Pro-Choice States Are Getting Creative

6.6.25

Click to skip ahead: Care Crisis has the story of a Texas woman denied care for her ectopic pregnancy. Attacks on Emergency Abortions reveals how the Trump administration’s batshit guidance could impact pro-choice states. In Protecting Abortion Pills, four Democratic AGs are asking the FDA to lift restrictions on abortion medication. In the States, news from West Virginia, Louisiana, New Hampshire, Illinois, and Pennsylvania. Legislation Watch flags a vital bill in California that protects providers and patients. And In the Nation, Trump’s federal judges and ‘Jane Crow’ laws.

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Care Crisis

If you haven’t read this Associated Press story about a Texas woman repeatedly refused treatment for her ectopic pregnancy, please take a minute.

Kyleigh Thurman had all the signs of an ectopic pregnancy. But instead of being treated, the 36-year-old was sent home with a pamphlet on miscarriage. By the time doctors finally intervened, she needed emergency surgery and lost part of her reproductive system.

A small consolation: A federal investigation found that Ascension Seton Williamson hospital had violated EMTALA—the emergency care law that’s now at the center of a political firestorm.

Thurman hoped the investigation would be a wake-up call for Texas hospitals. “I didn’t want anyone else to have to go through this,” she said.

But as the AP points out, now that the Trump administration has rescinded a policy requiring hospitals to provide emergency abortions under EMTALA, it’s not clear whether investigations like this one will happen again. Or if hospitals will face any consequences at all for turning women away.

And if the name Ascension sounds familiar, it should—I’ve reported on this Catholic hospital system before. A 2024 report from National Nurses United (NNU) found that Ascension is fueling the U.S. maternal mortality crisis. It’s even where Yeniifer Alvarez-Estrada Glick died—the first documented post-Dobbs death. Read more about Ascension below:

The Catholic Hospital System Killing Women

Attacks on Emergency Abortions

Earlier this week, I warned that when the Trump administration rescinded federal guidance requiring hospitals to provide emergency abortions, it wasn’t just about giving red states the okay to deny women care. This was about something bigger: a quiet nod toward fetal personhood that could impact emergency abortions in every state.

I flagged a telling line in the new policy—one that suggests the White House believes hospitals are legally obligated to treat the pregnant patient and the fetus equally:

“CMS will continue to enforce EMTALA, which protects all individuals who present to a hospital emergency department seeking examination or treatment, including for identified emergency medical conditions that place the health of a pregnant woman or her unborn child in serious jeopardy.” (Emphasis mine)

Today, law professor and author Mary Ziegler confirmed my fear—highlighting that same line in a new piece at MSNBC. “Understood in this way,” she writes, “EMTALA under the Trump administration could further restrict how doctors address emergencies, regardless of states’ abortion laws.”

Here’s more from her column:

“Much of the debate about EMTALA so far has focused on states where abortion is banned. But if the Trump administration does enforce EMTALA to protect fetal patients, will it impose penalties on hospitals in states that protect abortion as a right?

[The administration’s] interpretation is consistent with their broader ambition: to confer constitutional rights of fetuses from the moment of fertilization.”

And that’s the thing: the White House has been trying to codify fetal personhood from the start—remember this anti-trans executive order that defined life as beginning at conception?

I’ll have more on this push soon—and we’ll talk about it with Ziegler directly when she joins Abortion, Every Day for a livestream on June 19th.

In the meantime, if you’re looking for a solid explainer of what’s happening with EMTALA—or something to share with folks who need a clear breakdown—you can always count on PBS NewsHour:

Protecting Abortion Pills

In a moment when it feels like we’re constantly on defense, it’s nice to report some proactive moves: The attorneys general of New York, California, New Jersey, and Massachusetts are petitioning the FDA to lift unnecessary restrictions on mifepristone—arguing that the current rules aren’t justified “by science or law,” especially in states where abortion is legal and protected.

As New York AG Letitia James put it: “Given mifepristone’s 25-year safety record, there is simply no scientific or medical reason to subject it to such extraordinary restrictions.”

The four AGs are urging the FDA to scrap what's known as REMS (Risk Evaluation and Mitigation Strategy)—extra hoops that require special certification for pharmacies and prescribers, and force patients to sign a form saying they’ve chosen to end a pregnancy, even when they’re using the drug to manage a miscarriage.

California AG Rob Bonta’s office points out that those added restrictions have kept most primary care and family medicine providers from offering mifepristone. And in some cases, they even block emergency rooms from prescribing it for miscarriage care.

This petition from pro-choice states comes at the same time that Republicans are trying to restrict mifepristone—using a junk science ‘study’ from an anti-abortion organization as justification.

On that note: shout out to the Los Angeles Times for modeling how to tell the truth without falling into dangerous ‘both-sides’ bullshit. Check out how reporter Kevin Rector described conservatives’ new so-called research into mifepristone:

“At the Senate hearing, Kennedy cited ‘new data’ from a flawed report pushed by antiabortion groups—and not published in any peer-reviewed journal—to question the safety of mifepristone, calling the report ‘alarming.’”

See, that’s all it takes!

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In the States

Last week, I reported on a West Virginia prosecutor who says the state is ready and willing to charge miscarriage patients. Raleigh County Prosecuting Attorney Tom Truman warned that if women don’t want to be arrested for ‘improperly’ disposing of their miscarriages, they should “call 911” and alert law enforcement about their pregnancy loss. (Reminder: There are no laws in West Virginia or anywhere else about how to dispose of a miscarriage.)

Since then, that story has gone viral—with coverage everywhere from Newsweek and HuffPost to The Guardian and CNN. Now Truman says he was simply trying to warn women to “be careful.”

“It’s a different world now, and there’s a lot of discretion that prosecutors have, and some of them have agendas where they would like to make you an example,” Truman told CNN.

But legal repro experts say it’s pretty much never a good idea to call the cops when it comes to your pregnancy. Law professor Kim Mutcherson says, “It’s always a mistake to invite law enforcement into your reproductive life.”

For more on pregnancy criminalization—and its link to fetal personhood—make sure to watch my livestream conversation with Karen Thompson, legal director of Pregnancy Justice.

Let’s check in with Louisiana, where Republicans made abortion medication a ‘controlled substance’ a little over a year ago. Abortion is already illegal in the state, so the widely-criticized law has mostly impacted people’s ability to obtain the medications for other healthcare reasons.

For example, misoprostol—one of the two drugs you take to end a pregnancy—is also used to treat postpartum hemorrhage. But because of its classification as a controlled substance, the pills are locked up and require a special process to be checked out. Which is not exactly the safest move when it comes to a medication needed to stop someone from bleeding to death!

Lorena O'Neil at the Louisiana Illuminator—one of the best abortion reporters around—writes that the New Orleans Health Department has been keeping track of complaints from patients and providers since the law went into effect. As you can imagine, there are a lot of them.

One doctor tried to order the medication to help soften a patient’s cervix before a biopsy, but the pharmacists refused to fill it—believing it would be used to end a pregnancy. “This could lead to a delay in diagnosis of cancer,” the doctor wrote.

Another patient was refused misoprostol for an IUD insertion, and multiple people reported being refused the drug for miscarriages. Here’s what one woman wrote:

“I was denied misoprostol, essentially leaving me with my dead baby inside of me even longer because the pharmacist said he couldn’t give it to me. It was more horrific than it needed to be.”

Louisiana reproductive health and rights groups are challenging the law.

Meanwhile, we have some good news with our bad news in New Hampshire: The state House passed a shitty ‘parental rights’ bill yesterday, but at least legislators stripped out language that would have prevented teens from accessing contraception.

The original bill would have required parental consent for prescriptions and healthcare, but hundreds of New Hampshire healthcare providers signed a petition opposing the language. OBGYN Dr. Amy E. Paris said, “The best-case scenario is that young people discuss their contraceptive and sexual health decisions openly with their families; but the reality is that not all young people are in situations where it’s easy or they’re able or safe to do those things.”

That said, the version passed by the House still requires school administrators or teachers to give parents “accurate, truthful, and complete disclosure regarding any and all matters related to their minor child”—and would allow parents to sue otherwise.

Conservatives are increasingly using ‘parental rights’ as a guise to implement anti-LGBTQ and anti-sexual health policies in schools. (They’ve even used ‘parental rights’ to fight against pro-choice ballot measures.)

In better news…

The Illinois bill I told you about last month—the one that would allow the state to continue providing abortion medication even if the FDA restricts it—is heading to Gov. JB Pritzker's desk.

Essentially, HB3637 would allow patients to keep accessing abortion medication so long as it’s approved by the World Health Organization. It’s a way to circumvent any future Republican-led restrictions on the pills. (Which, let’s be honest, are likely.)

Republicans are furious, of course, accusing Democrats of removing safeguards meant to protect patients. But safety has nothing to do with it—they’re just pissed people might still be able to get an abortion. 🎻🎻

Also in Illinois, state officials have reaffirmed the right to emergency abortions—a proactive protection made in response to the Trump administration’s recent EMTALA move.

Meanwhile, a Pennsylvania bill that would require health insurance to cover all FDA-approved birth control methods has passed the state House! House Bill 1140 requires coverage for all contraception—including emergency contraception and over-the-counter options—without any costs like copays or deductibles.

In a statement, the Pennsylvania Women’s Health Caucus called the bill necessary in “uncertain times for reproductive healthcare.”

“As the federal government threatens attack after attack on Pennsylvanians’ access to reproductive healthcare, we must act to protect the millions of people across our Commonwealth who depend on their insurance coverage for access to safe, affordable, and effective contraception.”

Legislation Watch

All eyes on California, where a critically important bill is moving through the legislature—one that needs to be replicated in every pro-choice state.

As you probably know, several states—like New York and Maine—have passed laws allowing providers to keep their names off of prescription labels for abortion pills. The goal is to add an extra layer of protection for abortion providers in pro-choice states, who are being targeted with out-of-state criminal and civil charges. (Just look at Dr. Maggie Carpenter, who is facing a civil suit from Texas and criminal charges in Louisiana—where prosecutors want her extradited.)

Now California is stepping up with AB 260, which goes even further: it would allow both providers and patients to keep their names off abortion pill prescriptions. That added protection for patients is new—and it couldn’t come at a more urgent moment.

This year alone, a dozen states have introduced “equal protection” bills that would prosecute abortion patients as murderers. And Republicans are coming up with increasingly creative ways to punish people who need care: In Texas, it was a Trojan Horse bill to revive a 100-year-old ban. In Montana, they tried to charge women who traveled out of state for care with ‘trafficking’ their own fetuses.

All of which is to say: We need bills like this one in California everywhere—and we need them now.

AB 260 has passed the state Assembly, and is now up for debate in the Senate. So if you live in California, please contact your representatives and make some noise! And if you’re in another pro-choice state, push your lawmakers to pass similar protections for both providers and patients.

In the Nation

Trump’s nominees for lifetime federal judgeships started to appear in front of the Senate Judiciary Committee this week, where three refused to back off their anti-abortion records. Reproductive Freedom for All has some background on Joshua Divine, Maria Lanahan, and Whitney Hermandorfer—all of whom made pretty clear that they’d side with anti-abortion maniacs if given the chance.

Remember: Divine and Lanahan co-authored a major challenge against mifepristone last year, arguing that the abortion medication “starves the baby to death” and that women who take the drug would be “triggered” by their bathrooms.

Meanwhile, Michelle Goodwin at The Nation says that we’re entering a new “Jane Crow” era: “When the state in which a woman resides, becomes pregnant, and dies now determines whether she will be accorded basic civil and human rights.”

Goodwin, law professor and author of Policing the Womb: Invisible Women and the Criminalization of Motherhood, points specifically to Adriana Smith in Georgia, whose body is being kept alive against her family’s wishes because she was 9-weeks pregnant when declared brain dead.

“Black women being reduced to the status of ‘property’ and subjected to involuntary, forced labor and servitude that is sanctioned by unjust laws is nothing new.”

Her whole column is a must-read.

Quick hits:

• NBC News asks where women will go if Planned Parenthood shuts down;

• Mother Jones has a Q&A with Dr. Shelley Sella, abortion provider and author of Beyond Limits: Stories of Third-Trimester Abortion Care;

• And in international news, the United Nations Human Rights Committee said this week that Guatemala violated the rights of a 14-year-old girl who was forced to continue her pregnancy after being raped.

“The Trump administration does not care about what is medically necessary to save someone’s life. They don’t care about whether the children supposedly saved by rescinding this policy will grow up without their mother. They care about their perceived moral superiority. They care about controlling women.”

- Sara Pequeño, USA Today