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How Health Officials in Pro-Life States Are Quietly Dismantling Abortion Access

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Without the fanfare of a bill signing or a Supreme Court decision, the first state without an abortion clinic is in sight.

One spring day in 2017, Dr. Ernest Marshall received an inauspicious letter from the Kentucky Cabinet for Health and Family Services, the state’s health agency. Marshall, a Louisville native with a round face and a trimmed mustache, has been an OB-GYN and teacher with the University of Louisville School of Medicine for nearly four decades. For just as long, he’s owned what is now the state’s last abortion clinic. EMW Women’s Surgical Center sits on a stretch of sprawling, sparsely populated real estate in downtown Louisville, across from a cinema-sized money lender and down the block from a Subway restaurant.

Marshall’s mother had 13 pregnancies and “no way to control her reproductive life,” he’s said, by way of explaining his chosen career. “I think women should have a right to control the size of their family. I think that there are fetuses with congenital anomalies that are incompatible with life, and there are mothers whose [lives] are threatened by pregnancy, and I think there are cases of rape and incest.” He added, “I’ve dedicated my life to women’s reproductive health.”

The letter threatened to close Marshall’s clinic. His abortion facility license, renewed by Kentucky’s health agency 11 months earlier, was in fact “in error,” the letter stated. The clinic’s previously acceptable agreements with a hospital and an ambulance service now contained “deficiencies.” Kentucky law required clinics to have formal transfer and transport agreements with hospitals and ambulance services in the case of a medical emergency (even though hospitals and ambulances must serve all patients regardless of the deals). Marshall was given 10 calendar days to “cure” the deficiencies, or he’d face “an immediate revocation” of his license.

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Thanks !

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