The Roadmap to Mobile Planned Parenthood in the St. Louis Region and Southwest Missouri: State Laws, Abortion, and Access Points
Anticipating that possibility, Planned Parenthood opened a large clinic in 2019 in Fairview Heights, Illinois, just across the state line from St. Louis. Missouri had some of the nation’s strictest abortion laws even before the court released the Dobbs v. Jackson Women’s Health Organization decision, and state officials moved almost immediately to implement abortion bans in response to it.
“Our goal is to reduce the hundreds of miles that people are having to travel now in order to access care…and meet them where they are,” said Yamelsie Rodriguez, President of Planned Parenthood of the St. Louis Region and Southwest Missouri, said in an interview with NPR.
It can make care more complicated by having to travel out of state. In Illinois, a state surrounded by states that restrict or ban abortion, Dr. Sadia Haider treated patients.
The number of patients who come from across the region each year is increasing much more quickly than anticipated, Rodriguez said. “We just need more access points.”
One of the first tasks will be to determine the best routes for the mobile clinic. The organization is looking at data to determine where patients are going and look at healthcare facilities, churches, and other locations as possible stopping off points. Another important consideration will be safety and security for patients and staff, McNicholas said.
Keeping up with Out-of-State Abortion Laws: How Well Do Clinics Open? A Case Study of an Obstructive Patient
Those that have lost their lives in the political trenches are aided by the hope of these moments to stand up once more. Our sails are being inflated by the support of the general public, our colleagues in other specialties who are joining us in opposing abortion bans, and our governing bodies that are unashamed in opposing abortion bans.
The law that forced Tara and Justin to travel out of state has been put on hold by a judge and will not be enforced while litigation is pending. The upcoming mid-term elections are likely to have a major impact on what will happen next. I coordinate out-of-state abortion care for other states, so I have to keep up with abortion laws here.
The Guttmacher Institute expects clinics to close as more states pass abortion restrictions. “[Our] estimate is that ultimately there’s 26 states that are going to ban abortion, and again, we’ve only got 15 at this point,” she says.
I have had young women with chronic medical conditions, and even women with highly desired pregnancies, who find out they can’t get an abortion in their state, beg me to help them.
Imagine if you will someone said, “I have all of the skills and the tools to help you, but I can’t because our state politicians have told me I can’t.”
The Guttmacher analysis found that 26 of the clinics have closed down, which means they might never reopen.
Jones says that the clinics might have moved their medical supplies to other facilities. It’s not like they could open their doors tomorrow if the bans were lifted.
“I recently saw a patient from a Southern state with a very serious obstetric condition, an abnormal placenta, [which] can cause severe hemorrhage and morbidity if not treated appropriately,” she explained during the White House event this week. The patient had already tried to get care in her own state and elsewhere before coming to Illinois.
“We were able to provide the care required for this patient, which was unfortunately more complex than it needed to be because there were several weeks that ensued before the patient sought care and eventually saw us,” Haider said.
The Brooklyn Center for Reproductive Health Care Response to the Supreme Court’s Decision to Overturn Wade in the Post-Roe Context
The move is a response to the Supreme Court’s decision to overturn Wade, and was made to ensure students have access to abortion health care in the future.
“Barnard applies a reproductive justice and gender-affirming framework to all of its student health and well-being services, and particularly to reproductive healthcare. In the post-Roe context, we are bolstering these services,” Catallozzi and Grinage said.
The Food and Drug Administration last year relaxed decades-old restrictions on one of the medications, mifepristone, used to induce abortions in early pregnancy, allowing people to get it through the mail.
“While our students have access to high-quality reproductive health services in New York and particularly at [Columbia University Irving Medical Center], we are also preparing in the event that there is a barrier to access in the future, for any reason,” Catallozzi and Grinage said.
The lawyers of the hospital did not agree with my recommendation that the risks of Tara’s blood clotting disorder were more important than the potential benefit of carrying a fetus. Tara was ultimately able to get the care she needed in Michigan, but at great emotional burden, financial cost and delay. If, god forbid, something had gone wrong for Tara medically during the days she had to wait to terminate her pregnancy, I’m not sure what I would have done.
A hospital PR official asked the doctor to send along the reporter’s questions and her proposed answers because they were not involved in interviews at this time.
The doctor sent along the questions and answers and received a resounding “no” from the PR official: “We ask that you do not comment to the NY Times at this time.”
At a hospital in a different state, one that does allow abortion, a doctor said they “got called into the principal’s office” by hospital administrators after participating in a public event about abortion, even though at the event, the doctor never mentioned where they work.
“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.
Medical centers are having to deal with a lot of fear and confusion after new abortion limitations, according to an acting chief health care officer at the Association of American Medical Colleges.
“They don’t want themselves or the physicians to be put in a position where something is said that could be interpreted that’s going to cause a problem for both the clinician and/or the institution,” said McCoy, whose group represents more than 400 teaching hospitals and health care systems.
Family Violence During Pregnancies: The Feast of a Mother’s Cryptanalysis, Revealed by a Certified Pediatrician
The fetus was too young to survive outside of the womb, as the woman was 19 weeks pregnant. Her water had broken, an ultrasound showing no amniotic fluid around the baby. When abortion is allowed, pregnant women can have their pregnancies terminated since they have a high likelihood of developing an illness which can be a life-threatening emergency.
The passage of Texas laws have led to some women being denied abortions when their lives are in danger or the fetus has fatal birth defects. Even though the fetus had died, others have been denied abortions.
The doctor said that the patients deteriorated in front of their eyes because they were high-risk pregnancies.
“This has clearly been done to make us feel like criminals. That’s exactly how it makes us feel – like we’re doing something wrong,” she said. “I think we’re all pretty scared. I’m afraid of losing my job. Losing my job would be big, and I am the primary earner in my family.
The doctor told CNN that at the meeting, he was worried that high-level administrators would see the video and get a transcript to make sure he wasn’t connected to his employer.
Sensitivity to the U.S. Supreme Court Supreme Court, Protogalactic Abortion, and the Public Affairs of the UT Southwestern Medical Center
“I got the strong sense they’ll say no,” they said. “They worry about state funding sources and what happens if it gets controversial, so unfortunately instead of supporting us, they want everyone to play nice and quiet and not stir up any trouble.”
The battle comes with a high cost for everyone. Patients seeking abortion care should not be made pawns in politics or push 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 said the official told the residents that they could post the picture on their accounts, if they didn’t know where they worked.
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 has been shown a photo of the presentation.
The doctor said residents are hesitant to make trouble because when they go to look for another job, “the world is very small, and you rely on senior colleagues to make calls for you, and you won’t be able to find a position if you are perceived as being difficult.”
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.
The official told CNN that researchers could speak with them, but that they would be giving comments as private individuals.
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 speak for themselves.”
Oncologists have expressed concern that abortion bans could hurt pregnant cancer patients. Certain cancer tests and treatments that may harm a fetus are not available to pregnant women because abortion is not an option. As two breast cancer doctors wrote in August in The New England Journal of Medicine, abortion bans “will harm some of our patients” because sometimes, “we cannot offer complete or safe treatment to a pregnant person with a breast cancer diagnosis.”
The MD Anderson public relations office said that the doctors were not available for an interview, when CNN contacted them on September 9, to discuss what they have seen since strict abortion bans were passed in Texas.
MD Anderson said in a statement that its providers discuss the published data on the implications of delaying treatment due to pregnancy, and they refer patients to maternal 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 includes physicians that are experts in high-risk pregnancies, which is why Wade is the 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.
What do we really understand when we hear about abortion laws and what they are doing to the public? Response to an emailed comment from a woman in New York
People don’t understand what the laws are doing to real people because they don’t hear these stories. That’s what people need to understand and hear,” she said.
The hospitals and practices that declined the New York Times invitation were very nervous, according to her. I agree with you.
“There is a part of me that understands that as these laws continue to change rapidly, [for hospitals] to interpret what can be done and can’t be done varies in some places day to day. So I can understand someone taking a very cautious approach – why they might see the world that way,” she said.
She and other maternal-fetal medicine specialists got a call from their hospital administrators soon after the Supreme Court decision.
But on the call, “it became pretty clear that [the medical center] was not going to take a particularly activist approach” and would not make it easy for doctors to describe the impact of the new laws to the public.
She said people were in tears when they heard about the extent to which theinstitution was going to make this difficult.
Research has found that crisis pregnancy centers commonly disseminate misinformation. The Alliance’s study found that almost two-thirds of crisis pregnancy centers promoted false or biased information about abortion on their websites. That included false claims that abortions increased the risk of cancer or infertility. More than a third of clinics also advertised that they offered abortion pill reversal – and state-funded clinics were more likely than privately-funded ones to offer the unproven procedure and less likely to offer prenatal care, according to the study.
More than a half-dozen states bankroll crisis pregnancy centers at least partly with funds from Temporary Assistance to Needy Families (TANF), a federal welfare program. Federal funds are sent to states as a block grant, which gives state officials wide latitude in how to spend them, including on programs like alternatives to abortion.
Some of the organizations that receive money have been accused of spreading abortion misinformation or using the funds to advocate anti-abortion causes instead of helping women.
Patients looking for the same thing at multiple times a week, mistakenly walk through PDHC’s doors, according to a clinician who asked not to use her last name out of security concerns. Some patients have said that the employees of PDHC made them be late for their appointments or told them that abortion was unsafe.
Ayla Krueger went to PDHC with a friend who was looking for an STD test. She said that an employee claimed that condoms were only 50% effective, the spread of STDs could only be prevented if people avoided sex before marriage, and if a woman gets an STD.
“I was dumbfounded,” Krueger said of the encounter. My heart was breaking, thinking about girls who don’t know what to do.
The Duke University Medical Center’s Crisis Pregnancies Center – A View from the Left-Right Correspondence with an Empirical Professor
The center’s rhetoric was not accurate. According to a professor at Duke University Medical Center, the risk of infections during an abortion is really low. Crisis pregnancy centers often overstate the risk of abortions, and this is one example.
According to the center’s website, it also has yearly reports and pamphlets at the office. Abortion reversal is a medically dubious, unproven treatment that purports to undo a medication abortion but has been denounced by medical groups and found to be dangerous by researchers. A clinical trial that attempted to study abortion reversal was halted prematurely in 2019 when several participants suffered hemorrhaging.
Kathy Scanlon, PDHC’s president, declined an interview request and didn’t respond to CNN’s questions about Krueger’s allegations or abortion pill reversal.
“When facing an unexpected pregnancies, each woman deserves care and compassion, and the center has a lot of resources to help them,” she wrote in an email.
The 2012 academic study found that the majority of crisis pregnancy centers in North Carolina promoted false or misleading medical information on their websites.
The leaders of the crisis pregnancy center say they are helping women. Hartshorn founded the Columbus center and is chair of Heartbeat International, which is one of the largest global networks of crisis pregnancy centers.
The centers provide information that is very well-researched, medically referenced and document everything with multiple sources.
Source: https://www.cnn.com/2022/10/25/us/crisis-pregnancy-centers-taxpayer-money-invs/index.html
The Case against Abortion and Pregnancies in the Upper Midwest: Challenges to the Senate’s Eight-Year TANF Budget
The six-week abortion ban that went into effect after the Supreme Court’s decision, but is currently on hold, is being challenged in court. The Ohio State University clinic doesn’t do abortions and patients are referred to a surgical center on the other side of town.
While about 68% of families with children in poverty received cash assistance through TANF in 1996, when the program was created, that percentage declined to just 21% by 2020, according to a study by the Center on Budget and Policy Priorities, a nonpartisan think tank. In some of the GOP-dominated states, the percentage of TANF dollars used to support crisis pregnancy centers was lower.
“When you look at successes in reducing poverty by strengthening the safety net, cash assistance is the most effective way to help families,” said Aditi Shrivastava, who co-authored the study. States are spending less of their money on cash assistance because we don’t think the program should be doing that.
Many of the appropriations are written into spending bills passed by GOP-dominated state legislatures. Pennsylvania has given more than 70 million dollars to crisis pregnancy centers through Real Alternatives, an anti-abortion group that distributes state funding.
A 2017 report by the state auditor general found that Real Alternatives used hundreds of thousands of dollars of the money it received from Pennsylvania “to fund its activities in other states,” in what the auditor said was an example of the group “siphoning funds intended to benefit Pennsylvania women.” Real Alternatives denied the allegations in a statement, saying that they had “no basis in fact or law.”
The governor of Michigan vetoed the funding that Real Alternatives was supposed to distribute for crisis pregnancy centers. In a letter about the veto, Whitmer thanked a watchdog group that had issued a report accusing the organization of only helping a fraction of the pregnant women it had agreed to support.
Real Alternatives, which is also a recipient of TANF money from Indiana, said that the Michigan report was filled with half-truths and defamatory statements.
A bill that would have required crisis pregnancy centers to give clients only medically accurate information died in the legislature. The legislative leaders did not respond to requests for comment.
Title X funds birth control and reproductive health services, and there was additional federal funding lost by the organization under the Trump administration rule. The organization got the money again this year after the Biden administration reversed the rule.
Maria Gallo, a sexual and reproductive health epidemiologist at Ohio State University, said that state funding for crisis pregnancy centers shows how conservative lawmakers prioritize anti-abortion rhetoric over medical care for women.
In the wake of the Supreme Court decision, there will be a bigger disparity. According to Hartshorn, Heartbeat International has an online training program that gives people the knowledge to open new types of centers.
Source: https://www.cnn.com/2022/10/25/us/crisis-pregnancy-centers-taxpayer-money-invs/index.html
A Case Study in Women’s Care Center: a Philanthropy Lawsuit against a Woman whose Birth was Forbidden by Abortion
A study by the National Center for Responsive Philanthropy found that the groups have taken in more and more money in recent years: They received over $1 billion in revenue in 2019, the most recent year data was available, compared to about $771 million in 2015.
A woman who asked to be known as Eve lost her job when she suspected she was pregnant. She and her boyfriend went to Women’s Care Center in Columbus after finding the group on Google. She chose the center because of the promise of free contraceptives, which is why the state of Ohio gave it $700,000 in this year’s fiscal year.
Eve asked the staff about an abortion after her test came back positive. She said that they gave her a pamphlet which warned her that abortion doesn’t usually affect a woman’s ability to become pregnant in the future. Eve said the staff had demanded that she carry the baby to term.
Eve, who was at the center and then got an abortion, said that it became clear that they were against abortion quickly. The center didn’t respond to questions about Eve’s visit, but they were committed to accuracy, excellence and transparency in all they did.
I worry about my patients and providers. I ponder about how scared my patients are and how quickly they have their finances drained, how alone they must feel. They will think I did not fight hard enough for them, even though I know they can hear the cracks in my voice when I tell them the hospital said they weren’t sick enough.
When there is a next legal crisis that could harm your patients, it can be hard to practice medicine. I talk to hospital lawyers more frequently than any doctor should, because I am frustrated that patients can not get the same care in a different state.
Every time I am forced to turn a patient away, that burning candle inside me, once a roaring and passionate fire in a young student excited to embark upon a career of helping others, dims ever so slightly. This serious breach of my duty as a physician is not easily recovered from, even when I am powerless to do otherwise.
But most of all, I worry that the next lawyer I discuss a complex case with will not understand, and that the patient who needs an abortion will be denied. I worry they will lack the time, money, transportation, 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’m afraid they will die.
But I still experience joy in my job sometimes. A college student is still trembling after swallowing their first pill of their medication abortion regimen, whispering with increasing confidence, “I’m going to be ok.” When a transplant recipient knows she won’t have to go back on the transplant list when heralysis happens again while pregnant, the tears stops and she knows she’s okay.
The enormous weight on the shoulders of a single mom lifts, now that she can focus on the family she has and the career she wants, free of the constraints of an unwanted pregnancy. 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.
What Is My Patient? How I should feel about what I do and how I can take care of me, and what I can do for my patients
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. They should be able to receive accessible, compassionate care regardless of what state they live in. And doctors should be allowed to simply be doctors. I should not fear reprisals if I care for my patients.