His nomination as attorney general spells trouble.

While attorney general for President George H.W. Bush, William Barr was a vocal critic of abortion rights.
Wikimedia Commons

President Donald Trump on Friday announced he plans to nominate William Barr to replace Jeff Sessions as attorney general. Under Sessions’ guidance, the U.S. Department of Justice supported restrictive voter ID laws, defended the Muslim ban, endorsed separating asylum-seeking parents from their children, reversed Obama-era guidance protecting LGBTQ rights, and argued for a right to block undocumented immigrant minors in their custody from obtaining abortions. It’s hard to imagine the situation getting any worse for vulnerable people.

But if Barr is confirmed, that’s exactly what could happen.

Barr, a corporate lawyer who served as attorney general to President George H.W. Bush from 1991 to 1993, has long been a vocal critic of abortion rights. He’s called abortion a result of secular “fanatics” wreaking havoc on the “Judeo-Christian moral tradition.” During his 1991 confirmation hearings he told members of the Senate Judiciary Committee he believed Roe v. Wade was wrongly decided and should be overturned. While an attorney at the Department of Justice (DOJ) in 1991, Barr urged a federal court to lift an injunction preventing clinic protesters in Wichita, Kansas, from blocking access to abortion clinics there, saying it was better to let state law enforcement handle the protesters. This was at a time when the anti-choice “rescue” movement sent protesters to clinics in the hundreds and thousands to do whatever they could to disrupt clinic access, including forming human chains in front of clinics, barging in, and handcuffing themselves to medical equipment.

Of course, contrary to Barr’s belief, state law enforcement was often ill-equipped or unwilling to deal with abortion clinic protesters—to the point where Congress eventually stepped in and passed the Freedom of Access to Clinic Entrances (FACE) Act in 1994.

In 1992, the American Bar Association adopted a resolution to oppose state and federal restrictions on abortion rights. Barr, then attorney general, publicly opposed the resolution. And when Congress was considering federal legislation to protect abortion rights, he said he would advise President Bush to veto it. Barr repeatedly bemoaned the “permissiveness” of the “sexual revolution,” arguing it created moral upheaval leading to the country’s decline. He railed against the separation of church and state, especially in public schools. “This moral lobotomy of public schools has been based on extremist notions of separation of church and state or on theories of moral relativism which reject the notion that there are standards of rights or wrong to which the community can demand adherence,” Barr said in 1992 in a speech on juvenile crime.

Barr also defended the Bush administration’s use of DOJ staffers to investigate Anita Hill to try to discredit her testimony against U.S. Supreme Court nominee Clarence Thomas. More recently, he’s criticized the special counsel’s investigation into Russian interference in the 2018 presidential election.

By these measures, Barr may be the best candidate for attorney general Trump could choose to carry on Sessions’ mission at the Justice Department. And that should, frankly, terrify us.

During its first two years, the Trump administration has enabled and encouraged the rise of violent xenophobia through its own policies and statements. There’s little reason to believe a Justice Department run by Barr—who has publicly praised the administration’s militarization of force against immigrants—will do anything to tamp this problem down.

Despite the existence of federal law designed to protect abortion clinic access, the anti-choice movement under Trump has been more emboldened than ever to defy that law and dare the Justice Department to enforce it. With Barr at the helm, the chances of such enforcement are slim.

Barr’s nomination also comes at a time when evangelicals, backed by the DOJ, are urging the federal courts to allow them license to discriminate against LGBTQ people in all forms, from selling cakes to refusing adoptions and foster care placements based on religious beliefs. It comes as evangelicals lobby for more direct government funding of religious activity and greater entanglement of church and state, and for the right to deny care and services to thousands in the name of religious liberty.

As attorney general, Barr will almost certainly be a fierce supporter of those efforts.

Barr still must be confirmed by the Senate, but with Republicans in control and his time serving in the H.W. Bush White House that confirmation is all but a given. As attorney general, Jeff Sessions advocated brutal policies and used the force of the Justice Department against the most vulnerable. Should Barr be confirmed, he will no doubt do the same.

Source: https://rewire.news/article/2018/12/07/william-barr-once-said-roe-v-wade-should-be-overturned/

Joseph Silk is among a growing number of anti-choice activists holding or running for office who have called for the right to legal abortion to be ignored.

When it comes to his latest effort to criminalize abortion, Silk said: “I’m going to keep introducing it every year.”
Joseph Silk/YouTube

Oklahoma Republican state Sen. Joseph Silk says he wants to abolish abortion—and he won’t give up on bills to make that happen.

Silk pre-filed SB 13, the “Abolition of Abortion in Oklahoma Act,” in late November, prompting national headlines about the extreme bill. The legislation would criminalize abortion care in Oklahoma, making it a felony homicide punishable by life imprisonment. As Rewire.News’ Brie Shea reported, should the bill become law, “all parties involved in an abortion (physicians, nurses, the pregnant person, etc.) could potentially face murder charges.”

The bill isn’t Silk’s first attempt to pass such legislation. Silk introduced the “Oklahoma Bill Prohibiting Abortion After Conception” in 2017 but it wasn’t taken up for a vote. And the year prior, he introduced SB 1118, to define abortion as murder and criminalize it. State Republican leaders blocked the bill from proceeding that time as well, though it passed out of committee.

That 2016 bill was considered by extreme anti-choice group Abolish Human Abortion to be “the first abolitionist bill (of abortion) in the history of the United States.” The group is a part of a subset of anti-choice activists who seek the immediate and total abolishment of abortion rather than steadily chipping away at abortion rights. They call themselves “abolitionists” and liken their work to anti-slavery efforts.

“I’m an abolitionist,” Silk told Rewire.News. “I believe that the government has a primary role to protect life, especially innocent life.” Silk, too, compared the position to those who fought against slavery in the United States. It is “similar to slavery—there were groups that were abolitionists,” he said. “There were people that wanted to kind of regulate slavery and allow people to kind of earn their freedom, and then there’s abolitionists that know slavery is morally wrong and all people are created equal and we need to abolish slavery.’”

He hasn’t always viewed abortion this way. “I used to, when I was first elected, I would kind of run the typical pro-life measures that don’t really actually do anything—such as you can’t commit an abortion until you’ve watched an ultrasound first or hear a heartbeat first,” he said. But then, Silk said, he had a “paradigm shift” in his views after meeting with other “abolitionists” and having a “conversation of how pro-life groups and pro-life bills have really not done anything at all to curb abortion.”

“I only run abolition bills now,” he said.

Silk is one of a growing number of anti-choice activists holding or running for office who have called for the right to legal abortion to be ignored. Among them are Dan Fisher, who launched an unsuccessful bid for the Republican gubernatorial nomination in Oklahoma during the last election cycle. Fisher, a former Oklahoma state representative, ran on a platform that centered on “abolishing” abortion. When questioned about the punishments Fisher would propose for those who have or provide an abortion, a spokesperson for his campaign told Rewire.News it would be treated “much like your homicide laws.”

Silk supported Fisher’s run for office and extreme platform, introducing Fisher in March 2018 as part of a two-day campaign rally. As Right Wing Watch reported, Silk used the appearance to call those who opposed his anti-choice legislation the “enemy.”

“If you use your position of authority to protect the continuation of the slaughter of unborn children, you will always be my enemy,” he said. “And if you use your position of authority, I don’t care what level it’s at, but if you use your position of authority to keep the abortion mills running and protected, what is that other than a very, very evil act and abuse of authority?”

Also speaking at the rally, according to Right Wing Watch, was Matt Trewhella—an anti-choice radical who once signed a pledge suggesting that killing an abortion provider was “justifiable”—and Operation Save America’s Rusty Thomas. Trewhella has promoted Silk’s most recent anti-choice bill on his personal Facebook page, and has written about traveling to Oklahoma to promote his agenda in the state legislature.

The anti-choice activist traveled to Oklahoma in February of that year to “to conduct a citizen’s initiative calling for immediate interposition for the pre-born and total abolition of abortion,” according to a 2016 newsletter produced by one of Trewhella’s organizations, Missionaries to the Preborn. The newsletter notes that almost immediately after, Silk first moved on his legislation to criminalize abortion: “Just 72 hours later—an Oklahoma senator introduced the citizen intitiative [sic] in bill form,” it said.

Silk says Trewhella’s visit to the state in 2016 was not what motivated him to first introduce the bill. “However, I would say it was encouraging to see somebody very adamant and passionate about the abolitionist movement as well,” he said. “And so, he didn’t have anything necessarily to do … [with me] becoming an abolitionist, but he’s definitely been supportive of all that language which is very, very good to see.”

When it comes to his latest effort to criminalize abortion, Silk said: “I’m going to keep introducing it every year.”

In an interview with Oklahoma News 4, Silk appeared unconcerned that women could be punished for abortions under his legislation. When asked what he would say to a woman sentenced to life in prison for an abortion, the Republican replied: “I don’t know. The exact same thing I would say to a mother who just killed a 1-month-old or a 1-year-old child.”

“It’s a horrific act and there shouldn’t be any tolerance for it,” he said, referring to abortion. His legislation makes no exceptions for cases of rapeincest, or life endangerment.

Silk has suggested that the legislation isn’t designed to challenge the landmark abortion rights case Roe v. Wade, as it would instead instruct the state to ignore federal law on abortion. “The attorney general shall direct state agencies to enforce those laws regardless of any contrary or conflicting federal statutes, regulations, executive orders, or court decisions,” the legislation says. Silk told Rewire.News that “the goal of it is to essentially use state sovereignty to say … Roe v. Wade was constitutionally illegitimate, and it was immoral. So we as a sovereign state are not going to participate in the act of abortion.”

However, he sees a potential avenue for his bill to help undo abortion rights in federal courts. “I would love to see a bill be challenged all the way up to the Supreme Court and then the Supreme Court overturnRoe v. Wade or just say its a state issue. I would actively support those measures,” he said. “I’m looking at some things we can do to maybe get there.”

“I think, depending on what happens with Senate Bill 13 through the committee process, and there’s amendments and stuff like that, it may become a vehicle that would end up going up to the federal courts.”

Silk said in 2016 that his legislation could be used to tee up a challenge to abortion rights at the U.S. Supreme Court. “We need to attack the issue directly,” he told conservative conspiracy website WorldNetDaily. “Life begins at conception, and abortion is murder,” he said. “Until we start doing that, [the Supreme Court is] never going to be forced to overturn that ruling.”

Silk has introduced or co-sponsored several other anti-choice bills. Those include a failed measure he introduced in 2017 to require death certificates be issued to all aborted fetuses in Oklahoma and a failed effort to amend Oklahoma’s Heartbeat Informed Consent Act to force providers to determine if there is the presence of a fetal heartbeat before performing an abortion. In that case, if a fetal heartbeat was detected, the bill would have required the provider to tell the pregnant person that an “unborn human individual” has a heartbeat and inform them of the statistical probability of bringing the “unborn human individual” to term.

He expanded on his views on reproductive rights while speaking with Rewire.News, explaining that he “absolutely” supports banning some forms of birth control—something that could happen should his belief that “life begins at fertilization” be enshrined in law. “[A]ny birth control that allows an egg to be fertilized and then somehow disrupts the process, that should be banned because it is essentially taking human life,” he said. “Now, all other birth control types that don’t allow fertilization, that would be completely fine and there’s nothing morally wrong with any of that.”

Though he noted that SB 13 doesn’t specifically address it, Silk also objects to some in-vitro fertilization practices, which he said were “immoral.” “They fertilize a lot of eggs, use a couple of them, discard all the other fertilized eggs. Or freeze them for an indefinite period of time,” he said.

Silk has made efforts to restrict LGBTQ rights. He sponsored multiple iterations of a “Conscience Act,” which would allow for discrimination against LGBTQ people by allowing anybody in the state to refuse to provide “services, accommodations, advantages, facilities, goods or privileges to be used to promote, advertise, endorse or advocate for a specific marriage, lifestyle or behavior.” In an interview with the New York Times about so-called conscience measures in 2015, Silk said that “[Gay people] don’t have a right to be served in every single store.”

Silk doubled down on the statement, according to the Advocate in a subsequent post to his campaign website. “Yes, I did say that homosexuals do not have the right to be served in every store, just as I do not believe that I, my family, or anyone else have the right to be served in every private business,” he reportedly said. “The right to provide services should be the decision of the business owners. We need to keep our country free and stop this radical, intolerant, movement.”

Source: https://rewire.news/article/2018/12/05/meet-joseph-silk-the-oklahoma-republican-trying-to-make-abortion-a-homicide/

The Dáil should listen to the voters, not generate red tape that could stop vulnerable people getting the care they need

Dublin Castle on 26 May 2018. ‘In May 2018, after 35 years of harm and hypocrisy, the Irish people delivered an unequivocal mandate.’ Photograph: Charles McQuillan/Getty Images

In 1983, as the Irish electorate voted in favour of a constitutional ban on abortion, campaigners warned in bold print: “This Amendment Could Kill Women.”

It did.

Following the tragedy of Savita Halappanavar’s death in 2012, Irish politicians were forced to legislate on a 20-year-old supreme court decision, one that consecutive governments had conspicuously kicked into the long grass. In 1992, a judge had ruled that a suicidal teenage rape victim had the right to an abortion. When the government finally produced the Protection of Life During Pregnancy Act 2013, it was so clearly unfit for purpose that the Abortion Rights Campaign doubted it would enable a suicidal teenage rape victim to access a termination at all.

Those campaigners were right.

In 2014, a suicidal teenage victim of rape and torture was forced to carry her pregnancy to viability and deliver by C-section.

In May 2018, after 35 years of harm and hypocrisy, the Irish people delivered an unequivocal mandate – 66% of voters said it was time to repeal the eighth amendment. The rationale behind this result is not opaque, as some would have us believe. Neither is it a reflection of lesser-of-two-evils logic – where middle-ground voters accepted universal access to abortion up to 12 weeks because they understood it as the only way to protect victims of rape or incest.

Rather, exit polls show that 62% of people cited a woman’s right to choose as the motivation for their votes, and 55% cited women’s health. These were the electorate’s two main priorities. There is no ambiguity about what the people want.

With this mandate, you would think that Irish activists could stop playing Cassandra; could be done, finally, with issuing chilling prophesies that their country seems cursed to ignore.

Yet, as the regulation of termination of pregnancy bill emerges from the circus of the Dáil debates, it is apparent that our representatives are still not listening. A mandatory three-day waiting period; unnecessary criminalisation; casting the patient’s views of risks to her health or of the probable gestational date as clinically irrelevant; creating an unworkably high bar for access to abortion where the health of the pregnant person is at risk; and regulations that seem designed primarily to create barriers to safe, legal care – this is not what the Irish people voted for.

The three-day wait is a political concession that has no basis in best medical practice or clinical evidence. Its only purpose is to make access to care more difficult. And, as always, the most vulnerable will be the most affected – people with disabilities, single parents, people suffering partner abuse, people in precarious employment, people on low incomes, people who live in remote areas, and asylum seekers in Direct Provision facilities will all find it much harder to attend multiple appointments.

Add the stipulation that the doctor who originally examined the patient must be the one to carry out the procedure, and we run into senseless bureaucracy and scheduling issues. This requirement fails to acknowledge the team-based nature of medical care and, of course, it presents more obstacles to patients.

If you don’t stop to think through the actual ramifications of these unnecessary regulations, they might seem minor. What’s a three-day wait period? What difference does it make if the doctor who originally examined you must carry out the termination? But abortion is time-sensitive. For someone at 10 weeks of pregnancy, with childcare and work commitments, these stalling tactics are the difference between accessing safe, legal care at home and begging money for the boat to Liverpool.

The purveyors of red tape know this. They know that their hoop-jumping exercises will effectively prevent many vulnerable women, trans and non-binary folk accessing the care they need and should be legally entitled to.

Lawyers for Choice have expertly analysed the legislation and found myriad potential human right abuses. If our representatives fail to listen, I will surely soon be writing another column about another tragedy, another frustrated screed about how, once again, Ireland’s pro-choice advocates were right.

 Emer O’Toole is associate professor of Irish performance studies at Concordia University in Canada

Source: https://www.theguardian.com/commentisfree/2018/dec/04/abortion-law-ireland-voted-dail-listen?fbclid=IwAR0–s8d5a-VPATGmq1T30ZyZuIAO66dMVX8haGvOriX-rLjuMGMQzG-5kk

ThinkProgress asked House members if they support lifting the federal funding ban on abortion care. Here’s what they said.

BOSTON, MA – OCTOBER 01: NEW YORK DEMOCRATIC CONGRESSIONAL CANDIDATE ALEXANDRIA OCASIO-CORTEZ (IN BLUE) STANDS WITH BOSTON CITY COUNCILOR AND DEMOCRATIC CONGRESSIONAL CANDIDATE AYANNA PRESSLEY (R) AT A RALLY CALLING ON SEN. JEFF FLAKE (R-AZ) TO REJECT JUDGE BRETT KAVANAUGH’S NOMINATION TO THE SUPREME COURT ON OCTOBER 1, 2018 IN BOSTON, MASSACHUSETTS. (PHOTO BY SCOTT EISEN/GETTY IMAGES; EDIT BY: DIANA OFOSU/THINKPROGRESS)

For the past four decades, lawmakers in Washington, D.C. have largely prohibited federal dollars from paying for low-income people’s abortions. But with a record number of Democratic women elected to office in November and their party holding the majority in the House next year, momentum is building to lift the ban.

By ThinkProgress’ count, at least 183 House members support repealing the Hyde Amendment, a legislative provision that prohibits federal Medicaid dollars from covering abortion except in cases of rape, incest, or life endangerment. Hyde is not permanent law but written and passed through congressional appropriations bills annually. Reproductive rights and justice advocates are cautiously optimistic 2019 is finally the year Congress doesn’t attach the coverage restriction or other similar riders to an appropriation bill. The number of members backing repeal so far is a feat of its own.

Lawmakers will also have the opportunity to formally put an end to Hyde. Rep. Barbara Lee (D-CA) told ThinkProgress she will re-introduce the EACH Woman Act for the second time next year; the legislation ensures that anyone who gets health care through the federal government will have coverage for abortion services and that legislators cannot interfere with what private insurance covers. The bill needs support from at least 35 more representatives to pass, according to a ThinkProgress analysis.

ThinkProgress looked at the bill’s current co-sponsors, as well as endorsements from the pro-abortion rights group NARAL, which only supported candidates this election cycle who expressed support for repealing Hyde and the EACH Woman Act. We reached out to every House member who was not a co-sponsor or endorsed by NARAL to determine their position on Hyde, but did not hear back from every office by publication.

“As Co-Chair of the Pro-Choice Caucus, I’m looking forward to working with both the newly-elected and returning members to advance a pro-woman agenda in the new year,” Lee told ThinkProgress by email.

“That includes fighting against the Administration’s efforts to gut the Teen Pregnancy Prevention Program, protecting access to birth control and reproductive health care, ending discriminatory bans on abortion coverage, and ensuring students receive comprehensive sex education, grounded in evidence and science. It’s time to get to work.”

There’s a sense of optimism given the composition of the incoming House of Representatives. While a member’s gender doesn’t guarantee they’ll support Hyde repeal, it’s a strong predictor, according to a Data for Progress study that looked at Democratic House members’ stances on Hyde. That means the 35 newly elected Democratic women who will serve on the House next year increase the odds of repealing Hyde and codifying protections for abortion coverage. At least 102 women will serve on the House next year, including at least 43 women of color; of the 102, 89 are Democrats.

Of course, nothing is a guarantee. Members of Congress have been known to vote against bills they’ve co-sponsored and endorsements don’t always forecast someone’s future voting record. Still, the amount of support to repeal Hyde on the record so far is unprecedented. Support could even grow as pro-choice activists visit Capitol Hill next year.

All* Above All, an organization dedicated to lifting abortion coverage bans, noted the historic shift after the midterm elections and will now be spending a lot of time educating new members about the EACH Woman Act.

Simultaneously, they’ll be asking House members to pass clean appropriation bills. Usually, the Hyde Amendment is attached to an appropriation bill for the Department of Health and Human Services (HHS), along with other language that is used to block abortion coverage for other groups who also get health care through the federal government like the military, federal inmates, or Peace Corps volunteers.

“Given what the freshman class looks like, I think we’re going to have a lot of positive outcomes from that outreach,” said Destiny Lopez, co-director of All* Above All. “It’s like constant, vigilant education of members because yes, we have all of these amazing women and women of color and younger folks who have come into Congress now who hopefully are going to be with us without a lot of explanation because they’ll just get it.”

Congresswoman-elect Ayanna Pressley (D-MA) is among those who won’t need to be convinced.

“The Hyde Amendment disproportionately impacts low-income women, women of color, immigrants, and young people who rely on Medicaid for their healthcare coverage,” said Pressley in a statement to ThinkProgress. “I called for the Amendment’s repeal as part of the Equity Agenda I put forward during the campaign, and remain committed to working with advocates and activists to ensure unfettered access to abortion services, including through the passage of the EACH Woman Act.”

While the ultimate goal is to pass the EACH Woman Act (which won’t happen next year with this Senate and president), the short-term objective is to continue to garner more support. Five years ago, it was unconscionable that legislation like the EACH Woman Act would even exist, said Lopez; the bill was first introduced in July 2015. Holding a hearing or vote on the matter would be a step forward.

Meanwhile, prominent figures within the anti-abortion movement are concerned about the sea change. Just last year, the House passed a bill to codify the Hyde Amendment. Now, they are going to have to defend their gains.

“[W]e must also face the reality of a now pro-abortion led House of Representatives that is determined to thwart President Trump’s pro-life policy agenda. The pro-life movement cannot be complacent. We must be prepared to fight to hold the line on important pro-life policies such as the Hyde Amendment,” said Susan B. Anthony List President Marjorie Dannenfelser in a statement the day after the election.

The Hyde Amendment initially passed when only 19 women served on the House. After failing to pass the Human Life Amendment — which recognized the fetus as a “person” from the moment of conception — anti-choice lawmakers conceded to denying low-income people abortion coverage. Led by late Rep. Henry Hyde (R-IL), Congress first barred Medicaid from paying for abortion care in 1976. (There are a few narrow exceptions like for rape or incest but they generally don’t work. States can also opt to use public funds to cover abortion care, but less than half do.)

The 94th Congress looks very different than the 116th Congress, with female voters supporting Democrats more than usual in recent years.

“We brought the power of women of color in particular to the voting booth. And so when I think about abortion rights issues, one of the issues that most impact women of color is the Hyde Amendment,” Lopez told ThinkProgress.

About 51 percent of Medicaid enrollees of reproductive-age subjected to abortion coverage restrictions are women of color, according to All* Above All. When Medicaid doesn’t pay for the abortion, people who live near or below the federal poverty level have to apply for non-profit funds or pay for the procedure themselves; it’s usually a combination of both. An abortion can cost upwards of $3,500, depending on the zip code, facility, and how far along the pregnancy is.

“Just as we’ve been there for them right now, it’s time for our elected leaders to be there for us,” she added.

Source: https://thinkprogress.org/record-number-of-women-congress-repeal-the-hyde-amendment-3bfb3c527a49/?fbclid=IwAR3u03A-26OCSuptAhJoOGYV2NVkzUQ1Hpyz8WSann3UPq7ZAt7il4jOH5E

And a groundbreaking Supreme Court case could determine the fate of tribal land in Oklahoma—and the nation.

Abortion clinics and the ACLU are banding together to challenge a state policy that bans payment for abortion services before the mandated two-day waiting period is over.
Shutterstock

The American Civil Liberties Union announced last week that it will be appealing state citations issued against three Arkansas abortion clinics. The state board of health had upheld the citations after the state department of health determined that the clinics violated state law prohibiting physicians from collecting payment during the mandated 48-hour waiting period for people seeking abortions. The ACLU’s Reproductive Freedom Project and the ACLU of Arkansas will claim the law is unconstitutional and a violation of the fifth and 14th amendments’ right to equal protection and the right to privacy.

Now for a pressing reminder of why courts matter: Justice Daryl Hecht, a pro-choice judge on the Iowa Supreme Court, is retiring this month for health reasons. His retirement leaves a vacancy on the court, and Republican Gov. Kim Reynolds gets final pick from a group of nominees sent by the state’s judicial nominating commission. The Iowa Supreme Court will be deciding the constitutionality of a blocked fetal heartbeat law that bans abortion as early as six weeks into a pregnancy. We can be certain Reynolds—who signed the law and who earlier this year appointed her father to the judicial nominating commission—won’t be replacing Justice Hecht with another liberal. At the Faculty Lounge, Anthony Gaughan breaks down why this may spell trouble for abortion rights in Iowa—and ultimately for the rest of the country.

Courts

The U.S Supreme Court heard arguments last Monday in a case that will decide whether citizens can talk back to law enforcement without fear of consequences. Garrett Epps, a professor of constitutional law at the University of Baltimore, provides a great explanation of the case, including the legal history of citizens suing for “retaliatory arrest.”

Last week, the nation’s high court also heard a case over jurisdiction stemming from a crime committed in Native American territory in Oklahoma, which could have huge implications for tribal land rights and state rights. Rebecca Nagle, a writer, advocate, and citizen of the Cherokee Nation, provides a historical accounting of tribal land grabs and why Cherokee land rightswhich could affect half the stateshould be restored.

LGBTQ Rights

A handful of pending petitions before the U.S. Supreme Court involving employment, education, military, and religion could greatly expand LGBTQ equality or set back rights for generations to come.

Voting Rights

Former Georgia gubernatorial candidate Stacey Abrams and her allies last week filed a lawsuit over Georgia’s 2018 election. The suit claims the secretary of statewho was Abrams’ opponentand the state election board “grossly mismanaged” the election and deprived Georgians of the right to vote. Fair Fight Georgia, which was formed by Abrams, and Georgia Care in Action hope the lawsuit will fix the electoral system for future elections. At SlateRichard L. Hasen breaks down why the lawsuit’s method of attack—targeting the entire state electoral process rather than a singular focus like voter purges—is actually pretty genius.

Source: https://rewire.news/article/2018/12/03/gavel-drop-arkansas-will-be-in-court-in-case-over-abortion-fees-and-waiting-periods/

Mehnaz sits inside her home in Abbottabad, northern Pakistan. She has one son and six daughters. She has also had three abortions, fearing she would have more girls.
Diaa Hadid/NPR

When at 19 Mehnaz became pregnant for the fifth time, she panicked. She already had four daughters, and her husband was threatening to throw her out if she had another. So she did what millions of Pakistani women do every year: She had an abortion.

Like many of those women, her abortion was partly self-administered. “I kept taking tablets — whatever I laid my hands on,” she says. “I lifted heavy things” — like the furniture in her tiny living room. She drank brews of boiled dates — many Pakistanis believe the beverage triggers labor.

Mehnaz says she felt “a terrible pain in my stomach.” Her husband took her to a midwife, who told him the baby was dead. “She gave me injections and it came out,” Mehnaz says.

That was eight years ago. Since then she has had two more abortions, each time because she feared the baby would be a daughter.

Mehnaz, whose last name is being shielded to protect her identity, is one of millions of Pakistani women who have abortions each year. The deeply conservative Muslim country is estimated to have one of the highest rates of abortion in the world, based on a 2012 study by the New York-based Population Council, a nonprofit that advocates family planning. The rate that year was 50 abortions for every 1,000 women aged 15 to 44 — roughly four times higher than in the U.S.

According to family planning researchers, abortion provisions in the country’s penal code are vague. The procedure is “legal only in very limited circumstances,” notes the Guttmacher Institute.

The circumstances include a pregnancy that is dangerous to a woman’s health — or if there is a “need” for abortion, according to Zeba Sathar, the Pakistan director of Population Council, and Xaher Gul, a Karachi-based public health policy expert and lecturer who advises nonprofits. But what constitutes a “need” is not defined, they say.

What’s more, hospitals generally refuse to perform an abortion because most doctors believe it is illegal, Sathar and Gul say. Even when doctors know abortion is allowed in certain circumstances, they cite their own cultural beliefs to not undertake abortions except in urgent cases — for example, if a woman walks in with “an incomplete abortion,” Gul says.

That has left Pakistani women at the mercy of back-alley abortion providers.

Some of these women, like Mehnaz, will abort a fetus if they fear they are carrying a female child, who can be seen as an economic burden. But that’s not the only reason.

Pakistani women largely seek abortions because they either don’t know about contraception or cannot access reliable contraception — or they’ve stopped using contraception after suffering complications, Sathar says. According to her research, most of the women who seek abortions are married, poor and already have children. Only 30 percent of fertile-age women use modern contraceptives, according to a 2017 U.N. report.

“We found to our surprise that most of the women had more than three children, maybe as many as five,” Sathar says. “They were almost all — 90 to 95 percent — married. They were older, so they tended to be poorer, less educated.”

Pakistan’s high abortion and low contraception rates reflect a family planning policy in shambles, says Abdul Ghaffar Khan, director general of Pakistan’s population program wing. His office is meant to set the national family planning agenda, but Khan described the situation as “a bureaucratic mess.”

Family planning used to be the job of the federal government, but approval for a national policy languished for years.

In 2011, national authorities passed the matter to provincial governments. But at the provincial level, family planning is not part of the health ministry’s portfolio. It is part of a different office and has long been neglected and underfunded, Khan says.

That means women aren’t advised about contraception or supplied contraceptives when they are most amenable: after childbirth, receiving postnatal care or immunizing their babies, says Sathar of the Population Council. She described it as one of the chief “structural flaws of how we provide family planning.”

The issues with family planning are partly why Pakistan has one of the world’s fastest population growth rates, says demography expert Mehtab Karim, vice chancellor at Malir University of Science and Technology in Pakistan. That population boom has strained Pakistan’s land and water resources, crowded its schools, outstripped development plans and may lead to more instability in this nuclear-armed state. “It has a tremendous impact,” Karim says.

But changes may be coming. On July 4, Pakistan’s Supreme Court demanded hearings into the country’s family planning failures. A national policy may be put into action in the coming months, Khan says.

All this is too late for Mehnaz, who was married at 13 to her cousin in their tiny village and had four daughters in quick succession and seven children in all — six girls, one son. And three abortions. She is illiterate and said she didn’t know anything about sex or contraception early in her marriage.

In a group interview with NPR, about a dozen midwives who also provide abortions said they would only help a woman who already appeared to be miscarrying — like Mehnaz, who induced her own abortion before seeking help.

Mumtaz Begum, 60, stands in her clinic in Karachi, Pakistan. Begum says a midwife taught her how to induce abortions using medications freely available in Pakistan. Citing her religious faith, she says she would only help women who she believed were already miscarrying.

Diaa Hadid/NPR

“I don’t help with murder,” says Mumtaz Begum, a 60-year-old who lives in a slum in the port city of Karachi. She has no medical qualifications but says a midwife taught her how to induce abortions decades ago, using medications freely available in Pakistan.

On a recent day, Begum showed NPR those pills and injections. They were clustered on a dusty table alongside religious texts and a bag of onions in a dank room with peeling paint. The gurney where she treated women was littered with clothing. “I wipe it down before women come in,” she says.

Because many providers aren’t properly qualified, researchers estimate about a third of all women who undertake abortions in Pakistan suffer complications, ranging from heavy bleeding to a perforated uterus and deadly infections.

Health workers do reach out to women to provide information about family planning. Some 130,000 women are employed by provincial health ministries to do house visits across the country, teaching about birth control.

But Gul says health workers are poorly trained and in short supply. Budgetary shortages, supply problems and corruption mean they often don’t have contraceptives, or distribute expired contraceptives — and that there’s little follow-up on how to use them.

Mehnaz was paid a visit by two such workers. She says they gave her an injectionmeant to prevent conception for three months. She became pregnant again anyway. As before, she tried taking pills to induce an abortion but says they made her sick so she stopped taking them.

Three years ago she had her seventh child, a girl. She then tried taking the pill, offered by the visiting health workers.

She says it made her dizzy and she stopped taking it.

She again became pregnant but miscarried — and pleaded with doctors to sterilize her.

She says they told her she had to wait until she was 40 — or get a permission slip from her husband. He refused: “He says he can’t sign this, it’s a sin.”

She says he also refuses to use condoms or to stop having sex with her.

If she has another girl, her husband may well abandon her. If she tries to induce another abortion, her health could deteriorate.

“I am stuck,” she says.

With additional reporting by Saher Baloch in Karachi, Pakistan

Source: https://www.npr.org/sections/goatsandsoda/2018/11/28/661763318/why-the-abortion-rate-in-pakistan-is-one-of-the-worlds-highest?fbclid=IwAR0sSDlSQm_xN44iIbbeOFPAKCQTGMClFfv9SQr3XxerrUyEGqMpQ5z0JX8

Dr. Kimberly Remski was told by a potential employer that she couldn’t provide abortions during her free time, something she felt called to do. “I realized it was something I really needed to do,” she says.
Kim Kovacik for NPR

Doctors who are opposed to abortions don’t have to provide them. Since the 1970s, a series of federal rules have provided clinicians with “conscience protections” that help them keep their jobs if they don’t want to perform or assist with the procedure.

Religious hospitals are also protected. Catholic health care systems, for example, are protected if they choose not to provide abortions or sterilizations. Doctors who work for religious hospitals usually sign contracts that they’ll uphold religious values in their work.

But as the reach of Catholic-affiliated health care grows, these protections are starting to have consequences for doctors who do want to perform abortions — even as a side job.

Religious hospitals often prohibit their doctors from performing abortions — even if they do so at unaffiliated clinics, says Noel León, a lawyer with the National Women’s Law Center. León was hired about two years ago to help physicians who want to be abortion providers. They have little in the way of legal protection, she says.

“Institutions are using the institutional religious and moral beliefs to interfere with employees’ religious and moral beliefs,” León says.

This kind of legal argument, León says, may prevent doctors from providing care they feel called to offer. And since many clinics that provide abortions rely heavily on part-time staff, it may also prevent these clinics from finding the doctors they need to stay open.

Dr. Kimberly Remski sought help from León when she was job hunting. She is a primary care physician but had always been interested in women’s health. When she first set foot in a clinic that provides abortions, she realized it was her passion.

“A lot of the things we spend our time doing in training are monotonous, or you’re getting swamped in work,” she says. “I just remember leaving the clinic feeling like I was doing something really important.”

She interviewed for a job as a primary care doctor with IHA, one of the largest physician groups in Michigan, in 2017. She says she was clear about her desire to work one day a week in an independent clinic that provides abortions.

Part-time work is common for outpatient physicians, and Remski says the doctors she interviewed with were receptive.

“I was very upfront. I told that them that was a special interest of mine. I wanted to be able to pursue it,” she says.

She signed a contract, and started preparing for her move. Then she got a call that the offer was off.

Noel León oversees a National Women’s Law Center program that provides legal support to doctors who want to perform abortions.

Mary Mathis for NPR

Remski learned that her potential employer was actually owned by a larger Catholic hospital network called Trinity Health, and it requires physicians to “provide services in a manner consistent with the Ethical and Religious Directives for Catholic Health Care Services,” according to her contract.

And, she says, she was shocked to learn Trinity Health would also have had a say over how she spent her free time. IHA officials told her that she couldn’t work on the side as an abortion provider if she took the job, Remski says.

Trinity Health had merged with IHA in 2010, part of a wave of mergers that has led to a net increase in Catholic ownership of hospitals. According to a 2016 report from MergerWatch, an organization that tracks hospital consolidation, 14.5 percent of acute care hospitals are Catholic-owned or affiliated. That number grew by 22 percent between 2001 and 2016, while the overall number of acute care hospitals dropped by 6 percent.

And as Catholic-affiliated health care expands, says León, doctors increasingly encounter morality clauses that prohibit them from performing abortions.

León says she has worked with at least 30 physicians and nurse practitioners from 20 different states who faced problems similar to Remski’s when they disclosed to their employers, or potential employers, that they planned to provide abortions.

“They’re being told, ‘We can’t provide the care we went into medicine to provide,’ ” León says. “We shouldn’t be putting providers in the position of caring for their patients or keeping their jobs.”

Representatives of IHA would not agree to a phone interview about Remski’s situation, but spokesperson Amy Middleton explained in an email that IHA “works hard with our physicians to enable them to pursue other positions.” But, she added, “outside work that interferes with a physician’s ability to serve patients or contradicts the organization’s practices could present a conflict of interest.”

IHA physicians follow Catholic health care guidelines, Middleton wrote, which requires that physicians “not promote or condone contraceptive practices.”

Dr. Barbara Golder, the editor of the Catholic Medical Association journal, Linacre Quarterly, says that language about morality is ubiquitous in contracts — and that it is reasonable that religious institutions might not want to be associated with abortion providers.

“The person is seen primarily as Dr. X of Catholic hospital Y, and then it turns out that Dr. X of Catholic hospital Y is doing abortions on the weekends,” Golder says. “There’s sort of a cognitive dissonance about that. It’s in opposition to what Catholic health care is.”

According to Lance Leider, a Florida attorney who has reviewed hundreds of physician contracts, it is “exceedingly common” for contracts, not just at religiously affiliated hospitals, to include language about the reasons an employer can fire a doctor, including but not limited to morality clauses.

“There’s always a laundry list of things the employer can terminate the contract for,” Leider says. “There’s usually a catch-all. Anything that calls into question the reputation of the practice.”

These clauses tend to be vague, León adds, which means employers can invoke them to prevent a wide range of activities, like political activity, controversial posts on social media or, in religious hospitals, physicians spending time at clinics that provide abortions.

The restrictions may have ramifications not only for physicians but for many clinics that provide abortions. Smaller clinics may be staffed almost entirely with part-time doctors, and when they can’t find enough, they’re sometimes left unable to meet the demand for services.

“We don’t have full-time doctors,” says Shelly Miller, the executive director of Scotsdale Women’s Center in Detroit, one of the clinics where Remski worked. “We really cannot afford to have a provider sit here all day and wait for patients to come in.”

Through her involvement with the National Abortion Federation, Miller often talks with other directors of small clinics that provide abortions and sometimes other women’s health services. She says that many of her counterparts say they exclusively hire part-time physicians because they simply don’t need somebody full time. If more physicians are prohibited from part-time abortion work, it may put some smaller clinics out of business, Miller worries.

It’s hard to know exactly how many of these clinics primarily use part-time staff, according to Rachel Jones, who studies the demographics of U.S. abortion services at the Guttmacher Institute, a family planning research organization. Ninety-five percent of abortions take place in clinics as opposed to hospitals, Jones notes, which may be more likely to utilize a team of part-time staff.

León doesn’t have data to show how common it is for physicians to be threatened with termination for providing abortions. She guesses that doctors will either give up on providing abortions — or, like Remski did, look for a different job that allows them to. León spends much of her time speaking to groups of doctors about how to approach contract negotiation if they want to provide abortions.

Ultimately, Remski says, she parted amicably from IHA, since “it felt like the wrong place for me.”

She ended up finding a job at an urgent-care clinic in Michigan, which allowed her to work part time at three separate clinics that provide abortions. She has since moved to Chicago, where she also splits her time between providing abortions and primary care.

“I was providing a service that was needed and necessary,” Remski says. “I realized it was something I really needed to do.”


Mara Gordon is a family physician in Washington, D.C., and a health and media fellow at NPR and Georgetown University School of Medicine.

Source: https://www.npr.org/sections/health-shots/2018/11/26/668347657/for-doctors-who-want-to-provide-abortions-employment-contracts-often-tie-their-h?fbclid=IwAR0OSHpHRFZpwwY_WLrPBnmzeGEohrOF2_WwHwtOuGwVO1uTBU_8r9AUe5E