SALT LAKE CITY — Utah’s Republican Gov. Spencer Cox signed legislation into law Wednesday that will ban clinics from performing abortions next year, sparking a spate of confusion among clinics, hospitals and potential patients in the deeply Republican state.

Hospital and clinic administrators have not publicly detailed their plans to adapt to the new law, adding a layer of uncertainty on top of the fear that if clinics close, patients will not be able to access hospital care due to a variety of personnel and cost concerns.

With the law taking effect May 3, both the Utah Planned Parenthood Association and the Utah Hospital Association declined to detail how the increasingly tense legal landscape for providers in Utah will affect the access to abortion.

The turmoil reflects developments in Republican strongholds in the United States that have taken shape since the US Supreme Court struck down the Roe v. Wade, transformed the legal landscape and sparked a series of lawsuits in at least 21 states.

Utah legislators have previously saying the law would protect «the innocent» and «the unborn,» adding that they don’t believe the state needs abortion clinics after the high court struck down the constitutional right to abortion.

Although Planned Parenthood previously warned that the law could drastically hamper its ability to perform abortions, Jason Stevenson, a lobbyist for the association, said Wednesday that he would now look further at the wording of other provisions in the law that could allow clinics to request new licenses to perform abortions in hospitals. -equivalent services.

Under Planned Parenthood’s interpretation, he said in an interview, clinics will no longer be able to perform abortions with their current licenses. However, they plan to continue providing most of their services, such as STI and pregnancy tests and cancer screenings. Stevenson said they were «looking closely» at the licensing options in the law, but did not say whether the clinics would apply at this time.

Jill Vicory, a spokeswoman for the Utah Hospital Association, said in an email that it was «too early to comment» on whether the hospitals could soon be the only providers of abortion services in Utah, noting that each «will need to make a determination as to how to choose to proceed.»

If clinics stop providing abortions, experts worry that hospitals’ comparatively higher cost of care and staff shortages will make it more difficult to obtain a legal abortion in Utah, even though the law is not an explicit restriction on those seeking them in the state, where they remain legal for up to 18 weeks.

Dr. Carole Joffe, a professor at the University of California, San Francisco who has written about the social effects of reproductive health care, said de-licensing clinics would change the way abortions have been performed for decades. Historically, patients with low-complication pregnancies have received abortions mostly at outpatient clinics, which on average can provide them at a lower cost.

“Everything in a hospital is more expensive than in a clinic. To do an abortion in a hospital, you need more staff,” she said, noting that hospitals, with teams of anesthesiologists, doctors and surgeons, have historically provided them in emergency settings.

Another challenge facing already overstretched hospitals is staffing, Joffe said, both in terms of recruiting and getting staff to perform abortions. Especially in states where anti-abortion sentiment is strong, many doctors or nurses in hospitals may not want to provide them, she added.

“You have to draw from a group that may or may not be sympathetic to abortion, as opposed to a clinic where you’re not going to work unless you’re committed to making abortion a part of medical care,” Joffe said.

Abortion advocates say the confusion stems from unclear language about the license removal process. The law prohibits clinics from obtaining new licenses after May 2 and institutes a full ban on January 1, 2024. However, advocates are concerned about a separate provision in the 1,446-line bill that specifies, according to the state law, that abortions can only be performed in hospitals. .

Clinic-focused legislation has also raised questions about which types of facilities are best equipped to provide specialized care to patients, regardless of their socioeconomic status or location.

If clinics stop performing abortions, starting in May or into next year, it could redirect thousands of patients to hospitals and force administrators to devise new policies for elective abortions. To do so would require expanding their services beyond the emergency procedures they have previously provided, raising questions about the impact of the change on capacity, staffing, waiting lists, and costs. Approximately 2,800 abortions were performed in Utah last year.

The Utah Hospital Association said no hospitals provided elective abortions in the state last year.

The new restrictions are more likely to affect those seeking to terminate a pregnancy with medication, which explains the most of abortions in Utah and the United States. abortion medication it’s approved up to 10 weeks pregnant, mostly prescribed in clinics, and since an FDA rule change in the pandemic era, it’s increasingly being offered via telemedicine.

The new law takes on greater significance amid the legal limbo surrounding other abortion laws that have been signed in Utah.

Last year’s Supreme Court ruling triggered two previously passed laws: one 2019 ban about abortion after 18 weeks and a 2020 ban on abortions regardless of the trimester, with several exceptions that include cases of risk to maternal health, as well as rape or incest reported to the police. The Utah Planned Parenthood Association defendant about the 2020 ban, and in July, a state court delayed implement it until the legal challenges could be resolved. The 18-week ban has since been de facto law.

Abortion access advocates have denounced this year’s clinic ban as a back door that anti-abortion lawmakers are using to limit access while the courts deliberate. If abortions were restricted regardless of trimester to exceptional circumstances, the closures would have less far-reaching implications for patients seeking elective abortions from zero to 18 weeks pregnant.

The law also clarifies the definition of abortion to address liability concerns expressed by providers about the way exceptions are worded in state law, a provision the governor and Republican lawmakers called a compromise.