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Where do babies come from? Robert F Kennedy Jr doesn’t seem to know | Arwa Mahdawi

by Evelyn Reynolds 15 October 2025, 10:00

Robert F Kennedy Jr is the father of six children. He’s also the US health secretary. Two facts that might lead a reasonable person to assume he possesses a basic understanding of how foetuses develop.In a shocking development, however, it seems that Kennedy – an anti-vaxxer who says his brain was partly eaten by a parasitic worm – may not know what he’s talking about. During a cabinet meeting last Thursday, Kennedy reasserted unproven claims that taking the common painkiller acetaminophen, also known as Tylenol or paracetamol, while pregnant causes autism. Doubters of this theory, he said, were motivated by Trump derangement syndrome. To underscore his point, he referenced a TikTok video he’d seen of a pregnant woman “gobbling Tylenol with her baby in her placenta”.Foetuses, of course, develop in the uterus, not the placenta. It’s possible, if we are being generous, that Kennedy misspoke. Then again, he would hardly be the first US politician to make it clear he knows nothing about the female bodies he is so keen to legislate, would he?In 2019, for example, 25 Republicans – all white men – voted for a near-total ban on abortion in Alabama. During the debate, Clyde Chambliss, one of the bill’s sponsors in the Senate, noted that while he didn’t have medical training, “from what I’ve read, what I’ve been told, there’s some period of time before you can know that a woman is pregnant … It takes some time for all those chromosomes and all that.” Chambliss went on to say the generous bill allowed a woman to end her pregnancy “up until the point she is known to be pregnant”. Yeah, I don’t know what he means either.Then there’s the Ohio Republican John Becker, who once co-sponsored a bill prohibiting insurers from covering abortion services, except for a procedure “intended to reimplant” an ectopic pregnancy in a woman’s uterus. This is medically impossible. After this was pointed out, Becker said he’d never actually researched the issue.And there’s the Idaho lawmaker who once asked if a woman could swallow a small camera so doctors could conduct a remote gynaecological exam. No, he was told by a doctor, because swallowed pills don’t end up in your vagina. “Fascinating,” he replied.I could go on; I’m afraid there are endless examples. But I’ll end with the late Todd Akin, a conservative Missouri Republican, who said in 2012 that “legitimate rape” rarely results in pregnancy because “the female body has ways to try and shut that whole thing down”. Yep, that same crafty female body that grows babies in its placenta. Arwa Mahdawi is a Guardian columnist

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View image in fullscreenFor Erica L and her husband, in-vitro fertilization was the “nuclear option”.After two years of trying to conceive, Erica and her husband had no idea why they could not have a baby. Doctors said only that they had “unexplained infertility”, a non-diagnosis of a diagnosis that is given to an estimated 15% of people trying to conceive. Erica was not ideologically opposed to trying IVF, but felt daunted by the price and unpredictability.Then Erica stumbled across a clinic that specialized in “restorative reproductive medicine”, or RRM. The clinic did bloodwork on Erica and her husband and urged them to eat well-balanced foods and take supplements, as well as prioritize exercise and sleep. Erica also started tracking her temperature and menstrual cycle in intense detail.“We wanted to do everything that we could to try to have a baby as naturally as possible,” said Erica, who asked that her full last name not be published. “There’s a lot of invasive things that I just wasn’t comfortable with.”Restorative reproductive medicine is a decades-old name for a constellation of therapies that are meant to revive the “natural” fertility of people trying to conceive. Often, RRM entails prescriptions for hormones, supplements and lifestyle changes – such as adopting a better diet – as well as closely analyzing one’s menstrual cycle. Its practitioners also sometimes use aggressive surgeries to root out endometriosis, a common and chronic condition that occurs when tissue that is similar to uterine tissue grows outside of the uterus. And, critically, RRM practitioners avoid the use of assisted reproductive technology such as IVF.Top Republicans, rightwing organizations and even White House officials have recently begun to rally behind RRM, seizing on its promise to enhance fertility without resorting to IVF. Many anti-abortion conservatives revile IVF because it can create unused embryos – a practice they see as unethical, if not murderous, as they believe life begins at conception.Yet IVF remains staggeringly popular, to the point that Donald Trump pledged to make it free in the wake of a 2024 Alabama supreme court decision that imperiled the procedure. Now, conservatives are trying to pare back that commitment – and some fertility doctors, including ones who offer RRM, worry that the right is co-opting RRM as a Trojan horse in order to sell a fertility agenda to voters while undermining IVF.Backed by several high-profile anti-abortion groups, Republicans in Congress have repeatedly introduced legislation to bolster government-funded research and education on RRM. In March, the Heritage Foundation – the influential thinktank behind the notorious Project 2025 – released a 63-page report that endorsed RRM and slammed IVF.Then, in July, the Department of Health and Human Services posted a notice soliciting applications for a $1.5m grant to fund an “infertility training center” that would expand access to resources for “holistic infertility treatments” rather than assisted reproductive technology. In August, the Washington Post reported that the Trump administration is backing away from the president’s campaign promises about IVF, although a White House spokesperson rebutted that claim.View image in fullscreenDr Kaylen Silverberg is a reproductive endocrinologist who has advised administration officials, including Trump’s chief of staff Susie Wiles, about IVF. During his discussions with officials, Silverberg said he was asked about RRM.“I’ve been doing this for 31 years, and I’d never even heard the term,” said Silverberg, who is also advisory board chair of the advocacy group Americans for IVF. “So I started doing research about it. I realized that restorative reproductive medicine is just a pseudonym for a basic infertility evaluation.”Silverberg’s view is shared by many mainstream fertility doctors and organizations, who say that the difference between their work and RRM is less scientific than ideological. In their view, RRM is a rebranded version of everyday fertility medicine, minus IVF.RRM, with its focus on optimizing the body’s “natural” rhythms, is tapping into a growing interest in holistic health and wellness – one that is being increasingly politicized and expertly leveraged by the “Make America Healthy Again” (Maha) movement.But support for RRM alone, Silverberg said, cannot fulfill Trump’s campaign promises. “The problem is going to be if – and this is a big if – anybody tries to limit expansion of fertility access and care and coverage to restorative reproductive medicine.”‘There is another option’RRM is not a monolith. Some of its leading organizations and adherents take no position on IVF and reject the idea that RRM is ideologically driven or a new name for old medicine. Instead, they are drawn to RRM’s stance that infertility is not itself a disease but a symptom of something else that has gone wrong.Established in 2000, the International Institute for Restorative Reproductive Medicine (IIRRM), the preeminent group championing RRM, maintains a registry of RRM clinicians and collects data about its techniques’ efficacy.Dr Monica Minjeur, who was trained in family medicine and serves as the US director of communications and development for the International Institute for Restorative Reproductive Medicine, said RRM is “not an anti-IVF movement”. As far as Minjeur knows, no one in Congress has approached the institute to discuss RRM.“We will never say: ‘IVF should go away.’ We just mostly want people to realize: ‘Hey, there is another option,’ because so many couples are told IVF is your only option,” said Minjeur, who added that she is a Democrat.View image in fullscreenSome RRM advocates and groups do oppose IVF and have long aligned themselves with conservative causes such as the anti-abortion movement. One of the most well-known RRM techniques is NaPro Technology, which usually involves such tactics as cervical mucus tracking and has been pioneered by the anti-abortion Saint Paul VI Institute since the 1980s, when the Vatican condemned IVF. The institute’s website presents NaPro Technology as an alternative to IVF, which it calls “a highly abortive technology that often forces women to make abortion-related decisions”.In June, a new thinktank, the Maha Institute, held a roundtable discussion about women’s health and fertility. In her introduction to the discussion, Maureen Ferguson, a commissioner for the US Commission on International Religious Freedom with longstanding ties to the anti-abortion movement, sang RRM’s praises.“Traditional women’s health and fertility care has relied heavily on big pharma bandaids and workarounds that circumvent a women’s reproductive system,” Ferguson said. “Women of all political stripes appreciate healthcare that works in harmony with their body and restores health.”IIRRM wants to harness Maha advocates’ enthusiasm but is wary of being equated with the movement, according to Minjeur and Dr Tracey Parnell, the institute’s global director of communications and development. They described RRM and Maha as two sides of a Venn diagram.“We want to bring increased health to women and men and families,” Minjeur said of Maha. “Beyond that, there are definitely a fair amount of differences.”Parnell added: “We really truly are open to quite broad collaboration without being co-opted.”The rise of wellness cultureThe Make America Healthy Again movement is perhaps the best illustration of a broader push within American conservatism to incorporate the historically leftwing language of holistic health and “natural” treatments – in short, “wellness” – to advocate for traditionally rightwing aims, such as convincing women to have big families.This push started to gain steam in the years after the Covid pandemic, as trust in mainstream medicine started to falter: a survey of nearly half a million US adults found that trust in physicians and hospitals declined from roughly 72% to just 40% between April 2020 – the month after the pandemic broke out – and January 2024. As trust eroded, the wellness industry exploded. Between 2019 and 2023, it grew from $5.3tn to $6.32tn, according to the Global Wellness Institute, which defines wellness as the ongoing and individual pursuit of “optimal holistic health and wellbeing”.“Wellness” can encapsulate a wide range of activities, from undeniably healthy behaviors (such as exercising and eating nutritious foods) to practices that may be dangerous (such as drinking raw milk). These activities are yoked together by a deceptively simple ethos, according to Amy Larocca, author of the book How to Be Well: Navigating Our Self-Care Epidemic, One Dubious Cure at a Time.“In wellness, things that are natural are superior to things that are not,” Larocca explained.Wellness’s sales pitch can be particularly appealing to Americans, given the astronomical costs of traditional healthcare in the US. A single IVF cycle can run tens of thousands of dollars and most states do not require insurers to cover it. By contrast, countries such as Denmark and Sweden cover vast swathes of fertility treatments, including IVF.RRM treatments tend to cost far less than IVF, and may soon get even cheaper. In June, Arkansas’s Republican-dominated state legislature became the first in the country to pass a law requiring state insurance to cover RRM therapies.But critics say there is little quality evidence that RRM is more effective at helping people have babies than mainstream fertility medicine. The American Society for Reproductive Medicine, the American College of Obstetricians and Gynecologists, the Society for Maternal-Fetal Medicine and the Society of Gynecologic Surgeons are worried that other states may follow Arkansas’s lead; last week, the medical organizations sent a letter to urging the National Governors Association to reject pro-RRM legislation.Women’s health and infertility are especially ripe breeding groups for wellness because mainstream medicine routinely fails to take either seriously. Between 2013 and 2023, just 8.8% of research funded by the National Institutes of Health focused on women’s health. Women are also more likely to have their medical concerns dismissed. When women and people of color show up at emergency rooms with signs of chest pain, they usually wait longer; women are also less likely to be admitted.‘Many sobbing women’A year after Erica started working with the restorative reproductive medicine clinic, the clinic told her: “We’re really concerned that you’re not pregnant yet. You should be pregnant.”The RRM specialists suggested that Erica might have endometriosis, which affects about one in 10 women and girls worldwide and is believed to be a leading cause of infertility.It is also profoundly understudied. In 2023, a mere 0.06% of the NIH’s $47bn budget was earmarked for endometriosis research. Because many doctors dismiss the symptoms of endometriosis or lack the expertise to recognize it, it generally takes between five and 11 years to get a diagnosis.Erica went ahead with a surgery to diagnose and remove endometriosis tissue. RRM practitioners have suggested that the condition can be treated by a “one-and-done surgery” – as one RRM surgeon put it in the Heritage Foundation report – that aggressively excises endometriosis tissue.A month later, Erica got pregnant. Erica estimated that she and her husband spent, in total, about $2,500 on RRM.“We definitely wouldn’t have our daughter without them,” she said of RRM specialists.View image in fullscreenMany of RRM’s prescriptions are common sense: if you are trying to get pregnant, it can be helpful to take a holistic view of your health and know as much about your menstrual cycle as possible. But mainstream reproductive endocrinologists are skeptical of RRM’s position that infertility itself is not a disease, which runs counter to the World Health Organization’s definition of infertility. They also suspect that RRM may over-rely on surgery to treat endometriosis. One recent review of infertility treatments published in the New England Journal of Medicine found that while surgery can help mild cases of endometriosis, doctors should use IVF when it is severe. When treated with IVF, almost 40% of women under 35 who have endometriosis get pregnant within a single cycle, the review found.“We do a lot of surgery and other treatment options that can optimize a woman’s fertility. But in the end, there are many diagnoses that cannot be solved with those elements alone and need a very effective tool like IVF,” said Dr Rachel Weinerman, a reproductive endocrinologist and associate professor at Case Western Reserve University’s school of medicine. “You need to have a whole toolbox available to decide what is the right tool for that specific patient.”Dr Eve Feinberg, a reproductive endocrinologist at Northwestern University’s Feinberg school of medicine, first heard of RRM when she started treating patients who had tried it. If patients stick with RRM and defer the use of assisted reproductive technology for too long, Feinberg warned, some may become so old that they lose their chance to have biological children.“I’ve had many sobbing women in my office who really missed out on their fertility window by trying endless numbers of years of this method, who weren’t given the truth and weren’t given a chance to explore other methods because they were misled and they were told that this would work for them,” she said. “I counsel my patients that IVF has limitations. It doesn’t work for every patient. I didn’t feel like these women were adequately counseled in that way.”In an extensive memo it shared with the Guardian, IIRRM rejected many of the critiques of RRM as unfounded, including the idea that it over-relies on surgery. Physicians who provide IVF too often default to it, the institute contended, adding that it would welcome more research comparing RRM to conventional medicine.As someone who eats a mostly plant-based diet, runs religiously and avoids makeup, Feinberg considers herself to be more “natural” than most. She understands the appeal of the wellness-style language that surrounds RRM.“It’s being marketed as being holistic. It’s being marketed as being natural and ethical,” Feinberg said. But, she continued: “I think RRM plays into this fallacy that we can understand everything and we can fix everything. 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Texas threatens to sue organizations and doctor for increasing abortion pill access
by Evelyn Reynolds 20 August 2025, 19:32
The heated US war over abortion pills warmed up another degree on Wednesday, as the Texas attorney general, Ken Paxton, sent cease-and-desist letters to two organizations and an individual that he accused of mailing abortion pills to Texans or facilitating their shipment. Paxton threatened to sue if they do not stop their alleged activities.“These abortion drug organizations and radical activists are not above the law, and I have ordered the immediate end of this unlawful conduct,” Paxton said in a news release announcing the letters.The state of Texas bans virtually all abortions.Paxton sent the letters to Plan C, a website that provides information about how to obtain abortion pills; Her Safe Harbor, an organization that provides abortions through telemedicine; and Rémy Coeytaux, a doctor who has been accused of mailing abortion pills to a Texan.Debra Lynch, a nurse practitioner who works with Her Safe Harbor, said that Paxton’s letter would not stop the organization from sending abortion pills to people. If anything, Lynch suggested, it would spur the group on.“None of our providers are primarily concerned with our own wellbeing or our own legal status,” Lynch said. “All the horrors that women are facing because of these ridiculous bans and restrictions outweigh anything that could possibly happen to us as providers, in terms of a fine or a lawsuit or even jail time, if it were to come to that.”Lynch said that in the hours after news of Paxton’s letter broke, Her Safe Harbor received more than 150 requests from Texans who were afraid about abortion access and want to obtain pills that they may use in the future. Normally, Her Safe Harbor has around four to five providers taking calls from patients. Now, they plan to have at least 10 working “until this wave of fear subsides”.Neither Plan C nor Coeytaux immediately replied to the Guardian’s request for comment.In the three years since the US supreme court overturned Roe v Wade and unleashed a wave of state-level abortion bans, abortions have surged in the United States. This rise is due in large part to the availability of abortion pills and the emergence of “shield laws”, which have been enacted by a handful of blue states and aim to protect abortion providers who mail pills across state lines from out-of-state prosecution.By the end of 2024, clinicians working through shield laws were facilitating an average of 12,330 abortions per month, according to data from #WeCount, a research project by the Society of Family Planning.Enraged by this development, anti-abortion advocates have in recent months stepped up their campaign to crush abortion pill providers. In his cease-and-desist letters, Paxton – a Republican who is running to become a US senator – repeatedly cited the Comstock Act of 1873, an anti-vice law that bans the mailing of abortion-related materials. Although legal experts have long regarded the Comstock Act as a dead letter, several anti-abortion activists now believe that the fall of Roe has left the federal government free to fully enforce the act.Alongside 15 other state attorneys general, Paxton earlier this summer signed onto a letter imploring Congress to pass a law that would pre-empt states’ shield laws. He has also sued a New York-based doctor whom he accused of mailing abortion pills into Texas. Then, after a New York county court official said that the state’s shield law prohibited New York from enforcing a fine against the doctor, Paxton sued the official.Paxton’s cease-and-desist letters also follow similar letters sent by the Arkansas attorney general, Republican Tim Griffin. In July, Griffin sent a cease-and-desist letter to Possibility Labs, the parent company of Plan C, and to Mayday Medicines, the parent company of Mayday Health. Like Plan C, Mayday Health offers information about abortion pills, but does not directly sell them.Other anti-abortion activists are going after abortion providers through other legal avenues. A Texas man who said that Coeytaux supplied abortion pills to aid his female partner’s abortion has also sued Coeytaux in a federal wrongful death lawsuit. The man is being represented in court by Jonathan Mitchell, an anti-abortion attorney who masterminded a six-week abortion ban that took effect in Texas in 2021.Last week, Mitchell filed another federal wrongful death lawsuit against a different abortion provider. More
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Judge orders Trump administration to continue Medicaid funding to Planned Parenthood
by Evelyn Reynolds 28 July 2025, 19:05
The Trump administration must continue reimbursing Planned Parenthood clinics for Medicaid-funded services, a federal judge ruled on Monday, in an escalating legal war between the reproductive health giant and the White House over Republican efforts to “defund” Planned Parenthood.Days after Donald Trump signed his sweeping tax bill, Planned Parenthood sued over a provision in the bill that ended Medicaid payments for one year to abortion providers that received more than $800,000 from Medicaid in 2023, such as Planned Parenthood. The new court order, from US district judge Indira Talwani in Boston, will protect Medicaid funding for all Planned Parenthood clinics nationwide while litigation in the case continues.The order also replaces and expands a previous edict handed down by Talwani, which initially granted a preliminary injunction specifically blocking the government from cutting Medicaid payments only to Planned Parenthood affiliates that did not provide abortions or did not receive at least $800,000 in Medicaid reimbursements in a given year.“Patients are likely to suffer adverse health consequences where care is disrupted or unavailable,” Talwani wrote in her Monday order.“In particular, restricting members’ ability to provide healthcare services threatens an increase in unintended pregnancies and attendant complications because of reduced access to effective contraceptives, and an increase in undiagnosed and untreated STIs.”More than 80 million people rely on Medicaid, the US government’s insurance program for low-income people.It is already illegal to use Medicaid to pay for most abortions, but Planned Parenthood clinics – which treat a disproportionate number of people who use Medicaid – rely on the program to reimburse it for services such as birth control, STI tests and cancer screenings.In its lawsuit, Planned Parenthood had argued that it would be at risk of closing nearly 200 clinics in 24 states if it is cut off from Medicaid funds. These closures would probably be felt most strongly in blue states, since they are home to larger numbers of people who use Medicaid. A Planned Parenthood affiliate in California has already been forced to close five clinics as a result of the “defunding” provision.Planned Parenthood estimated that, in all, more than 1 million patients could lose care.“We will keep fighting this cruel law so that everyone can get birth control, STI testing and treatment, cancer screenings and other critical healthcare, no matter their insurance,” the Planned Parenthood Federation of America’s president and CEO, Alexis McGill Johnson, said in a statement after the Monday ruling.Planned Parenthood is battling overwhelming political and economic headwinds. Even if it prevails against the Trump administration, its affiliates could still be removed from Medicaid in red states, thanks to a June decision by the US supreme court in favor of South Carolina in a case involving the state’s attempt to kick Planned Parenthood out of its Medicaid program. On Monday, the state of Missouri also sued the Planned Parenthood Federation of America – the mothership organization that knits together Planned Parenthood’s network of regional affiliates – over accusations that the organization downplayed the medical risks of a common abortion pill, mifepristone, “to cut costs and boost revenue”. The lawsuit, which asks for more than $1m in damages, is part of an ongoing campaign by anti-abortion activists to cut off access to mifepristone.More than 100 studies, conducted across dozens of countries and over more than three decades, have concluded that mifepristone is a safe way to end a pregnancy.The Associated Press contributed reporting More
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Trump rescinds Emtala guidance protecting women in need of emergency abortions
by Evelyn Reynolds 3 June 2025, 20:00
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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‘A scary time to be a scientist’: how medical research cuts will hurt the maternal mortality crisis
by Evelyn Reynolds 15 February 2025, 11:00
On Tuesday, a few days after the Trump administration announced its plan to slash billions of dollars in funding for biomedical and behavioral research, an investigator at a maternal health research center in Pennsylvania told Dr Meghan Lane-Fall that the cuts may lead her to leave academia altogether.Lane-Fall urged her not to make any sudden moves. “It’s not like nothing has happened. No one’s threatened her job,” said Lane-Fall, a professor at the University of Pennsylvania. “But if she looks six months down the line, it looks uncertain.”She did advise her colleague to update her resume.Among the many fields of research threatened by the funding cuts is the growing effort to curb the US maternal mortality rate, which is far worse than in other rich nations. Not only could the cuts delay vital breakthroughs but women’s health experts warn they could also push promising young scientists out of the field.“Above and beyond the stalling of progress, we’re going to see this hollowing out of the workforce that’s been working on this research,” Lane-Fall said. “That will reverberate for years, if not decades.”Late last week, the Trump administration declared that the National Institutes of Health (NIH) would only reimburse 15% of researchers’ “indirect costs”, which can pay for expenses such as staff and laboratory maintenance. Normally, such costs hover at around 50% for elite universities. If indirect costs are capped at such a low percentage, scientists and the institutions where they work say they will not be able to carry out research.A court ordered that the Trump administration suspend the policy earlier this week, but this change – which was reportedly the work of the Elon Musk-run “department of government efficiency” (Doge) – casts into doubt the future of the NIH, the planet’s premier public funder of biomedical research. In 2023, the NIH spent more than $35bn on grants. If implemented, the new policy would endanger at least $4bn worth of funding, but its impact could go much further, imperiling the ability of research institutions – especially smaller ones – to do their work at all. The US maternal mortality rate almost doubled between 2018 and 2022, with rates of deaths among Black and Indigenous expecting or new mothers increasing at a disproportionally fast clip. States that Donald Trump won may be hit especially hard by NIH cuts: they are home to some of the country’s worst maternal mortality rates.To address this crisis, the NIH in 2023 launched a seven-year, $168m initiative to set up more than a dozen research centers to investigate and improve maternal health outcomes, as well as help train new maternal health researchers. The future of these centers – one of which is co-led by Lane-Fall – are now in question.“We’re working with agencies across 20 Michigan counties – that have more than 7 million people in them – to be able to improve services so that moms don’t get sick and die,” said Dr Jennifer E Johnson, a Michigan State University public health professor who helps run one of the research centers in Flint, Michigan. “To do that, we need offices. We need electricity. We need lights, heat, IT, infrastructure, people to create and sell the contracts. All of the support for that would be cut dramatically.”Normally, Johnson said, NIH reimburses about 57% of the indirect costs for Michigan State University’s grants, including hers. It’s not feasible, she said, for the university to cover those costs on its own or for her center to lower its indirect costs so substantially.“If we can’t turn on the lights and we can’t pay the rent and we can’t get people hired – I don’t know what we would do,” Johnson said. “The research is the car. All the infrastructure costs are the road. You can go a little while, but if there’s no maintenance on that, it’s a problem.”Several of the institutions that host the maternal health centers – which tend to focus on improving maternal mortality among people of color and rural communities – are set to lose millions over the NIH cuts. Stanford University officials have said the school, whose center aims to reduce the risk of dangerous postpartum hemorrhages, would take a $160m loss. The University of Utah, which studies how drug addiction impacts pregnancy, would lose $45m.The Guardian reached out to dozens of researchers who have NIH grants to study the health of women, children and parents. Many declined to speak, often citing the ongoing uncertainty of the situation. “I’m honestly not sure what to say as like most of my colleagues I was taken off guard and it’s really unclear how this will play out now that courts are involved,” one scientist, from Missouri, wrote in an email.While Republicans have generally been supportive of Musk’s slash-and-burn approach to the government in the last few weeks, some members of Congress have expressed alarm about the NIH cuts. “It’s pretty drastic. So I’m thinking we need to look at this,” Shelley Moore Capito, the West Virginia senator, told the Washington Post. Alabama senator Katie Britt said she planned to work with Robert F Kennedy Jr, the new leader of the Department of Health and Human Services, to address the impact. “A smart, targeted approach is needed in order to not hinder life-saving, groundbreaking research at high-achieving institutions like those in Alabama,” she told AL.com.One of the agencies behind the maternal health centers is the NIH’s Office of Research on Women’s Health – whose website has been hollowed out by the Trump administration’s recent, widespread purges of government websites. Links to pages on the Office of Research on Women’s Health website about “funding opportunities and notices”, “research programs and initiatives” and “supporting women in biomedical careers” have all vanished.“It is a scary time to be a scientist in the United States,” said Johnson, who is also concerned about recent reports of efforts at the National Science Foundation – an NIH sibling agency that focuses on scientific and engineering research – to scrutinize projects that include words like “women”, “disability” and “underrepresented”. Johnson continued: “All of a sudden, we’re working in a world where we’re not sure we’re going to be allowed to say what the data clearly shows.”On Monday, the day the new policy was supposed to take effect, the Association of American Medical Colleges sued to halt it.“Even at larger, well-resourced institutions, this unlawful action will impose enormous harms, including on these institutions’ ability to contribute to medical and scientific breakthroughs,” the association, which represents several of the US medical schools that host maternal health centers, said in its lawsuit. The association continued: “Smaller institutions will fare even worse – faced with more unrecoverable costs on every dollar of grants funds received, many will not be able to sustain any research at all and could close entirely.”A federal judge then ordered Trump to suspend the cuts, writing in a court order that implementing the cuts would cause “immediate and irreparable injury”. A hearing in the case is set for 21 February.However, it is unclear whether Trump will obey. Although the administration is legally required to heed court orders, a federal judge ruled in another case this week that Trump had defied an order to halt a separate freeze in federal funding. Disregarding court orders may tee up a showdown between the executive and judicial branches of the government – and a constitutional crisis.Regardless of when, how or if NIH grants function in the future, Lane-Fall believes the chaos unleashed by the Trump administration has already led science to suffer. Lane-Fall had to pause plans to hold a conference and told some postdoctoral students that they cannot yet move forward with research projects. She’s now worried that maternal health centers – who have built partnerships with local groups that champion doulas, breastfeeding among Black women and more – will not be able to compensate those groups.“One really important trend in maternal and child health research is that we are working now more with communities than we ever have before, because we understand that there’s a lot of lived experience and expertise in communities. Part of what makes that partnership possible is that we’re able to compensate them for their time,” Lane-Fall said. “When we go to those communities and we say: ‘We promised you money, but it might not be there’ – that is devastating.”Dr Nancy E Lane is haunted by the idea that the confusion will lead women’s health scientists to leave academia. A University of California, Davis, doctor who specializes in osteoporosis and osteoarthritis, Lane was part of a 2024 report calling for more NIH funding for women’s health. Between 2013 and 2023, just 8.8% of NIH grant dollars focused on investigating it.“My career has tremendously benefited from the resources from the National Institutes of Health. It’s what made me who I am,” Lane said. “How much will the current generation put up with this before they’ll just throw their hands up?” More
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Missouri abortion rights in legal limbo after constitutional protections take effect
by Evelyn Reynolds 6 December 2024, 17:52
An amendment to Missouri’s constitution protecting the right to abortion took effect late on Thursday, two years after the state banned the procedure – but abortions have not yet resumed in the state.The day after Missouri voters supported the measure to amend the constitution, Planned Parenthood affiliates in the state filed a lawsuit asking the court to strike down the state’s near-total abortion ban as well as a raft of other restrictions that, Planned Parenthood said, make it impossible to perform the procedure. In a hearing on Wednesday, the groups asked the Jackson county circuit judge Jerri Zhang to quickly issue an order to freeze the restrictions and allow abortions in the state to resume on Friday.However, the judge has not acted, and Missouri abortion providers remain in legal limbo, caught between contradictory provisions in the state’s constitution and its statutes. Under the new amendment 3, Missouri residents possess a “fundamental right to reproductive freedom”, including access to abortions until fetal viability.“I think it’s a simple case. I don’t think we are asking for something particularly extraordinary,” said Emily Wales, president of Planned Parenthood Great Plains in Missouri. “We have Missouri providers who travel to Kansas currently to provide care. It’s absolutely their hope to provide abortion services in their home state. So as soon as we get notice, we will rearrange our plans to ensure that Missourians have access to care.”Even before the US supreme court overturned Roe v Wade in 2022, paving the way for Missouri to ban abortion outright, abortions in Missouri had dwindled dramatically. One Planned Parenthood affiliate had stopped offering the procedure altogether, while the other could only do so at a single clinic, according to Planned Parenthood’s lawsuit. This decline was due, the lawsuit alleges, to a series of “impenetrable, onerous and medically unnecessary restrictions” that are still technically in place – such as requiring medication abortion patients to undergo a vaginal exam or mandating that abortion patients visit a clinic for counseling, wait 72 hours and then return for the procedure.Without a favorable court order from Zhang, Wales said: “There will be too many restrictions on the books that we just can’t actually comply with.”Andrew Bailey, Missouri attorney general, has said that amendment 3 means its near-total abortion ban is unenforceable. However, other restrictions can remain in place, including the requirement of a “72-hour reflection period”, Bailey argued in a recent court filing. Removing those requirements would infringe on women’s right to choose childbirth, he said, which is also included in amendment 3’s guarantee of “reproductive freedom”.“Regulations that ensure individuals have adequate time to choose between options – and will not be racked by regret – do not ‘delay’ rights under amendment 3; those regulations foster those decisions,” he wrote.Bailey argued that, rather than issuing a court order that would impact numerous abortion restrictions, Zhang should instead let these restrictions’ futures be decided over the course of litigation.With amendment 3’s impact in question, Missouri state legislators this week proposed a number of potential new restrictions. Lawmakers pre-filed at least 11 anti-abortion bills, according to a tally by the Kansas City Star. The state legislature may take up these bills when it reconvenes in January 2025. Republicans will control the state house, senate and governor’s mansion.skip past newsletter promotionafter newsletter promotionOne pre-filed bill would once again ask Missouri voters to amend the state constitution – this time to outlaw all abortions except in medical emergencies or in cases of rape. Another would endow embryos and fetuses with full rights and protections – a measure that, if enacted, would grant them a status known as “fetal personhood” and in effect ban all abortion.Yet another would ask voters to amend the Missouri constitution to, in the future, make it more difficult to pass ballot measures. Under that proposal, ballot measures would have to win both a simple majority of voters and win a majority of voters in more than half of the state’s congressional districts. (Right now, Missouri ballot measures must only win most voters in the state.)Mallory Schwarz, executive director of Abortion Action Missouri, remains committed to fighting these new efforts.“I think these attacks are only going to further enrage voters who just made a very clear decision,” Schwarz said. More
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Thanksgiving in America, when obsequious Trumpers genuflect to the president-elect | Arwa Mahdawi
by Evelyn Reynolds 30 November 2024, 13:00
JD Vance is being weird againMelania Trump has made it clear that her second stint at being first lady will be conducted entirely on her own terms. It’s been reported that she’s unlikely to move back to the White House and will spend a lot of the next four years flitting between New York and Florida. Maybe she’ll write another coffee table book. Maybe she’ll develop another caviar-infused skincare line. Who knows. But whatever she does, it’ll be in the service of her own interest, rather than the country’s.With Melania not particularly interested in being by Donald’s side, there’s a void to be filled. And it looks like JD Vance and Elon Musk are furiously competing to win the incoming president’s affections. Musk has basically been camping out at Mar-a-Lago since the election, and has earned “uncle status” according to Trump’s granddaughter Kai.The tech billionaire also had a seat at the Trump family table for Thanksgiving dinner, where he bopped to YMCA and presumably had a little giggle over a bizarre AI-generated video Trump tweeted which showed Donald popping out of a turkey Joe Biden was about to carve and gyrating. It’s not clear if Musk, who spent the rest of the day tweeting self-aggrandizing videos of himself, had any quality time with his children over the holiday but that seems to be his MO: urging people to have multiple kids while ignoring his own.JD Vance may be the next vice-president but from the looks of it, Musk very much seems to be Trump’s number two. Vance looks keen to change that, however, and celebrated Thanksgiving with a weird tweet of his own. The vice-president-elect posted an edited image of Norman Rockwell’s 1943 Thanksgiving painting Freedom from Want with Trump’s face Photoshopped on the patriarch and Vance Photoshopped over the wife. (To be clear: it’s not explicitly stated who the matriarch figure is in the painting but, while Rockwell’s cook is the model, the woman is often interpreted as being the wife of the man she’s standing next to.) In the original painting, the matriarch is holding up a turkey. In Vance’s version he – clad in an apron and blue dress – is holding up a very red map of America. Once upon a time Vance compared Trump to Hitler; now he’s eagerly doctoring pictures so he can depict himself as Trump’s trad wife.Why would Vance embarrass himself like this? Former Kamala Harris adviser Mike Nellis reckons “Vance is worried about Elon having more influence than him, so he thought posting this weird ass meme would win him favor again.” I’m not sure anyone should listen to a Democratic strategist about anything ever again but this interpretation does seem about right.While I couldn’t tell you exactly what went through Vance’s head when he posted an image of himself as an aproned matriarch, I can very confidently say that we have (at the very least) four more years of these sorts of posts. Forget the banality of evil, the Trump administration represents the inanity of evil: we’re going to see the passing of inhumane policies, the rollback of reproductive rights, and the gutting of public services alongside idiotic memes designed to “own the libs”. The online trolls have crawled out from below the bridge and now advise the president; the shitposters are in charge now.I guess it’s totally fine to threaten Muslim congresswomen in the US nowSpeaking of trolls, Trump-endorsed congressional candidate and Florida state senator Randy Fine tweeted a casual death threat to Rashida Tlaib and Ilhan Omar – the only Muslim women in Congress – this week. “The Hebrew Hammer is coming,” Fine tweeted. “[Rashida Tlaib] and [Ilhan Omar] might consider leaving before I get there. #BombsAway.” Can you imagine if Tlaib or Omar had delivered a similar message to Fine? It would be front-page news and Biden would have made an outraged statement. This was barely covered. Fine is the same guy, by the way, who cheered the murder of 26-year-old American citizen Ayşenur Ezgi Eygi, an activist reportedly killed by the Israeli forces while peacefully protesting illegal settlements in the West Bank.Blue Origin deletes video of female astronaut after sexist commentsAstronaut and MIT-trained engineer Emily Calandrelli became the 100th woman in space when she joined six space tourists in a Blue Origin launch. An Instagram video of her excited reaction to being in space was inundated with misogynistic comments, which led to Blue Origin taking it down. Being a woman in the public eye is a real barrel of laughs!A fifth woman has died as a likely result of abortion bansAccording to ProPublica, Porsha Ngumezi, a 35-year-old Texas woman, is the fifth woman who is known to have died because their medical care was delayed after miscarriages or because they couldn’t undergo legal abortions.Fox News’ Jesse Watters: ‘Trump’s going to treat Denver like a woman. He’s going to protect the city whether they like it or not’Poor Denver.Brazilian congressional committee votes for bill to ban abortion in all casesThat includes in cases of fetal deformation, rape or when the mother’s health is in danger. The proposed bill has to go to a special committee before it can advance further but the fact it has got this far is alarming.Walmart is the latest company to abandon its DEI initiativesThe right has declared war on DEI and it looks as if they’re winning. Not a good time for my (satirical) company Rent-a-Minority, I’ve got to say.Gen Z isn’t a big fan of dating apps“There is a growing romanticisation of in-person meeting and interaction,” one expert told the Guardian.Former ICC chief prosecutor says she faced threats and ‘thug-style tactics’Fatou Bensouda has said she experienced direct threats to herself and her family just for doing her job. Meanwhile, the US government and its allies continue to undermine the ICC and international law.Israel’s finance minister proposes ‘thinning out’ Gaza’s population“It is possible to create a situation where Gaza’s population will be reduced to half its current size in two years,” the Israeli finance minister, Bezalel Smotrich, said on Monday. (While these remarks were covered by the Israeli press, they strangely didn’t seem to be deemed newsworthy by a lot of the US press.) Israeli settlers are already preparing to occupy the strip and build new houses next to mass graves.The week in pawtriarchyWould you like to see a picture of a poorly penguin named Flop who learned to walk again because zoo staff made her a bespoke baby bouncer and treadmill? Of course you do. This Guardian piece is guaranteed to make you pen-grin. More
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‘This victory is a mandate’: rightwing groups ready with policy proposals for new Trump administration
by Evelyn Reynolds 8 November 2024, 12:00
As Donald Trump prepares to move back into the White House, he’ll have a host of rightwing groups trying to influence his staffing choices and policy proposals, including the group behind Project 2025, despite Trump’s insistence they won’t be involved.Democrats repeatedly ran attacks on Trump over Project 2025, the conservative manifesto that its writers want to guide a second Trump administration. Trump tried to distance himself from it and from the group behind it, the Heritage Foundation, one of DC’s biggest thinktanks.The Heritage president, Kevin Roberts, congratulated Trump on his “hard-fought victory” that came despite the “sham” indictments and against a “relentless leftwing machine”.“The entire conservative movement stands united behind him as he prepares to secure our wide-open border, restore the rule of law, put parents back in charge of their children’s education, restore America to its proper place as a leader in manufacturing, put families and children first, and dismantle the deep state,” Roberts said.Other groups, namely the America First Policy Institute, have avoided the limelight that backfired on Project 2025 and instead worked behind the scenes to ally themselves with Trump and seek to influence his administration. Trump named Linda McMahon, the chair of the institute’s board, as a co-chair of his transition team, giving the America First Policy Institute a critical role.The institute, started in 2021 and stacked with Trump allies, said in a tweet that it “stands ready to support bold governance that puts Americans first”. It also shared a video clip with the former acting United States attorney general Matt Whitaker talking about deportations and sanctuary cities, key alignments with Trump’s policy goals.“This victory is a mandate to restore our nation to a place of safety, opportunity, and prosperity rooted in freedom,” the America First Policy Institute said. “Together, we’ll secure borders, strengthen the economy, & uphold the freedoms that define us – for a stronger future.”The institute has held trainings for people that could serve in the Trump White House and has a lengthy agenda published online, complete with plans for immigration, education, energy and elections. The New York Times recently reported that the group has “installed itself as the Trump campaign’s primary partner in making concrete plans to wield power again”.The heads of both the America First Policy Institute and the Heritage Foundation have roots in the Texas Public Policy Foundation, a state-based conservative thinktank. Brooke Rollins, CEO of the America First Policy Institute, ran the Texas foundation for 15 years, and Roberts was the foundation’s CEO before he was tapped by Heritage.Another organization, America First Legal, is headed by former Trump adviser Stephen Miller. It has been filing lawsuits that boost Trump and other conservatives on issues like election fraud, diversity programs, public records disputes and government overreach. Miller could return to the Trump administration, but it’s likely the group will remain an outside rightwing legal monitor to help the incoming president.What could Trump’s policies be?Project 2025’s sprawling “mandate for leadership” details in 900-plus pages how each government agency could be altered under a conservative president. The project includes a database of potential hires and a training program for those who could staff a Trump administration, though Trump’s team has said none of the people associated with Heritage’s staffing suggestions would be hired. That would be a feat, given the extensive reach the project had – it was signed on to by more than 100 conservative groups, and many of those who wrote chapters or otherwise contributed had played some kind of role in the previous Trump administration.The project’s biggest suggestion is to designate exponentially more federal government employees as political appointees rather than non-partisan civil servants. It also wants to downsize the government. Trump’s plan also involves downsizing the federal government, something he tried to start implementing near the end of his first term.The project suggests many ways to restrict immigration, both through beefed-up border security and through limiting legal immigration programs for groups like students and low-skilled workers. That’s another pillar for Trump, who made mass deportations a central theme of his campaign.skip past newsletter promotionafter newsletter promotionOn education, the project wants to get rid of the Department of Education and increase the use of vouchers that use public money for private schools – both of which Trump has suggested as well. Conservatives have sought the dismantling of the department for decades, so far without success.Most chapters of Project 2025 mention discarding any programs that promote LGBTQ+ rights and diversity. Trump has railed against these ideals on the campaign trail, promising to root out trans women from sports and in schools.Abortion access is one area where Trump and the project could differ, though Trump’s plans for abortion have been muddled. The project wants to end federal approval of abortion pills, track abortion data and root out anything that is seen as promoting abortion as healthcare. It doesn’t call for a direct ban on the procedure, and Trump has said he wouldn’t approve of one either, but many of these policies would make access significantly more difficult.The America First Policy Institute suggests many of the same policies, though it wants to go further than Project 2025 with federal employees, the New York Times notes, by making most federal workers at-will employees who would not receive civil service protections.Other ideas the institute has pushed include, according to the Times, “halting federal funding for Planned Parenthood and for mandatory ultrasounds before abortions, including those carried out with medication. It seeks to make concealed weapons permits reciprocal in all 50 states, increase petroleum production, remove the United States from the Paris Agreement, impose work requirements on Medicaid recipients and establish legally only two genders.”A policy agenda pamphlet from the institute starts by discussing the Christian foundations of the US and imploring Christians to get involved in the government “before it’s too late”. The policy agenda for the pamphlet was written “through the lens of their biblical foundations and applications to provide Christians more information on the issues and solutions needed for the restoration of the nation”. More

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