News Abortion

Iowa Governor’s Office Reportedly Had Advance Notice About Telemed Abortion Challenge

Robin Marty

A lawyer in Iowa Gov. Terry Branstad's office was reportedly given advance notice that anti-choice advocates were launching a new effort to end the state's telemedicine abortion program, leading some pro-choice activists to wonder how involved the governor's office has been in the effort.

A lawyer in Iowa Gov. Terry Branstad’s office was reportedly given advance notice that anti-choice advocates were launching a new effort to end the state’s telemedicine abortion program, leading some pro-choice activists to wonder how involved the governor’s office has been in the effort.

According to documents obtained by the Des Moines Register, the governor’s legal counsel, Brenna Findley, received an email a week before Iowa Right to Life announced it would submit a petition to the medical board about ending telemed abortions in Iowa from Jenny Condon, the executive director of a local crisis pregnancy center and an outspoken telemed abortion opponent. “Attached are the signature pages of medical professionals on board with this petition,” wrote Condon in the email. “Let me know if I can do anything else. I could get more signatures but in this short of time I think these are a good start.” Copied on the email were the executive directors of Iowa Right to Life and the Iowa Catholic Conference.

Condon said that the note was a “heads up” and that although she and Findley had spoken in the past about their “concerns” about the program, Findley did not know about the petition before she received Condon’s email.

Jill June, president and CEO of Planned Parenthood of the Heartland, said she believes there is more of a connection. “The communication between the governor’s office and anti-abortion activists confirms that there has been a synchronized effort to acquire a vote outlawing Planned Parenthood’s telemedicine delivery system based entirely on politics rather than scientific fact,” June told the Register. “Even more concerning is that the governor’s office is trying to hide their involvement by passing off this ideological position as a health concern from medical professionals.”

Like This Story?

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

Donate Now

The board voted 8 to 2 on June 28 to initiate the state’s rulemaking process, a 60-day period for public comment before an actual ban can be considered—this despite concerns by some board members, as well as lawyers for the board and from the state attorney general’s office, that the board was moving too quickly. Findley, who was in attendance at that meeting, advised the board to proceed without delay.

Abortion opponents have long tried to ban the practice of telemed abortion. They claim that because patients do not need to be in the physical presence of a prescribing doctor when abortion-inducing medication is ingested, telemed abortions circumvent state guidelines.

A public hearing on the state’s telemed abortion practices is set for August 28.

News Abortion

Why You Won’t Hear About Abortion From Arizona’s Largest OB-GYN Network

Nicole Knight Shine

MomDoc imposes a virtual gag order on employees when it comes to abortion care, as a half-dozen former OB-GYNs, nurse practitioners, and support staff told Rewire in a series of interviews.

The voice on the other end of the phone is friendly, but unhelpful, when a Rewire reporter says she’s six weeks pregnant and would like an abortion.

“We don’t provide that,” Marie says.

Marie makes appointments for MomDoc, Arizona’s largest women’s health network. MomDoc is owned and run by Mormons who ascribe to a belief that opposes abortion in nearly all cases.

“Can you tell me where I can get an abortion?” the reporter asks.

Marie says she can’t. “I’m sorry,” she adds.

MomDoc imposes a virtual gag order on employees when it comes to abortion care, as a half-dozen former OB-GYNs, nurse practitioners, and support staff told Rewire in a series of recent interviews by phone and email. What they described affords a window into the workings of a private medical practice, one that opposes abortion care and attempts to suppress abortion access on religious grounds.

What MomDoc represents is a real-life test case pitting the power of religious beliefs against the provision of basic health information about a procedure that, according to the Guttmacher Institute, 30 percent of all U.S. women will have before age 45.

Like This Story?

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

Donate Now

It’s good business to oppose abortion in the sprawling Phoenix basin, home to the largest concentration of Mormons outside of Utah, according to the most recent U.S. Religion Census.

MomDoc CEO Nick Goodman didn’t respond to repeated requests for interviews and comment.

Started in 1976 by two Mormon OB-GYNs, MomDoc has 21 offices that operate under various names, such as Goodman & Partridge, MomDoc Midwives, MomDoc Women for Women, and Mi Doctora. MomDoc health-care centers offer reproductive services like birth control, and accept Medicaid patients, which means MomDoc is paid with federal dollars.

That Arizona’s largest OB-GYN practice opposes abortion care disturbs pro-choice advocates in a state where reproductive health access is constricted by forced waiting periods, parental consent requirements, and state-directed counseling intended to discourage patients.

Ethical guidelines from the American Congress of Obstetricians and Gynecologists (ACOG), a professional organization of 57,000 members, advise physicians who object to abortion on religious grounds to notify patients beforehand and to refer them to abortion providers.

“You need to give your patients all the options so they can make their own choice,” Julie Kwatra, legislative chair of the Arizona chapter of ACOG, told Rewire in a phone interview. “Not telling a patient information is in opposition to every rule of medicine.”

In 2012, Arizona’s right-leaning legislature instituted a religious privilege law that shields health-care professionals who hold religious beliefs from losing licensure.

These protections, critics argue, further stigmatize a legal medical procedure that’s already under attack in GOP-held legislatures nationwide.

MomDoc’s website and advertisements make no mention of its faith-based opposition to abortion rights, pro-choice advocates note.

“Drive down the freeway and every other billboard will be a MomDoc billboard on how they provide midwife care and how they really care about the family,” Kat Sabine, executive director of NARAL Arizona, said in a phone interview with Rewire. “To me it’s almost like locking down and cordoning off abortion care even more than it is in the community.”

By asking its employees to refrain from discussing abortion care, MomDoc runs counter to prevailing professional health-care norms to inform and refer patients, explained Lori Freedman, author of Willing and Unable, a book about doctors’ constraints on abortion.

“I think there’s an ethical problem there—this is information patients would want,” Freedman said a phone interview with Rewire.

It’s impossible to know how many religiously run practices across the country try to silence employees when it comes to abortion care. The executive director of the American Association of Pro-Life Obstetricians and Gynecologists said the group has not polled its 2,500 members on whether they refer patients to abortion providers, but said the organization’s overall position is “abortion hurts women.”

A recent attempt to muzzle a Washington, D.C., OB-GYN grabbed national headlines after her employer told her not to “put a Kmart blue-light special on the fact that we provide abortions.” Although the facility where the provider works doesn’t restrict access to abortion care, the case and MomDoc’s policy are both rooted in a federal measure called the Church Amendment.

Adopted in 1973 shortly after the landmark Supreme Court ruling Roe v. Wade, the Church Amendment offers protections for health-care workers at federally funded institutions who object to participating in abortions for moral or religious reasons. Attorneys for a Washington OB-GYN are arguing in a complaint filed with the Office for Civil Rights that those protections also extend to doctors who wish to speak up in favor of abortion.

MomDoc’s abortion taboo pervades its hiring and employment practices, former employees told Rewire. They asked Rewire not to reveal their names, fearing employment reprisals. Local OB-GYNs familiar with MomDoc, or whose colleagues had interviewed with the practice or work there, helped to corroborate these accounts.

“They brought it up at the [job] interview,” said an OB-GYN who worked for nearly five years in MomDoc clinics in the Arizona towns of Gilbert and Queen Creek. “They said they don’t do abortions, don’t talk about it, don’t refer [patients].”

The OB-GYN and others felt the prohibition was a condition of employment, saying that those who opposed MomDoc’s staunch anti-choice stance “got screened out.”

Once hired, the former OB-GYN said of abortion, “I talked about it, I know other doctors talked about it.”

Indeed, the former MomDoc OB-GYN said of discussing abortion care with patients: “I would always start off telling the patient, ‘I’m not supposed to talk about this, but I will.’” 

The former OB-GYN told Rewire that she’d caution patients to stay mum, and not tell her employer.

“Kind of saying, if you tell them I did [discuss abortion], I’m going to deny it,” the former OB-GYN explained, adding that discussing abortion wasn’t something she felt would lead to her termination.

The day-to-day reality of MomDoc’s abortion taboo seemed to depend on the employee’s position. Support staff described to Rewire how supervisors and team leads imposed an ongoing gag order on abortion.

“I was told in my training that abortion was not something we did, it was not something we promoted, it was not something we referred [patients to],” said an employee who worked in surgery and referrals from 2011 to 2012.

“They told us every conversation was recorded,” said a 72-year-old former appointment setter who worked for six years in MomDoc’s corporate office in Chandler, where she was told not to provide abortion information to callers. She said she’d occasionally “sneak in” a referral to an abortion provider.

“I worked in the medical field for 35 years, and I have never been told I can’t discuss a procedure,” the former scheduler said.

Asked how the policy was enforced, a former OB-GYN said, “I don’t remember anything being in my contract about abortions; it was more of a verbal thing.”

At times, the application of the anti-choice policy seemed uneven. A former nurse practitioner, who worked in Goodman & Partridge and MomDoc facilities from 2013 to 2014, said she was warned in a job interview not to talk about Plan B, emergency contraception that helps prevent pregnancy, rather than abortion.

“I was never told that directly that I couldn’t refer patients to abortion providers,” she recalled in a phone interview. “I had patients that did choose abortion, and I referred them.”

In the end, what the former employees described perhaps exposes the practical limits of imposing a religious gag order on a legal health-care procedure on staff who may not share their employer’s beliefs. Those in a position to do so may merely pay lip service to the prohibition.

“Obviously, when you have a crying teenager in front of you,” a former MomDoc OB-GYN said, “you’re going to help them, you’re going to refer them.”

Roundups Politics

Hello From Iowa: Three Things You Should Know About Monday’s Caucus (Updated)

Ally Boguhn

Monday’s Iowa caucus marked the first votes of the primary season, signaling that the race for the White House is truly underway.

Editor’s note: An earlier version of this article included reference to an unverified claim about vote counts in one Iowa precinct originally posted on C-Span by an “anonymous user” and reported elsewhere in the press. We do not consider the claim to be credible and have removed the reference to it in this piece. We deeply regret this error and are taking steps to prevent further such errors in the future.

Monday’s Iowa caucus marked the first votes of the primary season, signaling that the race for the White House is truly underway.

The night brought its fair share of surprises, including a too-close to call showing from the Democrats, the dropouts of several candidates, and the allocation of delegates, who will help decide the party’s nominee for president, quite literally left up to a coin toss.

Here are the night’s need-to-know details:

Like This Story?

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

Donate Now

In Some Precincts, the Difference Between a Clinton and Sanders Win Was Literally a Coin Toss

The allocation of some Democratic delegates was quite literally left up to a coin toss in many Iowa caucus locations in an otherwise extremely tight race between Hillary Clinton and Sen. Bernie Sanders (D-VT) is taken into account.

By the end of Monday night, Democratic presidential rivals Clinton and Sanders found themselves in a virtual tie with caucus results too close to call. Although Clinton has now been declared the winner, a statement from the Iowa Democratic Party called the race historically close, noting that some outstanding results remained to be accounted for last night, prolonging the final tally:

The results tonight are the closest in Iowa Democratic caucus history. Hillary Clinton has been awarded 700.59 state delegate equivalents, Bernie Sanders has been awarded 696.82 state delegate equivalents, Martin O’Malley has been awarded 7.61 state delegate equivalents and uncommitted has been awarded .46 state delegate equivalents.

As the Des Moines Register reported, several precincts left the final decision on delegate allocation up to a coin toss. There were at least six instances where, under the advisement of party leaders, Democrats decided winners in disputed cases based on flipping a coin—and Clinton was the winner each time. The coin toss is a longstanding method of deciding ties in the Iowa caucuses.

Ted Cruz’s Pandering to Evangelicals Paid Off Big

Sen. Ted Cruz (R-TX) has spent months building up his repertoire of ultra-conservative talking points and campaign promises, and Monday night it finally paid off, as the presidential candidate clinched a Republican victory in Iowa.

Cruz took home nearly 28 percent of the night’s votes, Donald Trump came in second with 24 percent, and Sen. Marco Rubio (R-FL) ranked third with 23 percent.

The Wall Street Journal attributed Cruz’s win in no small part to a “surge of evangelical Christians, along with support from the Republican Party’s most conservative voters,” no doubt stirred up by his extreme viewpoints.

“Mr. Cruz built his campaign on opposition to abortion, gay marriage and compromise by Republican leaders in Congress. That message produced a distinct uptick in evangelicals and other social conservatives attending Monday’s caucuses,” the Journal explained, noting that evangelical Christians made up 64 percent of GOP caucus attendees, up from 57 percent in 2007.

Cruz has spent months courting these voters, seizing on every opportunity that came his way to demonstrate his extreme opposition to abortion and LGBTQ equality.

Last week, Cruz announced the creation of an anti-choice coalition called “Pro-Lifers for Cruz,” tapping noted extremists such as Operation Rescue’s Troy Newman and the Family Research Council’s Tony Perkins to help lead the group.  

Cruz’s affiliation with these extremists followed months of endorsements from similarly notorious figures and organizations, including the anti-marriage equality organization National Organization for Marriage and Duck Dynasty’s Phil Robertson, who recently called same-sex marriage “evil” during a Cruz rally.

We Finally Say Goodbye to O’Malley and Huckabee

Only shortly after he said “Hello,” Mike Huckabee decided to say goodbye to his hopes of winning the White House in 2016, bowing out of the presidential race as the results showed him toward the bottom of the pack on caucus night.

The former Arkansas governor announced the suspension of his campaign in a Monday night tweet thanking his supporters. Although he will no longer have the benefit of the national campaign spotlight, representatives of Huckabee’s campaign promised he would continue to address the issues he ran on.

“He is going to continue to push for the issues he believes, but right now this is about thanking his staff and supporters and being with his friends and families and see what doors will open next,” Huckabee spokesman Hogan Gidley said, according to CNN.

Despite his consistent anti-choice rhetoric, Huckabee failed to build the same following in the 2016 race that helped him win the Republican Iowa caucus in 2008, as Cruz captured the key evangelical voting bloc instead.  

But that wasn’t for lack of trying. Huckabee used the campaign trail to tout his stringently anti-choice platform, going as far as to suggest that should he be elected president, he may use federal troops to stop abortion. The former presidential candidate also was a vocal proponent of using fetal “personhood” measures in order to outlaw abortion in the United States.

Democratic presidential candidate Martin O’Malley also decided to formally suspend his campaign amid disappointing caucus-night results, which earned him less than 1 percent of the votes.

“I want to thank everyone who came out to our events, and lent me their ear. Everyone who went out to caucus for me tonight, and lent me their voice. I give you my deepest gratitude,” O’Malley wrote in an email to supporters announcing the end of his campaign. “Together we all stood up for working people, for new Americans, for the future of the Earth and the safety of our children. We put these issues at the front of our party’s agenda—these are the issues that serve the best interests of our nation.”

O’Malley’s decision to end his White House run comes as news has broken that his campaign was struggling to remain afloat financially: His campaign’s latest Federal Election Commission (FEC) filings revealed he had taken out a loan to finance his run and still was unable to pay many of his staffers.

The former Maryland governor’s presidential platform had included calling for universal access to reproductive health care, instituting federal paid family leave, and providing a “living wage” by raising the federal minimum wage to $15 per hour.