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Case 3:18-cv-00428-HEH Document 1 Filed 06/20/18 Page 1 of 62 PageID# 1 IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF VIRGINIA RICHMOND DIVISION ) FALLS CHURCH MEDICAL CENTER, LLC d/b/a FALLS ) CHURCH HEALTHCARE CENTER, on behalf of its patients, ) physicians, and staff; WHOLE WOMAN’S HEALTH ) ALLIANCE, on behalf of its patients, physicians, and staff; ALL ) WOMEN’S RICHMOND, INC. d/b/a A CAPITAL WOMEN’S ) HEALTH CLINIC, on behalf of its patients, physicians, and staff; ) Case No. 3:18cv428 and VIRGINIA LEAGUE FOR PLANNED PARENTHOOD, ) each on behalf of its patients, physicians, and staff, ) ) Plaintiffs, ) ) v. ) ) M. NORMAN OLIVER, Virginia Health Commissioner; ) ROBERT PAYNE, Acting Director of Virginia Department of ) Health’s Office of Licensure and Certification; FAYE O. ) PRICHARD, Chairperson of the Virginia Board of Health; ) THEOPHANI STAMOS, Commonwealth's Attorney for Arlington ) County and the City of Falls Church; ROBERT TRACCI, ) Commonwealth’s Attorney for Albemarle County; SHANNON L. ) TAYLOR, Commonwealth’s Attorney for Henrico County; ) ANTON BELL, Commonwealth’s Attorney for the City of ) Hampton; MICHAEL N. HERRING, Commonwealth’s Attorney ) for the City of Richmond; and COLIN STOLLE, Commonwealth’s ) Attorney for the City of Virginia Beach, each in their official ) capacities, as well as their employees, agents, and successors, ) ) ) Defendants. ) ) ) COMPLAINT Case 3:18-cv-00428-HEH Document 1 Filed 06/20/18 Page 2 of 62 PageID# 2 TABLE OF CONTENTS PRELIMINARY STATEMENT .................................................................................................... 1 JURISDICTION AND VENUE ..................................................................................................... 6 PARTIES ........................................................................................................................................ 6 Plaintiffs................................................................................................................................... 6 Defendants ............................................................................................................................... 8 FACTUAL ALLEGATIONS ......................................................................................................... 9 Abortion is an Essential Component of Basic Healthcare ....................................................... 9 A. Methods of Providing Abortion Care ................................................................................ 10 B. Abortion is an Extremely Safe Medical Procedure............................................................ 12 The Commonwealth is Denying Virginians Their Constitutional Right to Access Abortion 15 A. The Challenged Statutes and Regulations.......................................................................... 15 B. Virginia has a Long History of Unconstitutionally Restricting Abortion Access ............. 19 Virginia’s Licensing Scheme, Hospital Requirement, and Physician-Only Law Target Access to Abortion Care with No Corresponding Benefit ............................................................ 25 A. There is No Legitimate Medical Reason to Regulate Abortion Differently Than Any Other Comparable Medical Procedure ................................................................................................ 25 B. The Licensing Scheme Provides Little to No Medical Benefit ......................................... 28 C. The Hospital Requirement Is Without Medical Justification and Outdated ...................... 31 D. Virginia’s Physician-Only Law is Outdated and Not Based on Evidence......................... 36 E. Virginia’s Medically Unjustified Laws Impose Heavy Burdens on Access to Abortion .. 38 The Two-Trip Mandatory Delay Law Provides No Benefits, Imposes Substantial Obstacles to Abortion Access, and Demeans People Seeking Abortion ....................................................... 46 A. Mandating an Unnecessary Trip to Obtain an Ultrasound 24 Hours Before an Abortion, and Receive Information that Serves No Purpose, Lacks Any Benefit .................................... 46 B. The Two-Trip Mandatory Delay Law Imposes Unjustified Burdens on Access and Shames People Seeking Abortion Care with No Corresponding Benefits................................ 51 The Harsh Criminal Penalties that Virginia Imposes in Conjunction with the Challenged Laws Punish Healthcare Professionals and Patients ..................................................................... 54 The Challenged Laws Cumulatively Impose an Undue Burden on Virginians’ Access to Abortion Care................................................................................................................................ 55 ATTORNEY’S FEES ................................................................................................................... 59 REQUESTS FOR RELIEF ........................................................................................................... 59 Case 3:18-cv-00428-HEH Document 1 Filed 06/20/18 Page 3 of 62 PageID# 3 Plaintiffs, by and through their undersigned attorneys, bring this complaint against the above-named Defendants, their employees, agents, and successors in office, and in support thereof allege the following: PRELIMINARY STATEMENT 1. In the half-century since it decided Roe v. Wade, 410 U.S. 113 (1973), the U.S. Supreme Court has, time and again, reaffirmed “the right of the woman to choose to have an abortion before viability and to obtain it without undue interference from the State.” Planned Parenthood of Se. Pa. v. Casey, 505 U.S. 833, 846 (1992). The right to decide when, whether, and how to have children is essential to the “ability of women to participate equally in the economic and social life of the Nation.” Id. at 856. 2. Most recently, in Whole Woman’s Health v. Hellerstedt, 136 S. Ct. 2292 (2016), the Court held that laws passed under the pretext of protecting women’s health, or any other interest, are unconstitutional when the burdens they impose on abortion access outweigh the benefits, if any, they confer. Id. at 2309–10. 3. Despite these clear constitutional protections, and the proven safety of abortion care, the Commonwealth of Virginia has spent over four decades enacting layer upon layer of unnecessary and onerous abortion statutes and regulations. These interlocking restrictions subject abortion providers and their patients to a vast array of requirements that fail to provide benefits sufficient to outweigh their burdens. These laws are not supported by medical evidence. Many are outdated and inconsistent with the standard of care. They serve only to place substantial burdens on and impede the ability of Virginians to access safe, legal, and high-quality abortion care. 4. Plaintiffs challenge several core components of Virginia’s burdensome statutory and regulatory scheme because each of the challenged laws, individually and in conjunction with related laws, lacks any legitimate justification, medical or otherwise; impedes Plaintiffs’ ability to 1 Case 3:18-cv-00428-HEH Document 1 Filed 06/20/18 Page 4 of 62 PageID# 4 provide safe, effective medical care; and has the purpose and effect of placing substantial obstacles in the way of patients’ access to abortion care in Virginia. They include: a. A statute that singles out any medical facility that provides five or more first trimester abortions per month and subjects it to stringent licensure requirements, Va. Code Ann. § 32.1-127(B)(1) (the “Licensing Statute”); b. The statute’s extensive, onerous implementing regulations, 12 Va. Admin. Code § 5-412 et seq. (the “Licensing Regulations”) (together with the Licensing Statute, the “Licensing Scheme”), that subject medical facilities providing five or more first trimester abortions per month to a medically unnecessary regulatory scheme that is far more burdensome than Virginia’s regulations governing providers of comparable office-based outpatient care; c. A statute criminalizing second trimester abortions performed outside of a licensed hospital, Va. Code Ann. § 18.2-73 (the “Hospital Requirement”), that draws medically unjustified, arbitrary, and obsolete distinctions based on the trimester framework and gestational age limitations; d. A statute forbidding trained, highly qualified advanced practice clinicians from providing abortion care, despite evidence that such healthcare providers can safely and effectively provide such care, Va. Code Ann. § 18.2-72, (the “Physician- Only Law”); e. A statute imposing a series of unjustified mandates requiring the provision of an unnecessary ultrasound and information that serves no legitimate purpose, plus the offering of materials containing irrelevant, misleading, and false statements, which collectively require each patient to make two trips to a facility and delay 2 Case 3:18-cv-00428-HEH Document 1 Filed 06/20/18 Page 5 of 62 PageID# 5 their care by at least 24 hours, Va. Code Ann. § 18.2-76 (the “Two-Trip Mandatory Delay Law”); and f. In conjunction with the other challenged laws, statutes criminalizing abortion care unless performed in accordance with the Licensing Scheme, Hospital Requirement, and Physician-Only Law, Va. Code Ann. §§ 18.2-71, 32.1-27(A), - 136 (the “Criminalization Laws”). 5. Each of these laws targets abortion providers and patients by imposing on them a unique regulatory scheme that affects virtually every aspect of care in ways that (a) are unjustified and unnecessary because they have nothing

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