Lawmakers convene on the House floor during a session at the Illinois State Capitol in Springfield. | Seth Perlman/AP file

There is a lot of noise these days about abortion. Tweets and speeches from partisan places bounce around in our heads, creating doubt and replacing facts with lies. This OB-GYN would like to set the record straight: No one is murdering newborns or ripping them out days before birth. Contrary to the way some headlines are presented, 88 percent of all abortions occur in the first trimester. Only 1.3 percent occur after 20 weeks gestation, and the vast majority of these are for dangerous fetal or maternal medical conditions I wouldn’t wish on my worst enemy.

I should know. I ended a loved and wanted pregnancy in 2009 in the second trimester, after learning my son, Thomas, would have suffocated to death had he been born. For my family, this was intrauterine palliative care. I am on the front lines of women’s health care. I have story after story of women and families who have ended pregnancies. It is never simple, never flippant.

It is always health care. It is always personal. It is never a place for government.

As a mother and OB-GYN, I strongly support HB 2495: The Illinois Reproductive Health Act. This bill would repeal the outdated and unenforceable criminal penalties for abortion care. It is terrible legal design to have multiple, contradictory laws on the books.

Counseling women on their pregnancy choices is my job. I trained long and hard for it. I spend sleepless nights worrying about moms and their babies. I have always found it ironic that those who call for the smallest government want to squeeze it into my exam room and uterus. Medical providers, like me, are the ones to listen to for health care guidance — not politicians.

Abortion is health care and has been since ancient times. It has no place in the criminal code.

Dr. Cheryl Axelrod, Wilmette

Repeal parental notification of abortion

I commend the Sun-Times for its editorial “For safety’s sake, repeal the Illinois Parental Notification Act” (Tuesday). I also commend our state legislators for advancing SB 1594, the bill to repeal the act and, in doing so, protect the health and safety of the young women of Illinois.

State law cannot dictate family dynamics. Young women who may decide to have an abortion will tell a parent, if they can. For those who can’t, they must have the ability to make their own decisions about their own future. Requiring judicial intervention is an extraordinary obstacle and punishment. Please contact your legislators now and entreat them to vote yes on SB 1594.


The Trump administration is trying to exclude abortion providers, so the state is trying to fund its own Title X program.

On Saturday, the Maryland House of Delegates passed a bill that would end the state’s participation in Title X, if the administration prevents the program’s federal family planning funds from going to clinics like Planned Parenthood that provide abortion or refer patients for abortion elsewhere. Instead, beginning in 2021, the governor would be instructed to set aside more state dollars to effectively create its own family planning program.

In 2017, Gov. Larry Hogan (R) signed a bill that created a state-based family planning program, in case the federal government decided to impose a gag rule. This new bill takes an additional step, declaring Maryland would not participate in a program that provides substandard care, explained Robyn Elliott, lobbyist for Planned Parenthood of Maryland.

“This is really about equity across Maryland,” Elliott told ThinkProgress. “Maryland has worked for many years to ensure everyone has access to a broad range of evidence-based contraception…. Why would we leave a part of Maryland out in terms of having access to the same high standard of care?”

The Maryland Department of Health receives between $3 million and $4 million dollars annually from the federal government under the Title X program, Elliott said. The state doles out these federal dollars to various providers, including eight Planned Parenthood clinics. Should the administration’s rule barring abortion providers from participating in Title X take effect, the state would no longer be able to dispense federal dollars to these clinics.

Under current law, federal dollars can’t pay for abortion services. Providers use Title X dollars to pay for other health services like contraception, pelvic exams, and cervical or breast cancer screenings. In 2010, Title X clinics prevented 53,450 cases of chlamydia, 8,810 cases of gonorrhea, 250 cases of HIV, 1,900 cases of cervical cancer, and 6,920 cases of pelvic inflammatory disease, according to the National Family Planning and Reproductive Health Association.

But the Trump administration argues that by allowing providers like Planned Parenthood to participate in the Title X program, federal officials are basically subsidizing abortion. (It’s worth noting Title X-funded clinics receive more money from Medicaid, a federal-state insurance program for low-income people.)

The administration’s new rule, issued in early March, fundamentally reshapes the country’s sole grant program dedicated to family planning. The grant program would require providers to physically and financially separate abortion from other medical services. Providers wouldn’t even be able to provide abortion referrals during pregnancy counseling. The administration is also giving crisis pregnancy centers an opportunity at receiving federal dollars, even though these centers have a history of misleading patients. Under the Trump administration, the Title X program would emphasize fertility awareness and abstinence education.

The administration is mirroring what conservative states have long tried to do. In 2011, Texas excluded Planned Parenthood from a Medicaid-based program that served around 244,000 women. Within a year, 82 clinics closed, a third of them run by Planned Parenthood.

“The exclusion of Planned Parenthood affiliates…in Texas was associated with adverse changes in the provision of contraception,” a 2016 study published in the New England Journal of Medicine found. “For women using injectable contraceptives, there was a reduction in the rate of contraceptive continuation and an increase in the rate of childbirth covered by Medicaid.”

Under the proposed bill, Maryland would create a state-based family program that continues to include abortion providers like Planned Parenthood.

“We want to make sure Marylanders who get family planning services under Title X have access to the very same methods as people with private insurance. It’s that plain and simple,” said state Rep. Shane Pendergrass (D), sponsor of the Maryland Title X bill.

“… Because of the federal rules, they will no longer have that access under Title X. So it’s time to walk away from the federal Title X dollars,” she added.

ThinkProgress reached out to the governor’s office for comment on the bill, but did not hear back by the time of publication.

Maryland is likely the first state aiming to mitigate the gag rule’s damage through legislative action. The state is also one of 21 others suing the administration over the rule. There are currently at least six lawsuits challenging the administration’s changes to the Title X program.

“We are singularly focused on and confident that the courts will block this unlawful regulation. Communities across the country recognize the peril that will befall their most marginalized residents if this rule takes effect. We are all fighting to protect providers and their patients however possible, and our hope is that our legal action will make it so that states don’t have to bear this burden, and many will be unable to do so,” Jessica Marcella, vice president of advocacy and communications at the National Family Planning & Reproductive Health Association, said in a statement to ThinkProgress.

Most legal experts think these lawsuits will have a tough time prevailing in federal court, as the Supreme Court previously upheld a similar Regan-era regulation.


In the most restrictive nations, women who terminate their pregnancies face lengthy jail terms

Women in England and Wales have had the right to seek an abortion since 1968, but more than 50 years on, many women around the world do not have the same choice.

A 2017 report by the Guttmacher Institute, which studies reproductive health laws, found that 42% of women of reproductive age live in countries where abortion is either banned or only allowed in specific circumstances.

The most common legal grounds for abortion worldwide is to protect the life of the mother, followed by serious risk to her physical or mental health.

Around half of the countries in the world allow abortion in cases where the pregnancy was the result of rape or incest, and a similar proportion recognise serious foetal abnormality.

However, in a few countries, abortion remains the ultimate taboo.

Which countries have the strictest abortion laws?

All but a handful of countries allow an abortion to be performed when the life of the mother is at risk. The exceptions are Malta, El Salvador, Nicaragua and Dominican Republic

Strongly Catholic Malta is the only European country to have a total ban on abortion, and a survey carried out last year by Malta Today suggests that liberalisation is a long way off.

Overall, 95.2% of those surveyed were opposed to abortion by request – known as elective abortion – even if it were restricted to the first 12 weeks of pregnancy. Less than half said that abortion should be allowed to save the life of the mother.

El Salvador’s harsh anti-abortion laws have come into the international spotlightin recent years, due to high-profile cases of women imprisoned for terminating their pregnancies, some of whom claimed to have actually suffered a miscarriage.

Unsurprisingly, abortion is also totally banned in Vatican City – however, given that the Holy See’s 800-strong population is overwhelmingly made up of Catholic clerics, this prohibition is largely theoretical.

Where is elective abortion legal?

At the other end of the scale, 63 countries and territories permit women to terminate their pregnancies at their request, although usually with some conditions – most commonly, a time limit on when the procedure can be performed.

Canada is the only Western nation where a woman can seek an elective abortion at any time in her pregnancy, although in practice only a handful of terminations occur during the third trimester, HuffPost reports.

What about the UK?

In all parts of the UK except Northern Ireland, women can freely obtain an abortion up to 24 weeks into their pregnancy. Terminations can be performed after this limit in exceptional circumstances, such as to save the life of the mother or due to a severe foetal abnormality.

Office for National Statistics and Department of Health and Social Care figures show that in 2017, 192,900 abortions were performed in England and Wales, compared to 679,106 live births.

Figures like these are often used to claim that more than 20% of all pregnancies are terminated. However, The Journal points out that this statistic is misleading as it does not take into account the thousands of pregnancies which end in miscarriage every year.


Democrats on the HELP committee join a growing chorus of congressional criticism of the “gag rule,” which is set to go into effect on May 3.

Sen. Patty Murray (D-WA), the committee’s ranking member, voiced support for a hearing.
Mark Wilson / Getty Images

A group of Senate Democrats sent a letter on Monday to committee leadership demanding a hearing on the Trump administration’s newly finalized rule restricting family planning funding, dubbed the domestic “gag rule” by opponents.

Democrats on the U.S. Senate Committee on Health, Education, Labor, and Pensions (HELP) explained their concern that the anti-choice restriction would force providers to violate medical ethics by banning referrals for abortion care. The letter also says that the rule’s requirement that clinics physically and financially separate Title X-funded family planning services from abortion services “appears to be aimed at and would disproportionately affect Planned Parenthood health centers, which currently serve over 40% of Title X network patients.” The letter says this could present a burden to other providers if Planned Parenthood, the country’s largest provider of Title X services, is cut from the program.

“The effects of this requirement would be devastating nationwide and in our home states,” the senators wrote. “We urge you to hold a hearing so we can fulfill our responsibility to scrutinize the policy with the due diligence it deserves …. The Committee should hear from patients, providers, entities receiving Title X funds, and state and local health departments, so we can directly assess the impact this final rule will have on people with low incomes’ ability to access high-quality family planning services.”

The letter was addressed to Committee Chair Lamar Alexander (R-TN) and Sen. Patty Murray (D-WA), the committee’s ranking member. It was signed by Sens. Elizabeth Warren (D-MA), Doug Jones (D-AL), Sen. Bernie Sanders (I-VT), and the seven other non-ranking Democrats on the HELP committee.

Murray voiced support for a hearing in a statement to Rewire.News. “I’m incredibly alarmed by President Trump’s rule that jeopardizes care for millions of women and families by undermining the historically bipartisan Title X program, and I support my colleagues’ request for greater scrutiny of this alarming plan,” she said. “Republicans should listen to the women, men, health care providers, city and county health officials, religious groups, and many other people across the country who have spoken up in opposition to President Trump’s harmful rule.”

Alexander did not respond to a request for comment from Rewire.News by the time of publication.

Democrats on the HELP committee join a growing chorus of congressional criticism of the gag rule, which is set to go into effect on May 3. Democrats on the U.S. House Energy and Commerce Committee sent a letter to U.S. Health and Human Services Secretary Alex Azar earlier this month questioning the rule’s legality.

Lawsuits seeking to prevent the rule’s implementation are starting to pile up. The American Civil Liberties Union filed a lawsuit in early March on behalf of the National Family Planning & Reproductive Health Association (NFPRHA) and Cedar River Clinics, a family planning provider based in Washington state. The Center for Reproductive Rights filed its own lawsuit on behalf of Maine Family Planning, the state’s sole recipient of the Title X family planning funds targeted by the administration. Attorneys general from 21 states are also filing suit against the rule.

NFPRHA Communications Director Audrey Sandusky expressed gratitude for congressional pushback against the gag rule in a statement to Rewire.News. “The Title X rule comes with enormous risk and sacrifice to the public’s health,” she said. “It attacks highly qualified providers and threatens the health and wellbeing of those served by this critical program. We are grateful to our champions on the Hill who can help shine a harsh light on the deeply troubling provisions and justifications of the rule that will directly impact the provision of family planning care in this country.”


April Lanham, center, allowed attendees at a legislative meeting in Frankfort, Ky., to listen to her fetus’s heartbeat.CreditCreditTom Latek/Kentucky Today, via Associated Press

A federal judge on Friday temporarily blocked a Kentucky law that prohibits abortion after a fetal heartbeat is detected, which typically happens around six weeks into pregnancy, before many women know they are pregnant.

The measure, which was signed into law on Friday by the state’s Republican governor, Matt Bevin, and was set to take effect immediately, was poised to become one of the strictest anti-abortion laws in the country.

But late on Friday, the judge, David J. Hale of the Western District of Kentucky, ruled the law was potentially unconstitutional. He halted enforcement for at least 14 days to “prevent irreparable harm” until he could hold a hearing.

The ruling came amid a yearslong effort to curb abortions in Kentucky, which has one remaining abortion clinic. Several other states are considering similar measures, known as heartbeat bills, as states move to restrict — or shore up access to — abortion in anticipation of a more conservative Supreme Court possibly ruling on the issue.

The Kentucky law was one of two measures seeking to restrict abortion that were passed by the state’s Republican-controlled legislature this week but are now being contested. The other, a bill that prohibits abortion if a woman wants to end her pregnancy because of the diagnosis of a disability in the fetus, among other reasons, is awaiting approval from the governor.

The American Civil Liberties Union challenged both measures in a lawsuit filed this week on behalf of EMW Women’s Surgical Center, the state’s only licensed abortion clinic.

“We think this is a very straightforward legal issue,” Brigitte Amiri, deputy director of the A.C.L.U.’s Reproductive Freedom Project, said on Saturday. “States can’t ban abortion. It has been well settled over 40 years ago in Roe v. Wade.”

The judge on Friday did not address the second bill and Ms. Amiri said the group planned to ask the judge for a ruling on it after it was signed into law.

Steve Pitt, general counsel to the governor, said on Saturday that ruling was not unexpected “given the minimal amount of briefing that has occurred.”

“This case or others like it from other states will result in major changes in abortions in the U.S. in the near future,” he said. “The A.C.L.U., Planned Parenthood and others favoring unlimited abortions know this and are in a panic.”

The governor has made anti-abortion legislation a priority of his administration and has welcomed the chance to fight for protections in court.

In a video message on Friday, he chided his “good friends at the A.C.L.U.” for challenging the second bill, which would ban abortions based on a fetus’s disability, sex or race, before it had been signed into law and suggested they needed a civics refresher from “Schoolhouse Rock!” on how legislation works.

“They frankly don’t care whether they are following the law or not,” said Mr. Bevin, who has expressed support for the bill. “They simply want to push their ideology.”

The landscape of the Supreme Court changed last year after Justice Brett M. Kavanaugh, seen as a reliable conservative, replaced the court’s longtime swing vote, Justice Anthony M. Kennedy, who retired. The change added urgency to the question of whether Roe v. Wade, the landmark 1973 ruling that made abortion legal nationwide, would survive the Trump administration.

But legal experts have suggested that any developments, at least in the near term, will most likely come at the state level, with states succeeding in smaller cases that limit — but not eliminate — the right to an abortion. Other states, including Iowa and North Dakota, have passed similarly prohibitive fetal heartbeat measures only to have them swiftly voided by the courts as unconstitutional.

Supreme Court decisions have given women a right to abortion until a fetus is viable outside the womb, usually around 24 weeks into pregnancy.

Ms. Amiri said the fetal heartbeat bill would effectively eliminate abortion in Kentucky. About 90 percent of abortions in the state are performed after six weeks, according to the lawsuit. The law would make an exception for procedures that were necessary to prevent death or serious risk to the woman.

She said Judge Hale’s ruling came as a “tremendous relief.”

“The clinic sees patients today, and before we got the ruling yesterday, they were in the process of canceling appointments,” Ms. Amiri said on Saturday. “It means they will be able to provide care today and that is incredibly important to every person who comes to the clinic.”


Tennessee City Officials Are Using Zoning Rules to Erode Access to Abortion

Carafem opened the Mt. Juliet clinic after seeing a spike in Nashville visitors to their Atlanta location. Last year, Nashville’s last two abortion clinics closed.
CityofMtJuliet / YouTube

The day after carafem, a provider of reproductive health-care services, opened in Mt. Juliet, Tennessee, a city council meeting was called. The lone council agenda item: a zoning amendment restricting surgical abortions to industrial areas.

The new carafem clinic, located in a commercial area, would be affected. The amendment passed unanimously. The hastily scheduled meeting lasted a grand total of four minutes.

Carafem hasn’t released a statement regarding what threat the zoning could pose to surgical abortions, which are not yet offered at the Mt. Juliet location, outside Nashville. The clinic today offers medication abortion and plans to offer abortion procedures.

“Writing zoning laws to deny access to essential health care is unfair and mean-spirited,” said Ashley Coffield, president and CEO of Planned Parenthood of Tennessee and North Mississippi. “I’m not aware of any other community in Tennessee that has used this approach to hurt a qualified medical provider that is just trying to help women get the care they need.”

Carafem opened the Mt. Juliet clinic after seeing a spike in Nashville visitors to their Atlanta location. Last year, Nashville’s last two abortion clinics closed. The Women’s Center closed in August, and Planned Parenthood temporarily stopped providing abortion care in December. While Planned Parenthood has resumed abortion services, the clinic is taking on fewer appointments but plans to ramp up soon. Meanwhile, Tennessee Republicans recently passed a so-called heartbeat bill—amounting to a total abortion ban—through the state house. The legislation would make abortion illegal as early as six weeks, before some people know they’re pregnant.

Reproductive rights and health care are under fire and Mt. Juliet officials are testing the legal temperature.

Ed Hagerty, the mayor of Mt. Juliet, is adamant that the last-minute zoning amendment had nothing to do with boxing out the new abortion clinic. When asked about the relation, he demurred. “All the city officials did was to amend the zoning ordinance, which all municipalities do from time to time,” he said. “The zoning ordinance exists to provide for the health, safety, and well-being of all citizens of Mt. Juliet, including those who are not yet citizens, whether they are visitors traveling through our city or those who may be moving here in the future.”

While Hagerty hasn’t shared his personal views on abortion, in 2015, he served as a judge for an annual anti-choice oratory contest for high school students, put on by the Tennessee chapter of the National Right to Life, the nation’s oldest and largest anti-choice organization.

Some Mt. Juliet city commissioners are more open about the intent of their zoning amendment. “If there is anything we can legally do to keep them [carafem] from opening in Mt. Juliet we will do it. I realize they have rights, but my constituents and I don’t want it here,” commissioner Brian Abston told local television station WTVF.

Commissioner James Maness agreed, sharing his thoughts on Facebook, “I am pro-life. The taking of innocent life is called murder. Abortion is not a matter of choice, it’s a matter of life and how we value life.” Hinting at the legal battle to come, Maness added: “Please don’t think this is over.”

Efforts to restrict access to abortion aren’t new in Tennessee. After Republicans gained a legislative supermajority in 2012, attempts to erode access soared. In the years following the Republican takeover, anti-choice bills, including a law requiring state-directed counseling and a 48-hour forced waiting period, entered the Tennessee legislature. The biggest change to abortion rights came in 2014 when Amendment 1, an amendment giving the state power to create and alter abortion laws, passed and added the following language to the state’s constitution: “nothing in this Constitution secures or protects a right to abortion or requires the funding of an abortion.” Its passage opened the floodgates for GOP-backed anti-choice legislation.

Despite the effort to drive out abortion providers, carafem is ready to provide health care services to those in need.

“Our doors remain open, as we continue to provide much needed reproductive health-care services, including access to abortion and contraception, to the women in and around the Nashville area,” said Melissa Grant, carafem’s chief operating officer. “We are overwhelmed by the number of clients who have expressed their gratitude for having access to the much-needed products and services we provide without having to travel hours to another clinic or state. We remain committed to serving women and couples in Tennessee, who truly need access to safe, affordable reproductive health care and family planning.”

Mt. Juliet residents are torn about the action taken against the abortion provider by the mayor and council.

“I can see why they want to [push out the abortion clinic], because we don’t want to be known as ‘Mt. Juliet, the place where you go to get an abortion,’ but at the same time, it is a medical procedure. There are a lot of components to it,” Tammy Drake, 49, a Mt. Juliet resident, told Rewire.News. “I try not to judge anyone because you don’t know what they’re going through, but on the other hand, I am a God-fearing woman.”

Another Mt. Juliet resident, Linda Sloan, 70, was happy to hear about the effort to drive out an abortion care provider. “I’m very proud to live in a community where abortion is a concern of the mayor and city council members. I’m glad I live in a conservative area where we stand up for unborn babies,” Sloan said.

Kevin Williams, also a city resident, told Rewire.News the city council’s decision “sounds contradictory.”

“If the clinic was permitted initially, then it should stay. I don’t like that—the backtrack. It seems like they made a last-minute change, perhaps due to pressure. And as far as the clinic, I don’t see a problem with it being there,” Williams, 25, said. “It’s up to the woman. A woman has to go through the nine months, the pain that me as a guy will never experience, so I don’t have any problem with the clinic. It’s totally the woman’s decision.”


Maine Democrats are pushing legislation to allow qualified advanced practice clinicians such as nurse practitioners, physician assistants, and certified nurse-midwives to provide abortions.

Scores of nurses across the United States are equipped to provide abortion services.

Maine’s ban on non-physicians providing abortion care may soon be scrapped thanks to a bill introduced by Democratic House Speaker Sara Gideon and Gov. Janet Mills (D-Freeport).

Announced Thursday, LD 1261 would allow qualified advanced practice clinicians (APCs) such as nurse practitioners, physician assistants, and certified nurse-midwives to provide abortion care. “Physician-only” laws are among the barriers aimed at curbing access to abortion; Maine’s physician-only law leaves only three publicly accessible health centers where patients can receive in-clinic abortion care—in Augusta, Bangor, and Portland. Patients in rural areas often travel hours for care even though there are qualified, experienced practitioners in their own communities. Such restrictions particularly affect people who already face systemic barriers to health care, including those with low incomes, people of color, and young people.

Mills introduced a similar bill last year when she was attorney general. Advocates are hopeful it will pass now that the state has a pro-choice governor and Democratic legislative majorities.

This could be significant in the underserved state, said Alison Bates, a nurse practitioner (NP) in Maine with Planned Parenthood of Northern New England.

“About 80 percent of counties in Maine have no abortion provider. So you can imagine the burden that is placed on patients seeking that care when they can’t afford it in their own communities,” Bates told Rewire.News. “This is an opportunity for us to align state law with the necessary scope of practice that’s within my purview as an APC and, in doing so, affords patients in Maine access to this service more broadly.”

If someone comes to her clinic seeking an abortion, Bates said she’s forced to turn them away, as per state law, because she has an NP and not an MD after her name. Yet scores of nurses across the United States are equipped to provide abortion services. Laws that prevent qualified nurses from providing such care have been challenged by providers in a handful of states, including in Maine.

The American Civil Liberties Union (ACLU) and Planned Parenthood filed a federal lawsuit in 2017 challenging the Maine ban on behalf of Planned Parenthood of Northern New England, Maine Family Planning, and several nurse practitioners. Bates is a plaintiff in the case, which is pending in the U.S. Court for the District of Maine.

“Enough is enough,” Oamshri Amarasingham, ACLU of Maine’s advocacy director, said in a statement. “Limited transportation options, brutal winters, and a shortage of health care providers—Mainers face more than enough obstacles to accessing needed health care without having medically unjustified laws piled on top. We’re thankful to Gov. Mills and Speaker Gideon for introducing this bill, which would dramatically improve Mainers’ access to safe abortion care in their own communities.”

Maine lawmakers in 1979 passed a law allowing only physicians to provide abortions. The law was drafted to protect women from back-alley abortions but has not kept pace with technology and practitioner abilities, according to Planned Parenthood.

Maine is one of ten states facing lawsuits to eliminate “physicians-only” laws, ThinkProgress reported. Thirty-three states bar advanced practice clinicians from providing abortion care.

The American College of Obstetricians and Gynecologists and the World Health Organization support allowing APCs to perform abortions in early pregnancy.

“Every woman in Maine should be able to access reproductive health care when and where she needs it, regardless of her zip code,” Gov. Mills said in a statement. “Allowing advanced nurse practitioners and physician assistants to perform medication-administered abortions, which are already permitted in other states, will ensure Maine women, especially in rural areas of our state, can access reproductive health care services. It is time to remedy this inequity that negatively impacts too many Maine women.”

Advocates are hopeful the bill will pass. Hearings are expected to be held in April.

“For patients and families in Maine, this is a huge gain towards de-stigmatizing abortion and making accessible and feasible holistic and comprehensive reproductive health care. It would be a remarkable success for the state of Maine,” Bates said.