“In a time when too many states across the nation are taking a step backward, Illinois is taking a giant step forward for women’s health. … When it comes to contraception, abortion, and reproductive care, this law puts the decision-making where it belongs: in the hands of women and their doctors.”
Those were the words of Illinois Governor J.B. Pritzker when he signed the Reproductive Health Act (RHA) into law on this day in 2019. According to a press release issued by his office, Pritzker was “making good on his promise to make Illinois the most progressive state in the nation for women’s reproductive rights.”
Six years later, what has the RHA brought Illinois?
The state is now home to more abortion clinics than ever. And, as a result of the RHA, they are almost entirely unregulated.
In the late 1970s the Chicago Sun-Times published an undercover series on the abortion clinics in Chicago at that time. The “Abortion Profiteers” series introduced readers to some rather unsavory characters and facilities. (For instance, one abortionist had a pet dog that would lick up the blood from the floor of his clinic.) After that series the Sun-Times decided to not allow abortion clinic advertising in the paper, since they could not recommend any of the clinics as safe places for women.
Enter the Illinois legislature, which wrote legislation to have abortion clinics licensed and inspected as Ambulatory Surgical Treatment Centers (ASTCs). That shut down some abortion clinics and raised the bar for the licensed ones. Many clinics did become licensed and inspected. Others closed.
But abortionists didn’t like the inspections and the standards and one (Richard Ragsdale) sued. His case, Ragsdale v. Turnock, was about to be heard by the U.S. Supreme Court when Illinois politicians got together and worked out a deal. They invented a category for abortion clinics that would allow lowered standards from Ambulatory Surgical Treatment Center standards. Some of the clinics remained ASTCs while others were classified as Pregnancy Termination Specialty Centers (PTSCs).
There was also a loophole wide enough for Planned Parenthood to drive a truck through resulting in Illinois Planned Parenthood abortion clinics having never been licensed nor inspected by the state (with the exception of the Planned Parenthood facility in Champaign, which was licensed for only a short time).
While up until the Ragsdale case was settled in 1990, abortion clinics had been inspected about every 2 years (and more frequently if deficiencies were found), after the decision almost all inspections halted. Beginning in 1998 and for more than a decade thereafter, there were no inspections of Illinois abortion clinics north of I-80 (widely considered to be the southern boundary of the Chicago metropolitan area) except for initial inspections of new clinics prior to opening.
In early 2011, news broke in Philadelphia of an abortion clinic run by Kermit Gosnell which would come to be called the “House of Horrors”. After reading the grand jury report of what occurred there, we decided to find out about what was happening in Illinois. When officials at the Illinois Department of Public Health (IDPH) realized that they were in the same situation as Pennsylvania by neglecting to inspect abortion clinics, they decided to restart inspections over the course of the next two years.
What resulted first was the closure in late 2011 of the Northern Illinois Women’s Center, the abortion facility formerly owned by the now deceased Ragsdale. Besides being filthy and having unsterile instruments, there was no registered nurse on staff for 3.5 years prior. (That was a major violation: the presence of an RN is necessary because the other workers have no required education in how surgical procedures are to be done safely).
Subsequently there were a few closures of other clinics that were demonstrably unsafe. One clinic’s owner voluntarily applied to close because he knew the facility was unsafe and would not pass inspection.
After this, IDPH began regularly inspecting the clinics that were licensed. At that time there were around 4 that were licensed as ASTCs and around 7 that were licensed as PTSCs. Over time some of them closed, probably for financial reasons. Planned Parenthood, however, continued to be unlicensed and unregulated and a few clinics started to pop up that were not licensed, including a new Family Planning Associates facility in Chicago. FPA had had a licensed ASTC (the Albany Medical/Surgical Center) which did late-term abortions with anesthesia, but when it closed in 2015, they moved their late procedures to their unlicensed, uninspected clinic on Washington Street in downtown Chicago. How is this safer for women?
At the time the Reproductive Health Act was passed in 2019, there were about three ASTC abortion clinics and four PTSCs as well as all the Planned Parenthood abortion clinics that were unlicensed and uninspected. And FPA. And other unlicensed independent clinics. The RHA eliminated the category of PTSC and eliminated the requirement that abortion clinics be licensed and inspected by the IDPH unless they chose to be ASTCs. Currently, there are only two abortion clinics that are licensed ASTCs. Because ASTCs report data to the state, we have some knowledge of what goes on there.
Hope Clinic for Women in Granite City had 8-11 women transferred by ambulance to a hospital each year from 2018-2022 (the most recent year reported).
American Women’s Medical Center in Chicago had to close multiple times during 2023 (the most recent year from which inspections are available) because they were not properly sterilizing their instruments. (See here, here, here, here, here, and here.)
But these are the clinics that are regularly inspected and licensed. There is absolutely no requirement for any of the abortion clinics in Illinois to be licensed or inspected.
Since the late Ragsdale’s former abortion clinic closed, one of its former abortionists has recently returned. He bought an old veterinary hospital in Rockford and has turned it into an abortion clinic. While veterinary hospitals are licensed and inspected by the state, his abortion clinic for humans is neither.
Women deserve better.
