Supreme Court decides a pro choice victory

From MSN  June 27, 2016

Supreme Court strikes down Texas abortion clinic regulations

"We're thrilled that justice was served and our clinics stay open," said lead plaintiff Amy Hagstrom Miller. (Photo: AFP/Getty)

“We’re thrilled that justice was served and our clinics stay open,” said lead plaintiff Amy Hagstrom Miller. (Photo: AFP/Getty)

WASHINGTON (AP) — The Supreme Court struck down Texas’ widely replicated regulation of abortion clinics Monday in the court’s biggest abortion case in nearly a quarter century.

The justices voted 5-3 in favor of Texas clinics that had argued the regulations were a thinly veiled attempt to make it harder for women to get an abortion in the nation’s second-most populous state.

Justice Stephen Breyer’s majority opinion for the court held that the regulations are medically unnecessary and unconstitutionally limit a woman’s right to an abortion.

Texas had argued that its 2013 law and subsequent regulations were needed to protect women’s health. The rules required doctors who perform abortions to have admitting privileges at nearby hospitals and forced clinics to meet hospital-like standards for outpatient surgery.

Breyer wrote that “the surgical-center requirement, like the adm


itting privileges requirement, provides few, if any, health benefits for women, poses a substantial obstacle to women seeking abortions and constitutes an ‘undue burden’ on their constitutional right to do so.”

Justices Anthony Kennedy, Ruth Bader Ginsburg, Sonia Sotomayor and Elena Kagan joined Breyer.

Chief Justice John Roberts and Justices Samuel Alito and Clarence Thomas dissented.

Thomas wrote that the decision “exemplifies the court’s troubling tendency ‘to bend the rules when any effort to limit abortion, or even to speak in opposition to abortion, is at issue.'” Thomas was quoting an earlier abortion dissent from Justice Antonin Scalia, who died in February.

Abortion providers said the rules would have cut the number of abortion clinics in the state by three-fourths if they had been allowed to take full effect.

When then-Gov. Rick Perry signed the law in 2013, there were about 40 clinics throughout the state. That number dropped to under 20 and would have been cut in half again if the law had taken full effect, the clinics said.

Texas is among 10 states with similar admitting privileges requirements, according to the Center for Reproductive Rights. The requirement is in effect in most of Texas, Missouri, North Dakota and Tennessee. It is on hold in Alabama, Kansas, Louisiana, Mississippi, Oklahoma and Wisconsin.

The hospital-like outpatient surgery standards are in place in Michigan, Missouri, Pennsylvania and Virginia, and it is blocked in Tennessee and Texas, according to the center, which represented the clinics in the Texas case.

Texas passed a broad bill imposing several abortion restrictions in 2013. Texas clinics sued immediately to block it claiming it impermissibly interfered with a woman’s constitutional right to an abortion. The clinics won several favorable rulings in a federal district court in Texas. But each time, the New Orleans-based 5th U.S. Circuit Court of Appeals sided with the state, at first allowing challenged provisions to take effect and then upholding the law with only slight exceptions.

The Supreme Court allowed the admitting privileges requirement to take effect in most of the state, but put the surgical center provision on hold pending the court’s resolution of the case.

The justices split largely along liberal-conservative lines in their emergency orders, with the court’s conservative justices voting repeatedly to let the law be enforced.

States Took the War on Uteruses to the Next Level in 2015

This Year, States Took the War on Uteruses to the Next Level

Nearly 400 bills were introduced, and 57 of them became law.

—By     Mother Jones  12.30.15

 Reproductive rights took a beating in 2015. According to a year-end report released by the Center for Reproductive Rights, nearly 400 anti-abortion bills were introduced across the country in 2015, up from 335 provisions introduced in 2014. The bills ranged from regulation of medication abortions to all-out bans on the most common method of second-trimester abortions, and the Guttmacher Institute reports 57 of them were enacted. The few pieces of good news can be found in access to contraceptives: Oregon became the first state this year to expand access to birth control medication by offering it over the counter for up to a year’s supply, and California passed a law that allows women to get birth control directly from a pharmacist.

In the final days of 2015, Gov. Cuomo in New York signed legislation that permits pregnant women to enroll in the state’s health insurance exchange at any point during the year by making pregnancy a “qualifying life event.” For everyone without a qualifying life event, enrollment is only available from October through December. New York is the first state to pass such legislation.

But generally, the good news has been limited. Here are some of the most impactful state restrictions that became law this year—and that are likely to affect millions of women of reproductive age:

Medication abortion restrictions: Arkansas’ HB 1578 requires providers to tell patients that the effects of the “abortion pill“—a drug called mifepristone, or RU-486, which is used in conjunction with another pill that is taken at home—can be reversed. This claim has been refuted by the American Congress of Obstetricians and Gynecologists and in medical studies. In the same measure, abortion counselors are required to include in their sessions inaccurate information about fetal pain during the procedure and women’s mental health problems after it. Multiple studies have debunked the claim that most women regret their abortions after the fact.

The state Legislature in Arkansas, which was ranked the second-worst state for women’s and children’s well-being by the Center for Reproductive Rights for its mass of restrictions this year, also passed laws banning telemedicine when it’s used for medication abortion. The technology—involving video conferencing and an automated drawer that pops out and contains the medication—has allowed physicians to administer mifepristone remotely. This method is particularly beneficial for women who live in rural parts of the state and cannot afford the time or money to drive to a clinic in a metropolitan area.

Arkansas implemented an additional restriction on medication abortion that requires doctors prescribing mifepristone to adhere to the original FDA-approved dosage. This sounds reasonable, but it actually decreases the effectiveness of the drug and increases the likelihood of nasty side effects. (Molly Redden reported on increased restrictions around medication abortion in Mother Jones‘ September/October issue.) Idaho also passed laws banning telemedicine specifically when it’s used for medication abortions by requiring physicians to be physically present while administering mifepristone. Doctors who administer the medication must also have admitting privileges at local hospitals or a written transfer agreement with another doctor who does have those privileges. These requirements often disqualify physicians from being able to offer abortion services.

Unprecedented bans against the most common procedure for second-trimester abortions: In April, Kansas passed legislation that made it the first state to explicitly restrict the most common procedure for second-trimester abortions. The wording of the law is ambiguous and does not use medical language—for example, it refers to the fetus as an “unborn child”—and it bans what is referred to as “dismemberment abortion.” In the law, the procedure is defined as “knowingly dismembering a living unborn child and extracting such unborn child one piece at a time from the uterus.” The focus of the law appears to be on the use of the dilation and evacuation method, a method considered by medical professionals to be the safest way to terminate a pregnancy, and which is used in most abortions after the 12th week of pregnancy. A Kansas district court judge, Larry Hendricks, blocked the law less than a week before it was to take effect, and the Kansas Court of Appeals heard oral arguments regarding the law’s constitutionality in early December. However, because the case is being presented before all the appeals judges rather than the traditional three-judge panel, the timing for a final ruling is uncertain.

Oklahoma passed a similar law targeting dilation and evacuation abortions, using even more gruesome language. The law defines “dismemberment abortion”—a popular term among “right to life” advocates—as ” purposely dismember[ing] a living unborn child and extract[ing] him or her one piece at a time from the uterus through use of clamps, grasping forceps, tongs, scissors or similar instruments that, through the convergence of two rigid levers, slice, crush, and/or grasp a portion of the unborn child’s body to cut or rip it off.” A temporary injunction in October was also applied by a judge in this case, and the law is pending a final ruling.

Waiting periods: North Carolina extended the waiting period from 24 hours to 72 hours, tripling the time between state-mandated abortion counseling and actually receiving an abortion. All 12 states in the Southeast have state laws that mandate a waiting period, with the exception of Florida, which tried to pass a 24-hour waiting period this year, but the law was blocked by a circuit court judge and is pending a final ruling. Oklahoma also passed a law that expanded the state’s 24-hour mandatory waiting period to 72 hours.

Tennessee Legislature scales back abortion access: Amendment One, which passed in late 2014, amended the Tennessee state constitution to declare that it does not protect a woman’s right to an abortion or funding for abortions (despite the well-known fact that state and federal dollars cannot legally be used to fund abortion, anyway). The amendment, which was one of the most expensive ballot measures in the state’s history, gave state lawmakers more power to control abortion access and opened the door to a number of restrictive measures in 2015. Twelve bills restricting abortion access were presented before the Legislature this year, including a mandatory 48-hour waiting period. Also in Tennessee, a woman who attempted to self-induce a miscarriage in her bathtub after 24 weeks of pregnancy now faces a first-degree attempted murder charge.

Less than six months after Amendment One was approved, Tennessee also passed a law requiring clinics performing more than 50 surgical abortion procedures per year to meet standards of ambulatory surgery center, which basically amount to hospital standards. This is an example of a TRAP law (short for Targeted Regulation of Abortion Providers), which focus not on women seeking abortions but on the practitioners who provide them. The additional construction, infrastructure, and maintenance costs can bankrupt these providers, as Mother Jones has previously reported.

Parental consent: By adding yet another requirement, Arkansas’ lawmakers tightened restrictions for women under the age of 18 who are seeking an abortion without parental consent. In order to waive the state’s parental-consent requirement, these young women must go through a judicial bypass procedure in which they appear before a judge to receive permission to have the procedure. But they now must also undergo an “evaluation and counseling session with a mental health professional” so that a judge can rule whether there is “clear and convincing evidence” that a minor is mature enough for the procedure and that an abortion is in her best interests.  The law does not mandate any kind of time limit on the court proceedings, so it’s possible a slow-moving petition could delay a teen’s pregnancy until it is illegal for her to go through with the abortion. The law also requires that a minor file the petition in a court in the county where she resides, further compromising her privacy.

Ban after 20 weeks: This year, West Virginia became the 15th state to ban abortions after 20 weeks of pregnancy. Although the governor vetoed the legislation, the state Legislature overrode his veto and passed the bill into law. The law is especially restrictive, offering no exceptions for victims of rape or incest, and it only provides a highly limited exception for women whose lives are endangered by their pregnancy or for fetal abnormalities. Arkansas lawmakers passed a similar ban on abortions after 12 weeks, but the measure was struck down in the US Court of Appeals for the Eighth Circuit. “By banning abortions after 12 weeks’ gestation, the act prohibits women from making the ultimate decision to terminate a pregnancy at a point before viability,” the appeals court said.

Elizabeth Nash, a state policy analyst at the Guttmacher Institute, said that even though 2015 was a tough year, it could get worse in 2016. “In 2016, abortion restrictions are again expected to be on the front burner in many state legislatures,” Nash said. “It does not appear that the pending US Supreme Court case is slowing down abortion opponents. We expect to see a host of abortion restrictions in 2016, including restrictions related to medication abortion, bans on abortion in the second trimester and TRAP laws including the disposal of aborted tissue.”

Becca Andrews is an editorial fellow at Mother Jones. Before moving to the Bay Area to attend UC-Berkeley’s Graduate School of Journalism, she worked for newspapers in the Nashville area. Follow her at @kbeccaandrews or email her at bandrews@motherjones.com.

Gloria Steinem Dedicates Book To The Doctor Who Changed Her Life

Gloria Steinem

Gloria Steinem

Feminist icon Gloria Steinem, who had an illegal abortion when she was 22 years old, dedicated her most recent book to the doctor who performed that procedure for her.

Steinem’s book My Life on the Road, which recounts her lifetime of travel and activism, opens with a dedication to Dr. John Sharpe, the doctor who helped Steinem end a pregnancy in London in 1957. At the time, elective abortion was still criminalized In England, but Steinem was desperate to avoid going through with the pregnancy and ultimately tying herself to a man who wasn’t right for her.

In the book’s dedication, Steinem writes that Dr. Sharpe referred her for an abortion at “considerable risk” to himself, and asked her to promise something in return:

Knowing that she had broken an engagement at home to seek an unknown fate, he said, “You must promise me two things. First, you will not tell anyone my name. Second, you will do what you want to do with your life.”

Dear Dr. Sharpe, I believe you, who knew the law was unjust, would not mind if I say this so long after your death: I’ve done the best I could with my life.

This book is for you.

In a recent interview with NPR’s Terry Gross, Steinem said she also attempted some of the “foolish things” that women of her generation did to terminate an unwanted pregnancy in the absence of legal abortion rights, including throwing herself down the stairs.

“I just knew that if I went home and married, which I would’ve had to do, it would be to the wrong person; it would be to a life that wasn’t mine, that wasn’t mine at all,” Steinem said in that interview. “It seems to me that every child has the right to be born loved and wanted, and every person has the right to control — male and female — to control their own bodies from the skin in.”

Research has confirmed that many women in the United States choose to end pregnancies for similar reasons. According to a qualitative study from the Guttmacher Institute, most women who have abortions say that they could not afford a baby, they did not want to be a single mother, or they did not want to have a child amid serious relationship problems with their partner.

There’s also evidence that reproductive health options are critical for allowing women to pursue their goals over the course of their lifetime. Women say that the ability to plan and space their pregnancies gives them the freedom to work toward becoming financially independent or getting a college degree.

Steinem wasn’t open about her decision to have an abortion until years later, when she was in her mid-30s and working as a reporter for New York magazine. She told Gross that, as she was covering an abortion speak-out and listening to other women talking about their own decisions to have illegal procedures, she suddenly realized that she wasn’t alone.

Hyde Amendment Restrictions on Abortion

Move Afoot to Overturn Hyde Amendment Restrictions on Abortion

By Eleanor J. Bader, February 06, 2015  Truthout

Abortion rights protest When Illinois Congressman Henry Hyde (1924-2007) introduced a legislative measure to cut off federal Medicaid funding for abortion in 1976 – leaving it up to each state to decide whether to use locally raised revenue to pay for the procedure – he understood that by incrementally chipping away at Roe v. Wade, he and his colleagues would be able to make headway in reducing access to reproductive choice.

“I certainly would like to prevent, if I could legally, anybody having an abortion, a rich woman, a middle-class woman, or a poor woman. Unfortunately, the only vehicle available is the Medicaid bill,” he told Congress.

And so began a relentless onslaught of federal, and then state, attacks on abortion, a campaign that has led to passage of a staggering 231 restrictions since 2011 and many hundreds more since Roe was decided in 1973. This, of course, has done little to appease lawmakers who want an outright ban on legal abortion.

On the federal level, the new Republican-led 114th Congress has acted quickly, demonstrating their gumption by introducing six separate antichoice measures during the first seven days of convening. One of them – a bill to make it impossible to buy health insurance policies that cover abortion through the Affordable Care Act – passed the House on Roe’s 42nd birthday.

Similarly, bans on abortion after 20 weeks, personhood amendments, and laws to force clinics to operate like ambulatory surgery centers are among the restrictions proposed in numerous state houses throughout the South and Midwest.

Obviously, advocates of reproductive justice are facing an uphill slog, but a coalition of activists, called All* Above All, is not only taking on the Hyde Amendment, but is working to promote a positive, pro-woman agenda that places eliminating poverty and challenging racism, sexism and classism at the core of its efforts. The campaign has already generated a great deal of grassroots momentum.

Kalpana Krishnamurthy, a staff person at Forward Together, a 25-year-old Oakland, California-based reproductive justice (RJ) group, participated in a summer 2014 All* Above All bus tour that travelled more than 10,000 miles and brought hard facts about Hyde to people in 12 disparate cities.

“Some people said that they clearly remembered when Roe was announced and couldn’t believe we were still fighting this battle; others who had not been born in 1973 were shocked to learn that this type of discrimination continues to exist,” she said.

“They were stunned to learn that women who attempt to access abortions but can’t are three times more likely to fall into poverty than women who are able to get the care they need. Many people also had no idea that Medicaid restrictions have such a disproportionate impact on people of color, who tend to be poorer than Caucasians overall.”

Other facts, among them that the Hyde Amendment impacts 9 million women between the ages of 15 and 44 – 1 in 7 US females – further angered those with whom Krishnamurthy and other All* Above All volunteers spoke, and it took no coaxing to get them to write letters to their elected officials in support of overturning Hyde. “Most agreed that the government should not put up barriers to abortion access,” she reported.

Lisa Weiner-Mahfuz, vice president of program and development at the Religious Coalition for Reproductive Choice, [rcrc.org] said that RCRC joined the coalition for just this reason. “The Hyde Amendment was constructed to systematically target women of color and working-class and poor communities, she said. “To marginalize and throw these communities under the bus is sinful and horrifying. Our faith tradition calls us to do something about it.”

In addition to working with All* Above All, RCRC has developed a program called It’s Time, a congregation-based campaign to raise issues of reproductive justice within churches, synagogues, temples and mosques. In addition, by working with the largely-secular All* Above All, RCRC is attempting to serve as a “bridge” between RJ and religious organizations. Along the way, RCRC is contesting the still-prevalent idea that all people of faith oppose choice and support patriarchy.

All* Above All is a project of the Coalition for Abortion Access and Reproductive Equity, a four-year-old entity initiated by the National Network of Abortion Fund (NNAF); and the National Latina Institute for Reproductive Health. “Every effort to defeat Hyde has been built on the ones that came before it,” Stephanie Poggi, executive director of NNAF, told Truthout.

“When Hyde first passed, there was a battle to repeal it, but it lost, and in 1981, the Supreme Court upheld the ban.” A dozen years later, in 1993, she continued, the Black Women’s Health Project launched another repeal effort. “This one succeeded in getting the rape and incest exceptions inserted into the amendment,” Poggi noted, a victory that allows pregnancies resulting from these types of violations to be terminated for anyone in any state who is covered.

It was a small, but not insignificant win, Poggi added, and subsequent organizing drives in 2000 and 2006 continued to build support for overturning Hyde. Some of the impetus, she said, came from the more than 80 abortion funds that raise private money from individual donors to help low-income women pay for abortions in the 32 states (and Washington, DC) that do not provide funding for them, something that would not be needed if Medicaid coverage was available.

Poggi further credited the leadership of women of color in the reproductive justice movement for pushing the interests of the most vulnerable constituencies into the limelight. “Thanks to the leadership of those who work directly with low-income women, All* Above All is the strongest anti-Hyde effort yet,” she said.

The coalition’s strategy is multi-tiered and long range. Right now, Poggi reports, All* Above All is concentrating on building support for overturning Hyde by reaching out to young people, people of color and activists “who already see how important it is to build support for this work.”

They are also working in states where Medicaid coverage is currently available, but considered vulnerable – Minnesota, Oregon and West Virginia – and are shoring up support for its continued provision.

“We need to protect the coverage that exists and make it stronger,” Poggi explained. “We’ll then try to expand into states without coverage. It’s our job to demonstrate how central Medicaid coverage for abortion is in ensuring that low-income women have decent lives. We also need to highlight the links between reproductive freedom and economic and racial justice.”

While All* Above All is intent on spreading this message to regular folks, it also wants to bring state, city and federal legislators on board. Kate Stewart is on the coalition’s steering committee and points out that at the conclusion of the bus tour, more than 175 activists converged on Washington, DC, for Hill Education Day meetings with 95 lawmakers, several of whom committed to working to overturn the amendment, all Democratic representatives: Rep. Katherine Clark (Massachusetts); Rep. Rosa DeLauro (Connecticut); Ted Deutch (Florida); Keith Ellison (Minnesota); Eleanor Holmes Norton (Washington, DC); Mike Quigley (Illinois); and Jan Schakowsky (Illinois).

A petition to President Obama, signed by more than 80 organizations, further demanded that Medicaid funding for abortion be included in the fiscal 2016 budget.

All* Above All has effectively demonstrated that “Medicaid coverage is not the third rail of reproductive health policy,” said Jessica Gonzalez-Rojas of the National Latina Institute. Nonetheless, not all of the 60-plus coalition members are able to make its demands a number one priority.

Cherisse A. Scott, founder and CEO of SisterReach, a three-year-old Tennessee group working to promote reproductive justice, cautions that it may be impossible to make overturning Hyde a central demand in every state. “Tennessee just passed Amendment One in November,” she said. “This means that if we lose Roe at the federal level, our state legislature will immediately make abortion illegal here. Our priority right now is educating people about what just happened, because a lot of folks believe abortion is already illegal. For the foreseeable future, Hyde will have to take a back seat.”

Still, to a one, All* Above All members agree that it is high time for the reproductive justice movement to be proactive. “We’re working to engage the women of color, young women and poor women who are the most impacted by restrictions on abortion,” said steering committee member Kate Stewart. “It’s a multifaceted campaign that takes a bold, positive, vocal and visible stand to lift coverage bans.”

Despite obvious challenges, she is heartened by the on-the-ground support All* Above All has received from people across the country.

That said, Jessica Gonzalez-Rojas of the Latina Institute concedes that the stakes remain extremely high, and she urges supporters to keep the focus on the ways the amendment impacts individuals and families.

“We should never forget Rosie Jimenez,” she concluded, “or her tragic legacy.” Jimenez was a 27-year-old Latina single mother and college student who is the first known victim of the Hyde Amendment. Her life was lost to septic shock following an illegal abortion two months after the amendment took effect. Although Jimenez had a Medicaid card, she lived in Texas, a state that does not provide the coverage she needed to terminate an ill-timed and unwanted pregnancy.

Eleanor J. Bader teaches English at Kingsborough Community College in Brooklyn, NY. She is a 2015 winner of a Project Censored award for “outstanding investigative journalism” and a 2006 Independent Press Association award winner. The coauthor of Targets of Hatred: Anti-Abortion Terrorism, she presently contributes to Lilith, RHRealityCheck.org, Theasy.com and other progressive feminist blogs and print publications. 

Abortion Lethal For Many Women

Abortion in Brazil: a matter of life and death

The day after Jandyra went for an abortion her body was found mutilated beyond recognition. Donna Bowater reports on the plight of millions of women who put their lives in the hands of gangs running dangerous clinics

By Donna Bowater  The Guardian February 1, 2015

Jandyra Magdalena who died from an illegal abortion

‘They don’t have consciences – they are monsters. These clinics are not thinking about the wellbeing of the woman’: Joyce Magdalena after the death of her sister Jandyra, above. Photograph courtesy of Jandyra’s family

Born five years apart, sisters Joyce and Jandyra Magdalena dos Santos Cruz lived together in a simple low-rise in Guaratiba, a poor neighbourhood of Rio de Janeiro, with Joyce’s four children, Jandyra’s two daughters, and their mother, Marie Ângela. Like many Brazilian families, their lives were inextricably meshed by economies of scale.

It was the honey-coloured eyes they also shared that Joyce Magdalena recognised last August, when Jandyra was found inside a burnt-out car. She had been mutilated, dismembered and charred beyond identification. She had climbed into the same car a day earlier, at a bus station in the nearby town of Campo Grande, to be taken for an illegal abortion.

“The press said they cut off her hands,” says Joyce. “It wasn’t just her hands. They took off her arms, legs, teeth. A woman so beautiful. OK, she committed a crime, but she was committing a crime against herself, against her own life. It didn’t hurt anyone.”

Were it not for the brutality of the case, Jandyra might have become just another statistic: another woman having one of the estimated one million abortions carried out every year in Brazil, where it is punishable by up to three years in prison. Even her death would have been unlikely to raise more than a passing mention. It is claimed that every two days a Brazilian woman dies while trying to end a pregnancy, and there are 200,000 hospital admissions a year as a result of bungled procedures. But Jandyra’s fate shone a light on the cruel, illegal trade in women’s desperation. It stirred women’s rights groups and activists, giving a high-profile face to their controversial cause: “How many more Jandyras?” and “We are all Jandyra” were the straplines on the protest posters in Copacabana last September.

According to the police investigation, she was the victim of a criminal gang running an “abortion business”. Along with two other women, Jandyra, aged 27, was met by the gang’s driver at the bus station so as to hide the makeshift clinic’s address, and driven to a rented home in a private condominium. The alleged gang ringleader, Rosemere Aparecida Ferreira, reportedly admitted to police that Jandyra had paid R$4,500 (£1,100) for the termination carried out by an unlicensed doctor, Carlos Augusto Graça de Oliveira, but said she had not been there at the time. Ferreira claimed she was later called by the driver to say only that there had been “a problem”.

It is suspected that Jandyra suffered fatal complications during the abortion, with prosecutors alleging the gang then disfigured her body to protect themselves by preventing her from being identified. Her limbs, fingers and dental arch were removed, and her body set alight. “I couldn’t do this to a dog, a cat, a parrot,” says Joyce. “They don’t have consciences – they are monsters. These clinics are not thinking about the wellbeing of the woman. They’re thinking about money.

While Jandyra’s death shocked Brazil, the death of a housewife in another botched abortion in Rio just a month later thrust the law into the spotlight immediately before October’s general election. Elizângela Barbosa, 32, died after a plastic tube was left in her uterus. She had been in a similar situation: she had three children and could not afford a fourth. “I don’t think she would have had so much courage, but she was really tormented about this,” says her sister Sandra Barbosa, still in shock. Sandra is now bringing up Elizângela’s seven-year-old daughter and one-year-old son, while her four-year-old boy stays with his father. Police arrested a woman called Ligia Maria Silva, who reportedly started performing clandestine abortions 20 years ago after carrying out her own.

“It’s totally illegal, so the women have abortions in the worst conditions,” says Dr Marcelo Burlá, president of the Gynaecology and Obstetrics Society of Rio de Janeiro state. “We have a lot of bad problems, like hysterectomies, like bleeding, like women not able to be pregnant again. All because we have a legal condition that doesn’t support the women who don’t want to have a baby.”

The right to choose: a pro-abortion march in São Paulo. Photo by Tiago Mazza Chiaravalloti/NurPhoto

The right to choose: a pro-abortion march in São Paulo. Photograph: Tiago Mazza Chiaravalloti/Rex

There are only a handful of exemptions to the ban on abortion – to save the mother’s life, if the pregnancy was a result of rape, or, in a recent controversial addition, if the foetus has anencephaly, a rare birth defect in which the brain and skull do not develop. By October, police in Rio had made 61 arrests as part of the 15-month-long Operation Herod, which investigated an illegal abortion set-up charging up to £1,800 per procedure. The gang allegedly carried out up to 20 abortions a day. In 2013 there were only 1,520 “legal” terminations carried out by the public health service.

In an otherwise sparse living room in Guaratiba, under an unforgiving bare light, there’s a little plastic Christmas tree sitting beside the TV. It is mid-November, three months after Jandyra’s death, and the festive season has been brought forward to give her motherless daughters, who are just eight and 11, some hope of happiness.

“We tried to convince Jandyra not to do it,” Joyce says. “But she thought she had no other option. In that moment of despair, she took this difficult decision.” Like many, Jandyra opposed abortion, but was faced with raising another child unwanted and unsupported by its father. “I think there should be a law that says after two children, we’ll tie the tubes. Two children is sufficient,” Joyce adds.

After her last pregnancy, Jandyra had wanted to have tubal ligation but, at 18, was told she was too young. Elective sterilisation is available on Brazil’s public health system for women over 25 or with at least two children, and with their husband’s consent. Joyce says there is a need for greater use of contraception in such a sexualised culture. “Women feel alone because the men in Brazil disappear,” Joyce tells me. “It’s a culture where women and men have various relationships; it’s a normal thing to have sex. But then men abandon women.” In a country where the minimum wage is £180 a month and where more than 11 million people live in favelas, each child can be too great a financial burden.

“It used to be that you finished school and you got a job,” Joyce says. “Now you don’t get anything. Imagine me, with four children – it’s going to be much harder than for someone who has two or one. I know it involves questions of religion. I’m evangelical; it’s very controversial. But my religion doesn’t have any problem with vasectomies, with tying tubes. I think we need a more rigorous law to protect women from desperate situations.”

Though definitive statistics are almost impossible to obtain, according to a pioneering field study, the 2010 National Abortion Survey, one in five Brazilian women have had at least one abortion by the age of 40 (in Britain the figure is one in three). Conservative estimates suggest 800,000 clandestine abortions are carried out a year, while pro-choice campaigners cite one million. “Women are afraid of telling us the truth,” says Debora Diniz, one of the authors of the study. “We have concrete reasons to believe that the number is even higher because women have reasons not to tell the truth, even using a secret ballot box.”

In Rio the scale of the organisation running clandestine clinics became clear during the police operation. Among those arrested were six doctors, two lawyers and several police officers. They were said to have co- ordinated illegal abortion centres in several neighbourhoods. The alleged gang leader, 88-year-old Aloísio Soares Guimarães, was reportedly found with statements for $5m in a Swiss bank account. Glaudiston Lessa, a police officer, told O Globo that the gang had carried out an abortion on a girl as young as 13.

When I meet Luciana Lopes, Rio’s co-ordinator for Brazil Without Abortion, a pro-life movement, the first thing I see is the stirrups of her new examination table. Also a gynaecologist, Luciana is setting up her surgery in the north of the city. She firmly rejects the estimated abortion rates. “If it’s clandestine, there’s no official information,” she says. “But even among the woman who do have abortions, many are not in favour. It’s not just about whether it’s legal or not – it’s a question of the woman living with committing murder. It’s a life that she is taking.”

I ask if she knows any women who have had abortions. “Many,” she says, nodding, but she adds that women are not criminalised for it. “We know that abortion carries risks to the life of the woman – illegal abortion as much as legal abortion,” she says, adding that the movement would like to see the legal exemptions removed and abortion completely criminalised. “Even if she is pregnant and doesn’t want the baby at all, doesn’t recognise the baby, the other line that we take is adoption. She doesn’t need to kill, doesn’t need to put her life at risk.”

Recent research suggests that 65% of Brazilians support the current restrictions on terminations. In the world’s biggest Catholic country, it is small wonder. But Brazil’s relationship with religion and abortion is more nuanced. In the 2010 abortion survey, faith appeared to play little part: most women who had abortions said they were also Catholic. Yet religious conservatism meant that despite two high-profile cases, abortion was hardly discussed during last year’s presidential election.

“Brazil is a country formed under the sign of the cross. Everything good and not so good that happened had the strong presence of the Catholic church,” says Eduardo Jorge, the Green Party presidential candidate who supports the legalisation of abortion. He says there is no explicit condemnation of abortion in the Bible. “We need more liberal and enlightened political leaders to talk to the people about their reasons. Only with dialogue and debate will it be possible to change the current law, which is retrograde and sexist, causing death and suffering to women and their families.” When I ask how long it might take to change the current legal situation, Jorge replies: “God only knows.”

Though there appears to be little link to religion, abortion is more common among women with low levels of education. Diniz says it’s not clear why, but one likely explanation is that they are using contraception methods incorrectly. “Abortion and the risks of illegality are basically a problem for the poor and black women of Brazil,” Diniz says.

Micheline Alves, 40, a journalist for a women’s magazine and a mother of two, has a very different abortion story. She lives in a chic boho neighbourhood in São Paulo, a world away from Guaratiba, Rio. At six weeks pregnant, she found a trusted doctor known among her circle of friends who would carry out abortions from his clinic in a hospital. Because of the early stage of her pregnancy, she paid £870. “The crazy thing for me in Brazil is that a middle-class person in a big metropolis like this can easily find a doctor who will do a safe abortion,” Micheline says.

For her, the decision was straightforward, made easier by access to a reputable medical professional. “The fact that I was already a mother made it all the more clear,” she says. “I have an idea of how much a child changes your life, and I was sure – without talking with my partner, before I told anyone – that it wasn’t time.”

On the day that Micheline went for her consultation, the names of 20 other women were tacked to the doctor’s wall, each one paying close to or just over £1,000 for the procedure. “This consultation was difficult, despite my conviction,” she says. “Firstly because it was clandestine. Also, however secure you are with your decision, the moment you meet with a doctor can feel strange. But in the end the process was very simple.”

Her misgivings centre on the inequalities of a clandestine business. She says her realisation that she was one of the “hidden” women prompted her to write about her experience.

“The doctor created a system that resolved a problem that Brazil is refusing to resolve,” she says. “It’s crazy because on the other hand, he also does it because it pays. But he’s a good doctor, does it correctly. He’s running a high risk. Abortions are being carried out in Brazil – it’s just that they are being carried out in very unequal conditions. In all these cases, the questions stay in the shadows, in the dark. You can’t have clear measures. You can’t leave all these people underground.”

Whatever the real number of women aborting pregnancies, the law that makes it a crime is not protecting them. With such a tangle of religious and moral opposition, change seems a long way off.

Meanwhile, in the absence of justice or answers, Jandyra’s family turn to their only comfort. “We have faith in God,” Joyce says. “Jandyra could be another statistic, but she’s not. She’s an icon of respecting other opinions, because we are against it, others are in favour, and we have to have a debate.”

When Joyce considers what she might ask those responsible, she says: “I want to know what really happened, whether she woke up or if she was totally anaesthetised when she died. They can do what they want with her body – flesh is flesh. But I want to know if she felt pain. It’s an answer we deserve.”

As Extreme on Abortion as Ever

Don’t Be Fooled: Republicans Are Still as Extreme on Abortion as Ever

By Zoë Carpenter  The Nation  January 22, 2015

bc A group of Republican men took to the House floor on Wednesday evening and delivered emotional speeches about the need to restrict women’s right to abortion. “A deeply personal issue,” Utah representative Chris Smith noted without a trace of irony, before musing on the pleasures of being a grandfather. Ted Yoho of Florida likened fetuses to an endangered species. “How can we as a nation have laws that protect the sea turtle or bald eagle, but yet refuse to protect the same of our own species?” he asked.

Their speeches anticipated a vote on the so-called Pain-Capable Unborn Child Protection Act, which would ban most abortions after twenty weeks of pregnancy. Originally scheduled for Thursday, the vote has now been indefinitely “delayed” because the bill, it turns out, was too extreme even for some members of the GOP. A number of female members objected to a provision that would have exempted rape victims from the ban only after they reported to police. Dissent grew throughout the week, and with as many as two-dozen Republicans ready to vote against the bill by late Wednesday, leaders pulled the whole thing.

Oh, well. Republicans immediately found another piece of bad meat to throw the mass of anti-abortion protestors who descended on Washington on Thursday for the annual March for Life: the No Taxpayer Funding For Abortion Act Titled just as misleadingly as the “Pain-Capable” legislation, this bill would have the most damaging effects in the private insurance marketplace, as Medicaid and other publicly funded programs are already barred from covering abortion services. House Republicans passed that legislation Thursday afternoon, as the anti-choice chants echoed across Capitol Hill.

According to the National Women’s Law Center, the bill “could result in the entire private insurance market dropping abortion coverage, thereby making such coverage unavailable to anyone.” It would permanently codify bans on abortion coverage for federal employees, residents of the District of Columbia, female inmates, women insured through the Indian Health Service, and women covered by Medicaid. It would also raise taxes on most small businesses.

The pivot was pure pandering. Representative Trent Franks, who introduced the twenty week ban along with Tennessee’s Marsha Blackburn, had noted previously that the vote was scheduled for the same day at the March for Life because of the “symbolism.” Many of the members who spoke on Wednesday in support of the ban gave more attention to promoting the march than to bill itself. “This week, the defenders of life in the thousands have and will come to Washington DC to support the sanctity of life,” said New Jersey Representative Chris Smith. “I want them to know we will keep fighting to defend the silent, unborn child.”

While reproductive rights groups received the failure of the twenty-week ban with glee, they quickly condemned the scramble to find a substitute bill. “Today’s exercise in the House is not about making public policy, nor is it about helping American women and families. It is about catering to a small minority of voters—anti-abortion activists who are descending on Washington for their annual march,” said NARAL Pro-Choice America President (and Nation contributor) Ilyse Hogue in a statement released Thursday.

It’s tempting to probe the political significance of a few female Republicans having the will, and enough muscle, to scuttle a bill that passed the House in similar form just two years ago. Maybe this one instance in which GOP leaders resisted the far-right fringe signals they’re finally waking up to the conclusion, encapsulated in the 2012 election post-mortem, that the party’s long-term success depends on women and minorities. And maybe not. (Call me when the House takes up immigration reform.)

But don’t overestimate the practical significance. Republicans are increasingly policing their optics and broadening their rhetoric—read Ran Paul’s rebuttal to the State of the Union for some silver tongue work concerning poverty, for example—but they are not ending their siege of legal abortion at the federal level or in the states, where the worst damage is being done. This would not be the first time that a high-level Republican chose not to highlight their extreme anti-woman principles and yet stuck to them. The twenty-week ban is likely to come up again this year, and it would be a dangerous bill even with a broader exception for rape victims. And out of the shadow of the March for Life, a vote will still be merely symbolic, as it’s unlikely to get through the Senate or to cross the president’s desk without a veto.

Those Making It Much Harder To Get An Abortion

Inside The Highly Sophisticated Group That’s Quietly Making It Much Harder To Get An Abortion

by Erica Hellerstein  December 2, 2014  Think Progress

AUL On a mild afternoon last April, Randy Grau, a Republican representative from Edmond Oklahoma, took to the state House to argue in favor of Senate Bill 1848. The bill, later signed into law, regulates standards for abortion centers and requires abortion providers to obtain nearby hospital admitting privileges. Clad in a crisp white dress shirt and light blue tie, Grau, a co-sponsor of the bill, turned to his peers and inhaled sharply: “On an unassuming street in Philadelphia, Pennsylvania, tucked in among houses, churches, little shops, right next to an elementary school, a building went by the name of the women’s medical society. Inside that women’s medical society, run by Dr. Kermit Gosnell, could only be described as a house of horrors.” He paused and cast his eyes to the floor before cataloging the conditions at Gosnell’s now-notorious Philadelphia abortion clinic: dirty equipment, blood-splattered floors, and untrained staff administering anesthetics.

“This bill will ensure that there’s proper standards and training of the staff that are helping perform these procedures,” the clean-cut young representative continued. “Does it prevent more abortions? I dunno. But I’ll tell you what I think it will do. It will ensure that none of these clinics prey upon women that are in a vulnerable and miserable position.”

To the outside observer, Grau’s position — pushing for regulatory standards he claimed were necessary to protect women’s health — might have seemed reasonable. But as the debate ensued, legislators from both sides of the political spectrum voiced their concerns. Some cited the Oklahoma State Medical Association’s opposition of the bill, which in a letter to the state senate insisted that it “may not reflect medical science or the best interest of the patient.” Others, like Republican Doug Cox, firmly rejected Grau’s argument that the proposed legislation would shield its intended constituents from harm. When pressed “How does this make life easier for patients?” by another House member, Cox, a physician who ultimately voted nay on SB 1848, replied, in a rare moment of candor that contradicted the party line: “Well, I’m not sure that it does.”

To the pro-choice advocates closely tracking the rash of anti-abortion bills introduced at the state level, however, Grau’s bill looked eerily familiar. His charges — that SB 1848’s abortion restrictions (also known as Targeted Regulations on Abortion Providers, or TRAP, laws), were being introduced to safeguard women’s health — had all been seen before. The language in the bill was strikingly similar to “The Abortion Providers’ Privileging Act,” a piece of model legislation introduced by Americans United for Life (AUL), a Washington-based anti-abortion organization that pens and propagates model legislation through ties with conservative legislators. In fact, a ThinkProgress examination found that parts of Grau’s bill were essentially written by AUL; the two are so comparable that in the section of SB 1848 outlining admitting privileges for abortion providers, only ten words from the AUL version are not used. (Oklahoma’s bill, for example, replaces “abortion clinic” with “facility providing abortions,” and “accredited hospital” with “general medical surgical hospital.”)

Not unlike the American Legislative Exchange Council (ALEC), AUL functions as de facto legislation mill for like-minded politicians and on-the-ground anti-abortion activist groups — offering model legislation that, according to its website, “enables legislators to easily introduce bills without needing to research and write the bills themselves.” The organization operates in relative obscurity despite its exceptionally far reach. According to an email obtained by ThinkProgress that was sent to AUL supporters, the group is responsible for one third (74) of the 200-plus anti-abortion laws that have passed since 2010. Elizabeth Nash, a Public Policy Associate at the Guttmacher Institute, says that 231 abortion restrictions were enacted between 2011 and 2014, which is nearly 20 percent more than what was seen in the entire decade before.

One such AUL-inspired law is Texas’s notorious House Bill Two (HB2), which has shuttered clinics and pushed women into the black market to buy abortion-inducing drugs. HB2, signed into law by AUL ally Rick Perry in 2013, belongs to a family of anti-abortion legislation called TRAP laws, which place burdensome restrictions on abortion centers and providers. These regulations, which have risen in popularity since 2010, have also found their way into AUL model legislation: A ThinkProgress examination found a handful of state TRAP bills that used AUL language in 2014 alone — Arizona, Illinois, New Hampshire, and West Virginia, for example, copied and pasted nearly every word of AUL’s admitting privileges requirement into their proposed legislation.

Despite medical evidence to the contrary, AUL’s role in shifting the abortion debate to a “death by 1000 cuts” strategy has proven effective. AUL employs a strategic brand of messaging that differentiates it from the openly religious fire-and-brimstone anti-abortion groups of the past. The organization packages its agenda with intentionally soft language about protecting women’s health, which some say has helped the group maintain a relatively low profile in spite of the scope of its influence. “The semantics display a retreat from extremism,” says Carol Joffe, a professor at the Bixby Center for Global Reproductive Health at the University of California, San Francisco. “One could argue they won by defanging the war on women.”

AUL’s Successful Anti-Abortion Campaign By The Numbers

That Grau’s bill so blatantly overlapped with AUL’s was no surprise to Hayley Smith, an Advocacy and Policy Associate at the ACLU who tracks anti-abortion state policy. “If you look at it, word for word, there are small differences but it is nearly the same. You can put them side-by-side, and even where they put the parenthesis is nearly exact. So it’s clear that there was copy and paste into bill form and insert Oklahoma, and it’s coming from someplace outside of Oklahoma, because the language is so similar.” Smith elaborated: “When you see a bill introduced in one state, and then you see a bill introduced across the country, and the language looks nearly exactly the same, you realize: Oh, this is all coming from the same base” — Americans United for Life — “and the intent is the same underlying each.”

In 2014, AUL consulted with legislators on 74 anti-abortion measures in 32 states, and was the driving force behind 11 anti-abortion laws; providing model legislation for states in Alaska, Arizona, Georgia, Mississippi, Oklahoma, and Nebraska. In 2013, it was behind 16 anti-abortion bills and worked in 31 states; in 2011, AUL consulted on and provided model language for 28 state laws. The annual AUL report in 2013 found that 35 states “made progress in defending life” in 2013, and in 2012 AUL was the driving force behind 19 anti-abortion laws.

An analysis by ThinkProgress reveals at least 13 bills that have been introduced on the state level have used language that is similar to AUL’s admitting privileges provisions, which have dealt a blow to abortion clinics across the country. SB 1848, for example, co-sponsored by Grau and signed into law by Oklahoma Governor Mary Fallin (R) last May, was recently put on hold after the Center for Reproductive Rights filed an emergency appeal with the Oklahoma Supreme Court.

Grau has been vocal about his relationship with AUL in the past. In 2011, he co-sponsored HB 1970, a bill drafted with AUL requiring abortion providers to follow the Food and Drug Administration’s outdated guidelines for medication abortions; in 2013, he co-sponsored HB 1361, a parental notification law based on AUL model legislation; and in 2014, he co-sponsored HB 2684, a follow-up to AUL-sponsored HB 1970.

The Oklahoma representative’s rhetorical strategy on the House floor is similar to AUL’s. The organization doesn’t deal in bullets and blood-soaked posters. Instead, it wraps its anti-abortion agenda in language about protecting women’s health — an emphasis on the mother rather than on the fetus — which, though not based on any real medical need or data, has proven to be remarkably effective.

“They’re trying to position themselves as these defenders of women’s health and safety,” says Amanda Allen, State Legislative Counsel at the Center for Reproductive Rights. “But these are measures that are coming from a national anti-abortion advocacy group that are really designed to close clinics in the state, under the bogus claim that they would protect women’s health and safety.”

The success of AUL’s framing can be traced back to its dynamic President and CEO, Charmaine Yoest, formerly of Mike Huckabee’s failed presidential campaign and The Family Research Council (deemed a hate group by the Southern Poverty Law Center). A soft-spoken mother of five with a polished brown bob, Yoest distances AUL from the anti-abortion community’s militant ideologues: She has been profiled across the media for her warm, subtle approach, dubbed “charismatic,” “especially good at sounding reasonable rather than extreme,” and the movement’s “kinder, gentler face.” But it is much more calculated than that. In a 2011 interview with The National Catholic Register, Yoest equated the organization’s approach to a “military strategy. We don’t make frontal attacks. Never attack where the enemy is strongest. We don’t want to re-create Pickett’s Charge at Gettysburg. We pick our battles. What we do is very much under the radar screen and not very sexy.”

The ALEC Of Abortion

AUL, founded in 1971 by conservative Catholic L. Brent Bozell, is often described as the primary legal arm of the anti-abortion movement. Its goal is to make abortion inaccessible through an approach many call “incrementalism” — blanketing the country in laws and court cases that choke abortion access at the state level — which contrasts an all-or-nothing absolutist strategy pushing to ban abortion outright. Regardless of their tactics, though, AUL and other anti-abortion advocates all have the same end goal: to abolish abortion in the United States. (From the organization’s website: “AUL knows that reversing Roe v. Wade can be accomplished through deliberate, legal strategies that accumulate victories, build momentum, and restore a culture of life.”)

The group has gotten a huge monetary boost from right-wing allies. In 2010, AUL’s legal arm, Americans United for Life Action, received $559,000 from the Center to Protect Patient Rights, a secretive non-profit group linked to the Koch Brothers that has injected nearly two hundred million dollars to in undisclosed donations to right-wing advocacy groups since 2009.

AUL’s Koch connection and collaboration with anti-abortion legislators to pass model legislation has prompted comparison to another bill mill that has come under fire from watchdog organizations: “They are the ALEC of the anti-abortion movement,” says Donna Crane, the Policy Director at NARAL Pro-Choice America. “If you think these ideas to restrict abortion are spontaneously coming to the hearts and mind of legislators across the country, think again. It’s all part of a very coordinated effort state-by-state to deny women their rights.”

The two groups have a symbiotic relationship. According to Wisconsin Representative Chris Taylor (D-Madison), AUL has been spotted at a series of ALEC conferences and policy summits, where it hands out copies of model legislation plucked from its crowning glory, a 400-plus-page book of anti-abortion sample bills called “Defending Life.” Rick Perry, who signed Texas’s AUL-inspired HB2 in 2013, penned the book’s introduction: “AUL plays a key role in developing and promoting legislation in all 50 states, legislation crafted to minimize the damage done by the abortion industry and its proponents,” he gushes.

Perry should know about the impacts of abortion restrictions. Last March, a group gathered outside the Whole Woman’s Health Clinic in McAllen, Texas, mourning the closure of the Rio Grande Valley’s last abortion clinic with a candlelight vigil. The clinic (which has since reopened temporarily) was barred from providing abortions after HB2, Texas’s omnibus abortion bill, went into effect.

For Women’s Health?

The Texas law, among other things, requires abortion providers to have hospital admitting privileges at clinics within 30 miles of where they practice and mandates that abortion clinics comply with ambulatory surgical center requirements. It has fallen heavily on the shoulders of low-income and undocumented women, many of whom can’t afford to travel across hundreds of miles and through internal border checkpoints to the nearest abortion clinic. Despite evidence that the restrictions will negatively impact Texas women’s health (forcing them into later term abortions which run a higher risk of complication) AUL has publicly claimed responsibility for the law.

Daniel Grossman, a gynecologist and Vice President of research at Ibis Reproductive Health, analyzed the impact of HB2 with the Texas Policy Evaluation Project. He says that the law will likely lead to an increase in DIY, or do-it-yourself, abortions. “We’re definitely seeing that women are attempting to self-induce abortions. They’re using herbs, medications, injections sometimes they get in Mexico, as well as hitting themselves in the stomach and throwing themselves down the stairs.”

Though unsupervised self-induced abortions carry significant risks, legal abortion is one of the safest medical procedures in the United States: A woman is 14 times more likely to die from giving childbirth than getting an abortion. More than 90 percent of abortions in the United States are performed in an outpatient setting, and less than .3 percent of abortion patients in the U.S. experience complications requiring hospitalization. In fact, surgical abortion has a complication rate comparable to other routine procedures performed in a doctor’s office, like dental extractions, vasectomies, endometrial biopsies and gastrointestinal endoscopies. On the rare occasion that an abortion-related complication does arise prior to 16 weeks of pregnancy, it can almost always be safely managed in an outpatient clinic.

From 2000-2009, the abortion-related mortality rate in the United States was 0.7 per 100,000 abortions — which was lower than the mortality rate for plastic and dental procedures. During the same time period, the mortality risk for abortion was equal to the traffic and marathon fatality rate in the US. The mortality rate for RAGBRAI bike racing is more than four times the abortion mortality rate, and, according to CDC data, the risk of death from a penicillin injection is twice that of abortion.

“But you don’t see any moves to make a penicillin shot only given in an ambulatory surgical center,” says David Grimes, a Clinical Professor in the Department of Obstetrics and Gynecology at the University of North Carolina School of Medicine. In North Carolina, he added, more people die in dentists’ chairs than in abortion clinics, but politicians are mum on TRAP-inspired dentistry regulations. “This clearly shows the state legislatures not being concerned about safety. There are all these public health problems they’re ignoring. They’re attacking one of the safest procedures in medicine because they don’t like it.”

AUL’s Chosen Facts

Like the big tobacco and climate denial industry, a crucial link in the legislation of anti-abortion measures is the establishment of an alternative set of scientific literature — unencumbered by the rules of evidence and standards of truth that define legitimate medical science — and insistence that data published by organizations such as the Centers for Disease Control (CDC) and World Health Organization (WHO), is inaccurate.

AUL has actively participated in this process. Like many anti-abortion organizations pushing TRAP laws, it rejects research from physicians about the impact of clinic and provider restrictions, and instead refers to internal “medical experts.” AUL’s Senior Counsel, Clarke Forsythe, for example, authored a paper called “A Fact Ignored by the WHO” with John Thorp, a North Carolina-based gynecologist whose testimonies have been used to defend admitting privileges laws. AUL’s model legislation cites research by Thorp, who served as a witness in anti-abortion cases in Alabama. Alaska, Arizona, Indiana, Mississippi, North Carolina, North Dakota, Texas, and Wisconsin, and was recently discredited by a federal judge in Alabama’s admitting privilege litigation for having “disturbing apathy toward the accuracy of his testimony.” The organization’s use of Thorp’s research “shows that they’re not grounded in science and medicine and women’s health, says Smith of the ACLU. “They’re grounded in politics and bias.”

AUL’s model legislation also cites anti-abortion advocate David Reardon’s research. Reardon received a degree in biomedical ethics from Pacific Western University in Hawaii, an unaccredited diploma mill that was shut down in 2006 and forced to pay half a million dollars in fines. Reardon’s theory that abortion causes clinical mental problems has been rejected by C. Everett Koop, Ronald Reagan’s Surgeon General and the American Psychological Association, and his research has been widely criticized by the British Journal of Psychology, and critiqued by UC Santa Barbara psychology faculty, to name a few.

Similarly, AUL routinely refers to Charmaine Yoest as a “Dr” — but she does not have any medical expertise. Instead, she holds a Ph.D. in philosophy of government from the University of Virginia. In fact, there appears to be just one M.D. on AUL’s Board of Directors and Board of Advisors combined — Dr. Monique V. Chireau. Her claim, that abortion causes mental health issues, has been refuted by the American Psychological Association; and in a July 2014 testimony against the Women’s Health Protection Act, Chireau cited research that has been challenged by the British Journal of Psychiatry for failing “to state obvious conflicts of interests and follow well-accepted scientific standards for the conduct and reporting of systematic reviews and meta-analyses.”

Because Chireau appears to be the only doctor on AUL’s staff, Board of Advisors, and Board of Directors, ThinkProgress contacted AUL for comment on the number of physicians that work with AUL to draft model legislation. A spokesperson from the organization replied in an email: “I don’t know that numbers of physicians per model bill is a rubric available,” adding that, “AUL talks with a wide network of specialist (sic) to ensure the best possible product.”

An Effective Strategy With Political Backing

However, medical experts find AUL’s abortion provisions troublesome. ThinkProgress reviewed sections seven and eight of AUL’s “Women’s Health Protection Act” with Grimes, who flagged more than 20 of the organization’s suggested administrative rules for abortion clinics. These included: rules requiring private procedure rooms for abortion clinic’s physical facilities; rules related to medical screening of abortion patients; rules requiring standards that conform to obstetric standards; rules outlining the use of appropriate precautions, including the establishment of intravenous access for patients undergoing second or third trimester abortions, and many more.

ThinkProgress also asked AUL for comment on objections from physicians that HB2’s provisions have crippled women’s access to reproductive services and haven’t impacted the safety of abortion in the state. “Abortion advocates routinely oppose health and safety standards for women,” AUL responded. “However, no case more clearly illustrates the need for them as the ‘ House of Horrors’ abortion clinic that was operated by Dr. Kermit Gosnell. It is appalling that women receive one standard of care for a breast biopsy but are left to the tender mercies of whatever an abortionist want to offer when the surgery is abortion.” However, Gosnell’s medical failures were already contrary to existing health care standards. What he did — performing abortions after 24 weeks, snipping babies’ necks, utilizing unlicensed employees — was illegal already and has no connection to the restrictions placed by AUL’s legislation.

The wave of abortion restrictions can be traced back to the results of the 2010 elections, which welcomed a new wave of Tea Party anti-choice Republican legislators. “Part of it is the coming together of conservative legislators and local organizations and model legislation at the right time,” she says. “The legislators wouldn’t be able to adopt these restrictions if the ideas weren’t available and there weren’t organizations on the ground willing to pursue them. You need all three pieces for it to work. It’s crazy.”

AUL’s admitting privileges and clinic standards requirements are both TRAP laws, which have been stunningly effective at shutting down abortion access on the state level. In the past decade, the number of states with TRAP restrictions has more than doubled: 27 states now have some type of TRAP law (up from 11 in 2000), and nearly 60 percent of women in the country of reproductive age now live in states with TRAP laws. As of this November, 22 states require that abortion clinics meet ambulatory surgical center requirements, and 14 require abortion providers to have admitting privileges (or an agreement with another physician who has admitting privileges) at a local hospital.

TRAP laws are designed to make as difficult as possible for women to access legal abortion services even though the procedure is still federally protected. They are dangerous precisely because they’re meant to sound reasonable, says Susan Berke Fogel, the Director of Reproductive Health at the National Health Law Program. “How many people really understand what it means to have hospital admitting privileges? Most people think, ‘that’s a very standard thing,’ and if a doctor has admitting privileges that that is somehow a mark of professionalism. Instead, it’s very common for doctors not to have admitting privileges at any particular hospital.”

Other TRAP restrictions — like hallway width and doorway requirements — are also medically unnecessary, says Grimes. “When I was at the CDC one of my jobs was to study every abortion-related death in the country, and I can say with certainty that there’s never been a woman who died in the US from an inadequate doorway in an abortion clinic. This is really a perversion of public health practice. The way public health works is that you identify a problem, you develop a solution, you implement the solution, and you monitor the effect. What you’re seeing is a brisk legislative response to a non-problem. “

Reproductive Rights in 2014

Why 2014 Could Be A Huge Turning Point For Reproductive Rights

By Tara Culp-ResslerThinkProgress

Equal Lives Roe v. Wade will mark its 41st birthday later this month, amid ever-increasing assaults on reproductive rights across the nation. According to the latest report from the Guttmacher Institute, states have imposed a staggering 205 abortion restrictions between 2011 and 2013. That legislation has attacked access to abortion from all angles — targeting providers and clinics, driving up the cost of abortion for the women who need it, making women travel farther and wait longer to get medical care, and outright banning the procedure. Since 2000, the number of states that Guttmacher defines as being “hostile” to abortion rights has spiked from 13 to 27.

That’s left abortion rights advocates on the other side, working hard to stem the tide of anti-choice attacks. Constantly warding off restrictive legislation hasn’t left much space for proactive policies to expand women’s reproductive freedom, like expanding access to maternity care or making family planning services more accessible to low-income women. Most of the headlines about abortion issues are bleak.

But there may be a shift on the horizon.

As the new year kicks off, the pro-choice community is beginning to lay the groundwork for a new kind of strategy. On the state level, they’re beginning to push for legislation that not only rolls back anti-choice restrictions, but also expands health care opportunities for women and their families. They’re striking a delicate balance between finding common ground with social conservatives — like focusing on preventative care and maternal health outcomes — while maintaining that abortion is also an important aspect of reproductive health. And grassroots activists are committed to nudging the dial forward on issues that have long been considered too controversial for the political sphere.

“The momentum has shifted,” Ilyse Hogue, the president of NARAL Pro-Choice America, told ThinkProgress in an interview. “Americans as a whole have had enough. We’re not just going to sit idly by and fight defensive fights and take these attacks on reproductive freedom sitting down. We’re starting to define what a new agenda for reproductive freedom looks like in the 21st century.”

A new agenda for reproductive freedom

So what does that agenda look like? In a political atmosphere that’s long segregated women’s health care from the rest of policy as a “culture war issue,” it involves a more comprehensive approach to reproductive freedom.

“Abortion access is ground zero of reproductive freedom; without it, we don’t have autonomy and self-determination over our lives. But it’s not as though our reproductive lives start and end there,” Hogue noted. “There’s a whole landscape out there of policies that have lagged far behind.”

Those policies include other health-related initiatives, like ensuring that women have access to family planning services and maternity care. They involve tackling sexual health issues, like cracking down on domestic abuse and rape. But they also include economic policies to help ensure that women have the resources to direct the courses of their lives and provide for their families — like equal pay legislation, affordable child care services, and efforts to prevent workplace discrimination. Rather than framing reproductive rights as a women’s issue, groups like NARAL are working on making the point that they’re also inextricable from the nation’s economic agenda.

On a national stage, some lawmakers have already made the shift to talking about women’s full equality in this way. House Democratic Leader Nancy Pelosi (D-CA) and Sen. Kirsten Gillibrand (D-NY) were particular champions of this fight in 2013, attempting to reposition women’s economic success as a national priority. “We want women to know that there’s a path, there’s a fight being made on these subjects,” Pelosi told ThinkProgress in July.

State legislatures starting to lead the way

Pelosi has focused on workplace equality as a women’s issue without necessarily coupling that effort with other areas of women’s rights, like abortion rights or sexual assault prevention. But state lawmakers are beginning to propose sweeping packages of women’s health legislation that include the full range of those issues.

For instance, Gov. Andrew Cuomo (D) pushed an ambitious Women’s Equality Act — which included measures to advance pay equity, outlaw discriminatory practices against women in the workplace and the housing sector, tighten penalties for sexual crimes, and reaffirm reproductive rights — in 2013. It ultimately failed to pass because some members of the legislature wouldn’t agree to its abortion-related provision, but the female members of the Assembly’s Democratic majority are ready to try again. They’re already urging Cuomo to take up the full version of the legislation again this year. They’re also framing these issues broadly, pointing out that advancing women’s equality is more than access to gender-specific health care. “We believe it is important to look at all of those barriers women face and to make sure we include issues such as access to affordable, high-quality child care, paid family leave and eldercare so that New York’s women and families have every opportunity for a dynamic future,” a statement from the Democratic Women Assembly Members explains.

Pennsylvania probably doesn’t immediately come to mind as a state that’s committed to protecting reproductive rights — Guttmacher rates the state as “hostile” to abortion, since it’s enacted several harsh restrictions on the procedure — but lawmakers are making a very similar push there. In December, a bipartisan group of lawmakers introduced the Pennsylvania Agenda for Women’s Health, a package of legislation that includes measures to strengthen workplace protections for pregnant women and nursing mothers, prevent anti-abortion harassment at health clinics, advance pay equity, and protect victims of domestic violence.

“The Pennsylvania Agenda for Women’s Health represents a genuine cross-section of issues and concerns facing women today,” Rep. Dan Frankel (D-PA), one of the lawmakers heading up the new initiative, explained when it was first introduced. “This is a comprehensive collection of bills based on what women want in regard to their own health.”

Just this week, a pro-choice coalition in Virginia unveiled the 2014 Healthy Families Legislative Agenda, another broad push to advance women’s health from this angle. After a high-profile gubernatorial race that resulted in the election of pro-choice Terry McAuliffe, reproductive rights activists are eager to begin undoing some of the damage to women’s rights in recent years. In addition to pushing to repeal the state’s forced ultrasound laws and harsh restrictions on abortion clinics, the coalition is also advocating for expanding Medicaid and increasing health coverage for low-income pregnant women.

“We are re-orienting ourselves a bit more toward offense and trying to take advantage we see in this immense backlash to these really radical attacks on women’s health care access,” Anna Scholl, the Executive Director of ProgressVA, explained to ThinkProgress. “I don’t want to minimize or underestimate the size of the hole that we have to dig ourselves out of… But we are taking a much more holistic approach to choice and to women’s health, putting together an agenda that we think will support families across the Commonwealth in every one of their childbearing positions.”

Are national lawmakers finally ready to go on the offense?

The end of 2013 signaled a potential shift in the way that Washington approaches abortion rights, too. Of course, getting pro-choice legislation past both chambers of Congress is far less likely than beginning to turn the tide at the state level. But national lawmakers are indicating that they may not be afraid to take a bold stance in favor of reproductive rights. In November, a group of Senate Democrats introduced the Women’s Health Protection Act of 2013, the first piece of national legislation in nearly a decade that is intended to protect — rather than dismantle — abortion rights. The Women’s Health Protection Act would prevent states from enacting medically unnecessary restrictions on abortion.

“This assault on essential, constitutionally protected rights has gone on too long,” Sen. Richard Blumenthal (D-CT), one of the co-sponsors of the legislation, explained in an op-ed when it was first unveiled. “We are introducing the Women’s Health Protection Act of 2013 this week to end it, once and for all.”

NARAL’s Hogue points to Wendy Davis, a relatively unknown state lawmaker who rose to national fame after fighting to defeat stringent anti-abortion legislation in Texas, as evidence that the American public is ready for more elected officials to go down this path. “When you actually take a strong, courageous stand on abortion access as part of a full suite of reproductive freedom, voters reward you. We’re going to see more of that, and we’re going to incentivize more of that,” she noted.

And grassroots activists are preparing to push lawmakers even further. The hostile environment around abortion has made elected officials wary to take any strong stance on expanding access to the procedure, particularly if that results in taxpayer dollars financing abortion. For nearly 40 years, the Hyde Amendment has outlawed federal funding for abortion, preventing low-income women who rely on Medicaid from using their insurance coverage to help pay for the procedure — and Democrats have largely refrained from doing anything to get rid of that policy. But this past fall, reproductive justice activists formed All*Above All, a coalition that hopes to bring a renewed momentum to the fight to restore abortion access to economically disadvantaged individuals.

“All*Above All pushes back on the long-running urban legend that funding abortion coverage is some kind of political third rail,” Kierra Johnson, Choice USA’s executive director, explained in a statement about the coalition’s launch. “This campaign offers people a fresh approach to declare their support for bold action to change these policies.”

Looking to 2014 and beyond

“I think we’re going to sort of hit our stride in 2014,” Hogue told ThinkProgress. “In 2014, we’re going to see a lot more offensive legislation. We’re going to start to see states really experiment with what policy packages look like that actually support women at all stages of their reproductive life, and we’re going to demand what we need to be thriving, equal members of American society.”

But change is slow, and after such a dramatic recent assault on women’s bodily autonomy, it will take time to pull the country back to the other direction. As ProgressVA’s Scholl noted, there’s still a lot of damage to undo. In deeply red states like Texas, much of that damage will only continue to worsen this year. And, of course, the pro-choice community may be mobilizing for 2014 — but so are abortion opponents.

According to Hogue, the shift will begin in 2014 and get even more dramatic in 2016 and 2018. It will take several trips to the ballot box to counteract the power that the Tea Party built up over the past three years. But there’s reason to believe that the American people, who have repeatedly rejected legislative attempts to restrict abortion, are ready for a dramatically different approach to reproductive freedom.

“It’s going to take longer than more election cycle to re-center the country where the actual center is, but make no mistake — this shift has started to happen,” she noted. “The pendulum will be swinging back in this direction for quite some time.”

Related, also by Tara Culp-Ressler:

In The Past 3 Years, We’ve Enacted More Abortion Restrictions Than During The Entire Previous Decade

Also Related, from Salon: More than half of US women live in a state denying abortion care: “By now you’ve already read the year-end roundups, so you know what a dismal year 2013 was in terms of reproductive rights. This week, the Guttmacher Institute added some context to recent trends in abortion policy by comparing the reproductive health restrictions passed over the last three years to those from the previous decade.” Full article in Salon