Health

Subterms

    More stories

    • 150 Shares189 Views

      in US Politics

      What is the Pepfar fight and what does it mean for Africa?

      by

      What is Pepfar and why is it in the news?Pepfar is an acronym for the US “president’s emergency plan for Aids relief”. It was set up two decades ago by George W Bush to address the HIV epidemic.It’s the biggest government-run fund of its kind. Since 2003, the project has donated about $110bn (£90.5bn) to governments, universities and nonprofits in 50 countries, either directly or through agencies such as USAid.Until now Pepfar has been funded in five-year cycles. In the past the programme has had virtually unanimous support from Republicans and Democrats. But the next funding cycle (from 2023 to 2028) became ensnared in US abortion politics and the fallout contributed to Congress missing the 30 September deadline to allow another five-year funding cycle for the initiative.What’s the link between Pepfar and abortion?US laws already prevent Pepfar (or any state agencies) from paying for abortion services, according to the California-based policy research group, Kaiser Family Foundation (KFF). But in May, a coalition of conservative thinktanks and lawmakers began to make waves with arguments that Joe Biden’s administration has “hijacked” Pepfar to promote abortion instead of treating and preventing HIV.That’s where the risk to Pepfar’s five-year budget emerged – because the Republican lawmakers then refused to sign off on a spending bill for Pepfar if there weren’t stricter rules in place to stop Pepfar funds from overlapping with abortion services in any way.According to Brian Honermann, deputy director of public policy at the US-based Foundation for Aids Research, the allegations that Pepfar has been usurped to push a “radical social agenda” overseas are “baseless” and “stitched together from unrelated policy speeches, documents and assertions about how those apply to Pepfar”.What will happen to Pepfar now?The multibillion-dollar health programme is a permanent part of US law. That means Pepfar funding will continue, but it will lose its favoured position of receiving five years of funding at a time.The failure to reauthorise Pepfar will mean some of its built-in rules will expire, including a guideline that requires 10% of Pepfar money to go to orphans and children in need.Will organisations and governments lose their Pepfar grants?The fund has enough money to pay governments and civil society organisations until September 2024 (about $6.8bn), but a state department spokesperson warns that Pepfar won’t escape unscathed in the long term.Moreover, getting funding for only one year at a time will make it harder for Pepfar to plan ahead and to source crucial HIV tools, such as condoms or medicine, at the best prices. This could ultimately imperil the people that rely on the fund’s support, the spokesperson warned.The symbolic power of a five-year commitment will also be lost, says Honermann. “It shows partner countries that the US is invested for a significant period of time and that Pepfar won’t just disappear.”The threat of a permanent ‘gag rule’Another factor has swirled around Pepfar’s funding drama: some lawmakers have said they’ll only agree to restart the five-year funding regime if the fund is once again subject to the “Mexico City policy”, also called the “gag rule”.The gag rule bans organisations and governments from providing or promoting termination of pregnancy services regardless of whose money they’re using to do it. It was expanded to apply to Pepfar for the first time in 2017. It is only ever enforced when there’s a Republican president in the White House, so is not currently in effect.And while there is no finalised legislation that would make a permanent gag rule a reality (and Honermann argues it would be unlikely to get past the Democrats), the threat of it may already have done some damage.Research conducted by Fòs Feminista, a global alliance that advocates for sexual and reproductive rights, found that the 2022 decision to roll back the national right to an abortion in the US had a contagious impact in a number of countries. In Nigeria, for instance, respondents told Fòs Feminista that local lawmakers were using the change in US abortion laws to push back on a more liberal law in their country. Terminations are legal in Nigeria only if carrying the foetus to term threatens the mother’s life.Recipients of US government funding are often so worried about losing it that they enforce abortion laws more harshly than is necessary. Research shows that confusion about whether the gag rule had been revoked at the start of the Biden administration resulted in the policy – and its harms – being in place for much longer in practice.And the Pepfar wrangling and attendant media coverage has already resulted in mixed messages reaching health advocates in Africa. Some South African activists told the Guardian they were concerned that the news would be calamitous for civil society in the country. Such organisations receive the most Pepfar dollars (44%) in South Africa according to 2020 tracking data. The government gets just under 1.5% of the money.Honermann says that there is an intentional political strategy to keep communication about the changes in restrictions vague. “It’s a way to encourage over-enforcement for fear of falling on the wrong side of this.”He adds: “For now, Pepfar will continue as long as funding is made available. But these political threats to the programme are ultimately playing with the lives of millions of people worldwide who rely on this programme.”What has the reaction been in Africa?Dave Clark is the chief operating officer at the Aurum Institute, a non-profit that works on HIV and tuberculosis (TB) projects in South Africa, Mozambique, Ghana, Lesotho and Eswatini.Aurum is a partner for Pepfar’s Dreams project which works towards an Aids-free future for girls and women aged 10 to 24 by providing HIV services, contraception and violence prevention support for women, adolescents and their sexual partners.One of the major strengths of Pepfar, Clark says, is that it’s a sure-fire source of carefully planned funding for global health in a world that is often more talk than action.He explains: “The debate in America should not throw us off saving lives. Pepfar is what it says on the label: president’s emergency plan for Aids relief. That’s its extraordinary power and legacy.” More

    • 125 Shares179 Views

      in US Politics

      US surgeon general on why loneliness threatens democracy | podcast

      by

      In a public advisory, written back in the summer, Dr Vivek Murthy warned of a growing ‘epidemic of loneliness and isolation’, which he believes is not just destined to affect the physical and mental health of individuals but could end up being detrimental to democracy itself.
      ‘The nation’s doctor’ speaks to Jonathan Freedland about why some bad faith actors are choosing to manipulate this problem and how political leaders on all sides can address it before it gets worse

      How to listen to podcasts: everything you need to know More

    • 138 Shares199 Views

      in US Politics

      New York City public hospitals to offer abortion care via telehealth

      by

      New York City public hospitals will now offer abortion care via telehealth, placing them among the first public health systems in the US to do so.The city’s mayor, Eric Adams, announced on Monday that abortion pill prescriptions would now be available by telephone or online, adding that such access can happen from “the comfort of your home”.As a result of the move, New York City residents will now be able to connect with health practitioners for those prescriptions, building on previous legislations to protect abortions rights in New York.“If you are clinically eligible, that provider will be able to prescribe abortion medication that would be delivered to your New York City address within days,” Adams said during Monday’s announcement.“We will not stand idly by as these attacks continue and the far-rights seeks to strip our citizens of their basic rights,” Adams added, referring to abortion restrictions being legislated across the country.Abortion rights organizations celebrated Monday’s announcement as an essential step to protect reproductive rights.“Today marks a historic win for abortion access in New York City,” said Wendy Stark, president and CEO of Planned Parenthood of Greater New York.“When we make abortion care more accessible, we empower individuals to make the best decisions for themselves, their families and their futures,” Stark added.The expanded access to abortion care comes after the supreme court’s elimination last year of the federal abortion rights established by Roe v Wade.Since then, at least 20 states have passed restrictions on abortions, the New York Times reports.Fourteen states, mainly in the south, have enacted total bans on the medical procedure.US courts have also limited access to abortion medication. In August, a US appeals court ruled that the abortion pill mifepristone should be regulated according to rules set prior to 2016.skip past newsletter promotionafter newsletter promotionIn August 2022, Adams signed legislation protecting the right to abortions in New York City after the supreme court’s decision to overturn Roe v Wade.The measures signed by Adams – six in total – also made abortion medication free at all of New York’s department of health and mental hygiene clinics.The New York state legislature has also passed legislation protecting medical professionals in the state who provide abortion pills to patients in places where the procedure is banned, the New York Times reported.Other Democratic-led cities and states have passed similar measures protecting reproductive rights.In January, the governor of Illinois, JB Pritzker, signed legislation expanding abortion access by allowing more practitioners to provide the medical procedure and mandating that agencies in the state cover the procedure, the television news outlet WTTW reported. More

    • 188 Shares189 Views

      in US Politics

      ‘Feels horrible to say no’: abortion funds run out of money as US demand surges

      by

      Laurie Bertram Roberts never expected Americans to keep forking over money to pay for other people’s abortions. But the abortion fund director didn’t think it would get this dire.When the US supreme court overturned Roe v Wade last year, people donated tens of thousands of dollars to Roberts’ organization, the Mississippi Reproductive Freedom Fund, which is dedicated to helping people afford abortions and the many costs that come with it. But, in August, Mississippi Reproductive Freedom Fund had to stop funding abortions. It’s now closed until January 2024.“We just don’t have the money,” said Roberts, who co-founded the fund a decade ago. “It’s a strategic decision, to focus on fundraising for the next couple months, so that when we reopen, we’ll have money.”For now, the fund – which has historically also helped people with other costs of living and parenting – is only offering access to its pantry of food and household supplies. This will be the longest the Mississippi Reproductive Freedom Fund has ever been shut down.“I didn’t think the emergency funding was gonna stay the same,” Roberts said in reference to the post-Roe donation spike. “But I didn’t expect for our funding to dip by 35 to 40% from last year.”When the US supreme court overturned Roe, Americans rushed to rage-donate millions to abortion funds and clinics scattered across the United States.Now, with the first year of post-Roe life in the rearview mirror, much of that money has been spent and the flow of donations has dried up for many organizations. And yet, as states continue to enact new bans and restrictions, the demand for help – and the cost of providing that help – has only grown.The Mississippi Reproductive Freedom Fund isn’t the only abortion fund that’s had to turn its lights off recently. In mid-June, just three days before the anniversary of Roe’s overturning, Indigenous Women Rising announced that its abortion fund had hit its monthly budget and would cease operations until July. The Mountain Access Brigade, which serves people in Appalachia, closed its support hotline for 10 days in July to save money. By mid-July, the Utah Abortion Fund announced that it had already exceeded its monthly budget and would close until late August.“You have increasing costs and decreasing donations,” said Hayley McMahon, who sits on the board of the Appalachian abortion fund Holler Health Justice and studies barriers to abortion at Emory University’s Rollins School of Public Health. “Those two things combined are a perfect storm for just absolutely wiping out abortion funds.”Much of the south and midwest have now banned or significantly limited abortion, forcing people in those states who want abortions to travel farther. Over the summer, Indiana, North Carolina and South Carolina all implemented significant new restrictions, which put even more pressure on abortion funds. In July, the Abortion Fund of Ohio helped 355 people. In August, the same month that neighboring Indiana outlawed almost all abortions, that number surged to 562.Lexi Dotson-Dufault, the Abortion Fund of Ohio’s patient navigation program manager, said that the money trickling into the fund is simply not enough to meet the demand. With three months left to go in 2023, the Abortion Fund of Ohio has already offered assistance to roughly 2,400 people. That’s 700 more than it helped in 2022, and almost three times as many people as it helped in 2021.“We don’t want to have to set limits as to what we can give people,” Dotson-Dufault said. “I think if the money doesn’t come in the way we need to, we will start to have to.”Three-quarters of US abortion patients have incomes below the federal poverty line. The cost of an abortion, meanwhile, has perhaps never been higher: more and more people have to travel for the procedure, buying flights and gas, booking hotel rooms, taking time off work. More than 60% of people who have had abortions have already given birth before, so they may also need to secure childcare.Although the vast majority of US abortions take place in the first trimester of pregnancy, abortion fund callers are more often in their second trimester, according to a study of callers to the National Network of Abortion Funds between 2010 and 2015. Post-Roe, people who work at abortion funds told the Guardian that they are now seeing even more people who are later on in their pregnancies – which becomes a problem both for abortion seekers and the funds, because abortion becomes more expensive later in pregnancy. It also becomes harder to find – not every clinic will perform abortions into the second trimester – so people often have to travel even further.From July 2021 through June 2022, the Missouri Abortion Fund spent about $235,000 helping people get abortions. Between July 2022 and June 2023, they spent over $1m – but they only helped 300 more people than the previous year, said Jess Lambrecht, the fund’s executive director. The typical client used to cost less than $1,000; now, they frequently cost multiple thousands of dollars.“Basically, our budget tripled, but so has our cost,” Lambrecht said.The Nevada-based Silver State Hope Fund has already been forced to become “very, very frugal” when giving out money, said Erin Bilbray-Kohn, the fund’s vice-president and acting executive. Within three days of Roe’s demise, Bilbray-Kohn raised $50,000 for the fund. But now, the fund’s finances have become so strained that it’s using the money it had once set aside to pay for next spring.Before Roe’s demise, the fund spent about $10,000 each year. Now, it’s spending $16,000 each month. So many people are desperate for help: the woman who got pregnant by her abusive partner, the woman with Type I diabetes whose pregnancy threatened her life, the girl whose college scholarship would have been jeopardized if she had a baby.“I wake up in the morning worried we’re not going to have enough funds,” said Bilbray-Kohn, who started to cry as she shared her clients’ stories. “I’m working really aggressively to try to raise that money so that we can fill up those coffers and be OK in the spring.”The Silver State Hope Fund is also currently suing, aided by the ACLU, to abolish a Nevada law that blocks people from using Medicaid to pay for abortions. Roughly 80% of the people calling the Silver State Hope Fund are Medicaid-eligible, Bilbray-Kohn estimated. If the fund wins its lawsuit, many of its current callers could rely on Medicaid instead and the fund could free up money to pay for other callers.Abortion funds aren’t the only abortion rights organizations that are now scrambling for money. The clinics left behind in states that have now banned the procedure are also struggling to stay open, as they pivot to offering more broad reproductive healthcare services.When the supreme court overturned Roe, the West Alabama Women’s Center had to stop performing abortions and send its patients out of state. Within 48 hours, it raised $180,000 for patients’ travel, recalled Robin Marty, the clinic’s executive director. “Now I go and I try to ask for any sort of funding online, and we can get maybe $50 to $100 every time I do it,” Marty said.As of late August, though, Marty estimated that she had enough money in the bank to pay her staff’s salaries through October.For now, the Mississippi Reproductive Freedom Fund’s phone line is still open; the organization is redirecting people towards other, open abortion funds. But the phone line will be shut down entirely for the month of December.“I know we are making the right decision, but it feels horrible to tell people no,” Roberts said. But, Roberts added, “If we’re not making strategic plans to make sure that we’re sustaining ourselves and sustaining fundraising, we’re not gonna make it. We won’t be here next year and we won’t be here the year after that and I want to make sure we’re still here. There’s not less of a fight to fight. It’s just getting more intense.” More

    • 150 Shares109 Views

      in US Politics

      Florida supreme court to hear abortion case that could drastically limit access

      by

      The Florida supreme court on Friday will hear arguments in a case that could drastically limit abortion access in the south-eastern United States.Abortion providers in Florida filed a lawsuit to block the state’s ban on abortion after 15 weeks of pregnancy.If the state’s high court upholds the 15-week ban, a separate, stricter law would take effect prohibiting abortion after six weeks, before most people know they are pregnant.“It would be devastating for providers to have to turn even more folks away under a six-week ban,” said Whitney White, a staff attorney with the ACLU’s Reproductive Freedom Project. “They’re already having to turn away patients under the current 15-week ban.”Friday’s hearing is the culmination of Republican efforts to end Florida’s legacy as a safe haven for abortion seekers in neighboring states. Five of the seven justices on the current state supreme court were selected by the conservative governor, Ron DeSantis, fueling the concerns of Floridians who support abortion access.After signing the six-week trigger ban into effect in April, Governor DeSantis said in a brief statement that he was “proud to support life and family in the state of Florida”. The Florida governor has been hesitant to discuss abortion on the campaign trial.A whopping 62% of American adults believe abortions should be legal in “all or most cases”, according to a 2022 report published by Pew Research Center. A 2020 Ipsos/Reuters poll found that 56% of likely voters in Florida believe abortion should be legal in most cases. And abortion rights supporters in Florida say the bans violate the explicit privacy protections found in the state constitution.Despite DeSantis’s conservative overhaul of the state’s high court, White remained confident about the case in the run-up to Friday’s hearing.“No justice of the Florida supreme court has ever written a decision questioning the conclusion that abortion rights are protected by the privacy clause,” White said.Florida Republicans passed the 15-week ban on abortion in April 2022, months before the US supreme court ended the federal right to abortion. That same month, a judge revived a 2015 state law that mandated patients wait 24 hours between getting an initial consultation for an abortion and undergoing the procedure.“It’s been one restriction after another,” said Dr Kanthi Dhaduvai, a Jacksonville abortion provider with Physicians for Reproductive Health.Dhaduvai felt “nervous and frustrated” about the hearing, fearing a court ruling that would make it impossible for her patients to receive “what is often life-saving care”.skip past newsletter promotionafter newsletter promotionRoughly half of Dhaduvai’s patients come to Florida from states like Georgia, Louisiana, Mississippi, Alabama – even Texas.“I think a lot of people are not aware as to how dangerous this could be, not just for Florida, but the entire region,” she said. “Florida has been a huge access point for people, we already have people traveling these great distances to get care.”In the months after the US supreme court overturned Roe v Wade, Florida saw the greatest increase in the number of legal abortions performed per month, according to a report released this April from the Society of Family Planning.“I’m still providing care and I’m going to continue providing care, within legal limits, even after the decision,” Dhaduvai said. More

    • 175 Shares199 Views

      in US Politics

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

      by

      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

    • 150 Shares129 Views

      in US Politics

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

      by

      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