Reproductive Rights Prof Blog

Chile Moves to Ease Strict Abortion Laws

Al Jazeera (Jul. 19, 2017): Chile Moves to Ease Strict Abortion Laws, by AFP News Agency:

In 1989, the dictatorial regime of Augusto Pinochet Ugarte outlawed abortion in Chile in all cases. Almost 30 years later, the law remains unchanged.

In 2015, Chilean President Michelle Bachelet advanced a proposal to decriminalize abortion at up to 12 weeks if the pregnant person's physical health was at risk, if the fetus would not survive the pregnancy, or in cases of rape. The reform also included an 18-week window for pregnant individuals under the age of 14. President Bachelet urged Chilean lawmakers to take up the legislation before the country's elections are held in November. The government's lower house, the Chamber of Deputies, has already approved the reforms and the issue now lies before the Senate, which began consideration on Monday, July 17th.

Consideration in the Senate did not come without hurdles. Senate President Andres Zaldivar advanced a proposal arguing that abortion when the mother's life is at risk should not legally be considered an abortion. That measure failed by just one vote following five hours of debate. The legislation finally passed the Senate in the early hours of Wednesday after a 17-hour session, and is now under reconsideration by the Chamber of Deputies. Should the law pass the lower chamber, it will head to President Bachelet for final approval.

Chile is one of just six countries in the world where individuals can be prosecuted for seeking an abortion irrespective of circumstances.

Why Women Still Must See A Doctor For The Pill, A Year After Tennessee Law Changed

Nashville Public Radio (Jul. 17, 2017): Why Women Still Must See A Doctor For The Pill, A Year After Tennessee Law Changed, by Chas Sisk

Early last year, Democrats and Republicans in the Tennessee Legislature co-sponsored and passed legislation that would allow pharmacists to prescribe birth control. Over a year later, pharmacists in Tennessee are still waiting on finalized rules from the Tennessee Department of Health.

State health officials say that final rule drafting has been "complicated." Originally scheduled to be published this summer, the Department has struggled to balance federal regulations with existing law.

The bill had widespread bipartisan support in Tennessee and the backing of major medical associations, pharmacist groups, and reproductive rights organizations. In the face of federal inaction on the issue and the FDA's resistance to over-the-counter birth control, Tennessee took matters into its own hands.

Under the law, women will still have to answer questions about their health before they can receive birth control pills at the pharmacy, and they'll have to be warned of potential side effects. Pharmacists are also required to write out the prescriptions, primarily for record-keeping purposes.

Tennessee will be just the fourth state to allow pharmacists to prescribe birth control, after California, Oregon, and Colorado. California's law spent 18 months in the rulemaking process, and Tennessee officials now expect the same for their own law.

Contraception is Lifesaving but Often Out of Reach

Human Rights Watch (July 10, 2017): Contraception is Lifesaving but Often Out of Reach, by Nisha Varia

This week, the Family Planning Summit met in London. The goal of this annual meeting is to bring governments, donors, and civil society together to discuss progress and future goals in expanding access to modern contraception for millions of women globally. 

Family planning and effective contraception saves lives. 

Complications from pregnancy and childbirth are the second leading cause of death for adolescents ages 15 to 19 globally and cause 800 women and girls to die each day. The World Health Organization estimates that at least 22,000 women die from abortion-related complications each year.

This year, many lobbied for the Summit to include conversations on the effects of the Trump administration's reimplementation of the "Global Gag Rule." The controversial policy prohibits foreign nongovernmental organizations from receiving any U.S. health funding if they use funds from any source to provide information about abortions, advocate for or provide abortions.

The policy affects $8.8 billion of foreign assistance. The anticipated consequences of the Gag Rule include increases in unplanned pregnancies and dangerous abortions as well as a higher maternal death rate. 

California's maternal mortality rate is a third of the American average. Here's why.

Vox (Jun. 29, 2017): California decided it was tired of women bleeding to death in childbirth, by Julia Belluz:

At the same time the global maternal death rate fell by nearly 44 percent, between 2000 and 2014, the United States watched its maternal mortality rate skyrocket 27 percent. Maternal mortality refers to "the death of a mother from pregnancy-related complications while she's carrying or within 42 days after birth." Childbirth is more dangerous in the U.S. than any other wealthy nation. The reason? The U.S. does not value its women. 

The United States is in the company of only 12 other countries whose maternal mortality rates have actually increased in recent years, including North Korea and Zimbabwe.

Researchers and health care advocates argue that a high maternal death rate is a reflection of how that culture views its women.

[In the U.S.,] policies and funding dollars tend to focus on babies, not the women who bring them into the world. For example, Medicaid, the government health insurance program for low-income Americans, will only cover women during and shortly after pregnancy.

Texas, having rejected Medicaid expansion and closed the majority of its Planned Parenthood clinics, has the highest maternal mortality rate in the developed world. California, however, has proven to be an exception within the nation. The California maternal mortality rate has steadily decreased over the same time that the rest of the nation's has risen, thanks in large part to the California Maternal Quality Care Collaborative (CMQCC). 

60% of maternal deaths are preventable and the complications that cause them should be anticipated. The CMQCC finds that even within an imperfect health care system, death from childbirth need not be an inevitability. Maternal deaths in the U.S. often result from common complications like hemorrhaging and preeclampsia. The CMQCC has enacted simple, lifesaving procedures over the last decade to reduce the number of unnecessary maternal deaths. And, they're working.

First, they aimed to lower the number of unnecessary C-sections performed. Cesarian sections are often prematurely offered by obstetricians who are short on time. The procedure can leave mothers with internal scar tissue that ultimately makes future pregnancies more dangerous by increasing the mother's risk of hemorrhaging. 

As many maternal deaths are a result of hemorrhaging--a mother can bleed to death within five minutes--doctors set out to prepare every delivery room in hospitals participating in their program with a "hemorrhage cart," equipped with everything necessary to handle a bleeding problem the moment it begins. 

In a recent study, researchers found a 21 percent reduction in severe complications related to hemorrhages in the hospitals participating in CMQCC's program. Hospitals not participating in the program saw only a one percent reduction. 

California has demonstrated that even in our messy and imperfect health care system, progress is possible. They’ve shown the rest of the country what happens when people care about and organize around women’s health. Policymakers owe it to the 4 million babies born in the US each year, and their mothers, to figure out how to bring that success to families across the country. 

How the current health care debate and the resulting volatility of the insurance market will affect the United States' maternal mortality rate going forward remains to be seen.

Supreme Court allows Wisconsin to enforce fetal protection law pending appeal

ABA Journal (July 7, 2017): Supreme Court allows Wisconsin to enforced fetal protection law pending appeal, by Debra Cassens Weiss:

Last week, the Supreme Court stayed a district court injunction of a Wisconsin fetal protection law.  The challenged law gave courts jurisdiction over pregnant women who “habitually lack[] self-control” in the use of alcohol and drugs “to a severe degree,” creating a substantial risk to the health of the child.  Justices Sotomayor and Ginsburg indicated that they would not have granted the stay.

The case was brought by Tamara Loertscher who was held in contempt and jailed for 18 days without prenatal care when she refused to report to a residential drug treatment center.  Once Loertscher finally obtained a lawyer, she was able to negotiate an agreement that allowed her to stay at home if she agreed to undergo out patient drug treatment and testing.  The subsequent tests were negative, and she gave birth to a health baby boy.

The district court found the statute unconstitutionally vague because  the concepts "habitual lack of self-control" and "substantial risk to the physical health of the unborn child" are not "amenable to reasonably precise interpretation."  An appeal to the 7th Circuit is pending with briefs due later this month.

The White House’s gender pay gap has more than tripled under Trump

Vox (July 6, 2017): The White House's gender pay gap has more than tripled under Trump, by German Lopez

In recent weeks, news outlets had been reporting that in Trump's White House women are making 80 cents for every dollar a man makes there. However, a new report for the conservative think tank American Enterprise Institute (AEI) explains that it is even worse. Women in Trump's White House are actually making 63.2 cents for every dollar a man makes there. The difference is credited to the way the gender pay gap is calculated. During President Obama's last year in office, women in his White House made 89.25 cents to every dollar a man made there. The AEI disputes the idea that the gender pay gap is due to discrimination, but rather other factors. Despite Trump's daughter Ivanka Trump's effort to speak out against the gender pay gap, so far the Trump administration has not  made any strides to change policy.

Groups condemn El Salvador’s jailing woman after miscarriage

Washington Post (July 7, 2017): Groups condemn El Salvador's jailing woman after miscarriage, by Associated Press

Human rights organizations around the world are condemning the latest sentencing of a woman in El Salvador. Evelyn Beatriz Hernandez Cruz, a 19 year old, was recently sentenced to 30 years in prison for aggravated homicide. Hernandez Cruz says she was raped and out of fear did not report the incident. She was unaware that she had become pregnant. In April of 2016 she experienced abdominal pain and "was taken to a hospital and treated for vaginal bleeding from an out-of-hospital delivery," but there was no fetus. Authorities decided to pursue a case against Hernandez Cruz and initially charged her with having caused an abortion after finding the fetus. Abortions are illegal in El Salvador with no exceptions. Later, authorities changed the charge against Hernandez Cruz to aggravated homicide. Hernandez Cruz has been in jail since the incident. 

 

Oregon Takes A Monumental Step To Protect Abortion Rights, Because It's Health Care

Romper (July 5, 2017): Oregon Takes A Monumental Step To Protect Abortion Rights, Because It's Health Care, by Jen McGuire

Oregon, the only state that currently does not enforce any regulations on abortion access, is on the brink of passing more legislation to protect abortion rights. If signed by Governor Kate Brown, this law would provide free abortions and postnatal care to all women in the state of Oregon including undocumented immigrant women. State Representative Julie Fahey sponsored this bill to ensure that a women's right to an abortion and access to health care will not be affected in Oregon regardless of any laws passed or repealed at the federal level. Currently, Senate Republicans are working on a health care bill that could potentially allow states to opt out of requiring insurance companies to pay for certain essential health care benefits. Oregon would be the fifth state to pass legislation protection abortion access as a precautionary measure if the Supreme Court were to overturn Roe v. Wade. 

Governor Brown is expected to review the bill soon, but could face opposition from state Republicans. Jonathan Lockwood, the spokesperson for the Oregon Senate Republican Conference, was quoted explaining how he does not believe that Oregonians are okay with funding "late-term, sex-selective abortions" and that this bill is "nothing more than a political gift card to Planned Parenthood." McGuire noted, however, that neither of these statements is true; 99 percent of abortions occur before 21 weeks and sex-selective abortions simply do not happen. 

Planned Parenthood: Indiana Judge's Ruling a Victory for Young Women

Saint Louis Post-Dispatch (Jun. 29, 2017): Planned Parenthood: Judge's Ruling a Victory for Young Women, by Rick Callahan (AP): 

A federal judge in Indiana Thursday blocked part of a new law that would have required a judge to determine whether a pregnant minor's parents should be notified if she sought an abortion. Republican Governor Holcomb of Indiana, who signed the law in April, frames it as a "parental rights issue."

Reagan-nominated U.S. District Judge Sarah Evans Barker who enjoined the provision also blocked two additional provisions--one requiring physicians to verify the relationship between a minor and her parents or guardians and another that would have prevented anyone assisting an un-emancipated minor seeking an abortion.

Attorney General Curtis Hill has not yet decided if he will appeal the Judge Barker's decision to the 7th Circuit Court of Appeals in Chicago.