Will Texas Report on Maternal Death?

3.12.25

Click to skip ahead: Attacks on Privacy has proof that Heartbeat International knew their centers were lying to women about HIPAA. Attacks on Data reports on a new Guttmacher recommendation to do away with mandatory abortion reporting. In the States, news from Texas, Missouri, Oklahoma, Kansas, Hawaii, New Jersey, and Montana. All Eyes on ‘Coercion’ looks at the rise of the anti-abortion term and where we might see it next. In the Nation, the latest on the attacks on abortion medication.

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Attacks on Privacy

Well this is wild: Heartbeat International, the country’s largest network of crisis pregnancy centers (CPCs), has all but admitted that their centers have been lying to women about HIPAA protections. Now we just have to see if Republican attorneys general will do anything about it.

First, some context: You probably already know that CPCs are incredibly deceptive. They lie to the women who walk through their doors about abortion, birth control, and even the women’s own pregnancies. They also tell clients any medical data shared with them is protected under HIPAA, even though these religious centers aren’t subject to the federal privacy law.

Abortion, Every Day has flagged this before: Last year, the newsletter found that Heartbeat centers were sharing women’s private medical information with non-medical staff and volunteers—and in some cases even making it available to anyone with an internet connection. At the same time, Heartbeat’s centers were falsely assuring women their information was safe under HIPAA.

Now there’s even more evidence of that calculated—and likely illegal—deception. The watchdog nonprofit Campaign for Accountability (CfA) found a Heartbeat webpage directing CPCs on what to say about HIPAA—confirming that the anti-abortion powerhouse knew their centers have been lying to women. Here’s a snapshot of the page:

But this isn’t just about rogue CPCs lying—these centers have been instructed from the top down. In AED’s 2024 investigation, I reported on a Heartbeat training video that walked affiliates through setting up their website. Part of that training included a privacy disclaimer with default language falsely suggesting HIPAA compliance: “I understand (Center) will hold in strict confidence all the information I provide except as required by law and HIPPA [sic] privacy standards…”

In other words, Heartbeat has actively encouraged its affiliates to use misleading language, giving women the false impression that the centers must legally protect their medical privacy.

CfA Executive Director Michelle Kuppersmith made it clear why Heartbeat is suddenly changing course: “Apparently only now, after CfA has pointed out the potential legal ramifications of these lies, is the organization actively recommending CPCs tell the truth.”

Attacks on Data

Let’s stay on privacy and data for a moment. One of the things AED has been banging the drum on is how the anti-abortion movement weaponizes abortion reporting—to shame patients, intimidate providers, and fabricate data that falsely paints abortion as dangerous.

That’s why I’m so glad to see the Guttmacher Institute calling for an end to state abortion reporting. Their latest policy recommendation makes clear that this data isn’t just being collected—it’s being used “to stigmatize, harass, or even prosecute abortion patients and providers—including in situations where abortion care is provided and obtained legally.”

Naturally, Republicans insist they’re only gathering this information to ensure abortion is “safe.” But as Kelly Baden, Guttmacher’s vice president for public policy, told the Associated Press, “It would be a mistake for anyone to assume now that the information a state could collect about abortion would not be used to harm people.”

Consider Indiana, where Attorney General Todd Rokita has made it his personal mission to make abortion reports public records like birth or death certificates. The goal is to ensure anti-abortion groups have access to the records so they can dig for supposed wrongdoing.

Usually that means finding out that a doctor has filed some paperwork late—or some other bureaucratic error that has nothing to do with patient care. But these activists don’t care about safety or accuracy—they just want to make abortion providers’ lives as difficult as possible.

There’s another reason to get rid of mandatory abortion reporting: It divorces abortion from all other kinds of healthcare. After all, you don’t see states collecting information about appendectomies or tonsillectomies. From Guttmacher:

“The premise that abortion care specifically and uniquely requires state surveillance both increases abortion stigma and perpetuates the idea that abortion should stand apart from other health care.”

To be clear, Guttmacher isn’t arguing that we should stop tracking abortion data entirely—just that it should be collected voluntarily, the way high-quality research is already being done through their Monthly Abortion Provision Study and the Society of Family Planning’s #WeCount project.

Because again, mandatory state reporting has never been about patient safety. It’s about finding new ways to restrict abortion and punish those who have them.

Read more from Abortion, Every Day on how Republicans use abortion reporting to punish providers and patients:

Killing Confidentiality

In the States

While we’re on the topic of data collection, let’s talk about Texas’ maternal mortality committee. You might remember that late last year, the committee announced it wouldn’t analyze maternal deaths from 2022 and 2023—which just so happen to be the first two years after the state passed its total abortion ban.

A few months before that, Republicans installed anti-abortion extremist Ingrid Skop on the committee. This is a woman who claims abortion is never medically necessary and that bans don’t endanger women.

It’s hard to believe those decisions are a coincidence. After all, Texas’ maternal mortality rate increased by 56% after the state’s abortion ban went into effect. I have to imagine Republicans are eager to prevent the release of any more damaging data.

Eleanor Klibanoff at the Texas Tribune dug into the politics behind the committee this week, highlighting the state rules that make real analysis harder—like restrictions on reviewing abortion-related deaths and redacting requirements. She also covers the efforts by Texas Democrats to change these policies.

You should read the full piece, but two things stood out to me:

First, the fact that Texas stopped participating in the federal program that every other state uses to track maternal deaths through the CDC. Instead, legislators approved $6 million for the state to create its own program to track maternal mortality. What could go wrong?!

Second, that Republicans are once again trying to sever abortion from healthcare. A new bill, Senate Bill 1831, would require Texas’ maternal mortality committee to investigate deaths linked to so-called ‘elective’ abortions—but not deaths from ‘medically necessary’ abortions.

This is a tactic we’re seeing everywhere. Just yesterday, for example, I wrote about a bill in Nebraska that wouldn’t require all women who have abortions to bury or cremate their fetal remains—just those who have ‘elective’ abortions.

They are telling on themselves again and again.

“State lawmakers should put on scrubs and answer the questions I face every day: How do I treat a patient with chronic kidney disease whose pregnancy threatens her life? How do I treat a young woman newly diagnosed with metastatic cancer who must choose between continuing a pregnancy or starting chemotherapy that could save her life? Texas state lawmakers don’t have the answers. Instead, they’ve written abortion bans that prevent me as an obstetrician-gynecologist from honoring my most fundamental medical oath: Do no harm.”

- Texas OBGYN Dr. Austin Dennard, Austin American-Statesman

Moving on to Missouri, where there is so much happening it’s hard to know where to start. In the interest of getting assholes out of the way, let’s begin with Republican Attorney General Andrew Bailey, who has been threatening Planned Parenthood over abortion medication—even though providers there aren’t even prescribing it.

If you need a refresher on Bailey, consider reading past AED coverage here and here. The short version is that he pulled out every dirty trick in the book in the lead-up to state’s pro-choice ballot measure vote. His goal? Stopping voters from having a direct say on the issue.

In a continuation of that attack on democracy, Bailey told Missouri clinics this week that he’d be serving them with a cease and desist letter—demanding that they stop prescribing abortion medication without an approved ‘complication plan.’

Leaving aside how absurd the entire concept of a ‘complication plan’ is—decades of research proves that abortion medication is safe and effective—Planned Parenthood calls Bailey’s letter “baseless political posturing.” They told the Missouri Independent that they have no plans to prescribe the pills until that plan is in place and approved.

What’s interesting, though, is that it’s not clear Planned Parenthood really needs to submit a ‘complication plan’ at all. Michele Munz at the St. Louis Post-Dispatch reported last month that while the organization’s legal team has advised them to comply, other experts point to a judge’s ruling enjoining the requirement. Law professor and former Planned Parenthood policy analyst Jamille Fields Allsbrook told Munz: “Maybe they’re just playing it safe. I don’t know.”

Understandably, lots of folks in the state are eager to get those pills in patients’ hands—and for organizations to ask for forgiveness rather than permission. I’ll have more on Missouri tomorrow, including Republicans’ attempt to get abortion rights back in front of voters again.

Nicole Sukenis writes at The Oklahoman that she may not have survived her pregnancy if Oklahoma House Bill 1224 were law. The bill would allow health care providers, insurers, and institutions to deny a patient care based on their ‘conscience.’ As Sukenis points out, “the bill doesn’t define what that means, nor does it list specific procedures or treatments that could be denied.”

“I survived because my medical team did their jobs without hesitation. My daughter is alive because the NICU team treated her immediately. No one should have to worry that a doctor, nurse, receptionist or health insurance company will let them suffer or die because of personal objections.”

We’re going to be hearing a lot in the coming months about so-called conscience protections; they’re a major conservative legal tactic, with multiple suits in the works from Alliance Defending Freedom. ‘Conscience’ laws also feature heavily in Project 2025, so we know they’re not going anywhere.

Meanwhile, Republicans across the country are trying to find ways to codify fetal personhood. The latest move comes out of Kansas, where legislators are advancing a bill to allow child support for pregnant women starting at conception. But we know this has nothing to do with helping women or children—it’s just a move to treat fetuses as people.

In better news…

Hawaii legislators have introduced a resolution calling on the attorney general to investigate whether CPCs in the state are violating privacy laws. (My guess? Of course they are!)

New Jersey is considering a bill that would require CPCs to post signage that discloses whether or not they’re licensed medical facilities or if they employ a physician.

And lots good news in Montana today: A judge has struck down two anti-abortion laws, ruling that they violated women’s constitutional rights. One of the laws mandated that only doctors provide abortions; the other banned Medicaid patients from having abortions unless they were the victim of rape or incest, or were in danger of dying.

Also in Montana, the wackadoo legislation from Students for Life claiming that abortion medication poisons the groundwater has failed. The bill is one of several around the country trying to force women who self-manage abortions with pills to bag up their blood as medical waste. You should read yesterday’s newsletter where I got into this a bit—because I don’t know that I have the mental fortitude to type out the horror of this legislation again tonight.

Quick hits:

• According to new estimates from two abortion funds in the region, the number of Iowa abortion patients seeking out-of-state care has more than tripled since 2023;

• The backlash against telehealth abortion provider Hey Jane continues on in Ohio;

• More on Florida Gov. Ron DeSantis’ war against citizen-led initiatives;

• And WyoFile writes of Wyoming’s new law, “There is absolutely nothing safe or compassionate about mandating a transvaginal ultrasound before a woman can be prescribed abortion pills.”

All Eyes on ‘Coercion’

I’ve tracked quite a few anti-abortion terms over the last few years, but I don’t know that any have skyrocketed in use the way ‘coercion’ has. Conservatives are repeating the word constantly in an attempt to quell voter backlash and distract from the fact that their laws force women to carry pregnancies against their will.

So far, anti-abortion activists and lawmakers have mostly wielded coercion as a pretext for restricting abortion medication—claiming that telehealth allows abusers to pressure women into taking pills or secretly slip them abortion drugs. We’ve also seen the term surface in the Louisiana case against a New York abortion provider and a mother helping her teen access care.

But coercion is working so well for conservatives that they’re slapping it onto everything these days. Take anti-abortion OB-GYN Ingrid Skop’s response this week to the Trump administration dropping the federal emergency abortion case in Idaho:

“This coercive effort by the prior administration to subvert existing laws to promote abortion was never necessary, as EMTALA has never been confusing for me or my obstetric peers.”

Let’s be clear: The Biden administration filed that lawsuit to ensure that hospitals in anti-abortion states provide life-saving abortions. But under conservative messaging, protecting women from preventable death is “coercion.”

All of which is to say: Watch out for this term wherever you can.

In the Nation

Andrea González-Ramírez at The Cut has a good rundown of the Republican attacks on abortion medication, from the move to make the pills ‘controlled substances’ in multiple states to the targeting of individual abortion providers.

Kirsten Moore, director of the EMAA Project which works on expanding access to abortion medication, told González-Ramírez that the attack she’s most worried about is the revived lawsuit from the attorneys general of Missouri, Idaho, and Kansas:

“The attorney generals are arguing that people in their state are still getting abortions when they shouldn’t be, because while the states banned abortion, they can get mifepristone. That’s obviously a novel argument, and I have no doubt that the Supreme Court would be happy to go along.”

Read Abortion, Every Day’s explainer on the lawsuit below:

The GOP's Attack on Abortion Pills is Here