Abortion Information


The legal fight around medication abortion – the two-pill regimen that allows women to terminate their pregnancies – escalated Wednesday with separate lawsuits filed in two states challenging their restrictions on the method.

One lawsuit was filed by GenBioPro, a major manufacturer of mifepristone, which is the first drug used in the medication abortion process, in West Virginia challenging the state’s laws limiting access to the drug, including the outright ban on abortion lawmakers passed last year.

The second lawsuit was filed by an OB-GYN in North Carolina and targets the requirements that state places on obtaining abortion pills that go beyond the federal standards for provision of medication abortion.

The lawsuits represent one of several new legal battlefronts that have emerged since the Supreme Court’s June ruling that reversed the decades-old Roe v. Wade precedent protecting abortion rights nationwide, allowing states to implement restrictions and bans on the procedure.

Medication abortion, which now makes up a majority of abortions obtained in the United States, has become a particularly acute flashpoint in the fallout from the Supreme Court’s decision. In November, anti-abortion advocates sued the US Food and Drug Administration, seeking to block its 20-year-old approval of mifepristone; the Texas federal court where that lawsuit was filed could rule as early as next month whether the FDA’s abortion pill policies should be halted.

While many states already have laws that prohibit medication abortion, legislators have signaled they’ll be exploring new ways to clamp down on the avenues abortion-seekers have for accessing abortion pills as statehouses reconvene this year.

The two new lawsuits in North Carolina and West Virginia make similar arguments, alleging those states’ restrictions run afoul of the US Constitution because they are preempted by federal law that gives the FDA the authority to approve and regulate medication abortion.

GenBioPro argues that West Virginia’s laws violate the authority the Commerce Clause grants Congress to regulate interstate commerce. Amy Bryant, the medical provider suing in North Carolina, alleges that the state’s stringent requirements on where women can access abortion pills, as well as its mandated waiting period for obtaining an abortion, are imposing “unnecessary costs on Plaintiff and her practice and interfere with her ability to provide medical care to her patients according to her best medical judgment and in accordance with federal law.”

A spokesperson for North Carolina’s Attorney General Josh Stein, a Democrat who is a defendant in the North Carolina lawsuit, said that his office was reviewing the complaint.

West Virginia Attorney General Patrick Morrisey, a Republican who was sued in the GenBioPro lawsuit, said in a statement his office was “prepared to defend West Virginia’s new abortion law to the fullest.”

“While it may not sit well with manufacturers of abortion drugs, the U.S. Supreme Court has made it clear that regulating abortion is a state issue,” Morrisey said. “I will stand strong for the life of the unborn and will not relent in our defense of this clearly constitutional law.”

Source: https://edition.cnn.com/2023/01/25/politics/abortion-mifepristone-west-virginia-north-carolina/index.html

Mainstream anti-abortion activists have long insisted they don’t want to punish people who get abortions. Now, that claim is being put to the test.

Mainstream anti-abortion activists have long insisted they don’t want to punish people who get abortions. Now, that claim is being put to the test.

Although many states are only a few weeks into their first state legislative sessions since Roe v. Wade was overturned, legislators in Arkansas and Oklahoma have already introduced bills that would punish abortion patients. In Alabama, the state’s attorney general initially said he could use a state law to punish people for ending their pregnancies, then tried to walk it back

These kinds of tactics are forcing anti-abortion activists to confront a long-simmering tension within their movement: What are they supposed to do with people who get abortions? Typically, abortion restrictions target providers, not patients. Within the anti-abortion movement, patients are treated like victims who have been bamboozled into ending their pregnancies by the predatory “abortion industry.” But now that Roe is gone and states are proposing policies to legally treat fetuses like people, that may not hold water for much longer.

“I think there are some people, and probably a fairly large group of people, for whom women’s innocence is conditional and they could be persuaded that it’s not real,” said Mary Ziegler, a professor at the University of California, Davis, law school who studies the legal history of reproduction. 

Speakers at the March for Life and National Pro-Life Summit in Washington, D.C. last weekend repeatedly suggested that only a lack of knowledge keeps abortion patients from seeing the “truth” about abortion, and that they can be converted to the anti-abortion cause. This is part of the thinking behind “sidewalk counseling,” the practice of standing outside abortion clinics to convince patients not to go inside, and behind crisis pregnancy centers, facilities that try to persuade people to continue their pregnancies. 

“We as pro-lifers have things in the right order, right?” Lauren Muzyka, of Sidewalk Advocates for Life, told National Pro-Life Summit attendees. “God comes first, a mother puts a child before herself. So you might say the right order, the natural law order, is God, baby, mom. But a woman in crisis mode, a woman in self-preservation mode, has all of that inverted.” Muzyka suggested that attendees find out how far into a pregnancy a patient is, then give them information about a fetus’ development. “We need to do everything in our power to meet her where she’s at and love her into a decision for life.”

But “fetal personhood,” the idea that fetuses deserve the full rights and protections granted to humans who have been born—and sometimes, that a fetus’ rights trump those of the person carrying them—also lies at the heart of the anti-abortion movement’s argument that abortion is wrong. Assuming the perspective of an anti-abortion activist, Ziegler asked, “If we’re serious about personhood, how can we not punish women?”

The Arkansas bill proposes that “all unborn children should be protected under the state homicide laws,” which could lead abortion patients to be prosecuted as murderers. The Oklahoma bill, introduced by Republican state Sen. Warren Hamilton, would amend the state’s current near-total abortion ban to remove language that currently blocks prosecutors from charging “a woman with any criminal offense in the death of her own unborn child.” 

This move isn’t totally unexpected from Hamilton, who in 2020 announced he would introduce a bill called, in part, the “Abolition of Abortion in Oklahoma Act,” which also banned abortion. He changed the name when he filed it in 2021, but the word “abolition” carries a unique weight within the anti-abortion world: A wing of activists who now identify as “abortion abolitionists” believe that abortion should be legally categorized as murder and that, because a fetus is a person, individuals who get abortions should be punished like murderers. (The anti-abortion movement, in general, is largely white.)

Ahead of his 2020 election, one of the major “abolitionist” groups, Free the States, endorsed Hamilton. Hamilton’s office did not immediately respond to a request for comment on his new bill.

Bills with “abolitionist” underpinnings have popped up intermittently in recent years. In 2021, a Texas legislator introduced a bill that would threaten abortion patients with the death penalty; similar legislation was also introduced in 2017 and 2019. Those bills, which proved to be PR disasters for anti-abortion activists, never advanced very far in the Texas legislature. Republicans and leaders of national anti-abortion organizations have condemned them; Catherine Glenn Foster, head of the influential organization Americans United for Life, told Vox of the 2019 Texas bill, “It’s something that I would fight back against and everyone I know in the movement would fight back against.” Hundreds of people testified at a committee hearing on the bill.

Punishing people for abortions is an incredibly unpopular position. Just 14 percent of U.S. adults say women should serve jail time if they have an illegal abortion, according to Pew Research Center. Even Republicans dislike the idea; just 21 percent think that women should be jailed. Sixteen percent of adults, though, say she should pay a fine or perform community service, while another 17 percent aren’t sure what should happen.

Men are also more likely than women to say that a woman should face a penalty for an illegal abortion.

Although abortion bans tend to punish medical providers, that idea is divisive, too: Only a quarter of U.S. adults support sending doctors and other providers to jail for performing illegal abortions, according to Pew.

However, abortion rights are also very popular. Three in five Americans believe abortion should be legal in all or most cases. Yet, thanks to years of dedicated and disciplined organizing, the anti-abortion movement successfully overturned Roe. 

It’s not that there are now more abortion “abolitionists,” according to Ziegler, but those who exist are becoming better organized. They may also be set to take advantage of what Ziegler calls “the enforcement problem.” Although abortion bans are now in effect in at least 13 states, those bans are proving difficult to enforce, thanks to the availability of abortion-inducing pills online and people’s ability to travel across state lines for abortions. 

Under current law, if a doctor performs an abortion on a person from a state with an abortion ban, that doctor isn’t at risk of prosecution. (One congressman from Indiana did recently say he would support legislation to stop someone from traveling out of state for an abortion in the first place.) Frustration with that loophole may lead some activists to push to punish someone, anyone, for getting an abortion—and the patient is usually the most visible target.

“Some people are saying, ‘What else are we really supposed to do?’” Ziegler said. “If the doctor or the abortion fund or whatever is in a different state or a different country and we want to stop this abortion and we don’t have a national tool, the only option left is punishing the pregnant person.”

Source: https://www.vice.com/en/article/5d3xgk/anti-abortion-murder-charge-bills

Former US President Donald Trump during the America First Policy Institute’s America First Agenda Summit in Washington, D.C., US, on Tuesday, July 26, 2022. Photographer: Al Drago/Bloomberg via Getty Images

The anti-abortion “March for Life” for decades demonstrated to Republicans that they could not reach the Oval Office without the support of the anti-abortion movement.

On Friday, marchers will gather in Washington with a decades-long mission accomplished, after the Supreme Court’s removal of a constitutional right to an abortion by overturning the Roe v. Wade decision last year.

That means this year’s march will be a time for celebration but also of debate about where the movement goes next with some campaigners seeking to restrict the procedure everywhere. But such a refocused goal carries big risks. Democrats after all belatedly leveraged their own energy over abortion in the midterm elections in a backlash against the right-wing Supreme Court majority that helped stave off a big Republican midterm election wave.

The March for Life also comes at an extraordinary moment when Donald Trump, the president who did more than any other to end Roe after a pact with social conservative voters that helped win him the 2016 GOP nomination, has launched an extraordinary attack on evangelical leaders he sees as insufficiently loyal, as CNN’s Gabby Orr, Kristen Holmes and Kaitlan Collins reported this week.

“Nobody has ever done more for Right to Life than Donald Trump. I put three Supreme Court justices, who all voted, and they got something that they’ve been fighting for 64 years, for many, many years,” Trump said in an interview on Real America’s Voice Monday, referring to the overturning of federal abortion rights.

“There’s great disloyalty in the world of politics and that’s a sign of disloyalty,” Trump told conservative journalist David Brody.

The comment was a window into Trump’s psychology, revealing his transactional understanding of politics and his highly developed sense of fealty he sees owed to him.

Trump nurses grievances – and political fears

The former president is specifically angry over the failure to immediately endorse his 2024 White House bid by some evangelical leaders who remain influential figures in the conservative movement. Trump’s third White House run has so far failed to pick up significant energy.

But Trump has also shown signs recently of questioning whether his purported greatest domestic achievement – the building of a generational conservative Supreme Court majority and its subsequent overturning of Roe – may end up hindering his hopes of a return to the White House in 2025. He wrote on his Truth Social platform earlier this month that the “abortion issue” had been poorly handled by many Republicans, especially those who insisted on no exceptions in the case or rape, incest or life of the mother, which he said “lost large numbers of voters.”

The former president’s comments are backed by exit polls from November’s midterms that showed more than a quarter of voters listing abortion as a top issue. About 61% said they were unhappy with the Supreme Court’s overturning of Roe v. Wade, and about 7 in 10 of those voters backed a Democratic House candidate.

In his Truth Social comments, Trump appeared to be seeking to offload blame for the Republicans’ failure to win back the Senate and the party’s smaller-than-expected House majority. Trump took on waves of criticism after the election for promoting extreme, election denying candidates who often lost in swing states in the midterm elections.

But it is notable seeing Trump navigate the shifting politics of abortion and apparently sizing up how it could affect his political prospects in future. After all, he was once unapologetically pro-choice before his foray into Republican politics dictated a shift in position and led to the bargain with evangelicals, which included an effective commitment to appoint anti-abortion justices to the Supreme Court in return for the crucial votes of social conservatives.

In the past, Trump has been a fixture of the March for Life rally, and in 2020, he became the first sitting president to attend in person as he geared up for his reelection race. He told marchers that “unborn children have never had a stronger defender in the White House.”

There is no sign yet that he will call into Friday’s event, which will include a detour to the US Capitol on its usual route to the Supreme Court to underline how Congress is now a focus of the movement, as Democrats seek to codify Roe v. Wade protections into law.

Did Trump make a tactical error?

Trump’s comments on abortion and his feuding with evangelical leaders raise the question of whether the former president has made a tactical error and is harming his 2024 candidacy by targeting a critical GOP primary voting bloc at a time when there are growing questions over whether he is still the dominant force in Republican politics.

Ralph Reed, the executive director of the Faith and Freedom Coalition, told CNN that there is “no path to the nomination without winning the evangelical vote. Nobody knows that better than President Trump because, to the surprise of almost everyone, he won their support in 2016.”

This question is especially acute in Iowa, the first-in-the-nation caucuses – for Republicans at least – in the 2024 primary season, which will be the first test of the ex-President’s hold over conservatives and evangelicals especially.

Trump didn’t actually win in Iowa in 2016, coming second to Texas Sen. Ted Cruz and just beating out Florida Sen. Marco Rubio, and the state has often not been a true barometer of how the GOP nominating contest will go.

However, it will take on extra significance in 2024 and is likely to be seen as a strong indicator of Trump’s appeal to the conservative base. A loss there would create a painful narrative as he headed into subsequent contests – especially since he strongly carried the state in the general elections in 2016 and 2020.

And it’s easy to come up with a list of potential GOP candidates that might have appeal in the state if they challenge Trump, including Florida Gov. Ron DeSantis, South Dakota Gov. Kristi Noem, former Vice President Mike Pence or Cruz once again. Only Trump so far is a declared 2024 Republican presidential candidate.

Trump would be in an odd situation in 2024, in that he is in many ways effectively an incumbent given his strong support in the GOP and the fact that he didn’t go away after losing reelection. But at the same time, he’s not a sitting president and looks likely to face a contested primary and so may be more exposed in early contests.

Still, while some conservative base voters might want to move on, there’s still strong goodwill among many toward Trump, gratitude for the change he brought during his term and admiration for his attitude.

“Many people forgave him for his misstatements and his missteps because they generally liked his ability to fight, even if that became a cliché for some people, Trump’s detractors,” said Timothy Hagle, an associate professor of political science at the University of Iowa who is an expert on the state’s politics.

This gets to point often missed about Trump. For many of his supporters, he offered an emotional as much as a political connection. His willingness to say what many grassroots conservatives thought and to assail institutions they despised, like the media or Washington experts and other elites, were as important as many of his often-ill-defined individual political positions.

And it’s also often forgotten that evangelical voters in places like Iowa do not necessarily vote as a bloc, or according to what their leaders or pastors recommend and may prioritize issues such as taxes over social questions if a candidate is deemed to be generally acceptable. That may give Trump more leeway than more conventional candidates in departing from traditional conservative orthodoxy even over abortion.

Still, Hagle said, even small numbers of disaffected Iowa voters could make a difference to Trump’s chances in the state if they don’t show up for him, as could more mainstream GOP caucus voters who may be taking a look at other aspects of his candidacy and those of potential rivals.

“Are they going to support Trump because he fights, or because of his economic position or his position on the border?” Hagle said. “The abortion stuff may not be as important to them, or will they go a different direction at this point?”

Source: https://edition.cnn.com/2023/01/20/politics/donald-trump-march-for-life-abortion/index.html

Anti-abortion demonstrators march toward the US Supreme Court during the March for Life on January 20 in Washington, DC.


Sunday marks exactly 50 years since the US Supreme Court granted American women abortion rights with the Roe v. Wade ruling – and comes about seven months after the court opened the door for much of the country to take them away with Dobbs v. Jackson Women’s Health Organization.

The court instantly created new fault lines throughout the country when it handed more control of abortion rights back to states. It also may presage a new rift within the GOP.

At this moment of greatest triumph for abortion rights opponents, there are real questions about how far lawmakers and potential 2024 presidential candidates will go to prove their opposition to abortion.

Pushing a 15-week ban in Virginia

One potential presidential candidate, Virginia Republican Gov. Glenn Youngkin, told Virginians to “choose life” during his State of the Commonwealth address this month. He’s backing that call up by pushing toward a 15-week ban. Current state law allows for abortion care up to about 26 weeks.

It would be a genuine achievement for Youngkin in Virginia, since he shares power at the legislative level in the state with Democrats, who have vowed to scuttle his plan.

A ‘nudge’ for DeSantis to go further than 15 weeks

Florida Gov. Ron DeSantis signed a 15-week ban into law before the Dobbs decision last year, but given the Republican majority in his state, he’s now being criticized by some conservatives for not going nearly far enough.

An aide to another potential GOP presidential candidate, Gov. Kristi Noem of South Dakota, has criticized DeSantis for not endorsing a more forceful restriction on abortion rights.

South Dakota has a near-total ban and, asked about DeSantis, Noem told CBS News this week that other Republican governors should do more.

“I would nudge every governor to do what they can to back up their pro-life record,” she said.

DeSantis is uncharacteristically quiet

When I asked CNN’s Florida politics expert Steve Contorno how far he expects DeSantis could go to restrict abortion rights, he told me the normally bombastic DeSantis has been sidestepping specifics ever since the Dobbs decision came out.

DeSantis released a vague statement promising to “expand pro-life protections” but has otherwise used an ongoing legal case over the 15-week ban as a shield for discussing what further steps he would take.

“People on both sides of the abortion debate have told me they expect some kind of legislation will come up that pushes the limit earlier than 15 weeks that could blunt further attacks like the one from Noem, but it’s not clear if DeSantis would support a full ban,” Contorno told me.

A ban that goes into effect after fetal cardiac activity is detected could be an alternative, he added, pointing out that DeSantis supported that type of legislation during his first run for governor in 2018.

Contorno also pointed out that Florida’s new Senate president, Kathleen Passidomo, told the Tampa Bay Times/Miami Herald she wants a 12-week abortion ban, but that she would include exceptions for rape and incest that are absent from the 15-week ban DeSantis signed into law last year.

Trump is feuding with evangelicals

Meanwhile, former President Donald Trump – who has announced he’s running again in 2024 – wants more credit from evangelical leaders for delivering the right-wing Supreme Court that is working its way through a total reexamination of US legal precedent and individual rights.

“Nobody has ever done more for Right to Life than Donald Trump,” Trump told the conservative journalist David Brody. “I put three Supreme Court justices, who all voted, and they got something that they’ve been fighting for 64 years, for many, many years.”

He alleged “great disloyalty” among evangelical leaders not appropriately supporting him now.

CNN’s Kristen Holmes, Gabby Orr and Kaitlan Collins wrote this week about Trump’s frustration with anti-abortion activists for not bringing more voters to the polls last November.

On his social media platform, Trump said abortion hardliners cost the GOP votes, especially “those that firmly insisted on No Exceptions, even in the case of Rape, Incest, or Life of the Mother.”

It is the definition of a Trumpian contradiction to both want credit for overturning Roe and be frustrated by the activists who wanted Roe overturned. But it also speaks to this larger issue of how Republicans should proceed on the issue.

A state-by-state look

Opponents of abortion rights want to go further and are plotting a series of new laws in GOP-controlled states.

CNN’s Jessica Schneider and Devan Cole note that 22 state governments are under unified GOP control, and as state legislatures come into session for the year, they are looking to further restrict access to abortion services. Read their full report.

Republicans in Wyoming, for example, have introduced a bill that calls for a full abortion ban, including on medication abortion, without exceptions for rape or incest, and which includes criminal penalties for anyone who performs abortions. The only exception would be in cases where the life of the mother is at risk.

Nebraska Republicans introduced a ban on all abortions after embryonic cardiac activity is detected at about six weeks of gestation.

States moving to protect abortion rights

Schneider and Cole note that Democrats are pushing back. Michigan Democrats, who now control the state government, are working to repeal an abortion ban in the state that dates back to 1931 but was on ice during the Roe years and was blocked by a judge in the immediate aftermath of the Dobbs decision.

Meanwhile, in Maryland, where Democrats have complete control, voters may see an amendment on their ballot in 2024 that would add abortion rights to the state constitution.

A need to rebuild momentum

CNN’s Veronica Stracqualursi talked to anti-abortion rights groups before they gathered Friday for the annual March for Life – which first occurred in 1974, a year after Roe, and now finds activists focused on passing more restrictive laws in states and trying to rebuild anti-abortion rights momentum after their Supreme Court victory in June.

“The pro-life movement has just experienced a major victory in the fall of Roe v. Wade, but our work to build a culture of life is far from complete,” Jeanne Mancini, the head of March for Life’s Education and Defense Fund, told Stracqualursi. Read her full report.

That may not be the case for supporters of abortion rights, many of whom credit the end of Roe with Democrats’ better-than-expected performance in the 2022 midterm election. While Republicans will be recalibrating, Democrats will try to carry that momentum built around abortion rights into the presidential election.

Source: https://edition.cnn.com/2023/01/22/politics/roe-v-wade-abortion-what-matters/index.html

ABORTION RIGHTS DEMONSTRATORS GATHER IN FRONT OF THE SUPREME COURT OF THE UNITED STATES ON TUESDAY, MAY 3, 2022 IN WASHINGTON, DC. (KENT NISHIMURA / LOS ANGELES TIMES VIA GETTY IMAGES)

“I will vigorously enforce Alabama law to protect unborn life.”

Alabama, one of the strictest anti-abortion states in the country, is ready to take its anti-abortion stance even further: It could prosecute people who take pills to end their pregnancies, Alabama Attorney General Steve Marshall said Tuesday.

Abortion is currently only allowed in Alabama in cases of medical emergencies. But the Alabama abortion ban, like most abortion bans, penalizes people who perform abortions, not the people who get them. In fact, the law, known as the Human Life Protection Act, explicitly declares that people who get abortions cannot be held criminally or civilly liable. 

But that won’t stop the attorney general’s office, according to AL.com. Instead, Marshall’s office could use another Alabama law to target abortion patients—a child endangerment law that was originally designed to protect children from the chemicals left behind by meth labs.

“The Human Life Protection Act targets abortion providers, exempting women ‘upon whom an abortion is performed or attempted to be performed’ from liability under the law,” Marshall told AL.com in a statement. “It does not provide an across-the-board exemption from all criminal laws, including the chemical-endangerment law—which the Alabama Supreme Court has affirmed and reaffirmed protects unborn children.”

A 2013 ruling by the Alabama Supreme Court ruled that the “chemical-endangerment law” could apply to fetuses. “The decision of this court today is in keeping with the widespread legal recognition that unborn children are persons with rights that should be protected by law,” one of the judges in the 2013 case wrote in a concurring opinion.

By legally deeming fetuses children, the decision reinforced the so-called “personhood movement,” an anti-abortion movement that works to further the belief that fetuses deserve all the rights and protections granted to humans outside the womb. This belief could have widespread implications across all U.S. law; in Georgia, for example, a recent abortion ban now lets people claim fetuses on their taxes

In Alabama, officials have used the chemical-endangerment law to target more than 1,000 women who allegedly used drugs while pregnant, according to AL.com. Prosecutors have, in at least 20 cases, now used fetal personhood ideas to bring criminal charges over a miscarriage or stillbirth, the Marshall Project reported last year, along with the Washington Post, AL.com, and The Frontier.

Marshall’s declaration also arrives just a week after the FDA announced that it would let regular pharmacies dispense abortion-inducing pills. The move could expand access to the procedure in blue states, but it would not apply to states that already have abortion bans on the books.

“Promoting the remote prescription and administration of abortion pills endangers both women and unborn children,” Marshall told AL.com. “Elective abortion—including abortion pills—is illegal in Alabama. Nothing about the Justice Department’s guidance changes that. Anyone who remotely prescribes abortion pills in Alabama does so at their own peril: I will vigorously enforce Alabama law to protect unborn life.”

Mainstream anti-abortion activists have long shied away from penalizing abortion patients directly, although a growing fringe movement, who refer to themselves as abortion “abolitionists,” believe that patients should be punished like murderers. Experts have also warned that, if prosecutors want to punish people accused of aborting their own pregnancy, they will find a way to do it. Last year, the legal advocacy group If/When/How found that, between 2000 and 2020, law enforcement in 26 states investigated or arrested at least 61 people for allegedly aborting their own pregnancy or helping someone else do so.

Source: https://www.vice.com/en/article/5d3vg8/alabama-attorney-general-prosecute-people-abortions

Protesters hold signs as they rally in support of Planned Parenthood.

When the Supreme Court overturned Roe v. Wade in June, Planned Parenthood made a vow.

“It is a dark day for our country, but this is far from over. We will not compromise on our bodies, our dignity or our freedom,” the organization said in a statement.

But with more than a dozen states enacting complete or partial bans on abortion following the Supreme Court decision, abortion clinics, like those operated by Planned Parenthood, and the protests they attract have become an even more potent symbol of the country’s deep divisions over reproductive health.

To minimize the effect these protests have on patients visiting Planned Parenthood clinics, the organization deploys volunteer clinic escorts to “help get patients to the door of our clinic with as little harassment from protesters and picketers as possible,” according to its website.

The result is a defensive role on the front lines of America’s abortion debate.

To understand the role and what it entails, we turned to Marian Starkey, a volunteer Planned Parenthood clinic escort in Maine who has been guiding patients past protesters at different locations since 2007.

Our conversation, conducted over the phone in late December and lightly edited for flow and brevity, is below.

The average day

LEBLANC: When you sign on for your clinic escort shift, what can the average day bring? I imagine every day is a little bit different.

STARKEY: To a degree. I mean, the difference really revolves around the public’s reaction to the protesters. Honestly, the protesters are pretty consistent. It’s generally the same people who show up every Friday.

Friday is the procedure day at Planned Parenthood. And so that’s the day that the protesters are there. They usually arrive around 8:30 in the morning and, depending on the weather, they’ll stay until 11 o’clock or sometimes later if it’s nice out.

They show up with massive signs that barely fit in their cars. They have to kind of squish them into the back seats of their cars when they leave at the end of the shift. The signs show fetuses in very advanced stages of development and pretty, pretty gruesome images, and they’re meant to shock and disturb patients and passersby, which they do.

They show up and they do a little prayer to start off their day. And then the men – it’s always men – will take turns preaching throughout the morning. I’ve never, in the 15 or 16 years I’ve been doing this, I’ve never seen a woman preach, always the dudes. Young ones, too.

I mean, men as young as probably 19 or 20 sort of get on their soapbox and preach at passing traffic, at the patients entering the clinic. But mostly at us.

The name game

STARKEY: Honestly, the patient traffic isn’t so heavy that there’s always somebody for them to be sort of focusing on. So they focus most of their attention on us greeters and try to learn personal information about us and then use that to sort of get under our skin.

I mean, they all know my name. They know that my mom’s a midwife. I hear about that a lot – that, you know, she brings life into this world and I take it out.

LEBLANC: Oh, wow.

STARKEY: Yeah, so it can be pretty targeted. We have a non-engagement policy across the country, so we don’t speak with them; we try not to even acknowledge them with eye contact. And so we just kind of look right through them or look up and down the sidewalk to see what’s going on with patients and people passing by.

And that doesn’t deter them from talking at us, but we don’t engage.

LEBLANC: How is it that they’re learning personal information about the clinic escorts?

STARKEY: The same way that we’re learning information about them, if I’m being honest. If they make the mistake of using each other’s names out on the sidewalk, then now we know their name.

They coordinate with each other using a Facebook page, and so if you go to that page, you can see a lot of their activity, and it can actually be kind of useful to see what they’ve got cooking. They’ll sometimes reveal plans for future protest events that they wanna do.

But it’s also a place to see their pictures, and so we can recognize who they are. And I imagine they do the same thing with us.

Preparing the patients

LEBLANC: So your goal is to basically shield the people using Planned Parenthood’s facilities from as much protester activity as possible?

STARKEY: Yeah, and to just keep the chaos to a minimum, if possible. Patients can’t tell when they turn the corner from the parking garage and start their walk down the sidewalk – they can’t tell who’s a protester and who isn’t and who’s on their side and who’s not.

And so when they make their appointments over the phone, they’ve already been warned there are protesters. They’ve also been told that there are clinical volunteers who are wearing these bright pink vests.

But I think sometimes that doesn’t even register for them because they’re just in such a state when they see what they have to walk through. So, you know, we’re just trying to keep things as calm as possible, and not engaging with them tends to be the best way to do that.

People are in all sorts of different mental states when they arrive. A lot of times just the presence of the protesters will make them cry. They have to walk down almost an entire block to get from the corner where the parking garage is to the front door of the clinic. And so I’m sure that can feel like an eternity for patients when they’re already upset.

And so a lot of times they’ll burst into tears or the partners that they’re with – their support person – will start screaming at the protesters.

A lot of times the men are actually the targets of the abuse from the protesters. They have sort of standard lines that they shout at them, like “real men don’t kill their children” and “be a father” or “don’t kill your child,” that sort of thing.

So yeah, it’s just chaos out there. It’s a circus.

How effective are the protests?

LEBLANC: Have you ever had someone come in that was so traumatized by the experience that they no longer want to go through with their procedure?

STARKEY: I haven’t seen that happen. The protesters, we will hear them sometimes boast about all of the lives that they’ve saved through people changing their minds. I haven’t seen it happen. So I’m not sure what they’re referring to when they say that.

I don’t know, maybe something’s happening behind the scenes that we’re not privy to. I’m not sure.

We have had patients for sure who, if there weren’t greeters on the corner, would not have walked down the sidewalk by themselves, and they told us that.

Post-Roe landscape

LEBLANC: You’ve been doing this a long time. I’m curious if you’ve noticed a change at all since the Dobbs decision that overturned Roe v. Wade?

STARKEY: Honestly I don’t think so. The protesters seemed happy about it, but not overjoyed. They have told us over the years in their preaching, but also just kind of the one-sided conversations they have with us, that they’re not political people. That for them, the person in charge is Jesus Christ and they’re not all that interested in the laws of man and the elected officials that we have.

What I have noticed that’s different is that people passing by are a lot angrier.

The morning of the decision, a man came by and just screamed in the faces of the protesters: “You finally got what you wanted, now you can get out of here.” And they just kind of calmly explained to him, “Well, no, because abortion is still legal in Maine, so we still have work to do, and we’ll be out here regardless.”

I had never before the Dobbs decision – I had never seen people passing by grab their signs and make off with them. And now that’s happened. I mean, I’ve probably seen that five or six times now.

Source: https://edition.cnn.com/2023/01/11/politics/planned-parenthood-volunteer-escorts-abortion-what-matters/index.html

ABORTION RIGHTS PROTESTERS DEMONSTRATE OUTSIDE U.S. SUPREME COURT JUSTICE SAMUEL ALITO’S HOME ON JUNE 27, 2022 IN ALEXANDRIA, VIRGINIA. (TASOS KATOPODIS/GETTY IMAGES)

Virginia’s proposed abortion ban could let a jury decide if an emergency abortion was really necessary.

A bill introduced Wednesday in the Virginia state legislature would ban almost all abortions after 15 weeks—and if a doctor agrees to end your pregnancy during a medical emergency, a jury of 12 random people could end up deciding whether their medical judgment was sound.

In other words, a doctor who wants to perform an emergency abortion without risking legal penalties will have to win over 12 people who likely have zero years of medical training.

Abortion is currently banned in Virginia after the start of the third trimester, except when it’s necessary to preserve a patient’s health or life. The proposed bill would not only narrow the window of time when people can get abortions, it would only permit abortions after that point in cases of rape or incest, or if the patient’s life is in danger or they’re facing “a serious risk of substantial and irreversible impairment of a major bodily function.” (Psychological and emotional risks, such as feeling like you’ll die of suicide if you can’t get an abortion, don’t count.) After Roe v. Wade’s overturning last summer, states across the country banned abortion except in cases of life endangerment. But doctors have argued that this “exception” forces them to watch as their patients inch closer and closer to death before they can perform an abortion.

“We’re waiting for patients to get sick, or get sicker, to be sick enough as to be able to intervene,” one maternal fetal medicine specialist told VICE News last year. Another OB-GYN added, “Someone can go from looking, clinically, in front of you, fine, talking to you, maybe appearing overall pretty well—and then all of a sudden their vitals can just tank and they can really get sick fast.”

Plus, some devastating fetal abnormalities are only detectable later on in pregnancy. Fetuses with those abnormalities may be deemed “incompatible with life,” meaning they will likely not make it to birth, die during birth, or die right after. Continuing with these pregnancies can be emotionally wrenching for would-be parents, and can risk the life and health of pregnant people

The problem with these laws, doctors have told VICE News, is that politicians who lack medical training are dictating medical policy. Now, unelected people could be doing the same in Virginia.

Under current Virginia law, a doctor needs to use their “good faith clinical judgment” to determine whether a patient needs an emergency abortion. In other words, if a doctor had to defend their actions on the stand, they would just need to prove to a jury that they believed at the time that the patient was experiencing a life-threatening emergency and that abortion was the best or only form of treatment.

But under the new Virginia bill, doctors would have to use their “best clinical judgment”—meaning that they would have to show that the emergency abortion was absolutely necessary to save the patient’s life. It’s a change that, although seemingly small, could undercut doctors’ ability to do their jobs and leave them more vulnerable to prosecution.

Ban like these can make physicians afraid to help even in true emergencies . In an affidavit filed last year in a lawsuit over Ohio’s now-suspended abortion ban, one doctor warned, “I am concerned that the law’s stiff criminal penalties are deterring some physicians from providing even legal care that is medically necessary.” 

The bill introduced Wednesday has just one sponsor, but Virginia Gov. Glenn Youngkin, a Republican, has said that he would support a 15-week abortion ban. Such a limit, he suggested to the Washington Post last summer, could be a compromise between Republicans and Democrats. 

In a statement Wednesday, Jamie Lockhart, executive director of Planned Parenthood Advocates of Virginia, rejected that idea.

“Let’s be clear: a ban is a ban, plain and simple,” she said.

Source: https://www.vice.com/en/article/k7bvzn/virginia-abortion-jury

After a change to US Food and Drug Administration rules, major pharmacy chains CVS and Walgreens say they plan to seek certification to distribute abortion pills where legally allowed.

The FDA said on its website Tuesday that pharmacies that become certified to dispense mifepristone, which may be used in a medication abortion, can do so directly to someone who has a prescription from a certified prescriber.

For the first time, this allows outpatient pharmacies to dispense mifepristone, said Lewis Grossman, a professor of law at the American University Washington College of Law.

But that doesn’t mean all pharmacies will dispense the medication.

“In terms of whether or not that is going to have any impact in states where abortion is banned, I think the answer is probably not,” Grossman said. “I don’t see any real effect there.”

It’s not clear which other pharmacies will seek certification or what impact it will have on abortion access in places where it’s banned or restricted.

“It’s not at all clear that many or all or most pharmacies, or pharmacies in more rural areas, or pharmacies in red states will do so in ways that meaningfully increases access to medication abortion,” Leah Litman, a professor of law at the University of Michigan, said in an email Wednesday.

Also, “mail order pharmacies have already been dispensing pills with the FDA’s permission,” she wrote. “So the possibility of getting medication abortion existed before this latest decision.”

A different standard

In a medication abortion, mifepristone is used with another drug called misoprostol to end a pregnancy. Mifepristone blocks a hormone called progesterone that is needed for a pregnancy to continue. Misoprostol can already be distributed by pharmacies.

In a statement Wednesday, Walgreens said it is “working through the registration, necessary training of our pharmacists, as well as evaluating our pharmacy network in terms of where we normally dispense products that have extra FDA requirements and will dispense these consistent with federal and state laws.”

CVS said in a statement, “We plan to seek certification to dispense mifepristone where legally permissible.”

Honeybee Health, an online pharmacy company that had been supplying and shipping abortion medications, posted on its verified Facebook page Tuesday that it “officially became the first pharmacy certified to dispense medication abortion.”

The online pharmacy can distribute the pills only in states where it’s allowed.

“At the onset of the pandemic, Honeybee Health quickly became the first digital pharmacy to supply and ship medication abortion. We are proud to partner with the majority of telemedicine abortion providers in the US and to work closely with our manufacturer to help set the high standards required for certification in response to the FDA’s adjustment to the REMS program,” the Facebook post says. REMS refers to the Risk Evaluation and Mitigation Strategy program for mifepristone.

But for many pharmacies, it will take some time to review and decide whether to undergo the certification process – and the certification process may be complicated.

“Mifepristone is not the kind of drug for which any kind of pharmacy certification is normally required,” Grossman said. “And this particular pharmacy certification regime seems much more onerous than one would expect for a random drug with a similar safety profile.”

The American Society of Health-System Pharmacists said in a statement that “FDA’s change does not mandate that pharmacies must stock or dispense mifepristone, nor does it supersede any state laws that restrict prescribing or dispensing of the medication.”

Affect on abortion access

There are questions remaining about how the changes might affect the abortion access landscape, Litman said.

“It’s not clear that the latest FDA move means that states couldn’t enforce different abortion restrictions against doctors who prescribe medication abortion, or pharmacists who fulfill prescriptions, or people who take medication abortion to induce an abortion,” she said. Additionally, it’s not clear whether someone living in a state with abortion restrictions can use telehealth services to get a prescription for mifepristone and have it delivered through the mail.

In places where abortion was banned or heavily restricted before the FDA update, it remains banned or restricted, said Elizabeth Nash, a principal policy associate of state issues at the Guttmacher Institute, a reproductive-health nonprofit.

“The FDA’s change in allowing dispensing at pharmacies means that there are more options for access for people in states where abortion is not heavily regulated and abortion rights are protected. Where abortion has been banned, abortion remains banned,” Nash said.

“What we are seeing now is that if a state has banned abortion, then medication abortion is unavailable. And I think we’re going to see how this tension plays out between the FDA’s authority over drugs and devices and the state laws,” she said. “We may see some court cases around this very issue as to FDA’s authority and state law.”

Andrea Miller, president of the advocacy group National Institute for Reproductive Health, praised the FDA’s changes, calling them an “important step forward” in terms of increasing access to abortion medication – but she said there is “an unfortunate reality.”

“The unfortunate reality is that there are more than a dozen states right now where abortion is illegal or close to fully illegal, it is banned. And unfortunately, just like people are forced to do now, it is likely that some people in states where abortion is banned may choose to travel to another state to seek medication abortion,” Miller said.

“We don’t believe that anyone should be forced to travel in that way, and certainly, as this moves forward, there are a lot of very smart lawyers who are looking at the question of how they’ll be incorporated into drugstores and pharmacy chains, and where that can happen – and how these different federal and state provisions interplay,” she said.

The FDA’s pharmacy certification for mifepristone requires pharmacies to track shipments and to keep records of prescribers, recipients and lot numbers of each drug dispensed. This “inhibits the creation of a secondary distribution network for this drug,” Grossman said, such as if people in a state with access send the drug to those in abortion-restriction states.

He asked, “Would a state that was prosecuting somebody for diversion have access to those records? Because if they do, then that is a disincentive to providing it to people in states that are banning it.”

Whether states can enforce restrictive abortion laws against people who “provide, facilitate access to, or obtain medication abortion” to someone in another state or within a state depends in part on a doctrine known as preemption, under which a state law that undermines the purpose or objectives of federal law cannot be enforced, Litman said.

In the current political climate, “it’s far from clear” whether the US Supreme Court would say the FDA’s recent actions “preempt” state laws restricting access to medication abortion, Litman said, or that state laws are preempted to the extent they regulate medication abortion.

Source: https://edition.cnn.com/2023/01/04/health/fda-abortion-pills-pharmacies-xpn/index.html

MELISSA GRANT, CHIEF OPERATING OFFICER OF CARAFEM, HOLDS UP PILLS USED FOR ABORTION AT THE HEADQUARTERS OF CARAFEM IN WASHINGTON, D.C., ON JULY 1, 2022. (AMANDA ANDRADE-RHOADES/FOR THE WASHINGTON POST VIA GETTY IMAGES)

It’s a move that will further expand access to abortion for some—but not for those in states with near-total abortion bans.

Pharmacies will now be allowed to dispense the abortion medication mifepristone to patients with a prescription, the US Food and Drug Administration announced Tuesday. It’s a move that will further expand access to abortion for some—but not for those living in states with near-total abortion bans.

“There are a handful of states that have outlawed abortion from the moment of conception. And so, frankly, it doesn’t do much work in those states,” said Nicole Huberfeld, a health law professor at Boston University’s School of Public Health. But Huberfeld says that the decision makes medical sense. “There was really no scientific reason to continue the serious constraints on accessing mifepristone.” 

Mifepristone blocks progesterone, a hormone needed for a pregnancy to continue, and can be used alongside the medication misoprostol—a drug often used to manage miscarriages—to induce an abortion in the first trimester of pregnancy. In the past, access to medicated abortion was restricted: Only certified healthcare providers could prescribe and dispense the medication. But according to the updated FDA rules, brick-and-mortar pharmacies can now obtain certification and dispense mifepristone directly to people who have a prescription from a certified prescriber.

The new rule is part of a change to the FDA’s risk evaluation and mitigation strategies (REMS) on the medication, and it follows a December decision that permanently extended rules that were initially temporarily introduced in 2021 because of the COVID-19 pandemic. Those rules make it possible for telehealth providers to prescribe mifepristone, and for the medication to be shipped by mail. 

Planned Parenthood and producers of the drug applauded Tuesday’s move for its potential to expand abortion access as the country grapples with the aftermath of the Supreme Court’s decision to overturn Roe v. Wade. At least 13 states now have abortion bans in effect.

For now, it’s unclear how many pharmacies will choose to undergo the certification process. Massive chains like Walgreens and CVS, in particular, may be hesitant.

“It’s hard to say if pharmacies want to wade into the extraordinary conflict that exists between states right now. And when I say extraordinary, I think that’s an understatement,” Huberfeld said. “These are medications that have been lawful for a long time. And it isn’t a question as to whether they’re safe and efficacious. It’s really just the politics. So one would hope that the politics wouldn’t muck up the medicine, but they may.”

What is clear is that the move won’t expand abortion access within states that already ban abortions. More than a dozen states have implemented near-total abortion bans, including some that specifically target mifepristone, and the FDA’s decision won’t affect those laws. CEO Evan Masingill of GenBioPro, which produces the generic version of mifepristone, told Politico that the FDA’s decision “will not provide equal access to all people,” though people seeking the medication could travel out of state to buy and take it—if they can afford to do so. 

There are also safety implications for pharmacies that choose to stock the medication. Abortion clinics and providers have dealt with enormous levels of harassment and violence over the years. In 2021, abortion clinics reported a 54 percent increase in vandalism, including incidents where bullets were fired through clinic windows, compared to 2020, according to the National Abortion Federation. Bomb threats also rose by 80 percent. 

However, abortion clinics also made easy targets for anti-abortion activists, because they provided the vast majority of abortions during the Roe era. If mainstream medical institutions treat abortion like a normal part of health care, it may become less dangerous to provide the procedure.

“If every pharmacy offers this medication, then it’s actually harder to target them, because then it becomes common rather than exceptional,” Huberfeld said.

For many, Tuesday’s news still represents a victory: People in blue states with access to abortion could benefit from being able to pick up pills at participating pharmacies, including those who don’t have a fixed home address or easy internet access. Those who don’t want a parent or partner to find the medication in the mail could also benefit from the added layer of privacy. 

“Today’s news is a step in the right direction for health equity. Being able to access your prescribed medication abortion through the mail or to pick it up in person from a pharmacy like any other prescription is a game changer,” said Alexis McGill Johnson, president & CEO, Planned Parenthood Federation of America, in a statement on Tuesday. 

“While we’re still fighting against bans and restrictions on medication abortion at the state level, it’s critical that people in states where abortion is legal have access to care.”

Source: https://www.vice.com/en/article/wxn9a9/fda-abortion-pill

Today, almost all — 96% — abortion procedures take place in clinics, not in hospitals or doctor’s offices. And many of those clinics are closing. Data from the Abortion Care Network estimate that the number of independent clinics in the US fell 35% over the last 10 years and that the pace of closure doubled in 2022, after the Supreme Court’s Dobbs decision overturned Roe v. Wade.

That has put enormous strain on the clinics that are still operating. After bans took effect in neighboring states, North Carolina saw a 37% increase in the number of abortions performed; Kansas, 36%; Colorado, 33%. Some providers now see 50 abortion patients per 12-hour shift, more than double the number they saw before Dobbs. And thousands of women haven’t been able to get the abortions they need; in just the two months following the decision, an estimated 10,000 women continued pregnancies they would have otherwise ended.

This got me wondering: Why do we rely so heavily on abortion clinics? Why isn’t abortion accessible through the same channels we use for other prescriptions or outpatient procedures? And in a country where 1 in 10 women traveled out of state to terminate pregnancies before Dobbs, why can’t doctor’s offices and hospitals pick up more of the load?

Before Roe v. Wade established a constitutional right to abortion in 1973, abortion access was uneven, to say the least. Illegal abortions took place anywhere — homes, hotel rooms — while medically supervised abortions occurred in hospitals and doctor’s offices, often after a board of (usually male) doctors approved a woman’s request to end her pregnancy. 

After Roe, reproductive rights activists opened clinics to improve access, according to Mary Ziegler, a professor at the University of California Davis School of Law and author of After Roe: The Lost History of the Abortion Debate. Clinics could offer care more cheaply, provide it closer to where patients lived and also deliver care that was more patient-centric and less judgmental. Still, hospitals performed about half of all abortions in the years immediately following Roe.

As time went on, hospitals became more skittish about providing a procedure that increasingly attracted protesters. Federal and state lawmakers also restricted funding for abortion — most notably through the 1976 Hyde Amendment — limiting some hospitals’ ability to offer the procedure and scaring away others.

The result is that although there are more than 6,000 hospitals in the US, by 2020 there were only 530 providing abortions — down from some 1,405 in 1982. Doctor’s offices have seen an even bigger drop, from 714 providing abortion in 1982 to just 266 in 2020. Hospitals now provide just 3% of all abortions, and doctor’s offices just 1%.

This means that a safe, mainstream medical procedure that a third of women will need at some point is now largely only available through standalone clinics. “It’s really siloed abortion care,” says Ushma Upadhyay, a public health social scientist and associate professor of obstetrics, gynecology and reproductive science at the University of California San Francisco. 

That separation stigmatizes abortion, making it seem as if it isn’t really health care. It also makes it easier for protesters to target patients and doctors, sometimes with vandalism or violence. And where there is only a single clinic for hundreds of miles, restricting access to abortion is as easy as forcing one clinic to close.

In the post-Dobbs era, we need all parts of the medical establishment to take a stronger stand — not only defending the right to abortion, but actually being willing to provide it. The American Medical Association has sought to protect doctors from prosecution and has called for insurers to cover abortion care. But there is more that individual doctors, hospital systems and health agencies should be doing. 

For one, more hospitals could decide to provide abortion services again. Yes, it’s true that legal restrictions bar abortion at some facilities (such as military hospitals) and complicate it for others (such as those attached to state universities). But more hospitals could offer terminations than currently do; after all, they did so in the past.

Individual OB-GYNs also could decide to offer abortion. They already use the same procedure used for first-trimester abortions to treat early miscarriages and post-partum blood clots. Yet although the US has more than 50,000 OB-GYNs, only 14% perform abortions. If more hospitals and OB-GYNs provided elective terminations, it would go some way to addressing the surge in demand at clinics abutting states where abortion is now illegal.

Policymakers in states where abortion is legal could further help by broadening the rules on who can prescribe abortion medication and perform first-trimester procedures. Many states have rules saying that only doctors can do so, but the procedure isn’t more medically complex than, say, inserting an IUD, which non-doctor providers — such as nurse practitioners or certified nurse-midwives — are allowed to do.

Research led by Upadhyay found that first-trimester abortions could be performed by nurse practitioners or midwives just as easily and safely as by OB-GYNs. This would allow thousands of medical professionals to offer abortion through local community health centers or other primary-care settings.

The FDA could also do more to make abortion medication available. Abortion pills account for more than half of terminations. During the pandemic, the FDA allowed the medication to be prescribed via a virtual visit, but imposed needless rules requiring that the prescriber get additional certification, as my colleague Lisa Jarvis has written. These rules should be scrapped.

The FDA could also decide to go further and make medication abortion available without a prescription, the way emergency contraception can be purchased directly from a pharmacy.

Democrats in Congress have failed to end the Hyde Amendment. But even under the status quo, federal agencies could make some progress by enforcing existing law. Hyde mandates that Medicaid must cover pregnancies caused by rape or incest as well as situations in which abortion is needed to save a patient’s life, but a 2019 Government Accountability Office report found that not all states abide by those rules. 

That means women who should qualify for a publicly funded abortion are either being turned away or having to find the money themselves. The Department of Health and Human Services and Centers for Medicare and Medicaid Services should ensure that these women are getting the care they’re entitled to.

These reforms wouldn’t solve the core problem — that abortion is banned in 13 states and overregulated in many others. “You should not need to travel or pay an exorbitant amount for basic health care,” as Erin Grant, deputy director for the Abortion Care Network, concisely put it.

And this isn’t to take away from the importance of clinics. For decades, these facilities have done vital work, not only offering abortion care but also mammograms, birth control and treatment for sexually transmitted infections — plus defending reproductive rights in court.

But our nation’s battered network of abortion clinics shouldn’t have to stand alone. The rest of the medical establishment, from individual doctors to hospital systems to health agencies, should stand with them. Doing so would send an unambiguous message: Abortion is health care.

Source: https://www.washingtonpost.com/business/abortion-clinics-shouldnt-have-to-stand-alone/2022/12/16/8dcf4032-7d46-11ed-bb97-f47d47466b9a_story.html

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