Abortion, Every Day (7.14.23)

Republicans want the medical records of women who get out-of-state abortions

In the States

Iowa Gov. Kim Reynolds signed a near-total abortion ban into law today, which went into effect immediately. The judge hearing the legal challenge to the ban says he needs until next week to decide whether to issue a temporary injunction blocking the law while the case makes its way through the courts. Here’s hoping that block comes down first thing Monday morning.

Without that injunction, the law not only bans nearly all abortions in the state, but leaves doctors with absolutely zero information about what the related criminal, civil, or licensing liabilities will be. The Des Moines Register points out that Republicans have left all questions about penalties to the Iowa Board of Medicine—which won’t determine those rules for some months. That means in the meantime, doctors have no information on what exactly they’re risking when, for example, they have to make a judgement call on whether a pregnancy is putting someone’s life at risk.

And as is always the case, the ‘exceptions’ for Iowa’s abortion law are deliberately vague. So much so that they’re virtually unusable—both for patients and doctors. The ban dictates, for example, that rape and incest victims must report their attack within a certain time period in order to qualify for an abortion—but gives no indication for how a physician is meant to confirm that the requirement was met.

There’s also no specifications around what constitutes ‘severe bodily harm’ for patients whose pregnancies might be putting their lives at risk, or details about what constitutes a fatal fetal abnormality. With no guidance on these so-called exceptions, and no idea about what legal and professional risks they’re taking, doctors will be left completely in the dark.

“It will be utter chaos,” says Democratic House Minority Leader Jennifer Konfrst.

“Doctors won’t know what to do. Patients won’t know what to do. There will be questions. And most importantly, there will be inconsistent care across the state because different doctors will interpret it differently—different patients will receive different kinds of care.”

You know this, but I’m going to say it anyway: All of this is the point. They want to sow confusion and chaos—and to make what the law means so unclear that no one would dare risk to provide or obtain an abortion.

With the abortion ban in effect, the OBGYN program at the University of Iowa is also struggling with how to legally operate: They could lose their accreditation if they don’t offer a way for residents to be trained in abortion care. When lawmakers were debating the bill, two medical students testified about exactly this scenario; Maren Betterman said, “This bill would force me to leave the state.”

Two more Iowa pieces worth reading: At the Des Moines Register, a maternal-fetal medicine physician explains how the law will put women’s lives at risk; and the community blog Bleeding Heartland gives recommendations on how you can help people in Iowa, with ideas that could work for folks both in and outside of the state.

One of the things we write about most often here at Abortion, Every Day are the unrelenting attacks on democracy—particularly when it comes to ballot measures. Republicans are pulling out every stop they can to keep the issue of abortion away from voters, who they know overwhelmingly support legal access. The latest example comes to us from Florida, where the Florida Phoenix reports that the anti-abortion organization Florida Voice for the Unborn has launched a “Decline to Sign” website seeking to stymie the work of pro-choice petitioners.

How? By asking people to “report the precise locations” of abortion rights petitioners so that anti-abortion activists can rush to their location to “counteract the pro-aborts by circulating petitions for the Human Life Protection Amendment, passing out flyers/postcards against the pro-abortion initiative, and displaying pro-life signs (including abortion victim imagery).”

To be clear: They want to harass petitioners, and scare voters out of getting anywhere near them. Laura Goodhue, executive director of the Florida Alliance of Planned Parenthood Affiliates, says the move is “anti-democratic.” I’d agree, and add a few other choice words.

Meanwhile, the undermining of democracy continues on in Ohio, where Republican efforts to raise the standards on ballot measures will come to a head next month during a special August election on Issue 1. The Ohio Capital Journal reports that Secretary of State Frank LaRose is pulling some wildly unethical shit: Last month, when some voters sent in old absentee ballot forms in opposition to Issue 1, their votes were rejected. But when supporters of Issue 1 did the same thing, LaRose announced that they would be counted.

Voting rights advocate Jodi Jackson says, “The whole thing just kind of smacks of just a sneaky, manipulative, last-ditch effort to get ahead.”

Speaking of sneaky, last-ditch efforts: The anti-abortion group that’s been campaigning against Ohio’s pro-choice ballot measure—spending millions in television ads that falsely claim it would allow minors to get gender-affirming surgery—has released yet another absurd ad. I couldn’t bring myself to embed it in the newsletter, but you can watch it here. It’s as ridiculous as you can imagine.

Related: If you want to hear more about the ballot measure effort in Ohio, Pod Save America spoke to Kellie Copeland of Pro-Choice Ohio:

Meanwhile, abortion rights advocates in Illinois are planning to protest in front of a Chicago anti-abortion center to raise awareness about the fake clinics. The demonstration, organized by multiple local reproductive rights groups, will feature speakers sharing the kinds of negative experiences they’ve had with similar centers. The activists are also hoping that the protest will push Illinois Gov. JB Pritzker to sign a bill that would allow the state attorney general to fine centers that lie to women. From Lisa Battisfore, founder of Reproductive Transparency Now:

“We want to show that people haven’t forgotten about this bill and encourage the governor to push forward with building up more of these consumer protections. And we want to let people know these centers exist and help them to learn more about them because most people don’t know the true nature of their mission.” 

I’ve been seeing a few news items about protests like these in front of anti-abortion centers, and I’ve gotta say—I’m here for it.

Quick hits:

• How North Carolina abortion patients and providers are struggling to adjust to the state’s new ban;

• The Seattle Times on how Idaho’s abortion ‘trafficking’ law impacts Native Americans, in particular;

• Virginia abortion providers speak about the increase in patients they’re seeing from surrounding states;

• And Oregon Gov. Tina Kotek has signed a law protecting the rights of those over 15 years-old to access abortion, with minors under 15 able to get care without parental permission in limited circumstances.

In the Nation

The House has (very narrowly) passed the Defense budget despite amendments that would reverse the Pentagon’s polices on abortion, gender-affirming care and more. The Washington Post called it “the most conservative National Defense Authorization Act in decade.”

The abortion policy—which covers travel costs for service members who need to leave their state for care—has been the center of a protest by Sen. Tommy Tuberville, who has been holding up military promotions over the rule for months.

Democrats were furious: Rep. Adam Smith, a ranking member of the House Armed Services Committee, for example, said that the amendments would make it more difficult to recruit service members. Rep. Ayanna Pressley said, “You should not have to forfeit your right to medical care when you enlist to serve your nation.” And Democratic Rep. Mikie Sherrill of New Jersey, a veteran on the Armed Services Committee, pointed out the policy’s reversal “would enact a dangerous health care travel ban.”

“Service members signed up to put their lives on the line for our freedoms, our national values, our constitutional rights. They did not sign up to put their lives on the line or their spouses’ lives on the line because they cannot get access to basic care.” 

This is important: Republican lawmakers and anti-choice activists claim over and over again that they don’t want to prosecute women for having abortions. (A lie they repeat even as lawmakers introduce bills to classify abortion as a homicide or try to find legal workarounds in order to charge women.) Conservatives also continually insist that they’re uninterested in regulating interstate travel—if women want to get abortions in other states, they say, there’s nothing they can do about that.

So why, then, are 19 state attorneys general pressuring the Department of Health & Human Services to allow them access to the medical records of those who get abortions out-of-state? That’s right, they want the ability to investigate those who leave their states for abortion.

You may remember that back in April, the Biden administration strengthened abortion-related privacy protections in HIPAA by prohibiting healthcare providers and insurance companies from disclosing any health information that could be used “to identify, investigate, prosecute, or sue patients, providers and others involved in the provision of legal reproductive health care, including abortion.”

Seems pretty straightforward: If you’re not interested in arresting women for abortion, or stopping them from traveling out of state for care, why do you need to know anything about the abortions they get in pro-choice states?

But in a June letter to HHS Secretary Xavier Becerra, the Republican AGs, led by Mississippi AG Lynn Fitch, demand the reversal of the rule, arguing that it “would unlawfully interfere with States’ authority to enforce their laws.”

In a particularly ridiculous line, the AGs also write that the Biden administration “has pushed a false narrative that States are seeking to treat pregnant women as criminals or punish medical personnel who provide life saving care.” I can’t possible imagine why anyone would think that! It’s not as if you’re writing a 17-page letter arguing that law enforcement should be able to investigate who is getting abortions out-of-state. It doesn’t exactly give the impression that Republicans are not interested in prosecuting women.

In addition to federal HIPAA protections, pro-choice states are using shield laws to block potential criminalization and lawsuits from other, anti-choice, states. But all of these protections are preemptive: we don’t know what out-of-state prosecutions will look like and how they might go down.

Kelly Baden, vice president of the Guttmacher Institute, told CNN, “Shield laws are the current kind of attempt to imagine where this continuing unfolding kind of chaotic legal landscape is going to end up, but the truth is, we just don’t know yet how they’re going to work in practice.”

Finally, The Guardian has a piece on a topic you know I’m obsessed with: the anti-abortion movement’s war on language. Reporter Ava Sasani looks at the way that activist and lawmakers are using confusing and misleading language to convince Americans that their bans aren’t really all that bad—in part, by refusing to call them ‘bans’ at all. Sasani also gets into the absolute uselessness of ‘exceptions’ and offers this vital reminder: anti-abortion activists know that these so-called allowances don’t worry and put people’s lives at risk. Rachel O’Leary Carmona, the executive director of Women’s March, says, “they don’t care about real people.”

“They know what they’re doing when they use this kind of language. This misinformation, making suggestions about what is and isn’t a ban, that’s a real threat that should be taken very seriously.”

Quick hits:

• Axios on how the newly-approved over-the-counter birth control pill will be a post-Roe game changer;

• Sen. Tammy Duckworth says that she’s hearing from both Republican women and men who are changing their votes over abortion rights;

• Ms. magazine on mifepristone as a fibroids treatment;

• And The New York Times on how President Biden criticizes Supreme Court decisions, but falls short of calling out the Court itself.

2024

Republican presidential candidates, minus Trump, will be making their case in front of a conservative Christian audience this weekend at the Family Leadership Summit in Iowa. That’s where Iowa Gov. Kim Reynolds signed the state’s new abortion ban into effect—leading to some speculation that she’s vying for a VP spot.

The Wall Street Journal reports that the powerful conservative behind the summit, Bob Vander Plaat, is thinking about endorsing someone other than Trump—which may be why the former president is skipping the conference. (God knows his ego can’t take that shit.)

We know that former Vice President Mike Pence is the anti-abortion movement’s favorite candidate—a position I’m sure he solidified this week when he said he believes women should be forced to carry doomed pregnancies to term. Pence said he’s heard multiple stories of women told that their fetuses wouldn’t survive, just to deliver healthy babies. I would love for him to look this young woman in the face and tell her that.

But The Chicago Tribune points out something interesting (and horrific): The other Republican presidential candidates refuse to say whether they agree with Pence. When asked by reporters, spokespeople for Trump and Florida Gov. Ron DeSantis declined to answer; Sen. Tim Scott’s campaign “pointed to an article that did not address the question of unviable pregnancies”; and Nikki Haley’s campaign gave a non-answer.

Care Denied

The horror stories coming out of anti-choice states feel like they’re ramping up: I think the more women are coming forward, the more empowered others feel to share their stories, as well. Today, it’s a woman from Kentucky who was denied abortion care despite her fetus being diagnosed with anencephaly—a condition that prevents the skull and brain from developing.

Alexis Smith had already picked out a name for her son by the time she was diagnosed at 19 weeks into her pregnancy:

“I was really mad at first, I was like, 'Why me?' I wish I would've had the option to do it here and with the doctors I trusted.”

Instead, Smith and her fiance were forced to travel all the way to Maryland for care, paying $7500 out-of-pocket for the procedure. As a result, Smith, who is a nursing student, had to withdraw from school just a few months because of her graduation.

“I had no choice,” she says. No choice at all.

Anti-Choice Strategy: Valorizing Maternal Illness & Death

I’m sorry for the stark title, but that’s what’s happening. It’s something I’ve written about before—and it’s certainly something they’ve done for a long time—but the further along we get into our post-Roe nightmare, the more we’re going to see conservatives making martyrs out of women who get sick and die during pregnancy. From a column I wrote in March 2022:

“It’s not just that Republican legislators see women dying as an unfortunate but acceptable consequence of making abortion illegal. In the conservative imagination, the most noble thing a pregnant woman can do is die so that a fetus can live. 

There’s a reason anti-choice groups valorize women who refuse life-saving treatment so that their pregnancies can come to term. And why our culture does the same thing more broadly, highlighting stories of pregnant women who decline cancer care or forgo other treatment that could save their life. Those who put the health of their pregnancy above their own lives are martyred, depicted as the ultimate mothers and perfect women.

To the politicians pushing anti-choice laws, women dying isn’t collateral damage—it’s just our job.”

This week, for example, the anti-abortion publication Pregnancy Help News published the story of a pregnant young mother of two, diagnosed with brain cancer, who declined chemotherapy and radiation in order to remain pregnant. I’m glad this woman had the choice to decide what was right for her and her family, but the anti-abortion movement props up stories like for just one reason: They hope that if they make getting sick or dying during pregnancy into a positive, that Americans won’t react quite so horribly as the maternal death rate shoots up.

It’s a way to prepare us for the inevitable.

Quote of the Day

“I felt God’s presence with me as I made the decision to end two pregnancies, and I felt no guilt, no shame, no sin. A forced pregnancy or birth is not holy.”

~Reverend Rebecca Todd Peters, The Washington Post

You Love to See It

Since Roe was overturned, abortion medication has been a vital piece of ensuring that people in anti-choice states have access to care. Tele-health companies and organizations like Aid Access have been saving graces for people who live on an areas where procedural abortions aren’t possible. So I was thrilled to see this news from Abortion, Every Day community member Linda Prine—who you also may know as the founder of the Miscarriage and Abortion Hotline:

“The clinicians at Aid Access are now mailing FDA approved abortion pills directly to patients in the restricted states for $150 and a sliding fee scale. We shipped hundreds a day over the past few weeks, thanks to our shield laws in NY, CO, VT, MA and WA! Pills arrive in 2-5 days!”

Really and truly love to see it.