A New Entrant into a Beleaguered Industry
Regardless of what one thinks about the practice of abortion, this much is clear: since the landmark Roe v. Wade decision abortion services have grown into a full-fledged industry - by some estimates a $400 million to $1 Billion industry. Partly because of the sensitive nature of the subject and partly because of the dogged determined of those who oppose the practice, abortion providers keep low organizational and individual profiles.
Given how many Planned Parenthood clinics and their staff have been threatened or killed, people working in this industry understandably loathe speak publicly and candidly about their strategic plans. If and when they do, the focus is always more on the needs of the clients than of that of the provider. A recent article appearing on MSNBC coming from KNBN-TV in Rapid City, South Dakota entitled "Pine Ridge Indian Reservation to offer abortions" illustrates all of this quite clearly:
If South Dakota's abortion ban stands, it won't ban them from all parts of the state. The Oglala Sioux tribe president wants to open a women's clinic on the Pine Ridge Indian Reservation that will offer abortions only if House Bill 1215 becomes law.(According to) Cecilia Fire Thunder, President, Oglala Sioux Tribe, "The best solution to abortion is to make sure that women have access to contraceptives, have access to family planning options, and that information needs to be out there at all times where all women of childbearing age have that information and use it."
For those reasons, Fire Thunder wants to open a women's clinic on Pine Ridge, providing women with birth control options and proper health care, and if 1215 passes the clinic would also provide abortions.
"We just want to make sure that something is done for women who make that decision. All we can do is provide that to them, no questions asked. It's their choice. It's between her and God and that unborn baby. And I honor that."
When I read the above statement I wondered at Fire Thunder's candor and apparent willingness to defy the state law. The next paragraph made clear that there was something very important- strategtically important- about this industry that I did not understand:
South Dakota Attorney General Larry Long says providing an abortion on the Pine Ridge Reservation is not unlawful because state law doesn't apply to sovereign land. "Roe vs. Wade is a federal law. Pine Ridge is a reservation that is under the jurisdiction of federal laws more than state laws."
According to the articel, this state of affairs does not mean that Pine Ridge will become home to South Dakota's abortion services industry:
But that doesn't mean just anyone can get an abortion. Long says providing and receiving abortions would be illegal if the person performing it and the woman were both non-Indian.
I am not a lawyer but the last three words of that sentence - "were both non-Indian" - sounds like one very big loophole. Fire Thunder is clearly aware of the potential for legal trouble here:
Fire Thunder says she is still looking into the legalities behind opening the clinic, but feels that the Reservation is in desperate need of this type of care. "We have around 30,000 people living at Pine Ridge, half of which are eighteen and under. So we're safe to say that maybe 8,000 of our residents are age 18 and under and female." Plans are in place to build a clinic regardless of the outcome of House Bill 1215.
I have a pretty good idea as to how to determine what the plans for the clinic, who might use it, and in what numbers. In 2000, South Dakota teens aged 15-19 had a rate of only just under 7 abortions per 1000 women. The population estimate for girls that age in 2000 was 30,219. That works to less than 200 statewide and less than 60 for the 8,000 teenage girls to which Fire Thunder alludes. One would not need a very large clinic to provide this few abortions to this few women. In fact, it is doubtful that even one full-time doctor would be needed. I reached this conclusion in part from this paragraph appearing in the San Francisco Chronicle which states that:
For now, it remains legal to get an abortion in South Dakota. About 800 a year are performed at a Planned Parenthood clinic in Sioux Falls, where doctors fly in once or twice a week from Minnesota, according to Marta Coursey, spokeswoman for Planned Parenthood Minnesota, North Dakota, South Dakota. It is the only abortion clinic in the state. The state ban takes effect July 1. Meanwhile, it faces hurdles.
Though we are not told how many doctors spend the equivalent of 75 days per year in Sioux Falls, if they perform 800 abortions a year, that works out to 11 per day. My guess would be that no more than 2-3 doctors at most are needed to handle that number, maybe less. The point is that the footprint of any clinic on a reservation would be very small if it is serving on the family planning and reproductive service needs of just Native American women and smaller still for Native teens. It's hard to envision how it would need more than 1 part-time physician. It is difficult to forsee any reason why the planned clinic would need to be as large as the Planned Parenthood clinic in Sioux Falls.
Now I know nothing about how many square feet such a clinic ought to be but I can surmise that those who do can tell the difference between the size of one that would be performing abortions for the local demand and one that found a loophole in the law and is picking up some of the Sioux Falls demand. You don't build big for demand you don't expect or want. Thus, the day they break ground for this clinic (assuming it is not part of an existing medical facility) much will be revealed about the anticipated scale and scope.
Soon time will out the strategy of this new entrant into this most beleaguered of industries, into an industry whose tragic mission it is to bar the entrance of new entrants into the world.
Update: This CNN report indicates that just one doctor working one day per week is sufficient to perform all of the abortions in South Dakota. The article profiles one of 4 doctors who fly in to South Dakota from Minnesota on alternate weeks to perform abortions for South Dakota women. Her name is Miriam McCreary, a 70 year old grandmother and on the day CNN followed her to Sioux Falls she performed 16 abortions. That number is interesting because it squares almost perfectly with the estimate of 800 provided above: 16 abortions/week * 52 weeks/year = 832 abortions per year.
Tags: abortion | Sioux Falls | Reproductive Rights | south dakota
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