Re: the impact of patchwork state abortion restrictions...
The effect is that women who have miscarriages are dying and experiencing unnecesary maternal morbidity because of lack of access to the standard of care when their babies - sadly - did not survive. We will have to wait for data from state Maternal Mortality Review Commissions (MMRCs), but I suspect that the data will paint a clear picture, when and if it comes to light.
Additionally, I suspect that there will be an increasingly long tail of deeply divided maternal health outcomes across states, driven by fewer doctors choosing to train and practice in restricted states. And the fewer trained doctors, the worse the quality of care will be in those states. Doctors will simultaneously receive less training in standard of care and see more acute cases.
We are seeing physicians respond to the state policy environment, but it's in the next generation.
Early studies and data on physician residencies are finding that OBs and pediatricians are starting to weigh the state policy environment *as heavily as the clinical program* when choosing residencies and where to practice. Where doctors train is where they are more likely to practice.
So far the data indicates that these choices will exacerbate existing phyiscian workforce shortages and maternal care deserts in states with more restrictive abortion laws (and anti-LGBTQ+ laws in peds context). And that appears true despite the fact that restrictive state laws do attract some physicians.
So I had the experience of being a health care attorney representing hospitals, health systems and professionals when Dobbs came down. I'm no longer in that role, but let me tell you... when I say that the risk assessment for providers (esp OBs and L&D nurses) is an incomprehensible shitshow, please believe that this is the understatement of the century.
I have two main takeaways: (1) the risk landscape is too varied for any provider or hospital to come to the same conclusion - some will prioritize patient standard of care and others will prioritize preserving licensure to continue to serve patients. (2) Not all doctors (and certainly not the huge volume of religiously affiliated hospitals and health systems) and united behind access to abortion, despite the standard of care.
There are conflicting risks - patient health and safety, legal, financial, professional - across every aspect of state abortion laws, including (1) state laws regulating the procedure of abortion itself; (2) state scope of practice laws which govern health care professional licensure and certification; (3) state health facility laws that govern safety and health standards and dictate what procedures can and cannot be provided in which facilities; (4) medical malpractice which puts providers at risk of litigation for falling below the standard of care; (5) EMTALA which explicitly contemplates L&D and requires EDs to provide stabilizing treatment (which includes abortion care); (6) federal funding restrictions in Hyde; (7) provider conscience and religious discrimination protections.
I was so happy to hear Beth mention Atul Gawande's 'The Itch' article from 2008. It too stuck in my mind for years. And when I spent much of 2024 battling a severe case of shingles that left me with post-herpetic itch that would not subside no matter what I did, it came into my mind straight away. I even wrote an article about my experience for a publication here in New Zealand and I hope it's OK to share the link. https://thespinoff.co.nz/society/29-07-2024/my-last-normal-day-when-shingles-leaves-behind-an-itch-you-cant-get-rid-of
I am quite possibly the only anti-abortion person in this audience. My reasoning is rooted in my beliefs about the sanctity of life and loosely aligns with the second grade teacher’s philosophy. A woman’s rights end where the unborn baby’s begin. I spent a lot of time studying the biological and ethical issues surrounding abortion before arriving at my beliefs and have tweaked them over time. Sarah, your interpretation of my beliefs is incorrect and your reasoning sounds simplistic. Laws are frequently a balance of beliefs and rights, prioritizing one group’s beliefs while interfering with another group’s rights. In this case, however, I am arguing for the rights of the unborn baby, not my rights to impose my own beliefs.
I voted against Trump in every election despite the messaging from the anti-abortion lobby. In terms of the law, I agree that the state-by-state patchwork is a nightmare. Ideally, I would have one ban for the entire country and it would carve out narrow exceptions for rape and incest. The law would be influenced by ethicists and doctors, not just politicians. I would save the woman’s life over the baby’s if necessary, but abortion would be rare.
None of you need to worry that I will actually bring this about. I’m one person in a very blue state. I mostly wanted to remind people that, as with most issues, this isn’t as black and white for all women, all voters, or even all Democrats as it is for all of you.
Thank you for engaging with my comment. To Tina’s questions, I believe that just because a law would be hard to write and enforce doesn’t mean it’s not worth having. Nuance is possible and matters, as all listeners of PP know. My viewpoint regards an unborn baby as a human life, at lease past a certain point (such as development of a heartbeat). I’m willing to acknowledge that its rights might be lesser than a living woman’s, but not that they don’t exist.
To Kathryn’s question about miscarriage, the medical community understands the difference between miscarriage care and elective abortion even if that distinction has become lost in the heated abortion discourse. We should treat a dead fetus with the dignity of any dead human body but of course it doesn’t have rights that outweigh the mother’s. You’re completely incorrect that my framework doesn’t allow for that. I intentionally used the phrase “elective abortion” in my first follow-up comment to clarify that point.
Again, no law is going to change because of my comment here. But laws are rooted in people’s moral and ethical beliefs. That is why we have laws prohibiting assault, drunk driving, larceny, etc. So it makes sense that abortion law could also be rooted in agreed-upon ethical and moral beliefs. I could tell you that my personal conviction means I will not trespass in your home or on your property, but I’m glad we have laws that means no one can do this rather than just relying on everyone’s own morality.
Thank you for sharing your beliefs honestly. I am pro-choice, but struggled with infertility and felt very strongly that my son's life was precious from the minute I saw that positive test. And he felt more precious to me the more he grew and the more I felt (and feel) him become his own person independent of me. It made me question the way the pro-choice movement treats life before viability. But it didn't change my beliefs. Unborn life can be precious and it doesn't make it easy to make tradeoffs between two lives (the life of the mother and the life of the baby).
Can I ask a question? If you are convicted in your moral and ethical beliefs on this topic why would the law matter to you? Do you believe that others can have principled moral and ethical beliefs that would lead them to distinct conclusions and choices under hard circumstances?
I can respect and understand - even if I disagree - your position that an unborn life is your priority over the mother's life and that you would make that choice. What happens if the unborn baby dies - in other words, the pregnancy miscarries? Do the rights of the deceased, unborn child still outweigh the rights of the living mother? Abortion care is used to manage miscarriages. There is no exception for miscarriage management in your framework. And other people may have principled convictions and ethical beliefs about saving the life of the mother to preserve the sanctity of life.
I appreciate you sharing your view. That could not have been easy feeling as you do that commenters here are a monolith who staunchly oppose what you believe. I assure you that is not correct. My assessment is that nearly everyone who lands at “pro choice” struggles with a variety of ethical, moral, and personal aspects of the issue. I believe that practicality is perhaps the one aspect agreed upon. For me, a national ban with narrow restrictions falls apart in the day to day practical issues. For one, it is well documented that we, as a society, already tend not to believe women when they have been raped. Therefore, I cannot support having to “prove” I was raped in order to obtain an abortion. What would happen if I was raped by my husband? Would I be able to obtain an abortion? What if he wants the baby that is a product of his rape? In that case would the baby’s rights plus my husband’s preference be more important than my rights? Or what if he tampered with my birth control? Would we create new laws that would make such actions a serious offense? Sounds difficult to prove. Then, at what point is saving my life worth the loss of an unborn baby? Because practically speaking, that is the scenario your solution creates. I would be sitting in a doctor’s office, dying, likely with other children at home (because mothers obtain the majority of abortions), likely grieving a very wanted child, wondering if I can thread the needle between sick enough and death to be granted an abortion by…lawyers? Committee? Ethicists? That scenario horrifies me more than abortion. Now that I have less rights than an unborn child, I am left asking, as a pregnant woman in this scenario, what other rights would you be comfortable stripping from me? For all of these practical complications, I am pro choice. Ethically, I am pro choice because it feels disingenuous to legislate against abortion in a country that is morally fine with causing death through war, capital punishment, and self-defense. Morally, I am conflicted.
I just want to say that it's an incredible compliment to Sarah and Beth and all the people here that you felt like this could post this comment.
I think, religiously, philosophically, on a lot of fronts, you and I have a tremendous amount of agreement. I am a person who felt like my babies were babies for the first 3 months while I was vomiting every single day.
And, I think (and my thoughts are really influenced by 10 years of listening to Sarah and Beth talk about this) abortion care as a legal issue is kind of impractical.
A person I know well had a pregnancy that ended because the baby was incompatible with life and continuing it was going to kill her. She believes abortion should be illegal in all instances. But the procedure that saved her life, was charted my her doctors as abortion. That word on her medical record nearly broke her. And I just think about her other kids. Her husband. The lives she's responsible for and to, and I am grateful that she had medical options available to her and is still here.
If her situation happened today in Texas, Tennessee, Kentucky, or a host of other states… she might not make it. And… that doesn't seem like good policy to me.
I don't think people should be casual about sex and pregnancy. But I do generally think that, for me, what I have to believe to think it should be criminalized is that women who get abortions are monsters. And, I think, what I have come to over time, is that they are people in difficult situations with no good options. I have a child in my life right now who is being raised by grandparents because his mother contacted cancer while she was pregnant and she had to choose between her pregnancy and her treatment. She chose her pregnancy. And I'm glad that this little guy is here, and he is thriving, and I'm glad to be a part of his story. But… I think there something important for him in this, too. He will never have wonder if his mom wanted him to have this life. *She* chose him. Not me. Not you. Not a legislator. His mother. She chose him. Even though she knew what it would cost her. Just something I think about when this comes up. I think every child deserves to be chosen and wanted.
I appreciate your willingness to share your beliefs in this space.
I'm also struggling with your last sentence. Having spent much time in spaces like this where pro-choice voters discuss abortion, I've seen lots of understanding of nuance on this issue. There are so many variables and perspectives that pro-choice voters are weighing when thinking about and discussing abortion.
To me, as a woman who never was pregnant and never wanted to be, the mysterious workings of pregnancy seem to make each pregnancy unique, each one requiring its own considerations. It seems to me an issue that's all about the nuance. It's impossible for me to read the comments here, especially the personal stories of women struggling with miscarriages under these new restrictions on medical abortion pills, and think of the this issue as "black and white."
Individual discussions probably are nuanced, but there seems to be a consensus in this audience that abortion should be widely available with minimal barriers and that those who support more restrictions are religious zealots seeking to control women and their bodies. That view does seem black and white.
I empathize with those struggling with miscarriage. It’s a terrible loss and in no way equivalent to elective abortion. However, mifepristone by mail has only been around for 3 years. It seems challenging but not insurmountable or barbaric to revert to the regulations from 2022 and prior.
I posted this comment on Sarah’s May 5th News Brief. Does anyone know if there’s been any work in this lane of abortion/women’s healthcare?
I wonder if anyone has thought about changing/nuancing the definition of ‘abortion’ to exclude the actual medical care needed if something happens in a pregnancy. I imagine this change would need to be upstream w/medical personnel & insurance companies.
So this is how a fair number of abortion restriction laws are drafted. Abortion or other terms such as miscarriage (e.g. spontaneous abortion), lethal fetal anomalies, or other related terms are defined to include certain activities and exclude others. Abortion restriction laws are often laws of exceptions. Which is why the results vary so widely from state to state and why some women are having to wait until they go septic to receive abortion care. In that example, the exceptions in state law do not include miscarriage management unless the woman's life is in danger, not just her health or future fertility.
The Pulitzer winner this year from Texas Monthly is amazing. I stood up and clapped in my house when he won. Texas Monthly had another story years ago on another hill country flood about Johnathan McCombs and his family that is haunting as well. When I first heard about the mystic girls I thought to myself why didn’t they install alarms after that tragedy. I would give my personal lifetime pulitzer to the grantland article on the building of the giant waterslide at schlitterbahn kansas city that ended up killing a kid.
A frustration of mine is Republican messaging in opposition to Democrat messaging. I *think* (and someone can tell me I'm wrong) that Democrats are much less monolithic than Republicans, which leads to a hodgepodge of messages from the left that are overpowered by lock step messages from the right. For example, NOT every Democrat believes what the GOP says they believe about gender, about Israel, about anything mentioned in this episode--even abortion! But if the GOP SAYS Democrats believe this, there's no way any individual on the left can refute the message.
Something I like to discuss with some anti-abortion people in my life (not everyone will engage) is the right to marry. I don't know any anti-abortion person yet who is heterosexual and married who likes the idea of crossing the border into the next state and not being married until they cross back over. And yet they're okay with women having different rights. Sometimes this argument lands, especially when I point out that it's not MY fault that U. S. churches co-opted what should be a civil contract and decided that's the definition of "marriage." They're the ones asking the government to do the work of the church and don't even see the irony. Empire, anyone?
Another gagger- “..the justices are saying, ‘We think that there are very few rights guaranteed to Americans. Those rights that do exist are sacrosanct, we interpret them so broadly that you can’t intrude on them in any way, and everything else can be intruded on in every way.’” 💀💀💀💀 i really do not think I have heard this reality put so well.
“..This was never about states rights— this was about red states rights…” 🔔🔔🔔🔔 unfortunately, this is many of our country’s issues summarized in one statement.
I struggle with this topic. I’m staunching pro-choice, and I don’t want mistoprostol to ever have a hint of criminal consequences.
And also, to say this drug is safe without in person follow up, will always feel reckless to me. Not because the drug is dangerous, but because every body is different, every pregnancy is different and if it doesn’t do its job, the consequences can be sepsis and death.
I’ve had four miscarriages. Three required misoprostol. Only once did it work without a D&C. Now I know I’m an outlier, but there were no signs it didn’t work, and I had retained tissue. The only thing that told me an infection was brewing was an ultrasound in person.
This drug shouldn’t be illegal, but women who take it do deserve follow up care to ensure no retained tissue threatens their ability to have kids in the future or even their life.
When you are delivering death, the outliers need to be a part of how best practices are established.
I stood up and clapped when I heard he won. This one from the previous flood has always stayed with me. I thought about it immediately when the mystic girls were missing and said to myself now why didn’t they put in more alarms after the McComb family tragedy.
To the sovereign injury of it all, the federal government is using the same against the states. The US is suing CA over our law regulating the treatment of egg-laying hens, claiming standing to “vindicate its sovereign interests.” (Legal nerds: US cannot claim preemption bc Supreme Court already said no wrt the same law’s treatment of pigs, plus federal law is about egg inspection and safety and CA is about treatment of hens.) So far the district court has said the US has not shown any actual injury sufficient for standing. The (Trump-appointed) judge said to allow standing based on such vague sovereign interest would allow the US to sue a state anytime it didn’t like a state’s policy. (Yes!) It seems like lots of folks are waiving sovereign injury around awfully casually. (The judge also could not resist chicken jokes, starting with “Seeking to enforce the pecking order between federal and state laws . . .”)
Re: the impact of patchwork state abortion restrictions...
The effect is that women who have miscarriages are dying and experiencing unnecesary maternal morbidity because of lack of access to the standard of care when their babies - sadly - did not survive. We will have to wait for data from state Maternal Mortality Review Commissions (MMRCs), but I suspect that the data will paint a clear picture, when and if it comes to light.
Additionally, I suspect that there will be an increasingly long tail of deeply divided maternal health outcomes across states, driven by fewer doctors choosing to train and practice in restricted states. And the fewer trained doctors, the worse the quality of care will be in those states. Doctors will simultaneously receive less training in standard of care and see more acute cases.
Re: physician response to abortion... part 2
We are seeing physicians respond to the state policy environment, but it's in the next generation.
Early studies and data on physician residencies are finding that OBs and pediatricians are starting to weigh the state policy environment *as heavily as the clinical program* when choosing residencies and where to practice. Where doctors train is where they are more likely to practice.
So far the data indicates that these choices will exacerbate existing phyiscian workforce shortages and maternal care deserts in states with more restrictive abortion laws (and anti-LGBTQ+ laws in peds context). And that appears true despite the fact that restrictive state laws do attract some physicians.
Re: physician response to abortion bans... part 1
So I had the experience of being a health care attorney representing hospitals, health systems and professionals when Dobbs came down. I'm no longer in that role, but let me tell you... when I say that the risk assessment for providers (esp OBs and L&D nurses) is an incomprehensible shitshow, please believe that this is the understatement of the century.
I have two main takeaways: (1) the risk landscape is too varied for any provider or hospital to come to the same conclusion - some will prioritize patient standard of care and others will prioritize preserving licensure to continue to serve patients. (2) Not all doctors (and certainly not the huge volume of religiously affiliated hospitals and health systems) and united behind access to abortion, despite the standard of care.
There are conflicting risks - patient health and safety, legal, financial, professional - across every aspect of state abortion laws, including (1) state laws regulating the procedure of abortion itself; (2) state scope of practice laws which govern health care professional licensure and certification; (3) state health facility laws that govern safety and health standards and dictate what procedures can and cannot be provided in which facilities; (4) medical malpractice which puts providers at risk of litigation for falling below the standard of care; (5) EMTALA which explicitly contemplates L&D and requires EDs to provide stabilizing treatment (which includes abortion care); (6) federal funding restrictions in Hyde; (7) provider conscience and religious discrimination protections.
I was so happy to hear Beth mention Atul Gawande's 'The Itch' article from 2008. It too stuck in my mind for years. And when I spent much of 2024 battling a severe case of shingles that left me with post-herpetic itch that would not subside no matter what I did, it came into my mind straight away. I even wrote an article about my experience for a publication here in New Zealand and I hope it's OK to share the link. https://thespinoff.co.nz/society/29-07-2024/my-last-normal-day-when-shingles-leaves-behind-an-itch-you-cant-get-rid-of
I am quite possibly the only anti-abortion person in this audience. My reasoning is rooted in my beliefs about the sanctity of life and loosely aligns with the second grade teacher’s philosophy. A woman’s rights end where the unborn baby’s begin. I spent a lot of time studying the biological and ethical issues surrounding abortion before arriving at my beliefs and have tweaked them over time. Sarah, your interpretation of my beliefs is incorrect and your reasoning sounds simplistic. Laws are frequently a balance of beliefs and rights, prioritizing one group’s beliefs while interfering with another group’s rights. In this case, however, I am arguing for the rights of the unborn baby, not my rights to impose my own beliefs.
I voted against Trump in every election despite the messaging from the anti-abortion lobby. In terms of the law, I agree that the state-by-state patchwork is a nightmare. Ideally, I would have one ban for the entire country and it would carve out narrow exceptions for rape and incest. The law would be influenced by ethicists and doctors, not just politicians. I would save the woman’s life over the baby’s if necessary, but abortion would be rare.
None of you need to worry that I will actually bring this about. I’m one person in a very blue state. I mostly wanted to remind people that, as with most issues, this isn’t as black and white for all women, all voters, or even all Democrats as it is for all of you.
Thank you for engaging with my comment. To Tina’s questions, I believe that just because a law would be hard to write and enforce doesn’t mean it’s not worth having. Nuance is possible and matters, as all listeners of PP know. My viewpoint regards an unborn baby as a human life, at lease past a certain point (such as development of a heartbeat). I’m willing to acknowledge that its rights might be lesser than a living woman’s, but not that they don’t exist.
To Kathryn’s question about miscarriage, the medical community understands the difference between miscarriage care and elective abortion even if that distinction has become lost in the heated abortion discourse. We should treat a dead fetus with the dignity of any dead human body but of course it doesn’t have rights that outweigh the mother’s. You’re completely incorrect that my framework doesn’t allow for that. I intentionally used the phrase “elective abortion” in my first follow-up comment to clarify that point.
Again, no law is going to change because of my comment here. But laws are rooted in people’s moral and ethical beliefs. That is why we have laws prohibiting assault, drunk driving, larceny, etc. So it makes sense that abortion law could also be rooted in agreed-upon ethical and moral beliefs. I could tell you that my personal conviction means I will not trespass in your home or on your property, but I’m glad we have laws that means no one can do this rather than just relying on everyone’s own morality.
Thank you for sharing your beliefs honestly. I am pro-choice, but struggled with infertility and felt very strongly that my son's life was precious from the minute I saw that positive test. And he felt more precious to me the more he grew and the more I felt (and feel) him become his own person independent of me. It made me question the way the pro-choice movement treats life before viability. But it didn't change my beliefs. Unborn life can be precious and it doesn't make it easy to make tradeoffs between two lives (the life of the mother and the life of the baby).
Can I ask a question? If you are convicted in your moral and ethical beliefs on this topic why would the law matter to you? Do you believe that others can have principled moral and ethical beliefs that would lead them to distinct conclusions and choices under hard circumstances?
I can respect and understand - even if I disagree - your position that an unborn life is your priority over the mother's life and that you would make that choice. What happens if the unborn baby dies - in other words, the pregnancy miscarries? Do the rights of the deceased, unborn child still outweigh the rights of the living mother? Abortion care is used to manage miscarriages. There is no exception for miscarriage management in your framework. And other people may have principled convictions and ethical beliefs about saving the life of the mother to preserve the sanctity of life.
I appreciate you sharing your view. That could not have been easy feeling as you do that commenters here are a monolith who staunchly oppose what you believe. I assure you that is not correct. My assessment is that nearly everyone who lands at “pro choice” struggles with a variety of ethical, moral, and personal aspects of the issue. I believe that practicality is perhaps the one aspect agreed upon. For me, a national ban with narrow restrictions falls apart in the day to day practical issues. For one, it is well documented that we, as a society, already tend not to believe women when they have been raped. Therefore, I cannot support having to “prove” I was raped in order to obtain an abortion. What would happen if I was raped by my husband? Would I be able to obtain an abortion? What if he wants the baby that is a product of his rape? In that case would the baby’s rights plus my husband’s preference be more important than my rights? Or what if he tampered with my birth control? Would we create new laws that would make such actions a serious offense? Sounds difficult to prove. Then, at what point is saving my life worth the loss of an unborn baby? Because practically speaking, that is the scenario your solution creates. I would be sitting in a doctor’s office, dying, likely with other children at home (because mothers obtain the majority of abortions), likely grieving a very wanted child, wondering if I can thread the needle between sick enough and death to be granted an abortion by…lawyers? Committee? Ethicists? That scenario horrifies me more than abortion. Now that I have less rights than an unborn child, I am left asking, as a pregnant woman in this scenario, what other rights would you be comfortable stripping from me? For all of these practical complications, I am pro choice. Ethically, I am pro choice because it feels disingenuous to legislate against abortion in a country that is morally fine with causing death through war, capital punishment, and self-defense. Morally, I am conflicted.
I just want to say that it's an incredible compliment to Sarah and Beth and all the people here that you felt like this could post this comment.
I think, religiously, philosophically, on a lot of fronts, you and I have a tremendous amount of agreement. I am a person who felt like my babies were babies for the first 3 months while I was vomiting every single day.
And, I think (and my thoughts are really influenced by 10 years of listening to Sarah and Beth talk about this) abortion care as a legal issue is kind of impractical.
A person I know well had a pregnancy that ended because the baby was incompatible with life and continuing it was going to kill her. She believes abortion should be illegal in all instances. But the procedure that saved her life, was charted my her doctors as abortion. That word on her medical record nearly broke her. And I just think about her other kids. Her husband. The lives she's responsible for and to, and I am grateful that she had medical options available to her and is still here.
If her situation happened today in Texas, Tennessee, Kentucky, or a host of other states… she might not make it. And… that doesn't seem like good policy to me.
I don't think people should be casual about sex and pregnancy. But I do generally think that, for me, what I have to believe to think it should be criminalized is that women who get abortions are monsters. And, I think, what I have come to over time, is that they are people in difficult situations with no good options. I have a child in my life right now who is being raised by grandparents because his mother contacted cancer while she was pregnant and she had to choose between her pregnancy and her treatment. She chose her pregnancy. And I'm glad that this little guy is here, and he is thriving, and I'm glad to be a part of his story. But… I think there something important for him in this, too. He will never have wonder if his mom wanted him to have this life. *She* chose him. Not me. Not you. Not a legislator. His mother. She chose him. Even though she knew what it would cost her. Just something I think about when this comes up. I think every child deserves to be chosen and wanted.
I appreciate your willingness to share your beliefs in this space.
I'm also struggling with your last sentence. Having spent much time in spaces like this where pro-choice voters discuss abortion, I've seen lots of understanding of nuance on this issue. There are so many variables and perspectives that pro-choice voters are weighing when thinking about and discussing abortion.
To me, as a woman who never was pregnant and never wanted to be, the mysterious workings of pregnancy seem to make each pregnancy unique, each one requiring its own considerations. It seems to me an issue that's all about the nuance. It's impossible for me to read the comments here, especially the personal stories of women struggling with miscarriages under these new restrictions on medical abortion pills, and think of the this issue as "black and white."
Individual discussions probably are nuanced, but there seems to be a consensus in this audience that abortion should be widely available with minimal barriers and that those who support more restrictions are religious zealots seeking to control women and their bodies. That view does seem black and white.
I empathize with those struggling with miscarriage. It’s a terrible loss and in no way equivalent to elective abortion. However, mifepristone by mail has only been around for 3 years. It seems challenging but not insurmountable or barbaric to revert to the regulations from 2022 and prior.
You're actually describing the belief of many pro-choice people.
I posted this comment on Sarah’s May 5th News Brief. Does anyone know if there’s been any work in this lane of abortion/women’s healthcare?
I wonder if anyone has thought about changing/nuancing the definition of ‘abortion’ to exclude the actual medical care needed if something happens in a pregnancy. I imagine this change would need to be upstream w/medical personnel & insurance companies.
So this is how a fair number of abortion restriction laws are drafted. Abortion or other terms such as miscarriage (e.g. spontaneous abortion), lethal fetal anomalies, or other related terms are defined to include certain activities and exclude others. Abortion restriction laws are often laws of exceptions. Which is why the results vary so widely from state to state and why some women are having to wait until they go septic to receive abortion care. In that example, the exceptions in state law do not include miscarriage management unless the woman's life is in danger, not just her health or future fertility.
The Pulitzer winner this year from Texas Monthly is amazing. I stood up and clapped in my house when he won. Texas Monthly had another story years ago on another hill country flood about Johnathan McCombs and his family that is haunting as well. When I first heard about the mystic girls I thought to myself why didn’t they install alarms after that tragedy. I would give my personal lifetime pulitzer to the grantland article on the building of the giant waterslide at schlitterbahn kansas city that ended up killing a kid.
https://grantland.com/features/the-wet-stuff-verruckt-waterslide-schlitterbahn/
A frustration of mine is Republican messaging in opposition to Democrat messaging. I *think* (and someone can tell me I'm wrong) that Democrats are much less monolithic than Republicans, which leads to a hodgepodge of messages from the left that are overpowered by lock step messages from the right. For example, NOT every Democrat believes what the GOP says they believe about gender, about Israel, about anything mentioned in this episode--even abortion! But if the GOP SAYS Democrats believe this, there's no way any individual on the left can refute the message.
Something I like to discuss with some anti-abortion people in my life (not everyone will engage) is the right to marry. I don't know any anti-abortion person yet who is heterosexual and married who likes the idea of crossing the border into the next state and not being married until they cross back over. And yet they're okay with women having different rights. Sometimes this argument lands, especially when I point out that it's not MY fault that U. S. churches co-opted what should be a civil contract and decided that's the definition of "marriage." They're the ones asking the government to do the work of the church and don't even see the irony. Empire, anyone?
“Asking the government to do the work of the church.” - spot on 👌🏼
Another gagger- “..the justices are saying, ‘We think that there are very few rights guaranteed to Americans. Those rights that do exist are sacrosanct, we interpret them so broadly that you can’t intrude on them in any way, and everything else can be intruded on in every way.’” 💀💀💀💀 i really do not think I have heard this reality put so well.
“..This was never about states rights— this was about red states rights…” 🔔🔔🔔🔔 unfortunately, this is many of our country’s issues summarized in one statement.
Sarah, huge +1 for the Fatal Distraction piece. I think about it all the time.
I struggle with this topic. I’m staunching pro-choice, and I don’t want mistoprostol to ever have a hint of criminal consequences.
And also, to say this drug is safe without in person follow up, will always feel reckless to me. Not because the drug is dangerous, but because every body is different, every pregnancy is different and if it doesn’t do its job, the consequences can be sepsis and death.
I’ve had four miscarriages. Three required misoprostol. Only once did it work without a D&C. Now I know I’m an outlier, but there were no signs it didn’t work, and I had retained tissue. The only thing that told me an infection was brewing was an ultrasound in person.
This drug shouldn’t be illegal, but women who take it do deserve follow up care to ensure no retained tissue threatens their ability to have kids in the future or even their life.
When you are delivering death, the outliers need to be a part of how best practices are established.
That is also reproductive freedom and care.
The most powerful Pulitzer winning long form piece just won. Just read it. Absolutely brilliant and crushing. https://www.texasmonthly.com/press-room/senior-editor-aaron-parsley-wins-2026-pulitzer-prize-for-feature-writing/
I stood up and clapped when I heard he won. This one from the previous flood has always stayed with me. I thought about it immediately when the mystic girls were missing and said to myself now why didn’t they put in more alarms after the McComb family tragedy.
https://www.texasmonthly.com/news-politics/when-the-river-rises/
YES. Heartbreaking, devastating, beautiful. I just read his follow up, and it is equally powerful. https://www.texasmonthly.com/news-politics/surviving-the-flood/
To the sovereign injury of it all, the federal government is using the same against the states. The US is suing CA over our law regulating the treatment of egg-laying hens, claiming standing to “vindicate its sovereign interests.” (Legal nerds: US cannot claim preemption bc Supreme Court already said no wrt the same law’s treatment of pigs, plus federal law is about egg inspection and safety and CA is about treatment of hens.) So far the district court has said the US has not shown any actual injury sufficient for standing. The (Trump-appointed) judge said to allow standing based on such vague sovereign interest would allow the US to sue a state anytime it didn’t like a state’s policy. (Yes!) It seems like lots of folks are waiving sovereign injury around awfully casually. (The judge also could not resist chicken jokes, starting with “Seeking to enforce the pecking order between federal and state laws . . .”)
I would LOVE a “book” club series on these incredible pieces of journalism.