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The States Where Abortion Could Be on the Ballot in 2024

The 19th, December 15, 2023

Seven states have directly voted on abortion since the U.S. Supreme Court overturned Roe v. Wade in June 2022 – and abortion rights advocates are so far undefeated with ballot measures. The most recent win came in November when Ohio became the latest state to vote to enshrine abortion rights in its constitution. Two blue state legislatures put abortion rights constitutional amendments on their 2024 ballots, while organizers in at least nine other states so far are leading citizen-driven efforts to put similar measures on the ballot. The proposed amendments have the potential to reshape abortion access around the country and even mobilize voters behind Democrats in critical 2024 battleground states and races. Abortion rights ballot measures outperformed Democrats on the ballot in California, Michigan and Vermont in the 2022 midterms. Currently, 23 states enable citizens to put constitutional amendments on the ballot, while others only allow a state legislature to put them before the voters. While not all ballot measures are necessarily constitutional amendments, most of the efforts in 2024 are behind reshaping state constitutions to enshrine reproductive rights. Passing a ballot measure is a highly expensive, time-consuming endeavor. First, organizers must decide on language for their ballot measure. Next, they must gather tens or hundreds of thousands of signatures to put on the ballot, anticipating legal challenges to the validity of their signatures or the ballot language itself. Successful campaigns require lots of spending and intensive get-out-the-vote efforts, especially in states that require a supermajority for the measure to pass. Here’s an overview of where abortion will – and could be – directly on the ballot in 2024 and the challenges advocates are facing in the states.

Physician Says Residency Programs Must Reassess Post-Roe Training for Miscarriage, Abortion Care

Idaho Capital Sun, December 21, 2023

More than a year after the U.S. Supreme Court overturned Roe, many have raised concerns about training for obstetrician-gynecologists, particularly in states with civil and criminal penalties for providers if they perform abortions. But researchers from the Person-Centered Reproductive Health Program at the University of California San Francisco have found there is reason to be concerned about training for family physicians in ban states as well. A study published in the November-December issue of the Annals of Family Medicine found that 29% or 201 of 693 accredited family medicine residency programs in the U.S., are in states with abortion bans or significant restrictions on abortion access. The study used publicly available data from the American Medical Association to conduct the analysis, and found 3,930 residents out of 13,541 were in states where abortion is banned or heavily restricted. This has implications for family physicians who are often tasked with helping patients manage early pregnancy loss, or miscarriage, the researchers said, as well as patients who self-manage an abortion at home with medication. Any of those patients might need follow-up care from a family physician, the study said. States Newsroom spoke with one of the lead researchers, Dr. Christine Dehlendorf, about the results of the study. Her responses have been edited for clarity and conciseness. […] SN: What does that mean for those residency programs? Dehlendorf: What that means is that residency programs need to be very intentional about their curriculum and seek out ways for residents to get experience with reproductive health care, including ways they can get that training out of state. […] SN: What supports can family physicians provide to those experiencing a miscarriage or who are self-managing an abortion? Dehlendorf: People need to be able to go to their primary care doctors with any questions they have, including about bleeding or other side effects. Early pregnancy loss is a very common experience, and the skill set for caring for that and first trimester abortion are very similar.

Pregnant Cancer Patients Often Have to Terminate. Abortion Pill Restrictions Could Make That Choice Even Harder

STAT, December 20, 2023

The patient had already made the agonizing decision to start chemotherapy to address her colon cancer, even though she was 30 weeks pregnant. Within a day, the decisions got harder: her colon perforated, and the pain was excruciating. She would need urgent surgery – and she would have to undergo an emergency C-section immediately. […] Pregnant cancer patients like Van Loon’s have always faced near-impossible choices between their lifesaving cancer treatments and their unborn children. But in a post-Dobbs America, restrictions on abortion access threaten to take the choice out of the patients’ hands, or those of their doctors. Right now, one in 1,000 pregnancies is affected by a concurrent cancer diagnosis each year, a number that could rise as the mean age for pregnancy in the U.S. continues to trend upward. Many chemo, radiation, and hormone therapies can cause fetal harm, particularly during the first trimester. This can include congenital birth defects, higher stillbirth rates, and low birthweight and blood counts. Severe complications from the disease, such as those experienced by Van Loon’s colon cancer patient, may also force decisions on whether to prioritize the mother or the fetus. The vast majority of pregnant cancer patients who choose to terminate their pregnancies do so in the first trimester, which is when the fetus is considered not viable, Van Loon said. That early, medication abortion, the most commonly used abortion method in the United States, can be used effectively. But the Supreme Court – which holds a 6-3 conservative majority – announced last week it will hear a controversial case threatening to limit access to the widely used abortion pill mifepristone, following competing lower court rulings and pressure from the Biden administration to review a Texas judge’s attempt to ban the drug. The Court’s decision in that and other abortion-related cases could also one day threaten fertility preservation efforts cancer patients rely on, experts said. “Pregnancy is a joyful time in most women’s lives. When it is catastrophized by a cancer diagnosis, these are some of the worst moments that I have shared with patients,” Van Loon said. Leading cancer groups have been outspoken about how continued abortion restrictions, including a potential mifepristone ban, will disrupt patient-first disease care

A Woman Who Had a Miscarriage Is Now Charged With Abusing a Corpse as Stricter Abortion Laws Play Out Nationwide

CNN, December 19, 2023

An Ohio woman who had sought treatment at a hospital before suffering a miscarriage and passing her nonviable fetus in her bathroom now faces a criminal charge, her attorney told CNN. Brittany Watts, 33, of Warren, has been charged with felony abuse of a corpse, Trumbull County court records show. “Ms. Watts suffered a tragic and dangerous miscarriage that jeopardized her own life. Rather than focusing on healing physically and emotionally, she was arrested and charged with a felony,” her attorney, Traci Timko, told CNN in an email. “Ms. Watts’ case is pending before the Trumbull County Grand Jury. I have advised her not to speak publicly until the criminal matter has resolved.” Though a coroner’s office report said the fetus was not viable and had died in the womb, Watts’ case highlights the extent to which prosecutors can charge a woman whose pregnancy has ended – whether by abortion or miscarriage. After last year’s Supreme Court decision overturning Roe v. Wade and the federal right to an abortion, a host of state trigger laws went into effect across the country that placed new restrictions or bans on abortion. In turn, some women carrying fetuses with fatal abnormalities have been barred from having an abortion in their home states. Other women with potentially life-threatening pregnancies have also been unable to get an abortion, as medical exemption clauses can be vague and medical providers fear severe legal consequences. When asked whether the charge against Watts may have been influenced by the repeal of Roe v. Wade, her attorney said ignorance is the main factor. “I believe that this charge stems from the lack of knowledge and/or insight that men have regarding the realities of miscarriage and women’s health in general,” Timko told CNN. “I don’t believe the fetal personhood issue was something they considered or found relevant. I believe this case demonstrates the need for education and showcases the sweep that the fetal personhood debate has even outside the context of abortion.”

Texas Medical Board Remains Silent on Abortion Laws, Despite Calls for More Guidance

The Texas Tribune, December 21, 2023

Last week, in rejecting Kate Cox’s bid to terminate her nonviable pregnancy, the Texas Supreme Court called on the Texas Medical Board to offer doctors more guidance on how to interpret the state’s abortion laws. “While the judiciary cannot compel executive branch entities to do their part, it is obvious that the legal process works more smoothly when they do,” the justices wrote. Dr. Sherif Zaafran, the board chair for the Texas Medical Board, declined to comment on the agency’s plans, but said it was unlikely the board would intervene while other court cases were proceeding. “We’re going to hold back on getting involved in anything until all these issues, at least at the judicial setting, are resolved,” board chair Dr. Sherif Zaafran told The Texas Tribune. “It wouldn’t be appropriate for us to start making any kind of movement or decisions while all that is out there still being adjudicated.” As the licensing and disciplinary agency for Texas doctors, the medical board has the power to revoke a doctor’s license for violating the state’s abortion ban. The agency has, in the past, offered guidance to doctors on new and controversial topics, including COVID-19, and could “assess various hypothetical circumstances, provide best practices, identify red lines, and the like,” the Supreme Court said. But many doctors, and the advocacy groups that support them, say additional guidance from the state medical board is not enough to allow them to feel confident performing an abortion in Texas. “Medical emergency exceptions, the way they’re written, don’t work in real life,” said Molly Meegan, chief legal officer at the American College of Obstetrics and Gynecologists. “So it’s very difficult for a medical board to give better advice than anyone else.” Even a thorough list of medical conditions that would justify an abortion can’t capture the complexities and nuances of every individual case, Meegan said, and the stakes are too high for doctors to try to guess. While guidance from the agency might help doctors protect their licenses, it wouldn’t stop a prosecutor from bringing criminal charges or the attorney general’s office from pursuing fines north of $100,000.

ICYMI: In Case You Missed It

No matter the outcome of this case, know three things: 1. Mifepristone is safe. 2. This decision is rooted in politics, not medicine. 3. Abortion providers aren’t going anywhere.https://t.co/pr0hApbA5z

– National Partnership (@NPWF) December 15, 2023

 

 

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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.