Slouching Towards Oblivion

Showing posts with label abortion. Show all posts
Showing posts with label abortion. Show all posts

Saturday, November 26, 2022

It's Not About Babies

It was never about babies.


And just where the fuck did anybody think this shit was headed?


Stacey Freeman was incarcerated for using drugs during pregnancy. But she wasn't pregnant.

Freeman, who lives in Gallant, Alabama, was being investigated by the Etowah County Department of Human Resources (DHR) for alleged drug use in January. During the investigation, one of her daughters told a DHR worker her mother was pregnant, according to a lawsuit Freeman filed against the Etowah County Sheriff's Office on November 7.

A caseworker confronted Freeman, who denied that she was pregnant and offered to take a pregnancy test at the courthouse. She did not get one.

Instead, the mother was arrested for chemical endangerment of a child and booked into the Etowah County Detention Center. She was left to sleep on the jail floor for 36 hours. Meanwhile, she was undergoing her menstrual cycle and asked for pads, which never came. She was told that her bond would be $10,000.

"It's just not even thinkable you could go off somebody's word to make an arrest of somebody being pregnant," Freeman's attorney Martin Weinberg told Newsweek. "You know, you're criminalizing pregnancy, then you find out they're not even pregnant."

The chemical endangerment of a child charge is based on the principle of "fetal personhood," a provision enshrined in the Alabama constitution. Since 2010, Etowah County has prosecuted more than 150 chemical endangerment cases involving pregnant and postpartum women, according to Weinberg.

Each of these women was held on a $10,000 cash bond and could not leave until they entered a drug rehabilitation program—bail conditions that are unconstitutional, said Freeman's lawsuit.

Over the last 23 years, prosecutors in Alabama have embraced some form of "fetal personhood" to bring criminal charges over a miscarriage or stillbirth in at least 20 felony cases, according to an analysis of court records and medical examiner data by The Marshall Project. Many of these prosecutions ended in lengthy prison sentences for women who were mostly poor and struggling with addiction.

Freeman was finally given a pregnancy test in her jail cell, which determined that she was not pregnant. She was questioned by Etowah County Sheriff Investigator Brandi Fuller for 20 minutes and allowed to leave—but not before the investigator "threatened, warned, and admonished Freeman" that she would be charged if Fuller discovered she was pregnant in the next several months, according to the lawsuit.

Weinberg said that Freeman has struggled with humiliation in her small, close-knit community since she was released.

"It's traumatizing, it's not something that somebody gets over," he said. "It's not a good thing for people to think you're on drugs and pregnant...she would not do that. That's her position, that 'I would not put somebody that I'm carrying to life in that position.'"

Newsweek reached out to the Etowah County Sheriff's Office for comment.

 READ MORE 

Saturday, October 08, 2022

IOKIYAR


Daddy State Awareness, rule 7
The law is my sword, but not your shield
The law is my shield, but not your sword

(pay wall)

Opinion
To clarify, I meant ban abortion except for Republican politicians


Ah! I see the confusion! Did I say total abortion ban? I apologize. I did mean “total,” of course, for you. But I intended it to be implied that the law would not be binding to all. I thought that would be audible — as most of my remarks are these days — as a kind of dog whistle?

All the particularly deserving were to be exempt from the ban — no, not children, necessarily; I think forced birth might be a powerful growth experience for them. No, not those for whom it is medically necessary, although I certainly would like voters to feel that probably the law was not a death sentence, whether or not that’s true. Victims of rape, or incest? No, no, I meant: Republican politicians.

I understand your confusion. You think that because I am invoking a value, I believe in it for myself. Actually myself is the last person who should have to be bothered by it! And if you have any questions, please consult my T-shirt, which has a little arrow pointing at my chin and says “I’m With The In-Group The Law Protects But Does Not Bind.” No, I don’t have any more of those (they sold out almost immediately!), but I have lots of “I’m With The Out-Group The Law Binds But Does Not Protect.” What size do you wear?

Do not come to me with my own logic and reasoning and ask me to apply it to myself or my candidates of choice, as though I were of the sort who is bound by law! Law is for other people! You saw me complaining about state secrets being shared, or files being improperly stored, and thought you could repeat my own words back to me as a “gotcha,” when I seemed to fall short in the same way? No chance! I cannot be gotten!

Don’t you understand? To me, everything is permitted! Judging myself by my own standards sounds, frankly, exhausting and impossible.

Do not think for a fraction of a second, though, that I will offer you any of the same leniency. I’m sorry, but you simply don’t have the leeway, given that you have to uphold your values and mine — and some other ones you probably didn’t even know I have you upholding!

Hypocrisy? For this to be hypocrisy, I would have to profess one thing and do another. So let me take this opportunity to apologize: If I have appeared to profess anything other than the raw desire for power, that was not my intention. If I at any point seemed to espouse values, that was a huge misunderstanding. I am very, very sorry!

See? No hypocrisy here! What a relief! Now, back to this ban. And, next, if we’re lucky, my plan to seize control of elections so I can weed out the votes with which I disagree. Remember, if I do it, it’s solving voter fraud, not committing it! Then, will I show my intense concern for the deficit by making it bigger, with tax cuts? Who knows! I am hypocrisy-proof and free as the wind!

The State Of Things

If this gets appealed all the way up to SCOTUS, will the supremes let stand a decision made by a court at the state level? Or will they basically abandon their position of "leaving it up to the states" (as articulated in the Dodd decision), and tell us that the federal level is where it has to be decided?

Alito and his merry band of "conservatives" have painted themselves into an interesting little corner.

(pay wall)

Arizona court halts enforcement of near-total abortion ban

An Arizona appellate court halted enforcement of the state’s near-total abortion ban late Friday, staying a lower court’s decision to reinstate an older law that allows the procedure only if it is needed to save the life of a pregnant person.

The order by the Arizona Court of Appeals followed a challenge by Planned Parenthood Arizona, a reproductive health organization, of a ruling in September by Pima County Superior Court Judge Kellie Johnson. The stay is in place until the appellate court can hear the appeal. Johnson had lifted a decades-long injunction on the near-total restrictions, which are rooted in an 1864 law that has no exceptions for victims of rape or incest and threatens abortion providers with imprisonment for as long as five years.

Judge Peter J. Eckerstrom, writing for the three-member panel that issued the stay, said the lower court may have erred in resurrecting the Civil War-era law, because it conflicts with more recent laws that provide abortion seekers more leeway. A law that permits abortions for up to 15 weeks took effect last month, putting it in conflict with the 1864 ban. State Attorney General Mark Brnovich (R), who opposes abortion rights and has said he plans to enforce the older law, had urged the courts to provide clarity on the issue.

Johnson, the Pima County judge, had ruled that the older prohibition, which was updated and codified in 1901, supersedes the 15-week ban enacted this year. She said in her order that the state legislature had expressly written the 2022 law so that it did not “repeal” the older ban.

Abortion is now banned in these states. See where laws have changed.

But the three appellate judges said that Planned Parenthood’s attorneys had “demonstrated a substantial likelihood of success” for their legal challenge against the stricter prohibitions.

“Arizona courts have a responsibility to attempt to harmonize all of this state’s relevant statutes,” Eckerstrom wrote in a one-page order, adding that the “acute need of [health care] providers, prosecuting agencies, and the public for legal clarity” had prompted the order.

The stay brings “temporary respite to Arizonans,” said Planned Parenthood Arizona president and chief executive Brittany Fonteno in a statement.

“Planned Parenthood Arizona is committed to defending reproductive freedom for all and continuing this fight until this 150-year-old law is taken off the books for good,” she said.

A Brnovich spokeswoman, Brittni Thomason, said in a statement that his office “understands this is an emotional issue, and we will carefully review the court’s ruling before determining the next step.” A decision by the appeals court on the 19th-century prohibitions could be appealed to the Arizona Supreme Court.

Reproductive rights have been in flux in many states since June, when the U.S. Supreme Court overturned Roe v. Wade, which established a nationwide right to abortion in 1973. The reversal returned that decision to Congress and the states. It has occasionally resulted in legal chaos. Several states did not update their abortion laws after Roe, meaning conflicting regulations may be on the books.

In Arizona, Brnovich and abortion rights activists both recently called for the state legislature to hold a special session to address the confusion, the Arizona Republic reported.

In Ohio — another state where reproductive rights have been curtailed since the overturning of Roe — a judge on Friday issued a preliminary injunction on a six-week abortion ban while a constitutional challenge is heard, citing individual liberty. The procedure is now permitted up to the 22nd week of a pregnancy.

Monday, September 26, 2022

Butt Out

Per Amendment 1, you have every right to maintain whatever imaginary friends you feel you need.

I'll just go ahead and demand that you take responsibility for keeping those friends friendly and harmless.


So tell your friends they won't be in on any decisions I make about my health or my healthcare or any other goddamned thing that's none of your fuckin' business.

(pay wall)

Opinion I don’t want your god in charge of my health care

Let’s say a patient is considering a tubal ligation after a planned Caesarean section because she doesn’t want to get pregnant again. Here are some factors that pertain to that decision: her vision of her reproductive future, her doctor’s advice, state regulations, the recommendations of the American College of Obstetricians and Gynecologists, the latest scientific research.

Here are some factors that, for most patients, do not pertain: “God’s purposes,” “God’s will,” “the truth that life is a precious gift from God.”

But if our hypothetical patient happens to be in a Catholic hospital, those factors — precisely those words — will be controlling the decision, whether or not she or her doctor believes in God’s plan. It’s plainly spelled out in the ethical directives of the U.S. Conference of Catholic Bishops: “Direct sterilization of either men or women, whether permanent or temporary, is not permitted in a Catholic health care institution.” She won’t get the operation no matter how medically safe and legal it is, no matter what she wants.

Clearly, she should have picked a different hospital. But with the expansion of Catholic health systems all over the country, that might not be an option. A 2020 report by Community Catalyst, a nonprofit health advocacy group, found that four of the 10 largest health systems in the country were Catholic. The Catholic Health Association says that Catholic facilities now account for more than 1 in 7 U.S. hospital patients.

That number is likely to grow, as Catholic health systems expand by merging with or acquiring secular hospitals and networks. This consolidation is happening near me, in the Albany, N.Y., area. As the Times Union recently reported, one of our large health systems, St. Peter’s Health Partners, part of a Catholic network, has begun merging with the secular Ellis Medicine, which will ultimately put “God’s will” in charge of Ellis Hospital and the Bellevue Woman’s Center, which provides pregnancy and maternity care.

That would mean no tubal ligations for contraceptive purposes. It would also mean no abortions, vasectomies, IUDs or in vitro fertilization. It would most likely constrain choices in end-of-life care and end gender-affirming care.

A patient deciding where to have her C-section — even if she still had a choice of hospitals — might not even know this. Why would she assume that a nonprofit hospital, buoyed by large infusions of state and federal funds, could legally withhold health care from its patients?

But that’s exactly what happens when the church has the ultimate say in medical decisions. Not just at hospitals, either: Urgent care centers and physicians’ practices that are part of a Catholic network might well refuse to prescribe birth control, or to provide abortion services or counseling.

New York State has taken pains to protect reproductive rights, beginning with the 2019 Reproductive Health Act, which codified the right to abortion. As state after state passes abortion bans in the wake of Roe v. Wade’s fall, I often think, selfishly, thank goodness I live in New York.

But I still live in the Commonwealth of Religious Deference, where rules can be broken and citizens can be denied basic services as long as someone has decided that’s the way God wants it.

Some lawmakers are pushing back. One recent bill sponsored by New York state Sen. Michelle Hinchey, which has passed the Senate and awaits an Assembly vote, would require that hospitals publish a list of “policy-based exclusions,” detailing the care they will not provide, on their websites. In Oregon, a new law gives state officials the authority to block hospital mergers that would result in restricted health-care access.

But beneath these efforts lies unchallenged the notion that Catholic hospitals are within their rights to deny care. That religious organizations, despite their public funding, do not have to abide by secular standards.

Blue states? Secular country? Doesn’t matter. The most shocking recent evidence that even New Yorkers live in a State of God Knows Best is a devastating New York Times report on the state’s Hasidic schools, which teach Jewish law and tradition but little English or math. In 2019, 99 percent of the thousands of Hasidic boys who took state standardized tests failed. Meanwhile, New York’s yeshivas receive plenty of education funding — “more than $1 billion” in government money over the past four years. Religious leaders systematically denied their students the constitutionally protected opportunity for a “sound basic education,” and political leaders let it happen.

Or at least they did. The New York State Board of Regents recently voted to require private schools to prove they were teaching basic subjects or else risk forfeiting public funding. Whether that rule will be enforced remains to be seen. But it’s a start.

I’d like to see the New York State Department of Health take the same approach to health networks: Prove you are providing patients with all the care that modern medicine has made possible, state law has made feasible and the Affordable Care Act has deemed essential, and you’ll get your tax exemptions and your Medicaid payments.

And if you happen to have a patient who believes contraception contravenes the will of God? She can choose not to get her tubes tied.

Thursday, September 15, 2022

Today's GOP Fuckery


(pay wall)

Lindsey Graham’s Unbelievably Cruel Abortion Ban

At the end of Senator Lindsey Graham’s news conference on Tuesday proposing a national ban on abortions after 15 weeks of pregnancy, a woman named Ashbey Beasley stood up and asked him a question inspired by her own excruciating loss.

“What would you say to somebody like me who found out that their son had an anomaly that was incompatible with life at 16 weeks?” she began. Beasley chose not to have an abortion, delivering her son at 28 weeks. “When he was born, he lived for eight days,” she said. “He bled from every orifice of his body, but we were allowed to make that choice for him. You would be robbing that choice from those women. What would you say to someone like me?”

Graham had no real answer. His bill contains narrow exceptions for rape, incest and life-threatening pregnancies, but not for severe fetal anomalies or pregnancies that are otherwise nonviable. So, faced with someone insisting that he consider the consequences of his proposal, he defaulted to a duplicitous anti-abortion talking point about global abortion laws.

“The world pretty much has spoken on this issue,” said Graham. “The developed world has said at this stage into the pregnancy the child feels pain, and we’re saying we’re going to join the rest of the world and not be like Iran.”

Graham was making an argument, common in anti-abortion circles, that American abortion laws are unusually permissive, and that banning abortion at 12 or 15 weeks would bring us in line with Europe. France and Spain, for example, both permit abortion for any reason through 14 weeks, and Germany through 12 weeks post-conception. “If we adopted my bill, our bill, we would be in the mainstream of most everybody else in the world,” said Graham. “I think there are 47 of the 50 European countries have a ban on abortion from 12 to 15 weeks.”

This is, at best, a highly selective reading of European abortion laws. It ignores the fact that, on most of the continent, abortion is state-subsidized and easily accessible early in pregnancy, so women aren’t pushed into later terminations as they struggle to raise money. More significantly, the restrictions on later abortions have broad exceptions.

Take German abortion laws, which are, for Europe, quite stringent. Until this summer, a Nazi-era ban on advertising abortion was still in effect, and abortion is still technically illegal, though it’s been decriminalized during the first trimester. After that, abortion is allowed to protect a woman’s physical or mental health, taking into account her “present and future circumstances.” For low-income women, abortion is publicly funded.

A woman in Ashbey Beasley’s devastating situation would be able to end her pregnancy almost anywhere in Europe. Indeed, what Graham is proposing has little analogue in the developed world. Even Iran — where abortion is, despite Graham’s nonsensical reference to the country, mostly illegal — allows women to petition a panel to get an abortion in cases of severe fetal disability.

Why did Graham leave such an exception, which the vast majority of Americans would almost certainly support, out of his proposed abortion ban? There are two possibilities, which are not mutually exclusive. Either he was pandering to the anti-abortion activists who, on Monday, sent a letter to Congress demanding federal action against states with liberal abortion laws, or he simply hasn’t thought very much about what pregnancy entails.

Most people who have gone through a pregnancy, or watched someone close to them go through one, know that there are certain white-knuckle benchmarks. At 10 weeks, you can get a blood test that checks for some prenatal genetic disorders, but it can tell you only your risk level. “Most of the time we make diagnoses around things like fetal abnormalities, genetic abnormalities, at around 15 to 20 weeks, when we can do an amniocentesis,” said Dr. Kristyn Brandi, an abortion provider in New Jersey and board chair of Physicians for Reproductive Health.

Then, at 20 weeks, pregnant patients are typically offered an anatomy scan, which checks, among other things, for problems like anencephaly, in which a fetus’s brain and skull fail to develop.

Graham would condemn every single woman who gets disastrous news from her amnio or her anatomy scan to carry a doomed pregnancy to term, unless she could prove that it was going to kill her. Whether thoughtless or deliberate, the cruelty of this is almost unfathomable.

Politically, Graham’s bill is a boon to Democrats. He seems to have been trying to shift the focus of the abortion debate to later abortions, where Republicans think they can paint their opponents as extremists. Instead, he has underlined Republican callousness toward the abortion patients likely to elicit the most public sympathy.

But Democrats shouldn’t be gleeful. Republicans have shown themselves willing to impose such draconian prohibitions in places where they have complete power. Recently, Kailee Lingo DeSpain, who said that in the past she was “your quintessential pro-life Texan,” told CNN about having to leave the state for an abortion after finding out that her fetus had heart, lung, brain, kidney and genetic defects and “would either be stillborn or die within minutes of birth.” How, asked DeSpain, “could you be so cruel as to pass a law that you know will hurt women and that you know will cause babies to be born in pain?”

At the moment, Republicans don’t have the ability to impose such a regime on the entire country. Nor are many of them interested in talking about national bans; some Republicans were furious at Graham for thrusting the issue into the spotlight. But Graham was probably right when he said, “If we take back the House and the Senate, I can assure you we’ll have a vote on our bill.” So far, Republicans have tried their best to give the anti-abortion movement what it wants. When Graham tells us what they intend to do to us, we should listen.

Saturday, August 27, 2022

The Dog That Caught The Car


The "straight-thinkers" in the GOP really didn't want Roe to be overturned. I'm one of those "liberals" who was sure that because the party was just playing the rubes, they'd always pull back just as it looked like the All-American Woman-Haters Club was about to make 'em do it.

And I think it's no kinda news that McConnell and McCarthy had that in mind too, but the crazies got their hands on the levers - which is what we've been warning about for 30 years - and they made it happen, and now what's left of the old guard is in that Wile E Coyote moment when they realize there's nothing under them but a very long fall to a very hard landing.


Couldn't happen to a nicer buncha guys.

 
(pay wall)

Buyer’s remorse could be creeping in for GOP on abortion

The signs are disparate, inconclusive and perhaps not fully applicable to the 2022 midterm elections. But virtually everything since the Supreme Court overturned Roe v. Wade back in June suggests Republicans have a political problem on their hands now that they’ve obtained their long-sought goal of being able to severely restrict and even ban abortion.

And if you look closely, you’ll see signs of potential buyer’s remorse creeping in.

To the extent Republicans rethink their extremely restrictive posture on abortion in the days ahead, a South Carolina state legislator might have provided a crystallizing moment last week.

At a hearing, state Rep. Neal Collins (R) recounted the arduous journey faced by a 19-year-old thanks to an abortion ban he himself supported. Collins said the woman’s fetus was not viable, but that attorneys told her doctor they couldn’t extract it because it still had a heartbeat — the standard set in the bill supported by Collins that had gone into effect just the week before.

“They discharged that 19-year-old,” Collins said. “The doctor told me at that point there is a 50 percent chance — well, first she’s going to pass this fetus in the toilet. She’s going to have to deal with that on her own. There’s a 50 percent chance — greater than 50 percent chance that she’s going to lose her uterus. There’s a 10 percent chance that she will develop sepsis and herself, die.”

Collins added: “That weighs on me. I voted for that bill. These are affecting people.”

It’s a dilemma previewed long before the Supreme Court’s momentous decision, including in this space. In many states, Republicans passed restrictive laws and what’s known as “trigger laws” that would ban almost all abortions, including in cases of rape and incest, and with stringent rules for exceptions to protect the mother’s health. Those measures worked well as messaging exercises, but now they will be law. And polls show those ideas are broadly unpopular.

Since the Supreme Court’s action, the evidence has pointed almost exclusively in one direction: that Democrats have been buoyed by the abortion issue taking on new prominence.
The conservative Wall Street Journal’s editorial board summarized it in a piece after the New York special election, titled “The GOP’s Abortion Problem.”

“Republicans are on the backfoot because they’re talking about abortion as if Roe were still the law, when it was easy to favor a total ban because it didn’t matter,” it wrote. “Now the policy stakes are real, and Republicans will have to make clear what specific abortion limits they favor and why.”

Republicans have been slow to do that. But there are signs that they recognize the peril of this issue’s sudden salience, and they’re charting divergent courses when forced to take positions.

In the New York special election, for instance, Republican Marc Molinaro said he opposed a federal abortion ban. Some GOP Senate candidates, particularly in the West, have effectively endorsed allowing abortion early in a pregnancy. Colorado Senate candidate Joe O’Dea has said abortion should be banned only after 20 weeks. Nevada Senate candidate Adam Laxalt endorsed banning abortion after 13 weeks. Arizona candidate Blake Masters called his state banning abortion after 15 weeks “a reasonable solution” after previously calling abortion “demonic” and likening it to genocide.

Efforts to reckon with rape, incest and other exceptions are less evident but are lurching forward in some red states. Arkansas Gov. Asa Hutchinson (R) has said he prefers the state to have them, but he has yet to press the issue with the state legislature. West Virginia’s state legislature added the exceptions after Democrats forced a vote on an amendment, though the final version of the bill remains uncertain. And Indiana Republicans split over an effort to nix rape and incest exceptions from their bill, leaving them in.

It’s too simple to say Democrats’ sudden signs of hope in their effort to keep Congress are exclusively the result of the abortion issue. It’s also possible this issue creates a Democratic turnout edge in primary and special elections that won’t be replicated in the general election, when more casual voters are more likely to vote.

What’s pretty clear, though, is that Republicans are in the kind of pickle the Wall Street Journal editorial board noted. They’ve now got this power to do something they’ve long said they aspired to do — and which their base demands — but which creates potential problems for them and their very real ambitions of reclaiming power in Washington. In many cases, as the video of state Rep. Collins shows better than just about anything, they’re now contending with the consequences.

At the very least, it’s a complicating factor. Now they must decide how much they fear that factor, and whether they can do anything about it without alienating the voters they’ve spent decades firing up about what was then a much more abstract — and apparently advantageous — issue.

Tuesday, August 23, 2022

This One Guy

I won't say he gets it, because he didn't commit to voting against these bills, or trying to amend existing laws - he just lodged his complaints. And while that's a start - a pretty good start considering what some of these yahoos are doing and saying - it's one guy in one small-ish state.

But it's a bit of a start.

Now This News - GOP State Rep Neal Collins

Sunday, August 07, 2022

Here It Comes


We've heard warnings from "the lefties" and from women all over the spectrum about the shit we can expect once the pinch-faced blue-nosed puritans get their way. And the shit is not just coming - it's already here - and it's been here for a while.

Women taking it into their own hands could pose a whole set of dangers, but there's some possibility that it just might be the "good news" part of this whole fucked up mess.

NYT: (pay wall)

Some Women ‘Self-Manage’ Abortions as Access Recedes

Information and medications needed to end a pregnancy are increasingly available outside the health care system.


Hannah, a woman in Oklahoma, self-managed her abortion last year, when local clinics were overwhelmed with patients from Texas. 

In states that have banned abortion, some women with unwanted pregnancies are pursuing an unconventional workaround: They are “self-managing” their abortions, seeking out the necessary know-how online and obtaining the medications without the supervision of a clinic or a doctor.

At first glance, the practice may recall the days before Roe v. Wade, when women too often were forced to take risky measures to end an unwanted pregnancy. But the advent of medication abortion — accomplished with drugs, rather than in-office procedures — has transformed reproductive care, posing a significant challenge to anti-abortion legislation.

Even before the Supreme Court's decision to overturn Roe v. Wade, medication abortions accounted for more than half of abortions in the United States. Federal regulators made access to the pills even easier during the pandemic by dropping the requirement for an in-person visit and allowing the drugs to be mailed to patients after a virtual appointment.

But many states never allowed telehealth abortion, and new laws prohibiting abortion apply to all forms of the procedure, including medications. So women in increasingly restrictive parts of the country are procuring the pills any way they can, often online, despite state prohibitions.

There are no reliable estimates of the number of women who undertake their own medication abortions, according to the Guttmacher Institute, which researches and supports abortion access.

With the overturning of Roe v. Wade, abortion is now banned in at least 10 states, according to a database maintained by The New York Times. Voters in Kansas on Tuesday rejected a ballot measure that would have removed abortion rights protections from the state constitution.

Limits of one sort or another are nonetheless expected in at least half of U.S. states, and so both sides of the divide are bracing for an increase in self-managed abortions.

Critics of abortion in any form insist that medication abortions are riskier than claimed, and even more so without medical supervision. The procedure should not be undertaken beyond 10 weeks gestation, they note, or performed without a doctor’s visit, because dating a pregnancy accurately is not always possible.

Other medical complications can be missed, they say — including ectopic pregnancy, in which the fertilized egg implants outside the uterus.

Claims that medication abortion is safe “are based on flawed and incomplete data, which prioritize convenience and cost over the health and safety of patients,” said Dr. Christina Francis, chair of the American Association of Pro-Life Obstetricians and Gynecologists, which opposes all abortions except to prevent permanent harm or death to the mother.

Physicians who support abortion tell a different story: There is plentiful evidence that medication abortion is safe, and women already carry out the procedure almost entirely alone at home, even if they do see a doctor to obtain the drugs. Self-management is not so different, supporters argue.

“It’s quite safe and effective based on studies we’ve done, national data provided by the states and the Guttmacher Institute, and the experience of other countries,” said Dr. Beverly Winikoff, the founder of Gynuity Health Projects, who performed much of the research on medication abortion that led to its approval in the United States more than 20 years ago.

The procedure typically involves taking two drugs: mifepristone, which stops the pregnancy by blocking a hormone called progesterone, followed a day or two later by misoprostol, which causes the uterus to contract.

More than half a million women had medication abortions in 2020 in the United States, and fewer than half of 1 percent experience serious complications, studies show. Medical interventions like hospitalizations or blood transfusions were needed by fewer than 0.4 percent of patients, according to a 2013 review of dozens of studies involving tens of thousands of patients.

A 2018 review by the National Academies of Sciences, Engineering and Medicine found that abortion medication ended pregnancies 96.7 percent of the time in gestations of up to nine weeks. The World Health Organization endorses self-managed abortion and says it can be used up to 12 weeks gestation.

Bags of medical abortion medication and follow-up instructions for patients were readied at the Trust Women clinic in Oklahoma City in December.Credit...Evelyn Hockstein/Reuters

Medication abortion “is noninvasive, doesn’t cause sepsis and doesn’t cause ruptures of internal organs,” like the illegal abortions of the pre-Roe era, Dr. Winikoff said.

“It doesn’t mean people can’t have excessive bleeding and need to get care occasionally, but those are not the dire circumstances of people from 50 years ago,” she added.

The drugs are regulated by the Food and Drug Administration, however, and are intended to be taken under a doctor’s supervision. The agency discourages internet purchases of mifepristone because patients will be “bypassing important safeguards,” officials said in a statement.

But the F.D.A. does not advise against online purchases of misoprostol (brand name Cytotec), which is used to treat a number of medical conditions. Misoprostol can terminate pregnancies by itself, recent studies have shown.

While no treatment is 100 percent safe, taking the pills “on your own at home does not affect your risk of complications,” said Dr. Carolyn Westhoff, an obstetrician gynecologist and professor at Columbia University and the editor in chief of the journal Contraception.

But self-management also means a woman does not have a familiar health care professional nearby to call in case of an emergency or complications. Dr. Westhoff and other experts fear that women performing their own abortions may be reluctant to seek medical help in states that have criminalized abortion.

Cassie, 20, who uses the pronouns they and them and asked that only a first name be used because they reside in Texas, where most abortions are banned after about six weeks of pregnancy, managed their own abortion in January.

Cassie, who already had a child and was struggling financially, filled out an online request form for abortion pills from Aid Access, which is based in Europe. The drugs took longer to arrive than expected, and when they did, Cassie’s pregnancy was already 12 weeks along.

“I just took them and prayed for the best,” Cassie said. They experienced heavy bleeding, nausea and “the worst cramps I’ve had in my entire life.”

“I was crying, curled up in a ball of pain in the middle of my bed,” they said.

When the bleeding did not subside, Cassie’s partner drove them to the hospital, where the remaining tissue was removed.

“That was its own horrifying experience of praying that they wouldn’t know or suspect I’d caused it myself,” Cassie said.

Both the know-how and the tools to perform an abortion are increasingly easy to access.

Women who live in states where abortion is legal can turn to U.S.-based telehealth providers like Abortion on Demand and Hey Jane, which offer detailed information to women seeking abortions and provide pills by mail after a video visit in states where these services are legal.

MYA Network provides physicians who answer questions about self-managed abortion, and Abortion Pill Info offers tips on keeping online research private.

For women in states with abortion bans, Plan C offers a number of workarounds, including a list of online pharmacies selling abortion drugs that the organization has tested and tutorials on setting up mail forwarding in another state to receive the drugs.

The site also refers people to Aid Access, which screens women online and orders abortion pills from overseas pharmacies that are sent in envelopes without return addresses, even to states where abortion is illegal. The group charges $150 or less, depending on income.

Hannah, a 26-year-old in Oklahoma, said she managed her own abortion with pills from Aid Access late last year, when local clinics, overwhelmed with patients from Texas, could not accommodate her.

Hannah, who asked to not be identified because abortion is now banned in her state, said she suffered from depression at times before she became pregnant, but had plummeted to a new low and was suicidal.

“I couldn’t afford a pregnancy and was not well enough, physically or mentally, to carry a pregnancy,” she said. Her self-managed abortion was “no worse than a normal period for me.”

A medication abortion cannot be distinguished from a miscarriage, and traces of the pills cannot be discovered if they are taken orally, said Dr. Rebecca Gomperts, a Dutch physician who founded Aid Access.

If a woman needs care after taking the pills, “we always tell people to say they had a miscarriage,” she said. “It’s exactly the same symptoms, and the treatment is exactly the same.”

A study of thousands of women in the United States who received abortion pills from a provider without an in-person visit during the pandemic found that the practice was safe.

Complications are the rare exception. Another recent study looked at self-managed abortions in Argentina and Nigeria, where abortion is banned except to save the life of the mother (and, in Argentina, in cases of rape).

Twenty percent of the nearly 1,000 women who participated in the study sought care at hospitals after the procedure, but most only wanted to confirm the abortion was complete. About 4 percent reported ongoing pain, fever or bleeding. Seventeen required procedures to complete the abortion, 12 stayed in the hospital overnight, and six needed blood transfusions, according to the study, which was published in The Lancet Global Health in late 2021.

The surprise finding was that while some of the women took the mifepristone-misoprostol combination, the success rate for those taking misoprostol alone — a widely used drug that can be purchased in countries like Mexico without a prescription and is fairly inexpensive — was higher than that of the two-drug combination.

Most state laws that restrict abortion make performing an abortion a crime for doctors, not patients. Only three states — South Carolina, Oklahoma and Nevada — have laws that explicitly make it a crime to end one’s own pregnancy.

Other states, however, have wielded child endangerment statutes or other laws against women suspected of terminating their pregnancies.

In Indiana, Purvi Patel was sentenced to 20 years in prison in 2015 for inducing a self-managed abortion; her conviction was overturned in 2016. In Texas, murder charges were brought against Lizelle Herrera earlier this year in relation to a self-managed abortion, but prosecutors said they would not pursue the case.

At least six states have introduced legislation establishing a fetus as a person, which will make it easier to prosecute women who terminate their own pregnancies, said Dana Sussman, the deputy executive director of National Advocates for Pregnant Women.

Both the American Medical Association and the American College of Obstetricians and Gynecologists, which support abortion as an essential component of health care, oppose criminalizing self-managed abortion, as they say doing so will deter women from seeking medical attention.

At the moment, health care providers are not legally required by any state to report patients they suspect of self-managing an abortion, according to If/When/How, an abortion-rights advocacy group. But laws are in flux.

“We’re operating in an area of complete uncertainty,” Ms. Sussman said.
Abortion Access in the United States
Demand for abortion pills is surging, setting the stage for new legal battles. For now, it is still legal in most states to receive abortion medication by mail and pharmacies risk violating federal civil rights law if they refuse to fill a prescription for abortion pills.

Plan B:
In the wake of the Supreme Court’s ruling, many women are stocking up on so-called morning-after pills. Here’s how these differ from abortion pills.

I.V.F.:
Legal experts say the end of Roe could make it easier to place restrictions on genetic testing, storage and disposal of the embryos created outside the womb.

Contraceptive Pills:
The Food and Drug Administration’s first application for a birth control pill that would not require a prescription has taken on new meaning after the Supreme Court decision.

Saturday, August 06, 2022

Women Will Die

...unnecessarily.

 And so will some of their children.

The federal government has said
the United States needs 9,000 more OB/GYNs,
and that the shortage will reach 22,000 by 2050.

WaPo: (pay wall)

A challenge for antiabortion states: Doctors reluctant to work there

Recruiters say OB/GYNs are turning down offers, a warning for conservative-dominated states already experiencing shortages


In a few years, Olgert Bardhi’s skills will be in high demand. A first-year resident in internal medicine at the University of Texas Southwestern Medical Center in Dallas, he’ll be a full-fledged physician by 2025 in a nation facing a shortage of primary care doctors.

The trouble for Texas: Because of the state’s strict antiabortion laws, Bardhi’s not sure he will remain there.

Although he doesn’t provide abortion care right now, laws limiting the procedure have created confusion and uncertainty over what treatments are legal for miscarriage and keep him from even advising pregnant patients on the option of abortion, he said. Aiding and abetting an abortion in Texas also exposes doctors to civil lawsuits and criminal prosecution.

The top courts in Texas and Ohio on July 1 allowed the Republican-led states to enforce abortion bans and restrictions after the Supreme Court overturned Roe. (Video: Reuters, Photo: Eric Gay/AP/Reuters)

“It definitely does bother me,” Bardhi said. “If a patient comes in, and you can’t provide them the care that you are supposed to for their well-being, maybe I shouldn’t practice here. The thought has crossed my mind.”

He is balancing his concern with his sense that he can do more good by staying, including counseling patients on obtaining contraception.

Bardhi’s uncertainty reflects a broader hesitancy among some doctors and medical students who are reconsidering career prospects in red states where laws governing abortion have changed rapidly since the Supreme Court struck down Roe v. Wade, according to interviews with health-care professionals and reproductive health advocates.

One large medical recruiting firm said it recently had 20 obstetrician-gynecologists turn down positions in red states because of abortion laws. The reluctance extends beyond those interested in providing abortion care, as laws meant to protect a fetus could open doctors up to new liabilities or limit their ability to practice.

It remains unclear how thoroughly career decisions being made amid the upheaval and confusion since the Supreme Court’s decision on Dobbs v. Jackson Women’s Health Organization will translate to a lasting geographic shift. But amid a national shortage of reproductive health practitioners, the early evidence indicates that red states have, at minimum, put themselves at a disadvantage in the competition for crucial front-line providers, experts said.

One large health-care staffing firm, AMN Healthcare, said clients in states with abortion bans are having greater trouble filling vacancies because some prospective OB/GYN candidates won’t even consider opportunities in states with new or pending abortion bans.


Tom Florence, president of Merritt Hawkins, an AMN Healthcare company, cited 20 instances since the Supreme Court ruling where prospects specifically refused to relocate to states where reproductive rights are being targeted by lawmakers.

“To talk to approximately 20 candidates that state they would decline to practice in those restrictive states, that is certainly a trend we are seeing,” Florence said. “It is certainly going to impact things moving forward.”

Three candidates turned down one of the firm’s recruiters, who was working to fill a single job in maternal fetal medicine in Texas, he said: “All three expressed fear they could be fined or lose their license for doing their jobs.”

In another example, a physician contacted by phone by an AMN Healthcare recruiter trying to fill a post in an antiabortion state “simply said, ‘Roe versus Wade,’ and hung up,” Florence said.

Florence said the shift has especially serious implications for small, rural hospitals, which can afford just a small number of maternal specialists or, in some cases, only one.

“They can deliver hundreds of babies each year and see several thousand patients,” he said. “The potential absence of one OB/GYN that might be in their community, if not for the Supreme Court decision, is highly significant. The burden will be borne by the patients.”

Tellingly, Florence added, none of the recruiters had encountered a single physician seeking to practice in a state because it had banned abortion.

In a 2021 Kaiser Family Foundation survey, 75 percent of OB/GYNs said their practices do not provide abortions for the purposes of terminating a pregnancy.

Yet broadly written abortion bans across the United States have cast a chill across the broader practice of reproductive health, say mainstream physician leaders who support abortion rights. In states without exceptions for the life and health of the woman, they say, routine standards of care are being scrapped.

They worry that limits on training for new doctors will undermine recruitment of young talent. They are concerned about restrictions on fertility treatment. They anticipate that conservative legislatures will seek to impose bans on certain types of contraception, including IUDs and Plan B medication. Most Republicans in the U.S. House voted last month against a measure protecting the right to contraception.

Additionally, many OB/GYN doctors, even if they don’t perform abortions themselves, believe strongly in patient autonomy and decision-making, said academic and clinical leaders.

“Even physicians in restrictive states have never had to deal with this kind of political interference and legislative oversight,” said Eve Espey, chair of the department of obstetrics and gynecology at the University of New Mexico and a physician at the UNM Center for Reproductive Health. “It’s an incredible intrusion into a wide swath of reproductive health care.”

A third-year OB/GYN resident at U-N. M., Alana Carstens Yalom attended medical school at Tulane University, in New Orleans. She had entertained the idea of going back to Louisiana for her medical practice. Not anymore. She wants abortion care to be a part of her OB/GYN practice, and Louisiana has a ban.

“Now I don’t think that is even an option for me,” she said.

Physicians, medical residents and medical students said in interviews they are worried about the impact on the profession. How to navigate careers in the new landscape is a major topic of discussion among both doctors and trainees, they said.

Mayrose Porter, an Austin native who is a student at Baylor College of Medicine in Houston, said she will apply to residencies in her home state but that the rest of the choices on her list will only be in states where abortion is legal. In the long term, Porter, a member of Medical Students for Choice, does not expect to practice medicine in Texas.

“The idea that myself and other future doctors are just not going to be here is sad for me personally and sad for the community,” she said, emphasizing she was speaking for herself only, not Baylor. “There’s some guilt that I’m abandoning the community I grew up in.”

In Nebraska, Methodist Health System in Omaha has just two specialists with expertise in high-risk pregnancies who also can perform dilation and evacuation procedures to remove a fetus. The hospital permits abortions only in situations that threaten the health and life of the woman. A group of OB/GYNs from Nebraska, including Methodist maternal fetal specialist Emily Patel, have formed a local political action committee to urge the legislature not to pass an abortion ban.

They are warning about “downstream effects” of an abortion ban on reproductive health more broadly.

A common example is for a woman whose water has broken around 18 or 19 weeks. The risks of continuing that pregnancy to the health of the woman and the fetus include developmental problems for the fetus and the risk of infection for the woman.

But under the proposed abortion ban in Nebraska, Patel said, it is not clear whether even explaining termination options in such a circumstance would be legal.

“Imagine we are in a state with a ban, and that fetus has a heart rate, and the patient sitting in front of me is not ill. This is going to be a tough situation for a physician to be in,” Patel said. “A physician is not going to want to be in a position where they are going to be criminally prosecuted for providing routine care and counseling.”

It’s the sort of legal uncertainty and danger that top doctors will seek to avoid, she added: “These states where bans are going into effect are going to have trouble recruiting for the next generation of OB/GYNs.”

Opponents of abortion said worries about legal jeopardy and restrictions beyond elective abortions are overblown.

“There’s a lot of mythology and misconception about what this means for reproductive health,” said Sandy Christiansen, an OB/GYN who is medical director of a Maryland Care Net pregnancy center, which encourages women to continue pregnancies. “There shouldn’t be any problems” treating a miscarriage with medication or surgical intervention, she said.

“They shouldn’t have to worry about their licenses if they are practicing a standard of care,” said Christiansen, who is a member of the American Association of Pro-Life Obstetricians and Gynecologists.

She did acknowledge some confusion: “Hopefully, the laws that will come along will clarify some of these things.”

Another member of the antiabortion physicians’ group, associate professor Susan Bane, at Barton College, a small Christian-affiliated institution in North Carolina, said she believes reluctance to move to states with abortion bans will be limited to the small percentage of OB/GYN doctors who want to perform elective abortions.

“If you’re going to be in medical school and you want to be an obstetrician and want to do abortions, you will choose a state where it’s legal,” she said.

Hospital systems in states with abortion restrictions, including Utah, Texas, Mississippi, Alabama and Ohio, did not respond to requests for comment or declined to respond to questions about how they are approaching potential retention and recruiting challenges.

A large health system based in Utah, Intermountain Healthcare, lists 10 OB/GYN physician vacancies on its website, the most of any specialty for which it is recruiting. A spokeswoman at Intermountain, apparently inadvertently, included a Post reporter on an email to the public relations team after The Post asked about challenges filling those vacancies in light of Utah’s abortion law: “We need to strategize a response to politely decline so that we can stay away from this issue.”

Doctors said they are grappling with the fallout from broadly worded legislation written by politicians without detailed medical knowledge. The environment creates a high degree of legal and professional risk for specialists, said David Turok, an associate professor of OB/GYN at the University of Utah who is also a board member of Physicians for Reproductive Health, which supports abortion rights.

“What we have is laws that are not representative of medical practice, that are not framed in ways that we think or speak as medical professionals,” Turok said, “and that makes it confusing.”

Officials in some states are working to clarify how abortion bans are going to be applied. The Louisiana Department of Health on Monday issued a list of 25 fetal conditions that can justify termination.

The legal uncertainty adds to the burdens on OB/GYNs. They must respond to deliver babies 24 hours a day, emergencies are emotionally stressful, and practitioners face some of the highest rates of malpractice lawsuits and accompanying insurance costs.

The federal government has said the United States needs 9,000 more OB/GYNs and that the shortage will reach 22,000 by 2050.

In Michigan, an old, pre-Roe abortion ban was renewed after the Supreme Court ruling. The looming ban has prompted Tim Johnson, a veteran of high-risk pregnancy care at Michigan Health, to consider moving out of the state. Although he is 73 and no longer provides elective abortions, he still treats patients and is not ready to retire. If Michigan’s abortion ban sticks, he may move to Maryland to practice, he said.

“I always said if (Roe were overturned) quickly like this, it would be terribly disruptive,” he said, “We are starting to understand how truly disruptive it is.”

Saturday, July 30, 2022

Today's Fuckery

The amendment question in front of Kansas voters is whether or not to let the Kansas Constitution stand as is, or to change it and make it OK for the legislature to shit-can the current protection of abortion rights.

And of course the "conservatives" pulled two of their favorite tricks.
  1. Make the wording as confusing as possible
  2. Put it on the primary ballot because more "conservatives" vote in the primaries

When a reasonable person reads that proposed change, they're very likely to agree with it. but it's trick. If you agree with the statement, and you think women have the right to choose, then you have to vote NO in order to preserve the right to choose.

I really struggle not to hate the fuck outa these fucking fuckers.

Tuesday, July 26, 2022

An Ad

None ya damn bidness, Greg. Fuck off and leave people alone.

Mothers Against Greg Abbott

Saturday, July 23, 2022

It Gets Worse


Please take all of this, strap it to a cinder block, and shove the whole thing up your ass.

Your pal,

Mike 

PS)

WaPo: (pay wall)

South Carolina bill outlaws websites that tell how to get an abortion

More states could follow, setting up a battle over the future of online speech across the country.


Shortly after the Supreme Court ruling that overturned the right to abortion in June, South Carolina state senators introduced legislation that would make it illegal to “aid, abet or conspire with someone” to obtain an abortion.

The bill aims to block more than abortion: Provisions would outlaw providing information over the internet or phone about how to obtain an abortion. It would also make it illegal to host a website or “[provide] an internet service” with information that is “reasonably likely to be used for an abortion” and directed at pregnant people in the state.

Legal scholars say the proposal is likely a harbinger of other state measures, which may restrict communication and speech as they seek to curtail abortion. The June proposal, S. 1373, is modeled off a blueprint created by the National Right to Life Committee (NRLC), an antiabortion group, and designed to be replicated by lawmakers across the country.


As the fall of Roe v. Wade triggers a flood of new legislation, an adjacent battleground is emerging over the future of internet freedoms and privacy in states across the country — one, experts say, that could have a chilling impact on First Amendment-protected speech.

“These are not going to be one-offs,” said Michele Goodwin, the director of the Center for Biotechnology and Global Health Policy at the University of California at Irvine Law School. “These are going to be laws that spread like wildfire through states that have shown hostility to abortion.”

Goodwin called the South Carolina bill “unconstitutional.” But she warned it’s unclear how courts might respond after “turning a blind eye” to antiabortion laws even before the Supreme Court overturned Roe.

Many conservative states’ legislative sessions ended before the Supreme Court’s decision, and won’t resume until next year, making South Carolina’s bill an anomaly. But some tech lobbyists say the industry needs to be proactive and prepared to fight bills with communications restrictions that may have complicated ramifications for companies.

“If tech sits out this debate, services are going to be held liable for providing basic reproductive health care for women,” said Adam Kovacevich, the founder and CEO of Chamber of Progress, which receives funding from companies including Google and Facebook.


Tech companies could soon be navigating a disparate patchwork of state laws, caught in the middle of a political tug of war between red states and blue states. Democrats are already considering new data privacy proposals to protect reproductive health data and other digital trails that could be used to prosecute people seeking abortion. Meanwhile, Republican states could attempt to preserve and collect that same data, which has been used as key evidence in cases against pregnant women.

Eric Goldman, a professor at Santa Clara University School of Law, said the First Amendment and Section 230, a bill that shields internet providers and tech companies from liability for the posts, photos and videos people share on their sites, provide a strong defense in many instances for websites and providers facing lawsuits over hosting information about abortion access.


But individuals could face liability for aiding and abetting people in accessing a criminalized procedure if they send messages about how to obtain an abortion or otherwise break the law.

For the NRLC, which wrote the model legislation, limiting communication is a key part of the strategy to aggressively enforce laws restricting abortion. “The whole criminal enterprise needs to be dealt with to effectively prevent criminal activity,” Jim Bopp, the group’s general counsel, wrote in a July 4 memo, comparing the group’s efforts to fighting organized crime.

In an interview with The Washington Post, Bopp said that the group has refined its blueprint for states since the South Carolina bill was introduced last month. The restrictions on websites and internet hosts in the July model bill language would only apply when the information is likely to be used “for an unlawful abortion in this state,” he said, not abortions generally, as the South Carolina bill says.

The group “tried to be very careful in vetting this so it doesn’t impinge on First Amendment rights,” he added. He said the provision was intended to limit the trafficking of abortion-inducing drugs, which throughout the interview he compared to the trafficking of fentanyl.


Yet there’s broad uncertainty about how courts would interpret such bills, which might lead to companies and websites taking down information about abortions for fear of lawsuits.

“The legal ambiguity works in favor of regulators,” Goldman said. “They can suppress a lot of constitutionally protected speech just because of fear of liability.”

Democrats are expected to respond to the conservative states’ with their own regulatory efforts, largely focused on protecting sensitive data. California State Assembly member Mia Bonta introduced legislation earlier this year that would protect people from law enforcement requests from other states to turn over information that would identify people seeking an abortion.

A staffer in Bonta’s office said she introduced the legislation amid concerns that the Supreme Court would overturn Roe. Planned Parenthood Affiliates of California approached her with the concept of the legislation. The bill will have a hearing in August, and Bonta’s staff is working on amendments to strengthen the legislation in the wake of the Dobbs v. Jackson Women’s Health Organization decision.

“Just because the Supreme Court has decided to strip us of the fundamental right to choose what [to do] with our bodies, doesn’t mean California will stand back and allow others to use our systems to obtain information to hurt people who are exercising a fundamental right here in California,” Bonta said.


Democrats in Congress have also introduced the “My Body, My Data Act,” which would create new privacy protections for reproductive health data. The bill has little chance of becoming law in a narrowly divided Congress, but Rep. Sara Jacobs (D-Calif.), the legislation’s architect, previously told The Post that she wants states to replicate the bill.

Privacy and tech advocacy groups are trying to gear up for the post-Dobbs battles. The Center for Democracy and Technology on Tuesday announced a new task force focused on protecting reproductive health information, which convened academics, civil rights groups and privacy organizations.

The Electronic Frontier Foundation, a privacy advocacy group, expressed support for the California privacy bill and is reviewing the South Carolina legislation. Hayley Tsukayama, a senior legislative activist at EFF and a former Post reporter, said the South Carolina bill has “serious problems.”

She’s anticipating that tech companies and their trade associations will be ramping up their lobbying efforts at the state level, especially early next year, when many states resume their legislative calendars.

“For tech companies and for folks interested in digital rights, it’s going to be a wild ride in the next few years,” she said.