The California bill would require public universities to provide medication abortion at student health centers on campus.

The College Student Right to Access Act was inspired by student activists at the University of California, Berkeley, who banded together in 2015 to advocate for medication abortions on campus. According to Phoebe Abramowitz, who joined the campaign as a freshman, students seeking abortions face unreasonable hardships.
David Litman / Shutterstock.com

After a four-year-long student-led campaign to expand access to abortion care, California may soon become the first state to require publicly funded universities to offer medication abortion on campus.

The California state legislature has until Friday to vote on the College Student Right to Access Act, sponsored by state Sen. Connie Leyva (D-Chino). If it does not move forward this week, the bill will be “carried over” to 2020 and the process will pick up when the legislature reconvenes in January, according to Elizabeth Nash, senior state issues manager at the Guttmacher Institute.

A previous version of the bill was vetoed by Gov. Jerry Brown (D) last year, but California’s new governor, Democrat Gavin Newsom, has signaled he would sign the bill into law.

The bill was inspired by student activists at the University of California, Berkeley who banded together in 2015 to advocate for medication abortions on campus. According to Phoebe Abramowitz, who joined the campaign as a freshman, students seeking abortions face unreasonable hardships.

“We talked to people who had to miss class and work to access abortion care,” she told Rewire.News. “At the time, there was a $300 co-pay [and] a confusing referral process.” For some students, navigating this bureaucracy meant they missed the 10-week window for medication abortion and instead had to seek a surgical abortion off-campus.

“I really do believe this [bill] is a major step for gender equity—and being able to access our studies along with other students,” Abramowitz said.

Medication abortion, also known as the abortion pill, is a non-surgical procedure that blocks the hormones needed for pregnancy and induces contractions through the use of two drugs. Because medication abortion is relatively straightforward and safe, more primary care physicians are beginning to offer it, according to Ushma Upadhyay, PhD, MPH, a researcher at Advancing New Standards in Reproductive Health (ANSIRH) at the University of California, San Francisco and an associate professor.

The California bill would require public universities to provide medication abortion on campus; its requirements wouldn’t apply to private or community colleges.

According to Nash, the only other state considering a similar policy is Massachusetts, although California is likely to be the first place it passes.

“California is a leader on reproductive health issues,” she said. “Other states look to California as a place to find policy ideas on a lot of different progressive issues. It stands to reason that this could be an issue that other states adopt.”

Today, abortion services are seldom available at university health clinics, Upadhyay said.

That’s despite research from the University of Illinois at Chicago that found medication abortion is “safe and feasible” to offer at student health clinics.

As part of her research at ANSIRH, Upadhyay has documented the many hurdles students face when seeking abortion care. In one study, she and her colleagues found that the average student at a California state school had to wait about a week for an off-campus appointment and pay an average of $600 for medication abortion services.

According to Upadhyay, if the California bill becomes law, it would benefit as many as 500 students per month. Each campus of California State University and the University of California would receive $200,000 to cover the startup costs of offering medication abortion services and would be required to begin providing the care by 2023.

Dr. Daniel Grossman, director of ANSIRH, said the funding should be “more than enough” to train staff and get student health centers ready to provide abortion care. After that, the campus health centers should be able to bill insurance for services.

“I am optimistic about this proposal because it makes sense from both a medical and educational perspective,” Grossman said in an email. “If it can work here, I think other states will follow our lead.”

Source: https://rewire.news/article/2019/09/11/california-students-get-a-second-chance-for-expanded-abortion-access-bill/

 

 

In a red state long hostile to abortion rights, this is believed to be a first-of-its-kind program for any U.S. city.

The city council of Austin, Texas, voted Tuesday to direct $150,000 to a program that will help people seeking abortions by paying for services like transportation, lodging, and child care.

It’s believed to be a first-of-its-kind program for a U.S. city.

“We hear on our hotline the struggles of arranging for travel, taking time off work, getting someone to take care of their kids making it to the appointment,” said Amanda Beatriz Williams, executive director of the Lilith Fund, a Texas group that financially helps people who want abortions.

Williams has spent several weeks talking to city council members and advocating for the provision, which she said will be structured as a competitive grant program. It was approved Tuesday as part of the city’s budget for the 2019 and 2020 fiscal year.

“People who are low-income, people of color, are disproportionately restricted from this safe care. And we don’t think that’s right,” she explained.

Unlike an unprecedented measure passed earlier this year in New York City, the Austin provision won’t pay directly for the abortion procedure itself. Doing so would be illegal in Texas, thanks to a recent law that bans local governments from having “transactions” with abortion providers or their affiliates.

That law went into effect after Austin, a blue spot in a red state, agreed to lease property to a Planned Parenthood health center for 20 years — for just $1 a year.

John Seago, legislative director at the powerful anti-abortion group Texas Right to Lifetold CNN that while the Austin measure might comply with the letter of Texas law, it doesn’t exactly jibe with its intent.

“The spirit of the law is that we’re not going to spend taxpayer dollars to support the abortion industry,” Seago said.

Texas has long been hostile to abortion rights. People who want abortions in Texas must still wait 24 hours after the initial consultation before they can undergo the procedure, and private insurance can’t be used to pay for abortions. Abortion clinics are also still recovering after restrictions passed in 2013 — and later struck down by the Supreme Court — led about half of the state’s abortion providers to close.

Now, in 2019, Southern states are ramping up their attacks on abortion, with multiple states passing laws to ban abortion as early as six weeks into a pregnancy. But Austin and New York City are among the local governments trying to make it easier to undergo the procedure. As of July, when many state legislatures had closed their doors for the year, six states had enacted 29 abortion rights-supporting measures.

In 2018, just three states enacted five.

“This was a real opportunity to encourage Austin to use their levers of power to bolster access at a time when the state of Texas, and unfortunately many states surrounding Texas in particular, are going in the opposite direction,” said Andrea Miller, president of the National Institute for Reproductive Health, which also supported the Austin measure.

Source: https://www.vice.com/en_us/article/wjwj9x/the-austin-city-council-just-voted-to-fund-abortion-access-for-low-income-women?utm_campaign=sharebutton&fbclid=IwAR0RR8zNY50WaMilmasoyXMAKpT_gk9WfDYf3QDHQQwgSUilFF848GtR9w0

Dr. Rebecca Gomperts says the government has seized abortion drugs she has prescribed from overseas to patients in the U.S. The drugs are approved by the FDA to induce abortion under a doctor’s direction.
Stormi Greener/Star Tribune via Getty Images

A European doctor who prescribes abortion pills to American women over the Internet is suing the Food and Drug Administration in an effort to continue providing the medications to patients in the United States.

The lawsuit being filed Monday in federal court in Idaho names several federal officials, including U.S. Health and Human Services Secretary Alex Azar.

In the lawsuit, Dr. Rebecca Gomperts says she believes federal officials have seized between three and 10 doses of abortion drugs she has prescribed through her organization, Aid Access, since March. It also says Gomperts believes the government has blocked Aid Access from receiving payments from some patients.

Gomperts’ attorney, Richard Hearn, said the goal of the lawsuit is to force the FDA to stop those actions and to prevent Gomperts or her patients from being prosecuted under federal law.

Hearn argues that for many women who live long distances from the nearest clinic, abortion pills ordered online are the only practical way to exercise their legal right to an abortion.

“Some women in the United States can exercise that right just by going down the street if those women happen to live in New York or San Francisco or other major metropolitan areas on either one of the coasts,” Hearn said in an interview with NPR. “But women in Idaho and other rural states, especially conservative states … cannot exercise that right.”

A handful of states have only one clinic that provides abortions, forcing patients to drive hundreds of miles to obtain one. Under the Trump administration, organizations that provide or refer patients for abortions face new restrictions on how they can obtain funding to provide other kinds of reproductive health care, which could push some providers to stop offering the procedure. And many states are attempting to restrict the procedure in state law or by imposing heavy regulations on clinics.

Since March 2018, the lawsuit says, 37,000 women from all 50 states in the U.S. have contacted Aid Access. Gomperts, who divides her time between Austria and the Netherlands, prescribed the medication to more than 7,000 U.S. patients seeking to end first-trimester pregnancies during that time, according to the lawsuit.

The drugs, mifepristone and misoprostol, are both approved by the FDA to induce abortion under a doctor’s direction. The World Health Organization recommends a protocol that involves taking the two drugs in tandem. Mifepristone is especially heavily regulated in the U.S. and cannot be obtained at a commercial pharmacy, making it difficult for many women to obtain it.

Gomperts uses telemedicine to consult with patients online, writes a prescription and provides instructions on how to request the medication from an exporter in India, Hearn said. The pills are then shipped to patients’ homes.

In March, the FDA issued a warning letter accusing Aid Access of violating federal law by misbranding and facilitating the improper distribution of the drugs. The letter said that the “sale of misbranded and unapproved new drugs poses an inherent risk to consumers who purchase those products.” The agency ordered Aid Access to stop distributing the medications in the United States or face repercussions, including the seizure of the drugs, without notice.

Gomperts stopped prescribing the medications to U.S. patients for about two months, from roughly mid-March to mid-May, before resuming, according to her attorney.

“The FDA is a huge institution. It’s very powerful, and it’s a form of intimidation that is quite severe,” Gomperts said in an interview with NPR. “I would say a form of bullying. And so I think it’s very important to stand up against it.”

Gomperts said she charges the equivalent of about $90 for patients in the United States, which covers the consultation, prescription and medication. She said patients who cannot afford that amount are asked to pay what they can.

Hearn said Gomperts has heard from women who say they’ve been contacted by federal officials and apparently had medications seized.

“A couple have gotten letters, one has gotten visited, and those pills were not delivered. And we have tracking information,” Hearn said. “The real fear about seizing medicines is not the loss of the medicine, but it’s prosecution of the woman in the United States … either by the state or the federal government, for ordering the pills.”

Hearn points to a separate federal indictment earlier this year, which accused a New York woman, Ursula Wing, of illegally importing and distributing abortion drugs. If convicted, the lawsuit says, Wing could face several years of prison time, federal fines or both.

FDA officials declined to comment on the pending litigation or any potential or pending regulatory actions against Gomperts and Aid Access. Asked if patients who purchase abortion pills could be prosecuted, officials said in a statement emailed to NPR that it is usually illegal to import drugs for personal use but that the FDA “generally does not take enforcement action against individuals” who do so.

The statement added, “FDA remains very concerned about the sale of unapproved mifepristone for medical termination of early pregnancy on the Internet or via other channels for illegal importation, because this bypasses important safeguards designed to protect women’s health.”

Gomperts said she believes patients can safely self-induce what is essentially an early miscarriage, provided they have proper information and support.

“What I think is very important is to really understand that women have been dealing with miscarriages forever,” Gomperts said. “And a medical abortion, abortion with pills, is very similar.”

Abigail Aiken, a public affairs professor at the University of Texas, Austin, has been studying Aid Access and its patients. In a recent study published in the journal BMJ, Aiken examines some of the reasons women seek abortion drugs online, including increased restrictions on the procedure in many states.

“There is certainly interest, and it appears to be becoming more intense,” Aiken said in an interview with NPR.

Aiken said some patients also prefer to take pills privately, at home, rather than going to a clinic. Others face obstacles such as ultrasound requirements, long waiting periods and cost, she said.

“There are some folks who would like to get to an abortion clinic, but they’re not able to,” Aiken said. “And this is especially pronounced in states that have restrictive abortion policies.”

Source: https://www.npr.org/2019/09/09/758871490/european-doctor-who-prescribes-abortion-pills-to-u-s-women-online-sues-fda

Evelyn Hernández is one of dozens of Salvadoran women imprisoned after miscarriages or obstetric emergencies due to the country’s strict abortion ban.

Evelyn Hernández spent 33 months in the Ilopango Women’s Prison during legal proceedings.

In April 2016, Evelyn Hernández was an 18-year-old high school student. During the unexpected birth of her child at her home near Cojutepeque in rural El Salvador, she suffered an obstetric emergency that resulted in the death of her baby. Hernandez was charged with aggravated homicide. She spent nearly three years behind bars before being released in February and acquitted by a trial court in August, the second time she’d been found innocent.

Now, the state-employed prosecutor in Hernández’s case is seeking to formally appeal that acquittal. If he succeeds, Hernandez will be jailed again—making her one of dozens of Salvadoran women imprisoned after miscarriages or obstetric emergencies due to the country’s strict abortion ban.

“What level of resources is the Salvadoran government spending on convicting these women?” asked Morena Herrera, president of the Agrupación Ciudadana por la Despenalización del Aborto (Citizen Group for the Decriminalization of Abortion). The Agrupación has accompanied and supported Hernández throughout the process of her trials. “And this is all against a woman who was then 18 years old, who was raped and became pregnant, and had an obstetric emergency, and who has been found innocent not once, but twice? And then the government delays and delays and delays the legal proceedings.”

“As Attorney General of the Republic, we are responsible for the support and accompaniment of women victims in any crime and in any of its modalities, but, in the case of Evelyn Hernández, there are no elements to consider her a victim of any fact, on the contrary, the only victim is her son,” the prosecutor said in a statement on Friday. “This appeal is the manifestation of the legal protection of … the life of a helpless being who depended absolutely on the care of his mother, who caused his death.”

Hernández spent 33 months in the Ilopango Women’s Prison during the various legal proceedings. The Supreme Court annulled the original conviction on September 26, 2018, on the grounds that there was insufficient evidence to justify the conviction. It ordered a new trial for her. As Rewire.News reported, she was released from prison on February 15, 2019, after her attorneys from the Agrupación pressured the government to obey a Salvadoran law that mandates that a person cannot be held for more than 24 months without a final verdict, which she never had.

Her most recent trial was monitored by the American Bar Association’s Center for Human Rights, which expressed deep concerns about the proceedings in its August 20 report. As the report notes, the state prosecutor argued that Hernández was “liable for aggravated homicide by omission: in other words, that Ms. Hernandez had failed to fulfill the duty of care that she owed her child.” She had “knowingly neglected to seek appropriate prenatal services during her pregnancy.”

The report continues: “Not a single prosecution witness, however, testified that Ms. Hernández had demonstrated awareness of her pregnancy. In fact, the primary prosecution witness on this subject, health worker Marjorie Lizeth Gonzalez de Mauricio, could only confirm that there were rumors Ms. Hernandez was pregnant. She further stated that Ms. Hernández and members of Ms. Hernández’s family had explicitly told her that Ms. Hernández was not pregnant”

“The state failed to establish that Ms. Hernández purposefully omitted to seek treatment during her pregnancy,” the ABA report says.

The prosecution’s other main argument, the report says, was that “Ms. Hernández did not provide her child with appropriate care upon birth.”

“The evidence in this regard, however, was similarly inadequate. Firstly, the testimony of medical experts left doubt as to whether the child was born alive. Experts who concluded the child was born alive noted that he had likely died from aspiration of fecal matter and/or amniotic fluid. This emergency could have led to near-immediate death, meaning that Ms. Hernández would have been unable to assist in any event,” the report concludes.

The ABA report raised other concerns, such as violations of doctor-patient confidentiality, lack of presumption of innocence, and treatment that violates the rights of a woman seeking emergency medical care.

As the Agrupación pointed out in a press statement on September 6, the attorney general is ignoring its legal obligation to “total objectivity” and to “investigate not only the facts and circumstances on which the responsibility of the accused is based or those that aggravate it, but also those that exempt it from it, extinguish it or attenuate it.”

Herrera and other feminists have pointed out that while the government uses its resources to continue interminable prosecutions of Hernández, prosecutors have not responded vigorously to the thousands of cases of pregnancies in minors resulting from rape or incest.

When Hernández spoke to the press after the first day of her trial in August, she said she had been raped by a gang member but had been afraid to say so publicly because of the death threats the aggressor made against her and her family. A report by the United Nations Population Fund, “Map of Pregnancies in Girls and Adolescents El Salvador 2017,” showed there were 19,190 pregnancies in 2017 among girls and adolescents between 10 and 19 years of age. (The age of consent in El Salvador is 17.) A 2017 studyshowed that the accused was only found guilty in 10 percent of rape cases reported to prosecutors in which the victim was under 15 years old.

The local court in Cojutepeque, where Hernández was first tried, must now decide whether to accept the request for appeal. Herrera explained that the process could take up to two years.

“This is scandalous to the media and the international community,” said Herrera. “And, it is scandalous to us as Salvadorans.”

Source: https://rewire.news/article/2019/09/09/after-her-newborn-died-evelyn-hernandez-was-acquitted-of-homicide-charges-but-the-prosecutor-still-wants-her-in-jail/

Today’s guest blogger is Dr. Jack Trigg

I’m afraid.

While there are many positive things happening in Birmingham and throughout our state, there are negative forces at work.

You have to wonder if our state politicians care about the lives of our citizens or if they just don’t know better.

As a physician I’m dismayed by recent actions of our state government with respect to matters of public health.

Alabama losing lives in rural areas

I entered The Medical College of Alabama (now UAB) in 1953 and was privileged to experience the marvelous development of medicine throughout our state, including a number of convenient small town hospitals enabled by the Hill Burton law.

Now there’s an epidemic of rural hospital closures.

Our state’s refusal to take several billion dollars from the federal government for Medicaid has contributed to the crisis for small rural hospitals. Other states that have accepted these funds have thrived.

The state’s larger cities (Birmingham, Montgomery, Dothan, Mobile, Decatur, Tuscaloosa, etc.) have excellent healthcare and service, UAB being the crown jewel.

But unfortunately many of the rural facilities fostered by the Hill Burton legislation have closed.

We are losing and will continue to lose Alabama lives as more and more rural hospitals close.

I’ve witnessed horror imposed on woman and children most people have never seen

Most people today don’t know what life was like before Roe v. Wade was passed in 1973. Many of today’s physicians don’t remember either.

Alabama’s regressive new abortion law risks thrusting us back into a pre-Roe v. Wade world, in which dangerous criminal abortions were commonplace, as were resulting infections, infertility, and deaths of thousands of women who sought and had illegal abortions.

After starting Medical School in 1953, I worked in clinical services beginning in 1954, later serving on the medical, surgical, obstetric, and pediatric wards, as well as others.

Before Roe v. Wade I was either witness to or responsible for the care of patients suffering from pelvic infections related to illegal abortions. Few survived, and many of those who did were completely infertile thereafter.

These were women with families, jobs, and loved ones who were now dead or impaired due to preventable infections!

This scene stopped immediately after Roe v. Wade became the law of the land.

My clinical experience with this lasted nearly 20 years (1954-1973).

I have not had such a patient since. This horrible illness disappeared with the passage of Roe v. Wade (which, was passed by a 7-2 margin by the U.S. Supreme Court.)

Now, maternal mortality due to illegal or unsafe abortion is almost zero per year, whereas before Roe v. Wade, it was at least 5,000 deaths per year, according to a 1966 study by the Guttmacher Institute.

Presently abortions are done in an operating room or delivery room by skilled personnel using sterile technique.

We need not return to a pre-‘Roe’ world in order to reduce abortion rates

On June 19, 2019, al.com ran an insightful article by Ben Baxter who was born to his teenage mother in the “abortion landscape of the 1980’s”. Mr. Baxter quotes many statistics documenting marked decrease in the abortion rate in women across the board and reduction in the birth rate for the past several years.

This is largely the result of the effort of churches, Planned Parenthood, and many professional and volunteer organizations that advise women about birth control and contraception and do a huge service for our indigent community with regard to women’s health issues.

Pregnancy is a medical condition and should be managed by the patient and her doctor. It is not a crime. Mr. Baxter is an example of the satisfying results of gentle persuasion of a mother to have a normal delivery when she may have initially wanted to end the pregnancy.

In conclusion, I feel that Alabama is a great, progressive state with multiple opportunities for growth, education, professional satisfaction and recreation.

However, it behooves our government to avoid taking self-defeating actions like declining Medicare funds and passing extremely restrictive abortion legislation.

Dr. Jack Trigg is a lifetime resident of Birmingham who trained at UAB Medical Center and then served his country as a physician at the hospital at Eglin Air Force Base. He engaged in the private practice of medicine from 1964 until 1998.

Source: https://www.al.com/opinion/2019/09/horrified-87-year-old-physician-pours-his-heart-out-to-alabama-politicians.html

A Vermont nurse’s objection to providing an abortion shows we need to be more discerning about who is worthy of serving the public.

Last week, the Department of Health and Human Services defended a registered nurse who claimed that the hospital she worked for violated her conscience by forcing her to assist with an abortion. The complaint, filed in May 2018, alleged that the nurse was a self-identified Catholic, and cites violations of the Church Amendment that protects healthcare workers “from impositions of certain requirements contrary to religious beliefs or moral convictions”—in this case, abortion.

Rule changes in the Department of Health and Human Services and new leadership at the HHS Office of Civil Rights have created a fundamental shift of these agencies from protecting patients to protecting providers. Unfortunately, this shift from patient-centered care to protecting providers is required for institutions that want to retain federal funding such as Medicare and Medicaid for essential health services. The University of Vermont Medical Center (UVMMC), where the nurse worked, stands to lose $1.6 million if it does not bring its policies into compliance with federal requirements.

The Trump administration’s decision to issue a violation against the hospital is both wrong and dangerous. As a nurse, clinician-scientist, and researcher whose work is centrally grounded in reproductive health, rights, and justice, I wish I could explain a few things to that Vermont nurse. Namely that nurses hold the tension of opposites—life, death, navigating transitions, advocacy, working with physician and family needs, communities, and policymakers. The American Nurses Association Code of Ethics and statement on reproductive health has clear instructions and guidelines about the conduct of professional nurses—“clients have the right to make reproductive health decisions based on full information and without coercion”—and nursing professionals must be prepared to discuss “all relevant information about health choices that are legal.” It is the guiding document of our service to the public.

I’d also like to remind her that this situation perpetuates a myth: that the only conscience claims that can be made are negative, framed as objection, rather than positive, as in the conscience-driven imperative to deliver care.

I can attest that healthcare workers provide abortion and other reproductive health services because of their moral beliefs, not in spite of them. I have spent the last 28 years of my nursing career providing direct clinical care to people needing and seeking abortions. My work and the work of my colleagues in abortion care is consistent with core nursing values, including human dignity, privacy, justice, autonomy in decision-making, precision and accuracy in caring, sympathy, and honesty.

To be clear, I respect people’s desires not to do things that go against their moral or religious beliefs. I know that professional nursing in the United States was established in religiously affiliated institutions. However, people shouldn’t go into healthcare if they don’t want to provide healthcare.

There’s a larger issue here that isn’t being discussed: Who is worthy to serve the public with comprehensive reproductive services, and what are the standards of care that should be provided?

Ever since Roe v. Wade decriminalized abortion in U.S., there has never been an honest reckoning about abortion within healthcare services, education, training, and research. Patients have always needed and sought abortions, healthcare providers haven’t always chosen to help patients who need or seek them, and despite the fact that the public has clear support for abortion, it remains a politically charged issue framed as a false dichotomy of opposite camps, when the truth is that it’s more complicated. The majority of pregnancies that end in abortion in the U.S. happen under medical supervision, which by definition is healthcare. The fact that, in most cases, you can’t just get an abortion from your regular provider or gynecologist has contributed to this incomplete conversation.

Even more disturbing, privileging the healthcare workforce over the needs of the public runs counter to our commitment to patient-centered care. People of color, and Black people in particular, are disproportionately more likely to receive care from public and religiously affiliated institutions that are affected by these conscience rules. What that amounts to is the fact that those who don’t have good insurance (or any insurance at all) have a lower standard of care forced on them. This is why the accommodations for conscience need to be re-examined as unethical and incompatible with the social contract to which members of the health professions commit.

These rules aside, we also need to more closely scrutinize the reasons students want to earn the right—yes, the right—to serve the public as a member of the health professions. It is a life of service that people shouldn’t enter simply because of consistent employment, decent wages, or the social capital afforded to those of us who do this work. Committing your life to the health professions is a path that’s both intellectually challenging and emotionally rewarding path. Part of my work as a faculty member is to determine who is worthy to serve the public—a duty I do not take lightly.

I recently had to ask this question of my fellow faculty and university administration as part of a now-defunct proposal to the Regents of the University of California, San Francisco, to merge with the Dignity Health System, a Catholic hospital. This partnership could have led to patients being denied gender-affirming care, abortion, and more. I asked the Regents to carefully consider all of the implications of the proposal, specifically what it means for a publicly funded university that serves as an anchor institution for the San Francisco community to merge with a religiously affiliated hospital with wildly different perspectives on human rights. Following public outcry, the school dropped its proposal.

Most of all, I would have asked this nurse to wrestle with why her discomfort with abortion kept her from empathizing with the person who needed it. My research has shown that nurses wrestle with ethically challenging care in real time, because there are few places in their educational preparation and on-the-job training to do so. Once afforded the opportunity to critically dissect their views and clarify their values, nurses are able to understand that the people we serve are experts by experience and know best what they need—more so than we do.

This is why service needs to be centered in how conscience claims—positive or negative—are accommodated.

Monica R. McLemore, PhD, MPH, RN, is an associate professor in the Family Health Care Nursing Department and a clinician-scientist at Advancing New Standards in Reproductive Health, a program of the Bixby Center for Global Reproductive Health, all at the University of California, San Francisco.

Source: https://www.vice.com/en_us/article/qvqda7/2018-midterms-new-york-abortion-law-reproductive-health-act

The Trump administration’s domestic gag rule is already hurting women across the country. Planned Parenthood, many state and local public health clinics, and countless independent family planning clinics have been forced to withdraw from the Title X program so they can continue to provide comprehensive medically accurate guidance on reproductive health and abortion to millions of low-income patients.

In the months to come, we may begin to see the damage of this alarming policy—limited access to affordable birth control, STI treatments, cancer screenings and even the closure of some family planning clinics.

In the meantime, pro-choice forces continue to fight back against this outrageous rule: Oregon, Illinois, New York, Washington and Hawaii have refused Title X funds under the new regulations; and 19 states and the District of Columbia, Planned Parenthood and the American Medical Association are seeking a permanent injunction against it.

(Fibonacci Blue / Creative Commons)

Independent clinics all across the country are disproportionately affected by these draconian rules. Many lack Planned Parenthood’s fundraising capabilities, and are not located in states that have additional funding to make up the loss. They are facing the very real possibility of being forced to reduce their staff, cutting back on hours and services, discarding sliding-scale payments or even closing their doors permanently.

The Trump-Pence Gag Rule punishes low-income patients and the health care professionals who serve them. We cannot allow this ruthless policy to continue to threaten Title X clinics—and we can win this by demanding that our policymakers rescind these rules immediately.

Act now to protect access to comprehensive reproductive healthcare.