News Maternity and Birthing

“Pro-life” Nebraska Governor to Veto Legislation Guaranteeing Prenatal Care to Immigrant Women

Kari Ann Rinker

The same Governor who signed the “fetal pain” bill will be using the same pen to veto the legislation reversing the policy whose effects will hurt wanted, pain capable infants.  The mothers of these wanted infants will experience their baby’s deaths prior to their first birthdays, as American infants residing on American soil.

Prenatal care… this should be one area where both sides of the abortion debate can come together, hold hands singing Kumbayah and work toward ensuring access for all women, regardless of their creed, politics, race or any other identifying factor.  I mean, the anti-choice side being willing to grant full “personhood” rights to fertilized eggs surely guarantees that medical care should be granted to these “persons” to insure healthy birth outcomes, right? Early and adequate prenatal care is key to healthy births.  Making sure policies are in place to insure wanted babies are able to be born and thrive in their first year of life just kinda screams “pro-life,” right?

Well, it seems that the Nebraska GOP is finding this concept problematic.  As a matter of fact, the Nebraska legislature is in the midst of a pretty heated exchange over prenatal care and the problem boils down to skin color, specifically the immigration status of the “pre-born” baby mamas.

The Associated Press reports:

Nebraska Gov. Dave Heineman promised Wednesday to veto a bill that would restore taxpayer-funded prenatal care coverage for illegal immigrants and singled out a fellow Republican leader who backed the measure.

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The governor told reporters he was “extraordinarily disappointed” in the Legislature’s first-round vote to advance the measure in the waning days of this year’s session.

Heineman aimed his criticism at Speaker of the Legislature Mike Flood, a Republican who supported the bill.

“Taxpayer funds should not be used for illegal individuals,” Heineman said, reading from a letter his office hand-delivered to the speaker’s office. “If this bill becomes law, Nebraska will become a magnet for illegal aliens. Nebraska will become the only state in the Midwest providing taxpayer-funded benefits to illegals. None of our neighboring states, Iowa, Missouri, Kansas, Colorado, Wyoming and South Dakota, provide taxpayer-funded benefits to illegals.”

This has been an ongoing battle for the Nebraska legislature.  It is also important to point out that this disagreement is ripe with conflicts for the GOP, both morally and fiscally.  The National Conference of State Legislatures calls it a “challenge” for states.  The NCSL also states the following:

Early and continuous prenatal care provides women with opportunities for ongoing assessment for one of the most significant complications of pregnancy — low birth weight. Low birth weight and very low birth weight which result from a failure of the fetus to fully develop (intrauterine growth retardation), the infant being born too soon (pre-term) or a combination of both, contribute substantially to infant mortality and childhood disabilities. Studies estimate that every dollar spent on prenatal care yields between $1.70 and $3.38 in savings by reducing neonatal complications. The savings increase dramatically when the long-term costs of caring for newborns with physical and developmental disabilities are considered, and are even greater when unforeseen maternal complications are avoided.

In addition to the cost savings associated with prenatal care, such care offers many undocumented women their first exposure to the United States health care system as well as their first opportunity since entering the United States to be screened and treated for communicable diseases. Perinatal identification and effective treatment of communicable diseases, such as TB, chlamydia (a sexually transmitted disease or STD) and HIV, can be lifesaving for both the mother and infant, protect communities from epidemics and save hundreds of thousands of dollars in remedial care. Epidemiologists have found that every dollar spent on prevention care for undocumented women, including prenatal care with screening for STD’s, saves over $13; and each prevented case of fetal HIV saves an estimated $400.

The NCSL broke down the fiscal implications, and there are also some obvious moral implications inherent in the GOP anti-choice push within state legislatures to grant personhood to fertilized eggs and fetuses, and Nebraska stands as a leader in the fetal rights obsession.  As Robin Marty pointed out in her previous reporting here at Rewire, Nebraska was the first state of pass the “fetal pain law,”… the law that is more aptly described as a pre-viability abortion ban within the state.  Supporters of the law often use the language “pain-capable human beings” when referring to post 20-week fetuses, even though medical and scientific evidence shows they are not pain-capable.

Yet these “pain-capable 20-week human beings” are among those currently being denied prenatal care in the state of Nebraska.  The Governor who signed the “fetal pain” bill will be using the same pen to veto the legislation reversing the policy whose effects will hurt actual, wanted, pain-capable infants, the same infants who are significantly more likely to become a part of Nebraska’s infant mortality statistic due to lack of prenatal care. The mothers of these wanted infants will be far more likely to experience their baby’s deaths prior to their first birthdays, as American infants residing on American soil.

The conflict highlights the fact that health care just shouldn’t be politicized.  Whether it is the right of women to obtain abortions from their physicians or the rights of women to obtain pre-natal care on US soil, regardless of immigration status.  The pro-choice movement is consistent in supporting a woman’s choice to access the health care that she needs….period and anti-choice politicians find themselves in the business of making continuous exceptions for their ever twisting, turning and contradictory policy pursuits.

News Human Rights

Lawsuit: Religious Groups Are Denying Abortion Care to Teen Refugees

Nicole Knight

The suit accuses the federal government of paying millions to religious grantees that refuse to provide unaccompanied minors with legally required reproductive health services.

Two years ago, 17-year-old Rosa was raped as she fled north from her home country in Central America to the United States. Placed in a Catholic shelter in Florida, the teen learned she was pregnant, and told shelter officials that if she couldn’t end the pregnancy, she’d kill herself. She was hospitalized for suicidal thoughts. Upon her release, the facility in which she’d been originally placed rejected her because of her desire for an abortion, according to a federal lawsuit filed Friday. So did another. Both, reads the lawsuit, were federal contractors paid to care for unaccompanied minors like Rosa.

Rosa’s story is one in a series sketched out in a 16-page complaint brought by the American Civil Liberties Union (ACLU) against the U.S. Department of Health and Human Services (HHS). The suit accuses the federal government of paying millions to religious grantees—including nearly $20 million over two years to the U.S. Conference of Catholic Bishops (USCCB)—that refuse to provide unaccompanied minors with legally required reproductive health services, including contraception and abortion. The grantees are paid by the federal Office of Refugee Resettlement (ORR) to house and care for young refugees.

The lawsuit, brought in U.S. District Court in San Francisco, amounts to a fresh test of the degree to which Catholic organizations and other faith-based groups can claim exemptions from federal laws and regulations on religious grounds.

“Religious liberties do not include the ability to impose your beliefs on a vulnerable population and deny them legal health care,” said Jennifer Chou, attorney with the ACLU of Northern California, in a phone interview with Rewire. “The government is delegating responsibility … to these religiously affiliated organizations who are then not acting in the best interest of these young people.”

Mark Weber, a spokesperson for the HHS, which includes the ORR, told Rewire via email that the agency cannot comment on pending litigation.

Escaping turmoil and abuse in their home countries, young refugees—predominantly from Central America—are fleeing to the United States, with 33,726 arriving in 2015, down from 57,496 the year before. About one-third are girls. As many as eight in ten girls and women who cross the border are sexually assaulted; it is unknown how many arrive in need of abortion care.

The federal ORR places unaccompanied minors with organizations that are paid to offer temporary shelter and a range of services, including reproductive health care, while the youths’ applications for asylum are pending. But documents the ACLU obtained indicate that some groups are withholding that health care on religious grounds and rejecting youths who request abortion care.

The 1997 “Flores agreement” and ORR’s contracts with grantees, which the ACLU cites in its lawsuit, require referrals to “medical care providers who offer pregnant [unaccompanied immigrant minors] the opportunity to be provided information and counseling regarding prenatal care and delivery; infant care, foster care, or adoption; and pregnancy termination.”

In 2016, the federal government awarded 56 grants to 30 organizations to provide care to unaccompanied minors, including 11 that the ACLU claims impose religious restrictions on reproductive health care.

In one case, ORR officials struggled to find accommodations for 14-year-old Maria, who wanted to end her pregnancy, according to the complaint. An ORR official wrote, according to a document the ACLU obtained, that the agency would have liked to transfer Maria to Florida to be near family, but “both of the shelters in Florida are faith-based and will not take the child to have this procedure,” meaning an abortion.

In another, the complaint reads, 16-year-old Zoe was placed with Youth for Tomorrow, a faith-based shelter in Virginia, where she learned she was pregnant. She asked for abortion counseling, which was delayed nearly two weeks, the complaint says. Learning of her decision to end the pregnancy, Youth for Tomorrow asked to transfer Zoe elsewhere because of its abortion prohibition, even though Zoe said she was happy at the shelter.

For vulnerable youths, such transfers represent a form of “secondary trauma,” according to the ACLU’s Chou.

“These women have already endured so much,” she told Rewire. “The process of transferring these youths from shelter to shelter tears them away from their only existing support system in the U.S.”

Federal officials, according to the complaint, were aware that the religious grantees would withhold abortion referrals. In one case, the Archdiocese of Galveston-Houston was awarded more than $8 million between 2013 and 2016, although it stated in its grant application that rape survivors wouldn’t be offered abortion care, but instead permitted to “process the trauma of the rape while also exploring the decision of whether to keep the baby or plan an adoption.”

The lawsuit also claims that a contract with the U.S. Conference of Catholic Bishops included language requiring unaccompanied minors who were pregnant to be given information and counseling about pregnancy termination, but the ORR removed that language after the USCCB complained.

The USCCB did not respond to Rewire‘s request for comment. But in a letter last year to the ORR, the USCCB and five religious groups, including some ORR grantees, wrote they could not facilitate health-care services for unaccompanied minors that run contrary to their beliefs.

The lawsuit is the second the ACLU has filed recently against the federal government over religious privileges.

Last month, the ACLU filed a Freedom of Information Act suit demanding that the federal Centers for Medicare & Medicaid Services release complaints against federally funded Catholic hospitals, where patients have reported being denied emergency medical care in violation of federal law.

In 2009, the ACLU also sued the federal government for allowing USCCB to impose religious restrictions on a taxpayer-funded reproductive health program for trafficking survivors. In 2012, a district court ruled in the ACLU’s favor, and the government appealed. The First Circuit Court of Appeal later dismissed the case as “moot” because the government did not renew USCCB’s contract.

Analysis Law and Policy

Georgia Legislators Respond to Health-Care Crisis by Funneling Money Toward Anti-Choice Facilities

Regina Willis

Rather than allocating money toward licensed centers that could provide care from trained professionals, or toward strengthening social safety nets, Georgia is poised to join a slate of 22 other states directing public funds to crisis pregnancy centers.

When Georgia resident Rebecca DeHart started experiencing the worst pain she’d ever felt, she turned to what she thought was a medical facility that could provide her care as an uninsured patient.

“I was crying, again I had not ever been in so much pain in my life. I was in tears, at the counter, I thought it was a medical facility. And I said ‘I need to see the doctor, I might have an ectopic pregnancy,'” DeHart testified during a recent Georgia House Health and Human Services Committee hearing.

“She put the [pregnancy] test kind of on a shelf above my head and she said, ‘We’ll get to your results but I want you to look at some things first.’ And she gave me a series of pamphlets …. It wasn’t until I opened a baby announcement with pictures of fetuses on the inside that I understood what was happening,” DeHart said.

DeHart had sought help at a crisis pregnancy center (CPC), one of thousands of facilities around the country whose primary goal is to dissuade patients from having an abortion.

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Georgia is facing a health-care crisis; it has one of the highest maternal mortality rates in the nation. It also ranks poorly on infant health and mortality. March of Dimes gave Georgia a “D” for preterm births in its 2015 Premature Birth Report Card, noting in an accompanying press release that “Babies who survive an early birth often face serious and lifelong health problems, including breathing problems, jaundice, vision loss, cerebral palsy and intellectual delays.” The organization also cited preterm or premature births as the leading cause of infant death.

These are symptoms of a wider problem in Georgia: an overall lack of access to facilities where patients, particularly those in rural areas, can obtain comprehensive reproductive health-care services.

Yet rather than allocating money toward licensed centers that could provide care from trained professionals, or toward strengthening social safety nets, Georgia is poised to join a slate of 22 other states directing public funds to CPCs. On Republican Gov. Nathan Deal’s desk right now is SB 308, which creates a potential $2 million grant program to fund CPCs. Deal has until May 3 to veto the legislation. If he does not, it will automatically become law.

In order to qualify to receive funding, an organization need only be a nonprofit operating for at least one year, “whose mission and practice is to provide alternatives to abortion services to medically indigent women at no cost.”

CPCs use deceptive tactics—like lying about the services they provide or implying they are a fully staffed medical clinic when they are not—to get pregnant folks in the door. Their sole goal is to keep these people from having abortions, including by providing medically inaccurate or misleading information about abortion procedures. As Georgia Life Alliance, an affiliate of the anti-choice National Right to Life organization, wrote on its blog in support of SB 308, “The open doors and compassionate support of Georgia’s pregnancy care centers are the most effective tool we have to reach the abortion-minded woman.”

Still, proponents of SB 308 have framed the grant program as a way to address pregnant Georgians’ need for care, especially when they do not choose abortion. “When our party has been a party pushing for decreased access to abortion facilities, and has so stressed the need not to have an abortion, I think we have a moral responsibility to say, ‘If you make the choice, if you choose life, and you need help, we’ll be there to help you,” said the bill’s house sponsor, Rep. Sharon Cooper (R-Marietta), during debate on the house floor last month.

The bill lists quite a few services that the grant program will fund, including pregnancy tests, sexually transmitted infection tests, and ultrasounds; nutrition education; housing, education, and employment assistance; adoption services; parenting education; baby supplies like clothing, car seats, and cribs; and information on receiving Medicaid coverage.

The bills’ opponents, however, expressed concern about the accessibility and quality of those services at CPCs.

“These CPCs, in large part, are simply not equipped to handle pregnant women’s care. Some of them provide only counseling and pregnancy testing,” said Sen. Nan Orrock (D-Atlanta) in opposition to the bill during debate on the senate floor. “Only a limited number of them provide ultrasound and sexually transmitted disease testing. And many [CPCs] have to refer out for prenatal and emergency care services.”

This was the case for Rebecca DeHart, who testified during the public committee hearing days before the bill went to the house floor. DeHart’s pregnancy test came back negative—she did not have an ectopic pregnancy—but she was still in a lot of pain.

“In the end … I had a cyst the size of an orange that burst on my ovary,” DeHart said she learned after going to a health clinic in her hometown, as the CPC was unable to diagnose or treat her medical condition.

DeHart, who is now the executive director of the Democratic Party of Georgia, said she was ultimately able to have a healthy pregnancy when she was ready, but the burst cyst did result in damage to one of her ovaries. “I am very happy that did not prohibit me, even though my ovary is damaged, from being able to have children later,” she said.

“A lot of these crisis pregnancy centers don’t have medical staff on board, and if they do, they are nurse practitioners, or maybe just sonographer technicians that might or might not have the ability to diagnose actual issues with high-risk pregnancies,” said Molly “MK” Anderson, public policy associate and lobbyist at the Feminist Women’s Health Center (FWHC), in an interview with Rewire. FWHC is a key opponent of the bill, with Anderson leading its lobbying and advocacy work.

Despite concerns about the quality and competency of care CPCs can provide, pregnant Georgians with few options may continue turning to them for services, a prospect that is only made more probable by this grant program.

The Georgia Obstetrical and Gynecological Society predicted that by 2020, 75 percent of Primary Care Service Areas (PCSA) outside Atlanta, “will lack sufficient obstetric services.” PCSAs are geographic regions based on Medicare patient travel to their primary care providers; Georgia has 159 counties, but 82 PCSAs outside Atlanta.

It was also hard to miss the talk at the capitol—from both Republicans and Democrats—about Georgia’s rural hospital closures. This growing problem, coupled with an existing lack of OB-GYNs, means pregnant Georgians find themselves with few options to receive care before, during, and after a pregnancy.

According to the Georgia Maternal and Infant Health Research Group (membership login required), “24 percent of all pregnant women in Georgia now drive more than 45 minutes to access their obstetric provider. These women are 1.5 times more likely to deliver preterm than women who drive less than 15 minutes.”

This lack of access also impacts the ability of pregnant Georgians to manage conditions—such as diabetes, high blood pressure, or anemia—that can become exacerbated by pregnancy, as well as to receive critical care during a high-risk pregnancy.

There are also disturbing racial disparities in access, or lack thereof, and maternal deaths. Throughout the country, Black women are approximately four times as likely to die from pregnancy complications as white women; however, this is not necessarily tied to a greater risk of an underlying complication.

“[I]n a national study of five medical conditions that are common causes of maternal death and injury… black women did not have a significantly higher prevalence than white women of any of these conditions. However, the black women in the study were two to three times more likely to die than the white women who had the same complication,” a 2011 report from the Association of Reproductive Health Professionals stated.

Democrats in both chambers asked why money was being allocated for the CPC grant program, but not for Medicaid expansion, which could potentially be a boon for both rural hospitals and Georgians who are or may become pregnant. For that matter, even as proponents of the bill articulated a need for pregnant people to receive support services, legislation to reduce access to government safety nets gained traction in both chambers: Rep. Cooper, the house sponsor of SB 308, was also the house sponsor of a bill to reduce the maximum time a person can receive cash assistance from the Temporary Assistance for Needy Families (TANF) program.

“And when we are considering bills like SB 389 to cut TANF benefits and make it harder on families with children, I think you can see the hypocrisy in passing SB 308. And additionally when we refuse to expand Medicaid to hundreds of thousands of Georgians, yet we want to give money for what is being seen as health-care services, I think you can see the hypocrisy in that as well,” said Rep. Dar’shun Kendrick (D-Lithonia) in opposition to the bill during debate on the house floor.

Both sides agree on at least one thing: SB 308 is about reducing the number of abortions. But providing grant money to CPCs to expand their reach, at a time when many Georgians struggle to access the reproductive health-care services they need, is dangerous policy. For pregnant Georgians seeking to carry a pregnancy to term, and those seeking to terminate a pregnancy, CPCs just won’t cut it.

“We are talking about facilities that offer services that are free—free pregnancy tests, free ultrasounds—and that often attracts people who are uninsured, who are in our [Medicaid] coverage gap, or don’t feel safe going to a provider,” FWHC’s Anderson said. “And these are folks who need care, need comprehensive care, need professionals who actually know what they are doing to provide care.”

“[SB 308] was under the guise of being comprehensive health care. Which I thought was a total sham,” said Oriaku Njoku, co-founder and executive director of Access Reproductive Care – Southeast (ARC-SE), referring to the extensive comments made by supporters of the bill in both chambers, in an interview with Rewire. ARC-SE was involved in the opposition to the bill at the state capitol.

“And the reason I say that is because when you are talking about comprehensive health care, to me that also includes abortion access, it also includes trans health, it also includes maternal mortality, infant mortality, like all of these things are included,” Njoku said. “And I definitely feel that this was a missed opportunity to do right by Georgians.”

This bill passed 31 to 16 in the senate along party lines, while the house saw a vote of 103 to 52, with several Republican members choosing to walk—that is, skip voting—rather than vote against their party. Gov. Deal has until May 3 to veto the bill; otherwise, SB 308 will become law.

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