Abortion – Abortion Clinics, Abortion Pill, Abortion Information

Just under 30 amicus briefs were filed for June Medical Services v. Gee on Monday, urging the Supreme Court to protect access to abortion and strike down a Louisiana law that could effectively eliminate abortion in the state. The “friend of the court” briefs represented about 200 organizations and more than 700 individuals.

Though many of the briefs came from pro-abortion rights advocates like Planned Parenthood and the American Civil Liberties Union, a handful came from non-partisan groups including the American Bar Association, the American Medical Association, the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics. Medical groups argued that the law in question – which requires doctors providing abortions to have admitting privileges at a nearby hospital – is medically unnecessary, while legal scholars wrote that there is already precedent that covers the issue: the 2016 Supreme Court decision in Whole Woman’s Health v. Hellerstedt that struck down a similar law out of Texas.

Religious groups, representing Christian, Muslim and Jewish communities, also submitted amicus briefs Monday, arguing that “religious traditions recognize women’s moral right to decide whether to terminate a pregnancy.”

“This diverse and unprecedented array of expert voices, individual women, and advocates paints a compelling portrait of the immense stakes in this case,” said Nancy Northup, president and chief executive officer of the Center for Reproductive Rights. “It’s clear that support for abortion access and the rule of law spans all political parties, all professions, and all walks of life.”

In Whole Woman’s Health v. Hellerstedt, 45 amicus briefs were filed in opposition to Texas’s admitting privilege law. Amicus briefs supporting Louisiana’s law are due on January 2.

“It is hypocritical for abortion providers and their supporters to claim the lawsuit is helping women when its end goal is to decrease the standard of care women receive from Louisiana abortion providers who have a long documented history of medical malpractice, disciplinary actions, and violations of health and safety standards,” said Louisiana Solicitor General Liz Murrill in an email to CBS News on Tuesday.

Last week, the Supreme Court announced it would hear oral arguments for June Medical Services v. Gee on March 4, 2020, devoting an entire day to it.  At the center of the case is Act 620, Louisiana’s “Unsafe Abortion Protection Act,” a 2014 state law not currently in effect. Similar to the Texas law that was struck down by the Supreme Court in 2016, Louisiana’s law requires doctors performing abortions to have admitting privileges at a hospital no more than 30 miles away. If the law is allowed to be implemented, all of Louisiana’s abortion clinics would close, as first reported last month by CBS News.

June Medical Services v. Gee is the first abortion-related case to be heard by the Supreme Court since the appointments of conservative Justices Neil Gorsuch and Brett Kavanaugh.

Last week, the Center for Reproductive Rights (CRR), the law firm representing June Medical, filed its opening brief, the first of four to be filed ahead of oral arguments. CRR outlined its argument against Act 620, identifying two reasons why it believes the regulation should be struck down by the high court. First, CRR argued that since the Supreme Court struck down the same type of restriction in Whole Woman’s Health v. Hellerstedt in 2016, Louisiana’s restriction should also be deemed unconstitutional. Second, the law in question “is unconstitutional even assuming the burdens here are less than in Whole Woman’s Health,” according to the brief.

Previous Supreme Court precedent says abortion restrictions cannot create an “undue burden” for women seeking the procedure.

Louisiana’s opening brief is due December 26.

Source: https://www.cbsnews.com/news/abortion-supreme-court-case-amicus-briefs-filed-for-june-medical-service-v-gee-louisiana-abortion-case-2019-12-03/?fbclid=IwAR05LKn1gIIP0lOt6Vln5Rh7CE0DrrQPGYRm_YkZagr81IurcccstIIJFbg

Women often required to visit multiple clinics for routine procedures, says report

One-stop shops should open in the high street, where women can go to get contraception, screening services, menopause advice and help with other health needs, while the morning-after pill should be sold off the shelf without consultation, say leading UK experts.

The Royal College of Obstetricians and Gynaecologists, which has been working on a blueprint for women’s health services for more than a year in conjunction with other groups and government, says services for women need to be completely overhauled to give them far more control over their health.

Its report launched today in the House of Commons, called Better for Women, says women with busy lives struggle to get the healthcare and advice they need. It sets out a strategy for reshaping the present fragmented NHS systems that require women to see different nurses and doctors in a variety of specialised clinics, as well as their GP practice, for procedures that should be routine.

A survey of 3,000 women shows that large numbers find it hard to get advice and care near home. More than a third (37%) said they could not get contraception services locally and 60% could not easily access unplanned pregnancy services, including abortion care.

The all-time high level of abortions is connected to the unmet contraceptive needs of women, says the report. In 2018, there were 200,608 abortions across England and Wales – an increase of 4% on the previous year.

Over a third (34%) of women did not attend their last cervical cancer smear test, the survey shows. Only half had locally available sexually transmitted infection services, 56% struggled to get help for painful periods and 58% could not get menopause services locally.

It’s not just special pleading for women, said Lesley Regan, president of the college. Many are carers and mothers and they influence the healthcare behaviours of everyone else. “If you get it right for women, you get it right for lots of other people,” she said.

Many of the services women need are preventive, such as cancer screening and contraception. Many are paid for from the public health budget, through local authorities, and have been cut because of the 40% reduction in that budget, said Regan.

“Women are falling through the cracks of very basic services that should be very easy to prevent or access,” she said. “This is not rocket science. We are not suggesting an expensive new solution. We’re just saying we need to think about women across their life course because so many of the things that affect women, for which they need the NHS, are predictable.

“We’re not delivering what women need where they need it,” she said. A smear test, contraception and an STI check could all be done by the same person in 15 minutes, she said. “But at the moment, girls and women are being pushed around from pillar to post because a nurse or the health practitioner or the GP that they visit hasn’t got the commission to actually do the other things as well.”

Some 45% of pregnancies are now unplanned, she said. “What we do know is that when they’re not planned, they have much more complex outcomes often, and that means they are more expensive to deliver, and we see the abortion rate is not going up in girls – the teenage-pregnancy strategy has worked very well – it’s in the 40-year-olds who can’t access contraception.”

Women should not have to go back to the GP for a new prescription for the pill every three months when it has been heavily researched for the last 60 years. “It’s far more dangerous to get pregnant than it is to be on the pill,” she said. Girls and women should be able to get the very safe progestogen-only pill from a pharmacist or online, the report says. The morning-after pill should be sold straight off the shelf without the need to speak to a doctor or pharmacist.

The report says all young people should be educated from an early age about women’s health, and health issues such as the support during menopause should be embedded in workplace policies.

The college says the changes would save money by enabling women to stay in better health. Sexual health experts from the faculty of sexual and reproductive healthcare and the Royal College of Midwives (RCM) voiced support.

Gill Walton, chief executive of the RCM, backed its findings, including those on abortion, which she said should be regarded as just another medical procedure. “This is an important report that puts women at the centre of health improvement that needs governments and those running our health services to take notice. Our whole health service needs to focus much more on prevention of ill health, and to invest in our health and social services to support that,” she said.

Source: https://www.theguardian.com/society/2019/dec/02/one-stop-shops-needed-for-womens-health-services

If we’re only fighting to codify Roe—and not to address the racist, classist disparities that have failed to make the full spectrum of reproductive health-care services a reality for so many—then we’re leaving people behind.

Last week, for the first time this election cycle, all of the moderators at a presidential debate and almost half of the participants on stage were women. Unsurprisingly, political representation for women changed the game, as moderators finally asked detailed questions about abortion and reproductive rights, such as whether candidates think there is room in the Democratic Party for anti-abortion Democrats. Additionally, Sen. Amy Klobuchar (MN) was asked whether she would intervene as president if Roe v. Wade were overturned by the U.S. Supreme Court, and states were allowed to outlaw abortion as a result.

Klobuchar’s promise to codify Roe into federal law was met with resounding applause from the audience in Atlanta, where Gov. Brian Kemp (R) signed a six-week abortion ban into law earlier this year. Codifying Roe has become an increasingly popular campaign promise in the Democratic field at a time when the president has put into place Supreme Court justices who are expected to overturn the precedent and many states are peddling one extreme abortion ban after another. But with so much at stake, it’s critical that Democratic presidential candidates recognize enacting a federal law to keep abortion legal must be the floor, not the ceiling.

Since 1973, the precedent of Roe has meant abortion access is dependent on socioeconomic status and ZIP code. As a result of the more than 1,200 state and federal laws that have been enacted since Roe—over a third of which were enacted in the last decade alone—abortion access has been decimated, even though abortion is still legal. One major hurdle to unfettered access to abortion is the Hyde Amendment, a federal budget rider that since 1976 has banned Medicaid insurance from covering abortion and rendered abortion a privilege based on income. Hyde, like the many state-level laws that similarly restrict insurance coverage of abortion, unjustly affects women of color. Due to a complicated “perfect storm” of racism, discrimination, and economic inequality, women of color are disproportionately enrolled in Medicaid and are therefore more likely to be harmed by Hyde than their white counterparts.

Our next president must do so much more than protect a legal precedent that simply does not function as it should to ensure each of us can access the health care we need. Democratic presidential candidates must challenge restrictions like Hyde, and promise to proactively ensure coverage for abortion and all reproductive health care. Further, more than simply promise to end Hyde, candidates should offer specific plans for how they would do so, and make it clear that they would not compromise on this in pursuit of policy gains in other areas.

Candidates must also take action on other existing state laws—from mandatory waiting periods, to parental involvement requirements, to mandated anti-choice counseling, to explicit abortion bans, to targeted regulations of abortion providers (TRAP) laws. These state laws block access to health care, stigmatize abortion, and punish and endanger anyone who may need an abortion but is marginalized by our health system. This includes people struggling financially, women of color, young people, immigrants, transgender men, and non-binary people.

And candidates must outline comprehensive plans to achieve real abortion access for all, and they should be asked about them at every debate.

We already know the toll of Democrats’ inaction and passively playing defense, all while anti-choice extremists enact barrier after barrier on reproductive rights. Georgia, where last week’s debate was held, has the highest maternal death rate in the nation, and it is especially high for Black women. When politicians block access to crucial health care like abortion and other reproductive health services, low-income people, and especially women of color, are the ones who pay the price. And if we’re only fighting to codify Roe—and not to address the racist, classist disparities that have failed to make the full spectrum of reproductive health-care services a reality for so many—then we’re leaving people behind.

The threat of losing Roe is serious. If the precedent is overturned in the coming years, both patients and abortion providers could face criminalization and many other dangerous, costly outcomes. And we know that means women of color would likely be targeted most harshly. We must fight to protect Roe—but we must also fight to expand it.

Since 1973, economic barriers, as well as other geographical and identity-based restrictions, have reduced abortion rights to the theoretical for far too many people. With the coming elections, we have the chance to fight for so much more than the status quo: We have a real opportunity to fight for reproductive justice for all. And we need to elect a president who’s going to lead the way, and seize that opportunity.

Source: https://rewire.news/article/2019/11/27/codifying-roe-isnt-a-plan-to-ensure-abortion-access/

Almost half of UK abortions in 2018 were not the woman’s first. Rebecca Reid asks why a second abortion comes with more stigma than the first.

There was shock from all corners of the internet today, at research that found that a small number of UK women have had more than six abortions in their lives. The research was presented without any extenuating circumstances about these women, nor explanations about their lives and the coverage, which has been barely concealed horror, belies the enduring stigma that comes with having had more than one abortion.

As with so much of my education about the adult world, it wasn’t until the episode of Sex and the City where Carrie wrestles with telling Aidan that she had an abortion in her twenties, that I realised having more than one abortion was even possible.

‘I’ve had two,’ says Samantha, as they sit around the table discussing who has and who hasn’t had one before. It was the only thing Samantha Jones, famous for discussing semen and sex swings, ever said that shocked me.

The idea that abortions should be a one-off occurance seems to be pervasive across the board. Imogen, 28, tells Grazia: ‘I had an abortion in my mid-twenties and regretted nothing. But when I had a pregnancy scare a year later (a false alarm) I thought, almost before I realised I was thinking it, I have to have this baby because I can’t have two abortions. Because it was a false alarm I never had to make the decision, but I know that not wanting to have ended two pregnancies would have been part my thought process, which is ridiculous because I am pro choice.’

‘I felt fine about my first abortion’ says Daisy, 30. ‘I was a teenager, I was at school, it seemed like a no brainer that I shouldn’t become a mum. But then I got pregnant again in a long term relationship in my late twenties and I felt like I should have known better. I was on the pill and it was a freak accident, but I still felt like the most irresponsible person in the entire world. I didn’t want to tell the people at my appointment that this was my second one, as if they were going to think that I was stupid. I even found myself thinking of the word “slutty”, something I would never say to anyone out loud.’

Despite the entrenched stigma of having more than one abortion, multiple abortions are extremely common. Last year in the UK 84,258 abortions took place. That’s not far off half of the UK total (205, 295). So why is admitting to having had two abortions so much more shocking than having had one?

There are still all sorts of internalised rules about having an abortion. If you’re very young, single or a rape victim then you’re having the ‘good’ kind of abortion. If you’re lax with your contraception, old enough to look after a baby or on your second abortion, it’s the ‘bad’ kind.

In reality, the most common age range to seek an abortion is 25-29, and 20% of women who have had an abortion are married at the time. 56% of women who have an abortion have already had at least one child.

Alongside misconceptions about who has abortions, there is a ‘fool me once’ sort of attitude, which makes one abortion acceptable while two or more carries an enormous stigma. As women we’re allowed to make one mistake, but making two takes it away from the realm of mistake and into the arena of irresponsibility.

Until I watched that episode of Sex and the City, I had subconsciously assumed that women who had abortions were so chastised by the whole experience that they should swear off sex until they were ready to give their husband 2.4 children. But that’s just not how it works. Women go back to having sex after abortions, and sometimes accidents happen. Two in every 100 condom usages fails, the pill isn’t foolproof and the morning-after pill only really works if you’re yet to ovulate. There is also the fact that women are subjected to rape and reproductive coersion.

If you’re sexually active for a long period of time, the chances of you having an unplanned pregnancy more than once aren’t exactly negligible.

I dislike my own shock towards people who discuss having had multiple abortions, because I know where it comes from. It’s a deeply repressed well, mostly filled up during my Catholic education, which believes on some level that abortions are punishments for having extra-martial sex, and that getting pregnant means you are irresponsible. I, like so many women, still struggle to shake the shame associated with ending an unplanned pregnancy.

It’s easy to feel that we’ve finished destigmatising abortion, because famous women talk openly about having them and they’re broadly speaking avalible to women in the western world. But that’s not the case.

Abortion is not the preferable way to manage pregnancy because it is invasive, time-consuming and painful, but it is an essential aspect of female reproductive healthcare, and whether you have had one, two or five, it should remain a choice, and a choice made free from judgement and stigma.

Source: https://graziadaily.co.uk/life/in-the-news/multiple-abortions/?fbclid=IwAR3QfyOKZSPHGbesAxUCYxzpCaQXUjCkfQjc9hcF-yd9QptKmLwuxVj4cU8

Activists said to serve the people most affected by abortion restrictions, the Atlanta Reproductive Justice Commission will have to tackle ways to make health care more accessible.

Atlanta officials are seeking ways to improve access to reproductive health care for the city’s most marginalized, six months after Georgia Republicans passed an unconstitutional six-week abortion ban.

The Atlanta City Council approved a resolution last week to create a Reproductive Justice Commission designed to mitigate the effects of the state’s near-total ban, which outlaws abortion care six weeks into pregnancy, before many know they’re pregnant. Georgia is one of several states with Republican-majority legislatures that passed a near-total abortion ban this year.

The Georgia law was temporarily blocked by a federal judge in October.

The Atlanta commission will research policy and recommend ways to “increase awareness around access to reproductive care as well as public and private resources.” It will focus on how to improve health outcomes “related to reproductive, maternal and infant health, and abortion access in Atlanta.”

Council member Amir Farokhi, who introduced the Reproductive Justice Commission resolution, said Atlanta’s charter does not allow the commission to “get involved with public health or social service work,” since that is the county’s purview. Instead, the commission can examine zoning and potential improvements to transit routes and locations for reproductive health-care facilities. The commission, Farokhi said, could also make sure city workers have access to reproductive health care.

Although the Atlanta Reproductive Justice Commission may point out opportunities for better funding of reproductive health-care services, there will be no public funds allocated to the commission, Farokhi said.

Kenyetta Chinwe, a project coordinator for the Atlanta-based reproductive justice group SisterSong, said to better serve the people most affected by abortion restrictions, the commission will have to tackle ways to make health care more accessible.

“People who are marginalized and disenfranchised from society are already feeling the effects of access to health care in general and reproductive health care,” Chinwe said. “Georgia has a high maternal mortality rate, and that disproportionately affects women and trans and nonbinary people of color in the state, so any time you implement something that is going to restrict health care it’s going to impact the groups already affected.”

Atlanta is a majority Black city. Four percent of the population is Asian, and 4.6 percent are Latinx, according to the U.S. Census Bureau. In 2015, Gallup found Atlanta had the 19th highest LGBTQ population among major metropolitan areas, at 4.2 percent of the population. Twenty-two percent of people in Atlanta live in poverty, compared to 12.3 percent across the United States.

High rates of maternal death for Black women in Georgia are at a crisis level, and reproductive justice activists say abortion restrictions and other barriers to health care only exacerbate the problem. The maternal mortality rate for Black women in Georgia is 66.6 deaths per 100,000 live births, compared to 43.2 for white women. Georgia has the highest maternal mortality rate in the United States. Research shows that states with more abortion restrictions have worse health outcomes for parents and children, and that racism can play a motivating role in these restrictions, according to a 2018 Center for American Progress report.

Atlanta is the latest city to push back against Republican-backed near-total bans on abortion. City councils in  Toledo, Cleveland, and Columbus have passed resolutions opposing Ohio’s near-total ban. Meanwhile, local officials in states like New Mexico and Texas have passed anti-choice resolutions that reproductive rights advocates say could confuse those seeking abortion care.

The Atlanta commission is supposed to ensure marginalized groups have a say in the recommendation process. The commission, which will meet for three years, will have seven members. Two will be appointed by the mayor, one by the district health director of the Fulton County Board of Health, one by the council president, and the rest by council members from districts across Atlanta. None of these appointments had been made by the time Rewire.News spoke to Atlanta officials.

“It’s important that those appointees are knowledgeable about reproductive justice and health-care issues but also demographically representative of the populations most affected. A lot of this is up to politics. People will appoint who they want to appoint and we’ll see how this plays out,” Farokhi told Rewire.News. “But my sense is that at least the members of council who care about this issue are likely to choose someone under the guidelines in the resolution. We’ll be very mindful that the commission is appropriately diverse [and has] representatives of everyone who is affected by this issue.”

Advocacy groups, including SisterSong, approached Farokhi after he introduced a resolution in May opposing the state’s near-total abortion ban. SisterSong is part of the Amplify campaign, a project of six Georgia-based reproductive justice organizations to advocate for the protection and expansion of abortion access.

“We will do our best to advocate and make sure there are community members on the commission as well as people who have the best interest at heart for the most marginalized in the city,” said Chinwe, SisterSong’s project coordinator for Amplify Georgia.

Beyond the blocked near-total abortion ban, Georgia has a long list of abortion restrictions. Patients are required to receive counseling that aims to discourage them from having an abortion and wait 24 hours before receiving an abortion; an abortion must be performed before 20 weeks post-fertilization; there is a forced parental notification requirement; and health plans under the state exchange for the Affordable Care Act—also known as Obamacare—can only cover abortions in the most severe health cases. Abortion is only covered in insurance policies for public workers when the life of the pregnant person is in danger.

Farokhi said the commission’s goal of increasing awareness of reproductive health-care options is particularly important in the South, where abortion clinics have closed due in part to medically unnecessary anti-choice laws designed to shutter facilities.

“Often times, because the legislative steps taken by [the] Republican legislature have been fairly draconian and being near a major city, there’s either confusion or absence of knowledge that there are reproductive health-care resources available in the state,” he said. “So we have to make sure that one, people know that abortion is legal and that two, you have access to it in Georgia in a number of different manners.”

He said it was important for Atlanta to lead on this issue as the capital of the state, the state’s most populous city, and “the economic and cultural hub of the Southeast.”

“I think there is symbolic importance of Atlanta placing a flag in the sand on the side of access to health care and to women’s bodily autonomy and bodily autonomy generally regardless of gender,” Farokhi said.

Source: https://rewire.news/article/2019/11/26/atlanta-wants-to-blunt-the-impact-of-georgias-near-total-abortion-ban/

Passing landmark abortion rights legislation in Illinois was just the start. Obstacles remain for many in the state.

Despite a landmark pro-choice law and Democratic Gov. J.B. Pritzker’s promise to make Illinois “the most progressive state in the nation for access to reproductive health care,” barriers remain for people seeking abortion care, according to abortion rights advocates and providers.

Passed by Illinois Democrats in June, the Reproductive Health Act declared abortion a “fundamental right” and wiped away unenforced anti-choice provisions enacted in the last 44 years, including husbands’ ability to block their wives’ abortions and a variety of medically unnecessary targeted regulations of clinics. The law allows advanced practice nurses to provide surgical abortions and requires private insurance plans to cover abortion like other pregnancy-related care. Abortion rights advocates hope the law will lead to greater access across the state and for people in neighboring states that severely restrict abortion, including Indiana, Missouri, and Wisconsin.

“We’ve made fantastic progress in ensuring access to abortion in the past couple of years,” Brigid Leahy, senior director of public policy at Planned Parenthood Illinois, told Rewire.News.

But barriers remain, as insurers and state agencies have yet to fully catch up to the new pro-choice policies. And the law does not address other issues that affect patients, including Illinois’ parental notification law, a dearth of clinics in parts of the state, and a growing number of Catholic hospitals in Illinois that don’t offer a full spectrum of reproductive health care.

Lee Hasselbacher, senior policy researcher at the Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health at the University of Chicago, said the act removed a nonenforceable ban on later abortion care and codified some court orders. While not a change in current policy, the codification allays fears about dormant anti-choice laws. The act also established an “affirmative right” to abortion that could affect future state court rulings.

“When any case comes up in the future, it has to be judged against that law,” she said.

She said good implementation will be key in making Illinois a model state for access to abortion care.

“The most pressing thought for folks right now, among the providers I talk to, is: ‘Now that we have some of these good laws in place, how do we make sure they’re implemented well and that access continues to improve through their implementation?’” Hasselbacher told Rewire.News.

Insurance Coverage Challenges 

The inflection point for abortion access came in September 2017, when then-Gov. Bruce Rauner (R) signed HB 40, which allowed Illinois Medicaid and state employees’ plans to cover abortion care. But the administration didn’t follow up. Hasselbacher said after the legislation became law, there was a lack of support from the state government.

“[There was] not a lot of clarity at the time from the state agency,” she told Rewire.News. “Previous to the current administration, there wasn’t as much support for this law being put into effect. Folks were feeling frustrated trying to contact the state agency trying to get guidance.”

Two years after the law took effect, many clinics still struggle because of low reimbursement rates or the complicated process of getting approved to bill Medicaid.

“We didn’t physically bill Illinois Medicaid until two months ago,” Alison Dreith, executive director of Hope Clinic for Women in Granite City, told Rewire.News, adding that a donor was helping cover the difference for Medicaid patients seeking abortion care. “We had to get a whole new electronic medical records system that would allow us to bill Medicaid and do a lot of complying with the state. When those reimbursement rates came back to us, they were very low.”

Dr. Allison Cowett, co-medical director at Family Planning Associates in Chicago, told Rewire.News that it was only in the past few weeks that the rate was updated from what it was in the 1970s.

Even so, more abortions are state funded than before the law. The Illinois News Network reported a 274 percent increase in abortions paid for by Illinois Medicaid over the first six months of 2018, after HB 40 went into effect. Despite the sharp increase, it was from a low baseline: In the first six months of the previous year, Medicaid only covered 84 abortions. These were likely cases of life endangerment, health risk, or pregnancies that resulted from rape or incest.

Medicaid paid an average of $77 per procedure, 6 percent of what clinics had billed, based on 2018 figures the Illinois News Network reported.

Even for providers who were already contracted with Medicaid and have a process for billing, challenges remain. Until the start of November, billing Medicaid involved paperwork that differed from the electronic claims that were usually sent, according to advocates and providers. Leahy of Planned Parenthood Illinois said the process required a separate staff person to take care of the billing.

“Every Medicaid provider will tell you how slow it is to be reimbursed by Medicaid,” she said. “But if you layer in [that] this process is slowed down even more because everything’s being processed on paper by hand, it is quite a problem. … We’re very pleased the system is changing and that the department is now going to be treating the billing of abortion just like all the other services that Medicaid covers, which is what the [HB 40] law says it should be doing.”

Hasselbacher said one of the biggest effects of the Reproductive Health Act could be the requirement for private insurance to cover abortion like any other pregnancy-related care, but that it hasn’t actually had an impact yet because plans haven’t yet been updated. She said she expects the change to become clear over the next few months as insurance plans are updated for the next calendar year. She noted that the law doesn’t change common issues people have with their insurance like high deductibles, which have been rising in the United States.

Along with high-deductible plans, Megan Jeyifo, executive director of the Chicago Abortion Fund, said many are left out of Medicaid and private insurance coverage, including some people who have little income but are over the Medicaid threshold.

As insurance funding increases in the state and the need for travel increases, abortion funds are shifting their resources to cover travel and other costs beyond the procedure. The Chicago Abortion Fund is doing more case management as well. Jeyifo said it was a major shift since the time she started, when the fund would typically send the patient a voucher for the cost of the procedure.

“It’s way more logistics,” she said. “Way more.”

Case management could involve helping arrange the appointment, travel, or child care, Jeyifo said. And the fund is increasingly dealing with needs beyond the procedure itself.

“We are checking in with folks, and making sure, if they have other issues in their life, that we can provide other resources for them,” she said. “It’s an honor to be able to do this with folks. But it’s absolutely different than it was previously.”

‘The Last Remaining Legal Obstacle’ 

The 1995 Parental Notification Act, which was stayed by an injunction until 2013, was not affected by the Reproductive Health Act. The law requires minors to notify their parents that they’re getting an abortion at least 48 hours beforehand. Leahy called it the “last remaining legal obstacle” for abortion access in the state. It presents an unnecessary hurdle for teens seeking abortion care, she said, and it is potentially dangerous to pregnant teenagers in abusive or otherwise unsafe homes.

“We would really refer to it as a teen endangerment act,” she said.

The ACLU of Illinois, which battled the law in court, has documented a number of instances of harm coming to teenagers in other states due to parental notice requirements. After the law went into effect, the ACLU of Illinois created a project to represent teenagers free of charge in judicial bypass hearings.

Cowett characterized the forced parental notification law as a “major barrier,” and noted that virtually every request for a judicial waiver gets approved—a 2015 Chicago Tribune story reported that the ACLU attorneys in the state had never had a client’s petition turned down.

“Everyone who goes through the judicial bypass end[s] up being granted, so why are we putting young women in this uncomfortable position?” Cowett asked.

Advancing New Standards in Reproductive Health (ANSIRH) at the University of California, San Francisco conducted a study on 1,577 women at Hope Clinic both before and after Illinois’ parental notification law went into effect in 2013. The study compared outcomes between minors and young adults who were close in age but not affected by the law. The study found that fewer minors overall received abortions after the law. Among minors traveling to Illinois from out of state, the proportion receiving a second trimester abortion increased. The percentage of parents of minors who were aware of the abortion increased, with no corresponding change in parents’ support.

An earlier study found that the number of minors receiving abortion care slightly decreased following implementation of the law, though researchers could not conclude that the difference was significant.

Researchers noted in both papers that, because the studies only looked at people receiving abortion care, they could be underestimating the effect, and that the decline could be attributable to the ongoing decline in abortions across age groups, including adolescents.

Illinois representatives advanced a bill this year to repeal the Parental Notification Act, but it never got out of committee.

Abortion Care Deserts Persist 

Many of Illinois’ clinics are concentrated in or around Chicago, meaning pregnant people in most parts of the state have to travel to get an abortion. According to 2017 data from the Guttmacher Institute, 90 percent of counties in Illinois don’t have a clinic, leaving about 37 percent of women of reproductive age, or nearly a million women, needing to travel to access abortion. The number of Illinois abortion care providers peaked in the years after Roe v. Wade, declining from 87 clinics in 1976 to 37 in 2000. It has since plateaued and stands at 40 today.

Dreith said that despite progress, the decline in clinics remains an impediment to access for many.

“Illinois is similar to California in that clinics are also closing,” she told Rewire.News. “There are large swaths of the state with no provider.”

The lack of clinics in the northwest corner of the state means a number of Illinois residents come to the Emma Goldman Clinic in Iowa. Many of those callers used to be served by a Peoria, Illinois, clinic that closed in June, Francine Thompson, executive director of the Iowa clinic, told Rewire.News.

One consequence of leaving Illinois for care is that the pregnant person’s abortion is not eligible for state funding, Thompson said. “The financial barriers are certainly big ones,” she said.

Dreith said the distance meant patients at her clinic often need to arrange child care, travel, and time off work in addition to the appointment.

Meanwhile, a growing number of hospitals in the state are owned by Catholic health-care systems that don’t provide abortion or contraception. For low-income people in Cook County, most of the available Medicaid managed care plans leave them disproportionately reliant on Catholic hospitals, according to a recent study Rewire.News on in June. Nearly 15 percent of people in Cook County live under the poverty line.

Beyond restrictions, many advocates Rewire.News spoke to are concerned about patients misunderstanding the law, fed by anti-choice information, worried social media posts, and headlines that lack context. Dreith said she has fielded panicked calls from patients who didn’t realize an anti-choice law they saw in the news was in another state, blocked by a court, or both.

She said she wanted “to reassure patients in Illinois and surrounding states that we’re working hard to be as welcoming as possible.”

Leahy echoed her comments, encouraging pregnant people seeking abortion services to reach out to a clinic or use online tools like Planned Parenthood’s Abortion Care Finder.

“There are people who really want to help you with getting the care that you need,” she said.

Source: https://rewire.news/article/2019/11/21/in-illinois-struggles-in-putting-pro-choice-legislation-into-action/

The hotel ballroom is packed when the spoken-word poet Staceyann Chin takes the stage on a Saturday morning in late October. At least 1,100 mostly women and nonbinary people of color have filled the vast space in the Hyatt Regency in Atlanta in anticipation of her performance and of Stacey Abrams’ keynote address, which will come next.

Chin’s first poem is a polemic against President Donald Trump, which elicits yells of support along with sharp laughs and applause. But the second performance, called “Tsunami Rising,” is when the audience explodes. In a monologue describing how black women have been brutalized, beaten down and discarded since before the founding of America, Chin expresses both the rage she feels at being ignored and the adoration she has for her fellow women of color. “If you are itching to light a f-cking bonfire in the house of the white patriarchy, come stand with black women,” she says.

Many in the room are on now on their feet, tears streaming down their cheeks. When Abrams, who lost the Georgia gubernatorial race in 2018 but has since launched voting-rights and census-participation campaigns, steps up to the podium, she urges attendees to turn their pain into action. “My campaign began with the notion that you could center communities of color and you could speak to the marginalized and the disadvantaged,” she says. “More importantly, you could hand them the microphone.” By the end of her talk, the room is on its feet again. Everyone must help ensure that “justice becomes a verb in the United States,” she says.

This mix of fury and joy, celebration and action, defines the weekend at SisterSong’s biennial Let’s Talk About Sex conference, which despite its name is about much more than sex. It’s a training institute, healing retreat, information-sharing opportunity and 2020 strategy session for people working to advance the cause of reproductive justice. “My campaign was a love song to SisterSong,” Abrams says in her speech.

Reproductive justice, unlike the more mainstream phrasing reproductive rights, goes beyond contraception, abortion access and the idea of being “pro-choice.” According to the SisterSong Women of Color Reproductive Justice Collective, it’s “the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.” The framework demands consideration of all the ways reproductive health can be affected by other factors, from race, religion or sexual orientation to financial, immigration or disability status to environmental conditions. “It’s about liberation,” says SisterSong executive director Monica Simpson, “and it’s about dismantling systems of oppression that make our lives hard in this country but also that make it impossible for us to have the access and the choices that we want to have.”

While women’s-health groups like Planned Parenthood and NARAL attract the most national attention, today’s political climate, the country’s changing demographics and a growing recognition of the importance of women of color to progressive politics have combined to put new focus on the work and ideology of reproductive justice. In recent years, groups committed to this work have added chapters and attracted new volunteers and donors. And in June, SisterSong became the named plaintiff in a lawsuit challenging Georgia’s new law prohibiting abortion once cardiac activity from a fetal pole is detectable–sometimes known as a “heartbeat” ban. It was the first time the group has gotten involved in such a high-profile lawsuit, and it catapulted SisterSong into the spotlight.

As Democrats increasingly see women and people of color as key to their 2020 strategy, the leaders of the reproductive-justice movement believe they can provide a model for how to mobilize people across the country. “This is a moment for a reckoning,” says Kimberly Inez McGuire, the executive director of URGE: Unite for Reproductive and Gender Equity, which focuses on mobilizing young reproductive-justice advocates. “It’s not enough for our progressive comrades to sit on the sidelines anymore.”

The reproductive-justice movement came into its own in June 1994, when a group of mostly white women gathered at a conference in Chicago to hear about the Clinton Administration’s proposal for health care reform, which de-emphasized reproductive health care in an attempt to head off Republican criticism. The few black women present were concerned. There was little focus on health services like pre- and postnatal care, fibroid screenings or STI tests, and seemingly no understanding of how black women’s “choices” around parenthood and reproductive care were often constrained by things like income, housing and the criminal-justice system. So 12 black women leaders gathered in a hotel room to discuss how to address these disparities.

The group called themselves the Women of African Descent for Reproductive Justice and bought full-page ads in the Washington Post and Roll Call that featured over 800 signatures calling for any health care reform package to include the concerns of black women. Three years later, 16 organizations including black, Asian-American, Latina and indigenous women got together to create SisterSong, a collective devoted to the reproductive and sexual health of women and gender-nonconforming people of color, based in Atlanta.

Over the years, SisterSong and other reproductive-justice groups have remained separate from more mainstream reproductive-rights groups. While they support each other’s work, reproductive-justice leaders have sometimes felt that the bigger organizations wanted to collaborate only when it was convenient. “We have the language, we have the connections, and we know how to talk to our people,” Simpson says. “For a long time it was very transactional.” But in 2014, there was a shift. After a New York Times story about reproductive-rights groups expanding their “pro-choice” message did not mention the efforts of reproductive-justice advocates, Simpson, joined by other movement leaders, wrote an open letter to Planned Parenthood. “This is not only disheartening but, intentionally or not, continues the co-optation and erasure of the tremendously hard work done by Indigenous women and women of color (WOC) for decades,” Simpson wrote. This forced the two movements to sit down and discuss how they could better work together.

SisterSong now provides training on the history and ideology of reproductive justice to local Planned Parenthood affiliates, and Planned Parenthood clinics provide medical care and services that SisterSong does not. There’s a need for both, Simpson says. “Organizations don’t have to be everything to everybody,” she adds.

Nia Martin-Robinson, director of black leadership and engagement at Planned Parenthood, says the 2014 letter was a learning opportunity. The organization has since deepened its commitment to “making sure that we’re giving credit, space, visibility and power to the folks who have been leading this work around the reproductive-justice movement,” she says. Planned Parenthood was a top sponsor at SisterSong’s conference this year. But the relationship could always be stronger. “We’re still on that journey,” Simpson says.

The SisterSong conference offered a range of workshops on a variety of hot-button progressive topics, including environmental justice, immigration and Palestinian solidarity, as well as training for medical providers, nonprofit leaders, lawyers and researchers, and how-to sessions on everything from campus organizing to the entrepreneurship of stripping. At one session, attendees discussed strategies for incorporating disability advocacy into their work. Another workshop concluded with participants chanting, “I am worthy of pleasure!”

On the second night, attendees let loose at a dance party that lasted well past its scheduled three hours. “There’s not a lot of places that the organizers in our community can show up to just be recharged,” says Danielle Rodriguez, SisterSong’s national conference coordinator. This feeling of solidarity was crucial for attendees like Bridgette Agbozo, a 22-year-old from North Carolina whose family came to the U.S. from Ghana. “As a young person who grew up in the U.S. South and coming from an immigrant background, these are not conversations I grew up having,” she says after leaving a workshop where she sought advice on how to square her love for activism with thoughts of going to law school. “It’s really reaffirming to be around people who get it.”

The increased influence of the movement was apparent at the conference. After the 2016 race, in which 94% of black women voted for Hillary Clinton, many nonprofits realized that they needed to speak more directly to women of color, who are instrumental to efforts to expand the base. SIECUS, formerly known as the Sexuality Information and Education Council of the U.S., has historically not been part of the reproductive-justice movement, but it recently rebranded with a new mission of using sex education to push social change. “When you center these voices of those who are most at risk,” SIECUS president and CEO Christine Soyong Harley says, “you actually come up with the best solutions for our society.” URGE went from hosting chapters solely on college campuses to also building “city activist networks” in recognition of the fact that not all young people who want to organize attend college. National Latina Institute for Reproductive Health has seen a swell in grassroots involvement and other groups wanting to help their cause. And National Asian Pacific American Women’s Forum is investing in get-out-the-vote efforts, after seeing people turned away when trying to vote in Georgia in 2018, says executive director Sung Yeon Choimorrow.

Reproductive-justice leaders are quick to note that people of color have struggled to access care for much longer than Trump has been in office. But since the election, the flood of new policies affecting immigrants, LGBTQ people, women and those relying on programs such as Medicaid and Title X funding has created a new pressure. This year alone, states have passed 25 laws that would ban some or most abortions, according to the Guttmacher Institute, a research group that supports reproductive rights, and the uninsured rate increased for the first time in nearly a decade.

When SisterSong sued Georgia over its ban on abortions as early as six weeks–before many women know they are pregnant–it was a big moment for the group and the movement. “A lot of abortion lawsuits erase women of color,” says Sean J. Young, legal director of ACLU of Georgia, which is serving as counsel on the case, along with the Center for Reproductive Rights and Planned Parenthood. (Feminist Women’s Health Center, Planned Parenthood and other Georgia medical providers and their patients are also plaintiffs.)

Many abortion lawsuits focus on doctors and patients. But in this case, the legal team is arguing that the law will also hurt SisterSong and the advocacy organizations and pregnant people it represents. “When the government bans abortion, it forces such organizations to divert their limited resources to combat the ban,” Young says.

Shortly after Kenyetta Chinwe joined SisterSong in January to start its Amplify project, which aims to build relationships with faith leaders, Georgia’s legislature took up its abortion bill. So rather than focusing on outreach to religious communities, she spent weeks at the state capitol with the group’s state director lobbying against the bill.

The staff also travels to provide training to other social-justice groups, to nonprofits and, increasingly, to service providers and even medical schools on how to incorporate the values of reproductive justice into their work. SisterSong now has 65 organizational members and nearly 500 individual members in its coalition. But with just seven full-time staffers and a budget that allowed for spending $1.7 million in 2017 (compared with, say, Planned Parenthood’s $318 million for the fiscal year ending in June 2017), the group is stretched thin.

People outside the movement have quietly adopted some of the priorities of the reproductive-justice community. In 2016, the Democratic National Committee added language advocating the repeal of the Hyde Amendment, which bans the use of federal funding for most abortions, to its platform for the first time, something reproductive-justice groups had pushed for years. Kamala Harris has been using the phrase reproductive justice since at least 2017. Elizabeth Warren features a reproductive-justice section on the women’s-health policy page of her website. And Julián Castro has mentioned the term in multiple presidential debates. His campaign manager, Maya Rupert, spent most of her career as an activist and is familiar with this work, but says the ideas come from the candidate, who listened to women of color and wanted to incorporate reproductive-justice values into his policies. “It is a testament to the unbelievable organizing and activism work that black women have been putting in for years and years and years,” Rupert says of seeing more candidates talking about reproductive justice.

Some philanthropic foundations have reallocated their budgets to give more grants to reproductive-justice groups and help them build organizing capacity. The Ford Foundation, for example, has doubled some reproductive-justice groups’ funding to $1 million each year. And Groundswell Fund, which supports more reproductive-justice groups than any other foundation in the U.S., not only increased its own funding to such groups after the 2016 election, giving $2.9 million from its core fund last year, but also ramped up its work with other foundations to increase investments in reproductive justice. “Philanthropy has a hard time funding women of color,” says its founder and executive director Vanessa Daniel. “Things are moving in a good direction but at a glacial pace.”

For those gathered at the conference, there’s a tough fight ahead. Movement advocates fear the Supreme Court’s conservative majority could overturn Roe v. Wade or render another decision that would make abortion inaccessible in states with Republican legislatures. Choimorrow says she is glad to see the broader culture recognize the importance of reproductive justice, but wants to push some national organizations to do more work before the 2020 election. “I think the winning strategy is actually to expand your messaging,” she says. Women of color are already doing this, she adds. “Maybe it’s time for you to really get out of the way so that women of color can lead.”

Which is perhaps the point. At one of the most popular panels at the conference, four executive directors of progressive organizations, all people of color, spoke about the challenges of championing the concerns of their communities in historically white-led environments. The next day, attendees erupted in cheers when Georgia state representative “Able” Mable Thomas, one of the “founding mothers” of the reproductive-justice movement, announced she is running for the U.S. Senate.

These are moments that make Simpson optimistic. “Folks are ready to fight back, and they want to fight back with a movement that understands them,” she says. “We are creating our own stages, we’re creating our own tables, we are grabbing our own microphones to talk about these issues, to move our work forward. Folks are going to have to catch up.”

Source: https://time.com/5735432/reproductive-justice-groups/

They’re convenient, private, affordable—and often logistically or legally impossible.

In the spring of 2017, Emma Donnelly, a junior at the University of Southern Maine, read an article that inspired her to take action. Students at the University of California, Davis, had organized to get a vending machine on their campus that sold emergency contraceptives for half of what they cost at a typical drug store. To Donnelly, this seemed like a simple solution to a persistent problem on college campuses: how to get convenient, discreet, and affordable access to a potentially life-altering product. What she didn’t know was that bringing one of these machines to her school would take two years, a surprise farmers market encounter, a major legislative battle, and a new state law with far-reaching impacts for health care across the state of Maine.

Access to emergency contraceptives in the United States has always been difficult, especially on college campuses like USM. Although the university has three campuses, it has only two health centers, which are open from 8 a.m. to 4:30 p.m. on weekdays, meaning that students who need access to emergency contraceptives from the health center over the weekend have to wait until Monday to get them. While the recommended window to take emergency contraceptives such as Plan B is 72 hours, it’s more effective at preventing pregnancy if taken sooner. Every hour someone has to wait to take an emergency contraceptive increases the risk of an unwanted pregnancy.

Students can also purchase emergency contraceptives from local drug stores. The main USM campus, in Portland, has two stores within walking distance, and the Gorham campus, where Donnelly was enrolled, has one, but none of them is open 24/7. For students who need immediate emergency contraception, the nearest 24-hour store is 42 miles from Portland and 37 miles from Gorham. And the costs at all of these stores can be a barrier. The average price of an emergency contraceptive at CVS and Walgreens, the two major retailers in the area, is between $40 and $50. Students who can’t afford these prices or access these stores are forced to wait, in a situation where every hour counts.

Donnelly was particularly concerned about finding a way for victims of sexual assault to gain easy and anonymous access to emergency contraceptives. According to the National Sexual Violence Resource Center, 1 in 5 women is sexually assaulted while in college. But victims who want emergency contraceptives are often deterred from getting them by logistical and privacy challenges. A 2018 report by the American Society for Emergency Contraception (ASEC) found that only 60 percent of drug stores in the United States stock emergency contraceptives on the shelves. Of those stores, 57 percent lock the product in a case that requires store employees to open it. Many stores also ask for identification to purchase emergency contraceptives, even though in 2014, Plan B and its generic counterparts were approved by the FDA for all age groups without requiring identification. This process can make many people feel as if they are being recorded or purchasing something elicit. “For someone who’s experiencing stress or potentially trauma, [this process] is actually a really big barrier,” explains Kelly Cleland, a Princeton researcher and coordinator for ASEC.

When Donnelly first went about trying to get the emergency contraceptive vending machines on campus, she figured it would be a straightforward process. She spoke to her director of health services, who immediately embraced the idea. Then they ran into a problem: It was illegal in Maine to sell emergency contraceptives in vending machines, due to a set of obscure 1930s laws that blocked the sale of any over-the-counter medications in vending machines. “I didn’t think by any stretch of the imagination that it would ever be illegal,” recalls Donnelly. At least three states expressly prohibit vending-machine sales of over-the-counter products, and five others prohibit them unless there is an exception from a regulatory body. Before Donnelly could get her school administration on board, she would have to go to the state capitol.

But the push actually began with a chance encounter at a local farmers market in Gorham. Maine state Rep. Maureen Terry, who represents most of USM, was selling her homemade granola when Donnelly, a member of the student council, was doing her weekly community outreach. They got to talking about vending machines, and Terry says she was instantly convinced to support legislation to change the vending machine law. “I thought for sure it would be a no-brainer,” says Terry.

However, as the nearly 15-year battle to get Plan B and its successor Plan B One-Step approved for over-the-counter usage illustrates, nothing is a no-brainer when it comes to emergency contraception. One of Terry’s colleagues told her “a bill about women’s reproductive rights is not something that [he was] interested in,” she says. Other state lawmakers, she says, repeated common misconceptions around emergency contraception, such as the idea that they can cause abortions. (In fact, emergency contraceptives prevent fertilization of an egg, whereas abortion medications are used after fertilization and implantation.)

But Terry, a mother of three daughters, persisted, and in January she introduced LD 37—”An Act To Allow for the Sale of Nonprescription Drugs through Vending Machines”—in the legislature. Two months earlier, Maine had elected its first female governor, Janet Mills, who was much more sympathetic to reproductive health care issues than her predecessor, Paul LePage. Despite testimony from anti-abortion activists claiming that the legislations would endanger children and provide on-demand abortions, Mills signed it in June.

Next school year, USM will have its very first emergency contraceptive vending machine, which will provide emergency contraceptives at roughly $20 a pack, less than half what students would pay at traditional pharmacies.

But Cleland is aware of only 13 colleges that have emergency contraception vending machines on campus.

At Yale, students ran into the same problem as Donnelly, when they discovered, after voting to install an emergency contraceptive vending machine, that selling over-the-counter medications in vending machines was illegal in Connecticut. Instead the student council moved forward with a “sexual wellness” vending machine, which includes condoms, lubricants, and tampons.

State laws aren’t the only challenges students face in expanding access to emergency contraceptives. When Rachel Samuels, then a student at Stanford University, first tried to get emergency contraceptive vending machines on her campus in 2015, she says she was met with pushback and indifference from college administrators. “It took dozens of meetings and consistent emails even after I graduated for any real progress to take place,” she says. In 2017, three months after she graduated, Stanford placed a vending machine in a gender-neutral bathroom in the student health center, which students can access 24/7. It dispenses emergency contraception for $25.

Samuels says it was worth the fight. At the local CVS, she says, many of her classmates reported feeling judged by pharmacists and said accessing emergency contraception was stressful and embarrassing, particularly for victims of sexual assault.

“Universities need to do better,” says Samuels. “They need to listen to survivors, and they need to work with survivors to make the process better, because right now it’s so hard for survivors, and this is just one tiny thing that hopefully will make it a little bit easier for them.”

Student activists may soon have new tools to navigate the confusing landscape of emergency contraception on campus. Researchers at ASEC and the National Health Law Program, a progressive health care policy organization, have teamed up to create a comprehensive guide for students who want emergency contraceptive vending machines on their campus.

ASEC has worked to connect students at different colleges to talk about the various barriers to getting contraceptive vending machines on campus. Cleland, the ASEC coordinator, has shown students how to navigate state laws and regulations and taught them best practices for mobilizing college administrators. She is working to create a step-by-step guide that will walk students through the process, based on their state and type of campus. Liz McCaman, a staff attorney for the National Health Law Program, is working with colleagues on a database of state laws and regulations regarding the sale of emergency contraceptives in vending machines so students like Donnelly can know the legal challenges before they sit down with administrators.

Donnelly is excited for tools like this to exist. “I think it’s a cool opportunity to be able to collaborate with people from other states, and also to see what other people have been doing and how they went about their project,” she says.

Source: https://www.motherjones.com/politics/2019/11/when-students-cant-get-emergency-contraception-from-vending-machines-sometimes-theres-no-plan-b/