You don't throw rocks and then hide your hands.
Aug 7, 2022
Meanwhile, Over At CPAC
via The Lincoln Project
"There's no such thing as misinformation."
And we've hit a new high in "conservative" lows.
Here It Comes
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![]()
Medication Abortions:
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
- Indiana Governor Signs First Post-Roe Abortion Ban, With Limited Exceptions
Republicans Begin Adjusting to a Fierce Abortion Backlash
- Biden Issues Executive Order on Abortion Access, Calling for More Study
- Kansas Votes to Preserve Abortion Rights Protections in Its Constitution
- They Had Miscarriages, and New Abortion Laws Obstructed Treatment
- Tracking the States Where Abortion Is Now Banned
Medication Abortions:
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:
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.:
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:
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.
Inching Ever Closer
The US Senate is about to finish up their Vote-A-Rama thing, and they should be able to put the Inflation Reduction Act in Nancy Pelosi's capable hands pretty quickly.
- snip -
Senator Kyrsten Sinema, Democrat of Arizona, announced on Thursday that she would support moving forward with her party’s climate, tax and health care package, clearing the way for a major piece of President Biden’s domestic agenda to move through the Senate this weekend.
To win Ms. Sinema’s backing, Democratic leaders agreed to drop a $14 billion tax increase on some wealthy hedge fund managers and private equity executives that she had opposed, to change the structure of a 15 percent minimum tax on corporations, and to include drought money to benefit Arizona.
For decades, as prescription drug costs soared, Democrats battled with the pharmaceutical industry in pursuit of an elusive goal: legislation that could drive down prices by allowing Medicare to negotiate directly with drug makers.
Now they are on the verge of passing a broad budget bill that would do just that.
Bits and pieces via NYT: (pay wall)
- snip -
Senator Kyrsten Sinema, Democrat of Arizona, announced on Thursday that she would support moving forward with her party’s climate, tax and health care package, clearing the way for a major piece of President Biden’s domestic agenda to move through the Senate this weekend.
To win Ms. Sinema’s backing, Democratic leaders agreed to drop a $14 billion tax increase on some wealthy hedge fund managers and private equity executives that she had opposed, to change the structure of a 15 percent minimum tax on corporations, and to include drought money to benefit Arizona.
For decades, as prescription drug costs soared, Democrats battled with the pharmaceutical industry in pursuit of an elusive goal: legislation that could drive down prices by allowing Medicare to negotiate directly with drug makers.
Now they are on the verge of passing a broad budget bill that would do just that.
- snip -
At the center of the climate and tax package that Democrats appear to be on the verge of passing is one of the most significant changes to the United States’ tax code in decades: a new corporate minimum tax that could reshape how the federal government collects revenue and alter how the most profitable companies invest in their businesses.
The proposal is one of the last remaining tax increases in the package that Democrats are aiming to pass along party lines. After months of intraparty disagreement over whether to raise taxes on the wealthy or roll back some of the 2017 Republican tax cuts to fund their agenda, they have settled on a longstanding political ambition to ensure that large and profitable companies pay more than $0 in federal taxes.
How the Deal Was Salvaged:
The proposal is one of the last remaining tax increases in the package that Democrats are aiming to pass along party lines. After months of intraparty disagreement over whether to raise taxes on the wealthy or roll back some of the 2017 Republican tax cuts to fund their agenda, they have settled on a longstanding political ambition to ensure that large and profitable companies pay more than $0 in federal taxes.
How the Deal Was Salvaged:
A frenzied and improbable effort by a tiny group of Democrats, carried out over 10 days and entirely in secret, succeeded in reviving the centerpiece of President Biden’s domestic policy plan.
Climate:
Climate:
The bill would put the United States much closer to its goal of cutting global warming pollution in half by 2030.
Inflation:
Inflation:
The package, which includes tax increases, lower drug prices and other provisions aimed at reducing the federal budget deficit, could alleviate rapid price gains over time.
The Math of the Deal:
The Math of the Deal:
The legislation, which involves at least $260 billion in spending over 10 years and an even larger raise in taxes, has prompted Republican claims that the bill would be too expensive and represent a giant tax increase. But outside estimates found the bill to be fiscally responsible.
Sinema Will Support Bill:
Sinema Will Support Bill:
Senator Kyrsten Sinema, Democrat of Arizona, her party’s last remaining holdout, said that she would support the package. To win Ms. Sinema’s support, Democrats agreed to drop a modest change to the so-called carried interest loophole, which allows wealthy hedge fund managers and private equity executives to pay lower tax rates than entry-level employees.
What's in it?
WaPo: (pay wall)
All Or Nothing At All
I've long maintained that there's something wrong with the polling, and I think it has to be obvious there's a lot that's wrong with the reporting.
Losing Sight of Piecemeal Progress: People Lump and Dismiss Improvement Efforts That Fall Short of Categorical Change—Despite Improving
Abstract
Fourteen experiments (N = 10,556 adult participants, including more than 20,000 observed choices across 25 issues) documented how people perceive and respond to relative progress out in the world, revealing a robust “negative-lumping” effect.
When Biden (eg) has gotten more done in 2 years than most presidents manage in 4, but his approval rating is still underwater, there's something wrong with the way we're doing things.
Here's a hint at the problem form Sage Journals:
Losing Sight of Piecemeal Progress: People Lump and Dismiss Improvement Efforts That Fall Short of Categorical Change—Despite Improving
Abstract
Fourteen experiments (N = 10,556 adult participants, including more than 20,000 observed choices across 25 issues) documented how people perceive and respond to relative progress out in the world, revealing a robust “negative-lumping” effect.
As problematic entities worked to better their ways, participants shifted to dismiss them if they fell short of categorical reform—despite distinctions in improvement.
This increased dismissal of relative gains as “all the same” was driven by the belief that falling short signals an eschewal of doing the bare minimum and lacking serious intent to change, making these gains seem less deserving of recognition.
Critically, participants then “checked out”: They underrewarded and underinvested in efforts toward “merely” incremental improvement.
Finally, in all experiments, participants lumped together absolute failures but not absolute successes, highlighting a unique blindness to gradations of badness. When attempts to eradicate a problem fail, people might dismiss smaller but critical steps that were and can still be made.
It's The Climate Change, Dummy
Flash flood in Death Valley strands about 1,000 people in national park
Without a certain stability in weather patterns, we get real trouble, and that trouble will come more often, at an accelerating pace, and eventually the ripples of each disaster will overlap the ripples from all the other disasters.
When this week's Once-In-A-Thousand-Years Flood happens in Death Valley, it fucks things up for a comparative handful of tourists and their car insurance carriers. When it kills 40 Kentuckians - some of whom will never be found because they're 5 miles down stream, buried under 8 feet of mud - and whole areas are rendered unproductive for some years to come, we have to begin to grasp the broadening scope of "Nature Bats Last".
BTW - I wonder how long it'll take the Suits at the insurance companies to figure out how to fuck people over on this one. After all, when we could be preventing these terrible things from happening - but we don't - well, was it really a "natural" disaster? Wasn't it really your own fault? Sorry - claim denied.
WaPo: (pay wall)
Death Valley National Park was closed Saturday after exceptional amounts of rain drenched the park Friday, triggering flash floods that left about 1,000 visitors and park staff stranded.
The park received 1.46 inches of rainfall at the Furnace Creek area — just shy of the previous calendar day record of 1.47 inches, set on April 15, 1988. This amounts to about three-quarters of what the area typically receives in an average year, 1.94 inches, and is the greatest amount ever recorded in August, The lowest, driest and hottest location in the United States, Death Valley averages just 0.11 inches of rain in August.
The National Park Service said in a news release Saturday that the national park roads remain closed, but “visitors who were previously unable to leave the area hotels [were] able to carefully drive out with law enforcement escorts.” It said water has receded in most areas of the park and “extensive mud and gravel deposits” remain.
As of Saturday morning, “everything is going well,” said Nikki Jones, a server assistant at a restaurant in the park’s Ranch Inn, who also lives there and posted a video of the flooding from her colleague on Twitter. Jones told The Washington Post that the floodwaters receded Friday afternoon, but light debris remain on the roads.
“CalTrans has done an amazing job to get it cleaned up as soon as possible,” she told The Post in a Twitter message. “I drove on the roads today.”
Jones said some people are stranded at the Inn at the Oasis because of trapped cars, “but people are able to get out of the park today.”
“The floodwaters pushed dumpster containers into parked cars, which caused cars to collide into one another,” the National Park Service said in a statement Friday. “Additionally, many facilities are flooded including hotel rooms and business offices.
The torrent was triggered by the Southwest monsoon, which develops each summer as prevailing winds shift from out of the west to out of the south, drawing a surge of humidity northward. This moisture can fuel vigorous downpours that douse the parched desert landscape. Because there is little soil to soak up the rains, any measurable rains can cause flooding in low-lying areas, and heavier rains can collect into normally dry creeks, triggering flash floods.
This year’s Southwest monsoon has been particularly intense — which has helped relieve drought conditions in the region but also resulted in many significant flood events. Serious flooding has recently affected areas around Las Vegas and Phoenix.
The park received 1.46 inches of rainfall at the Furnace Creek area — just shy of the previous calendar day record of 1.47 inches, set on April 15, 1988. This amounts to about three-quarters of what the area typically receives in an average year, 1.94 inches, and is the greatest amount ever recorded in August, The lowest, driest and hottest location in the United States, Death Valley averages just 0.11 inches of rain in August.
The National Park Service said in a news release Saturday that the national park roads remain closed, but “visitors who were previously unable to leave the area hotels [were] able to carefully drive out with law enforcement escorts.” It said water has receded in most areas of the park and “extensive mud and gravel deposits” remain.
As of Saturday morning, “everything is going well,” said Nikki Jones, a server assistant at a restaurant in the park’s Ranch Inn, who also lives there and posted a video of the flooding from her colleague on Twitter. Jones told The Washington Post that the floodwaters receded Friday afternoon, but light debris remain on the roads.
“CalTrans has done an amazing job to get it cleaned up as soon as possible,” she told The Post in a Twitter message. “I drove on the roads today.”
Jones said some people are stranded at the Inn at the Oasis because of trapped cars, “but people are able to get out of the park today.”
“The floodwaters pushed dumpster containers into parked cars, which caused cars to collide into one another,” the National Park Service said in a statement Friday. “Additionally, many facilities are flooded including hotel rooms and business offices.
The torrent was triggered by the Southwest monsoon, which develops each summer as prevailing winds shift from out of the west to out of the south, drawing a surge of humidity northward. This moisture can fuel vigorous downpours that douse the parched desert landscape. Because there is little soil to soak up the rains, any measurable rains can cause flooding in low-lying areas, and heavier rains can collect into normally dry creeks, triggering flash floods.
This year’s Southwest monsoon has been particularly intense — which has helped relieve drought conditions in the region but also resulted in many significant flood events. Serious flooding has recently affected areas around Las Vegas and Phoenix.
The Death Valley flood also comes amid a series of extreme rain events over the Lower 48 states. Over the week spanning the end of July and beginning of August, three 1-in-1,000 year rain events occurred — inundating St. Louis, eastern Kentucky, and southeast Illinois. Earlier this summer, Yellowstone National Park also flooded.
Death Valley holds the record for the highest temperature ever recorded on Earth, as well as several runners-up. Officially, Death Valley reached 134 degrees on July 10, 1913, but some climatologists have questioned the legitimacy of that reading. The next highest temperature on record, 131 degrees from Kebili, Tunisia, set July 7, 1931, is also controversial. Last summer and the summer before, Death Valley hit 130 degrees, which may be the highest pair of reliably measured temperatures on Earth if the 1931 Tunisia and 1913 Death Valley readings are disregarded.
The rainfall inundated the park, trapping vehicles in debris, according to a video tweeted by John Sirlin, an Arizona-based storm-chaser. He wrote that roads were blocked by boulders and palm trees that had fallen, and that visitors struggled for six hours to leave the park.
Earlier this week, flash floods hit parts of western Nevada, forcing the closure of some roads leading to the park from Las Vegas. Flash floods also hit parts of northern Arizona.
Sirlin told the Associated Press that Friday’s rain started around 2 a.m. and was “more extreme than anything I’ve seen there.”
“There were at least two dozen cars that got smashed and stuck in there,” he said, adding that he saw washes flowing several feet deep although he did not see anyone injured, and the NPS reported no injuries as of Friday.
Last July, rare summer rains also soaked Death Valley, bringing 0.74 inches in a day at Furnace Creek approximately two weeks after the park set the world record for the hottest daily average temperature, at 118.1 degrees Fahrenheit.
Scientists say human-caused warming of the climate is intensifying extreme precipitation events. The Intergovernmental Panel on Climate Change found some evidence that rainfall from the Southwest monsoon has increased since the 1970s.
Aug 6, 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.”
Today's GOP Fuckery
Chris Pritt (R-Wackdoodle WV) argued in the House of Delegates on Friday that making absent fathers pay child support would encourage more women to seek abortions, either in state or out of state. The argument was made during a debate on West Virginia’s near-total abortion ban legislation.
Pritt, of course, was quick to cry foul - out of context - or whatever.
WV State Rep. Pritt (R) attempts to argue that making absent fathers pay child support will encourage more abortions.
WV State Rep. Pritt (R) attempts to argue that making absent fathers pay child support will encourage more abortions.
(verbatim)
PRITT: “Let's say you've got a father who doesn't want to really be involved in the life at all, really. He knows that if she carries through the pregnancy he's going to have possibly some sort of child support obligation. And so what he wants to do is he wants to in a sense encourage her to go and find a way to get an abortion because he knows that if it's a certain individual, if he has any kind of familiarity with her, he knows that she might be of such state of mind, she may be in such a vulnerable position that she decides, it's not worth everything he's going to put me through to carry this, this pregnancy forward. It's going to be easier, it's going to be better for me to go and just terminate this life. And so, what she does is she goes over to Virginia, she goes over to some other state, where abortion is legal, and she goes and gets the abortion. And so I think that's a really clear possibility if we enact the Second Amendment here, I don't want to be doing anything whatsoever that is encouraging, folks to go and get an abortion.
These guys are assholes.
And (IMHO) because they're assholes, they think everybody else is an asshole, and so of course we'll do whatever asshole things they dream up and project onto us. And the darker the better. The worst things they can imagine is something they're convinced all those nasty liberal women will do.
Aug 5, 2022
Podcast
The Universal Judge Gable Standard:
"You must tell the truth while you testify. This is not your show. You need to slow down, and not take what you see as opportunities to further the message you're wanting to further, and instead, only answer the specific and exact questions you have been asked. You believe everything you say is true but it isn't. Your beliefs do not make something true. That is what we're doing here. Just because you claim to think something is true does not make it true. It does not protect you - it is not allowed. You're under oath. That means things need to be true when you say them. Don't talk."
A judge scolded right-wing conspiracy theorist Alex Jones on Tuesday for lying under oath during his defamation trial in Travis County, Tex.
— The Washington Post (@washingtonpost) August 3, 2022
“You must tell the truth while you testify,” Judge Maya Guerra Gamble said. “This is not your show.”https://t.co/YzxxNm93Op pic.twitter.com/4sQ48lJEgU
Moms Demand Action
The editors at business Week are chickenshit
The Bidening
Hal Sparks
Aug 4, 2022
That Cheney Ad
I'd make common cause with Beelzebub if it took Trump down, and blew a big whole in MAGA world.
Here's the previous title-holder of America's Biggest Threat To It's own Democracy:
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