Abortion, Every Day (7.7.23)

In the States

In response to Ohio pro-choice advocates turning in nearly double the number of signatures they needed to get abortion rights on the ballot, anti-abortion groups and conservative media are on the attack. As predicted, they’re ramping up their anti-trans talking points, claiming that the ballot measure is a way for evil liberals to strip away parents’ rights and allow children to have gender-affirming surgery. What’s also interesting is that they’re hyper-focused on the fact that some of the signature-gatherers were from out-of-state and contracted by the ACLU. Obviously, hiring petitioners is not new or out-of-order, but conservative media hopes that they can use the talking point to bolster their argument that big, bad lefty groups are coming into Ohio to trick voters.

Right on cue: Mike Gonidakis, president of Ohio Right to Life, is out campaigning for Issue 1—which would raise ballot measure standards from a simple majority to 60% of the vote. And in an interview this week, he said Ohio should “have a higher standard so we can protect our constitution from out-of-state rich men and women who want to come and buy their way in.” Insert world’s biggest eye-roll here. (Also, something tells me that Gonidakis isn’t exactly hurting for cash.)

Speaking of Ohio, I really loved this column from U.S. Rep. Shontel M. Brown, a co-sponsor of the Women’s Health Protection Act (WHPA). Rep. Brown wrote in response to a recent article about the volunteer pilot group Elevated Access, which flies people out of anti-abortion states to get the care they need:

“It sounds like something out of another time and place, evoking memories of people escaping East Germany or North Korea, reliant on small planes, heroic pilots, and promises of anonymity. People should not have to flee Ohio. But after the Supreme Court’s ruling in Dobbs v. Jackson Women’s Health, many people, especially women, people of color, transgender people, feel like they need to.”

It really is unbelievable when you pause for a moment to think about: people secretly flying out of their states for abortions. The fact that they need to travel at all for basic care is a nightmare.

Just ask Heather Maberry, the Kentucky woman forced to raise thousands of dollars and travel to Illinois for an abortion after she found out her fetus was developing without all of its skull and brain. I shared Maberry’s story last month, but if you want to hear more from her about the cruelty of these bans, she and her husband spoke to CNN this week.

In less horrific news, let’s talk about what’s going on in New York, because Democrats there are working on the kind of pro-active protections we need most right now. The Equal Protection of Law Amendment will be on the ballot in November 2024, giving voters the chance to protect abortion rights in the state constitution. What’s so cool about this amendment, though, is that it’s connecting the protection of abortion rights to other related issues: The amendment would prohibit discrimination based on “race, color, ethnicity, national origin, age, disability creed, religion, or sex, including sexual orientation, gender identity, gender expression, pregnancy, pregnancy outcomes, and reproductive healthcare and autonomy.”

Here’s what Emma Corbett, state director of communications for Planned Parenthood Empire State Acts, told The 19th:

“The ERA isn’t just about a single issue. Fewer and fewer voters are single-issue voters these days. There’s this real opportunity to codify those freedoms for New York, and I think voters are gonna respond positively to that.”

Love that, and very much agree. It’s also incredibly important that New York is doubling down on abortion rights protections right now, a moment when pro-choice states are being inundated with out-of-state patients.

Some more good news, this time out of Maine: Last night, the state Senate voted to legalize abortion after 24 weeks, if deemed necessary by a doctor. Nicole Clegg, CEO of Planned Parenthood of Northern New England, said, “Voters elected reproductive rights champions to lead this state in a Post-Roe world, and today, these state senators responded with action.”

There’s been a ton of controversy and tension in Maine over this legislation, with anti-abortion activists painting it as extremism rather than what it is—necessary healthcare. (We’re going to see more and more of conservatives focusing on abortions later in pregnancy—Abortion, Every Day will have a few pieces on the issue in the coming weeks, so keep an eye out.)

Republicans continue to be pissed off in Arizona, where Gov. Katie Hobbs granted state Attorney General Kris Mayes with the authority to prosecute abortion cases, taking that ability away from district attorneys. (Mayes has said she would not target abortion-related ‘crimes’.) Obviously, reproductive rights activists in the state are pleased with the decision: Brittany Fonteno, president of Planned Parenthood Arizona, says, “This executive order will help ease the fear and uncertainty that swept through Arizona in the year since Roe was overturned.”

And while Republicans are calling on Hobbs to rescind the order, she’s refused, tweeting yesterday, “I will continue to use my legal authority to protect Arizonans from extremists who want to prosecute women and doctors for their healthcare decisions.”

Keep an eye on: Iowa, where Gov. Kim Reynolds just called a special legislative session in order to push through an abortion ban. We haven’t seen what Republicans’ bill will look like yet, but the assumption is that 1) it will be legislation that bans abortion after ‘cardiac activity’ and 2) that Republican lawmakers have already agreed on the language of the bill in order to move it forward as quickly as possible.

I’ll keep you updated as I find out more—but if anyone in Iowa has an advanced copy of the text of the bill, I’d love to see it!

Also, if you’re in Iowa and want to make your voice heard on abortion rights, Planned Parenthood is organizing a protest on Tuesday at the state Capitol. Mazie Stilwell, director of public affairs for Planned Parenthood Advocates of Iowa, says, “Now is the time for Iowans to raise their voices and hold their elected officials accountable for every vote they take in their march to take away our rights and bodily autonomy.”

Quick hits:

• Public radio in Kansas has a rundown of the new anti-LGBTQ and anti-abortion laws that have taken effect, including the mandate that doctors tell patients they can ‘reverse’ abortion medication;

• The Salt Lake Tribune on the connection between an anti-porn law in Utah and an anti-abortion law in Texas;

• And The Marshall Project looks at just how ‘pro-life’ Texas is with their investigation into a county jail that caused a woman to miscarry after denying her prenatal care.

In the Nation

Never forget who these people really are. NPR went to the National Right to Life convention last month, and interviewed James Bopp Jr., general counsel for the organization. Bopp was furious over the pro-choice activism that’s emerged post-Roe: specifically the volunteers and funds that are helping women to travel out of anti-abortion states for care. (Essentially, he’s mad at women helping other women.)

Bopp said, “[There is] this incredible network of people and organizations, both financial, ideologically, who are supporting illegal abortions in your state, trafficking your women and girls.” (Emphasis mine)

Your women and girls. Wonder who he’s directing that message to? When given the chance, they will reveal their misogyny every single time. (And if Bopp’s name sounds familiar, it’s because he’s one of the activists leading the charge away from using the word ‘ban’.)

I missed this terrific guest essay in The New York Times from Dr. Christine Henneberg, who says “abortion providers must share the ordinary and extraordinary stories we witness.” Henneberg writes about Dr. Caitlin Bernard, the Indiana abortion provider who was punished by Republican leaders after she shared the story of a 10 year-old rape victim—and how conservatives don’t just want to ban abortion, but “silence the doctors who bear witness to the disastrous consequences of such cruel and unjust legislation.”

What I really appreciated about the piece, though, was Henneberg’s insistence that doctors share not just the most tragic, extraordinary stories they encounter:

“[O]rdinary abortion stories play an important role in the fight for abortion rights and reproductive justice. They remind us that abortion is normal. They humanize the one in four women in America who will have an abortion in her lifetime.”

It’s a good reminder of something I’ve been saying often these days: Every abortion denied is a tragedy.

We’ve written a bit before about Sen. Tommy Tuberville’s continued hold-up of military promotions—something he’s been doing in protest of a policy that allows service-members in anti-choice states to take time off to travel for care. (Travel that will be reimbursed.) PBS Newshour did a short segment that serves as a good explainer of what’s been going on, and the consequences of blocking the advancement of military members:

Inside Philanthropy took at look at whether “rage giving” on abortion rights really has dropped off since Roe was overturned, speaking to ten national nonprofits that work on the issue. The good news is that some of the groups said that their funders are just as angry as they were when the decision first came down. President of Ipas, Dr. Anu Kumar, for example, said that donors still have a “rightly placed sense of urgency and panic.” And Yolanda Miranda of the National Latina Institute for Reproductive Justice, told reporter Dawn Wolfe that foundations are being more “cutting edge” in recognizing how abortion bans disproportionately harm marginalized communities.

Where funders need to do better, activists said, is seeking out lesser-known abortion rights organizations, as opposed to always giving to already-well-funded bigger groups. Nikki Madsen of the Abortion Care Network says, “This leads to a cycle of giving that doesn’t center the people most impacted by abortion bans and results in independent clinics, abortion funds and advocates working on the front lines in their communities being under-resourced.”

Quick hits:

• The 19th on how Republicans are trying to throw anti-abortion measures into spending bills;

• POLITICO on how tracking abortion data is going to be more difficult than ever;

• And Republicans are mad that the Biden administration may not move the permanent headquarters of Space Command to Alabama because of the state’s abortion ban (something the White House has denied).

Stats & Studies

A new study in Obstetrics & Gynecology that reports abortion medication could be safe to use after the first trimester. The research looked at women who took the medication between nine to 16 weeks into pregnancy; about half of them only took misoprostol, instead of the two drug regimen. Ninety percent of the patients were able to have their abortions without further medical intervention, and 5% percent required a procedure to complete the abortion. From Dr. Daniel Grossman, an OBGYN professor at the University of California, San Francisco:

“This paper adds to previous research indicating that self-managed abortion with medications is safe and effective, including after 12 weeks of pregnancy. As clinic-based abortion care becomes less available in many parts of the country due to state-level bans, self-managed abortion will become more common, as we are already seeing.”

Anti-Choice Strategy: Updates

Remember when I told you just yesterday about the way that Republicans were doubling down on anti-abortion centers? And how they’re funneling millions of taxpayer dollars into religious organizations that don’t do shit to help women? Well, today The Kansas City Star published an investigation into the over $8 million that Missouri is pouring into its ‘Alternatives to Abortion’ program—a campaign that doesn’t give material support to pregnant people or families, but simply directs them to anti-abortion organizations.

To start, abortion is illegal in Missouri—so why does the state need to allocate millions of dollars to convince women not to have them? Wouldn’t that money be better spent subsidizing services that women being forced into pregnancy really need? And while the state’s Alternatives to Abortion website claims that they’ll help people with food, baby clothing, housing costs and more, we know that anti-abortion centers actually offer very little—if anything—in terms of actual tangible support.

Then, of course, there’s the fact that these centers straight up lie to people—and so the state is spending millions to trick women into thinking that they’re going to a real clinic that will offer real help and care, just to find themselves at a religious center. As Katie Baylie of Planned Parenthood Great Plains points out, “When a patient goes to a crisis pregnancy center, they’re getting theology over accurate information.”

In addition to the millions in funding to the program, Missouri’s Department of Social Services is giving over $250k to a “a Christian anti-abortion marketing firm” who will promote the program. What kind of work do they do? They have workarounds for internet searches that may block misleading ads from anti-abortion centers. Scott Baker, a spokesperson for the company, told The Kansas City Star, “There are artificial hurdles put in place by Google and some of these other platforms…that we’ll work to overcome on behalf of these A2A contractors.”

To recap: Missouri is spending millions of dollars to convince women not to have abortions (even though abortion is illegal) by funding religious organizations that lie to the state’s citizens.

What I’d like to know: Does any of this money go to groups that allow for the discussion of birth control? We know that the anti-abortion centers getting funding from Louisiana, for example, prohibit dispensing or talking about contraception. It would be nice to know if this is the case across the country (which I’m assuming it is).

The Care Crisis: Maternal Mortality

Since Roe was overturned, there’s been a massive exodus of OBGYNs and maternal fetal medicine specialists from anti-abortion states. We hear the same story again and again: They want to stay and help, they’re heartbroken to leave, but the law gives them no choice. They can’t stay in a place where doing their job could land them in jail and following the law could get someone killed.

The states losing those doctors are having an increasingly difficult time replacing them; medical students and residents aren’t eager to set up their careers in places where they can’t learn the full spectrum of reproductive health care, and where they can’t fully help their patients.

As a result, it’s not just abortion clinics or OBGYN practices that are closing up shop, but entire hospital maternity wards. The closures, which we’ve seen in places like Idaho and South Carolina, are happening most often in rural areas. The latest casualty of state abortion bans is Henry County Medical Center in western Tennessee, which is shuttering all services related to pregnancy and childbirth. The hospital cited financial difficulties for the closure—something we’ve heard from other medical centers closing their maternity wards—but clearly there’s a connection between the financial health of an institution’s OBGYN services and their ability to recruit or retain doctors.

Tennessee Rep. Gloria Johnson tweeted about the news, writing, “When you combine the draconian abortion ban and the GOP refusal to expand Medicaid, far too many TN lives are being put at risk as more hospitals are in danger of closing.” The nearest hospital where women can give birth is over an hour away.

But even when doctors do stay in anti-choice states, and when hospitals remain open, patients are still unable to get the care they need. In Oklahoma, for example, where a recent report showed that most hospitals in the state don’t have a clear idea of when they can offer a life-saving abortion, doctors are still struggling to figure out how they can legally help patients under the law.

OBGYN Dr. William Po, vice chair of Oklahoma’s ACOG chapter, says there’s no way to provide the standard of care when criminal penalties are in play:

“We all want to do the right thing. We all want to follow the law. We all want to save our patients and give good medicine. And when you have a law with such a blanket statement, it’s difficult to navigate those waters.”

All of these factors—the physician exodus, hospital closures, legal confusion and more—mean that the nation’s already bleak maternal mortality crisis is only going to get worse. And because Republicans know that those numbers are going to look really bad really soon—especially in anti-abortion states—they’re already working to hide the data. States like Idaho are fully dismantling maternal mortality committees, and anti-abortion groups are working to sow distrust in credible statistics on maternal death from places like the CDC.

And so as we keep talking about reproductive health and the consequences of abortion bans, please keep in the back of your head that we are not getting the full story from legislators. That’s why I’m doing this work here: to make sure they don’t get away with this shit.