Virginia Health Commissioner Karen Remley resigned Thursday in protest of the state's strict new regulations for abortion clinics.

Remley said the politicized fight over the regulations, which require abortion clinics to meet the same, tougher code standards as hospitals, made it impossible for her to continue as the state's top health official. Abortion rights supporters have portrayed the new regulations as an attempt to restrict access to legal abortion services.

"Unfortunately, how specific sections of the Virginia Code pertaining to the development and enforcement of these regulations have been and continue to be interpreted has created an environment in which my ability to fulfill my duties is compromised," she wrote in a letter to colleagues.

The state Board of Health approved the new regulations sought by the General Assembly, but initially decided not to apply those tougher standards to existing clinics. State Attorney General Ken Cuccinelli refused to sign off on the new rules, however, unless they also covered existing facilities. The health board last month met again and reversed it's earlier position as Cuccinelli wanted.

"We wish Dr. Remley the very best in her future endeavors, and offer our thanks for her years of service to the commonwealth," Cuccinelli's Deputy Communications Director Caroline Gibson said.

The new regulations will require some abortion providers to make physical improvements to their facilities, from enlarging operating rooms to adding parking.

Abortion rights supporters claimed the regulations were a back-door effort by General Assembly Republicans to restrict access to abortion. Supporters of the measure said the new standards help ensure the health and safety of women.

Remley was appointed by former Gov. Tim Kaine, a Democrat, in 2008, and reappointed by Gov. Bob McDonnell, a Republican, in 2010.

"I greatly appreciate Dr. Remley's tremendous public service over the past four years," McDonnell said. "As commissioner, she served two governors from two different parties, and all the citizens of Virginia, with constant professionalism, intellect and dedication. She was a tireless public servant, and we will miss her in the administration."

Kaine praised Remley's efforts to reduce Virginia's infant mortality rate and to ban smoking in bars and restaurants.

"It's unfortunate that a political focus on limiting women's access to health care has prompted her resignation after many years of diligent and faithful service to the commonwealth," said Kaine, now a candidate for the U.S. Senate.

Remley's resignation was effective immediately.

Full text of the resignation email:

From: Remley, Karen (VDH)
Sent: Thursday, October 18, 2012 2:33 PM

Subject: Thank you to all

Dear Colleague,

Many of you may wonder as you open this email why this is out of sync from my weekly emails. First let me say that through this mode of communication I have felt a collegiality and friendship with each of you that I have treasured regardless of our opportunities to meet face to face.

Today’s message is very hard to write, as I am sharing with you a difficult and important decision I have made. As you know, over the past year VDH has been developing and implementing regulations of all abortion facilities in Virginia. I have worked to guarantee the process of survey and licensure would be fairly and thoughtfully applied across the Commonwealth. As of today, all twenty abortion facilities that are eligible for licensing have been inspected, where necessary, plans of correction were received and approved, and within the next few days all will be fully licensed for the coming year.

Unfortunately, how specific sections of the Virginia Code pertaining to the development and enforcement of these regulations have been and continue to be interpreted has created an environment in which my ability to fulfill my duties is compromised and in good faith I can no longer serve in my role. I have submitted my resignation from the position from State Health Commissioner effective today.

I am so humbled, proud and in awe of each of you. Through your leadership, drive and commitment to public health principles, I have been able to walk alongside you for five years, participating in so many important preventive, innovative and improvement initiatives, each one demonstrating your professionalism, passion and strength. I am honored to be a very small part of these endeavors. I will not try to list VDH’s achievements here, as there are too numerous to name. There are so many wonderful things we have achieved to advance health that I am content to reflect, remember, and smile.

Every one of you, whether it be in the Office of Environmental Health, Licensing and Certification, EMS, Chief Medical Examiner, Risk Communications, Preparedness and Response, Epidemiology, Family Health Services, Drinking Water, Minority Health and Health Equity, Internal Audit, Human Resources, Administration, Finance, Budget, Procurement, Information Management, Vital Records, Commissioner and each and every one of our Local Health Departments- where public health truly plays out every minute every day --- truly inspire me. I thank each of you for the education, support and kindness you have demonstrated to me, to the public, and to your colleagues. I know you will continue the mission we are all so passionate about.

I am truly grateful to have worked with each and every one of you.

Karen Remley, MD, MBA, FAAP
Commissioner, Virginia Department of Health