Indiana abortion facility will operate without license until hearing

SOUTH BEND, Ind. -- After a nearly two-year legal battle, an unlicensed abortion facility started booking appointments in a location in South Bend June 19 and planned to begin offering chemical abortions the week of June 23 amid strong objections from the local community.

The story began in 2017, when the Texas-based Whole Woman's Health Alliance applied for a license to open a chemical abortion facility. The Indiana Department of Health denied the license in early 2018, citing deficiencies in the application and concerns the business was not reputable because some of its affiliated clinics had incurred serious violations.

The alliance, or WWHA, subsequently filed suit in the U.S. District Court of the Southern District of Indiana to challenge the constitutionality of the state's license requirements and other regulation of abortion services. The alliance also asked for a preliminary injunction to suspend those laws so it could operate unregulated until the district court rendered a decision, scheduled for 2020.

Indiana Attorney General Curtis Hill filed a motion to dismiss the suit on grounds that the Supreme Court and appellate courts have long upheld the right of states to license abortion providers. The state also asked for the court to stay the preliminary injunction until the case was decided.

However, on May 31 of this year, the district court granted WWHA the preliminary injunction to allow it to operate the South Bend facility without licensing or regulation. Two days later, Hill appealed that decision to the U.S. Court of Appeals for the 7th Circuit. He also asked the district court for an immediate stay to prevent the unlicensed abortion facility from opening until the appeals court weighed in.

On June 7, the district court denied that stay request, so on June 9, the attorney general filed a motion at the court of appeals to prevent that opening, saying:

"The district court has declared that something as ordinary and fundamental as state licensing -- which the state does for everything from nursing homes to day care centers -- can be invalidated in the name of the right to abortion. This ruling turns the right to abortion into a cudgel against state licensing laws that the Supreme Court long ago declared to be perfectly valid."

On June 21, the 7th Circuit announced it will hear oral arguments in the case July 11. At least until that hearing, WWHA will be allowed to operate without any regulation.

Many local residents have voiced strong objections to an outside group coming into the community, challenging Indiana laws and values, and expecting to operate without any state oversight whatsoever.

The Diocese of Fort Wayne-South Bend has a strong defense of life community in South Bend, many of whom are active in the local and state Right to Life organizations and Apostolate of Divine Mercy, which have vocally and tenaciously fought the opening of the facility.

A national pregnancy support center founded in South Bend, the Women's Care Center, also has acted to oppose the facility and to provide an alternate, pro-life presence nearby. In 2018, a rezoning request that would have allowed the Women's Care Center to locate a care center next door to the abortion facility was passed by the South Bend City Council, but vetoed by Mayor Pete Buttigieg, who is running for president.

The center subsequently acquired a commercial site across from the WWHA and plans to open a new center there in July.

Local doctors also have voiced strong objections to a facility that provides chemical abortions because they would be called on to surgically remove dead babies when the abortion medications fail to expel the unborn baby, which happens in 6 to 10 percent of chemical abortions.

In the U.S., the most available and used drugs for chemical abortions is a combination of mifepristone -- also known as RU-486 -- and misoprostol.

Also, chemical abortions can cause serious complications for the woman, who requires competent diagnosis prior to the abortion and a physical exam afterward.

Hill, the state's attorney general, addressed this issue at a June 15 pro-life rally that drew over 200 people to St. John the Baptist Church, which is just a few blocks from the abortion facility. Hill noted that the state has a responsibility to license all professions to keep citizens from harm.

"How anyone can determine that having a clinic of this nature where they use chemicals to abort a child could not impose some kind of dangerous concern for a woman's health is beyond me," he said, pledging to uphold state law.

At the heart of all the legal wrangling over WWHA is the nature of the business; it has two other abortion facilities, one in Virginia and one in Texas. One of the main reasons the Indiana Department of Health denied the license was that the health alliance failed to list on its application six affiliated clinics in Texas, Minnesota, Maryland and Virginia, some of which have had serious violations.

According to National Right to Life News, a 2017 Texas health department report found numerous health and safety offenses at their locations in that state from 2011 to 2017. These included rusty equipment, failure to properly disinfect and sterilize instruments between use, a lack of proper written operation procedures, improper storage of hazardous chemicals, unsanitary surfaces and a failure to follow up with patients.

Amy Hagstrom Miller, who is president and CEO of the Whole Woman's Health Alliance, claimed that the nonprofit alliance is a separate entity from the for-profit abortion chain that she owns called Whole Woman's Health.

She founded the nonprofit after a legal battle against Texas abortion laws left her with debt. In one of those cases, Whole Women's Health v. Hellerstedt, the Supreme Court ruled in 2016 that some Texas laws caused an "undue burden" on women.

Hagstrom Miller's national strategy is to "shift the stigma around abortion in our culture" and challange laws in states she considers "extremely hostile" to abortion. To fund those efforts, she founded the WWHA as a nonprofit to receive donations.

For example, money from the TARA Health Foundation funded WWHA's Indiana license application, according to that foundation's website. It says it gives grants to organizations "that improve women's and girls' health."

In 2017, WWHA took in nearly $1 million in donations or grants, according to the group's IRS 990 Form.

Hagstrom Miller claims that, while she owns the Whole Woman's Health for-profit facilities and their management company -- alternately called Whole Woman's Health or the Booyah Group -- the nonprofit Whole Woman's Health Alliance is not owned by her, but is controlled by a board of directors.

However, the Indiana Department of Health found that the lines between the two entities were blurred and that Hagstrom Miller has actual control of both businesses. Further, the management company she owns provides services for the nonprofit chain as well as the for-profit chain.