This June marked two years because the Dobbs ruling successfully overturned nationwide protections for entry to abortion as a constitutional proper. In that point, we’ve seen 21 states ban abortion or limit the process earlier in being pregnant than the usual set by Roe v. Wade. The structure trade has remained largely absent on this concern, chalking it as much as abortion being seen as too taboo and controversial to have interaction in straight moderately than for seeing it what it’s: A well being and reproductive care process, and an especially frequent one at that. One in 4 folks able to being pregnant in the US can have had at the least one abortion.
As a healthcare architect whose tasks have coated your entire care continuum, I do know this to be unequivocally true: Abortion entry is healthcare.
When I’ve spoken in regards to the concern of abortion and structure, sure members of our design group have requested me to exchange the phrase abortion with “one thing else” or not use it in any respect. And the AIA’s Academy of Structure for Well being has refused my requests to create a presentation to raised educate their members on points on the intersection of abortion entry, the constructed atmosphere, and state and federal coverage.
In a occupation that’s dedicated to designing areas that help optimum affected person well being, security, and wellbeing, it’s our responsibility to step up and apply our experience the place we are able to towards that mission with out passing worth judgements on the providers being offered. And it couldn’t be timelier. New reporting factors to the toll that stringent restrictions have taken: 171,000 folks had been compelled to journey out of state final yr for abortions and there are an increasing number of tales popping out about ladies’s lives being placed on the road looking for care. Research present maternal loss of life charges in states that limit abortion entry are 62 % greater than in states the place abortion is extra simply accessible.
We’re witnessing what occurs the place that isn’t trade commonplace follow and satisfactory architectural steering for abortion care services. The less services which can be accessible, the larger persons are put in danger. Interval. In an election yr the place all types of reproductive care and household planning have been placed on the desk, it has by no means been extra vital to have accessible tips of normal follow. And simply because it’s seen as too difficult to tackle is much more motive to deal with this concern straight moderately than draw back.
So, I made a decision to take it on straight with my friends by submitting an modification to the Amenities Pointers Institute’s Pointers for Design and Development of Outpatient Amenities upcoming 2026 version. The Facility Pointers Institute (FGI) is a corporation that develops and publishes among the most vital tips for the design and development of hospitals, outpatient services, and residential well being, care, and help services in the US. The Institute determines each commonplace trade follow in healthcare design and state-level code and laws. But, these gold requirements have a severe design flaw—the FGI has by no means offered direct design steering for abortion clinics and services for instance of a reproductive healthcare facility typology.
I defined in my proposal how this addition to the rules may stop clinic closures and enhance affected person security by offering higher entry to abortion care in states the place abortion stays authorized. Out of the just about 1,800 proposals for amendments submitted, the proposal to straight point out abortion care had extra in-favor opinions from the general public interval commenting course of than every other proposal. As well as, the FGI’s Profit-Price Committee agreed with the proposal. A member of that committee even publicly commented it was an “vital clarification” to incorporate abortion clinics for instance of reproductive healthcare within the revisions. Frustratingly, the FGI’s Well being Pointers Revision Committee (HGRC) nonetheless determined to reject the proposal with out satisfactory motive or rationalization. I can solely speculate on the totally different explanation why.
I perceive that the rules usually attempt to present design requirements based mostly on health-related dangers of procedures as a substitute of the particular procedures themselves. To somebody unfamiliar with connections between U.S. abortion and care and the constructed atmosphere, it may need even appeared as if the proposal’s scope started to creep too far into specifics. The wholesale rejection was a transparent indication the HGRC committee didn’t have the required reproductive healthcare experience wanted to make an knowledgeable determination the topic. In the event that they did, the FGI would have already realized that their inaction to say the phrase abortion of their tips contributes to anti-abortion lobbyists and state politicians with the ability to cross constructing facility requirement TRAP (Focused Restriction on Abortion Suppliers) legal guidelines extra simply.
TRAP legal guidelines create burdensome and medically pointless laws on abortion constructing facility necessities with the aim of forcing abortion services to shut. It was disappointing to understand that a company that prides itself on producing essentially the most widely known planning and development tips within the healthcare design trade shaped a committee that was fully ignorant to the truth that states with TRAP legal guidelines topic abortion-providing services to totally different necessities than, for instance, different surgical procedures topic solely to outpatient-based surgical procedure (OBS) legal guidelines. For instance, a examine printed within the American Journal of Public Well being in 2018 discovered that TRAP legal guidelines had been extra seemingly than OBS legal guidelines to require facility licensing and process rooms.
If the HGRC committee had taken the time to correctly educate themselves after calling consideration to TRAP legal guidelines, they might have realized this uncommon want for specificity would have superior the standard of abortion healthcare. Easy language can fight TRAP legal guidelines that systematically shutter abortion clinics throughout the states.
Though the FGI revisions committee rejected the preliminary proposal to incorporate abortion services of their 2026 outpatient tips, I consider it’s not too late for them to alter course this yr. Ultimate revisions haven’t been printed, so I’m encouraging our design group to take this chance to recommend the FGI reconsiders the rejection of my proposal going to Contact Us – Facility Pointers Institute (fgiguidelines.org) There is not going to be one other likelihood to revise the FGI tips till the 2030 Revision cycle. With a lot uncontrolled in America right this moment and the place the stakes couldn’t be greater, participating with this concern is one tangible approach that architects could make a distinction. The time for motion is now.
Jordan Kravitz is a healthcare venture architect, medical planner, and researcher. She is the writer of “A State By State Information To Understanding Outpatient Abortion Clinics In Relation To Entice Legal guidelines And The Constructed Surroundings.”
