Abortion, Every Day (8.2.23)

The fake study being used to ban mifepristone

Hey, this is Grace Haley, Abortion, Every Day researcher. I’m bringing you the newsletter and I thought I’d start with Kansas today:

In the States

On the anniversary of Kansas’ historic vote rejecting an anti-abortion ballot measure, a suspicious package was left in front of the Trust Women Clinic in Wichita, Kansas—the same clinic operated by abortion provider Dr. George Tiller before he was assassinated in 2009. Police shut down a major road in the area, and evacuated residents and business owners as they investigated. This is part of a larger national trend of increasing violence and harassment against abortion providers. (Thank you to an Abortion, Every Day reader in Kansas for flagging this story.) While it’s been a year since Kansas overwhelmingly voted to defend abortion rights in their state, that message has been ignored by Republican lawmakers—who continue to push anti-abortion legislation.

As Indiana clinics stop providing abortions, physicians and activists are sounding the alarm about the consequences of the state’s new ban. (As Jessica mentioned yesterday, abortion is technically still legal in the state until the Supreme Court certifies its ruling, but most providers in the state have stopped offering abortion care.)

Indiana has one of the worst maternal and infant mortality rates in the country, and the state’s OBGYNs are concerned about how abortion bans will compound these systemic pressures. It’s a reasonable worry, especially given the statistics we highlighted yesterday of the millions of women living in both abortion access and maternal health deserts. The doctors who spoke to Indiana public radio also cited concerns over the impact that forced pregnancy will have over the local economy and the impending exodus of doctors and resident students.

The mayor of Indianapolis, Joe Hogsett, echoed those fears in an op-ed at the Indianapolis Star today—writing about how the ban will impact Indiana’s medical staffing shortages and poor maternal health outcomes. The state is already an unsafe place for patients, and the crisis will only get worse after a ban is in effect. Hogsett also points out that lawmakers aren’t out celebrating the passage of the law, likely because of how deeply unpopular it is in the state.

All of this means that those seeking abortions will have to leave Indiana for now; and experts say that the majority of patients seeking out-of-state care are traveling to Illinois rather than Michigan for care. Public radio station WMUK reports that abortion rights activists say that because Michigan has a 24-hour waiting period, the patients they work with tend to go to Illinois instead to avoid wait times for care. 

Ohio activists are calling out state Attorney General Dave Yost for his attempts to roll back HIPAA protections. Yost is one of the 19 state AGs who want to be able to access the medical records of out-of-state abortion patients. Jaime Miracle of Pro-Choice Ohio, one of the groups supporting the pro-choice ballot measure in the state, says it’s bad enough that Yost and his ilk are forcing women to travel for care: “Now, Yost wants access to your medical records when you do cross state lines to get legal abortion care? Ohioans deserve better.”

Newly-appointed Wisconsin Supreme Court Justice Janet Protasiewicz was sworn in yesterday, saying that she will be committed to “fairness and impartiality” in her role. “We all want a Wisconsin where our freedoms are protected,” Protasiewicz said. 

I wanted to highlight this piece interviewing Iowa college students in the state about how they’re dealing with their post-Roe reality. (Not exactly good news, but inspiring nonetheless.) Anna Behrens, for example, a Des-Moines native and president of the University of Iowa Student Advocates for Planned Parenthood, says that “speaking out as a younger person gives hope.” She continued, “You think, maybe everyone in my generation can get it right this time and protect everyone’s rights that they deserve.”

Quick hits:

• NPR/St. Louis Public Radio spotlights the anti-democratic measures Ohio and Missouri Republicans are taking against pro-choice ballot measures;

• The Los Angeles Times reports on how the California Senate candidates vying for Sen. Dianne Feinstein’s seat support Supreme Court reform and court expansion to protect abortion rights;

• A Teton County judge is asking the state of Wyoming to provide evidence in court for its abortion ban;

• A Catholic hospital in Tyler, Texas dedicated a monument this morning as a memorial “to children lost due to abortions, miscarriage and stillbirth”;

• And a piece on how the lawsuit brought by 15 Texas women denied abortion care could act as a blueprint for similar challenges across the country.

In the Nation

The authorization of PEPFAR—the highly successful global AIDS program—is set to expire on September 30 as the anti-abortion fight over its reauthorization continues. As you may recall, anti-abortion Republicans are blocking its reauthorization over allegations that PEPFAR funding is going towards abortions (which is not only false, but illegal). The Washington Post reports that The Heritage Foundation, along with Family Research Council and Susan B. Anthony Pro-Life America, are threatening lawmakers over PEPFAR—saying that if they reauthorize the program, they’ll be docked on the organizations’ scorecards (an important part of anti-abortion politicians’ reelection campaigns).

Meanwhile, the Biden administration formally launched the Bureau of Global Health Security and Diplomacy that will now oversee PEPFAR within the State Department. The administration made little mention of the reauthorization blockage during their announcement of the new bureau.

A Trump-appointed federal judge reinstated a law in Guam that requires patients to meet with doctors in person before obtaining abortions. The ACLU criticized the decision and how it “imposes unnecessary obstacles on people seeking abortion in Guam.” Advocates also worry about the future care crisis, as abortion-seekers in Guam have relied on telemedicine providers to obtain abortion care.

Quick hits:

• More on the Biden-Tuberville battle over abortion and Space Command headquarters;

• Bloomberg published an investigation on how some distributors of abortion medication in low-income countries are buying their products from companies with “a record of making substandard drugs”;

• And Axios on how giving birth in America continues to get deadlier as the care crisis deepens.

Stats & Studies

The study cited in US District Judge Matthew Kacsmaryk’s decision in the Texas mifepristone case is under investigation—along with the peer review process it went through. One of the issues includes a conflict of interest between the lead author of the paper and Susan B. Anthony Pro Life America’s Charlotte Lozier Institute. The complaint alleges that the authors “exaggerated their findings and visually misrepresented them in ways that are grossly misleading… their study doesn’t actually show what Kacsmaryk said it does: that medication abortion leads to significantly high rates of complications.” 

For example, the study—which looked at Medicaid patients’ visits to the emergency room—says that abortion medication leads to an increased risk of ER visits. This is something Abortion, Every Day has written about before: Citing ER visits as a serious adverse reaction is extraordinarily misleading. Going to the ER is not the same as receiving treatment or having a serious complication. And as the we’ve reported previously, going to the ER at all after an abortion is rare: one study shows that less than 1% of abortions were followed by a trip to an emergency room; and half of the women who go to an ER after an abortion are simply sent home because they’re fine. 

From States Newsroom reporter Sofia Resnick: 

“A medication abortion is an induced miscarriage and necessarily involves bleeding. First-time medication abortion patients often go to the ER because they don’t know what is normal. And that’s especially true if they don’t have a regular medical provider, like many people on Medicaid, [University of California San Francisco reproductive health researcher Ushma] Upadhyay said.”

Still, Kacsmaryk used this study—which was “designed, funded and produced” by Susan B. Anthony Pro Life America—to try to ban mifepristone. It’s just more proof that a central part of the anti-abortion movement’s strategy is using false data and studies to push their agenda forward.

A new poll from Gallup shows the lasting impact of the overturning of Roe: approval of the Supreme Court has dipped to an all-time low, and it is especially low for Democrats. Only 17% of Democrats say that they approve of the Supreme Court—one of the lowest percentages over the past two decades. One interesting point from the poll: The 45 percentage point gap between Republicans and Democratic approval mirrors a similar gap from eight years ago after the court legalized same-sex marriage when GOP approval for the Supreme Court was at a record-low. 

Care Denied

The Washington Post followed up—both in their Post Reports podcast and in a piece this week— with the Texas teenager they wrote about last year who was forced to have twins because of the state’s abortion ban. It’s powerful listening to Brooke and her now-husband Billy tell their own story in their own words: of what life is like to parent as teenagers, the way it felt to be forced to drop out of school to account for an unplanned pregnancy, and how Brooke “doesn’t understand why some antiabortion activists see them as the ultimate success story.”

“[Brooke said] she felt sick thinking of all the young girls forced to carry pregnancies they didn’t want. ‘If you really didn’t want something, and then you’re forced to go through with it…it’s still really very hard,’ she said.”

The story also highlights themes we’ve documented in this newsletter:

• The Care Crisis: When Brooke found out she was pregnant, the Texas abortion ban was set to go into effect within 48 hours and no abortion clinics had available appointments; 

• Anti-Abortion Crisis Pregnancy Centers: Brooke went to a center to get an ultrasound, where they talked her out of driving to New Mexico for an abortion;

• The Impact of Denied Care: The forced pregnancy severely impacted their economic and education status. 

This is all compounded by the maternal care crisis: There was a 4% decline in hospitals with labor and delivery services between 2019 and 2020, according to new data from the nonpartisan health advocacy group March of Dimes. The report details how bad the crisis is in many rural anti-abortion states. For example, Alabama and Wyoming “lost nearly one-quarter of their birthing hospitals in that time period, while Idaho, Indiana and West Virginia lost roughly 10 percent.” Experts anticipate the numbers to only get worse, as the report relies on pre-Dobbs data.

As the American care crisis worsens, abortion rights advocates are doing their best to pick up the slack. This week, Cosmopolitan profiled the Miscarriage and Abortion Hotline—a volunteer-run helpline for those who need advice about self-managing abortion (and more). Founder Dr. Linda Prine, says, “We’ve increased in size twice since Dobbs. When you’re on, you don’t move from your seat. You’re answering calls and texts nonstop.” Cosmo points out that the hotline—the only one of its kind in the country—has become just one of a vital network of abortion care and rights resources.

Call or text the Miscarriage and Abortion Hotline at 833-246-2632

Attacks on Abortion Providers

We’ve written before about the increasing attacks on abortion providers and clinics—and what happened today in Kansas is just the tip of the iceberg. The National Abortion Federation (NAF), for example, has reported an over 200% increase in burglaries and arson. Today, however, Reuters highlights a more specific growing threat: Doxxing.

“The first time I got a letter I thought to myself ‘how the hell did they get my address?’,” Alison Dreith told reporters. Dreith, who works for the Midwest Access Coalition, says she’s moved four times in five years in part because of all the threats she’s had sent to her home. “They want to scare me into inaction,” she says. 

Laura Hecht-Felella, a lawyer with C. A. Goldberg, PLLC, a firm that specializes in online harassment, says, “We’re seeing an increase in anti-abortion extremists weaponizing public records requests to inappropriately obtain deeply personal information about abortion providers”—like addresses, phone numbers, even marriage and birth certificates. 

Doxxing also tends to go hand-in-hand with online threats. NAF’s chief program officer said the most common hate messages on social media include "Death to abortionists," "Burn in hell," and "Time to bomb abortion clinics.” The abuse has gotten so bad, Reuters reports, that companies like DeleteMe—which helps people get their personal information off the internet—have seen their clients in the reproductive health arena triple.

Anti-Abortion Strategy: Defund Planned Parenthood

Republican Sens. James Lankford and Josh Brecheen have sent a letter to the DHHS Inspector General calling for an investigation into Planned Parenthood’s finances concerning the Coronavirus Aid, Relief, and Economic Security (CARES) Act. They allege Planned Parenthood misused federal funding for abortions—a common complaint used by anti-abortion activists. Their letter is one more addition to a constant public barrage of attacks on pro-choice organizations.

This move also follows a larger anti-abortion strategy portraying Planned Parenthood as the face of a predatory abortion industry that preys on vulnerable women, and abuses systems as a means to an end to get richer. Abortion, Every Day has reported on this tactic before, and how anti-abortion leaders are laying out their vision for the future of the anti-abortion movement: ban medication abortion, spend more money in state-level races for outspoken anti-abortion candidates, pressure executive branch resolutions in a GOP-controlled White House, call on Congress to pass fetal personhood legislation using the 14th amendment, get rid of rape and health exceptions from current abortion bans, and defund Planned Parenthood.

Co-signers of this letter include Republicans trying to court public attention from the anti-abortion movement: Sens. Tim Scott (Republican presidential candidate who supports a federal abortion ban), Tommy Tuberville (Senator leading the anti-abortion crusade against military promotions), and Marco Rubio (co-signer of many anti-abortion measures in the Senate). We expect to see more of these post-Roe talking points from the anti-abortion movement spring up in Congress as 2024 draws closer.

Abortion and the Music Industry

I traveled to the Newport Folk Festival over the weekend and had some illuminating conversations with performers at the festival about abortion and the music industry now that it's been over a year since Dobbs.

Musicians on tour are conflicted over what direction the music industry should chart while adapting to a post-Roe America. On all sides there is a motivation to not be complacent, however there is a divide over what that means. Some artists want to boycott states with abortion bans and drive economic incentives as a form of protest. Others want to “ride into the eye of the storm,” show up for communities living in states with abortion bans and use their voices as platforms to bring attention to anti-abortion policies. 

Musicians are particularly vulnerable to the pressures driving the post-Dobbs care crisis. Although music companies have announced they would cover travel expenses for their employees who are forced to travel out of state for abortions (CAA, Live Nation and Sony Music are all examples of this trend), artists are often left unprotected and vulnerable to the whims of abortion bans. This is compounded by the fact that almost half of musicians do not carry any health insurance at all and artists make less than $43,000 across their entire revenue pipeline on average according to the U.S. Bureau of Labor Statistics.

I spoke to Carmel Holt, host of the SHEROES podcast, which amplifies women in the music industry. According to Carmel, there’s a strong fear within the industry of alienation from their record labels, their audiences, and their personal safety when reflecting on how to show up as an abortion advocate. She described what felt like a dark past that has engulfed so many of the spaces musicians are navigating: “Nothing makes me feel more heartbroken than women feeling like they can’t say what they think.”