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American College of Obstetricians and Gynecologists

If we can’t ban it, we’ll BS about it

The “it” in question is of course abortion, with the state of Texas lying to women about its effects and risks.

Death and infertility were just two of the risks a doctor described to Kryston Skinner when she chose to have an abortion last year.

The 23-year-old knew it wasn’t the right time for her to become a mother, though Skinner dreamed of children in the future. The thought of not living to see that day, or becoming infertile, terrified her.

But some of the information she was given was misleading or medically wrong, contained in a long, controversial booklet that state lawmakers require doctors to give women at least 24 hours before an abortion procedure.

Medical experts have long denounced the booklet, saying important sections — such as those connecting abortions to the likelihood of breast cancer and infertility — are wrong.

Now, the Department of State Health Services is planning an update of the booklet, called A Woman’s Right to Know. The new draft doubles down on information highly contested by medical experts and the pro-abortion rights community, stoking the flames of a debate going back more than a decade.

The booklet was mandated by a 2003 anti-abortion law intended to guarantee informed consent from women seeking abortions. It contains information on the developmental stages of a fetus, risks of abortion and other options for pregnant women.

The state is supposed to consult with medical organizations to provide “objective,” “nonjudgmental” and “accurate scientific information” in the booklet. DSHS spokeswoman Carrie Williams said the original booklet was written by a group of agency officials, legislators and public health and medical professionals.

The recent revisions were made “after reviewing medical research and information from experts in the field.” The process included consulting the American Congress of Obstetricians and Gynecologists, she said.

But the group said the state has not incorporated any of its recommendations, which included removing scientifically unsupported language that suggests getting an abortion increases the risk of breast cancer, and that women who have abortions are more likely to become depressed or suicidal.

Here’s the draft of the new booklet, the current booklet, and a letter from the American College of Obstetricians and Gynecologists telling the state that the draft booklet full is of BS. It’s another egregious example of doctors and scientists saying one thing, and a bunch of anti-abortion activists claiming they’re wrong because they want them to be wrong. Remember how much whining there was about Obamacare interfering with the doctor-patient relationship? This is what actual interference with that relationship looks like, since no doctor who isn’t a quack would ever choose to give this booklet to patients. Perhaps this would make a good legal test of the new standard for abortion restrictions. The Austin Chronicle has more.

Planned Parenthood petitions Fifth Circuit for en banc review of HB2 ruling

From the inbox:

Today, Planned Parenthood affiliates in Texas filed a petition on behalf of their patients to request that the full bench of the Fifth Circuit Court of Appeals consider the constitutionality of harmful abortion restrictions that were struck down by  a federal district court last fall. On March 27, a three-judge panel of the court upheld the Texas law, making safe and legal abortion virtually impossible for thousands of Texas women to access. Similar laws have been blocked by federal courts in Alabama, Mississippi, and Wisconsin, and the U.S. Court of Appeals for the Seventh Circuit last December affirmed a preliminary injunction against enforcement of Wisconsin’s law.

In the petition filed today, Planned Parenthood argues that the three-judge panel’s ruling warrants closer review by the full court because it conflicts with decades of applicable Supreme Court precedent and if allowed to stand would have terrible implications for women’s health and rights.

Statement from Yvonne Gutierrez, executive director of Planned Parenthood Texas Votes Action Fund:

“The three-judge panel’s ruling on March 27  failed the women of Texas, and severely limits a woman’s access to safe and legal abortion in vast regions of the state. This hardship further impacts women who have already lost access to birth control and preventative health care at the hands of a small group of politicians who are trying to impose their beliefs on all Texans.

Planned Parenthood will continue providing services, including abortion, to women across the state and we will work to combat these laws in the state house and the court house. Texas women need leaders who will defend the ability to make decisions about their own reproductive health, and who will protect women’s access to basic health care – including birth control.”

The three-judge panel that ruled on March 27 includes a judge who is openly hostile to Roe v. Wade. The Fifth Circuit has repeatedly upheld laws that impose medically unnecessary restrictions on abortion and take health care away from Texas women in need. In a highly unusual move, last October, it abruptly stayed a lower court’s permanent injunction issued after a three-day trial on the abortion restrictions.  In 2012, it allowed Texas to bar all Planned Parenthood health centers from participating in a preventive health care program. Earlier that year, it upheld an especially cruel and demeaning forced ultrasound law. 

The March 27 ruling upholds a law requiring doctors who provide abortions to obtain admitting privileges at a local hospital — a requirement that leading medical associations like the American College of Obstetricians and Gynecologists (ACOG) and the American Medical Association (AMA) oppose because it harms women’s health and interferes with the doctor-patient relationship.

The lawsuit, Planned Parenthood v. Abbott, was jointly filed on September 27 on behalf of more than a dozen Texas health care providers and their patients by Planned Parenthood Federation of America, the Center for Reproductive Rights, the American Civil Liberties Union, and Texas law firm George Brothers Kincaid & Horton.  In striking down the measure as unconstitutional after a three-day trial, U.S. District Judge Lee Yeakel said the admitting privileges requirement has “no rational relationship to improved patient care” and also “places an undue burden on a woman seeking an abortion.”  Despite that ruling, a panel of the Fifth Circuit allowed the law to take effect on November 1, 2013, while the case was on appeal and a different panel held it constitutional on March 27.

See here, here, and here for the background, and here for the Trib story. Needless to say, I expect exactly zero joy out of this, but ya gotta do what ya gotta do. The real question is whether or not to press our luck with SCOTUS when the Fifth Circuit rejects this petition.

Four things to work on now that the omnibus anti-abortion bill is reality

1. Organize, organize, organize. Maintain the energy and sense of urgency that originated with the #StandWithWendy filibuster. This is a good way to draw people in while the iron is hot.

Progressives and Planned Parenthood took their opposition to the abortion-restricting bill winding its way through the Texas Legislature on the road to Houston Tuesday with the orange-tinged “Stand with Texas Women” tour.

Hundreds gathered in a sea of tangerine, apricot and melon at Discovery Green to welcome the motorcoach carrying state Sen. Wendy Davis, several other Democratic state legislators and Planned Parenthood Action Fund president Cecile Richards.

After a debut rally in Austin on Tuesday morning, the carrot-colored bus made an evening stop in Houston to oppose the bill’s anticipated effect on access to preventive health services and abortions. Rallies also are planned Wednesday in Dallas and Fort Worth.

[…]

“It’s time to get the Texas Legislature out of our exam rooms,” said Richards, daughter of former Democratic Gov. Ann Richards. “It’s wasn’t just that Gov. Perry and some of his allies in the Legislature ended the women’s health program and cut more than 130,000 women in Texas off of preventive care, but now the Legislature is considering a bill that would force dozens more health centers in this state to close down – close their doors – making it even harder for women to get care and ending access to safe and legal abortion.”

Don’t forget the veto of the Lilly Ledbetter bill, too. Democrats have underperformed with Anglo women in Texas compared to the country as a whole. The last two sessions have been very hard on women in Texas. These past few weeks I’ve seen a ton of stuff on Facebook from people I don’t normally think of as being politically oriented, some of whom I had no idea were on my side of this. We need to build on this. Stace, Egberto Willies, and Texas Leftist have more on the Houston event, and the Press has a photo slideshow.

2. Remind people who have aligned with the GOP in the past because of certain specific issues that they’re not dealing with the same party now. I’m thinking specifically of doctors and other medical professionals, who loved the GOP ten years ago when tort “reform” was on the agenda. BOR has an open letter from a couple of docs who’d like the Lege to stay out of their exam rooms.

While we can agree to disagree about abortion on ideological grounds, we must draw a hard line against insidious legislation that threatens women’s health like Texas HB2 (House Bill 2) and SB1 (Senate Bill 1).

That’s why we’re speaking to the false and misleading underlying assumptions of this and other legislation like it: These bills are as much about interfering with the practice of medicine and the relationship a patient has with her physician as they are about restricting women’s access to abortion. The fact is that these bills will not help protect the health of any woman in Texas. Instead, these bills will harm women’s health in very clear ways.

We’re setting the record straight, loudly and unequivocally, with these simple messages to all politicians: Get out of our Exam Rooms.

I would submit to the members of The American Congress of Obstetricians and Gynecologists, the Texas Medical Association, and other organizations that formally opposed SB1 and HB2 that if they want legislators that won’t interfere with the doctor/patient relationship, they need to vote against legislators that do interfere with the doctor/patient relationship, and that includes everyone who voted for these bills, including the handful of Dems who did so. Do it in March and do it again in November as needed. Nothing will change until the leadership changes.

3. Prepare for the inevitable litigation.

The Guttmacher Institute reported earlier this week that more new abortion restrictions were enacted in the first half of 2013 than in all of 2012; 2013 now ranks second to 2011 as a landmark year for antichoice legislation.

Now from a superficial point of view, the latest batch of state antichoice actions have focused on the relatively safe ground (politically and to a lesser extent constitutionally) of late-term abortions, where the Supreme Court has allowed some leeway in the past. But since most of the “fetal pain” laws have been accompanied by what Guttmacher calls “TRAP” measures—Targeted Regulation of Abortion Providers—they are clearly intended to restrict access to all clinical abortions at any stage of pregnancy, and certainly have that effect.

Since the current constitutional standard for abortion restrictions remains Casey v. Planned Parenthood’s ban on measures that place an “undue burden” on the right to choose, most of these new state laws are clearly in the “danger area” constitutionally. Just yesterday, a federal district court judge in Wisconsin temporarily blocked implementation of that state’s new regulations on abortion providers pending a showing that it did not violate Casey. Federal court challenges are likely in other states as well.

So the long-awaited day of a fresh SCOTUS review of the constitutional law of abortion (last visited by the Court in the 2007 Carhart v. Gonzales decision upholding a federal “partial-birth abortion” ban) may soon be upon us. It could even happen sooner that expected: at the end of the recently concluded term, SCOTUS agreed to hear an appeal of a case involving a Oklahoma restriction on the use of RU-486 that could involve a reinterpretation of Casey. And in any event, the shrewd adoption by antichoicers of the strategy of justifying restrictions as “health and safety regulations” seems designed to exploit the loophole opened up in Carhart by Justice Kennedy that invited policymakers to make their own determinations of women’s health interests.

Litigation is hardly risk-free, as there are four solid votes to overturn Roe and Casey, and who knows what bee will be in Anthony Kennedy’s bonnet by the time the appeals make their way to SCOTUS. The best thing that could happen between now and then would be for Kennedy and/or Scalia to retire, but of course we can’t count on that. But what other choice is there? Let’s bring our A games and keep our eyes open about what could happen when we go down this road.

4. Fight back with reason and with ridicule. In my post about Tuesday’s action in the House, I included a link to Baptist Standard editorial about all the things that the state of Texas and its Republican leadership is not doing for the post-born. Many Democratic legislators filed and fought for amendments to HB2 that would have tried to address some of these things, but of course the Republicans and the “no one is more pro-life than me” author of HB2 rejected them all. That needs to be a campaign issue – really, it needs to be THE campaign issue – in 2014. But it’s also time for our legislative Democrats, who have fought the good fight with honor and perseverance, to not always be so high-minded. A little snark can go a long way, as Lisa Falkenberg demonstrated.

Women will always bear the brunt of the responsibility for family planning and pregnancy, which is why the folks in Austin are back at it again this week, trying to help the little women in this endeavor by protecting their health with unnecessary regulations and restricting access to constitutionally protected medical options.

Still, I can’t help but think the men of this state are worthy of some Texas-style reproductive protection as well. The Legislature’s compelling interest in restricting the reproductive rights of Texans shouldn’t stop at lady parts.

Gentlemen of Texas, it’s with sincere concern for your health and safety – and a hat tip to legislation pioneered in Oklahoma, Georgia, Illinois, Virginia and Ohio – that I hereby propose the following pro-life omnibus bill to regulate your man parts.

The bill is already written, someone just needs to file it at the next opportunity. File it for what’s left of this session. Of course it won’t go anywhere. That’s not the point. Someone needs to do this.

UPDATE: “I want you to be angry and remember,” Wendy Davis says at the Fort Worth rally. That’s what I’m talking about.

Ultrabad

So now that we’ve finally disposed of the single most important issue facing Texas today in the Senate, perhaps we can move on to other matters thay may be of interest, like the budget and CHIP and windstorm insurance and unemployment and…Ha ha ha, just kidding. Who needs to debate those issues when we can talk about forcing women who want to get an abortion to get an ultrasound first? That’s the idea behind Sen. Dan Patrick’s SB 182, which will be heard by the State Affairs committee this Thursday at 1 PM. Floor Pass has the background on this little charmer, in which the modern day Republican Party finds another reason to ignore its self-professed philosophy of getting government out of people’s lives. I mean, who doesn’t want Dan Patrick and Frank Corte making medical decisions for other people? Who cares what the American Medical Association, American Medical Women’s Association, American College of Obstetricians and Gynecologists, and American Public Health Association – all of whom oppose procedure-specific requirements that get in the way of the doctor-patient relationship – think? Frankly, I’m surprised that Patrick and Corte didn’t include a provision that would require all these women to get a diagnosis over the phone from Bill Frist before proceeding. Anyway, if you think that maybe it isn’t such a good idea for Dan Patrick and Frank Corte to get involved a patient’s private business, now would be a good time to give your Senator a ring and let him or her know that. Thanks very much.