Abortion Information

Depending on the outcome of a court decision this week, Arkansas could become the seventh state in the country to have only one abortion clinic. Women in the state could also lose access to any abortions after 10 weeks into their pregnancy.

On Monday, Judge Kristine Baker, appointed by President Obama in 2012, heard challenges to three of Arkansas’ recently-passed anti-abortion bills. If the laws are allowed to be implemented, it would force the closure of the state’s last surgical abortion clinic, Little Rock Family Planning Services. Planned Parenthood Little Rock would be the state’s last remaining abortion clinic, but would only be authorized to provide medical abortions, a method used up until 10 weeks into a woman’s pregnancy.

If Judge Baker doesn’t block the legislation from going into effect, the new laws will begin on Wednesday.

Arkansas’ anti-abortion laws in question are among the more than 300 pieces of legislation introduced this year that regulate and restrict access to abortion, the most in any single legislative session since the 1973 Roe v. Wade decision, according to the Guttmacher Institute, a pro-abortion rights research organization. In six states, lawmakers have successfully passed “heartbeat” bans, laws that prohibit abortions after a fetal heartbeat is detected, which typically happens five or six weeks into a woman’s pregnancy. Critics of the new laws say that’s before most women know they’re pregnant.

Alabama’s lawmakers went a step further, passing a total ban on abortions in the state.

The new state laws have not taken effect, and all but Missouri’s face court challenges.

This legislative session, Arkansas lawmakers passed 12 anti-abortion bills, three of which are being challenged in this week’s lawsuit. The state’s “Cherish Act” bans the procedure after 18 weeks into a woman’s pregnancy and its “Down Syndrome Discrimination by Abortion Prohibition Act” makes it a felony offense for physicians to perform an abortion if they believe the woman is seeking the procedure because fetal Down Syndrome was detected.

However, Senate Bill 448 could have the most impact on abortion access. The law, which was never given a name, requires that “a person shall not perform or induce an abortion unless that person is a physician licensed to practice medicine in the state of Arkansas and is board certified or board-eligible in obstetrics and gynecology,” according to the bill’s language.

As of Monday, Arkansas only had two functioning abortion clinics, both in Little Rock: Planned Parenthood and Family Planning Services. If SB448 is allowed to be implemented, Family Planning Services, the only clinic the provides surgical abortions in the state, would be forced to close because the clinic’s one provider “isn’t OB/GYN board-eligible or certified,” said Elizabeth Nash, a senior states issue manager at Guttmacher. While Planned Parenthood has physicians who would meet the requirements of the new law, the clinic only provides medical abortions and can’t accommodate additional patients, according to Nash.

Emails to Planned Parenthood and Family Planning Services were not immediately returned.

If Judge Baker does not block the laws from implementation, Arkansas will become the seventh state with only one abortion clinic, joining Kentucky, Mississippi, Missouri, North Dakota, South Dakota and West Virginia. According to the American Civil Liberties Union, the state had eight abortion facilities in 1992. The number dropped to four by 2014.

Earlier this month, Arkansas went down to two providers when Planned Parenthood Fayetteville announced that it would be closing its doors due to “increasing problems with our landlord,” Planned Parenthood Great Plains Chief Executive Officer Brandon Hill said in a statement. In a court filing, Hill wrote that Planned Parenthood had contacted dozens of properties, but had been unable to find a willing landlord.

Source: https://www.cbsnews.com/news/abortion-in-arkansas-arkansas-could-become-seventh-state-with-one-abortion-clinic-this-week-2019-07-22/

In 2016, candidate Donald Trump said that determining whether abortion is legal should “go back to the individual states.”

Today, states are indeed setting the terms. While hundreds of laws restricting abortion have passed in the states since Roe, creating significant barriers for many, particularly low-income women, women of color, young women and women living in rural communities, this year, a shocking number of states from Alabama to Ohio have acted with exceptional vigor, passing near-total bans in rapid succession.

But the actions of politicians racing to inspire a challenge to Roe v. Wade have not gone unanswered. Following, and in expectation of, the new anti-abortion restrictions, many states have moved with renewed resolve to protect abortion rights, building on the groundwork advocates and legislators have been laying for years. Their actions brim with an urgency that is on the rise across the country, as voters come face-to-face with the reality that, with a conservative majority on the Supreme Court, abortion access as we know it could truly disappear.

Recent polling shows that in no state do a majority of people want to ban abortion in all circumstances. Yet that is essentially what a handful of states pushed through. The result? An invigoration of the political will to ensure that abortion rights remain a reality that has set the country on a new trajectory as we head into the 2020 election.

This reaction mirrors what the National Institute for Reproductive Health (NIRH) has observed in focus groups across the country. When we asked voters if they would take action to improve abortion access, they often gave lukewarm responses — presuming that access is secure even in states with severe abortion restrictions. But when participants learned of the hundreds of restrictions that states have passed to try to push abortion out of reach – scripts that providers must read containing inaccurate information, waiting periods, medically unnecessary ultrasounds, politically motivated regulatory schemes that shuttered clinics and more – people grew enraged at these attacks on abortion access. Once the threat is revealed, action soon follows.

The momentum is unprecedented.

A number of blue states passed laws to protect abortion rights in the 1990s, but since then most have relied on federal law – after all, Roe ensures that abortion is still legal in all 50 statesIn the first six months of 2019, however, states have enacted 94 bills designed to protect and expand access to not just abortion but to the full range of reproductive care, including contraception, maternal health and sexuality education – a nearly 30 percent increase in proactive legislation from this timeframe last year, according to NIRH’sGaining Ground: 2019 Midyear Report. And specifically related to abortion, eight states enacted eleven laws to protect abortion rights and expand access to this care.

New York’s Reproductive Health Act (RHA), passed in January, removed abortion from the state’s criminal code and now treats the procedure as health care, and it enshrines the same protections guaranteed by Roe. Since then, Illinois and Rhode Island have followed suit with similar legislation, as has Vermont, which passed an even more expansive law, and is led by a Republican governor. Nevada passed a law to ensure women cannot be prosecuted for ending a pregnancy, and Maine passed legislation requiring the state’s Medicaid program to cover abortions, demonstrating another way for states to increase access. And although it did not pass a law, New Mexico moved further than it ever has toward repealing its pre-Roe criminal abortion ban, setting the stage for future action.

The renewed threat has created pushback even in states that have been noteworthy for their legislature’s antipathy toward reproductive freedom. In Wisconsin, four anti-abortion bills were passed, but newly elected Governor Tony Evers promptly vetoed the dangerous legislation, following in the footsteps of North Carolina Governor Roy Cooper who also recently vetoed an anti-abortion bill saying it was “unnecessary interference between doctors and their patients” and would have criminalized healthcare providers for a “practice that simply does not exist.”

Recent abortion bans have brought to the fore the fact that abortion rights and access to reproductive health care is a fundamental part of the fabric of our society. And, nationwide, it’s clear: with the exception of a small minority of extremists, people across the country want that fabric to remain intact.

Source: https://time.com/5624770/abortion-rights-states-nirh-report/?fbclid=IwAR2PUM_d_De0Z4XhwRXq7Xkg0r_29PysgobbcoORvIFg4jFOtbPKmAkpO4s

A lawsuit claims two anti-choice North Dakota laws violate doctors’ constitutional rights by forcing them to “convey false information and non-medical statements” to patients.

The plaintiffs say such laws harm patients and jeopardize the patient-physician relationship. The lawsuit says these two laws violate the constitutional rights of doctors by forcing them to “convey false information and non-medical statements” to patients.

A law passed by North Dakota Republicans requiring physicians to misinform their patients about medication abortion being “reversible” won’t go into effect on August 1 as a legal challenge continues.

The American Medical Association (AMA) and the Center for Reproductive Rights filed a lawsuit last month on behalf of the Red River Women’s Clinic, North Dakota’s only abortion clinic. The suit challenges two laws that require doctors to tell their patients “misleading and patently false information.”

HB 1336, signed by Gov. Doug Burgum (R) in March, would force doctors to tell patients that “it may be possible to reverse the effects of an abortion-inducing drug”—a medically unsupported statement.

The state reached an agreement with plaintiffs last week that it would not begin enforcing HB 1336 until Chief U.S. District Judge Daniel L. Hovland rules on the request for a preliminary injunction.  The state’s response to the request for a preliminary injunction is due Friday, and the plaintiffs may file a response by July 31. The federal judge is expected to issue a decision in a month. The state attorney general’s office is reviewing the complaint, a spokesperson said in an email.

Though the concept of abortion reversal has not been accepted by legitimate medical organizations, it remains popular among anti-choice legislation mills and state lawmakers.

“Our claim in this lawsuit is that the government should not, and really cannot, constitutionally force physicians to act as a mouthpiece for the state, speak controversial messages, or messages which are patently false, as it entails forcing physicians to violate their medical ethics and impose harms on their patients,” Molly Duane, an attorney with the Center for Reproductive Rights, told Rewire.News.

Medication abortions involve a combination of two drugs—mifepristone, taken first, and then misoprostol. The abortion pill “reversal” is “unproven and unethical” according to the American College of Obstetricians and Gynecologists (ACOG). A paper by two California doctors opposed to abortion rights has been used as evidence by Republican lawmakers to pass “reversal” bills, even though the study only involved six women, as Rewire.News reported in its 2017 False Witnesses series.

Filed June 25, the AMA lawsuit also challenges the state’s 2009 Abortion Control Act, which forces doctors to inform their patients that an abortion “will terminate the life of a whole, separate, unique, living human being.”

The plaintiffs say such laws not only harm patients and jeopardize the patient-doctor relationship but also violate doctors’ constitutional rights by forcing them to “convey false information and non-medical statements” to patients.

Tammi Kromenaker, director of Red River Women’s Clinic in Fargo, told Rewire.News she is “pleased to be partnering with the AMA to fight for the integrity of the information that we have to give to our patients. We believe that it is important for all of those who believe in integrity in medicine and that, simply put, patients shouldn’t be lied to, come together to take a stand against misinformation. Patients should not be given medically inaccurate information as part of their decision making process.”

The abortion landscape in North Dakota is “bleak,” Kromenaker said, with a quarter of her clinic’s patients having to drive between two-and-a-half to four hours each way.

Burgum signed a bill in April banning dilation and evacuation abortions and criminalizing physicians who perform the common second trimester abortion procedure, though the bill will not take effect until a federal appeals court or the U.S. Supreme Court allows its enforcement.

North Dakota has a range of abortion restrictions in place, according to NARAL. These include a ban on abortions after 20 weeks, a parental consent requirement for minors, a forced 24-hour waiting period, a ban on private health insurance covering abortion, and a law preventing abortion coverage for public workers.

Lawmakers in eight states have passed laws requiring abortion providers to tell patients about abortion “reversal,” and in five states those requirements are in effect. In March, Arkansas expanded its existing law to require providers to notify patients in writing that medication abortion can be stopped midway. Oklahoma legislators approved a similar bill criminalizing physicians who fail to inform patients about the possibility of reversing the process.

Arizona paid $550,000 in legal fees in 2017 after facing a challenge over a 2015 law promoting abortion “reversal.” Arizona doctors called the law “tantamount to quackery,” and the governor eventually signed a bill repealing the measure, Rewire.News reported.

“This is a troubling trend in abortion restrictions because this isn’t really about the abortion procedure itself, so much as it is targeting physicians who happen to provide abortion care and really their free speech rights and their ability to provide the best and most quality care to their patients,” Duane said. “The premise of this lawsuit is to highlight the fact that physicians have First Amendment rights just like everybody else, and that they do not lose their rights just because they are providing abortion care.”

Source: https://rewire.news/article/2019/07/17/north-dakota-law-forcing-doctors-to-spread-abortion-misinformation-wont-take-effect-yet/

It seems some people don’t know what they have until it’s almost gone.

Escalating attacks on abortion rights may be contributing to a surge in pro-choice sentiment, according to a new ABC News/ Washington Post poll.

The findings show support for abortion has hit a 24-year high in the U.S., with 60 percent of Americans agreeing that the procedure should be legal “in all or most cases,” and 27 percent saying it should be legal “in all cases.”

The poll was conducted between June 28 and July 1, in the aftermath of a wave of extreme anti-abortion legislation from states like Alabama and Georgia, whose proposed laws criminalized providers and made no exceptions for survivors of rape or incest. Conservatives see the passage of these laws as a sign that they’re winning the fight over abortion rights—but pro-choice adovcates say the growing extremity of anti-abortion legislation has only encouraged more Americans to stand up in support of choice. Others say the upward trend is something 2020 presidential candidates in particular should take note of, as abortion will likely be top of mind for many voters at the ballot box.

“American people see how extreme these attacks are, and they see the real intention of these politicians—which has nothing to do with medicine and science, but everything to do with misogyny, and control, and power over women’s bodies,” Planned Parenthood President Leana Wen told VICE. “We’ve known for many years that there is a big disconnect between these extreme bans that politicians are passing and the will of the American people.”

In May, polling from HuffPost/YouGov found that 56 percent of Americans didn’t think other states should follow Alabama’s example of passing legislation amounting to a total ban on abortion. HuffPost polling editor Ariel Edwards-Levy explained that the reason the law was so “deeply unpopular” was simple: “Most Americans don’t hold absolutist opinions on abortion,” she wrote, “and even fewer hold views as unwaveringly anti-abortion as the legislation itself.”

As ABC News points out, public opinion on legal abortion hasn’t been consistent over time. The last two decades have seen significant dips in support for abortion rights, as well as fleeting spikes. Though it can be difficult to pinpoint a clear cause and effect for polling results, Alina Salganicoff, the director of women’s health policy at the Kaiser Family Foundation, suggested the equivalent 1995 peak in support for abortion rights might have been due to the rise in restrictions resulting from the landmark 1992 Supreme Court ruling on Planned Parenthood v. Casey.

Casey really allowed states to regulate abortion,” Salganicoff explained. “Out of Casey, we ended up having all of these laws requiring waiting periods and parental consent—all of the things that have challenged abortion access.”

For decades, a majority of Americans have believed abortion should be legal “under certain circumstances,” but Salganicoff said it’s not unusual to see support swell amid renewed attacks on certain rights and protections. She saw something similar when Republicans threatened to repeal the Affordable Care Act: The Kaiser Family Foundation tracked the favorability of the Obama-era healthcare law every month since it was signed, and found support began to rise after President Donald Trump, who campaigned on “repeal and replace,” took office.

“In situations where a particular law or protection has been threatened, there’s increased awareness about what that law means, and what would happen if it went away,” Salganicoff said. “With the ACA, people were suddenly concerned about losing pre-existing protections, essentially health benefits, preventative care services—all of these things people might not have known were in the ACA before.” It seemed that some people didn’t know what they had until it was almost gone.

It may not be a completely analogous situation, she said, but attacks on abortion have at the very least raised people’s awareness and highlighted what’s at stake.

Grassroots organizations involved in electoral politics say the rise in support represents an opportunity for the Democratic Party to take a more unapologetic stance on abortion. Though historically Democrats have been thought of as the definitive party for choice, last year House Speaker (then House Minority Leader) Nancy Pelosi said though she’d like to see all 2018 Democratic candidates support abortion rights, the party shouldn’t impose a “litmus test” on its members. And in May, the Democratic Congressional Campaign Committee drew ire for again throwing its support behind anti-abortion Democrat Dan Lipinski, who is being challenged from the left for the second time by pro-choice candidate Marie Newman.

“The party has not always embraced abortion rights fully and it certainly should,” said Maria Langholz, a spokesperson for the Progressive Change Campaign Committee, which helps progressive candidates get elected. “We believe it’s every woman’s right to choose and that this is about recognizing the dignity and humanity of women. That’s where the Democratic Party should be.”

Langholz says Democrats have begun to move further left on the issue, and she finds it promising that abortion rights have already been a point of discussion for 2020 presidential candidates. Langholz said Massachusetts Senator Elizabeth Warren has distinguished herself especially by rolling out a comprehensive plan to protect abortion access if Roe v. Wade were to be overturned. Among other strategies, Warren has proposed passing federal legislation to enshrine abortion rights into law, taking the decision out of the hands of a conservative-leaning Supreme Court, as has New York Senator Kirsten Gillibrand.

Democratic strategists agree, and say 2020 candidates should take advantage of swelling support for abortion rights, and show voters they take seriously the conservative threats posed to them right now.

“Democrats must clearly and emphatically embrace abortion rights, and that includes a litmus test for judges,” said Rebecca Katz, the founder of Democratic consulting firm New Deal Strategies. “At a time when the Republicans are systematically taking away women’s rights state by state, we can’t afford to have a Democratic nominee waver on abortion access.”

That means it may no longer be enough to merely say one is “pro-choice.” Langholz said she would like to see more 2020 Democrats hash out their policies on reproductive health, and take cues from recently elected progressive members of Congress, who she sees as pushing the party further left.

“On the whole, I would say that right now the progressives in Congress have shifted what is possible, and this is true on abortion, this is true on climate,” Langholz said. “To me this is proof that by talking about our values we’re able to move what is considered the center or mainstream. These polling numbers to me suggest exactly that.”

Source: https://www.vice.com/en_ca/article/j5wzag/conservative-attacks-are-making-abortion-rights-more-popular-poll?fbclid=IwAR0P0oeTa0g-wVhz3sQ_X7L3FCfBHphb0_wO5StJmNtUkz7-DxYJG8O723g

“How can you sit back? The rapidity with which some of these laws have taken place is very frightening. It’s happening way too quickly,” one activist said.

Grandmothers for Reproductive Rights at the Women’s march in Washington on Jan. 21, 2017.Bill Tompkins / Getty Images file

Jane Fisher still remembers feeling terrified driving to New York City from her Connecticut college campus for a 3 a.m. appointment with an abortion doctor almost 50 years ago. She had heard countless horror stories of women getting sick and dying from unsafe abortions, so she decided to travel in the dead of night to a clandestine clinic in the neighboring state, which recently legalized abortion.

The procedure, which safely terminated her unwanted pregnancy, yielded a sigh of relief for Fisher, but the panic-ridden experience resonated for a long time, eventually sparking a passion in her for reproductive rights.

Jane Fisher
Jane Fisher in Concord, New Hampshire in 1979.

“Women deserved better,” she said. “I needed to do something about it.”

After college, she began protesting and working with well-known reproductive rights activist Bill Baird until abortion became legal in 1973 with the landmark Roe v. Wade Supreme Court decision.

Now at 70, the retired clinical social worker has once again felt the call for action after feeling like what she’d fought so hard for is facing a new threat.

“Abortion rights are under attack in such a deep way now,” she said, referring to the wave of anti-abortion laws recently passed. “How can you sit back? The rapidity with which some of these laws have taken place is very frightening. It’s happening way too quickly.”

Fisher belongs to an abortion-rights group comprised of women who grew up in the pre-Roe v. Wade era called Grandmothers for Reproductive Rights. The group lobbies state legislatures, has an avid presence at women’s marches and hosts educational discussions on reproductive justice.

Like Fisher, many activists who spoke out in defense of a woman’s right to choose in the ’60s and the ’70s said they have felt the call to action again, and this time they feel a greater urgency to get involved because they remember what life was like when abortions were criminal.

Jane Fisher and Judy Kahrl
Jane Fisher and Judy KahrlCourtesy Grandmothers for Reproductive Rights

“We can’t go back to that,” said Karen Mulhauser, 76, who protested for reproductive justice in the ’60s. “Young people sometimes don’t believe that Roe could be reversed because they’ve grown up seeing abortion always being available, but that’s why women need to tell stories of what it was like when it wasn’t.”

Mulhauser said she was forced to self-induce an abortion at 19 years old when she had no legal way to obtain one. She still remembers standing in a “pool of blood” struggling to get back to campus afterwards.

She went on to become the executive director of the National Abortion Rights Action League in the ’70s and the ’80s, after working as a pregnancy counselor and a volunteer for Planned Parenthood.

These days, she’s busier than ever doing voter engagement work and mentoring young women who are looking to further the abortion rights cause.

In the last year, anti-abortion advocates have made a concerted push to siphon access to the procedure by pressuring states to pass restrictive abortion laws aimed at triggering the Supreme Court to overturn more than 40 years of federal abortion protection under Roe v. Wade.

So far, nine states have passed such laws, including Alabama, whose law makes abortion at any stage of a pregnancy a felony punishable by 10 to 99 years or life in prison if it goes into effect.

Other states, such as Ohio and Louisiana, have introduced “heartbeat” bills which outlaw abortions when a fetal heartbeat is detected, which usually occurs around six weeks, before many women know they are pregnant.

Heather Booth, 73, founded an underground network as a college student out of Chicago in 1965 called “Jane” that helped women obtain abortions until they became legal.

After Roe was decided, Booth began working on a host of other social change efforts including financial reform, marriage equality and immigration policy.

But in the wake of the recent challenges to abortion, Booth has lent her voice back to women’s reproductive rights by promoting strong organization and voter mobilization in the face of what she feels is a more powerful opposition than before.

“The opposition is now more virulent, partisan, well-funded and organized for political purposes in ways that it was not quite the same before Roe,” she said. The strict and very clear partisanship surrounding this issue wasn’t the same level back then, she said.

Several other activists from the pre-Roe era echo Booth’s sentiment.

“Watching the last year or two has been absolutely agonizing,” said Sheila Spear, 78, a ’60s activist who recently joined Grandmothers for Reproductive Rights’ educational outreach branch. “In the ’60s, I don’t think many women were openly pursued by the law the way people are now. They weren’t threatened with going to jail for the rest of their lives.”

Sheila Spear
Sheila SpearCourtesy Sheila Spear

“It’s ridiculous that despite our past efforts, this next generation of women may still be denied their reproductive rights,” she said. “It’s worse this time because we know better.”

Spear feels the threat to abortion rights has reached peak level.

Abortions will not cease, even if it’s outlawed, said Norma Dreyfus, 79, a retired doctor who worked the septic abortion ward in New York City as a medical student in the mid-1960’s. She still vividly remembers the horrors of seeing women who underwent illegal or self-induced abortions, who were infected, hemorrhaging and dying.

Women will go back to doing whatever it takes out of desperation, which will lead to unsafe and dangerous outcomes, she said. “We’ve already seen it happen.”

In 1965, illegal abortions accounted for 17 percent of all deaths attributed to pregnancy and childbirth, according to the Guttmacher Institute, a group that studies reproductive rights. Although the numbers of deaths was likely higher as the data only reflected reported deaths, the institute reported.

Dreyfus feels her unique perspective on the medical side of botched abortions will help spread the cause, which is why she’s actively involved in advocacy and has even testified in front of the Maine Legislature regarding two bills on abortion rights.

Jeanne Galatzer-Levy, 68, a former member of “Jane,” had retired into a quiet life after working as a science writer in Chicago until she too felt the winds around abortion begin to shift.

Jean Galatzer Levy
Jean Galatzer-Levy in the 1960s.

“I’ve become much more active than I ever was before,” she said. “It’s important to tell our story because the story is still relevant. I wish it wasn’t, but it still is.”

She’s particularly worried about low-income women, who are almost always disproportionately affected by restrictive abortion access.

“Middle-class women are always going to be able to get abortions because there will always be places they can go that will give them safe abortions. It’ll just be harder for poor women to gain access to safe places,” she said.

According to a 1960’s study of low-income women in New York City, 77 percent said that they had attempted a self-induced procedure, the Guttmacher Institute reported.

But Galatzer-Levy is hopeful the new generation will take heed the stories of women who knew life before abortion was legal and will help move the cause forward.

“I’m really excited by what I see in the new women’s movement and the new activism,” she said. “They are moving it along,” she said.

Fisher has charged herself up for the next round of action with nothing short of the same passion she had as a young college student. She now has a new generation of women to fight for and to fight alongside, she said.

“It’s time we all get active and pay attention to reproductive justice because these rights are fundamental to all women, and we have to have each other’s backs,” she said. “We absolutely cannot go backwards.”

Source: https://www.nbcnews.com/news/us-news/call-action-activists-who-fought-roe-v-wade-are-back-n1028631

“I just can’t believe that they are so arrogant as to impose this rule on trusted medical providers in our state while the litigation is happening,” said George Hill, president and CEO of Maine Family Planning, shown at a rally in July 2018. Joe Phelan/Kennebec Journal

Maine Family Planning will forgo hundreds of thousands of federal dollars rather than move its abortion services or close its clinics.

The decision was a response to a Trump administration rule that puts new restrictions on abortion providers that receive federal family planning grants. Despite pending legal challenges across the country, the federal government announced Monday it would begin to enforce the rule. Critics including the American Medical Association say the restrictions will limit access to abortion and other medical care for low-income patients, while supporters say taxpayer dollars should not go to abortion providers even though the money is used for other services.

So Maine Family Planning announced Tuesday that it will not accept any more federal money and instead dip into its reserves to maintain its existing services across the state. The nonprofit has been part of the federal Title X program for 50 years and is one of the first to leave it over the new restrictions. Planned Parenthood, which is the largest grant recipient, also has told news outlets that it will not comply with the rule. Others have made similar statements since the rule was proposed earlier this year.

“I just can’t believe that they are so arrogant as to impose this rule on trusted medical providers in our state while the litigation is happening,” said George Hill, president and CEO of Maine Family Planning.

He said he did not want to prevent medical providers at Maine Family Planning clinics from discussing abortion with patients.

“It came down to a mind’s-eye picture of a young person, 15 or 16 years old, getting a pregnancy test result that she doesn’t want and asking one of our providers what her options were and might she be able to get an abortion,” he said. “I don’t want to put our providers in the position of having to respond with simply a referral for prenatal care or the statement that they cannot talk about abortion.”

An official from the U.S. Department of Health and Human Services said the government is working with grantees to help them come into compliance with the rule. She said she has not heard from other grantees about withdrawing from the program.

“While the final rule prohibits referral for abortion as a method of family planning, nondirective counseling on abortion is permitted,” Mia Heck, director of external affairs in the Office of Assistant Secretary for Health, wrote in an email. “The final rule protects Title X healthcare providers so that they are not required to choose between participating in the program and violating their own consciences by providing abortion counseling and referral.”

Federal money cannot pay for abortions except in the case of rape, incest or to save the life of the woman. The Title X program pays for birth control, STD tests and cancer screening for low-income people.

Maine Family Planning is the only Title X grantee in the state and receives nearly $2 million from the program each year. It runs 18 clinics and shares the federal funds with Planned Parenthood clinics and other health centers in Maine. The money represents more than a quarter of the agency’s annual revenue, and more than 23,000 patients in Maine access services through the program ever year.

The new rule bans family planning clinics that receive Title X funds from making abortion referrals – what critics are calling a “gag rule.” The clinics also will be barred from providing abortion services in the same buildings where they provide health services paid for by Title X funds, a requirement that would increase costs for many providers.

Maine Family Planning has said that expense would force it to stop offering abortion services at all but one of its clinics. Under that scenario, Mainers would have only three publicly accessible locations for abortion care across the state – the flagship Maine Family Planning Clinic in Augusta, the Mabel Wadsworth Center in Bangor and the Planned Parenthood location in Portland.

Maine Family Planning and the national Center for Reproductive Rights sued the federal government in U.S. District Court in Maine, and that lawsuit is one of several filed across the country. Federal judges in different courts have alternately blocked the rule and allowed it to take effect, but Hill said no order currently blocks it.

So the federal government announced Tuesday that it would begin to enforce the rule. Hill said he was about to board a plane to Washington, D.C., for a national meeting of Title X grantees when he got the news. Instead, he canceled his flight and spent three hours at the airport organizing the organization’s response. The board agreed to dip into reserves to maintain operations as usual, he said.

“This is the rainy day,” Hill said. “There’s no better use for it than now.”

Hill was unsure whether Maine Family Planning would be required to return any money to the federal government. The nonprofit has received nearly $880,000 so far this year, and it will forgo $825,000 through the end of 2019.

Tax documents show the nonprofit has relied on those reserves to cover operating losses in recent years. It had net assets of $4.7 million at the end of 2016, the most recent year available. Its expenses that year were more than $8.2 million. Hill said the board would need to look for new funding sources if the rule does hold up to pending legal challenges.

“It’s unsustainable in the long term, that’s for sure,” Hill said. “The situation is urgent.”

Some Maine elected officials released public statements Tuesday in support of Maine Family Planning. They included Maine House Speaker Sara Gideon, a Democrat, and U.S. Sen. Angus King, an independent.

“The Trump Administration’s gag rule is a misguided, backward effort to deny Maine people critical health care like cancer screenings and reproductive health services,” said Gov. Janet Mills, a Democrat. “Further, it is an attack rooted in ideology – not in concern for public health – and it will only result in reduced access to health care and less healthy people. …

“I applaud Maine Family Planning for their commitment to keep their health centers open for as long as possible, and my administration will work with them to evaluate if there is any way state government can be helpful.”

Teresa McCann-Tumidajski, the executive director of the Maine Right to Life Committee, said that low-income families can still access free contraceptive services at federally qualified heath centers that provide an array of health care services, but do not perform abortions.

“We are pleased that the 9th Circuit has upheld this ruling which protects our hard-earned tax dollars being used by organizations that promote and provide for the wholesale destruction of innocent human life,” she said.

Source: https://www.pressherald.com/2019/07/16/maine-family-planning-will-forgo-federal-funds-over-abortion-gag-rule/

“It’s vulnerable women who are criminalized. It’s exactly the same thing that will happen in the United States.”

In El Salvador, where abortion has been banned in all circumstances since 1998, activists drew similarities between the two countries’ situations—and told Rewire.News that those concerned about reproductive rights should look to unite with allies beyond their own borders.
Courtesy of Kathy Bougher

Legislatures around the United States have passed increasingly tight restrictions on abortion in the past few years. As the overturning of Roe v. Wade becomes a more realistic possibility, some activists have looked to those in other countries with abortion bans for guidance.

In El Salvador, where abortion has been banned in all circumstances since 1998, activists drew similarities between the two countries’ situations—and told Rewire.News that those concerned about reproductive rights should look to unite with allies beyond their own borders.

“What happens in the United States is not unimportant in our countries,” said Morena Herrera, founder and president of the El Salvador-based Agrupación Ciudadana por la Despenalización del Aborto. “The 1973 Supreme Court decision [legalizing abortion in the United States] has been a reason for hope, a point of reference for women in the world.”

Overturning Roe v. Wade, based on Herrera’s experience, will likely lead to the return of clandestine, illegal measures to have abortions—sometimes risking people’s safety in the process.

In both the United States and El Salvador, Herrera said, “The most vulnerable are the most affected by restrictive legislation. Obviously, this includes women who live in poverty, but also younger women, and those who have less information and less power to make decisions about their own reproductive processes.”

“Let’s be real,” said Paula Avila-Guillen, director of Latin America Initiatives for the Women’s Equality Center. “This is not about protecting a fetus or a possible life. This is about controlling women’s bodies, but it’s also very connected with white supremacy and controlling certain women’s bodies.”

“Women who are privileged will be able to find an abortion. That is nothing different than what we see in El Salvador. It’s vulnerable women who are criminalized,” she said. “It’s exactly the same thing that will happen in the United States.”

The Consequences in El Salvador

In El Salvador, anyone suspected of having an abortion can end up arrested—sometimes while they’re still in the hospital. That includes people who have had obstetric emergencies or miscarriages, who often didn’t know they were pregnant in the first place.

In addition to outlawing all abortion, the Salvadoran government has manipulated the law to convict some women who have obstetric emergencies of aggravated homicide, with a prison term of 30 to 50 years. To date, the Agrupación Ciudadana has worked to free 37 such women from prison. At least 17 remain incarcerated—and as long as the law is in effect, more can be charged and jailed.

Maria Teresa Rivera, for example, served more than four years of a 40-year prison sentence after having an unattended precipitous birth in the latrine of her home. She almost bled to death before arriving at the hospital, where she was charged with abortion and then aggravated homicide. Although she had sought medical attention for various infections during the previous months, neither she nor the medical personnel who treated her had realized she was pregnant. After the Agrupación supported her in a new trial and she was freed from prison in 2016, the government made clear it intended to retry her andimprison her again. She requested and was granted political asylum in Sweden; she is believed to be the only person in the world granted asylum for abortion-related reasons.

Sonia Tábora, meanwhile, spent 12 years in legal limbo after she had a stillbirth in the coffee fields behind her family’s modest rural home in 2005. She was convicted of aggravated homicide and spent more than seven years in prison before she was found innocent in 2012 and again in 2017 after a higher court insisted on another trial; the last court determined that the government owed her reparations.

The fear of being prosecuted like these women has had ripple effects around the country—including, activists say, a number of suicides among adolescents.

The study “¿Sin opciones? muertes maternas por suicidio (Without options? Maternal deaths by suicide)” released by the United Nations Population Fund (UNFPA) in May, analyzed 14 cases of suicide among young pregnant women in El Salvador.

In covering the study for La Prensa Gráfica, Evelyn Machuca noted 18 additional cases that El Salvador’s Institute of Forensic Medicine defined as “suicides where the precipitating factor was an unwanted pregnancy.”

Hugo González, UNFPA representative in El Salvador, told La Prensa Gráfica that “the common denominator in all the cases were the expressions of violence, the absence of information, the lack of comprehensive sexual education, and gaps in the public health system.”

“One of the keys to reducing these numbers and to preventing these situations is, without a doubt, comprehensive sexual education,” according to González, who also raised the need for an “obligatory discussion that the country must have around the decriminalization of abortion.”

“Pregnancy in girls and adolescents must be considered as one of the most impactful forms of violence on the personal aspirations and health of this population,” the UNFPA report emphasized.

“These situations of suicide [in El Salvador] derive from situations adolescents face that have no exit, [which] derive from situations of violence,” Herrera told Rewire.News.

Although there is little existing data for adolescents in the United States, Herrera said, “I’m almost certain that if the U.S. advances this restrictive legislation, they’re going to have to incorporate the variable of suicide among pregnant adolescents.”

Pregnant people, especially adolescents, in El Salvador also face the risk of maternal death. The country’s maternal mortality rate is significantly higher than the United States’ rate, which is itself rising.

“One of the risks of maternal mortality in adolescents—adolescence is a risk factor in general—is premature birth,” said Hererra. “Girls and adolescents face an increased risk of premature birth.”

She pointed out that the Ministry of Health has said “that if you want to reduce infant mortality and diseases in newborns, you have to reduce premature births. And to do that, we must reduce pregnancies in girls and adolescents.”

Activists also fear what may happen when people who need abortions turn to self-managed practices, some of which are riskier than others.

“I see this going to where you do your own abortion,” said Avila-Guillen. “I see how a spike in unsafe abortion will correlate with girls and adolescents trying to Google how to do your own abortion and probably dying. That might be more likely than an increase in suicides.”

“When you have this combination of policies—restrictions on abortion, lack of sexual education, and lack of access to contraception—what you are creating is all the circumstances to actually have a spike on the number of abortions because women will be desperate and do whatever they need to do,” she continued. “That is what ends up sending women either to prison or to hospital beds or to the cemetery.”

“We still don’t know what the reality would be in the U.S. for women and girls and trans people if Roe v. Wade is overturned,” she said.

Medication abortions—which use misoprostol and mifepristone—fall under El Salvador’s ban, but misoprostol is somewhat available through clandestine networks and in some pharmacies for on-label use, such as for ulcers. Some activists say that this has led to a decrease in deaths from “knitting-needle type” abortions. And indeed, there has been rising interest in the United States in self-managed abortion because of restrictions, safety concerns, or personal preference.

Still, Herrera warns that the ban on medication abortion means that someone can’t seek help if they encounter fake pills or unsafe practices from suppliers.

“Yes, [medication] abortion has changed the effect of the consequences of abortion in general,” she said. “However, the clandestine conditions of illegality and lack of safety continue with [medication] abortions because a woman does not have any safety if she confronts bad practices. She cannot make a legal claim.”

Dr. Guillermo Ortiz Avendaño, now with the reproductive rights organization IPAS, was formerly the head of the perinatology department at the National Women’s Hospital of El Salvador. There, he oversaw the case of Beatriz, a woman with lupus and other health concerns who was pregnant with a fetus with anencephaly in 2013. Her quest for a life-saving abortion became a public turning point in the fight to decriminalize abortion in El Salvador.

Abortion bans are “a huge step backward not only in terms of human rights, but also in terms of women’s health,” Ortiz Avendaño told Rewire.News in a phone interview.

Because health providers “have an ethical commitment to women, they will do their best to prevent situations where women are [at] risk,” Ortiz Avendaño said. “However, this can put providers in the position of facing legal uncertainty. They must walk the line between what is permitted and what isn’t while a woman’s health deteriorates.”

“It will become more complicated for women who are searching for services while their pregnancies advance. This puts the women and their doctors at greater risk,” he said. “I’ve already seen this with women in the U.S. who are undocumented and have difficulty finding a provider while their pregnancies are advancing.”

Another significant issue in El Salvador that could arise in the United States, too, is the lack of data on abortions, medical or surgical, legal or clandestine. There is no way to know how many abortions actually occur, the age of those involved, and other important public health data points.

“There is a lack of any kind of registry on abortion in the country,” Herrera pointed out. There are no data points about the results of medication abortion’s availability “because there are no statistics in the country. With the change of the law [in 1998 which ended all legal abortions] that changed what was recorded. We just don’t know.”

What U.S. Activists Can Learn

As in the United States, there are groups on the ground in El Salvador who have fought for the right to access abortion.

The Agrupacion, which has been publicly working to decriminalize abortion since 2009, has been able to “show some of the consequences this legislation has created—the criminalization of women, the judicial brutalization in those processes of criminalization, the confusion between spontaneous abortion or loss of pregnancy spontaneously in advanced stages,” Herrera said.

The Agrupacion works to decriminalize abortion under specific circumstances, to gain the release of women who have been unjustly imprisoned on abortion-related charges, and to change public perceptions around abortion. Its strategies include legal defense, legislative action, media and communications work, direct action, and national, regional, and international alliances.

“I believe that in the political spectrum we still need to work more, to move the will and to make a decision [to change the anti-abortion law]. I think that it will be important to highlight the political consequences for politicians of not widening their perspectives. In that I think that is a pending task, because today they have very few or no consequences,” she said.

“In our part of the world, the little we have we’ve had to fight tooth and nail for every little bit,” said Monserrat Arévalo, director of the Salvadoran feminist organization Mujeres Transformando. “Maybe this is a message for our compañeras in the United States that in fighting for rights, the time is coming to turn the gaze to the south … and see the great cumulation of political struggle that we have in these regions in order to work together as sisters. See these struggles that are so visionary and creative, because I’m convinced that this is not isolated. This is a global struggle that is linked to capitalism too.”

“We must find ways to work together right now and share experiences,” she continued. “How can we share strategies and adapt them to our own realities?”

Source: https://rewire.news/article/2019/07/16/abortion-has-been-illegal-in-el-salvador-for-two-decades-heres-what-activists-say-u-s-feminists-should-know/

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