Abortion, Every Day (3.22.24)

House Republicans quietly endorsed a 15 week ban

Mar 22, 2024

New Texas Medical Board Rules

The Texas Medical Board met today to issue guidance to doctors on when a patient can be given a life-saving abortion. (A sentence that is just insane to write to begin with.) Unfortunately, the board didn’t give much clarity.

The new rules are embedded here, and are clearly pretty unhelpful. For the most part, the guidelines seem to repeat what’s in the Texas abortion ban, and uses general language about what constitutes a medical emergency. A couple of things stuck out to me:

The board defined what would count as damage to a ‘major bodily function’, like issues that impacted patients’ brains, bowel or reproductive functions. I just found myself dumbstruck that there needs to be rules about what parts of a person are valuable enough to warrant giving them life-saving care.

The guidelines also mandated that doctors document what kind of “diagnostic imaging, test results, medical literature, second opinions, and/or medical ethics committees” were used to determine an abortion was necessary. It also noted that physicians should document “whether there was adequate time to transfer the patient, by any means available to a facility or physician with a higher level of care or expertise to avoid performing an abortion.”

Again, we’re talking about women’s lives and they want doctors to take the time to do imaging, get consults and even transfer a patient rather than just give them the care they need. They are enshrining, again and again, how little they care about it.

The Texas Tribune reports that some of the women who are suing the state after being denied abortion care were at the meeting, and testified after the proposed language was announced. Plaintiff Kaitlyn Kash, who is pictured sobbing at the meeting, said, “I have yet to hear something in these rules that will address what happened to me and my family.”

“I heard you say you don't make the law, but I'm here today because I tried to get the Legislature to act when I lobbied last session and couldn't even get an amendment on fetal anomaly out of committee. I tried to get the courts to help us explain what would happen in my situation as a plaintiff, and they said that we needed to wait for you. And now you're saying it's not your responsibility either. So where else am I supposed to go?”

Every Subscription Counts

Anti-Choice Strategy: False Maternal Mortality Data

You all know I’ve been tracking the way that conservatives are trying to hide the impact of abortion bans on maternal mortality: Anti-choice groups have been sowing distrust in maternal death data, for example, claiming that it’s inaccurate or can’t be trusted—a strategy to preempt the post-Roe increase in mortality they know is coming. We’ve even seen Republicans in states like Idaho disband their maternal mortality review committees entirely.

Now there’s a new tactic: doctors on Texas’ newly-formed maternal mortality task force say they’re being prevented from counting deaths caused by the state’s abortion ban.

The Austin Chronicle reports that since 2013, the task force has been prohibited from reporting on deaths “pertaining to voluntary or therapeutic termination of pregnancy.” And while abortion is incredibly safe, doctors (correctly) expect that there will be deaths due to patients ending their pregnancies in dangerous ways, or delays in abortion care.

Incredibly, the task force gets information about pretty much every other death of a pregnant woman—including those who have been in car crashes—but not any related to abortion.

At a public meeting of the task force today, Chair Dr. Carla Ortique called on the public to voice their outrage:

“It's my hope, that members of the public, the media, professional organizations, community organizations, and all that recognize that the preventable death of a mother is unacceptable will hear these updates and understand the importance of engaging in efforts to ensure that the work of this committee is able to continue and will raise their voices.”

It’s clear that this committee needs all the information possible to paint a full picture of maternal mortality since Texas passed its ban. But I’ll tell you something else I’m worried about: you know from my past investigations that the state is essentially forcing doctors to make inaccurate reports about abortion ‘complications’ as a way to falsely claim abortion is dangerous.

My worry is that deaths and harms that have been caused by the ban will be attributed to abortion itself. For example, if a patient needs to get an out-of-state abortion because her care in Texas is delayed, and then complications arise out of waiting—that’s a problem with the ban, not the abortion. The same is true if a patient who has self-managed an abortion develops an infection but is too afraid to seek care because of the state’s law.

In the States

In Kentucky, the cruelty is the point. A bipartisan bill seeking to lower the state’s abysmal maternal mortality rate was moving steadily along—and then Republicans added in language that would require doctors advise women with doomed pregnancies to stay pregnant rather than get abortions.

The Lexington Herald Leader reports that the bill—which provided services and help to new moms—had wide support. The bill recently got a 90-0 vote in the House. But then came the language that I’ve been warning about in my Calculated Cruelty series.

Republican Rep. Kim Moser added in language requiring that doctors direct patients with lethal pregnancies to a “perinatal palliative care program, or perinatal palliative care support services.” The language comes directly from the bill I told you about earlier this month, legislation that caused Kentucky Democrats to walk out. At the time, Rep. Lindsey Burke called it “an insult to grieving parents everywhere.”

Because the legislation had gotten previous unanimous support—and because Moser added the language in late in the game—many Democrats voted in favor of the bill without realizing what had been substituted in. Unbelievable and so, so sneaky.

Love to bring you good-ish news every once in a while: Wyoming Gov. Mark Gordon has vetoed legislation that would have made it more difficult for abortion clinics in the state to operate. The bill was a TRAP law, requiring clinics to operate as “ambulatory surgical centers” in an attempt to shut down any remaining abortion providers in the state.

Now, the reason this is just good-ish and not great news is that Gordon only vetoed the legislation because he thought it might delay the abortion case that’s before the state Supreme Court, which, he says, “would have only sacrificed additional unborn lives in Wyoming.”

Still, let’s take our wins where we can. Libby Skarin of the ACLU of Wyoming, for example, said the group was “thrilled” with the veto, and that the proposed regulations “have nothing to do with patient safety or providing good care.”

Virginia Gov. Glenn Youngkin appointed a Republican to the state Board of Health who once suggested that pregnancy after rape is rare. Yesli Vega, a former congressional candidate suggested that women are raped might not get pregnant because “there’s so much going on in the body.”

“It’s not something that’s happening organically,” she said. “You’re forcing it.” After public outrage, Vega now says, “I don’t doubt that a victim of rape can become pregnant.”

The Washington Post points out that the Virginia Board of Health has had “influence” over abortion in the state in the past, including being in charge of setting restrictions on clinics in 2011. And as I’m sure you remember, Youngkin himself is an anti-abortion extremist—a stance that didn’t serve him well this past November.

Maine lawmakers advanced a shield law yesterday to protect providers and patients of abortions and gender-affirming care. This is the bill I told you about last week that got conservatives so mad, sixteen Republican Attorneys General wrote a threatening letter to legislators.

They claimed that the bill—which would allow anyone harmed by out-of-state anti-abortion litigation to bring a civil suit in response—was “state-sanctioned culture war litigation tourism.” (Remember, these are the same people pushing legislation that allows citizens to sue each other over abortion—they just don’t like when we play the same game!)

Quick hits:

ABC News has more on the 13 year-old rape victim who was forced into childbirth in Mississippi;
Abortion is key to North Carolina voters in Lieutenant Governor’s race;
Arizona Republicans are mad at the Attorney General’s warning on crisis pregnancy centers;
And the Kansas City Star on Kansas Republicans’ legislation on ‘coercion’.

Language Watch

In October, I warned that anti-abortion groups were trying to redefine ‘late’ abortion. Now, there’s no such thing as ‘late’ abortion—it’s a made-up term. That’s what makes it so powerful for conservatives, they can define and redefine it at will.

In 2023, the president of March for Life Action, Jeanne Mancini, wrote an op-ed characterizing “dangerous and extreme late-term abortions” as anything after 12 weeks. Other anti-abortion groups followed suit around the same time they started pushing 15-week bans (nationally and on a state-level) as ‘reasonable middle-ground’ bills.

For example, the Charlotte Lozier Institute—the ‘research’ arm of Susan B. Anthony Pro-Life America—put out a paper arguing for a national 15 week ban by calling it a “Federal Limit on Late Abortion.” In it, ‘late’ abortion was characterized as an abortion after the first trimester, whereas abortions after 20 weeks were called '“extremely late.”

This week, anti-abortion leaders doubled down on that definition: After Donald Trump made some noise about possibly supporting a 15-week national ban, Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America, said, “President Trump is right: protecting babies from painful late-term abortions is a place of national consensus.” (Emphasis mine) Let’s not even get into her using the word ‘consensus’ again because I’m sure you’re sick of me harping on that one, but you can see what’s happening here.

What’s so dangerous about this is that while there isn’t a real medical definition of ‘late’ abortion, Americans colloquially think of it in the same world as ‘abortion up until birth’—they’re imagining something very different than a 12-week abortion. So using the term ‘late’ allows Republicans and anti-abortion groups to mislead voters about when they’re looking to ban abortion. I’ll be keeping an eye on this one on in the next few months.

Listen Up

Slate’s “What Next” podcast has an episode on abortion bans and domestic violence that’s definitely worth listening to. The guest is reporter Julianne McShane, who speaks about her work investigating how Oklahoma’s ban impacted victims in the state. You can check it out below:

In the Nation

House Republicans have quietly endorsed a national 15 week abortion ban, legislation that would force women to carry nonviable pregnancies to term. And in keeping with Republicans’ ever-shifting definition of what a ‘late’ abortion is, the 15-week ban is titled the “Protecting Pain-Capable Unborn Children from Late-Term Abortions Act.”

Rolling Stone points out that the endorsement was tucked away in the Republican Study Committee’s 2025 budget proposal; the RSC represents 80% of House Republicans. Oh, and the bill could also do away with IVF—so much for that ‘middle ground’ they keep talking about!

The Supreme Court is hearing arguments next week on mifepristone, one of two medications used to end a pregnancy. As you likely know by now, the abortion medication has been at the center of an ongoing court battle: Anti-choice groups were successful in convincing the 5th Circuit Court of Appeals that there should be significant restrictions on mifepristone; now that case heads to the Supreme Court.

The short version is that the legality of mifepristone is not at risk, but access and availability of the medication is.

If the Supreme Court upholds the lower court’s ruling, it revert access to mifepristone to pre-2016 rules: the drug would only be approved through seven weeks of pregnancy, the medication would have to be prescribed and picked up in person, and mifepristone would be banned from being mailed or prescribed via tele-health. (This would be a good time to re-read our explainer on the Comstock Act.)

All of which is to say: mifepristone doesn’t have to be illegal for a bad SCOTUS ruling to have a widespread, horrific impact. After all, since Roe was overturned, an increasing number of patients—especially those in states with bans—have relied on telemedicine and the mailing of abortion medication to get care. Just this week, new research came out showing that medication abortions account for 63% of American abortions.

For more information on the case, KFF has a terrific report with background on the legal and medical implications; Vox has a legal explainer that also gets into the debunked science that Judge Matthew Kacsmaryk first used to rule against the medication; The 19th looks at what the impact of a negative ruling would be on telehealth and other types of medication; and always listen to “Boom! Lawyered,” which gets into the nitty gritty of the case and two things to watch out for.

And, of course, I’ll have more for you next week.

Quick hits:

A new poll shows that 80% of Asian Americans, Native Hawaiians and Pacific Islanders believe abortion should be legal in most or all cases;
The Economist calls on the Supreme Court to reject more restrictions on mifepristone;
Phoebe Gates tells Bustle about why she’s furious over the attacks on abortion rights;
And another Republican congressman quietly deleted his anti-abortion bonafides from his campaign website.

Censoring Abortion

Let’s talk about suppression of pro-choice speech this week—including my own! A TikTok I posted of a 4 week abortion was going viral yesterday when all of a sudden it just…stopped. I realized that TikTok had labeled it as ‘violent and graphic content’ that was ineligible for the For You Page—meaning people wouldn’t be able to see it unless they came to my page specifically. You can see for yourself how ‘graphic’ it actually is here.

The good news is that the video had nearly 150k views before this happened, but imagine how many more people could have seen it—and learned what early abortion really looks like—if TikTok didn’t decide that there was something ‘graphic’ about the truth.

Meanwhile, a coalition of Midwest abortion funds were stopped from putting up billboards in Illinois and Indiana that expressed support for abortion seekers. Chicago Abortion Fund (CAF), Hoosier Abortion Fund (HAF), and the Women’s Medical Fund (WMF) of Wisconsin tried to push out a multi-state pro-abortion billboard campaign that read, “In the heartland, we look out for each other. Abortion funds are here for you.”

The groups say after initially agreeing to run six billboards, Lamar Advertising pulled their support.

Something similar happened to Don't Ban Equality, a coalition that makes the business case for abortion rights and and works with companies from Ben & Jerry’s to H&M. The group was rejected after seeking out a Times Square billboard that would read, “Abortion access is every business’s business.”

TSX Broadway said abortion is “a political topic in the U.S which is not allowed in our platform.” The ad was even rejected again after the group changed the language to “reproductive health is every business's business."

Thankfully, both Don't Ban Equality, and the abortion funds were able to find other placement for the ads. But it just goes to show that no matter how popular abortions rights are—and they are very popular!—people will always find a way to make it ‘controversial’.