Monday’s ruling could be the first step in making medication abortion easier—and safe—to access.

Efforts to block medication abortion have nothing to do with patient safety and everything to do with discouraging robust public health policy regarding pregnancy and abortion. Phil Walter/Getty Images

Medication abortion access just got a little easier and safer for patients during the COVID-19 crisis. It’s about damn time, and it should stay this way forever.

A federal judge in Maryland issued an order on Monday blocking the Trump administration from enforcing a restriction that prevents patients from accessing medication abortion without a doctor’s visit, on the grounds that it likely unduly burdens abortion rights in the middle of a pandemic.

The ruling has the potential to radically shift the medication abortion landscape. Here’s how.

When the COVID-19 pandemic was first taking hold in this country, anti-choice lawmakers did not see the virus, which has now killed over 135,000 people and counting, as a crisis. They saw an opportunity to use one public health crisis to create another by attempting to restrict abortion access. So did members of the Trump administration who, early in the pandemic, refused to suspend restrictions the U.S. Food and Drug Administration (FDA) imposes on mifepristone, one of two drugs used together as medication abortion to end pregnancies and as miscarriage management.

FDA guidelines require patients who are prescribed mifepristone to travel to a hospital, clinic, or medical office to pick up the medication rather than fill the prescription by mail. Of the more than 20,000 drug products the FDA regulates, mifepristone is the only one that must be picked up in person but can then be self-administered at home without clinical supervision.

When used for purposes other than terminating a pregnancy, the FDA permits mifepristone to be mailed directly to a patient’s home.

Doctors from the American College of Obstetricians and Gynecologists (ACOG) urged the FDA to lift the in-person restrictions on mifepristone. Despite the fact that the FDA had suspended similar restrictions on other medications (ones not related to abortion), the agency refused. So advocates sued. On Monday, a federal judge told the Trump administration it must make the medication available by mail for patients using it for an abortion, and blocked the FDA from enforcing its in-person requirement. 

U.S. District Judge Theodore Chuang concluded that the “in-person requirements” for patients seeking medication abortion care impose a “substantial obstacle” to abortion patients and are likely unconstitutional during a pandemic.

“Particularly in light of the limited timeframe during which a medication abortion or any abortion must occur, such infringement on the right to an abortion would constitute irreparable harm,” Judge Chuang wrote in the 80-page decision that accompanied the preliminary injunction.

The decision does not apply to mifepristone for miscarriage management.

“The FDA’s medically unjustified requirement has long stood in the way of communities of color getting the reproductive health care we need—and now, during the pandemic, it is putting us at unnecessary risk for COVID-19,” Monica Simpson, executive director of SisterSong Women of Color Reproductive Justice Collective, said in a statement following the decision.

“Today’s ruling recognized the simple truth that people should not be forced to choose between getting the care they need and protecting their health. This Administration should stop spending its time trying to make it harder for people of color to get the medical care we need, and instead trust us to make our own reproductive decisions and remove barriers that violate or prohibit our human right to self-determination.”

The decision is a critical first step in removing those barriers, perhaps for good. Monday’s injunction will stay in place for 30 days after the COVID-19 public health emergency declaration from the Trump administration expires.

More importantly, if that emergency declaration expires while the lawsuit remains pending in federal court—a distinct possibility given the slog of litigation—then ACOG and the other parties can petition the court to extend its preliminary injunction. That would mean that the FDA could continue to be barred from enforcing its in-person restrictions governing mifepristone. And the longer patients have access via mail to mifepristone for abortion care, the harder it will be for the Trump administration to persuasively argue that patients must be forced to pick up their mifepristone prescriptions in person.

The fight over medication abortion during the pandemic is far from over, though. Conservative states like Indiana and Louisiana have already tried to intervene in this lawsuit to defend the administration and the FDA restrictions; Judge Chuang issued a separate order effectively telling attorneys general from those states to pound sand. And I expect the Trump administration to appeal this decision immediately, which opens the door to the possibility a panel of Trump judges could reverse it.

For now, however, the decision stands. And it’s a good one—except for the fact that it doesn’t extend to patients experiencing a miscarriage. Those patients still have to face exposure risk from traveling to a doctor’s office or clinic to pick up medication in person during a pandemic.

What Monday’s decision really drives home, though, is that the fight over medication abortion is entirely a political battle. Medication abortion is safe. It’s effective. Efforts to block it have nothing to do with patient safety, and everything to do with discouraging robust public health policy regarding pregnancy and abortion. There’s no reason why patients shouldn’t be able to access mifepristone for abortion or miscarriage care via mail, both during this pandemic and once it’s over. Judge Chuang’s decision is the first step in recognizing that truth.

Source: https://rewire.news/article/2020/07/15/medication-abortion-access-is-about-to-radically-change/?fbclid=IwAR2sJB_4sEcpMFTCus1_ygep6bqNN23HFFTc3Sfwxi5_KdWIlc99uxKLhOw

Attacks on reproductive freedom have the greatest effect on communities that already face significant barriers to accessing health care.

Last year, I went to Georgia after Gov. Brian Kemp signed a six-week ban into law and heard from women who had to make the most heartbreaking decisions to end life-threatening pregnancies.
John Amis/AFP via Getty Images

Last month, the U.S. Supreme Court blocked the implementation of a law that would have left just one clinic and one doctor authorized to perform abortions in Louisiana, a state of more than 4.5 million people and 50,000 square miles.

Even though four justices ignored the Court’s own precedent, the ruling in June Medical Services v. Russo gave reproductive health, rights, and justice supporters across the country the chance to breathe a sigh of relief. But as we began leafing through the pages of the opinions, cracks started to appear, reminding us that our freedom remains up for grabs and our fight is nowhere near over.

Chief Justice John Roberts made it clear his critical deciding vote was not an endorsement of the right to access to abortion care, but of following the Court’s precedent. In June Medical Services, Roberts cited the precedent set by Whole Woman’s Health v. Hellerstedt, a case about an identical Texas law. That ruling prevented Texas from making it nearly impossible to access abortion services, and Roberts specifically noted that he “continue[s] to believe [it] … was wrongly decided.”

In his opinion, Roberts also highlighted the fact that “neither party ha[d] asked us to reassess the constitutional validity” of the undue burden standard set in Planned Parenthood v. Casey. Advocates view this statement as an open invitation for future challenges to Casey, an already limited upholding of the ruling in Roe.

Roberts’ message was clear: Because the Louisiana law was too similar to the law in question in Whole Woman’s Health, he could not deliver the ruling anti-abortion activists wanted. But that doesn’t mean he won’t in a future case about a different state law.

And states will try again. Republican lawmakers across the country continue to introduce TRAP (targeted restriction on abortion providers) laws and laws that ban abortion as early as six weeks—before many people even know they are pregnant. And they will continue attempting to pass other laws that restrict access to essential reproductive health care.

Last week, Tennessee Gov. Bill Lee signed a bill that bans abortion at nearly every stage of pregnancy. Almost immediately after it was signed into law, advocates were able to block it temporarily, but that fight is not over.

And in Georgia, after a federal judge struck down the state’s horrifying and discriminatory six-week abortion ban, Gov. Brian Kemp immediately vowed to appeal the ruling. Last year, I went to Georgia after Gov. Kemp signed that bill into law. In the state capitol, I heard from women who had to make the most heartbreaking decisions to end life-threatening pregnancies. Their stories forcefully rebutted the duplicitous arguments behind these laws: that a state would know better than a woman what the ramifications of her choices are.

For those who fight against these draconian laws, these recent court rulings were well-earned victories. But the fact that we are still fighting these battles, and that the Supreme Court just undercut access to contraception, reminds us how much is still at stake.

On July 8 in Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania, the Supreme Court ruled that employers could limit employees’ access to birth control coverage under the Affordable Care Act by citing religious or moral objections. That decision could leave more than 125,000 women without contraceptive coverage from their employers. It’s outrageous. No one’s boss should be able to decide whether or not they can access any medication.

Abortion and contraception are health care. Abortion is as common a medical procedure as a knee replacement, a tonsillectomy, or LASIK. Doctors provide contraceptive prescriptions and devices as frequently as they prescribe blood thinners. Any conversation about reproductive health should be led by the real experts—individuals and their doctors, not right-wing politicians.

To undermine access to needed care during a pandemic—when we should be making it easier to access health care, not harder—is unconscionable. Attacks on reproductive freedom have the greatest effect on communities that already face significant barriers in accessing health care, including people of color, people with low incomes, people living in rural areas, and LGBTQ people.

This ongoing push to limit access to both abortion services and contraception makes it clear that the only thing these extreme policies want to reduce is a woman’s freedom to make her own choices about her health and her future.

We have to use our voices and our votes to defend that freedom. We have to fight to have more women at the table, to protect our courts, to codify Roe, to repeal the Hyde Amendment, and to guarantee access to reproductive health care in every community. And we have to wage these battles on every front—from the states and the courts to Congress and the White House.

The other side has made it clear they will never stop. Until everyone in this country recognizes that reproductive rights are nonnegotiable human rights, neither can we.

Source: https://rewire.news/article/2020/07/20/despite-supreme-court-win-abortion-rights-are-still-not-safe/

Abortion access does not look the same for everyone in the United States. That’s because whether or not someone can access an abortion is often tied to factors like income, transportation, insurance coverage, ability to find childcare, and more. COVID-19 has highlighted the inequities in the U.S. system. Dr. Bhavik Kumar, Medical Director for Primary and Trans Care at Planned Parenthood Gulf Coast and National Medical Spokesperson for Planned Parenthood Federation of America sits down to talk with us about those inequities and how they span across the full spectrum of healthcare.

Because abortion access coincides with one’s socioeconomic resources, barriers to abortion care (such as Targeted Regulation of Abortion Provider laws) oftentimes disproportionately impact who are already marginalized. This includes Black Americans, people of color, low-income folks, the LGBTQ+ community, and young people. In the recent California Turnaway Study of almost 1,000 people, researchers found that people who were denied access to an abortion had 4x greater odds of living below the federal poverty level. Clearly, when people are forced to carry a pregnancy to term, they are more likely to live in poverty.

 In the midst of the pandemic, Texas (where Dr. Kumar’s practice is located) made accessing abortion care even more difficult, enacting policies that ended up forcing patients to come into clinics five to six times before being able to have the procedure. COVID-19 has further underscored existing inequities in the U.S.’ healthcare system, especially when it comes to Black and brown people. This is unacceptable, given that equitable access to care (including sexual and reproductive health care) is a human right. It is also important that inclusive and culturally-competent care be given to LGBTQ+ patients; Planned Parenthood has recently expanded their ability to provide care to transgender and gender nonconforming folks.

Jennie: Welcome to RePROs Fight Back, a podcast where we explore all things reproductive health, rights and justice. I’m your host, Jennie Wetter, and I’ll be helping you stay informed around issues like birth control, abortion, sex education and LGBTQ issues and much, much more– giving you the tools you need to take action and fight back. Okay, let’s dive in.

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Jennie: Welcome to this week’s episode of RePROs Fight Back. I’m your host, Jennie Wetter, and my preferred pronouns are she/her. So this week has been a bit of a week. Nothing like, major has happened. I mean, there was the birth control decision that was not great, but my head has just not been in it this week. I have been just really distracted and not able to focus on the things I’ve needed to do. And with everything that’s happening in the world with COVID still raging and spreading so much, make sure you’re wearing your masks. If you’re going out the fight for black lives and making sure Black Lives Matters is still ongoing, and it’s going to be a long fight to make sure that we reach equality and equity in America. So, you know, we need to be prepared for again, a marathon and not a sprint. This is going to be a lot of work for a long time. And so that means also being kind to yourself. So this week I didn’t get a lot accomplished that I wanted to do. That’s okay. I had really productive Friday. I feel a little better about that, but like the rest of the week, wasn’t super productive. I got some things done, but nowhere near as much as I would like, especially because I have two books sitting here staring at me that are going, “read me! read me!” for interviews I want to do on the podcast. But I would like to read the books first, so I need to make time to get it done. And I just have been so distracted and focused on so many other things that my head just hasn’t been in it. And it’s okay. Like I think we all need to take time and figure out ways to be kind to ourselves and what we need to do and know that not every week is going to be super productive with everything going on right now. Like sometimes you’re just going to have a bad week where you’re not going to get the things done you want and forgive yourself for it. So that’s where I’m at right now. I am forgiving myself for having a bad week. I’m recording this on Friday and I’m looking forward to the weekend where I can hopefully rest, recharge, reset my brain and get a lot accomplished next week. So with that, I think we’ll get into maybe a couple of housekeeping things. I usually put this at the end, but I’m sure not everybody makes it to the very end, but I want to make sure people are hearing it one. If you like the podcast, please make sure to rate and review, particularly on Apple podcasts, it helps people find the podcast. So that would be awesome. But too, if you have topics you want us to cover or issues you want us to talk about or a person you want us to talk to always feel free to reach out. You can email me jennie@reprosfightback.com or you can reach out to us on social media. We’re on Facebook and Twitter at repros fight back and on Instagram at reprosfb… always feel free to reach out. We’re happy to take suggestions or topics that people would really like us to talk about. And I think those are the big, main things. I just wanted to make sure that people were hearing that. Cause I think sometimes it gets buried at the end and I would love to hear what y’all think that I’m sure you have things that you would like us to talk about that we haven’t discussed yet. So for this week’s episode, I had a really great conversation with Dr. Kumar with Planned Parenthood. He is a provider in Texas and we talked about abortion access and health equity and the things we can do to ensure that everybody is getting access to the care they need. It was a really wonderful conversation and I hope you all enjoy it. So with that, I will take you to my interview with Dr. Kumar. Hi, Dr. Kumar. Thank you so much for being here today.

Dr. Kumar:Thanks for having me.

Jennie: So before we get started, do you want to do a quick introduction and include your preferred pronouns?

Dr. Kumar: Sure. My name’s Dr. Bhavik Kumar, and I’m the Medical Director for Primary and Trans Care at Planned Parenthood Gulf Coast in Houston, Texas, and I’m also the National Medical Spokesperson for Planned Parenthood Federation of America.

Jennie: Great. So do you maybe want to tell a little bit about what brought you to this work and to work in Texas?

Dr. Kumar: Yeah, so I grew up in Texas, my family and I moved here when I was about 10 years old, and Texas is home to me– my family and my friends live here. I went to school including college and medical school here. So, you know, if you know anyone from Texas, a lot of Texans tend to have pride about their state and I’m starting to be one of those people. There’s a certain culture about Texas. And so I consider myself a Texan. I grew up here and, you know, I, I’m a brown-skinned gay man, cis-gendered man, my family and I are immigrants. And we were also undocumented for about 11 years. And so I think a lot of that fed into my outlook on life. And at some point, I decided I wanted to help people. And, you know, part of that was wanting to help people to make the world a better place. And, you know, for people like me who have lived experiences that are different from perhaps what we see in the mainstream that we deserve better. And so when I was in medical school, I started to get involved with an organization called Medical Students for Choice, where I learned a lot about abortion and how common it is, how safe it is, but how do you providers that were in the country, especially in places like Texas. And that just hit home for me. I said, “Whoa, that is not right. Somebody’s got to do something about it.” And you know, sort of theoretically, I was like looking around thinking, “who’s going to do that?” and thought, well, if nobody else is going to do it, I have to do it. I feel strongly about this. And so my whole career since then has really been about showing up for people who need medical care and the places where it’s most restricted and best part of why I ended up in Texas providing abortion and also providing primary care and trans care and being out about it, meaning, you know, sharing my experience, sharing my story, talking about the work I do, showing my face and my name and being unapologetic about it.

Jennie: So one of the things you touched on was access and, you know, there was the Supreme Court case a week or two ago now for the June Medical Services. So it was a victory, but that didn’t solve all the access issues. Do you want to talk about that a little bit?

Dr. Kumar: Yeah. The Supreme Court ruling was definitely a great decision to have, I personally had a lot of anxiety, you know, several weeks before.

Jennie: Right.

Dr. Kumar: And if it had not gone the way it did things could have been a lot worse. I’m very happy and relieved to have had that. But you know, at the end of the day, how awful that the Supreme Court has to decide what rights a person has and doesn’t have in states like Texas, there are so many restrictions that are already in place, right? And we can go through the numerous restrictions, like the mandatory delay and the restrictions on young people trying to access care restrictions on use of Medicaid and private insurance, especially. And I think what’s important when we talk about abortion access is yes, there aren’t a lot of restrictions yet there are high profile cases. So it’s like the one that was just decided. But ultimately what I see day to day when I’m taking care of people, is that a lot of people I see will tell me, “you know, I never thought I would need an abortion. I never thought I’d be here.” I hear that all the time. And I think that’s, what’s really unique about abortion is that, you know, those of us who do this work, think about it and talk about it a lot. But so many people across the country don’t think about it. Maybe have heard about it in passing. And don’t think that they’ll be somebody who will need an abortion at some point in the lifetime. So it oftentimes feels very distant for some people, especially for folks that I take care of. And then when they come to the point where they do need access to an abortion, and they realize how many restrictions there are, how many that they have to go through, how difficult it can be, how expensive it is in states like Texas, where you can’t use your insurance and you do have to come up with the money on your own, it can be really, really difficult. And then I think it’s also important to talk about how, when you have to access an abortion, you’re not doing it in isolation from all the other things in your life, right? So how much money you make, how many kids you may already have taking care of those children, the logistics of making an appointment coming back again, because there is a delay and all the other laws that are in place are only compounded for folks that are already marginalized, right? And so that’s going to be black folks, people of color, folks that have a low-incomes, LGBTQ+ folks who are already facing barriers to accessing healthcare. And so what I see every day is a lot of folks who make it to the health center, aren’t able to get the care they need, but the folks who have to wait several weeks, the folks who have to, you know, wait a couple of paychecks to save up the money or the folks who are black people of color, folks who are low-income. And so all of these things are just compounded. And then the folks that never come back, right, or the folks that are not able to get care in my state of Texas and have to go elsewhere. And I know that some of them weren’t able to get the care that they needed. A lot of them weren’t able to access abortion and were probably forced to carry the pregnancy to term, there’s not that many other options out there. And so access looks very different for different people, especially based on where you live.

Jennie: So one of the things that, you know, we were talking about people not being able to get the care they want because of abortion restrictions. I think this might be a really good time to talk a little bit about the Turnaway study. Do you maybe want to mention a little bit about what the results of that were?

Dr. Kumar: Yeah, sure. The Turnaway study is a really groundbreaking study that came out of California from Diana Foster. And I think one of the most important and impactful findings was that folks that were denied access to an abortion and the study, which included almost a thousand people, was that when they weren’t able to access an abortion, they had four times greater odds of living below the federal poverty level. And I think it’s important for folks to understand what the federal poverty level is. So right now, for a family of four, it’s about $26,000 annual income for the entire household. So when we talk about access to abortion and being able to access it or not, it’s so clear that when folks are not able to access an abortion and they’re forced to carry a pregnancy to term, it’s not just that pregnancy. It’s not just that person, and then they go on and they’re fine. They’re more likely to live in poverty– when somebody is living in poverty, their children are more likely to live in poverty. When you look at the folks in our country who live at or below federal poverty line, its mostly black people followed by Latinx folks. And so when we think about how does this impact somebody, how does the restriction play out in somebody’s life when they’re not able to access abortion? What’s it doing? And the research is showing us what it’s doing is it’s keeping people in poverty and that’s mostly Black and brown people. So these restrictions and conversations about access to abortion is not just in that silo of whether or not they can access it. And that’s it, it’s all connected. It’s connected to income. It’s connected to your ability to have an education; it’s connected to your ability to parent. It’s connected to multigenerational trauma. That is very difficult for a lot of people to come out of. And I think for me, it’s very clear that abortion restrictions are inherently racist because the consequences of them are what I just described. It keeps people in poverty, it directly impacts Black and brown people uniquely in a very different way. And each of these restrictions on their own may not do much, but it’s that layering effect. And in reality, when it’s impacting those folks in those and governments, mostly white men continue to pass these laws that impact folks, Black and brown communities in a very specific, unique way that takes generations to come out of. Then it’s clear how racist things are. And I see it playing out and the lives of my patients, the stories that they tell me every day. And so I feel very strongly about it, but I think it’s been very difficult for us to get people to understand what it means and were lucky to have a study, like the Turnaway study that now gives us a lot of that research and evidence to say, here it is, right. This is what’s happening to people. This is the research.

Jennie: And, you know, it’s so like with the Supreme Court case, right? You’re talking about one law in isolation and not necessarily discussing this whole picture, like you just painted where they’re all kind of interacting to put obstacles in the way of people’s access to care.

Dr. Kumar: Yeah, exactly. And I think that’s, what’s so difficult for so many people to understand, you know, when I was talking to folks about this Supreme Court case, when we talk about admitting privileges, it’s just such an obscure sort of thing. Right? So even folks that do know a lot about healthcare and know a lot about abortion access, it just seems so silly to be talking about admitting privileges, especially a couple of years after the Supreme Court already decided on an identical case. And, you know, I would see a lot of people sort of scratching their head. Like why are we here? And we’re sort of not recognizing that this is by design. They’re making a stink about admitting privileges in Louisiana as if it’s the most important thing. And for a little bit of time, it was. But in reality, this is a long-term game. All of these restrictions playing together and restrictions on abortion access aren’t in isolation, right? And each person’s lived experience, they’re experiencing oppression from so many different places, all compounded at the same time. And it plays out in people’s lives in a very different way. And when we talk about restrictions

Jennie: Yeah. And you also had the restrictions that were in place in Texas during COVID, where they were basically a ban on accessing abortion. And there were court decisions that kind of kept going back and forth.

Dr. Kumar: Yeah. Texas is very unique. I think compared to a lot of other states when it comes to abortion access and you know, a lot of folks would say that Texas is sort of the place where a lot of things get tried when it comes to restricting abortion access. Some folks will say things that happened in Texas don’t stay in Texas. And most recently the governor of Texas issued an executive order, which then our attorney general decided to specifically name abortion and say that as this pandemic was starting and there was a lot of uncertainty, we weren’t sure what this virus was going to do. People weren’t sure how to respond to it. A lot of people were being laid off their jobs, folks were being asked to stay at home, not travel as much, right? And then the government of Texas decided you cannot access abortion. But right now we’re going to completely say, you’re not able to and forced all of us to then engage in this back and forth through the courts that went on for several weeks and folks were coming to us needing care. We couldn’t give them answers. We didn’t have answers for them. We had to tell them to either wait or to travel out of state again when you’re not supposed to be traveling. And some folks that I saw in the health center came maybe five or six times until they were able to get an abortion, which is absurd. Right? If the government was truly interested in protecting people from COVID-19, you wouldn’t make somebody come to the health center five or six times to get healthcare. He wouldn’t stop in the middle of a day from taking care of people when they’re signing consent forms…or about to take the medication, that doesn’t make sense. And none of these abortion restrictions are designed to make sense. And I think the most recent Supreme Court ruling is another example of that. We spend so much time thinking about, well are admitting privileges needed? What is the purpose of them? It’s just really about health and safety. Abortion is extremely safe. We’ve been doing this for centuries and it’s only gotten safer. It is extremely sensitive. It has nothing to do with health and safety. It has to do with oppressing people.

Jennie: Another thing that the COVID epidemic really pointed out was the lack of health equity currently in the system and how COVID was disproportionately impacting Black and brown people.

Dr. Kumar: Yeah. I think COVID-19 has really brought a lot of this to the forefront. And we’re seeing that many different parts of the country in different ways. I think what we’ve learned since the COVID pandemic started is that Black and brown people are the large majority of our frontline workers. Whether it’s the folks in the grocery stores, whether it’s the folks stocking our shelves, or even healthcare workers, we depend on them to provide the services that we need. But when it comes to accessing healthcare, there is a lot of difficulty in access in that care. There’s a history of racism. There’s a history of bias within the health system that uniquely impacts the Black and brown community. And when it comes to looking at how things are playing out in the pandemic, we see that we expect folks to show up for us when we need them for our central services, like our groceries and pharmacies and also healthcare. But then the systems that are supposed to be protecting them are not showing up or not protecting them. And they aren’t more risks than anybody else. And then we also see that the, uh, transmission, then the rate of hospitalization, and more importantly, the rate of deaths are higher among Black communities and brown communities. And we’ve known all of these things all along, but what the pandemic is doing is servicing in a different way and showing us exactly what’s happening beneath the surface. And I think because people maybe have a different capacity to engage with all of this, it’s coming out in a different light. And I think people are paying more attention, which is a great, because we need that attention. We need things to change, but it’s always been there. This is not new. We’re just seeing it in a different light.

Jennie: Yeah. And then inequitable access to care includes sexual and reproductive health care as well.

Dr. Kumar: Yeah, absolutely. So at Planned Parenthood, we provide sexual reproductive health care—we’re a leader in providing that care. And a lot of people depend on us. They trust us. They come to us knowing that we are able to provide that care. And also we are expanding the types of care we provide. So I’m a family medicine physician. I provide primary care here. And that’s really based on knowing what our communities need. The people that we take care of absolutely have a need for sexual reproductive healthcare, including abortion, but also have other problems like high blood pressure. They need medicine for their diabetes and so much more, right? Colds and coughs. And we need to respond to that. And Planned Parenthood is doing exactly that. Some of our health interests have been providing primary care for more than 10 years. Some are a little bit newer, but it’s all in response to what our communities need, what our patients need. And I think Planned Parenthood has done a great job at showing up and being responsible for that. And we’re doing the best we can for the people who depend on us.

Jennie: So another area where you definitely see disparities and lack of access to care is talking about inclusive and culturally competent care for LGBTQ+ patients.

Dr. Kumar: Yeah, absolutely. So Planned Parenthood is one of the leading providers for LGBTQ+ patients as well, especially for trans patients. So one of the most recent services that we’ve expanded is trans care and specifically gender affirming hormone therapy for trans people and gender nonconforming folks. And I’m proud to be the medical director for that care here. And you know what I see in Texas and Louisiana, a lot of folks that have not been able to find a provider who offers this kind of care and will say that they, you know, were looking on the internet. Some of them have bought things to help manage their transition on their own simply because they haven’t been able to find a provider. And so it’s great that Planned Parenthood is able to offer these services for folks and that folks trust us for this. And, you know, again, when we think about all of the things that are happening in people’s lives, accessing healthcare doesn’t happen in a silo, right? They are having to deal with so much discrimination, whether it’s homophobia or transphobia and accessing health care is included in all of that. People have anxiety about being misgendered or having their dead name used on their ID or perhaps their insurance card, or perhaps the provider just not getting it, or maybe somebody at the health center, you know, not treating them with respect. And at Planned Parenthood, we were lucky because all of our centers are very aware and keen on making sure we have a welcoming space for people that people feel comfortable in, that we offer our pronouns as well as welcome theirs and provide the care that people need. And we also elicit feedback. “What else do you need? What can we be doing differently?” And I think that’s really important. And that is a type of partnership where we partner with our patients, we partner with our communities through various educational engagement and activities. And we try to show up for the people who need us.

Jennie: Yeah. It’s so important to have places, you know, you can trust to get that care because recently there was the Supreme Court case where they ruled you couldn’t be fired because of who you were. But the Friday before, there was also a ruling out of HHS saying that it expanded the rights of doctors and physicians to discriminate against people they provide healthcare to. So it’s so important to have providers that the LGBTQ community knows they can trust.

Dr. Kumar: Yeah, absolutely. The Supreme Court has given us some good rulings and also some not so great rulings, but again, it goes back to how awful that, you know, people have to depend on the Supreme Court for their dignity, for their humanity and the court decides such basic things for people. And I think it’s important to point out just the blatant disregard for human beings lives when they’re not, you know, what other people have respect for, you know, and that includes trans people and all LGBT folks and so many other folks as well. Right? And I think a lot of the decisions point to that, and it’s also, you know, again, the decision on job discrimination is great and I’m appreciative of it, but how unnecessary that we even have to like be thankful that, you know, we can’t be fired from our jobs. Like that is such a basic right that we should have, but here we are fighting over several years just to have that basic need met. And you know what, it reminds me of the difference between survival and thriving. We’re being, given the ability to survive, to work and not be fired from our jobs or to seek healthcare or not seek healthcare in this example, right? Those are all elements of survival and we’re not able to thrive, unfortunately.

Jennie: That’s all very true. So let’s talk about what we can do. What are things that Planned Parenthood is doing and what we personally can do?

Dr. Kumar: Yeah. I think the first thing is to, you know, assess the status quo and be informed. I think a lot of this information, like I mentioned, especially coming from the court can be confusing. And I think a lot of us are now more engaged. And so staying engaged and being informed is one of the most important things. The other thing that I’ve been telling everyone to do is to center Blackness and that can happen in so many different ways and so many different spaces. So whether it’s in your personal life or in your professional life, every space you navigate, every person you interact with everything that you’re doing, I’m asking everyone that I know to center Blackness. When you look around and you see Black people, whether it’s in your workplace, in your neighborhood, in your home, you know, your friend circle, your social media circles, whatever, everything you should analyze with a lens that says why aren’t there more Black people here, who’s being left out, and then expand that, why are there not more brown people? Why are there not more trans people? And what are you going to do to make a change with that? I think sometimes even though it seems simple to just call that out and name it, that’s how you start. And it takes champions to bring that forward, especially in spaces where it can be a little bit more hostile to do that. And I personally, as a brown person, depend more on white people to carry that work forward. And I think that’s very important. So one of the things that I think we can all do is to center Black people. [We should also be] showing up and doing the work that we need to do both internally and externally. Like I said, we’re expanding a lot of the care. We provide health centers, whether it’s trans care or primary care, where thinking about how we can interact with our communities in different ways, we are partnering with various organizations knowing when we need to show up and be present and join forces with folks. And also recognizing when we may need to take a step back and let others see, I think collectively we’re all trying to go in the same direction and doing the best we can. That also requires that we take a moment to reflect on what we are bringing to the table and where we may be falling short and that we start working on that. So all of things are important, but I think it’s most important in this moment to show up for Blackness and center that, and also to show up for trans folks, especially Black trans folks, and to center them in a lot of the conversations we’re having.

Jennie: Great. Are there things, so you already kind of touched on this with, you know, looking around at your friend groups and everywhere you’re going in, centering black people. Are there any other actions that listeners should be taking?

Dr. Kumar: You know, for abortion access, connecting with your local abortion funds and donating. There is always a great thing to do. People who need access to abortion oftentimes cannot afford it. That tends to be the number one reason why they have difficulty accessing abortion. So connect with your local abortion fund, work with them, volunteer with them. If they need you donate, if you can donate to Planned Parenthood, support the work we’re doing as well, stay engaged. And you know, it’s also 2020. This is an election year here in Texas. Right now we are in a runoff election… make sure you vote in your state when you’re able to definitely in November. And it’s not going to be immediate that we’ll see change. Um, after the November election, if things go the way I hope they do. But I think that is also very important that we all get out and have our voices heard and make sure that we change the way things are and how they are now.

Jennie: Well, Dr. Kumar, thank you so much for being here and talking with us today.

Dr. Kumar: Thanks so much for having me.

Jennie: Thanks for listening everyone. And we’ll see you on our next episode of RePROS Fight Back. For more information, including show notes from this episode and previous episodes, please visit our website at reprosfightback.com. You can also find us on Facebook and Twitter at RePROS Fight Back, or on Instagram at reprosfb. If you like our show, please help others find it by sharing it with your friends and subscribing, rating and reviewing us on iTunes. Thanks for listening.

This week, a federal judge in Maryland ruled that people can now access abortion pills through the mail during the pandemic, rather than having to go to a doctor’s office, clinic or hospital.

But the ruling won’t change anything for Louisiana women and abortion patients.

That’s because Louisiana has its own law forcing abortion patients to make in-person clinic visits before receiving the medication. The office of Attorney General Jeff Landry confirmed to WWNO/WRKF that the decision will have no impact on medication abortion access in the state.

The decision came after the American College of Obstetricians and Gynecologists (ACOG) and others sued the Department of Health and Humans Services (HHS) earlier this year over rules requiring in-person visits in order to obtain the pills during the coronavirus outbreak, despite the agency’s push for widespread adoption of telehealth.

The suit argued HHS was singling out mifepristone, the first of two drugs used in medication abortions, and called the in-person requirement “medically unnecessary,” pandemic or no pandemic.

U.S. District Judge Theodore Chuang found the requirement created a “substantial obstacle” to abortion access during the outbreak.

“By causing certain patients to decide between forgoing or substantially delaying abortion care, or risking exposure to COVID-19 for themselves, their children, and family members, the In-Person Requirements present a serious burden to many abortion patients,” Chuang wrote.

Medication abortion is used in early pregnancy. It’s approved for use up to 10 weeks of gestational age by the U.S. Food and Drug Administration.

Louisiana was among 10 states in the South and Midwest that sought to intervene in the case because, they said, it would undermine states with laws that require in-person medication abortions. Those states include Mississippi and Alabama, which are now seeing dramatic rises in coronavirus cases. The judge denied the request and said the ruling wouldn’t impede state laws that go beyond federal requirements.

Louisiana is one of 18 states with laws that require medication abortion to be provided by a physician, and for that physician to be physically present when the patient takes the first pill. Many abortion-rights groups argue these requirements are onerous and designed to restrict abortion access.

In the wake of the decision, ACOG President Eva Chalas called mifepristone “a safe medication” and said the “FDA’s in-person dispensing requirements provide no medical benefit to patients.”

“The FDA’s burdensome in-person dispensing requirement for mifepristone has had a disproportionate effect on communities hit hardest by the pandemic, including communities of color who already face existing inequities and structural barriers to care,” she said.

Source: https://www.wwno.org/post/here-s-why-you-still-can-t-access-abortion-pills-mail-louisiana-despite-pandemic?fbclid=IwAR2yjHObKS7WySIaHeM10XHKmUK-6m_SCoIQYw91KIwLsipWnMfdRaooTIc

The measure sought to ban abortions once a “detectable human heartbeat” was present, with some limited exceptions

Demonstrators hold signs during a protest against Georgia’s “heartbeat” abortion bill outside of the Georgia State Capitol building in Atlanta, Georgia, U.S., on Saturday, May 25, 2019. Photographer: Elijah Nouvelage/Bloomberg via Getty Images

A federal judge on Monday permanently blocked Georgia’s 2019 “heartbeat” abortion law, finding that it violates the U.S. Constitution.

U.S. District Judge Steve Jones ruled against the state in a lawsuit filed by abortion providers and an advocacy group. Jones had temporarily blocked the law in October, and it never went into effect. The new ruling permanently enjoins the state from ever enforcing House Bill 481.

Georgia’s measure sought to ban abortions once a “detectable human heartbeat” was present, with some limited exceptions. Cardiac activity can be detected by ultrasound as early as six weeks into a pregnancy, before many women realize they’re pregnant, according to a legal challenge. The bill narrowly passed the Georgia General Assembly amid intense lobbying for and against.

Those who challenged the lawsuit said the ruling proves their contention that the measure was unconstitutional. Lead plaintiff SisterSong, an Atlanta-based group that fights abortion restrictions on behalf of African American and other women of color, called it a “huge win for bodily autonomy.”

“No one should have to live in a world where their bodies and reproductive decision making is controlled by the state,” SisterSong Executive Director Monica Simpson said in a statement.

Republican Gov. Brian Kemp, who has supported the restriction, immediately vowed an appeal.

“We will appeal the court’s decision,” Kemp said in a statement. “Georgia values life and we will keep fighting for the rights of the unborn.”

The prospects of an appeal are uncertain, though, considering the U.S. Supreme Court last month struck down other abortion restrictions from Louisiana.

Women in Georgia can currently seek an abortion during the first 20 weeks of a pregnancy.

Both the state and those challenging the law asked Jones to rule without a trial, saying there were no disputed facts. Jones granted the challengers’ motions for summary judgment and denied the state’s motions, finding the law violated the 14th Amendment.

“The court rejects the state defendants’ argument that the statutory purpose solely concerns “promoting fetal well-being,'” Jones wrote. “Instead, HB 481’s specific references to Roe v. Wade and ‘established abortion related precedents’ … lends support to plaintiffs’ argument that the purpose of H.B. 481 was to ban or de facto ban abortion.”

Jones refused to leave any parts of the law in effect, which would have also granted personhood to a fetus, giving it the same legal rights as people have after they’re born. For example, a mother could have claimed a fetus as a dependent to reduce taxes.

U.S. Supreme Court precedent has for nearly five decades held that states cannot ban abortion prior to the viability of a fetus, and since Georgia’s law does just that it is unconstitutional, the law’s opponents argued. The state argued that the law promoted fetal well-being. It was widely considered as one of a number of attempts to create fresh legal challenges to abortion after two new conservative justices were confirmed to the Supreme Court. The high court, by a 5-4 ruling on June 29, struck down another of those challenges involving regulations from Louisiana.

The legal director of the American Civil Liberties Union of Georgia, one of the groups that brought the lawsuit, said any appeal would be fruitless.

“The district court blocked Georgia’s abortion ban, because it violates over 50 years of Supreme Court precedent and fails to trust women to make their own personal decisions,” Sean Young said in a statement. “This case has always been about one thing: letting her decide. It is now up to the state to decide whether to appeal this decision and prolong this lawsuit.”

Georgia Attorney General Chris Carr, a Republican, said he would appeal the ruling but declined further comment.

At least eight states passed so-called heartbeat bills or other sweeping bans in 2019, including Alabama, Georgia, Louisiana Kentucky, Mississippi, Missouri, Ohio and Tennessee. South Carolina is still considering one. All of the new bans joined the fate of earlier heartbeat abortion bans from Arkansas, North Dakota and Iowa in being at least temporarily blocked by judges. Louisiana’s ban wouldn’t take effect unless a court upholds Mississippi’s law.

In a separate ruling Monday, a U.S. district judge in Tennessee blocked a Tennessee law that Republican Gov. Bill had signed hours earlier banning an abortion as early as six weeks into pregnancy and prohibiting abortions based on race, sex or diagnosis of Down syndrome.

Source: https://www.nbcmiami.com/news/national-international/federal-judge-strikes-down-georgia-abortion-restrictions/2261607/?fbclid=IwAR3o0JwcttypUFBXMpBSUWOCgY5hLk4MO1DO_0R3BXlwX92W8Q78YwM3Tv4

For six years, my lawyers have been fighting a law that would have shut down the abortion clinic I run in Shreveport, Louisiana — Hope Medical Group for Women. On Monday, we won in the U.S. Supreme Court, which struck down the law, meaning we can stay open for our patients. I am relieved that the court saw through Louisiana’s deceitful attempts to shut us down, but I’m still deeply worried.

I wish the relentless attempts by politicians to shut down our clinic would finally stop. I know they won’t.

Our win was critical because it saves the few clinics remaining in Louisiana. When I started working at Hope Medical Group 28 years ago, we were one of 11 abortion clinics in Louisiana. Over the years, I’ve watched the other clinics disappear, wondering whether we will be next. Today, there are only three left to serve the roughly 1 million women of reproductive age in Louisiana. This is because of the seemingly endless laws designed to shut down clinics. Louisiana has more abortion restrictions than any other state in the country, 89 to be exact.

It should come as no surprise that these abortion restrictions disproportionately impact Black women and other marginalized communities. Women of color make up 70% of abortion patients in Louisiana, according to 2015 data, and they already face obstacles to accessing health care, as we’ve seen during the COVID-19 pandemic. Privileged people with resources will always be able to access abortion. Largely, it’s vulnerable communities who are being denied the ability to determine their futures and make decisions about their own bodies and families.

Vulnerable women face high obstacles

Many of the women we see each day have traveled hundreds of miles to reach us because there are so few clinics left. By law, our patients must wait 24 hours after their initial visit to the clinic before they can return to have an abortion. Th means many must pay for a hotel room or sleep in their car if they have one; take more time off work and lose wages; and pay for childcare if, like most of our patients, they have children. Given that 75% of abortion patients nationwide are poor or low-income, these are often insurmountable obstacles.

Abortion safety, not politics: I wrote Louisiana’s pro-life law. The Supreme Court ruled against women’s health.

And if that wasn’t enough, in 2016 the Louisiana Legislature passed a law that increased the waiting period to 72 hours, which would triple the height of this hurdle for patients. We are now challenging that law in court as well.

Try explaining these laws to the woman crying on the phone because she has bills due, children to care for and no means to get to a clinic once, let alone twice. The same woman who is afraid to take a few days off her low-paying job because she is one lost paycheck from total despair. Or the woman desperately trying to escape an abusive relationship. These women fuel me to keep fighting.

Our patients frequently ask why they must go to a clinic, often hours away from their home, to have an abortion. Why can’t they get an abortion at a doctor’s office or their OB-GYN? That would seem to make sense, especially because nearly 40% of abortions today are simply done by taking two pills.

Kathaleen Pittman in Washington, D.C., in March 2020. Center for Reproductive Rights

But Louisiana — and many other states — have made commonsense abortion policies illegal. The state forces physicians who provide five or more abortions a year to be licensed as an abortion clinic, meaning they must comply with a mountain of laws and requirements. It is a clever tactic: Prevent people from having an abortion anywhere but an abortion clinic, then pass every law imaginable to shutter those clinics.

Restrictions not about safety

The laws we must comply with are intentionally tedious, dictating even the size of our procedure rooms. The Louisiana Department of Health regularly shows up unannounced to conduct unwarranted, multiday inspections of our clinic, and they can revoke our license for any deficiency, no matter how insignificant. These kinds of exhaustive regulations do not exist for any other medical facilities or doctors’ offices. They only target abortion clinics, and they have nothing to do with improving care for our patients.

Research and evidence: Science prevails in Supreme Court ruling on abortion law that provided no medical benefit

Abortion is one of the safest outpatient medical procedures in the United States, according to a five-year study by Advancing New Standards in Reproductive Health. It should be treated no differently than other medical services, but in reality, being an abortion provider in the South means we must be more than just health care workers. We’re forced to fight every day just so we can do our jobs, whether that means fighting anti-abortion laws in court so our clinic can stay open, or consoling our patients after they’ve been harassed by protesters outside. Our physicians have even had protesters show up at their homes and private offices.

All too frequently, there are new anti-abortion laws passed that we must learn to comply with somehow. I have our lawyers at the Center for Reproductive Rights on speed dial and often call them multiple times a week to make sure the state has no excuse to shut us down.

Lawmakers claim that these restrictions are meant to protect women, that they care about their health and safety. That was the state’s argument in the case we won Monday. This is a laughable claim considering Louisiana has the highest maternal mortality rate in the country — and lawmakers have failed to act to reduce this rate. Maternal mortality has actually increased an alarming 28% in the past four years. The mortality rate for Black women is even more dire.

States have passed more than 450 anti-abortion laws since 2011, and the law struck down by the Supreme Court Monday was just one of them. This week we won the battle, and that means we can stay open to fight another day. But after working at an abortion clinic in the South for nearly three decades, I’m still just as frightened for the future.

If these laws keep piling up, it is not a matter of whether we will be forced to close, but when.

Kathaleen Pittman is the clinic administrator at Hope Medical Group for Women — an abortion clinic in Louisiana and the lead plaintiff in June Medical Services v. Russo.

Source: https://eu.usatoday.com/story/opinion/voices/2020/06/30/supreme-court-june-medical-services-abortion-rights-access-column/3283212001/

Federal judges blocked controversial abortion restrictions out of Georgia and Tennessee on Monday, a pair of key victories for abortion rights advocates after a flurry of so-called “heartbeat bans” swept state legislatures last year.

The bills — passed in Georgia in spring 2019 and in Tennessee last month — ban abortions after the detection of a fetal heartbeat, which can occur as early as six weeks into pregnancy and before many women even know they’re pregnant.
The bills highlight the longstanding battle over abortion rights playing out in state legislatures. That clash most recently made its way up to the Supreme Court, where Supreme Court Chief Justice John Roberts moved to block a controversial Louisiana law restricting abortion access in siding with the liberal justices — while potentially leaving the door open to more state abortion limits.
US District Judge Steve Jones of Georgia, who temporarily blocked the law in October, cited Supreme Court decisions Roe v. Wade and Planned Parenthood v. Casey that uphold a woman’s right to a pre-viability abortion in his decision to permanently strike down the law on Monday.
“In sum, the undisputed material facts in this case lead to one, indisputable conclusion: that Section 4 of H.B. 481, by prohibiting a woman from terminating her pregnancy upon the detection of a fetal heartbeat, constitutes a pre-viability abortion ban,” Jones wrote.
He added, “As this ban directly conflicts with binding Supreme Court precedent (i.e., the core holdings in Roe, Casey, and their progeny) and thereby infringes upon a woman’s constitutional right to obtain an abortion prior to viability, the Court is left with no other choice but to declare it unconstitutional.”
CNN has reached out to the office of Republican Georgia Gov. Brian Kemp, who was named in the lawsuit, for comment.
The American Civil Liberties Union, Planned Parenthood and the Center for Reproductive Rights, representing several abortion care providers, challenged the law in June 2019. Monica Simpson — executive director of the abortion care provider SisterSong Women of Color Reproductive Justice Collective, the top plaintiff in the lawsuit — called the decision “tremendous.”
“No one should have to live in a world where their body and reproductive decision-making is controlled by the state,” she said in a statement. “And we will continue to work to make sure that is never a reality in Georgia or anywhere else.”
In Tennessee, a federal judge temporarily blocked the state’s heartbeat bill from going into effect after Gov. Bill Lee, a Republican, signed it into law earlier that day. The ACLU, the Center for Reproductive Rights, Planned Parenthood and several Tennessee abortion providers had challenged the bill in federal court last month on the same day that state lawmakers passed it, filing suit against Tennessee Attorney General Herbert Slatery and other state officials.
“The Act will immediately impact patients seeking abortions and imposes criminal sanctions on abortion providers,” US District Judge William Campbell wrote of the law, citing “the time-sensitive nature of the procedure.”
Campbell added that the abortion rights groups “have demonstrated a strong or substantial likelihood of success on the merits of their claims that the restrictions (in the law) are unconstitutional under current law.”
CNN has reached out to Lee’s office for comment.
Samantha Fisher, a spokeswoman for Slatery, said in a statement, “The Court issued a temporary restraining order to maintain the status quo. We look forward to the next step, arguing the merits in a preliminary injunction hearing.”
Tennessee had joined not only Georgia but Kentucky, Louisiana, Mississippi, Missouri and Ohio in passing similar bills. All have been kept from going into effect by court actions.
Tennessee’s bill made exceptions to protect the life of the woman but not for instances of rape or incest. Georgia’s had some exceptions for situations of medical futility or where the mother’s health is at risk as well as in cases of rape or incest before the 20-week mark, if an official police report has been filed.

Source: https://edition.cnn.com/2020/07/13/politics/abortion-bans-block-georgia-tennessee/index.html?fbclid=IwAR0xY8oJWERuVq0S5M4QENklABH9RdjwT_GpwayT7wTDVfSb6CHWbLC52g4

A federal judge has agreed to suspend a rule that requires women during the COVID-19 pandemic to visit a hospital, clinic or medical office to obtain an abortion pill

SILVER SPRING, Md. — A federal judge agreed Monday to suspend a rule that requires women during the COVID-19 pandemic to visit a hospital, clinic or medical office to obtain an abortion pill.

U.S. District Judge Theodore Chuang in Maryland concluded that the “in-person requirements” for patients seeking medication abortion care impose a “substantial obstacle” to abortion patients and are likely unconstitutional under the circumstances of the pandemic.

“Particularly in light of the limited timeframe during which a medication abortion or any abortion must occur, such infringement on the right to an abortion would constitute irreparable harm,” the judge wrote in his 80-page decision.

Chuang’s ruling will allow healthcare providers to arrange for mifepristone to be mailed or delivered to patients during the public health emergency declared by the secretary of the U.S. Department of Health and Human Services. The U.S. Food and Drug Administration approved mifepristone to be used in combination with a second drug, misoprostol, to end an early pregnancy or manage a miscarriage.

“By causing certain patients to decide between forgoing or substantially delaying abortion care, or risking exposure to COVID-19 for themselves, their children, and family members, the In-Person Requirements present a serious burden to many abortion patients,” Chuang wrote.

The states of Indiana, Louisiana, Alabama, Arkansas, Idaho, Kentucky, Mississippi, Missouri, Nebraska and Oklahoma had asked to intervene in the lawsuit. The 10 states argued that the case could impact how they enforce their own state laws that relate to or reference the FDA’s regulation of mifepristone.

Chuang rejected their request last month. The judge said the federal case would not eliminate any state’s ability to continue to regulate abortion medication “above and beyond” the FDA’s requirements.

“Nevertheless, this is a tremendous victory for abortion patients and for science and common sense,” said American Civil Liberties Union attorney Julia Kaye.

The American College of Obstetricians and Gynecologists and other groups sued HHS and the FDA in May to challenge the rule. ACLU lawyers represent the groups.

Skye Perryman, chief legal officer for the American College of Obstetricians and Gynecologists, said the FDA’s restrictions on mifepristone are not medically necessary and “do not advance the health and safety of patients.”

“Today’s ruling recognizes the hardship and undue burden that many women have faced obtaining essential health care during the COVID-19 pandemic,” Perryman said.

Plaintiffs’ attorneys argued that the FDA’s in-person requirements infringe on a woman’s constitutional rights to an abortion and violates the due process clause of the Fifth Amendment.

Government lawyers have argued that the requirements are necessary to ensure that patients safely use mifepristone. The FDA rule requires patients to pick up the single tablet of mifepristone at a hospital, clinic or medical office and sign a form that includes information about the medication’s potential risks.

The judge said suspending the requirements aligns with public health guidance to eliminate unnecessary travel and in-person contact.

Chuang granted the ACLU’s request for a preliminary injunction on due process grounds. He noted that federal regulators have waived in-person requirements for many other drugs “for the specific purpose of protecting public health.”

The group’s lawsuit says mifepristone is the only one of more than 20,000 FDA-regulated drugs that patients must receive in person at a hospital, clinic, or medical office “yet may self-administer, unsupervised, at a location of their choosing.”

The judge didn’t set any geographic limitations on the injunction. Referring to the nature of the pandemic, he said that “crafting relief that attempts to account for both the unpredictable changes and nuanced regional differences across 50 different states over an extended period of time is simply infeasible.”

More than 4 million people in the U.S. have used mifepristone and misoprostol to end an early pregnancy; the two-drug combination accounted for 39% of all U.S. abortions in 2017, the lawsuit says.

The lawsuit says the FDA rule has “particularly severe implications for low-income people and people of color, who comprise a disproportionate share of impacted patients and who are already suffering and dying from COVID-19 at substantially higher rates.”

In March, dozens of anti-abortion advocates signed a letter to HHS Secretary Alex Azar in which they called for halting abortion procedures during the pandemic. “Their continued operation depletes sorely needed personal protective equipment and leads to complications that will further overwhelm already overextended emergency rooms,” the letter said.

Azar and FDA Commissioner Stephen Hahn also were named as defendants in the suit.

Marjorie Dannenfelser, president of the Susan B. Anthony List anti-abortion group, expressed disappointment in the judge’s ruling: “The current FDA regulations are reasonable and necessary to protect women from serious and potentially life-threatening complications of abortion drugs, including intense pain, heavy bleeding, infection, and even death,” she said in a statement.

Source: https://abcnews.go.com/Health/wireStory/judge-women-abortion-pill-doctor-visits-71755793?fbclid=IwAR3Df_KeuO7pBj4-3b_XknodzFEUWLGdX5vzUYsajlZdLpWhZ4LWiTmSfWI

  • You can temporarily take it at home during the Coronavirus pandemic

Our ability to offer abortions is a vital part of healthcare and cements the right among women and girls across the world to make decisions about their own bodies.

It’s estimated that that one in three women in the UK will have an abortion by the time they’re 45.

Knowing this, it is essential that we are as informed as possible about what abortions are, the different ways a woman can undergo a termination, how to access the health service and what the process entails.

As well as more invasive procedures, if a pregnancy is at an early enough stage, one of the types of termination offered is the ‘medical abortion’, which involves taking two different medicines in tablet form, to end a pregnancy.

From how an abortion pill works and how to organise a termination, to the cost of an abortion pill and understanding the ‘pill by post’ service, we’ve rounded up everything you need to know about this form of termination.

What are the different methods of abortion?

The are two main types of abortion: a medical abortion (otherwise known as the abortion pill) and a surgical abortion.

The abortion pill involves taking a medicine to terminate the pregnancy, whereas a surgical abortion involves the removal of the pregnancy via a procedure at a doctor’s surgery.

abortion pill
PORNCHAI SODAGETTY IMAGES

In the UK, we allow terminations to occur up to the 24th week of pregnancy. However, in certain circumstances, an abortion can take place after this time period for reasons including a risk to the mother’s life or if there are severe issues with the foetus’ development.

The NHS states that patients should be offered a choice of which method they’d prefer whenever possible. And, according to Dr Yvonne Neubauer, Associate Clinical Director for MSUK, ‘in theory, both medical and surgical abortion can be offered up to the legal limit of 23 weeks and 6 days. However, abortion services may only offer certain methods within a particular pregnancy range depending on local protocols and expertise.’

Between six and nine weeks of pregnancy, the abortion pill is usually the preferred method of termination, as it involves very little time at the clinic.

‘Beyond 10 weeks’ gestation, [while medical abortions are still possible] women have to stay overnight and so most women opt to have a surgical procedure, since it’s a quicker process,’ a spokesperson from the The British Pregnancy Advisory Service (BPAS) tells ELLE UK.

Official government figures show that approximately 180,000 abortions are carried out in England each year, with medical abortions the most common choice to end a pregnancy.

What is the abortion pill?

An abortion pill (actually a series of two different tablets) is not to be confused with a morning after pill. Their chemical components are entirely different.

Planned Parenthood clarifies this common confusion, explaining: ‘The morning-after pill, also known as emergency contraception, helps prevent pregnancy; the abortion pill, also known as medication abortion, ends pregnancy.’

‘There is no evidence that emergency contraception can cause an abortion if it is taken when already pregnant,’ adds a BPAS spokesperson.

A medical abortion involves taking not one tablet but two different types of medicines.

The first tablet contains a medicine called mifepristone. Its job is to block the main pregnancy hormone, progesterone. Without this hormone, the lining of the uterus breaks down, ending the pregnancy’s viability.

The second medicine called misoprostol. This is a chemical that forces the womb to begin cramping, a bit like the contractions of labour. This drug helps your body to eject the now inviable pregnancy.

abortion pill
LIGHTFIELDSTUDIOSGETTY IMAGES

How do you take the tablets?

These medicines are prescribed by the hospital or abortion clinic and are usually taken one to two days apart.

Following an assessment, those who decide to proceed with the termination will usually be asked to sign a consent form and the clinic or hospital will arrange a date for the abortion. Patients are able to change their mind at any point up to the start of the abortion.

‘The mifepristone tablet can be taken at the hospital or clinic, and you’ll be able to go home afterwards and continue your normal activities,’ the NHS explains.

A day or two later, a patient must take the second medicine, the misoprostol. This tablet should be placed under the tongue, between the cheek and gum or inside the vagina.

A BPAS spokesperson tells us that it is inadvisable for someone to take the first pill without the second.

‘The first pill (mifepristone) is regarded as the start of the abortion procedure,’ they explain. ‘Some anti-abortion campaigners have tried to claim that the effects of mifepristone can be reversed, but there is no evidence to support this.’

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Within a period of four to six hours after taking the second medicine, the lining of the womb will break down, which can involve pain, bleeding and ultimately, the passing of the pregnancy from your body. In most cases, the vaginal bleeding and discomfort should subside within several hours, or up to a day, but some discomfort and bleeding can continue for up to two weeks.

‘Sometimes you need to take more doses of misoprostol to get the pregnancy to pass,’ the NHS adds.

The abortion pill does not require surgery or an anaesthetic. However, occasionally, the pregnancy does not pass and a further procedure is needed to remove it.

Can you take the abortion pill at home?

For years, medical abortions in England have had to be initiated in a hospital, by a specialist provider or a licensed clinic.

However, in March, the governments in England, Wales and Scotland made a landmark decision to change the law, now allowing women and girls to take the abortion pill for early medical abortions (up to 10 weeks into the pregnancy) in their own homes during the Covid-19 outbreak.

‘This measure will be on a temporary basis and must follow a telephone or e-consultation with a doctor,’ the Department of Health in England stated at the time of the announcement.

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In response to the news, Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologists, said: ‘This change in practice will reduce pressure on the health system while limiting the unnecessary risk of infection for women, their families and health workers.’

The at-home medical abortion is now commonly referred to as ‘pill by post’ or ‘remote abortion pill treatment’.

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‘This service is a safe and legal way to end a pregnancy at an early gestation without needing to attend a clinic for treatment,’ explains BPAs.

Those wanting a pill by post will have to complete a consultation and medical assessment over the phone. During the consultation, BPAS will explain the known risks and complications of the treatment, which can be read here.

If you opt for a pill by post, you will receive the treatment package from a pharmacy from one to three days after the telephone consultation. If, for any reason, the package is delayed in the post, the organisation advises women take the tablets as directed once they do arrive.

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Note: The package is plain with no indication of its contents, it will be tracked but not signed for.

The package will contain the following:

  • Abortion pill medication (one tablet mifepristone and six tablets of misoprostol – packaged together or separately)
  • Pregnancy test
  • Codeine (only provided if suitable)
  • Progestogen only contraceptive pills (if requested and suitable)

When it comes to passing the pregnancy, BPAS advises women to use sanitary towels to monitor the bleeding and notes that a woman’s next period might be heavier than usual.

The majority of patients will pass their pregnancy at home, or a place of their choosing, and decide how they wish to dispose of its remains. ‘They can be flushed down the lavatory or wrapped in tissue, placed in a small plastic bag and put in the dustbin,’ BPAS notes.

How much does an abortion pill cost?

In the majority of UK cases, the abortion pill is free of charge.

BPAS and abortion provider Marie Stopes UK (MSUK) state that the majority (97-98 per cent) of women who require their services have their treatment paid for by the NHS (or another governing body).

In order to assess a patient’s eligibility for an NHS-paid abortion, BPAS requires their address and the name and address of their GP. Those who choose to be treated privately at the organisation will need to pay for their abortion.

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According to the service’s prices from April 10 2019, the total price (including an initial consultation and treatment) of an abortion pill (under 10 weeks) is £480. You can see the full list of prices here.

BPAS also offers special prices for women from the Republic of Ireland, and the Channel Islands (Jersey and Guernsey).

The majority women who require abortion services have their treatment paid for by the NHS

‘While abortion care is not available on the NHS for women in Northern Ireland, in June 2017 the UK Government announced they would commit to cover the cost of abortion care for women from Northern Ireland who are treated in England,’ explains Marie Stopes.

Visit the Abortion Support Network to donate to fund abortions and travel of clients from outside of the UK here.

What risks are involved with the abortion pill?

Common side effects for women following an early medical abortion can include feeling dizzy, nauseous, a headache and temporary flushes or sweats which usually pass after a few hours.

However, there are more serious risks associated with both a medical and surgical abortion depending on far along you are in your pregnancy.

The NHS explains that before 14 weeks of pregnancy, the main risks of an abortion pill include requiring another procedure to remove parts of the pregnancy that have stayed in the womb, plus heavy bleeding.

From 14 weeks of pregnancy, the risks include needing a follow-up procedure to remove parts of the pregnancy that have stayed in the womb and there is more risk of infection or injury to the womb. Find out more about any complications here.

Abortion is an extremely safe procedure, and it’s even safer the earlier it is performed,’ states a BPAS spokesperson.

‘With early medical abortions, there is a small chance of infection, or that the procedure may not be successful, which is why we provide all women with information on the signs and symptoms to look out for and a pregnancy test to take home with them.’

Dr Neubauer tells us that the majority of women choosing to have an abortion ‘are sure that this is the right option for them, but a small number prefer to have counselling to help them with their decision’. Both BPAS and MSUK offers pre-and post-abortion counselling to all clients.

Does an abortion pill affect fertility?

Having an abortion will not affect your chances of becoming pregnant and having normal pregnancies in the future, the NHS outlines.

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BPAS emphasises this in the Q&A section on its website, noting: ‘There is absolutely no evidence that safe, legal abortion will lead to infertility. In fact, after an abortion, fertility returns almost immediately.’

The NHS notes that many women are able to get pregnant immediately after a termination and advises them to start using contraception right away if they don’t want to get pregnant again.

‘There’s a very small risk to your fertility and future pregnancies if you develop a womb infection that is not treated quickly. The infection could spread to your fallopian tubes and ovaries – known as pelvic inflammatory disease (PID).’

However, most infections are treated before they develop to this stage.

Can you buy abortion pills online?

Abortion pills are sold online but it is illegal to take them without medical approval in the UK.

According to data from the Medicines and Healthcare products Regulatory Agency (MHRA), which regulates medicines in the UK, there were 375 abortion pills seized in 2018, up from 270 in 2015 and 180 in 2014. In recent years, some women have been jailed for taking abortion pills bought online.

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In July 2020, The Independent reported that several charities and MPs called for the law to change when it comes to the consumption of online abortion pills at home.

Abortion is an extremely safe procedure, and it’s even safer the earlier it is performed

They argue the law disproportionately affects women and girls in ‘abusive relationships who seek illicit medication online’ who are unable to visit clinics ‘for fear their abuser will discover their pregnancy’.

How do you organise an abortion?

When it comes to getting an abortion, it’s important to note that terminations are only carried out under the care of an NHS hospital or licensed clinic.

There are three main ways to get an abortion on the NHS which include:

  • Speak to a GP and ask for a referral to an abortion service. The GP should refer you to another doctor if he or she has any objections to abortion
  • Contact a sexual health clinic and ask for a referral to an abortion service
  • Self-refer by contacting an abortion provider directly (eg. BPAS or Marie Stopes UK).

A BPAS spokesperson tells us that in the UK, GP surgeries don’t fall under the category of a ‘licensed clinic’ so many women ‘prefer to skip the GP visit and self-refer instead’.

If you want to go ahead with an abortion, you can find pregnancy termination services via the NHS website here. All you need to do is enter your location (postcode or town) into the website and it will give you a list of locations where you can enquire about a termination.

If you want to book a termination through BPAS, for example, you will have to make a consultation before your treatment to ensure it’s legal and safe to proceed. Call 03457 30 40 30 to book an appointment or make an enquiry, request an appointment via this form or request a callback.

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You can make an appointment directly with BPAS without first consulting your GP or genitourinary medicine (GUM) clinic.

‘If you come to us for an abortion, we’ll ask for your reasons for wanting one, which we’re required to do by law,’ Marie Stopes explains on its website. ‘Two doctors need to make sure the requirements of the Abortion Act are met, and sign the relevant certificate. We will arrange this for you.’

The NHS notes that you should not have to wait more than two weeks from when you (or a doctor) first contacted an abortion provider regarding the termination.

Will an abortion be on a person’s medical record?

This entirely depends on how a patient has gone about organising their abortion.

‘If you ask your GP to refer you for an abortion it will automatically be put on your medical records at the time of your visit to your GP,’ the UK Health Centre explains.

However, if you go to a private abortion clinic, it won’t be automatically put on your medical records due to confidentially rules.

‘It is possible that sometimes if you are to be referred for an abortion through the Family Planning Association or Sexual Health Clinic that your abortion information is not sent onto your GP,’ the Centre states.

‘This may not be automatically be put onto your medical records even though it would be NHS funded.’

If a patient calls BPAS or Marie Stopes for advice regarding an abortion, they are not required to tell the service who they are and they won’t receive a call back unless they request one.

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When it comes to contacting a GP, both BPAS and Marie Stopes state that they won’t disclose information to a patient’s GP or contact them without their permission.

The latter adds that the only circumstance where it would do this would be ‘when needed for emergency medical care or safeguarding concerns’.

It explains: ‘All clinical professionals are bound by the code of confidentiality and data protection laws.’

Additionally, BPAS says that while it wouldn’t contact a GP without a patient’s permission, they might need to share some personal information with other healthcare providers or organisations in order to provide care, such as gaining NHS funding or to understand a person’s medical history. You can read more about how BPAS uses your information here.

What are the laws surrounding abortion in the UK?

According to the Abortion Act 1967, in England, Scotland and Wales, you can legally have an abortion up to 23 weeks and six days of pregnancy.

In March 2020, Northern Ireland changed its abortion laws to allow terminations to be carried out in all circumstances in the first 12 weeks of a pregnancy. After that time period, abortions are legal in some cases – for example, there is no term limit in cases of fatal foetal abnormalities.

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In England, Scotland and Wales, there is no gestational limit for abortions if there’s proof of a fatal foetal abnormality or a significant risk to the mother’s life if they were to proceed with the pregnancy.

Source: https://www.elle.com/uk/life-and-culture/culture/a33233965/abortion-pill/?fbclid=IwAR2Vf6JUvPpDnBSR_b47ZGukZdxyO6LdtVEtnr4wuyQ9Nw0kbMDeCi75gXk

The Supreme Court ruled broadly Wednesday in favor of the religious rights of employers in two cases that could leave more than 70,000 women without free contraception and tens of thousands of people with no way to sue for job discrimination.

In both cases the court ruled 7-2, with two liberal justices joining conservatives in favor of the Trump administration and religious employers.

In the more prominent of the two cases, involving President Barack Obama’s health care overhaul, the justices greenlighted changes the Trump administration had sought. The administration announced in 2017 that it would allow more employers to opt out of providing the no-cost birth control coverage required under the law, but lower courts had blocked the changes.

The ruling is a significant election-year win for President Donald Trump, who counts on heavy support from evangelicals and other Christian groups for votes and policy backing. It was also good news for the administration, which in recent weeks has seen headline-making Supreme Court decisions go against its positions.

In one of those earlier cases, the court rejected Trump’s effort to end legal protections for 650,000 young immigrants. In another, the justices said a landmark civil rights law protects gay, lesbian and transgender people from discrimination in employment.

Another particularly important decision for Trump is ahead. The justices are expected to announce Thursday whether Congress and the Manhattan district attorney can see the president’s taxes and other financial records he has fought to keep private.

In its second big ruling on Wednesday, the court sided with two Catholic schools in California in a decision underscoring that certain employees of religious schools can’t sue for employment discrimination.

Lay teachers whose contracts had not been renewed had sued their schools. But Justice Samuel Alito wrote in his majority opinion: “When a school with a religious mission entrusts a teacher with the responsibility of educating and forming students in the faith, judicial intervention into disputes between the school and the teacher threatens the school’s independence in a way that the First Amendment does not allow.”

The court’s birth-control decision was cheered by conservative groups, and White House spokeswoman Kayleigh McEnany joined in. “Today’s Supreme Court ruling is a big win for religious freedom and freedom of conscience,” she said in a statement.

Liberal groups and Democrats, including House Speaker Nancy Pelosi, decried the decision, which she called a “fundamental misreading” of the health care law. Presumptive Democratic presidential nominee Joe Biden said the decision will make it “easier for the Trump-Pence Administration to continue to strip health care from women.”

The Trump administration is still seeking to overturn Obama’s Affordable Care Act in its entirety. It has joined Texas and other Republican-led states in calling on the justices to do just that. The case is scheduled to be argued in the court term that begins in October.

Justice Clarence Thomas, writing for the majority of the court, said in Wednesday’s decision that the administration has the authority to make its birth-control coverage changes and followed appropriate procedures in doing so.

The government has estimated that the rule changes would cause between 70,000 women and 126,000 women to lose contraception coverage in one year.

Justice Ruth Bader Ginsburg cited those numbers in dissenting.

“Today, for the first time, the Court casts totally aside countervailing rights and interests in its zeal to secure religious rights to the nth degree,” she wrote in a dissent joined by Justice Sonia Sotomayor.

Birth control coverage has been a topic of contention since the health care law was passed.

“The ACA’s contraceptive mandate … has existed for approximately nine years. Litigation surrounding that requirement has lasted nearly as long,” Thomas wrote.

Initially, churches, synagogues and mosques were exempt from the contraceptive coverage requirement. The Obama administration also created a way by which religiously affiliated organizations including hospitals, universities and charities could opt out of paying for contraception, but women on their health plans would still get no-cost birth control. Some groups complained the opt-out process itself violated their religious beliefs, and years of legal wrangling followed.

After Trump took office, officials announced changes. Under a new policy issued by the Department of Health and Human Services, more categories of employers, including publicly traded companies, can opt out of providing no-cost birth control to women by claiming religious objections. The policy also allows some employers, though not publicly traded companies, to raise moral objections and do the same.

The changes were blocked by courts after New Jersey and Pennsylvania challenged them.

Future administrations could attempt to alter the Trump administration rules. And two liberal justices who sided with the administration, Elena Kagan and Stephen Breyer, suggested the legal fight over the administration’s changes may continue.

Pennsylvania Attorney General Josh Shapiro said in a statement after the ruling, “This fight is not over.”

In the religious-schools discrimination case, the court had ruled unanimously in 2012 that the Constitution prevents ministers from suing their churches for employment discrimination, but the justices didn’t rigidly define who counts as a minister.

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Associated Press writer Mark Sherman contributed to this report.

Source: https://apnews.com/65d64e383b5b90cb8620c35ab2bcaecc?fbclid=IwAR39Wc7VBl6kFCq7cOHKCzvGuAdtRYD7eYj7_FcaT_lJoSM9Rprp47Pmzwo