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The Fight Over Medication Abortion Is Just Getting Started

The Washington Post, November 29, 2022

The fight over abortion pills is heating up, as conservatives turn their focus to medication abortion. In the past two weeks: A conservative group sued the Food and Drug Administration in an effort to revoke approval of a drug used in medication abortions. A major antiabortion group launched an effort to use environmental rules to limit access to the pills. On the other side, nine Democratic senators are urging the FDA to quickly finish work to permanently make the pills more accessible. But such efforts are merely scratching the surface of the battles to come. Advocates on both sides of the debate say they expect the issue of medication abortion to explode into the limelight next year as most state legislatures convene for the first time since Roe v. Wade was overturned in June. Medication abortion accounted for more than half of all abortions in the United States even before the nation’s highest court overturned the constitutional right to an abortion. Abortion rights supporters are motivated to protect access to the pills, as antiabortion groups try to clamp down their use in a post-Roe world. “From our discussions with state lawmakers and policy leaders, it’s clear that this is the No. 1 issue for those who desire to protect life and women going into the 2023 state legislative sessions,” said Steven Aden, the chief legal officer and general counsel at the prominent antiabortion group Americans United for Life. In the states: One top priority for antiabortion advocates: Increasing the number of states that require in-person medical screenings for medication abortions, per Stephen Billy, the vice president of state affairs at SBA Pro-Life America. Roughly 18 states essentially ban the use of telehealth for medication abortion, such as requiring providers to be in the same room as the patient or an outright prohibition on obtaining the drugs through telemedicine, according to Elizabeth Nash, a principal policy associate at the Guttmacher Institute, a research group that supports abortion rights. This number includes some states with abortion bans on the books, which are interpreted as restrictions on both medication and surgical abortions. The crux of the issue boils down to this: In 2000, the FDA approved mifepristone for medication abortion, and the drug is used with a second pill, misoprostol, to induce what’s essentially a miscarriage. The agency has said the drugs are safe and effective for use in the first 10 weeks of pregnancy.

Googling Abortion? Your Details Aren’t As Private As You Think

The Guardian, November 29, 2022

In the wake of the US supreme court’s overturning of Roe v. Wade, Google pledged fresh policies to protect people’s abortion-related data. But new research has shown the way our location and other personal data is stored remains largely unchanged, raising fears that intimate details of a person’s abortion search could be used to penalize them. Google responds to tens of thousands of requests each year from law enforcement agencies seeking access to the vast troves of data collected on its users. In one six-month period in 2021, the most recent data publicly available, Google received nearly 47,000 law enforcement requests, affecting more than 100,000 accounts, and responded with some amount of data to 80% of them. The Dobbs decision sparked concerns that such data could be used to prosecute people seeking abortions in states where it is banned – for instance, if they searched for or traveled to an abortion clinic. Google responded to those concerns by saying it would delete entries for locations deemed “personal”, including “medical facilities like counseling centers, domestic violence shelters, abortion clinics, fertility centers, addiction treatment facilities, weight loss clinics, cosmetic surgery clinics”. The company did not indicate how long after a user visited a “personal” location it would delete the data. “If our systems identify that someone has visited one of these places, we will delete these entries from Location History soon after they visit,” the company said in July, pledging to make the change “in the coming weeks”. The tech advocacy group Accountable Tech conducted an experiment in August and October to test Google’s pledge. Using a brand new Android device, researchers with the group analyzed their Google activity timeline, where the company shows what information is logged about an account holder’s actions. This activity helps make Google’s services “more useful” to users, according to the company – for instance, by “helping you rediscover the things that you’ve searched for, read and watched”. However, any information collected by Google is potentially subject to law enforcement requests, including the data logged in “My Activity”. The group found that searches for directions to abortion clinics on Google Maps, as well as the routes taken to visit two Planned Parenthood locations, were stored in their Google activity timeline for weeks after it occurred. At the time of this article’s publication, the information was still stored and available at myactivity.google.com.

Working in Extreme Heat Is Risky for Pregnant Workers, Advocates Say Passing the Pregnant Workers Fairness Act Could Help

The 19th, November 28, 2022

In Minnesota, a pregnant letter carrier said she had to use sick time to avoid working outside on hot days, draining her time off before her baby was even born. A Missouri retail worker quit her job after she said she was denied access to water, fearing that heat could impact her pregnancy. These are just a few of the testimonies that A Better Balance, an advocacy organization that aims to improve conditions for caregivers in the workplace, has collected in their fight to pass the Pregnant Workers Fairness Act (PWFA). The legislation would require employers to provide reasonable accommodations for pregnant people, like water breaks or rest breaks, or a temporary change in work duties. And in the face of extreme heat and wildfires accelerated by climate change, which will worsen working conditions, advocates are urging Congress to pass it. The bill passed the House in 2021 with overwhelmingly bipartisan support, and advocates say it has enough votes to pass in the Senate. They are calling on Senate Majority Leader Chuck Schumer to bring it to a vote before the newly elected legislature takes office in January, which would start the legislative process over. “We see what happens when workers aren’t able to get accommodations and are forced to choose between continuing to work and really risking their health and getting pushed out and then not having a job when they have a baby on the way and losing critical income,” said Sarah Brafman, the national policy director for A Better Balance. “Passing this bill is a matter of dignity, respect, acknowledgement and, frankly, decency.” The Pregnancy Discrimination Act of 1978 was meant to provide these protections to pregnant workers already, but its vague language has made it hard to enforce. The American Disabilities Act, also has been viewed as a tool to protect pregnant workers, but it requires that the person prove they need an accommodation due to a complication with their pregnancy. It does not offer blanket protections to pregnant people. The PWFA, on the other hand, would more clearly define what is considered a reasonable accommodation and the responsibility employers have to their pregnant employees. “It would close a gap in our laws by guaranteeing that pregnant and postpartum workers can get reasonable workplace accommodations, for pregnancy, childbirth and lactation so that they can stay healthy and working,” Brafman said.

How ‘Religious Liberty’ Threatens HIV Prevention and Reproductive Justice

Rewire News Group, November 30, 2022

On the heels of dismantling the constitutional right to abortion, the Christian conservative legal movement has set its sights on opposing access to pre-exposure prophylaxis, more commonly known as PrEP, a daily medication that reduce a person’s chances of contracting HIV. Jonathan Mitchell, the architect of Texas SB 8, represents two Christian businesses that oppose the Affordable Care Act’s preventive services provision, which requires insurance providers to include PrEP in their health-care plans. The plaintiffs in Braidwood Management v. Becerra allege that “the PrEP mandate forces religious employers to provide coverage for drugs that facilitate and encourage homosexual behavior,” which they argue violates the Religious Freedom Restoration Act. In September, U.S. District Judge Reed O’Connor, a federal judge in Texas with infamous ire for the Affordable Care Act, sided with the plaintiffs, writing in his decision that the PrEP mandate burdens the plaintiffs’ religious exercise and the government does not “show a compelling interest in forcing private, religious corporations to cover PrEP drugs.” Braidwood v. Becerra is not the first time conservatives have weaponized stigmas around sexual and religious liberty to nullify people’s reproductive rights. In 2014, the Supreme Court ruled in Burwell v. Hobby Lobby that corporations don’t have to cover contraception in their insurance plans for employees if doing so violates their religious beliefs. The strategy to undermine both PrEP and contraception access underscores that HIV prevention and justice is reproductive justice. “At the surface, it is another barrier for young people to get access to PrEP,” said Louie Ortiz-Fonseca, LBGTQ health and rights director at Advocates for Youth who founded the organization’s Engaging Communities around HIV Organizing (ECHO), a collective of young people living with HIV who organize to decriminalize HIV and create content around de-stigmatizing HIV. They said they’ve worked with organizations who thought young people “should not be having sex or worrying about PrEP.” The Braidwood ruling “further reinforces that and gives that position even more power to create challenges for young people, particularly young Black and brown people, to access PrEP,” Ortiz-Foseca said. PrEP reduces a person’s risk of contracting HIV by around 99 percent. But without insurance, this vital medicine could cost more than $21,000 annually. Ortiz-Fonesca said societal power imbalances are also another roadblock to PrEP access. “There are people in power that can decide no or yes that you have access to a pill that is backed by science” Ortiz-Fonesca said.

U.S. Overturn of Roe Will Embolden Anti-Abortion Movements Abroad

Ms. Magazine, November 29, 2022

The U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, which ruled that there is no U.S. constitutional right to abortion, will have ripple effects around the world, according to the International Center for Research on Women’s (ICRW) policy brief, “U.S. Foreign Policy Implications of Overturning Roe v. Wade.” While Dobbs did not change existing U.S. foreign policy regarding abortion, the brief argues that it will embolden anti-abortion movements abroad, contribute to global stigmatization of abortion, cause confusion for policy implementation and open the door for new restrictions—all of which will negatively impact the health, economic resources and well-being of women throughout the world. Dobbs is a reminder that current U.S. foreign aid restrictions “are not aligned with best health care practices nor consistent with human rights and bodily autonomy principles.” The primary restriction, the Helms Amendment, prohibits the use of U.S. foreign assistance to pay for the performance of abortions “as a method of family planning,” but has been over-implemented, ignoring congressionally permitted exceptions. The global gag rule (GGR), which blocked U.S. global health funding to any organization that provides, counsels, refers or advocates for abortion, was rescinded by the Biden administration in January 2021. But, the enabling legislation remains in the Foreign Assistance Act of 1961. Every Republican president since Reagan has imposed the GGR, making it almost certain to be reimposed, should Democrats lose the White House. The politics and policies of the United States—the largest bilateral family planning donor—have outsized worldwide impacts. The General Accounting Office (GAO) found that confusion and fear resulting from the Trump administration’s 2017 reimposition and expansion of the GGR contributed to service reduction, including family planning services not prohibited by law. U.S. shifts in policy, including Dobbs, have a chilling effect and deter implementing partners from offering comprehensive services. World Health Organization (WHO) guidelines designate abortion care as an essential service, necessary to save women’s lives. According to the WHO, 45 percent of abortions globally are unsafe and about 7 million women per year receive hospital care due to unsafe abortions. So, any reduction in services will harm health outcomes and increase maternal mortality. The ICRW brief recommends the Biden administration take mitigating actions, including: confirming that Dobbs does not impact U.S. global programming on abortion, clarifying what is permissible under U.S. law, calling for repeal of the Helms Amendment in budget requests, and fulfilling all international human rights obligations regarding reproductive rights.

Black and Latina women are most impacted by abortion bans AND job loss due to needing accommodations during pregnancy. It’s time to #ProtectPregnantWorkers by bringing the Pregnant Workers Fairness Act to a vote. It’s about equity. pic.twitter.com/eYmr0l8PdB

— National Partnership (@NPWF) November 18, 2022

EDITOR’S NOTE

Join us on Friday, December 16, at 1 p.m. Eastern for a very special virtual event marking the launch of our latest report: “Our Communities Hold the Solutions”: The Importance of Full-Spectrum Doulas to Reproductive Health and Justice. This event will feature a screening of the short film MISO, the story of Cat, a young woman who finds herself pregnant but doesn’t want to be who enlists the help of Sophie–a local doula who helps Cat through a self managed abortion. The short film will be followed by a panel discussion and Q&A featuring members of the team behind MISO as well as our partners from the Southern Birth Justice Network and Ancient Song Doula Services moderated by Shaina Goodman, Director of Reproductive Health and Rights at the National Partnership. You can learn more about the event and register to join us by clicking here .

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