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Report: Pregnant people face “systemic” barriers in states with abortion restrictions

Axios, August 25, 2022

States that have enacted abortion restrictions or bans are doing little to “support the health and economic security of pregnant and birthing people and their families,” according to a new report from the National Partnership for Women & Families first shared with Axios. Why it matters: Republicans have sought to position themselves as pro-woman and pro-family in attempts to counter criticism that the party cares about children only before they’re born. The report, which comes as three states are poised to enact trigger bans, shows that gaps in policies remain. Details: Every state that has failed to adopt Medicaid expansion – 12 in total – has implemented some form of restriction on abortion, the report notes. This leaves 2.2 million adults uninsured, the majority of whom are women of color. Several states that have abortion restrictions in place also lack postpartum Medicaid coverage beyond 60 days after birth, which the report calls a critical gap given that 33% of pregnancy-related deaths occur in the postpartum period. Black women are especially vulnerable as they are 3.5 times more likely to suffer a late maternal death compared to white women. But only 11 states and D.C. offer paid leave, including paid parental, family and medical leave, per the report. Most of the states that do not are somewhat or very restrictive on abortion. Many of these states also lack workplace protections like fair scheduling and pregnancy accommodations, notes the report, which points to Latina, Black and immigrant workers who are more likely to hold inflexible jobs and be denied requests to have a bottle of water on hand or sit instead of stand. State of play: “Then, and even more so now, getting care involves navigating multiple barriers, such as needing to travel long distances, take multiple days off from work and/or caregiving responsibilities, make multiple medically unnecessary visits to a provider, and having to pay out of pocket for abortion care,” the report states. “These barriers are further compounded by lost wages due to a lack of paid leave or sick days, the cost of accommodations and child care, and a lack of personal transportation.” Such policies have a disproportionate effect on communities of color, according to the report. Black and Native women are already three and two times more likely to die from pregnancy-related complications, respectively, compared to white women.

New Near-Total Abortions Bans Are Taking Effect in Five States This Week

The 19th, August 25, 2022

Idaho, Oklahoma, Tennessee and Texas will begin enforcing near-total abortion bans Thursday, and a fifth state – North Dakota – is set to do so Friday. By the end of the week, 12 states will have outlawed abortion in almost all instances. Abortions were legal in three of those states before this week, though they were difficult to obtain. After Roe v. Wade was overturned June 24, ending the federal right to an abortion, Idaho and Tennessee began enforcing six-week bans. Until Friday, abortion is legal in North Dakota up until 22 weeks of pregnancy, but the state’s sole clinic has already moved across the Red River, relocating in neighboring Minnesota. Oklahoma and Texas have already begun enforcing laws banning abortions, but the laws taking effect Thursday add new legal punishments for people who provide the service. The laws mark a new phase in the post-Roe world. All but Oklahoma’s bans are so-called trigger laws – state abortion bans that were crafted in anticipation of the Supreme Court eliminating federal abortion rights, which it did in its Dobbs v. Jackson Women’s Health Organization decision. Some of these laws were written to take effect 30 days after the Supreme Court issued its judgment in the case, a formality that occurred July 25. North Dakota’s ban required the attorney general to certify that Roe had been overturned – which he did June 28 – but a state judge intervened to delay enforcement until this Friday. Oklahoma’s latest ban, Senate Bill 612, was passed this spring as part of a wave of anti-abortion laws erected in anticipation of the Dobbs decision. That ban made performing an abortion a felony, with a punishment of up to 10 years in prison and a fine of $100,000. Texas’ trigger law also makes performing abortion a felony and includes a fine of $100,000 per abortion performed. Beyond the dozen states banning abortion, three others – Ohio, Georgia and South Carolina – are enforcing laws that ban abortion after six weeks of pregnancy. Florida is enforcing a 15-week ban, and in Utah, abortions are banned after 18 weeks of pregnancy. Tennessee’s ban has added to a regional abortion desert in the Southeast. Now, people seeking abortions in the South have few options – they can travel to North Carolina, Illinois or Indiana (where an abortion ban takes effect September 15). People who are under 15 weeks can also travel to Florida.

U.S. Judge Blocks Idaho Abortion Ban in Emergencies; Texas Restrictions Allowed

Reuters, August 24, 2022

A federal judge on Wednesday blocked Idaho from enforcing a ban on abortions when pregnant women require emergency care, a day after a judge in Texas ruled against President Joe Biden’s administration on the same issue. The conflicting rulings came in two of the first lawsuits over Biden’s attempts to keep abortion legal after the conservative majority U.S. Supreme Court in June overturned the 1973 Roe v. Wade decision that legalized the procedure nationwide. Legal experts said the dueling rulings in Idaho and Texas could, if upheld on appeal, force the Supreme Court to wade back into the debate. About half of U.S. states have or are expected to seek to ban or curtail abortions following Roe‘s reversal. Those states include Idaho and Texas, which like 11 others adopted “trigger” laws banning abortion upon such a decision. Abortion is already illegal in Texas under a separate, nearly century-old abortion ban that took effect after the U.S. Supreme Court’s decision. Idaho’s trigger ban takes effect on Thursday, the same day as in Texas and Tennessee. In Idaho, U.S. District Judge B. Lynn Winmill agreed with the U.S. Department of Justice that the abortion ban taking effect Thursday conflicts with a federal law that ensures patients can receive emergency “stabilizing care.” Winmill, who was appointed to the court by former Democratic President Bill Clinton, issued a preliminary injunction blocking Idaho from enforcing its ban to the extent it conflicts with federal law, citing the threat to patients. […] “The Department of Justice will continue to use every tool at its disposal to defend the reproductive rights protected by federal law,” Garland said. The DOJ has said that it disagrees with the Texas ruling and is considering next legal steps. U.S. District Judge James Wesley Hendrix ruled in the Texas case that the U.S. Department of Health and Human Services went too far by issuing guidance that the same federal law guaranteed abortion care. Hendrix agreed with Texas Attorney General Ken Paxton, a Republican, that the guidance issued in July “discards the requirement to consider the welfare of unborn children when determining how to stabilize a pregnant woman.” Hendrix, an appointee of former President Donald Trump, said the federal statute was silent as to what a doctor should do when there is a conflict between the health of the mother and the unborn child and that the Texas law “fills that void.”

Despite Being Legal in Most States, Self-Managed Abortion Is Being Criminalized

Prism, August 24, 2022

Since abortion rights were overturned in June by the Supreme Court, a spotlight has been placed on self-managed abortion as an alternative for patients in states where clinician access may be all but impossible. But in a new report by If/When/How, the reproductive justice policy organization found that while only seven states have explicitly criminalized self-managed abortion, people are still being charged for it in states across the country. As the reproductive landscape continues to shift in post-Roe America, If/When/How’s report points to what that future of criminalization may look like–reinforcing that those who are already vulnerable to racist and unjust systems will be most impacted. “At this moment, we’re in a scary time,” said Laura Huss, the senior researcher for If/When/How. “Things are shifting every day. The future of abortion criminalization will look like in this country is racist, unjust, and dehumanizing people at every turn.” As states continue to ban abortions and some people face criminal charges for private social media messages discussing terminating pregnancies, legislators and prosecutors have already turned their sights on medication abortion as another target for bans and criminalization. Self-managed abortions are abortions managed outside of the medical system, typically using medication accessible by mail and authorized by the FDA. But, according to Huss’s research in the If/When/How’s report, from 2000 to 2020, 61 cases were documented in which people were criminally investigated or arrested for self-managing their abortion or helping someone else access theirs. […] By doing a deep analysis into each case, Huss thought to illuminate who is being targeted for criminalization, and how these cases make their way into and through the criminal process. According to Huss, overzealous prosecutors and police misapplied criminal laws to arrest people under statutes not meant to apply to allegations of self-managed abortions. They circumvented the law’s parameters to charge people with crimes regardless of what their state law authorizes. This included laws meant to address the handling of human remains, concealment of a birth to practicing medicine without a license, child abuse, assault, murder, and homicide all being misapplied to allegations of self-managed abortion.

Why IVF Is in Jeopardy in the Post-‘Roe‘ Era

Rewire News Group, August 23, 2022

For people trying to build families through medicine, specifically in vitro fertilization, anti-abortion legislation is another barrier to an already inaccessible source of hope. Injection after injection of hormones, egg retrieval, psychological stress on par with cancer patients, and the persistent, nagging question: Will it work this time? And now this process, which is already riddled with stress and doubt, has become even more stressful and murky. For people with the capacity for pregnancy, the fall of Roe v. Wade means they have been thrust into a world where their reproductive autonomy is sacrificed for embryos, and the damage is far-reaching. For IVF patients, their future is clouded with uncertainty, further financial burden, lower chances of success, and a higher risk of complications. The baby that would make it all worth it in the end is further out of reach. Why anti-abortion laws can affect IV: An IVF cycle starts by inducing ovulation, so doctors can collect multiple eggs. The harvested eggs are fertilized in a lab, resulting in multiple embryos. The embryos are sometimes tested for genetic abnormalities, with doctors only keeping and storing the viable embryos, and discarding the rest. One or more viable embryos are transferred into the uterus. Since this process is heavily centered on embryo creation and disposal, anti-abortion laws are especially concerning for the IVF community. “It could lead to limits being placed on how many eggs can be fertilized, whether embryos can be frozen, genetically tested, and the disposition of embryos if an individual or couple decides they no longer need to use the embryos to conceive or build a family,” said Dr. Lucky Sekhon, board-certified OB-GYN, Reproductive Endocrinologist, and Infertility specialist at RMA of New York. Sean Tipton, chief advocacy and policy officer for the American Society for Reproductive Medicine (ASRM), said the concern is less that the laws are going to overtly restrict or prohibit IVF procedures, but that it might happen accidentally. Thirteen states have passed “trigger” laws that outright ban or severely inhibit abortion care. Because Roe v. Wade was passed before the advent of assisted reproductive technology (ART), many of these laws don’t account for IVF, but their wording may still have inadvertent implications.

ICYMI: In Case You Missed It

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— National Partnership (@NPWF) August 15, 2022

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Note: The information contained in this publication reflects media coverage of women’s health issues and does not necessarily reflect the views of the National Partnership for Women & Families.