Friday, April 29, 2016
NBC News (April 29, 2016): Abortion in Europe: Rebecca Gomperts Takes Entrepreneurial Approach, by Cassandra Vinograd:
Ten years ago, Dr. Rebecca Gomperts founded Women on Waves, a ship that sailed to countries where abortion was illegal to offer abortion services in international waters. Since 2006, Gomperts and Women on Web have been using the internet to provide information about abortion and to ship medication to self-induce abortion to women around the world. The website uses an online platform that refers women to doctors after they complete an online consultation. Women who use the service are asked to make a donation, but services are free for women who can’t afford to donate.
In addition to providing women with access to medication abortion, Women on Web’s helpdesk receives 10,000 emails a month. Its staff is trained in a dozen languages and includes five doctors. Many of the website’s visitors are from countries like Poland, which has one of the most restrictive abortion laws in Europe. However, messages to the website indicate that even in countries with less restrictive laws, access to information about abortion still remains a challenge. Indeed, although Women on Web is based in Europe, its helpdesk receives many inquiries from the U.S.
Monday, April 25, 2016
Washington Post (April 23, 2016): Abortion doctors would lose medical licenses under new Oklahoma bill, by Niraj Chokshi
The Oklahoma legislature continues to pass legislation designed to undermine women's access to abortion. Last week the legislature passed a bill that would bar doctors who perform abortions from obtaining or renewing medical licenses. The bill will become law unless it is vetoed by the Governor.
The Oklahoma Medical Association oppose the legislation because it overrides physical judgment. In a statement, the Center for Reproductive Rights criticized the bill as "cruel and unconstitutional."
Saturday, April 23, 2016
Rewire (April 21, 2016): Congressional Testimony: Anti-Choice Measure Would Turn People of Color Into 'Suspects in the Exam Room,' by Kanya D'Ameida,
At last week's Congressional Hearing for the Prenatal Nondiscrimination Act, Miriam Yeung, Executive Director of the National Asian Pacific American Women's Forum was the only witness invited to testify against the bill. This week, 56 people of color, who have had abortions, sent a letter to Congress adding their voices in opposition to the bill.
Introduced by Rep. Trent Franks (R-AZ), chairman of the House Judiciary Subcommittee on the Constitution and Civil Justice, the bill seeks to impose criminal penalties on providers who perform abortions knowing that they are sought on the basis of the fetus’ race or sex.
It also seeks to criminalize anyone who coerces a person into seeking a race- or sex-selective abortion; anyone who raises funds for the procedure; or anyone who transports a woman into the United States or across state lines to obtain the abortion—and imposes a penalty ranging from a fine to a five-year prison term.
The letter states that the bill singles out the reproductive choices of women of color for scrutiny and would undermine their relationship with their health care providers. The bill is based on the presumption that Asian-American communities have a preference for male children despite the fact that research actually shows that Asian American and Pacific Islander communities have more girls on average than white counterparts.
In her testimony last week, Miriam Yeung criticized the bill for promoting stereotypes that "Black women are unable to make reproductive health decisions for their own families" because it accuses "Black women of being irresponsible and, worse, intentionally deselecting babies who share their own race" and that "Asian-American families do not value the lives of their girl children." Rather than pushing PRENDA, Yeung encouraged Congress to
to support racial equality in a real way: by addressing health-care disparities in communities of color, and protecting the sanctity of the doctor-patient relationship by supporting open, honest communication with one’s medical provider—which we know to be critical to quality medical care. This bill promotes the exact opposite—forcing doctors to act as police interrogators in their exam rooms, ultimately making women more reluctant to share their personal experiences for fear of their private information being made public. When medically accurate, safe, and nonjudgmental patient counseling is taken away, women—especially those vulnerable to domestic violence or trafficking—lose the chance to seek help from their health care providers.
Thursday, April 21, 2016
Kut.org (April 19, 2016): After FDA Label Change, Clinics See More Women Using Medications for Abortions, by Ashley Lopez:
Three weeks after the FDA changed the label for mifepristone, the country's most widely used abortion drug, Texas clinics are seeing an increase in medication abortion.
Texas law requires that doctors administering mifepristone follow FDA labelling requirements even though the old label was inconsistent with current medical standards. According to Sarah Wheat at Planned Parenthood of Greater Texas, under the old FDA label, Texas law required that women make four separate visits to their abortion provider. Texas HB 2, passed in 2013, also resulted in the closure of many abortion clinics, greatly increasing the distance women needed to travel to make those visits. The unnecessary trips and the distance to providers forced many women to have surgical procedures rather than medication abortions. Since the new FDA label has been in effect, Wheat say Planned Parenthood has seen a "four-fold increase" in women choosing medication abortion.
In addition to reducing the number of doctors visits, the label change also allows doctors to lower the dose of mifepristone and prescribe a mediation abortion later into pregnancy. While the change in the FDA label has an immediate effect in Texas, many states passed laws that adopted the old FDA requirements verbatim. Indeed Arizona passed such a law after the new FDA requirements went into effect. Unless the legislatures amend those laws to reflect the new FDA standards, women in those states will be subjected to unnecessary requirements and out-of-date medical protocols.
Tuesday, April 19, 2016
Inquisitor (April 10, 2106): California Birth Control Law Allows Pharmacists to Dispense Contraception Practically Over-the-Counter, by John Houck:
Earlier this month a California law went into effect that allows pharmacists to distribute self-administered hormonal contraceptives. The law was passed in 2013, but did not go into effect until April 8, 2016 because of regulatory hurdles.
Although women are not required to get a doctor's prescription, access isn't quite "over-the-counter."
To get birth control, a woman will need to answer some questions about her health as well as consult with a pharmacist to determine the most appropriate contraceptive method. A woman’s blood pressure will have to be measured if the particular method poses a high blood pressure risk.
After the consultation, a woman can request a specific type or ask the pharmacist for a recommendation. Once the method is chosen, instructions for use and information regarding side effects will be explained. Some methods, like implants or intrauterine devices, are only available from a doctor.
Birth control administered in this manner will be covered by insurance plans that include birth control. Oregon and Washington already have similar legislation in place, and Hawaii, New Mexico and Alaska are considering similar measures.
Monday, April 18, 2016
Startribune (April 12, 2016): APNewsBreak: North Dakota to pay abortion clinic $245k, by James McPherson:
Last week, North Dakota agreed to pay the attorneys fees of the state's sole abortion clinic following the clinic's successful challenge of a 2013 law prohibiting abortions as soon as a fetal heartbeat is detected. The law would have banned abortions as early as six weeks and clearly violated existing constitutional protections for abortions.
After it passed, the law was almost immediately enjoined by a federal district court. And, in July 2015, the Eighth Circuit, agreed with the district court's conclusion that the law was unconstitutional because it prohibited abortions pre-viability. In January, the Supreme Court declined to hear the case. Because lawyers who successfully represent a plaintiff asserting a violation of constitutional rights are entitled to attorneys fees, North Dakota agreed to pay a settlement of $245,000. In addition, records obtained by AP indicate that through January, the state had spent over $320,000 to defend its abortion laws, most of which was spent on the fetal heartbeat law.
Janet Crepps, an attorney for the Center for Reproductive Rights [which represented the clinic], said she hoped the settlement would send a message to North Dakota and other states. "From the beginning, the state recognized it was embarking on an expensive lawsuit, defending a clearly unconstitutional law," Crepps said. "It has cost the state a good bit of money," Crepps said. "A measure could have been passed to help the people of North Dakota."
Sunday, April 17, 2016
Independent (April 12, 2016): The UK's abortion shame: Northern Ireland urged to stop prosecuting women under abortion ban, by Sioban Fenton:
Northern Ireland is under pressure for recent criminal prosecutions of women for abortions. Earlier this month, a 21 year old woman pled guilty to procuring her own abortion and received a three month suspended sentence. She became pregnant at age 19 and could not raise the money to to travel to England to have a legal abortion. Instead, she purchased medication over the internet to self-induce an abortion. She was reported to authorities by her housemates.
A second woman is due to stand trial in Belfast on April 27 for helping her daughter access pills to induce an abortion. Local media has reported the prosecutors are considering bringing two additional cases for illegal abortions.
Although Northern Ireland is part of the United Kingdom, the UK's 1967 Abortion Act, does not apply there. Instead an 1861 act criminalizing abortion remains in effect, and abortions are only legal if a woman's life or mental health is in danger. As a result, many women travel to England for abortions if they can afford the travel costs.
The UK has been criticized by the UN Human Rights Committee which has recommended that Northern Ireland's abortion law be amended. Leading MPs also have criticized the prosecutions and advocate ending the criminalization of women. MP Liz Kendall stated:
We must end the criminalisation of women in Northern Ireland who, often in desperate circumstances, decide to terminate their pregnancy. Currently, women wishing to terminate a pregnancy are either forced to travel to other parts of the UK, or, if they don’t have the money, attempt an abortion themselves, putting their safety at risk. That is no choice. Women in Northern Ireland should have access to safe abortions, in hospitals or clinics, like women in the rest of the UK.
In an effort to highlight the inequality of Northern Ireland's current law, Claire Bailey, Deputy leader of the Green party has said she is considering proposing legislation that would allow the prosecution of men under a new criminal offense of "reckless conception."
Saturday, April 16, 2016
Social Europe (Apr. 6, 2016): The Polish Church and Government Open New Attack on Women's Reproductive Rights, by Gavin Rae:
In Poland, which has one of the most restrictive anti-abortion laws in Europe, Catholic officials are urging more restrictive regulation. Currently, abortion is available in only three instances: (1) there is a high probability that the fetus will suffer severe and irreversible damage or have an incurable life-threatening disease; (2) continuing a pregnancy threatens the woman’s life or health; or (3) the pregnancy is the result of a criminal act. As in other countries with restrictions on abortion, wealthy women travel to other countries to terminate their pregnancies, and poor women resort to unsafe, backstreet procedures. The new law is an attempt to end nearly all abortion in Poland by limiting it to cases where the pregnant woman's life is directly threatened by continuing the pregnancy. The proposal also increases the jail time for those who perform abortions from two to five years and imposes penalties on anyone who disseminates information about abortion options abroad.
The Catholic church is prominent in the push for the new law. The ruling party leaders are staunch Catholics who received influential church backing in the last elections. They are determined to use their power to enshrine Catholic doctrine in national policy. The move is a reflection of a regime that is becoming increasingly authoritarian.
Tuesday, April 12, 2016
New York Times (Apr. 8, 2016): Fathered by the Mailman? It Mostly an Urban Legend, by Carl Zimmer:
Stories about adultery and uncertainty about paternity permeate mass media and popular culture. At the dawn of the era of DNA testing, some data suggested that up to 30% of the children born to married couples were the product of adultery. But those data involved requests by husbands who suspected their wives' had extramarital paramours. New research suggests that births of children from wives' adulterous liaisons actually occurs very seldom.
The new study looks at inheritance of the Y chromosome. The Y chromosome is passed down in almost identical form from fathers to sons. By studying the chromosomes of living related men in various countries (Spain, Italy, Germany, Mali and Belgium), researchers came up with an adulterous paternity rate of less than one percent.
One reflection of the low rate may lie in the inefficacy of human sperm to compete for fertilization as compared to other species'. "The only way for men to have evolved comparatively ineffectual sperm," according to one researcher, "was for them to have experienced high rates of paternity over time." She added that better assurances of paternity lead to higher investments of fathers in their children. These investments have been critical to the survival of the species given that humans are completely helpless when they are born.
Friday, April 8, 2016
New York Times (Apr. 8, 2016): "Periods for Pence" Campaign Targets Indiana Governor over Abortion Law, by Mitch Smith:
Indiana Governor Mike Pence signed Indiana's draconian abortion bill into law on March 24th. Now, a campaign to call attention to the unbelievably restrictive law has emerged on Facebook. In an unusual strategy, the campaign, Periods for Pence, features a call for women to contact the governor's office "to report our periods." The campaign is meant to call specific attention to the requirement that miscarried fetuses be interred or cremated.
“I would certainly hate for any of my fellow Hoosier women to be at risk of penalty if they do not ‘properly dispose’ of this or report it,” one post says. “Just to cover our bases, perhaps we should make sure to contact Governor Pence’s office to report our periods.”
As of 3:00 p.m. Friday, Periods for Pence has more than 41,000 likes.
Thursday, April 7, 2016
New York Times (Apr. 2, 2016): Abortion and Punishment, by Katha Pollit:
In her op-ed, Pollit discusses how, in the aftermath of Donald Trump's outrageous remark that women should be punished for having abortions, anti-abortion forces have been hastily devising ways of appearing to be compassionate toward women. Why this would be so, if abortion is murder, is one of the baffling contradictions of the anti-abortion front. To describe women as "victims" of a culture of death fomented by parents, husbands, boyfriends, and health care professionals is to deny that women can hardly be "frail flowers" to obtain abortions these days:
If you consider how determined a woman has to be to get an abortion in much of the country these days and how much energy states expend trying to dissuade her, it's hard to see her as a frail flower. If abortion is murder, the woman is less like a victim and more like someone who hires a hit man. In law, both parties are culpable.
Abortion opponents' only choice, Pollit reasons, is to patronize women, "to portray them as irrational, ignorant and childlike, perhaps even temporarily insane." Nonetheless, that is hardly an excuse for murder, at least not one that would matter in our legal system. And it appears that some states are taking this reasoning seriously, as Purvi Patel found out in Indiana, Anna Yocca in Tennessee and Jennifer Whalen in Pennsylvania. If this is what abortion opponents have in mind as compassion, then Trump wasn't far off the mark.
Wednesday, April 6, 2016
New York Times (Apr. 2, 2016): Arizona Governor Signs Abortion Bill that Skirts F.D.A. Decision, by Erik Eckholm:
The Food and Drug Administration recently relaxed its guidelines for use of the abortion-inducing drug mifepristone, which is used in approximately one in four abortions. Arizona has passed a law requiring abortion providers to follow the original guidelines. The original guidelines, based on studies conducted in the 1990s, recommended doses of mifepristone that have since been deemed unnecessarily high and recommended its use in pregnancies of up to seven weeks, instead of the ten-week pregnancies. Medical researchers have determined that mifepristone is safe in pregnancies of up to ten weeks.
The conservative Christian group that promoted the legislation called the new F.D.A. guidelines outrageous. Opponents of the law see it as an attack on women.
Friday, April 1, 2016
Think Progress (March 28, 2016): Inside The Christian Right's Strategy to Keep Fake Abortion Clinics Open in California, by Alex Zielinski:
Called “crisis pregnancy centers” (CPCs), these clinics advertise free pregnancy tests to get patients in the door, but ultimately lean heavily on junk science and spiritual guilt to talk women out of having an abortion. In January, California became the first state in the country to enact a law successfully cracking down on the state’s nearly 350 misleading clinics.
California's Reproductive FACT Act requires that CPCs hand out a pamphlet providing information on how to obtain birth control, abortion and prenatal care. It also requires that CPCs that do not have a medical license let patients know.
However, efforts to enforce the law have stalled because of lawsuits filed by anti-choice organizations, who claim that the law violates freedom of speech and religious freedom rights. Although four courts have denied motions for preliminary injunctions, it has not stopped the organizations from suing city and county attorneys in small communities. Their strategy appears to be to encourage the communities to agree not to enforce the law in exchange for an offer to drop the case.
So far, only one city -- Grass Valley, a town of 12,000 located an hour north of Sacramento -- has openly accepted this settlement.
"This is not a policy statement. It simply comes down to the cost -- Grass Valley is a small city," said Michael Colantuono, the city attorney for Grass Valley charged in the lawsuit.
Colantuono says that it will be up to the State Attorney General to defend the case because the city doesn't have the money to litigate. Other counties and municipalities may make the same calculation.
Thursday, March 31, 2016
Los Angeles Times (March 29, 2016): Utah governor signs bill requiring abortion anesthesia, by Hallie Golden:
On Monday, Utah's governor signed a bill that would require doctors to give anesthesia to women having abortions at 20 weeks or later. The law will be the first of its kind and has been criticized by doctors for increasing health risks to women by giving them unnecessary heavy sedation. According to the bill's sponsors, the purpose of the law is to prevent the fetus from feeling pain. However, there is no medical evidence that a fetus can feel pain at 20 weeks. In order for anesthesia to reach the fetus, a pregnant woman would have to be given "general anesthesia which would make her unconscious and likely require a breathing tube, or a heavy dose of narcotics."
Despite the law's alleged purpose to avoid fetal pain, it does not apply to women who have abortions because their life is at risk or because the fetus is not viable outside the womb. Because of the law's broad definition of abortion as "the intentional termination or attempted termination of human pregnancy after implantation of a fertilized ovum through a medical procedure carried out by a physician or through a substance used under the direction of the physician," the law could be interpreted to apply to women who seek to induce labor early due to a problem with the pregnancy or because the woman is past her due date.
New York Times (March 31, 2016): New FDA Guidelines Ease Access on Abortion Pill, by Sabrina Tavernise:
The Food and Drug Administration has updated its guidelines on mifepristone, the drug that is used for medication abortions. The change brings the guidelines in line with the current standard medical protocol. The new guidelines reduces the dosage to 200 milligrams from 600 milligrams, decreases the number of visits a woman must make to a doctor to two from three, and extends the period when she can take the pill to 10 weeks from seven weeks.
Although drugs are commonly used off-label, many states have passed laws that require that medication abortion drugs only be used in accordance with FDA guidelines even though the old guidelines were based on clinical evidence from the 1990s. As a result, the laws required doctors to prescribe higher dosages, required women to make more visits to their doctor and limited the availability of the drug to earlier stages of pregnancy.
The change in the guidelines should allow doctors to prescribe mifepristone consistently with medical best practices in states that require that the FDA guidelines be followed. However, many states have independently codified elements of the old protocol, such as the number of doctors' visits required. It is unclear whether the change in the FDA guidelines will trigger reform efforts in those states.
Wednesday, March 30, 2016
Politico (May 27, 2016): Slew of anti-abortion laws may thwart Zika research, by Brett Norman:
Research to prevent the spread of the Zika and the birth defects associated with it may be stymied by new state laws prohibiting or restricting fetal tissue research. On Friday, Florida passed anti-abortion legislation that includes a prohibition on donating aborted tissue. Five states, North Dakota, South Dakota, Oklahoma, Ohio and Indiana have gone further, banning research on aborted fetal tissue and Arizona is expected to pass a similar prohibition. Florida lawmakers have been criticized because Florida is one of the states at greatest risk to be affected by Zika given the state's proximity to areas affected by the virus.
Fetal tissue research was important for research to develop vaccines for other diseases such as rubella, chickenpox, rabies and hepatitis A. Because Zika has been linked with birth defects, research on fetal tissue is important to help scientists understand how the virus disrupts fetal development and develop possible treatment.
Robert Golden, dean of the University of Wisconsin School of Medicine and Public Health, helped fight off an effort to ban fetal tissue research that had gained traction in his state last fall. He said politicians who would obstruct the work but take advantage of the benefits are hypocrites.
“With the horrors of the Zika virus and its almost certain spread to Florida, to me it’s unfathomable that anyone there would want to restrict this research,” Golden said.
Tuesday, March 29, 2016
Think Progress (March 29, 2016): How to Make Sense of the Baffling Order the Supreme Court Just Handed Down on Birth Control, by Ian Millhiser:
On Tuesday, the Supreme Court handed down an unusual order seeking more briefing in Zubik v. Burwell, a challenge to Obama administration regulations intended to expand access to birth control. Under the regulations at issue in Zubik, most employees must include contraceptive coverage in their employer-provided health plan. Employers who object to birth control as religious groups, however, may either fill out a form or write a brief letter seeking an exemption from this requirement. Once they do so, they are permitted to offer insurance that does not cover birth control, and, in most cases, their insurance provider will offer a separate, contraception-only plan to the employer’s workers.
The Supreme Court's order instructs the parties to “file supplemental briefs that address whether and how contraceptive coverage may be obtained by petitioners’ employees through petitioners’ insurance companies, but in a way that does not require any involvement of petitioners beyond their own decision to provide health insurance without contraceptive coverage to their employees.” The Court appears interested in whether the employer could notify the insurance company that it does not wish to provide birth control when they contract for insurance and the insurance company could then notify employees that it will separately provide contraceptive coverage cost-free separate from the employers' plan. This solution would allow employees to receive coverage from the employer's insurer and avoid the need to purchase a separate policy.
The catch, however, is that it may not be possible for the federal government to put such a solution in place, at least without a change to federal law. Employer benefits are governed by complex federal statutes such as the Employee Retirement Income Security Act (ERISA). The Obama administration found authorization for its current rules in the existing ERISA statute, but it is not entirely clear that current law will enable them to move forward with the idiosyncratic solution described in the Supreme Court’s Tuesday order. Indeed, it is likely that one reason that the Court asked for additional briefing in this case was to determine whether the government has the authority to implement the justices’ preferred solution under ERISA.
Religion Dispatches (March 24, 2016): Why Zubik is Especially Important For Women of Color, by Elizabeth Platt and Kira Shephard:
Commentary around Zubik v. Burwell has focused on whether opting out of the Affordable Care Act (ACA)'s contraceptive mandate burdens the free exercise rights of religious non-profits. The non-profits currently have an accommodation that allows them to opt out of paying for contraceptive coverage which triggers their insurer providing coverage using separate funds. However, the non-profits claim that the act of opting out violates their rights because it will allow women to obtain contraceptive coverage through their employer health plan. If the non-profits win, it could result in the loss of contraceptive coverage for thousands of women.
Because of the importance of contraception to women's health the Institute of Medicine recommended that contraceptive care and counseling be included as preventative care that does not require a co-pay under the ACA. Platt and Shephard argue that a ruling in favor of the religious non-profits could have a particularly harsh impact on women of color who have the highest rates of unintended pregnancy, abortion, and maternal mortality.
Eliminating the disparities in reproductive health care, including high rates of unintended pregnancy, involves increasing access to contraception and contraceptive counseling. Access to contraception allows women of color to plan whether and when they have a child, which provides them with greater financial stability and freedom. Women of color, on average, earn significantly less than white women, and many cannot afford to pay for quality contraception.
NPR (March 28, 2016): Pregnant and Addicted: The Tough Road to Family Health, by Sarah Jane Tribble:
The number of people dependent on opioids is increasing, including women of child-bearing age. However, it is difficult for pregnant women with substance abuse problems to get help. "Nobody wants to touch a pregnant woman with an addiction issue."
According to the American Congress of Obstetricians and Gynecologists, women who are pregnant should have medically assisted therapy that at least temporarily replaces the opioids they are using with drugs that are more stable, like methadone. Withdrawal should be discouraged during pregnancy if medically assisted therapy is available.
Quitting opioids cold turkey is dangerous for the infant and could increase the risk of preterm labor or fetal death.
NPR profiles a pregnant woman who was turned away from two hospitals and several clinics before receiving opioid replacement therapy.
Thursday, March 24, 2016
Rewire (March 24, 2016): Justices Against "Hijacking," and Other Unsettling Details from the "Zubik v. Burwell" Oral Arguments, by Greg Lipper:
There was some cause for optimism coming into Wednesday’s argument in Zubik v. Burwell. Eight of nine federal appeals courts—including the ultra-conservative Fifth Circuit—have upheld the accommodation process for religiously affiliated nonprofits wanting to opt out of providing the birth-control coverage. Might the Supreme Court finally send these Affordable Care Act challenges to the great courtroom in the sky?
Not so fast: When it comes to reproductive rights, trips to the Supreme Court are always dicey. Wednesday’s oral argument reveals, on the one hand, that the justices on the Court’s liberal wing believe that the accommodation imposes no substantial burden on religious exercise and is necessary even if it does. On the other hand, Chief Justice John Roberts and Justice Samuel Alito (and presumably Justice Clarence Thomas) clearly think that the accommodation burdens the objectors’ religious exercise and cannot otherwise be justified.
Greg Lipper summarizes Wednesday's Supreme Court argument.