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Roe v. Wade.

Bonfire said:
I have ZERO confidence in SCOTUS at this point. Follow the Constitution? Naw, not if you can misinterpret it and rewrite it.
Click to expand...

Yep, didn't each of the newest appointees say they believed in precedent? I guess that only applies to certain precedents. Not the ones they don't like. They lied just to get through confirmation. Sorry, but for lying like that, they should not only be removed, but disbarred.
 
Matata said:
I've no confidence in them either but I have to hope that any attempt to overturn either of those decisions would lead to a massive rebellion at least on the part of a huge number of women.
Click to expand...

They.don't.care. :x2
 
Bonfire said:
Oh clearly the conservatives on SCOTUS have an agenda and it’s not the Constitution.
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Unfortunately they all have an agenda and none of them innocent
 
Tell me these people aren't monsters.
Go on.
8-12 year olds.
jessica.substack.com

Abortion, Every Day (2.21.24)

Tennessee GOP says child rape victims must carry pregnancies to term
jessica.substack.com jessica.substack.com
Here's your judge.
www.huffpost.com

Alabama Justice Who Ruled That Embryos Are ‘Children’ Appeared On QAnon Conspiracist's Show

Alabama Chief Justice Tom Parker indicated on the show he was a proponent of the “Seven Mountains Mandate,” an explicitly theocratic doctrine at the heart of Christian nationalism.
www.huffpost.com www.huffpost.com
 
@ItsMainelyYou I’d LOVE to be more involved in this thread but I’d be banned quickly and I’d end up getting the entire thread removed

BECAUSE WE CANNOT TALK ABOUT ANYTHING HERE THAT MIGHT OFFEND A SPONSOR
 
ItsMainelyYou said:
Tell me these people aren't monsters.
Click to expand...

Yes, there are many monsters all around us. Unfathomable yet here we are...the thing is we cannot pick and choose...if our behavior is monstrous regarding some issues how can one expect it to be civilized and compassionate in other areas? Sorry I am skirting around the specifics because as Monnie said we would be banned if we spoke the truth with details and facts. But think about what I am saying. Look at Tik Toc. Look at Instagram. Look at any and all social media. Do you see compassionate "humanity" in those posts? I do not. The opposite is what I see. Hence my prediction for a poor prognosis for mankind. While I may not be around to see my prediction come true I am quite sure, if we remain on this path, that is what shall happen. And TBH it would be a blessing to the rest of the planet including animals and the earth. Because we are destroying everything good in our path.

"Humans are a plague on this earth"
David Attenborough

​

 
Judaism's view on abortion and when human life begins. I agree 100%


"
  • Does Jewish law state that life begins at conception? No, life does not begin at conception under Jewish law. Sources in the Talmud note that the fetus is “mere water” before 40 days of gestation. Following this period, the fetus is considered a physical part of the pregnant individual’s body, not yet having life of its own or independent rights. The fetus is not viewed as separate from the parent’s body until birth begins and the first breath of oxygen into the lungs allows the soul to enter the body.
  • Does Jewish law assert that it is possible to murder a fetus? No, Jewish law does not consider a fetus to be alive. The Torah, Exodus 21:22-23, recounts a story of two men who are fighting and injure a pregnant woman, resulting in her subsequent miscarriage. The verse explains that if the only harm done is the miscarriage, then the perpetrator must pay a fine. However, if the pregnant person is gravely injured, the penalty shall be a life for a life as in other homicides. The common rabbinical interpretation of this verse is that the men did not commit murder and that the fetus is not a person. The primary concern is the well-being of the person who was injured.
  • According to Jewish law, is abortion health care? Yes, Jewish sources explicitly state that abortion is not only permitted but is required should the pregnancy endanger the life or health of the pregnant individual. Furthermore, “health” is commonly interpreted to encompass psychological health as well as physical health. NCJW advocates for abortion access as an essential component of comprehensive, affordable, confidential, and equitable family planning, reproductive, sexual health, and maternal health services.
  • What does Jewish law say about the rights of the person who is pregnant and the rights of the fetus? Judaism values life and affirms that protecting existing life is paramount at all stages of pregnancy. A fetus is not considered a person under Jewish law and therefore does not have the same rights as one who is already alive. As such, the interests of the pregnant individual always come before that of the fetus.
  • Do abortion bans unduly favor one religious viewpoint over another? Yes, different religions believe that human life begins at different stages of development. Science can explain developmental timelines, but philosophic and religious viewpoints largely determine what exactly defines “life” or “personhood” for each individual. NCJW believes, as the First Amendment to the US Constitution guarantees, that no one religion should be enshrined in law or dictate public policy on any issue — including abortion.

"
 
@missy and @PinkAndBlueBling -

I stole your posts (missy, yours is just the link) and reposted them on my FB page. Let me know if that's not ok, and I'll remove.
 
This is funny and ridiculous, but the person has a point!

GHiJe3_XUAArhqy.jpg
 
ItsMainelyYou said:
Tell me these people aren't monsters.
Go on.
8-12 year olds.
jessica.substack.com

Abortion, Every Day (2.21.24)

Tennessee GOP says child rape victims must carry pregnancies to term
jessica.substack.com jessica.substack.com
Here's your judge.
www.huffpost.com

Alabama Justice Who Ruled That Embryos Are ‘Children’ Appeared On QAnon Conspiracist's Show

Alabama Chief Justice Tom Parker indicated on the show he was a proponent of the “Seven Mountains Mandate,” an explicitly theocratic doctrine at the heart of Christian nationalism.
www.huffpost.com www.huffpost.com
Click to expand...

And this is why women will end up going for back door abortions again.
 
@Snowdrop13, If I recall correctly you are not in the US. Does the country (I believe Sweden) you live in feel the US has lost it’s mind on the abortion issue?
 
Calliecake said:
@Snowdrop13, If I recall correctly you are not in the US. Does the country (I believe Sweden) you live in feel the US has lost it’s mind on the abortion issue?
Click to expand...

Hi @Calliecake, I wish I lived in Sweden but no, I’m in the U.K. I think overall we’re pretty puzzled about a lot of things that are happening in the US at the moment. Our own abortion laws have been set since the 60’s and don’t really excite much coverage, I think, apart from a tiny, religious minority they are just accepted as they are. Personally, growing up I always looked to the States as the “Land of the Free”, being a source of great modernity and culture, somehow you seem to be going backwards? It worries me a bit.
 
"

Alabama Passes Law Protecting IVF Providers From Legal Liability​

— But lawmakers shied away from addressing legal status of embryos created in IVF labs​

by Associated Press March 7, 2024


Facing pressure to get in vitro fertilization services restarted in the state, Alabama's governor swiftly signed legislation into law Wednesday shielding doctors from potential legal liability raised by a court rulingopens in a new tab or window that equated frozen embryos to children.

Republican Gov. Kay Ivey signed the bill after it was approved in a late-night session by lawmakers scrambling to address a wave of criticism after services were halted at some of the state's largest fertility clinics. Doctors from at least one clinic said they would resume IVF services on Thursday.



"I am pleased to sign this important, short-term measure into law so that couples in Alabama hoping and praying to be parents can grow their families through IVF," Ivey said.

Republicans in the GOP-dominated Alabama Legislature opted to back the immunity proposal as a solution to the clinics' concerns. But they shied away from proposals that would address the legal status of embryos created in IVF labs, action that some said would be needed to permanently settle the issue.

The Alabama Supreme Court last month ruled that three couples whose frozen embryos were destroyed in an accident at a storage facility could pursue wrongful death lawsuits for their "extrauterine children." The ruling, treating an embryo the same as a child or gestating fetus under the wrongful death statute, raised concerns about civil liabilities for clinics. Three major IVF providers paused services.

The new law, which took effect immediately, shields providers from prosecution and civil lawsuits "for the damage to or death of an embryo" during IVF services. Civil lawsuits could be pursued against manufacturers of IVF-related goods, such as the nutrient-rich solutions used to grow embryos, but damages would be capped to "the price paid for the impacted in vitro cycle."



Patients and doctors had traveled to Montgomery to urge lawmakers to find a solution. They described appointments that were abruptly canceled and how their paths to parenthood were suddenly put in doubt.

Doctors from Alabama Fertility, one of the clinics that paused IVF services, watched as the bill got final passage. They said it will allow them to resume embryo transfers "starting tomorrow."

"We have some transfers tomorrow and some Friday. This means that we will be able to do embryo transfers and hopefully have more pregnancies and babies in the state of Alabama," Mamie McLean, MD, said after the vote.

The University of Alabama at Birmingham similarly said it is "moving to promptly resume IVF treatments."

Liz Goldman was at home giving her daughter a bottle as she watched the Senate vote on a livestream. "She didn't understand, but it made me excited," Goldman said of her daughter.



Goldman, whose daughter was conceived through IVF after a uterus transplant, hopes to become pregnant with a second child. But her plans were cast into doubt when IVF services were paused. With a team of doctors involved in her care, she couldn't just move to another state, she said.

"I'm super thankful. The past two and a half weeks have been the most stressful time of my journey and I've been through a lot," Goldman said.

Republican Sen. Larry Stutts, MD, an obstetrician who cast the lone no vote in the Senate Wednesday, said the bill is an "IVF provider and supplier protection bill" and does not protect patients.

"It is actually limiting the ability of mothers who are involved in IVF to have recourse and it is placing a dollar value on human life," Stutts said.

House Democrats proposed legislation stating that a human embryo outside a uterus cannot be considered an unborn child or human being under state law. Democrats argued that was the most direct way to deal with the issue. Republicans did not bring the proposal up for a vote.



"We aren't providing a solution here," said Rep. Chris England, a Democrat from Tuscaloosa. "We're creating more problems. We have to confront the elephant in the room."

State Republicans are reckoning with a crisis they partly helped create with anti-abortion language added to the Alabama Constitution in 2018. The amendment, which was approved by 59% of voters, says it is state policy to recognize the "rights of unborn children."

The phrase became the basis of the court's ruling. At the time, supporters said it would allow the state to ban abortion if Roe v. Wade were overturned, but opponents argued it could establish "personhood" for fertilized eggs.

England said the legislation is an attempt to play "lawsuit whack-a-mole" instead of confronting the real issue -- the implications of personhood-like language in the Alabama Constitution.

The American Society for Reproductive Medicine, a group representing IVF providers across the country, says the legislation does not go far enough. Sean Tipton, a spokesperson for the organization, said this week that the legislation does not correct the fundamental problem, which is the court ruling "conflating fertilized eggs with children."



The bill's sponsors, Republican Sen. Tim Melson, MD, and Republican Rep. Terri Collins, said the proposal was the best immediate solution they could find to get IVF services resumed.

"The goal is to get these clinics back open and women going through their treatment and have successful pregnancies," Melson said.

Republicans are also trying to navigate tricky political waters -- torn between widespread popularity and support for IVF -- and conflicts within their own party. The leaders of several anti-abortion and conservative groups, including Students for Life Action and Susan B. Anthony Pro-Life America, urged Ivey to veto the bill, which they called a "rash reaction to a troubling situation."

"Any legislation on this issue must take into consideration the millions of human lives who face the fate of either being discarded or frozen indefinitely, violating the inherent dignity they possess by virtue of being human," they wrote.



Melson and Collins said lawmakers may have to explore additional action, but said it's a difficult subject.

"I think there is too much difference of opinion on when actual life begins. A lot of people say conception. A lot of people say implantation. Others say heartbeat," Melson said when asked about proposals to say frozen embryos couldn't be considered children under state law.

Melson, who is a doctor, said any additional legislation should be "based on science and not just gut feelings."

"I can tell you right now there are a lot of different opinions on what the right thing to do is," he said.




"
 
missy said:
"I can tell you right now there are a lot of different opinions on what the right thing to do is," he said.
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It can be wrong to do something that is right. It's wrong to kill yet we send our soldiers to kill others and risk their own deaths to protect the country. It's wrong to kill yet we pull the plug on loved ones who have no hope of recovery. It may be morally wrong to end a potential human life still in utero yet it is right for a woman to choose what happens to her body and to choose her medical care.

missy said:
"I think there is too much difference of opinion on when actual life begins. A lot of people say conception. A lot of people say implantation. Others say heartbeat," Melson said when asked about proposals to say frozen embryos couldn't be considered children under state law.
Click to expand...

It's been my opinion for a very long time that the debate on when life begins is useless. While a more brutal approach, we need to accept (never gonna happen) that (1) abortion at any stage of fetal development is the ending of a potential human being and (2) the decision should be made only between the person carrying the potential human being and her medical care provider.

When it comes to abortion, ignorance is bliss. If we enact federal law protecting the right to abortion, stop talking about it, stop keeping stats on it, then those who oppose abortion won't know when or how often it happens and then they can't continue to hold on to their anger and moral outrage about something they can't prove exists.

Screenshot 2024-03-08 at 9.54.30 AM.png
 
Matata said:
the decision should be made only between the person carrying the potential human being and her medical care provider.
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100% agree-this is what it boils down to

:appl:
 
Someone gave a speech last night and included some remarks about Roe v Wade, looked the SCOTUS justices right in the eyes and said “With all due respect justices, women are not without electoral or political power…you're about to realize just how much.” I hope that prediction comes true.
 
Thank you for your reply @Snowdrop13. I always wonder if people living elsewhere think our country has lost their mind.
 
Calliecake said:
I always wonder if people living elsewhere think our country has lost their mind.
Click to expand...

I have a friend who lives in Sweden and during previous conversations he has described the US as a "false democracy" where basic human rights are constantly violated. He has a friend over there, a young mother with a special needs kid, and, as you can imagine, their life isn't at all easy, so it's a bit personal for him. And besides, Sweden is quite a phenomenal country, really raising the bar. Few places can compare and compete.

I also live in Europe and I am saddened by everything I see. My country has a whole lot of issues all on its own, but even so... to be fully honest, if I was given the free choice to stay here or to move to the US... I wouldn't. Not that there aren't good things, much better things there. But the things that would be worse carry a lot more significance for me, personally, and so they outweigh the good.
 
"

Trump Suggests He Would Support a National 15-Week Abortion Ban​

— At the same time, he said, "It shouldn't be a federal issue, it's a state issue"​

by Associated Press March 20, 2024



Donald Trump suggested Tuesday that he'd support a national ban on abortions around 15 weeks of pregnancy, voicing for the first time support for a specific limit on the procedure.
The Republican former president has taken credit for striking down a federally guaranteed right to abortion by appointing three U.S. Supreme Court justices who voted to overturn Roe v. Wade. As he seeks the White House a third time, Trump has refrained from embracing any specific limit on the procedure, warning it could backfire politically, and instead suggesting he would "negotiate" a policy on abortion that would include exceptions for cases of rape, incest, and to protect the life of the mother.

But in a radio interview Tuesday, Trump criticized Democrats for not endorsing a ban that would limit abortions in states that still allow the procedure.
"We're going to come up with a time -- and maybe we could bring the country together on that issue," Trump said while calling into the "Sid & Friends in the Morning" show on WABC.
Trump went on to say: "The number of weeks now, people are agreeing on 15. And I'm thinking in terms of that. And it'll come out to something that's very reasonable. But people are really, even hard-liners are agreeing, seems to be, 15 weeks seems to be a number that people are agreeing at."
At the same time, Trump seemed to suggest reluctance to a federal ban.
"Everybody agrees -- you've heard this for years -- all the legal scholars on both sides agree: It's a state issue. It shouldn't be a federal issue, it's a state issue," he said.

Last month, Trump's campaign dismissed reportsopens in a new tab or window that he privately had expressed support for a ban on abortion after 16 weeks of pregnancy, calling the report "fake news." The campaign did not offer details on Trump's plans, only saying he planned to "negotiate a deal" on abortion.
Later Tuesday, after casting his ballot in Florida's Republican presidential primary, Trump was asked by a reporter about a ban on abortions at 16 weeks and said, "We'll be talking about that soon."
Abortion rights have been a galvanizing issue for voters in recent years, and Democrats and President Joe Biden's campaign are preparingopens in a new tab or window to spotlight the issue as a clear split from Trump in the 2024 election.
Polling has consistently shown that most Americans believe abortion should be legal through the initial stages of pregnancy. About half of U.S. adults said abortions should be permitted at the 15-week mark, according to an Associated Press-NORC Center for Public Affairs Research poll conducted last June.

"
 
"

An important abortion case​

Author HeadshotBy Emily Bazelon
Staff Writer, NYT Magazine
How safe is it to take abortion pills? The F.D.A., the nation’s authority on drug regulation, says that it’s very safe. But the agency’s judgment is the topic of a sweeping challenge that the Supreme Court will hear tomorrow. The case could curtail Americans’ access to mifepristone, the first pill taken in a two-drug regimen for a medication abortion.

Pills now account for most abortions in the United States. Increasingly, people take the medications at home. About 14,000 medication abortions per month are now prescribed online, with pills sent through the mail.

In today’s newsletter, I’ll explain how the suit against the F.D.A. seeks to shut down this form of access and impose other restrictions. A decision in the plaintiff’s favor would change the landscape of abortion not state by state, like the effects of the 2022 ruling that overturned Roe v. Wade, but across the country.

Post-Roe America​

The abortion opponents who sued the government in tomorrow’s case, F.D.A. v. Alliance for Hippocratic Medicine, are frustrated by how common abortion has remained. Since the high court struck down Roe, 16 states have banned or severely restricted the procedure. In those places, some women who would have ended their pregnancies are carrying them to term, as my colleagues Margot Sanger-Katz and Claire Cain Miller have explained. But the total number of abortions across the country has not fallen. It may actually have increased.

That’s in large part because of abortion pills, which the F.D.A. first approved in 2000. “In the six months after the Supreme Court overturned Roe, the rise in the supply of pills outside of clinics significantly made up for the reduction in abortions otherwise,” said Abigail Aiken, a professor of public affairs at the University of Texas at Austin with a new study on the topic. In some states, CVS and Walgreens recently started dispensing mifepristone along with misoprostol, the second abortion pill, in stores with a prescription.

Protesters holding signs stand outside the Supreme Court.
Outside the Supreme Court in June. Haiyun Jiang for The New York Times​
The F.D.A. laid the foundation for these changes. In 2016, it let nurses and others prescribe mifepristone. It also permitted patients to take the pill 10 weeks into pregnancy, extending the limit from seven weeks. In 2021, the F.D.A. allowed providers to send mifepristone by mail, lifting a rule that had required an in-person medical visit. “Study after study has shown that when mifepristone is taken in accordance with its approved conditions of use, serious adverse events are exceedingly rare,” the F.D.A. said in its Supreme Court brief.

The F.D.A.’s judgment​

The plaintiffs in today’s case, a coalition of anti-abortion physicians and medical groups, say the F.D.A. is wrong. They fault the agency’s collection of data and argue that some complications go unreported, creating an incomplete picture of risk. Last year, the U.S. Court of Appeals for the Fifth Circuit agreed, ruling that the F.D.A.’s database of adverse events was “insufficient” and thus its decisions in 2016 and 2021 were invalid.

The F.D.A. says that it is using its standard system for reporting drug complications — and that it has reviewed extensive research showing that mifepristone is safe, including to take at home. Its job, the agency argues, is not to “act based on perfect data, which seldom exists” but rather to “act reasonably based on the information available.” (And in February, a journal retracted two studies highlighting purported risks of mifepristone.)

Because the F.D.A. followed its standard approval process, a victory for abortion opponents could undermine its authority to determine whether anydrugs are safe. The case has unsettled the pharmaceutical industry. Congress intended the F.D.A., not the courts, to be the “expert arbiter of drug safety,” drug companies and investors argued in a brief. They said the Fifth Circuit created “an impossibly rigid new standard for drug approval.”

Another question is whether the plaintiffs are even allowed to challenge the F.D.A. As a rule, litigants have to show that they have been harmed by an action to sue over it. The anti-abortion physicians say they may have to provide emergency care to women with incomplete abortions or other complications from taking mifepristone. The Fifth Circuit ruled this was enough, based on the likelihood that it could happen. But Supreme Court precedent rejects a statistical conception of standing.

The plaintiffs also argue that they would be harmed by feeling that they had to help complete an abortion against their conscience. The government says that this conception of harm is hypothetical. The F.D.A.’s regulations for mifepristone, after all, don’t require any doctor to do anything.

What happens next?​

If the F.D.A. loses, it’s unclear what will happen. Providers in the U.S. could still prescribe and ship misoprostol, the second abortion pill. Taken in higher doses without mifepristone, misoprostol is 88 percent effective, according to one study; the two-drug regimen is 95 percent effective or more. Misoprostol-only abortions also tend to include more hours of pain and cramping, with more side effects like nausea and diarrhea. So the upshot could be more physical discomfort for American women.

Another possibility is that more people will order the standard combination of mifepristone and misoprostol from foreign suppliers, though that market isn’t really legal.

Whatever the court decides, the future of medication abortion is in the hands of the voters as well. The president decides who runs the F.D.A. The agency has continued or expanded access to mifepristone under the past five presidents. That includes Donald Trump. But with Roe overturned and control of the F.D.A. up for grabs in 2024, there’s much more pressure to restrict abortion pills than there was before.

"
 
"

Abortion Shield Laws: A New War Between the States​

Doctors in six states where abortion is legal are using new laws to send abortion pills to tens of thousands of women in states where it is illegal.

Behind an unmarked door in a boxy brick building outside Boston, a quiet rebellion is taking place. Here, in a 7-by-12-foot room, abortion is being made available to thousands of women in states where it is illegal.

The patients do not have to travel here to terminate their pregnancies, and they do not have to wait weeks to receive abortion medication from overseas.

Instead, they are obtaining abortion pills prescribed by licensed Massachusetts providers, packaged in the little room and mailed from a nearby post office, arriving days later in Texas, Missouri and other states where abortion is largely outlawed.

This service and others like it are operating under novel laws enacted in a half-dozen states — Massachusetts, Washington, Colorado, Vermont, New York and California — that have sought to preserve abortion access since the Supreme Court overturned the nationwide right to abortion in June 2022. The laws have been in use only since the summer and have not been tested in the courts, but they are already providing abortion access to tens of thousands of women in states with bans, especially low-income patients and others who cannot travel.

Called telemedicine abortion shield laws, they promise to protect doctors, nurse practitioners and midwives licensed in those six states who prescribe and send abortion pills to patients in the nearly two dozen states that ban or sharply restrict abortion.

The laws stipulate that officials and agencies of their states will not cooperate with another state’s efforts to investigate or penalize such providers — a stark departure from typical interstate practices of extraditing, honoring subpoenas and sharing information, legal experts on both sides of the abortion issue say. Many expect them to ultimately be challenged in federal court.

Abortion opponents see the laws as brazen infringement on state sovereignty.

“You have states not just picking their own strategy but really trying to completely sabotage the governing efforts of their neighboring states,” John Seago, the president of Texas Right to Life, said.

“It can’t stand, and we can’t be content with this new development,” he added.

The threat of shield laws is one reason that three states — Idaho, Kansas and Missouri — petitioned to join a case the Supreme Court will hear next month that seeks to bar the mailing of abortion pills and to require in-person doctor visits instead of telemedicine. The petition was denied.

“When you have states actively seeking to circumvent each other’s laws, that raises a very real legal problem that will stretch far beyond just the abortion sphere,” said Will Scharf, a Republican candidate for attorney general in Missouri, who helped draft anti-abortion legislation when serving as policy director for the state’s governor six years ago.

Pills have become the most common abortion method nationally, and abortion rights advocates consider shield laws a crucial way to counter the wave of bans enacted since the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization.

“This might be the most important event since Dobbs on so many levels,” said Rachel Rebouché, the dean of Temple University Law School, who has worked with shield law advocates and legislators. “Thousands and thousands of pills are being shipped everywhere across the United States from a handful of providers. That alone speaks to the nature of what mailed medication abortion can do.”

Before shield laws were enacted, Aid Access, one of the organizations in the forefront of telemedicine abortion, served patients in states with bans by issuing prescriptions from Europe and shipping pills from a pharmacy in India. Pills could take weeks to arrive, potentially putting patients beyond 12 weeks’ gestation, the recommended threshold for taking the medication.

More on Abortion Issues in America​

With shield laws, “some people who might not have gotten an abortion if they had to take off work and go to a clinic, or wait three weeks and all of that, are doing it now,” said Dr. Linda Prine, a New York shield law provider.

Aid Access providers are now using shield laws to serve about 7,000 patients a month, nearly 90 percent of them in states with bans or severe restrictions, according to Dr. Abigail Aiken, an associate professor at the University of Texas at Austin, who studies Aid Access data.
The shield laws upend the usual telemedicine model, under which out-of-state health providers must be licensed in the states where patients are located.
Beyond providing abortion access to individual patients, the shield-law movement carries broader implications for abortion politics, and supporters are working to enact similar laws in as many states as possible so the approach becomes commonplace, according to Francine Coeytaux, a co-founder of Plan C, a clearinghouse for medication abortion information.
“The shield laws are about a state’s legislative and justice system having skin in the game,” she said.




Carol, who asked to be identified by her middle name to help keep her role private, met me behind the brick building outside Boston and escorted me through a back door, down a warren of hallways. Others who rent offices in the building haven’t asked what she does there, she said, adding: “I’m kind of hoping that most people aren’t really that curious about what’s going on.”

At a plain white table, Carol, who has a master’s degree in public health, began her routine: checking a spreadsheet of prescriptions; printing out labels with medication information and patients’ names; printing address labels with tracking numbers and adding them to the spreadsheet.


Patients contact this service and others online and fill out forms providing information about their pregnancy and medical history. Carol’s colleague, Lauren Jacobson, a nurse practitioner, writes prescriptions, evaluating whether patients are medically eligible. They can be up to 12 weeks pregnant and must have no disqualifying medical issues like an ectopic pregnancy or a blood-clotting disorder. Patients and providers can communicate by email or phone if needed.

“We’re a free country,” said Ms. Jacobson, who sometimes writes 50 prescriptions a day. “So let’s put that to the test. Here we are and we’re not going to be intimidated, and we have our states backing us.”

Carol pulled the two abortion medications from storage boxes: mifepristone, which stops a pregnancy from developing, and misoprostol, taken 24 to 48 hours later to spur contractions to expel pregnancy tissue.


“I don’t really consider myself a rule breaker,” she said. “So it’s funny that here I am sitting in this tiny little closet surrounded by pill bottles.”
A silhouette of a woman walking out a door carrying a bag.

Carol and others who use shield laws to send abortion pills to patients are taking precautions to protect themselves, including not traveling to states with abortion bans, where they could be more vulnerable to arrest.Credit...Sophie Park for The New York Times
The operation resembles a small-scale assembly line, preparing medication for six packages at a time: one mifepristone pill in a manufacturer’s prepackaged box and 12 misoprostol tablets counted out by hand from bottles of 100 supplied by a wholesaler. Carol slid the medications into plain envelopes lined with bubble wrapping, along with a 10-page pamphlet from the mifepristone manufacturer and illustrated instructions from Aid Access about taking the medication and expected side effects, like cramping and bleeding.
She drove several miles to a post office to mail the envelopes.
“Getting ready for Christmas?” another customer in the post office asked one day, she recalled.
“Surprise, I’m actually Santa Claus,” she replied cheerfully.
One of Carol’s envelopes arrived at the home of Ashley Dickey in Texas.

Ms. Dickey has two young children and said she had experienced serious postpartum depression after those pregnancies. She said she dissolved in tears when she became pregnant again and concluded that she could not manage another pregnancy and raise another child. “It’s just not good for anybody,” she said.
When she learned she could receive pills by mail, “I was so grateful,” she said, adding, “If I would have had to travel somewhere, it would have been catastrophic, financially and then just emotionally.”



Reaching low-income patients​

Supporters say shield laws are already making substantial progress toward an important goal: helping patients who cannot afford — financially or logistically — to travel to another state for an abortion.

“It’s reaching the ones that were impacted the most: low-income, poor people, communities of color, Indigenous,” said Michelle Colón, the executive director of SHERo Mississippi, an organization supporting reproductive rights for people of color.

Nationally, there are three main providers: Aid Access; the Massachusetts Medication Abortion Access Project (called The MAP); and a service called Abuzz, which does not yet serve all states with abortion bans. They charge $150 or $250, though all three services provide pills for reduced prices or even at no cost, based solely on what patients say they can pay.

Dr. Rebecca Gomperts, a Dutch physician who founded Aid Access, said over half of its shield-law patients cannot pay full price. About a third of The MAP’s patients can afford only the service’s $5 minimum, said Dr. Angel M. Foster, director of The MAP.

But shield-law providers say it is uncertain whether they can sustain their pay-what-you-can approach. Most providers are
absorbing the cost for thousands of patients who can’t pay full price. So far, most abortion funds — organizations that provide financing to help patients obtain abortions — have not given money for sending pills to anti-abortion states, partly because they do not know if shield laws would protect the funds.
“I’ve had several funds say, ‘Our lawyers say we cannot do this,’” said Susan Yanow, a longtime reproductive health activist working with The MAP, who has nonetheless gotten some funds to contribute.
A few funds openly support shield-law activity. “We are here to boldly make a statement,” said Karen Middleton, president of Cobalt Abortion Fund in Colorado, which gives $2,500 a month to that state’s provider. And some advocates are starting funds, including Jodi Jacobson, an activist based in California, who said she wanted to support “providers who are losing money” performing what she called “medical civil disobedience.”



Several Republican attorneys general from states with strict abortion prohibitions declined requests to discuss shield laws. But Mr. Scharf, who is challenging Missouri’s incumbent attorney general in the Republican primary, predicted that the shield laws would almost certainly be challenged in court.

“Constitutional litigation is obviously an option here,” he said. “Ultimately, whenever you get attempts like this to circumvent our constitutional system of federalism, that’s going to be something that’s litigated.”

Dr. Seago of Texas Right to Life said taking action against shield-law providers would be “a difficult challenge” that would require “the right case,” including a patient “on the receiving side of those illegal activities” who would cooperate with a civil suit or prosecution.

“We can definitely promise that in a pro-life state like Texas with committed elected officials and an attorney general and district attorneys who want to uphold our prolife laws, this is not something that’s going to be ignored for long,” he said.

Many shield-law providers are taking precautions, including not traveling to states with abortion bans, where they could be more vulnerable to arrest. Some are not sending pills to states where they have family. Some are creating trusts to protect their assets from civil suits.

“At any moment, I might get a cease-and-desist order, or I might get a lawsuit, or I might get some district attorney coming after me, I have no idea,” said Dr. David Wiebe, who operates under Colorado’s shield law. “I’m absolutely flying out at full risk here.”

The MAP has taken several protective steps. All of its prescribers are within Massachusetts. Pills are stocked and packaged at a separate location by workers hired by Cambridge Reproductive Health Consultants, a nonprofit Dr. Foster leads. “Our model is about distributing risk,” she said.

One national mail-order pharmacy, Honeybee Health, based in California, is evaluating whether it can send pills to states with abortion bans under California’s shield law, a step that would allow providers in any shield-law state to send their prescriptions to Honeybee and avoid stocking and shipping pills themselves.

Honeybee’s co-founder and president, Jessica Nouhavandi, said she hoped to do so, but worried about jeopardizing her business, which dispenses other medications too. If an anti-abortion state like South Carolina pulled her license, “what happens to my thousands of South Carolina patients who get their blood thinners from me?” she said.

Another unknown is the outcome of the lawsuit by abortion opponents seeking to curtail mifepristone. An appeals court rulingeffectively barred the mailing of mifepristone and required in-person doctor visits. The case is now before the Supreme Court.

“If we prevail on that, all these shield laws will be rendered moot at that point because then there’ll be a federal policy prohibiting such a transaction,” said Erik Baptist, senior counsel for the Alliance Defending Freedom, which represents abortion opponents in that case. Some shield law providers say they will look for legal ways to continue.

Texas, which has strict bans, is home to about a third of shield-law patients, including Elizabet, who asked to be identified by her middle name to protect her privacy. She considered traveling to California, where a friend lives, but medication abortion at a clinic there would cost $750, plus transportation expenses.

She was relieved to find Aid Access and to receive pills mailed from Massachusetts. Although abortion bans target providers and not patients, she said she was still nervous about people in Texas finding out.

“That’s been very scary,” she said, “but I was like, you know what, I have to trust it.”
Weeks later, Elizabet said she planned to visit a doctor for birth control, but worried about being asked if she’d taken abortion pills.
Ms. Jacobson, who prescribed her the medication under Massachusetts’ shield law, reassured her, noting that there was no medical reason to disclose having taken abortion pills.
“The symptoms that the abortion pills cause are exactly the same as those that a miscarriage causes, so there is no possible way for a provider, a doctor, to look at you, do any test and know that you took the pills,” she said, adding, “We’ve helped a lot of people navigate situations in places like Texas.”
Pam Belluck is a health and science reporter, covering a range of subjects, including reproductive health, long Covid, brain science, neurological disorders, mental health and genetics. More about Pam Belluck

"
 
I think it was asked up thread what others outside of the US think of the current situation (or maybe it was another thread). Newspapers in the UK routinely report on the abortion situation and this article was on the BBC website this morning https://www.bbc.co.uk/news/world-us-canada-68580015 "Anti abortion activists plan backdoor strategy to US ban."

The article talks about a very old law that could be resurrected and that prevents items related to contraception and abortion being transported by post. According to the article it's also something that could be implemented with a degree of ease and that activists are trying to keep quiet, not sure how true that it, but for that reason I thought it was worth sharing.
 

More Medication Prescribed for Self-Managed Abortion After Roe Fell​

— While in-clinic abortions fell, many found other ways to access care​

by Rachael Robertson, Enterprise & Investigative Writer, MedPage Today March 25, 2024


A photo of a female physician talking to her young female patient via a laptop.

Provision of medications for self-managed abortions increased in the 6 months after Dobbs v. Jackson Women's Health Organization, a cross-sectional study found.
In the July through December period after the decision was issued in June 2022, there were an additional 27,838 (95% credible interval [CrI] 26,374-29,175) provisions of medication for self-managed abortion compared with pre-Dobbs levels, and excluding imputed data only slightly changed the results (27,145, 95% CrI 25,747-28,246), reported Abigail R.A. Aiken, PhD, of the LBJ School of Public Affairs at the University of Texas at Austin, and colleagues.

Accounting for nonuse of some medications, the researchers estimated that an additional 26,055 (95% CrI 24,739-27,245) self-managed medication abortions occurred that wouldn't have if not for Dobbs, they wrote in JAMAopens in a new tab or window.
Community networks accounted for 51.4% of all provisions, telemedicineopens in a new tab or window for 37.2%, and online vendors for 11.4%.
Previous research has shown an overall drop in abortions after the Dobbs decision overturned Roe v. Wade in June 2022. In the 6 months after Dobbs, an estimated 32,260 fewer abortions took place, according to the #WeCount reportopens in a new tab or window from the Society of Family Planning. This was expected, as traveling for abortion care can be expensive and logistically taxing. In the first half of 2023, the birth rate in states with abortion bans increased by 2.3% compared to states without total bans.
Ultimately, Aiken's group concluded that, despite fewer people accessing abortion from formal healthcare settings post-Dobbs, "a substantial number were able to access abortion medications outside the formal healthcare setting, despite state-level bans and restrictions," which suggests that self-managed medication abortions became more mainstream. The authors also cautioned that such individuals face unique legal risks and could have difficulty accessing post-abortion healthcare.

Caitlin Gerdts, PhD, MHS, vice president for research at Ibis Reproductive Health in San Francisco, who wasn't involved in the study, told MedPage Today that it "draws attention to two things healthcare providers need to educate themselves about as more people self-manage abortions post-Dobbs" -- how to advise patients considering this option and "how to avoid actions that put patients at risk of criminal investigation for their pregnancy outcomes."
Gerdts emphasized that the estimated number of self-managed medication abortions is not an indicator that abortion bans cause no harm. "Abortion bans cause delays in care seeking, isolate pregnant people who need care, and criminalize those who support them in accessing the care they need," she said.

Self-managing a medication abortion involves taking misoprostol alone or in combination with mifepristone (Mifeprex). On Tuesday, the Supreme Court will hear oral arguments in the case FDA v. Alliance for Hippocratic Medicineopens in a new tab or window (AHM) that will determine access to mifepristone.

Aiken's study was paired with two viewpoint articles that both urged the Supreme Court to rule in favor of the FDA and gave further context on the ramifications of potential rulings. One group led by Eve Espey, MD, MPH, University of New Mexico in Albuquerque, wrote that "a ruling against the FDA will push telemedicine abortion toward these informal online pathways, further stigmatizing a basic component of comprehensive healthcare."
In the other article, Holly Fernandez Lynch, JD, MBE, of the University of Pennsylvania in Philadelphia, and Aaron S. Kesselheim, MD, JD, MPH, of Harvard Medical School in Boston, wrote that "the Supreme Court should avoid inappropriate intrusion into FDA's public health mission by firmly rejecting efforts to second-guess the agency's scientifically supported approach to relaxing mifepristone restrictions."
Aiken's group analyzed data from March 1 to December 31, 2022, which was broken into two time periods: the pre-Dobbs baseline from March 1 to April 30 and the post-Dobbs time period from July 1 to Dec. 31. They analyzed provision volume data, which authors defined as the number of provisions of the abortion medications, from online telemedicine organizations, community networks, and online vendors. Eleven of the 15 unique sources (constituting most, if not all, active sources for self-managed abortion in the U.S.) provided data for the study, and the remaining four online vendors' data was estimated based on outbound clicks on their websites. For umbrella organizations, they aggregated data across subsources to avoid duplicates. Advance provision data was excluded and missing values were imputed.

To estimate actual use, authors multiplied the provision of medications by an assumed usage rate, which varied by source type. Based on preexisting data, the assumed use rate of medication obtained via telemedicine was 88%, via community networks was 98.5%, and from online vendors was 86%. The primary outcome was the provision and use of medications for self-managed abortion.
Aiken and colleagues noted several limitations, including that they were not able to cross-reference provisions across sources, which meant that some shipments from multiple sources could have been for the same person, although applying a use rate helped mitigate this problem. Plus, while sources excluded advance provision, not all asked about clinical history; and thus it's unknown whether provisions were for immediate or future use. Additionally, not all data sources kept formal records, and the authors therefore couldn't verify all data. Lastly, the authors could only obtain 2 months of pre-Dobbs data.
In the future, research should explore the relative contributions of service delivery models, they suggested.

  • author['full_name']

    Rachael Robertson is a writer on the MedPage Today enterprise and investigative team, also covering OB/GYN news. Her print, data, and audio stories have appeared in Everyday Health, Gizmodo, the Bronx Times, and multiple podcasts.
 

Texas Medical Board Doesn't Specify Abortion Ban Exceptions in Proposed Rules​

— Critics call for further clarification around medical exceptions of Texas abortion ban​

by Joyce Frieden, Washington Editor, MedPage Today March 25, 2024


The Seal of the Texas Medical Board over a photo of the Austin skyline at dusk

The Texas Medical Board has issued proposed rulesopens in a new tab or window for when emergency abortions can legally be performed under the state's 6-week abortion ban -- but it won't specifically enumerate those exceptions.
The proposed rules come in response to a law that took effect in September 2021, which banned abortions after 6 weeks' gestation except to save the life of the mother; there are no exceptions for rape or incest. The question that emergency physicians and other clinicians who provide abortions must now answer is, under what circumstances an abortion would meet that life-saving condition.

"The Texas Supreme Court heard a case around a particular individual, and as part of that rulingopens in a new tab or window, they said that it would help for the Texas Medical Board to provide some guidance as far as the exceptions for abortions under the statute," Sherif Zaafran, MD, president of the Texas Medical Board, said during an online interview with MedPage Today at which a press person was present.
Zaafran was referring to the case of Cox v. Texasopens in a new tab or window, in which Kate Cox, a 31-year-old expectant mother of 20 weeks' gestation, filed a suit seeking permission to have an abortion after her fetus was diagnosed with full trisomy 18. The court ruled against Cox, who ended up traveling out of state in order to terminate the pregnancy.
"At that point, we didn't really delve into it too much," said Zaafran. "We just kind of stayed a little bit away from the issue since a lot of it was in litigation."

However, after the case was over, "we did get a formal petition from two lawyers" asking that we write rules on when abortion would be permissible, "and we as a medical board are required to give an answer to that petition -- we have 60 days to answer that," he said. "And that petition essentially asked us to ... give some ideas as far as looking at a list of exceptions and so forth."
The board issued its proposed rules on Friday; the rules do not give specific circumstances in which an emergency abortion would comply with the law, except for ectopic pregnancies -- which are already listed as an exception in the law itself.

Pro-choice groups were not happy with the proposed rule. "While we are hopeful that the Texas Medical Board will take seriously this opportunity to help clarify the medical exception to Texas' abortion ban, its current proposal falls short of that goal," Molly Duane, JD, senior staff attorney at the Center for Reproductive Rights, said in a statement Friday. "The rules [that the] Texas Medical Board proposed today contain more of the same rhetoric we have been hearing for years: that physicians should just read the language of the exception and exercise their reasonable medical judgment."

But Zaafran said there were good reasons that the board didn't get specific in its rules. "It's the exact same process of what you would prudently do in an emergency type of setting. That has not changed," he said. "You as a physician, understand that there may be a case where somebody's life is in danger, or where there may be permanent bodily injury or harm. And in all those instances ... whether it involves abortion or not abortion, we always ask the same thing, which is use your medical judgment and determine if it is an emergency."
One issue is that what constitutes an emergency requiring an abortion may be different depending on location, he continued. "What you may do in a rural area may be very different from what you may do in an urban area. And that's why having an exhaustive list doesn't really work. Because the circumstances and the place where it may happen may be very different."

For example, he said, "if you're in a rural area and the person goes into heart failure, and you don't have the capabilities to use an ECMO [extracorporeal membrane oxygenation] machine. ... They may not have that capability in a rural area. [Or] let's say somebody came and they were severely septic. In an urban area, we may be able to, in that hospital, do a lot of interventions that you may not be able to do in a rural area. So the answer in the rural area may be yes, you need to do an abortion because that is the best we can do to save the patient's life, but in an urban area it may be a completely different circumstance, depending on what the capabilities are."
Another concern with the proposed rules relates to its list of documentation requirements. "The proposed rules create a new and extremely burdensome documentation system that physicians must use when providing abortions under the exception that includes documenting whether there was 'adequate time to transfer the patient by any means available' to a different facility to avoid having to perform an abortion," Duane said in the statement. "This is not what medical providers and patients need."

Zaafran said the requirements were only what would normally be necessary in such cases. "We're not increasing the burden," he said. "We're re-clarifying what we expect to answer why you are determining that something is an emergency, or why something may cause permanent harm. We would do that with anything, [such as] whether it's stating why you are taking somebody back because they have a brain bleed. And if you don't do it immediately, then there may be permanent harm. ... So all we did is reiterate what the process is."
The board will be soliciting commentsopens in a new tab or window on the proposed rules for a minimum of 30 days, he said, and will decide at its June meeting whether to accept the proposed rules as they are, or to make changes and solicit more comments. The board also is planning to have a public meeting -- both online and in-person -- for people to express their opinions on the proposed rules. Details will be posted on the board's websiteopens in a new tab or window when they become available.
  • author['full_name']

    Joyce Frieden oversees MedPage Today’s Washington coverage, including stories about Congress, the White House, the Supreme Court, healthcare trade associations, and federal agencies. She has 35 years of experience covering health policy.
 
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