NEWS: They had miscarriages, and new abortion laws obstructed treatment

Repro Health Watch

July 21, 2022 | Abortion, Reproductive Rights

 

They Had Miscarriages, and New Abortion Laws Obstructed Treatment

The New York Times, July 17, 2022

Last year, a 35-year-old woman named Amanda, who lives in the Dallas-Fort Worth area, had a miscarriage in the first trimester of her pregnancy. At a large hospital, a doctor performed a surgical procedure often used as a safe and quick method to remove tissue from a failed pregnancy…Eight months later, in January, Amanda, who asked to be identified by her first name to protect her privacy, experienced another first-trimester miscarriage. She said she went to the same hospital, Baylor Scott & White Medical Center, doubled over in pain and screaming as she passed a large blood clot. But when she requested the same surgical evacuation procedure, called dilation and curettage, or D&C, she said the hospital told her no. A D&C is the same procedure used for some abortions. In September 2021, in between Amanda's two miscarriages, Texas implemented a law banning almost all abortions after six weeks into pregnancy. Following the reversal of Roe v. Wade, numerous states are enacting bans or sharp restrictions on abortion. While the laws are technically intended to apply only to abortions, some patients have reported hurdles receiving standard surgical procedures or medication for the loss of desired pregnancies. Amanda said the hospital didn't mention the abortion law, but sent her home with instructions to return only if she was bleeding so excessively that her blood filled a diaper more than once an hour. Hospital records that Amanda shared with The New York Times noted that her embryo had no cardiac activity during that visit and on an ultrasound a week earlier. "She reports having a lot of pain" and "she appears distressed," the records said. "This appears to be miscarriage in process," the records noted, but suggested waiting to confirm and advised a follow-up in seven days.

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Biden Admin to Pharmacies: Refusing to Fill Contraception and Abortion Pill Prescriptions Could Break Federal Law

POLITICO, July 13, 2022

Senior Biden administration officials announced Wednesday that they are reminding tens of thousands of pharmacies around the country that they risk violating civil rights laws if they refuse to fill orders for contraception or abortion medication or discriminate based on a person's pregnancy status. The action comes a few weeks after the Supreme Court overturned Roe v. Wade and gave more than a dozen states a green light to ban abortion, and aims to respond to a wave of reports that pharmacies in those states are refusing to not only fill prescriptions for abortion and contraception pills but also other medications that they speculate could be used off-label to terminate a pregnancy. "Under federal civil rights law, pregnancy discrimination includes discrimination based on current pregnancy, past pregnancy, potential or intended pregnancy, and medical conditions related to pregnancy or childbirth," reads new guidance, which the Department of Health and Human Services is sending to more than 60,000 retail pharmacies this week. Citing provisions in the Affordable Care Act and the Rehabilitation Act of 1973, the memo argues that pharmacies that receive federal funding can't discriminate based on their views on contraception and abortion "in regard to supplying medications; making determinations regarding the suitability of a prescribed medication for a patient; or advising patients about medications and how to take them." The guidance includes several examples of situations that could be a legal violation, including a pharmacist refusing to fill a prescription for the abortion pill mifepristone for someone experiencing the kind of early miscarriage that the pill is used to treat. A senior HHS official told reporters on a call Wednesday that patients who believe they have been discriminated against by a pharmacy can file a complaint on the website of the agency's Office of Civil Rights and that office would investigate it and work with the pharmacy in question on a "corrective action."

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Biden Administration Looks to Protect Abortion Rights of Migrant Minors Following Dobbs Ruling

CNN, July 21, 2022

The Biden administration is working on ways to protect the abortion rights of pregnant migrant minors who are in government custody following the Supreme Court's ruling overturning Roe v. Wade last month, according to a source familiar with the discussions. The Supreme Court's decision to eliminate a constitutional right to abortion has placed added pressure on the administration to protect abortion rights, including for those in government custody. Federal agencies have been caught in the crosshairs as they try to navigate states that ban or will ban abortion. The Department of Health and Human Services, for example, is charged with the care of migrant children who arrive in the United States without a parent or guardian until they're released to a sponsor, like a relative, in the country. Some of those minors can be pregnant when they come into custody, making the shifting legal landscape difficult for shelter providers to navigate. "The Dobbs ruling has created an untenable and dangerous situation for pregnant girls in the custody of the Office of Refugee Resettlement, many of whom have fled from extreme violence and abuse," said Neha Desai, senior director of immigration at the National Center for Youth Law. "It is critical that this administration take a stand to protect the basic health of these girls by issuing clear guidance ensuring access to abortion services for girls, regardless of what state they happen to be placed in," she added. As of July 18, there were 11,483 children in HHS custody, according to government data. It's unclear how many pregnant girls are currently in custody, or how many have sought abortions. Minors are given an initial medical exam, including a pregnancy test for girls. If pregnant, the Office of Refugee Resettlement, an agency within HHS, usually places girls in licensed shelters that can provide needed services. ORR has previously released guidance specific to reproductive health care services, including abortion.

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How Limiting Access to Abortion Limits Access to Birth Control

FiveThirtyEight Politics, July 13, 2022

Planned Parenthood has been controversial since its 1916 founding, but the latest wave of political battles against it began in earnest in 2007, when then-Rep. Mike Pence introduced an amendment to a House of Representatives' appropriations bill to block federal funds from going to the organization's nationwide network of reproductive health clinics. Planned Parenthood was targeted because it's the largest abortion provider in the United States, but it wasn't its abortion services that were on the chopping block. Federal law already prohibits federal funds from being used for abortion services. Instead, the bill would have ended payments to Planned Parenthood for other health services, like cancer screenings, testing for sexually transmitted infections, regular reproductive health exams and contraception. The goal of Republican pro-life lawmakers like Pence has long been to put abortion clinics out of business. But what the long-running fight against Planned Parenthood and other abortion providers shows is that access to abortion and birth control are often linked. In fact, almost all clinics that provide abortion services also provide contraceptive services. In many states, anti-abortion politics can limit patients' access to contraception, especially low-income women who rely on publicly funded clinics. That could be even more true as some abortion clinics around the country start to close following the Supreme Court's ruling last month overturning the constitutional right to abortion. For many people worried about an unplanned pregnancy, all of the tools that they might use to prevent one – from birth control to abortion – are out of reach simply because of where they live. "My biggest fear right now is the fact that, as we are heading into this post-Roe phase, is that red states – and especially red Southern states – where there are already so few Planned Parenthoods, are going to lose them and as those are in essence, the same place that people can even get contraception, it's going to make all of this so much more dire," said Robin Marty, director of operations for the West Alabama Women's Center.

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Colleges Navigate Confusing Legal Landscapes as New Abortion Laws Take Effect

NPR, July 19, 2022

If a University of Michigan student walks into the school's Ann Arbor health center and learns they're pregnant, the health worker's response is never exactly the same. "It's easy to list: 'Well, you can continue a pregnancy, or you can consider a medication abortion or ... a surgical procedure,'" says Dr. Susan Dwyer Ernst, chief of gynecology at the University Health Service. "But we take those conversations in the context of the human being who's sitting in front of us." In the wake of the U.S. Supreme Court's overturning of Roe v. Wade, Ernst has been thinking a lot about how those conversations with students will change. Michigan is one of several states with long-standing abortion laws that weren't enforced while Roe guaranteed the constitutional right to abortion. Now, as abortion-banning state laws take effect, university health centers across the U.S. are trying to figure out their rights and responsibilities when counseling students. And another thing is adding to the confusion: In some states, it's unclear whether individuals could be prosecuted for helping pregnant students get the resources they need to obtain an abortion, including transportation or funding. "While some states have laws that specifically make aiding and abetting an abortion illegal, it may still be illegal to do so in other states even if they don't have that language in their abortion statute," says Kimberley Harris, who teaches constitutional law and reproductive rights at Texas Tech University School of Law. States typically have laws that make it illegal to aid someone in committing a crime, like robbing a bank. "If abortion is a crime, it would be illegal to aid and abet someone in procuring an illegal abortion," Harris says. Dr. Jessica Higgs, president of the American College Health Association, which represents over 700 institutions of higher education, says larger universities are likely better equipped to navigate this confusing legal landscape.

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