The rule is an attack on good family planning care, reproductive health advocates say.

On Friday, the Trump administration announced that it will impose a domestic gag rule for health care providers that aims to defund Planned Parenthood and restrict people’s access to quality reproductive health care.

This rule would upend Title X, a federal grant program administered by the Department of Health and Human Services (HHS) and the country’s only federal family planning program. Planning services funded through Title X support testing and treatment for sexually transmitted infections, cervical and breast cancer screenings, birth control, and contraception education.

The rule does not allow abortion referral and does not allow agencies that receive Title X funds to provide abortion, even though they are using nonfederal funds to do so. Regardless of what pregnant patients say they want from their reproductive health care, the rule would mandate that physicians refer those patients for social services and prenatal services. The rule also requires the financial and physical separation of Title X projects and facilities “from programs and facilities where abortion is a method of family planning.”

Earlier this month, Emily Stewart, vice president of public policy at Planned Parenthood Federation of America/Planned Parenthood Action Fund, said the rule will harm the 4 million people the program serves, the majority of whom have an income at or below the federal poverty level.

“This is a program that is designed to make sure that people who are struggling to make ends meet are able to get not only birth control but STD screenings and cancer screenings and well woman exams. For a lot of people receiving care under this program, this program is the difference for them in terms of whether they have access to health care or not,” she said.

The rule is set to take effect gradually 60 days after it is published in the Federal Register. However, the mandatory financial and physical separation of facilities’ activities will take effect later, at 120 days and one year after it is published in the register, respectively.

Stewart added, “The rule itself seeks to dismantle the nation’s birth control program in two ways — No. 1 is to gag health providers, which makes it illegal for people participating in the program to refer patients for abortion. This is completely unethical and that is why it has been opposed by every major medical association including the American Medical Association. Everyone regardless of income deserves access to the best medical care.”

This practice would go against informed consent and shared decision-making in medical ethics as defined by the American Medical Association. The AMA says physicians should tell patients about “the burdens, risks, and expected benefits of all options, including forgoing treatment.”

The American Nurses Association (ANA) released a statement condemning the proposal in May. Their statement read:

As the most “honest and ethical” profession, nurses must guard against any erosive policy that hinders patients from making meaningful, informed decisions about their own health, or that blocks access to care. The Code of Ethics for Nurses outlines that the nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population. This proposed rule interferes with that relationship and violates basic ethics of the profession.

In a statement to ThinkProgress, Guttmacher Institute Senior Policy Manager Kinsey Hasstedt said about the rule, “Since day one, the Trump administration, along with its anti-abortion and anti-contraception allies, has made it clear that they want to undermine and restrict people’s access to family planning care. The Title X program, which provides confidential, high-quality, medically accurate family planning services to four million people every year, has been one of their main targets.”

HHS has already taken a number of steps to restrict reproductive health services.

Last year, HHS created a new division within the Office for Civil Rights, called the Division of Conscience and Religious Freedom. This division is supposed to ensure that health care providers don’t have to provide services, such as abortion, that they object to morally or religiously. The department also released guidelines for Title X grant applications that concerned physicians and reproductive health groups. The document mentioned “natural family planning” such as the rhythm method and other tactics for preventing pregnancy that do not involve contraceptives.

Stewart said that all of the policies that HHS has pursued are part of the same attack.

“The intent here that the administration is pursuing is to completely dismantle the birth control program that has been operating for decades and to replace it with a health care system designed to deny access to full information and care,” Stewart said. “It’s part of a much larger agenda designed to undercut people’s access to health care … They are trying to deny people access to information about their bodies and they are using every single tool in their toolbox to do it.”

“Title X is our nation’s gold-standard family planning program that serves low-income patients for free,” Ruth Harlow, ACLU Reproductive Freedom Project Senior Staff Attorney, said in a statement to ThinkProgress on Friday. “Now the Trump administration wants to prevent Title X patients from receiving full information about their care options and drive many of the most experienced health care providers from the program. Nobody should be denied access to reproductive health care or receive inadequate care because of their lack of income. We won’t sit back while Trump upends the family planning safety net as part of his anti-woman, anti-poor, and anti-health care agenda.”

The International Women’s Health Coalition released a statement to ThinkProgress explaining that it believes the funding restrictions will lead to increases in unwanted pregnancies and delay diagnosis and treatment of sexually transmitted infections and reproductive cancers.

Numerous studies have found that other health care providers would be unable to fill the gap left by Planned Parenthood. One study from the National Campaign to Prevent Teen and Unplanned Pregnancy found that in 105 counties across the country, Planned Parenthood is the only clinic offering comprehensive contraceptive services.


Legislators proposed several anti-choice amendments in the house judiciary committee’s debate on H.57, which would codify abortion rights into state law.

Legislators proposed the amendments in the Vermont house judiciary committee’s debate on H.57, which would codify abortion rights into state law. The committee voted down the amendments.
Jordan Silverman/Getty Images

Vermont Republicans on Wednesday tried to jam seven anti-choice amendments into legislation designed to protect abortion rights in the state should Roe v. Wade be overturned by the U.S. Supreme Court’s conservative majority.

GOP legislators proposed the amendments in the Vermont house judiciary committee’s debate on H.57, which would codify abortion rights into state law. The committee voted down the amendments.

The amendments ran the gamut of typical anti-choice efforts to curtail reproductive rights, ranging from fetal “personhood,”which would outlaw abortion and many kinds of contraception, to physician-only abortions and parental consent requirements. Vermont state Rep. Carl Rosenquist (R-Franklin 1), who proposed the “personhood” amendment, compared women to kangaroos that apparently value their roos more than women do their babies.

Vermont House Rep. Nader Hashim (D-Windham 4), who voted against the anti-choice measures, said the amendments were an attempt by abortion rights opponents to create more restrictions when Democrats are trying to secure reproductive rights in Vermont with a conservative majority on the Court.

“I think a lot of these amendments are partly an attempt to subvert what H.57 is meant to do, which is protect what has already been in practice for the last 46 years. Some of these would completely turn around H.57 and actually create more restrictive laws for women,” Hashim told Rewire.News.

The Roe protection bill will be debated on the house floor and is expected to pass with a majority vote tonight before it heads to the state senate. Democrats control both of Vermont’s legislative chambers, and Gov. Phil Scott (R) has said he would support legislation to protect Roe. 

Vermont would become the latest state to codify Roe protections into state law.


The volunteers who walk women past lines of anti-choice protestors say things are getting worse out there.

Despite the fact that abortion is still technically legal everywhere in America, actually obtaining one is getting harder and harder. One reason: the increasing numbers of anti-abortion activists stationed outside the clinics. Reports of trespassing and harassment by these protestors have more than tripled since 2016, making clinic “escorts” more important than ever. Here, three of them tell us their stories:


Rachel Z., 29, Chicago, Illinois

Yes, there are protestors in blue states too.

In college, I had a friend who got an abortion. It was really emotionally difficult for her, not because she was unsure of her choice but because the protestors outside the clinic were so awful. What she went through made me so angry that I decided to do something about it.

I started volunteering as a clinic escort through an independent volunteer network. At the facility where I’m stationed most often, there’s a parking lot across the street. Escorts stand outside the clinic and over by the lot to watch for patients. We can usually spot them: They’ll look lost, or it’ll be a young woman with a partner. That’s our cue. We say hi and offer to walk them across the street, to create a barrier between them and any protestors. It’s funny—people think of Chicago as this liberal bastion that wouldn’t have anti-choice protestors, but we definitely do. On a given day, there are between 5 and 15 activists standing outside our clinic. Occasionally, they keep their distance and just kind of pray quietly, but they can also get very physical with the patients and escorts. Our rules are not to engage with them, and I agree with that. But they’ve put their hands on us; they’ve put their hands on the patients. It’s technically assault, but calling the cops is kind of a coin flip—we don’t know who they’re going to side with or if they’ll even care.


Since 2016, the protestors have definitely gotten more confident. It used to be a lot quieter at our clinic—they’d say Hail Marys, but they wouldn’t really bother anyone. Now there are a lot more of them, and they’re more aggressive. They’ll tell the patients they’re murderers; they’ll get up in their faces and hold up huge pictures of fake, bloody fetuses. One man screams so loud we can hear him even when we get inside the clinic. There’s even a Christian school in the suburbs that busses kids down here once a month to protest for extra credit.

“People think of Chicago as this liberal bastion that wouldn’t have anti-choice protestors, but we do.”

One time, an ambulance pulled up to the clinic. It was a particularly heavy day with a lot of antis—that’s what we call the anti-choice protestors—and they went NUTS. They swarmed the ambulance, screaming and yelling, and filming this person on the stretcher being wheeled out. It’s possible they thought it was a botched abortion (we found out later from staff that someone had fainted and seized in the waiting room). The paramedics actually yelled at them for violating the patient’s privacy and said they would call the cops if they didn’t stop. The antis claim to be out there to counsel and help patients, but that incident reminded me that they’re really there to shame and violate.


Another time, a man came outside to smoke a cigarette and seemed very shaken. He started to talk with us escorts and told us that his wife had been pretty far along, but that the fetus was incompatible with life—the delivery would have been a stillborn. He had clearly never really thought much about the abortion debate, so to speak. He was grieving and heartbroken over a very wanted baby and horrified that people were waving signs and screaming that he and his wife were murderers. Seeing him walk his sobbing wife out to their car later in the shift has stayed with me for many years.


Ashley J., 35, Louisville, Kentucky

When your state has only one clinic, things can get intense.

I escort a few times a month at EMW Women’s Surgical Center, the only remaining abortion clinic in the entire state of Kentucky. We have people coming from all over the state as well as from Tennessee, Indiana, and West Virginia. West Virginia has one clinic left. Indiana has a fair amount of them, but it can be easier to get an abortion in Kentucky. Indiana has a very burdensome informed-consent process where you have to go to the clinic, wait 18 hours, then come back. Kentucky also has a waiting period, but you can do the first appointment over the phone.

I don’t think people really understand what escorting looks like in a state with only one abortion clinic. We draw a lot of protestors, usually 50 to 60 people outside whenever the clinic is open, from Tuesday through Saturday. There are only about 20 escorts each day, so we’re outnumbered. It can get really hostile—they’re definitely more emboldened now. On Mother’s Day 2017, protestors sat down in front of the clinic doors to block patients from coming in, in order to “save the mothers” from getting abortions.


We don’t spend a lot of time with the patients, so we don’t really get to hear their stories. We just walk alongside them, maybe give them an idea about what to expect. I like to say things like, We’re coming up on protestors, they’re probably going to hand you a pamphlet, you’re welcome to take it but don’t have to, things like that. Sometimes I just make small talk about the weather, to keep their spirits up. I think most patients just like that they have someone to walk with.


It’s none of our business why they’re having abortions. If they go in the clinic and decide abortion isn’t for them, that’s fine. We just want to support them in having safe access to a doctor and making whatever decision they want.


Helen L., 29, San Diego, California

I saw a “crisis pregnancy center” divert patients from the clinic.

I started escorting in 2015 at a clinic in San Diego. We’d be there every Saturday morning from 7 a.m. until around lunchtime. The clinic opened at 8, but a lot of patients would drive in early from Tijuana and wait in their cars, so we’d wait there with them. We’d also get a lot of terrified-looking teenagers who had come without their parents. I think it’s so important for someone to be there to say, It’s your right to do this, and you should be allowed to do it freely.

Unlike Planned Parenthoods, which have private parking lots, our clinic was on the upper level of a strip-mall-type area with a public parking lot. A lot of times, we didn’t know where the protestors were legally allowed to be, and so they’d get really close to the patients, even sometimes riding up in the elevator with them. The escorts had bright yellow shirts because we wanted to be as visible as possible. We’d always have someone speaking Spanish, if we could. A lot of the antis spoke Spanish and lied to the patients, saying there were risks of cancer and infertility from having an abortion. They’d show women a picture of an ambulance outside our clinic and tell them the paramedics were just there last week, when really the ambulance had come once, years ago. They’d lie to patients and say the doctor hurt women and that people had died.


In 2016, a crisis pregnancy center opened up right next door. Now the anti-choice “sidewalk counselors,” as they call themselves, no longer had to redirect patients to another address miles away. Their new clinic had a very similar name, and the tactics they used were horrifying. They’d put a little chair outside with a box of donuts on it, to lure women over there. If they could trick a patient into taking a donut, she wouldn’t be allowed to get surgery, since she had eaten. We had to stand outside and say “Don’t eat anything! You won’t be able to get your procedure!”


Having rights doesn’t really mean anything if people are tricked out of exercising them or are too afraid to exercise them because of a line of protestors. I’m about as privileged as it gets—white, British, cisgender—so it’s important for me to be out here.


Illinois Democrats’ pro-choice push could help providers cope with an influx of out-of-state patients by expanding the number of medical professionals who can provide in-clinic abortion services.

Illinois Democrats’ efforts to secure access to reproductive health care are in stark contrast to surrounding states. Republicans in Missouri and Indiana have enacted some of the most restrictive abortion laws in the United States, including mandatory counseling and forced waiting periods to receive abortion care.

Illinois Democrats recently introduced legislation to secure and expand reproductive rights, changes that could have far-reaching effects, as people travel to Illinois to secure abortion care that is difficult to access in neighboring states.

And one part of that legislation could help providers cope with that influx of out-of-state patients by expanding the number of medical professionals who can provide in-clinic abortion services.

The two bills proposed last week in the Illinois General Assembly would repeal decades-old statues intended to criminalize abortion providers and require parental notification for minors to receive abortion care. The measures have large Democratic support in the general assembly where Democrats hold supermajorities in both chambers.

“It’s pushing back against a deliberate strategy of the anti-abortion movement of stigmatizing and siloing women’s reproductive health care, and these bills are saying we need to treat reproductive health care like any other health care,” Colleen Connell, executive director of the American Civil Liberties Union (ACLU) of Illinois, told Rewire.News.

The Reproductive Health Act (HB 2495), proposed in the Illinois House by state Rep. Kelly Cassidy (D-Chicago), would repeal a 1975 law that includes criminal penalties for doctors who offer abortion care, though it has been largely blocked by the courts. The legislation also seeks to repeal targeted regulations on facilities that provide abortion services, repeal laws that have allowed husbands to block their wives from obtaining abortions, and require all private health insurance companies in the state to provide coverage for abortions. The Reproductive Health Act builds on a law Illinois lawmakers passed two years ago requiring Medicaid and state group health insurance plans to cover abortion, Connell said.

The legislation would repeal the state’s ban on so-called partial-birth abortion, which is unenforceable. Anti-choice activists use “partial birth abortion,” an unscientific term, to describe an uncommon type of dilation and evacuation abortion (D and E) known as an “intact D and E.”

Another key provision of the Reproductive Health Act would allow advanced practice nurses and clinicians to provide in-clinic abortions. Current law only allows for physicians to provide these procedures while advanced practice nurses are limited to providing medication abortion. Allowing nurse practitioners to provide in-clinic abortions will increase the number of providers in the state, potentially meeting an increased demand should patients from surrounding areas continue to seek care in Illinois, said Liz Higgins, associate medical director of Planned Parenthood of Illinois.

“Adding in-clinic abortions for nurse practitioners would be a huge benefit of this bill,” Higgins said, noting that nurse practitioners already provide a range of reproductive health care, including IUD insertion and other gynecological procedures. “Limiting in-clinic abortions for advanced practice nurses is really just harming our patients by limiting access to health care in a timely manner.”

Illinois Democrats’ efforts to secure access to reproductive health care are in stark contrast to surrounding states. Republicans in Missouri and Indiana have enacted some of the most restrictive abortion laws in the United States, including mandatory counseling and forced waiting periods to receive abortion care. It’s not uncommon for providers in Illinois to see women traveling from surrounding states to seek care they couldn’t receive closer to home, said Julie Lynn, spokeswoman for Planned Parenthood of Illinois. In 2017, more than 5,500 women traveled from out of state to terminate a pregnancy in Illinois, according to the Chicago Tribune.

“We’re always thinking about how our patients are going to be impacted as well as people at large because there are states surrounding us with extremely restrictive laws regarding reproductive health care access,” Lynn said. “So if there’s anything we can do in Illinois to lessen that burden on anyone then we want to make sure to do that.”

Missouri is one of five states with a forced 72-hour waiting period between counseling and an abortion procedure. Both Missouri and Indiana ban the use of telemedicine to administer medication abortion and require minors to receive parental consent before terminating a pregnancy.

Illinois had 40 abortion-providing facilities in 2014, according to the Guttmacher Institute. Last year Missouri only had one. Planned Parenthood operates 17 health centers in Illinois, 15 of which provide medication abortion and five that provide in-clinic abortions, Lynn said.

The second bill, SB 1594, which was introduced in Illinois’ state senate last week, would repeal the 1995 Parental Notice of Abortion Act, which requires  minors to notify a guardian before receiving abortion care or otherwise appear before a judge and receive a judicial bypass. The law was blocked by the courts from 1995 to 2013, but has been enforced in Illinois for the past five years after the Illinois Supreme Court upheld it.

Although the measure is smaller in scope than the Reproductive Health Act, Higgins said repealing the Parental Notice of Abortion Act is crucial to eliminating barriers to health care for minors.

“A majority of minors are already telling a family member or trusted adult if they are getting an abortion, but unfortunately a handful of patients live in dangerous family situations and aren’t able to tell their parents or a trusted adult,” Higgins said. “Making them go before a judge is putting more barriers in front of these patients, and we want to make sure we’re not making this harder on young people.”

The pro-choice proposals in Illinois follow similar efforts in states like Massachusetts, where lawmakers are working to expand access to medication abortion. New York Democratic lawmakers recently passed a measure to secure abortion rights should conservatives on the Supreme Court overturn Roe v. Wade, while lawmakers in New Mexico are working to repeal the state’s decades-old abortion ban. Rhode Island Democrats are working to pass a measure that would enshrine abortion rights into law despite resistance from anti-choice Democratic leaders in the state.

“It’s extremely important to modernize the law because with the current landscape and makeup of the Supreme Court, no one knows what the future of reproductive rights in this country is going to be,” Lynn said. “Looking at the makeup of the Supreme Court, it’s not in favor of reproductive health so we want to make sure we are doing whatever we can to protect and expand those rights and most importantly acknowledge abortion as health care and take it out of the criminal code.”


Democratic governors in Illinois, Maine, Kansas, Wisconsin, Michigan, and California are seeking to expand health-care access and LGBTQ protections.

One week after taking office, Gov. J.B. Pritzker issued an executive order declaring his commitment “to ensuring that Illinois is the most progressive state in the nation for protecting women’s reproductive rights.”
WGN News / YouTube

As Republicans maintain a hold over the U.S. Senate and the Trump administration continues to threaten health care, reproductive rights, and LGBTQ rights, new governors are flexing their muscles to address those issues on the state level.

“At a time when the Trump Administration is rolling back LGBTQ acceptance at every opportunity, it’s reassuring that the nation has governors … who will put their foot down and make sure LGBTQ people and marginalized communities have a seat at the table,” said Zeke Stokes, GLAAD’s chief programs officer, in a statement to Rewire.News. “Their inclusive approach to governing sends a signal to others that all voices must be present in order to get things done for the people they serve.”

Democrats flipped seven governorships in 2018, bringing the total number of states under Democratic leadership to 23. Breaking up the GOP’s hold over multiple state governments will make it harder for those states to enact legislation that endangers the LGBTQ community or limits access to health care.

Here are six states where new Democratic governors have issued executive orders expanding health care, reproductive rights, and LGBTQ rights since taking office last month.


Gov. Gavin Newsom’s predecessor, Jerry Brown, was also a Democrat who worked to expand health-care coverage and protect reproductive rights. Already, California’s new governor has made it clear that he plans to continue down the same path.

Newsom’s first official act in office was centered around health care—specifically, lowering prescription drug and health-care costs. The executive order he signed the day he was sworn in tasked his Department of Health Care Services with negotiating the pricing and purchasing of prescription drugs so that public and private purchasers don’t have to negotiate with drug companies themselves. Assembly Health Committee Chair Jim Wood told Kaiser Health News last month that negotiating prices could save the state hundreds of millions of dollars that could go toward insurance subsidies or coverage for young unauthorized immigrants.

Newsom’s state budget proposal also seeks to expand Obamacare subsidies for health-care coverage and create the nation’s most generous paid parental leave policy by guaranteeing six months of partially paid leave. He also called for the state’s Medicaid program to cover undocumented immigrants up to the age of 26. Undocumented youth were previously only eligible until the age of 19.


One week after taking office, Gov. J.B. Pritzker issued an executive order on the anniversary of Roe v. Wadedeclaring his commitment “to ensuring that Illinois is the most progressive state in the nation for protecting women’s reproductive rights.” His directive moved to ensure the state government complies with a law signed by former Republican governor Bruce Rauner in 2017 that removed provisions of the state’s “trigger law” and allowed abortion coverage in Medicaid and state health plans.

Pritzker’s order guarantees that state employees’ health insurance covers abortion. According to local news outlet WQAD, the new governor’s directive acted “to make sure state departments are complying with the law.” A circuit judge dismissed a lawsuit by anti-choice groups seeking to stop the law from taking effect, and an appellate court upheld that dismissal last fallPritzker said he was “concerned” that the law wasn’t being properly enforced for state employees, as the Chicago Sun-Times reported.

When it comes to protecting or expanding abortion access, Elizabeth Nash, senior state issues manager at the Guttmacher Institute, explained that it’s rare for governors to use their executive powers. “Governors haven’t used their authority in this way very often. Obviously, we’ve seen it on the other side,” Nash said, pointing to South Carolina Republican Gov. Henry McMaster’s 2017 executive order directing state agencies to stop funding medical practices affiliated with abortion clinics.

“Illinois made its changes before [Pritzker] became governor, and that took several years … to get that bill through the legislature,” Nash said. “This is one way to put your stamp on an issue.”

While Pritzker’s order focused on better enforcing the existing law, it also allowed him to highlight where he stands on the issue.

“This executive order will ensure there are no barriers to women exercising their right to choose under state employee group health insurance plans,” Pritzker tweeted in January. “Access to reproductive health care is a right—for women of all incomes, for women in all areas of our state, and for women with both private and government-funded health insurance.”


Gov. Laura Kelly’s first official action after taking office in January was to ban anti-LGBTQ discrimination against state employees. The executive order, signed on January 15, states that no state agency shall “discriminate, harass, or retaliate against an individual in employment” on the basis of sexual orientation, gender identity or expression, or other factors such as race and religion. The order reversed former Republican governor Sam Brownback’s 2015 repeal of a previous iteration of the ban and extended the protections to state contractors.

“In a perfect world, we wouldn’t need executive orders like this,” Kelly told reporters at a January news conference, according to the Associated Press. “It’s important that, until we become a perfect world, that we make sure that we’ve got the kinds of things in place that move it towards perfection.”

Kansas’ first two openly LGBTQ state lawmakers are now working to ban discrimination based on sexual orientation and gender identity by all employers in the state. Kelly has indicated she would sign the bill if it reaches her desk.


Gov. Janet Mills’ first executive order fulfilled her campaign promise to expand Medicaid. State residents voted for expansion in 2017, but former Republican governor Paul LePage refused to implement it and fought expansion in court. The lawsuit ultimately only delayed when Maine residents could sign up for MaineCare health insurance, as Mills began implementing the expansion as soon as she took office.

“Expanding health care and lowering the cost for Maine people and small businesses is a top priority of my administration, and I look forward to working with the Legislature to achieve that goal,” Mills said in a press release.

Later that month, Mills reversed her predecessor’s attempt to enforce work requirements for Medicaid and require people to pay premiums if they only use Medicaid for family planning services. LePage’s proposal had already been approved by the Trump administration, but Mills informed the U.S. Centers for Medicare & Medicaid Services that the state would no longer accept the terms of the pending Medicaid waiver.

“Making sure people are healthy is the first step in making them eligible for work,” a spokesperson from Mills’ office said in an email to Rewire.News last month.


Michigan’s new governor took the same stand against LGBTQ discrimination as Kansas. In an executive order issued her first month in office, Gov. Gretchen Whitmer put into place additional LGBTQ protections for state employees by prohibiting any type of discrimination based on sexual orientation or gender identity. The protections also extended to state contracting, grants, and loan programs.

“The State of Michigan must be a model of equal opportunity—reaching out to people, knocking down barriers, treating everyone fairly, and dispelling prejudices that hold Michigan and its residents back,” the January 7 directive reads.

The move was praised by LGBTQ organizations, including the Human Rights Campaign (HRC), which noted in a January press release that Michigan is one of 31 states that lack “fully inclusive, comprehensive statewide non-discrimination protections for the LGBTQ community.”

“Elections matter,” HRC Michigan State Director Amritha Venkataraman said in the press release. “In one of her first actions as governor, pro-equality champion Gretchen Whitmer has extended long overdue non-discrimination protections to members of the LGBTQ community.”


Gov. Tony Evers took action last month to fulfill his campaign promise to increase access to health care. In one executive orders, Evers called for the state’s Department of Health Services to develop a plan to expand Medicaid. In a second executive order, he directed state agencies to protect people with pre-existing conditions.

Evers’ directives didn’t actually expand Medicaid, as he would need the approval of Wisconsin’s Republican-controlled legislature to do so. But they sent the message that his administration is committed to finding ways to improve access and affordability.

“Giving more people access to healthcare is a no-brainer,” he tweeted January 22. “My budget will seek to expand Medicaid—providing care to more people while saving taxpayers hundreds of millions of dollars.”

In another executive order, Evers prohibited state agencies from discriminating against employees on the basis of sexual orientation, gender identity, or other factors such as disability or political affiliation.

“Discrimination in any form is wrong, and through his actions today—signing his first executive order since taking office — Governor Evers continues to demonstrate that he will fight day in and day out to uphold the Wisconsin values of fairness, justice and equality,” HRC Wisconsin State Director Wendy Strout said in a January press release.


Anti-abortion advocates have been misleading the public. Beth Vial sets the record straight.

In this op-ed, Beth Vial tells her abortion story.

In recent weeks, New York and Virginia have made headlines for their efforts to cut the medically unnecessary regulations on later abortion. The bills sought to ensure that people seeking abortions would no longer have to travel out of state for care and, in Virginia’s case, ask one — not three — doctors for approval. The policies even made it into the president’s State of the Union address. Anti-abortion advocates have been intentionally misleading the public about the policies and misrepresenting what later abortion is and why people have them. I know because I had an abortion at 28 weeks.

I’m 23, and I have polycystic ovary syndrome (PCOS) and irritable bowel syndrome, which means I’m in a constant state of pain; I have absent and irregular — if present at all — periods, nausea and vomiting, weight fluctuation from the PCOS, as well as cramping and more from the IBS-C/D, all of which are symptoms of an early pregnancy. I’d recently heard about a friend of a friend who didn’t know she was pregnant and went into premature labor. The idea of being pregnant for that long and not knowing scared me, and taking a pregnancy test is pretty standard anytime I go to the doctor to address PCOS-related issues. So I took a pregnancy test just in case, but the test came back negative and a doctor told me I was infertile due to my PCOS. When the symptoms persisted, though, I sought further care.

It was then that I found out I was pregnant, and then that I started experiencing challenges to accessing an abortion.

Unsure of what to do after I learned I was pregnant, an aide at my doctor’s office told me to go to a clinic, which turned out to be an anti-abortion crisis pregnancy center, for a free ultrasound I thought I needed. There I filled out the paperwork, took a pregnancy test, and went into a small room with a counselor, who gave me a ton of literature and talked to me about my options. Because the crisis pregnancy center didn’t have nurses on staff, she said I would need to go to a different location for an ultrasound. I started to feel weird about the way they were trying to convince me not to have an abortion. But I was panicking, so I was willing to accept any free help I could get.

At the second clinic, they gave me a “diagnostic ultrasound” and broadcasted the image on a huge television screen. They pointed at the fetal parts and said macabre things like “Let’s check to make sure the head is attached.”

I was sobbing and couldn’t bear to look at the screen. They handed me six ultrasound images and said I was 16 weeks pregnant. I explained I wanted an abortion, but they said it was dangerous. I now know it’s a very safeprocedure. I realized they were never going to help me, so I left.

The next day I went to a hospital near my home to get a real ultrasound. That’s when I couldn’t believe what they told me: I was actually 26 weeks pregnant.

All the while, the anti-abortion advocates from the centers I had visited kept calling me day and night, harassing me about my decision. I finally yelled at them on the phone and blocked their number. They made an already stressful situation worse — something crisis pregnancy centers frequently do. They use deceptive practices, like telling someone they are much earlier or later in their pregnancy than they really are, or frightening people with myths about abortion, seemingly in an attempt to sway people away from the procedure.

When I finally saw a doctor who could provide me with an abortion, she said she had to get approval from the hospital board because of hospital policy, which was denied. I cried. I didn’t know what I would do. I didn’t want to continue the pregnancy because I was too sick, not ready, and I simply couldn’t afford it.

Despite living in Oregon, a state with one of the most progressive abortion laws in the nation, I encountered so many obstacles to accessing abortion just because of my situation. Eventually, my doctor referred me to a clinic in New Mexico, but that meant I had to fly across the country just to get an abortion — and it would be expensive. Because I was later in my pregnancy, the abortion would cost $10,500, another $1,500 for blood work and ultrasounds, and about $1,000 to fly there. My insurance would only cover $200.

The clinic told me about the Northwest Abortion Access Fund, an organization that helps people cover the cost of their abortions when they can’t afford it. They helped me cover $1,000, and the National Abortion Federation helped me out with another $1,000. It seemed insurmountable. But thanks to some loved ones, I was able to raise the money.

Two weeks later I flew to New Mexico and stayed with a family friend for six days. It was a long process, but I was able to get the abortion I needed.

Afterward, I searched the Internet to look for later-abortion stories like mine. Most focus on fetal anomalies and health issues, and not the barriers that keep us from being able to access care by design. In fact, research shows that the anti-abortion restrictions on early abortion have created an increased need for later abortion in Texas. I know I’m lucky — I live in a state with no restrictions on when in pregnancy an abortion is allowed and Medicaid coverage of abortion care, yet it can still be inaccessible if we’re misled or just can’t afford it. This is especially true for young people.

People are also impacted by financial constraints in getting access to abortion services. Young people are less likely to be able to afford travel for multiple clinic visits. Even with access to reliable transportation, if we live in an abortion desert or in one of the eight states with only one abortion clinic, we may miss school or work to make it to our appointments. It also means risking disciplinary action by our schools, teachers, or bosses.

A nation that acknowledges our constitutional right to abortion is not the same as a nation that makes abortion accessible to us when we need it. There are no rights without access.

Beth Vial is a leader with Youth Testify, a collaborative program for people who’ve had abortions that is associated with Advocates for Youth‘s 1 in 3 Campaign and National Network of Abortion Funds‘ We Testify. Vial also serves on the board of directors at the Northwest Abortion Access Fund.


“In 2019 we shouldn’t be fighting for the presumption of innocence when a woman loses a pregnancy.”

Evelyn Hernández Cruz, inside the gates of the Ilopango Women’s Prison in El Salvador on Friday, hugging her mother while her father looks on.
Jorge Menjivar

Evelyn Hernández Cruz, 21, was released from the Ilopango Women’s Prison in El Salvador on Friday after 33 months of incarceration for charges of aggravated homicide after she experienced an obstetric emergency in April 2016 during which her baby died. She still faces a re-trial on April 4 of this year on the same charges, but she was granted release under alternative measures to imprisonment as she awaits retrial.

The Agrupacion Ciudadana por la Despenalización del Aborto, or Citizen Group for the Decriminalization of Abortion, in El Salvador has supported her throughout her ordeal and has maintained that she was unjustly accused and convicted. Twenty-two other women remain incarcerated on similar charges related to the country’s absolute ban on abortion.

Hernández’ legal team appealed the original conviction from July 5, 2017, as reported by Rewire.News, but it was upheld in August 2017. Upon appeal to the Criminal Court of the Supreme Court of Justice, that court annulled the original conviction on September 26, 2018, on the grounds that there was not sufficient evidence to justify the conviction. The evidence submitted in the original trial demonstrated that her baby died from meconium aspiration, which occurs when a newborn or fetus aspirates its first feces produced before birth. This can take place before, during, or after birth, and is not a process that the pregnant person can control.

After annulling the decision, the Supreme Court remanded the case to the trial court, which ruled in December 2018 that a new trial must be held, but specified that a different judge must hear the case. But Hernández remained incarcerated, which violated Salvadoran law that prohibits holding an accused person more than 24 months in prison without a final resolution to a case.

In the Court’s decision, which Rewire.News has reviewed, attorney Bertha De Leon argued that Hernández’ right to the presumption of innocence and her right to liberty were violated by her continuing incarceration. De Leon requested that Hernández be released on alternative measures while awaiting her new trial. De Leon’s request was granted on February 14, and Hernández was released on February 15.

Under the alternative measures, she is required to maintain the same residence, stay in the country, and be present for her new trial scheduled for April 4.

The Agrupacion contends that Hernández’ case is part of a pattern in which young women, living in marginalized conditions and lacking access to adequate health care and sexual education, are criminalized by state institutions when they arrive seeking emergency medical care at public hospitals after experiencing obstetric emergencies. The organization continues to fight to free the other 22 women currently imprisoned with similar cases.

Mariana Moisa, communications coordinator of the Agrupacion, spoke with Rewire.News about the effects of the court’s decision to annul Hernández’ original conviction. Moisa said:

There are huge benefits from this decision from the High Court that can help other women in similar cases. They are listening to the legal argument that women are being accused of serious crimes under circumstances that are very unclear. They acknowledge that for Evelyn, and indirectly other women, too, it is extremely difficult to show that there was an intention to do harm on the part of the woman.

This decision also shows that there are some changes in the judicial system. Until recently it was just a given that all these women were bad people. Now there is a window of doubt on that view. It’s a sign that Salvadoran society is changing. Even a year ago one of the major newspapers was publishing terrible stories about Evelyn, pages of horrendous accusations. Now, stories leave open the possibility that women like Evelyn could be innocent.

The downside to the decision was that the court could have absolved her at that point, and they didn’t. Now she still has the uncertainty of the April 4 trial.

On this day of celebration for Hernández’ freedom, Moisa also pointed out the dangers of normalizing this struggle. She warned, “What we have to watch out for as we celebrate, rightfully, each time a woman is freed from prison, is that this struggle does not become normalized. We don’t want to naturalize this fight because it exhausts us, it wastes resources that we shouldn’t have to use. This is not a normal situation.”

Moisa explained how the law hasn’t always been this way. “Only when the law changed in 1997,” when the legislature reformed the law to prohibit all abortions, “did we start to see normal occurrences as crimes,” she said.

“In 2019 we shouldn’t be fighting for the presumption of innocence when a woman loses a pregnancy. We shouldn’t have to be proving that motherhood is not related to crime. We should have full human rights as Salvadoran women,” said Moisa.