1). “First State Law to Criminalize Abortion ‘Trafficking’ May Inspire Others”, Abortion Access - Health, April 7, 2023, Christine Vestal, Stateline, at <https://stateline.org/2023/04/07/first-state-law-to-criminalize-abortion-trafficking-may-inspire-others/>.
2). “More States Shield Against Rogue Abortion Prosecutions”, Abortion Access - Health - Justice, May 4, 2022, Christine Vestal, Stateline, at <https://stateline.org/2022/05/04/more-states-shield-against-rogue-abortion-prosecutions/>
3). “The Pill Takes A Step Toward Simpler Access”, May 11, 2023, Pam Belluck, 1,341 words, The New York Times.
4). “Tracking the States Where Abortion Is Now Banned”, Updated May 10, 2023, Allison McCann et. al., The New York Times, at < https://www.nytimes.com/interactive/2022/us/abortion-laws-roe-v-wade.html >
Introduction by dmorista: The vital and extremely important struggle over Reproductive Health Care continues particularly on the State by State level. This merely proves the lie, of the reactionary Supreme Court, that their ruling overturning Roe v. Wade would merely turn the decision over to the “laboratories of democracy” (the absurd moniker given to the individual U.S. States, where the price of buying or renting legislators or governors, is much lower than it is in the U.S. Federal Governmental apparatus). State legislatures are inundated by the political activities and programs of such far-right organizations as the American Legislative Exchange Council (ALEC) and a large number of fanatical Forced-Birth organizations.
The state-level struggles continue and, to their credit, various Blue-States have taken important actions to protect the access to Reproductive Health Care. These have included negating the legal attempts by Red-State Forced Birth regimes to apply criminal and/or civil sanctions against people seeking abortion or helping people seeking abortions and stockpiling of 3 years worth of Mifepristone, for use in their states in case the blatantly Judge-Shopped court ruling from, the Amarillo Texas District Court, is upheld.
On the national level, there was cowardice and a defeatist attitude in the Biden White House; those weaknesses prevented the administration from declaring a national crisis and making Federal Lands available to Reproductive Health Care facilities. Red States are always full of military bases and other Federal facilities, over which their State Level Forced-Birth Agenda has no jurisdiction whatsoever. Such a move would, in addition to demonstrating the relative power of the individual reactionary controlled States versus the Federal Government, as far as power and jurisdiction over this issue are concerned; it would have also provided a major boost and mobilization issue for the activists and movement. Of course, truly activating and mobilizing the majority of the population, who are opposed to the most egregious elements of the Right’s Social Agenda, is not a real priority of the Democrats, merely the somewhat less dangerous of the two duopoly parties.
In a regulatory agency initiative reported in Item 3)., “The Pill Takes A Step Toward Simpler Access”, the article notes that the FDA is considering making birth control pills available on an over-the-counter basis. Just what the response will be, by the Right and their Forced-Birth minions, is difficult to say. But we can be sure it will be vigorous and aimed at restricting access to safe birth control in the Red States of the Authoritarian Heartland of the increasingly fascist U.S. Still this is a positive development. Map 1 shows what I referred to as the Authoritarian Heartland in an earlier post.
Item 1). “First State Law to Criminalize Abortion ‘Trafficking’ May Inspire Others”, offers a review and analysis of the move by the Idaho State Legislature to create a new crime “abortion trafficking” and to criminalize people who attempt to help distraught teen-age girls who are pregnant. As always the Forced-Birth operatives hide behind the supposedly sacred family while advocating for police-state measures. Item 2)., “More States Shield Against Rogue Abortion Prosecutions”, was published about a year ago. It looks at the fact that, even in Blue States with specific protections for abortion rights, reactionary prosecutors can jail and conduct trials of women who are pregnant claiming bogus murder or manslaughter charges. This situation is far worse in reactionary dominated Red States in the Authoritarian Heartland. Item 4)., “Tracking the States Where Abortion Is Now Banned”, presents a fine series of maps that show the status of abortion rights in the 50 states as of May, 2023.
Looking at the development of fascism in the U.S., Paul Street expressed it perfectly where, in his latest article posted here at The Class Struggle, he wrote: “When it comes to weapons of mass slaughter that are used to wreak bodily havoc and death from coast to coast, the Republi-Christian-Fascist Right is militantly opposed to government regulation. But when it comes to procedures and medications meant to enable women and girls to be in control of their own bodies and protect their own health, the Republi-Christian-Fascist Right is for militant state control. …. It might seem like a contradiction: for libertarian deregulation and bodily endangerment when it comes to guns vs. for Big Brother state regulation and bodily endangerment and slavery when it comes to the womb. …. (however) In the arch-patriarchal Christian white nationalist neofascist world view, however, there’s no contradiction.” (Emphasis added).
Jessica Valenti (one of the leading web figures who is documenting the horrific developments and the arrogance of the political minority who continue to implement their unpopular extremist social agenda) pointed out concerning: “.... conservative lawmakers, they’re well aware of how Americans feel about abortion restrictions and want to keep the issue as far away from voters as possible. (Emphasis added).
"Republican legislators across the country have been working overtime to prevent Americans from having a say on abortion rights, no longer bothering to hide their obvious disdain for democracy. In states like Ohio, Missouri and Florida, for example, they’re working to raise the standards on ballot measures to require a much higher percentage of voters to pass. (In Ohio and Missouri, they want 60% of the vote instead of a simple majority; in Florida they’re trying to raise it to nearly 67%.) ....
(And in discussing) “ …. the legislature’s original proposal to restore Mississippi’s initiative process said nothing about abortion. But, he told journalists, the GOP was worried that citizens would be able to use ballot measures to restore abortion rights—so they added in a provision to stop them. (Emphasis added) ....
"A study last week from the PRRI (Public Religion Research Institute) showed what other polls have proven for decades: Americans overwhelmingly support abortion rights, even when they live in red states. Lawmakers in Mississippi and beyond know that if it’s up to voters, abortion will be legal." (See, "The GOP is Undoing Democracy to Ban Abortion", March 1, 2023, Abortion Every Day, at < https://jessica.substack.com/p/the-gop-is-undoing-democracy-to-ban >)
We might note that the situation in the State Legislatures is pretty unfavorable to any recovery of the lost ground in Reproductive Health Care Rights. The Map Below demonstrates that situation as of May, 2023. The delineation between Republican Party as opposed to Democratic Party control is defined as the control of the Lower House of the Legislature.
It is worth noting that the actual number of State Legislators is not as skewed as the effective control over the legislative process.
Of course, these numbers in Table 1, reflect only a partial recovery from the major losses in state legislatures and local offices that began in the mid-term elections in 2010, when 800 legislative seats held by Democrats, were taken by right-wing Republicans. This was a result of major spending campaigns undertaken by various far-right interest and action groups in state and local elections. Cheap and effective, the New Republic noted that the Democratic Party was the weakest it has been since 1920. The article stated that:
“The GOP takeover of state governments was no accident. In 2010, Republicans poured $30 million into state races—three times more than Democrats—
as part of a deliberate strategy to control the once-in-a-decade process of congressional redistricting. As a result, Republicans picked up 675 legislative seats and gained control of twelve state legislatures. In 2014, the GOP spent another $38 million on state races and picked up ten more legislatures. ….
“Republicans have been deliberately building their advantage at the state level since 1994, when they took control of 15 state legislatures. Groups like the corporate-backed American Legislative Exchange Council and the State Policy Network began using state legislatures as laboratories for conservative ideas, funneling policy proposals from Newt Gingrich’s “Contract with America” to state lawmakers.” (See, “The Democrats’ Biggest Disaster: Forget Washington—the party is weaker at the state level than it’s been in nearly a century.”, November 22, 2016, Nicole Narea & Alex Shephard, The New Republic, at < https://newrepublic.com/article/138897/democrats-biggest-disaster >)
1). “First State Law to Criminalize Abortion ‘Trafficking’ May Inspire Others”, Abortion Access - Health, April 7, 2023, Christine Vestal, Stateline, at <https://stateline.org/2023/04/07/first-state-law-to-criminalize-abortion-trafficking-may-inspire-others/>.
(Caption: A sign reading “My body, my Choice,” is taped to a hanger on a streetlight in front of the Idaho State Capitol Building in May 2022. Idaho has become the first state to try to stop minors from leaving to get an abortion without parental consent; other states may follow. Sarah A. Miller/Idaho Statesman via The Associated Press)
Amid a flood of residents fleeing states that ban abortions to seek legal procedures or medication elsewhere, Idaho has become the first state to try to stem that exodus — at least for minors.
Abortion is illegal at all stages of pregnancy in Idaho and a dozen other states. The law signed by Republican Gov. Brad Little Wednesday creates a new crime of “abortion trafficking,” threatening prosecution for any adult who helps transport a pregnant Idaho girl to get an abortion without her parents’ consent.
Abortion rights advocates and legal experts say they expect other states to follow Idaho’s approach — and eventually to extend interstate travel prohibitions to adults.
The U.S. Constitution does not explicitly include a right to interstate travel, but it is implied. Idaho’s new law attempts to skirt that issue by criminalizing only the in-state portion of a trip to another state to procure an abortion. In other words, it focuses on transportation to the Idaho state line.
“Abortion opponents are testing the waters around abortion bans with this Idaho law, because state lawmakers realize they’re facing a real uphill climb in courts because of the federal right to travel,” said Elizabeth Nash, principal policy associate at the Guttmacher Institute, which supports abortion rights. “Other states will be watching closely to see how this plays out.”
Idaho’s travel ban is based on wording in a model abortion law proposed by the National Right to Life Committee for lawmakers to introduce in their states.
Carol Tobias, president of the anti-abortion organization, said the section of the model law on unlawful abortion trafficking of minors “is intended to send a strong message that parents are responsible for their girls and nobody else should be taking their daughters to medical appointments without their knowledge.”
Providing information on abortions is allowed under Idaho’s new criminal statute. But giving abortion pills to a pregnant girl or harboring or transporting her without a parent’s consent is punishable by two to five years in prison. The law also allows family members to sue any health care provider, whether in-state or out-of-state, who performs an abortion on an Idaho minor.
Rebecca Gibron, CEO of Planned Parenthood Great Northwest, told the Idaho Capital Sun that her organization intends to challenge the law.
Right to Travel
Ever since the U.S. Supreme Court overturned the federal right to abortion last June, abortion rights advocates have anticipated that states where abortion is illegal would try to prevent their residents from leaving the state to legally end their pregnancies. But the implied constitutional right to interstate travel was seen as a deterrent.
In the U.S. Supreme Court’s Dobbs v. Jackson Women’s Health decision, Justice Brett Kavanaugh wrote in his concurring opinion that the decision does not allow a state to bar a resident from traveling to another state to obtain an abortion.
Idaho’s new law attempts to avoid that legal hurdle by defining the abortion trafficking crime as transporting a pregnant girl within the state. But even without that language, David Cohen, professor of law at Drexel University in Philadelphia, said Idaho’s law could survive legal challenges in state and federal courts. That’s because state constitutions vary widely on the question of interstate travel and the U.S. Constitution does not explicitly guarantee it.
As a result, Cohen and others say the issue likely will have to be decided by the Supreme Court.
“And given how abortion changes everything,” he said, “there’s no way to predict how the Supreme Court will rule on such a law other than to follow its views on abortion.”
Parental Consent
Minors make up only a small percentage of patients who receive abortions in the United States, according to data from the federal Centers for Disease Control and Prevention. Of the roughly 620,000 Americans who received abortions in 2020, only 8.2% were girls aged 15 to 19, and only .2% or 1,333 were younger than 15.
Despite the small numbers, state laws requiring clinicians to either notify or get the consent of parents before performing abortions on a minor have been around since the 1970s, shortly after the federal right to abortion was established by the Supreme Court in Roe v. Wade.
But courts have since required states to include judicial bypass provisions that allow a judge to waive parental notification and consent requirements for minors in cases involving rape, sexual abuse, incest and other circumstances.
Parental consent and notice laws still exist in most states. Reproductive rights advocates argue that such laws limit minors’ reproductive rights.
In addition, two states — Arizona (2013) and Arkansas (2014) — have laws on the books that are similar to Idaho’s new law, making it a crime to help a minor get an abortion without their parents’ knowledge. But those laws — enacted when abortion was legal in every state — were intended to bar people from helping a minor leave the state to circumvent parental notice and consent laws. A 2005 Missouri law that required minors to get parental consent to travel for an out-of-state abortion was struck down.
Parental consent is still required in 12 states where abortion remains legal: Arizona, Indiana, Kansas, Massachusetts, Michigan, Nebraska, North Carolina, North Dakota, Ohio, Pennsylvania, Rhode Island and South Carolina.
Parental notice is required in six states where abortion is legal: Colorado, Delaware, Iowa, Maryland, Minnesota and Montana. And both consent and notice are required in four states where abortion is legal: Florida, Utah, Virginia and Wyoming.
And in 11 states where abortion is banned — Alabama, Arkansas, Idaho, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, Tennessee, Texas and Wisconsin — parental consent is still required. Parental notification is required in South Dakota and West Virginia, where nearly all abortions are banned, and in Georgia, where abortion is banned at six weeks of pregnancy, before most people know they’re pregnant.
“Right now, these teens don’t have anywhere to go, and that includes foster teens and teens whose parents may not be supportive,” said Alina Salganicoff, senior vice president and director of women’s health policy at the Kaiser Family Foundation, which supports abortion rights. “Judicial bypasses are extremely difficult and traumatic for a minor to go through and challenging to get done, particularly in a timely way.
“Young people who’ve been victims of sexual violence are, in many cases, unlikely to report these acts and they’re extremely vulnerable. They need an adult they can trust and, in some cases, it’s not their parent,” she said.
In Idaho, Kerry Uhlenkott, legislative coordinator for Right to Life of Idaho, said she and the new law’s sponsors were motivated by a story they heard from a single mother whose teen daughter was “trafficked” to an abortion clinic in Oregon without her knowledge.
“A school counselor became aware that the girl was pregnant and took her to a clinic in Oregon without the mother’s consent,” Uhlenkott said. “The mother was horrified that this happened without her knowledge or consent, and she was just heartbroken that she wasn’t involved in the decision. That’s what got us involved.”
2). “More States Shield Against Rogue Abortion Prosecutions”, Abortion access - Health - Justice, May 4, 2022, Christine Vestal, Stateline, at <https://stateline.org/2022/05/04/more-states-shield-against-rogue-abortion-prosecutions/>
(Caption: Police form a line outside the U.S. Supreme Court early Tuesday amid protesters, after a draft opinion obtained by Politico showed that a majority of justices voted for overturning Roe v. Wade. Some states are aiming to prevent rogue prosecutions of people who manage their own abortions. Alex Brandon/The Associated Press)
Editor’s note: This story has been updated to correct Farah Diaz-Tello’s name and title.
Last month, 26-year-old Lizelle Herrera was arrested in Texas and charged with murder over a self-induced abortion.
A hospital had reported the abortion to law enforcement. But prosecutors later acknowledged she shouldn’t have been prosecuted and dropped the charge. “In reviewing applicable Texas law, it is clear that Ms. Herrera cannot and should not be prosecuted for the allegation against her,” Starr County District Attorney Gocha Allen Ramirez said in a news release.
If the U.S. Supreme Court weakens or overturns the right to abortion as expected in the months ahead, health advocates warn that more people who manage their own abortions using U.S. Food and Drug Administration-approved medications, herbal remedies or other non-medical methods will be falsely arrested on charges of violating abortion bans, homicide laws and other criminal statutes.
The justices have voted to strike down Roe v. Wade, according to a draft majority opinion written by Justice Samuel Alito that circulated inside the Supreme Court in February and was obtained by Politico. “Roe was egregiously wrong from the start,” Alito wrote in the leaked draft. Justices could change their votes during deliberations, and the decision won’t be final until published, but it revealed the court’s thinking.
“Once federal protection of abortion is gone,” said Drexel University law Professor David Cohen, “we can expect to see more overzealous local prosecutors taking aggressive actions against people for self-managed abortions and other pregnancy outcomes.”
Lawmakers and criminal justice officials in a handful of states are trying to prevent these rogue legal actions, which conflict with current state laws and in all but a few cases have been overturned by courts. But even in left-leaning states, the new efforts have faced pushback, and advocates fear more women will be charged.
Ever since the Supreme Court guaranteed the right to abortion in its 1973 decision, state laws restricting the procedure have held abortion providers, not pregnant people, responsible. Even before the landmark ruling, state laws stopped short of holding pregnant people responsible for the procedure, according to legal scholars.
But prosecutors who have charged women with self-induced abortion have argued they violated a variety of other state laws, including manslaughter, fetal homicide and homicide by child abuse, according to research by National Advocates for Pregnant Women, a nonprofit that provides legal defense for pregnant women.
Physicians, public health officials and women’s advocates have long cautioned that arrests for self-managed abortions and miscarriages will disproportionately stigmatize low-income people, immigrants and women of color who already lack access to reproductive health care.
The number of such cases has been rare: roughly 1,700 arrests and other legal actions since 1973, including surveillance and child services interventions, according to National Advocates for Pregnant Women. But legal experts and civil rights advocates think that attempts to prosecute women for self-managed abortions will rise as state abortion bans tighten and more women choose to end their pregnancies on their own.
“It has never been politically popular to enact laws that punish women for abortions,” Cohen said. But as more states ban the procedure, local prosecutors will likely become emboldened to take matters into their own hands, he said.
States Aim to Stop Prosecutions
California Attorney General Rob Bonta, a Democrat, warned state law enforcers in January not to use the state’s homicide laws or other statutes to punish individuals for self-managed abortion or other pregnancy loss.
In an April 27 letter, he urged attorneys general in all 50 states to alert law enforcement officials similarly to refrain.
“For years, state actors across the country have subjected individuals experiencing pregnancy to improper and discriminatory criminal prosecutions, detention and surveillance,” Bonta wrote.
“Criminal statutes meant to protect people who are pregnant from the violent acts of others have been misapplied to penalize them for any number of activities” that may result in harm to a fetus or a pregnancy loss, he wrote.
In April, Colorado enacted a broad reproductive health law that, among other protections, ensured that a person could not be prosecuted for pregnancy-related death or harm to a fetus. Washington state enacted a law in March that protects people seeking an abortion and those who aid them from legal action from the state.
In 2019, Illinois and New York enacted provisions excluding a pregnant person from fetal homicide laws, and Rhode Island repealed its fetal homicide law.
This year, lawmakers in California and Maryland have considered similar bills, clarifying that a person may not be punished for the death of a fetus due to any acts or omissions during their pregnancy or shortly thereafter.
Although mainstream anti-abortion groups agree with abortion rights advocates that homicide and other state statutes should not be used to punish pregnant women for abortion, the bills aimed at protecting them from prosecution have met fierce opposition in both California and Maryland.
In both states, opponents claimed that a provision in the proposed law, which would exempt pregnant people and medical professionals from prosecution for the death of an infant shortly after birth due to pregnancy complications, was tantamount to legalizing infanticide.
Both bills would prohibit prosecution of or civil lawsuits against a pregnant person for pregnancy-related harm or death and allow victims of spurious arrests to sue their prosecutors. The California bill remains active this session, but its likelihood of passage is uncertain. The Maryland bill was in a committee when the state’s session ended last month.
Roughly three dozen states have fetal homicide laws that increase penalties or create a separate crime when a violent attack on a pregnant woman results in the death of a fetus, according to the National Conference of State Legislatures. In most of the states, the wording of feticide laws explicitly excludes the pregnant woman from any fault.
New laws and bills in states that aim to protect people who self-manage their abortions are meant to underscore what most fetal homicide laws already make clear.
Disproportionate Harm
Herrera, the Texas woman who was arrested on a murder charge related to a self-induced abortion, was released after three days when a local district attorney ruled her case invalid. But the repercussions of her case extend well beyond the border town where she was jailed.
Medical professionals say they worry that media attention to her case and others, as well as the looming Supreme Court decision that could allow abortion to become illegal in more than half of the country, will create widespread fear among low-income and marginalized people who already are disproportionately targeted by law enforcement and lack adequate access to health care.
“Once strict abortion laws take effect, we can’t completely rule out the possibility of unsafe abortions,” said Dr. Jamila Perritt, CEO of Physicians for Reproductive Health, which advocates for equal access to reproductive medical care, including abortions.
“But with greater access to online medications, the risk is much less than it used to be. Self-managed abortion can be safe and effective,” she said. “The risk is not a medical one, it’s a legal risk.”
Herrera’s arrest was a direct result of a hospital reporting an abortion to law enforcement. The same is true for the vast majority of people arrested for self-managed abortion, miscarriage or stillbirth, Perritt said.
Most people do not need to see a doctor or go to a hospital when taking medication to induce an abortion. They can complete the procedure in the privacy of their homes. But for those who do need medical care, fear of arrest should not be a deterrent, she said.
Last year, the American Public Health Association published the results of a survey of more than 7,000 women, showing that self-managed abortion was nearly three times more prevalent among Black women than White women and somewhat higher among Hispanic women. According to the public health association, the results indicate that women of color “may face heightened barriers to accessing clinical care or prefer self-managed abortion due to experiences of stigma, discrimination, and structural racism.”
Major medical organizations, including the American Medical Association and the American College of Obstetricians and Gynecologists, have decried the criminalization of pregnant people for abortion and warned medical professionals not to report a patient for the loss of a pregnancy, which they say violates privacy laws and medical ethics.
Medication Abortions Drive Concerns
Despite recent declines in the total number of abortions, due in part to increased access to contraception, nearly 1 in 4 women in the United States will have an abortion by age 45, according to research organization the Guttmacher Institute, which advocates for abortion rights. Medical abortions accounted for more than half of all abortions in 2020, according to a Guttmacher report published in March.
As medication abortions have risen, so have state laws attempting to limit their availability. April Lockley, medical director of the Miscarriage and Abortion Hotline, said her organization was founded to help women manage the process on their own. Recently, she said, the group has been fielding a growing number of calls from women who are unsure whether medication abortion remains legal in their state.
In Texas, Republican Gov. Greg Abbott signed a law that took effect Dec. 2, making it a felony to provide the pills after seven weeks into a pregnancy or to ship the pills through the mail.
The rise in medication abortions, combined with more aggressive state abortion bans in the last two years, spells increasing risk of arrest and prosecution for people who self-induce abortion, said Farah Diaz-Tello, senior counsel and legal director of If/When/How, a group of national advocates for reproductive justice that represented Herrera in the recent Texas case.
“Increasingly strict state regulation of abortion providers has driven many providers out of business. That train has left the station, and it isn’t coming back,” Diaz-Tello said. “More people are going to be self-managing abortions, and more people are going to be criminalized for it.”
3). “The Pill Takes A Step Toward Simpler Access”, May 11, 2023, Pam Belluck, 1,341 words, The New York Times.
The agency is expected to decide this summer whether to allow the first nonprescription sales of an oral contraceptive in the United States.
A panel of advisers to the Food and Drug Administration voted unanimously on Wednesday that the benefits of making a birth control pill available without a prescription outweigh the risks, a significant step in the decades-long push to make oral contraception obtainable over the counter in the United States.
If the F.D.A. approves nonprescription sales of the medication, called Opill, this summer, it could significantly expand access to contraception, especially for young women and those who have difficulty dealing with the time, costs or logistical hurdles involved in visiting a doctor, reproductive health experts say.
''I think Opill has the potential to have a huge positive public health impact,'' said one advisory committee member, Kathryn Curtis, a health scientist with the Centers for Disease Control and Prevention's division of reproductive health.
Approval is not a foregone conclusion, however. F.D.A. scientists who analyzed data submitted by the pill's maker, HRA Pharma, raised concerns about whether women with medical conditions that should preclude them from taking the pill -- primarily breast cancer and undiagnosed vaginal bleeding -- would follow the warnings and avoid the product.
The agency's reviewers also questioned whether a company study reliably demonstrated that consumers would follow the label's directions to take the pill at roughly the same time every day and use another form of contraception or abstain from sex if they happened to miss a dose. The F.D.A. analysts also raised questions about whether younger adolescents and people with limited literacy could follow the directions.
''The F.D.A. has been put in a very difficult position of trying to determine whether it is likely that women will use this product safely and effectively at the nonprescription setting,'' said Dr. Karen Murry, deputy director of the F.D.A.'s office of nonprescription drugs, during the advisory panel's discussion session on Wednesday afternoon.
''We can't just approve it based on the experience in the prescription setting without the applicant doing adequate studies to look at what's likely to happen in the nonprescription setting,'' she said. ''But I wanted to again emphasize that F.D.A. does realize how very important women's health is and how important it is to try to increase access to effective contraception for U.S. women.''
The advisory committee's members overwhelmingly said that those concerns were vastly outweighed by the public health need in a country where nearly half of all pregnancies are unintended and by the long history of safety and efficacy of Opill, which was approved for prescription use 50 years ago.
''The panel expresses confidence in the effectiveness, not only in the general population of females, but also in adolescent populations and those with limited literacy,'' said Maria Coyle, the chairwoman of the committee, a pharmacist and an associate clinical professor at Ohio State University. ''The panel seems very comfortable with the limited number of risks from the medication itself.''
Several panelists said Opill might actually be safest for adolescents because they are very unlikely to have breast cancer, the main medical condition that precludes taking hormonal contraception.
''Adolescents really urgently need this,'' said Dr. Leslie Walker-Harding, a panelist who specializes in adolescent medicine and the chief academic officer and senior vice president of Seattle Children's Hospital. Young people often start off with contraception they can buy over-the-counter, and other such methods, including condoms, are much less effective than pills, which prevent pregnancy 93 percent of the time with typical use.
Most adolescents have ''no or a lower efficacy of birth control methods available to them,'' Dr. Walker-Harding said, adding that ''this would dramatically increase the ability of kids not having unintended pregnancies.''
The panelists included obstetrician-gynecologists, adolescent medicine specialists, a breast cancer specialist and experts in consumer health behavior and health literacy.
Several said they believed few breast cancer patients would be at risk because their oncologists would advise them against using the pill. And many panel members who frequently prescribe birth control pills said that because doctors didn't typically monitor patient adherence and often only saw such patients annually, there was no advantage to requiring a prescription.
Since the Supreme Court overturned the national right to an abortion last year, the accessibility of contraception has taken on more urgency. But even before that, the move to make a nonprescription pill available for all ages has garnered a groundswell of support from specialists in reproductive and adolescent health and groups like the American Medical Association, the American College of Obstetricians and Gynecologists and the American Academy of Family Physicians.
In a survey by the health care research organization KFF, more than three-quarters of women of reproductive age favored an over-the-counter pill, primarily because of convenience.
While some Catholic organizations have spoken out against over-the-counter birth control, most anti-abortion groups have been quiet on the issue. A vast majority of hundreds of comments submitted before the hearing supported approval of Opill. So did most of the 37 people who spoke during the hearing's public comment portion on Tuesday, including young women who gave impassioned testimony about facing challenges obtaining prescription pills.
For proponents of over-the-counter pills, the main issue is affordability.
''This will not be a win if it is not affordable, covered by insurance and available to folks of all ages,'' Kelly Blanchard, the president of Ibis Reproductive Health, said at a briefing on Monday organized by Free the Pill, a pro-over-the-counter coalition.
The Affordable Care Act requires only coverage of prescription contraception, and although some states have laws mandating coverage of over-the-counter methods, most states do not. The KFF survey found that 10 percent of women would not be able or willing to pay any out-of-pocket cost. About 40 percent would pay $10 or less per month, and about a third would pay $20 or less.
FreÞüdeÞürique Welgryn, the global vice president for women's health at Perrigo, which owns HRA Pharma, said recently that the company planned to ''make sure that the product is affordable to women'' and that it would have a consumer assistance program.
Opill is known as a ''mini pill'' because it contains only one hormone, progestin, in contrast to ''combination'' pills, which contain both progestin and estrogen. A company that makes a combination pill, Cadence Health, has also been in discussions with the F.D.A. about applying for over-the-counter status.
HRA Pharma reported that participants in a study took Opill on 92.5 percent of the days they were supposed to take it. Most participants who missed a pill reported that they had followed the label's directions to take mitigating steps such as abstaining from sex or using a condom, said Dr. Stephanie Sober, the company's U.S. medical liaison. She said that among 955 participants, only six became pregnant while using Opill.
Most people who said they had missed doses attributed that to running out of pills before they could get to one of the study's resupply sites, results that, Dr. Sober said, ''illustrate precisely the barriers to adherence that could be lessened by switching Opill to the O.T.C. setting.''
But F.D.A. reviewers were concerned that about 30 percent of participants reported taking more pills than had been dispensed to them, a phenomenon called ''overreporting'' or ''improbable dosing.'' The reviewers wrote that ''because the reported dosing was not possible, it leaves us with no clarity on what one-third of study participants actually took -- or if they took any drug at all.''
Several advisory committee members said that the company's data wasn't perfect but that they were convinced that most people would use Opill appropriately and that the safety risks were low for those who did not.
''I think this represents a landmark in our history of women's health,'' said one panelist, Dr. Marjorie Gass, a retired obstetrician-gynecologist. ''Unwanted pregnancies can really derail a woman's life and especially an adolescent's life. So I'm very pleased that the F.D.A. is seriously Full ban in effect
4). “Tracking the States Where Abortion Is Now Banned”, Updated May 10, 2023, Allison McCann et. al., The New York Times, at < https://www.nytimes.com/interactive/2022/us/abortion-laws-roe-v-wade.html >
Article Starts Here:
Legal status of abortion
About half of states are expected to try to enact bans on abortion or gestational limits on the procedure. In some of these states, abortion remains legal for now as courts determine whether bans can take effect. Abortion remains legal in the rest of the country, and many states have added new protections since Dobbs.
Most abortions are now banned in 14 states following the Supreme Court’s decision to overturn Roe v. Wade. Georgia also bans abortion at about six weeks of pregnancy, before many women know they are pregnant.
In many states, the fight over abortion access is still taking place in courtrooms, where advocates have sued to block enforcement of laws that restrict the procedure. Other states have moved to expand access to abortion by adding legal protections.
Latest updates
1). The governor of Vermont signed two bills that are intended to shield abortion patients and providers from laws in other states. The measures also explicitly protect access to abortion pills.
2). The Supreme Court halted lower court rulings to limit availability of the abortion pill mifepristone, as an appeal moves forward. For now the pill remains widely available in states without restrictions.
The New York Times is tracking abortion laws in each state after the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, which ended the constitutional right to an abortion.
Legal status of abortion
About half of states are expected to try to enact bans on abortion or gestational limits on the procedure. In some of these states, abortion remains legal for now as courts determine whether bans can take effect. Abortion remains legal in the rest of the country, and many states have added new protections since Dobbs.
Maps of Abortion Status in the Various States:
Table with the State Details:
More details on the current status of abortion in each state are below.
Note: Weeks of pregnancy are counted since the last menstrual period.
By Allison McCann, Amy Schoenfeld Walker, Ava Sasani, Taylor Johnston, Larry Buchanan and Jon Huang. Additional reporting by Margot Sanger-Katz and Kate Zernike.
Correction:
June 24, 2022
An earlier version of this article misstated the legal status of abortion in Utah. As of 4 p.m. on June 24, the state attorney general had issued a statement saying the state’s abortion ban had been triggered, but it had not yet been authorized by the legislature’s general counsel. By 8:30 p.m., the counsel authorized the ban and it went into effect.
Correction:
June 28, 2022
A table in an earlier version of this article misstated which abortion ban is being challenged in Texas state court. Abortion rights supporters are challenging a pre-Roe ban, not the state’s trigger ban.
considering this, and I look forward to it being on the market.''
This article appeared in print on page A1, A18.
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