Doctors’ Reactions to the Federal Abortion Ban

Dr. Paula Hillard

Physicians are full of questions about how the Supreme Court's ruling will affect them and their patients. This decision endangers women's health and makes it harder for physicians to provide the best possible care to women.

Editor’s Note, July 8th, 2008: In response to the recent flurry of news coverage concerning Barack Obama’s statements on late term abortion, the federal abortion ban, and health exceptions for pregnant women, Rewire is republishing relevant articles that we hope
will focus the debate and add the crucial voices of those who are directly affected by these laws – women and physicians.  

The Supreme Court dealt a stunning blow to doctors last Wednesday, when they upheld a federal law banning a particular abortion method. As a board member of Physicians for Reproductive Choice and Health (PRCH), I’ve spoken with many abortion providers in the days since the ruling. They are full of questions, concerned about their patients and confused about the language of the ruling. Most of all, the physicians I’ve spoken with are asking how this ruling affects the way they practice medicine and the safety of the treatments their patients receive.

As physicians, we have a responsibility to act in our patients’ best interests—but the Supreme Court has just allowed Congress to override doctors’ expert opinions and ban a specific abortion method. This decision endangers women’s health and makes it harder for physicians to provide the best possible care to women. The doctors I’ve spoken to are angry and upset that they can no longer use a method they consider safest and best for many patients.

Dr. Christopher Estes shared a story with PRCH about a patient he treated last year. In an op-ed he wrote for The Daily News, Dr. Estes recalls treating a woman he calls Lisa. She was pregnant with her third child, and suffering from a heart condition that developed during her last delivery.

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"Her condition had worsened substantially within the last week, and we were not sure how much longer her heart could withstand the strain of her pregnancy," he says. Dr. Estes believed the safest treatment for Lisa was an abortion using the method Congress has banned. "I will have to think long and hard about what I will do the next time I take care of a patient like Lisa. What am I supposed to say to her? ‘I’m sorry, but you’re part of the small fraction of women our laws ignore?’"

It is absurd to think that politicians know more about medicine than the physicians who care for women every day, yet that is just what this decision says. Even as Justice Kennedy acknowledged that some of Congress’ findings were "factually incorrect," his opinion upheld the law as written.[img_assist|nid=3187|title=undefined|desc=|link=none|align=right|width=150|height=190]

The Supreme Court’s decision asserts many things that are simply not true. For instance, the ruling contends that because some women might regret having an abortion if they knew what was involved, the state should anticipate that and protect them. Essentially, this ruling says that untrained politicians can make medical decisions for all of America—even when doctors vehemently disagree with Congress’ supposed findings.

The language used in both the law and the Court’s decision troubles physicians. PRCH member Dr. Amy Autry notes that so-called "partial birth abortion" isn’t even a medical term: "That’s just a lay term," she says. "What they describe could be actually almost any abortion procedure."

Though Kennedy’s opinion refers to the procedure as intact dilation and evacuation, many physicians I’ve spoken to still aren’t clear about which abortion methods they can legally use. Dr. Deborah Oyer, another PRCH member, spoke to National Public Radio about the ban. "How to define exactly where the line is between legal and illegal in the procedures we do isn’t clear to me," she notes. "If I interpret it as drawn in one place and the courts interpret it somewhere else, I may have crossed the line."

Doctors are rightfully concerned about crossing that legal line. According to the act, we face up to two years in jail and hefty fines if convicted of violating the law.

We’ve heard from legal experts that the ban will go into effect 25 days after the Supreme Court decision, which gives doctors a tiny window to puzzle through the legalese and make plans to continue providing quality care to women. In the meantime, physicians are consulting with their lawyers—and with other colleagues and professional organizations—to make sense of the ruling.

Ultimately, this decision won’t change the need for abortion in America, or the desire of pro-choice physicians to care for our patients based on the best medical evidence. What we must do now is speak up about the dangerous effects this decision could have: fewer options for patient care, no legal protections for women’s health, and a wide-open door for further restrictions on abortion and other medical procedures. What’s next? Will Congress ban every medical procedure they personally oppose?

I have no doubt that the Supreme Court’s ruling on the federal abortion ban will have repercussions for years to come. As doctors, we are angry and outraged at this intrusion into women’s personal healthcare decisions. But we are also getting organized to fight back against the next wave of incursions on reproductive health. The Supreme Court may not think women’s health is paramount, but we do and we’re not backing down.

News Politics

Clinton Campaign Announces Tim Kaine as Pick for Vice President

Ally Boguhn

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

The Clinton campaign announced Friday that Sen. Tim Kaine (R-VA) has been selected to join Hillary Clinton’s ticket as her vice presidential candidate.

“I’m thrilled to announce my running mate, @TimKaine, a man who’s devoted his life to fighting for others,” said Clinton in a tweet.

“.@TimKaine is a relentless optimist who believes no problem is unsolvable if you put in the work to solve it,” she added.

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

Kaine signed two letters this week calling for the regulations on banks to be eased, according to a Wednesday report published by the Huffington Post, thereby ”setting himself up as a figure willing to do battle with the progressive wing of the party.”

Charles Chamberlain, executive director of the progressive political action committee Democracy for America, told the New York Times that Kaine’s selection “could be disastrous for our efforts to defeat Donald Trump in the fall” given the senator’s apparent support of the Trans-Pacific Partnership (TPP). Just before Clinton’s campaign made the official announcement that Kaine had been selected, the senator praised the TPP during an interview with the Intercept, though he signaled he had ultimately not decided how he would vote on the matter.

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Kaine’s record on reproductive rights has also generated controversy as news began to circulate that he was being considered to join Clinton’s ticket. Though Kaine recently argued in favor of providing Planned Parenthood with access to funding to fight the Zika virus and signed on as a co-sponsor of the Women’s Health Protection Act—which would prohibit states and the federal government from enacting restrictions on abortion that aren’t applied to comparable medical services—he has also been vocal about his personal opposition to abortion.

In a June interview on NBC’s Meet the Press, Kaine told host Chuck Todd he was “personally” opposed to abortion. He went on, however, to affirm that he still believed “not just as a matter of politics, but even as a matter of morality, that matters about reproduction and intimacy and relationships and contraception are in the personal realm. They’re moral decisions for individuals to make for themselves. And the last thing we need is government intruding into those personal decisions.”

As Rewire has previously reported, though Kaine may have a 100 percent rating for his time in the Senate from Planned Parenthood Action Fund, the campaign website for his 2005 run for governor of Virginia promised he would “work in good faith to reduce abortions” by enforcing Virginia’s “restrictions on abortion and passing an enforceable ban on partial birth abortion that protects the life and health of the mother.”

As governor, Kaine did support some existing restrictions on abortion, including Virginia’s parental consent law and a so-called informed consent law. He also signed a 2009 measure that created “Choose Life” license plates in the state, and gave a percentage of the proceeds to a crisis pregnancy network.

Regardless of Clinton’s vice president pick, the “center of gravity in the Democratic Party has shifted in a bold, populist, progressive direction,” said Stephanie Taylor, co-founder of the Progressive Change Campaign Committee, in an emailed statement. “It’s now more important than ever that Hillary Clinton run an aggressive campaign on core economic ideas like expanding Social Security, debt-free college, Wall Street reform, and yes, stopping the TPP. It’s the best way to unite the Democratic Party, and stop Republicans from winning over swing voters on bread-and-butter issues.”

News Abortion

Parental Notification Law Struck Down in Alaska

Michelle D. Anderson

"The reality is that some young women face desperate circumstances and potentially violent consequences if they are forced to bring their parents into their reproductive health decisions," said Janet Crepps, senior counsel at the Center for Reproductive Rights. "This law would have deprived these vulnerable women of their constitutional rights and put them at risk of serious harm."

The Alaska Supreme Court has struck down a state law requiring physicians to give the parents, guardians, or custodians of teenage minors a two-day notice before performing an abortion.

The court ruled that the parental notification law, which applies to teenagers younger than 18, violated the Alaska Constitution’s equal protection guarantee and could not be enforced.

The ruling stems from an Anchorage Superior Court decision that involved the case of Planned Parenthood of the Great Northwest and the Hawaiian Islands and physicians Dr. Jan Whitefield and Dr. Susan Lemagie against the State of Alaska and the notification law’s sponsors.

In the lower court ruling, a judge denied Planned Parenthood’s requested preliminary injunction against the law as a whole and went on to uphold the majority of the notification law.

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Planned Parenthood and the physicians had appealed that superior court ruling and asked for a reversal on both equal protection and privacy grounds.

Meanwhile, the State of Alaska and the notification law’s sponsors appealed the court’s decision to strike some of its provisions and the court’s ruling.

The notification law came about after an initiative approved by voters in August 2010. The law applied to “unemancipated, unmarried minors” younger than 18 seeking to terminate a pregnancy and only makes exceptions in documented cases of abuse and medical emergencies, such as one in which the pregnant person’s life is in danger.

Justice Daniel E. Winfree wrote in the majority opinion that the anti-choice law created “considerable tension between a minor’s fundamental privacy right to reproductive choice and how the State may advance its compelling interests.”

He said the law was discriminatory and that it could unjustifiably burden “the fundamental privacy rights only of minors seeking pregnancy termination, rather than [equally] to all pregnant minors.”

Chief Justice Craig Stowers dissented, arguing that the majority’s opinion “unjustifiably” departed from the Alaska Supreme Court’s prior approval of parental notification.

Stowers said the opinion “misapplies our equal protection case law by comparing two groups that are not similarly situated, and fails to consider how other states have handled similar questions related to parental notification laws.”

Center for Reproductive Rights (CRR) officials praised the court’s ruling, saying that Alaska’s vulnerable teenagers will now be relieved of additional burdensome hurdles in accessing abortion care. Attorneys from the American Civil Liberties Union, CRR, and Planned Parenthood represented plaintiffs in the case.

Janet Crepps, senior counsel at CRR, said in a statement that the “decision provides important protection to the safety and well-being of young women who need to end a pregnancy.”

“The reality is that some young women face desperate circumstances and potentially violent consequences if they are forced to bring their parents into their reproductive health decisions. This law would have deprived these vulnerable women of their constitutional rights and put them at risk of serious harm,” Crepps said.

CRR officials also noted that most young women seeking abortion care involve a parent, but some do not because they live an abusive or unsafe home.

The American Medical Association, the American College of Obstetricians and Gynecologists, and the Society for Adolescent Medicine have said minors’ access to confidential reproductive health services should be protected, according to CRR.