“It is the work of a bully and a coward to pick on the most vulnerable demographic you can imagine: pregnant undocumented refugees.”

While Jane Doe, the unaccompanied immigrant minor “held hostage” by the Office of Refugee Resettlement (ORR) because she wanted an abortion, was eventually able to access care on October 25, the legal battle surrounding ORR’s anti-choice policy is ramping up.

The Trump administration implemented a revised policy in March 2017 “that allows [shelters] to wield an unconstitutional veto power over unaccompanied immigrant minors’ access to abortion,” according to court documents. This directive prevents unaccompanied immigrant minors in their care from obtaining abortion care by prohibiting federally funded shelters from taking “’any action that facilitates’ abortion access to unaccompanied minors in their care without ‘direction and approval’” from ORR Director Scott Lloyd.

Lloyd told the Christian Broadcasting Network on October 30 that ORR’s policy was “under review.” But Brigitte Amiri, a senior staff attorney with the American Civil Liberties Union’s (ACLU) Reproductive Freedom Project, told Rewire there is “no evidence in court proceedings that the policy is under review in any way.”

“People may think we got this victory for Jane Doe and that everything is great and OK now,” Amiri said. “Yes, Jane Doe was able to get the abortion she had the constitutional right to access, but it’s important to understand that the policy she was subjected to is still in place, and it will be in place until the court allows us to proceed as a class action and gives us a preliminary injunction as a class to prevent the federal government from imposing the policy on other girls going forward. Make no mistake: This policy still exists and is still being enforced.”

The ACLU filed a brief this week to proceed with its class action suit on behalf of unaccompanied immigrant minors in ORR custody being blocked from accessing abortion care, like Jane Doe. The ACLU is asking that Jane Doe be the class representative.

The federal government, which has taken unusual steps surrounding the case—including seeking to penalize the attorneys working on Jane Doe’s behalf—says that Jane Doe is an inappropriate class representative because she was eventually able to access abortion care.

Meanwhile, the Department of Justice (DOJ) is fighting for the ability to share information related to Jane Doe’s abortion with her potential sponsors, citing the First Amendment.

Referring to its own policy on information sharing, ORR says that Section 8.101 of the agency’s policies and procedures “in no way prevents ORR from using and disclosing a minor’s information as ORR carries out its custodial duties on the minor’s behalf, including information the minor’s medical care providers and potential sponsors regarding important and relevant personal and medical facts.”

Jane Doe has now been in ORR custody for months and has had multiple sponsors denied by the agency. Amiri told Rewire she doesn’t know the exact reason the teen is still in custody. A federal appeals court on October 20 gave the teen until October 31 to secure a sponsor so that she could access abortion care, and the federal government said it could find Jane Doe a sponsor by that date. But as of November 30, Jane Doe is still without a sponsor. This means that had Jane Doe’s attorneys not continued to fight for her to access care sooner than the October 31 deadline, she would have passed the 20-week mark and been forced to carry an unwanted pregnancy.

ORR operates within the Department of Health and Human Services (HHS), which contracts with local shelters to care for unaccompanied immigrant minors. Amiri said that young people on average spend 34 days detained in these shelters before being released to sponsors in the United States. But the length of detainment can vary for a number of reasons, including the nationwide backlog on adjudicating immigration cases and the lengthy nature of the asylum process. But there may be more nefarious reasons at play.

Advocates say there is reason to believe ORR is dragging its feet trying to find sponsors for unaccompanied immigrant minors so they can be transferred to Immigration and Customs Enforcement (ICE) custody and placed in detention once they turn 18. In Jane Doe’s case, ORR’s inaction may be retaliatory.

Susan Hays, legal director for Jane’s Due Process, an organization providing legal representation to pregnant minors in Texas, told Rewire that she suspects Jane Doe’s sponsorship opportunities have been “sabotaged.”

“They want to tell any potential sponsor she’s had an abortion, that is what the federal government is fighting for. And let’s say a potential sponsor [for Jane Doe] is a beloved family member who is against abortion and they would reject her if they knew—that’s the risk [the federal government] wants Jane Doe to run. It is absolutely retaliation,” Hays said.

According to court documents, the federal government has taken great pains to inform the parents of unaccompanied immigrant minors in ORR custody that their child is seeking abortion care, even when these young people have received a judicial bypass and their parents remain in their country of origin. The federal government says there may be medical reasons for telling a potential sponsor that Jane Doe has had an abortion procedure. The fallacy behind that, Hays said, is that having an abortion doesn’t affect one’s health, despite a sustained anti-choice propaganda campaign stating otherwise.

Anti-Choice Extremism in the Immigration System

The myth the federal government is using to justify the violation of Jane Doe’s right to privacy can be traced to Lloyd, an anti-choice radical who has emerged as a staunch opponent of reproductive rights in an administration full of similar ideologuesNothing in his background indicates Lloyd is qualified or equipped to lead ORR or to “counsel” pregnant people in ORR custody against seeking abortion care, which he admitted to doing when speaking to the Christian Broadcasting Network.

Immigration advocates see Lloyd as an ideological pick by the Trump administration as it ushers “anti-choice fanaticism” into the immigration system. Lloyd’s personal beliefs mirror those of anti-choice extremists and men’s rights activists, as evidenced by his published writings. Emails recently released by the ACLU as part of court proceedings reveal how deeply entrenched anti-choice extremism has become within ORR.

One emails says a shelter must confirm a minor will receive anti-abortion counseling as a condition of her release. In another email, HHS officials are informed that shelters are required to alert ORR before doing anything to facilitate an abortion. A memo from Lloyd reveals that another teen received a judicial bypass to obtain abortion care, but her shelter was instructed to hinder her from moving forward. It remains unknown if the minor was able to access the medical procedure.

Lloyd has a well-documented history with so-called crisis pregnancy centers (CPCs), or fake clinics, which provide people with false information to dissuade them from seeking abortion care. Lloyd instructed ORR Deputy Director Jonathan White via email to ensure a minor in custody in Arizona get an ultrasound and counseling at Choices Pregnancy Centers, an anti-choice fake clinic. These clinics comprise almost all of the approved counseling centers listed by ORR for minors requesting abortion care. An investigation by Reveal found that this list came from the anti-abortion advocacy group Heartbeat International, whose mission is “to make abortion unwanted today and unthinkable for future generations.”

Hays told Rewire she is worried that young people in ORR custody who want abortion care may not realize they are being funneled into anti-choice fake clinics. They may be too afraid to voice their desire to have an abortion, given that so many come from countries where abortion is criminalized.

Government documents indicate Lloyd “receives, or for some time this year received, weekly updates concerning each pregnant [unaccompanied child]’s location, the circumstances of her pregnancy, her gestational age, and whether she requested information regarding abortion,” according to the brief filed by the ACLU. Amiri, who has worked on issues related to ORR since 2008, said she has “never seen anything like this.”

Amiri told Rewire that Lloyd is “literally inserting himself” into the patient-provider relationship, forcing girls to not only obtain permission from the federal government before they access abortion care, but to consult the federal government about every aspect of their pregnancy. Hays said her overarching concern is that teens in custody will be forced to carry unwanted pregnancies and the “world may never know.”

There were around 726 pregnant unaccompanied minors in ORR custody in 2014, 450 in 2015, and 682 in 2016, according to court filings by the ACLU. A court filing filling from the federal government revealed that there were 43 unaccompanied immigrant minors in ORR custody as of October 16, 2017.

Hays said ORR officials put “their boot down on shelter’s necks,” when they implemented the new anti-choice policy in March. What she means is that shelters depending on contracts with the agency were faced with a choice: Help a young person get an abortion and risk getting funding removed, making it impossible to care for any other immigrant minors. Or toe the line and prevent a young refugee from getting the abortion care she wants. Hays said it’s easy to see “who got sacrificed.”

“It is the work of a bully and a coward to pick on the most vulnerable demographic you can imagine: pregnant undocumented refugees,” Hays said. “Scott Lloyd is fixated on the reproductive capacity of adolescent refugees to the point of being creepy. The fact that Scott Lloyd is flying across the country, presumably on the taxpayer’s dime, to sit down with a teen girl he’s never met and talk to her about her reproductive status is so inappropriate it’s mind boggling.”

https://rewire.news/article/2017/11/30/trump-officials-obsession-pregnant-immigrant-minors-still-shaping-federal-policy/

I got the call from my husband. The genetic counselor he’d spoken to over the phone had shared our files with other geneticists in the obstetrics office who all confirmed our baby’s fatal condition. He also said, with confusion and disbelief in his voice, the counselor had mentioned Colorado as a possible option for obtaining our termination. His voice grew raspy as he said it again into the phone: Colorado.
We lived in Brooklyn. Our world-class maternal fetal medicine doctors were in Manhattan.
It is hard to overstate the shock upon realizing your government has the final say over whether or not you can receive a medical procedure and, therefore, what you can do with your body. It is actually a little embarrassing to admit my naiveté now since, as a 35-year-old college-educated woman, I should have known.
But to know this kind of thing, you need to be paying attention.
Last month, we learned of a pregnant 17-year-old girl being held in the state of Texas after fleeing to the U.S. from Central America. This young Jane Doe was firm in her decision to seek an abortion, which she was repeatedly denied. And to be clear, she was not asking the government for an abortion. She was simply asking for a brief leave to receive an abortion paid for by private funds. Ultimately, a D.C. appeals court ordered the Trump administration to stop blocking Jane’s health care, and she was finally able to receive an abortion, albeit weeks after she first sought it.

IT IS HARD TO OVERSTATE THE SHOCK UPON REALIZING YOUR GOVERNMENT HAS THE FINAL SAY OVER WHETHER OR NOT YOU CAN RECEIVE A MEDICAL PROCEDURE AND, THEREFORE, WHAT YOU CAN DO WITH YOUR BODY.

It also turns out that Jane is kind of a badass. In a statement, she said, “No one should be shamed for making the right decision for themselves. I would not tell any other girl in my situation what they should do. That decision is hers and hers alone.”
As we watched this situation unfold in horror, we also learned the Trump administration is forcing deliberate anti-abortion policy and that there are more Janes.
While, at first glance, it might seem I have nothing in common with this young girl, and indeed I have absolutely no idea what it is like to flee my home under unfathomably abusive conditions and travel to a foreign country in search of amnesty only to be taken hostage and denied a private, personal medical procedure while a bunch of white men in suits preach to me about Jesus. But I do know what it is like to be denied abortion care by the state, in my case the state of New York. And it is horrifying.
In April of last year I was pregnant for the second time with a very wanted baby boy after my first pregnancy ended in a devastating miscarriage at 10 weeks. I finally reached the third trimester of pregnancy after what felt like an endless litany of complications, an experience I recounted to Jezebel last year. Our baby had bilateral clubbed feet, velamentous cord insertion, and his hands were tightly clenched in every ultrasound. He rarely moved.
As the bad news racked up, we were also given small crumbs of hope in the form of growth — incremental, but growth nonetheless.
At 30 weeks, we went into our high-risk maternal fetal medicine office for a routine appointment, excited that we were getting close. We believed we were finally “out of the woods” and ready to be parents to a little baby boy, who we knew would have some issues, but we were so ready to meet. He was our little fighter already.
But now our doctor found a new, alarming condition. I had developed severe polyhydramnios, or high fluid levels and, most crucially, our baby had stopped growing. Completely. All of the complications taken together told our doctors our baby had a fatal muscular condition that prevented him from being able to swallow. Swallowing is how a fetus practices breathing.
We asked our doctor what this would mean for our baby boy if we made it to term. He explained that the baby would live a very short time, likely minutes, before choking to death.
All of the hope we’d been desperately clinging to for eight months was gone in an instant.
Please hear me: If you have not been in this situation, you have no fucking clue what you would do. If you have never been told that the baby you’ve been carrying for eight months and want more than anything is so sick that there is no future, no hope, no life for him possible, then I assure you: You have no possible idea what you would do.
We could not imagine a scenario where I would carry this pregnancy for another two months only to watch a little baby suffer and die. And listen, maybe your religion or your personal philosophy does not allow you to see this situation as we did. But again, are you speaking from a place of first-hand knowledge or a theoretical? Because if it’s theoretical, again, you have no actual idea.
In “the old days” before my abortion, I’m embarrassed to admit I used to think, What kind of woman gets an abortion at 6-7-8 months? Or I would make ignorant, self-righteous statements, such as, “Oh I’m pro-choice absolutely, but I would just never personally have an abortion.” Now I look back at that dumb-dumb-oh-so-dumb woman and equate it to saying I’d personally never get chemo. Yeah, bitch? You’ve never had cancer!
Or my favorite “old me” uneducated opinion: Sure, limits sound like a reasonable compromise. People should be able to decide they want an abortion by, say, four months. Yeah, that sounds right.
You see, at the time I was grappling with abstractions. I was pro-choice theoretically, but I’d never had a crisis pregnancy, or even considered crisis pregnancies in general, so I didn’t know what I was talking about. I was quite literally ignorant.

WE COULD NOT IMAGINE A SCENARIO WHERE I WOULD CARRY THIS PREGNANCY FOR ANOTHER TWO MONTHS ONLY TO WATCH A LITTLE BABY SUFFER AND DIE.

And thanks to internalized sexism, I’d allowed my brain to contemplate a narrative of the absent-minded woman who up and decides to get an abortion at 40 weeks out of…”convenience.” The word “convenience” now makes my skin crawl. I am embarrassed that I would ever sell my fellow women up the river like that, even if just by entertaining the idea.
But now, I know. I know it deep inside my bones. Any “belief system” that relies on you having to cast women as evil, callus, or incapable of making their own decisions is a system hell-bent on selling you a steaming pile of patriarchal bullshit.
After receiving our final, horrible diagnosis, we, along with our doctors, decided that the best course of action would be to terminate the pregnancy. This decision was made to spare everyone involved as much suffering as possible.
But when we went to the maternal-fetal medicine office for what would be our last appointment, the doctor explained that there was a 24-week cut off for abortions in New York State, with no exceptions for the health of the pregnant person or in cases of fetal non-viability. If we wanted to terminate the pregnancy, we would have to travel across the country to Colorado, far away from our regular doctors who had been with us every step of the way.
And that’s when it first really hit me: It wasn’t enough that we were losing all hope we had to raise this baby boy. I was meant to feel shame too.
If I sound angry, it is because I am. I can always touch that acute, burning sensation of fury I felt in the doctor’s office, because it remains so close to my throat. It’s just kind of on simmer until I meet yet another woman who had to travel for an abortion, or when I meet a doctor with horror stories about patients who were not as lucky as me and had to carry their doomed pregnancies to term, or when the news introduces us to someone like Jane Doe.
I remain furious that women’s health decisions are ultimately being made by dudes-who-aren’t-doctors, but who have a whole lot of opinions that, by design, fly in the face of science, medicine, and compassion. And please spare me your compassion for the “unborn child.” When anti-choice advocates are waking up at 5 a.m. on a Saturday to throw grotesque little baby dolls and shout, “Shame!” at the men in Congress who have let the Children’s Health Insurance Program expire, they might be able to make a credible claim to caring for “life.”
It has been a month since Jane received her abortion. So where are we now with the GOP’s dangerously aggressive anti-abortion agenda?
Earlier this month the justice department, led by Jeff Sessions, filed a petition to the Supreme Court accusing Jane’s ACLU attorneys of “misleading the government over the procedure’s timing in an effort to evade a review by the top court.” In layman’s terms, the Trump administration was out-lawyered by Jane’s counsel who knew the justice department was trying every delay tactic in the book to try and get Jane past Texas’ 20-week cut off.
The GOP’s new tax plan, essentially a cash-grab on behalf of our nation’s most wealthy citizens, includes “personhood” language for fetuses, allowing them their own savings accounts. Of course, this has nothing to do with savings accounts and everything to do with sneaking anti-choice language into a tax plan.
And in the federal Senate, there is a push to bring a 20-week abortion ban to the floor for a vote. It is not based on science. It is not based on widely accepted medical knowledge. It is based on fear and ideology.
While this bill has little chance of passing (though I’m not sure how any of us can think that about anything, ever again), it will give Republicans a chance to go on the record as being pro-shame. They’ll get to make long speeches and wheel out their ultrasound machines, focusing on the mighty powerful fetus, however small, while women further fade from the conversation.
Like the “before” me, the girl who existed in my body with my name who was ignorant to the invisible thumb of the government pressing against her uterus, we are all starting to see what happens when threats to our rights move from the abstract to the acute.
If we do not fight these attacks with the full weight of our strength as relatively privileged people, our angry daughters will wonder what the fuck we were all doing while the American government was holding teenage girls hostage as tactical practice for their war against all women.

“For too long, Dan Lipinski has ignored the needs of working families across Illinois, by pushing his fringe ideological agenda at the expense of women and families across the state.”

Democrat Marie Newman was endorsed by national progressive groups this week in her primary challenge against anti-choice Rep. Dan Lipinski to represent Illinois’ 3rd District, pointing to the congressman’s record opposing reproductive and LGBTQ rights.

NARAL Pro-Choice America, MoveOn.org, Democracy for America, the Progressive Campaign Change Committee, and the Human Rights Campaign announced endorsements of Newman on Tuesday and planned to come together in Chicago on Wednesday to speak in support of the candidate.

Lipinski, who won his seat after his father stepped down in 2004, has made no secret of his anti-choice views, though they break from the Democratic Party’s plank on abortion rights. He co-chairs the Congressional Pro-Life Caucus and sits on the federal advisory board of anti-choice group Democrats for Life of America.

“For too long, Dan Lipinski has ignored the needs of working families across Illinois, by pushing his fringe ideological agenda at the expense of women and families across the state,” Ilyse Hogue, president of NARAL Pro-Choice America, said in a Tuesday statement. “Congressman Lipinski is way out of step with his constituents and with Democratic party principles when it comes to women’s rights, LGBT equality, and the basic freedoms that Americans hold dear.”

Charles Chamberlain, executive director of Democracy for America, said in a statement that his organization was supporting Newman “because Illinois voters deserve a Democratic congressional delegation that is as unflinchingly committed to fighting for abortion rights and LGBT equality as they are to standing up to any other racial and economic injustice.”

Lipinski is one of only two Democrats in the U.S. House of Representatives to sign on to a GOP-backed measure this year to restrict abortion beyond 20 weeks of pregnancy, based on the false claim that a fetus can feel pain at this point in a pregnancy. He has co-sponsored other anti-choice measures such as a permanent ban on federal abortion funding, voted to defund Planned Parenthood, and has questioned evidence-based guidelines for medication abortion.

Newman in April announced her intent to challenge Lipinski. Already, Lipinski’s views on reproductive health care have been a contentious issue in the primary race.

Her campaign platform includes calls to expand access to health care through “Healthcare-For-All solutions” and criticizes Lipinski’s opposition to reproductive rights. “Consistent with the Roe v. Wadedecision, I believe that reproductive decisions belong with women and her right to choose, not with government or politicians,” her campaign site says, noting that Lipinski “has voted consistently to defund Planned Parenthood and eliminate a woman’s right to choose.”

Lipinski’s district is rated as “Solid Democrat” by the Inside Elections with Nathan Gonzales/Roll Call ratings, meaning the seat is likely to remain in the hands of Democrats no matter who wins the March 20 primary in 2018.

https://rewire.news/article/2017/11/29/progressive-groups-back-challenger-anti-choice-congressional-democrat/

The stigma affecting abortion doctors starts at the very beginning.

Dr. Kelly Pfeifer flies from San Francisco, California to Overland Park, Kansas one weekend every month to perform abortions.

She says she donates her time for selfish reasons; she loves the work, people, and state. She even managed to catch a Katy Perry show after work once. Dr. Pfeifer likes to downplay her role and says she’s on a mini vacation, but her part-time work in Kansas is critical as there are only two full-time abortion doctors statewide.

When she’s not researching the opioid epidemic for a California health care foundation, Dr. Pfeifer performs abortions at a local Planned Parenthood in Kansas. She donates her services; the clinic only reimburses her for travel and stay.

Given the restrictive abortion laws in the state, it’s cumbersome to be a provider in Kansas compared to California, said Dr. Pfeifer. She added that it’s harder for the patients of course. In Kansas, a patient seeking an abortion needs to receive counseling and then wait 24 hours to get the procedure.

“In California, they could come and leave within an hour and here there are all these additional steps,” said Dr. Pfeifer. This is even more concerning for the patients who travel long distances due to the provider shortage, she added. Ninety-eight percent of Kansas counties have no abortion clinic.

“I live in a progressive state that allows me to be married to a woman — to lead a life without discrimination,” Dr. Pfeifer told ThinkProgress. “I am aware that a lot of people don’t have that privilege.”

Dr. Pfeifer is impressed by her colleagues caught in the political web. It can be dangerous to be an abortion provider in a conservative state. In fact, it was the murder of George Tiller, a Wichita abortion provider who was killed by an anti-abortion extremist in 2009, that galvanized Dr. Pfeifer to provide abortions in underserved areas. But unlike her Kansas colleagues, Dr. Pfeifer is able to fly home, leaving the politics behind.

A physician shortage  

Access to abortion is based on income and ZIP code. While it’s necessary to understand restrictions from the patient perspective, it’s also important to understand that abortion access is dependent on physicians willing and able to provide the procedure.

More broadly, the country will soon face a serious doctor shortage. The demand for physicians is outgrowing the supply, and the Association of American Medical Colleges projects that by 2025, there will be a shortfall of somewhere between 61,700 and 94,700 physicians. There are already shortages in some specialties; almost half of all U.S. counties lack a single practicing obstetrician and gynecologist.

There are a host of reasons for this, including changing demographics and institutional inefficiency. But there are a few medical professions where stigma contributes to the shortage, like physicians who perform abortion.

While other medical professions try to remedy the shortage by incorporating mid-level practitioners or telemedicine, this cannot work for abortion doctors in some states — specifically those who administer medication abortion. Even though the World Health Organization has said physician assistants and advanced nurse practitioners can provide safe medication abortion, 34 states require it to be administered through a licensed physician. Similarly, research studies have said medicated abortions via telemedicine are safe, but 19 states outlawed such practice.

Physicians need to be trained and amenable to perform abortions. A recent study found that of the 1,800 practicing OB-GYNs surveyed, only 14 percent provided abortion services while 97 percent of them had patients sought the procedure. While the abortion rate is at the lowest level since Roe v. Wade, the demand for access is unwavering.

“She was 14 when her mother brought her in because she was pregnant and stated that ‘they’ already decided that she wanted to continue the pregnancy.”

The shortage of physicians who perform abortion is particularly acute in the midwest and south. Similar to Kansas, for example, there are about four full-time abortion doctors in Oklahoma. In neighboring Missouri, there are three abortion doctors. Just south of that in Arkansas, where over 1.5 million females live, there are three physicians who perform abortions. Only one performs surgical abortions and the other two perform medication abortions, where women take two drugs to terminate a pregnancy up to 10 weeks.

Earlier this year, when Dr. Stephanie Ho — one of the three abortion providers in Arkansas — needed to get a second physician to agree to handle any complications from medication abortions she provided in order to comply with a new state law (Act 577), she called almost 70 providers statewide and sent a follow-up letter to every OB-GYN. Every person she contacted either said no or didn’t reply, and ultimately, Dr. Ho was unable to find a back-up physician. Most of the people she contacted cited issues with abortion within their group practice or religious affiliated-hospital. (A court halted the law’s effect.)

The stigma doesn’t just affect physicians who are able to perform abortions — it can start at the very beginning, back when students in medical school are seeking the training they need.

Dr. Ho said she began facing hostility long before her work at Planned Parenthood. Rather, it began when she was a family medicine resident at the University of Arkansas Medical Sciences (UAMS).

University of Arkansas for Medical Sciences hosts the state's only OB/GYN residency program (Credit: UAMS)
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES HOSTS THE STATE’S ONLY OB/GYN RESIDENCY PROGRAM (CREDIT: UAMS)

Specifically, it started during her second year of residency. A patient she had seen for two years became pregnant. “I couldn’t be happy for her,” Dr. Ho said. “She was 14 when her mother brought her in because she was pregnant and stated that ‘they’ already decided that she wanted to continue the pregnancy.”

After seeing the consequences of unintended pregnancy, she realized she wanted to be a physician who provided the full range of reproductive health services, including abortion. But this training was not offered in the UAMS family planning residency program. Faculty never told Dr. Ho outright that she couldn’t talk about abortion, but she was criticized and discouraged from learning about abortion or talking about it with patients.

During her third year rotation, Dr. Ho sought training in Denver, Colorado, which would teach her how to provide surgical abortions up to 12 weeks. Reasonable request, she thought, given there were no programs or persons in Arkansas qualified to train her. But it was challenging to get the school to agree.

Eventually she was able to, but whenever she talked about her Colorado training afterwards, she felt she had to be discreet. When Dr. Ho was invited to speak about her training by phone to an advocacy group, she had to lie to her residency clinic and say she was heading to a doctor’s appointment instead.

“So, there I was, in my car – hiding behind the dark tint and window shades covering the front windshield” talking about the experience, she said. “All the while hoping no one noticed that my car was running with me inside – not at a doctor’s appointment.”

She eventually completed her residency program at UAMS in 2011. At 36 years old, she’s now the youngest abortion provider in Arkansas; her other two colleagues are approaching retirement age, including the only doctor that performs surgical abortions.

The obstacles in medical school

Dr. Ho graduated nearly six years ago, but the barriers she described then still persist today. Legislative obstacles remain; for instance, qualified physicians still cannot perform abortions at UAMS. Amendment 68 of the state constitution bans the use of public funds to pay for abortion, and UAMS receives state funding.

“Leadership at UAMS is afraid of the state legislature because we answer to the state government and know how conservative state politics are.”

The state legislature has passed the most restrictive abortion policy in the country in recent years, and local politics appear to have trickled down to UAMS, according to a handful of medical students ThinkProgress spoke to — be it through the culture or institutional policy. In short: if students want to learn about abortion, they have to take it upon themselves to learn. They can go to the only two clinics statewide: Planned Parenthood – Fayetteville Health Center or Little Rock Family Planning Services.

“It’s not to say the department is against teaching these sorts of things,” said one fourth-year medical student in Little Rock who has spoken to faculty about this issue and asked to remain anonymous as he’s currently applying to residency programs. “Their hands are tied quite a bit… it goes back to state funding.” State appropriations account for nearly 7 percent of the school’s budget.

While there are some pro-choice faculty members, they err on the side of caution because of the local politics, said the fourth-year medical student. The department head of obstetrics and gynecology told the student during a closed-door meeting that he would like UAMS to be part of the Ryan Program, a California-based initiative that offers nationwide residency programs the opportunity for more abortion and family planning resources. But given the abortion culture war currently playing out in the state legislature, it’s unlikely.

Abortion education in medical schools is limited. Residency programs, where soon-to-be doctors learn specialties by practice, can be too. The American Congress of Obstetricians and Gynecologists (ACOG) says there are three general approaches to abortion care training in residency programs: “opt out” where residents learn about the procedure unless they have religious or moral objections, “opt in” where training is available upon request, and programs where no training is provided. “Opt out” training results in greater exposure to abortion practices and complicated abortion techniques. But a 2013 national survey found that of 161 OB-GYN residency programs, only 54 percent of respondents said they received routine abortion training.

2011 study found that abortion training is uncommon in family planning residency. The RHEDI program offers financial and technical assistance to integrate abortion care into family planning residency. A fourth-year UAMS student who spoke to ThinkProgress on the condition of anonymity said she isn’t applying to any Arkansas family planning residency programs but is interviewing at a couple of RHEDI– affiliated residency programs out-of-state.

“It’s something that stands out to me as a strong part of the education there,” she said of programs affiliated with RHEDI — not just with abortion training but contraception, miscarriage management, and family planning overall.

UAMS has minimal abortion training, according to a handful of students who looked into the residency programs and spoke with ThinkProgress. UAMS Vice Chancellor for the Office of Communications & Marketing Leslie Taylor said OB-GYN residents need to opt in to receive it; ACOG says this approach can create a burden on trainees.

EMILY THARP WANTS TO BECOME ARKANSAS’ NEXT ABORTION DOCTOR. (PHOTO PROVIDED BY THARP)

Emily Tharp is a first year medical student at UAMS who wants to be an abortion doctor. Residency is three years away, but she already has a plan: she’ll apply to an obstetrics and gynecology residency program because already one conservative state requires every abortion provider be OB-GYN-certified; given the politics, it’s not impossible that her home state Arkansas will be next.

“I don’t think I would have a good time having to do my residency — to learn about abortion in Little Rock. It’s been implied to me that I will encounter judgement if I run my mouth about it.”

Tharp wants to work in Arkansas given the shortage, but she won’t apply to the only OB-GYN residency program in the state, which is at UAMS.

UAMS is not affiliated with the Ryan program which, she says, ensures a more holistic reproductive health curriculum. And there’s only one provider in the state who can train her in surgical abortions, provided he doesn’t retire by then. And another caveat: stigma.

“Leadership at UAMS is afraid of the state legislature because we answer to the state government and know how conservative state politics are,” Tharp said. “You can find people at UAMS admin who are sympathetic… but they’re afraid of the political ramification.”

“I don’t think I would have a good time having to do my residency — to learn about abortion in Little Rock,” she said. “It’s been implied to me that I will encounter judgement if I run my mouth about it.”

While the stigma against abortion is pervasive in Arkansas, she still loves the state; she loves the color palette of the trees during the fall, the food (namely cheese dip), and her family. Her family of course will worry about her career choice as it can be dangerous and — as Tharp explained it: they care about “southern properness.”

“I’m already a lesbian — it doesn’t bother me,” said Tharp. “People who care about me the most, won’t care — won’t dislike me. I’ll be fine. I’m not worried about myself. I know they will be.”

Exposure to integrated abortion training is more prominent in Northeast and West Coast programs. These schools also tend to be more competitive, a point that worries Tharp. She hopes her tailored application helps her match with a residency program that provides comprehensive abortion training. Because after she graduates, she’ll be an abortion provider, not just a physician who provides abortion. That’s what often happens after providing abortion services. For example, Dr. Ho gave up her own private practice in Arkansas to provide abortions. Now she works at Planned Parenthood, where security and support is assured.

“I’m pretty much 100 percent fine with maybe not being a normal OB-GYN because of my abortion practices,” Tharp said. “That’s kind of what I’ve come to accept.”

https://thinkprogress.org/training-the-next-generation-of-abortion-doctors-45cd46403b6a/

“RJ is a model not just for women of color, nor just for achieving reproductive freedom. RJ is a model for organizing for human equality and well-being,” writes author Dorothy Roberts in her foreword to the new anthology.

As the SisterSong Women of Color Reproductive Justice Collective celebrates its 20th year of organizing and activism on behalf of women of color across the globe, the organization’s members and supporters have compiled an essay collection called Radical Reproductive Justice covering a range of reproductive justice perspectives.

Killing the Black Body author Dorothy Roberts aptly explains in her foreword to the anthology, “RJ is a model not just for women of color, nor just for achieving reproductive freedom. RJ is a model for organizing for human equality and well-being. The world needs radical reproductive justice.”

The book is as revolutionary and revelatory as it is vast, with writers who are fighting for their inclusion despite their anti-abortion stance; critiquing what it means to be an ally, as an ally; and creating space for more difficult conversations about how programs and organizing around reproductive health and autonomy often erase trans people. It is these moments, appearing throughout the anthology, that reveal what the editors—SisterSong co-founder Loretta Ross, CUNY School of Public Health professor Lynn Roberts, New Mexico Highlands University professor Erika Derkas, University of Michigan consultant on race and ethnicity Whitney Peoples, and the late activist lawyer and legal scholar Pamela Bridgewater Toure—mean by radical reproductive justice, and why the theory is an imperative for people who support bodily autonomy in how they think, act, and write about these issues.

Reproductive justice, a term coined by Black women in 1994, centers “three interconnected human rights values: the right not to have children using safe birth control, abortion, or abstinence; the right to have children under the conditions we choose; and the right to parent the children we have in safe and healthy environments.”

I’ve read numerous books, essays, and articles on the framework, including a few by its co-founder Loretta Ross. The essays contained in Radical Reproductive Justice offer the most powerful critique of the ways in which “allies” tend to normalize oppression, consciously or not. Divided into four parts—historical context; theory; policy, practice, and activism; and poetry—the anthology empowers readers to better understand the roots of reproductive justice and how the theory can be molded and used by other fresh perspectives “to build an [even more] expansive vision for universal justice” than what the founders may have envisioned.

Ross explained to me on the phone that RRJ, as she calls the book, “is different because we took a more radical approach to describing reproductive justice than I have in my previous writing. It has a stronger critique of white supremacy, neoliberalism, [and] identity politics,” she said.

As just one example, INCITE! co-founder Andrea Smith, in her essay “Beyond Pro-Choice versus Pro-Life: Women of Color and Reproductive Justice,” explains how the “pro-life versus pro-choice paradigm is a model that marginalizes women of color, poor women, and women with disabilities. It reifies and masks the structures of white supremacy and capitalism that undergird the reproductive choices women make, and narrows the focus of our political goals to the question of the criminalization of abortion.” She instead pushes for a “nationally coordinated women of color movement” that makes “the dismantling of capitalism, white supremacy, and colonialism central to its agenda, and not just as principles added to organizations’ promotional material designed to appeal to women of color.” Such a movement would offer advocates more freedom “to think more creatively about who we could work with in coalition while simultaneously allowing us to hold those who claim to be our allies more accountable for the positions they take.”

Ross highlighted in our interview how the reproductive justice framework “is broad enough to include a lot of different perspectives,” including those that the co-founders didn’t necessarily agree with. “But that was our point,” said Ross, “to show how we could use the framework in some inventive and creative ways to build a forward-looking movement.”

One such article is a piece that also took me by surprise. It’s an essay written by poet Mary Krane Derr, published posthumously and titled “Card-Carrying Marchers and Sister Travelers: Pro-Life Feminists and the Reproductive Justice Movement.” In it, Derr makes the case for collaboration between reproductive justice advocates and self-described pro-life feminists who do not support abortion—nor do they support its criminalization or harming people as a consequence of their stance—but do support contraception.

Ross explained that during the ten years that this book was in production, “Mary Krane and I had extensive conversations about her essay before she passed, and I frankly told her there were parts of [her] historical account that I didn’t agree with; she is misinterpreting things that I don’t remember or the evidence doesn’t support.”

“But at the same time, she got me to understand that within the anti-choice movement, there is a left, a center, and a right, and she represents the feminist wing of the anti-choice movement,” Ross continued. “And they are under severe attack and critique within their own anti-choice movement for being so feminist …. That [is something] I didn’t really understand or know about.”

“But Mary’s wasn’t the only ‘pro-life’ essay in there, it’s just that she was the only one out as being ‘pro-life,’” Ross pointed out. “If [a contributor] didn’t choose to write about their identity, one doesn’t know that the book contains all of those registers of voices.”

RRJ shows the reader the potential reproductive justice has to transform our society into a culture that is accepting of human rights-centered folks with different views toward achieving justice. But those conversations aren’t easy to have, and those relationships aren’t easy to maintain. When asked for advice on having those tough discussions, Ross said, “with love and respect for ourselves first, because if you don’t love and respect yourself, it’s hard to extend it to someone else.”

“I think the best way to approach this is with strength and integrity and honesty,” Ross added. “Know what you believe in, analyze why you believe it, and then make space for other people to have their beliefs.”

Storytelling is a critical component of the process because it allows reproductive justice advocates to center their truth in their work and organizing. “Storytelling is a reclamation project of reclaiming your voice, your self, your truth, helping you to discharge all of the negative things you’ve internalized about those things, so that you can use your fullest and best thinking to figure out what you want to do with the rest of your life,” explained Ross.

An essay that exemplifies that is Lucia Leandro Gimeno’s contribution, titled “The Reluctant Reproductive Justice Organizer and Birthworker.” As the director of the Queer & Trans People of Color Birthwerq Project, Gimeno reflects on his experience as a transmasculine femme doing justice work, calling attention to the “tension and disconnect between RJ and trans justice … and how [people] deal or don’t deal with the contradictions and big questions around honoring where we come from in order to figure out where the hell we’re going.” One such question that is begging to be addressed, he notes, is how “we enter a conversation that acknowledges the misogyny and erasure of women and the transphobia that also erases women (cis and trans)?”

Building from Caroline R. McFadden’s example in a different essay (about “critical white feminism” theory), it’s on cisgender people to identify the ways in which we uphold transphobia by generalizing our experiences as the norm, thereby continuing to erase trans people from conversations critical to their survival. As Gimeno writes, “If we look at our traditions around birth and community and family, they have always included [cis and trans and queer and straight folks]. Part of what colonization and white supremacy have done is erase the fact that we need each other and that we are being attacked by the same systems.”

In McFadden’s essay, the anti-racist feminist writer speaks directly to white “allies,” who have more work to do when it comes to examining their own stories and the ways in which they experience reproductive privilege. Titled “Reproductively Privileged: Critical White Feminism and Reproductive Justice Theory,” the essay lays out her fear of repeated history in which white feminists “generalize our experiences as the norm” and fail to show true concern when “our experiences aren’t at the center of a theory or a praxis.” Writes McFadden, “white feminists understate the ways in which whiteness and privilege facilitate problematic theorizing that assumes a hubristic universality, while at the same time criticizing cisgender white men for doing the same.” She adds that although “the feminist movement loudly rejects instances of overt racism, the movement reflects the dominance of whiteness by normalizing it.” As an example of this theory in practice, McFadden describes how white organizers of the Women’s March initially “failed to incorporate the same anti-sexist and anti-racist frameworks of the black women’s march in 1997” all while co-opting the name of that Philadelphia march—the original Million Women’s March.

McFadden argues that anti-racist white women must focus on their own communities and actions instead of trying to effect “change in communities of color.” She concludes, “White feminists must take responsibility for ourselves and our mistakes, demolish and rebuild our current conceptualization of reproductive oppression, and use our shared power to move forward toward a world of infinite possibilities achieved through reproductive justice.”

As someone who works in the media, I wondered while reading the book about the ways in which my fellow journalists might help to reinforce a human rights culture. A logical conclusion would be for those working in the media to consider their role in pathologizing communities of color through every editorial move they make. Personally, I’m thinking about whether there are areas where I’ve dehumanized communities of color (I’m a Black woman, but white supremacy does not infect only white people) in my everyday decision making, from assigning stories to, on a more basic level, perpetuating damaging frameworks. Rewire does a great job of centering those most affected by systemic oppressions, but there’s always room for growth, especially as we dig deeper into the injustices faced by people who’ve been polyvictimized, including undocumented immigrants and Native communities.

People in the media can also do more to stay vigilant about asking the right questions when it comes to individual events. In the book, Ross discusses the story of Keisha, a pseudonym. Ross took the 12-year-old to an abortion appointment, and to this day, some seven years later, the image of the young woman sucking her thumb has stayed with her. “It just broke my heart,” said Ross on the phone. “And then her mother’s boyfriend was just hovering over us.”

When reporting that story, there’s a lot of context and questions to raise, but which is the most important angle? For advocates like Ross, “the problem wasn’t that Keisha needed an abortion, the problem was that she shouldn’t have had [to get one]—why did she need one? What else was going on in her life?”

And there’s the fact “that [Keisha and her mother] had to come from Chicago to Atlanta to have those services. Why weren’t those services available where she was, locally?” Ross asked. There’s also the abuse part of Keisha’s story, she explained: “Our failure to protect vulnerable girls like her—it’s not Keisha’s fault.”

Ross raised the issue of contraception too. “I particularly was pained by the fact that her mother refused birth control for both of them,” said Ross. “And, of course, when you’re being an abortion doula you can’t ask these intrusive questions.” But there are larger context questions around why someone might “equate taking birth control with being sinful,” Ross pointed out, and why people are “still taught that sex and sexuality concerning women is a sin.”

“There’s just so many things going on with [Keisha’s] story—that just was an emblem of why we needed [reproductive justice theory], because we couldn’t explain all these other things without that,” said Ross.

Reporting through a reproductive justice lens, then, empowers publications to tell fuller stories and to view their subjects as whole people.

There’s also the ongoing problem of false equivalence. As Ross explained to me during our interview, “You see it a lot in covering of the white supremacist movement, where [in news stories] there has to be white supremacists who are pro-fascists and equivalent to them are anti-fascists …. That’s just like saying, everybody’s human and being a multimillionaire human is no different than being an impoverished one.”

This comes into play when the reproductive justice framework is pitted against “pro-choice” or “pro-life” ideologies. As the editors of RRJ explain in their introduction, “It is important to underscore … that RJ is neither an oppositional nor a peace-making ideology; it is an emergent radical theory that recasts the problem using the human rights framework.” Or, more to the point: “RJ centers the lives of communities of color instead of the middle-class white people on both sides of the abortion debate.”

As we move into a radical reproductive justice future, our role as media makers is to continue searching for and telling honest stories, and that includes not painting any particular experience with one broad brush. Radical Reproductive Justice reminds us that no movement is a monolith and no one experience is the norm. Our stories should reflect that truth.

https://rewire.news/article/2017/11/28/future-radical-reproductive-justice/

U.S. Congressman Tim Murphy in August.

A text message sent in January to U.S. Rep. Tim Murphy by a woman with whom he had an extra-marital relationship took him to task for an anti-abortion statement posted on Facebook from his office’s public account.

“And you have zero issue posting your pro-life stance all over the place when you had no issue asking me to abort our unborn child just last week when we thought that was one of the options,” Shannon Edwards, a forensic psychologist in Pittsburgh with whom the congressman admitted last month to having a relationship, wrote to Mr. Murphy on Jan. 25, in the midst of an unfounded pregnancy scare.

On Wednesday, Murphy released a statement in which he says he will not seek re-election. 

A text from Mr. Murphy’s cell phone number that same day in response says, “I get what you say about my March for life messages. I’ve never written them. Staff does them. I read them and winced. I told staff don’t write any more. I will.”

The congressman has been lauded by the Family Research Council, for his stance on abortion, as well as for family values, generally. He also has been endorsed by LifePAC, which opposes abortion rights, and is a member of the House Pro-Life Caucus, an affiliation that is often cited by his office.The text message exchange was included among a series of documents obtained by the Pittsburgh Post-Gazette.

Ms. Edwards declined to comment on the documents.

Repeated voice mail messages left on Mr. Murphy’s cell phone on Tuesday were not returned.

Another — a six-page memo to Mr. Murphy purportedly written by his chief of staff, Susan Mosychuk — described a hostile workplace in which Mr. Murphy repeatedly denigrated employees, threatened them and created a state of “terror.”

Ms. Mosychuk could not be reached for comment despite repeated attempts Tuesday to speak with her. A staff member in Mr. Murphy’s office said the congressman’s communications director, Carly Atchison, was also unavailable after apparently conferring with Ms. Atchison.

“We have received your message and goodbye,” the staffer said before hanging up.

The June 8 memo, titled “Office Conduct and Behavior: Harassment/Legal Compliance,” says that there had been an “ongoing and ever more pronounced pattern of sustained inappropriate behavior” from the congressman.

The memo criticized his “inability to hire and retain competent staff, abysmal office morale,” as well as “hostile, erratic, unstable, angry, aggressive and abusive behavior.”

According to the memo, the office has had nearly 100 percent staff turnover in one year and that the office has lost more than 100 staffers since Ms. Mosychuk started working with Mr. Murphy. Ms. Mosychuk began working with him in 2003.

The memo says that its purpose was to detail the problems as they related to the office manual as well as the Congressional Accountability Act and seek corrective action.

The memo recounted events from June 2 and June 5 involving a visit Mr. Murphy made to his home district.

“You were storming around as we walked in, and as we sat down for prep — having just arrived literally moments ago — you started in on the [legislative director] and verbally abused him, harassed him, chastised him and criticized all his work products. You called many of the work products that he literally gave up his weekend to produce as ‘useless.’ You pushed other documents off the table onto the floor because they weren’t what you wanted. Then you got angry and demanded we find the documents that you had just thrown on the ground.”

The memo also referenced a town hall meeting Mr. Murphy held on June 5 and said that Mr. Murphy drove the car with staff to events later that day. As he drove in a torrential downpour, the memo says, his driving was “dangerous and erratic,” while he read his iPad, played YouTube videos and texted.

Mr. Murphy said in a Nov. 27 email to Ms. Edwards that he “fell into” a relationship with a woman named “Susan” when his daughter left for college.

“I did not see its toxicity until I was months into it,” he wrote to Ms. Edwards. He said he lacked the confidence to break it off. “I decided on a long term plan to try to stabilize my life abd[sic] extricate myself from that relationship by building my strength in other areas. While I was belittled and berated and while my confidence was at its nadir i decided to do some things to demonstrate my own courage.”

That is when he decided to join the Navy Reserves, he said.

According to military records, Mr. Murphy was commissioned on Jan. 1, 2009, and served in the Operational Health Support Unit at Walter Reed National Military Medical Center in Bethesda, Md., from September 2009 until April of this year.

He submitted his retirement on Sept. 11 and received an honorable discharge dated Sept. 13, records show.

As chief of staff, Ms. Mosychuk is paid $168,411. Ms. Mosychuk also drew pay from Mr. Murphy’s re-election campaigns, taking time off from her legislative job for the work, according to information provided on statements of financial disclosure that senior staff members are required to file. She reported receiving a total of $152,000 between 2008 and 2012, according to disclosures archived by the website LegiStorm. Data from 2014 was not immediately available, and she did not report earnings in 2016.

Ms. Mosychuk previously worked for former U.S. Rep. Bob Barr, R-Ga., the House Oversight and Government Reform Committee, the Florida House of Representatives, and Citizens Against Government Waste.

The relationship between Mr. Murphy and Ms. Edwards was first exposed as part of her divorce proceedings from her husband, Jesse Sally, a sports medicine physician.

Dr. Sally filed for divorce from Ms. Edwards in July 2016. Then, this past summer, his attorney filed a request with the courts to depose Mr. Murphy as part of that court action.

Mr. Murphy and Ms. Edwards fought to quash the subpoena, but Allegheny County Common Pleas Judge Kathryn Hens-Greco denied their request, saying that the information Mr. Murphy would provide could be relevant to the underlying court action.

Judge Hens-Greco set a deadline of Sept. 29 for Mr. Murphy to be deposed.

That has still not happened, and argument on that and other issues is set for Wednesday.

In a statement he released on Sept. 6, Mr. Murphy portrayed what had occurred as “an affair with a personal friend,” but in court documents and testimony, Ms. Edwards presented it as a long-term relationship.

In the Nov. 27 email with Ms. Edwards, Mr. Murphy described his marriage as troubled.

He wrote that when he first met Ms. Edwards he was singularly focused on passing his mental health reform legislation following the school shooting at Sandy Hook Elementary School.

“I was not looking for a relationship with anyone,” he wrote. “But we formed a true bond. It grew deep and fast. It became love. It became in love.”

According to court records, Ms. Edwards’ relationship with Mr. Murphy began professionally regarding that mental health legislation in the fall of 2015, and developed first into a friendship and then months later into a romance. She alleges in court documents and testimony that there was no physical intimacy until May 2016 -— after she and her husband had technically separated.

Dr. Sally, in court records, alleges that the relationship with Mr. Murphy and Ms. Edwards began in February 2016.

It was early this year that the text exchange over abortion was prompted by a Jan. 24 Facebook post by Mr. Murphy: “The United States is one of just seven countries worldwide that permits elective abortion more than halfway through pregnancy (beyond 20 weeks). It is a tragic shame that America is leading the world in discarding and disregarding the most vulnerable,” he wrote.

Mr. Murphy noted in that post that he sponsored and voted for a bill prohibiting the use of federal funds to pay for abortions and said he had hope that “we will once again be a nation committed to honoring life from the moment of conception and ensuring American taxpayer dollars are never spent to end a life before it even begins.”

He is currently a co-sponsor with 181 other legislators of the Pain-Capable Unborn Child Protection Act, which would bar abortion after 20 weeks except in cases of rape, incest or where the pregnancy poses a threat to the life or physical health of the mother. Mr. Murphy voted for the bill Tuesday evening, according to Roll Call. It passed 237 to 189.

http://www.post-gazette.com/news/politics-nation/2017/10/03/rep-tim-Murphy-pro-life-sought-abortion-affair-shannon-edwards-susan-mosychuk-pennsylvania-chief-of-staff-congress-emails-texts/stories/201710030018?utm_term=Autofeed&utm_campaign=Echobox&utm_medium=Social&utm_source=Twitter#link_time=1507061392

The bans on non-intact dilation and evacuation—an overwhelmingly common method of second-trimester abortion—could force Justice Anthony Kennedy to decide which he values more: evidence-based lawmaking or the power of the state to promote fetal life.

Last week a federal district court ruledunconstitutional a Texas provision that bans the most common form of second-trimester abortions. The decision was an important win in what is emerging as the next big fight over abortion rights: criminalizing abortion procedures and providers in the name of promoting “fetal life.”

But it’s not the end of the road. With the Fifth Circuit Court of Appeals sitting in the middle of this fight, there is a good chance it will make its way all the way up to the U.S. Supreme Court. If and when that happens, abortion rights advocates have to hope Justice Anthony Kennedy is on their side—and it’s not so clear he will be.

Anti-choice advocates pivoted to non-intact dilation and evacuation (D and E) bans like the one in Texas almost immediately following their 2016 loss in Whole Woman’s Health v. Hellerstedt. In Hellerstedt, the Supreme Court struck as unconstitutional provisions of a different Texas law that required abortion clinics to meet the same architectural standards as stand-alone surgical centers, even if the clinic provided no surgical services, and that required doctors performing abortions to have admitting privileges at nearby hospitals.

Despite Texas lawmakers’ claims, the 5-3 majority in Hellerstedt found no evidence that the requirements advanced patient safety. The Court ruled that for restrictions to survive constitutional scrutiny, it was not enough for lawmakers to simply assert patient safety as a justification for attempting to curb abortion access—they also needed evidence to back up those assertions.

The Hellerstedt decision effectively cut off the ability of anti-choice lawmakers to target abortion clinics for closure, reduce access to abortion services and other reproductive health care, and then claim that doing so is necessary to protect patients.

Promoting patient safety, though, is only one part of the constitutional analysis. States can also pass laws that restrict abortion access, even prior to viability, if those restrictions advance the state’s “profound” interest in promoting fetal life without enacting an “undue burden” on would-be patients. This is the part of the analysis anti-choice advocates are now testing with their D and E bans.

The idea of a “profound” state interest stems from Roe v. Wade. In particular, it arose the last time anti-choice advocates had a win before the Supreme Court: in 2007 in Gonzales v. CarhartGonzales upheld the federal “partial-birth” abortion ban, an unscientific term developed by anti-choice advocates to describe an intact D and E abortion—also known as a “D and X” abortion—a relatively uncommon method of ending a pregnancy in the second trimester.

But before Gonzales came Stenberg v. Carhart, the 2000 decision that struck down Nebraska’s “partial-birth” abortion ban. The Nebraska law contained no exception for the health of the pregnant person, a feature that would doom it before the a majority of the Court. Anti-choice advocates took immediate notice of why the law had failed and regrouped, passing the federal Partial-Birth Abortion Ban Act of 2003. That law was modeled almost entirely on the unconstitutional Nebraska statute with one difference: It contained a small exception for when the pregnant person’s health was in danger. Four years later, the Supreme Court upheld the new version of the ban in Gonzales after striking the nearly identical one in Stenberg.

In both cases, however, Justice Kennedy voted to uphold the bans, siding first with the dissent in Stenbergand then the majority in Gonzales. In Stenberg, Kennedy authored a dissent deeply critical of the majority for framing the analysis of the constitutionality of the ban from the perspective of an “abortionist” rather than the state’s interest in regulating the medical profession so that it does not become “disdainful” to life, “including life in the human fetus.” In his dissent, he describes the procedure at issue as deserving of “the most severe moral condemnation, condemnation reserved for the most repulsive human conduct.”

Kennedy’s condemnation wasn’t limited to only “partial-birth” abortions, however. He extended it to all D and E procedures. He then picked this thread up again in his majority opinion in Gonzales, writing, “No one would dispute that, for many, D and E is a procedure itself laden with the power to devalue human life.”

Still, although Kennedy condemned D and E abortions generally, the Court’s decision to uphold the federal ban pre-viability was based in part on the availability of non-intact D and E abortions around the country—precisely the procedure under attack right now in Texas’ Whole Woman’s Health v. Paxton.

Earlier this year, Texas lawmakers passed their D and E ban as part of SB 8, a piece of Frankenstein legislation stitching together as many anti-abortion provisions as possible. Reproductive rights advocates challenged the D and E provision in the law almost immediately, arguing it was an unconstitutional pre-viability ban because the result of the measure would be to effectively cut off second-trimester abortion care entirely. Because D and E abortions happen when a patient is between 15 to 20 weeks pregnant and the fetus not viable, the law basically bans abortion before viability. Texas lawmakers defended the measure, arguing that while the law did target the most common form of second-trimester abortion, other, less common, methods of terminating a pregnancy in the second trimester exist. Therefore, they said, the law was not a pre-viability ban. Furthermore, the state argued, the ban was a legitimate exercise of its interest in promoting fetal life.

In August, a federal district court agreed with the plaintiffs that the measure was an unconstitutional pre-viability ban and temporarily blocked the measure from taking effect. Last week’s decision made that temporary order permanent.

The opinion issued by Judge Lee Yeakel blocking the measure is as airtight as reproductive rights advocates could ask for. Yeakel, a President George W. Bush appointee, is the same judge that ruled against the state of Texas again and again in Hellerstedt. Similar to Hellerstedt, in Paxton, Yeakel determined that Texas had failed to offer any evidence to support its claims that banning D and E abortions promoted its interest in fetal life without unduly burdening a patient’s right to chose. That is because, Yeakel determined, the evidence failed to show that the other methods advanced by the state for terminating an abortion were available and safe. Therefore, Yeakel ruled, the D and E ban had the effect of banning most second-trimester abortions.

The state of Texas immediately appealed the decision. If history is any guide, the Fifth Circuit Court of Appeals will find a reason to side with the state and overturn the order blocking the ban. And if it doesn’t, attorneys for Texas will push the Roberts Court to do so.

There is at least one good reason, however, for the Roberts Court to stay out of this fight. At least seven states other than Texas have enacted D and E bans. And in those states where the laws have been challenged, federal and state courts have been unanimous in finding them unconstitutional. That means there’s no legitimate legal disagreement as to the constitutionality of D and E bans, which means there’s no dispute for the Court to settle.

But anti-choice activists didn’t spend all that money getting Associate Justice Neil Gorsuch appointed to the bench to have the Court pass on a fight like the one in Paxton, though. Given the facts that Justice Samuel Alito is the justice who refers petitions from the Fifth Circuit to the Supreme Court for review, and Justices Clarence Thomas and John Roberts are reliably anti-choice votes along with Gorsuch, anti-choice advocates will likely have four votes to take the case on. The question is whether they have the fifth vote from Justice Kennedy to win.

In Hellerstedt, Justice Kennedy voted with the majority to strike the Texas abortion restrictions. He didn’t author any separate opinion, so presumably he agreed with Justice Stephen Breyer’s opinion that made it very clear that lawmakers must have evidence and data to back up claims that the abortion restriction they are advancing actually serves the state interest they assert—in that case, advancing patient safety. In Paxton, Texas has again failed to offer any evidence to support its reasoning, so hopefully Kennedy would vote to strike the D and E ban as he did the admitting privileges and surgical center requirements. But again, in Stenberg and Gonzales, he made it very clear he supports the power of the state to regulate away pre-viability abortion procedures in the name of advancing its interest in fetal life.

Overall, the D and E bans could force Kennedy to decide which he values more: evidence-based lawmaking or the power of the state to promote fetal life.

There is another lesson to draw from Stenberg, Gonzales, and the fight over “partial-birth” abortion. Anti-choice advocates started that fight in the states, and when they lost, they evolved their strategy and advanced it through federal legislation. Should the Court take Paxton or a similar case and rule against the bans, there is every reason to think anti-choice advocates will follow the Stenberg/Gonzales playbook and advance a slightly revised federal version.

Those are a lot of “ifs.” And by their nature, cases take time. Probably long enough, in fact, for a Supreme Court justice or two to retire. If conservatives get their way, that will lead to a Court willing to undo abortion rights altogether.

https://rewire.news/article/2017/11/27/second-trimester-ban-supreme-court/

Tougher abortion rules in one state are a warning to the rest of the country.

PORTRA IMAGES VIA GETTY IMAGES

Missouri women seeking an abortion regularly head to the Hope Clinic in Granite City, Illinois, 15 minutes from downtown St. Louis. More than half of the clinic’s patients come from Missouri, many looking to bypass their home state’s mandatory three-day waiting period — one of the longest in the country.

That waiting period law became more stringent one month ago, when a deceptively subtle tweak took effect to little notice. It requires that the doctor who will perform a woman’s abortion must also walk her through the state-mandated counseling session three days earlier, rather than giving that task to a qualified nurse, physicians assistant or counselor.

Reproductive rights experts in Missouri and around the country warn that it will take months before they can measure the true impact of this change, but staff at the bustling Hope Clinic are already feeling its effect.

Dr. Erin King, an OB-GYN and the interim clinic director, suggested that more Missouri women might be crossing over to Illinois to escape the onerous requirement.

“I would say in our office today we’re probably seeing double the number of patients we would see on a similar day three weeks ago,” said King, who spoke to HuffPost two weeks after the law took effect. “On the phone, every day since that law went into effect … we have had at least five and 10 patients calling and being upset about it. Or being confused about it. Or wondering what the change was and what is happening.”

Republican state legislators who passed the bill including the waiting period measure in a special session over the summer contend it will help protect the health and safety of women in the state.

For years, Missouri has had only one abortion provider, a Planned Parenthood clinic in St. Louis, although several more Planned Parenthood outposts around the state have begun or will soon begin to offer abortion services. The reproductive health care organization, together with the American Civil Liberties Union, sought to block the law, arguing that it places an “undue burden” on women seeking an abortion, potentially forcing them to drive hundreds of extra miles and delaying their care.

But the law went into effect on Oct. 24 after a judge ruled against Planned Parenthood and the ACLU ― a result that rattled reproductive rights advocates.

“We certainly did not think this was going to be the outcome,” Alison Dreith, executive director of NARAL Pro-Choice Missouri, told HuffPost. “It kind of left the state scrambling to figure out what this means.”

Dreith said she understands firsthand how Missouri’s restrictions can drive women out of state. She opted to travel to Illinois when she had an abortion last year.

Broader research looking at state-mandated waiting periods finds they do not necessarily change women’s minds about getting an abortion. Most women have made their decision by the time they seek care, and most find a way to follow through on it.

“What they do is create hardships for women,” said Dr. Sarah Roberts, an associate professor with Advancing New Standards in Reproductive Health, a research group at the University of California, San Francisco.

Roberts worked on a 2016 study looking at Utah’s 72-hour waiting period, which it found increased women’s financial burden and logistical challenges, and pushed at least one patient past her provider’s gestational limit for abortion. Women ended up waiting an average of eight days between their initial visit and the procedure, Roberts said. She warned about an overall “lengthening and strengthening” of waiting period laws across the country.

In Missouri, the “strengthened” waiting period law will make schedules trickier for busy doctors and resource-strapped clinics. “There aren’t that many highly trained gynecologists who can do abortion procedures, and you’re now taking their time to do all of these consents ahead of time,” King said.

She also noted how unusual it is to mandate that the doctor performing a procedure handle the prior counseling of the patient. “In no other field of medicine is that the case,” King said. “Patients undergo procedures all the time where they are ‘consented’ in a very thorough manner by a trained health care professional who may not necessarily be the exact person doing their procedure.”

Eyes from both sides of the abortion debate see Missouri as a test case for how much leeway states have to introduce new waiting periods and bolster those already on the books. In 2011, not a single state had an abortion waiting period longer than 24 hours, according to Elizabeth Nash, senior state issues manager with the Guttmacher Institute, and only seven states had policies that required women to make two trips to a clinic. Now, eight states have waiting periods of 48 or 72 hours, and seven additional states require at least two visits.

“I think of this as sort of an underground trend,” Nash told HuffPost. “I don’t know if those two words can really go together, but yes, we’ve been seeing more waiting periods. And it hasn’t gotten the kind of attention that some of the other trends have.”

Meanwhile, in her clinic just outside Missouri, King is also waiting to see the full effects of this latest abortion regulation. History leads her to believe she’ll see even more patients fleeing Missouri’s restrictions and walking through her doors. Before Missouri first instituted a 72-hour waiting period, only 40 percent of the clinic’s patients came from that state, she said. By last year, the figure was up to more than 50 percent.

“The thing that is most concerning about [what is happening] in Missouri is that there are what would seem like small changes to the existing law,” Kin said, “but that will make an enormous impact on the patients.”

https://www.huffingtonpost.com/entry/missouri-waiting-period-law_us_5a12f395e4b0e97dffeeebbe?utm_campaign=hp_fb_pages&utm_source=women_fb&utm_medium=facebook&ncid=fcbklnkushpmg00000046

CNN

A few weeks out from Alabama’s special election, Republicans in Washington are walking a fine line. They aren’t directly endorsing Roy Moore, but they’re also not pushing him to drop out of the race. Moore was accused by multiple women of making inappropriate sexual advances when they were teenagers and he was in his 30s, and two alleged he assaulted them. He has vehemently denied all the allegations, and many conservatives have stood behind him during this time, including a Trump adviser who compared child molestation to abortion in his defense of Moore, saying “there’s no moral high ground” between the two.

Stephen Moore, an economic adviser to President Trump, told CNN’s John Berman on Monday that the Republican Senate candidate isn’t any worse than his Democratic opponent, Doug Jones. “I think Judge Roy Moore was kind of a creep, and I think these are obviously very serious allegations against him,” Stephen began. “But I also think that it is appropriate for the people of Alabama to make this decision.” (Stephen Moore has no relation to Roy Moore.)

The economist touted the same argument the GOP has stuck with since the child molestation allegations surfaced: It’s up to the people of Alabama to decide who they want to represent them in the U.S. Senate. Stephen Moore simultaneously called the Republican candidate creepy and disparaged his opponent, making it clear that he wants Roy Moore to win despite his alleged past.

“By the way, the Democrat is no saint, either,” he told CNN, referencing Jones. “The Democratic candidate is for partial birth abortion in a state that’s highly Christian and Catholic. So there’s no moral high ground here.”

Berman replied: “Except one is an alleged child molester.”

However, Stephen doubled down on his claim that abortion is just as bad as child molestation, explaining that many Alabama voters view “partial birth abortion” (a term pro-lifers use to describe dilation and extraction abortions) as “tantamount to murder.”

It’s true that Jones is running on a pro-choice platform and promised not to support national legislation seeking to ban abortion at 20 weeks. As the candidate said in October:

His views on abortion have made it difficult for some Republicans to abandon the GOP candidate to vote for him — in fact, a Republican woman was quoted in the Los Angeles Times saying that she’s “torn between voting for a pedophileand voting for a person who believes in abortion.” A recent JMC Analytics poll also showed that almost 40 percent of Alabama evangelicals are more likely to support Roy following the allegations of inappropriate sexual behavior. Stephen Moore’s argument played into this conservative struggle that prioritizes protecting fetuses over children.

Four women have alleged Roy made sexual advances when they were between 14 and 18 and he was in his 30s. Two additional women claimed he assaulted them, one of whom alleged he forcibly kissed her when she was 18. The Senate candidate has denied all allegations of sexual misconduct, calling it “fake news” and telling Fox News he doesn’t “remember ever dating any girl without the permission of her mother.” Moore even used the allegations as a fundraising tactic, claiming Democrats were spreading lies about him to discredit his campaign.

Although the White House said President Trump believes Moore would “step aside” if the child molestation allegations are true, his administration and most GOP leaders haven’t explicitly called for the Alabama candidate to drop out. Stephen Moore equating child molestation with abortion further highlights how far the party is willing to go to rationalize disturbing allegations against its members.

A pro-choice supporter carries a placard which reads ‘Abortion is healthcare, it should be free, safe and legal’ / Getty

Countries where abortion is illegal have slightly higher abortion rates than countries where the procedures are legal, the research found

Making abortion illegal does not reduce the number of terminations women have, a study has concluded.

The research, published in the Lancet medical journal, analysed the abortion rates of countries around the world where abortion is legal and those in which terminations are a criminal offence. It found that rates of the procedures were similar regardless of the legal status of abortions.

In countries where abortions are legal on a woman’s request, 34 women in every 1,000 have one. In countries where abortions are always illegal or legal only if a woman’s life is in danger, 37 women in every 1,000 have one.

The slight increase in rates where abortion is illegal may be due to these countries also tending to have more restricted access to contraception which increases conception rates.

The obvious interpretation is that criminalising abortion does not prevent it but, rather drives women to seek illegal services or measures.

Professor Diana Greene Foster

Professor Diana Greene Foster from the University of California said of the findings: “The obvious interpretation is that criminalising abortion does not prevent it but, rather drives women to seek illegal services or measures. But this simple story overlooks the many women who, in the absence of safe and legal services, carry unwanted pregnancies to term. Women who live in countries where abortion is illegal often have little access to the whole range of family planning services, including contraceptive supplies, counselling, information and safe abortion.”

A spokesperson for Marie Stopes International said: “This study reinforces the fact that restricting access to abortion makes no significant difference to the number of women who choose to have one. Instead, restrictions make it more likely that women will turn to unsafe practitioners, whose methods range from counterfeit drugs to industrial poisons or wire coathangers. Every 11 minutes, a woman dies from complications related to unsafe abortion. In 2016, this is unacceptable and entirely preventable.”

http://www.independent.co.uk/life-style/health-and-families/health-news/women-in-countries-where-abortion-is-illegal-just-as-likely-to-have-one-as-countries-where-it-is-a7025671.html