NEWS: Group using ‘shield laws’ to provide abortion care in states that ban it

by | Jul 27, 2023 | Repro Health Watch

Group Using ‘Shield Laws’ to Provide Abortion Care in States That Ban it

The Guardian, July 23, 2023

Dr. Linda Prine is providing abortion access to people in all 50 states, even those that have banned it. That might seem like an admission to be discreet about in post-Roe America, but Prine and her colleagues at Aid Access, a telemedicine abortion service, are doing it openly and in a way they believe is on firm legal ground. On 14 July, Aid Access announced that over the past month, a team of seven doctors, midwives and nurse practitioners have mailed medication abortion to 3,500 people under the protection of “shield laws”, which protect clinicians who serve patients in states where providing abortion is illegal. As soon as she learned about shield laws, Prine knew it represented an opportunity to go on the offensive, for those bold enough to try it. “It made me think, OK, we need to fight back,” Prine said. “We can’t just take this lying down. We’ve got to do something. And this was what we can do.” From its origins, Aid Access has always been willing to test legal boundaries. It was started in 2018 by the Dutch physician Dr Rebecca Gomperts. At the time, FDA regulations prevented licensed US providers from mailing mifepristone, one of the two drugs in the medication abortion regimen, so Aid Access was structured like Gomperts’ other telemedicine service, Women on Web. That process involved abortion seekers filling out an online consultation, and if eligible, Gomperts wrote a prescription from Europe and the pills were dispatched by a pharmaceutical partner in India. Then, in 2020, Covid hit. And a federal judge suspended the FDA’s in-person dispensing requirement for mifepristone. For the first time, legally prescribed medication abortion could be put in the mail. Aid Access used this opportunity to implement a hybrid model: in states where telemedicine abortion was legal, US clinicians handled the prescriptions, while in states where it wasn’t, the pills continued to be mailed from India. One drawback of shipping from India was the packages could take weeks to arrive. In addition to the stress and uncertainty involved in waiting, the time lag could push people past the 12-week limit recommended by the World Health Organization.

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Ohio Vote on Abortion Seen As 2024 Bellwether

The Hill, July 26, 2023

An Ohio ballot measure in November that would enshrine abortion access in the state constitution stands to be a bellwether on the issue ahead of next year’s elections. Groups on both sides of the issue say the vote in November could provide more insight into how salient the battle over abortion access remains more than a year out from the overturning of Roe v. Wade. In particular, the vote will be closely watched by Democrats, who have signaled abortion rights will be at the center of their platform in next year’s presidential election. Earlier this month, abortion-rights advocates submitted 710,000 signatures for a ballot measure on abortion, twice the 413,000 needed for a ballot measure. On Tuesday, Ohio Secretary of State Frank LaRose certified abortion-rights advocates had enough signatures to place their measure on the ballot in November. “Seeing this level of enthusiasm in Ohio shows that this is going to be a salient issue and is an issue that is top of mind for voters no matter where they live,” said Ryan Stitzlein, vice president of political and government relations at NARAL-Pro Choice America. A USA Today Network/Suffolk University poll released Monday found that 58 percent of voters said they supported the abortion-rights amendment, while only 32 percent said they opposed it. “It’s another data point in what we have seen since the Dobbs ruling last June, is that the decision by the Supreme Court and the subsequent actions that Republican, anti-abortion lawmakers have been making are totally out of step with the American people,” Stitzlein said. Anti-abortion advocates say the poll doesn’t tell the whole story of what is happening on the ground in Ohio. “In November, voters will look more closely at the proposed amendment and see that it covers more than just abortion by its own language,” said Mark Weaver, an Ohio-based GOP strategist. “The poll doesn’t ask them that.” The proposed amendment says “every individual has a right to make and carry out one’s own reproductive decisions, including but not limited to decisions on contraception, fertility treatment, continuing one’s own pregnancy, miscarriage care, and abortion.”

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A Growing Share of Americans Think States Shouldn’t Be Able to Put Any Limits on Abortion

FiveThirtyEight, July 25, 2023

The Supreme Court’s 2022 decision in Dobbs v. Jackson Women’s Health Organization transformed the politics of abortion, turning an issue that once mattered mostly to conservative Christians into a powerful voting issue on the left. But new polling suggests that the decision could also be reshaping the way abortion-rights supporters think about the issue — specifically, whether abortion is something that should be regulated by the government at all. A new and intriguing finding from PerryUndem, a nonpartisan research firm, suggests that a significant chunk of abortion-rights supporters may now oppose any government restrictions on abortion — even limits on later abortion that were largely uncontroversial before Dobbs. The researchers asked 4,037 registered voters if they supported a constitutional amendment establishing reproductive freedom. Half of the sample read an amendment identical to the ballot measure that passed in Michigan in 2022; the other half read the same amendment except the researchers removed language that allowed the state to regulate abortion after viability, or when a fetus can live outside a woman’s body. PerryUndem found that respondents who received the version of the ballot measure with no government regulations included were 15 percentage points more likely to say they would “definitely” vote for it: Forty-five percent said they would “definitely vote yes” on the version with no restrictions, while 30 percent said they would “definitely vote yes” on the version with a viability restriction. The results were particularly pronounced among Democrats and women of reproductive age (ages 18 to 44), who were much more likely to support the version of the amendment without restrictions. While just one initial finding, this survey lines up with other public opinion research suggesting that over the past few years, a subset of Americans have gotten more supportive of unrestricted abortion in the late second and early third trimester of pregnancy. That’s a big shift from just a short time ago, when pressing to expand viability limits was a political lightning rod for Democratic politicians in states like New York and Virginia.

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Abortion-Rights States Begin Shielding Digital Data Near Clinics

Bloomberg Law, July 24, 2023

States positioning themselves as abortion safe havens are beginning to shield location information that can be gleaned from mobile phones, and to protect the privacy of other data that can show who is visiting a health-care facility. Beginning this summer, Washington, Connecticut, and New York are establishing first-of-their-kind data privacy safeguards for health-related information, in part to prevent anti-abortion groups from targeting people who terminate their pregnancies. A similar Nevada law will take effect next March. Other states, led by California, are passing or proposing measures that aim to limit out-of-state law enforcement agencies access to certain kinds of data collected by big tech companies like Alphabet Inc. and Meta Platforms Inc. First-of-its-kind legislation pending before the governor in Illinois would protect abortion seekers traveling to the state from being tracked by out-of-state police using data from license plate readers. The state policies reflect a growing recognition that traditional legal approaches to keeping medical data private fall short for information held outside health-care settings, such as a doctor’s office, since the Supreme Court last summer struck down a national right to abortion in Dobbs v. Jackson Women’s Health Organization. “Washington was the state that started us out on this trend of passing a health-specific data privacy law,” said Felicity Slater, a legislative policy fellow at the nonprofit Future of Privacy Forum. “It’s gone significantly beyond just responding to Dobbs. States have created new protections for a broad range of personal information.” Many of the new state policies add safeguards for reproductive health-related information from menstrual period-tracking entries to purchases that might reveal a person’s pregnancy status. While about half of US states have banned or restricted access to abortion over the past year, six states—California, Connecticut, Maryland, Nevada, New York, and Washington—have enacted laws that would limit the collection, use, or disclosure of private health information, especially data related to reproductive care. At least six other states have considered bills concerning health data-sharing in the past year. Some of the state measures, including Maryland’s law, try to stem the flow of electronic health records related to medication abortion and other sensitive services without patient consent.

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Maternal Deaths Are Expected to Rise Under Abortion Bans, but the Increase May Be Hard to Measure

ProPublica, July 27, 2023

Since the Supreme Court overturned Roe v. Wade last year, doctors have warned that limiting abortion care will make pregnancy more dangerous in a country that already has the highest maternal mortality rate among industrialized nations. The case of Mylissa Farmer, a Missouri woman, is one example. Last August, her water broke less than 18 weeks into her pregnancy, when her fetus was not viable. She was at risk for developing a life-threatening infection if she continued the pregnancy. Yet during three separate visits to emergency rooms, she was denied abortion care because her fetus still had a heartbeat. Doctors specifically cited the state’s new abortion law in her medical records and said they could not intervene until her condition worsened. She eventually traveled to Illinois for care. Even for people who don’t develop sudden life-threatening complications, doctors note that carrying a pregnancy to term is inherently risky because rapid physical and hormonal changes can exacerbate chronic health conditions and trigger new complications. If more people are forced to continue unwanted pregnancies, there are bound to be more pregnancy-related deaths: A study by the University of Colorado estimates a 24% increase in maternal deaths if the United States bans abortion federally. They predicted the increase would be even higher for Black patients, at 39%. Currently, 14 states have total abortion bans. Additionally, when abortion is illegal, it makes the procedure more dangerous for those who still try to terminate their pregnancies. The World Health Organization found that unsafe or illegal abortions account for up to 10% of maternal deaths worldwide. As the United States enters its second post-Roe year, advocates say it’s important to gather data on the impact abortion bans are having on the health of pregnant people to help both policy makers and voters understand the life-or-death consequences of the restrictions. Without such accounting, they say, the public may remain ignorant of the toll. Maternal mortality rates would be a crucial gauge of impact. Despite the stakes, experts say, at least in the short term, it may be difficult or impossible to track the number of lives lost due to limits on abortion access.

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