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      Abortion providers on two years of Texas ban: ‘We’re living in a devastating reality’

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      Nearly a year before the US supreme court eviscerated Roe v Wade, the court allowed an unprecedented abortion ban to take effect in Texas, serving as a harbinger of what was to sweep over the rest of the country.The most restrictive abortion law at the time, with no exception for rape, incest, or lethal fetal abnormality, Senate Bill 8 barred care after six weeks of pregnancy, and carried a private enforcement provision that empowered anyone to sue a provider or someone who “aids or abets” the procedure.The move successfully wiped out almost all abortion care in the second-most populous state in the US. When Dobbs v Jackson Women’s Health Organization hit, the state doubled down, criminally banning all care and solidifying itself as the largest state in the US to outlaw abortion.In the two years since, Texas abortion providers – some of the first in the US to experience a nearly post-Roe world – reflect on the devastating and lasting effect of the severe law, the trauma they felt denying patients care, and the struggle they faced when deciding whether or not to flee the state or stay put.Dr Jessica Rubino: ‘The law forced me to be a bad doctor’ When Senate Bill 8 took effect, Dr Rubino felt like she was on a “sinking ship”. The abortion provider and family medicine specialist was forced to turn away dozens of patients at Austin Women’s Health Center – including one who was experiencing kidney failure. At the same time, patients below the six-week mark were rushing to choose abortion care before it was too late, leaving thoughtful decision-making behind.“I had to tell people there’s nothing I can legally do for you, unless you’re on death’s doorstep,” said Rubino. “The law forced me to be a bad doctor.”“It was heartbreaking and soul-crushing,” she continued. “I was watching a healthcare disaster play out in real time, knowing that this law not only affects our state but is causing a ripple effect in every other state. With SB 8 – and even years before the law – we saw the writing on the wall with Roe and tried to warn everyone, but I’m not sure who was listening.”Rubino also recalled a conversation she had six months prior to SB 8 with colleagues across the state who appeared united, vowing to continue providing care despite the law’s consequences. People are going to die, she told them, we should take the “personal hit”. However, that wave of defiance never materialized. Rubino lacked critical mass.She soon fell into an “extreme” depression; it was difficult to get out of bed each day and she eventually sought mental health therapy and antidepressants. Her brain felt “broken”, she said. After Dobbs, she stopped performing abortion for nearly a year, exacerbating her gloom.“Having to deny patients the healthcare you are trained – and able – to give them is something you never get over. It’s not only medically unethical, it’s morally wrong,” said Rubino. “It was traumatizing, and it still haunts me.”SB 8, she said, was the tipping point for abortion providers in Texas like her who have been forced to navigate onerous laws over the years that compromise the care they give, including a mandatory sonogram and 24-hour waiting period that incorporates relaying erroneous medical information, bans on insurance coverage for care, restrictions on minors’ access to abortion, and more.In May, under the advice of attorneys and those closest to her, Rubino and her family left Texas with no plans to return. She worked at a clinic in Bristol, Virginia, where she largely served patients in banned southern states, before moving to DC in late August to help expand abortion services at a reproductive health clinic there.Rubino still struggles with the decision to flee Texas, while also acknowledging the legal inability to continue her calling.“There is a sense of guilt, of letting down the community I serve. Sometimes I feel like I gave up on these people,” she said.She also worries that a national abortion ban could once again pull her away from the community she now treats. She considers one day working in the UK or New Zealand.Rubino feels deeply anxious about the fate of the patients she has left behind and mentioned a recurring patient, a victim of domestic violence, whose partner blocked her access to birth control.“She’s going to call and I’m not going to be there,” said Rubino. “She’s not in a safe situation and we know staying pregnant can lead to more abuse, and even death by an abusive partner. The safest thing for her would be to get an abortion but now she’s not going to have that choice.”Dr Ghazaleh Moayedi: ‘Inhumane and illogical’ Testifying before Congress three separate times to oppose abortion bans and uplift the right to access, Dr Ghazaleh Moayedi has made her mark as an outspoken and passionate reproductive justice advocate for Texans.But the road wasn’t always clear for the doctor: unsure of what to do after graduating college, Moayedi’s friend recommended she take a nanny job. Her boss was Amy Hagstrom-Miller, the head of a network of abortion clinics and then major figure in Texas reproductive rights who would go on to lead several legal challenges against the state, including a 2016 US supreme court victory. Moayedi began working in Miller’s clinic, where she saw her interests collide.As a “brown, Muslim” n Iranian American woman who grew up in Texas, Moayedi quickly realized the majority of state abortion doctors – largely white men – did not reflect the diversity of the patients they treated, and vowed to fix that.“I could feel a palpable racial and cultural divide,” she said. “None of the doctors looked like the people we take care of. I wanted to be a provider that helped represent the communities we serve. I decided to go to medical school with that goal as a driving force.”Moayedi has worked in Texas abortion care since 2014, weathering the roller coaster of state abortion laws, including a 2020 order to ban abortion under the pretense of the Covid emergency, which, at the time, upended her plans to start her own practice.After SB 8, she transitioned her care to Oklahoma. When Oklahoma’s abortion law took effect, she switched gears, providing ultrasounds in Texas to those traveling to and from out-of-state abortion care. Moayedi then became uncertain if she could safely venture to states where abortion was still legal, as the Texas attorney general, Ken Paxton, encouraged local prosecutors to go after providers shortly after Roe fell. She and abortion funds sued the state for legal protection, and paused their services in the meantime.After securing a court victory, Moayedi has worked to build an abortion and miscarriage telemedicine practice, still in the process of getting off the ground. She is now licensed in 20 states – but only half allow abortion telemed. She also travels to Kansas, a safe haven state, to provide care.“I’ve had to really pivot quite a bit. It’s been absolutely wild,” she said. “My practice doesn’t look anything like I thought it would. For now, my goal is to stay in Texas but we’ll see what happens.”Moayedi says the law’s “inhumane and illogical” impact is especially pronounced when she is treating a patient in another state only to discover they’re from not just the same city as her, but the same neighborhood.“Here we both are, hundreds of miles away from our home and support system, just to receive healthcare,” she said. “Moments like those just hit you in the gut.”As a complex family planning specialist, Moayedi constantly worries for patients with “potentially catastrophic” high-risk pregnancies, especially as the Texas law offers only vague medical emergency exceptions, leading patients to near-death experiences. She receives calls from colleagues wondering if pregnant patients with complications, like C-section scar ectopic pregnancies, can receive care in Texas. She often refers them out of state to be safe.“I really don’t have words to describe the deep, deep pain I feel,” said Moayedi. “These laws are insulting, disgusting, cruel, and absolutely pointless.”The provider and advocate expresses disappointment with the federal administration, who she feels has failed to meaningfully protect abortion providers and patients since SB 8 took effect.“The Biden administration’s response has been a limp handshake,” she said. “We want to see tangible, bold action to restore or at least prevent the further erosion of reproductive rights. We need unwavering support – not a leader who can barely say the word ‘abortion’.”Kathy Kleinfeld: ‘SB 8 was meant to be a fear tactic that paralyzed care’ Kathy Kleinfeld will never forget the desperation that swept over Houston Women’s Reproductive Services after SB 8 took effect. Anxious patients begged her and her staff to perform abortion care past the six-week mark, even offering money under the table and other favors.“They were crying and pleading with us, saying ‘I’ll do whatever you want,’” said Kleinfeld. “It was so heartbreaking, there was nothing we could do.”Patients – as well as clinic staff – held their breath during each ultrasound, hoping the pregnancy would fall under the state-mandated time frame. For those past the mark, Kleinfeld and colleagues became “dystopian travel agents” connecting patients with out-of-state care.After 30 years of providing abortion in Houston, Kleinfeld had never experienced anything so chaotic and devastating. Then Dobbs hit.“It felt like everything we experienced with SB 8 was magnified – it was like SB 8 on steroids,” said Kleinfeld. “The intensity, the confusion, the chaos all became so overwhelming.”While she was forced to halt abortion care, Kleinfeld did not want to leave her patients behind. One month after the fall of Roe, she regrouped, considerably downsizing her 5,000 sq-ft clinic and cutting her staff by more than half. She now provides pre- and post- abortion ultrasounds for those traveling out of state, as well as abortion clinic referrals. Her clinic is only one of two former independent abortion providers in Texas – and just a handful across the US – that have not closed or moved away.“We did not want to completely abandon pregnant people in Houston,” said Kleinfeld. “We felt it was still really important to adapt and provide this necessary service. It feels absolutely awful to not be able to offer abortion care, but at the same time, we feel grateful to be able to still help patients in whatever way we can.”Her clinic received around 1,200 visits this year, with most traveling to and from New Mexico, Colorado and Kansas.The fear unleashed by SB 8 two years ago still lingers today: Patients are scared to disclose that they want or have had an abortion; they are fearful to bring a partner or family member with them to a procedure out-of-state or even to the ultrasound at Kleinfeld’s clinic, worrying that a loved one may be in legal trouble for “aiding or abetting” care.“We still have to explain to patients all the time that it is not illegal to help someone obtain a legal abortion,” said Kleinfeld. “SB 8 was meant to be a fear tactic that paralyzed care and instilled anxiety in patients, and even after Dobbs, we are still seeing its impact.”Dr Alan Braid and Andrea Gallegos: ‘Waving our hands hands on top of a burning building’As a medical resident in 1972, Dr Alan Braid will never forget treating a 15-year-old girl in a San Antonio emergency room who was suffering from sepsis – a life-threatening blood infection – after a botched and illegal abortion, her vaginal cavity packed with rags. Braid and doctors did everything they could but the infection was so severe, she died a few days later from massive organ failure. That year, he saw another two teenagers die from illegal abortions.It was then that Braid realized that abortion care was vital and medically necessary, an inextricable component of overall healthcare. One year later, Roe would help solidify and protect Braid’s mission.For the next 45 years, he provided ob-gyn and abortion care in Texas. When Senate Bill 8 hit, it felt like 1972 all over again, he said.“To repeat history and expect a different outcome is insanity. Women will be injured and women will die – again – without access to healthcare,” said Braid.With a passion for reproductive rights, Andrea Gallegos joined her father’s practice as manager of Alamo Women’s Reproductive Services a few years ago. She describes the impact of SB 8 as “devastating” to patients, many of whom were saddled with multiple barriers to care. Even when staff would offer to pay for travel or the procedure itself, patients – still bound by the inability to find child care or time off work – couldn’t make the journey out of state.Braid felt like he had to fight back. In an act of overt defiance, the provider performed an abortion on a patient beyond the six-week limit. He was not only acting out of medical duty but hoped to invoke a legal challenge that would eventually halt SB 8.“I don’t think any of us really thought SB 8 would last – it’s so blatantly unconstitutional and just crazy, we figured the courts – even a court as conservative as the fifth circuit – would recognize the law needs to be stopped,” said Gallegos.While Braid’s intentional act of resistance attracted an outpouring of nationwide support, the lawsuits against him ultimately failed to halt SB 8, leaving the provider feeling largely defeated.He and his team continued to navigate the draconian law, routinely sending patients to their Tulsa, Oklahoma, clinic, where the caseload tripled within the first couple of months, placing a strain on the out-of-state provider.When Oklahoma’s governor signed into law an abortion ban – modeled after Texas’s SB 8 – in April 2022, Braid was forced to shutter the critical pipeline for Texans.“It felt like we were waving our hands on top of a burning building, trying to warn everyone else that this is what it’s going to look like for the rest of the country soon,” said Gallegos. “While we see the lack of access, the forced travel, the domino effect on surrounding clinics now everyday post-Dobbs, in Texas we were experiencing it first.”Following Roe’s demise, Braid was forced to close the doors to his San Antonio clinic and stopped practicing abortion care in Texas after nearly five decades. In May, he officially moved to Albuquerque, New Mexico, where he has set up a clinic in the safe haven state.Gallegos relocated to Carbondale, Illinois, in July, a spot nestled between abortion-hostile states, to oversee a new clinic there.Leaving Texas – and friends and family behind – is deeply “bittersweet” for the father-daughter duo: there is a sense of “abandonment” but also a recognition that the move was necessary.“It’s not easy to completely start over but I know this is where I’m supposed to be,” said Gallegos.For the abortion providers, it’s also a painful reminder of the growing inequity of reproductive healthcare across the US.“It hits me hard knowing geography has played such a significant role in privilege to access to what I consider basic healthcare,” said Gallegos. “Geography should not determine if you can have a safe or dangerous pregnancy. We are living in a devastating reality.”Braid, now in his late 70s, describes working in New Mexico as “refreshing”, as he can “just be a doctor” and not “have to call attorneys” for guidance every step of the way, as he did in Texas.However, he has left his home state – and the place where he learned to be a physician so many years ago – with a tinge of regret, wishing he not only provided one abortion in violation of SB 8, but several more, convinced that the act of rebellion would have eventually led to a successful court battle that brought down the law. His daughter seeks to allay his remorse.“I remind my dad that the law was so unprecedented, so hard to predict and navigate, none of us knew what would happen,” said Gallegos. “In the end, the whole point of SB 8 was to elicit fear in abortion providers and sadly, that’s exactly what it did.” More

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      Ohio Republicans accused of trying to mislead voters with abortion ballot wording

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      Abortion rights advocates in Ohio filed a lawsuit on Monday, claiming that state Republican leaders are trying to confuse voters on a ballot measure about access to reproductive healthcare.Last week, the Ohio ballot board – led by the Republican secretary of state, Frank LaRose – approved the wording of Issue 1, a November ballot measure that will ask voters if the state constitution should guarantee a right to abortion, contraception, fertility treatment and miscarriage care.The new lawsuit accuses the ballot board’s Republican majority of presenting voters with a confusing summary of Issue 1 in an attempt “to mislead Ohioans and persuade them to oppose the amendment”.According to the lawsuit filed with the Ohio supreme court, the ballot board was asked to “put the clear, simple 194-word text of the Amendment itself on the ballot, so that voters could see exactly what they were being asked to approve”.Instead, the board approved a summary of the amendment that is longer than the amendment itself, replacing the term “fetus” with “unborn child”. The summary also does not mention the other forms of reproductive healthcare guaranteed by the amendment, like access to contraception and fertility treatments.The summary does not change the content of the constitutional amendment itself, but abortion rights advocates worry that it will mislead voters at the ballot box, dissuading Ohioans from supporting Issue 1.“The ballot board’s members adopted politicized, distorted language for the amendment, exploiting their authority in a last-ditch effort to deceive and confuse Ohio voters ahead of the November vote on reproductive freedom,” said Lauren Blauvelt, a spokesperson for Ohioans United for Reproductive Rights, the abortion rights coalition leading the lawsuit.The legal battle over the language of the Ohio ballot measure is the latest attempt to block voters from passing a state constitutional amendment on reproductive rights.Earlier this month, Ohio Republicans held a costly special election in an attempt to make it more difficult for voters to amend the state constitution. In a resounding failure for the Ohio GOP, voters overwhelmingly rejected the proposal, opting to keep the current method of passing citizen-led amendments.A recent poll from USA Today Network/Suffolk University showed rising support for a state constitutional amendment protecting the right to abortion.LaRose last week tweeted that the amendment was a move from “the radical left”.In the ballot board meeting, LaRose told members that he thought his summary of the amendment was “fair and accurate”.“We tried to summarize that the best way we can and make it a clear statement here in the ballot language of what this amendment would actually do,” he said.LaRose, an avowed abortion opponent, launched his campaign for US Senate last month.The Ohio Capital Journal revealed that LaRose’s campaign received a $1m donation from a new soft-money group established by the conservative lawyer David Langson, who also funded at least two additional campaigns to block the passage of the reproductive rights amendment.Other Ohio Republicans – like the state attorney general, Dave Yost – share LaRose’s staunch opposition to abortion.But the lawsuit commended the attorney general for setting aside his personal views on abortion to “lawfully and impartially” complete his “amendment-related duties”.In March, Yost approved the summary language of the amendment submitted by abortion rights advocates, writing in a certification letter that the language was a “fair and truthful” explanation of the proposed changes to the Ohio constitution.“My personal views on abortion are publicly known,” Yost wrote.But the attorney general added that he could not “use the authority” of his office to unfairly influence state policy.He added: “Elected office is not a license to simply do what one wishes.” More

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      Girl, 13, gives birth after she was raped and denied abortion in Mississippi

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      A 13-year-old girl in Mississippi gave birth to a boy after she was raped as well as impregnated by a stranger – and then was unable to get an abortion, according to a Time magazine report published on Monday.The mother of the girl, who uses the pseudonym Ashley in the report, was looking to get an abortion for her daughter but was told the closest abortion provider was in Chicago – a drive of more than nine hours from their home in Clarksdale, Mississippi.Ashley’s mother, referred to as Regina in the report, told Time that the cost of getting an abortion in Chicago was too expensive when considering the price of travel, taking time off work and getting the abortion for her daughter.“I don’t have the funds for all this,” Regina told Time.The report is the latest in a series of horrific personal accounts that have surfaced after the US supreme court overturned the nationwide abortion access rights which had been established by the Roe v Wade precedent. Since the decision, titled Dobbs v Jackson Women’s Health Organization, 14 state laws banning abortion have gone into effect, according to the Center for Reproductive Rights.The women’s health clinic that was at the center of the case was the last abortion provider in Mississippi until it closed last summer after the Dobbs decision.Last summer, just a week after the ruling, a local newspaper in Ohio reported that a 10-year-old who was raped had to travel to Indiana for an abortion because of restrictions in her state. A man was found guilty last month of raping and impregnating the girl in that case, and he received a sentence of life imprisonment.Other stories detail how women nearly died because doctors had to wait until their life was at risk to perform an abortion – or that many women now have to travel long distances to get any kind of reproductive healthcare. An estimated 25 million women ages 15 to 33 live in states that have abortion restrictions.With respect to Monday’s Time report, Ashley discovered she was pregnant after her mother took her to the hospital for uncontrollable vomiting. Regina noticed that Ashley was behaving differently, staying in her room when she used to enjoy going outside to record TikTok dances. Upon receiving bloodwork showing Ashley was pregnant, the hospital contacted the police.“What have you been doing?” a nurse asked Ashley at that time, according to the report. The hospital ultimately directed Ashley to the Clarksdale Women’s Clinic, which provides OB-GYN services. The clinic did not respond to requests from the Guardian for comment.“It was surreal for her,” Dr Erica Balthrop, Ashley’s physician, told Time. “She just had no clue.”Before Dobbs, Balthrop could have directed Regina to a Memphis abortion clinic that was a 90-minute drive north, or to Jackson Women’s Health, which is a 2.5-hour drive south. But Mississippi – along with all the states surrounding it – has banned abortion.Mississippi, along with many other states that also ban abortions, technically make exceptions for when the pregnancy is from rape or is life-threatening. But abortions granted under these exceptions are extremely rare and poorly tracked.In January, the New York Times reported that Mississippi made two exceptions since the state’s abortion ban went into effect. The state requires that a rape be reported to law enforcement in order to qualify for a legal abortion.skip past newsletter promotionafter newsletter promotionTwo out of three sexual assault cases in the US are not reported to the police, according to Rainn, or the Rape, Abuse & Incest National Network, an anti-sexual assault nonprofit. Even if an exception is made, a person must travel out of their state to get an abortion procedure if their state bans it.The laws exacerbate longstanding health inequalities in Mississippi, where Black women are four times more likely to die from pregnancy-related complications compared with white women, according to the state’s health department. According to the Guttmacher Institute, 60% of women who seek abortions are people of color and about half live below the federal poverty line.Regina said she filed a complaint with the Clarksdale police department after she learned Ashley was pregnant. She told Time that her daughter ultimately opened up about what happened: a man came into their front yard while she was making TikToks outside while her uncle and sibling were inside and assaulted her. Ashley said she did not know who the man was and that no one witnessed the attack.The police department confirmed to Time that a report had been filed. But the agency declined to comment publicly on the case since it involved a minor.After 39 weeks of pregnancy, Ashley gave birth to a boy, whom they nicknamed Peanut. Ashley told Time the birth was “painful”.“This situation hurts the most because it was an innocent child doing what children do, playing outside, and it was my child,” Regina told Time. “It still hurts, and is going to always hurt.”
      Information and support for anyone affected by rape or sexual abuse issues is available from the following organisations. In the US, Rainn offers support on 800-656-4673. In the UK, Rape Crisis offers support on 0808 500 2222. In Australia, support is available at 1800Respect (1800 737 732). Other international helplines can be found at ibiblio.org/rcip/internl.html More

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      Republican senator will ‘burn the military down’ over abortion policy, says Democrat

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      The Alabama Republican senator Tommy Tuberville is “prepared to burn the military down” with his block on promotions in protest of Pentagon policy on abortion, the Connecticut Democratic senator Chris Murphy said.“I think everybody’s been hoping that Senator Tuberville would back down,” Murphy told reporters at the Capitol on Tuesday.“And I think we have to come to the conclusion that that is not happening and that he is prepared to burn the military down.“Maybe Republicans were hopeful that leading up to the August break he would relent. He didn’t, and we now have to adjust our strategy.”Last year, the conservative-dominated US supreme court removed the federal right to abortion. Since February, Tuberville has been protesting Pentagon policy that allows service members to travel for abortion care if their state does not provide it.His method is to place a hold on all promotions to senior ranks that are subject to Senate confirmation, usually a pro forma process carried out with unanimous consent.Senior military leadership is increasingly severely affected, the US Marine Corps and US Army without permanent leaders and the joint chiefs of staff facing a similar predicament when the current chair, Gen Mark Milley, steps down next month.Nikki Haley, the former governor of South Carolina now running for the Republican presidential nomination, also said Tuberville should back down.“We do not have a chief of staff of the army for a first time in 200 years,” Haley told the conservative radio host Hugh Hewitt. “More than 300 vacancies. It’s a mess.”Haley said Hewitt should call Tuberville “and ask him to stop screwing up the military, because we’re on the brink of a conflict with China and we cannot have this”.Joe Biden has called for Tuberville to step down. So have hundreds of military spouses. Tuberville has refused. Mitch McConnell, the Republican leader in the Senate, has said he does not support Tuberville’s protest but has not moved to stop it. Senate rules give individuals the ability to hold up proceedings. Furthermore, Tuberville retains support among his own party, in both chambers of Congress.skip past newsletter promotionafter newsletter promotionOn Tuesday, Murphy said Republicans should support a temporary change to Senate rules, in order to process promotions that are now held up.“I just think we have to start thinking creatively about breaking this logjam,” he said. “There is no world in which we can use floor time for these nominations. It’s logistically impossible.”Murphy also said Tuberville, a former football coach and now a prominent Trump supporter, “is not going to back down” because “he thinks he’s become a celebrity folk hero in the fringe right.“He’s having the time of his life. If you want the military to function, you’re going to have to find a creative way to get around this guy.” More

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      Why Maryland became a haven for abortion care after Roe’s fall

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      When the US supreme court upended the federal right to abortion enshrined in Roe v Wade, the immediate task before Democrats seemed simple: keep abortion legal in as many states as possible.But over a year since Roe’s demise, some leaders in the reproductive rights movements worry that Democrats have tunnel vision, focusing their messaging and resources entirely on the legal tug-of-war over abortion bans in the midwest and south.“Voters want to understand: what are you going to do to make things better? They don’t want to just hear, oh, we’re not going to ban abortion. That’s important, but that’s not good enough,” said Andrea Miller, president of the National Institute for Reproductive Health, which supports abortion rights.Miller said the fight to keep abortion legal is just one frontier in the larger battle for reproductive healthcare. She spent the past year pushing blue states to pass legislation that makes abortion easily accessible, affordable and without stigma for patients and providers.In recent months, Maryland has emerged as an example of how Democratic lawmakers can take proactive steps to bolster abortion access, even in states where the procedure is and will likely remain legal.Maryland is one of just eight states that require private insurers to cover abortion care with no cost-sharing.In April 2022, in anticipation of the supreme court ruling on abortion, Maryland Democrats passed a bill that allows nurse practitioners, physician’s assistants, and other medical health professionals to supervise abortions.“Before, we would only allow doctors to do it, even though nurse practitioners, midwives, all these other medical professionals are able to handle the similar things like miscarriages and deliveries,” said Maryland House Delegate Joseline Peña-Melnyk, one of the bill’s sponsors.The law also directs the state to invest $3.5m a year for abortion-care training.If Roe fell, Maryland’s solidly Democratic legislature could ward off any attempts at criminalizing abortion patients or providers. But keeping abortion legal was not good enough. Peña-Melnyk and her colleagues wanted to ensure that Maryland’s abortion clinics would have the capacity to deal with an inevitable surge of out-of-state patients.“This case ending Roe didn’t come out of nowhere, we saw it coming, so when the legislative session started in 2022, we started preparing,” Peña-Melnyk said.She said Maryland’s investment in reproductive healthcare helped prepare the state for the coming months, when West Virginia, Ohio and other neighbors enacted a dizzying web of abortion restrictions.The push to bolster abortion resources in Maryland is part of what attracted Dr Anne Banfield to the state.Dr Banfield spent over a decade of her career as an OB-GYN at a rural hospital in West Virginia. She relocated to Maryland in spring 2022, just after a leaked draft opinion revealed that the supreme court was poised to upend abortion rights.“When I was in West Virginia, there was this constant hum in the background of, oh, what are the politicians going to do next,” she said. “You don’t realize how much that negatively impacts your overall outlook until the pressure is gone.”One year after Banfield moved, Maryland governor Wes Moore signed a new set of protections for abortion providers and patients, including a measure that shields the state’s doctors from legal liability if they provide an abortion to out-of-state patients.“Listen, we are a rural hospital, it is a place that typically has challenges recruiting providers,” Banfield said.But in the past few months, Banfield said she has been able to hire recent graduates from top residency programs.“I can look at these candidates and say, this is a place where you can come and practice full-spectrum reproductive healthcare,” she said. “Here is a place where you will be protected.”skip past newsletter promotionafter newsletter promotionStates without affirmative protections for patients and providers could see increased “brain drain”, with doctors like Banfield relocating to places like Maryland. Reproductive health workers are increasingly wary of states that do not proactively push to make abortion more affordable and freely accessible, beyond basic questions about legality.Hanan Jabril, a full-spectrum doula and abortion rights organizer in Wisconsin, is preparing to apply to medical school in hopes of becoming an OB-GYN.“Where I’m applying, where I want to end up, it’s something I’ve been thinking about for years, and the political climate of different states is a huge part of that decision,” said Jabril. “States like Wisconsin are just hemorrhaging residents in OB-GYN especially, because the work is being criminalized by these bans.”When Roe was overturned last year, an 1849 law banning abortion went back into effect in Wisconsin. The 19th century ban is currently facing a legal challenge that is expected to land before the Wisconsin supreme court.Jabril was part of a coalition of progressive organizers that helped elect a liberal justice to the state supreme court in April. With a liberal majority on the court, Wisconsin is poised to overturn the state’s 1849 law.But Jabril said that overturning the ban on abortion isn’t good enough.“It’s important, but I think people forget that this fight didn’t start last year,” they said.Jabril said there are cost barriers to accessing abortion that have long predated the overturn of Roe. Because of the Hyde amendment, passed in 1977, states are banned from using federal Medicaid dollars to pay for abortions, with very narrow exceptions.Of the 32 states following the Hyde amendment, just four states help pay for abortion in cases where a pregnancy could cause long-lasting damage to a patient’s physical health.Jabril wants to train and practice medicine in a state like Maryland or Illinois, which has voluntarily opted to use state dollars to cover all or most medically necessary abortion.“People don’t realize how much more there is to abortion access than just, the law says it’s OK,” said Jabril. “If you can’t pay for it, or if there’s no provider within driving distance, then abortion is still not accessible.” More

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      Lawsuit filed in Iowa to block Republicans’ six-week abortion ban

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      Abortion providers in Iowa have filed a lawsuit to block state Republicans’ latest attempt to ban the procedure after six weeks of pregnancy, before most people even know they are pregnant.Last week, Iowa lawmakers passed a six-week ban on abortion in a rare special legislative session, called by Governor Kim Reynolds, who signed the bill on Friday afternoon. The law takes immediate effect, further shrinking the options available to people seeking abortions in the midwest.“In a rare and historic special session, the Iowa legislature voted for a second time to reject the inhumanity of abortion and pass the fetal heartbeat law,” Reynolds said on Friday.The move to restrict abortion in Iowa came less than one month after a deadlocked state supreme court blocked enforcement of a near-identical six-week ban. Reproductive justice advocates across the country condemned Reynolds’ decision to call a special session on abortion.“Every dirty trick in the book is being used to pass these extremely unpopular abortion bans,” said Kimberly Inez McGuire, executive director of Unite for Reproductive & Gender Equity (Urge), a progressive advocacy group that supports abortion rights.“They don’t want to do it in the light of day, that’s why we’re seeing these special sessions, that’s why we’re seeing bans passed in the middle of the night,” she added.Abortion providers in Iowa said they were unsurprised that the state GOP used a unique legislative tool for the sole purpose of restricting reproductive freedom. Francine Thompson, executive director of the Emma Goldman Clinic – one of two abortion providers in Iowa and a plaintiff in the new lawsuit – said the ban’s passage was expected yet appalling.She said there was a cruel irony to the timing of the governor’s announcement of the special session, which came just after Independence Day, “a day we typically associate with celebrating our freedom from oppressive and tyrannical governments”.Staff at the Emma Goldman Clinic spent hours this week on the phones with nervous patients confused by the legal status of abortion in Iowa.“Since Dobbs, the phone lines are always jammed,” Thompson said. “The most recent calls are not really in an attempt to get seen before the law goes into effect, but are clients seeking information to wade through the chaos of rapidly changing access and the myriad of restrictions in surrounding states.”The six-week ban is confusing, in part, because it closely resembles a 2018 law that was blocked by an Iowa district judge years before Roe v Wade was overturned. Earlier this year, Reynolds asked the Iowa supreme court to reverse the district judge’s decision. The state justices split 3-3, leaving the lower court’s order in place, meaning the 2018 ban remains unenforceable.The lawsuit against the new six-week ban is expected to reach the Iowa supreme court, which last year ruled that the state constitution does not guarantee the right to abortion.But last month, the 3-3 deadlock happened after one justice, Dana Oxley, opted to recuse herself from the case because of a conflict of interest with her old law firm. It is unclear if Justice Oxley will recuse herself again, causing another split ruling.Iowa Republican lawmakers might not care about the outcome of the legal battle. They win political points with their core, conservative voter base simply by reconvening at the state capital to pass an abortion ban.“Because of gerrymandering, Iowa Republicans aren’t really worried about losing to a Democrat, but they are at a real risk of being primaried,” said Mary Ziegler, a law professor at University of California, Davis.If the ban is struck down, Republicans can blame the courts, a convenient boogeyman in the tug-of-war over state abortion law. The good-faith attempt to pass a six-week ban is enough to reassure anti-abortion lobbying groups and socially conservative donors.skip past newsletter promotionafter newsletter promotionZiegler said ideological posturing is especially important for Governor Reynolds ahead of the Iowa caucus, which helps select the Republican presidential nominee. Reynolds’ endorsement could therefore change the future of her party.But first, Ziegler said, the governor “needs to prove her conservative credentials” on abortion.Reynolds signed the ban at the Family Leadership Summit, a gathering of evangelical Christians and social conservatives in Des Moines. The event attracted 2024 Republican presidential hopefuls such as Florida’s governor, Ron DeSantis, and the former vice-president Mike Pence.Just as Reynolds was signing the six-week ban, attorneys for Planned Parenthood and the Emma Goldman Clinic asked an Iowa judge to temporarily block the six-week ban from taking effect while litigation proceeds. That decision is expected this week.Dr Emily Boevers, an Iowa OB-GYN at one of the state’s last remaining rural hospitals, braced for an anxious weekend. She volunteers her weekends providing abortion care at the Planned Parenthood clinic in Iowa City, though she does not offer abortions in her everyday work at the hospital.Boevers is one of two OB-GYNs in her home county – the other is expected to retire this fall. She is worried that the six-week ban could drive doctors in her specialty out of Iowa, worsening the region’s existing shortage of maternal healthcare providers.“North of me, there is not another hospital for 50 miles,” said Boevers.She said the criminalization of abortion brings “a level of hostility towards obstetric care in all its components” that will “invariably harm” the already dwindling OB-GYN workforce in Iowa.“Forcing experts in women’s health to withhold care from our patients, it goes against many of our moral codes,” Boevers said. “As an obstetrician-gynecologist, I trust my patients to make the best decision for their situation.” More

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      Tensions flare as Iowa passes six-week abortion ban – video report

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      Iowa’s state legislature voted on Tuesday night to ban most abortions after about six weeks of pregnancy, a time before most women know they are pregnant. Republican lawmakers, who hold a majority in both the Iowa house and senate, passed the anti-abortion bill after the governor, Kim Reynolds, called a special session to seek a vote on the ban. The bill passed with exclusively Republican support in a rare one-day legislative burst lasting more than 14 hours More