Abortion – Abortion Clinics, Abortion Pill, Abortion Information

There’s no real evidence that it works — and no data on the side effects.

Three mifepristone abortion pills are held in a hand on December 1, 2000. Bill Grenblatt/Liaison/Getty Images

“Even if you’ve taken the abortion pill, you can still change your mind,” proclaims the website of a group called Alternatives Pregnancy Center.

The center offers what it calls “abortion pill reversal,” a treatment it claims can stop a medication abortion that’s already been started. Many organizations around the country are beginning to offer the procedure, and a growing number of states require that patients seeking abortions be told about it.

But there’s a problem. “All of the evidence that we have so far indicates that this treatment is not effective,” Daniel Grossman, an OB-GYN and the director of Advancing New Standards in Reproductive Health, a research group at the University of California San Francisco, told Vox.

Pioneered by an anti-abortion doctor in California, abortion “reversal” involves taking the hormone progesterone after the first dose of abortion medication. However, reproductive health experts, including the American Congress of Obstetricians and Gynecologists, say there’s no evidence the procedure actually works to stop an abortion from happening. And, they warn, no one knows what the side effects might be of taking progesterone in an effort to reverse abortion medication.

But Republican-controlled state legislatures are increasingly passing bills requiring doctors to tell patients about the possibility of abortion reversal. The latest is Ohio, where the state Senate passed such a bill last week; the legislation now goes to the state House for consideration.

Anti-abortion groups argue that progesterone is safe and the laws are just a way to make sure patients are aware of their options. But reproductive health advocates say pregnant people around the country are essentially becoming test subjects in an unscientific and unethical experiment.

“It’s one thing when states were forcing abortion providers to give information that was inaccurate about the risks associated with abortion,” Grossman said. “This takes it to a whole new level.”

A California doctor claims abortion medication can be “reversed” with progesterone

Typically, a medication abortion works like this: The pregnant patient takes a pill, called mifepristone, meant to stop the pregnancy from progressing. Then, up to 48 hours later, the patient takes a second pill, misoprostol, that induces contractions and causes the uterus to empty. Mifepristone has been FDA-approved since 2000, and the procedure works to end a pregnancy about 95-99 percent of the time.

But in 2012, Dr. George Delgado, a family medicine physician in San Diego who identifies as pro-life, announced that he had developed a method to reverse the process, according to NPR. If patients changed their minds about the abortion after taking mifepristone but before taking misoprostol, he said, taking progesterone could help the pregnancy continue.

In a paper published that year, he said that of six patients who had received progesterone injections after taking mifepristone, four were able to continue their pregnancies.

When his research came to the attention of anti-abortion advocates, states around the country started passing laws requiring doctors to tell patients that medication abortions could be reversed. The first, Arkansas, passed its law in 2015, and such laws are now on the books in at least eight states, though courts have blocked enforcement in some. Five states — including Arkansas, which expanded its requirements — have passed laws this year alone, according to HuffPost.

Ohio could become the sixth — the bill passed the state Senate last Wednesday and now heads to the House, where Republicans have a majority. The state’s Republican governor, Mike DeWine, has signed abortion restrictions in the past, including a ban on the procedure after about six weeks’ gestation, which has been blocked in court.

Abortion “reversal” isn’t backed up by evidence

Abortion opponents and groups identifying as pro-life argue that abortion reversal laws are necessary to make patients aware of their options.

“Women should be given full, informed consent when they are considering an abortion,” Ingrid Skop, the chairman-elect of the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG), told Vox.

“Because the abortion pill regimen can be reversed,” she said, “they should be given that information.”

But many medical experts say there’s no evidence that progesterone does anything to reverse abortion. In a 2017 statement, the American Congress of Obstetricians and Gynecologists said that Delgado’s 2012 paper, involving just a handful of patients, was “not scientific evidence that progesterone resulted in the continuation of those pregnancies.”

As the group noted, mifepristone on its own does not always work to end a pregnancy, with up to half of patients who take mifepristone alone remaining pregnant. That’s why mifepristone is prescribed with misoprostol to complete an abortion. So it’s possible that Delgado’s patients who remained pregnant would have done so regardless of whether they received progesterone.

In 2018, Delgado published another paper, this time looking at the effect of progesterone on 547 patients who took it after taking mifepristone. He found that in 48 percent of cases, the patient went on to have a live birth, with the rate going up to 64 percent if the progesterone was administered by injection.

Critics, however, point out that this paper was not published in a mainstream scientific journal but rather in Issues in Law and Medicine, a journal that has featured anti-abortion legal analysis as well as articles promoting the debunked theory of a link between vaccines and autism, as Rewire.News reports.

And according to Grossman, the design of the research may have inflated the success rate of the treatment. Some providers involved only prescribed progesterone after an ultrasound confirmed that the pregnancy was continuing, meaning that people for whom mifepristone didn’t work well to begin with may be overrepresented in the data.

In addition, Grossman said, it’s not clear from the paper whether patients were informed that the treatment was experimental. Delgado has not responded to Vox’s request for comment, but he told NPR that before his 2018 paper, he told patients that abortion “reversal” was a “novel treatment.” Now, he says, “we have a substantial amount of data. There is no alternative. And it’s been proven to be safe,” so, “why not give it a chance?”

Progesterone is sometimes prescribed during pregnancy for other reasons, like to prevent premature labor in the second and third trimesters, Grossman said. But there’s no data on whether it’s safe to give after mifepristone or to take throughout pregnancy, as “reversal” patients are sometimes advised to do.

“The impact on patients of mifepristone combined with high doses of progesterone is virtually unstudied,” Kathryn Eggleston, medical director of the sole abortion clinic in North Dakota, wrote in an affidavit obtained by HuffPost. Researchers do not know, she said, whether the combination could cause birth defects, for example.

Moreover, as Grossman noted, the prescription of an unproven treatment to pregnant women has disturbing echoes in America’s past. “We know that abortion patients are more likely to be women of color and low-income women,” he said, and these are “populations that have had research performed on them that was clearly unethical.” For example, in the 19th century, Dr. J. Marion Sims conducted gynecological research, including operations without anesthesia, on enslaved women.

However, there are researchers working on a study of abortion “reversal” designed to meet ethical and scientific standards. Mitchell Creinin, an OB-GYN and professor at the University of California Davis, is conducting a controlled study of progesterone treatment that has been approved by an institutional review board, according to NPR. The results should be available next year.

For now, though, abortion providers say laws like the one proposed in Ohio will hamper their ability to ethically care for pregnant people.

“Abortion reversal is unproven, unscientific, and potentially unsafe,” Tam Nickerson-Scott, clinic operations director at Preterm, Ohio’s largest abortion provider, told Vox. “We certainly don’t want to give out false information to our patients.”

Crisis pregnancy centers are offering an unproven treatment to pregnant people

It’s not clear how many people are currently being prescribed abortion reversal in the United States. But Skop, the AAPLOG chair, believes it is “very common” and says that most “pregnancy resource centers” — facilities that offer counseling with an anti-abortion bent, also called crisis pregnancy centers — offer the procedure. Obria, an anti-abortion group with facilities around the country that recently received a federal family planning grant from the Trump administration, advertises the procedure on its website.

It’s also not clear how patients who do get progesterone treatment pay for the medication. Unproven treatments are typically not covered by insurance, Grossman noted. Skop said that patients sometimes pay for progesterone out of pocket and that sometimes pregnancy centers may cover the cost.

Meanwhile, one of the biggest questions around abortion reversal is how many people really want to undo their abortions once they’ve started. Some say the number is significant. “Women do regret their abortions,” said Skop. “I’ve been practicing for 23 years, and I’m also the board chairman of a pregnancy resource center, and we see it frequently.”

However, research shows that most patients are actually quite sure about their decisions to have an abortion. One recent study found that, on average, abortion patients were as or more sure of their decision to have an abortion than people facing other medical procedures, such as knee surgery. Another found that 95 percent of abortion patients did not regret the procedure.

But it’s possible that abortion reversal laws could actually lead to more regretted abortions. In her affidavit, Eggleston, the North Dakota provider, wrote that abortion reversal laws could encourage people to get medication abortions before they are ready to do so, by giving them the mistaken impression that the procedure can be easily reversed if they change their mind.

For Nickerson-Scott, meanwhile, the Ohio bill “just causes more hurdles” in a state where patients already have to go through a 24-hour waiting period and a total of three doctors’ appointments to complete a medication abortion. Instead, Ohio patients deserve “autonomy over their bodies,” she said. “We have to trust people that they are the expert of their lives.”

“I have never heard anyone who has come through our doors and who has told me that they have regretted their abortion,” Nickerson-Scott said. “What I do hear is, ‘Thank you for being here.’”

Source: https://www.vox.com/identities/2019/11/11/20953337/abortion-pill-reversal-ohio-bill-law-pregnancy?fbclid=IwAR1HJTzN80QTE6HgUexahqOY4wTw4pviI0Ju8rYYwCnQxiOkQ7G8VHID_cM

A woman rests her hands on her baby bump at a prenatal care group session at El Centro de Corazón, one of the many clinics that competed with the Heidi Group for funding.
Photo: Marie D. De Jesús, Houston Chronicle / Staff photographer

An anti-abortion group that came under fire for failing to provide services to thousands of Texas women must repay $1.5 million in overpayments and prohibited costs, state investigators said Thursday.

The findings, announced by the office of the health inspector general, are a new blow to the Heidi Group. The organization had hoped to replace Planned Parenthood as a top family planning provider, but was cut off from millions in funding last year after failing to serve tens of thousands of low-income women.

The office said on Thursday it had uncovered “serious contractual violations” and is expanding its inquiry to the entire span of the Heidi Group’s contracts, going back to 2016. That could mean additional repayments.

Forensic accountants found the group had paid medical providers hundreds of thousands in excess fees, had overspent on payroll and fringe benefits, and had expensed thousands in unallowable costs like food, gift cards, clothing and retail membership fees, according to a copy of the internal investigation obtained by the Houston Chronicle.

The inquiry covered a seven month period, from September 2017 to March 2018.

“It’s a travesty when you look at all the women who should have been receiving services and were not because of this,” said Rep. Donna Howard, D-Austin. “We’re talking about women who don’t have means to afford health care like many of us do.”

The commission originally awarded the Heidi Group $6.7 million, despite concerns it had never contracted with the state and had no experience serving women in clinical settings. The nonprofit, created years ago as an activist outfit, promised to serve nearly 70,000 women each year, but only ended up serving a few thousand by 2017, according to health officials.

When the group’s clinics began falling short of their goals, officials were slow to shift money to higher performing providers.

Representatives for the Heidi Group quickly disputed the findings, saying the payments had been approved and budgeted from the beginning by the Health and Human Services Commission.

“Everything we did was according to the contract,” CEO Carol Everett said.

Everett and her attorney, former inspector general Stuart Bowen, insist they served several thousand more than the state reported, citing 30,500 patients over three years.

The report on Thursday said Everett had incentivized health providers with a $50 per claim “bonus,” which had never been authorized by the state. Everett “could not provide a budget amendment, adequate documentation, or a clear methodology to justify the added expenditure,” the report said. Combined, those extra payments alone totaled $769,000.

The Heidi Group had struggled financially before it contracted with the state in 2016, and there were inconsistencies in its tax filings, the Chronicle previously reported.

The group’s former accountant told investigators he had no experience with government accounting and had never been made aware of the financial requirements of the state contracts and Everett’s subcontractors, according to the report. Everett later fired him after state officials began raising concerns.

Leslie Willkom, a former employee who left the Heidi Group earlier this year and has been critical of its leadership, called the penalty “shocking.”

“It’s a shame,” she said. “They could have really done a lot with that money, and they just didn’t.”

Source: https://www.houstonchronicle.com/news/houston-texas/houston/article/HeidiGroupFindings-14818472.php?fbclid=IwAR0OnxWINpsKXcETxzmX1P6whY7r15JQ26yfCOYSAc7b4_D1XV8FcUr4SQw

Some pro-choice advocates worry these bills might be the first in a “wave of bills” focused on the reason someone is getting an abortion.

The “Down Syndrome Discrimination by Abortion Prohibition Act,” was introduced by Sen. Jim Inhofe (R-OK) in the U.S. Senate as S 2745 and by Rep. Ron Estes (R-KS) as HR 4903 in the U.S. House of Representatives.
Chip Somodevilla / Getty Images

Congressional Republicans introduced a set of bills last week that would ban abortion “on the basis of Down syndrome,” arguing that they’re standing up for people with disabilities. But pro-choice and disability rights advocates say these “reason” bans—which target the reason a pregnant person seeks an abortion—don’t actually address the discrimination people with disabilities face, and instead create dangerous barriers to care.

The “Down Syndrome Discrimination by Abortion Prohibition Act,” was introduced by Sen. Jim Inhofe (R-OK) in the U.S. Senate as S 2745 and by Rep. Ron Estes (R-KS) as HR 4903 in the U.S. House of Representatives. The bills are seemingly the first federal attempt to ban abortions on the basis of a prenatal diagnosis of Down syndrome, according to Elizabeth Nash, senior state issues manager at the Guttmacher Institute.

The bills would ban doctors from “knowingly perform[ing] an abortion being sought because the baby has or may have Down syndrome,” according to a press release on Inhofe’s website. Physicians could face a fine and/or up to five years in prison if they perform an abortion knowing that the reason is based on a test result or prenatal diagnosis of Down syndrome.

The bills also state that “if the doctor does not know whether Down syndrome is a contributing factor,” the doctor must first ask a pregnant person if they are “aware of any test results indicating that the child has Down syndrome,” and then inform them of the ban. If a doctor fails to do so before performing an abortion, they would also face a fine and/or up to five years in prison.

Pro-choice advocates say that bans like S 2745 and HR 4903 will create dangerous situations in hospitals and exam rooms. In 2017, Ohio passed a similar ban, which was recently blocked by a federal judge. Kellie Copeland, executive director of NARAL Pro-Choice Ohio, told Rewire.News the bill would make the patient “feel like they have to keep the circumstances of their pregnancy a secret .… There’s just no scenario where creating that environment between a doctor and a patient is a good idea.”

Copeland said that when Ohio’s bill was debated on the floor of the state legislature, lawmakers offered amendments that would improve services for families with children with Down syndrome, but they were all tabled. “The proponents of [Ohio’s bill] claim that this was to prevent discrimination against people with Down syndrome, or those families,” she said. But, like most other abortion restrictions, Copeland said Ohio’s law is about “finding a way to eliminate abortion access in as many instances as possible.”

Neither the National Down Syndrome Society (NDSS) nor the National Down Syndrome Congress took a position on Ohio’s bill, according to NPR, and both declined Rewire.News’ request for comment on the federal bill. Down syndrome advocacy groups “didn’t ask to be put in the middle of this debate or to be politicized,” Copeland said.

In fact, most Down syndrome advocacy groups are “pro-information,” which means they support laws that encourage or mandate that physicians give accurate, evidence-based information to people who receive a prenatal or postnatal Down syndrome diagnosis.

Jen Jacobs, executive director of the Down Syndrome Diagnosis Network (DSDN), told Rewire.News that the organization also does not have an official stance on abortion bans. DSDN focuses on “ensuring that families who are getting a new diagnosis are getting accurate, current information along with it at the same time, because we’re finding that that just does not happen,” Jacobs said. Providers often give pregnant people and families outdated information about Down syndrome, or they focus entirely on the medical aspect of the condition and not on the social implications or the “bigger picture,” she said.

As a result, pro-information groups like NDSS pushed Congress to pass the Prenatally and Postnatally Diagnosed Conditions Awareness Act in 2008 to try to address some of these issues. It was supposed to “increase the readiness of accurate, up-to-date and balanced information about Down syndrome to women and families considering prenatal testing,” according to NDSS’ website. But after Congress passed it, the law “was never funded and, in the absence of funding, advocates in several states have taken up the issue with their state legislatures.”

Jacobs noted that there’s no evidence that the federal ban introduced last week would help pregnant people who receive a prenatal Down syndrome diagnosis. “I think the intent behind it is to help be a more inclusive society, and to recognize that there are people with disabilities in our society and that all of those things are a natural part of life,” Jacobs said. “I just am not sure that it’s making the bridge to getting all of that really good information to families when they get a new diagnosis.”

Copeland went further, saying “reason” bans don’t provide services to children with disabilities or their families, but they also open up another avenue lawmakers can use to chip away at abortion access. She said Ohio’s law and the new federal versions might be the first in a “wave of bills” focused on the reason someone is getting an abortion.

“I am concerned that this then opens them up to add all sorts of other reasons, or to require patients to disclose why,” Copeland said. “They haven’t gone to that extent yet, but certainly this I think opens the door to that.”

It’s unlikely that the federal bills will pass in the House given the chamber’s Democratic majority, but the bill received some indirect support from President Trump at the start of October for Down Syndrome Awareness Month. He stated in his presidential message: “We must devote our efforts to ensure that the United States continues to exhibit reverence for human life—both born and unborn.” He also said his administration is dedicated to fostering opportunities for people with Down syndrome, but he didn’t specify how he would accomplish that.

Source: https://rewire.news/article/2019/11/08/a-new-abortion-ban-makes-its-way-to-congress-for-the-first-time/?fbclid=IwAR2qJ7v2q-J8LDEEXg5FMak0iwH6MONS9wUkGdbb2qmeEJZ4MvDBS2lH0G0

Only one in three women would tell their family if they were considering an abortion, according to a new poll. Nine-in-ten women identify as pro-choice but experts say there is still a stigma in discussing a termination.

A survey of 2,684 women for Marie Stopes International, which provides abortions, found most would hide the issue from their family.

Just over a third (34%) would speak to their friends and only 62% would tell their partner.

A new campaign has been backed by outgoing MP Heidi Allen (Picture: PA)

Some 6% of women would not talk to anyone apart from a medical professional about their decision, the survey found.

Of the women polled, 92% said they were pro-choice and 79% said abortion should be talked about more openly.

The charity has launched a new campaign – #SmashAbortionStigma – in a bid to help women feel ‘informed, educated and supported’ about their choices.

It is backed by Liberal Democrat MP Heidi Allen, novelist Marian Keyes and Derry Girls actress Siobhan McSweeney.

Amy says she does not regret having an abortion when she was at college (Picture: Marie Stopes International)

Amy, 28, had an abortion when she was 17 after her contraception failed. She said: ‘Even though I was completely confident in my choice, I only told a few people at the time. In hindsight, I felt silenced because it wasn’t something people spoke about.

‘The day after my abortion, I went back to college. My teacher asked me if I was feeling better and I remember nodding, trying not to cry.

‘It wasn’t the abortion that upset me, I was upset that I couldn’t tell the truth – I felt as though I had a dirty little secret that I couldn’t share with anyone.

‘As I grew older, I started to realise that I wasn’t ashamed of my abortion. It was the responsible thing to do for my own happiness.’

Healthcare worker Amity already had two older children and did not want to start all over again (Picture: Marie Stopes International)

Amity, 40, is a registered midwife and works in abortion care. She became pregnant while her husband was on the waiting list for a vasectomy and her children were nine and 11 at the time.

She said: ‘When I found out I was pregnant, I knew I didn’t want to start all over again. I told my husband and a few close friends who were very supportive, and it gave me the chance to talk through my options before I came to the decision.

‘Although I am generally quite open about my abortion, even I don’t always feel comfortable talking about it.

‘When I went back to work, I didn’t tell people why I had been off in case they were taken aback.’

Katriana was reluctant to tell her parents but eventually confided in her mother and realised she had been in a similar situation years earlier (Picture: Marie Stopes International)

Katriana, 24, from London felt she could not tell her Catholic parents about her decision.

She added: ‘I thought about telling my friends but I didn’t want to burden anyone with what I was going through. I lost so much sleep in the two-and-a-half week wait between the phone call and the procedure and it was such a stressful, dark time.

‘It was really sad because I needed support from someone close to me and I was on my own.’ Katriana burst into tears at work and her boss persuaded her to tell her mother.

She added: ‘I couldn’t look her in the eye as I told her, but my mum held my hand and told me that she understood and that she had also had an abortion at a similar age to me – telling her was one of the best things I’ve ever done.

‘If I had been able to find stories of other women, it would have helped me to recover from my experience so much quicker. It was the stigma that made me feel guilty and made me feel like I was doing something wrong.’

Holly said her parents were supportive but her then-partner made her feel guilty for wanting to discuss it (Picture: Marie Stopes International)

Holly, 26, was in a controlling and emotionally volatile relationship and said while her parents were supportive, her partner made her feel guilty for discussing it.

She added: ‘I think it’s really important that we are able to talk about abortion more openly. Abortion is not shameful, an embarrassment, or wrong. It should be every woman’s right.’

Dr Caroline Gazet, clinical director for Marie Stopes UK, said: ‘In the UK, one in three women will have an abortion in her lifetime, yet we know that abortion stigma can make women feel judged, shamed and silenced.

‘Women want to talk, and our research shows that open and honest conversations about abortion help women and girls feel informed, educated and supported when it comes to making their own choices about their own bodies.

‘The UK is a pro-choice nation, but with a small minority of anti-choice voices threatening abortion rights worldwide, it is more important than ever that we smash abortion stigma and champion the right of women to access abortion care.’

Source: https://metro.co.uk/2019/11/06/most-women-would-not-tell-their-family-about-an-abortion-11047467/?fbclid=IwAR0ROcwlROePkxS4_QH-F4HL3w9EFaAHW5pQnwuCl6dfB_b32hux6amLAWY?ito=cbshare

Pro-choice advocates described this week’s wins in Virginia and Kentucky elections as monumental victories for reproductive rights.

Pro-choice Democrat Andy Beshear is the apparent winner in the Kentucky race for governor, and his campaign has declared victory. But Bevin, who trailed Beshear by roughly 5,000 votes, has refused to concede and formally requested a recanvass.
John Sommers II / Getty Images

Abortion Rights Groups Declare Victory After Tuesday’s Elections

Democrats scored major victories across the country in this week’s elections, flipping control of the Virginia General Assembly and scoring an apparent victory in Kentucky’s gubernatorial race. Pro-choice advocates lauded the wins as monumental for reproductive rights.

“Reproductive freedom has won the day,” said Kelley Robinson, executive director of Planned Parenthood Votes, of the election results. “Voters made their voices heard loud and clear that when politicians fail to stand up for our rights—including abortion access—we will take that fight straight to the ballot box.”

“In a southern, traditionally red state, Andy Beshear ran a campaign that addressed abortion access head-on, vowing to protect Kentucky residents’ constitutional rights in the face of the Trump administration’s assault on Roe v. Wade,” Andrea Miller, president of the National Institute for Reproductive Health (NIRH) Action Fund, said in a statement. “ In defeating [Matt] Bevin, Kentuckians have made clear that they are ready to fight for every person’s right to make their own decisions about their bodies, lives, and futures. As we head into the 2020 campaign season, I urge candidates to look toward Kentucky as a reminder of the passionate support for abortion access in all corners of the United States.”

Kentucky’s race for governor was considered crucial for abortion access. The state is home to a single abortion clinic, and its current governor, Republican Matt Bevin, has sought to make sure that number drops to zero. Pro-choice Democrat Andy Beshear is the apparent winner in the race, and his campaign has declared victory. But Bevin, who trails Beshear by roughly 5,000 votes, refused to concede and formally requested a recanvass. Given that some leaders in the state’s GOP-held state legislature have signaled they may get involved, this race is still worth keeping an eye on. The recanvass is set for November 14, according to Secretary of State Alison Grimes (D).

Virginia Democrats’ decisive victory in Tuesday’s elections hands the party a trifecta capable of passing liberal priorities previously held back by GOP legislators. That could include codifying Roe v. Wade (Democratic Gov. Ralph Northam said on the campaign trail in 2017 that he supported an amendment to the state’s constitution to safeguard abortion rights), undoing the state’s forced 24-hour waiting period for abortion, and other efforts to safeguard and expand access to reproductive health care.

Reproductive rights aren’t the only big issue that may see a shift after Tuesday’s elections—Medicaid expansion eligibility, gun control, and the ratification of the Equal Rights Amendment may all now see movement.

Beto O’Rourke Dropped His Criminal Justice Platform—Then He Dropped Out of the Race

Former U.S. Rep. Beto O’Rourke dropped out of the race for the Democratic presidential nomination last week. “Though it is difficult to accept, it is clear to me now that this campaign does not have the means to move forward successfully,” he said in a post on Medium. O’Rourke listed some of what he considered the highlights of his campaign, including his plan to address climate change and taking what he called “the boldest approach to gun safety in American history.”

O’Rourke’s departure from the race came a few days after he released his criminal justice platform in a post to Medium. His “Comprehensive Plan to End Mass Incarceration and Reform Our Criminal Justice System to Prioritize Rehabilitation” didn’t contain a section devoted specifically to reproductive rights, but it did include a vow to end “the deprivation of health care in prison.” He also promised he would enforce the First Step Act’s ban on shackling pregnant people and its requirement that the Bureau of Prisons provide menstrual products to incarcerated people.

As Vaidya Gullapalli explained in a piece for the Appeal, an independent news outlet focused on criminal justice issues, O’Rourke’s plan “reflects a public consensus among the field of Democratic presidential candidates that the scourge of mass incarceration must end and the pressure to announce ambitious plans in response.”

“What remains to be seen is how much of a priority criminal justice will be for the candidates beyond the primary,” wrote Gullapalli.

The release of O’Rourke’s criminal justice platform followed plans from other 2020 Democratic presidential candidates, including former U.S. Housing and Urban Development Secretary Julián Castro. Castro’s plan promised to address reproductive justice for the incarcerated including “requiring free access to reproductive health care.”

What Else We’re Reading

“Abortion Is Not a Losing Issue. Yesterday’s Election Proved It,” writes Bridget Read for the Cut.

Castro’s presidential campaign “will fire its staff in New Hampshire and South Carolina,” Politico reported on Monday.

Sen. Elizabeth Warren (D-MA) said she would undo a Trump administration policy banning transgender people from serving in the military “on the first day of [her] presidency.”

Sen. Kamala Harris (D-CA) has a new bill addressing the gap between when schools close and when parents get out of work.

2020 Democratic presidential candidate Andrew Yang spoke with LGBTQ Nation about how he would get the Equality Act through a Republican filibuster, and it is …. something.

“Single-Payer Advocates Are Being Drawn Into the Wrong Debate,” argues Libby Watson for the New Republic.

Sen. Jeanne Shaheen (D-NH) will face “an anti-abortion foe in 2020” the New Hampshire Union Leader reported.

Jed Duggar, a reality TV show star from 19 Kids and Counting, is running for a seat in the Arkansas State House of Representatives—and he’s already highlighting his anti-choice platform.

Source: https://rewire.news/article/2019/11/08/campaign-week-in-review-reproductive-freedom-has-won-in-tuesdays-elections/

Anti-choice advocates were confident going into yesterday’s state elections. The Susan B. Anthony List, a group that has seized on Donald Trump’s presidency to try and finally overturn Roe v. Wade, had spent $750,000 on ads, mailers, and door-knocking on behalf of incumbent Governor Matt Bevin, who is incredibly unpopular except for one issue (or so they thought): abortion. Since he’s known for trying to throw poor people off of Obamacare and blaming striking Kentucky teachers for the death of a 7-year-old girl who was home from school, Bevin’s best chance of beating Democratic opponent Andy Beshear was supposed to be his bombastic anti-abortion stance.

Except that it wasn’t. The race is still too close to officially call, but as of now, Beshear is ahead by 5,300 ballots, poised to become a governor of Kentucky who ran on protecting abortion rights. Kentucky voters rebuked the narrative that GOP operatives have been trying to sell us us with state ban after state ban: that America’s protection of reproductive choice, enshrined in a constitutional amendment since 1973, is no longer popular nationwide.

And Kentucky wasn’t the only loss for the anti-choice lobby. In Virginia last night, Democrats flipped both houses in the state legislature, finally wresting narrowly held control from Republicans. This is particularly notable because the state was recently the epicenter of a bitter fight over access to late abortion care: After Democratic lawmaker Kathy Tran introduced legislation that would have reduced onerous state requirements around terminating a pregnancy in the third trimester, she was accused of “supporting infanticide” and faced a torrent of death threats. Conservatives gleefully used the controversy to argue that such unapologetic pro-choice positions would alienate voters and ensure Trump’s re-election. But they misjudged. “Today’s Election Will Determine The Future Of Late-Term Abortions In Virginia,” the Federalist wrote. It did — just not in the way they hoped. Tran ultimately kept her seat.

“SBA List used the Kentucky governor’s race and the Virginia state elections the same way they used the 2016 presidential race,” Robin Marty, author of Handbook for a Post-Roe America, told the Cut, “by investing all of their money and resources into motivating voters who were wavering on GOP politicians to believe that opposing abortion is the only issue that should matter. And they failed. Spectacularly.”

The results are a blow to the coordinated, decades-long effort by far-right groups to overturn Roe through state laws and an anti-choice judiciary, which has been terrifyingly successful so far; the Supreme Court announced on October 4 that the court would consider a Louisiana abortion law, the first major test of Roe since Justice Brett Kavanaugh was confirmed last year. SBA List helped hammer through the confirmation of both anti-choice justices Kavanaugh and Neil Gorsuch.

“For 2020 they will no doubt try again, focusing on small populations in swing states to give them just the right margin to win the electoral college for Trump, despite his massive unpopularity. They could still pull it off, because their pockets are deep, but clearly it will be a much harder battle than they were expecting,” Marty says.

Last night’s results should be a bellwether for not just abortion rights, but for many progressive policies Democrats will be running on in future state elections, and in 2020. Supposedly controversial issues like abortion, Medicare for All, the Green New Deal, and free college tuition are, in fact, widely popular, and the GOP’s attempts to consolidate power by turning them into poison pills should embolden Democrats, not push them to appeal to some ostensibly “moderate” base — despite what some people have been trying to tell us.

Speaking of a so-called moderate base, Joe Biden’s hometown of Scranton just elected its first woman mayor: a 39-year-old insurgent candidate who ran on finally defeating “the same old boys club.” Its members far and wide should be worried.

Roger Severino, director of the Office for Civil Rights at the Department of Health and Human Services, was a major driver of the rule struck down Wednesday. A federal judge found the rule issued earlier this year — making it easier for health care workers to refuse care for religious reasons — to be an overreach by the department.
Aaron P. Bernstein/Getty Images

In a blow to the Trump administration, a federal court in Manhattan has knocked down a rule that would make it easier for doctors and other health care workers to refuse care for religious reasons.

U.S. District Judge Paul Engelmayer ruled Wednesday that the Department of Health and Human Services, which issued the regulation earlier this year, exceeded its authority and “acted arbitrarily and capriciously” in promoting it.

The department’s violations of federal law, according to the judge’s opinion, were “numerous, fundamental, and far-reaching” — and he vacated the rule entirely, just over two weeks before it was set to take effect on Nov. 22.

The Trump administration had asserted that the rule would give health care providers the freedom to opt out of providing care or services — such as abortions — that violate their conscience. Employers that did not comply with the rule could have had their federal funding withdrawn.

“This rule ensures that healthcare entities and professionals won’t be bullied out of the health care field because they decline to participate in actions that violate their conscience, including the taking of human life,” Roger Severino, director of HHS’s Office for Civil Rights, argued in a written statement when the regulation was issued in early May.

The rule’s critics, however, saw it as a means of allowing health care workers to circumvent rules against discrimination. And they quickly took the Trump administration to court — with more than two dozen states, cities and organizations such as Planned Parenthood filing lawsuits against Severino and Health and Human Services Secretary Alex Azar. Those suits were later consolidated into one case, which Engelmayer oversaw.

There’s also another lawsuit against this rule, filed in the U.S. District Court for the Northern District of California. The plaintiffs in that consolidated case include the state of California, Santa Clara County and organizations such as Lambda Legal. It wasn’t immediately clear what Wednesday’s ruling means for the case in California.

As NPR has reported, this rule was part of a big push from the Office for Civil Rights to bolster “religious freedom” in health care. Severino, who is Catholic and formerly of the conservative Heritage Foundation, has argued that previous administrations did not fully enforce existing law that protected what supporters call health care workers’ “conscience rights.”

To remedy that, Severino created a Conscience and Religious Freedom Division in January 2018, and in May of this year, his office issued this rule.

The rule was designed to bolster the rights of providers to opt out of care, even without prior notice of their objections to their employer. It also expanded the type of workers who are able to file complaints about rights violations to include billing staff, receptionists and anyone else who in any way “assist[s] in the performance” of a procedure.

Complaints of such violations are relatively rare — for a decade, the office would receive an average of one complaint like this each year. Severino frequently pointed to a jump in those complaints to 343 last year as proving the need for this rule. He attributed that increase to a strong message from his office that they were “open for business” when it came to issues of religious freedom.

However, that increase in the number of complaints is “demonstrably false,” according to Engelmayer’s ruling. Nearly 80% of all the complaints given to the court were about vaccinations — unrelated to health care workers and their religious beliefs in providing care.

The judge writes that only 21 — or 6% — of the complaints that the government provided the court are even potentially related to providers’ moral or religious objections. During oral arguments, the government’s attorney conceded that the real number of complaints was “in that ballpark.”

“This conceded fact is fatal to HHS’s stated justification for the Rule,” Engelmayer writes. “Even assuming that all 20 or 21 complaints implicated the Conscience Provisions, those 20 or 21 are a far cry from the 343 that the Rule declared represented a ‘significant increase’ in complaints.”

In a statement to NPR, the government said, “HHS, together with DOJ, is reviewing the court’s opinion and so will not comment on the pending litigation at this time.”

Closing the last abortion clinic in the Dayton, Ohio, area would have a major effect on people of color and those with low incomes, groups that make up a large portion of Dayton’s population.

Gov. Mike DeWine (R) has pledged to continue Kasich’s assault on abortion access.
Justin Merriman / Getty Images

Unrestricted abortion would be available in Northern Ireland up to 12 or 14 weeks under UK Government proposals.

Ministers are bound to introduce a system governing terminations by next spring.

MPs at Westminster forced the Northern Ireland Office (NIO) to act after legislation passed earlier this year reformed the most restrictive laws surrounding child birth in the UK.

An official consultation said: “Twelve weeks gestation has been considered because it is the end of the first trimester of pregnancy and in England and Wales 90% of abortions are performed within this timeframe.

“However, an alternative approach would be allowing for a termination up to 14 weeks gestation without conditionality, as some women and girls may have been delayed in finding out that they are pregnant and others may need more time to reach a decision.”

Abortion is a deeply divisive issue in Northern Ireland.

Abortion is a deeply divisive issue in Northern Ireland (Niall Carson/PA)

The DUP failed in a last-ditch bid at Stormont to thwart legalisation last month.

The British Government said it was concerned that it may not be appropriate for a new process to be applied that requires a woman or girl to give evidence that the pregnancy is a result of sexual crime and to obtain certification from a medical professional on that basis.

Its consultation added: “No certificate of opinion may be required from a doctor for the early termination (up to 12/14 weeks gestation), because it is proposed that termination will be available up to this gestational limit without any medical grounds being required to be met.”

Mental well-being grounds may allow an abortion after 14 weeks under the proposals.

Abortion without time limit may be available in cases of fatal foetal abnormality or where a woman’s life was at risk or she was in danger of suffering permanent injury.

Any medical practitioner may perform the procedure and flexibility would be shown about where, recognising the use of pills at a woman’s home.

Later stage abortions would take place in hospital.

A provision allowing medics to opt out on conscientious objection grounds would cover the course of treatment.

An exclusion or safe zone would be in place allowing women to obtain the procedure without facing protest.

Source: https://www.irishexaminer.com/breakingnews/ireland/unrestricted-abortion-proposed-for-ni-up-to-14-weeks-961796.html?fbclid=IwAR0c6SGMXWnraEQ0nkvvt683YC3anpwJEv8YUfiLP5TDUG1viLrEAFNs4pA

Dr. Yashica Robinson, one of the last remaining abortion providers in Alabama, is taking on the state’s abortion ban law alongside Planned Parenthood and the American Civil Liberties Union of Alabama.

A Notasulga, Alabama native, Robinson decided she wanted to go into obstetrics when she became a teen mother. She attended medical school at Morehouse School of Medicine and completed her residency in obstetrics and gynecology at the University of Alabama at Birmingham School of Medicine.

Today Robinson works at her OBGYN office in Huntsville and provides abortion care at that city’s Alabama Women’s Center, one of Alabama’s last three remaining abortion clinics. Both offices are under a constant barrage of protesters, some who film patients entering and exiting and broadcasting them onto Facebook live.

Alabama is one of nine states who passed abortion ban laws this year. In May, Gov. Kay Ivey passed a law banning nearly all abortion, including pregnancies conceived by rape or incest. Robinson is the lone person – along with Planned Parenthood and the ACLU of Alabama – who filed a lawsuit challenging the law. A federal judge issued a preliminary injunction on Oct. 29, temporarily prohibiting the law from going into effect until the law makes its way through higher courts.

Abortion is still legal in all 50 states. Alabama’s two other abortion clinics are West Alabama Women’s Center in Tuscaloosa and Reproductive Health Services in Montgomery.

Why did you decide to be one of the plaintiffs in the state’s abortion ban case?

As a physician, I care deeply for my patients. I know how critical abortion care is. I understand how bans like the one Alabama passed hurt patients who are already marginalized the most. The majority of my patients do not have the resources to challenge these unconstitutional laws themselves. Therefore, I feel it is my responsibility to stand and fight on their behalf.

Why did you decide to go into gynecology and then decide to perform the entire spectrum of women’s healthcare?

My passion for helping people led to a career in medicine. Becoming pregnant as a teenager influenced my decision to choose Obstetrics and Gynecology as a specialty. I understand that women need different types of care over the course of their reproductive life span – comprehensive contraceptive education, prenatal care, abortion care without judgment and compassionate management of miscarriages. I did not decide to go into gynecology, and then perform the entire spectrum of women’s healthcare. Abortion care is simply part of the work that defines a specialist who is an Obstetrician-Gynecologist. I chose to care for women, and refused to be bullied into negating part of my duties by leaving abortion care out of my practice.

What needs did you see in the state for more doctors who perform abortions?

There is a critical need to provide more protections for abortion providers and their families against harassment and violence in their communities and at work. The hostility and stigma leads to a shortage of physicians who are trained and willing to provide this needed medical service for patients. It also leads to a dearth of medical professionals willing to provide proper referrals. This hurts patients. There is also a need for local law enforcement agents to be educated and willing to be responsive when abortion providers and their patients are violated.

Why did you decide to be one of the plaintiffs in the state’s abortion ban case?

As a physician, I care deeply for my patients. I know how critical abortion care is. I understand how bans like the one Alabama passed hurt patients who are already marginalized the most. The majority of my patients do not have the resources to challenge these unconstitutional laws themselves. Therefore, I feel it is my responsibility to stand and fight on their behalf.

How does your community/family respond to the work you do?

There are many people in my community who are supportive and appreciate the need for the care that I provide. Of course, there are many who staunchly oppose the work I do, and they work hard to drive me out of the community. It is unfortunate that those against comprehensive health care for women, are the ones who are most vocal and active. My family members are supportive. Any concern they have comes from their concern for my safety.

Yashica Robinson: My patients are complex, unique, thoughtful.

I am a mother and an OB/GYN. Every day I care for women and honor the decisions they make about their bodies, their families and their futures. I deliver babies, support patients through miscarriage and I provide abortions.

Source: https://www.al.com/news/2019/11/one-of-alabamas-last-remaining-abortion-providers-fights-back.html?fbclid=IwAR3fZ3C0Gz4MfiA3LZAOm75i4N5X0AjopqL-oEkvAuKwWiqO2YFnoWxKpMU