A Bit of Good News

In Kansas, U.S. District Judge J. Thomas Marten has ordered the state to immediately resume funding for Planned Parenthood:

WICHITA, Kan. -- A federal judge on Monday blocked implementation of a new Kansas law that would strip federal family planning funding from the state's Planned Parenthood chapter, dealing Republican lawmakers their second major legal setback to their recent moves against abortion providers.

[...]

Planned Parenthood said it would be forced to close its clinic in the western Kansas city of Hays unless the court immediately prohibited the state from stripping it of $330,000 in federal Title X annual funding. It contended that its 5,700 patients would also face higher costs and have less access to services and longer wait or travel times for appointments.

[...]

Monday's hearing was the first legal test of the statute. Planned Parenthood is challenging its constitutionality based on the Supremacy Clause, which prohibits states from imposing conditions of eligibility on federal programs that are not required by federal law.

Kansas has defended the statute as a matter of state sovereignty, arguing that an injunction would unconstitutionally replace the state's discretion with the court's judgment.

This is the second in good rulings in favor of access and care in Kansas. Last month, an injunction was granted against the new licensing regulations that essentially put two clinics out of business.

***

In Indiana, the Indiana Housing Community and Development Authority--NOT the Family and Social Services Administration which typically handles financial distribution/oversight of health care services and federal/state money--has granted Planned Parenthood of Indiana $6,000 in neighborhood assistance grants.

Planned Parenthood of Indiana President and CEO Betty Cockrum says the $6,000 should help the group leverage $12,000 in donations.

The Authority wasn't going to give the money because of the garbage law that worked to defund the organization but decided to after Judge Pratt's injunction against the law in June.

New NC Restrictions Will Become Law

A month ago, NC gov Beverly Perdue got our quote of the day when she said this in regards to vetoing the proposed legislation that created new hurdles to women seeking a legal health service:

"Physicians must be free to advise and treat their patients based on their medical knowledge and expertise and not have their advice overridden by elected officials seeking to impose their own ideological agenda on others."

Well, yesterday the NC legislature has overridden her veto. The law requires women to have an ultrasound, a 24-hour waiting period, and state-written counseling delivered as a speech by her doctor. Women will be required to hear about the health risks of abortion and also "abortion alternatives". Apparently women who are seeking abortions in NC have no awareness of any other option and haven't thought them out, amirite?

Oh and it gets even better because anyone who does not follow these new regulations can now be sued by a woman who had an abortion--or one who nearly did and changed her mind. Or her spouse/partner. Or her parent(s)/guardian(s). OR her sibling(s).

The new law will take effect in 90 days.

Today in Totally Not Terrorism

[Trigger warning for anti-choice terrorism.]

There are a lot of things that don't get called terrorism in this country, but chief among them is the anti-choice movement, which is the most brazen, unapologetic terrorist campaign in the US, its co-ordination and orchestration done right out in the open, where no one in the media or politics will call it what it is. It is an inherently violent ideology, backed by a decades-long campaign of intimidation, harassment and violence directed at abortion providers and abortion seekers, that is ignored by one party and mainstreamed as a central plank of its party platform by the other.

Tuesday night, in McKinney, Texas, another Planned Parenthood clinic was the target of another incident of Totally Not Terrorism, during which, fortunately, no one was physically injured:

A heavy glass door is all that stood between damaging flames threatening a family planning clinic in McKinney and an arsonist's sights.

McKinney police and fire crews responded to a small fire that broke out around 10:05 p.m. Tuesday at the front door of the Planned Parenthood clinic, located in a block of stories in the 1700 block of Eldorado Parkway, clinic, police and fire officials confirmed on Wednesday.

...Holly Morgan, director of communications for Planned Parenthood of North Texas in Dallas, said the person or persons involved in the attack threw a Molotov cocktail, consisting of diesel fuel in a glass bottle with a lit rag, at the clinic's front door.

...The incident is also unique because the McKinney location does not provide surgical procedures or abortions for their approximately 4,000 clients, Morgan said.

"It's an all-preventive care location: well-woman visits, breast and cervical cancer screenings, birth control," she said. "They don't provide legal safe abortions, only preventive care."

This shit doesn't happen in a void. Now even clinics that are providing exclusively preventative care to women are being targeted by terrorists because of the incendiary rhetoric of Republicans across the nation who demonize abortion, demonize abortion providers and abortion seekers, and mendaciously frame Planned Parenthood as an abortion mill.

As an interesting side note, the original URL at which this story appears to have been located now takes you to a story about a local town winning an award for online financial transparency. That story also appears in their Most Popular, Most Emailed, and Most Commented sections, which seems wildly unlikely given the content.

The mysterious switcheroo happened after Ben Armbruster linked to it from Think Progress. (I mentioned it to him this morning, and now his piece has been updated with the correct link, which he also helpfully provided to me.) Naturally, I can certainly imagine how and why such a mysterious switcheroo might have happened, although I'm quite certain such expressions of cynicism would be resoundingly dismissed as the fantastic hysteria typical of people who write about Lady Business.

More Recommended Reading

The "We've Got You Covered" Birth Control Blog Carnival care of the National Women's Law Center and Planned Parenthood. There is so much good reading here. SO MUCH!

Texas Defunds Planned Parenthood

Last Thursday I posted about how Ohio has written a Medicaid work-around for defunding Planned Parenthood. Well that little strategy was copied (almost word-for-word, I suspect a lobby writing this and giving it to congressepeople) in recently signed Texas legislation. Rick Perry signed, late Tuesday, SB 7 (various format download), which is a huge piece of legislation overhauling health care access/payments/etc within the state of Texas. Buried in that is distribution for family planning services (pages 90 & 91 in .pdf format):

SECTIONA1.19. (a) Subchapter A, Chapter 531, Government Code,is amended by adding Section531.0025 to read as follows:

Sec.A531.0025. RESTRICTIONS ON AWARDS TO FAMILY PLANNING SERVICE PROVIDERS.

(a)Notwithstanding any other law, money appropriated to the Department of State Health Services for the purpose of providing family planning services must be awarded:

(1) to eligible entities in the following order of descending priority:

(A) public entities that provide family planning services, including state, county, and local community health clinics and federally qualified health centers;
(B) nonpublic entities that provide comprehensive primary and preventive care services in addition to family planning services; and
(C) nonpublic entities that provide family planning services but do not provide comprehensive primary and preventive care services; or

(2)as otherwise directed by the legislature in the General Appropriations Act.

(b)Notwithstanding Subsection (a), the Department of State Health Services shall, in compliance with federal law, ensure distribution of funds for family planning services in a manner that does not severely limit or eliminate access to those services in any region of the state.

(b) Section 32.024, Human Resources Code, is amended by adding Subsection (c-1) to read as follows:

(c-1) The department shall ensure that money spent for purposes of the demonstration project for women’s health care services under former Section 32.0248, Human Resources Code, or a similar successor program is not used to perform or promote elective abortions, or to contract with entities that perform or promote elective abortions or affiliate with entities that perform or promote elective abortions.

As I noted in the Ohio post, Planned Parenthood is not a "federally qualified health center". Here are Texas' numbers (via Guttmacher):

•In 2006, 158 family planning centers in Texas received support from Title X. They included:

Health department clinics: 32
Community health centers: 16
Planned Parenthood clinics: 31
Hospital outpatient clinics: 24
Other independent clinics: 55

•These centers provided contraceptive care to the following numbers of clients:

Health department clinics: 29,020
Community health centers: 12,480
Planned Parenthood clinics: 78,490
Hospital outpatient clinics: 41,170
Other independent clinics: 59,080

They want to take away funding for all of the clinics and over 78K+ people will lose their health care center. How many people are employed that will lose their jobs because PP in Texas has to close clinics? Rick Perry, by the way, is toying with the idea of a presidential run.

***

In somewhat related news, this is a week of heightened harassment for people who work helping women:

...Operation Save America has about 300 people from throughout the country picketing this week at various sites of clinics, physician offices and homes of people with connections to providing abortion services.

Yes, that's right. They're outside people's homes with signs and bullshit just like they do at clinics.

March 10th was National Abortion Provider Appreciation Day but this week seems like a particularly good week to say thanks, again, to those who work every day to provide health care services to women in the face of threats of violence and continual harassment at their work places--and at their homes. To the doctors, the nurse practitioners, the midwives, the nurses, the medical assistants, the office staff and administrators, and the volunteers: Thank You.

The War for Women

How about a little potential good news to start the day?

Virtually all health insurance plans could soon be required to offer female patients free coverage of prescription birth control, breast-pump rentals, counseling for domestic violence, and annual wellness exams and HIV tests as a result of recommendations released Tuesday by an independent advisory panel of health experts.

The health-care law adopted last year directed the Obama administration to draw up a list of preventive services for women that all new health plans must cover without deductibles or co-payments. While the guidelines suggested Tuesday by a committee of the National Academy of Sciences' Institute of Medicine are not binding, the panel conducted its year-long review at the request of Health and Human Services Secretary Kathleen Sebelius.

In a statement, Sebelius praised the committee's work as "historic" and "based on science and existing literature."

"We are reviewing the report closely and will release the department's recommendations...very soon," she added.

There is no guarantee these recommendations will be adopted, and, naturally, the "pro-life" brigade is already throwing a shit-fit about the possibility because, despite whatever bullshit rationale they tack onto their protestations, they hate women having agency, choices, and autonomy. But, as Digby points out, this is a fight worth having, especially because "liberals will win it."

Think Progress has more.

Back to Ohio

Back in June, I posted about the Ohio House debating and passing three hideous pieces of legislation.

Yesterday, the Ohio Senate passed SB 72, which is the companion/mirror bill of HB 78--both are being called "post viability abortion" bills. It passed 22 - 7 and now goes to Gov Kasich for signing (which he is expected to do).

As a reminder, SB72/HB78 says things like:

2) No abortion shall be considered necessary under division (B)(1)(b) of this section on the basis of a claim or diagnosis that the pregnant woman will engage in conduct that would result in the pregnant woman's death or a substantial and irreversible impairment of a major bodily function of the pregnant woman or based on any reason related to the woman's mental health.

They are counting viability to be measured at 20 weeks gestation and abortion to be banned thereafter. More lowlights and link to full text here.

On Tuesday, new legislation was entered into the House that is designed to defund Planned Parenthood (companion legislation is expected in the Senate). HB 298 rewrites laws governing distribution of funds and is a Medicaid work around. The new legislation says:

Sec. 3701.033. (A) All funds distributed by the department of health for the purpose of providing family planning services, including funds the department receives through the "Maternal and Child Health Block Grant," Title V of the "Social Security Act," 95 Stat. 818 (1981), 42 U.S.C. 701, as amended, and through Title X of the "Public Health Service Act," 84 Stat. 1504 (1970), 42 U.S.C. 300a, as amended, shall be awarded as follows:

(1) The department shall award funds with foremost priority given to eligible public entities that provide family planning services, including community health clinics and similar health facilities operated by state, county, or local government entities.

(2) To the extent funds are available after the department determines that all eligible public entities have been fully funded under division (A)(1) of this section, the department may award funds to nonpublic entities in the following order of descending priority:

(a) Federally qualified health centers, as defined in section 3701.047 of the Revised Code;

(b) Nonpublic entities that provide comprehensive primary and preventive care services in addition to family planning services;

(c) Nonpublic entities that provide family planning services, but do not provide comprehensive primary and preventive care services.

(B) This section does not apply to grants awarded by the department under section 3701.046 of the Revised Code.

Sec. 5101.101. (A) All funds distributed by the department of job and family services for the purpose of providing family planning services, including funds the department receives through Title XX of the "Social Security Act," 88 Stat. 2337 (1974), 42 U.S.C. 1397, as amended, and funds received through Title IV-A of the "Social Security Act," 110 Stat. 2113 (1996), 42 U.S.C. 601, as amended, to be used for purposes of providing Title XX social services, shall be awarded as follows:

(1) The department shall award funds with foremost priority given to eligible public entities that provide family planning services, including community health clinics and similar health facilities operated by state, county, or local government entities.

(2) To the extent funds are available after the department determines that all eligible public entities have been fully funded under division (A)(1) of this section, the department may award funds to nonpublic entities in the following order of descending priority:

(a) Federally qualified health centers, as defined in section 3701.047 of the Revised Code;

(b) Nonpublic entities that provide comprehensive primary and preventive care services in addition to family planning services;

(c) Nonpublic entities that provide family planning services, but do not provide comprehensive primary and preventive care services.

(B) This section does not apply to the medicaid program.

If you were wondering, Planned Parenthood is not a federally qualified health center. And, of course, Planned Parenthood does not "provide comprehensive primary and preventive care services in addition to family planning services" as said in (b). So, basically, they'll "fully fund" state agencies first--then if any money is left: FQHCs, then any non-public clinics that provide comprehensive primary care, and then they might give money to organizations like Planned Parenthood. And we all know just how much money Ohio is rolling in these days, right?

To realize some of the effect this will have on Planned Parenthood in Ohio, here is information about how Title X (mentioned in Sec. 3701.033.) works there:

•In 2006, 79 family planning centers in Ohio received support from Title X. They included:

Health department clinics: 16
Community health centers: 4
Planned Parenthood clinics: 26
Hospital outpatient clinics: 11
Other independent clinics: 22

•These centers provided contraceptive care to the following numbers of clients:

Health department clinics: 11,360
Community health centers: 1,570
Planned Parenthood clinics: 68,300
Hospital outpatient clinics: 13,940
Other independent clinics: 24,980

Planned Parenthood saw more patients--and this is just for Title X services--than all the rest combined (which totals 51,850).

You can read full text of the proposed legislation & its list of sponsors and co-sponsors here.

Number of the Day

80: The number of abortion restrictions enacted so far this year in state legislatures across the United States. That number is "more than double the previous record of 34 abortion restrictions enacted in 2005—and more than triple the 23 enacted in 2010. All of these new provisions were enacted in just 19 states."

Injunction Granted Regarding NYC Consumer Protection Law

Several months ago NYC's city council passed a law (39 - 3) that said "crisis pregnancy centers" must be upfront about the services they do or do not provide--such as abortion, prenatal care, what sort of referals they give, & emergency contraception--and must post this information in English and Spanish in "clinics" and in their advertisements. Mayor Bloomberg signed it the same month.

Mayor Michael Bloomberg, who had earlier signaled that he supported the measure, said anyone who doesn't like the law is free to sue. He said he believes in a woman's right to choose.

"I sign the bill with a conscience, clear conscience that it is providing information and it is not taking sides," Bloomberg said.

The law was due to take effect tomorrow. Anti-abortion groups took Bloomberg up on that offer to sue and today, they won an injunction:

The new law, scheduled to take effect Thursday, poses a significant threat to abortion opponents’ First Amendment rights, U.S. District Judge William H. Pauley III said in a sweeping 22-page ruling Wednesday that imposed a preliminary injunction.

[...]

Opponents of abortions rights, who run many of these centers, said requiring them to post a sign about abortions in their facilities violates their free-speech rights.

“We’re absolutely, completely vindicated” by the judge’s ruling, said Chris Slattery, president of Expectant Mother Care Frontline Pregnancy Centers, one of the plaintiffs in the case.

Slattery called the law a “gross violation of the first amendment.” He criticized city lawmakers, who he alleged “could care less about the First Amendment rights of the citizens who advocate life.”

Yeah those city lawmakers, caring about the women of their city not being deceived by misleading advertising and questionable business practices. Those nasty legislators saying you had to be honest about the services you provide in their city (since you weren't willing to be upfront yourselves). How terrible of them. Really.

News & Updates: New Jersey, North Carolina, & (more!) Kansas

First up is New Jersey. Recently NJ's governor Christie line-item vetoed several parts of the state's budget. Those parts are, as you'd expect, social services including family planning. On Monday the state Dems attempted to override the vetoes. Unfortunately, they failed on all measures:

TRENTON — In a day high on emotion but short on results, Senate Democrats on Monday tried to undo 15 of Gov. Chris Christie’s budget cuts to social welfare programs, one by one.

They failed 15 times.

[...]

The only Republican to vote against her colleagues — indeed, the only member of her party to vote against a Christie veto since he took office — was State Sen. Jennifer Beck (R-Monmouth), who sided with Democrats to restore $7.5 million for family planning clinics.

[...]

As the session wore on, tempers flared. While debating the $7.5 million for family planning, state Sen. Gerald Cardinale (R-Bergen) said “a significant portion of it would go to an organization like planned parenthood, which is in my mind a promoter of child prostitution.”

Cardinale's remarks were shouted down, though to no avail.

***

In North Carolina, a Raleigh clinic was vandalized when someone spray-painted "baby murder" and "you shall not murder" on the building. The clinic does not offer abortion services.

Besides vandalism, Planned Parenthood in North Carolina is facing defunding from a republican-drafted budget. They have gone to court to block that from happening and have requested an early hearing:

Planned Parenthood of Central North Carolina said it would probably have to close a Durham health clinic, end a teen pregnancy prevention program, and lay off eight employees if a judge doesn't step in by September.

Wow, there's some great job creation right there. By the way, the Durham clinic does not provide abortion services.

***

And now, Kansas. Yes, there's more from Kansas.

Back in May Kansas jumped on the bandwagon of defunding Planned Parenthood, which has brought the state to court. So, the state has hired Koch Bros-affiliated attorneys to defend itself:

[T]he state of Kansas has hired an expensive team of private attorneys — the same attorneys who represent the billionaire Koch brothers — to defend the state against Planned Parenthood in court.

The state typically employs its attorney general as a defense counsel at no extra cost to Kansas taxpayers. But defendants Gov. Sam Brownback and Robert Moser, secretary of the Kansas Department of Health and Environment, filed a motion to delay their court hearing on Friday because they had hired Foulston Siefkin, a private law firm, to handle the case.

Huh. I had no idea the state of Kansas had so much money laying around! Planned Parenthood, by the way, is being represented by pro-bono attorneys.

Now this business of defunding Planned Parenthood and the Title X money has not affected just Planned Parenthood: a small clinic in the relatively small city of Dodge City is facing closure. Dodge City Family Planning Clinic was started 35 years ago because the then-state health dept couldn't do family planning services. The clinic does not provide abortion services but does provide contraception, other women's health services, plus some health care for men. Their patients are low income and under/un-insured people. However thanks to this vendetta against Planned Parenthood, the clinic is looking at a $39K hole in its budget and the future is looking pretty bleak:

Clinic director Karla Demuth learned last month that the clinic would not receive federal dollars in 2012, due to a budget provision that cut off federal family-planning funding for Planned Parenthood. The provision says federal money for family planning must go first to public health departments and hospitals, leaving no money for Planned Parenthood.

[...]

The clinic normally receives federal dollars through the Kansas Department of Health and Environment. The United Way of Dodge City provides some funding, and service fees make up the rest of the clinic's $100,000 budget.

But the clinic has lost $39,000 in federal funding — roughly 39 percent of its budget — because it does not qualify for family-planning money under the new law, Demuth said Monday.

"We don't provide primary care," she said. "We're not with the health department. We're not a federally qualified health clinic. Therefore, we're ix-nayed."

Ford County, where the clinic is located, is apparently aware of this situation but commissioners haven't decided what, if anything, to do about it.

In the meantime, Demuth said she has considered raising clinic fees to generate more revenue but has not made a decision yet. But she worries that boosting fees will discourage people from seeking medical services.

"We're here for the people that can't pay," she said. "So you try to be sure to offer services for those, but you can't stay open by sliding fees."

Ah, the "culture of life": eliminating health care & health education, reducing access to health care, putting people out of business, and putting people out of jobs.

More Attacks on Planned Parenthood

Another ironically-named group, Americans United for Life (AUL), has put out a ginormous publication in an attempt to discredit Planned Parenthood. The group claims it went through 20 years of Planned Parenthood records in an effort to expose the organization as...something.

In an executive summary of the report, AUL noted that Planned Parenthood “often tries to underplay the significance of abortion to its business model. However, as this report details, abortion has a tremendous impact on Planned Parenthood’s bottom line. This is true to a greater degree each year, and Planned Parenthood has plans to expand its abortion business.”

The report was given out on capitol hill and the group is trying to get a congressional investigation happening into the group. Predictably, the anti-abortion camp is positively jubilant at this report.

Planned Parenthood released a rebuttal, of course, some of which can be read here. I wanted to know what the actual "media release" said, so I emailed Tait Sye, Planned Parenthood's press contact, and asked for the media release. She very nicely emailed it back to me.

TO: Interested Parties
FROM: Planned Parenthood
RE: Fact Check on AUL’s Misleading "Report" on Planned Parenthood
DATE: July 7, 2011

Planned Parenthood statement on Americans United for Life (AUL)’s ideologically-driven publication:

“Planned Parenthood is proud of the trust millions of women place in us every year to provide high quality health care. We approach our work with a deep sense of responsibility to the patients we serve, and recognize that the importance of our work is growing because in many communities, we are often the only source of affordable quality health care for women.

It’s clear that a strong majority of Americans support Planned Parenthood, since a recent CNN poll shows 65 percent of Americans support continued funding for Planned Parenthood to provide primary and preventive health care, including contraception, cancer screenings, and STD tests and treatment, through public health programs like Medicaid.

The publication manufactured by AUL rejects scientific evidence, promotes false health claims, and recycles misleading and discredited charges, as well as old issues that have already been addressed. In an effort to undermine women’s access to Planned Parenthood, AUL draws unfounded and inaccurate conclusions from select pieces of data often taken out of context.

Simply put, this ‘so-called’ report actually insults the intelligence of anyone who reads it.

Planned Parenthood takes seriously our role and responsibility as a trusted health care provider. We promptly address any concerns that are raised, and take corrective action if necessary. Our top priority is and always will be providing high quality health care to women.

In contrast, AUL’s policies are in direct conflict with what the vast majority of Americans support. For instance, AUL opposes common forms of birth control. And as evidenced by their ‘so-called’ report, they have little regard for the facts or improving women’s health outcomes."

Planned Parenthood goes on to highlight some of the report, here is the rest of the release in full (emphasis theirs):

FACT CHECK: A cursory review of AUL’s “so-called” report reveals a number of distortions and misrepresentations:

AUL Claim: AUL’s “so-called” report [ed note: report is .pdf -- Misty] claims a 2010 US General Accounting Office report “demonstrates that even the federal government does not know” how much federal funding Planned Parenthood receives. (pg. 8)

FACT CHECK: This is a recycled charge about alleged missing money that a 2011 PolitiFact fact check rejected as “Pants on Fire” lie. Planned Parenthood health centers are similar to hospitals and other providers that receive payments from public programs like Medicaid for specific medical visits, treatments, and procedures. Planned Parenthood undergoes routine audits to ensure proper use of public funds.

AUL Claim: AUL’s “so-called” report claims “some Planned Parenthood clinics appear willing to provide inaccurate and misleading information regarding fetal development and the risks of abortion to women’s health…. Planned Parenthood failed to provide the young woman who sought its advice essential information, including the fact that induced abortion increases the risk of miscarriage by 55 percent in subsequent pregnancies, and that there exists a heightened risk of suicide and psychiatric admissions to women who have had an induced abortion.” (p.22)

FACT CHECK: This is blatantly false and scientifically inaccurate. A 2008 American Psychiatric Association report found no reliable evidence that abortion is linked to suicide. Their report says, “In the view of the TFMHA (Task Force on Mental Health and Abortion), the best scientific evidence indicates that the relative risk of mental health problems among adult women who have an unplanned pregnancy is no greater if they have an elective first-trimester abortion than if they deliver that pregnancy.” A Guttmacher report states, “Several reviews of the available scientific literature affirm that vacuum aspiration—the modern method most commonly used during first-trimester abortions—poses virtually no long-term risks of future fertility-related problems, such as infertility, ectopic pregnancy, spontaneous abortion or congenital malformation.” The European Journal of Contraception and Reproductive Health Care states in a study abstract, “Abortion is clearly safer than childbirth. There is no evidence of an association between abortion and breast cancer. Women who have abortions are not at increased risk of mental health problems over and above women who deliver an unwanted pregnancy. There is no negative effect of abortion on a woman's subsequent fertility.”

AUL Claim: AUL’s “so-called” report says: “Notably, the RU-486 regimen often fails to cause a complete abortion…. off-label use by Planned Parenthood clinics up to 63 days or beyond is common, despite the increased risk of failure and the increased risks to women’s lives and health.” (pg. 22)

FACT CHECK: AUL is false in asserting a high failure rate of medication abortion (RU-486). Medication abortions are successful about 97 percent of cases. AUL is also false in asserting that Planned Parenthood’s use of evidence-based protocol is unsafe. A study in Obstetrics and Gynecology (12/08; Vol. 112; No.6) showed a 96.2 percent efficacy in the buccal protocol up to 63 days (Planned Parenthood’s protocol). Planned Parenthood’s Medical Standards and Guidelines are evidenced-based and the 63 day protocol was only approved after research was completed and published in the leading peer-reviewed journals. It is common practice for evidence-based protocol or off-label use of drugs. A study published in the Annals of Internal Medicine showed that 21 percent of all prescriptions were for off-label use of drugs.

AUL Claim: AUL’s “so-called report” says, “Planned Parenthood’s ‘services’ for its pregnant clients are overwhelmingly abortions…. In sum, abortion represented over 97 percent of PPFA’s pregnancy-related services in 2009.” (pg. 2)

FACT CHECK: This is a recycled charge similar to a misleading claim made by Rep. Jean Schmidt that PolitiFact fact checked, and called “false.” They write, “(t)he anti-abortion groups came up with the 98 percent figure by comparing the number of abortions to the number of procedures in the other two categories… But there are problems with that calculation. First, it assumes that pregnant women only go to Planned Parenthood for one of those three options.”

AUL Claim: AUL’s “so-called” report says, “Ectopic pregnancies ‘treated’ with the RU-486 regimen can rupture and kill the woman.” (p.22)

FACT CHECK: There is no evidence from published research studies to suggest that mifepristone increases the likelihood of rupture in an ectopic preganancy. In fact there are several studies, including a Cochrane review of 35 studies, that demonstrate that mifepristone increases the success of standard medical treatment for ectopic pregnancy (methotexate). This would suggest that if mifepristone has any impact on the natural course of an ectopic pregnancy it is positive.

AUL Claim: AUL’s “so-called” report says, “Planned Parenthood boasts of its role in the approval of a new drug, ella, yet provides considerable misinformation about the drug.” (pg. 24)

FACT CHECK: It is false to assert that Planned Parenthood is providing misinformation about ella. The health information on Planned Parenthood’s website is medically accurate and evidenced-based. It is written and fact checked by health professionals. For patients that receive emergency contraception (EC), the information shared during the consent process is as follows: How does EC work? One type of EC (Plan B One-Step, Next Choice) is made of one of the hormones made by a woman’s body — progestin. Another type (ella) blocks the body’s own progestin. Both types of EC keep a woman's ovaries from releasing eggs — ovulation. Pregnancy cannot happen if there is no egg to join with sperm.

AUL Claim: AUL’s website says: “Some drugs classified as ‘contraceptives’ by the FDA, such as Intrauterine Devices (IUDs) and Plan B (the so-called ‘morning after pill’), can kill an embryo by blocking its ability to implant in the uterus…. Thus, if HHS decides to include ‘contraception’ as ‘preventive care,’ all insurance plans will be required to provide coverage of these abortion-inducing drugs.”

FACT CHECK: It is scientifically and medically inaccurate to claim that contraceptives such as IUDs and Plan B are “abortion-inducing drugs.” They prevent pregnancy, not induce an abortion. It is further scientifically and medically inaccurate to claim that blocking implantation is an “abortion.” A World Health Organization letter states, “To date, there is no scientific evidence supporting the contention that hormonal contraceptives and IUD prevent implantation of the fertilized ovum.”

In short, a quick review of AUL’s “so-called” report reveals an uncredible document with significant scientific errors and misleading health claims. It’s clear that AUL is an ideological organization that will not let facts get in the way of their goal to overturn Roe v. Wade, and undermine women’s ability to go to Planned Parenthood and see the health care provider they trust.

AUL has, of course, released a rebuttal that can be found at their site. The Heritage Foundation is hosting AUL's lawyer in a conference today on their site as well. AUL CEO and President Charmaine Yoest makes no bones about that AUL's intention to use its resources to help strip Planned Parenthood of federal funding and it's come up with model legislation for states to use (which they've titled "Joint Resolution to Promote Women’s Safety by Investigating and Defunding Planned Parenthood and Other Abortion Providers"). By the way, the basis for defending this "legislation" is based on discredited Live Action videos done by virulent, obsessive Planned Parenthood hater Lila Rose.

In an effort to keep momentum for a congressional hearing and get their agenda moving faster, AUL included--in it's report given out on capitol hill--a list of 44 “potential witnesses for congressional hearings”. Florida Rep Cliff Stearns (R-idiculous), who sits on the House Energy and Commerce Oversight and Investigations Subcommittee, has indicated he might, indeed, push for investigation because he's not convinced there is any good reason to fund Planned Parenthood at all.

Today in Anti-Woman Douchecanoery

First up is New Hampshire. Oh, New Hampshire. The NH Council voted last week to not renew a contract with Planned Parenthood there. PP there has operated under a limited pharmacy lisence based on that particular contract. Without the contract, the clinics are now no longer dispensing contraception. The reasoning for the denial of the contract? The same, tired bullshit about not wanting taxpayers to fund an organization that provides a medical service some people don't like.

The Planned Parenthood contract, which accounts for about 20 percent of its annual New Hampshire budget, would have paid for education, distributing contraception, and the testing and treatment of sexually transmitted infections. The organization's abortion practice is paid for by private donations, Trombley [Steve, president and CEO of Planned Parenthood of Northern New England] said, with audits ensuring no public money is used.

Last year, Planned Parenthood provided contraception for 13,242 patients in New Hampshire, Trombley said. The organization also provided 6,112 breast exams, 5,548 screenings for cervical cancer and 18,858 tests for sexually transmitted infections. If the contract is not renewed, Planned Parenthood will drastically reduce its services, Trombley said. The organization employs 80 people in New Hampshire.

Planned Parenthood treats 52 percent of patients whose care is subsidized by the New Hampshire state family planning program, Trombley said. It provides its services on a sliding scale based on income, with 70 percent of patients paying nothing or near nothing for birth control pills because they earn less than 150 percent of the federal poverty line.

The centers are turning away 20 - 30 people per day--people who cannot afford to pay full cost for contraception. Some, in part, due to lack of insurance. Don't, however, look to the council to necessarily care:

Another executive councilor who opposed the contract, Raymond Wieczorek of Manchester, said he had asked if the contract could exclude the issuance of condoms. Wieczorek said he supports paying to test for sexually transmitted diseases but does not believe the state should subsidize contraception.

"If they want to have a good time, why not let them pay for it?" he said.

Really, that just says it all right there, don't you think?

Next up: More Wisconsin.

In Wisconsin, an anti-abortion group is demanding the attorney general start enforcing a provision added onto Scott Walker's budget clusterfuck that is directed at university med students and their ability to learn adequate and comprehensive patient care procedures.

State law has long prohibited the use of public funds to pay physicians to perform most abortions. As amended by the Republican-controlled Legislature last month, that state law now specifies that UW Hospital and Clinics is in fact a state “agency” and subject to this law.

UW Health asked Gov. Scott Walker to veto the provision, charging that the claim UWHC uses state funds is “incorrect” and will set a dangerous precedent with “disastrous consequences” that will ripple far beyond the controversial issue of abortion training. UW claims that without the training, which involves two rotations for one month outside the university premises at Planned Parenthood clinics, its gynecology and obstetrics training program could lose its accreditation and women in Wisconsin could lose access to many health services across the state, not just abortions.

[...]

Dr. Fredrik Broekhuizen, the medical director for Planned Parenthood of Wisconsin who also has an academic practice at the Medical College of Wisconsin in Milwaukee, says it is vital for medical students to be trained in abortion services.

“There are medically indicated pregnancy terminations, and physicians need to have skills to do that,” says Broekhuizen. He notes that even physicians who do not work in abortion clinics may well need to perform an abortion.

“There are situations where patients have fetal death in utero at 16 to 18 weeks of gestation,” he says. “The mode of delivery in the case of a dead fetus is exactly the same procedure as an abortion procedure. So learning these techniques is an essential part of what an ob/gyn needs to know in order to provide comprehensive care to women, regardless of where they choose to practice.”

And this is why, he says, the accreditation organization for ob/gyn programs requires that training in abortion services be offered. “Residents can opt out if they have moral objections, but that should be part of the training.” And without elective abortion procedures offered at UW or any other Madison hospital, the only option for such training is Planned Parenthood, he adds.

In opposing the Republican budget measure, UW Hospital officials also argued that UW does not pay for the training because Meriter Hospital funds that portion of resident training.

The "Right to Life" group opposes this reasoning saying that it's just "legalistic manipulations". The group blathers on about how "residents need to be instructed how to save, preserve and respect life, not how to kill preborn children..." but they obviously don't give a shit about saving, preserving, or respecting the lives of women who need the medical procedures a resident learns how to do in training. Just for one example: after 10 weeks gestation, a miscarriage is more likely to be incomplete and a woman may need a D&C. Does this so called "pro-life" group care? No. They don't. They don't give a shit about women except as incubators for those "preborn children" (once born, though, those same people scream "BOOTSTRAPS!").

There are not words to describe my contempt for these anti-life crusaders. They like to point at pro-choice people and call them "pro-death" but pro-choicers aren't the ones condemning women to not have access to medical care or comprehensively trained physicians.

A bit more on the Yamhill Co. situation

Last Monday I wrote about Bridget Burkholder's situation where she, an inmate with pre-trial status in Yamhill County (Oregon), needed an abortion and the county would not let her have a furlough to get it nor provide supervised transportation without a court order (but no court order was going to happen). Plus there's that county ordinance that prevents any county employee from "facilitating the performance of an abortion". In the end, Ms. Burkholder was transferred to a mental health facility where she may or may not get the abortion she needs. Anyway, back on Monday (before her transfer), I noted that the county prosecutor, Michael Videtich, had this to say about it:

"Also, this isn't a scenario where there is a medical emergency. I understand that there is a timeline, but it's not an emergency. This is an elective procedure she has a right to have. But she can post bail."

At the time I pointed out to Mr. Videtich that, no, it's not "an elective procedure" as if abortion is just like eyelash tinting. Oregon District Attorney Brad Berry has now followed right along with Videtich:

[Berry] raised the question, "If we wouldn't allow her to have her breasts reduced in this state," or have a benign tumor removed, how could she be allowed to choose an abortion? [...]

Seriously? No. Just no. Neither of those elective procedures are really comparable to abortion. Because what happens if you do not have the benign tumor removed? Probably nothing serious to a person's health. Not have breast reduction? There may be back issues, which can possibly be severe and debilitating. However, what happens if an abortion doesn't happen? Pregnancy--which is not just some easy process even in "textbook good" pregnancies (trust me on this one, Mr. Berry--I know of which I speak here). Labor. Delivery. What happens to the child? Will Ms. Burkholder be forced to put the child in foster care? Find some relative? What will the effects of that potentially do to her (and the child)? So no, Mr. Berry, not having an abortion is not like not having breast reduction or not removing a benign tumor.

Also? That reasoning makes me wonder about Sheriff Crabtree's insistence that he couldn't do anything for her because of her pre-trial status. Sounds like if she was a "regular" inmate, she wouldn't have had the abortion anyway what with your breast reduction reasoning there.

Berry was apparently questioned about the whole idea of "if she can't make the decisions about abortion...what about being competent enough to carry a pregnancy and give birth to a child?" Berry said that:

"If she lacks the mental competence to opt one way", he said, "Then it's hard to argue she doesn't also lack the mental competence to opt the other, putting her potential [legal] guardian in a tough spot."

Berry also assured that everyone in Yamhill County acted with utmost professionalism and neutrality and no one had any intention on influencing "the ultimate outcome" in regards to Ms. Burkholder's abortion.

Whether Ms. Burkholder does get the abortion or not, no one will probably know (at least not for some time) due to medical privacy laws.

Quote of the Day

[Trigger warning for terrorism.]

"You're looking for me. I'm here."—Dr. Mila Means, a physician trying to open an abortion clinic in Wichita, Kansas, who responded to a letter she received advising her to check under her car each morning "because maybe today is the day someone places an explosive under it" by driving a bright-yellow Mini Cooper emblazoned with lightning bolts.

[H/T to Shaker The Great Indoors.]

My Planned Parenthood: The Carnival Collection

As you might have noticed, ahem, today was the My Planned Parenthood Carnival, which I co-hosted with Tami of What Tami Said. The hub for the carnival, at which links to all the other participating blogs can be found, is here. There is so much good reading there!

And, naturally, submissions posted at own blogs are still being accepted.

Shakesville ran My Planned Parenthood Stories all day, too, of course, and here is the full collection, in case you missed any of them:

Angie: Planned Parenthood Saved My Life

Deeky: Today's Visit

Elizabeth in Chicago: A Simple Story

Liss: Like a Trusted Friend

K: Forever Grateful

Portly Dyke: The Radical Notion of Choosing Parenthood

Sonia: Thank You

Lili: I Can Trust Planned Parenthood

Vanshar: About the Menz

koach: For My Sister

Fannie: Healthier

Tenya: I Turned to Planned Parenthood

Teaspoon: Planned Parenthood Was There

Talonas (Lt. Chubbins): Better Parents

Gretchen in Washington: My Life's Backdrop

Mustang Bobby: A Part of My Life for Fifty Years

M: Planned Parenthood Saved My Daughter

My profound thanks to Tami, who is just a total rock star, to everyone who participated, and to everyone who sent private notes of thanks, encouragement, and support.

This isn't an end; this is just a beginning. There were be more carnivals to come—and I hope that they get increasingly bigger, louder, wilder, until we are making such a grand cacophony of clattering teaspoons that we can no longer be ignored.

My teaspoon. My voice. My choice. My Planned Parenthood.

Update on Ms. Burkholder & Yamhill Co.

On Tuesday, I posted about Bridget Burkholder, the incarcerated woman who needs an abortion and was denied transportation due to her pre-trial status by the Sheriff, general inaction by the judge at the time, and the complication of a 14 yr. old county ordinance. They--Judge Collins and Sheriff Crabtree--also weren't convinced she was mentally competent enough to decide to choose to have an abortion.

Late yesterday she was committed to a mental health facility:

On Wednesday, Collins issued a magistrate’s hold ordering the county’s civil commitment investigator, Todd Sprague, to evaluate Burkholder’s mental status. He issued a report, which Collins relied on to order her to a mental health facility. She will leave Thursday morning.

The decision regarding the abortion will be left up to doctors at the new facility.

In order to obtain a medical procedure--one even the prosecutor acknowledged she has a right to have--her best bet, thanks to the officials past and present in Yamhill Co., is being committed. And that's certainly not a guarantee.

Reminder: The My Planned Parenthood Carnival Is Tomorrow!

Information here.

No bail money? No abortion.

Yamhill County, Oregon, is a a beautiful place in terms of scenery. It's home to many of Oregon's wineries and stunning forestry. The Visitor's Association says:

Yamhill Valley is authentic Oregon. A place where the good life is cultivated every day. Where world-class wineries dot the verdant rolling hills, and roadside farm stands intersect with bicycle brigades. Where historic main streets meet urban-style bistros. Where imagination still takes flight and you're never too old to stay and play.

I actually live relatively close to Yamhill County--if I have to drive to Salem (Oregon's capitol), I spend the vast majority of the time driving though Yamhill County. Truly, it is a lovely place.

Picturesque, however, doesn't necessarily mean much. This little slice of "authentic Oregon" currently has a woman in jail awaiting trial. The woman, Bridget Burkholder, needs an abortion. The county is refusing to provide transportation--which it does do for medical care. The county has, essentially, said that if she can come up with the $6500 bail, she's more than free to go get an abortion.

Bridget Burkholder, a 23-year-old Portland resident, is awaiting trial on arson, criminal mischief and disorderly conduct charges after she allegedly damaged a McMinnville motel room in what authorities feared was preparation to set herself on fire.

[...]

At a Thursday hearing, Hanson [Abraham, defense attorney] told Circuit Judge John Collins that his client was running out of time. He asked Collins to grant her a conditional release so she could make an appointment scheduled for the following morning.

However, such a release would be unsupervised. After hearing from both Burkholder and the jail's licensed social worker, Patricia Brown, Collins denied the release.

Collins said Sheriff Jack Crabtree had the legal authority to have her escorted to Salem and back for her clinic visit. He said he had no authority to order a medical furlough himself, but said, "I believe the sheriff does, whether the inmate is under pre-trial or sentenced status."

Sheriff Crabtree is outright refusing to do so without a court order. At Ms. Burkholder's hearing, Ms. Brown (the social worker) said that Ms. Burkholder was doing well with psychiatric treatment, though she may still pose a risk to herself and other people. Also at the hearing the prosecutor, Michael Videtich, had this to say:

"Also, this isn't a scenario where there is a medical emergency. I understand that there is a timeline, but it's not an emergency. This is an elective procedure she has a right to have. But she can post bail."

But, no, she cannot just post bail: she does not have the money to do so. Also Mr. Videtich? Abortion is not an "elective procedure" akin to, say, eyelash tinting. All medical procedures are technically "elective", that makes them no less necessary. This is, in fact, an emergency. Simply because she is not about to die right now makes it no less urgent. I see your false equivalence and call your bullshit.

All Ms. Burkholder is requesting is transportation. She does not want the county to pay for the abortion. She does not want someone from the county to be her support person. Still, Sheriff Crabtree is unmoved and refusing: he is waiting for a court order and that's final.

That may seem outrageous--and it is. It's not surprising, though, because way back in 1997 two county commissioners--Tom Bunn and Rob Johnstone--passed Ordinance 634 (.pdf) which says (in part):

THE YAMHILL COUNTY BOARD OF COMMISSIONERS ORDAINS AS FOLLOWS:

Section 1.

(a) No person shall, while serving as agent for Yamhill County, facilitate by any means the performance of an abortion, other than to the extent required by state and federal law.

(b) No person shall be required to perform, assist, or facilitate the performance of an abortion. The refusal to perform, assist, or facilitate the performance of, or provide abortion services, shall not constitute grounds for civil or criminal liability, disciplinary action or discriminatory treatment.

(c) This ordinance shall in now be construed as limiting a person's choice in facilitating an abortion when not acting as an agent of Yamhill County. However, under no circumstances shall county resources be used.

The News Register article notes that at those commissioners's directives, the county's health departments stopped providing family planning and assistance (though they never offered abortion services)--and stopped doing so for a decade.

Meanwhile, time is ticking down for Ms. Burkholder.

Update on South Dakota

Back in March South Dakota gov Dennis Daugaard signed into law a bill that would require women seeking an abortion to have a 72 hour wait, go to a "crisis pregnancy center", and that doctors must tell a women about all sorts of "complications" she may have due to the abortion. Remember: South Dakota has ONE clinic and its doctors must come in from out of state to provide abortion services.

Yesterday, one day before the law was to start taking effect, U.S. District Court Chief Judge Karen Schreier found in favor of Planned Parenthood, who sought an injunction of the law. You know, beyond the defunding via Medicaid, I think part of the strategy against Planned Parenthood is to drain them via legal fees and their now-constant need to battle for women in court. But I digress! Judge Schreier wrote a 61-page decision, some of which I'll excerpt, but you can also download and read it from here. As Reuters notes:

South Dakota has been at the center of some of the most bitter recent fights over abortion, which was legalized in 1973 by the U.S. Supreme Court in Roe v. Wade.

State lawmakers passed laws in 2006 and 2008 to ban most abortions unless they were necessary to save a woman's life. Voters later overturned both bans.

We've written A LOT on South Dakota and its attempts to ban abortion--which I noticed when I went looking for the post about the law. South Dakota was one, if you recall, who also proposed to make killing an abortion provider "justifiable homicide" (the bill was later shelved). Hostile is an understatement.

Onto Jude Schreier's ruling. The excerpts are long--and the ruling is truly an example of common sense and awesomeness.

On the Pregnancy Care Center clause (emphasis mine):

Defendants argue that the patients’ free speech rights are not implicated because a pregnant woman is only required to “speak” inasmuch as she is required to disclose that she is pregnant and that she has chosen to undergo an abortion. First, the plain language of the Pregnancy Help Center Requirements contradict defendants’ construction. Subsection 3(a) of section 3 states that the “pregnant mother must . . . have a private interview to discuss her circumstances that may subject her decision to coercion.” An interview necessarily requires questions and answers. And defendants offer no explanation on how an interview “to discuss her circumstances” could be done without the pregnant woman actually disclosing “her circumstances.”

Second, and in the alternative, if the pregnant woman does not have to actually discuss her circumstances during an interview and she only has to disclose that she is pregnant and has chosen to undergo an abortion, the Pregnancy Help Center Requirements still implicate the patient’s free speech rights. At the very least, the requirements on their face compel a patient to not only disclose that she is pregnant and is seeking an abortion, but also to disclose the name of her abortion physician so the pregnancy help center knows to whom to send the written statement or summary of assessment. See Section 6 of the Act (authorizing a pregnancy help center to forward “documents to the abortion physician”). This compelled disclosure necessarily reveals private factual information, such as she is pregnant, she is choosing to undergo an abortion, she has spoken with an abortion physician, and the name of her abortion physician. And she is being compelled to disclose this information to someone who is opposed5 to her decision to undergo an abortion. Even these “limited” compelled disclosures implicate the protection afforded by the First Amendment’s Free Speech Clause.

[...]

[...] If the woman wishes to consult with a pregnancy help center, read pamphlets, or study the website, she is free to do so. Because the Pregnancy Help Center Requirements only apply to women who have chosen to undergo an abortion, they do nothing to inform pregnant women who may not be seeking an abortion but are seeking information about alternatives to abortion and information about assistance for raising children.

Defendants argue that using printed materials or the patient’s physician to provide information to pregnant women who have chosen to undergo an abortion have not always been successful. Thus, according to defendants, the legislature is allowed to experiment with different message delivery mechanisms in an attempt to ensure that the woman is fully informed. The court rejects defendants’ underlying assumption that legislatures are allowed to use more intrusive means that regulate speech because the alternatives are not 100 percent successful in achieving a compelling state interest.

[...]
On the Crisis Center being an undue burden

With the relevant cases in mind, the next issue is whether the Pregnancy Help Center Requirements create “a substantial obstacle to a woman’s choice to undergo an abortion.” See Miller, 63 F.3d at 1458. The plain language of sections 3, 4, 5, and 6 makes it clear that a woman can obtain an abortion if, and only if, she first consults a pregnancy help center when she otherwise would not. Forcing a woman to divulge to a stranger at a pregnancy help center the fact that she has chosen to undergo an abortion humiliates and degrades her as a human being. The woman will feel degraded by the compulsive nature of the Pregnancy Help Center Requirements, which suggest that she has made the “wrong” decision, has not really “thought” about her decision to undergo an abortion, or is “not intelligent enough” to make the decision with the advice of a physician.

Furthermore, these women are forced into a hostile environment. Aside from its compulsive nature, the hostility of the consultation is evidenced by the fact that section 5 of the Act establishes that the only entities that can be listed on the state registry of pregnancy help centers are those that routinely “consult[] with women for the purpose of helping them keep their relationship with their unborn children” and that “one of [their] principal missions is to educate, counsel, and otherwise assist women to help them maintain their relationship with their unborn children.” A pregnancy help center cannot have even “referred any pregnant women for an abortion at any time in the three years immediately preceding July 1, 2011.” Requiring these women to “have a consultation,” and a “private interview” with a “pregnancy help center” destroys “[t]he right to avoid unwelcome speech” that is “protected in confrontational settings.” Cf. Hill v. Colorado, 530 U.S. 703, 717 (2000). And it forces an unnecessary confrontation on one of the most volatile subjects in America. See Stenberg v. Carhart, 530 U.S. at 920 (acknowledging that “[m]illions of Americans believe that . . . abortion is akin to causing the death of an innocent child”); Casey, 505 U.S. at 852 (recognizing that “some deem [abortions as] nothing short of an act of violence against innocent human life”).

There are clear ideological differences between a woman who has chosen to undergo an abortion and a “pregnancy help center.” When considering these differences, a woman will likely be unwilling to actually consult with a pregnancy help center because she will fear being ridiculed, labeled a murderer, subjected to anti-abortion ideology, and repeatedly contacted by the pregnancy help center. Moreover, a woman may likely believe, rightly or wrongly, that her decision to have an abortion could become public information. And it will not matter to her that in the future she may be able to obtain legal relief from the pregnancy help center worker who disclosed the information. By then it will be too late. Thus, rather than risk having such information being made public or to avoid “consulting” with someone who is not supportive of her decision to have an abortion, she will be forced to remain pregnant.

On the 72 hour waiting period:

With regard to whether the 72-Hour Requirement constitutes a substantial obstacle, plaintiffs argue with supporting evidence that women could be forced to wait up to one month between their initial consultation and the abortion procedure if the same physician is required to conduct both the initial consultation and the abortion. See Docket 10-6 at 6 (“[D]ue to the physicians’ schedules, a woman could be delayed up to a month in order to have two appointments with the same physician.”). This is because there is only one clinic in South Dakota, which provides abortions one day a week on average. Docket 10-6 at 4. And the three to four physicians who perform the abortions take turns flying into Sioux Falls about once a month. Docket 10-6 at 4. Defendants argue that such a delay will not occur because there is no requirement that the initial consultation be performed by the same physician who performs the abortion.

[...]

Even if the physician who performed the abortion was not required to have conducted the initial consultation, the 72-Hour Requirement still creates a substantial obstacle considering the circumstances that surround many of the women who choose to undergo an abortion in South Dakota. For example, 56 percent of women who chose to undergo an abortion “during the year beginning March 1, 2010,” had “incomes that [were] 100% or less than the federal poverty level.” Docket 10-6 at 4. And 87 percent of the women who chose to undergo an abortion during that same time period lived “at or below 200 percent of the [Federal Poverty Level].” Docket 10-6 at 4. Furthermore, approximately 30 percent of the women who chose to undergo an abortion during this time period traveled more than 150 miles to the abortion clinic, for a total of 300 miles. Docket 10-6 at 3.

Because the 72-Hour Requirement effectively requires two trips, almost every woman will be forced to cope with the financial burdens created by the additional trip. These burdens are great when considering the fact that approximately 87 percent of the women are at or below 200 percent of the Federal Poverty Level. For many of these women, it stands to reason that they will be unable to afford the second trip and will abstain from obtaining an abortion even though they have chosen to undergo one. And women who live farther away are even more likely to be unable to afford a second trip. The inability to pay for the additional trip also becomes worse for the women who are stay-at-home mothers because they will be required to make additional arrangements for childcare. Docket 10-6 at 4. And if a pregnant woman has a job, she will be required to take twice as much time off from work. Docket 10-6at 4. The court finds that these financial circumstances constitute a substantial obstacle for a large fraction of the relevant cases.

The effective doubling of the financial burden created by the 72-Hour Requirement is arguably insignificant when compared to the other obstacles created by the 72-hour delay. For example, even if the delay between the initial consultation and the abortion is only one week, pregnant women who choose to undergo an abortion can be denied the ability to undergo a medication abortion, which may be their chosen method of abortion, because of the delay. Docket 10-6 at 2-3. A medication abortion is only available until 9 weeks after the first day of the woman’s last menstrual period, after which time a surgical abortion is required. Docket 10-6 at 2. For those women who refuse to undergo a surgical abortion in such situations, the 72-Hour Requirement effectively denies them of their right to an abortion. As to those women who choose a surgical abortion near the end of the first trimester, the delay created by the 72-Hour Requirement will prevent them from being able to obtain any abortion in South Dakota because these abortions are only available through the first 13.6 weeks after the first day of the woman’s last menstrual period. Docket 10- 6 at 2-3. It stands to reason that the number of women who are effectively denied their right to undergo an abortion increases as the required period of delay increases.

Moreover, it is generally accepted that women are often the victims of abuse. And abusers often forcibly impregnate their partners to maintain control or increase their control over their women. Docket 10-7 at 7-8. [...] For those women who are in such relationships, the 72- Hour Requirement creates an incredible obstacle because it requires them to make separate trips, which for many is effectively impossible to do because two trips double the chances of being “caught” and punished by the abusive partner. Docket 10-7 at 9-10. [...]

On the "risk factors" requirement (what docs had to say to patients regarding "complications":

Under South Dakota law, when a statute is “not ambiguous,” “[i]t is to be assumed that [the statute] means what it says and that the legislature has said what it meant.” Kreager v. Blomstrom Oil Co., 298 N.W.2d 519, 521 (S.D. 1980) (citation omitted). Thus, the Act requires the physician to tell the patient about “any factor . . . for which there is a statistical association with an increased risk of” “any adverse physical, psychological, or emotional reaction, for which there is a statistical association with legal abortion, such that there is a less than five percent probability that the statistical association is due to sampling error” that can be found anywhere in the nearly forty years of published literature covered by the Act. The literature covered by the Act also includes studies conducted in countries where abortion may be legal, but not practiced as safely as in the United States. And nothing in the text of the statute permits physicians to use their medical judgment to avoid disclosing information that is untrue, misleading, or irrelevant.

[...]

Defendants argue that the physician is free to explain to the patient that this type of forced disclosure is untruthful or misleading. The court rejects this argument because even if the physician is allowed to tell the patient that the previously disclosed information is untruthful or misleading, then that information is irrelevant to the patient. And a physician cannot be forced to disclose information that is “untruthful, misleading or not relevant to the patient’s decision to have an abortion.” See Rounds, 530 F.3d at 735.

[...]

The second issue is whether the Risk Factors Requirement constitutes a substantial obstacle. The Risk Factors Requirement departs from standard medical practice by mandating that physicians identify, retrieve, and review every article published in English, after 1972, in every peer-reviewed journal indexed by PubMed or MEDLINE or PsycINFO that could trigger an assessment or disclosure obligation because it could include a “risk factor” or “complication” as defined in the Act. After this undertaking, physicians are required to assess every patient for the resulting list of “risk factors,” discuss the assessment, and disclose the associated “complications,” as well as “the rate at which those complications occur both in the general population and in the populations of persons with the risk factor.” See Section 3(6) of the Act.

[...]

Even if a physician could formulate a search and retrieve all of the required materials, the volume of articles the physician would have to review and analyze would be prohibitive. For example, a search for the term “abortion,” restricted to journals published in English between January 1973 and July 2010 yields more than 45,000 results in PubMed and more than 2,000 results in PsycInfo. Docket 10-12 at ¶ 24. Even ignoring the fact that some responsive articles will be missed in the above search, no physician could review the thousands of articles yielded by searching the two databases.

[...]

The barrier imposed by the Risk Factors Requirement is compounded by the Act’s provisions imposing civil liability on physicians who perform abortions. The Act creates a new civil action by the woman or her survivors against both the physician and the facility where the abortion was performed if the physician fails to comply with any of the Act’s requirements, including the Risk Factors Requirement. Future plaintiffs may receive a wide range of damages and attorneys’ fees.18 Moreover, the Act creates a presumption that a woman would not have had the abortion if the physician had complied with the Act’s requirements.

This presumption is a rebuttable presumption. But the Act provides that if a physician presents evidence rebutting the presumption, the “finder of fact” must determine whether the woman would have consented to the abortion “if she had been given . . . all information required by this Act to be disclosed[.]” See Section 9(3) of the Act. And as explained above, this includes information that is presented in an article as being true but is actually untrue and therefore misleading or irrelevant. Understandably, physicians will be unwilling to perform abortions when faced with likely litigation that will include this type of situation.

[...]

The third issue in the undue burden analysis is whether the Risk Factors Requirement is a substantial obstacle in a large fraction of the relevant cases. Every woman who chooses to undergo an abortion will be unable to obtain one because the Risk Factors Requirement applies to every woman who seeks an abortion in South Dakota and no physician will be able, or willing, to perform an abortion without violating these requirements. The Risk Factors Requirement is therefore a substantial obstacle in a large fraction of the relevant cases. Thus, plaintiffs are likely to demonstrate that the Risk Factors Requirement constitutes an undue burden on a woman’s constitutional right to a pre-viability abortion.

Governor Daugaard said he wasn't surprised by the ruling and thinks it is merely a "setback". He is particularly fond of that 72 hour period which he called in a written statement regarding the ruling "time to reflect and let women make good choices". (Ahem, fuck you.)

Leslee Unruh, who is a founder of one of the "crisis pregnancy centers" registered to provide "counseling" to women under the new law, is promising to file a motion to intervene in the lawsuit on the state's behalf:

Unruh said the Alpha Center plans to introduce evidence from the women who told South Dakota legislators that they'd been coerced into having abortions and that Planned Parenthood failed to learn that before going ahead with the procedure.

"I don't want those women to feel discouraged tonight," Unruh said Thursday. "I do feel very strongly that this law will ultimately be upheld."

Planned Parenthood is going to fight everything about that move. As for South Dakota itself:

Attorney General Marty Jackley said his staff intends to take time to fully digest the ruling before making its next move.

"At this point, I need to fully review the decision and discuss it with the attorneys involved in the case, the governor and legislative leadership," Jackley said.

And so they regroup to plan the next method of denying women access to health care.

Kansas Update

This post is now updated

This post has been updated again, 7/01

So back on Monday I posted about Kansas's backdoor method of denying women access to health care.

There are now no abortion providers in the state:

TOPEKA, Kan. (AP) - A Planned Parenthood clinic in Kansas has been denied a state license to allow it to continue performing abortions as of Friday. That means Kansas will become the only state without a clinic or doctor's office performing abortions, at least temporarily.

Aid for Women was denied outright without inspection when the center said they would need to renovate. The Center for Women's Health (who also would have needed renovation) canceled its inspection and filed a federal lawsuit. All were in the Kansas City area and, according to this article, the next nearest clinic is in Columbia, Missouri. According to Google Maps, Columbia is--at best, depending on route and coming only from Kansas City (KS)--130 miles away.

[UPDATE] Planned Parenthood Kansas & Mid-Misouri just announced that they received a license to continue operations. So, there is just one clinic in the state of Kansas. Also, a hearing is scheduled for Friday regarding the lawsuit filed by the doctors who run The Center for Women's Health.

[UPDATE II, 07/01] Federal Judge Carlos Murguia has granted the request from Aid for Women and the Center For Women's Health for a preliminary injunction. So, for now, the law is blocked and unenforceable.


[H/T to Steph Harold, @IAmDrTiller]