Abortion, Every Day (1.4.23)

In the states…

Texas teenagers can no longer get birth control without explicit permission from their parents—which adds a whole new layer of hurdles for a young vulnerable population. In fact, thanks to a decision removing health class as a graduation requirement for high schoolers, less than a third of Texas high school students took a health class between 2016 and 2020, according Healthy Futures of Texas. Students must have written permission in order to learn anything about human sexuality and if they do get a sex ed class it’s most often abstinence-only education, which is honestly worse than learning nothing at all. (This investigation into how impossible it is for Texas teens to get accurate information or reproductive health care is a must-read.)

You already know that Arizona now has a 15-week abortion ban that can be enforced in the state, but the good news is that the state’s new Attorney General Kris Mayes says that she believes the law is unconstitutional. That means that she is going to make clear to state attorneys that she doesn’t want abortion cases prosecuted: “There’s a lot we can do in the Attorney General’s office to protect a woman’s right to privacy.” You can watch an interview with her from this morning here:

In Kansas, Republicans are considering a move to try to restrict abortion rights despite a pro-choice ballot measure win showing what we know from polls: Voters want abortion to remain legal. Democrat Rep. Jo Ella Hoye told The Topeka Capital-Journal, “It's just, at this point, completely unnecessary…we've had the voters weigh in, we actually know how they feel on this issue.”

Indiana’s medical licensing board will convene on Dr. Caitlin Bernard next month. Dr. Bernard was the abortion provider who helped the 10 year-old rape victim from Ohio and consequently was the target of a harassment campaign by the Indiana Attorney General. AG Todd Rokita, a real piece of shit, wants Dr. Bernard to have her medical license revoked because she spoke up about the horrific consequences of abortion bans and embarrassed Republicans in the process.

Also in Indiana, Republican lawmakers say they won’t be proposing new abortion legislation until the state Supreme Court comes back with a decision on the currently blocked ban.

Iowa’s new Attorney General started off her tenure by defending the state’s blocked abortion ban. Brenna Bird made clear in her campaign that she would support efforts to block abortion, saying “I’m 100 percent pro-life, and it will be my job as attorney general to defend the law that the legislature would pass.”

Quick hits:

• The first Minnesota House hearing on abortion rights will happen tomorrow, with Democratic leaders promising to enact even stronger protections for reproductive rights and health;

• New Hampshire lawmakers will convene on a number of abortion-related bills, including moves to ban abortion and Democratic efforts to further protect abortion rights;

• And pro-choice advocates in Rhode Island are pushing for the Equality in Abortion Coverage Act, which would ensure abortion is covered by health care plans and Medicaid.

In the nation…

Fantastic news today: The FDA has changed its rules around abortion medication to allow the pills to be dispensed at retail pharmacies. (Previously, women had to pick up the medication in person from a doctor or get them from special mail-order pharmacies.) This comes in the wake of a broad set of attacks on abortion medication from conservatives, who are suing the FDA over their decision to even make the medication available at all. The change in regulations means that pharmacies like CVS or Walgreens could carry the medication—which would seriously increase access to medication abortion, which accounts for over half of abortions in the U.S.

That said, we have no idea if these pharmacies will decide to carry the medication. Big chains already allow their pharmacists to deny prescriptions—even for birth control—if they have moral reservations about it. And as The New York Times points out, “while abortion pills may constitute a small percentage of a pharmacy’s sales, they could have a big impact on its public profile.” These companies may decide it’s just not worth the trouble they’ll get from anti-abortion groups. (I’ll let you know if I hear of any pro-choice campaigns around pressuring big name pharmacies to do the right thing!)

Also in abortion medication news: The Department of Justice said that the US Postal Service can continue to deliver abortion medication despite Roe being overturned.

A coalition of conservative organizations sent Republican lawmakers a letter outlining their list of demands on abortion, POLITICO reports. The letter—which comes from representatives from groups like Susan B. Anthony Pro-Life America, Focus on the Family and Students for Life—pressures Republicans to pass a national ban on abortion and legislation that targets the mailing of abortion medication and the FDA’s loosened regulations on the medication. Fuck them.

I was so happy to see this piece in NPR about an organization, the TEAMM Project, that trains emergency room doctors in miscarriage management. Even before Roe was overturned, most doctors in emergency rooms had never performed a uterine aspiration—despite the fact that nearly one million women a year will need such care in an ER. Women who are having miscarriages are generally treated in three ways: They’re given medication to help complete the miscarriage, they’re given a D&C or uterine aspiration, or doctors recommend “expectant management”—essentially watchful waiting to see if the miscarriage completes on its own.

From Dr. Kelly Quinley, who volunteers as a trainer with TEAMM:

“We effectively decide for patients, without having a conversation with them, that they go home and wait. But what if home is three hours away? What if they're traveling the next day? What if they can't get into their OB-GYN? When we send patients home, they're going to bleed in a time frame nobody can predict, and when it happens it might be inconvenient or it might be dangerous.”

NPR also has a section in the article on manual vacuum aspiration (MVA) abortion—which we need to be talking about more. When people think of an abortion procedure, they generally think of an electric vacuum aspiration; but in the first trimester, doctors can use manual aspiration: The way I usually describe it to people is think about the suction of a simple syringe, that’s how simple it is. It’s something not nearly enough doctors are trained in or even aware of—and in a post-Roe world, that needs to change. You can see what a MVA tool looks like here, and learn more about the procedure from the MYA Network (who you probably know from those pictures of early abortion).

STAT News has a roundup of stories from women with disabilities about how barriers to reproductive care have impacted their lives. It’s an important read, and brings up a lot of the nuances that are lost in the national conversation about abortion and reproductive rights. From 22 year-old Brianne, who is in remission from acute myeloid leukemia, and had graft-versus-host disease on her reproductive organs:

“Even if I did get pregnant, I would have struggles actually carrying a child to term. I would be scared to go to a doctor in Georgia and tell them what’s going on. None of the providers down here have probably seen anyone who has ever had vaginal GVHD or who has had a transplant…theoretically, the only place I can go is Atlanta, but I can’t drive. It’s four and a half, five hours away from here. So I haven’t actually seen an OB/GYN in over a year.”