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Where Restrictions on Abortion Pills Could Matter Most

The New York Times, March 2, 2023

A judge is poised to rule in a case that seeks to revoke the approval of the most common, safe and effective abortion pill regimen, with the potential for consequences to be felt in every state. Nationally, more than half of reported abortions rely on medication, which is approved for use through the 10th week of pregnancy. Abortion pills are preferred among many patients and providers for their convenience, privacy and cost. Around 40 percent of the country’s clinics, including more than 80 telehealth providers, offer medication abortions only. A judge is poised to rule in a case that seeks to revoke the approval of the most common, safe and effective abortion pill regimen, with the potential for consequences to be felt in every state. Nationally, more than half of reported abortions rely on medication, which is approved for use through the 10th week of pregnancy. Abortion pills are preferred among many patients and providers for their convenience, privacy and cost. Around 40 percent of the country’s clinics, including more than 80 telehealth providers, offer medication abortions only. Ms. Kieltyka’s organization relies on medication for about 60 percent of abortions and operates 17 medication-only clinics in mostly rural areas. More than half of all abortions — and 64 percent of abortions before 10 weeks of pregnancy — relied on abortion pills in 2020, according to the Centers for Disease Control and Prevention. And in states like Colorado, Iowa, Maine, Nebraska, Vermont and Wyoming, the share of abortions done with medication was 70 percent or higher. (A few large states that also depend on medication abortion, including California and Illinois, did not report data or did not report data by method type to the C.D.C.) About 5.6 million patients in the U.S. have used mifepristone followed by misoprostol for a medication abortion since the approval of the regimen in 2000. Experts say the share of abortion patients choosing medication, rather than procedures such as aspiration, is now higher because of the growth in telehealth abortion services. Patients increasingly turned to this option during the pandemic and after 13 states banned abortions following the overturn of Roe> last year.

Texas Abortion Funds Likely Safe From Prosecution, Federal Judge Rules

The Texas Tribune, February 24, 2023

A federal judge issued a favorable ruling for Texas abortion funds, indicating they likely cannot be criminally charged for helping people travel out of state to terminate their pregnancies. U.S. District Judge Robert Pitman temporarily blocked prosecutors in eight counties from pursuing charges against anyone who helps someone get an abortion outside of Texas. But his ruling indicated he believes the laws he has enjoined them from enforcing may not actually be in effect at all. This lawsuit, filed two months after the overturn of Roe v. Wade, was brought by abortion funds, nonprofit groups that help pay for abortions and related expenses, including out-of-state travel, hotels and child care. After the overturn of Roe v. Wade, the funds stopped paying for Texans to leave the state, citing their fear of being prosecuted under the state’s intersecting abortion bans. In the lawsuit, they cited examples of Attorney General Ken Paxton and state lawmakers expressing an intent to bring charges against abortion funds. But Pitman ruled Friday that Paxton could not enforce Texas’ abortion bans against anyone who helped pay for an abortion out of state and dismissed him from the suit. Pitman analyzed Texas’ three abortions laws: the ban on abortions after about six weeks of pregnancy, commonly known as Senate Bill 8; the so-called trigger law, which went into effect in July; and the pre-Roe statutes, which were in effect before the U.S. Supreme Court deemed them unconstitutional in 1973. Keep tabs on Texas politics and policy with our morning newsletter. Since SB 8 is enforced through private civil lawsuits, neither Paxton nor local prosecutors play any role in enforcing that statute, Pitman noted. Paxton and the district attorneys do have the power to enforce the trigger law, which comes with a sentence of up to life in prison and a minimum $100,000 penalty. The law criminalizes anyone who performs an abortion, except to save the life of the pregnant person. But it cannot be enforced beyond state lines, Pitman found. The law “does not express any intent, much less a clear one, to apply extraterritorially,” he wrote. “Accordingly, there is no plausible construction of the statute that allows the Attorney General or local prosecutor to penalize out-of-state abortions.”

Lawmakers Warn Biden on Feds Aiding Anti-Abortion Investigations

Axios, February 28, 2023

Democrats in Congress are warning the Biden administration that federal agencies could be indirectly aiding state and local law enforcement investigations that could result in the prosecution of abortion providers and patients. Driving the news: Sens. Ron Wyden (D-Ore.) and Mazie Hirono (D-Hawaii) and Rep. Sara Jacobs (D-Calif.) expressed concern that FBI and Department of Homeland Security resources could be used to help undermine access to reproductive care, according to a letter lawmakers sent Monday evening. The assistance “could undermine our shared goals, providing support to state and local law enforcement that could be used to surveil and prosecute abortion,” the lawmakers add. Zoom in: The lawmakers do not cite any specific instances in which information-sharing led to a prosecution. “There likely won’t be a ‘smoking gun’ or specific evidence of this happening. It could already be happening, but we don’t know,” a House Democratic aide told Axios. The big picture: Federal agencies collect personal and digital data that state and local law enforcement can access, according to a letter by over 50 civil rights and abortion rights groups sent in December to the Biden administration. Abortion rights advocates worry that since the overturning of Roe v. Wade, law enforcement authorities could demand personal data of suspected abortion patients from tech companies. State of play: A report from the Center for Democracy and Technology notes that the FBI has Regional Computer Forensic Laboratories — some located in states with abortion bans — that help police access relevant electronic data. The FBI’s National Domestic Computer Assistance Center was created to “facilitate the sharing of technical solutions and know-how among law enforcement agencies,” helping police access phone data. Each state also has at least one fusion center, which are “law enforcement hubs that stockpile and share data to aid state and local investigations,” the report says. While these centers were created following the 9/11 attacks to focus on counter-terrorism, a report from the Brennan Center found that many of their activities have no connection to terrorism. “We’re still in early stages of how exactly [anti-abortion] prosecutions and investigations are going to be carried out,” said Jake Laperruque, deputy director of the center’s Security and Surveillance Project.

Why Accurate Data on Abortions Matters — and Why It’s So Hard to Collect

The 19th, February 27, 2022

Collecting abortion data has always been difficult: People are often unwilling to share their experiences with researchers, and the United States has no centralized count of abortions performed. Every state collects data differently, and some refuse to share it with federal researchers due to privacy concerns. Sometimes researchers have to estimate abortion incidence based on historical trends because up-to-date data isn’t available. It’s a challenge with broad implications for information on reproductive health, one that has been compounded by the Supreme Court’s decision in Dobbs vs. Jackson Women’s Health Organization, which allowed states to ban abortion. Less accurate abortion data means less information to share with policymakers about the impacts of restrictions — but also spills over into many areas of public health. Abortion data is a key supplement to studies involving the rate of pregnancies. Incomplete data on abortions could lead to less accurate calculations on the failure rates of various contraceptives and less knowledge about who gets pregnant. It could also lead to less information about the kind of reproductive support people need. There are two long-running major national abortion data-gathering efforts in the United States: the Centers for Disease Control and Prevention’s Abortion Surveillance Report, which began collecting data in 1969, and the Guttmacher Institute’s Abortion Provider Survey, which began data collection in 1973. Additionally a pop-up survey launched in April 2022 by the Society for Family Planning, called WeCount, is expected to provide abortion data through one year after the Dobbs verdict. With these three surveys, the major trade-off is whether researchers want timely data or demographically rich data. WeCount tracks abortions in each state every month, but that’s the only information the researchers collect from facilities. The CDC and Guttmacher gather that information — plus valuable demographic data including patients’ ages or race as well as what type of abortions were provided. Isaac Maddow-Zimet, senior research associate at the Guttmacher Institute, explained that the reason there are so few data sources is because it is incredibly difficult to ask people about abortion directly. Regardless of whether surveys are conducted in-person or online, many people do not report that they have had an abortion.

Pregnant People in the United States Seeking Abortion Do Not See Adoption as an Alternative

Guttmacher Institute, February 28, 2023

People in the United States who want and need abortions do not consider adoption an equally acceptable substitute, according to a new Guttmacher Institute study published in Contraception X. The study adds to a growing body of evidence countering the inaccurate and harmful narrative that adoption is an alternative to abortion. The study is particularly timely, as the overturning of Roe v. Wade in June 2022 has led to a crisis in abortion access across the United States. As of February 22, abortion is banned in 12 states and unavailable in two others, with more states expected to enact bans. Adoption Is Not an Equal Alternative to Abortion: The new study is based on in-depth interviews with 29 individuals who had traveled either across state lines or more than 100 miles within state to seek abortion services in Michigan and New Mexico in 2015. Just three interviewees reported that they had even weighed adoption against abortion, and all interviewees felt that adoption was a particularly unsuitable choice for them. “Interviewees were aware of the option of adoption and rejected it as an option for them,” says Guttmacher Institute Senior Research Scientist Liza Fuentes. “Their decisions not to pursue adoption were grounded in their values about what it means to be a loving and responsible parent.” Three main reasons for rejecting adoption emerged from the interviews. First, the interviewees saw the decision to continue the pregnancy and give birth as inseparable from the decision to parent. Participants described continuing the pregnancy and giving birth—including the associated risks to their health and well-being, physical discomforts and emotional changes—as the entry point to parenting. As one participant said, “If I was going to have this baby, then I’m its mom.” In addition, participants rejected the possibility of adoption because of the profound emotional pain they anticipated when it came time to place the child for adoption. Second, participants said that choosing adoption would mean abandoning their parental duty. In one interviewee’s words, “I don’t think I could carry a child to term, deliver it and then kind of just hand it to someone else. I think at that time, if I am making that decision to keep the baby [instead of having an abortion], I think it’s then up to me to be the parent.”

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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.