -.01(4). This rule also applies to the offices of individual doctors if they meet the minimum procedures quota or advertising requirements. Tucker v. State Dept. of Public Health, 650 So. 2d 910 (Ala. Civ. App. 1994). Violations may result in criminal penalties. Ala. Code § 22-21-33 (Enacted 1949; Last Amended 2008). The licensing requirement has the following conditions:
Each abortion provider shall be classified as "ambulatory health care occupancy" - a type of ambulatory surgical center. This classification includes certain physical-plant requirements, such as submission of architectural drawings and plans, as well as sprinkler system plans and other materials necessary to show compliance. H.R. 57, 1st Reg. Sess. (Ala. 2013) (Enacted 2013).
Abortion providers must have admitting and staff privileges at an acute care hospital in the same "standard metropolitan statistical area" that permits the physician to perform procedures reasonably necessary to treat abortion-related complications. No exception is made for rural areas, and nothing in the statute requires a hospital to agree to such an arrangement. Ala. Admin. Code. r. 420-5-1-.03(6)(b). H.R. 57, 1st Reg. Sess. (Ala. 2013) (Enacted 2013).
Each abortion provider or reproductive-health center also must have a medical director who is a board-eligible or -certified OB/GYN despite the fact that there are numerous medical specialties that can safely provide and oversee abortion care and have at least 12 months experience treating gynecological problems in a surgical environment. Ala. Admin. Code. r. 420-5-1-.02(5)(c).
Every abortion provider must maintain ultrasound equipment and perform an ultrasound before every procedure, regardless of whether the sonogram is medically appropriate or necessary. Ala. Code § 26-23A-6 (Enacted 2002).
Every abortion provider must remain on the premises during and after each procedure and until all patients are discharged. Each discharge order must be signed by the physician. H.R. 57, 1st Reg. Sess. (Ala. 2013) (Enacted 2013).
Restrictions on Who May Provide Abortion Services
Alabama prohibits certain qualified health-care professionals from providing abortion services.
Only a physician licensed by the state to practice medicine or osteopathy may provide the procedure. Ala. Admin. Code r. 420-5-1-.01(2)(j), -.03(4)(a); Ala. Code § 26-23A-7 (Enacted 2002).