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Attorney General Patrick Morrisey Office of the Attorney General West Virginia State Capitol Building 1, Room 26-E

Charleston, WV 25305 August 16, 2013 Re: Attorney General Review of Abortion Laws Dear Attorney General Morrisey: Physicians for Reproductive Health is a doctor-led national advocacy organization that uses evidence-based medicine to promote sound reproductive health policies. We work to make quality reproductive health services an integral part of medicine. As physicians, we support access to comprehensive reproductive health care services for all women. We believe that politics and ideology should not enter into the doctor-patient relationship. We also oppose medically unjustified regulations that serve only to hinder access to safe and legal abortion. Approximately 90 percent of all abortions in this country occur early in pregnancy.1 Both medication and surgical abortion are very safe and effective procedures,2 and both are the standard of care for most women who want to terminate a pregnancy. Risk of death from either medication or surgical abortion is over 20 times less than for childbirth.3 Rates of infection and serious complications following a medication or surgical abortion are also extremely low.4 Regulations governing abortion practice should be rooted in evidence-based medicine, serve legitimate health interests, and not impede access to

Meckstroth K, Paul M. First trimester aspiration abortion. In: Paul M, Lichtenberg S, Borgatta L, Grimes DA, Stubblefield PG, Creinin MD, eds. Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care. Sussex, UK: Wiley Blackwell; 2009: 135.
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Meckstroth K, Paul M. First trimester aspiration abortion. In: Paul M, Lichtenberg S, Borgatta L, Grimes DA, Stubblefield PG, Creinin MD, eds. Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care . Sussex, UK: Wiley Blackwell; 2009: 136. See also Grimes DA. Risks of mifepristone abortion in context. Contraception. 2005; 71(3):161 and Bartz D, Goldberg A. Medication abortion. Clin Obstet Gynecol . 2009; 52(2)140-150.
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Koonin, L, Strauss, L, Chrisman, C, Parker, W. Abortion Surveillance United States, 1997. MMWR Surveillance Summaries. 2000; 49(S S11); 1-44. Centers for Disease Control. Available for download at http://www.cdc.gov/mmwr/preview/mmwrhtml/ss4911a1.htm.
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Meckstroth K, Paul M. First trimester aspiration abortion. In: Paul M, Lichtenberg S, Borgatta L, Grimes DA, Stubblefield PG, Creinin MD, eds. Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care . Sussex, UK: Wiley Blackwell; 2009: 138.

abortion care. When abortion becomes less accessible, it becomes less safe. Women may delay their care as they locate a provider, travel greater distances, or even seek the services of an unlicensed provider.5 In 2008, 96% of West Virginia counties had no abortion provider and 84% of women in West Virginia lived in those counties.6 While West Virginia women have the right to safe, legal abortion, in reality there are few facilities that provide this essential care. We urge the state to consider measures that would expand access to safe and legal abortion, not limit the ability of a woman to access care or intrude upon her relationship with her health care provider. Unfortunately, we have seen numerous other states abuse their power to regulate by instituting ideologically motivated, medically unjustified rules under the guise of patient safety. West Virginia women come from all walks of life, from every situation imaginable, and women who seek abortions have weighed all the options and know in their hearts that this private decision is best for themselves and their families. They should not bear the heavy burden of regulations that have no medical benefit or basis. Physicians for Reproductive Health appreciates the opportunity to submit these comments and will continue to monitor this process as it moves forward. Sincerely,

Nancy Stanwood, MD, MPH Board Chair

For example, in Pennsylvania, a state with restrictive laws that limit womens access to abortion, Kermit Gosnell preyed on low-income women who had few options to obtain the care they needed. His practice was illegal, unethical, and unsafe.
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State Facts About Abortion. The Guttmacher Institute (available for download at http://www.guttmacher.org/pubs/sfaa/west_virginia.html).

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