Roe v Wade

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      Dozens of independent abortion clinics closed in 2023 post-Roe, study finds

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      Dozens of independently owned reproductive health clinics shuttered in 2023, the year after the US supreme court overturned Roe v Wade, according to a new report from the Abortion Care Network.The group found that 23 independently owned clinics closed this year, on top of the 42 that shuttered in 2022, leaving over a dozen states, mainly in the American south and midwest, without a single brick-and-mortar clinic that provides abortion.“Even before Roe fell, we were the only abortion clinic in a very rural, very underserved state with limited access to health care, and now that’s all been exacerbated,” said Katie Quinonez-Alonzo, executive director of Women’s Health Center of West Virginia.Like most independent clinics in the United States, the Women’s Health Center of West Virginia struggled to keep its doors open after the supreme court decision paved the way for the state to ban abortion last year. The clinic still provides other reproductive and sexual health services, like gender-affirming care for transgender patients.“We want to stay here in our community and help the patients that are still counting on us, but it’s been one uphill battle after another,” Quinonez-Alonzo told the Guardian.The Women’s Health Center of West Virginia is an especially crucial lifeline for low-income, uninsured people in the state, who rely on the clinic for routine gynecological check-ups. Those services became harder to offer after West Virginia banned abortion, slashing the clinic’s revenue by roughly half a million dollars.This year, Quinonez-Alonzo anticipates a roughly $350,000 budget deficit.Independently owned clinics – in contrast with bigger players like Planned Parenthood – provide the majority of abortions in the United States. According to the ACN report, “indie” clinics make up the majority of clinics operating in states that are most hostile to abortion, and offer the broadest range of options for patients seeking the procedure. ACN researchers found that 73% of indie brick-and-mortar clinics offer both medical and surgical abortions, compared with just 42% of Planned Parenthood affiliates – so as they dwindle in number, so do options for women seeking care.Before the supreme court overturned Roe, the West Alabama Women’s Center provided over half of the abortions in the state.“In the deep south, it was always indie providers that were the ones providing abortions. Very few Planned Parenthoods existed in our region,” said Robin Marty, executive director of West Alabama Women’s Center.“Alabama used to have three Planned Parenthoods, we have just one now, the others have closed,” Marty said. “We’re still here, though.”After Alabama enacted a sweeping ban on abortion, the Tuscaloosa clinic refocused on protecting newly pregnant people’s access to affordable prenatal healthcare.But Alabama is one of 10 states that has not expanded Medicaid, leaving roughly one in seven women of childbearing age without any form of health insurance. The state allows newly pregnant women to apply for Medicaid, but that requires a doctor’s letter confirming the pregnancy.“But of course, as these people do not have insurance, they can’t get into a doctor in order to get this letter for Medicaid,” Marty said. “This is why we’re seeing so many people in Alabama who don’t have prenatal care in the first trimester.”Even after a patient receives a doctor’s letter confirming their pregnancy, it can take four to six weeks for the state to approve coverage. To help care for uninsured and pregnant people in Alabama, Marty said her clinic provides free prenatal care until a patient’s Medicaid coverage is approved. If financial trouble forces the clinic to close, a bad maternal health landscape will get worse.“The people in our community need prenatal care and birth control and STI testing just as much as they need abortion,” Marty said. “For these patients, there isn’t another healthcare provider here for them.” More

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      House speaker Mike Johnson likened abortion to ‘American holocaust’

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      Before he became speaker of the US House of Representatives, the Louisiana Republican congressman Mike Johnson likened abortion to “an American holocaust”.“The reality is that Planned Parenthood and all these … big abortion … they set up their clinics in inner cities,” Johnson told a radio show in May 2022, in comments aired by CNN on Tuesday. “They regard these people as easy prey.”But while these remarks may sound stunning, anti-abortion activists often refer to abortion in the United States as a “holocaust”. This isn’t even the only time that Johnson has made the comparison.“During business hours today, 4,500 innocent American children will be killed,” Johnson wrote in a 2005 op-ed for the Shreveport Times, which was recently resurfaced by CBS News. “It is a holocaust that has been repeated every day for 32 years, since 1973’s Roe v Wade.”In that op-ed, Johnson also said the judicial philosophy that undergirded Roe – and allowed for the removal of the feeding tube of Terri Schiavo, a womanwith severe brain damage who became a cause célèbre among anti-abortion activists – to be “no different than Hitler’s”.Johnson went on to add that abortion had led to a dearth of “able workers” and a crisis for social security, a claim he would repeat at a House hearing years later.Comparisons between US abortion and the Holocaust date back decades, with anti-abortion advocates writing books in the 1980s with titles such as The Abortion Holocaust: Today’s Final Solution. Although the mainstream United States may have grown less tolerant of the comparison, it has never disappeared from anti-abortion circles, which are predominantly Christian.In fact, it’s sometimes used as a recruitment tool. One prominent anti-abortion group even claims anyone born after the supreme court decided Roe in 1973 is a “survivor of the American abortion holocaust” and invites young people to become “boots on the ground” in recognition of their aborted peers. In 2019, Texas Right to Life – a powerful anti-abortion group in Texas – held a training for young anti-abortion activists where leaders screened documentaries about the Nazi Holocaust and urged the activists to “write down three similarities between the Holocaust and abortion”.These kinds of comparisons have even made their way into law. In a 2019 abortion case, the supreme court justice Clarence Thomas wrote an opinion claiming that abortion was on the verge of becoming “a tool of modern-day eugenics”. Alabama’s near-total abortion ban, which was first passed in 2019 and took effect after the US supreme court overturned Roe v Wade last year, suggested abortion was worse than famous 20th-century atrocities.“More than 50 million babies have been aborted in the United States since the Roe decision in 1973,” the ban reads, “more than three times the number who were killed in German death camps, Chinese purges, Stalin’s gulags, Cambodian killing fields, and the Rwandan genocide combined.” More

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      ‘Abortion is a winning issue’: rights victories in 2023 US elections raise hopes for 2024

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      More than a year after the US supreme court overturned Roe v Wade, handing states the power to decide if and how to ban abortion, voters have again overwhelmingly rejected attempts to curtail access to the procedure. A string of successes for abortion rights groups on Tuesday are raising hopes among Democrats that, despite recent dismal polls, the issue will lift their odds in 2024.In Ohio, the only state to hold an abortion-related ballot referendum in 2023, more than 56% of voters agreed to enshrine the right to the procedure into the state constitution. In Virginia, Democrats won back full control of the state legislature after Republicans campaigned on the promise of a “sensible limit” that would ban most abortions past 15 weeks of pregnancy. In Kentucky, the incumbent Democratic governor, Andy Beshear, bested his anti-abortion Republican opponent. And in Pennsylvania, in a race dominated by talk of abortion, Democrats won a seat on the state supreme court.On Tuesday evening in downtown Columbus, Ohio, abortion rights advocates crowded into a hotel ballroom to watch as results streamed in. Once the vote was called in their favor, the conversation in the room immediately turned to the topic on everyone’s minds: what does the victory mean for next year? In 2024, abortion-related referendums may be on the ballot in roughly a dozen states, including in critical swing states like Nevada, Florida, Pennsylvania, Arizona and Iowa. Democrats will almost certainly lean on the issue to buoy their party in races for Congress and the White House. And Tuesday’s results in Ohio raise hopes that they might be able to pluck voters from the other side. While Joe Biden lost Ohio in 2020, garnering only about 45% of the vote, Issue 1, the proposal to add abortion rights into the state constitution, won with an estimated 56% of the vote on Tuesday. That sweep indicates that Republican voters are abandoning their party on this issue.“Abortion is a winning issue, including in states that are considered red,” said Kimberly Inez McGuire, executive director of Urge: Unite for Reproductive & Gender Equity. “Young people, black voters, rural voters – voters all across the state came out and we saw support in every single corner of the state. The lesson for other states is: don’t take anyone for granted. Don’t assume they’re gonna support you, but also don’t assume that they’re gonna oppose.”The issue turns voters out in high numbers, which could also prove a boon for Biden at a time of low enthusiasm: nearly 4 million people voted this year on Issue 1, according to early data from Ohio’s secretary of state office. That’s only slightly less than the 4.2 million people who turned out to vote in Ohio’s gubernatorial race last year – even though 2023 was considered an “off-off” election year.The failures in Ohio and Virginia also leave Republicans without a clear roadmap for messaging on abortion – an issue that led them to underperform in the 2022 midterms. In Ohio, opponents of the ballot initiative, Issue 1, focused much of their message not on the morality of abortion, but on the idea that Issue 1 threatened parents’ rights to know if their children underwent an abortion or gender-affirming care. (That claim is dubious, legal experts told the Guardian.) In Virginia, Republicans tried to take advantage of Americans’ lack of support for abortion in the second and third trimester by proposing to ban abortion past 15 weeks with exceptions for rape, incest and medical emergencies.Both efforts were viewed as tests for next year – had either message won over voters, Republicans across the country may have adopted them in their own races in 2024. Now, their strategy is in question, and any course they choose risks alienating key constituencies. “If the GOP moves to the center on abortion, they’re afraid that they’ll lose conservative donors and base voters – who are the ones who tend to be the most passionate Republican voters, the ones who turn out the most reliably and also people who donate a lot of money,” said Mary Ziegler, a University of California, Davis School of Law professor who studies the legal history of reproduction. “Republicans have been trying to finesse that, with pretty much no success to date.”Despite being directly responsible for overturning Roe v Wade through his appointments to the supreme court, Donald Trump has attempted to stem the damage by distancing himself from much of his party, coming out against a national abortion ban. But polling shows that voters don’t necessarily trust Republicans who say they will not totally ban abortion. That may be in part due to their decades-long partnership with an anti-abortion movement that would like to eliminate the procedure entirely.Hours before polls closed on Tuesday, Jamie Curry, Ohio regional coordinator for the anti-abortion group Students for Life, tried to convince passing Ohio State University students that Issue 1 was too extreme. “You seem to be in favor of a commonsense, middle of the road, but there’s plenty of people who align more pro-choice and are voting no on this issue,” Curry told one student.But Curry’s message of moderation and compromise were contrasted by her group’s nearby poster board, which read: “All human beings are valuable persons, no matter their stage in life.”“Republicans can spend their money saying that, ‘We are the moderates on this,’” said Joey Teitelbaum, vice-president of research for Global Strategy Group, a Democratic polling firm. “But in voting for Democrats in Virginia and voting for Andy Beshear, where abortion was a major part of that race and the communications, voters are clearly saying, ‘We do not trust Republicans on this.’” More

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

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      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

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      Anti-choice states aren’t satisfied. Now they want to punish traveling for abortions | Moira Donegan

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      How free can any woman be in a country where her right to control her body and family depends on the jurisdiction where she happens to live? Republicans are looking to find out. Over the past few weeks, as Republican officials in anti-choice states seek to make their abortion bans enforceable and compel women into childbirth, a new front has opened up in the abortion wars: roads. The anti-choice movement, through a series of inventive legal theories and cynical legislative maneuvers, is now attacking women’s right to travel.In a court filing last month, the Alabama attorney general, Steve Marshall, wrote that he believed his office had a right to prosecute those who help women travel across state lines in search of an abortion. The filing comes in a lawsuit from two women’s health clinics and an abortion fund, which sued Marshall after he publicly stated his intention to criminally investigate organizations like theirs, which provide financial and logistical help to pregnant patients seeking to leave the state. In his response, Marshall unequivocally stated that Alabama, which bans all abortions with no rape or incest exemption, views any effort to help women cross state lines as a “criminal conspiracy”.“An elected abortion performed in Alabama would be a criminal offense,” Marshall’s office writes. “Thus, a conspiracy formed in the state to have that same act performed outside the state is illegal.” The filing goes on to dismiss the free speech, expression and association claims of the fund and the two clinics.Meanwhile in Texas, two counties and two cities have passed laws banning so-called “abortion trafficking” – that is, the transport or assistance of anyone seeking an abortion – on the roads that pass through their territories. The “trafficking” in this moniker refers to the fetus: “The unborn child is always taken against their will,” Mark Lee Dickson, the architect of these bills, told the Washington Post. Like Texas’s SB 8, the bounty-hunter ban that outlawed abortions in Texas at six weeks before the fall of Roe, these travel bans are also enforced via lawsuits by private citizens – the law is designed to allow those who are displeased by an abortion to sue the friends, feminists and allies of the pregnant patient who helped her to get one.Dickson and his political partner, the SB 8 architect Jonathan Mitchell, are pushing the provision in border cities and towns along major interstate highways. And like SB 8, the law is less likely to be used by strangers to prevent abortions than by abusers to punish ones that already happened. As an example of the ideal use of his bill, Dickson told the Washington Post that a husband who did not want his wife to get an abortion could use it to sue the friend who offered to drive her – thus somewhat giving away the game that the goal of such a provision is to ensure that men’s private domination and abuse of women is recognized as a right enforceable by civil law.Texas and Alabama are not alone. Earlier this year, Idaho became the first state to criminalize abortion-related travel when it enacted a law making it a felony to help a minor cross state lines for an abortion. Meanwhile, Missouri made headlines last year when Republicans introduced bills that would criminalize anyone helping state residents to obtain abortions elsewhere.Is any of this constitutional? No. But that doesn’t mean the laws will be struck down. The novel enforcement mechanism of the Texas laws, in particular, which are enforceable not by the state or municipality but only by the lawsuits of private citizens, make it hard for any pro-choice group to get standing to challenge them. That’s the point: the bills are constructed to evade judicial review. And though Justice Brett Kavanaugh, for one, has said that he would disapprove of anti-choice states’ attempts to prevent women’s travel, the supreme court, including Kavanaugh, has already blessed abortion ban by civil suit with its sanction of SB 8.But the point of these laws is not, exactly, to enforce them, except perhaps in the event when they are used by domestic abusers to further their control and torment of the women they’ve imprisoned – as is already happening. The real point is to chill legal conduct, and to prevent the people, mostly women – the sisters, friends, abortion fund staffers, colleagues and local feminists who any abortion patient might turn to for help – from acting on their own moral convictions.The law is punitive, not preventive: it is designed not to intervene in abortions before they happen so much as to punish them after the fact. It is designed, too, to frighten: the very vagueness of these laws, and the fear of punishments for violating them, will inevitably keep those who would assist an abortion from doing so. The point is to threaten with humiliating, ruinous lawsuits and life-altering criminal prosecutions any woman who might act on her conviction that another woman deserves to control her own body. The point is to punish and declare illegal women’s friendship, confidences and feminist solidarity itself.In their attempts to keep women walled inside anti-choice states, and to criminalize both friendship and flight, the abortion travel bans have been compared to the 19th century’s fugitive slave law. I for one believe that American chattel slavery does not make a good comparison; its horrors fail as metaphor. But one does not need to draw any moral equivalence to see the parallels of the emerging political divide. An untenable conflict is arising between states where women are free to control their bodies and states where they are not, and the latter group is not respecting the laws of the former.The nation cannot sustain this division, and it will not: either abortion will soon become legal nationwide, or it will soon be banned nationwide. For their part, the anti-choice movement seems very confident which direction we’re heading.
      Moira Donegan is a Guardian US columnist More

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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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      in US Politics

      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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      in Elections

      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