Maryland legislators have passed landmark legislation to protect the health and dignity of incarcerated women.

Maryland’s Democratic-majority General Assembly last week passed two bills with bipartisan support to ensure the prison system develops policies on medical care for pregnant inmates and detainees, and provides free feminine hygiene products to people who are incarcerated.

“We are the first in the nation to do this and it says a lot,” Diana Philip, executive director of NARAL Pro-Choice Maryland, told Rewire.News. “It is a great foundational law and a good risk-management tool for the administration. These two bills will lead the reform that so many people are looking for.”

Expected to go into effect October 1, HB 787/SB 629 requires every correctional facility in the state to have a robust policy in place for the medical care of pregnant inmates, including prenatal testing, labor and delivery, abortion care, postpartum care, access to child placement services, and counseling. Incoming women have to be provided with the policy. This is important, advocates said, because pregnant people often don’t know their rights or even expect health care in prison.

Former inmates have shared harrowing stories of never getting prenatal testing results, a total absence of pregnancy options counseling, denial of abortion care, unlawful shackling, and even forced cesarean sections, Philip said.

“Pregnant inmates are not any less deserving of proper medical care to ensure their own health and the health of their child,” said lead sponsor of the house bill Del. Kathleen Dumais (D-Montgomery County).

The companion bill, HB 797/SB 598, requires correctional facilities in Maryland to have a written policy and sufficient supply of free menstrual hygiene products as needed. It sounds like a basic necessity, but many imprisoned women go without pads or tampons. The products can be expensive or simply unavailable, advocates said.

“Menstrual hygiene products should be considered basic necessities for women,” said state Sen. Susan Lee (D-Montgomery County), who sponsored the Senate bill. “Ensuring women in prison have access to these products is simply the right thing to do.”

Even vendors realize when prisons cut shipments from 1,000 to 200 pads a month to save money, said Monica Cooper, former inmate and co-founder of the Maryland Justice Project, an advocacy group that pushes for prison reform.

These are “dignity bills” and she hopes Maryland lawmakers will inspire other state lawmakers to follow suit, Cooper told Rewire.News.

Despite a 700 percent increase in women’s incarceration since 1980, prison policies and services have not been updated to better accommodate women. “It’s almost as if incarcerated women are an afterthought,” Cooper added.

It’s “mind blowing” that these commonsense policies are not in place everywhere, especially during a woman’s most vulnerable and at-risk time of her life, said Julie Magers, leader of the Maryland Prisoners’ Rights Coalition.

“I’ve received many many complaints from women I’ve interviewed about the lack of basic hygiene and health care so to have these bills pass. It’s landmark and so incredibly needed,” she told Rewire.News.

She has heard from a woman who was put into medical isolation after she miscarried with no aftercare provided; a woman who was shackled during labor and was forced to walk in chains after giving birth; women threatened with solitary confinement for bleeding through their uniforms during menstruation when they had maybe three pads for their entire menstrual cycle, or worse, none.

Maryland already has an anti-shackling law on the books but that policy is often not enforced, advocates said.

“You’re a prisoner so it doesn’t matter. We hear that frequently. I think that’s how (women) are made to feel,” Magers said. “One of the problems women face a lot is the lack of proper care being directly related to the fact that they are prisoners. That’s not how it should be. It shouldn’t be a matter of whether they are prisoners; they are human beings.”

Formerly incarcerated women like Kimberly Haven recently amplified the subject via the #MeToo campaign by sharing how she made sanitary products using toilet paper during her 15-month stint at a Maryland prison. This led to toxic shock syndrome and eventually,  an emergency hysterectomy.

“We had no access some days to pads or tampons and some days not even to toilet paper,” said Sherell Evans, a former inmate and member of the Maryland Justice Project. “As you can imagine, in a facility that houses over 1,000 inmates, things can get pretty messy. Some people would tear up sheets to use as sanitary napkins, they were making homemade tampons out of paper and different stuff …. It was a very, very terrible situation.”

While accurate numbers of incarcerated women are hard to find, the Maryland Correctional Institution for Women in Jessup, the state’s only all-female facility, houses between 800 to 1,000 women. Advocates estimate there are more than 2,000 women detained or imprisoned statewide.

Both bills were priorities for the statewide coalition Reproductive Justice Inside, which advocated for the reforms with partner members that included doctors, midwives, lawyers, professors, and students.

“I commend our partners in the Maryland ​General ​Assembly and at Reproductive Justice Inside who worked tirelessly to pass these important measures,” said Gloria Totten, president and founder of the nonprofit Public Leadership Institute, a nonpartisan nonprofit. “I would encourage other states to follow this example and ensure that incarcerated women have access to essential health care needs such as menstrual hygiene products and information ​about​ all pregnancy outcome options including abortion.”

Republican Gov. Larry Hogan’s office did not return messages seeking comment on if he would sign the bills, but the legislation passed both chambers of the legislature with enough votes to override a potential veto.

Source: https://rewire.news/article/2018/04/18/maryland-give-inmates-new-reproductive-health-care-rights/

The U.S. Court of Appeals for the 7th Circuit on Thursday affirmed a district court’s ruling striking down two provisionsof an Indiana law that restricts access to abortion care and imposes burdensome regulations on abortion providers.

Officials from Planned Parenthood of Indiana and Kentucky (PPINK) and the American Civil Liberties Union (ACLU) of Indiana on Friday praised the court’s decision during a joint press conference.

Kenneth Falk, legal director of the ACLU of Indiana, said during the press conference that existing law makes it “crystal clear” that a pregnant person has an absolute right to determine whether to terminate a pregnancy.

“Indiana sought to invade that right,” Falk said. “The law was, in effect, trying to overrule the U.S. Supreme Court.”

HB 1337 made numerous changes to state laws, including requiring forced counseling and mandatory ultrasounds for abortion patients, creating regulations on physicians who provide abortion care, and banning fetal tissue donation that has led to the development of vaccines and has had other public health benefits.

Physicians are prohibited from providing abortion care if the physician knows that the pregnant person is seeking the common medical procedure solely because of the “race, color, national origin, ancestry, sex, or diagnosis or potential diagnosis of the fetus having Down syndrome or any other disability.”

The omnibus anti-choice bill was passed by wide margins by the GOP-dominated Indiana legislature. It was signed into law in March 2016 by former Gov. Mike Pence (R).

The ACLU of Indiana in April 2016 filed a lawsuit in federal court on behalf of PPINK, as well as two abortion providers. The lawsuit challenged the so-called final disposition and anti-discrimination provisions of the law. The plaintiffs claim the law imposes an undue burden on a person’s right to choose abortion care, that the the law violates due process and equal protection under the 14th Amendment, and that it infringes upon the First Amendment right of free speech.

District Court Judge Tanya Walton Pratt in September 2017 ruled that the law was unconstitutional, and the Seventh Circuit Court’s three-judge panel unanimously upheld Pratt’s decision.

Judge William Bauer wrote in the 40-page decision that anti-discrimination provisions “clearly violate well-established Supreme Court precedent” and the fetal tissue regulations “have no rational relationship to a legitimate state interest.”

Christie Gillespie, president and CEO of PPINK, said in a statement that there was “no medical basis for these restrictions,” and that the state was interfering in the relationship between patients and medical professionals.

“Every person deserves the right to make their own personal decisions about abortion,” Gillespie said.

Indiana’s Republican Attorney General Curtis Hill has not stated if the state will appeal the court’s decision. Falk said he would not be surprised if the state sought review in the U.S. Supreme Court.

Source: https://rewire.news/article/2018/04/20/court-deals-blow-pence-era-indiana-anti-choice-law/

An Ohio federal appeals court on Wednesday affirmed a lower court order blocking a law that would have stripped Planned Parenthood clinics in the state of family planning money used to provide health-care services to people with low incomes.

The Sixth Circuit Court of Appeals sided with Planned Parenthood and ruled unconstitutional a law that would have effectively defunded the health-care provider.

Gov. John Kasich (R) in February 2016 signed into law a measure that would have stripped Planned Parenthood of $1.3 million in state and federal taxpayer funds, and diverted that money to health-care clinics that don’t perform abortions and don’t contract with organizations that provide the medical procedure.

The GOP-backed law would have barred Planned Parenthood from providing health care and educational services through six federal health programs, none of which are related to abortion care. These include the Healthy Moms, Healthy Babies program and access to free screenings for sexually transmitted infections. These programs are of particular benefit to people of color, those with low incomes, and LGBTQ people.

Weeks after Kasich signed the bill into law, Planned Parenthood officials filed a lawsuit and sought a preliminary injunction to block it. Planned Parenthood argued that the law infringed on its First Amendment rights by denying state and federal funds “because of–and in retaliation for–their constitutionally protected advocacy for abortion rights and affiliation with other organizations that also advocate for abortion rights and/or provide abortion services.”

The district court sided with Planned Parenthood.

Applying the unconstitutional conditions doctrine—a legal doctrine that bars conditioning a person’s receipt of a governmental benefit on that person waiving a constitutional right—the district court determined that the anti-choice law impermissibly conditioned funding under programs unrelated to abortion based on a recipient’s forgoing exercise of its First Amendment rights to free speech or association, and forgoing provision of abortion services protected by the Due Process Clause.

The state appealed to the Sixth Circuit, but the Sixth Circuit sided with Planned Parenthood.

Writing for the three-judge panel, Helene White—a George W. Bush appointee—wrote that the law “violates Plaintiffs’ due process rights by imposing unconstitutional conditions.”

White was troubled by the reduced access to health care that would result if Ohio could condition the provision of public funds on forgoing abortion services. White noted that clinics would no longer be able to provide health-care services for free: “Thus, as a condition of retaining access to abortion free of undue governmental interference, Ohio women must [forgo] the extensive and subsidized access to health services under federal programs that they previously enjoyed,” she wrote.

“Although Ohio women do not have a right to the programs, they do have a right not to have their access to important health services curtailed because their major abortion providers opted to protect women’s abortion rights rather than yield to unconstitutional conditions.”

Reproductive rights advocates applauded the decision.

“We are thrilled that today’s decision will safeguard our patients’ access to care,” Jerry Lawson, CEO of Planned Parenthood Southwest Ohio, said in a statement.

“This victory is critically important for tens of thousands of Ohioans across our state that rely on Planned Parenthood for care and education each year. Our patients deserve to have their health care come before political agendas; this isn’t about politics, it’s about access to health care.”

Source: https://rewire.news/article/2018/04/18/sixth-circuit-ohio-republicans-cant-defund-planned-parenthood/

New analysis about Republicans’ proposed 20-week abortion ban says the common medical procedure is safe, and that delays in care caused by restrictions are why some are forced to seek abortion care later in pregnancy.

The Congressional Research Service (CRS), a division of the Library of Congress that provides policy analysis to members of the U.S. Congress, sought to respond to common questions about the ban in a report published last week. It did not address issues of constitutionality or state regulations on abortion at 20 weeks, nor did it “provide an ethics or morality discussion of second trimester abortion or whether a fetus is a person and has a right to life.”

Dr. Diana Greene Foster, director of research at University of California, San Francisco’s Advancing New Standards in Reproductive Health (ANSIRH), who was cited in the report, called it “very good” in an in email to Rewire.News. “It succinctly compiles a lot of the recent research on later abortions,” Foster said. “I hope that policy makers read it.”

Many of the questions answered in CRS’ report speak to talking points used by the GOP to demonize later abortion care.

For example, Republicans have long pushed a ban on abortion at 20 weeks, or 22 weeks’ gestation, based on the dubious claim that a fetus can feel pain at this point in a pregnancy. But CRS’ report pointed to a fact sheet from the American College of Obstetricians and Gynecologists (ACOG) as the authority on the matter, quoting a 2013 statement that said a “human fetus does not have the capacity to experience pain until after viability.”

“Rigorous scientific studies have found that the connections necessary to transmit signals from peripheral sensory nerves to the brain, as well as the brain structures necessary to process those signals, do not develop until at least 24 weeks of gestation,” the statement said.

The CRS report addressed how mental health can be affected by having abortions. In particular, it pointed to research finding that having an abortion does not increase the risk of mental health disorders.

Abortion rights opponents often claim that the procedure can have harmful long-term psychological effects, though there is no evidence to support that charge. A 20-week ban authored by the anti-choice group Americans United for Life and adopted by the GOP-majority Arizona legislature in 2012 falsely suggests that those who have abortions are at risk for  “psychological or emotional complications.”

When it comes to whether later abortions are safe, the report says that “for women in the United States, the mortality rate associated with childbirth or continuing the pregnancy is higher than the abortion mortality rate.” Though it notes that the risk of mortality goes up as gestational age increases, CRS pointed to research from the National Academy of Sciences, Engineering, and Medicine that found the risk of death from abortion care to be less than the risk of death during colonoscopies, dental procedures, and adult tonsillectomies.

The report mentioned how often later abortion care is performed due to fetal anomaly and life endangerment, speaking to pro-choice advocates who say that later abortions are often for these reasons. Here, CRS again pointed to Foster’s work.

“Based on limited research and discussions with researchers in the field, Dr. Foster believes that abortions for fetal anomaly ‘make up a small minority of later abortion’ and that those for life endangerment are even harder to characterize,” it said.

Though she referred to it as “an extremely minor point in an otherwise excellent report,” Foster noted a small difference between her opinion and how it was characterized in CRS’ analysis.

“What I really believe is that nobody knows what fraction of later abortions are for these reasons,” said Foster. “I wouldn’t state that fetal anomaly and life endangerment are a small minority of later abortions because nobody has statistics on this.”

The report addressed the question of why some may experience delays in seeking or receiving abortion care. Along with factors such as a delay in finding out about a pregnancy and difficulty finding funds for care, the report pointed to federal and state-level restrictions on abortions as a factor.

CRS’ analysis noted recent iterations of the Pain-Capable Unborn Child Protection Act and the Born-Alive Abortion Survivors Protection Act “would require that infants born alive following an abortion procedure be transferred to a hospital for treatment.”

But, the report says, “the legislation makes no provision for the treatment costs or subsequent care needed to support these children, who could become wards of the state.”

“Infants born at 23 weeks’ gestation do not have sufficiently developed lungs and cannot breathe on their own; such infants will die at birth if not given life-sustaining therapies,” it goes on, later explaining that the long-term costs associated with premature infants may also be higher.

“In addition to the health care costs that extremely premature infants will generate post-NICU, other costs—such as day-care services, respite care, school—are likely to be much greater than those for full-term babies,” it said.

CRS’ report did not address whether there is evidence of infants “born-alive” after an abortion, another myth perpetuated by anti-choice activists, though it did address the “medical issues” premature infants face.

Source: https://rewire.news/article/2018/04/18/congressional-report-debunks-anti-choice-talking-points-gops-20-week-abortion-ban/

UPDATE, April 16, 10:28 a.m.: Arizona Gov. Doug Ducey (R) last week signed SB 1394.

Controversial Arizona legislation expanding the amount of information collected about abortions performed in the state and questioning patients about their abortions is one step away from the governor.

The bill adds requirements for abortion care providers to report medical complications to the state health department, and it asks patients to explain whether their reason for getting an abortion was rape, incest, fetal or maternal health, domestic violence, sex trafficking, or coercion.

An earlier version had asked if one of the reasons for the abortion was an extramarital affair. Abortion patients can choose not to answer these questions.

SB 1394, which cleared the GOP-majority house Monday on a party-line vote, needs a quick approval in the Republican-controlled state senate before going to Gov. Doug Ducey (R), an abortion rights foe.

The Republican backers of SB 1394 maintain the bill safeguards women’s health, but Democratic lawmakers during a floor vote on Monday called the legislation burdensome, intrusive, and politically motivated.

“I stand with a chorus of women who say … ‘Why did I have an abortion: It’s none of your business,’” said state Rep. Athena Salman (D-Tempe).

Laws in nearly every state require physicians to send a report every time they perform an abortion. Arizona law already requires abortion care providers to ask patients about their marital status, race, ethnicity, and education, past miscarriages, and prior abortions.

Some state laws hew to draft legislation from the influential anti-choice group Americans United for Life, which maintains that “American abortion data is inaccurate and often misleading.” Mostly Republican-controlled states have advanced 80 new abortion reporting requirements since January 2017, with mixed success.

Rep. Kirsten Engel (D-Tucson) questioned the motivation for adding a new layer of regulation on abortion, which is safer than childbirth.

Championing the bill was the state’s influential Center for Arizona Policy, a lobbying group behind dozens of abortion restrictions. Opposing it were representatives from the American Congress of Obstetricians and Gynecologists, Arizona Public Health Association, Arizona Chapter of the American Academy Of Pediatrics, and Arizona Medical Association.

“Why don’t we have docs in favor of this? They don’t want to do more reporting,” suggested Rep. Eddie Farnsworth (R-Gilbert), when a member noted that medical groups oppose the bill.

Democrats attempted to amend the bill to roll back existing abortion restrictions. Salman introduced an amendment to impose reporting requirements on crisis pregnancies centers, or fake clinics, which are unregulated even though, Salman said, the facilities often look like health clinics and typically offer pregnancy tests and ultrasounds.

Responding to Salman’s amendment, Farnsworth said fake clinics were not medical providers. “They’re not practicing medicine. If they are, then they’re already breaking the law.”

Rep. Daniel Hernandez (D-Tucson) suggested if the bill’s sponsors were serious about protecting reproductive health, then patients should also be asked whether the reason for the abortion was that they lacked inadequate access to affordable birth control or comprehensive sexual education. He offered an amendment to do so.

The Democrats’ amendments were defeated.

An earlier Republican-led amendment would’ve required a fetal tissue sample from patients who said the reason for the abortion was sexual assault. But the fetal-tissue provision didn’t make the final cut.

“This is not about women’s health,” Salman said before the vote. “This puts the government in the room with a woman and her doctor in a decision that is intimate and private that the Supreme Court has found constitutional.”

Source: https://rewire.news/article/2018/04/10/arizona-republicans-want-know-want-abortion-care/