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    Trump rescinds Emtala guidance protecting women in need of emergency abortions

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    The Trump administration on Tuesday rescinded Biden-era guidance clarifying that hospitals in states with abortion bans cannot turn away pregnant patients who are in the midst of medical emergencies – a move that comes amid multiple red-state court battles over the guidance.The guidance deals with the federal Emergency Medical Treatment and Labor Act (Emtala), which requires hospitals to stabilize patients facing medical emergencies. States such as Idaho and Texas have argued that the Biden administration’s guidance, which it issued in the wake of the 2022 overturning of Roe v Wade, interpreted Emtala incorrectly.In its letter rescinding the guidance, the Trump administration said that the Centers for Medicare and Medicaid Services (CMS) “will continue to enforce Emtala, which protects all individuals who present to a hospital emergency department seeking examination or treatment, including for identified emergency medical conditions that place the health of a pregnant woman or her unborn child in serious jeopardy. CMS will work to rectify any perceived legal confusion and instability created by the former administration’s actions.”Abortion rights supporters said on Tuesday that rescinding the Biden administration’s guidance will muddy hospitals’ ability to interpret Emtala and endanger pregnant patients’ lives. Since Roe’s collapse, dozens of women have come forward to say that they were denied medical treatment due to abortion bans. A reported five pregnant women have died after having their care denied or delayed, or being unable to access legal abortions.“This action sends a clear message: the lives and health of pregnant people are not worth protecting,” Dr Jamila Perritt, an OB-GYN and the president of Physicians for Reproductive Health, said in a statement. “Complying with this law can mean the difference between life and death for pregnant people, forcing providers like me to choose between caring for someone in their time of need and turning my back on them to comply with cruel and dangerous laws.”Last year, the US supreme court heard arguments in a case involving Idaho’s abortion ban, which at the time only allowed abortions in cases where a woman’s life was at risk. In contrast, most state abortion bans permit abortions when a patient’s “health” is in danger – a lower standard that could make it easier for doctors to intervene. Idaho’s standard, the Biden administration said, blocked doctors from providing abortions in some emergencies and thus violated Emtala’s requirement that hospitals must stabilize patients.Ultimately, the supreme court punted on the issue by ruling 6-3 on procedural grounds that the case had been “improvidently granted”, indicating they should have never taken it up in the first place.“This court had a chance to bring clarity and certainty to this tragic situation and we have squandered it,” wrote Ketanji Brown Jackson, the supreme court justice, at the time. “And for as long as we refuse to declare what the law requires, pregnant patients in Idaho, Texas and elsewhere will be paying the price.”skip past newsletter promotionafter newsletter promotionThe Trump administration’s Tuesday move is not unexpected. In March, the administration moved to drop out of the case over the Idaho abortion ban. A local Idaho hospital later filed its own lawsuit over the ban. More

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      Trump is using his assault on government to retaliate against women | Judith Levine

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      Last week, a federal judge blocked the justice department from canceling $3.2m in federal grants to the American Bar Association (ABA). The court agreed with the ABA’s claim that the administration was retaliating against it for taking public stances against Donald Trump.But how had the US president retaliated? Which grants had he clawed back? Those supporting programs that train lawyers to defend victims of domestic and sexual violence.It was just one of Trump’s many acts of aggression against perceived enemies that just happen to – or quite deliberately – target women.During the 2016 presidential campaign, after the release of the “grab ’em by the pussy” tape, Vox’s Libby Nelson noted that there was something fundamentally different about Trump’s sexism from the sexism of his predecessors. “Usually, the critique of Republican candidates has been based on policy – healthcare access and abortion rights – or on attitudes heavily influenced by religion,” she wrote. But “Trump’s anti-feminism owes more to the gleeful vulgarity and implicit threats of violence of 4chan than the traditional debate over what a woman’s role should be in the public square.”Trump II is both a personal and a political misogynist – a chimera with the soul of a snake and the brains of a policy wonk, transplanted from the authors of the Heritage Foundation’s Project 2025.The widest target of Trump’s aggression is the universe of people capable of having babies. Four days after the inauguration, his administration directed the justice department’s civil rights division to cease enforcing the Freedom of Access to Clinic Entrances (Face) Act, which prohibits harassment or blockage of patients entering abortion clinics. His administration dismissed three ongoing cases, pardoned 23 convicted violators of the law, and limited future prosecutions to “cases presenting significant aggravating factors, such as death, serious bodily harm, or serious property damage”.In March, he began withholding tens of millions of dollars from Title X, the only federal program supporting reproductive healthcare. The move was not explicitly anti-abortion – the Hyde Amendment banned federal funding for abortion 50 years ago – but it was surely aimed at pleasing religious fundamentalists who oppose all interference with “natural” baby-making. Lots of providers, including some Planned Parenthood affiliates, immediately collapsed, leaving millions of people with no family planning, cancer screening or prenatal services. Now, having failed repeatedly to defund Planned Parenthood through legislation, Republicans are trying to hide the dirty deed in the budget. And like much of the “waste, fraud, and abuse” targeted by the so-called “department of government efficiency” (Doge), these cuts would cost taxpayers far more than they would save: according to the Congressional Budget Office, the cost will be $300m over the next 10 years in unwanted births and shifts of reproductive services to other providers.Trump isn’t sparing mothers who want to be mothers, either. A week ago, funding to study maternal mortality was rescinded and most of the workers who monitor and improve maternal and child health at the Centers for Disease Control and Prevention were placed on leave. The cuts came just after researchers at the National Institutes of Health published a paper documenting a huge rise in mothers’ deaths in childbirth or within a year afterward, most notably among Native American and Black women; the authors urged the government to make combatting these deaths “an urgent public health priority”.Where women’s bodies are now subject to harm by intentional neglect, they will also be more vulnerable to harm by violence. Before his inauguration, Trump called for the execution of rapists. A few months later, the justice department suspended grant applications from non-profits providing emergency shelter, legal assistance, and crisis services to victims of domestic and sexual violence under the Violence Against Women Act. The agencies were caught promoting “woke” agendas – evident from the word “gender”, as in “gender-based violence”, in their mission statements. The grant program appears to be back up on the justice department website, but no one knows for how long.In late April, the administration zeroed out all funding for training, auditing, data collection and victim support under the Prison Rape Elimination Act (Prea), which Congress passed unanimously in 2003. Prea does not protect migrants in detention, but the Department of Homeland Security was nevertheless subject to oversight, and that included investigating sexual abuse by Ice employees. Not any more. In spite of thousands of complaints of sexual violence against detained women and children, the Trump administration closed the department’s three watchdog agencies, including the offices through which detainees could lodge complaints.As part of its elimination of anything suggestive of diversity, equity and inclusion (DEI), the administration halted the military’s sexual assault prevention training. The defense department reported in 2023 that nearly a quarter of active-duty women were subject to sexual harassment – and they are just the ones who risked coming forward.The policies that smash the legal bulwarks against sexual violence and those that put pregnant people’s lives at risk make for the most compelling subject lines on fundraising emails from advocates for women, people of color and other legally protected classes hardest.But the disproportionate harm these folks are suffering from the decimation of the federal workforce by Doge is possibly most consequential, because it may not be reversible. Women and Black people are more likely to work in government jobs than in the private sector; a recent McKinsey analysis found that women, particularly women of color, are promoted at higher rates in public institutions than in private corporations. But government jobs also provide union representation, job security, pensions and other benefits that lift people of color into the middle class and allow them to accumulate the property and wealth denied them since slavery – benefits that do not accrue to home health aides, chambermaids and workers in the other low-paid, precarious occupations where women and people of color predominate.“For those who have been wronged and betrayed, I am your retribution,” vowed candidate Trump at the Conservative Political Action Conference early in 2023. But it is Trump himself who feels most wronged and betrayed, with women – the pussy-hatted protesters who overran Washington on the second day of his first administration, the sex worker Stormy Daniels, who publicly poked fun at his self-celebrated endowment, the magazine writer E Jean Carroll, awarded tens of millions of dollars in damages for his sexual assault and defamation – perhaps the greatest wrongdoers and traitors. Even Melania is no longer pretending to like him.Like his woman-hating followers, this man, who has used his wealth and his body to impose his will on women, feels sorely victimized by them. Now he has more power than any other man in the world to exact his revenge.

      Judith Levine is a Brooklyn journalist and essayist, a contributing writer to the Intercept and the author of five books. Her Substack, Today in Fascism, is at judithlevine.substack.com More

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      The Trump administration is defending abortion pill access in court. What?

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      The Trump administration on Monday asked a federal court to dismiss a lawsuit that takes aim at the abortion pill mifepristone – a move that stunned many observers for what seemed a defense of the drug by a president who has overseen the most dramatic rollback of abortion rights in modern US history.At first blush, it may seem a victory for abortion access – but experts worry that, in reality, the move preserves the administration’s ability to play coy about any future plans to attack abortion rights.When Donald Trump first returned to the White House earlier this year, US anti-abortion activists had high hopes for the man who helped orchestrate the downfall of Roe v Wade. They thought he might use a 19th-century anti-vice law to effectively ban abortion nationwide. Failing that, they imagined that he might use the power of the Food and Drug Administration to roll back access to mifepristone or even yank it from the market entirely.Instead, over the last few months, the Trump administration has attempted to dodge the issue entirely. The Monday request, to a Texas judge who has become a reliable vote for abortion opponents, continued that pattern.The lawsuit seeks to roll back several FDA regulatory changes that have, over the last decade, considerably expanded access to mifepristone, one of two drugs typically used in US medication abortions. It revives a lawsuit that led to a stinging 9-0 defeat for abortion rights opponents when the court ruled the lawsuit’s plaintiffs, a group of anti-abortion doctors, did not have the legal standing to sue in the first place.Rather than let the matter die, the Republican attorneys general of Idaho, Kansas and Missouri moved to take over the case as its new plaintiffs. Judge Matthew Kacsmaryk of the US district court for the northern district of Texas, where the case is being heard, agreed to let the attorneys general move forward.However, in its Monday filing, the Trump administration argued that there is no reason why the case should proceed in Texas.“At bottom, the states cannot keep alive a lawsuit in which the original plaintiffs were held to lack standing, those plaintiffs have now voluntarily dismissed their claims, and the states’ own claims have no connection to this district,” the administration wrote.Abortion rights supporters have long pointed to one reason why the case was filed in Texas: Kacsmaryk. A Trump appointee with a track record of abortion opposition, Kacsmaryk once took the unprecedented step of ruling to reverse the FDA’s 2000 approval of mifepristone, which would lead to its removal from the market.Nicole Huberfeld, a health law professor at Boston University’s School of Public Health, found it “a little funny” that the Trump administration’s filing seemed to call out its own side for judge-shopping.It is possible that Trump, who was never exactly a true believer in the anti-abortion movement, has now soured on it. While the movement helped propel him to the White House in 2016, it became something of an albatross for him in 2024, as outrage over Roe’s collapse led abortion rights to become one of the election’s top issues.Yet Huberfeld found the filing more notable for what it did not say: namely, it shied away from revealing the Trump administration’s plans for mifepristone. She believes the administration may try to change mifepristone access through the FDA, and that the legal reasoning in Monday’s filing could be used against a future lawsuit by blue states against new restrictions.“They’re basically saying that the states don’t get to just challenge FDA policy because they want to,” Huberfeld said. “Which, in my view, is a set-up for anticipating that blue states may try to challenge any changes on mifepristone rules.”FDA Commissioner Martin Makary could, for example, move to reverse regulations that permit people to dispense abortion pills through telehealth – which accounts for about a fifth of all US abortions – or eliminate mifepristone’s approval. Project 2025, the notorious playbook of policy proposals authored by the conservative thinktank the Heritage Foundation, urged the FDA to do exactly that.Last month, Makary told the Semafor World Economy Summit that he had “no plans to take action” on mifepristone. However, he added: “There is an ongoing set of data that is coming into the FDA on mifepristone. So if the data suggests something or tells us that there’s a real signal, we can’t promise we’re not going to act on that data.”Decades of studies, conducted in more than a dozen countries, have found that mifepristone is safe and effective. However, anti-abortion groups have repeatedly pushed studies that claimed to find that mifepristone is dangerous. (Some of those studies have been retracted.)“My guess is that the Trump administration is trying to walk the fine line of not looking like it’s threatening access to mifepristone while also, potentially, through the FDA trying to limit access to mifepristone,” Huberfeld said. “In other words, I don’t think the FDA’s actually going to be hands-off.” More

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      Having as many babies as possible is not the only way to show you love humanity | Zoe Williams

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      ‘Perpetuating humanity should be a cross-politics consensus,” read an article in the Atlantic last week, “but the left was mostly absent at a recent pronatalism conference.” It’s such a simple proposition – everyone loves babies and wants the species to perpetuate, right? – but pronatalism has provoked a ferocious battle on the American left. Should they be trying to engage meaningfully at a preposterous far-right conference? Or should the left stop self-flagellating and start organising?But what is pronatalism – and is it really borderline fascist? I don’t want to think about slippery, bad-faith, rightwing claptrap any more than you do, but in an era in which US politics can sneeze and the world catches encephalitis, we do, regrettably, have to think about bad-faith everything, all the time.The motivation of the pronatalists is that birthrates are in decline, in some places (such as South Korea) so precipitously that the nation will soon cease to meaningfully exist. It has been a bugbear of the right, particularly the alt-tech right, for almost a decade. In 2017, Elon Musk wrote on Twitter: “The world’s population is accelerating towards collapse, but few seem to notice or care.” That was before he owned the platform, so few people noticed or cared. It has also been a thematic staple of Viktor Orbán’s rhetoric in Hungary, reinforced in 2019 by a large-family tax-break policy that in February became an income tax exemption for mothers of two or three children.The ideas factories pushing birthrates have always been much more opaque about their politics; often, they frame their ideas to suit whomever they are talking to. When I interviewed Simone and Malcolm Collins, venture capitalists turned pronatal advocates, a couple of years ago, their line was that progressive politics needed higher birthrates. Political persuasion was “40% to 70% heritable”, Malcolm told me. “If you systematically delete everyone who cares about the environment from the gene pool, that means, within a couple of generations, you’re going to see a dramatic drop in the number of people who care about the climate, even as the collapse becomes more intense.”At the last count, the Collinses had four children, plus a number of frozen embryos, which Simone intends to incubate at 18-month intervals. “We’re going to keep going until physically I can no longer have kids – and that will be when they forcibly remove my uterus,” she said. It was a dystopian image with a number of obvious follow-ups, the first of which was: who are “they”? But I didn’t ask any of them, because her perception of force, authority, uteruses, children and the world seemed dark and personal, like a subconscious gaping open.Nor did I pursue whether Malcolm could possibly believe that you could sell to people who care about the environment the idea that only their biological children would be genetically capable of caring about the environment. It could be the child of someone who arrives on a small boat that solves our political malaise. What about the heritability of staunch determination? Did they ever think about that?But, all too often, ethnonationalism is implicit in the pronatalist narrative: a low birthrate can’t be offset by migration, because they are not talking about people in general. They are talking about the right kind of people.In the intervening years, Musk has had a bunch more children, often boasting of the example he is setting. Trump started saying: “You have good genes, you know that, right?” to his followers. Last week, the US health secretary, Robert F Kennedy Jr, floated the idea that “if you are healthy, it’s almost impossible for you to be killed by an infectious disease in modern times”, which medics rebutted because it’s not true. But we should all fear its drumbeat: good stock is different; anyone who succumbs to an infectious disease wasn’t “healthy” to begin with.These connections are often intellectually baggy – Musk’s desire to populate Mars with his own seed doesn’t map neatly on to RFK’s anti-vax agenda, while Orbán’s pronatalism sounds like socially conservative gender oppression, yet pronatalist forums tie themselves in knots trying to sound “woke”. But if this isn’t about ethnonationalism, then why aren’t the pronatalists crying out for countries with low birthrates to receive refugees with open arms? Zoe Williams is a Guardian columnistDo you have an opinion on the issues raised in this article? If you would like to submit a response of up to 300 words by email to be considered for publication in our letters section, please click here. More

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      ‘We are failing’: doctors and students in the US look to Mexico for basic abortion training

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      On paper, it should not be difficult for Dr Sebastian Ramos to learn to perform abortions. As a family medicine doctor, Ramos works in a specialty that frequently provides the procedure. He lives in deep-blue California, where it is still allowed. And the administrators running Ramos’s residency program – a kind of apprenticeship that US doctors must undergo to become full-fledged physicians – support Ramos’s desire to learn how to do it.But over the course of his three-year-long residency, Ramos is guaranteed just three days’ worth of training at Planned Parenthood. Residents get to participate in only a handful of abortions.“That’s just not enough if you want to practice abortion care,” said Ramos, who asked to go by a shortened version of his last name to protect his privacy. “I knew that if I wanted to do this, I needed more experience.”That’s why, earlier this month, Ramos traveled to a clinic in Mexico City for two weeks’ worth of training in abortion provision. During his first week at the clinic, which is run by the global organization MSI Reproductive Choices and its Mexican arm Fundación MSI, Ramos performed roughly 60 abortions.In the years since the US supreme court overturned Roe v Wade, paving the way for more than a dozen states to ban virtually all abortions, a small but growing number of would-be abortion providers have begun to leave the country in search of an education. In 2023, MSI trained nine American doctors to perform abortions at clinics in Mexico. In 2024, it trained 27. So far this year, it is on track to double that number.View image in fullscreen“On one hand, it’s a tremendous relief to know that medical students and residents aren’t going to have to forego this very important part of their training in their education,” said Pamela Merritt, executive director of Medical Students for Choice. Last year, Merritt’s organization helped eight medical students and residents receive abortion training in Mexico and the UK.Merritt continued: “It’s also incredibly sad that in the United States, we are failing to train people even to the standard of care indicated by abortion bans.”Every abortion ban in the US permits abortions to save a patient’s life. But without adequate training, doctors may not be skilled enough to perform abortions even in those dire circumstances.‘It’s a shame’Medical schools and residency programs are run by massive hospitals that are heavily dependent on public funding; such institutions tend to be, by nature, leery of anything as controversial as abortion. The Accreditation Council for Graduate Medical Education (ACGME) has required OB-GYN residencies to teach doctors how to perform abortions since the 1990s, but rather than offer training in-house, hospitals have often farmed their residents out to freestanding abortion clinics for training.Even before Roe fell, this system was faulty: a 2019 study found that, despite the ACGME requirement, just 64% of OB-GYN residency programs offered “routine training with dedicated time” for abortions. Family medicine residents who want to learn to perform abortions face a greater disadvantage, since the ACGME does not require their residency programs to offer any kind of abortion training.View image in fullscreenEven most OB-GYN residents, program directors reported in the 2019 study, did not achieve what doctors call “competency” when it came to abortion. Without competency – a qualification that’s measured through a melange of doctors’ knowledge, skills and attitudes – doctors may not be able to safely perform abortions on their own.Abortion training and competency is now even harder to come by. Since Roe’s collapse, more than 100 abortion clinics have closed. Those that are left are often besieged by patients fleeing abortion bans, leaving them without the time and space to teach everybody who wants to learn.If an OB-GYN residency program is located in a state that bans abortion, ACGME rules currently dictate that the residency “must provide access to this clinical experience in a different jurisdiction where it is lawful”. The ACGME declined to respond to a request for information about how many residency programs are currently compliant with its abortion-training requirement, although records show that no OB-GYN programs have lost their accreditation status in the last year. Patricia Lohr serves as the director of research and innovation for the British Pregnancy Advisory Service (Bpas), a UK non-profit that provides abortions up until about 24 weeks of pregnancy. Lohr trained to become an OB-GYN in the US. “Having been a resident and a medical student in the United States, I could really see the importance of having access to abortion education that wasn’t entirely reliant on what was being delivered within academic training programs,” Lohr said. “Because often, abortions weren’t being provided in those academic hospitals.”View image in fullscreenWhen Lohr moved to the UK, she quickly moved to create a two-week training program at Bpas where medical students could learn about abortions and observe – but not perform – the procedure. In the years since Roe fell, that training program has received a surge of applications from American medical students and residents.“It’s a shame that people would have to travel to learn a basic part of women’s health care,” Lohr said. “There are many trainees out there at the moment who would like to obtain abortion skills, but cannot get it locally, and so they get diverted into doing something else.”Lauren Wiener, a New Jersey medical student, had originally planned to travel to Arizona in summer 2022 to learn how to provide abortions. But when Roe’s fall led Arizona abortion providers to temporarily stop working, Wiener had to cancel her trip. Instead, she ended up undergoing a week-long training at Bpas last fall.“It is something that you need to know how to do, because there are emergency situations,” Wiener said of abortions. “You might not want to electively perform an abortion at 24 weeks, but if someone comes in and they’re miscarrying, you need to know how to evacuate that uterus. It’s a skill you need to have to save a life.”‘We will be there’While training in the US dwindles, the country’s increasingly conservative approach to abortion has also put it at odds with much of the rest of the world. Only four countries – including the US – have tightened their abortion laws over the last 30 years, while more than 60 countries and territories have loosened theirs, according to a tally by the Center for Reproductive Rights.Mexico is one of them. In 2023, its supreme court decriminalized abortion nationwide; the procedure is now available in about half of all Mexican states. And providers aren’t the only people taking advantage of Mexico’s liberalized abortion laws: last year, Fundación MSI provided first-trimester abortions to 62 women from the United States.“Training, training, training – it is key, to have less danger for actual patients,” said Araceli López-Nava, managing director of MSI Latin America. “We understand how difficult the situation is becoming in the US, so we’re happy to help.”The organization has the capacity to train up to 300 doctors a year to perform abortions, López-Nava estimated.View image in fullscreenMSI is not, however, a solution for everybody. Would-be trainees need to speak Spanish. And although the organization has in past years trained medical students, MSI’s Mexico clinics have started focusing on teaching residents who have already performed 20 abortions. Because residents have already chosen their specialties and secured berths in residency programs – which can be highly competitive – they are more likely to become abortion providers.Training in Mexico can also be pricey, especially since the program does not pay for travel and lodging. Ramos’s entire trip cost about $5,000, although a scholarship helped him cover most of the costs.“It’s a way, at least for me, to be exposed to a different medical system, learn from different providers from a different country, exchange knowledge,” Ramos said. “I feel like I’m being adequately prepared to meet the needs of my patients in the US.” More

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      Trump administration eviscerates maternal and child health programs

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      Multiple maternal and child health programs have been eliminated or hollowed out as part of the Department of Health and Human Services (HHS) layoffs, prompting alarm and disbelief among advocates working to make Americans healthier.The fear and anxiety come as a full accounting of the cuts remains elusive. Federal health officials have released only broad descriptions of changes to be made, rather than a detailed accounting of the programs and departments being eviscerated.“Pediatricians, myself included, are losing sleep at night – worried about the health of the nation’s children,” said Dr Sue Kressly, president of the American Academy of Pediatrics.“The one that stands out to me is the Maternal and Child Health Bureau. There is no way to make our country healthier by eliminating expertise where it all starts, and it all starts at maternal and child health.”The health secretary, Robert F Kennedy Jr, announced HHS would eliminate 10,000 jobs as part of a restructuring plan. Together with cuts already made by Elon Musk’s unofficial “department of government efficiency”, HHS is likely to lose 20,000 workers – roughly one-quarter of its workforce.“We aren’t just reducing bureaucratic sprawl,” Kennedy said. “We are realigning the organization with its core mission and our new priorities in reversing the chronic disease epidemic.”Piecemeal and crowd-sourced information, which has filled the vacuum left by a lack of information from the health department, appears to show maternal health programs slated for elimination, many without an indication of whether they will be reassigned. The Guardian asked HHS to comment on the cuts but did not receive a response.The picture of cuts was further muddied on Thursday when Kennedy told reporters, according to Politico: “We’re going to do 80% cuts, but 20% of those are going to have to be reinstalled, because we’ll make mistakes.”In the aftermath of the height of the Covid-19 pandemic, there’s been much conservative criticism of public health agencies, particularly the Centers for Disease Control and Prevention (CDC). Pandemic policy continues to be an animating force within the Republican party, whose supporters are cynical about the value of federal public health programs following federal vaccine mandates.The cuts to maternal health programs may serve a second purpose for Republicans.Such programs have come under fire in some conservative states, in part because the experts involved investigate deaths that could have been prevented with abortion services – now illegal or severely restricted in nearly two dozen conservative states.As part of the restructuring, the administration announced 28 divisions would be folded into 15, including the creation of a new division, called the “Administration for a Healthy America”, or “AHA”.The administration argued the “centralization” would “improve coordination of health resources for low-income Americans and will focus on areas including, primary care, maternal and child Health, mental health, environmental health, HIV/Aids and workforce development”.Meanwhile, experts in HIV/Aids, worker health and safety, healthcare for society’s most vulnerable, and experts in maternal and child health have received “reduction in force” notices, a federal term for layoffs, or have been placed on administrative leave with the expectation of being eliminated.“It certainly appears there was a particular focus on parts of HHS that dealt with women’s or reproductive health,” said Sean Tipton, chief policy officer at the American Society for Reproductive Medicine, about the cuts.He added: “How in the world you can justify the CDC eliminating the division of maternal mortality is beyond me.”Among the divisions hard-hit was the Health Resources and Services Administration (HRSA), an operating division of HHS like the CDC, which housed the the Maternal and Child Health Bureau. HRSA lost as many as 600 workers.The CDC’s division of reproductive health, which studies maternal health, appeared to have been nearly eliminated, according to multiple reports, with some of the division’s portfolio also expected to be folded into AHA.skip past newsletter promotionafter newsletter promotionThe entire staff of a gold-standard maternal mortality survey, a program that was called the Pregnancy Risk Assessment Monitoring System, was also put on leave, Stat reported. The epidemiologist in charge of the CDC survey, Jennifer Bombard, wrote to colleagues on Tuesday: “[T]he entire CDC PRAMS team, including myself, has received the Reduction in Force (RIF) notice from HHS today.”A HRSA hotline that had fielded calls from new moms seeking mental health support was also cut, Stat reported. Layoffs at the Administration for Children and Families have jolted providers of federally backed high-quality childcare for low-income families, a program called Head Start.The CDC’s only experts on infertility were laid off, just days after Trump described himself as the “fertilization president” at an event marking Women’s History Month. The team had collected congressionally mandated statistics on fertility clinics’ success rates. Without the workers, it is unclear who at the department will help fertility clinics comply with the law.“I’m astounded, sad, perplexed,” said Barbara Collura, president of Resolve: The National Infertility Association. “Infertility impacts one in six people globally, and now we don’t have anybody at the CDC who knows anything about infertility and IVF?”A division of the CDC called the National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention also appeared to be gutted, with the director Jonathan Mermin placed on administrative leave. Among the center’s many tasks, it worked to curb the spread of congenital syphilis, a debilitating disease that is on the rise in the US.The March of Dimes, an influential non-profit whose mission is to improve the health of mothers and babies, said the cuts “raise serious concerns” at a time when maternal mortality rates remain “alarmingly high”.“As an OB-GYN and public health leader, I can’t overstate the value these resources and programs – and our partners across CDC, HRSA, and NIH – have brought to families and frontline providers,” said Dr Amanda Williams, the interim chief medical Officer at the March of Dimes.“We rely on the data, research, clinical tools and partnerships built by the Division of Reproductive Health (DRH) and HRSA to protect maternal and infant health – especially in communities hit hardest.”Heads of National Institutes of Health (NIH) centers were also forced out – and, apparently, offered reassignment to the Indian Health Service to be stationed in Alaska, Montana or Oklahoma, the journal Nature reported. Such large-scale reassignments are unprecedented, according to Stat.Among those to be placed on leave was one of the federal government’s pre-eminent leaders of research, the director of the National Institute of Allergy and Infectious Diseases (NIAID) Dr Jeanne Marrazzo. Marrazzo had expertise in sexually transmitted infections and women’s reproductive tract infections – a background that gave health advocates hope of curbing the US’s sky-high STD rates. Dr Diana Bianchi, director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, was also forced out.“These cuts are significant,” Kressly said. “And the policy and program changes that are made because the cuts impact real people in real communities, and I’m not just talking about the people who lost their jobs.” More

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      Trump officials to cut Planned Parenthood family planning funds

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      The reproductive health provider Planned Parenthood said the Trump administration would cut federal family planning funding as of Tuesday, affecting birth control, cancer screenings and other services for low-income people.Planned Parenthood said that nine of its affiliates received notice that funding would be withheld under a program known as Title X, which has supported healthcare services for the poor since 1970.The Wall Street Journal reported last week the US Department of Health and Human Services planned an immediate freeze of $27.5m in family planning grants for groups including Planned Parenthood.Planned Parenthood says more than 300 health centers are in the Title X network and Title X-funded centers received more than 1.5m visits in 2023. It not say how much funding would be halted by the Trump administration.The White House and HHS did not immediately respond to a Reuters request for comment. An HHS spokesperson said last week the department was reviewing grant recipients to ensure compliance with Donald Trump’s executive orders.Alexis McGill Johnson, president and CEO of Planned Parenthood, predicted that cancers would go undetected, access to birth control would be severely reduced, and sexually transmitted infections would increase as a result.“President Trump and Elon Musk are pushing their dangerous political agenda, stripping health care access from people nationwide, and not giving a second thought to the devastation they will cause,” McGill Johnson said in a statement.Trump has named billionaire Musk, who helped the president get elected, to head up an initiative to target government agencies for spending cuts.Conservatives have long sought to defund Planned Parenthood because it also provides abortions. However, US government funding for nearly all abortions has been banned since 1977. More

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      The rise of pronatalism: why Musk, Vance and the right want women to have more babies

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      In his first address to the United States after becoming vice-president, JD Vance stood on stage and proclaimed: “I want more babies in the United States of America.” Weeks later, Donald Trump signed an executive order pledging support for in vitro fertilization, recognizing “the importance of family formation and that our nation’s public policy must make it easier for loving and longing mothers and fathers to have children”.In late January, a Department of Transportation memo directed the agency to prioritize projects that “give preference to communities with marriage and birth rates higher than the national average”. And last week, it was reported that Elon Musk, the unelected head of the government-demolishing “department of governmental efficiency” and a man who has said that the “collapsing birth rate is the biggest danger civilization faces by far”, had become a father of 14.Republicans have long heralded the importance of “family values”. But in these developments, many see mounting signs of a controversial ideology at work: pronatalism.Pronatalism is so contentious that people often struggle to agree on a definition. Pronatalism could be defined as the belief that having children is good. It could also be defined as the belief that having children is important to the greater good and that people should have babies on behalf of the state, because declining birth rates are a threat to its future. Perhaps most importantly, pronatalism could be defined as the belief that government policy should incentivize people to give birth.While people on the left might agree with some pronatalist priorities, pronatalism in the US is today ascendant on the right. It has become a key ideological plank in the bridge between tech bro rightwingers like Musk and more traditional, religious conservatives, like the speaker of the House, Mike Johnson – who once said in a House hearing that abortions were harming the economy by eliminating would-be workers.But there are plenty of widening cracks in that bridge and, by extension, Trump’s incoherent coalition.‘Hipster eugenicists’In the US, interest in pronatalism has historically coincided with growing anxiety over changing gender norms and demographics, according to Laura Lovett, a University of Pittsburgh history professor and the author of the book Conceiving the Future: Pronatalism, Reproduction, and the Family in the United States, 1890-1930. In the 1920s, pronatalism’s prominence grew after women gained the right to vote, as people worried about women working and wielding power outside the home.“When Theodore Roosevelt uses the term ‘race suicide’, he actually blames women who are going to college for the first time for that eventual suicide of the right, white race. There’s this linkage between women’s educational and aspirational futures and the declining birth rate,” Lovett said. “There was this anxiety that white, native-born, middle-class women were having smaller families.”Historically, US pronatalism was also tied to an interest in eugenics – and some of the more tech-minded, modern-day pronatalists do want to use breeding to fashion a better human race. Malcolm and Simone Collins, parents of four who have become standard-bearers for the burgeoning popularity of pronatalism among Silicon Valley venture capitalists, have championed “no-holds-barred” medical research to engineer the “mass production of genetically selected humans”. They have joked to Business Insider about making business cards declaring themselves “hipster eugenicists” – although they have also rejected the idea that they are performing eugenics, stressing that they think racism is “so dumb” and that the only bloodlines they are altering are their own.The Collinses, who support Trump, have spent hundreds of thousands of dollars on in vitro fertilization (IVF) and screening their embryos for IQ, risk of depression and other markers. (Scientists aren’t convinced that it is possible to screen embryos for IQ.) These kinds of practices – which the Collins have called “polygenics” – draw a wedge between the Silicon Valley pronatalists who back Trump and his more traditional pronatalist supporters. The anti-abortion movement, which was critical to getting Trump elected in 2016, has long opposed IVF, largely because it can lead to unused or discarded embryos.In signing his pro-IVF executive order, Trump appears to be siding with the “tech right” (and the broader electorate, among which IVF remains extremely popular). When Musk recently brought his son X Æ A-Xii to the Oval Office, Trump called the four-year-old a “high-IQ individual”.View image in fullscreen‘Restructuring society’While the Collinses are avatars for the emerging pronatalist tech right, Lyman Stone is one of the highest-profile pronatalists from a more traditionally conservative background.“Pronatalism has to be disciplined by a commitment to human liberty and human flourishing – and this is coming out of work on reproductive justice, basically. People have a right to have the families they want to have, and for some people, that means no family,” said Stone, a demographer who in 2024 established the Pronatalism Initiative at the right-leaning Institute for Family Studies. “The focus of pronatalism, in my view, generally is not and certainly should not be on family gigantism, and instead should be on helping young people overcome the barriers and obstacles to romantic and family success in their life.”In practice, Stone said, pronatalists should help people get married earlier in life so that they can start having children younger. That could mean, he said, everything from improving mental health services to creating better childcare programs. Stone’s frequent collaborator, Brad Wilcox – a University of Virginia sociology professor and author of the book Get Married: Why Americans Should Defy the Elites, Forge Strong Families and Save Civilization – pointed to several policies that he thinks would help strengthen “family formation”, such as expanding the child tax credit and converting federal land into affordable housing.“Pronatalism is not just a fiscal program. It’s a program of restructuring society in a way that treats family goals as worthy, worth supporting and socially important,” Stone said.Asked if he supports abortion rights, Stone clarified: “No, I would draw the line at destruction of human life.”Many of these policy proposals could comfortably fit into a left-leaning political platform – in fact, they may be more at home on such a platform than within today’s Republican party. Although Vance said on the campaign trail that he would like to expand the child tax credit, a move that could cost trillions of dollars in federal spending, Republicans have instead committed to slashing the government budget by at least $1.5tn.Instead, elected Republicans have tended to invoke pronatalist rhetoric in support of their top culture-war causes.They have repeatedly condemned gender-affirming healthcare for allegedly “sterilizing” people; in 2022, as Idaho weighed whether to ban kids from accessing the care, one Republican state legislator said: “We are not talking about the life of the child, but we are talking about the potential to give life to another generation.” When a Republican lawmaker from Michigan introduced a resolution to condemn same-sex marriage, he told reporters: “This is a biological necessity to preserve and grow our human race.” And last year, in a lawsuit to cut access to a common abortion pill, the Republican attorneys general of Idaho, Kansas and Missouri argued that access to the pill had “lowered birth rates for teen mothers”, leading to a falling state populations, “diminishment of political representation and loss of federal funds”.In practice, pronatalism – especially when paired with anti-abortion policy – often overlooks the disproportionate effect that having more babies has on women, according to Elizabeth Gregory, director of women’s gender and sexuality studies at the University of Houston. Childbearing can reshape a woman’s entire future.“This idea that the child is the only person in the dyad loses a real understanding of how embedded and dependent children are on their mothers,” Gregory said. “Fertility affects many, many parts of culture and talking about it can’t be reduced to just a few soundbites.”Falling birth ratesBirth rates are, indeed, on the decline. To remain stable, populations must reproduce at a “replacement rate” of 2.1; in other words, each mother must have 2.1 babies. The US currently averages closer to 1.6. (South Korea, which maintains the world’s lowest fertility rate, had a rate of just 0.75 in 2024.)Experts are split over how to address this problem. The world’s population is at a record high, and immigration to rich countries could offset declines in fertility – but, as the medical journal the Lancet warned in a 2024 issue, “this approach will only work if there is a shift in current public and political attitudes towards immigration in many lower-fertility countries”. If countries remain hostile to immigration while their birth rates fall, they will probably end up with a shrunken labor force that is unable to support an ageing population.There is evidence that Americans would like to have more children. A 2023 Gallup poll found that 47% of Americans think an ideal family has one or two children, while only 2% said families should have zero. At the same time, a Pew poll that same year found that 47% of American adults under 50 say they are unlikely to ever have children. Of those, nearly 60% say they just don’t want kids. Nearly 40% said they couldn’t afford to have kids or that the “state of the world” had convinced them not to.“We’re living in a moment where – I would say, unfortunately – marriage and parenthood have become ideologically polarized,” Wilcox said. More

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      Trump signs executive order expanding access to IVF, says White House

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      Donald Trump has signed an executive order to expand access to in vitro fertilization, White House press secretary Karoline Leavitt said on Tuesday.“The Order directs policy recommendations to protect IVF access and aggressively reduce out-of-pocket and health plan costs for such treatments,” Leavitt said in a post on Twitter/X.More details soon … More