52 Comments

The portion on Washington needs a little local commentary for how big of an issue this is. Spokane is the largest city between Seattle and Chicago north of Salt Lake City. It's the medical hub for all of eastern Washington, north Idaho, and parts of western Montana and eastern Oregon. It's also home to a nursing school, two medical schools, a campus of a PA school, an RT school, and a nurse anesthetist program. It's also home to the VA with the largest geographic catchment outside of Alaska. The consolidation of the largest trauma centers in such a large region cannot be understated.

Expand full comment

Also remember Idaho has no medical school, neither does Alaska, Montana, or Wyoming. They rely on the WAMI agreement to train physicians in Washington. It just compounds the issue. Western Washington is highly liberal, Eastern isn't. And Spokane the border town providing tons of care to Idaho and Montana residents is purple.

It's so important we can protect smaller local clinics and hospitals for the care needed, but also the training.

Expand full comment

If you want a feel good read, check out the comments in the NYT article. The birth control and IVF topics are a home run. Feel free to school some (mostly men) who post that they are for “womens right to birth control” because 1) they are not understanding that condoms could be next and 2) it proves what I have been saying that tooooo many men believe birth control is solely a woman’s responsibility. They say who they are by their comments. 3) there are some who need schooled. That said, the vast majority are saying Rs are going too far even for some MAGA people. Hmmmm. Maybe there needs to be an ad with a married man trying to buy condoms. Put them on the offensive. I mean, “they never thought Rs would go after womens birth control” so why wouldn’t they go after all birth control? Preposterous? Maybe not. Plant the seed.

Expand full comment

Abbie Phillips will be speaking tomorrow. Starts at 10am. If you haven’t watched her in action, she’s really good.

https://www.budget.senate.gov/hearings/no-rights-to-speak-of-the-economic-harms-of-restricting-reproductive-freedom

Expand full comment

Contraception is birth control.

Abortion is birth control.

Birth control that prevents implantation is a perfectly acceptable means of birth control. IUDs prevent implantation of the blastocyst into the uterus. This is the basic function of any IUD. It can also do other things when other things are added to it, but the most basic form of the IUD, the "inert" IUD does that and only that. But any IUD is at least an inert IUD and will always do what an inert IUD will always do. This is only logical. To describe the function of an IUD any other way is suspiciously political, not rational.

Is preventing implantation abortion? If you believe that human life needs to be respected as a person the instant the ova unites with the sperm and you also believe that abortion of an embryo or fetus that is implanted and functioning in union with the uterus is murder, then logic suggests that you believe that preventing implantation is abortion. I would say that abortion is strictly any regime that removes or expels anything that has merged with the uterus. Flushing out a free floating blastocyst or preventing its implantation is not abortion.

To claim that anti-abortionists who say that IUDs prevent implantation are lying about IUDs is simply wrong. But to say that this really has nothing to do with abortion is more to the point and confronts the strictly superstitious or religious point of view that a fertilized ova deserves consideration as a person.

So what do we call preventing implantation if not abortion? Good question.

Expand full comment

Health care. Family planning.

Expand full comment

Please make sure you rest! COVID is not something you can push through…doing so will cause a backslide in recovery! It can take up to two months to fully recover (even with resting!). And that means both brain and body. I’m still a long hauler after my initial (and only) illness in March 2020 and not resting my brain now is the biggest contributor to any crashes I have. Plus my neurologist thinks working full time while acutely sick and after made my brain fog worse.

While it’s lessened, there’s still a 12% chance to becoming a long hauler. Abortion info is super important but so is your health!

Expand full comment

Wishing you full healing Amy G & Jessica. Long Covid is in fact real. We will be here when you return Jessica!! Take care of yourself. Self health should be your 1st priority!

Expand full comment

On a more serious note, STAT, an excellent publication about the health care business, has a new article by Olivia Goldhill, "Protocols Intended to Be Extra Conservative Are Now Heralded as Evidence of Mifepristone's Risk," (Feb. 27, 2024), https://www.statnews.com/2024/02/27/mifepristone-abortion-pills-fda-approval-safety-protocols/. Goldhill says that while the Hippocratic Medicine plaintiffs say that the protocols the FDA originally used to approve mifepristone prove it is a hazardous drug, in fact the FDA acted with special care because they knew it was a controversial drug. The FDA used one pathway to approval to impose additional review, not less.

Expand full comment

And it had been approved in many countries, with success of the drug, prior to the US.

Expand full comment

A lot of our current problems are due to the belief that America is special and nobody else's experience applies--pretty much everyone else has universal health care and paid vacations, for example.

Expand full comment

I made that comment because many Rs in Congress and some in state legislatures have recently used other (carefully selected) countries to attempt to prop up their feelings (not based on science or even fact at times). The reason the US doesn’t have universal healthcare & require paid vacations is due to capitalism, in my opinion.

Expand full comment

One of the first articles I ever published--about 50 years ago!--was a Modest Proposal that scientists should get to work on fetus transplantation. It's more timely than ever with the question of what to do with embryos created for IVF. All we have to do is grab a Republican and implant the embryo in her or, preferably, him. I'm sure they'll enjoy the Miracle of Life. And of course we'll send them the hefty medical bill.

Expand full comment

It's too much. Please, please take care of yourself.

Expand full comment

I know this is small but just don’t go to any religious affiliation hospitals or clinics. Screw them. Take your business elsewhere (if you can). Do your research before you need care.

Expand full comment

All pregnant women should inquire which hospital their doctors have delivery rights in before choosing a doctor, if they have choices and if their insurance has options. At minimum, they should understand where those hospitals stand on all types of maternity care as well as who makes decisions about emergency maternal healthcare - docs or hospital lawyers/admin.

Expand full comment

KFF Health News has a good piece about that: Rachana Pradhan and Hannah Recht, "The Powerful Constraints on Medical Care in Catholic Hospitals Across America," (Feb. 17, 2024), https://kffhealthnews.org/news/article/catholic-hospitals-affiliates-ethi[...]. It says that for 800,000 people, the only hospital in which to give birth within a 0ne-hour drive is Catholic or Catholic-affiliated, which is also true for 16% of births.

KFF also has great research tools, including State Profiles for Women's Health, www.kff.org/state-profiles-for-womens-health, which includes abortion policies, abortion data, and maternal and infant health statistics, and the Abortion in the US dashboard, https//www.kff.org/womens-health-policy/dashboard/abortion-in-the-u-s-dashboard/ covering legal issues, key facts, medication abortion, coverage, polling, and related state health data.

Expand full comment

Please take care of your health, Jessica. We need you to be around and Covid can be quite debilitating. Rest up. And thanks for all you do.

Expand full comment

Pregnant women in Missouri cannot get divorced, same with texas, arkansas, Arizona

Expand full comment

JFC that's insane!

Expand full comment

Jessica, thanks for continuing to report about Idaho. A minor correction, we have lost three maternity wards in the state, not 2. Caldwell ID announced in the last several weeks it was closing its maternity ward. Officially they are saying fewer women are getting pregnant in that area. That’s absolutely untrue, it’s because they have lost all their obstetricians and cannot recruit more.

Expand full comment

Oklahoma is a no-go state. A legislator there called LGTBQ people "filth." Jesus would plotz.

Expand full comment

STOP. INCLUDING. VIABILITY. LANGUAGE. It’s a made up concept and pregnancy outcomes are too variable to define it. Stop throwing it in ballot measures and attempt to “appear reasonable” to people who will never get on board. Stop fucking over people who need care in their second and third trimester. JUST. STOP.

Expand full comment

Thank you!

Expand full comment

States are already limiting women’s ability to travel freely. What’s next? Legislating where doctors have to live and work? Assigning them to anywhere USA that needs doctors?

Expand full comment

The more I think about Biden the more frustrated I'm getting...... Gavin Newsom and JB Pritzker are doing more for women than our own president. Either one of these guys would be a great Democratic Presidential nominee in 2028. We need super aggressive.....big moxy. Not just reproductive healthcare, but the goddamn SCOTUS, limitations and expansion.

Biden isn't that. I get it..... Biden has domestic and foreign policy to think about.

We need a ass kickers in the white house.

Expand full comment

I disagree. There would be no abortion EMTALA case before the Supreme Court without Biden, his administration was the only one who cared about whether we doctors in Idaho could save the lives of our miscarrying patients.

Expand full comment

Yeah that's true. And he got abortion access and funding for our military members even with Tubbs 10 month stunt. I saying he should do more. I feel he can. If Trump plans to make wide sweeping changes for the worse, then why can't Biden do same thing for the better

Expand full comment

You are right. The DNC is proving to be pretty toothless. What is the catalyst that forces its hand?

Expand full comment

Their constituents are the catalyst.

Kamala is traveling around the US talking about abortion and reproductive Health Care. No doubt she is the correct person to be talking about it, it ain't Joe.

US democracy and repro health deserves more and better. They ( dems) need to grow some balls and strategy. I'm a big fan of JB and Gavin. We NEED strong smart well spoken men to also talk openly and forcefully about these topics. The optics currently from the White House make it appear that only women are talking about this topic. I'm just saying we need to speak loudly about reproductive healthcare for all..... Because men don't want unplanned pregnancies either. Men & women have the same concerns on repro Healthcare..... We need to be united in our demands.

Expand full comment

Agree and I keep thinking about the Diana Sawyer interview with the men whose wives have gone through awful pregnancy/miscarriage situations. The one that should really reverberate through the south is, “I couldn’t protect my wife.” Men need to wake up & realize this won’t just be their wives, but also their daughters.

Expand full comment

Biden has never supported abortion or women’s reproductive rights so he is unable to strongly represent. I don’t understand why the Democratic party doesn’t put more muscle behind our rights but they never have. I have stated this before our political system is made up of a majority of men, plain and simple. They don’t have an urgent need to represent or protect women’s rights.

If the Democratic party had a stronger, clearer message about women’s healthcare and rights and access and actually supported it they would win by a landslide.

Expand full comment