Saturday, November 23, 2019

SCOTUS Will Hear An Abortion Rights Case With Major Implications

Bustle (Nov. 13, 2019): SCOTUS Will Hear An Abortion Rights Case With Major Implications, by Jo Yurcaba:

The Supreme Court of the United States will hear the Louisiana abortion case June Medical Services v. Gee. The case was appealed from the 5th Circuit by June Medical and challenges a state law that will require abortion-providing clinics to have admitting privileges at a local hospital.

Louisiana, in the course of the appeal, also seeks the have the Court overturn "third-party standing" precedent. This long-standing rule allows clinics and providers to sue on behalf of their patients. Without such a rule, many pregnant persons would not choose to lose their anonymity by filing a case or else may not have the means to pursue comparable litigation in defense of their rights.

Anti-abortion activists and lawmakers hope to eliminate third-party standing as a way to keep challenges to abortion restrictions out of courts in the first place. Should the court strike down the validity of third-party standing, it may also call into question prior abortion precedent--including 1973's landmark Roe v. Wade--which was won without a direct patient-plaintiff.

Third-party standing was established just three years after Roe. Justice Blackmun at the time held that physicians have a unique ability to speak for their patients, stating that the physician is particularly qualified "to litigate the constitutionality of the State's interference with, or discrimination against" a person's abortion rights. Blackmun specifically acknowledged the gamut of challenges those facing abortions face. Experts cite, for example, that half of all women who get abortions are low-income and certainly cannot match the resources of their abortion providers in defending their rights.

Travis J. Tu, Senior Counsel for the Center for Reproductive Rights, is arguing the June Medical Services case before SCOTUS and says that overturning third-party standing could "take a wrecking ball to 40 years of abortion jurisprudence." 

June Medical Services echoes a prior case SCOTUS decided in 2016: Whole Woman's Health v. Hellerstedt. Hellerstedt ruled that Texas' House Bill 2, which attempted to implement similar targeted regulations of abortion providers (TRAP), was unconstitutional and placed an undue burden on persons seeking abortion access. 

Despite the 2016 decision in Hellerstedt, the 5th Circuit decided against precedent, upholding the Louisiana law. 

Proponents of laws imposing admitting privileges generally justify them on the purported ground that they protect the health of pregnant persons seeking abortions. In reality, many hospitals will not grant admitting privileges, because they are not necessary. 

TRAP regulations at their core are intended by anti-abortion activists to regulate abortions out of legal existence. Like the law at issue in June Medical, TRAP regulations generally require abortion providers to have admitting privileges at local hospitals, but they may also impose other requirements, including that abortions only be provided in certain, costly, far-more-complicated facilities than is reasonably necessary. The intended effect of TRAP laws is the same: severely limiting, if not outright abolishing, any clinics or providers who can legally offer abortions. 

If the Louisiana law is upheld, June Medical Services will be the only remaining abortion-providing clinic in the state after two others are regulated out of existence. The eventual decision in June Medical will bring comparable consequences, whichever way it goes, for the many pending cases challenging similar abortion-restricting laws around the country. 

November 23, 2019 in Abortion, Abortion Bans, Anti-Choice Movement, Current Affairs, In the Courts, Politics, State and Local News, State Legislatures, Supreme Court, Targeted Regulation of Abortion Providers (TRAP) | Permalink | Comments (0)

Thursday, October 31, 2019

Alabama abortion law temporarily blocked by federal judge

The Washington Post (Oct. 29, 2019): Alabama abortion law temporarily blocked by federal judge by, Ariana Eunjung Cha and Emily Wax-Thibodeaux:

A federal district court in Alabama blocked the state's extremist abortion ban, passed in May, earlier this week. The law would almost entirely proscribe the termination of a pregnancy in Alabama, including in cases of pregnancy resulting from rape or incest. The single exception to to the ban would be in the case of serious risk to the life of the pregnant person.

Alabama state representative Terri Collins--the author of the bill--has framed the law as a direct challenge to Roe v. Wade, and stated in response to the preliminary injunction that this decision "'is merely the first of many steps'" in the anti-abortion movement's "effort to preserve unborn life." Rep. Collins aims for challenges to the law to make it to the Supreme Court and called this week's ruling "both expected and welcomed" on the journey to SCOTUS.

Judge Myron H. Thompson, who penned the decision out of the U.S. District Court for the Middle District of Alabama, "wrote that it violates Supreme Court precedent and 'defies' the Constitution."

The Alabama law joins eight other states' blocked attempts at restricting abortion access unconstitutionally. 

October 31, 2019 in Abortion, Abortion Bans, Current Affairs, In the Courts, Politics, State and Local News, State Legislatures, Supreme Court | Permalink | Comments (0)

Tuesday, October 29, 2019

California Governor Signs SB 464 into Law, Requiring Perinatal Health Providers To Receive Implicit Bias Training

Essence (Oct. 10, 2019): California Now Requires Perinatal Health Providers To Receive Implicit Bias Training, by Tanya A. Christian: 

California Governor Gavin Newsom signed the "California Dignity in Pregnancy and Childbirth Act" (SB 464) earlier this month, which mandates implicit bias training for health care providers serving pregnant persons. State Senator Holly Mitchell authored the bill. Reproductive justice-oriented groups, including Black Women for Wellness, NARAL Pro-Choice America, Act for Women and Girls, as well as California Nurses Association all backed the law, which earned unanimous support in the state legislature. 

The law is aimed at reducing maternal mortality among Black women--who face a disproportionately high rate--in the United States. It will require all care providers to both engage with bias training and improve their data collection processes in order to better understand the causes behind pregnancy-related deaths.

"As it stands, the U.S. leads the developed world in the number of pregnancy-related deaths. Black women compromise a large portion of those casualties, presenting a risk of mortality that is three to four times that of White women."

California currently has the lowest maternal mortality rate in the country and hopes to improve it further through SB 464.

October 29, 2019 in Medical News, Pregnancy & Childbirth, Race & Reproduction, Reproductive Health & Safety, State and Local News, State Legislatures, Women, General | Permalink | Comments (0)

Thursday, September 12, 2019

Medication abortion reversal is "devoid of scientific support," judge rules in North Dakota

Sept. 10, 2019 (CBS News): Medication abortion reversal is "devoid of scientific support," judge rules in North Dakota, by Kate Smith: 

Legislators in North Dakota recently mandated physicians tell patients who are receiving medication abortions that the procedure may be reversed. North Dakota House Bill 1336 bases its text "on a pair of studies that have been contested by The American Medical Association and the American College of Obstetrics and Gynecology." 

Judge Daniel Hovland, on Tuesday, September 10, issued a 24-page decision granting an injunction against the bill, which he said is "devoid of scientific support, misleading, and untrue." Further elaborating that:

'State legislatures should not be mandating unproven medical treatments, or requiring physicians to provide patients with misleading and inaccurate information...The provisions of [Bill 1336] violate a physician's right not to speak and go far beyond any informed consent laws addressed by the United States Supreme Court, the Eighth Circuit Court of Appeals, or other courts to date.'

The lawsuit against the Bill was filed by the American Medical Association and Red River Women's Clinic. Red River is North Dakota's only legal abortion provider. According to research conducted by the Guttmacher Institute, people seeking abortions in the state must, in addition to very likely traveling long distances to reach the clinic, "undergo a state-mandated 24-hour waiting period." Minors may not receive an abortion in North Dakota without notifying their parents, and the state limits the ways a private insurance provider may cover the procedure. 

A separate North Dakota state law "requires physicians to tell patients that abortion terminates 'the life of a whole, separate, unique, living human being.'" The AMA and Red River suit also challenges this law, but the court has not yet addressed this claim, thus far only issuing the preliminary injunction against House Bill 1336.

September 12, 2019 in Abortion, Abortion Bans, Anti-Choice Movement, Fetal Rights, In the Courts, Mandatory Delay/Biased Information Laws, Medical News, Politics, State and Local News, State Legislatures, Targeted Regulation of Abortion Providers (TRAP) | Permalink | Comments (0)

Friday, July 26, 2019

Another State Could Soon Insert Anti-Abortion Propaganda Into Public Schools

July 19, 2019 (Rewire.News): Another State Could Soon Insert Anti-Abortion Propaganda Into Public Schools, by Erin Heger: 

Ohio--the only U.S. state without standardized health education--may soon require public schools to focus on the “humanity of the unborn child” in health education curriculum. 

House Bill 90, introduced by the state's GOP legislature, infuses anti-abortion language into health and science materials for students and would restrict schools from providing any abortion-related information or referrals to students facing pregnancy. The legislature aims for school programs to thoroughly detail information about fetuses and gestation, promoting carrying any pregnancy to term.

In 2016, Oklahoma also introduced similar legislation (calling it the "Humanity of the Unborn Child Act"), however it has not yet been implemented in the state due to "budget constraints."

Both HB 90 in Ohio and Oklahoma’s Humanity of the Unborn Child Act state their intended purpose is an “abortion-free society.” However, not informing young people of all their options does little to prevent abortion and instead leaves people not knowing what to do or where to turn when they do face an unintended pregnancy, said Cameron Brewer, an educator with Planned Parenthood Great Plains.

“If we are restricting the information students have access, to then we are doing them a disservice as educators,” Brewer told Rewire.News. “My goal as an educator is to make sure my students have all the information they need to make the best decisions for them.” 

July 26, 2019 in Abortion, Abortion Bans, Anti-Choice Movement, Culture, Fetal Rights, Politics, Reproductive Health & Safety, State and Local News, State Legislatures | Permalink | Comments (0)

Thursday, July 25, 2019

Telemedicine Abortion is Safe

July 23, 2019 (Rewire.News): Telemedicine Abortion is Safe, No Matter What Anti-Choice Lawmakers Claim, by Auditi Guha: 

A study released July 9 finds that outcomes for medication-driven abortion through telemedicine are comparable in-person medication abortion.

The results support the importance of telemedicine for reproductive health and safety particularly for those who cannot easily reach abortion clinics due to oppressively-restrictive anti-choice legislation. 

Medication abortion has been legal in the United States for nearly twenty years and is supported by the American College of Obstetrics and Gynecologists, National Abortion Federation, and Planned Parenthood. The procedure uses a combination of mifepristone and misoprostol pills and the telemedicine aspect helps clinicians have a wider reach in authorizing and supervising the process through remote video conferencing.

Telemedicine medication abortions have often been provided in clinics where the licensed clinicians video conference in while the patient is in clinic with nurses or other professionals, but direct-to-patient telemedicine abortion services are growing. Most patients requesting these services live in abortion-hostile states where they cannot easily reach a clinic at all.

The anti-choice movement has responded by working to restrict access to telemedicine abortion as well as in-clinic abortion services. Legal bans or restrictions currently exist in Arkansas, Idaho, Mississippi, and Utah. 

The recent study, though, "indicates that telemedicine abortion is 'a safe and effective way of ending an early pregnancy, with very rare complications' and can provide the same quality of health care patients receive at a health center," according to Dr. Julia Kohn, national director of research at Planned Parenthood Federation of America and the lead author of the study.

Kohn further says: "In many ways, this study does reaffirm what we already know: Medication abortion via telemedicine is safe and effective at ending an early pregnancy."

July 25, 2019 in Abortion, Abortion Bans, Anti-Choice Movement, Current Affairs, Medical News, Pregnancy & Childbirth, Pro-Choice Movement, Reproductive Health & Safety, Scholarship and Research, Science, State and Local News, State Legislatures, Women, General | Permalink | Comments (0)

Tuesday, July 9, 2019

Vaginal exams on unconscious, non-consenting patients are legal in 42 states

Jun. 26, 2019 (Vice): Med Students Are Doing Vaginal Exams on Unconscious, Non-Consenting Patients, by Hannah Harris Green: 

For decades, medical students around the country have been expected to perform pelvic exams on unconscious women--not for the patient's benefit but solely for the student's experience. Sometimes these exams are performed multiple times by different students on the same patient. The exams involve a student inserting "two gloved fingers into the patient’s vagina and [placing] one hand on her pelvis in order to feel the uterus and ovaries." This patient is never asked for consent prior to the procedure nor is she informed of the exam afterward.

One former student--now a pediatrician in Baltimore, Maryland--learned of these procedures during his OB/GYN rotation while studying at the University of Pennsylvania Medical School in the 1990s. He refused to participate, joining in a movement to ban the practice. Ari Silver-Isenstadt took a year out of his medical studies to study the ethical implications of this practice at Penn's School of Education. He subsequently published a study in 2003 in the American Journal of Obstetrics and Gynecology that found that over 90 percent of students at the five Pennsylvania medical schools he had focused on had performed vaginal exams on non-consenting, unconscious patients. He noted that students' initial discomfort with the procedure quickly dissipated as it became a regular part of their rotations. 

California became the first state to ban these invasive exams in 2003, the same year of Silver-Isenstadt's study. Since then, Illinois, Virginia, Oregon, Hawaii, Iowa, Utah, and Maryland have followed suit. Additional states that have introduced similar legislation this year include Connecticut, Minnesota, Missouri, Nebraska, New Hampshire, New York, Oklahoma, Washington, and Texas. No federal legislation yet addresses the issue. 

Some medical schools have also banned the practice institutionally as well--like Harvard--but others, including Duke University, consistently ask their medical students to perform pelvic exams sans consent throughout their education. 

While the procedure invades the privacy of any patient, consequences can be particularly severe for patients with a history of sexual trauma who either find out a pelvic exam was performed on them while unconscious or else wake up during the produce, as did Ashely Weitz in 2007.

Weitz said testifying about her experience in support of Utah's law in February was nerve-racking, especially because she expected there to be other women at the hearing at the state house with similar experiences, but she was the only one. Given the nature of these exams, people don’t know if it's happened to them. She said it was “a very healing practice to say 'this shouldn't happen to me, it shouldn't be happening in the way that it is happening in an institution.'” But there are still parts of the incident that she hasn’t recovered from. “It changed the way that I sought and received medical care,” she said. “I was, you know, thereafter very certain that I was never going to be sedated or unconscious in a manner that would have allowed that situation to happen again. So it was in itself very traumatizing.”

Utah's ban on unconscious pelvic exams was signed into law in March of this year. It requires both medical students and doctors to get explicit consent to perform such exams on anesthetized women. A law professor at the University of Illinois, Robin Fretwell Wilson, credited Weitz's testimony as the primary driving force behind the state legislation. 

Wilson herself advocates for requiring specific consent for any pelvic exams. While opponents to legislation requiring consent argue that general consent forms signed upon entering a teaching hospital already cover these exams, Wilson and other advocates for patient protections assert that it is ethically wrong to practice procedures that are of no benefit to the patient without direct consent.

Many advocates, including Weitz, connect the growing opposition to these vaginal exams to the rising tide of the #MeToo movement in recent years. "The #MeToo movement has helped people like Weitz better understand that the violations they endure are part of a wider cultural problem."

Wilson acknowledges that even 10 or 15 years ago, the attitude toward this practice was completely different. "At the time, medical school faculty 'were more than willing to stand their ground and say, "not only do we do it, but the patients in our hospitals have a duty to participate."' . . .  15 years ago, many schools 'did not see it as an issue.'"

Advocates of legal regulations requiring patient consent, though, still fear that enforcement of the new laws will be difficult. "In order for authorities to find out, students would need to both be aware of the law and willing to report wrongdoing by their supervisors, so [Silver-Isenstadt is] hoping the culture is what will ultimately change."

July 9, 2019 in Culture, Medical News, Miscellaneous, Scholarship and Research, State Legislatures, Women, General | Permalink | Comments (0)

Thursday, June 13, 2019

Missouri’s lone abortion clinic must remain open for now

Jun. 10, 2019 (Politico): Judge says Missouri’s lone abortion clinic must remain open for now, by Rachana Pradhan: 

On Monday, a judge blocked Missouri's attempts to close its last remaining abortion clinic. Planned Parenthood, which operates the clinic, has struggled against state officials' attempts to shutter the clinic based on claims of violations, which jeopardize its licensing.

Judge Michael Stelzer had previously granted the Planned Parenthood clinic reprieve from the states' attempts to deny license renewal upon the clinic's license lapse in May, and Stelzer has now directed Missouri health officials to make a decision as to whether to renew the clinic's license by June 21.

Planned Parenthood officials attest that the licensing conditions were essentially pretextual and "accused state officials of orchestrating a politically motivated probe to stamp out abortion." Last month, Missouri lawmakers banned almost all abortions beyond week eight of a pregnancy.  

Missouri is just one of six U.S. states that have only one clinic providing abortions.

June 13, 2019 in Abortion, Abortion Bans, Anti-Choice Movement, Current Affairs, In the Courts, In the Media, Politics, Pro-Choice Movement, Reproductive Health & Safety, State and Local News, State Legislatures, Women, General | Permalink | Comments (0)

Tuesday, June 4, 2019

Illinois affirms the “fundamental right” to abortion by passing a new bill

Jun. 1, 2019 (Vox): Illinois affirms the "fundamental right" to abortion by passing a new bill, by Gabriela Resto-Montero: 

Illinois, in a newly-passed bill called the Reproductive Health Act, states that a “fertilized egg, embryo, or fetus does not have independent rights." The passing of this law thus grants pregnant people in Illinois the protected right to terminate their pregnancies. The Act was passed on Friday, May 31, 2019 and is expected to be signed by the governor.

State Senator Melinda Bush sponsored the bill and declared Illinois "a beacon for women's rights, for human rights." The legislation "repeals a 1975 state law that required spousal consent, waiting periods, placed restrictions on abortion facilities, and outlined procedures for pursuing criminal charges against abortion providers." It also "rolls back some state restrictions on late-term abortions by repealing Illinois’ Partial Birth Abortion Ban Act," a law that had not yet been enforced due to court injunctions.

While legislative threats to reproductive rights grow in numbers and severity throughout the country, Illinois is one of the first states to take concrete steps toward cementing the right to abortion--among other reproductive rights--within its borders. Other states (i.e. Alabama, Georgia, Ohio, Missouri, Indiana, Kentucky, Mississippi) are vying for a slot on the SCOTUS docket and with it a chance at the overturning of Roe v. Wade and its Constitutional protections. 

Recently, though, the Supreme Court signaled it is not quite ready to re-consider Roe. "In its decision regarding an abortion law passed by Illinois’ neighbor, Indiana, justices struck down one provision while affirming another part of the law, largely avoiding the question of whether abortion should be legal."

Planned Parenthood and the American Civil Liberties Union are leading the way with lawsuits aimed at preventing the so-called "heartbeat laws," and comparable legislation threatening reproductive rights and the safety and dignity of pregnant persons, from going into effect within anti-abortion state legislatures. "The Planned Parenthood Action Fund reports that so far in 2019, there have been 300 anti-abortion bills introduced in 36 states."

Illinois is not the only state working to protect abortion rights, though. "Some 13 states including New Mexico, Rhode Island, and Nevada have proposed bills to include a right to abortion in their Constitutions. While many of those efforts are still in their early stages, Vermont passed a bill to include the protection in its Constitution last week."

June 4, 2019 in Abortion, Abortion Bans, Anti-Choice Movement, Current Affairs, Fetal Rights, Politics, Pro-Choice Movement, Reproductive Health & Safety, State and Local News, State Legislatures | Permalink | Comments (0)

Tuesday, April 9, 2019

Alabama Lawmakers Want to Make Abortion a Felony

The Cut (Apr. 3, 2019): Alabama Lawmakers Want to Make Abortion a Felony, by Amanda Arnold: 

States' attempts to severely restrict access to abortion services show no signs of slowing down, and in one state, the race to prohibit the procedure has indeed turned down the path of total criminalization. 

The bill, HB314, was proposed proudly by Alabama representative Terri Collins and would classify performing any abortion as a Class A Felony, which carries a sentence of 10-99 years in the state. The single exception included in the bill is if "foregoing the procedure would pose a 'a serious health risk to the unborn child’s mother.'"

Of course, as a blatant violation of precedent under Roe v. Wade and the established Constitutional right to an abortion, the bill, should it pass, would immediately be subject to legal challenges. In a showing of support for the extreme anti-abortion movement, though, 65 of Alabama's 105-member House co-sponsored HB314.

The ACLU of Alabama pointed out that, in addition to the "egregious infringement on women’s reproductive rights" that the bill represents, HB314 "will potentially cost taxpayers 'hundreds of thousands' of dollars to cover the bill’s legal fees."

April 9, 2019 in Abortion, Abortion Bans, Current Affairs, Politics, State and Local News, State Legislatures | Permalink | Comments (0)

Saturday, March 30, 2019

The Flood of Court Cases That Threaten Abortion

New York Times (Mar. 28, 2019): Opinion: The Flood of Court Cases That Threaten Abortion, by Linda Greenhouse:

Within the next few weeks, Linda Greenhouse writes, a challenge to Louisiana’s abortion law will arrive at the Supreme Court as a formal appeal. Louisiana requires that doctors who perform abortions in the state "do the impossible by getting admitting privileges in local hospitals." The law, she writes, is “substantially similar” to the Texas law the Supreme Court declared unconstitutional in Whole Woman’s Health v. Hellerstedt in 2016, and yet the United States Court of Appeals for the Fifth Circuit "implausibly upheld the Louisiana law nonetheless."

A majority of the Fifth Circuit is at war with the Supreme Court’s abortion precedents, writes Greenhouse, and was even before the Trump administration filled five vacancies on the appeals court. The Trump-appointed judges "clearly understand their marching orders": one of those judges, James C. Ho, wrote in a published opinion on “the moral tragedy of abortion,” a gratuitous comment that Greenhouse says "served to make him stand out from the crowd."

Meanwhile, Chief Judge Ed Carnes of the United States Court of Appeals for the 11th Circuit began his opinion striking down an Alabama law that criminalizes the procedure most commonly used to terminate a pregnancy in the second trimester: “Some Supreme Court justices have been of the view that there is constitutional law and then there is the aberration of constitutional law relating to abortion. If so, what we must apply here is the aberration.” In a footnote to his 36-page opinion, Judge Carnes refused to call doctors who perform abortions either “doctors” or “physicians,” noting that “some people” regarded those designations “as inapposite, if not oxymoronic in the abortion context.” He called them “practitioners.” He also described the constitutional right to abortion as something the Supreme Court had decided to “bestow on women.”

Alabama has appealed the decision, Harris v. West Alabama Women’s Center, to the Supreme Court, noting in its brief that eight other states have enacted the same law. The justices will consider in mid-April whether to hear the case.

Greenhouse, in her decades of reporting on the federal judiciary, says that she cannot "remember seeing such expressions of outright contempt for the Supreme Court. In this age of norm-collapse, something has been unleashed here."

In another appeal pending before the Supreme Court, this one from Indiana, the Seventh Circuit struck down a law that makes it a felony for a doctor to perform an abortion if the patient wants to terminate her pregnancy because the fetus has been diagnosed with Down syndrome or “any other disability.”

In an opinion concurring with the majority decision, Judge Daniel Manion accused the Supreme Court of making abortion “a more untouchable right than even the freedom of speech.” While the outcome of this case was “compelled,” he said, “it is at least time to downgrade abortion to the same status as actual constitutional rights.”

Indiana’s appeal, Box v. Planned Parenthood of Indiana and Kentucky, arrived at the Supreme Court in October. The justices have taken it up at their private conference eight times and will consider it again at the conference scheduled this Friday.

Greenhouse is most concerned by the recent Sixth Circuit decision, where that court upheld an Ohio law that bars state public health money from going to any organization that performs abortions, namely Planned Parenthood. Planned Parenthood is the largest provider of H.I.V. testing in Cleveland, Akron and Canton. It performs abortions at three of its 27 clinics in the state.

Writing for the court, Judge Jeffrey Sutton found that Planned Parenthood had no right to invoke the doctrine of unconstitutional conditions because while women have a right to obtain abortions, neither Planned Parenthood nor any other abortion provider has the right to perform them.

Greenhouse concludes that she doesn’t "know whether Planned Parenthood will appeal the Ohio decision, Planned Parenthood v. Hodges."

"It’s received little attention — not surprisingly. As framed by the appeals court, it’s not the kind of issue that sends culture warriors to the barricades. But there’s no chance that the justices will miss its significance. Is it the small-target case they have been waiting for? Could be."

March 30, 2019 in Abortion, Abortion Bans, Anti-Choice Movement, In the Courts, Politics, President/Executive Branch, State and Local News, State Legislatures, Supreme Court | Permalink | Comments (0)

Tuesday, March 12, 2019

The Challenges of Innovating Access to Abortion

The New Yorker (Mar. 6, 2019): The Challenges of Innovating Access to Abortion, by Sue Halpern:

As states across the country continue to enact burdensome and medically unnecessary restrictions on safe and legal abortion care, last week the New Yorker examined the landscpe for access to abortion care via telemedicine.

Hawaii has one of the least restrictive abortion policies in the country, and yet services are still hard to come by due to geographic challenges. In 2018, only two of the Hawaiian islands had abortion providers: Maui and Oahu. As a result, medication abortion via telemedicine is a vital service to Hawaiian women seeking care.

Telemedicine—obtaining medical services over the phone or through the Internet—is not a new phenomenon. In the U.S., it began to take off in the late nineteen-fifties, and a 2016 federal grant to increase access to health care in rural areas has made it more mainstream.

TelAbortion, a service provided by the reproductive-health initiative Gynuity, enables a woman to terminate a pregnancy in the privacy of her own home, but with medical oversight. The service is available in Hawaii, Maine, New York, Oregon, and Washington as a five-state trial launched by Gynuity in response to the ever-diminishing availability of abortion services in the United States.

Although the five states in the TelAbortion trial have some of the most accommodating abortion laws in the country, Gynuity is only able to run the trial with a waiver from the F.D.A., which has put onerous restrictions on the distribution of abortifacients. Mifepristone is one of only seventy-five F.D.A.-approved medications controlled through its Risk Evaluation and Mitigation Strategy (REMS), and only one of fifty with its most stringent restrictions. According to the F.D.A., REMS, which regulates such drugs as Thalidomide, which is known to cause birth defects, is a drug-safety program for “medications with serious safety concerns to help ensure the benefits of the medication outweigh its risks.” The REMS mandates that mifepristone only be dispensed to a patient in a clinic, medical office, or hospital. A doctor can’t send a patient to their local pharmacy with a prescription for the medication, because pharmacies are not allowed to carry the drug. This limits the ability of physicians to administer the medication and of patients to obtain it, despite nearly twenty years of evidence demonstrating its safety and efficacy. The American Congress of Obstetricians and Gynecologists has recommended eliminating the REMS altogether. An F.D.A. panel of experts recommended eliminating one aspect of the REMS in 2016 when the mifepristone REMS came up for review. It was overruled by the F.D.A. commissioner, an Obama appointee.

Medication abortion should make access to care easier, but some of the more recent restrictions passed by state legislatures also make getting medication abortion, which is already constrained by the REMS, more difficult. Seventeen states require that a clinician be physically present when mifepristone is taken. Thirty-four states require those clinicians to be licensed physicians. Women who obtain and self-administer medication abortion outside the traditional medical establishment, typically from an Internet pharmacy, may be subject to arrest and imprisonment. In 2013, a woman in Pennsylvania who had ordered them online for her daughter was sentenced to a nine-to-eighteen-month jail term for “providing abortion without a medical license, dispensing drugs without being a pharmacist, assault and endangering the welfare of a child.”

It is now possible to order these medications through AidAccess, a program overseen by a doctor in the Netherlands. While no one has been arrested, the promulgation of fetal-homicide laws—thirty-eight states now have them—and aggressive prosecutors puts women at risk of arrest if they obtain them in this manner.

According to the Guttmacher Institute, “these laws are even being used to pursue women who are merely suspected of having self-induced an abortion but in fact had suffered miscarriages.”

March 12, 2019 in Abortion, Abortion Bans, Politics, State Legislatures | Permalink | Comments (0)

Tuesday, March 5, 2019

Texas gave anti-abortion group millions for women's health, despite warnings

Houston Chronicle (Feb. 25, 2019): Texas gave anti-abortion group millions for women's health, despite warnings, by Jeremy Blackman:

In May 2016, Carol Everett sent an email to fellow anti-abortion activists detailing “an extraordinary pro-life opportunity.” Her nonprofit, the Heidi Group, she said, had spent the past year pushing for nearly $40 million in funding to help Christian pregnancy centers “bless many poor women” across Texas. The opportunity she was discussing? An application to become one of the state’s leading family planning providers as part of the Healthy Texas Women program, which offers free women’s health and family planning services to eligible, low-income women.

Everett had never contracted with the state and had no clinical background. Many of the pregnancy centers she cited don’t provide contraception, a core family planning service. Still, state health officials gave her significant public funding anyway, ignoring warning signs and overruling staff that recommended millions less in funding, according to a review of the contracting by the Houston Chronicle. When Everett’s clinics began failing, Texas delayed for months in shifting money to higher performing clinics and chose to devote vast amounts of time to support Everett and her small, understaffed team.

The Heidi Group was not the only contractor that struggled in Healthy Texas Women. By the end of the first year, others had met just 46 percent of their combined patient targets. They had spent just over a third of their proposed fee-for-service expenditures, the state’s preferred source because every expense can be tracked. Those excelling early on were established providers versed in the state’s complex billing procedures. For them, the program has been a boon from the beginning, increasing funding for equipment and staff, and adding reimbursements for a larger swath of health services. Still, many of the smaller, less-experienced clinics could not scale up quickly enough and felt they had not received adequate training on billing and enrollment delays.

The state's separate Family Planning program within HHS had twice the success rate, both in spending and patient targets. Though the 39 Healthy Texas Women contractors had access to more money in the first year, those in the Family Planning program outspent them by several million dollars, which the state said it could not immediately verify. Because of its less stringent eligibility requirements, Family Planning program providers say they can more easily meet need where it exists. And for many of them, that is with immigrant and undocumented families.

Though it’s impossible to say how many more women could have been served had the resources been shifted sooner, several competing clinics involved in Healthy Texas Women burned through their funding early in the grant cycle, surpassing their targets for both spending and patients treated. Had they been sent some of the $6.75 million sitting in wait for the Heidi Group, the door could have opened for thousands more women to receive access to contraception, STD screenings and breast exams.

“We would definitely have been able to serve more,” said Marcie Mir, the chief executive officer of El Centro de Corazon, which serves immigrant communities in East Houston.

The Houston Chronicle’s review included emails, internal records, and interviews with two dozen people, and found that the Texas HHS made repeated concessions, and not just to the Heidi Group. State health officials lowered the standards for applicants in two new women’s health programs, including Healthy Texas Women, and revised past patient counts, making it easier to show growth. Quality control measures were stalled, and only the Heidi Group received on-site clinical assessments in the first year, despite similar problems with other contractors.

At least one top Republican, Governor Greg Abbott, laid the groundwork for Everett’s selection, controlling her appointment to an influential committee helping to develop the new programs, according to records. The health official who allocated Everett's award has close personal ties to the conservative Texas Public Policy Foundation, whose founder, Dr. James Leininger, has been a key donor to the Heidi Group, as well as to Abbott.

Everett’s funding was revoked last fall after two years of poor performance, and auditors are reviewing whether the Heidi Group mishandled funds.

Despite an uptick in number of people served in 2017 from the previous year, Texas still served 100,000 fewer patients than in 2010, despite spending about $35 million more in 2017, including federal dollars.

What has happened in Texas may be a preview for the country at large. The Trump administration on Friday announced it is cutting family planning funding to abortion affiliates, a decision that further undermines groups like Planned Parenthood, which provide the bulk of non-abortion services to low-income women nationally. The move, much like the one in Texas years ago, is expected to direct millions toward faith-based providers.

March 5, 2019 in Contraception, Politics, Religion and Reproductive Rights, State and Local News, State Legislatures | Permalink | Comments (0)

Wednesday, February 27, 2019

Bill that bans abortions in Tennessee after fetal heart beat sails through House committee

The Tennessean (Feb. 26, 2019): Bill that bans abortions in Tennessee after fetal heart beat sails through House committee, by Anita Wadhwani:

A Tennessee House committee voted 15-4 in favor of a bill that would ban most abortions in that state, getting one step closer to a vote by the legislature on one of the most restrictive abortion bans in the nations. Tuesday's vote in the health committee means the so-called "fetal heartbeat" ban moves on to a vote by the House of Representatives.

The bill bans nearly all abortions after a fetal heartbeat is detected, which typically occurs early in a pregnancy and usually before a woman knows she's pregnant. The bill includes a medical emergency exception.

A similar bill failed in 2017 after the state's attorney general determined it was "constitutionally suspect" and unlikely to survive legal challenges.

After the hearing, the ACLU of Tennessee announced it plans to file a lawsuit should the measure become law.

The bill includes no exceptions for pregnancies that result from rape or incest — a point Democratic lawmakers stressed during their remarks in the committee room that was packed with both supporters and opponents of the ban.

The ban redefines fetal viability as the point when a fetal heartbeat is detected, typically at about 6 weeks of pregnancy, and would make it a Class C felony for anyone to perform an abortion after this point, punishable by three to 15 years in prison and fine of up to $10,000.

Tennessee Governor Bill Lee supports the bill.

February 27, 2019 in Abortion, Abortion Bans, State and Local News, State Legislatures | Permalink | Comments (0)

Friday, February 15, 2019

'Rosie's law' aims to lift ban on Medicaid coverage of abortions in Texas

KXAN (Feb. 14, 2019): 'Rosie's law' aims to lift ban on Medicaid coverage of abortions, by Tulsi Kamath:

 Austin state representative Sheryl Cole recently introduced "Rosie's Law" in the Texas Legislature to expand insurance coverage for low-income Texans enrolled in the state's Medicaid program. 

"Rosie's Law repeals the prohibition on using state funds for abortion care, the Texas version of the federal Hyde Amendment, which prohibits federal funding for abortion care," Lilith Fund officials wrote in a press release. "This bill would add abortion care to the list of services for which Medicaid recipients area eligible."

The proposed bill is named after Rosie Jimenez, a woman who died in McAllen, TX in the late 1970s after she couldn't pay for a legal abortion and had to opt for a cheaper, unsafe option.

"We must fight hard for government assistance for those who just don't have it. We have to stand together as women, regardless of income, regardless of race, regardless of personal circumstances, because we as women are the anchors of our families," Rep. Cole said. "And as the anchors, we have to make sure we are in charge of those decisions and at the very least we don't die." 

Medicaid funding in Texas is currently only available for abortions in cases where the pregnancy is a product of rape or incest, or if there is danger to the life of the pregnant person or fetus, according to the press release.

February 15, 2019 in Abortion, State and Local News, State Legislatures | Permalink | Comments (0)

Wednesday, February 13, 2019

Campus Vending Machines Offer Emergency Contraception Without the Stigma

The Verge (Feb. 11, 2019): Campus vending machines offer emergency contraception without the stigma, by Lux Alptraum:

Thirteen years after a heated battle resulted in over-the-counter approval for emergency contraception, the product is finally shedding some of its stigma, and college campuses are leading the charge toward normalization.

In the fall of 2018, Yale’s Reproductive Justice Action League proposed a new plan to improve the health and wellness of its student population: emergency contraception vending machines. Unfortunately, the university announced that it was halting the plan because of a little-known state law banning vending machines from being used to distribute over-the-counter medications.

Similar laws exist around the country and are currently being challenged. This week, a bill was introduced in Maine at the request of students at the University of Southern Maine that would allow some over-the-counter medications — including emergency contraception — to be sold in vending machines.

But more broadly, says Alptraum, "there’s no denying that our national conversation about [emergency contraception] has undergone a major shift toward normalization: emergency contraception is now available at health clinics, drugstores, and, yes, in vending machines."

For students on isolated college campuses, though, distance is an additional hurdle, says Rachel Samuels, the Stanford alumna who led the charge for more accessible on-campus emergency contraception. At Stanford, Samuels says, the nearest pharmacy is about a 25-minute walk away with no guarantee that emergency contraception will be in stock. On rural campuses, access to pharmacies is usually even more limited.

When Stanford students began petitioning for on-campus access to emergency contraception a few years ago, they looked to vending machines as a solution. The result of that organizing is a small, high-tech vending machine called a Vengo that is located in the all-gender restroom in Stanford’s student center. It allows students to confidentially access My Way brand emergency contraception (and condoms) at any hour of the day. The pill costs $25, which is less than the $26 that the student health center charges or the $40 or $50 Plan B tends to retail for at pharmacies, though that’s more than twice what the same brand retails for on Amazon.

Still, in 2018, the machines sold 329 units of emergency contraception, and Stanford plans to add a second Vengo machine on campus in 2019. Vengo machines have also started dispensing EC at Columbia University in New York and George Mason University in Virginia.

February 13, 2019 in Contraception, Sexuality, State Legislatures | Permalink | Comments (0)

Monday, February 11, 2019

An Overview of State Abortion Laws

NPR (Feb. 9, 2019): An Overview of State Abortion Laws, by NPR Weekend Edition Saturday:

On Saturday, NPR's Scott Simon spoke with Julie Rovner, chief Washington correspondent for Kaiser Health News, about new abortion laws in state legislatures across the country.

On Thursday, the U.S. Supreme Court blocked Louisiana from enforcing a restrictive abortion law. The court will likely hear a challenge to the merits of that law this fall. Many states are moving to pass a number of new abortion laws to prepare for the possible overturn of Roe v. Wade.

Rovner discussed efforts by anti-choice legislators to pass legislation in order to bring the issue of abortion to the Supreme Court again and again, as well as efforts by pro-choice legislators to safeguard abortion access in the event that Roe v. Wade is overturned. Rovner also discussed the Trump Administration's impending plans to "evict Planned Parenthood" from Title X, the federal family planing program.

Listen to the interview below:

February 11, 2019 in Abortion, Abortion Bans, In the Courts, State Legislatures | Permalink | Comments (0)

Friday, February 8, 2019

NY’s Reproductive Health Act is Not Radical; It Simply Recognizes that the Lives and Dignity of Pregnant People Count Too

NY’s Reproductive Health Act is Not Radical; It Simply Recognizes that the Lives and Dignity of Pregnant People Count Too (Feb. 7, 2019), by Cynthia Soohoo:

Not surprisingly, President Trump’s attack on New York’s Reproductive Health Act during Tuesday night’s State of the Union address blatantly mischaracterized the RHA. But it also underscores a glaring gap in anti-abortion advocates’ pro-life views -- the right to life and dignity of people who are pregnant.

The RHA continues to recognize a state interest in fetal life and prohibits abortions after 24 weeks in almost all circumstances. However, the law also recognizes that in some situations, denying a pregnant person the ability to end a pregnancy imposes serious and irreparable harm on her, including situations where the pregnancy endangers her life and health. And in those situations, the state cannot force the pregnant woman to continue the pregnancy against her will. This is consistent with current Supreme Court jurisprudence and international human rights law. The UN Human Rights Committee made this explicit in a recent General Comment clarifying that while states can regulate abortions, they should not do so in a manner that violates the right to life of the pregnant person or her fundamental human rights.

The RHA does no more than protect the human rights of pregnant people. The law only allows abortions post-24 weeks in two situations. First, abortions are allowed where the fetus will not survive outside of the womb. The RHA recognizes that a woman should not be forced to continue what was often a wanted pregnancy -- knowing that the fetus will not survive -- against her will. In such cases, the state’s interest in protecting a viable fetus is not at issue, and human rights experts have held that denying a woman access to an abortion in these circumstances is cruel, inhuman and degrading treatment.  

Second, the RHA allows a woman to have an abortion where continuing the pregnancy endangers her life or health. Some women may choose to continue pregnancies in these circumstances. But the RHA acknowledges that the pregnant person must be allowed to make her own choice taking into account the risk that she faces and the impact her death or disability would have on her family and community.

In both situations covered by the RHA, human rights experts have held that state denial of an abortion violates the human rights of the pregnant person. In fact, concern over state prohibition of abortions in those circumstances led UN human rights experts to write to the U.S. to encourage passage of laws like the Reproductive Health Act. This is not a radical position. It is merely the recognition of the value of the life and dignity of pregnant people. The failure of critics of the RHA to understand this is a glaring gap in their “pro-life” views.

February 8, 2019 in Abortion, Current Affairs, In the Media, International, Politics, Pregnancy & Childbirth, President/Executive Branch, Reproductive Health & Safety, State Legislatures, Women, General | Permalink | Comments (0)

Supreme Court Blocks Louisiana Abortion Restrictions

The New York Times (Feb. 7, 2018): Supreme Court Blocks Louisiana Abortion Restrictions, by Adam Liptak:

The Supreme Court blocked the Louisiana admitting-privileges law that Justice Alito issued a stay for just last week in June Medical Services v. Gee

The law would have effectively limited the abortion providers in the state of Louisiana to one, by requiring such providers to have admitting privileges at nearby hospitals. Many hospitals either would not extend such privileges or were not in the required 30-mile radius of the abortion-providing clinics at risk under the law. While initially passed in 2014, the Louisiana law has been entangled in lawsuits ever since. SCOTUS struck down a similar statute in Texas in 2016 in Whole Woman's Health v. Hellerstedt

The Supreme Court stayed enforcement of the Louisiana law, but it may ultimately decide to take the case for full review.  This would allow the Court to reconsider the clarification provided by Hellerstedt on the "undue burden" standard, initially implemented in Planned Parenthood v. Casey (1992). This standard says that legislation that has either the purpose or effect of placing a substantial obstacle in the way of a pregnant person seeking to exercise their constitutional right to an abortion creates an undue burden on them, and is therefore unconstitutional. Medically unnecessary laws that offer minimal, if any, health benefits to pregnant persons while increasing their obstacles to seeking an abortion constitute "undue burdens."

The vote was 5 to 4, with Chief Justice John G. Roberts Jr. joining the court’s four-member liberal wing.

February 8, 2019 in Abortion, Abortion Bans, Anti-Choice Movement, Current Affairs, In the Courts, Politics, Pro-Choice Movement, Reproductive Health & Safety, State and Local News, State Legislatures, Supreme Court, Targeted Regulation of Abortion Providers (TRAP), Women, General | Permalink | Comments (0)

Thursday, January 31, 2019

Idaho legislators seek to criminalize abortion

East Idaho News (Jan. 30, 2019): Idaho legislators seek to make abortion murder, by Mark Price:

Rep. Heather Scott, (R-Blanchard), and freshman Rep. John Green, (R-Post Falls), released a draft of a bill that would repeal the Idaho statute exempting women or anyone participating in abortion from being charged with murder.

By repealing the exemption, any abortion, without exception, performed in Idaho would be considered murder. The woman who has the abortion and the person who performs the abortion could both be prosecuted for murder.

“We either define life as a fetus, or we don’t,” Scott said. “A woman can go out of state if she needs an abortion. But we just wouldn’t do it in our state. We’ll protect life in our state.”

Green said he rejects the idea the bill would go against federal law or Roe v. Wade. The 1973 United States Supreme Court ruling in Roe v. Wade legalized abortion across the country.

The proposed legislation would not allow the prosecution of anyone who has had or participated in an abortion in the past.

Sen. Dan Foreman (R-Moscow) proposed a similar bill in 2017. The bill would have charged women who had and doctors who performed abortions with first-degree murder. It did not find traction during the session.

January 31, 2019 in Abortion, Abortion Bans, State and Local News, State Legislatures | Permalink | Comments (0)