A federal judge has temporarily blocked an anti-abortion law in Idaho restricting people’s ability to travel to other states for the procedure.
During the 2023 legislative session, state lawmakers passed a law restricting “abortion trafficking,” which it describes as an adult bringing a child across state lines for an abortion with the intent to conceal it from the child’s parents or guardians.
Kelly O’Neill, staff attorney for the nonprofit Legal Voice, said a U.S. district court judge agreed to their preliminary injunction request, blocking the law while the case is decided.
“The judge agreed that the law is unconstitutional and that it violates First Amendment freedoms, the right to interstate travel, and that it’s unconstitutionally vague and that it’s confusing,” O’Neill outlined. “A person can’t determine what conduct is legal and what might land you in prison for a minimum of two years.”
Idaho has some of the most restrictive abortion laws in the country, with the procedure banned in nearly every instance. While abortions have decreased in the state, research shows they’ve increased in neighboring states where it is protected since Roe v. Wade was overturned, such as in Washington.
O’Neill noted Idaho is not the only state where lawmakers are attempting to restrict abortion.
“There’s a huge wave of anti-abortion laws coming out of Idaho in particular and every state in the nation,” O’Neill pointed out. “People are working and doing their part to try to push back against those and restore options of choices and freedom, and this is certainly a way that we’re helping to do that.”
The suit challenging the Idaho law was filed in July. The parties involved gave oral arguments in September.
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A Kansas state court judge has blocked several abortion-related restrictions, in a decision which is bound to have an effect in neighboring Missouri.
It is being considered a win for the Center for Reproductive Rights and Planned Parenthood on behalf of Kansas abortion providers. The ruling blocks laws requiring providers to give government-scripted information to patients, and to impose mandatory waiting periods, which delay care.
Alice Wang, staff attorney at the Center for Reproductive Rights, argued the restrictions violate the Kansas Constitution, including the rights to abortion and free speech.
“These restrictions are especially harmful now that Roe v. Wade was overturned, and Kansas clinics are overwhelmed with patients from neighboring states where abortion is banned,” Wang pointed out. “Abortion is a human right, and Kansans deserve accurate, candid medical information.”
Judge Krishnan Christopher Jayaram wrote the restrictions only serve to “stigmatize the procedure and instill fear in patients that are contemplating an abortion, such that they make an alternative choice, based upon disproven and unsupportable claims.”
Emily Wales, president and CEO of Planned Parenthood Great Plains, said patients should not be denied care because they printed a form in the wrong color or format.
“We have been forced to turn away patients for reasons that are medically wrong and ethically unjustifiable,” Wales pointed out. “Despite post-Dobbs, we’ll do as we’ve always done, provide our patients with expert care informed by best medical practices. Our first question will be about care, and not font size.”
There have been hearings on multiple abortion-related laws in Kansas this year, including a ban on the most common procedure used after 14 to 15 weeks of pregnancy, known as dilation and evacuation. Abortion has been illegal in Missouri since last June.
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Maternal mortality, or death from pregnancy-related issues, nearly doubled in the U.S. between 2018 and 2021 – and a person who is Black is three times more likely to die from these issues than one who is white. Nebraska ranked 17th
for maternal mortality, with a higher rate than the national average during those years.
Ashlei Spivey, executive director of the organization “I Be Black Girl,” which works in Nebraska for reproductive justice, said data show some practitioners take Black patients’ complaints of pain less seriously, with some erroneously believing Black people have a higher pain tolerance.
“How can we make sure medical practitioners – no matter if they’re the OB or the phlebotomists – are getting cultural awareness training, that they’re being in tune to the experiences of all the different types of patients that they’re seeing, especially their Black patients,?” she said.
Awareness-raising events during this Black Maternal Health Month will culminate with a Reproductive Justice Summit on October 27th. Spivey said the speakers and breakout sessions will cover a number of issues that affect “reproductive well-being,” including housing, transportation and wages. The keynote speaker will be renowned activist, author and professor Angela Davis. Registration closes after today.
Spivey said one of the steps they’re taking is working with partner agencies to increase the number of doula-friendly
hospitals in the state.
“They’re a trained companion that can help, and know that pregnant person more intimately,” she explained. “And so they know this is this person’s birth plan, how can we make sure that it’s honored, and help that person have power and choice when working with their medical team – to address some of the things around not being heard.”
Research shows doulas have a positive impact for both mothers and babies, and several states now include Medicaid coverage for doula care.
Spivey sees the “transactional” nature of U.S. healthcare – factors like insurance billing, what’s covered and what isn’t, and how many patients a practitioner is expected to see in a day – as contributing to the risks for patients.
“I think we need to remove that as transactional and really spend time with people, understanding what they’re needing, and also making sure people feel empowered to hold doctors accountable. You know, people feel like they’re the experts – they don’t want to question,” she continued.
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By Carrie Baker for Ms. Magazine.
Broadcast version by Roz Brown for Texas News Service reporting for the Ms. Magazine-Public News Service Collaboration
Earlier this month, the pharmaceutical company GenBioPro announced the names of 18 brick-and-mortar pharmacies that are now dispensing the abortion pill mifepristone. They are the first pharmacies to publicly acknowledge doing so after the FDA in late 2021 finally loosened medically unnecessary restrictions on mifepristone that blocked pharmacy distribution for decades.
“At GenBioPro, we firmly believe everyone has a right to access evidence-based health care and safe and effective medicines, and that includes medical abortion,” said Evan Masingill, CEO of GenBioPro, which successfully obtained FDA approval in 2019 for the first generic mifepristone tablet.
The pharmacies listed on their website include independent community drugstores, university-affiliated outlets and compounders located in nine states, including in Arizona, California, Maryland, New York, Pennsylvania, South Carolina, Washington, Wisconsin and Texas. There are no chain pharmacies on the list, although CVS and Walgreens say they plan to dispense the medication soon.
“While it’s hopeful to see some brick-and-mortar pharmacies on this list, the large pharmacy chains are notably absent,” said Amy Merrill, co-director of Plan C, which provides information on at-home abortion with pills. “Chain pharmacies could play a major part in expanding access, both because of their numerous locations and because they’re the only ones with the resources to stand up to bullying by extremist politicians and their supporters.”
When the FDA approved mifepristone in 2000, the agency blocked pharmacies from dispensing the medication, instead requiring doctors to give the medication directly to patients. In December of 2021, the FDA announced they would for the first time allow brick-and-mortar pharmacies to dispense mifepristone-if they were certified with the FDA. In the ensuing months, the FDA negotiated with pharmacy representatives, GenBioPro and Danco, maker of the brand name mifepristone, to develop a certification process.
Finally, in January of 2023, the FDA announced the new certification process for pharmacies to dispense mifepristone. CVS and Walgreens immediately announced they would apply for certification to dispense mifepristone.
In response, anti-abortion advocates staged boycotts at CVS and Walgreen pharmacies and 20 conservative state attorneys general threatened legal action against these companies if they dispensed mifepristone in their states. Then 23 attorneys general issued a statement supporting medication abortion at CVS and Walgreens stores.
CVS acknowledged their pharmacies were not currently dispensing mifepristone, but said they were working through the steps required for certification.
“Once certified, we plan to dispense mifepristone in states where legally permissible in the near future,” Amy Thibault of CVS Pharmacy told Ms.
Walgreens will also soon dispense the medication. “We are in the last stages of finalizing certification, and once certified, we will dispense this medication consistent with federal and state laws,” said Fraser Engerman, senior director of external relations at Walgreens.
In addition to listing pharmacies dispensing mifepristone, GenBioPro has updated their website to help prescribers, pharmacies and patients understand the new FDA rules on mifepristone and learn how to access abortion pills. The website has up-to-date information about how pharmacies can become certified to dispense mifepristone, and how medical professionals can become certified to prescribe mifepristone and dispense the medication directly to patients or through certified pharmacies. They also offer patient education and support resources in English and Spanish, with some resources available in additional languages, including Portuguese, Arabic, Chinese, Vietnamese, French, Haitian and Russian.
“We will continue to do everything in our power to ensure that these … changes benefit as many people as possible and work toward truly universal access,” said GenBioPro, noting that not everyone will have equal access because some states restrict abortion.
In addition to brick-and-mortar pharmacies, there are several mail-order companies dispensing mifepristone, including Honeybee Health and American Mail Order Pharmacy.
While many people prefer to receive abortion pills privately by mail, others may want to pick up the medications in person either because:
- they do not have a reliable or confidential mailing address,
- they cannot wait for the medication to arrive by mail because they are experiencing a miscarriage or health-threatening pregnancy, or
- they live in a state with an early gestational ban.
Advocates expressed frustration at how long it’s taken for pharmacies to begin dispensing mifepristone.
“Mifepristone is the only medication that’s seemingly regulated in a cultural manner: Can you imagine any other safe, common and essential medication being withheld from people who need it, even when they live right down the street from a pharmacy, and even after it’s received long-overdue approval to be there?” said Merrill.
While pharmacy access to abortion pills slowly expands, the anti-abortion movement is trying to remove mifepristone from the market.
In November of 2021, anti-abortion doctors and a dentist filed a lawsuit, Alliance for Hippocratic Medicine v. FDA, asking an anti-abortion federal judge in Amarillo, Texas, to reverse the FDA’s approval of mifepristone.
In April, the judge ruled the FDA improperly approved mifepristone in 2000 and stayed the approval-a ruling put on hold by the Supreme Court until it issues a final ruling in the case. On appeal, the Fifth Circuit Court of Appeals reversed in part, but still sharply restricted access to mifepristone nationwide. The Justice Department has appealed the decision to the Supreme Court.
“This is why Plan C is dedicated to researching and listing alternate routes of access on our website, so people know about their full range of options to get safe abortion pills in the US,” said Merrill. The Plan C Guide to Pills provides information about how to obtain abortion pills in all 50 states, including through telemedicine, community support networks, and vetted websites selling abortion pills.
Meanwhile, if restrictions are put in place, clinicians are prepared to continue offering telehealth abortion with misoprostol alone.
“We all deserve better. And until our government, policymakers and industries can protect full rights and access, people will continue to need activist providers and community networks, and Plan C will continue to spread the word that these options exist,” said Merrill.
Carrie Baker wrote this article for Ms. Magazine.
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