NEWS: Abortion pill providers experiment with ways to broaden access

Repro Health Watch

September 8, 2022 | Abortion, Reproductive Rights

 

Abortion Pill Providers Experiment With Ways to Broaden Access

The New York Times, September 3, 2022

As bans and restrictions proliferate across the country, abortion pill providers are pushing the envelope of regulations and laws to meet the surging demand for medication abortion in post-Roe America. Some are using physician discretion to prescribe pills to patients further along in pregnancy than the 10-week limit set by the Food and Drug Administration. Some are making pills available to women who are not pregnant but feel they could need them someday. Some are employing a don’t-ask-don’t-tell approach, providing telemedicine consultations and prescriptions without verifying that patients are in states that permit abortion. These changes are easing access to the pills for patients in states that have curtailed abortion, and also in states where it remains legal, but where clinics have longer wait times as patients flood in from restrictive states. Some of the practices, like not confirming that telemedicine patients are located in states that allow abortion, may run afoul of anti-abortion state laws or fall into uncharted legal territory, but they may also be challenging to police, reproductive health experts said. “We’re going to see these different approaches by organizations as they assess what the laws say and develop their rationale for how to provide care,” said Elizabeth Nash, state policy analyst for the Guttmacher Institute, a research group supporting abortion rights. “We just don’t have a road map about how to provide medication abortion post-Roe, so it’s all being created right now.” Abortion opponents criticized the efforts, calling them risky for women. Tessa Longbons, senior research associate at the Charlotte Lozier Institute, an anti-abortion organization, said the method had greater rates of complications and failure after 10 weeks that “could just put women at risk.” Providing pills to women who are not pregnant, she said, creates a risk that a woman “could take it anytime or someone that it wasn’t initially prescribed to could end up taking it.” Medication abortion, which was legalized in the United States in 2000, typically involves two drugs: mifepristone, which blocks a hormone necessary for pregnancy development, followed 24 to 48 hours later by misoprostol, which causes contractions that expel pregnancy tissue.

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U.S. Veterans Agency to Offer Abortions in Cases of Rape, Health Risks

Reuters, September 2, 2022

The U.S. government will provide abortion services for the first time ever to veterans in cases of rape or incest, or when the pregnancy puts the life of the woman at risk, even in states that have banned or restricted the practice, the U.S. Department of Veterans Affairs said on Friday. The agency said in a policy document that it decided to offer abortions to veterans in response to a wave of U.S. states enacting bans and restrictions on such services since the Supreme Court ended the nationwide right to abortion in June. The department determined that change was needed "to protect the lives and health of veterans" and the rule was meant to "avert imminent and future harm" to veterans, the document said. "This is a patient safety decision," Veterans Affairs Secretary Denis McDonough said in a statement. Representative Mark Takano, the Democratic chairman of the House Committee on Veterans' Affairs, applauded the decision, which he said was part of the department's responsibility to serve the needs of veterans, including providing "equitable and unrestricted access to the full spectrum of reproductive healthcare." Mike Bost, the ranking Republican on the committee, sharply criticized the new policy, which he said was "illegal." "Abortion is wrong, and Congress prohibited VA from providing it decades ago," Bost said in a statement. "I oppose it and am already working to put a stop to it." The abortion issue is expected to play a consequential role in gubernatorial and state legislative races around the country this fall. Democrats aim to leverage anger over the Supreme Court's recent overturning of Roe v. Wade, which guaranteed American women access to abortion services, ahead of the Nov. 8 midterm elections. [...] Veterans Affairs healthcare providers will determine whether the pregnancy is a risk to the life and health of the veteran on a case-by-case basis, the department said. In cases of rape or incest, self-reporting by a veteran would constitute sufficient evidence to justify the abortion, it said. The new policy removes or changes some provisions in the medical benefits package for veterans that excluded abortion services until now, according to a document submitted to the Office of the Federal Register as an "interim final rule."

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The Language We Use to Talk About Pregnancy and Abortion Is Changing. But Not Everyone Welcomes the Shift

CNN, September 4, 2022

From patient waiting rooms to the halls of Congress, the language being used to talk about reproduction is shifting. Across the US, mainstream institutions such as the American Civil Liberties Union, the Centers for Disease Control and Prevention and CNN are increasingly opting for gender-neutral terms such as "pregnant people," "people who get abortions" and "birthing parent" in favor of "women" when referencing pregnancy, fertility and abortion. These shifts in terminology signal an effort to be inclusive of transgender and nonbinary people who can also get pregnant. But the changes have also prompted pushback -- not just from Republican politicians who are openly hostile to LGBTQ people but also from some cisgender women (women whose gender identity conforms with the sex they were assigned at birth) who consider themselves LGBTQ allies and who support abortion rights. “We're not just talking about the same people that we were before. We're broadening the scope," said Kristen Syrett, an associate professor of linguistics at Rutgers University. "And I think that's where people get more uncomfortable because it's so different from the way we've been thinking of reproductive rights and pregnancy for a long time." Debates about language can seem arbitrary at a time when so many no longer have access to abortion services in their home state. But at the crux of these debates are questions about who is targeted by restrictive laws and policies, who is affected and who is included in the conversation. Using inclusive language to talk about abortion recognizes that not only cis women can get pregnant, said Gillian Branstetter, a communications strategist at the ACLU's Women's Rights Project and LGBTQ & HIV Project. Some trans men and nonbinary people can also get pregnant, as can cis girls and trans boys. This is also true in the opposite: Not all women are able to get pregnant. Some cis women struggle with fertility, while trans women lack uteruses. [...] There's scant data on how many trans and nonbinary people get pregnant and receive abortions given that medical systems in the US track them as female. A 2019 study from Rutgers University suggests that up to 30% of trans men experience unplanned pregnancies, and a 2020 study from researchers at the Guttmacher Institute and Planned Parenthood estimated between 462 and 530 trans and nonbinary people received abortions in 2017 (the CDC reports that approximately 609,000 total abortions were performed that year).

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Google Workers Battle Company Over 'Life and Death' Abortion Policies

ABC News, September 7, 2022

Immediately after the Supreme Court released a ruling that overturned Roe v. Wade, in June, a slew of major U.S. companies, like Meta and JPMorgan Chase, announced that they would cover travel costs for employees who seek legal abortions outside their home state. Google went a step further. Having already expanded its abortion coverage to include such travel, the company told employees it would allow them to apply to relocate without their providing a reason why. More recently, after receiving questions from federal lawmakers, the company last month began rolling out a product update that will set default results on Google Maps and local locations for the search query “abortion clinics near me” to only include institutions that perform abortions. The change will exclude from default results institutions that do not provide the operation, such as pregnancy centers that often attempt to dissuade a woman from seeking an abortion. Users who choose to manually expand the results beyond those displayed, however, will be able to see institutions that do not provide abortions, a Google spokesperson said. In addition, Google Maps and local search results will include labels showing whether an institution does or might not provide an abortion, a Google spokesperson said. Still, outspoken employees at Google say the company hasn’t gone far enough in its response to the overturning of Roe — both on product performance and employee treatment. The Alphabet Workers Union, or AWU, an advocacy group made up of more than 1,000 employees, has called on Google to strengthen its approach to abortion-related issues or risk an escalation in employee pressure. The AWU functions as a “minority union,” which means it pressures the company through worker organizing but does not formally represent workers in collective bargaining. [...] Google should extend abortion-related health benefits to contract workers, whom AWU estimates make up roughly half of company staff, the group says. Moreover, AWU has called on Google to remove pregnancy centers entirely from search results that appear after a query such as “abortion clinic near me,” rather than merely setting the default search results in Google Maps and local locations to exclude such groups. Under the current policy, the app and site display pregnancy centers in an expanded set of search returns.

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A 1931 Law Criminalizing Abortion in Michigan Is Unconstitutional, a Judge Rules

NPR, September 7, 2022

Enforcement of Michigan's 1931 abortion ban was blocked Wednesday by a judge who replaced her temporary order with a permanent injunction. Michigan Court of Claims Judge Elizabeth Gleicher ruled the Michigan Constitution's due process clause is expansive enough to cover reproductive rights. "The Michigan Constitution protects the right of all pregnant people to make autonomous health decisions," she wrote, and later: "Exercising the right to bodily integrity means exercising the right to determine when in her life a woman will be best prepared physically, emotionally and financially to be a mother." Gleicher's initial temporary order pre-dated the U.S. Supreme Court's Dobbs v. Jackson Women's Health Organization ruling in June. Dr. Sarah Wallett, the chief medical officer for Planned Parenthood of Michigan, says this means abortion rights are protected while there's still a lot of litigation pending. "But this does help reassure providers and patients who are really worried that that might not always be the case in Michigan," she told the Michigan Public Radio Network. Michigan's dormant abortion law would threaten abortion providers with felony charges. Gleicher's opinion was somewhat technical. It did not directly bar prosecutors from filing charges against abortion providers. Instead, she instructed Michigan Attorney General Dana Nessel to inform prosecutors that abortion rights remain protected. Nessel has already said she won't file charges under the 1931 law. The distinction is meaningless, according to attorney David Kallman, who represents county prosecutors who say they are allowed to file criminal charges under the 1931 law. "Unbelievable," he said. "Talk about a shift and a change in our constitutional form of government. I didn't realize the state of Michigan now, according to Judge Gleicher, controls and runs all 83 county prosecutors' offices in this state." This is one of several abortion-related legal cases in play in Michigan. It could join at least three decisions that have been appealed to the Michigan Supreme Court. There's also a separate case that seeks to put an abortion rights amendment on the November ballot. The court is expected to rule this week on a challenge to the petition campaign, which gathered nearly 750,000 signatures — a record — in an effort to put a proposed reproductive rights amendment on the November ballot.

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