News Law and Policy

Federal Appeals Court Rules Indiana Can’t Eliminate Funding for Planned Parenthood

Jessica Mason Pieklo

With two federal appellate courts split on the issue of indirect funding bans, will the Roberts Court be the final word?

The Seventh Circuit Court of Appeals upheld the core portion of a preliminary injunction and ruled that Indiana cannot cut off funding for Planned Parenthood or any qualified health care provider because the organization provides abortions.

The law, HEA 120 bars abortion providers from receiving Medicaid funds for any medical services. and was the first in a series of state attempts to de-fund Planned Parenthood. “This law was an attempt by politicians to punish organizations that are providing legal services,” said Talcott Camp, deputy director of the ACLU Reproductive Freedom Project in a statement. “Elected officials should not place politics above women’s health.”

It’s the second victory for women in less than a week. On Friday a federal judge granted a preliminary injunction blocking similar attempts by Arizona to de-fund Planned Parenthood. In August the Fifth Circuit Court of Appeals upheld Texas’ funding ban. With the Seventh Circuit and the Fifth Circuit split on the constitutionality of these “indirect funding” bans, the Supreme Court could be asked to settle the matter.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Analysis Law and Policy

Indiana Court of Appeals Tosses Patel Feticide Conviction, Still Defers to Junk Science

Jessica Mason Pieklo

The Indiana Court of Appeals ruled patients cannot be prosecuted for self-inducing an abortion under the feticide statute, but left open the possibility other criminal charges could apply.

The Indiana Court of Appeals on Friday vacated the feticide conviction of Purvi Patel, an Indiana woman who faced 20 years in prison for what state attorneys argued was a self-induced abortion. The good news is the court decided Patel and others in the state could not be charged and convicted for feticide after experiencing failed pregnancies. The bad news is that the court still deferred to junk science at trial that claimed Patel’s fetus was on the cusp of viability and had taken a breath outside the womb, and largely upheld Patel’s conviction of felony neglect of a dependent. This leaves the door open for similar prosecutions in the state in the future.

As Rewire previously reported, “In July 2013 … Purvi Patel sought treatment at a hospital emergency room for heavy vaginal bleeding, telling doctors she’d had a miscarriage. That set off a chain of events, which eventually led to a jury convicting Patel of one count of feticide and one count of felony neglect of a dependent in February 2015.”

To charge Patel with feticide under Indiana’s law, the state at trial was required to prove she “knowingly or intentionally” terminated her pregnancy “with an intention other than to produce a live birth or to remove a dead fetus.”

According to the Indiana Court of Appeals, attorneys for the State of Indiana failed to show the legislature had originally passed the feticide statute with the intention of criminally charging patients like Patel for terminating their own pregnancies. Patel’s case, the court said, marked an “abrupt departure” from the normal course of prosecutions under the statute.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

“This is the first case that we are aware of in which the State has used the feticide statute to prosecute a pregnant woman (or anyone else) for performing an illegal abortion, as that term is commonly understood,” the decision reads. “[T]he wording of the statute as a whole indicate[s] that the legislature intended for any criminal liability to be imposed on medical personnel, not on women who perform their own abortions,” the court continued.

“[W]e conclude that the legislature never intended the feticide statute to apply to pregnant women in the first place,” it said.

This is an important holding, because Patel was not actually the first woman Indiana prosecutors tried to jail for a failed pregnancy outcome. In 2011, state prosecutors brought an attempted feticide charge against Bei Bei Shuai, a pregnant Chinese woman suffering from depression who tried to commit suicide. She survived, but the fetus did not.

Shuai was held in prison for a year until a plea agreement was reached in her case.

The Indiana Court of Appeals did not throw out Patel’s conviction entirely, though. Instead, it vacated Patel’s second charge of Class A felony conviction of neglect of a dependent, ruling Patel should have been charged and convicted of a lower Class D felony. The court remanded the case back to the trial court with instructions to enter judgment against Patel for conviction of a Class D felony neglect of a dependent, and to re-sentence Patel accordingly to that drop in classification.

A Class D felony conviction in Indiana carries with it a sentence of six months to three years.

To support Patel’s second charge of felony neglect at trial, prosecutors needed to show that Patel took abortifacients; that she delivered a viable fetus; that said viable fetus was, in fact, born alive; and that Patel abandoned the fetus. According to the Indiana Court of Appeals, the state got close, but not all the way, to meeting this burden.

According to the Indiana Court of Appeals, the state had presented enough evidence to establish “that the baby took at least one breath and that its heart was beating after delivery and continued to beat until all of its blood had drained out of its body.”

Therefore, the Court of Appeals concluded, it was reasonable for the jury to infer that Patel knowingly neglected the fetus after delivery by failing to provide medical care after its birth. The remaining question, according to the court, was what degree of a felony Patel should have been charged with and convicted of.

That is where the State of Indiana fell short on its neglect of a dependent conviction, the court said. Attorneys had failed to sufficiently show that any medical care Patel could have provided would have resulted in the fetus surviving after birth. Without that evidence, the Indiana Court of Appeals concluded, state attorneys could not support a Class A conviction. The evidence they presented, though, could support a Class D felony conviction, the court said.

In other words, the Indiana Court of Appeals told prosecutors in the state, make sure your medical experts offer more specific testimony next time you bring a charge like the one at issue in Patel’s case.

The decision is a mixed win for reproductive rights and justice advocates. The ruling from the court that the feticide statute cannot be used to prosecute patients for terminating their own pregnancy is an important victory, especially in a state that has sought not just to curb access to abortion, but to eradicate family planning and reproductive health services almost entirely. Friday’s decision made it clear to prosecutors that they cannot rely on the state’s feticide statute to punish patients who turn to desperate measures to end their pregnancies. This is a critical pushback against the full-scale erosion of reproductive rights and autonomy in the state.

But the fact remains that at both trial and appeal, the court and jury largely accepted the conclusions of the state’s medical experts that Patel delivered a live baby that, at least for a moment, was capable of survival outside the womb. And that is troubling. The state’s experts offered these conclusions, despite existing contradictions on key points of evidence such as the gestational age of the fetus—and thus if it was viable—and whether or not the fetus displayed evidence of life when it was born.

Patel’s attorneys tried, unsuccessfully, to rebut those conclusions. For example, the state’s medical expert used the “lung float test,” also known as the hydrostatic test, to conclude Patel’s fetus had taken a breath outside the womb. The test, developed in the 17th century, posits that if a fetus’ lungs are removed and placed in a container of liquid and the lungs float, it means the fetus drew at least one breath of air before dying. If the lungs sink, the theory holds, the fetus did not take a breath.

Not surprisingly, medical forensics has advanced since the 17th century, and medical researchers widely question the hydrostatic test’s reliability. Yet this is the only medical evidence the state presented of live birth.

Ultimately, the fact that the jury decided to accept the conclusions of the state’s experts over Patel’s is itself not shocking. Weighing the evidence and coming to a conclusion of guilt or innocence based on that evidence is what juries do. But it does suggest that when women of color are dragged before a court for a failed pregnancy, they will rarely, if ever, get the benefit of the doubt.

The jurors could have just as easily believed the evidence put forward by Patel’s attorneys that gestational age, and thus viability, was in doubt, but they didn’t. The jurors could have just as easily concluded the state’s medical testimony that the fetus took “at least one breath” was not sufficient to support convicting Patel of a felony and sending her to prison for 20 years. But they didn’t.

Why was the State of Indiana so intent on criminally prosecuting Patel, despite the many glaring weaknesses in the case against her? Why were the jurors so willing to take the State of Indiana’s word over Patel’s when presented with those weaknesses? And why did it take them less than five hours to convict her?

Patel was ordered in March to serve 20 years in prison for her conviction. Friday’s decision upends that; Patel now faces a sentence of six months to three years. She’s been in jail serving her 20 year sentence since February 2015 while her appeal moved forward. If there’s real justice in this case, Patel will be released immediately.

News Family Planning

Lawsuit Challenges Arizona’s Attempt to Defund Planned Parenthood

Nicole Knight Shine

The Republican-backed law specifically targets abortion providers, excluding any facility from Medicaid that fails "to segregate taxpayer dollars from abortions, including the use of taxpayer dollars for any overhead expenses attributable to abortions.”

Planned Parenthood and the American Civil Liberties Union (ACLU) asked a federal court to block an Arizona law defunding Planned Parenthood, arguing in a legal challenge filed Thursday that the Arizona measure is “illegal.”

The GOP-backed law, signed by Republican Gov. Doug Ducey in May, specifically targets abortion providers, excluding any facility from Medicaid that fails “to segregate taxpayer dollars from abortions, including the use of taxpayer dollars for any overhead expenses attributable to abortions.”

Federal law already bars health-care providers from using Medicaid dollars for abortion care, except in cases of rape, incest, or life endangerment.

In an 18-page complaint, the plaintiffs argue that the restriction is impermissible under Medicaid statutes, and they ask for an injunction on the law, which goes into effect August 6. Planned Parenthood said in an emailed statement that the law could slash funding for birth control, cancer screenings, and preventive care, affecting more than 2,500 Medicaid patients in the state.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

The Arizona Health Care Cost Containment System, the state Medicaid agency, did not respond to a request for comment.

Jennifer Lee, staff attorney at the ACLU, called the Arizona law “another attempt to intimidate doctors who provide abortion and to punish low-income women in particular,” in a statement announcing the lawsuit. Planned Parenthood operates 11 medical centers in the state, including three in underserved and impoverished communities with high rates of infant mortality, according to the court filing.

At least ten states, including Arizona, have attempted to strip Planned Parenthood of funding—the fallout from a string of deceptive smear videos masterminded by David Daleiden, the head of the anti-choice front group the Center for Medical Progress, who now faces a felony record-tampering charge.

“This case is about the people who rely on us for basic care every day,” said Cecile Richards, president of Planned Parenthood Federation of America, in an announcement of the Arizona suit. “We’ll continue fighting in Arizona, and anywhere else there are efforts to block our patients from the care they need.”

The Arizona law represents the state’s second attempt to defund Planned Parenthood. In 2014, the Ninth Circuit Court of Appeals affirmed a lower court decision finding a similar defunding measure, HB 2800, violated federal Medicaid law.

In April, the federal Centers for Medicare & Medicaid Services sent a letter to all 50 states saying that cutting funding to qualified providers solely because they provide abortion care violates federal law.

Independent analysis suggests gutting Planned Parenthood funding exacts a toll on health care.

2015 report from the Congressional Budget Office indicated that health-care access would suffer under Planned Parenthood funding cuts, with the potential for $650 million in additional Medicaid spending over a decade and thousands of more births.

In Texas, births surged 27 percent among low-income women who were using injectable birth control but lost access to the service when the state cut Medicaid funding to Planned Parenthood, according to a study published in the New England Journal of Medicine.