Unsafe abortion clinics exposed in Florida: What health inspectors and reporters found.

How the politics of abortion protects bad clinics.
Feb. 22 2011 7:23 AM

The Sunshine State

What reporters and health inspectors found in Florida's worst abortion clinics.

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Photo of Gregory Coler, Director of the Illinois Dept. of Children & Family Services, Jan. 1979 - Dec. 1983
Greg Coler
William Saletan William Saletan

Will Saletan writes about politics, science, technology, and other stuff for Slate. He’s the author of Bearing Right.

On Sept. 22, 1989, Florida Gov. Bob Martinez called a press conference to address news of dangerous conditions at the Dadeland Family Planning Center, a Miami-area abortion clinic. The revelations, published by the Miami Herald, included a woman's death. They indicated that the state's supervision of abortion clinics was grossly inadequate. Martinez ordered the state Department of Health and Rehabilitative Services to draft emergency regulations for the clinics.

Pro-choice groups didn't take the announcement well. Martinez was leading a campaign to make Florida a model pro-life state. Two months earlier, he had called a special legislative session, scheduled for October, to enact abortion restrictions including strict clinic regulation. So when the governor issued his Sept. 22 order, alarms sounded. Abortion providers called a meeting to prepare legal defenses against the emergency rules. The Florida Abortion Council, which represented the state's leading clinic operators, served notice that it was ready to sue.

The bad news from the clinics was just beginning. On Sept. 25, HRS officials marched into the Dadeland facility, suspended its license, and slapped a "CLOSED" sign on its entrance. Greg Coler, the department's secretary, described what his inspectors had found. The clinic's suction equipment had a dark red residue. The staff couldn't recall when it had last been cleaned. Surgical tools were stored in bloody paper towels. Oxygen tanks were leaking in smoking areas. Expired drugs were kept on hand. "This clinic is the closest thing to a back-alley abortion mill that you can find, considering that abortion is legal," said Coler.

Why hadn't the state noticed these conditions before? Coler pointed to a 1982 order by a federal judge, which had struck down most of Florida's authority to police abortion clinics. Unless the laws were changed to broaden his agency's authority, Coler said he couldn't tighten clinic standards.

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That was fine with FLAC. The council said it wouldn't accept further regulations even if they simply codified standards already required by the privately run National Abortion Federation. "No matter how many regulations you write, people are going to operate illegally," argued FLAC's president. The owner of the Dadeland clinic urged pro-choicers to stand together against Martinez. "Do you see that we're being harassed?" she asked the press. "Do you see that it's the governor doing this?"

Tips from former patients and clinic workers began flowing to HRS. On Sept. 27, HRS inspected and shut down a second clinic. "There was actually an abortion-suction device in this place that had green mold growing in it," Coler reported. "There wasn't any soap in the place, so our inspectors had to go next door to wash their hands." Blood coated the stirrups at one operating table. Dirty emergency equipment was found at the bottom of a packed closet.

Some of the discoveries HRS held up as "horrifying"—repeated use of sterilized surgical tools, for example, or the use of a kitchen colander to strain tissue for lab tests—were safe and common practice. But these characterizations were errors of ignorance, not ideology. A few years earlier, Coler had helped found and finance two groundbreaking  birth control programs in Illinois. Over the past month, he and his staff in Florida had tried to scale back Martinez's regulation schemes. HRS officials were simply embarrassed that a reporter had caught them asleep on the job. They were scrambling to look vigilant.

Rather than help clean up, pro-choice leaders stonewalled. First they complained that the state Department of Professional Regulation was plotting to tighten licensing rules for abortions in doctors' offices. Then they claimed that by failing to crack down on doctors' offices as well as clinics, HRS proved it wasn't really concerned about health. Meanwhile, they cited HRS's regulatory failure as evidence that further regulations wouldn't help. "If they can't enforce the laws that exist," asked a state senator, "why do they need stronger laws?"

Sensing defeat, Martinez gave up on his original regulatory plan. Instead, on the advice of HRS, he proposed milder sanitation, staffing, and equipment rules drawn from the National Abortion Federation standards—with which half of Florida's abortion clinics already complied—and from standards already imposed on birthing centers. Still, pro-choicers wouldn't budge. "It's ludicrous that the governor himself is willing to admit that 30 of the 48 clinics are doing a fine job, and HRS can't find serious problems in the other 18, yet he wants to waste taxpayer money to impose all these new rules," said Janis Compton, the director of the Florida Abortion Rights Action League.

Two days after the governor's retreat, another political threat collapsed. The Florida Supreme Court ruled that a 1980 amendment to Florida's constitution protected the right to abortion. Even if the U.S. Supreme Court were to overturn Roe, abortion would remain legal in Florida. The grounds to fear state oversight of the clinics were dwindling. And the bad news from HRS kept coming: On the day of the ruling, officials inspected and closed a third clinic. Backup equipment didn't work; medicine was expired; old blood contaminated some instruments. According to Coler's report: