Abortion Information


Following the Supreme Court’s decision in Dobbs vs. Jackson Women’s Health Organization, which turned the issue of abortion access back to the states, nearly one-third of all US states have banned or severely restricted access to the procedure. At least seven states, including Alabama, Kentucky and Missouri, have banned abortions with no exceptions for rape or incest.

Health care providers and abortion activists have continued to file legal challenges to stop bans in several states from being enacted. In South Carolina, a judge has temporarily blocked a six-week ban from going into effect, though the state’s House recently passed a bill banning nearly all abortions. In North Dakota, a judge blocked the state’s trigger ban the day before it was set to go into effect.

As these legal challenges make their way through the courts, patients seeking access to the procedure must navigate a complicated patchwork of legislation, often necessitating travel journeys of hundreds of miles.

Here’s where abortion access currently stands in the United States.

Source: https://edition.cnn.com/2022/08/31/us/abortion-access-restrictions-bans-us/index.html

MCKAYLA WOLFF LEFT AND KAREN WOLFF, RALLY FOR ABORTION RIGHTS AT THE CAPITOL IN ST. PAUL, MINN., ON SUNDAY JULY 17, 2022. (JERRY HOLT/STAR TRIBUNE VIA GETTY IMAGES)

Republican candidates, many of whom began their runs for office this year trying to out-extreme each other on their anti-abortion views, are very quickly discovering that those positions aren’t palatable to the overwhelming majority of their constitutents. 

Spooked by polls showing that control of the Senate is effectively a toss-up, as well as the Kansas abortion referendum and House special elections where Democrats are overperforming President Joe Biden’s 2020 showing, Republican candidates are now reportedly gutting their websites of their previously hard-line positions on abortion. 

Blake Masters, the Peter Thiel-backed Arizona Senate candidate, ran an ad last week saying he supports “common-sense regulation around abortion” after attacks from his Democratic opponent, Sen. Mark Kelly. He also published an overhaul of his website that removed a reference to him being “100 percent pro-life,” according to NBC News

Now, Masters’ website says he supports “a law or a Constitutional amendment” banning abortions in the third trimester, which make up roughly 1 percent of abortions in the U.S. and are almost always done in order to protect the health of the pregnant person.

In Arizona, which President Joe Biden narrowly won in 2020, flipping it from the GOP for the first time in decades, the legal status of abortion remains unclear. There’s currently an ongoing court battle over whether a 1901 ban predating Arizona statehood is enforceable, but a judge issued an injunction against enforcing it last month, and Planned Parenthood resumed providing abortions there this week

Michigan state Sen. Tom Barrett, who’s running for a U.S. House seat, deleted from his website last week a “values” section that described him as pro-life, according to the Detroit News. Barrett later told the paper he doesn’t “watch my own website every day,” but that his staff “probably were updating things based upon the issues that were most salient right now.” 

Other Republican candidates around the country are, shall we say, brushing up their campaign websites, Politico reported Monday

Christian Castelli, a House candidate in North Carolina, posted on his website before a contested primary in May that he would “protect the unborn from conception to birth,” according to Greensboro-based Fox 8. Castelli’s issues page now contains no mention of abortion.

And Colorado Republican House candidate Barbara Kirkmeyer, a state senator, spoke at the state’s March for Life in Denver in January and celebrated the fall of Roe v. Wade as an “exciting day for those of us who have toiled for the pro-life cause for so long!”

But although as recently as last month her campaign website said she would “defend the sanctity of life” if elected to Congress, Politico reported, abortion is now missing from her website entirely. 

Polls since the Dobbs decision in June have consistently shown that a majority of Americans oppose the ruling, and an AP poll last month found a majority would also support a federal law guaranteeing abortion access. 

Source: https://www.vice.com/en/article/m7g7da/republicans-scrub-abortion-policies-roe

Abortion restrictions do not exist in a silo—they worsen the availability and quality of care for all pregnant patients. Gayatri Malhotra/Unsplash

Abortion bans are not only inhumane, they are also imprecise, hinging on medically inaccurate beliefs.

With the Supreme Court’s recent overturn of Roe v. Wade, many people in the United States have lost community access to life-saving abortion care. At Texas Policy Evaluation Project, our latest research in Texas documents how abortion bans and their threat of civil and criminal penalties negatively impact the health care of all pregnant people in our state.

Enacted a year ago today, Texas SB 8 restricts abortion at about five to six weeks’ gestation, before many people even know they’re pregnant. After its implementation, we have witnessed both the devastating impacts on abortion access and the emotional consequences for pregnant people seeking abortion care. At the Texas Policy Evaluation Project, our recent study found that the abortion restrictions in SB 8 also created a chilling effect for clinicians who care for pregnant people and adversely affected patients experiencing medical complications during their pregnancies.

Abortion bans are not only inhumane, they are also imprecise. They hinge on medically inaccurate beliefs that abortion care exists outside of routine pregnancy care and that pregnancy complications have a clearly outlined definition or path.

SB 8 allows only narrow exemptions for when people may receive abortion care. Physicians must document that there is a medical emergency with an imminent threat of death to provide hospital-based care for pregnancy complications that occur after detection of embryonic cardiac activity. This ban therefore obfuscates necessary, immediate interventions for people with pregnancy complications like the bag of water breaking at 18 weeks, a pregnancy growing through a cesarean section scar, or heart failure. The upcoming abortion “trigger” laws of many other states have similarly narrow exemptions as the one in Texas.

In other words, abortion restrictions do not exist in a silo—they worsen the availability and quality of care for all pregnant patients.

We interviewed clinicians across Texas who cared for pregnant patients with complicated pregnancies. This included maternal-fetal medicine specialists, OB-GYNs, and genetic counselors. We also interviewed pregnant patients who had health complications or received a concerning fetal diagnosis and tried to access abortion care in Texas or out of state. After SB 8 and now post-Roe, many of these patients are no longer eligible for hospital-based abortion care in Texas.

Because of the diversity of interpretations of SB 8, physicians are making decisions about the care of pregnant people based on the fear of repercussions.

A mother of four told us that when she was 14 weeks pregnant, she required hospitalization for blood clots that traveled to her lungs. She was terrified and asked five doctors for an abortion, but they refused to discuss anything with her because of SB 8. After being hospitalized again for complications, doctors told her “the only thing they could deduce was that the pregnancy was causing the blood clots.” She asked, “Well, if this is an at-risk pregnancy—I have four other kids that need me, that are alive right now that need me. What happens if I die because of a blood clot?” They still refused to talk to her about an abortion. The only person who offered her any information about abortion was the OB, who “didn’t even tell me. She wrote it down in a book” after her shift was over.

As states pass bans that include limited exceptions for the life of the birthing person, various hospital systems, legal teams, and individual providers will interpret these very narrow exemptions differently. Physicians are already being placed in positions where they have to wait until their patients are “on death’s door” to feel emboldened enough to apply exemptions. Physicians are telling us that they feel like “worse doctors” when they are unable to offer patients timely, evidence-based care.

Because of the diversity of interpretations of SB 8, physicians are making decisions about the care of pregnant people based on the fear of repercussions rather than the best, evidence-based care. Some physicians do not feel like they can offer standard medical interventions for patients experiencing complications and some have resorted to using less common or outdated practices like an early second-trimester cesarean section because these procedures might not be considered an abortion by surgical support staff or formally reported as abortions. This surgery increases a patient’s immediate risks for complications as compared with dilation and evacuation or labor induction and can have negative implications for future pregnancies.

Pregnant people in these situations have described feeling hurt, confused, and overwhelmed when they realized they cannot access the abortion care they need close to home. People who experience multiple structural oppressions have been and will continue to be most impacted by abortion bans. People without the resources to travel out of state for abortion care will be forced to continue pregnancies that will not survive or could be detrimental to their health. Patients who have the means to travel may not be willing to risk waiting until they are deemed sick enough to be cared for under the medical emergency exemptions in state laws—and instead will take their chances traveling by car or by plane with a medically dangerous pregnancy complication.

Both pregnant patients who wait and those who travel out of state are being placed in unnecessarily risky circumstances by laws that defy evidence-based medical practice. Timely access to abortion care is a human right and absolutely critical for the safety and wellbeing of all pregnant people and our communities at large.

Source: https://rewirenewsgroup.com/2022/09/01/abortion-bans-threaten-all-pregnancy-care/

OLEG REBRIK/GETTY IMAGES

Even Artwork About Abortion Is Legally Risky Now

Visitors to an installation at a reproductive justice conference last weekend were greeted by a warning.

“If you live in a state where self-managed abortion is illegal, be aware of criminalization risks,” read a sign, its warnings rendered in orange against a blue background and beneath a pair of ominous eyes. “The information in this exhibit is intended to advocate for greater understanding and availability of self-managed abortion, not to recommend or advise that any person obtain and manage an abortion.”

The people behind the installation, the sign added, could not answer any questions about obtaining a medication abortion or performing a self-managed one. 

The installation, titled the “Self-Managed Abortion Stigma-Free Zone,” was an exhibit at the Let’s Talk About Sex! conference in Dallas, hosted by the reproductive justice collective SisterSong. Through a series of Ikea-style room façades and placards about how self-inducing your own abortion works, it aimed to approximate the experience of a self-managed abortion. (The exhibition ended on Sunday, with the close of the conference.) But the installation and its organizers, the Abortion On Our Own Terms campaign, were haunted by a fear: What if someone arrests or sues them over this information?

In the two months since the Supreme Court overturned Roe v. Wade, abortion-rights activists have grappled not only with a new wave of abortion bans but also with the risk that simply spreading information about abortion could land them in the crosshairs of law enforcement. This installation was perhaps especially perilous: Not only was it about self-managed abortion, which remains permitted across much of the country but still carries legal risks, but it took place in Texas, one of the most anti-abortion states in a country that’s full of them.

In addition to a near-total abortion ban triggered by the fall of Roe, which took effect last Thursday, Texas has long had a law on the books that lets people sue one another for helping abortion patients get the procedure past roughly six weeks of pregnancy.  

“We knew, coming to Texas, that we would have to take certain precautions. We consulted with legal counsel,” Kimberly Inez McGuire, steering committee member of the Abortion On Our Own Terms Campaign, told VICE News.

“I have a 1-year-old daughter and I was going to bring her with me, but I made the decision to actually also bring my mother, because on the off-chance that we were unjustly and illegally arrested for doing this, I wanted to make sure there was someone to take care of my kid.”

Anti-abortion activists already seemed poised to attempt to tighten the boundaries of what, exactly, people can say about abortion. Ahead of Roe’s then-anticipated demise, the National Right to Life Committee debuted model legislation that proposed punishing people for “aiding or abetting an illegal abortion,” which they defined as including “giving instructions over the telephone, the internet, or any other medium of communication regarding self-administered abortions or means to obtain an illegal abortion,” as well as “hosting or maintaining a website, or providing internet service, that encourages or facilitates efforts to obtain an illegal abortion,” among other actions. 

State legislators in South Carolina have started to run with the idea. In late June, just days after Roe fell, state senators introduced a bill to ban people from providing information “by telephone, internet, or any other mode of communication regarding self-administered abortions or the means to obtain an abortion,” or running a website that does something similar. 

McGuire told VICE News that the Abortion On Our Own Terms exhibition falls squarely under the protection of the First Amendment. But as she walked around the conference wearing a T-shirt emblazoned with the words “mife” and “miso”—references to mifepristone and misoprostol, the drugs commonly used to induce a medication abortion—McGuire wasn’t shy about discussing the risks of the art.

“This is constitutionally protected free speech,” McGuire said. “That doesn’t mean that a rogue law enforcement officer might not misunderstand or that someone who’s seeking to sabotage this might not misrepresent what we’re doing here.”

If law enforcement wants to go after somebody for self-managing an abortion, experts warn, they’ll find a way to do so. At the time of Roe’s overturning, just three states had explicit laws against self-managed abortion on the books. But between 2000 and 2020, at least 61 people across 26 states faced criminal consequences for self-managing an abortion or helping someone else do so, according to research published by the legal advocacy group If/When/How earlier this month.

The installation’s organizers were so cautious that they also put up a sign suggesting that even visitors to the installation needed to watch out. This sign warned that “talking about self-managed abortion can be complicated and risky” and urged people to use some suggested, “vetted social media copy” if they wanted to share information about the exhibit on social media. 

Despite the lurking danger, the exhibit tried to cultivate a soothing, if relentlessly practical, atmosphere. The exhibit included a faux-kitchen, a bed with a pillow that read “Good Vibes,” and a toilet. That toilet was part of the exhibit’s focus on destigmatization: Having a self-managed abortion will very likely involve sitting on a toilet. The installation even set up a chair for someone to sit next to the toilet, as if whoever was sitting there could hold the hand of the person going through the abortion. (Medical experts widely agree that self-inducing an abortion using mifepristone and misoprostol, early on in pregnancy, can be safe.) 

The installation also offered information about Euki, an app developed by a group that supports self-managed abortion in order to help people track their reproductive health. Earlier this month, the app earned a rave review from Mozilla over its privacy features.

“It’s the only period tracker app that the cops can’t use to fuck with you. So we are making sure that people know that there’s an app available that doesn’t store their information,” McGuire said. “Because unfortunately, as we’re seeing, Facebook messages are being used to criminalize people.”

McGuire, who also serves as executive director of URGE: Unite for Reproductive & Gender Equity, said that she hopes to take this installation on the road. She envisions showing it at community centers, college campuses, health centers; perhaps future iterations of the installation could include the packaging for abortion-inducing drugs, so people can get familiar with what it looks like.

But the calculation of what information the exhibit can safely include changes from state to state and even from day to day, as the landscape of anti-abortion laws shift. 

“As we share this information, we’re [doing] an ongoing assessment of the risks and we want to share as much as possible while also protecting our staff,” McGuire said. “This exhibit is being staffed this weekend by three women of color. We’re also about protecting our people.”

Source: https://www.vice.com/en/article/4axapj/texas-abortion-art-legality

GETTY IMAGES

Anna*, 23, knew that she could not have another child.

She also knew that she wouldn’t get an abortion in Texas, where she lives, as the state has one of the strictest abortion laws in the United States.

So the mother of a four-month-old turned to social media to search for solutions. She found a number online, and sent a desperate text on WhatsApp: “I need an abortion”.

Across the border in Monterrey, Mexico, Sandra Cardona received the message.

Six years ago, Ms Cardona, 54, founded the Red Necesito Abortar (I Need an Abortion Network) to help Mexican women get access to abortion pills, because terminating an abortion was severely restricted in the country at the time.

She chose the name so that women who needed an abortion could find it easily online.

The group sends misoprostol, a medication that induces abortion, to women who ask for it, and helps house some of them when undergoing the procedure at their headquarters in the northern state of Nuevo Leon.

Some come to Ms Cardona to get the medicines “and we explain (the procedure) to them,” she said. “And some want to stay and we ‘accompany’ them,” – meaning to sit with them and take them through a protocol established by the World Health Organization that lays out how to use the pill when there is not a doctor present.

While in the past, they have largely helped women in Monterrey and migrants heading north, the number of Americans has steadily increased over the past year.

“A year or so ago I attended to the first woman,” Ms Cardona told BBC. “I do not speak English, but with the help of Google we understood each other.”

Anna arrived in Monterrey one afternoon in October. That night, she had her abortion and left the next morning.

She has not been the only one, Ms Cardona said. “The demand from Texas has grown a lot” – a reflection of the divergent paths Mexico and its northern neighbour have taken on abortion.

A pharmacy in Nogales, México borders the state of Arizona
Image caption,Mexico is seeing an influx of American women seeking out abortions

In September 2021, a historic ruling was handed down in Mexico, when the country’s Supreme Court of Justice unanimously struck down a law punishing abortion in the northern state of Coahuila, effectively decriminalising it across the country.

That same month, the US state of Texas just across the border put into effect what was one of the most restrictive abortion bills in the US at the time. Texas Senate Bill 8 (SB8) prohibited abortions after the sixth week of conception, a point at which many women still do not know that they are pregnant.

The law permits citizens – whether they be in the state or not – to file a lawsuit against anyone who helps a woman get an abortion past that date.

And with the US Supreme Court’s 2022 decision to overturn Roe v Wade – which had guaranteed women’s right to abortion nationwide for almost 50 years – abortion access is becoming even more restricted.

On 25 August, a law further limiting abortions triggered by the overthrow of Roe goes into effect in Texas.

But even before the Roe decision, the number of registered abortions in Texas was falling. According to government figures, there were about half as many abortions in Texas during the six months ending in February 2022, compared to the same time period the previous year.

“If you want to know how post-Roe America will look like, (Texas) is a good testing ground for it,” Jackie Dilworth, an activist for Whole Women’s Health, one of the state’s largest abortion providers, told BBC.

Fewer abortions registered in Texas does not necessarily mean that fewer abortions are being carried out. Many are being done in states with less restrictive abortion laws, or across the southern US border, in Mexico.

Woman holds a sign in support of Texas anti-abortion law
Image caption,Texas S.B.8 is known as the “heartbeat act”

Ms Cardona said she has received so many messages from women in the US, she is turning her second-floor study into a place for them to stay.

“Earlier, we were letting them borrow our bedroom but we saw the need to open up more space,” she said. “It will be called the ‘aborteria’ (the abortion house)”.

And Red Necesito Abortar are not the only ones preparing to expand their work. There is an entire network of groups and activists along the US-Mexico border who also offer services, said Mariela Castro, who works for Marea Verde (Green Tide) Chihuahua, another Mexican organisation that helps women access abortions.

According to Ms Castro, women also go to Mexico because the states they live in do not have enough reproductive health services or financing.

Some women buy pills on their own at Mexican pharmacies. Others are put in contact with people who can go with them to the chemist.

Boxes of misoprostol
Image caption,The drug misoprostol is used to prevent ulcers, and the contractions it causes is similar to a miscarriage

The service these networks offer operates in a grey area.

In the US, abortion pills are supposed to be prescribed by healthcare providers to a patient in jurisdictions where the procedure is allowed by law.

The US government-approved procedure for medically induced abortions combines two drugs, mifepristone and misoprostol.

The first works by blocking progesterone. Without that hormone, the uterine lining will thin and an embryo will not stay attached.

The second drug, misoprostol, is taken 24 to 48 hours later. Originally developed in the 1970s primarily to treat stomach ulcers, it was quickly discovered to also induce abortion and has been accepted for that use by the World Health Organization (WHO).

Within hours of ingestion, the drug causes the uterus to contract and expel the embryo. The process causes pain and bleeding, however, and in very rare cases, serious complications like sepsis and uterine damage.

The two-pill regime is approved for use up to 10 weeks of pregnancy in the US, and is now the most common method for abortion in the country.

Mexican abortion networks like Red Necesito Abortar only send misoprostol, because mifepristone is not readily available.

The WHO says misoprostol-only abortions are acceptable when mifepristone cannot be obtained, but it is not the method approved by the US Food and Drug Administration.

Moreover, sending the pills to places where medication abortion is restricted or banned “could potentially be considered a crime,” said Grace Howard, Assistant Professor of Justice Studies at San Jose State University, California.

Even before the Supreme Court Roe reversal, in the first five months of 2022, lawmakers proposed 117 restrictions across 22 states specifically on medication abortion, including outright bans.

In recent days, abortion – including medication abortion – has been prohibited in at least 10 states, and nearly a dozen more are expected to follow.

“Generally speaking, the law is going to be applied in the location where the pills are delivered to and where the person takes them,” said Prof Howard. “But they’re unlikely to extradite people from Mexico.”

The limits of their responsibilities are also unclear. Ms Castro says that Marea Verde’s role ends when “the person who requested the service is totally satisfied” and that the group trains its volunteers on first aid and emotional support, and consults doctors if complications occur.

But anti-abortion activists argue that these semi-clandestine networks put women at risk because they don’t provide medical services like health screening. They also say these medicines are dangerous.

“Mailing drugs that can cause injury, infertility, and even death in women when there are no health and safety standards applied is reckless and deadly policy,” Kristi Hamrick, Students For Life’s spokesperson – one of the largest anti-abortion organisations in the US – told BBC.

Her group is looking into how to stop access to abortion pills from abroad, she said.

Medical experts point out that women who seek help from foreign activists to access abortion pills do so out of desperation, and reject the claim that abortion pills are medically unsafe.

“However, it is important that people taking medications at home have access to safe, non-judgmental, and supportive care within the formal medical system if they need it at any point,” said Dr Nisha Verma, a specialist in Obstetrics/Gynaecology in Atlanta and member of the American College of Obstetricians and Gynecologists.

A pro-life activist holds a sign saying "choose life" at an abortion protest in Dallas, Texas in January 2022
Image caption,A pro-life activist holds a sign saying “choose life” at an abortion protest in Dallas, Texas in January 2022

Jane*, a 22-year-old artist from San Antonio, Texas, ended a pregnancy early with tablets from Mexico. It was her second abortion.

To help her in the process, the group that she had contacted assigned her a “caseworker”.

“She FaceTime, Skype or Zoom me and we would talk,” she told BBC. “She walked me through all my options, and when I decided to do the self-managed abortion, she called me and told everything that going to happen to me, like if I bled more than two Maxi [sanitation] pads in an hour, then that’s a dangerous amount of blood and I should go to the hospital,” she said.

“I had her phone number and I was texting her all day (the day of the abortion). (She acted) like a caseworker should do, just helping me feel safe and making sure I had everything I needed,” Jane explained.

A self-managed abortion with pills “is very painful: it causes nausea, diarrhoea, vomiting,” she said. “It’s very hard on your body”.

But Jane turned to the Mexican network for reasons of cost – the same medication from the US is much more expensive than getting misoprostol from across the border, she said.

She has helped other women seeking abortions by putting them in contact with the organisation that helped her, Jane said.

“I think there’s a lot of women who wish that they could talk but are unfortunately scared and being silenced by everything that’s going on in Texas right now,” she said.

Mexico-based pro-choice activists say they want to do more to help get abortion pills to Americans who want them.

Veronica Cruz, of Las Libres, a pioneer in the defence of medication abortion in Mexico, said Mexican abortion networks are working with US-based counterparts to distribute the pills to women on the US side of the border.

“It is a crazy thing. We always saw the United States like an example country on this matter,” said Ms Cruz, of Las Libres. “Now the world is in reverse.”

*Some names of women who received abortions have been changed to protect their privacy.

Source: https://www.bbc.com/news/world-us-canada-61874921

Students in states where abortion is banned are getting creative when it comes to sharing information on abortion access.

A few days before the Texas abortion ban went into effect in September 2021, a QR code plastered on a Texas Tech University bathroom stall in Lubbock posed a question: “Need to be un-pregnant?”

The sticker was placed there by C, a rising senior, who estimates that she has distributed and posted between 150 and 200 QR codes around campus.

“People really, really don’t like abortion in Lubbock,” C, who asked to be identified only with her first initial due to safety concerns, told VICE News. A few months before C started distributing QR codes, it had been dubbed a “sanctuary city for the unborn.”

In states that have banned abortion, students like C are distributing QR codes that take users to websites that sell pills that induce abortion. The QR code stickers are the brainchild of Plan C, an organization that provides information about access to abortion pills. The code leads to the organization’s website, where links to platforms for purchasing abortion pills are a few clicks away. 

For the first time in decades, students are returning to college campuses for the fall semester without the national right to abortion. For some students, this means finding creative ways of communicating information about abortion access.

“I think the fears that I have are the exact reason why it’s so important to have a way to anonymously spread information,” C said.

Launched in 2021, Plan C’s sticker program has fielded requests from every state, the organization said. Over half a million QR code stickers have been distributed—132,000 of which have been provided to individuals who said they were students.

“I think the fears that I have are the exact reason why it’s so important to have a way to anonymously spread information.”

C herself was first exposed to the QR code stickers when Plan C began distributing them to students on her campus. Shortly after her initial encounter with the group, she started distributing QR codes herself. “Save this card in a safe place just in case one day future you (or a friend) needs to become un-pregnant,” the card read. 

She said that some students appeared disgusted upon being handed a QR code card but would briefly examine it en route to the trash can. 

Then, to her surprise, some would quietly pocket it.

C said that for each person who ended up disposing of their QR code, there were probably ten more who kept it. “I think it’s important that we provide that information despite what people believe or what they advocate for. They need that access,” she said.

WASHINGTON UNIVERSITY LAW STUDENT ELENA LEVAN’S PLAN C ADVOCACY MATERIALS, INCLUDING QR CODE STICKERS (ELENA LEVAN)

In 2020, medication abortions accounted for over half of U.S. abortions, according to the Guttmacher Institute. Some abortion pill providers, such as the group Hey Jane, are not currently shipping to the 19 states that have telemedicine abortion restrictions. And some people have already indicated that they will try to get around these restrictions, despite possible legal consequences. 

Abortion restrictions tend to target people who provide abortions, not the people who undergo them. But there’s no guarantee that abortion patients won’t get swept up in a law enforcement dragnet—and, indeed, many already have. And although the vast majority of states do not have explicit laws forbidding self-managed abortion, experts warn that if a prosecutor wants to go after someone for having one or helping someone else do so, they’ll find a way to do it. 

Even in states like Kansas, where in-clinic abortion is currently legal, the ever-changing post-Roe legal landscape has resulted in a patchwork of shifting laws and statutes that even those who pay close attention can find confusing. Abortion-rights advocates worry that even just providing information about abortion could potentially open them up to scrutiny from law enforcement.

“We think the moment that we are being censored and shut down from sharing information on a medically safe option in a certain state, then that is the moment we live in a very different United States.”

Amy Merrill, co-founder of Plan C, told VICE News earlier this summer that the organization has had conversations about threats to the legality of its work.

“We keep coming back to our First Amendment rights to share information,” Merrill said. “We think the moment that we are being censored and shut down from sharing information on a medically safe option in a certain state, then that is the moment we live in a very different United States.”

When Claire Burke, a rising sophomore at Barnard College, returned home to Kansas in possession of QR code stickers she obtained from Plan C at school, she didn’t hesitate to distribute them to friends and post them in public locations around Kansas City. 

In Kansas, abortion remains a topic of contention even after voters upheld the abortion protections in the state’s constitution in August. Burke said that many of her friends at home were concerned prior to the vote, and when they approached her in search of more information, she would hand over the QR code.

“The biggest goal is to make sure that people have access not only to the information but to the pills themselves,” she told VICE News.

Elena LeVan, a law student at Washington University in St. Louis and member of advocacy organization If/When/How: Lawyering for Reproductive Justice, recently ordered 500 pieces of advocacy material from Plan C, including QR code cards and stickers for her organization to distribute during the first week of school. In Missouri, abortion is banned at conception except in cases of medical emergency. 

But LeVan wanted to be prepared for the fall semester; she said she also plans to place them in “random” places, like toilet paper dispensers. 

“I think our university hasn’t really taken a strong stance on abortion,” LeVan told VICE News. “So a lot of this is going to be left up to students to spread these resources and get people connected with information.” 

A joint statement by the chancellor and the dean of the School of Medicine following the Supreme Court overturning of Roe v. Wade focused on “dialogue” as opposed to healthcare access. The debate surrounding abortion “is too frequently reduced to polarized points of view with little to no room for constructive dialogue… As a university that places great value on diversity of thought and opinion, we are far from homogeneous in our points of view on this or any topic.” The administrators then encouraged students to come together as a community in the aftermath of the ruling.

In addition to the Plan C materials, LeVan ordered QR code stickers from ineedanA.com, a platform that provides resources for individuals seeking an abortion, including links to websites selling abortion pills by mail. According to the organization, they have distributed over 2,000 packets containing about 24 QR code stickers per packet—all of which have been hand-packed by a team of five volunteers at a dining room table.

The organization, which has since limited its sticker campaign to donors, volunteers, and organizations, said it’s received over 200 sticker requests mentioning the word “campus,” as well as additional requests mentioning student groups and sororities.

In South Dakota, one activist started her own QR code sticker initiative. Taking advantage of a sticker sale through the graphic design website Canva, Krista prints stickers with QR codes leading to aidaccess.org, a service that ships abortion pills to the U.S. from abroad.

“It’s definitely not a perfect solution by any means,” Krista, who asked to be identified only by her first name out of concern for her safety, told VICE News. “But I think it’s a step in the right direction until we can see some significant changes in our political sphere and our legislature.”

On July 1, a law banning telemedicine abortion went into effect in South Daokta. Gov. Kristi Noem also recently announced that she would take action toward implementing a ban on mail-order abortion pills, but that individuals seeking them should not face prosecution. 

In addition to plastering the stickers around various cities in South Dakota, Krista has distributed them to Students for Reproductive Rights, a student group at the University of South Dakota. She also plans to issue them to a student group at South Dakota State University, about two hours north.

“Maybe they don’t think they’ll ever need it, but one day something unexpected happens and they may be like, ‘Well, maybe I should see if that QR code if that sticker is still there.’”

The current president of Students for Reproductive Rights at the University of South Dakota, Lexi McKee-Hemenway, lauded the QR codes because they’re discreet and easy to use. McKee-Hemenway said she herself has been distributing QR codes since receiving them from Krista, and though she has yet to distribute them on campus, she anticipates seeing them around in the fall.

“It’s so much easier to be able to just go up and scan the code and be taken somewhere versus having to type in a whole entire web address,” she said. “I want people to have access, I want them to be able to get their necessary healthcare… Even if that means that they have to do it themselves.”

Burke, the sophomore at Barnard, said that if she were to encounter any opposition, she feels confident her community would back her up.

“Anyone who organizes in red states is used to resistance, and I think that this is an especially volatile issue,” she said.

In Texas, where private citizens can file civil lawsuits against anyone who performs or “abets” an abortion, C is more concerned about action being taken by Lubbock residents, rather than by her fellow students. Despite her fears, she continues to distribute the QR codes in the hopes of providing students with information and options.

“Maybe they don’t think they’ll ever need it,” she said, “but one day something unexpected happens and they may be like, ‘Well, maybe I should see if that QR code sticker is still there.’”

Source: https://rewirenewsgroup.com/article/2022/07/12/the-outsized-role-prosecutors-will-play-in-a-post-roe-world/

LIUDMILA CHERNETSKA/GETTY IMAGES

But she is ‘mature’ enough to raise a child.

A panel of Florida judges ruled Monday that a parentless 16-year-old failed to prove she’s mature enough to get an abortion—leaving her to give birth and, potentially, raise a child instead.

The anonymous 16-year-old, who lives with a relative, is currently pursuing her GED and dealing with the recent death of a friend, according to court papers detailing the judges’ ruling. A trial judge decided that she was “credible” and “open,” and acknowledged that “she is not ready for the emotional, physical, or financial responsibility of raising a child.”

Still, that judge rejected her request to end her pregnancy anyway. The Monday ruling, from three judges from Florida’s 1st District Court of Appeals, affirmed that rejection. Although one judge wanted to send the case back to the trial judge for review, two others said that wasn’t necessary.

The 16-year-old, the judges wrote, “had not established by clear and convincing evidence that she was sufficiently mature to decide whether to terminate her pregnancy.”

Before the overturning of Roe v. Wade earlier this summer, 38 states required that minors involve their parents in their decision to get abortions. Most of those states also set up a process known as a “judicial bypass,” a court proceeding where judges review whether to let minors get abortions without their parents’ permission or knowledge. 

But judges’ determinations, and their criteria for making them, can often seem arbitrary or even nonsensical. Earlier this year, a Florida circuit judge ruled that a 17-year-old shouldn’t get an abortion because, in part, her GPA was too low and she didn’t care for any younger siblings. But an appeals court overturned that ruling, pointing out that the 17-year-old didn’t have any younger siblings.

In a review of 40 judicial bypass cases—which tend to remain sealed, unless appeals courts are asked to weigh in—Mother Jones found one 2006 Florida case where a minor said she couldn’t financially or emotionally handle raising a child. The judge then used that claim to prove that she wasn’t ready for an abortion.

Now that Roe has been overturned, abortion remains legal in Florida up until 15 weeks of pregnancy. At the time of her meeting with the trial judge, the 16-year-old was 10 weeks into her pregnancy.

There is a chance that she could, however, evade the judicial bypass process entirely, as one judge said in the Monday ruling. In her petition for an abortion, the 16-year-old wrote that her guardian “was fine” with her decision to terminate her pregnancy. If the guardian signs a waiver, the 16-year-old could get her abortion anyway.

Source: https://www.vice.com/en/article/z34mk9/florida-abortion-16-year-old-judicial-bypass

While modern medicine has since taken over for medical procedures like abortions in Hawaiʻi, many traditional practices to maintain health and well-being continue.
 Cage Rivera/Rewire News Group illustration

Hawai’i has a history of supporting abortion care long before it was colonized, and the tradition of protecting bodily autonomy continues today.

Long before Westerners set foot in Hawai’i, Native Hawaiians used spiritual and herbal medicinal healing practices called lā’au lapa’au to maintain their health and treat illnesses. They especially used traditional medicines to support health practices like birth control and abortion—some of which are still practiced today.

When a person started to menstruate, they stayed at the hale pe’a (menstruation house) set away from the community.

“The further away a temple is from the community, the more mana [divine power] it has, and the same goes for the hale pe’a,” said Makana Kāne Kuahiwinui, a Hawaiian language teacher and waimaka lehua (menstruation) researcher. “They’re so far because it has such great mana coming from women; that time is considered so sacred.”

The elders and other family members cared for the young children of people who stayed at the hale pe’a. As they grew, children were well aware of this time for their mothers, aunties, and grandmothers to go menstruate. Menstrual health matters were not just openly discussed, they were celebrated, and set the tone for other practices related to reproductive health.

Hawai’i was the first state to decriminalize abortions in 1970, three years before Roe v. Wade protected the right to abortions in the Constitution.

While it is unknown how many abortions took place in old Hawai’i, the practice is well documented and not new to the islands.

“Hawaiians knew the health of the community is the health of a woman,” Kāne Kuahiwinui said.

That’s why, for those like the U.S. Sen. Mazie Hirono of Hawai’i, a Japanese immigrant raised in the state, protecting reproductive freedom continues to be at the top of her priorities.

When the draft of the Supreme Court opinion overturning the right to abortion was leaked in May, Hirono delivered a speech on the Senate floor on the need to defend reproductive rights. Hirono said abortion is one of the reasons she became an activist. She also expressed concern for people across the country who do not live in states like Hawai’i that protect their right to an abortion.

In the 14 years that Hirono has represented Hawai’i , she stands at the forefront of fighting for a person’s right to and access to abortions—and not just in the Aloha State.

Hirono’s advocacy for reproductive freedom includes introducing the My Body, My Data Act to protect personal reproductive health; introduced the Affordability Is Access Act to expand over-the-counter access to birth control; hosted a roundtable with patients across the country on how the abortion access shaped their lives; urged the U.S. Department of Health and Human Services to take action to expand access to medication abortion; joined 32 colleagues to introduce the Expanding Access to Family Planning Act to protect access to reproductive health-care services and much more.

And her advocacy for abortion rights follows a long tradition of preserving pregnant people’s bodily autonomy in Hawai’i.

Ceremonies and rituals

In Hawai’i, multigenerational homes are popular and large families are desired. However, spacing out children was also encouraged to ensure the quality of life in raising other young children in the home. Hawaiians used herbal medicine and other practices to space out or stop future pregnancies.

“There were certain plants used for contraceptives for men and for women,” said Adam Keawe Manalo-Camp, an anthropologist and writer for Ka Wai Ola News, a newspaper of the Office of Hawaiian Affairs. “One particular medicine lowered the sperm count for the male to not produce children.”

When a person did not want any more children, they could ho’opā (make stop) using ceremonies and rituals, always with prayer. If needed, lāʻau pā was taken, a medicine that prevents fertilization, much like the emergency contraceptive Plan B. A medical procedure could also permanently or temporarily close the womb.

In some cases, people wore a girdle made of braided cordage from coconut husk, human hair, and animal intestines wrapped around their bodies to let others know she was chaste, as desired by her parents or her lover.

Types of abortion

While Native Hawaiians believed in growing their families and people, several methods and tools were used to administer abortions prior to the introduction of Western medicine. There are two known types of abortions. One is ‘ōmilo, which refers to a medical abortion and hoene were abortions induced by plant medicines taken orally, applied externally, or inserted as a douche to expel the fetus.

“One of the main methods used was ‘awa mixed with some other types of herbs,” said Sean Chun, Native Hawaiian healing practitioner and Kupuna Council chair for Ho’ōla Lāhui Hawai’i.

“The ‘awa used back then was 25 to 40 years old, so a lot stronger. And the idea behind that is, it relaxed the muscles. Women did use specific types of ‘awa, too.”

The root of the ‘awa plant was commonly used as a relaxant in medicine, ceremony, and leisure throughout Polynesia. Other known plants used in abortion procedures include hau, noni, ‘ōhiʻa ‘ai, and young kī.

Herbal medicines were specifically grown, concocted, and administered precisely.

“They had kāhuna [experts and practitioners] that could help with conception, herbal concoctions, lomilomi [massage], everything,” Chun said. “The fetus and mother were taken care of very, very well.”

Kāhuna worked closely with their patients, unlike the typical doctor-patient relationship today. Kāhuna knew if a pregnant person’s life was at risk or predicted when the life of the child was at risk. If an abortion was thought to be necessary and in the best interest of the pregnant person or fetus, kāhuna treated with medicines or procedures.

“It was important to ho’oulu lāhui, to grow the nation,” Chun said. “A lot of prayers and song are about growing the nation. So it was important to protect women.”

Traditional meets modern

When the missionaries first arrived in Hawaiʻi, they documented accounts of abortion and were appalled by the practices they thought to be common. However, Hawaiians made calculated decisions to protect themselves, their family, and their community.

“Our kūpuna [ancestors] practiced abortions and had a very healthy relationship with the ‘āina and medicine. Our kūpuna did what was best for our health,” Kāne Kuahiwinui said.

While modern medicine has since taken over for medical procedures like abortions in Hawaiʻi, many traditional practices to maintain health and well-being continue.

Today, healing practitioners like Chun treat their patients with traditional herbal remedies backed by spiritual guidance, similarly used in old Hawai’i.

Chun said the traditions and practices supporting reproductive health culturally influenced Hawaiʻi to become the leading state in legalizing abortions.

“Anytime you come from a culture that is nature-based, you’re going to have a closer tie to anything, like female health.”

Reasons for abortions

In addition to a kāhuna, pregnant people often saw a pale keiki (midwife). Pale keiki observed signs such as which side of the stomach the fetus sat or symptoms like swelling the pregnant person experienced that determined diagnosis and treatment.

“Sometimes, a pale keiki detected that the fetus had a severe deformity and they felt that the life of the child would be deeply impaired and the more humanitarian practice was to abort it,” Keawe Manalo-Camp said.

The arrival of non-natives also exposed Hawai’i to new disease, such as sexually transmitted diseases.

“More abortions happened in the 19th century because women were getting STDs and the babies were coming out with various problems—especially with syphilis,” Keawe Manalo-Camp said.

There are also accounts of women being kidnapped and raped. And “instead of having them suffer, the woman would be given a medicinal abortive,” Keawe Manalo-Camp said.

Times of scarcity and war in old Hawai’i, as well as life-threatening conditions, also prompted pregnant people and the community to make the decision to abort the fetus.

“If a war broke out and women and children were hiding in the forest, women would commit an abortion to keep the community safe so that she wasn’t heard screaming if she had to go into labor,” Kāne Kuahiwinui said. “This could happen far along into the pregnancy or even after the baby was born. Abortions also took place if it was a matter of saving the woman from dying, too.”

The ali’i (chiefs and chiefesses) practiced abortions for different reasons.

Keawe Manalo-Camp said one of the reasons Hawaiians normalized abortions was because ali’i recieved them. Incest was common among the aliʻi, particularly to protect the child and royal lineage. Because of this, some fetuses were detected to have severe deformations, and they thought it would be better to have an abortion than not to.

Above all else, Hawaiians loved babies and large families. If a pregnant person did not want the child, families in the community would beg for it. Hawaiians would hānai (adopt) an unwanted child and raise it as if they were their own.

The afterlife

Hawaiians were spiritually driven and considered the beginning of life with the first hanu (breath). The fetus was not thought of as a living person yet—in opposition to what conservatives are pushing, that a fetus has “personhood.” While Hawaiians cared for the fetus’ ‘uhane (spiritual life), it was only considered a full life when its body, spirit, soul, and breath all came together in existence.

While Native Hawaiian people had access to and practiced abortions, they still cared for the afterlife of the fetus much like the placenta.

Kāne Kuahiwinui said Native Hawaiians would not bury, but kanu (plant) the placenta of a child in hopes for something to grow. Families practiced similar traditions for a fetus.

Families also planted the afterbirth or fetus in specific places like mountains for hunting families or in the ocean where family guardians dwelled. Hawaiians planted the fetus right under the doorway or around the home so that the family could protect it, care for it, and hope for life in the form of plants to grow.

“Your bones are going to go back into the earth that you love, into that ʻāina [land] that your family is in and people can make sure that no one is desecrating it,” Kāne Kuahiwinui said.

Source: https://rewirenewsgroup.com/article/2022/08/17/in-hawaii-indigenous-abortion-care-traditions-meet-modern-medicine/

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.(GETTY)

At least 61 people were criminalized for alleged self-managed abortions between 2000 and 2020.

If you are looking to end your own pregnancy, your own doctor may be your downfall. 

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, according to a report released earlier this week by the legal advocacy group group If/When/How. And in 45 percent of those cases, it was healthcare providers or social workers who tipped off police.

In another 26 percent of the cases, people “entrusted with information”—like partners, parents, and friends—reported their ostensible loved one to police.

“The research really clearly confirms that the biggest threat to the privacy of abortion seekers is other people,” said Laura Huss, senior researcher for If/When/How. “That breakdown of trust and ethics and the patient-doctor relationship is really alarming.”

The report, which examined the criminalization of self-managed abortions while Roe v. Wade was still the law of the land, offers a stunning glimpse at how people who get abortions in this post-Roe era may be targeted and threatened by law enforcement. Although abortion opponents often insist that they do not want to punish pregnant people for abortions, abortion rights supporters have long pointed out that pregnant people have already faced criminal consequences—and there’s no way to ensure they’ll be kept out of an anti-abortion dragnet.

Indeed, that future is already coming to pass: Earlier this week, Nebraska law enforcement charged a 17-year-old and her mother with a litany of misdemeanors and felonies after they allegedly sought to end the 17-year-old’s pregnancy through a medication abortion. 

Currently, just three states have laws on the books that explicitly target self-managed abortions. But if prosecutors want to pursue charges, abortion rights experts say they’ll find a way to do so. In the Nebraska case, both individuals are facing charges that apparently refer to the 17-year-old’s fetus as a “dead human body”—language that elevates the fetus to the status of personhood, suggesting that it deserves the same rights and protections as people who can get pregnant.

In 43 percent of the cases uncovered in the If/When/How report, law enforcement weighed applying homicide or murder charges to people who sought to end their pregnancies or helped others of so. People of color were twice as likely as white people to face the possibility of those charges.

Out of the 61 cases, 43 continued through the criminal court process. Of those, 4 ended with a guilty verdict after a trial, 19 ended with a guilty plea, and 23 were dismissed or dropped. But just because someone may have avoided jail doesn’t mean that they walked away without consequences.

“In several cases, people lost custody of their existing children temporarily or permanently,” the report found. “In one case in which local authorities declined to prosecute after acknowledging the self-managed abortion was not unlawful, the woman was still turned over to immigration authorities for deportation.”

Most of those 43 cases also involved people living in poverty.

Throughout Roe’s slow collapse and ultimate overturn, reporting has often focused on how data from tech companies and, in particular, period tracking apps may be used to surveil people looking to end their pregnancies. But Huss said that, in all 61 cases, If/When/How found zero examples of authorities using data from period tracking apps.

People’s electronic records are, however, far from safe. In some cases, Huss said, police would get tipped off to a potential self-managed abortion and then then use someone’s texts and search history to build a case against them. (In the Nebraska case, Facebook turned over private chats.) 

If/When/How is not aware of a single law that requires health care providers to alert police to self-managed abortions, according to Lauren Paulk, who studies this issue as If/When/How’s senior research counsel. In fact, Paulk said, revealing a patient’s potential self-managed abortion may violate that patient’s privacy rights. 

Sometimes, providers get confused about their legal obligations, since they’re subject to other mandatory reporting requirements. But, Paulk added, “There have been cases where health care providers were anti-abortion and so reported the patient to law enforcement.”

Paulk is convinced that that, as abortion foes consider avenues to further limit the procedure in the wake of Roe’s devastation, they will try to change health care providers’ obligations to include reporting people for abortions.

“It’s clear that they either actively want to criminalize pregnant folks or don’t care that they are criminalized,” Paulk said. “I don’t put anything past them. They’ve really tried everything.”

Source: https://www.vice.com/en/article/qjkvjb/police-self-induced-abortion-arrests

Primary care providers must care for the whole patient—including when they need abortions, Dr. Christine Dehlendorf says.
 Rewire News Group illustration

It cannot be that if a patient wishes to continue a pregnancy, then they are my patient, but that I should not care for them if they want an abortion.

As a family physician, I am committed to caring for patients of all ages, from cradle to grave, in all the complexity of their lives and their families. I see patients with all manners of concerns and illnesses—from pediatric asthma to adolescent sport injuries to depression, diabetes, and untreatable cancer. And, of course, pregnancy.

Some of my patients rejoice in the news of a pregnancy, others are conflicted, and still others are dismayed. Regardless, for all of them, it is a moment with implications on their lives and their health. As their family physician, it is both my job and my calling to be there with them as they face this experience and support them—whatever they choose to do next.

For my patients who wish to parent, I can begin prenatal care immediately. For those who want to have an abortion, I can provide them with that care too. And for those who are unsure, I counsel and support them to make the decision that is right for them.

Unfortunately, politicians who want to ban abortion are threatening this commitment to supporting patients in all their reproductive health decisions. Now that the Supreme Court has decimated the constitutional right to abortion, clinics in hostile states will no longer be able to provide abortions. States will be free to pass more onerous restrictions. Clinics in supportive states will be overwhelmed with demand from both people in their area and from patients traveling for care. We’re seeing some of this already.

In the face of this need in our communities, primary care providers must join the struggle and normalize and integrate abortion. I chose family medicine to care for the whole person, to be a partner in my patients’ lives, and to trust them in their decision about their health care. The increasing regulation of abortion care strikes at the core of who we are as primary care physicians.

It cannot be that if one of my patients becomes pregnant and wishes to continue to pregnancy, then they are my patient, but that if they wish to have an abortion, I should not care for them. Refusal to provide that care continues a stigmatizing narrative that abortion is different than other health care and leaves our patients with dwindling options.

Abortion care, especially medication abortion, is a safe and simple procedure that primary care providers can learn to integrate into their practices.

But while access to abortion has been attacked in state houses and court rooms, too many of us in medicine have been silent. My colleagues and I in family medicine have a particular role to play in this fight—to work to ensure patients have the option to receive this care as part of an ongoing relationship with a trusted provider. And there is a need for those in a wide range of medical specialties— including pediatrics, internal medicine, and emergency medicine—to join us.

Right now, only a fraction of abortions happen in physicians’ offices. Abortion care, especially medication abortion, is a safe and simple procedure that primary care providers can learn to integrate into their practices. Primary care offices are located all over the country, including in places that don’t have any abortion providers. It’s our responsibility to our patients to provide it.

Providers can learn how to provide medication abortion and start providing this care with support from organizations like the Reproductive Health Access Project. Professional organizations like the American Academy of Family Physicians can speak out in favor of abortion access and invest resources in training providers. The Biden administration can make it easier for primary care providers to offer medication abortion by removing the remaining unnecessary FDA regulations.

Together we must work to expand access in a critical time. Those of us who maintain the legal ability to provide this care for our patients need to do so in our community, so that others can get the care they need.

Our country is entering into a challenging time where restrictions on reproductive autonomy will reverberate through families and communities. Providing abortions to our patients is a concrete thing we can do to lessen the harm that can and will be done. Our commitment to our patients and the values of our profession will be tested in this crisis, and we must rise to the challenge.

Source: https://rewirenewsgroup.com/article/2022/07/14/why-primary-care-providers-like-me-must-become-abortion-providers/

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