Interference between Arizona abortion laws and California’s pre-statehood law for pregnant women, and an appeals court ruling against Planned Parenthood

“Let me be crystal clear that today is a good day,” Fonteno said. According to the Arizona Court of Appeals, abortion through 15 weeks will remain legal if a licensed physician complies with the state’s other laws.

“Arizona courts have a responsibility to attempt to harmonize all of this state’s relevant statutes,” Eckerstrom wrote, mirroring arguments made by attorneys for Planned Parenthood.

Eckerstrom wrote that a stay is appropriate “given the acute need of healthcare providers, prosecuting agencies, and the public for legal clarity as to the application of our criminal laws. Notably, in the underlying litigation both parties sought some form of such clarification from the court.”

Following the court ruling, the Arizona Attorney General’s Office will review the decision and make a decision on the next step.

“We are working diligently already to resume abortion care in the Tuscon area, and unfortunately with such a big operation as Planned Parenthood, as the biggest abortion provider in the state, resuming care isn’t as easy as flipping on a light switch,” Fonteno said.

The law was temporarily suspended in Ohio, and was due to expire next week. The suspension of the state’s abortion ban will provide more certainty to abortion providers and women.

Petranek was interested in how this was going to play out in Texas, which had banned abortion after about six-weeks. The ban had repercussions on pregnant women’s care.

The language in the 15-week ban says that it won’t repeal the pre-statehood law. It contains an exception if the life of the mother is at risk, but not for rape or incest.

Planned Parenthood and other abortion rights advocates have repeatedly said that Arizona’s competing abortion laws create confusion for providers and patients.

The appeals court said Planned Parenthood has shown it is likely to prevail on its argument that the trial court erred by limiting its analysis only to the attorney general’s request to lift the 50-year-old injunction and refusing to consider the later laws passed by the Legislature to regulate abortion.

The lawsuit was filed on behalf of five women and two doctors who were denied needed fertility care because of Texas’s abortion ban.

The Arizona Court of Appeals did not overturn the 1864 law that imposes a 2 to 5 year sentence on anyone who helps with an abortion and no exceptions for rape or incest.

One Phoenix clinic has come up with a workaround to allow patients who can use abortions pills to get them delivered to the California-Arizona border for pickup. It’s less than a day to get abortion pills, which are effective up to 12 weeks, from a two-day trip to one that can be done in a day.

Sepper asserts that doctors and hospitals should give patients more information about their diagnoses and options because of the Texas abortion ban. She says that providing information, even giving referrals, is not in line with the criminal bans. She says that hospitals don’t speak to patients about abortion because they’re afraid of lawsuits.

The doctor went to her hospital’s public relations office to ask for permission to do the interview, saying that she holds a leadership position on the maternal mortality committee.

The doctor was contacted by the PR official, who told him to stay away from the NY Times.

Observation of a Midwest Obstetrician in the Eighties: Implications of New Abortion Bans for Medical Centers and Universities

Like this doctor, an obstetrician in the Midwest felt a “chilling effect” when their employer said they could speak publicly about abortion only if they didn’t mention where they worked.

“If [they] don’t speak up, who is going to provide the evidence about the effect [abortion bans are] having on patients?” asked Dr. Erika Werner, who chairs the health policy and advocacy committee at the Society for Maternal-Fetal Medicine and is the chair of obstetrics and gynecology at Tufts Medical Center in Boston.

Dr. Rosha McCoy, acting chief health care officer at the Association of American Medical Colleges, said medical centers and universities are having to deal with a great deal of “fear” and “confusion” in the aftermath of new abortion limitations.

She says doctors are confused about what they can and cannot do, which is why they are inappropriate or bad people. “And they’re also scared about what the consequences may be if they break these extremely confusing laws.”

According to a report in the News-Leader, a doctor wrote in the chart of a woman who had a water break at 18 weeks that current Missouri law made it impossible for her to receive an abortion because she was at risk of getting an STD. That hospital is now under investigation for violating a federal law that requires doctors to treat and stabilize patients during a medical emergency.

The doctor, a specialist in high-risk pregnancies who works at a public university, said that they had watched patients degrade infront of their eyes.

A doctor who was angry at the University: How to help people in need of abortion care and how to talk to them about how to lose their jobs

The intention was to make us feel like criminals. She said it makes us feel like we are doing something wrong. I think we are all scared. I’m afraid of losing my job. I’m the primary breadwinner in my family, so losing my job would be a big, big deal.”

The doctor said that it was frightening that high-level administrators had watched a video. [of the event] and obtained a transcript to make sure I in no way made a connection to my employer.”

“I got the strong sense they’ll say no,” they said. They worry about state funding sources, and if it gets controversial, they want everyone to be quiet, and not cause any trouble.

The battle comes at a high cost for all of us. Patients seeking abortion care and providers of that care should not be leveraged as political pawns or pushed to the forefront of national elections.

Despite these statements from respected national organizations, a university official told the residents to also remove the photo from their personal social media accounts, according to the doctor familiar with the situation. The doctor added that a little bit later, the official told the residents they could post the picture on their own accounts, as long as they didn’t identify where they work.

A month later, at a mandatory lecture, university lawyers gave the residents a presentation about the limits of free speech, according to the doctor. CNN is able to see a portion of the presentation.

The doctor said residents are reluctant to make trouble because they rely on other people to find them a job, and they may not get a job if they are seen as difficult.

Investigating the impact of abortion laws on high-risk maternal-fetal medicine: A CNN interview with two oncologists at MD Anderson Cancer Center

In the past year, the University of Texas Southwestern Medical Center has issued more than 150 news releases detailing advances in the lab, studies conducted by its doctors, awards for its researchers and a new culinary medicine program, among dozens of other topics.

When CNN pushed back, explaining that journalists often speak with study authors, the official said the researchers, if interested, could speak with CNN, but “they will be providing comments as private individuals, independent of their role with the state.”

CNN then received this response from the medical center’s director of public relations: “UT Southwestern continues to review the U.S. Supreme Court opinion in conjunction with Texas laws and will not be commenting at this time. The findings give an idea of themselves.

CNN reached out to two oncologists at MD Anderson Cancer Center in Houston, one of the largest cancer centers in the US, to ask them about their experiences treating pregnant patients, considering that Texas has had strict abortion limitations for more than a year.

MD Anderson says that its providers discuss the implications of delayed treatment with patients when they are pregnant, and use the data to refer them to fetal medicine specialists.

On October 7, CNN pressed further to speak with the doctors, and an associate vice president said they were working on coordinating the interviews, but none was made available prior to the deadline for this story.

The Society for Maternal-Fetal Medicine has physicians who are experts in high-risk pregnancies and Wade is their chief public affairs officer. A few months ago, a reporter from The New York Times Magazine approached Wade with the idea of embedding a photographer in a high-risk maternal-fetal medicine department.

Source: https://www.cnn.com/2022/10/12/health/abortion-doctors-talking/index.html

The Supreme Court Decision to Disallow Civil Disobedience In Maternal-Fetal Medicine: When Do Doctors Give Up Their Role?

“When people don’t hear these stories, they don’t understand the reality of what these laws are doing to real people, and I think real people are suffering. She said that people need to hear that.

She said the hospitals and practices that declined The New York Times’ invitation told her that “this would make our attorneys and public relations colleagues very nervous.’ That’s right.

She argues that the law needs to be clarified. She says that it puts providers and patients at risk. “And to abdicate all responsibility for making the laws, before drafting the laws in a way that will work for physicians on the ground, is just irresponsible.”

The Supreme Court decision came right after she and other maternal-fetal medicine specialists got on the phone.

The medical center didn’t want to make it difficult for doctors to explain the impact of the new law to the public, and that was one of the reasons for the call.

She said people cried on that call and 50-year old women were in tears when they realized how hard it was going to be.

The people who come to me are faced with something they can not possibly have imagined because I am a specialist in high-risk patients. I think of them every now and then when there’s a mother carrying twins who is faced with either aborting one fetus or losing the other. A frightened 21-year-old with a life-threatening infectious illness developed two days after her water broke.

There’s a middle ground for doctors, between going to jail and not giving the care they feel is needed. In many of the reported cases in which patients were endangered because doctors denied or delayed necessary care, she says civil disobedience wasn’t called for. Instead, doctors need to become more comfortable working up to the limits of the law.

Every time I am forced to turn away a patient, I see that burning candle inside of me, once a roaring and passionate fire in a young student excited to embark upon a career of helping others. I can’t recover from this serious violation of my duty, even when I am powerless to do so.

I worry that the next lawyer will not understand and that the patient will not be allowed to have an abortion. I worry they won’t have time, money, and support to get the care they need. And this denial, which is not in alignment with my medical opinion or the patient’s wishes, will forever alter their life. I am scared they will die.

But I still experience joy in my job sometimes. A college student whispered with increasing confidence after they had taken the first pill of their medication abortion regimen that they were going to be ok. The tears of transplant recipients dry when they know that they won’t have to go back onto the transplant list when their health fails again.

When a single mom can focus on her family instead of trying to get pregnant, she no longer has the burden of carrying a heavy child rearing burden. I take some comfort from knowing that the shattered hearts of Tara and Justin – who desperately wanted the baby they had to say goodbye to – can finally start to heal now, knowing they did what was right for Tara’s health and spared their baby, who could not have lived, a short lifetime of pain.

The Wisconsin Patient’s Choice Problem: Why abortions are dangerous and unsafe in the first three years of medical practice in the U.S.

Patients should be allowed to simply be patients, to make medical decisions that align with their faith, family needs and their health, without interference from the government. Regardless of where they live, they should have access to compassionate care. And doctors should be allowed to simply be doctors. I shouldn’t fear reprisals for providing care to my patients.

The researchers found that slightly more than half – 55% – of US births in 2020 were in the 26 states currently with abortion bans or restrictions. Women in that age group accounted for the majority of births in those states. 45% of the births in the abortion-access states were to women under 30.

Clinics in states like Colorado, Illinois and New York have also seen more patients as women travel out of state for abortions. But the shift to telemedicine makes sense for practical reasons. First, having an abortion with pills at home, which has the physical effects of miscarrying, is as safe and effective in the first trimester as going to a clinic.

13 states have banned abortion except for a medical emergency, if the patient is pregnant or pregnant with a baby. It can be difficult for doctors to make a decision on what constitutes a medical exception.

“That’s just nuts,” Dr. Matthew Wynia says. He’s a physician who directs the Center for Bioethics and Humanities at the University of Colorado. “[A hysterotomy is] much more dangerous, much more risky – the woman may never have another pregnancy now because you’re trying to avoid being accused of having conducted an abortion.”

Three physicians from the state joined the lawsuit. In affidavits shared with NPR, they say the law and their fear of prosecution has already impacted their medical decision making and their “ability to provide necessary and appropriate care in Wisconsin.”

AMA’s resolutions earlier this month to support the doctors who do get charged in the future for providing abortions in keeping with medical ethics and standards of care are a good first step, he says. Those policies give direction to a task force to provide policies, legal strategies and financial resources, but there is no timeline for more details on what shape that will take.

She told a congressional subcommittee this summer that Ob-Gyns’ “medical expertise and years of training make it very possible for us to discern when we need to intervene to save a woman’s life.”

” By the 1940s you get more of a crack down on abortion, and it’s framed as a vice or an organized crime organization”, says Ziegler. “In the 1950s, hospitals begin forming therapeutic abortion committees in part to protect themselves from prosecution or lawsuits,” she says, so abortions could be allowed in certain circumstances, like emergencies.

She says that in the 1960’s people began to try to get arrested because they wanted to draw attention to what they perceived to be vague abortion laws.

In Washington, D.C., there were at least 16 cases of illegal abortions where Dr. Milan Vuitch was involved. In 1967, Leon Belous was found guilty of referring a woman for an abortion. He appealed his case all the way to the state supreme court and won.

“If I don’t work in the morning I will die,” says the Ob-Gyn based in Indiana, who provides abortions. In the last couple of years, NPR has reported on increased threats to abortion clinics.

“There is no way that I would risk my personal freedom and jail time for providing medical care,” McHugh says. “I would love to show my children that I am brave in the world, but our society will not allow me to be a civil-disobedient citizen in the way that some of these articles suggest, because I would be imprisoned, I would be fined, I would lose my license and I very well could be assassinated for doing that work.”

She isn’t sure if calling to openly defy abortion laws is a good idea. “I don’t even see the point,” King says. She adds that another consideration is how few providers there are who do abortion care — any doctor who’s sitting in jail or waiting for a legal fight to resolve is one fewer person who’s able to take care of patients.

“That is when you believe a law is unjust and you do not believe disobeying it in public will change it, but there is an identified other in danger in front of you that you have the resources to help,” she explains. “So that’s the Underground Railroad, that’s hiding Jews from the Nazis — there’s a long tradition of that as well.”

Reproductive Health Care Delays in Wisconsin: The Case of a Mother and Her Three-Children Trying to Have an Abortion

It also means that if only a few labor and delivery units are available, then the facilities will become over-whelmed with patients, which may cause delays in care, similar to states that only have one abortion clinic. “This is not how healthcare should be. People in zip codes shouldn’t be denied access to reproductive health care services.

Wynia says that health care workers need more support in the face of laws that may push them to violate their ethical obligations.

In order to assure patients that they will receive competent care even if it violates state abortion statutes, he wants hospitals, accrediting organizations, and medicine to unite.

Strong leadership at the institutional level could embolden doctors to follow their medical judgment and cause fewer instances of doctors delaying care to consult legal experts, Wynia says. In the face of tough cases, he hopes doctors will think, “If we do the right thing, we may end up in court, but we know we’re not alone in this — we know we’ve got the whole medical establishment behind us.”

The situation: A mother of two children decided to stop attempting to have a third child because she wouldn’t be able to obtain abortion in Wisconsin, where it is not allowed.

Petranek, 31, and her husband Daniel have two children – a 7-year-old son and 4-year-old daughter. Her pregnancies had been hard on her body, she says, and risky, because she is diabetic. She and her husband still wanted to have three children. “I have three brothers and he has one brother – we kind of liked [a number] in the middle of that,” she says.

She was afraid she wouldn’t be there if abortion became illegal in Wisconsin, so she fell into a different path and decided not to have more children

Devastated, she went home to wait for the miscarriage to resolve. It was the second time she’d miscarried and she was anxious about possible complications. She says the days passed miserably because she had nausea, abdominal pain and backaches. She got a bug after a few days.

She looked at a leaked Supreme Court opinion while resting under a heating Pad and realized that she’s going to have to pay a heavy price for this.

An old law made abortions illegal in Wisconsin and she was aware of that. Petranek was focused on growing her family so she had no plans to end her pregnancy. If abortion became illegal, that could affect what doctors cared for her if something went wrong.

Pregnant patients with diabetes, like Petranek, have elevated risks of birth defects, preterm birth, preeclampsia and more. She says that her diabetes is well managed, but it is still a risk. If doctors and nurses in places that ban abortion are uneasy about being accused of violating the law, then it can be difficult to get care for those with potentially life-threatening conditions.

I knew I couldn’t do it again, she says. “It wasn’t even a conscious decision, it was just like – I will not put myself through that again if I don’t have the confidence that I will be able to come out the other side.”

During her first miscarriage years ago, Petranek ended up in the E.R. Doctors gave her a dilation and curettage, or D&C, procedure to stop the bleeding – the same procedure that’s used for many abortions.

She says she was told to wait weeks for her first baby appointment because of Louisiana’s abortion ban. When she started to have heavy bleeding and labor-like pains, she sought care at two separate ERs, but both times, she was sent home without a clear understanding of whether she was miscarrying or her treatment options. The experience led her and her husband to decide not to have more children for now.

She says the physical and emotional strain of her pregnancies makes her fall apart.

Getting Away: Pregnancies Aren’t Always That’s Why We’re Trying to Get More Babys, But We Are Trying To Get More Care

She says those fears are based on what she calls “misinformation” that miscarriage treatment could be affected by Wisconsin’s law. She says that if we’re talking about an ectopic pregnancy, a loss, these are not a way to form an abortion.

Democratic Governor Tony Evers supports the lawsuit against the 1849 ban. The Republican-controlled legislature wanted it to stay in place and rejected the governor’s call to call a special session to overturn it. Assembly Speaker Robin Vos and Senate Leaders Devin LeMahieu and Chris Kapenga – all Republicans – declined NPR’s requests for an interview for this story.

At stake is whether people should try to have more than one child at a time, when to start trying, and how close in age children should be.

The decisions are often made with other people in mind, like a family, friends or faith leaders. She believes that a new aspect needs to be added after the overturning of the Wade decision: the state laws regarding contraceptives and care for pregnant women.

How that calculus plays out may come down to personal risk tolerance. Cutler notes pregnancies often don’t go as planned – at least one in five women have miscarriages and one in four women have abortions in their lifetimes. There are other serious risks in pregnancy too, such as hypertension, ectopic pregnancy, and depression. And the U.S. maternal mortality rate is much higher than other industrialized countries around the world.

Researchers are attempting to measure many different effects of abortion restrictions such as how many additional babies will be born, how many people will cross state lines for care, and more.

She says that the intentions of a pregnant woman are nuanced. She says that there are people who want to get pregnant and other people who want not to be pregnant, and it is a challenge to get the nuanced data.

A Wisconsin Right to Life Activist Reveals the Birth of a Baby, or a Pregnant’s Dream Comes to an End

Wisconsin’s ban on abortion is disputed by anti-abortion groups. Gracie Skogman, legislative director for Wisconsin Right to Life, says “it’s heartbreaking to hear of any woman who feels that she would not be able to have care for miscarriage.”

Petranek is concerned that he won’t be able to get timely or appropriate care during a pregnancy complication if he does not have the baby.

She says that it was written by men and was written at a time when C-sections and all surgeries were done without anesthesia and when problems of pregnancy and labor were poorly understood. In the 1850s, women were second class citizens, with few to no rights.

The patient’s perspective: Kristen Petranek and her husband have started regularly using birth control – condoms for now, but she’s looking into longer-term options like a vasectomy for her husband or an IUD for herself.

Petranek is resolute about the decision, but also sad, and reminders of what she’s lost are everywhere. She might have had a baby over Thanksgiving if she hadn’t misCarried. “It was good that I had the distraction of the holiday but I kept thinking, ‘I would have been holding a newborn right now,’” she says.

She says she thinks about it every day – the loss of the pregnancy this spring, and the loss of the chance to add to her family in the future. “We were planning to have a third child, but we did not have a baby yet,” she says.

And she says, she finds herself looking at her 4-year-old daughter in a new way. “I have to reconcile with the fact that she’s truly, always going to be my youngest child now, when I always pictured her as a big sister someday.”

She says that the cultural problem with people who call themselves pro-life is that they don’t accept the consequences. “Women that they know, women who want to be mothers, women who go to church every week – are going to be the ones that are also suffering.”

The new report – by researchers at Boston University and the Commonwealth Fund – includes data on state-by-state abortion policies and health outcomes among mothers and babies from sources including the US Centers for Disease Control and Prevention, the Health Resources and Services Administration and the nonprofit March of Dimes.

Zephyrin said, “What’s most surprising is, states have within their power to avoid these outcomes.” “States really have it in their power to enhance maternal health capacity, really create the systems that are necessary to ensure that every person has an opportunity for a safe and healthy birth and life, whether we’re talking about recruiting maternity providers, providing more birthing centers, supporting the range of reproductive health services, expanding Medicaid, investing in postpartum Medicaid extension.”

The analysis also revealed that 39% of counties in states restricting abortion access fit the criteria to be considered “maternity care deserts,” meaning there is limited or no access to maternity health care services, such as an ob/gyn, hospital or birth center with obstetric care or certified midwives. In comparison, 25% of counties in abortion-access states can be considered maternity care deserts.

Separate research published in 2020 in the journal Women’s Health Issues found that although maternal mortality overall continues to increase in the United States, the maternal death rate in states that have expanded Medicaid has had less of an increase than in non-expansion states.

Dr. Kristyn Brandi, the American College of Obstetricians and Gynecologists’ Darney-Landy Fellow, said she is not surprised by the findings in the new report because the “issues around reproductive health care are intricately linked.”

OB-GYN Follow-Up of Kaitlyn Joshua’s Miscarriage in Louisiana: Implications for Medical Treatment and Pregnancies

BATON ROUGE, La. – When Kaitlyn Joshua found out she was pregnant in mid-August, she and her husband, Landon Joshua, were excited to have a second baby on the way. They have a 4-year-old daughter, and thought that was just the right age to help out with a younger sibling.

She wouldn’t comment on Joshua’s situation, but Jenny Villavicencio thinks it’s a bad idea to wait until after the 12th week of the baby’s life.

“They specifically said, ‘We now no longer see women until they’re at least 12 weeks,’” Joshua recalls. “And I said, ‘Oh Lord. Is it because of something that I think? They said yes.

During those early weeks of pregnancy, Joshua experienced symptoms she hadn’t dealt with in her first pregnancy: mild cramping and spotting. Joshua did not have access to a doctor, so she didn’t know what to do.

The dangers of pregnancies for Black women like herself are well known by Joshua. She also knew about Louisiana’s dismal maternal health statistics: The state has one of the highest rates of maternal deaths in the country, and Black women are at a higher risk than white women.

Joshua remembers one nurse telling her: “‘It appears that you could be having one. We don’t want to say that is what it is. Let’s just keep watching. You can continue to come back. We’re praying for you.

She didn’t want to go to the first ER so she called her mother and husband and said that she would go to Baton Rouge General. There, a security guard put her in a wheelchair. Her jeans had blood on them. Staff gave her another ultrasound, and the technician told her she’d lost a lot of blood.

The doctor told Joshua that if she was miscarrying, she should go back home and wait for a follow-up appointment with her OB-GYN.

Miscarriage treatment is also time-sensitive, McLemore added. She says that, ideally, a patient like Joshua would have had OB-GYN care even before she got pregnant so that she had more consistent care, which could have helped give her more autonomy over how to treat her miscarriage.

Since Louisiana’s ban took effect, some doctors have warned that the law’s language is vague, and that fear and confusion over the law would lead to delays in pregnancy care.

Ellie Schilling, a lawyer with Lift Louisiana, a reproductive justice organization that challenged Louisiana’s law in state court, says that while the law allows for miscarriages to be treated, it is written in legal language that doesn’t translate easily into medicine, or necessarily line up with an individual patient’s set of circumstances. And this puts doctors in a very difficult situation.

For the miscarriage exception, in order not to be liable for providing an abortion, physicians must provide “a positive diagnosis, certified in writing” in a woman’s medical records, as well as an ultrasound, to prove that the pregnancy “has ended or is in the unavoidable and untreatable process of ending.”

Baton Rouge General, the second ER, says it still provides the options for patients and their families in the way that it once did. In a statement, Dr. Kathleen Varnes, an ER doctor, said the hospital “sympathizes with the pain and anxiety” Joshua experienced but that it believes her care was “appropriate.” Every patient is different, she said, adding “there are times when waiting and observing is the right approach, and other times when medication or a procedure may be necessary.”

In September, at a Louisiana Department of Health meeting, Dr. Joey Biggio, the chair of maternal and fetal medicine with Ochsner Health, Louisiana’s largest health system, said some OB-GYN doctors were afraid to provide routine care.

Many people don’t want to provide care for patients if they’re worried about being threatened by the Attorney General’s office. We need to figure out a way to provide clear, unambiguous guidance, or we’re going to see some of the consequences of this.

Miscarriages can be dangerous – they can cause hemorrhaging and infections that lead to sepsis – and it makes sense that patients would seek answers and treatment options from health care providers, says Monica McLemore, a registered nurse and the interim director for the Center for Anti-Racism in Nursing at the University of Washington.

We need to apologize for the harms that we have committed as a health care provider. It’s really sad that the care that she sought for herself was not provided to her,” McLemore says.

Source: https://www.npr.org/sections/health-shots/2022/12/29/1143823727/bleeding-and-in-pain-she-couldnt-get-2-louisiana-ers-to-answer-is-it-a-miscarria

Is it a miscarria? Explaining why she’s afraid to go out and tell her kids, or what she wants to tell her

They’re trying to pair language with patients to see if they have reached the threshold of what’s deemed appropriate. She says, “Have we not?”

Monica McLemore, the nurse who researches racism and maternal health at the University of Washington, says research shows that Black patients are less likely to be listened to and believed.

And that can fuel distrust of the health system. People who don’t like how they were treated during pregnancy can be less willing to seek care in the future, she added.

“I love my kid. And so, she constantly makes me want another her. But in this moment, it’s just too dangerous to get pregnant in the state of Louisiana,” Kaitlyn says. “I don’t think you should risk your life for a baby right now.”

Source: https://www.npr.org/sections/health-shots/2022/12/29/1143823727/bleeding-and-in-pain-she-couldnt-get-2-louisiana-ers-to-answer-is-it-a-miscarria

Reconciling the Birthrights of Abortion with Other Laws: The NARAL Pro-Choice Alliance argues that the FDA is not to be trusted with its decisions

This story was produced in partnership with WWNO and KHN. It was edited by Carrie Feibel, Jane Greenhalgh, Diane Webber and Carmel Wroth. The art direction and design was handled by the two people. Photographs by a female photographer.

“The statutes, read together, make clear that physicians are permitted to perform abortions as regulated” by other abortion laws, the appeals court wrote.

The law was asked for to be implemented by Attorney General Mark Brnovich after the Supreme Court overturned the landmark decision.

The procedure was stopped in the state because of the “personhood” law and stopped again when the judge allowed the 1864 law to be enforced.

The Bans in Montana, North Dakota, Ohio, South Carolina, Utah, and Wyoming are not in effect at the moment while courts decide if they can be enforced.

This research shows that the high stakes of the lawsuit and we can only expect the worst from the federal judge. Americans want access to abortion, but anti-choice bad actors are dead set on restricting reproductive freedom by any means possible,” said Angela Vasquez-Giroux, the group’s vice president of communications and research.

If Kacsmaryk sidetracks, abortion care would be phased out, according to NARAL Pro-Choice America.

“More generally, if longstanding FDA drug approvals were so easily enjoined, even decades after being issued, pharmaceutical companies would be unable to confidently rely on FDA approval decisions to develop the pharmaceutical-drug infrastructure that Americans depend on to treat a variety of health conditions,” the FDA wrote.

“A preliminary injunction would interfere with Congress’s decision to entrust FDA with responsibility to ensure the safety and efficacy of drugs. In discharging this role, FDA applies its technical expertise to make complex scientific determinations about drugs’ safety and efficacy, and these determinations are entitled to substantial deference.”

Danco, which makes mifepristone, also made a similar request to the FDA’s in a court filing, stressing that the lawsuit could decimate the company’s business.

Amarillo, Texas: a case study of Kacsmaryk’s activism in biden administration and Trump’s immigration ban

Kacsmaryk, meanwhile, is assigned every civil case filed in Amarillo, another division in northern Texas. The judge has ruled in favor of Texas in disputes over Biden administration’s LGBT protections and the president’s attempts to end Trump-era migration restrictions. He’s in the national spotlight for the ruling he will make on the medication abortion case.

In December, Kacsmaryk stopped the Biden administration from ending the so-called “Remain in Mexico” program. And he has overseen Texas cases challenging vaccine mandates, the gender identity guidance issued by the US Equal Employment Opportunity Commission and the administration’s limits on the use of Covid-19 relief funds for tax cuts.

The White House biography says that before joining the court, Kacsmaryk worked for a religious liberty legal group and was mainly involved with religious liberty litigation and briefs in the Supreme Court.

The case is being closely watched by a number of interested parties, including Republican and Democratic state attorneys general. Two different multi-state coalitions filed statements of fact with the court on Friday urging them to either act one way or another.

And a coalition of 22 Republican attorneys general asked the court to issue the preliminary injunction, arguing the FDA exceeded its authority when it approved the medication.

In order for the case to be successful, a ruling by Kacsmaryk in favor of thePlaintiff would have far reaching consequences for every corner of the country.

And activists are mobilizing in Texas around the issue, with the Women’s March planning to hold a rally at the federal courthouse in Amarillo, Texas, on Saturday.

The fight for reproductive rights is not unlike the fight for gay rights in the states, said Rachel Carmona, the executive director of Women’s March.

How the doctor in Texas is telling her about abortion laws: The story of Lauren Miller, an OB-gynna, traveling out of state

On Thursday, Kacsmaryk told the people that he had until the 24th to respond to the Danco file, which will be closed after that time.

In the months that followed, more Texas patients with medically complex pregnancies were turned away, and several of those faced life-threatening conditions. Miller and another patient were both told by the doctors that they needed to have one of their twins terminated in order to make sure the other twin didn’t die.

A genetic counselor told her that carrying both fetuses could put the healthiest one at risk. The doctor told her that she couldn’t do anything in Texas and that she needed to leave the state.

That’s exactly what she did. At 15-weeks pregnant, Miller traveled to Colorado for a “selective reduction” procedure in which she had a healthy twin.

When she returned to Dallas and continued her prenatal care, she found herself navigating silence around abortion. She wondered, if the ultrasound technician knew she’d traveled out of state for an abortion, could she get reported? “It feels like we’re talking in code, because you don’t know where any of us are,” Miller says.

What Miller did does not violate current abortion laws in Texas, legal experts say. Some doctors in Texas won’t say the word “abortion” in the exam room because of the fear of being sued for performing abortions.

The first amendment of the constitution protects free speech, according to Elizabeth Sepper, professor of law at University of Texas at Austin. She said that doctors have independent speech rights to speak to their patients. Doctors should not be afraid to say the a-word.

Lauren Miller’s OB- doctor asked NPR not to use her name because she is not authorized by her employer to speak with the media.

“I have colleagues who say cryptic things like, ‘The weather’s really nice in New Mexico right now. You should check it out. “I’ve heard traveling to Colorado at this time of year is really nice,” says Miller’s OB-GYN. Patients have to be well-educated enough to pick up on these hints, do their own research, and figure out what to do next. They also have to have the means to travel or find funding to do so, if they want to pursue abortion.

There are some lawmakers in the state who would like to go further. The Texas Freedom Caucus put out a list of priorities last month that included “Stop those aiding and abetting out-of- state abortions by implementing Texas law.” A spokesperson for the caucus did not respond to NPR’s interview request.

Telling a mother to go get care out-of-state: A case study on “the law’s poorly written,” warns a doctor in Texas

That doctors can counsel their patients without violating legislation is complicated, and hasn’t been tested in court. “The law’s vague – it’s really poorly written, probably on purpose,” says Palmer, adding, “Nobody wants to be defendant number one on this.”

She recalls one Texas patient whose fetus had acrania, where the fetus has no skull. It’s a fatal condition for the fetus. “That was a doctor who didn’t tell her, ‘Go get care out-of-state,’” says Espey. “She was an immigrant. It took her six weeks to figure out how she could afford the trip to New Mexico for an abortion.

While pregnant women in Texas have access to many genetic testing options, and can act on that information early in their pregnancies, it’s not possible to act on that information.

Palmer is the doctor in Fort Worth. “We are asking questions that we can only provide limited resources for the answer,” she says. “And it is really frustrating as a physician to not be able to provide full care for patients.”

Source: https://www.npr.org/sections/health-shots/2023/03/01/1158364163/3-abortion-bans-in-texas-leave-doctors-talking-in-code-to-pregnant-patients

The Texas Attorney General’s Brief on Cases Filed in a “Serial” Division of the D.C.S. Courthouse

Texas Republicans did well in the last election even after the state’s abortion restrictions took effect, so there’s no appetite for them to bring it up again. “I think Republican legislators realize, ‘We passed these bills into law, we weren’t punished at the ballot box,’” he says. “So what is the incentive to do anything different?”

Steinhauser doesn’t hear a lot about it in the capital. “I think that you’re probably not going to see a lot of change in the session this year. “

She says that they would have had a chance to give information for free. This whole process of trying to get information would not become so complicated. Where do we go?”

She has been caring for her one year old and preparing for the arrival of her baby at the end of March. She says that she’s civically engaged. “I have no qualms, when something’s going on, calling a member of Congress, writing an email, staying informed, [sending] the letter to council.”

The Department of Justice is now refuting its claims that Texas is shopping for cases to bring against the Biden administration.

The Lone Star State’s pattern of filing cases has hindered the department’s ability to pick judges to hear them, which is something it has been trying to change.

Reuveni, the DOJ attorney, meanwhile, stressed that their motion wasn’t targeted at Tipton, whom the department thought was a fair judge, but rather it was aimed at Texas’ tactics. Reuveni said that the case wouldn’t have an issue if it was assigned randomly to Tipton, as he had transferred the case to a court division with other judges.

With its tactics, Texas can “circumvent the random assignment system by never filing in Divisions where they have a non-trivial chance of not knowing what judge they are likely to be assigned,” the DOJ said in brief submitted to Tipton this week.

There are many reasons for the cases to be filed where they are. She claimed the Biden administration had a plan to undermine the public’s trust in the legal system.

Forum shopping is a strategy embraced by litigants on the left and the right. Progressives were strategic in where they brought cases against the Trump administration. Legal experts say that the practice of filing lawsuits in courthouses when there are several Democratic-appointed judges in the area is different from the current trends.

Tipton, however, seemed largely unconcerned with Texas’ tactics of targeting its cases at his courtroom, as he grilled a DOJ attorney on whether the department was suggesting the judge would be unfair.

Tipton told the DOJ attorney, Erez Reuveni, that the department could help with the perception of fairness by saying on the public record that it believed that Tipton, as a judge, would give them a fair shake.

Olson told Tipton that the specific immigration case was filed in Victoria because Paxton’s office felt like it knew how the judge ran his court room and because Tipton was familiar with the statutes relevant to the case.

Hendrix, another Trump appointee, hears two-thirds of the civil lawsuits filed in the Lubbock division, which is located in northwest Texas and is several hours’ drive from the state’s biggest cities. DOJ, with its Monday request in the spending legislation case, asked the judge to move the lawsuit to DC or to Austin. The National Board’s grant to a non-profit organization in Houston is the main allegation, according to the department.

The Alliance for Hippocratic Medicine filed its paperwork in Amarillo just a few months before filing the lawsuit. However, the organization’s attorney pushed back on allegations that the filing location was chosen strategically to get the case before Kacsmaryk.

“Congress has authorized the American public to sue federal agencies where the American public has actually been injured and where they reside,” Baptist said. “And that’s exactly what Dr. Jester did here. The other people filed this case because he lives in Amarillo and we filed it there.

Leif Olson, an attorney in Paxton’s office, told Tipton at last week’s hearing that “I don’t know why our office chooses to file in seven divisions over and over,” referring to the seven divisions DOJ highlighted in its briefs.

Having the case decided quickly is in the public’s interest, Your Honor. In the Victoria Division, that is available.

It would go a long way in addressing your perception concern if the public heard the Department of Justice say it. the judge said.

Lorentz Invariance in Texas: A Loss of Abortion in the Aftermath of a Birth: Five Women Sue the State of Texas

AUSTIN — Five women who were denied abortions under Texas law while facing medical crises are suing the state, asking a judge to clarify exceptions to the laws.

The Texas Attorney General is named in the suit. By forwarding a “guidance letter” about the state ban triggered by the Supreme Court decision, his office said Paxton would continue to defend and enforce the laws.

For a story published in early 2022, just months after SB 8 took effect, Zargarian spoke to NPR using only her first name out of fear of repercussions for herself or her doctor; she agreed to go public with her full name as part of the lawsuit. The doctors at Zargarian’s hospital denied her an abortion because her water broke too young for the fetus to survive. Fearing the prospect of severe infection, she flew to Colorado for a termination.

Speaking to NPR last year, John Seago of Texas Right to Life — a major force in pushing SB 8 through the state Legislature — said it was “politically advantageous for some of these groups that oppose the bill … to just say this is unreasonable.”

The goal of the new suit is to make the state of Texas give clear instructions to their doctors about how to handle patients with serious medical problems while pregnant.

“What is a doctor to do in Texas right now? They had to come forward and seek clarification. They had courage in doing so.