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John Oliver on how states' abortion restrictions make the procedure impossible for women

Abortion is supposed to be legal in America. But over the past few years, states have passed a lot of restrictions on abortions — to the point that they've become largely inaccessible to many women across the country.

On Sunday's Last Week Tonight, John Oliver took a look at these restrictions, which have led to the closure of at least 70 abortion clinics in a dozen states since 2010, leaving four states — Mississippi, Missouri, North Dakota, and South Dakota — with just one abortion clinic altogether.

"If you're thinking, 'How is that possible?' Well, it's in no small part because the key Supreme Court decision concerning abortion is no longer Roe v. Wade," Oliver said. "It's the 1992 Planned Parenthood v. Casey ruling that said states can create restrictions as long as they don't place an undue burden that places a substantial obstacle in the path of a woman seeking an abortion — meaning women can be asked to jump through a few hoops, just not too many."

As a result, state lawmakers have passed TRAP laws (targeted regulations of abortion providers) that they say are meant to protect women's health but really just make it much more difficult to access an abortion.

State lawmakers passed 231 abortion restrictions between 2011 and 2014. Javier Zarracina/Vox

Take, as one example, a law passed in Texas: It requires that abortion centers meet the same building standards as outpatient surgical centers and obtain hospital admitting privileges. While these might seem like sensible ideas, the regulations impose rules on abortion centers that they simply can't meet.

For example, one Texas clinic was shut down because its halls were not 8 feet wide to, in theory, allow two surgical gurneys to pass through a corridor. "It's just not something that is likely to happen at a small abortion clinic," Oliver said. "About 90 percent of abortions occur in the first trimester, when they are generally nonsurgical procedures with no cutting and only mild sedation. They usually involve suction or just taking medication."

In other words, abortion centers are asked to take on standards that don't apply to the way they work — and often they can't meet these standards, forcing them to shut down entirely.

Yet backers of these regulations continue arguing they're necessary to make abortion centers safer and, therefore, protect women's health.

"Yeah, but are you, though?" Oliver asked. "Because it's worth noting both the AMA and the American College of Obstetricians and Gynecologists have argued there is simply no medical basis for requiring local admitting privileges."

Moreover, legal abortions have a mortality rate of 0.00073 percent. "That is nearly 10 times less than what one study found was the risk for dying as the result of a colonoscopy," Oliver said. "And let's agree, by the way, all of us: Death by colonoscopy has to be one of the worst ways to die."

But with all the restrictions some states are passing, abortion has become impossible for some women, even young rape victims. In a video played by Oliver, Marva Sadler, the clinical director of Whole Woman's Health in Texas, explained how she had to reject one such patient.

"In order to see her, I need to put her to sleep. And in order to do that, I need a nurse anesthetist. And because of this crazy law, it is impossible to find people to work for us," Sadler said. "She's 13 years old. And she is a victim of rape. And she drove four hours from McAllen to San Antonio. And we had to turn her away."

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