Abortion, Every Day (4.10.23)

In the states…

Today, The Washington Post published an absolute horror story out of Florida, where the legislature just passed a 6-week ban. Caroline Kitchener tells the story of two friends who were both denied abortion care, one of whom nearly died. (Please note that Florida’s 6-week ban hasn’t been signed into law yet; so this happened under the state’s 15-week restriction.)

The details of the story are hard to bear—but, still, I urge you to read the whole article. Not just because we need to bear witness to the suffering these laws are causing, but because Kitchener’s reporting gets at something incredibly important: how common pregnancy complications are. The two friends at the center of this piece, for example, suffered from the same condition—preterm prelabor rupture of the membranes (PPROM)—just days apart.

And as was the case last week, when two heartbreaking stories came out of Texas and Idaho, conservatives have responded with a collective shrug and an admission that this is simply how the law is meant to work. When former Florida state senator Kelli Stargel, who sponsored Florida’s 15-week abortion ban, was asked about an exception for PROM cases, she responded, “The bottom line is we value life, and we would like to protect life. We don’t want to give a gaping exception that anyone can claim.”

Related: It’s been telling to watch which Republicans are trying to hide their anti-choice extremism and who are doubling down on it publicly. In Oklahoma, for example—where the state Supreme Court recently ruled that the state’s abortion ban must allow for care to save a pregnant person’s life—Republican Senate President Greg Treat’s responded to the decision by calling it “offensive” and claiming it left “the door wide open potentially on the elective abortion side.” This was a decision to save people’s lives. And he called it offensive. Their shamelessness is only growing.

I told you last week that Idaho’s Attorney General said the state’s abortion ban didn’t just prohibit doctors from providing abortions in the state, but from referring patients for abortion care out-of-state, as well. (A shocking continuation of the attacks on free speech in the state.) In a letter to Republican Rep. Brent Crane, Raúl Labrador wrote that the law “prohibits an Idaho medical provider from either referring a woman across state lines to access abortion services or prescribing abortion pills for the woman to pick up across state lines.”

Well, just a few days after Idaho health care providers sued over the guidance, Labrador said that the letter had been “mischaracterized.” In another letter to Crane, he wrote, “It was not a guidance document, nor was it ever published by the Office of the Attorney General…Accordingly, I hereby withdraw it.” In response, Idaho Rep. Lauren Necochea tweeted that she was relieved, but remained “deeply concerned that Idaho's new AG is this reckless and extreme.” (There’s been concern over Labrador’s broad interpretation of the state’s ban.)

Speaking of reckless and extreme! In Iowa, Attorney General Brenna Bird decided that the state should no longer pay for rape victims’ emergency contraception. Really and truly. Bird’s Press Secretary, Alyssa Brouillet, says that the AG is “carefully evaluating whether this is an appropriate use of public funds.” Ruth Richardson, CEO of Planned Parenthood North Central States, called the decision “deplorable and reprehensible,” because it is. Flagging this not just for the horror of it, but as a reminder that this is how they ban birth control: Not all at once, but with a slow chipping away process that makes contraception less and less available.

I’ve been writing quite a lot about Republican lawmakers’ effort to redefine abortion. Abortion is a medical intervention to end a pregnancy, but Republicans want to define it as an intention, instead. Today, for example, The Topeka Capital-Journal gets into how Republicans have employed this strategy in Kansas, pushing legislation that says certain abortions—like treatment for ectopic pregnancies and miscarriages—aren’t abortions at all. It’s a pretty transparent move: Conservative lawmakers are desperate to reclaim a political narrative that is definitely not going their way, and appoint themselves the arbiters of abortion against all medical and scientific reality.

Colorado abortion providers are expecting to see even more of an increase in patients if the ruling against abortion medication stands. Like so may other pro-choice states, Colorado has already seen a huge influx in out-of-state abortion patients post-Roe. But Aurea Bolaños Perea, of the Colorado Organization for Latina Opportunity and Reproductive Rights (COLOR), says they are “prepared to meet the moment”:

“We feel confident that we will be able to distribute medication to whoever needs it. We learned from a very difficult place last year about what happens when we remove a federal protection.”

Other pro-choice states are proposing legislation to help with the continuing strain on abortion providers. Jessica González-Rojas, former executive director of the National Latina Institute for Reproductive Justice and current New York Assemblymember, for example, is pushing for the state to pass the Reproductive Freedom and Equity Act (RFEA):

“The RFEA would create a recurring grant program managed by the Department of Health that would provide capacity building to abortion providers for things like staffing and training; fund uncompensated care; and ensure nonprofits…can continue to address the practical needs of patients.”

In Texas, the Houston Chronicle has a profile of two doctors are fighting back against the state’s abortion ban, OBGYNs Damla Karsan and Judy Levison. Karsan says, “It’s making women second-class citizens. It boggles my mind that we’re at this point in 2023.” 

And in Ohio, where we’ve been paying close attention to the pro-choice amendment likely be in front of voters this November, Republicans are wavering on their support of an August special election to change ballot measure rules. Perhaps a response to how very unpopular the idea is?

Quick hits:

• The Iowa Supreme Court is set to hear arguments over whether the state can enforce a 6-week abortion ban;

• Washington First Assistant Attorney General, Kristin Beneski, spoke to MSNBC about their pro-choice lawsuit win and what that means for abortion medication protection in the states who signed on;

• Stateline on how Idaho’s ‘abortion trafficking’ bill could inspire other states to pass similar legislation;

• California is having a hard time cutting ties with Walgreens as promised because of the company’s relationship with the state Medicaid program;

• And Minnesota Democrat Sen. Amy Klobuchar spoke to NPR about the Texas ruling on abortion medication.

In the nation…

I’m trying not to be too pissed and disappointed, but here we are. The Biden administration had months to prepare for Judge Matthew Kacsmaryk’s ruling on abortion medication—with activists calling on them again and again to lay out a plan of action.

Yet after Friday’s ruling, President Joe Biden released a bland statement, saying that he and Vice President Kamala Harris “will continue to lead the fight to protect a woman’s right to an abortion, and to make her own decisions about her own health.” Continuing with, “that is our commitment,” without making much of a fucking commitment at all. Where is the rousing speech? Where is the fury?

And while the Justice Department has appealed Kacsmaryk’s ruling (as expected), the administration is ignoring the advice of experts, who have called on the FDA to use enforcement discretion to keep mifepristone available. In a series of tweets, Kamara Jones, a spokeswoman for the Department of Health and Human Services, said that it would “set a dangerous precedent for the Administration to disregard a binding decision.”

Do you know what sets a dangerous precedent? Allowing an activist judge to undo over twenty years of science, medicine and progress in a sham ruling. A dangerous precedent is watching as conservatives undermine democracy and the judicial system and deciding to play it safe.

As the former deputy commissioner of the FDA, Joshua M. Sharfstein, put it in The New York Times today, “Trust in the agency’s work rests on the idea that decisions that affect a nation are based on facts, not ideology or influence.”

Both Rep. Alexandria Ocasio-Cortez (New York) and Sen. Ron Wyden (Oregon) have called on Biden to ignore the ruling—but as law professor David Cohen points out, what legal experts and pro-choice advocates are calling for is not actually ‘ignoring’ or defying the ruling, but allowing the FDA to exercise appropriate and lawful authority:

“If the FDA uses its enforcement discretion, what it is doing is recognizing that approval is stayed, not ignoring it. In the face of a drug with stayed approval, the FDA is saying we are assessing what drugs are unsafe and risky, and going after those, not mifepristone.”

And by the way, it’s not just Democrats calling on Biden to allow for enforcement discretion: Republican Rep. Nancy Mace from South Carolina is urging the same! Is the White House really going to let a South Carolina Republican be more progressive than they are?

After all, there’s a reason that Republicans are largely staying quiet on the decision out of Texas. They’re terrified! They know that the ruling is deeply unpopular, as are abortion bans. Even the Wall Street Journal editorial board called abortion “a political gift to Democrats,” while Fox News questioned Senator Lindsey Graham about the wisdom of going after abortion when it seems to be so popular.

Why in the world hasn’t the White House understood the same message?

Meanwhile, executives at over 250 pharmaceutical and biotech companies—including the chief executives of Pfizer and Biogen—signed onto a letter today supporting the FDA and condemning Kacsmaryk’s ruling, which they called on to be reversed:

“If courts can overturn drug approvals without regard for science or evidence, or for the complexity required to fully vet the safety and efficacy of new drugs, any medicine is at risk for the same outcome as mifepristone.”

In related news, Dr. Linda Prine—founder of the Miscarriage and Abortion Hotline—spoke to Amy Goodman at Democracy Now about the fight to keep abortion medication available, and how the hotline’s work has changed along with the attacks on abortion rights.

And something to keep an eye on: One of the makers of mifepristone, Danco Laboratories, says that they might add miscarriage as a use on the label—something Democrats have been pushing for a while now. I’ll keep you updated as I find out more.

Quick hits:

• NPR has an explainer on a misoprostol-only protocol for ending a pregnancy;

• The New York Times on how Kacsmaryk’s ruling undermines the FDA’s authority more broadly;

• Both Axios and The Washington Post get into how the language of Kacsmaryk’s ruling mirrored anti-abortion language;

• And the Associated Press has a short explainer on how the Comstock Act relates to all of this.

Keep an eye on…

Republicans are shitting their pants after Wisconsin, and they’re really struggling to come up with a message on abortion. This weekend, I told you about how some lawmakers think the answer is pushing 12- to 15-week bans and calling them a ‘compromise’, while others are doubling down on their laws working as intended.

But now we have a new talking point making the rounds. When North Carolina’s Tricia Cotham switched parties, giving Republicans the votes they needed to override a veto on their abortion ban, I told you that the language she was using sounded very familiar. She said that women were “much more” than abortion and that abortion wasn’t the only or most important issue that women face—messaging that conservative women’s groups have been using for the past few years.

This weekend, that talking point popped up again when Texas Republican Rep. Tony Gonzales was asked about the ruling on CNN. Gonzales said that if we cared about women’s health we should “get off the abortion conversation.” He continued, “Women have a whole lot other more other issues other than abortion. Let’s talk about the other things that are happening in this world.” Gonzales then went on to show a photograph of two women who died in a car crash involving migrants—a planned-out moment that did not have the impact I believe he thought it would.

So definitely keep an eye open for more of this message from conservatives: the idea that women shouldn’t be reduced to one issue. It’s a bizarre tactic—saying abortion isn’t all that important as story after story of women ending up septic or carrying dead fetuses come out in the media. But I’m more than happy to see them give it a shot!

Mainstream media catches on…

Feminists have been yelling about how popular abortion rights are for years—decades, even. And for all of those years, we were told to quiet down and let Democrats take a ‘big tent’ approach on the issue. Again and again, we were warned not to alienate centrists; the assumption being that abortion was a fringe, controversial issue. Political pundits painted abortion as something ancillary to the bigger, more important, real, issues.

Now all of these same pundits are very, very interested in reproductive rights. Joe Scarborough on MSNBC’s Morning Joe, for example, weighed in on the abortion medication ruling, saying that abortion restrictions were going to cost Republicans elections, and that the mifepristone decision “is going to expedite the collapse.” And on Meet the Press this weekend, Chuck Todd predicted that the presidential election is going to be strongly influenced by abortion rights. Ya think??

Glad to see mainstream pundits talking about abortion, obviously, but it would have been nice to have them on board before Roe was overturned.