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Google regularly gives law enforcement agencies access to swaths of location data. Lawmakers now want Google to curtail that data collection to stop it landing in the hands of right-wing prosecutors.

Over 40 members of Congress, led by senator Ron Wyden and representative Anna G. Eshoo, urged Google to limit its location data gathering efforts so as to stop it being used by right-wing prosecutors if the Supreme Court reverses the protections offered by Roe v. Wade, according to a copy of the letter released by Wyden’s office on Tuesday.

Google is of particular importance if those protections are scrapped because the company collects a massive amount of location data through its Android operating system and apps, and makes that information available to law enforcement. If seeking or providing abortion services becomes a crime in large parts of the U.S., for example, investigative agencies would generally be within their right to request access to such data if it was part of a valid law enforcement investigation. Google controversially regularly responds to so-called reverse location data warrants or geofence warrants, and provides information on all of the devices it detected as being in a certain area at a certain time. 

“We are concerned that, in a world in which abortion could be made illegal, Google’s current practice of collecting and retaining extensive records of cell phone location data will allow it to become a tool for far-right extremists looking to crack down on people seeking reproductive health care. That’s because Google stores historical location information about hundreds of millions of smartphone users, which it routinely shares with government agencies,” the letter reads.

“While Google deserves credit for being one of the first companies in America to insist on a warrant before disclosing location data to law enforcement, that is not enough. If abortion is made illegal by the far-right Supreme Court and Republican lawmakers, it is inevitable that right-wing prosecutors will obtain legal warrants to hunt down, prosecute and jail women for obtaining critical reproductive health care. The only way to protect your customers’ location data from such outrageous government surveillance is to not keep it in the first place,” the letter continues.

Google did not immediately respond to a request for comment.

Google has fulfilled reverse location data warrants for years, and their use has steadily become more popular among law enforcement agencies. In a report published in August, Google said it received 982 such warrants in 2018, 8,396 the following year, and then 11,554 in 2020, TechCrunch reported at the time. The vast majority of those requests came from state and local authorities, and geofence warrants at some points made up one quarter of all demands for data from U.S. agencies, according to the report.

Police officers have used the technique to investigate robberies, arson, and murder. Innocent people have also been swept up in such investigations simply for being in a particular place at a certain time. In 2019, The New York Times reported on the case of Jorge Molina, who was arrested on suspicion of being connected to a murder because of a geofence warrant. After spending a week in jail, he was released when authorities identified another suspect. 

Earlier this month TechCrunch reported that a group of tech giants that included Google supported a New York bill that would outlaw the use of geofence warrants.

Motherboard has reported on multiple companies that sold access to location data related to Planned Parenthood and other family planning clinics, resulting in multiple companies removing that data from public purchase.

Source: https://www.vice.com/en/article/v7d5m3/40-members-of-congress-google-stop-location-data-abortion-rights


If enacted, it would be even stricter than the Texas six-week ban.

The Oklahoma state Legislature on Thursday passed a bill that would ban almost all abortions, starting at fertilization, and let individuals sue people over illegal abortions.

If signed by Republican Gov. Kevin Stitt, who has pledged to back abortion restrictions, it will take effect immediately. The law would be the strictest anti-abortion law in the country. 

This new Oklahoma ban, which had already passed the state Senate, passed the state House 73-16 on Thursday. Under the bill, abortions would be permissible only to “save the life of the unborn child” or the life of the pregnant woman “in a medical emergency,” or if the pregnancy is the result of rape or incest that has been reported to law enforcement.

People who undergo abortions cannot be sued under this bill. But abortion providers and people who help an individual obtain an illegal abortion may be liable to pay at least $10,000. 

The bill is based off of the Texas abortion ban, which lets individuals sue anyone who “aids or abets” an illegal abortion. However, that Texas ban, passed last September, blocks abortions as early as six weeks into pregnancy rather than at fertilization.

The impact of the Texas abortion ban has been devastating for both patients and providers. The month after the ban took effect last fall, in-clinic abortions in Texas fell by almost 60 percent. Many of the patients turned away from Texas clinics fled to Oklahoma—which, just weeks ago, enacted its own version of a Texas-style, six-week abortion ban, in a move that effectively vaporized abortion access for both Texans and Oklahomans.

“The effect even in that short period of time has been dramatic,” Trust Women, an abortion clinic network with a location in Oklahoma City, said in a statement Thursday. “Our patients are frightened, confused about the new reality they now live in. They are angry at a government that continues to demonstrate a reckless and enthusiastic disregard for their lives.”

Trust Women, which also has a clinic in Wichita, Kansas, pledged that its clinics will stay “open and accessible to pregnant people who need help finding resources and providers wherever abortions remain legal.”

It also arrives as the country waits for a ruling in a Supreme Court case that could overturn Roe v. Wade, the 1973 Supreme Court decision that legalized abortion nationwide. Earlier this month, a leaked draft opinion from the majority-conservative Supreme Court indicated that the justices do plan to overturn Roe, which would let states once again regulate abortion as they see fit.

Without Roe’s protections, abortion would be outlawed in Oklahoma. The state is one of at least 13 states that have laws on the books that would ban the procedure as soon as Roe is overturned. In total, roughly half of the United States is certain or likely to ban abortion if Roe falls, according to the Guttmacher Institute, which tracks abortion restrictions.

Source: https://www.vice.com/en/article/m7v8w4/oklahoma-abortion-ban-fertilization

 Austen Risolvato/Rewire News Group illustration

After my first abortion failed, I had to travel from Michigan to Indiana because the cost of an abortion at a clinic was half the cost.

In April 2020, I had a second abortion after the first one failed. Because I first sought an abortion during the height of the pandemic lockdowns, some providers weren’t open. To add to the difficulty, I was on Medicaid, which does not cover abortions under the Hyde Amendment, so I was going to have to pay $800 at Planned Parenthood to have an abortion in Michigan.

I instead bought abortion pills online from Plan C, a group that advocates for access to abortion pills, and took one, hoping it would work. Statistics told me that misoprostol would be effective on its own 85 percent to 93 percent of the time, and because I was only a few weeks along, I wasn’t concerned that it wouldn’t.

Days later, nothing had happened. I knew that pregnancy tests might display a positive result for a week or more, so when I tested positive again the next week, I brushed it off. The following week, I made an appointment at an Indiana abortion clinic, where the cost of an abortion was half that of the Michigan clinic’s. I wanted to be sure that the abortion pill alone had worked, and that I wasn’t part of the small percentage of pregnant people who experienced a failed abortion.

When the nurse inserted the wand for a vaginal scan, she couldn’t find anything. She sent the doctor in to be sure. Thirty minutes of uncomfortable pressure later, a tiny speck appeared on the screen. I was exactly six weeks pregnant, which meant that when I took the pill two weeks prior, I was about four weeks pregnant. If I had been living in a state where abortion was banned at six weeks’ gestation, I wouldn’t have been able to get abortion care after the first one failed. My life would be dramatically different than it is today.

Politicians who write six-week abortion bans do so knowing that most pregnant people do not know they are pregnant at six weeks. Being six weeks pregnant means you’re two weeks out from a missed period. These laws, especially those similar to Ohio’s “heartbeat bill,” are full abortion bans.

I live in Michigan, where we have two pro-choice politicians at the highest levels of state government: Democratic Gov. Gretchen Whitmer and Attorney General Dana Nessel. Later this year, voters will head to the polls to decide whether to re-elect them. The election’s consequences are dire: If they do not win, state Republicans have vowed to ban abortion.

Last month, Whitmer asked the courts to overturn the state’s ban on abortion, a 1931 Penal Code under Chapter III that bans all abortions, even in cases of rape and incest. The law makes having an abortion a felony manslaughter charge and prescribing or selling abortion “pills, powder, drugs, or combination of drugs” a misdemeanor charge. If the Supreme Court reverses Roe v. Wade, as they’re expected to do in Dobbs v. Jackson Women’s Health Organization, reversing Michigan’s ban would make abortion a protected right in the state.

Michigan is one small step closer to protecting the right to abortion in the state. On Tuesday, Michigan Court of Claims Judge Elizabeth Gleicher granted a preliminary injunction blocking enforcement of the 1931 ban.

Our Midwestern neighbor, Illinois, has always been ahead of us when it comes to expanding access. Even if Gov. J.B. Pritzker, the pro-choice Democrat leading Illinois, is voted out of office, it would be difficult to ban abortion in the state.

Terry Cosgrove, CEO and President of Personal PAC, a political action committee working to elect pro-choice legislators in Illinois, explained the state’s two existing abortion laws: HB 40, which in 2017 repealed restrictions on Medicaid abortion coverage and the trigger law that would ban abortion statewide if it were no longer federally protected, and the Reproductive Health Act, which in 2019 repealed the criminalization of unwanted pregnancies. But, as Cosgrove said, “nothing is permanent, and we have the most consequential election in 50 years in Illinois” in November.

Cosgrove discussed concerns about the Illinois Supreme Court seats that are up for election in November. “They are just waiting to have the justices who will decide to put aside the right to privacy,” he said of Republican lawmakers in Illinois.

In Indiana, where I got my abortion after my first failed attempt, the situation is different. If Roe v. Wade is dismantled, there is no doubt that the state would ban abortions as quickly as possible. According to the Guttmacher Institute, state lawmakers enacted 55 abortion restrictions and bans over the last decade.

Jean DeWinter volunteers both as a storyteller for Planned Parenthood and as a patient escort for Whole Women’s Health in South Bend, Indiana, where I was treated after my failed abortion. It is 1 of 7 clinics in the Indiana, and just one of two in the northeastern part of the state.

DeWinter fears for the loss of that right in her state. When she got her abortion as a teen, she faced pushback from her family and others, who attempted to coerce her into not getting one.

“It was a complicated situation,” DeWinter said. “I advocated for myself. I did not have any help in terms of ‘adult help.’ It was done in secret behind my parents’ back.”

DeWinter noted the slim possibility that Indiana’s Republican Gov. Eric Holcomb would veto an anti-abortion ban; in March, he vetoed a transgender sports ban in the state, which has led to tension in the Indiana statehouse, where Republicans hold the majority.

If abortion is banned in Indiana, clinics would be immediately shuttered and there would be no use for her as a clinic escort. Doctors at Whole Women’s Health only come to Indiana as visiting doctors to provide abortions—so if abortion is banned in the state, there would be no reason for them to return. Like DeWinter, these doctors face harassment and threats from protesters.

“Once you’ve been called a murderer to your face, I don’t think it could get any worse than that,” DeWinter said about the harassment. If abortion is banned, those abuses with only get worse.

No clinic escorts, no doctors, no abortion. Illinois and Michigan would have to do what California and Colorado have done this year and become a “sanctuary state,” where the right to have an abortion is a state law, protecting in- and out-of-state patients. Midwesterners in states like Ohio, Indiana, and Kentucky would have to travel to seek abortions in the nearby states of Illinois and Michigan.

States like Illinois and Michigan may have some safeguards to protect the right to choose in the Midwest, but for poor pregnant people, pregnant people with no support system, pregnant people who aren’t aware of how to obtain an abortion, and more, it’s simply not enough—particularly in light of the leaked draft opinion published by Politico that indicates the Supreme Court plans to overturn Roe v. Wade.

Having to travel to another state for a safe and effective abortion was an experience that has forced me to advocate for pro-chocie policies and candidates, and to share my experience. But I’m not unique. Voting for pro-choice candidates and choosing to become a clinic escort are two important ways that abortion can be protected, legally and literally.

Source: https://rewirenewsgroup.com/article/2022/05/20/my-governor-supports-abortion-rights-but-i-still-had-to-travel-out-of-state-for-care/


The law dates from 1931, but a judge ruled it cannot be enforced if Roe is struck down.

A law that could ban abortions in Michigan if the Supreme Court decimates the national right to the procedure has been put on ice, thanks to a court order Tuesday.

A Michigan Court of Claims judge has issued a preliminary injunction blocking the 1931 law, which predates Roe v. Wade, the 1973 Supreme Court decision that legalized abortion nationwide. Planned Parenthood of Michigan sued over the law in April, in anticipation of the possibility that the majority-conservative Supreme Court would overturn Roe and leave states free to ban abortion.

Under Judge Elizabeth Gleicher’s ruling, the 1931 law cannot be enforced if Roe is struck down.

“After 50 years of legal abortion in Michigan, there can be no doubt that the right of personal autonomy and bodily integrity enjoyed by our citizens includes the right of a woman, in consultation with her physician, to terminate a pregnancy,” Gleicher wrote in her ruling.

The Supreme Court is expected to officially rule in the coming weeks in a Mississippi abortion ban case that could determine Roe’s fate, but a draft opinion leaked earlier this month indicates that the justices do plan to overturn the landmark ruling. Without Roe, the war over abortion would become a series of state-by-state battles

As of early May, nine states, including Michigan, have abortion bans on the books that predate Roe and that are currently not in effect—but could be resurrected to outlaw abortion if Roe falls. Thirteen states have also passed so-called “trigger laws,” which are post-Roe abortion bans that are currently unenforced, but would kick in once Roe is overturned.

In total, 26 states are certain or likely to ban abortion if Roe is overturned, according to the Guttmacher Institute, which tracks abortion rights.

Abortion rights activists in Michigan are also currently at work on a ballot initiative that would enshrine the right to abortion in the state constitution. That initiative, they hope, will appear on ballots in the state’s November elections.

Source: https://www.vice.com/en/article/akvxj8/michigan-judge-halted-abortion-ban

Overturning Roe v. Wade will have devastating consequences for disabled people, who often use abortion services because they experience substantial disadvantages.
 Austen Risolvato/Rewire News Group

Disabled people’s bodies have been policed even when abortion has been a right. In a post-Roe world, we must protect their abortion rights, too.

As we learned from Politico’s reporting last week, the Supreme Court is poised to strike down its landmark Roe v. Wade decision. Overturning Roe will be devastating for all people, but most deeply for historically marginalized groups, including people with disabilities.

Nevertheless, when disability is invoked in discourse concerning abortion, it is typically regarding abortions based on fetal disability diagnoses. Yet by framing disability and abortion only in the context of disability-selective abortions, activists, scholars, and policymakers fail to recognize that it is actual people with disabilities—not fetuses with disability diagnoses—who are harmed by abortion restrictions.

In a forthcoming UCLA Law Review article, I write about how disabled people have both an increased need for abortion services and decreased access. Simply put, people with disabilities must be included in all efforts to protect abortion rights.

The attack on abortion rights reflects the legacy and continuation of a history in which reproduction has been weaponized to subjugate disabled people and other historically marginalized communities. As such, disabled people are acutely aware of what happens when the government gains control of our bodies. In particular, people with disabilities have faced a lengthy history of threats to bodily autonomy, including forced sterilization. Eugenics aimed to “improve” the human race by restricting procreation of those deemed undesirable—disabled peopleimmigrantsBlack peopleIndigenous peopleLGBTQ people, and incarcerated people. Black disabled people were especially subjected to forced sterilization.

Forced sterilization gained the blessing of the Supreme Court in the infamous 1927 Buck v. Bell decision. At 17 years old, Carrie Buck, who was deemed “feebleminded,” became pregnant after being sexually assaulted by her foster parents’ relative. To ostensibly hide the pregnancy that resulted from sexual violence, she was committed to the Virginia State Colony for Epileptics and Feeble Minded, where her mother was also institutionalized. After giving birth, Buck’s daughter, Vivian, was adopted by her foster family. The institution then sought to sterilize Buck per the state’s involuntary sterilization law.

After a series of appeals, the Supreme Court upheld Virginia’s law allowing institutions to condition a patient’s release upon sterilization as constitutional. In reaching this holding, Justice Oliver Wendell Holmes Jr. stated that the forced sterilization would benefit Buck’s welfare and that of society. He then proclaimed, “Three generations of imbeciles are enough.” Following this decision, more than 30 states enacted compulsory sterilization laws. By the late 20th century, roughly 70,000 Americans, many of whom had disabilities, were forcibly sterilized.

Even today, people with disabilities continue to endure state-sanctioned reproductive oppression. For example, a National Women’s Law Center report published in January found that 30 states and the District of Columbia still have involuntary sterilization laws on their books. In these states, guardians, who are appointed by courts to make decisions on behalf of disabled people, are often the ones choosing whether a person is sterilized, even if it is against that person’s wishes. Notably, research indicates sterilization is a standard procedure for disabled people. Guardians, also known as conservators in some states, are also permitted to make decisions about contraception, as demonstrated by Britney Spears’ case.

Despite enduring a lengthy history of reproductive oppression, people with disabilities have been largely ignored from discourse about abortion rights. This exclusion is particularly problematic because overturning Roe will have devastating consequences for disabled people, who often use abortion services because they experience substantial disadvantages.

First, access to comprehensive reproductive health services, including abortion care, is crucial for disabled people because they are at greater risk of health disparities. According to research, people with disabilities have higher rates of maternal mortality and morbidity than people without disabilities. Moreover, some disabled people take medications that must be stopped prior to pregnancy. Without abortion services, disabled people who have unintended pregnancies will be put in an impossible situation: Having to choose to suddenly end medication and risk harmful side effects, or continue medication that could harm them and their children.

Ultimately, restricting access to abortion will force pregnant people with disabilities to accept risks associated with pregnancy irrespective of their beliefs or health, placing some in considerable harm. This is both dangerous and cruel.

Second, abortion is important for people with disabilities because they experience severe economic disadvantages. According to the National Council on Disability, “people with disabilities live in poverty at more than twice the rate of people without disabilities.” They also have considerably lower employment rates. These inequities are heightened for disabled people who are further marginalized. For example, Black people with disabilities are nearly 55 percent more likely than white people with disabilities to live in poverty. LGBTQ disabled people also experience substantial economic disadvantages.

The bodily autonomy and self-determination that disabled people have fought so hard for will be completely undermined.

In light of the dire economic circumstances experienced by people with disabilities, reducing access to abortion services will only worsen the situation. In fact, 49 percent of people who have abortions live below the poverty line, and many people seeking abortions do so because they cannot afford the costs associated with childrearing. Thus, it is reasonable to assume that some people with disabilities need abortion services because the disproportionate poverty they endure makes them unable to afford to raise children.

Even now, abortion is out of reach for many people with disabilities. Researchers estimate that the average cost of an abortion procedure at about ten weeks in the United States is just over $500, and the median cost of an abortion procedure at 20 weeks’ gestation is $1,195. Given that most abortions are paid for out of pocket, these high costs can be prohibitive for disabled people. Moreover, a 2018 study found that 27 U.S. cities are “abortion deserts”—cities where people must travel at least 100 miles to reach an abortion provider. In addition to the high costs of abortions, which many disabled people cannot afford, some are unable to travel to an abortion provider because of lack of accessible transportation, especially in areas with limited to no abortion providers.

Ultimately, abortion access is essential for people with disabilities achieving some level of economic security. Some disabled people who have abortions likely do so because of their severe economic disadvantage, and increased abortion restrictions will only worsen these inequities. If abortion rights are further restricted, some disabled people will be forced to continue pregnancies and have children against their wishes and economic means, or they will seek unsafe methods of abortion.

Third, people with disabilities have inadequate access to reproductive health services and information, such as sex education and contraception, which makes abortion all the more important. Most people who have abortions do so because having a baby would disrupt their work, education, or ability to care for others. At the same time, research suggests that disabled people have higher rates of unintended pregnancies than nondisabled people. Disabled people also encounter significant barriers to accessing contraception, leading to decreased usage. Significantly, increased access to contraception is statistically associated with a reduction in abortion rates, which means that if disabled people had greater access to contraception they could be less likely to have an abortion.

The high rates of unintended pregnancies among people with disabilities likely also results from inadequate access to sex education and other information about reproduction and pregnancy prevention. Many students with disabilities are denied even basic sex education. Finally, the increased rate of unintended pregnancies among disabled people is also likely a consequence of the inadequate reproductive health care available to them. In other words, the pervasive barriers that disabled people encounter when seeking reproductive health services and information—combined with the numerous inequities they experience—underscore the necessity of abortion rights for disabled people.

Finally, abortion access is significant for people with disabilities because they are uniquely vulnerable to sexual assault, intimate partner violence, and reproductive oppression.

People with intellectual disabilities are seven times more likely than others to experience sexual violence. Disabled people also contend with increased rates of intimate partner violence, which increases their need for abortions. People with disabilities are also at heightened risk of reproductive coercion. Thus, the high rates of sexual assault, intimate partner violence, and reproductive coercion experienced by disabled people likely contribute to increased rates of unintended pregnancies, and consequently an increased need for abortions.

As the Supreme Court moves to overturn Roe, abortion rights activists must recognize the importance of abortion for people with disabilities. The bodily autonomy and self-determination that disabled people have fought so hard for will be completely undermined.

It will have devastating consequences for people with disabilities. It will bring us back to a time when the government controlled disabled people’s bodies—something we are still fighting against today. Disabled people must be intentionally and fully included in all efforts to protect abortion rights. We can no longer wait.

Source: https://rewirenewsgroup.com/article/2022/05/10/abortion-is-a-disability-issue/

Candace Do / The Daily Princetonian

We are about to celebrate our 50th reunion — half a century since we graduated from Princeton. We find it bitter indeed to see the draft Supreme Court opinion reverse the strides we thought we were making, as part of one of the first classes of Princeton women, towards a world of equity and fairness for women of all races and social and economic positions. 

We ask our classmates, and the community of Princeton, to protest the logic that ties us to a constitutional originalism which resists any movement toward justice but, rather, moves us backwards. As Jill Lepore so aptly put it in The New Yorker, “Women are indeed missing from the Constitution. That’s a problem to remedy, not a precedent to honor.” 

Instead, we want to call attention to this urgent truth: We hang on a precipice, balanced between the draft opinion and the final Supreme Court ruling on Roe v. Wade. The right to manage one’s own health and most intimate personal and family decisions without outside interference is at risk right now and should be preserved to ensure social justice for ourselves, for our classmates, and for the world Princeton purports to serve.


Women of 72

Susan M. Squier 

Daryl English

Judith White

Joan Matthews

Helene Fromm 

Holly Lovejoy

Jacqueline Ariail

Claudia M. Tesoro

Barbara Julius

Alice Kelikian

Diana Foster

Meggan Moorhead 

Ann Sease Monoyios

Yaffa Ventura-Beck 

Anna Baird Chitty 

Vera Marcus

Helena Novakova

Angenette Duffy Meaney

Larissa Brown

Sherry Peltz Leiwant

Jerri Donovan

Carol Rahn

Barbara Geller

Mary Watkins

Susan Brownstone Eig

Ellen Moriece Rome

Mary Baldwin

Elizabeth Houghton

Friends of the women of 72:

Christine LaLonde Robinson ‘73

Mara Melum ‘73

Carol Obertubbesing ‘73

Macie Green Hall VanRensselaer ‘73

Beth N. Rom-Rymer, ‘73

Nancy Teaff ‘73

Source: https://www.dailyprincetonian.com/article/2022/05/letter-women-princeton-class-72-classmate-alito-abortion

The intense politicization of abortion in U.S. public discourse obscures its status as a health and health care issue. Medical centers may therefore not be doing the careful preparation needed to manage the health system–wide impact of abortion’s criminalization. What follows is a framework for preparation in a state where abortion will become illegal.

At the University of Michigan, we’ve been actively preparing for the loss of abortion care since the December oral arguments in Dobbs v. Jackson Women’s Health Organization made explicit the Supreme Court’s eagerness to overturn Roe v. Wade. In Michigan, a 1931 law criminalizing abortion will come into effect if Roe is overturned. It’s among the strictest laws in the country, permitting abortion only to “preserve the life” of a pregnant person.

Our preparations to date raise far more questions than they answer. Every new voice joining our efforts brings new questions; thoughtful planning, in this and in everything, requires a diverse set of people at the table.

In Michigan, we’ll be able to continue providing “life preserving” abortion care. When my family planning colleagues and I perform abortions in critically ill patients in the intensive care unit (ICU), it’s reasonably clear that we’re working to “preserve the life” of a pregnant patient. Pregnancy demands intense work from all organ systems, which the bodies of critically ill people often cannot accommodate. Ending a pregnancy is an effort to save them. These patients may have severe exacerbations of underlying conditions, such as heart failure or lupus. Or they may have pregnancy-related illnesses in the first or second trimester, such as eclampsia or chorioamnionitis with sepsis.

Beyond such cases, however, it’s unclear what, precisely, “lifesaving” means. What does the risk of death have to be, and how imminent must it be? Might abortion be permissible in a patient with pulmonary hypertension, for whom we cite a 30-to-50% chance of dying with ongoing pregnancy? Or must it be 100%? When we diagnose a new cancer during pregnancy, some patients decide to end their pregnancy to permit immediate surgery, radiation, or chemotherapy, treatments that can cause significant fetal injury. Will abortion be permissible in these cases, or will patients have to delay treatment until after delivery? These patients’ increased risk of death may not manifest for years, when they have a recurrence that would have been averted by immediate cancer treatment. We’ve identified countless similar questions.

Of course, patients facing such risks are the minority of those currently receiving abortion care. Most will not “qualify” for abortion under Michigan’s law and will have only three options: leave the state for care, self-manage an abortion, or give birth. All three have enormous effects on health systems, including primary care and subspecialist care across adult and pediatric settings. All three affect insurers and medical education programs. And since more than half the medical workforce can become pregnant, health systems’ human resources will also be affected.

People with the necessary resources and support will seek care out of state. Many, especially teens, won’t have those resources. According to the Guttmacher Institute, half of Americans seeking abortion care live on incomes under the federal poverty level and another 25% live on incomes one to two times that level, which may make travel out of reach. In Michigan, the average travel distance for care will increase from less than 20 miles to more than 260 miles. Most patients seeking an abortion are already parents, so travel is complicated by child care needs. Many cannot afford to lose wages or will be fired if they take time away.

Nevertheless, health systems in states where abortion is illegal will play vital roles for patients who can leave their state. Clinicians in states with bans should (but may not be allowed to) offer referrals or pretravel “teeing up.” This may include ultrasound, blood work, and perhaps “fast track” subspecialist consultation to ensure that patients with underlying illnesses can safely receive care on arrival at an out-of-state outpatient facility. Hospital systems will need to determine whether neighboring states will have capacity to see their patients who require hospital-level care and will need to develop plans for transferring already hospitalized patients across state lines. Insurers will need to decide whether to cover out-of-state abortion care and associated travel expenses.

The second option is self-managed abortion. Over 20 years’ experience shows that pregnant patients can safely have an abortion at home after receiving the Food and Drug Administration–approved regimen of mifepristone and misoprostol in a medical office. Increasing evidence from around the world shows that self-sourced mifepristone and misoprostol, and misoprostol alone, are safe and effective as well.1 Patients without access to these medications — those without Internet access or a credit card, or with no private way to receive mail, or those who simply don’t know about it — might use methods that are ineffective or, worse, dangerous. These may include insertion of implements, objects, or caustic substances into the cervix or vagina; ingestion of poisons; or intentional trauma. Many care providers, out of compassion and conscience, will want to steer people away from potentially life-threatening methods and toward safe ones, though some states may try to prohibit even such guidance. Health systems should consider what a “harm reduction” approach to abortion would look like in their setting.2

Health care providers, especially in emergency department and primary care settings, will need to become familiar with the normal course of self-managed abortion with medications and its rare complications, as well as complications of unsafe methods. Because medication-induced abortion is safe, many patients who seek follow-up care will require only confirmation that their abortion is complete or outpatient intervention if it’s incomplete. Ensuring that abortion is complete is also important because misoprostol can be associated with fetal birth defects in the rare cases in which it does not end the pregnancy. Patients who use unsafe methods, on the other hand, may require lifesaving critical care for sepsis, hemorrhage, pelvic-organ injury, or toxic exposures. Clinicians will need to intervene only rarely in cases of mifepristone–misoprostol use and simultaneously be ready for aggressive treatment when patients use dangerous methods.1

Because mifepristone and misoprostol are safe, the biggest risks to patients may be legal ones: threat of reporting, arrest, and detention. Pregnant patients who have bleeding in pregnancy or pregnancy loss may be vulnerable to reporting and criminal prosecution, whether they took measures to end the pregnancy or are having a miscarriage; spontaneous pregnancy loss and self-managed abortion with medications are virtually indistinguishable. Data show that health care providers are most likely to report Black pregnant patients and those living on low incomes to the authorities.3 Hospitals will need clear policies for all staff regarding this risk and regarding medical record documentation in this new climate. Currently, no state requires reporting of suspected self-managed abortion.1

People who can’t travel for care or manage their own abortion will give birth. Recent unpublished updates to older estimates — from economist Caitlin Myers and other researchers — are that 18 to 57% of women deciding to end a pregnancy in counties where travel distances for abortion care increase will give birth.4 This estimate translates to a 5-to-17% increase in births in Michigan, which already has maternity care deserts. Requiring labor and delivery units to work over capacity will affect all birthing people, not just those who would have ended their pregnancy. It will affect newborn care as well. Neonatal ICUs, and later pediatricians, will see more babies, including some with substantial medical needs in infancy and beyond, whose parents might have ended their pregnancy after receiving fetal anatomical or genetic diagnoses. It is not at all clear that medical and social safety nets for families of children with disabilities or complex medical needs will expand as need does.

Maternal mortality will increase because abortion is far safer than childbirth. Data from the Centers for Disease Control and Prevention show that the risk of dying from childbirth is 50 to 130 times greater than dying from an abortion. Demographers estimate that maternal mortality will increase by 21% under a ban — but, echoing existing disparities, 13% among White and 33% among Black birthing people.5 These estimates don’t account for additional likely increases in mortality from unsafe abortion. Undoing the systemic inequities and racism that lead to such disparities will become even more urgent than it already is.

The perinatal mental health needs of pregnant patients who are continuing undesired pregnancies, including those resulting from sexual assault, will undoubtedly intensify as well, further stressing an overtaxed mental health care system.

The implications of an abortion ban extend to additional dimensions of reproductive health care. Absent clear policies permitting it, doctors may hesitate to treat patients with ectopic pregnancy, inevitable miscarriage, or previability rupture of membranes when fetal cardiac activity remains. Hospital pharmacies, doctors, midwives, and advanced practice clinicians will need to consider whether they’ll continue to stock and offer the best evidence-based medication treatment for spontaneous abortion — mifepristone and misoprostol, the same medications used in abortion care — whose use could bring accusations of criminal activity. Infertility care practices may need to halt provision of selective reduction for multifetal pregnancies resulting from superovulation or in vitro fertilization (IVF); without multifetal reduction, loss of the entire pregnancy, premature delivery with concomitant risks of neonatal complications or death, and clinically significant maternal complications are likely. Some IVF practitioners may decline to provide treatment altogether, given the potential for embryo loss in IVF. And health care providers everywhere will need to ensure all forms of contraception are readily available, without barriers to access.

The overturn of Roe will also affect medical education. Abortion training opportunities are required for accreditation of obstetrics and gynecology residency and complex family planning training programs, and they are an integral part of some nursing, midwifery, advance practice clinician, family medicine, maternal–fetal medicine, and gynecologic oncology training. Programs will need to consider out-of-state training, with its accompanying licensure and logistic issues. Patients will feel the downstream effects if abortion training halts: if trainees can’t learn “non-lifesaving” abortion care, within a generation there may be no one left to perform “lifesaving” abortions. Routine care such as miscarriage management will also be affected; one of the best predictors of a physician’s providing the full range of miscarriage-management options is having had abortion care training as a resident.

Finally, our health system is disproportionately “manned” by women — including nurses, medical assistants, administrative assistants, inpatient-unit clerks, phlebotomists, x-ray technicians, and more, as well as physicians. It’s not clear how smoothly health systems will function when a larger fraction of the workforce is pregnant, on parental leave, or traveling for abortion care.

Health systems that view abortion exclusively as a political or partisan issue, perhaps one they’d like to avoid, will soon bear witness to the reality that abortion care, or lack thereof, is a health care and health equity issue. Avoiding the issue will not be possible, short of abandoning care and equity missions altogether. Thoughtful preparation is needed now.

Source: https://www.nejm.org/doi/full/10.1056/NEJMp2206246?query=TOC&cid=NEJM%20eToc,%20May%2012,%202022%20DM1031907_NEJM_Non_Subscriber&bid=972898681

Louisiana’s anti-abortion Democratic governor John Bel Edwards has, thus far, supported abortion restrictions in the state.
 Josh Brasted/Getty Images for Resilience Force

Louisiana Republicans want abortion to be a homicide—despite admitting it’s unconstitutional.

When news of the leaked draft Supreme Court opinion overturning Roe v. Wade broke last Tuesday, protesters gathered across the country to voice their dissent—including in Louisiana. A day later, state lawmakers ignored those cries, advancing a bill that, if passed, would criminalize abortion as homicide.

Last Wednesday, Louisiana HB 813 advanced out of legislative committee and was sent to the full House for debate, “despite at least one of the representatives voting in favor acknowledging the bill is unconstitutional,” the Daily Advertiser reported.

Because fuck the Constitution, right?

The bill establishes fetal “personhood” and criminalizes all abortions as homicide “without regard to the opinions and judgments of the Supreme Court of the United States in Roe v. Wade.”

Because, apparently, fuck the highest court in the land too!

Louisiana HB 813 is not “just” an abortion ban. This is an entire revocation of pregnant people’s rights and the criminalization of pregnancy outcomes. Everything from miscarriage care to IVF will be affected—and pregnant people will have no say in any of it.

As it stands, the bill has no exceptions: Not for rape, incest, or the life of the pregnant person—no matter how old they are. But Louisiana lawmakers have already made it pretty clear they don’t care about their youth, having introduced HB 989 earlier this year, which further complicates the judicial bypass process and requires the order to expire after ten days even if it is granted.

Oh, and people of color? Black women? The people who make up about 42 percent of Louisiana’s population and 72 percent of those receiving abortions? They’ll have no say in the matter either.

With a GOP-controlled legislature and an anti-abortion Democratic governor, John Bel Edwards, there’s little to stop this bill turning Louisiana into a surveillance state where pregnant people have fewer rights than fetuses.

Source: https://rewirenewsgroup.com/article/2022/05/09/louisiana-bill-would-jail-patients-for-abortions/

Abortion activists protesting outside the Supreme Court on Monday.
 Austen Risolvato/Rewire News Group

The moment we’ve warned about is here—a leaked opinion draft, first reported by Politico, shows the Supreme Court is poised to overturn Roe v. Wade.

Last night, Politico’s Josh Gerstein and Alexander Ward leaked a purported draft opinion in Dobbs v. Jackson Women’s Health Organization that overturns both Roe and Casey—on the heels of congressional Republicans preparing to take the Texas abortion ban nationwide.

Yes, you read that correctly. The moment we’ve been warning about is here.

Politico’s reporting of a leaked draft of the Supreme Court opinion that fully overturns Roe v. Wade and Planned Parenthood v. Casey—written by the ultimate civil rights troll Samuel Alito and confirmed Tuesday morning in a statement by Chief Justice John Roberts—took my breath away.

The conservative justices were deadly serious when they suggested during oral arguments in Dobbs v. Jackson Women’s Health back in December that they were open to entirely rewriting abortion rights jurisprudence. We should take them at their word, even if that word is, for the moment, a leaked draft opinion.

But there’s more. Republicans are already making plans based on that leaked draft opinion.

How do I know this? For starters, as the Washington Post reported this week, while abortion-friendly states look to shore up protections while they can, leading anti-abortion advocacy groups and their congressional buddies have been meeting behind the scenes to hash out a strategy for taking Texas’ near-total abortion ban nationwide.

Energized by the Supreme Court allowing Texas SB 8 to take effect in September and anticipating a big win in the Mississippi 15-week abortion ban case Dobbs v. Jackson Women’s Health, some Senate Republicans are reportedly looking to advance a bill that would ban abortion nationwide as soon as fetal cardiac activity can be detected, which can be as early as six weeks in pregnancy.

We need to believe Republicans when they say banning abortion nationwide will be a top priority if they take power in 2024. And we also need to remember that they have a history of changing the rules to get their way (remember Supreme Court nominee Merrick Garland?), and prepare for the very real possibility that the 2024 presidential fight will be all about abortion.

Conservatives love to project their plans, and this plan to ban abortion across the country—states’ rights be damned—is one of their top priorities.

In fact, the conservative propaganda machine is already grinding out there on this strategy. Last week the Wall Street Journal published an op-ed expressly calling on the Court to overturn Roe in the Mississippi case. In a piece titled “Abortion and the Supreme Court,” the Journal’s editorial board really goes for it: “This is the moment for the Justices to return the issue to the voters.”

Here’s the key bit:

Far better for the Court to leave the thicket of abortion regulation and return the issue to the states. A political uproar would ensue, but then voters would decide on abortion policy through elections—starting in November. … In Dobbs the Court can say that such a profound moral question should be decided by the people, not by nine unelected judges.

A central piece of anti-choice propaganda is that overturning Roe would simply “send abortion back to the states” and that would be the end of that, as the Journal’s editorial board suggests. But in the span of less than a week, conservative activists have proven this is a lie by forecasting their plans for a nationwide ban that absolutely removes abortion from the states entirely.

We’ll see a lot more of this kind of presto chango nonsense from conservatives once the Court releases its decision in Dobbs v. Jackson Women’s Health and the fallout accelerates. Trust that I’m going to call it out every time.

Source: https://rewirenewsgroup.com/article/2022/05/03/the-supreme-court-draft-opinion-heard-round-the-world/

With Roe at death’s door, will the party finally change its tune?

Protesters in New York City’s Foley Square demonstrate against a Supreme Court draft opinion striking down Roe v. Wade. Photo: Sabrina Santiago

The news of Samuel Alito’s draft majority opinion overturning Roe v. Wade on Monday didn’t just break — it shattered. It was the unexpected timing, yes. And the unprecedented nature of the leak. And the retro-pig stylings of the draft’s author, who made ample use of the term “abortionist” and unctuously averred that “a right to abortion is not deeply rooted in the Nation’s history and traditions,” as if any of the hard-won protections of oppressed classes were deeply rooted in this nation’s history and traditions. But it was also, simply, the reverberations of the hammer dropping, sending the chill of undeniable reality down every spine — of family and friends and, one would think, the highest-ranking Democrats in Congress.

But as millions reeled on Monday night, the top leadership of the Democratic Party could only generate words that ultimately felt bloodless. In a joint message, Nancy Pelosi and Chuck Schumer called the draft “an abomination, one of the worst and most damaging decisions in modern history,” yet still could not bring themselves to use the word abortion. They said that the “party of Lincoln and Eisenhower has now completely devolved into the party of Trump,” and seemed to revel in the fact that every Republican senator who voted for Trump’s justices “will now have to explain themselves to the American people,” as if this would provide any comfort to those who are apparently on the brink of losing a right that has been protected for 50 years.

Joe Biden waited until 9:30 Tuesday morning to publicly weigh in with a statement that was also allergic to the word abortion, mentioning it only once, four paragraphs down. Biden made pleas to “basic fairness” and “the stability of our law,” concluding with a message that it was “on voters to elect pro-choice officials this November.” Sir, we elected you, and you didn’t get out of bed to speak to the American people the night this devastating document leaked.

It was not just that the party leadership gave us anemic utterances when they should have treated the leak as the emergency that it is, with siren emoji. It was that they got the story wrong, just as they have gotten the story wrong for decades.

Schumer and Pelosi’s bizarre assertion that this looming rollback of rights was emblematic of “the party of Trump” is profoundly ahistorical. The overturn of Roe, whatever form it takes, will not be the product of the “party of Trump.” It is the party of Ronald Reagan, who came to power in 1980 on a platform that included a “human life amendment.” It is the party of George H.W. Bush, who flipped on his previous support for abortion rights to become Reagan’s vice-president and, eventually, his successor to the White House. It’s the party that put Clarence Thomas and Samuel Alito on the bench. It is the party that stole a Supreme Court seat from a president who was elected by a majority of voters, and that used the Electoral College and the Supreme Court itself to ensure the White House was occupied by Republican presidents who had lost the popular vote, but could nevertheless appoint justices who had been grown in a Federalist Society lab to strike down freedoms supported by a majority of Americans.

So no, where America finds itself is not in a world transformed by Donald Trump. Rather it’s one in which generations of Republicans have been open about their brutal aim, while Democratic leaders have repeatedly asked voters to trust them in a fight that, up to the very night Roe was struck down in draft form, they refused to accurately describe or perhaps even discern.

That communicative failure points to one of the ways that Democratic leadership has been repeatedly outstripped by their opposition. Yes, the right has strategized on a local level, manipulated systems more cannily, and invested patiently, building their power over years while Democrats have gone for short-term plays.

But what the right has also been far better at is telling stories. So much of their power has been built on compelling narrative, racist parables, xenophobic tall tales, sexist fables, pulled-from-the-ether fictions that they have committed to with every fiber of their regressive and punitive hearts and sold with gusto to an American public. Think about the characters invented out of whole cloth: Fraudulent voters! Welfare queens! Comet Ping Pong sex traffickers! Donald Trump, successful businessman! Brett Kavanaugh, who believes in stare decisis!

Among their most successful characters has been the fetus: a figure with pudgy cheeks and a fully formed heart, bearing little relationship to any developmental or biological reality. The lies built around the fetus are easily disproved; no party that actually valued this guy — and the culture of life, family, and innocence they claimed he embodied — would also starve real live children of food, housing, health care, and education.

But rhetorically, Democrats have had their lunch money stolen repeatedly by these fantasists. In part because, while Republicans could commit to their bit with theatrical force, the left has been unwilling to embrace the real, nonfiction, moral urgency of their cause. The narrative material, the compelling claim on the hearts and minds of voters who want more justice and more equality, has been sitting right there for Democrats this whole time. And unlike the right-wing stories, this narrative has the benefit of being true: how a right to abortion is fundamental to human and familial flourishing, to dignity and economic security, to health and love and happiness and thriving.

There have been Democratic politicians who have tried. I will never forget listening to Wisconsin representative Gwen Moore, who had been on her way to Radcliffe College when she found herself unintentionally pregnant at 18. She spoke movingly on the House floor in 2011 of how, in 1970, she didn’t even have the dime to use a pay phone to call an ambulance when she went into labor, how as a single mother on meager welfare benefits she often had to stretch formula with water and feed her three children ramen “at the end of the month to fill up their little bellies so they won’t cry.” She connected the lack of reproductive health care to lack of affordable housing and other government-supported injustices, pointing out that opponents on the right don’t even want the children whom they’d force into the world to have health insurance: “Public policy has treated poor children and women … with utter contempt.” Moore knew who she was fighting and what she was fighting for.

So did her colleague Jackie Speier, a California congresswoman who in that same session was moved to unexpectedly speak of the abortion she’d had, when a wanted pregnancy had gone wrong at 17 weeks gestation. Later, Speier would describe how her offices had been flooded with calls from “people crying on the phone,” relaying their own experiences of having needed abortion care.

These stories — stories that clearly resonated, that went viral even — were not taken up as gospel, were not repeated by their party’s leadership all over cable television and on the radio, were not made the center of a Democratic fight. Instead, leadership submitted to the fiction that abortion is an issue that is too electrically charged and too dangerous to take up full-throatedly, even though 70 percent of Americans do not want Roe overturned.

Democrats have truth and majorities and moral righteousness on their side, but they seem more interested in leveraging their role as purported stewards of reproductive rights to win the next race. There is already an abundance of Beltway chatter about how the backlash to Dobbs v. Jackson Women’s Health Organization could mean a reversal in Democrats’ dismal midterm fortunes. It’s the kind of horse-race speculation that is stomach-turning for anyone who has actually stopped to consider how many people will face criminalization, forced births, and an inability to get care they want or need, so that Democrats can scoop up a couple of swing seats. And for what? If they avoid a drubbing thanks to Dobbs — which is a dubious bet — what will they do with their winnings?

None of what is unfolding now is about short-term strategy or single-cycle results. Nor is it about a single presidential administration. When Roe is gutted or gone, we are looking at decades, lifetimes of harm, and a whole new terrain, in which the perils will not look like those of the past.

The Democratic Party shouldn’t look like the past either. The fight into the future must be different — really different — than it has been over the past five decades, since the old way of business has seemingly resulted in a colossal failure that the party has yet to reckon with, let alone take any responsibility for. That fight must be led by new voices, many of whom have been characterized by their more timid colleagues as disruptive and difficult, as radical and controversial, even when the cases they are making are in fact very popular with American voters, when the persuasive and powerful stories they tell are real.

In the hours after the decision draft was leaked, California representative Katie Porter pointed out that “not a single justice knows what it’s like to be one of the 10-plus million single parents in America. I do, and I support a woman’s right to choose.” Washington representative Pramila Jayapal tweeted, “As one of the 1 in 4 women in this country who have chosen to have an abortion, I am outraged & disgusted.” Alexandria Ocasio-Cortez called on Congress to codify Roenoting sharply and righteously that “people elected Democrats precisely so we could lead in perilous moments like these … It’s high time we do it.” Elizabeth Warren, livid on the streets of Washington, offered a corrective to the lame, pointless “party of Trump” narrative laid out by her bosses, correctly stating, “The Republicans have been preparing for this day for decades.”

The tragedy is that the Democratic Party now faces its own decades-long battle. Decades of cruelty and injustice. Decades in which there will be ample, grievous time to get the stories right.

Source: https://www.thecut.com/2022/05/roe-v-wade-abortion-democrats.html?fbclid=IwAR0vdbVPfTvmfn4Dns97jk2PjqYgr0hnuVF0_QyGWwg7xlE0r4Gpowy3ufE