Abortion Ruling Leaves Pregnant Women, Doctors in Limbo Over High-Risk Care
The Washington Post, June 27, 2024
One month after Kelsie Norris-De La Cruz was turned away from a Texas hospital with a life-threatening pregnancy complication, the 25-year-old college senior learned about a federal law that could have protected her during the most frightening medical episode of her life. Just knowing about the Emergency Medical Treatment and Labor Act, known as EMTALA, made her feel she had some degree of power, Norris-De La Cruz said: The federal government required doctors and hospitals to provide abortions in emergency situations like hers – even in states where abortion is illegal. If she had another high-risk pregnancy, she hoped, she could invoke the federal law to demand treatment. Norris-De La Cruz was crushed to learn Thursday that the Supreme Court, while allowing emergency abortions to resume in Idaho for now, had not ruled to broadly affirm EMTALA protections for abortion care, leaving patients who face pregnancy complications in limbo, unsure what kind of care to expect at hospitals in states with strict anti abortion laws. If the justices had protected emergency abortions outright, she said, “I would have felt like I had a tool … power over my own body and my own life. I’m on birth control right now and still terrified.” The Supreme Court ruling provides temporary relief for doctors in Idaho, the state at the center of the legal challenge. But justices chose not to answer the larger question of whether the four-decade-old EMTALA compels medical providers nationwide to offer abortions when a physician deems it necessary to stabilize a pregnant woman.The case returns to the U.S. Court of Appeals for the 9th Circuit, where litigation will continue. On a call with reporters, Idaho Attorney General Raúl R. Labrador said he hoped the 9th Circuit judges would interpret “the tea leaves from the Supreme Court and understanding that … the Biden administration’s overreach needs to end.” The Supreme Court’s decision – first revealed Wednesday, after the court accidentally posted a near-final version of its ruling – leaves the national abortion landscape unsettled.
Texas Abortion Ban Linked to 13% Increase in Infant and Newborn Deaths
NBC News, June 24, 2024
A Texas law that banned abortions in early pregnancy is associated with a stark increase in infant and newborn deaths, a study published Monday in JAMA Pediatrics found. Lawmakers passed Texas Senate Bill 8, or SB8, in September 2021. The state law banned abortions as soon as a fetal heartbeat is detected, which can be as early as five weeks. This effectively banned abortion in the state, which used to allow abortion up to 22 weeks of pregnancy. The law did not include exemptions for congenital anomalies, including conditions that will cause a newborn to die soon after birth. The new study compared infant death rates in Texas from 2018 to 2022 to those of 28 other states. The data included newborns 28 days or younger and infants up to 12 months old. Infant deaths in Texas rose by nearly 13% the year after SB8 was passed, from 1,985 in 2021 to 2,240 in 2022. During that same period, infant deaths rose by about 2% nationwide. Babies born with congenital anomalies also increased in Texas, by nearly 23%, but decreased by about 3% nationwide. “This is pointing to a causal effect of the policy; we didn’t see this increase in infant deaths in other states,” said Alison Gemmill, assistant professor of population, family and reproductive Health at the Johns Hopkins Bloomberg School of Public Health, who led the research. While some congenital anomalies can be corrected after birth, including cleft palate and some heart defects, others are deemed “incompatible with life.” “The specific increase in deaths attributable to congenital anomalies really makes an ironclad link between the change in the law and the terrible outcomes that they’re seeing for infants and families,” said Nan Strauss, senior policy analyst of maternal health at the National Partnership for Women & Families, who was not involved with the research. “The women and families have to suffer through an excruciating later part of pregnancy, knowing that their baby is likely to die in the first weeks of life.”
Two Years After Roe’s Overturn, There Are More Abortions in America – But They’re Harder To Get
The 19th, June 24, 2024
Two years after the Supreme Court overturned Roe v. Wade, the number of abortions performed in the country is up. But that’s only part of the story. In many places, they are also much harder to get or provide. Clinicians nationwide provided more than a million abortions in 2023 – the highest in the country’s recorded history – in the first full year since Roe’s fall, according to the nonpartisan Guttmacher Institute. That’s the result of a dramatic change in how people get abortions: Rather than receiving clinic-based care in their home states, people are increasingly traveling across state lines, or going online to obtain drug prescriptions. Almost 200,000 people traveled to another state for an abortion. Data from the Society of Family Planning suggests that 1 in 5 are now done through telemedicine, in which a health care professional prescribes and mails abortion pills for a patient to take at home. Yet those changes have stretched the nation’s abortion network to its limits. Providers in many states report weeks-long wait times. For patients, traveling is more expensive and time-consuming, and nonprofit abortion funds don’t have enough money to support everyone who calls for help. And while telemedicine has expanded access – both in places where abortion remains legal, and in states with bans – abortion opponents, reeling from a recent loss at the Supreme Court, are still looking for new ways to curtail access to the pills involved, mifepristone and misoprostol. “It’s an inequality story,” said Caitlin Myers, an economist at Middlebury College who studies abortion trends. “The poorest and most vulnerable people get trapped. A lot of people still get out. And then there’s this group of people for whom figuring out how to make a multi-day trip – monetary costs, time off work, child care – all of that is just impossible. And some of them use telehealth successfully, and some of them don’t.”
Pregnancy in America Is Starting To Feel Like a Crime
Vox, June 25, 2024
Imagine you’re eight months pregnant, and you wake up in the middle of the night to a bolt of pain across your belly. Terrified you might be losing your pregnancy, you rush to the emergency room – only to be told that no one there will care for you, because they’re worried they could be accused of participating in an abortion. The staff tells you to drive to another hospital, but that will take hours, by which time, it might be too late. Such frightening experiences are growing more common in the wake of the Supreme Court’s 2022 Dobbs v. Jackson Women’s Health decision, as doctors and other medical staff, fearful of the far-reaching effects of state abortion bans, are simply refusing to treat pregnant people at all. It’s part of what some reproductive health activists see as a disturbing progression from bans on abortion to a climate of suspicion around all pregnant patients. “People are increasingly scared even to be pregnant,” said Elizabeth Ling, senior helpline counsel at the reproductive justice legal group If/When/How. The fall of Roe has led to an ever-widening net of criminalization that can ensnare doctors, nurses, and pregnant people alike, leading to devastating consequences for patients’ health, experts say. Complaints of pregnant women turned away from emergency rooms doubled in the months after Dobbs, the Associated Press reported earlier this year. Concerns about such treatment, combined with stories of people like Kate Cox, who was denied an abortion despite the risks her pregnancy posed to her health, have made some Americans afraid of conceiving: In one recent poll, 34 percent of women 18 to 39 said they or someone they knew had “decided not to get pregnant due to concerns about managing pregnancy-related medical emergencies.” Such surveys, along with ER records and calls to helplines, reveal a sense that in a post-Dobbs America, any pregnancy can be dangerous – to patients, to doctors, or both. “The fact that people are viewing the condition of pregnancy as something that makes them vulnerable to state violence is just so heartbreaking,” Ling said.
Abortion Is Becoming More Common in Primary Care Clinics as Doctors Challenge Stigma
NPR, June 21, 2024
It’s a typical Tuesday at Seven Hills Family Medicine in Richmond, Va. The team – which consists of Dr. Stephanie Arnold, registered nurse Caci Young and several medical assistants – huddles to prepare for the day. Arnold, a primary care physician, runs through the schedule. The 9 a.m. telemed appointment is for chronic condition management. At 10 a.m. there’s a diabetes follow-up. The 11 a.m. appointment is to go over lab results for potential sleep apnea, then there are appointments for knee pain and one for ADHD results review. The schedulers fit in a walk-in patient who has a suspected yeast infection. And then, at 1 p.m, a patient who took the bus from Tennessee is scheduled for an abortion. “It’s a little bit of everything, which is very typical of family medicine,” Arnold says. The patient from Tennessee is one of three abortion procedures Arnold will do today at this clinic, where abortion is “just in the mix,” Arnold says. In lieu of standalone clinics offering abortions, or telehealth appointments where patients get abortion medication by mail, family doctors are offering an abortion option in a familiar setting. This trend of primary care integrating medication or procedural abortions, usually in early pregnancy, is growing in states where abortion is legal. While there is little data on how common this is becoming, NPR heard from primary care doctors across the country who said they are expanding their practices to provide abortion care. “There’s no reason for this care to be siloed,” says Arnold, who is very public about her offerings, which include abortions up to 12 weeks of pregnancy and gender-affirming care. “I don’t feel like it’s any different than my management of diabetes or chronic pain or endometriosis – this is just a routine part of my day.”
ICYMI: In Case You Missed It
Today, the Supreme Court dismissed – for now – a challenge to EMTALA's protections for emergency abortion care. However, The Court missed an opportunity to state clearly and unequivocally that EMTALA’s protections preempt state abortion bans. https://t.co/GTW0blcX4g
— National Partnership (@NPWF) June 27, 2024
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