Abortion in the news

The Biden administration, under pressure from advocates, finally comes out swinging

There’s only one health care issue that will be on the ballot this November, and that’s abortion.

Health care pundits like myself can tick off a half dozen other issues we would like to see the candidates address this year: prescription drug prices and the Biden program to rein them in; the future of Medicare and Medicare Advantage; how to respond to the next pandemic; how to address the opioid, behavioral health and obesity epidemics.

But those will have to wait until later in the fall. And even then, they will take up at most about 30 seconds during one of the debates – should debates even take place this year (see Republican primaries for precedents).

Instead, over the next 10 ½ months we will be being hearing a lot about the one issue that should motivate not just women voters, but everyone concerned about the right to health care in America and who should get to determine what is appropriate.

Politically, it is very much in President Biden’s interest to put the right to abortion front and center. Every time abortion was on the ballot since the Supreme Court overturned Roe v. Wade 18 months ago, maintaining abortion rights won solidly. That included statewide ballot initiatives in Ohio, Kentucky and Kansas – major bastions of Trumpism and Red State conservatism.

That’s not surprising. An overwhelming majority of the public, including a hefty minority (38%) of Republican and Republican-leaning voters, supports abortion rights. Even a substantial fraction of abortion opponents agree abortion should be legal for women victims of rape or incest, or when continued pregnancy jeopardizes a pregnant woman’s life or health, which the bans and near-bans passed or being contemplated in Republican-run states would prevent.

Sensing the prevailing political winds are at their backs, abortion rights activists have put protective measures on at least 11 statewide ballots this fall. They include potential swing states like Arizona, Nevada and Florida.

Criticism mounting

Over the weekend, anticipating this week’s 51^st anniversary of the Roe decision, President Biden’s reelection campaign came under repeated criticism for failing to put abortion rights front and center in his political messaging. On Face the Nation, Michigan governor Gretchen Whitmer called on the president to let people know that he is fighting for their right to choose. “He should use more blunt language,” she said.

Writing on Slate, Substacker Jill Filipovic (or at least their headline writer) accused the Biden campaign of whiffing on the issue. She reminded the campaign that it will galvanize voters, and is inseparable from the issue of saving democracy, which the campaign has so far used as its main issue:

Biden, his team, and the Democratic Party can’t undo the past. But they can certainly learn from it. One key takeaway is that moderate and swing voters may very well be swayed by the argument that another Trump term will mean even more scaling back of abortion rights in the U.S.—more pregnant women losing or almost losing their lives, more children forced to carry a rapist’s baby, more devastated wanting-to-be mothers forced to risk their lives and birth dead or dying babies, more women who simply cannot afford another child being plunged further into poverty and desperation.

His critics should have waited a day. As if on cue, the Biden campaign team over the weekend rolled out a campaign commercial entitled Forced that features a Texas OB/GYN, a mother of three who “desperately” wanted another baby. She couldn’t get an abortion in the Lone Star state after she learned the developing fetus was unviable and her continued pregnancy would jeopardize her own health.

“That was because of Donald Trump overturning Roe v. Wade,” she said, staring straight into the camera. “The choice was completely taken away. I was to continue my pregnancy, putting my life at risk. It was every woman’s worst nightmare. And it was absolutely unbearable.”

Powerful stuff. And a reminder that the anti-abortion movement, despite numerous media stories suggesting they are in disarray after recent referendum defeats, continues to push highly restrictive laws in states where Republicans hold unchecked political power. Since Chief Justice John Roberts and five right-wing justices ruled in Dobbs v. Jackson Women’s Health Organization that abortion is not a protected constitutional right, 14 states have enacted or enforced total bans on abortion. Seven more have passed restrictions like a ban after six weeks of pregnancy (when many women don’t even know they are pregnant), according to the Guttmacher Institute.

Prevarication reigns on GOP side

Both Donald Trump and Nikki Haley, the remaining Republican candidates in the race to unseat Biden, have dodged questions about whether they will sign a bill that would ban abortion in every state, including those that already protect the right in their constitutions. They realize they need to appeal to more moderate audiences, like those in New Hampshire where Trump tonight will probably dispatch his final challenger for the Republican nomination.

Speaking earlier this month at a Fox News Town Hall, Trump prevaricated about where he stands on the issue. “For 54 years they were trying to get Roe v. Wade terminated, and I did it and I'm proud to have done it,” he said. Then, when asked about a national law that would totally ban abortion, he sent a veiled message to those seeking a total ban. “It's going to work out. Now, the number of months [when a ban begins] will be determined.”

One month, six weeks, whatever. “You have to win elections," he said. “Otherwise, you're going to be back where you were, and you can't let that ever happen again.”

As for Haley being more moderate on the issue – fuhgeddaboudit. She is “unapologetically pro-life,” but claims now to want to find a national consensus on abortion access. Yet her actions in South Carolina leave little doubt how she would act as president should Republicans seize control of the House, Senate and White House in the November election.

While in the legislature, she backed two “right to life” bills that would limit abortion access statewide, including one that defined that life begins at the moment of fertilization. The legislation made no exceptions for rape, incest or the health of the mother.

High court plunders on

Meanwhile, the Supreme Court isn’t finished with abortion. In April, it will hear arguments in a case out of Idaho where it let stand a lower court decision that said Idaho’s strict abortion ban outweighed the federal law known as EMTALA, the Emergency Medical Treatment and Labor Act. The law, signed by President Ronald Reagan, requires hospitals provide emergency care to anyone needing it despite ability to pay. That includes an abortion, if necessary to save the life of a pregnant woman.

The Center for Reproductive Rights, which represented the woman seeking an abortion in Idaho, has filed similar suits in Tennessee and Texas. The non-profit legal team isn’t seeking to overturn those states’ strict anti-abortion laws. It only wants clarification on when EMTALA applies.

How tricky that can be was revealed by another case that’s making news. The Associated Press reported last Thursday that the Biden administration’s Health and Human Services Department rejected an EMTALA complaint filed by a woman who had been denied an abortion in an Oklahoma hospital ER after showing up complaining of severe pain and nausea. Though the administrative gave no reason for its action, CMS launched a website and issued a press release today that seeks to clarify both patient rights and hospital and physician responsibilities under EMTALA.

According to CMS, a patient, no matter what their insurance status, has 1) the right to an appropriate medical screening exam to check for an emergency medical condition; 2) treatment if they have an emergency until the condition is stable; and 3) transfer to another hospital if needed.

The Oklahoma woman, Jaci Statton, 26, received number one but not numbers two or three.  She was told to wait in the parking lot until her condition worsened enough to qualify for an abortion under the state’s strict ban, according to the A.P.

She eventually learned she had a partial molar pregnancy, which if left untreated could cause hemorrhaging, infection, and even death. She had to go to another state to get an abortion.

Well, partial molar pregnancy was a new one on me. So, I looked for medical insight from sources I like to think I can trust. The Cleveland Clinic explains partial molar pregnancies this way: “In a normal pregnancy, the egg receives one set of 23 chromosomes from one parent and one set of 23 chromosomes from the other parent, for a total of 46 chromosomes. In a partial molar pregnancy, the egg receives two sets of chromosomes from the partner with a penis, usually because two sperm have fertilized one egg. The egg now has 69 chromosomes, instead of the normal 46.”

After marveling at the virility of this magical penis, I thought: Hmmm, this doesn’t sound good. The prognosis for such fetuses was definitive. Again, from the Cleveland Clinic’s website: “A partial molar pregnancy can’t survive.” As for the more common molar pregnancy, the United Kingdom’s National Health Service says: “A molar pregnancy will not be able to survive.”

And, if you want to know what the risks to the woman who suffers one of these doomed conceptions, you can read this story on the Johns Hopkins Medicine website, entitled “Molar Pregnancy and Choriocarcinoma: Maggie’s Story.” Choriocarcinoma is a fancy word for a very fast-growing cancer of the womb, which can be prevented by quick removal of the nonviable fetus through abortion.

Now, who would you like to be making the decision on whether to abort: The doctors in the ER who discover the situation or the ideologically-driven political hacks, whether on the bench or in state legislatures, that are being given the right by the current Supreme Court to take over the practice of medicine?