Monday, June 4, 2018
The Advocate (June 3, 2018): Absent on an abortion-related issue in Louisiana? It's probably a Democratic legislator, by Tyler Bridges:
During the past three legislative sessions in the Louisiana legislature, seven Democrats missed more than half of the votes on abortion, an issue fraught with political peril for some Democrats in this state.
Two Democrats from New Orleans — state Rep. Neil Abramson and state Rep. Gary Carter Jr. — missed 15 of the 17 votes taken during the 2016, 2017 and 2018 legislative sessions. Both men said that other legislative business caused them to miss the votes. The other five who have missed at least half of the votes are state Sen. Karen Carter Peterson, D-New Orleans; state Rep. Walt Leger III, D-New Orleans; state Rep. Barbara Norton, D-Shreveport; state Rep. Marcus Hunter, D-Monroe; and state Rep. Randal Gaines, D-LaPlace.
No Republicans missed more than half of the 17 votes, according to the group’s score card.
Five of the seven Democrats did not vote on the most controversial abortion bill during the 2018 legislative session, Senate Bill 181, which would ban abortions after 15 weeks. That bill passed the House 81-9 with 14 abstentions and the Senate 24-1 with 14 abstentions. Current Louisiana law prohibits abortions after 20 weeks.
Gov. John Bel Edwards has signed the 15-week bill into law, but it will take effect only if a federal court upholds a similar Mississippi law under legal challenge by abortion rights groups that label it as "cruel" and "unconstitutional." Both measures would impose the strictest bans in the country.
Louisiana Democrats like Gov. Edwards, Rep. Katrina Jackson, D-Monroe, and Sen. Regina Barrow, D-Baton Rouge, hold anti-abortion views that put them at odds with the Democratic Party nationally and the party’s recent presidential candidates.
Some Democrats, however, don’t want to anger Democrats who support abortion rights, a key constituency, or conservative voters who do not support abortion, whose support may be necessary in some elections, said Bernie Pinsonat, a Baton Rouge pollster and political consultant. Pinsonat said he is not surprised that the legislators who have missed the abortion votes are Democrats.
Voting anti-choice is especially important for Republican candidates, Pinsonat said, noting that 18 to 22 percent of the electorate consists of single-issue, anti-abortion voters.
In a 2016 interview, Rep. Abramson declined to state his views on abortion. “That’s a broad question,” he said when asked whether he supported women having the right to an abortion. “I’m not going to get into the details of all of this,” he said when asked whether he opposed abortion except in the cases of limited exceptions, a common Republican position.
Rep. Carter said he has not intentionally missed abortion votes and said his position on the issue is clear: “I support women having the right to choose as well as to be able to make their own decisions about their health and their bodies,” he said. Had he been present for the vote, Carter said he would have voted against the 15-week abortion ban.
Tuesday, May 29, 2018
May 29, 2018 (New York Times): Supreme Court Allows Arkansas Abortion Restrictions to Stand, by Adam Liptak:
Today the Supreme Court declined to grant certiorari in a case challenging an Arkansas law that requires that doctors providing medication abortions have a contractual agreement with a doctor who has hospital admitting privileges in case complications arise. In 2016, an Arizona district court preliminarily enjoined the law before it went into effect. The district court decision was issued before Whole Woman's Health v. Hellerstedt but applied a similar test balancing the benefits and burdens of the law. Because of the low complication rate for medication abortion, the district court enjoined the law finding that it was "a solution in search of a problem." The 8th Circuit vacated the decision holding that a facial challenge to the statute required the district court to make a finding estimating the number of women who would be unduly burdened by the statute.
Planned Parenthood has said that it is unable to find doctors in the state with hospital admitting privileges who are willing to enter into contracts, and it will stop providing medication abortions in the state if the law goes into effect. There are currently only 3 abortion providers in the state, two of which are operated by Planned Parenthood and only provide medication abortion. The third provider, located in Little Rock provides both surgical and medication abortions.
The case now goes back to the district court to make further findings.
Friday, May 25, 2018
May 24, 2018 (The New Yorker): Ireland’s Vote on Abortion Is a Referendum on the Nation’s Future, by Margaret Talbot:
On Friday, Irish voters will decide whether to repeal the Eighth Amendment to the country’s constitution, which bans abortion under nearly all circumstances. The vote will help expose how much the Catholic Church’s hold in Ireland has weakened, following years of revelations about child sexual abuse perpetrated by priests and about the Church’s mistreatment of “fallen women,” who had become pregnant out of wedlock (in 2013, Ireland’s Prime Minister at the time, Enda Kenny, issued a state apology for the Church-run Magdalene Laundries, where such women were confined as unpaid workers, often in drudgery and cruelty).
Though the Yes side—those who want to eliminate the Eighth Amendment—can count on the support of many of the country’s leading politicians and is still ahead in the polls, the gap seems to be narrowing. The most recent polls show that almost one in five voters are still undecided, a figure that raises the spectre of a surprise victory for those who want to keep abortion illegal.
The vote is also an opportunity for tech companies to show how transparent they can be about political advertising and how much they can protect themselves against foreign interference (American anti-abortion activists are among those trying to influence the outcome of the vote). Google announced earlier this month that it would refuse advertising related to the referendum. Facebook said that it would bar such advertising by foreign groups.
Friday’s vote will be a test of whether women in Ireland will continue to be coerced and shamed if they do not want to carry their pregnancies to term. The Eighth Amendment, which has been in place since 1983, has not stopped abortion in Ireland. Making the procedure illegal never has—and that is worth remembering, not only in Ireland but in the United States, where the Trump Administration has given new impetus to those who would like to overturn Roe v. Wade.
Between 1980 (when abortion was not legal in Ireland but was less restricted than after the amendment) and 2016, 168,703 Irish women and girls obtained abortions in England and Wales, according to the United Kingdom’s Department of Health and Social Care. In 2016, the latest year for which such statistics are available, the number was 3,265. This is almost certainly an underestimate, since it only includes women and girls who give Irish addresses when they show up at hospitals in Liverpool and other English cities. The number also leaves out a smaller group of Irish women who go to countries other than England, such as the Netherlands. And it does not count women who obtain abortion-inducing pills on their own.
In 1992, the Irish legislature passed an amendment that made it legal for women to travel abroad for an abortion. This outlawing-and-outsourcing arrangement has come at an enormous cost to Irish women. In November of 2011, a woman named Amanda Mellet, a charity worker living in Dublin with her husband, had a routine scan for her first pregnancy. It revealed that, at twenty-one weeks, the fetus had a chromosomal disorder that kills ninety-five per cent of babies in utero and had heart defects that made survival impossible. A midwife informed Mellet that she had two choices: continue the pregnancy or “travel,” which, as she told the Washington Post recently, brought to mind “Ireland’s history of spiriting deviant women away in conditions of secrecy and shame.”
To Mellet, the journey she made to Liverpool for the abortion felt like a banishment that deliberately denied her the care and the counselling that she should have had in her own country. She flew home twelve hours later, still bleeding. “Not only did we have to make this horrible decision about what to do in the case of a fatal condition,” she told the Post, “we had to leave the country like criminals, speak in euphemisms to hospital staff in Ireland, pay thousands to end a pregnancy, all the while my heart breaking at having to say goodbye to my darling baby girl.” In a case brought by the Center for Reproductive Rights on Mellet’s behalf, the United Nations Human Rights Committee ruled, in June, 2016, that the state had violated Mellet’s rights to freedom from cruel, inhuman, or degrading treatment, as well as her privacy and equality before the law.
It is not just the most terrible cases that should be considered when thinking about the Irish ban on abortion—or about the American pro-life movement’s push to ban the procedure here. If Irish voters set aside the amendment, Irish legislators will be able to enact new laws that will likely make abortion freely available to women in the first twelve weeks of pregnancy, with restrictions thereafter—a framework similar to that of many other countries in Europe. That will certainly provide safety and dignity for women in tragic predicaments. But new laws will also help women in more commonplace ones, who aren’t prepared, for any number of reasons, to bear a child, and who should not be forced to do so. It will allow women, in other words, the ordinary autonomy that all men have.
Polls in Ireland close at 10PM local time on May 25th.
Thursday, May 24, 2018
University of Minnesota Medical School fellowship removed from University website after article stirs controversy
May 23, 2018 (Minnesota Daily): University-hosted abortion fellowship removed after article stirs controversy, by Cleo Krejci and Madeline Deninger:
A University of Minnesota Medical School fellowship application was removed from a University website following controversy surrounding its reproductive healthcare training, which included abortion procedures. The posting was taken off the website in early May after Campus Reform, a conservative news organization, published an article on the topic, which sparked discussion about the fellowship among anti-abortion groups, University officials and lawmakers.
Medical School Dean Jakub Tolar said in a statement the fellowship, which was slated to begin this upcoming fall, was delayed for at least one year while the medical school examines the "value" of the training.
The Reproductive Health Access Project (RHAP) would have funded the fellowship, said Lisa Maldonado, RHAP’s executive director. After completing the program, the fellow would be encouraged to remain in reproductive health following the conclusion of the fellowship with Planned Parenthood in St. Paul. RHAP has sponsored and funded similar fellowships around the United States for the past ten years.
One day after the article was published, Minnesota Citizens Concerned for Life, an anti-abortion advocacy group, contacted University President Eric Kaler and state legislators to express concern about the fellowship. University officials decided to remove the position from the University’s website following MCCL’s statements, a University spokesperson said.
After legislators were contacted by MCCL, Dean Tolar sent a letter addressed to Minnesota State Senator Michelle Fischbach, R-Paynesville, laying out the fellowship’s future at the University.
“In the future, we will have a more robust and comprehensive review process for positions and training programs to ensure proper due diligence and proper notification to stakeholders,” Tolar said in the letter.
Wednesday, May 23, 2018
May 22, 2018 (CBS News): Trump emphasizes importance of 2018 victories to abortion-opposing group, by Kathryn Watson:
Speaking to the anti-abortion Susan B. Anthony List ("SBA List") at that organization's 11th Annual "Campaign for Life" Gala Tuesday night in Washington, D.C., President Trump emphasized the importance of the 2018 midterm elections. The president's remarks come shortly after histo pull federal funding from health facilities that make referrals to abortion clinics.
"We must work together to elect more lawmakers who share our values," he said to the audience.
The federal funding rule change is being cheered by many anti-abortion activists and lawmakers, as it will pull funding from groups like Planned Parenthood. The move, White House press secretary Sarah Sanders said last week, "would ensure that taxpayers do not indirectly fund abortions." Critics of the administration and of anti-abortion policies say the change could seriously restrict funding for essential women's health services like cancer screenings.
"My administration has proposed a new rule to prohibit Title X funding from going to any clinic that performs abortions," Mr. Trump said Tuesday night, to applause from his audience.
The SBA List raises funds for federal candidates who oppose legal abortion. Vice President Mike Pence spoke to the group last year. The SBA List hasn't always supported Mr. Trump. Before he was nominated, the group urged voters to look elsewhere within the GOP for its 2016 champion, and called Mr. Trump "unacceptable."
On Tuesday night, SBA List president Marjorie Dannenfelser said the upcoming midterm elections are important, and that Roe v. Wade must be overturned.
Tuesday, May 22, 2018
May 15, 2018 (Rewire.News): Alejandra Pablos, Asylum Seeker and Reproductive Justice Advocate, Speaks Out, by Tina Vasquez:
In a recent interview with Rewire.News, reproductive justice and immigrant justice advocate Alejandra Pablos spoke about her experience of being arrested at a peaceful protest in January, her recent detainment at Arizona’s Eloy Detention Center, and the work she wants to do moving forward for immigrants in the United States with criminal records.
Pablos has become a prominent activist and community organizer in the reproductive justice and immigrant justice movements, most recently working as the Virginia Latina Advocacy Network field coordinator for the National Latina Institute for Reproductive Health (NLIRH) and a member of We Testify, an abortion storytelling leadership program of the National Network of Abortion Funds. Pablos also works with Mijente, a social justice organizing network.
In March 2018, after a check-in with ICE in Tucson following her January 2018 arrest in Virginia during a peaceful protest against deportations outside of the Department of Homeland Security (DHS), Pablos was detained at Eloy Detention Center in Arizona despite having a pending asylum case. Pablos would spend more than 40 days in detention—a time that she found personally challenging but simultaneously affirming. Pablos made deep connections with other detained women, discussing her work with them and how she both personally and politically seeks to complicate narratives surrounding abortion and immigrants who have criminal records.
In the interview, Pablos speaks on her experience of being arrested, being detained at Eloy, the conditions at the detention facility, and what it is like to be under ICE's custody:
"...when you’re in ICE’s hands, you don’t know when you’re going to come home. It’s not like the regular criminal justice system. You can be detained by ICE indefinitely. They can hold you without a bond hearing. You may never go to court. That’s how it is for a lot of people."
Many of the women detainees Pablos met have court dates set for 2019, but ICE requires that they remain detained until their hearings. Speaking of the legal support available to detainees, Pablos said "there are a couple of [advocacy] groups working inside Eloy—Casa Mariposa and the Florence Project—but they just provide legal aid. Casa Mariposa provides some support to a very small percentage of women." Eloy Detention Center provides no support groups for women detainees, despite many of the women detainees being survivors of domestic abuse and substance abuse.
Pablos details what she calls prison-like conditions at Eloy, including a lack of access to adequate medical and mental health care, no access to interpretation services, and poor hygiene.
Going forward, Pablos says she wants to work with local organizations in Arizona to make sure domestic violence survivor groups are established at Eloy. More broadly, she wants to act to effectively combat what she calls the criminalization of immigration, or "crimmigration."
Says Pablos, "when one of us is arrested, what role do organizations play, what responsibility do they have to us? We need protection and we need people to put their bodies on the line for us or beside us. I don’t want to just have conversations about this; I want to help come up with solutions."
Saturday, May 19, 2018
Trump Administration Seeks to Prevent Family Planning Funding Recipients from Providing Abortion Services or Referrals
May 17, 2018 (New York Times): How New Abortion Restrictions Would Affect Women's Health Care, by Julie Hirschfield Davis:
Currently, the federal government prohibits the use of federal funds for abortions. Now, the Trump administration is proposing a rule that would make health care organizations that provide or refer women for abortions ineligible from receiving federal funding for family planning services -- essentially seeking to punish organizations or pressure them to stop providing or referring women to abortion services.
The proposed rule traces its origins back to the Reagan administration, but legislation prohibiting government funding to Planned Parenthood and other organizations that provide abortion services has become popular at the state level. Last year, the Trump Administration made it easier for states to defund Planned Parenthood by signing legislation repealing an Obama administration rule that barred state and local governments from withholding federal funding from health care providers to pay for non-abortion health care services -- contraception, STDs, fertility, pregnancy care, and breast and cervical care -- if they also provided abortions. The Obama rule prohibited withholding federal funds from health care providers for any reason other than their ability to provide the funded services. The new Trump rule would take the decision out of the hands of states and impose a nationwide prohibition on the receipt of Title X family planning funds by Planned Parenthood and other organizations that provide or refer women to abortion services. (States have also tried to prohibit Planned Parenthood from receiving reimbursement for patient care through Medicaid, a much larger source of funding, but they have been largely unsuccessful because the Medicaid statute specifically provides that patients have a right to choose their provider.)
Title X was passed in 1970 to provide federal family planning assistance for low income women. In 2014, an estimated 4,100 clinics used Title X funding to provide low-cost or free contraception, typically for individuals without health insurance coverage who do not qualify for Medicaid. Planned Parenthood currently serves 41% of women who receive subsidized or free family planning using Title X funds. According to the New York Times, "In one-fifth fo the counties in which they are located, Planned Parenthood centers are the only federally funded option," and in two-thirds of the 491 counties in which Planned Parenthood operates, it serves at least half of all women receiving contraceptive care from federally subsidized facilities.
The Reagan era rule on which the Trump rule is reportedly based required physical separation between Title X health care facilities and facilities that provide abortions and also prohibited the provision of any abortion related information or counseling. Although the Supreme Court held that the rule was constitutional in the 1991 case Rust v. Sullivan, the rule was prevented from going into effect by court and legislative challenges. In 1993, President Clinton suspended the rule and new regulations repealing the Reagan era rule were formalized in 2000. Although the Supreme Court's 5-4 decision in Rust has not been reversed, the rule was unpopular (both the Senate and House voted to repeal the gag rule) and the case was decided before the Supreme Court's recent case in Whole Woman's Health v. Hellerstedt. Perhaps seeking to decrease the risk of a successful litigation challenge or legislative response, the Trump Administration's new rule drops the prohibition on discussing abortion.
But Democrats and abortion rights advocates said the practical result of the proposal would be to silence medical caregivers the same way that an explicit gag rule would because they would no longer be allowed to refer women to providers that perform abortions.
“It is a distinction without a difference,” said Kashif Syed, a senior analyst at the Planned Parenthood Federation of America. “Blocking doctors from telling patients where they can get specific health services in this country is the very definition of a gag rule.”
The Trump administration released a summary of the proposal on Friday, but has not released the final language of the proposed rule. Officials at Planned Parenthood said they would have to see the text of the proposed rule before deciding whether to take legal action. Governor Jay Inslee of Washington state and NY's Governor Cuomo are also considering possible legal challenges.
Mother Jones (May 15, 2018): This Map Depicts Abortion Access Across America and It's Really Bleak, by Jackie Flynn Mogensen:
A new study published earlier this week maps abortion facilities across the United States. The study found that 27 major cities are more than 100 miles from their nearest abortion provider and dubs areas in the South and Midwest as "abortion deserts."
For instance, residents of Kentucky, Mississippi, Missouri, North Dakota, South Dakota, and West Virginia are all limited to one in-state abortion facility, researchers from UC Berkeley and UC San Francisco found. The 27 “abortion deserts”—defined as major cities with populations over 50,000 where residents would have to travel 100 miles or more to get an abortion—include places like Chattanooga, Tenn.; Green Bay, Wisc.; and Springfield, Mo.
The worst major city for abortion access is Rapid City, South Dakota, where women must travel 318 miles to get an abortion.
The map reflects the fact that between 2011 and 2014, the number of abortion clinics dropped by 22 percent in the Midwest, 13% in the South and 6% nationwide. This situation may only continue to worsen:
“As states continue to pass, implement, and defend restrictions on abortion,” the authors write, “it is possible that the number of abortion facilities will continue to decrease in those states with the most restrictions.”
Friday, May 18, 2018
New York Times (May 16, 2018): U.S. Fertility Rate Fell to a Record Low, for a Second Straight Year, by Sabrina Tavernise:
For the second straight year, the fertility rate in the United States fell to a record low. A country's fertility rate is the number of births per 1,000 women ages 15-44. In 2017, the U.S. fertility rate was 60.2 births down 3% from 2016. The number of births has also declined to its lowest level since 1987.
Fertility rates are essential measures of a society’s demographic balance. If they are too high, that can strain resources like housing and education. If they are too low, a country can face challenges replacing its work force and supporting its older adults, like in Russia and Japan. In the United States, declines in rates have not led to drops in the population, in part because they have been largely offset by immigration.
Fertility rates tend to drop during difficult economic times, but the U.S. fertility rate has not rebounded since a deep decline with the recession in 2008. The continuing low birth rates puzzle demographers, especially since there are is a growing number of women of childbearing age.
“It’s hard to tell whether this is a dip that we periodically see in fertility or this is a long-term trend due to major social changes,” said Donna Strobino, a demographer at the Bloomberg School of Public Health in Baltimore.
It could be that social forces are at work. "Women are postponing marriage, becoming more educated and are more likely to be the primary breadwinners for their households." Women also may be delaying having children because "prime childbearing years" are crucial years for advancing careers. Currently, 1 in 5 births are to women 35 or older.
The decline has disproportionately impacted minorities. Between 2007 and 2016, the fertility rate for Hispanic women dropped more than 27%. The rates for blacks and Asians dropped 11% and 5%, respectively, while the rate for whites dropped 4%.
Thursday, May 17, 2018
Rewire (May 16, 2018): The Curious Case of the Coroner, the Telltale Sewer, and DNA Testing of Fetal Remains, Farah Diaz-Tello:
Last week after fetal remains were discovered in the city sewer system, the coroner in Augusta, GA sent tissue samples to the Georgia Bureau of Investigation for DNA testing to try to identify the person who had the miscarriage or abortion.
While this is an alarming turn of events—possibly the first time law enforcement has publicly announced intent to use DNA to look for a person who has had a miscarriage or abortion—it is unsurprising in the context of the documented pattern of police and prosecutors trying to find novel ways of punishing people for losing or ending pregnancies. Most recently, a Virginia woman was charged with “concealing a dead body,” a felony, after disposing of a fetus miscarried at around 30 to 32 weeks gestation. She pleaded guilty but challenged the applicability of the statute to fetal remains; the Court of Appeals of Virginia ruled against her, upholding her sentence of five years, with five months to be served behind bars.
Although the coroner claims that he seeks identification for the safety of the person who lost the pregnancy, stating, "I just want to make sure [the person who had the miscarriage] isn't getting an infection or bleeding out," the claim seems suspect given that the DNA test could take weeks. Although authorities, don't know whether the fetal remains resulted from a miscarriage or abortion, the request for DNA identification is bizarre given that Georgia does not criminalize self-induction of an abortion. The coroner's request might be motivated by the fact that the fetus appeared to be at 20 weeks gestation which is the legal limit for clinics to provide abortion in the state.
Wednesday, May 16, 2018
BBC (May 16, 2018): Abortion in Ireland - what is the law?:
On May 25, voters in the Republic of Ireland will vote on constitutional reform which would allow the government to introduce legislation easing the country's ban on abortion. According to Kitty Holland, in the Guardian:
Two weeks from the vote, the outcome is far from clear. While several months, even weeks, ago a Yes vote seemed inevitable, polls are narrowing. A survey last weekend, in the Sunday Independent found 45% in favour of repeal, 34% against, 18% undecided and 4% not expressing an opinion.
Currently in Ireland, a woman is only allowed to terminate a pregnancy when her life is at risk. Attempts to change the law have been prevented by the eighth amendment to the Ireland's constitution, which was enacted in 1983. Under the amendment, the state acknowledges "the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right." Although 1992 amendments specifically allowed women to travel to other countries to obtain abortions and recognized their right to information about services available outside of Ireland, the eighth amendment has prevented Ireland from easing its abortion restrictions.
Women in Ireland who obtain illegal abortions can face up to 14 years in prison. Because of the restrictions, in 2016, 3,265 women traveled from Ireland to the UK to obtain an abortion.
In 2017, a Citizens' Assembly was set up to advise the Irish government on constitutional change. It voted to replace or amend the eighth amendment. This has led to the current referendum where the Irish people will vote on whether to repeal the eighth amendment, allowing Irish lawmakers to set the country's abortion laws.
The vote is expected to be close with both sides actively campaigning with everyone from obstetricians to fashion designers to weighing in. A recent campaign ad depicting a man in uniform and the slogan "Men protect lives. Children expect to be protected. Vote No to abortion on demand" has prompted the Irish Army to tweet that it does not take a position on the referendum. According to Holland in the Guardian:
Though most political parties back repeal, the main government parties, Fine Gael and Fianna Fáil, are allowing members a free vote. The biggest parties’ campaigning is low-key, and – uniquely in any recent referendum campaign – the government is not publishing campaign literature or putting up posters. The campaign, on both sides, is being driven by civil society.
The referendum is being closely watched around the world. In Ireland the online space for referendum campaigning is not regulated, leading to concerns that foreign groups were trying to influence the referendum and that sites claiming to provide unbiased views could actually be traced to anti-abortion campaigns. Although such activities are not illegal, in response concerns about the impact of social media on election integrity earlier this month, Facebook announced that it would block political advertising from groups based outside the country and Google has stopped selling ads on either side of the debate.
Monday, May 14, 2018
Elizabeth Kukura's article Obstetric Violence has appeared in the Georgetown Law Journal at 106 Geo. L. J. 721 (2018). The article can be downloaded at https://ssrn.com/abstract=3167375.
The abstract follows:
Maternity care in the United States is in a state of crisis, characterized by high cesarean rates, poor performance on various mortality and morbidity measures, and a steep price tag. There are many factors that impede access to high-quality, evidence-based maternity care for certain women. Grassroots organizers have raised awareness about the extent to which giving birth in the United States has become overly medicalized. Perhaps less widely known, however, is the extent to which women experience abuse, coercion, and disrespect while giving birth.
Inspired by activists in Latin America, advocates in the United States have begun to adopt the language of “obstetric violence” to describe and condemn such mistreatment. However, the existing research on obstetric violence is limited, which complicates the task of defining the problem and identifying solutions. To that end, this Article explores the profound mistreatment that some women experience during childbirth at the hands of their health care providers. It identifies various types of provider behavior that qualify as obstetric violence and paints a broad picture of how childbirth can be a damaging experience for some women, even when they leave the hospital with a healthy baby. Having developed a nuanced view of provider mistreatment and its implications, this Article then examines the current failure of law and regulation to provide meaningful prevention or recourse. It concludes by suggesting forms of advocacy within the legal and health care systems that offer promising approaches to shifting maternity care culture and, ultimately, to securing necessary changes in the tort system for women harmed by provider mistreatment during childbirth.
Thursday, May 3, 2018
The Hill (May 2, 2018): Iowa lawmakers pass strictest abortion law in the US, by Julia Manchester:
On Wednesday, May 2, 2018, Iowa legislators passed "the heartbeat bill." The legislation bans abortions once a fetal heartbeat is detected. Essentially, the heartbeat distinction would ban abortions by the sixth week of pregnancy.
Opposition to the bill claims that it would ban abortions before some women even know they're pregnant.
The passage of the bill comes as the Trump administration has taken a hard-line stance on abortion, spurring a slew of abortion laws across the nation.
Nineteen states adopted a total of 63 restrictions to the procedure in 2017, which is the highest number of state laws on the issue since 2013, according to the Guttmacher Institute.
The bill now goes to Gov. Kim Reynolds's (R) desk, but, if signed, is expected to be challenged as a violation of Supreme Court precedent including Roe v. Wade.
Wednesday, May 2, 2018
The New York Times (April 26, 2018): Supporters of El Salvador’s Abortion Ban Foil Efforts to Soften It, by Elisabeth Malkin:
El Salvador remains one of six Latin American countries with a total ban on abortion after the Legislative Assembly failed to debate and vote on a measure that would have relaxed the ban in two circumstances: when the mother's life is in danger and in the case of a minor becoming pregnant as a result of rape.
In El Salvador, abortion is criminalized and punishable by up to eight years in prison for both doctor and patient. Human rights groups around the world have a lobbied for a change in the harsh policies that sometimes criminalize women who have late-term miscarriages. These women have historically been charged with abortion or even aggravated homicide.
Advocates aiming to soften the total ban had been lobbying for months, but their efforts were unsuccessful when the former, left-wing-led national legislature adjourned last week without voting on the proposals. A new Legislative Assembly convenes this month, dominated by conservatives who are not expected to revive the debate or offer reform proposals.
Saturday, April 28, 2018
Mic (Apr. 9, 2018): Black Mamas Matter Alliance is launching the first National Black Maternal Health Week, by Nataleg
“The goal of the week is to deepen the conversation around black maternal health and amplify black women leaders who are working on the issue,” BMMA steering committee chair Elizabeth Dawes Gay said.
As part of the inaugural National Black Maternal Health Week, organizers are hosting community events in California, Florida, Georgia, Maryland, Massachusetts, New Jersey, Ohio, and Texas to raise awareness about the racial gaps in maternal health and to discuss solutions to closing them. Events include screenings of Death by Delivery, a documentary about black maternal mortality; panels featuring black women advocates; and educational workshops on yoga for birth and postpartum stages.
The conversation around black maternity reached national headlines after tennis superstar Serena Williams revealed in a January interview with Vogue, that she had a serious health scare — blood clots in her lungs — after giving birth to her daughter, Alexis. But when Williams, who has a history of blood clots, first requested a CT scan and blood thinner medicine, her medical practitioners did not listen to her.
Lynn Roberts, co-editor of Radical Reproductive Justice and professor at CUNY Graduate School of Public Health and Health Policy, spoke on the impact racism has on the treatment people receive, at the Schomburg Center for Research and Culture in Harlem in March.
“There is a different level of care afforded to people of color, indigenous people, poor people and trans people,” said Roberts.
Organizers for National Black Maternal Health Week are using social media to drive conversation using the hashtag #BMHW18.
Indiana Public Media (Apr. 23, 2018): Planned Parenthood Challenges Indiana’s 2018 Anti-Abortion Law, by Brandon Smith:
Planned Parenthood and the ACLU want a federal judge to strike down parts of Indiana’s new anti-abortion law.
The lawsuit challenges the 2018 law’s new abortion complication reporting requirements and mandated yearly inspections of abortion clinics. Prior to the new law's enactment, such inspections were optional.
The law requires medical providers who treat women for complications arising from abortions to report detailed patient information to the state.
Planned Parenthood of Indiana and Kentucky and the ACLU of Indiana argue the complication reports are unconstitutionally vague. For instance, one provision requires reporting of “any adverse physical or psychological condition arising from the induction or performance of an abortion.” The suit filed in federal court Monday calls that “so broad as to be meaningless.”
Many of the purported abortion complications the law lists "are both extremely rare for abortions and are more likely to occur after other medical procedures," according to the suit. One condition the law lists — blood clots — is a typical and short-lived side effect of having an abortion, it argues.
The suit challenges the yearly inspection mandate because it says no other health care facilities in the state face such a requirement.
This is the sixth lawsuit brought by Planned Parenthood against the state since 2011. The health care provider has won partial or complete victories in each of the previous five.
Thursday, April 26, 2018
CNN (Apr. 20, 2018): Indiana abortion law signed by Mike Pence ruled unconstitutional, by Clare Foran:
A federal appeals court has ruled that an Indiana abortion law signed by Vice President Mike Pence when he served as the state's governor is unconstitutional.
Friday, April 20, 2018
Human Rights Watch (April 16, 2018): A Backward Step for Reproductive Rights in Chile, by José Miguel Vivanco:
Last year, under former Chilean president Michelle Bachelet, Chile's Congress passed reproducive health reform that lifted a 28-year blanket ban on abortions in the country. While the reform did not make abortion wholly available, it removed the ban under three circumstances: when the pregnant person's life is at risk; if the pregnancy is a result of rape; and if the fetus is deemed "not compatible with life outside the womb."
Even with the reform--upheld as constitutional in August 2017--several barriers remained in place even under these circumstances. For example, doctors and whole hospitals could invoke a right not to perform abortions on the basis of conscience. If they chose to invoke this right, though, the original reform required a stated reason for abstaining and also required those abstaining to register as such in a timely manner. The goal of this rule was to ensure continuity of coverage at a hospital, so that pregnant persons qualifying for an abortion would not be denied one due to lack of access.
Under current Chilean President Sebastián Piñera, the requirement of providing a reason for objecting to performing abortions, along with the requirement of assurance of continuity of coverage, were dropped completely.
These rule modifications were issued by the Health Ministry and have international human rights groups concerned that the reproductive health of women and girls will not be protected in Chile.
For example, a person pregnant with a non-viable fetus, or a pre-teen rape victim, might find themselves unable to receive an abortion, because the local hospital does not want to potentially offend politicians or invoke the wrath of anti-abortion groups. As such, the only potential abortion-provider in a given town has chosen "on the basis of conscience" not to provide them and will not be required to justify that decision. Human Rights Watch recommends that
The Chilean government should review and amend the rules to ensure that access to legal abortion is protected. Otherwise it risks letting conscientious objection be used as a pretext to deny important newly recognized rights of women and girls.
Thursday, April 19, 2018
The New York Times Magazine (April 11, 2018): Why America’s Black Mothers and Babies Are in a Life-or-Death Crisis, by Linda Villarosa:
Villarosa of The New York Times Magazine profiles several black mothers and their pregnancy, child birth, and health care stories while exploring the extraordinarily wide disparity in care that black women receive compared to white women.
The U.S. is one of only 12 countries whose maternal mortality rates have actually increased in recent years and now has a mortality rate worse than 25 years ago. Maternal mortality refers to "the death of a woman related to pregnancy or childbirth up to a year after the end of pregnancy." Women of color are three to four times more likely to die from pregnancy-related causes as white women.
Moms are not the only ones facing the consequences of underdeveloped care.
Black infants in America are now more than twice as likely to die as white infants — 11.3 per 1,000 black babies, compared with 4.9 per 1,000 white babies, according to the most recent government data — a racial disparity that is actually wider than in 1850, 15 years before the end of slavery, when most black women were considered chattel.
In the past, many explanations for the disparity turned to poverty, assuming that it was poor and uneducated black women and their babies that suffered the most. But the crisis does not consider class lines, it turns out. "In fact, a black woman with an advanced degree is more likely to lose her baby than a white woman with less than an eighth-grade education."
In 2014, Monica Simpson--the executive director of SisterSong, an organization dedicated to reproductive justice for women of color, and a member of advocacy group Black Mamas Matter Alliance-- testified before the United Nations Committee on the Elimination of Racial Discrimination. She called on the United States to “eliminate racial disparities in the field of sexual and reproductive health and standardize the data-collection system on maternal and infant deaths in all states to effectively identify and address the causes of disparities in maternal- and infant-mortality rates.” That the United States has not done so is a violation of the international human rights treaty, she says.
This is important for many reasons, one of which is the dramatic effect that society and systemic racism have on a pregnant person's "toxic physiological stress levels." This stress increases the chances for hypertension, pre-eclampsia, and other dangerous pregnancy complications, and it is exacerbated by the pervasive, systemic racial bias embedded in the United States' health care system. Racial bias, discrimination, and the toll it takes on women of color throughout their lives and pregnancy contributes to increased maternal complications across all class and education levels.
Even when controlling for income and education, African-American women had the highest allostatic load scores — an algorithmic measurement of stress-associated body chemicals and their cumulative effect on the body’s systems — higher than white women and black men. ...Though it seemed radical 25 years ago, few in the field now dispute that the black-white disparity in the deaths of babies is related not to the genetics of race but to the lived experience of race in this country.
Community care systems that incorporate the medical and personal support of doulas and midwives have proven to increase black women's chances at a healthy pregnancy, delivery, and postpartum experience.
"One of the most important roles that doulas play is as an advocate in the medical system for their clients." A doula may sometimes be the only person consistently present with the mom-to-be during her birth experience, too. One study of 2,400 women found that "more than a quarter of black women meet their birth attendants for the first time during childbirth, compared with 18 percent of white women."
Doulas “are a critical piece of the puzzle in the crisis of premature birth, infant and maternal mortality in black women.”
Rachel Zaslow, a midwife and doula in Charlottesville, Virginia established Sisters Keeper--a collective of 45 black and Latina doulas in Charlottesville. They offer free birthing services to women of color.
'The doula model is very similar to the community health worker model that’s being used a lot, and successfully, throughout the global South,' Zaslow says. 'For me, when it comes to maternal health, the answer is almost always some form of community health worker.' Since 2015, the Sisters Keeper doulas have attended about 300 births — with no maternal deaths and only one infant death among them.
An analysis of a similar program in New York City showed that, over a five-year period, moms receiving the support of the doula program experience half as many preterm and low-weight babies compared to other community members.
Wednesday, April 18, 2018
ReliefWeb (April 6, 2018): Bringing reproductive health care to Syria’s underserved Al-Tabqa, Report by European Commission's Directorate-General for European Civil Protection and Humanitarian Aid Operations:
Seven months ago, the Syrian city Al-Tabqa was re-taken from the Islamic State. Displaced families are returning to the city in droves, and the population has increased close to 200% over the last year.
Basic critical health care is still lacking in the city, though. Recently, UNFPA supported the development of a new health clinic, which opened in January 2018. 460 women received treatment in the first two weeks of the clinic's operations, including one 30-year-old Syrian woman's delivery of twins.
Under the control of ISIL, contraceptives and other reproductive care were unavailable to women. The new clinic continues to face challenges in its liberation, too, as access to Al-Tabqa for those who wish to return or relocate has been hampered by destroyed infrastructure and lingering landmines. Various agencies are working to improve these conditions, but in the meantime, the Al-Tabqa clinic has managed to become fully-equipped, staffed, and ready to help serve the estimated 6,800 pregnant women in need of care.