30-mile rule

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The 30-mile rule is the following regulation against abortion first passed in 2005 in Missouri: "Any physician performing or inducing an abortion who does not have clinical privileges at a hospital which offers obstetrical or gynecological care located within thirty miles of the location at which the abortion is performed or induced shall be guilty of a class A misdemeanor, and, upon conviction shall be punished as provided by law." § 188.080 R.S.Mo. (2005).

In February 2019, this rule properly prevented an abortion clinic in Columbia, Missouri, from reopening with an abortionist who lacked nearby hospital privileges.[1]

At least four states (Missouri, North Dakota, Utah, and Louisiana) have admitting privileges law currently in effect. At least eight additional states require abortion clinics to have a formal agreement for transferring patients to a nearby hospital, which is not as effective.

In Texas, a special session of the legislature passed a version of this law in July 2013, in HB 2, and it has become perhaps the biggest abortion legal case since Roe v. Wade. After a federal district court enjoined (invalidated) the law, three days later an all-women panel of the U.S. Court of Appeals for the Fifth Circuit unanimously reinstated it. Two business days later, on November 4, 2013, Planned Parenthood filed an emergency appeal to the U.S. Supreme Court, but it responded by giving the State of Texas 8 full days to file a brief in reply to the abortion clinics' arguments. On Nov. 19, 2013, the Supreme Court then ruled 5-4 against Planned Parenthood, and thereby allowed the 30-mile rule to remain in effect. Then, on Mar. 27, 2014, the Fifth Circuit affirmed the constitutionality of the law.

Texas HB 2 (2013) (passed in 2nd special session, July 2013)
SECTION 2. Subchapter A, Chapter 171, Health and Safety Code, is amended by adding Section 171.0031 to read as follows:
Sec. 171.0031. REQUIREMENTS OF PHYSICIAN; OFFENSE. (a) A physician performing or inducing an abortion:
(1) must, on the date the abortion is performed or induced, have active admitting privileges at a hospital that:
(A) is located not further than 30 miles from the location at which the abortion is performed or induced; and
(B) provides obstetrical or gynecological health care services; and
(2) shall provide the pregnant woman with:
(A) a telephone number by which the pregnant woman may reach the physician, or other health care personnel employed by the physician or by the facility at which the abortion was performed or induced with access to the woman's relevant medical records, 24 hours a day to request assistance for any complications that arise from the performance or induction of the abortion or ask health-related questions regarding the abortion; and
(B) the name and telephone number of the nearest hospital to the home of the pregnant woman at which an emergency arising from the abortion would be treated.
(b) A physician who violates Subsection (a) commits an offense. An offense under this section is a Class A misdemeanor punishable by a fine only, not to exceed $4,000.

Missouri's bill closed 1 of only 3 remaining abortion clinics within 60 days of passage. Planned Parenthood even backed off its legal challenge in order to avoid a bad precedent for it. Missouri's bill is perfectly constitutional and Roe v. Wade says nothing to invalidate it. In fact, there is language in Roe v. Wade supporting this bill: "The [state's] interest obviously extends at least to the performing physician and his staff, to the availability of after-care, and to adequate provision for any complication or emergency that might arise."

In 2012, Mississippi also passed a version of this bill as Miss. H.B. 1390, but it is currently enjoined by a federal court ruling from enforcement. On April 16, 2012, the Governor signed into law this requirement that abortions only be performed by an abortionist who has privileges at a local hospital, which would enable him to handle complications:

All physicians associated with the abortion facility must have admitting privileges at a local hospital and staff privileges to replace local hospital on-staff physicians. All physicians associated with an abortion facility must be board certified or eligible in obstetrics and gynecology, and a staff member trained in CPR shall always be present at the abortion facility when it is open.

Tennessee passed a weaker form of this bill in 2012, known as the "Life Defense Act" (HB 3808), which became effective July 1, 2012 and then resulted in the closing of at least one abortion clinic:

(1) A physician may not perform an abortion unless the physician has admitting privileges at a hospital licensed under title 68 that is located:
(A) In the county in which the abortion is performed; or
(B) In a county adjacent to the county in which the abortion is performed.[2]

(2) The physician who performs an abortion or a health care provider licensed pursuant to title 63 under the supervision of the physician shall notify the patient of the location of the hospital at which the physician has privileges and where the patient my receive follow-up care by the physician if complications arise.

In 2013, conservative Governor Scott Walker signed a version of this rule into law in Wisconsin. Wisconsin's version is currently blocked by a federal judge.[3]

Unsuccessful examples

Other states have passed ineffective forms of this law, or not passed them at all. Florida passed a diluted version of this bill, which was introduced in 2005 as H.B. 1041. In 2006 these additional states had pending versions of this rule requiring an abortionist to have admitting privileges at a nearby hospital (which many abortionists lack, and end up dumping emergency victims on other doctors), but liberal opposition prevented these bills from passing in a meaningful form:


  1. https://www.columbiatribune.com/news/20190222/judge-denies-planned-parenthood-order-to-resume-columbia-abortions
  2. There are 95 counties in Tennessee, and most counties are adjacent to several other counties. It's unlikely an women suffering from complications would go to an adjacent county for treatment, unless she lived near a border.
  3. http://host.madison.com/news/local/govt-and-politics/judge-extends-abortion-law-restraining-order-to-rule-later-on/article_cfe258e7-679e-521b-8042-a115f29e4c0d.html

See also