Their Medications Cause Pregnancy Issues. Post-Roe, That Could Be Dangerous
The Washington Post, July 25, 2022
Karen Kaiser says she will never forget her feelings of dread and sadness as she hurried past picket lines of antiabortion protesters in 2008. In the waiting room of a Maryland Planned Parenthood, "I remember crying," she said. Kaiser had decided to have an abortion in part because she was taking a medication called Depakote to control her bipolar disorder. The drug, which is also used to treat seizures, is known to contribute to embryo malformation and to have other harmful effects on a fetus. "I wouldn't have been able to sustain [the pregnancy], but also we were worried about the side effects of the Depakote on the baby," said Kaiser, now 47 and living in Lanham, Md. Such worries are now rising for patients with disabilities, doctors say, in the weeks since the Supreme Court overturned Roe v. Wade. Americans with disabilities – including psychiatric, chronic and physical ones – say they will be disproportionately affected by the loss of federal abortion protections and are being overlooked in the discussion. Studies have found that those with disabilities experience higher rates of sexual violence – which can lead to abortions – in addition to higher rates of unplanned pregnancies and a higher risk of death during pregnancy than people without disabilities. They may also take medications, including Depakote, that can have harmful effects on pregnancy, according to neurological studies. Doctors say six-week abortion bans in states such as Texas would criminalize abortions before many patients discover they are pregnant and after their embryos were already exposed to such drugs. The effects of Depakote, which has the generic name valproate, and other potentially harmful medications are evident "very early in pregnancy," said Marlene Freeman, associate director of the Center for Women's Mental Health at Massachusetts General Hospital. Potential embryonic and fetal impacts of anti-seizure drugs include spina bifida, cleft lip and autism, studies show.
Interstate Abortion Travel Is Already Straining Parts of the System
The New York Times, July 23, 2022
The reversal of Roe v. Wade did not affect the legal status of abortion in New Mexico, where seven clinics are still operating. But that does not mean an abortion is easy to obtain there. The wait times for abortions at five of the clinics have been at least three weeks because of an influx of women from nearby states that have banned or restricted abortion. Some clinics were so full they couldn't book new appointments. Of the other two, one serves only patients seeking medication abortion before the 11th week of pregnancy, and the other is on the border with Texas, a drive of more than six hours from some parts of New Mexico. Of all the states, New Mexico has been most affected by interstate abortion travel in making appointments, according to a nationwide survey of clinics by a research team led by Caitlin Myers, a professor of economics at Middlebury College who studies the effects of reproductive policy. But the data suggests that as more bans go into effect, women who need to travel to another state for an abortion may have more difficulty getting appointments. It may even become hard for those living in some states where it remains legal. In most of the country, the average wait time for abortions before the overturning of Roe was around five days. That has increased only slightly, according to the survey, conducted July 11-14. In cities near states with bans, though, wait times were already starting to get longer, the survey found. Twenty-two percent of such clinics were booking appointments more than three weeks out. In cities farther from states with bans, 8 percent were. Thirteen percent of clinics still open were unreachable or were so full they were not taking new appointments. "Even assuming patients can overcome the navigational barriers to get to states where abortion is legal, it is going to be incredibly difficult to provide that care to everyone," said Dr. Katherine Farris, the medical director for a Planned Parenthood affiliate in the Southeast. On a recent day in Roanoke, Va., she saw patients from six states.
The Role of Independent Funds to Help People Access Abortion Is Growing
NPR, July 25, 2022
Kim Floren has spent the last several weeks trying to comfort people panicking about the end of Roe v. Wade. "Everybody has been on the spectrum from just being in tears to total panic about what they're going to do," said Floren, who runs South Dakota's Justice Through Empowerment Network, one of more than 100 independent abortion funds around the country. Abortion funds raise and distribute money to people who need help paying for abortions, including procedure and travel costs. In 2020, funds across the country helped nearly 45,000 people pay for abortions. Most funds serve specific states or regions, while others focus on particular populations like Indigenous women. Some, like Floren's, are run entirely by volunteers. Others are part of clinics or larger organizations like Planned Parenthood. Some abortion funds have been around for decades, but their importance to abortion access is growing in a post-Roe world, especially in states like South Dakota that now ban abortion. "They're going to be really vital for people to access legal abortion out of state," said Gretchen Ely, a professor of social work at the University of Tennessee and one of the country's few abortion fund researchers. Ely's research has shown that abortion funds primarily serve people in their 20s who already have kids and often lack full-time work, stable housing and safe relationships. She also found that about half of abortion fund clients are Black, compared to around one-third of overall abortion seekers. "They serve people who have the greatest needs," Ely said. Abortion funds provide more than money: Brittany Mostiller first learned about abortion funds in 2007. She was 23 years old and sharing a two-bedroom apartment on the South Side of Chicago with her three kids, her sister and her niece. She had just carried an unplanned pregnancy to term in February, which she said pushed her into a depression. Things got worse in July when she found out she was pregnant again.
Catholic Hospitals' Growth Impacts Reproductive Health Care
AP News, July 24, 2022
Even as numerous Republican-governed states push for sweeping bans on abortion, there is a coinciding surge of concern in some Democratic-led states that options for reproductive health care are dwindling due to expansion of Catholic hospital networks. These are states such as Oregon, Washington, California, New York and Connecticut, where abortion will remain legal despite the U.S. Supreme Court's recent ruling overturning Roe v. Wade. Concerns in these blue states pertain to such services as contraception, sterilization and certain procedures for handling pregnancy emergencies. These services are widely available at secular hospitals but generally forbidden, along with abortion, at Catholic facilities under the Ethical and Religious Directives set by the U.S. Conference of Catholic Bishops. The differing perspectives on these services can clash when a Catholic hospital system seeks to acquire or merge with a non-sectarian hospital, as is happening now in northeastern Connecticut. State officials are assessing a bid by Catholic-run Covenant Health to merge with Day Kimball Healthcare, an independent, financially struggling hospital and health care system based in the town of Putnam. "We need to ensure that any new ownership can provide a full range of care – including reproductive health care, family planning, gender-affirming care and end-of-life care," said Connecticut Attorney General William Tong, a Democrat. Lois Utley, a specialist in tracking hospital mergers, said her organization, Community Catalyst, has identified more than 20 municipalities in blue or purple states where the only acute care hospitals are Catholic. "We are definitely sliding backwards in terms of comprehensive reproductive health," Utley said. "Catholic systems are taking over many physician practices, urgent care centers, ambulatory care centers, and patients seeking contraception won't be able to get it if their physician is now part of that system." According to the Catholic Health Association, there are 654 Catholic hospitals in the U.S., including 299 with obstetric services. The CHA says more than one in seven U.S. hospital patients are cared for in a Catholic facility.
North Carolina and Florida Become Southern Abortion Havens
Stateline, July 26, 2022
In the month since the U.S. Supreme Court ended the federal right to abortion, red states in the Deep South have been one-by-one criminalizing nearly all abortions. As of this week, most abortions are banned in Alabama, Georgia, Mississippi and South Carolina. Other states in the South also have strict abortion bans that are in flux because of court appeals. But on the geographical edge of this block of Deep South states, abortion is expected to remain legal in two states, at least until the November elections. Southerners are flocking to both Florida and North Carolina for clinical and medication abortions – in North Carolina as late as viability, typically between 24 and 28 weeks of pregnancy, and in Florida, until 15 weeks of pregnancy. Neither state set out to become an abortion oasis, and neither state will necessarily remain one after the midterm elections. But abortion providers and their patients are evolving with quickly changing circumstances. In an example of the whiplash in the region, the Tampa Bay Abortion Fund was helping Floridians who were more than 15 weeks pregnant travel north to Georgia for an abortion until early last Wednesday afternoon, founder Kelly Nelson said, when a Georgia court suddenly switched the state's abortion limit from 22 weeks of pregnancy to six weeks. Now, Georgians seeking abortions are driving south to Florida or north to North Carolina, depending on where they live. And Nelson's group has begun helping its Florida patients who are more than 15 weeks pregnant travel mainly to Illinois, where well-funded health clinics and a supportive state government are prepared to provide abortions for tens of thousands of out-of-state patients every year for the foreseeable future. "Our perspective is that anyone who wants an abortion can get one if they know who to call," she said. "No matter what politicians do, there will always be organizations like mine that will make abortion possible. In Florida, we're planning for the worst."
ICYMI: In Case You Missed It
The 1557 proposed rule would restore essential civil rights protections for millions of people, including those seeking reproductive health care. We applaud @WhiteHouse @HHSGov @SecBecerra for working to make health care more affordable and more equitable.— National Partnership (@NPWF) July 25, 2022
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