1). “Abortion, Every Day (3.4.24): More anti-abortion studies under fire”, Mar 4, 2024, Jessica Valenti, Abortion, Every Day, at < https://jessica.substack.com/
2). “Study cited by Texas judge in abortion pill case retracted”, Feb 05, 2024, Sofia Resnick, States Newsroom, at < https://www.newsfromthestates.
3). “Researchers call for more abortion studies to be retracted”, Feb 27, 2024, Sofia Resnick, States Newsroom, at < https://www.newsfromthestates.
4). “Inside Missouri Republicans’ effort to curb direct democracy to stop vote on abortion”, Updated March 03, 2024, Kacen Bayless, The Kansas City Star, at < https://www.kansascity.com/
5). “How Louisiana Has Become a Microcosm of the Abortion Access Fight”, Mar 1, 2024, Cecile Richards, Time, at < https://time.com/collection/
6). “The vasectomy boom: After Dobbs, younger men are stepping up: Planned Parenthood clinics in some states are providing vasectomies — and plenty of younger men want them”, Mar 3, 2024, Nicole Karlis, Salon, at < https://www.salon.com/2024/03/
~~ recommended by dmorista ~~
Introduction by dmorista: The Battle over restoring, and enhancing, Reproductive, Contraceptive and Abortion rights in the U.S. rages on, parricularly in the overtly fascist and in the semi Fascist Red States. Now that the Super-Tuesday primary elections have eliminated Nikki Haley and ensured that Trump will be the Republican Candidate. And those primaries have also shown that Joe Biden will no doubt win enough delegates to become the Democratic Party's nominee; though with extremely weak support and enthusiasm from that party's base.
The strongest single issue the Democratic Party has is their weak support for Reproductive Health Care rights. Biden however (as Valenti points out in Item 1)., “Abortion, Every Day (3.4.24): ...” is not even a tepid supporter having made recent statements like this speaking to Evan Osnos at the New Yorker: “I’ve never been supportive of, you know, ‘It’s my body, I can do what I want with it.' ” (Biden continued), “But I have been supportive of the notion that this is probably the most rational allocation of responsibility that all the major religions have signed on and debated over the last thousand years.”
Valenti commented on this statement writing: “So he doesn’t subscribe to the idea that women’s bodies are their own—but is willing to support abortion rights in as much as major religions agree? And who runs major religions, pray tell?” (Emphasis added) It is worth pointing out that the influence of religion on the overall American population has fallen dramatically in recent decades, even as it has been used by right-wing operatives to mobilize the shrinking portion of the population that is still in thrall to religion and the wannabe Theocrats who espouse it.
A total of 7 articles have been either withdrawn from scientific journals from Sage Publications (3) or are under serious challenge from other scientific publishers (4). The 3 that have been withdrawn were listed Item 2)., “Study cited by Texas judge ...” and were all used in rulings by the reactionary tool, Judge Matthew J. Kacsmaryk, of the Forced-Birth movement who presides over the Federal District Court in Amarillo, Texas. These articles were published from 2019 – 2022. Sage withdrew the articles and that fact is reported in Item 2, noting that: “Two of the key studies cited by plaintiffs and judges as evidence that medication abortion should be pulled from the market or heavily restricted have been retracted because of undeclared conflicts of interest and unreliable findings, academic publisher Sage announced Monday.”
Item 2 further reported that: “The lead author for each study was James Studnicki, Charlotte Lozier’s vice president and director of data analytics, who was on the editorial board of 'Health Services Research and Managerial Epidemiology' at the time the studies were published.
The Item 2). article then quoted a statement by Sage that stated: “Upon submission, the lead author declared no conflicts of interest and all authors declared the same within each article; however, all but one of the article’s authors had an affiliation with one or more of Charlotte Lozier Institute, Elliot Institute, and American Association of Pro-Life Obstetricians and Gynecologists – all pro-life advocacy organizations that explicitly support judicial action to restrict access to mifepristone, …”. (Emphasis added)
Recently, as pointed out in Item 3)., “Researchers call for more ...”, 4 more Scientific Journal articles are being challenged for mistakes in the methodolgy and the obvious bias and conflicts of interest by the Forced-Birth operatives who wrote them. These are older articles, ranging from 2002 to 2011 that have been cited in court rulings and deliberations in the U.S. and other countries. The questionable articles are listed in Item 3).
Attempts to put Abortion Rights and Reproductive HealthCare Rights on state ballot initiative continue in several states, including Florida, Arkansas, Arizona, Colorado, and Missouri. The Forced-Birth dominated Missouri State Government is scared of and very much opposed to the attempt to pass a ballot initiative in that state. Item 4)., “Inside Missouri Republicans’ ...” discusses some of the recent moves the Rethug legislators, Governor, and other Rethug operatives have taken. The article points out that shortly after the Abortion Rights movement officially began the campaign to collect the signatures to put the measure on the ballot that Rethug Forced-Birth operatives responded angrily in part saying:
“ 'This is life or death,' said Sen. Rick Brattin, a Harrisonville Republican. 'Are we going to advance an initiative petition to solidify and protect that process to ensure that this evil, vile practice does not make its way into a constitution?'
“ 'Many of us are pro-life in here,' said Sen. Denny Hoskins, a Warrensburg Republican. 'We want to make sure that it is harder to get something passed in the Missouri Constitution.'
“Brattin and Hoskins, in their speeches on the Senate floor in January, demanded their colleagues take up and pass legislation that would make it harder for Missourians to amend the state constitution through the state’s century-old initiative petition process — a stark acknowledgment that Republicans must weaken direct democracy in order to stymie the abortion rights campaign.” (Emphasis added)
Farther down the article discussed yet another far-right Missouri Legislator, Rethug Brian Seitz of Branson where Bayliss wrote quoting Setiz: “ 'We’re being extremely proactive to do everything that we can to make sure that abortion is not ensconced within our Missouri state Constitution,' he said. 'We have to protect life in this state.' ”
Next is a fine editorial comment written by Cecille Richards (formerly the leader of Planned Parenthood) appearing in Item 5)., “How Louisiana Has Become ...”. She penned a fine short but semi-comprehensive analysis of the current situation and how it might evolve, using the extremist controlled situation in Louisiana as an example. And finally Item 6)., “The vasectomy boom: …”, looks at the response of men, particularly young men to the harsh theocratic / fascist regimes in control of much of the country. Significantly, rising numbers of young men are choosing to have vasectomies and just end any chance of an unwanted, and potentially disastrous, pregnancy with their female partners. Using vasectomy is a fairly drastic move for young men, but it reflects the harsh police state conditions and the generally grim economic conditions faced by young people in much of the country.
We should not forget that the theocrats, religious fanatics, and right-wing extremists conducted a 40+ year terror campaign against abortion providers and vulnerable women. This terror campaign killed 11 people, some of them physicians but also receptionists, and one security guard, dozens of abortion clinics were bombed or burnt, the terror campaigners issued thousands of bomb and arson threats, hundreds of thousands of women were intimidated by aggressive demonstrators. We should not be surprised to continue to see coercive and vicious methods used to enforce these unpopular bans and harsh control over women's reproductive decisions.
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Abortion, Every Day (3.4.24)
Click to skip ahead: In Attacks on Democracy, ballot measure news from Mississippi, Missouri and Arizona. In the States, the Nebraska Supreme Court is hearing a challenge to the state’s abortion ban, and news from North Carolina, Wyoming and Colorado. In the Nation, good and bad news on abortion medication. In Media Muck-Ups, I’m pissed at USA Today. In 2024 news, please someone tell Joe Biden that if he doesn’t have anything nice to say about abortion he shouldn’t say anything at all. In the World, a quick look at the news out of France. In Stats & Studies, we might see more retractions of anti-abortion ‘studies’ soon. Care Denied features a terrific piece from Cecile Richards. And finally, in You Love to See It, over-the-counter birth control is here!
Attacks on Democracy
Mississippi Republicans have moved forward with legislation that would restore the ballot measure process in the state—but not for abortion rights. That right, they want to give voters the right to bring an issue forward, so long as it’s not an issue they disagree with.
Meanwhile, The Kansas City Star has a big piece on Missouri Republicans’ efforts to quash voters’ voices. If you’re a regular reader, you know that the state GOP has been attacking democracy left and right—pulling out any possible stop they can to prevent voters from having a say on abortion rights.
In fact, Republican Sen. Denny Hoskins says, “Our entire Republican majority, 24 state senators, decided that this was our No 1. priority.” (Senate Minority Leader John Rizzo says, “That should tell you all you need to know about the Republican Party in the state of Missouri.”)
Missouri Republicans’ latest move is an attempt to change ballot measure rules—a shift that would essentially give conservative rural districts the power to reject amendments even when they’re supported by the overwhelming majority of voters.
Maggie Olivia of Abortion Action Missouri told the Kansas City Star, “They know that they’re not going to win unless they can get away with their dirty tricks.”
Anti-abortion groups in Arizona are also trying to stop voters from having a say—they’re organizing against a pro-choice ballot measure, working to stop the proposed amendment from moving forward. For example, NBC News reports that Arizona Right to Life has a “team of lawyers on retainer waiting to scrutinize each and every signature that’s submitted.” (Remember, conservative groups in multiple states have been claiming that signatures aren’t valid, and are using claims of voter fraud to try to stop ballot measures.)
In the States
The Nebraska Supreme Court will hear arguments tomorrow morning in a challenge against the state’s ban on abortions and gender-affirming care. The suit, brought by Planned Parenthood and the ACLU of Nebraska, argues that the law violates the state constitution’s rule around single-subject laws. Because the law restricts both abortion care and gender-affirming care, it is very clearly not about a single subject!
Nebraska passed the 12-week ban last year, around the same time that North Carolina was considering a similar law and Republicans were making the broad argument that 12-week bans were a reasonable ‘middle ground’. They’re not.
Speaking of North Carolina: Abortion is center stage in the gubernatorial race, where Republican frontrunner Lt. Gov. Mark Robinson is a rabid anti-abortion activist. (Seriously, he said he believed the founders of Planned Parenthood were “witches.”) Robinson’s likely opponent will be state Attorney General Josh Stein, who is a vocal abortion rights supporter.
North Carolina already has a 12-week abortion ban, passed by a Republican supermajority after former-Democrat Tricia Cotham switched sides. Democratic Gov. Roy Cooper wasn’t able to veto the law—so you can imagine what a Republican, anti-abortion governor would mean for the state. If you had any doubts, consider what Robinson said when caught on a hot mic:
"We’ve got [abortion] down to 12 weeks. The next goal is to get it down to 6, and then just keep moving from there."
An anti-abortion bill moved forward in Wyoming late last week—legislation that seeks to shut down the last remaining abortion clinic in the state. The bill would require abortion clinics (and again, there’s only one) to be within 10 miles of an admitting hospital and to be licensed as an ambulatory surgical center.
This is a familiar tactic in TRAP Laws; when Republicans can’t ban abortion, they try to regulate clinics out of existence under the guise of patient safety. Because remember, while Wyoming passed two abortion bans—one broad ban and another specifically targeting abortion medication—both were blocked by a judge as they’re battled out in court.
Finally, Aspen Public Radio looks at the ballot measure effort in Colorado, where pro-choice activists are seeking to enshrine abortion rights in the state constitution—which would offer more protections and lift a prohibition on using state dollars for abortion care.
Quick hits:
More on California’s move to expand the reproductive health workforce;
And Texas Republicans claim that IVF is already protected in the state.
In the Nation
In case you missed it: CVS and Walgreens announced late last week that they’re going to start dispensing mifepristone, one of the drugs used to end a pregnancy. The retail pharmacy chains said they had gotten the certification required by the FDA and would begin to dispense the medication gradually, starting in states where doing so is legal. Which is great! But…
Representatives from the chains also said that they wouldn’t be dispensing mifepristone in states where the law was “unclear.” I’m super curious what ‘unclear’ means in this case. (You may recall that around this time last year, Kansas Attorney General Kris Kobach successfully pressured Walgreens out of dispensing abortion medication in the state even though the medication is legal.)
I understand the companies have to protect their staff and pharmacists from legal repercussions, of course—but here’s hoping they don’t just do the bare minimum. The other not terrific news is that the pharmacies noted that they would not be dispensing the drug by mail. Obviously, medication-by-mail has become a huge focus since Roe was overturned, with Republicans attacking telehealth and mifepristone.
Speaking of just that: Susan Rinkunas in Jezebel flags that Republican lawmakers filed an amicus brief in the Supreme Court mifepristone case, using the Comstock Act. What’s just as incredible is that the legislators didn’t cite the Act by name, but instead referred to it by its federal statute number (18 U.S.C. 1461 and 1462). You can guess why—Republicans don’t want voters to know what they’re up to, and exactly what Comstock could do. From Rinkunas:
“Read broadly, it could be used to not only ban medication abortion, but by prohibiting shipments of medical supplies used in clinics, it could outright ban abortion procedures in all 50 states. Yes, even ones with laws that protect abortion.”
For more on the Comstock Act, read Abortion, Every Day’s explainer here. For a list of Republicans and conservative groups who signed onto amicus briefs supporting the mifepristone attack, click here.
Quick hits:
Vox has a fetal personhood explainer;
The editorial board at the Los Angeles Times writes that IVF will never be protected under fetal personhood laws;
Salon on the rise of younger men getting vasectomies;
And The New Republic on why Republicans’ IVF fight has nothing to do with ‘babies’.
Media Muck-ups
Why in the world is USA Today using the term ‘chemical abortions’? For some inexplicable reason, the publication uses the nonsense anti-abortion term in both the headline and reporting of a piece about Wyoming abortion restrictions.
To be clear: there is no such thing as ‘chemical’ abortion. There is, however, medication abortion. ‘Chemical’ abortion is not a medical or scientific term; it’s a political phrase that’s been deliberately crafted conservative groups seeking to make abortion medication seem dangerous or poisonous.
It’s bad enough that publications repeat the term when quoting anti-abortion legislators and activists—but that, at least, is defensible. What’s not defensible is media outlets using ‘chemical abortion’ as if it’s a credible medical term. Shameful stuff.
If you appreciate all the work that goes into Abortion, Every Day, consider supporting the newsletter with a paid subscription:
2024
I feel bad for whoever is in charge of reproductive rights messaging at the White House. Imagine putting in all this work to make abortion the top campaign issue—carefully crafting messages and speeches—just to have Joe Biden muck it up time and again. I mean really, can’t someone reign him in??
From his 30-second spiritless defense of abortion rights in last year’s State of the Union address and saying he’s not “big on” abortion, to reiterating (twice!) that he doesn’t support “abortion on demand”—whenever the president has the chance to talk about abortion, it’s as if he goes out of his way to be as middling and offensive as possible.
Biden’s latest comments to The New Yorker this week, however, may take the cake. When asked about how he would protect abortion rights in a second term, the president talked about restoring Roe and said this: “I’ve never been supportive of, you know, ‘It’s my body, I can do what I want with it.’”
Biden continued, “But I have been supportive of the notion that this is probably the most rational allocation of responsibility that all the major religions have signed on and debated over the last thousand years.”
So he doesn’t subscribe to the idea that women’s bodies are their own—but is willing to support abortion rights in as much as major religions agree? And who runs major religions, pray tell?
Again, I know there are terrific people over there working on this issue—and I can’t imagine how frustrating it must be to do that work just to have Biden say something like this. But this is not how we win on abortion.
In the World
While the U.S. increases restrictions and bans on abortion, other countries are moving forward with protections. Today, legislators in France voted to enshrine abortion in the country’s constitution. (The New York Times says the country is the first to do so, but ABC News reports that the former Yugoslavia protected abortion in their constitution in 1974.)
Prime Minister Gabriel Attal said, “We are sending the message to all women: Your body belongs to you.” More from Attal:
“We are haunted by the suffering and memory of so many women who were not free. We owe a moral debt [to all the women who] suffered in their flesh…To enshrine this right in our constitution is to close the door on the tragedy of the past and its trail of suffering and pain. It will further prevent reactionaries from attacking women. Let’s not forget that the train of oppression can happen again. Let’s act to ensure that it doesn’t, that it never comes this day.”
The new amendment says that abortion is a “guaranteed freedom,” and that government can’t interfere in the current laws up to 14 weeks into pregnancies. Now, obviously this is good news—that said, a 14-week restriction is not the same thing as a guaranteed right to abortion! (Just ask the people who haven’t been able to access care.)
Stats & Studies
Remember how two major anti-abortion studies were retracted by their publisher? Well, we may see some more of that soon. Last week in the British Medical Journal, a group of 17 distinguished researchers, scholars, and physicians called for the retraction or correction of four more anti-abortion studies.
The four studies, all written by anti-abortion activists, falsely connect abortion to mental health issues like depression and anxiety. Sofia Resnick of States Newsroom has a terrific report on the BMJ piece that calls for the retraction of the pieces, where spoke to lead author Julia H. Littell.
Littell, a professor at the Graduate School of Social Work and Social Research at Bryn Mawr College, says that a lot of the damage from the ‘studies’ is already done, but it’s still vital that the record is corrected:
“How that’s going to play out in courts is a whole different story. It’s quite possible that some expert witnesses, and maybe even judges, will continue to cite these papers, even if they are retracted. But we think it’s really important to get this corrected, so that the downstream effects on medicine and public policy aren’t dire.”
And that’s the rub—these are the studies that anti-abortion lawmakers and judges are using to defend their attacks on reproductive rights! There’s a reason, after all, that the anti-abortion movement is putting so much effort into creating fake ‘research organizations’ and drumming up fake statistics. They know they they don’t have a scientific leg to stand on, so they’re working to create their own.
The other thing I really appreciated about Resnick’s piece is that she highlights the hard work involved in trying to get these studies corrected or retracted. Credible researchers are often doing this on their own time and dime. And as BMJ co-author Chelsea Polis said, the work is “unappreciated, generally unrewarding, [and] sometimes dangerous.” (Stay tuned for more on how you can help support efforts to debunk anti-abortion studies.)
Care Denied
Please take the time to read this incredible TIME magazine column from former Planned Parenthood president Cecile Richard. Cecile looks at how Louisiana is a microcosm for the broader abortion rights fight—from a ban being passed against voters’ wishes to the massive hurdles to access. What sticks out the most in her piece, though, is the amazing activism happening on the ground:
“Everywhere I go, people are sharing their own stories, and doing brave, important work in incredibly tough circumstances. Because when the alternative is giving up on entire swaths of the country, there’s really no alternative. ‘It’s like walking through the mud,’ one clinic staff member told me. ‘It isn’t easy, but you just have to keep going.’”
What a quote. Definitely read the whole piece.
You Love to See It
We could all use some good news, and this definitely qualifies: the first over-the-counter birth control pill will be available later this month. ‘
That means people can buy the contraception without a prescription, as easily as they would any other drugstore medication. The manufacturer of Opill is suggesting a $20 a month or $50 every three months price-tag. NPR has more on the drug here.
This is great and long overdue news—especially because it comes at the same time that Republicans are launching a quiet war on birth control.
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Study cited by Texas judge in abortion pill case retracted
Experts have said that mifepristone, part of a two-drug regimen, has a record of safety and efficacy in more than two decades of use. (Chris Coduto/Getty Images for UltraViolet).
Two of the key studies cited by plaintiffs and judges as evidence that medication abortion should be pulled from the market or heavily restricted have been retracted because of undeclared conflicts of interest and unreliable findings, academic publisher Sage announced Monday.
States Newsroom was the first to report last year that Sage had opened an investigation into some of the research featured prominently in the initial Alliance for Hippocratic Medicine v. U.S. Food and Drug Administration case, whose appeal goes before the U.S. Supreme Court next month. The case is centered on mifepristone, part of a two-drug regimen used to terminate pregnancies and to manage miscarriages.
Sage retracted three studies published in its journal “Health Services Research and Managerial Epidemiology,” which were funded and produced by the Charlotte Lozier Institute, the research arm of the influential Susan B. Anthony Pro-Life America, which works to elect federal and state anti-abortion lawmakers.
“Following Committee on Publication Ethics (COPE) guidelines, we made this decision with the journal’s editor because of undeclared conflicts of interest and after expert reviewers found that the studies demonstrate a lack of scientific rigor that invalidates or renders unreliable the authors’ conclusions,” reads a statement issued by Sage.
The studies are:
- “A Longitudinal Cohort Study of Emergency Room Utilization Following Mifepristone Chemical and Surgical Abortions, 1999–2015” (2021)
- “A Post Hoc Exploratory Analysis: Induced Abortion Complications Mistaken for Miscarriage in the Emergency Room are a Risk Factor for Hospitalization” (2022)
- “Doctors Who Perform Abortions: Their Characteristics and Patterns of Holding and Using Hospital Privileges” (2019)
The lead author for each study was James Studnicki, Charlotte Lozier’s vice president and director of data analytics, who was on the editorial board of “Health Services Research and Managerial Epidemiology” at the time the studies were published.
“Upon submission, the lead author declared no conflicts of interest and all authors declared the same within each article; however, all but one of the article’s authors had an affiliation with one or more of Charlotte Lozier Institute, Elliot Institute, and American Association of Pro-Life Obstetricians and Gynecologists – all pro-life advocacy organizations that explicitly support judicial action to restrict access to mifepristone,” the Sage statement reads. One of those groups, AAPLOG, is a plaintiff in the Alliance v. FDA lawsuit.
In a statement, Studnicki and Tessa Longbons, senior research associate, called the Sage retraction a “baseless ideological attack on our scientific research and experts. To date, Sage hasn’t identified a single substantive objection to the studies to the research team. However, Sage has launched a political assault against an organization whose research has been cited in major pro-life legal victories, such as the Dobbs decision and the AHM v. FDA case. Even after reviewing and publishing this study and standing by it for years, Sage has now caved to outside partisan pressures that dominate elite circles,’’ Studnicki and Longbons said.
“Sadly, this incident points to a larger, newer phenomenon, which is, many of our scientific institutions no longer stand in defense of open inquiry. Rather, what we’re seeing is a biased faction in the medical community (that) holds all the power and attempts to suppress any research that cuts against their approved, pro-abortion narrative,’’ Studnicki and Longbons said.
Last year, pharmaceutical sciences professor Chris Adkins contacted Sage with his concerns about the 2021 “Longitudinal Cohort Study,” which was cited by U.S. District Judge Matthew Kacsmaryk as evidence that the anti-abortion doctor-plaintiffs had standing to sue because “they allege adverse events from chemical abortion drugs can overwhelm the medical system and place ‘enormous pressure and stress’ on doctors during emergencies and complications.”
That paper looked at Medicaid patients’ visits to the emergency room within 30 days of having an abortion and concluded that medication abortion is excessively risky.
“I can’t prove that there was intent to deceive, but I struggled to find an alternative reason to present your data in such a way that exaggerates the magnitude,” Adkins told States Newsroom at the time. “They’re misrepresenting its conclusions to begin with.”
The epidemiology and public health experts who conducted an independent post-publication peer review of the three studies ultimately agreed with Adkins. Regarding the 2021 and a follow-up 2022 paper using the same dataset, the experts found “fundamental problems with the study design and methodology,” “unjustified or incorrect factual assumptions,” “material errors in the authors’ analysis of the data,” and “misleading presentations of the data.”
The 2019 article, using a different dataset, contained “unsupported assumptions,” “misleading presentations of the findings,” and “demonstrate a lack of scientific rigor and render the authors’ conclusion unreliable,” the experts found.
Experts have cited mifepristone’s safety and efficacy with more than 5.6 million uses over the past two decades. The FDA has recorded 28 deaths but has stated that the drug cannot be identified as the cause of those deaths.
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Researchers call for more abortion studies to be retracted
Julia H. Littell, a professor at the Graduate School of Social Work and Social Research at Bryn Mawr College, said that in the post-Roe era, as abortion restrictions increase, pressure has mounted to correct the record on abortion safety. Littell is the lead author of a commentary in the British Medical Journal calling for the retraction of four older abortion-related studies. (Getty Images)
Health and science experts published a commentary in the British Medical Journal on Tuesday calling for the retraction of four older abortion-related studies that, despite documented flaws, have influenced major anti-abortion decisions over the past 20 years, including the 2022 U.S. Supreme Court decision that overturned federal abortion rights.
The commentary comes the same month academic publisher Sage Journals retracted studies calling into question the long-established safety record of the abortion drug mifepristone, which were produced by anti-abortion activists shortly before they sued the U.S. Food and Drug Administration over the same drug.
The timing of these two events is coincidental, lead author Julia H. Littell told States Newsroom (she said the authors submitted their article last year, and it only recently completed the peer review and editorial process). But she said that in this post-Roe era, as abortion restrictions increase, pressure has mounted to correct the record on abortion safety.
“There’s a lot of damage that has been done, and probably will continue to be done, but it’s really important that scientific and medical journals correct these kinds of mistakes so that people don’t lose faith in science,” said Littell, a professor at the Graduate School of Social Work and Social Research at Bryn Mawr College. “How that’s going to play out in courts is a whole different story. It’s quite possible that some expert witnesses, and maybe even judges, will continue to cite these papers, even if they are retracted. But we think it’s really important to get this corrected, so that the downstream effects on medicine and public policy aren’t dire.”
The authors, 17 experts on reproductive and mental health and scientific methods from around the world, are calling for the correction or retraction of four studies published between 2002 and 2011, which they say erroneously attributed women’s mental health issues to abortions they had, in some cases by confusing correlation with causation and failing to correct for factors that explained the relationship.
“It turns out that women who have abortions may be more likely to have mental health problems to begin with,” Littell said. “They tend to be living in greater situations of adversity; they tend to be more exposed to domestic violence and other forms of interpersonal violence. … And when you don’t control for that, which is absolutely a predictor of abortion, then yes, later on, it looks like they have more serious mental health problems. But the problem was there all along. Abortion isn’t really predicting that. Abortion is co-occurring with that.”
The studies were authored by a handful of longtime anti-abortion activists and have received intense scrutiny and criticism over the years, but continue to be cited by lawmakers and judges to defend anti-abortion policies, including the FDA case the U.S. Supreme Court will hear next month.
The studies are:
- “Depression and unintended pregnancy in the National Longitudinal Survey of Youth: a cohort study,” published in 2002 in the British Medical Journal (which also published Tuesday’s commentary). The authors of this study are longtime abortion opponent David C. Reardon, who also co-authored two of the recently retracted Sage articles, and Jesse R. Cougle. The cohort study concluded that the risk of depression was higher in women who had an abortion compared with those who continued an unwanted first pregnancy. But the commentary writers say an independent re-analysis of the same data found that the study incorrectly identified unwanted first pregnancies and did not control for pre-pregnancy levels of depression. The journal made partial corrections, but the commentary authors say “serious methodological problems remain uncorrected.”
- “Generalized anxiety following unintended pregnancies resolved through childbirth and abortion: a cohort study of the 1995 National Survey of Family Growth,” published in 2005 in the Journal of Anxiety Disorders, and written by Cougle, Reardon, and Priscilla K. Coleman, a retired Bowling Green State University professor of human development and family studies, and a longtime anti-abortion activist. The study concluded that abortion was associated with higher rates of anxiety than giving birth, but, according to the commentary authors, an independent re-analysis showed that pre-existing levels of anxiety and exposure to domestic violence accounted for this association.
- “Induced abortion and anxiety, mood, and substance abuse disorders: isolating the effects of abortion in the national comorbidity survey,” published in 2009 in the Journal of Psychiatric Research and authored by Coleman, Catherine T. Coyle, Martha Shuping, and frequent anti-abortion expert witness Vincent M. Rue. This analysis concluded that abortion increased the likelihood of various mental health problems and substance use disorders, but the commentary authors say the results could not be replicated because of incorrect statements about the methodology.
- “Abortion and mental health: quantitative synthesis and analysis of research published 1995-2009,” published in 2011 in the British Journal of Psychiatry, authored by Coleman. This was a meta-analysis that ultimately concluded that abortion accounts for a substantial increase in the risk of adverse mental health outcomes. The commentary authors say the study failed to meet methodological criteria for systematic reviews, noting that 11 of the 22 included studies were authored or co-authored by the sole author of the meta-analysis.
“We believe that journal editors and their publishers have an ethical obligation to correct the scientific record in these cases,” the commentary writers said, several of whom have been studying the health impacts of abortion for years. They are calling for the 2002 and 2005 articles at minimum to be accompanied by expressions of concern and the 2009 and 2011 articles to be retracted “because of the overwhelming and incontrovertible evidence of their methodological flaws, inaccurate results, and invalid conclusions.”
Littell, an expert on meta-analyses, said the 2011 study is the most egregious, in part because there was only one author, which is not the recommended standard for this type of tedious and difficult analysis. She said she was among several researchers who wrote letters to the editor of the British Journal of Psychiatry more than a decade ago calling for its retraction. The commentary writers estimate it has been cited in at least 25 court cases and 14 parliamentary hearings across six countries.
Neither Coleman, Cougle, or Reardon responded to requests for comment by the time of publication.
These researchers have long stood by their work and some continue to testify as expert witnesses in abortion-related lawsuits. Coleman in a rebuttal submitted to the British Journal of Psychiatry in 2022 blamed renewed calls to retract her research on pro-abortion bias. “I have not been the only recipient of this form of bullying due to publishing research results that run counter to a political agenda,” Coleman wrote.
The British Medical Journal told States Newsroom in a written statement: “We are grateful for the concerns raised in the analysis article that we have published today. The issue remains under consideration by our research integrity team. We will make our final decision public once we have completed our internal process”
The remaining three journals did not respond to a request for comment by the time of publication.
Correcting the scientific record: ‘If we don’t, who will?’
The commentary writers also say they are trying to restore public confidence in science.
“It is a concern to me that people will begin to, if they haven’t already, lose trust in science if they can’t rely on the publications out there to be valid,” said Antonia Biggs, associate professor and social psychologist at the University of California San Francisco’s Advancing New Standards in Reproductive Health, which produced the Turnaway Study. That research found that women who have abortions do not suffer worse mental health outcomes than those denied abortions. “It is the responsibility of us as researchers or publishers to adhere to science and to make sure that the scientific record is accurate. If we don’t, who will?”
UCSF professor Diana Greene Foster, who led the longitudinal Turnaway Study, also co-authored the commentary. (Editor’s note: Reporter Sofia Resnick contributed proofreading and editing to Foster’s 2020 book about the study.) UCSF professor Ushma Upadhyay, another commentary co-author and Turnaway Study researcher, is also pursuing a paper re-examining the retracted Sage research.
Chelsea Polis is another commentary co-author who has been involved in efforts to retract flawed reproductive-health-related research. She is a senior scientist of epidemiology at the Center for Biomedical Research at the Population Council, which developed the abortion pill at the center of the FDA lawsuit, along with contraceptives and other reproductive health products.
In 2022, the journal Frontiers in Psychology published Coleman’s critique of the Turnaway Study but, according to Inside Higher Ed, re-examined the article post-publication after critics, including Biggs and Polis, pointed out that Coleman’s article had been edited and peer reviewed primarily by scientists from the anti-abortion think tank the Charlotte Lozier Institute.
Also in 2022, Polis led a group of 16 scholars who submitted their concerns to the British Journal of Psychiatry about Coleman’s 2011 meta-analysis. An investigative article published by the British Medical Journal reported that an independent panel had determined that the 2011 study should be retracted. But according to the BMJ, the Royal College of Psychiatrists, which owns the British Journal of Psychiatry, overruled the panel after Coleman threatened to sue. Panelists and editorial board members resigned in protest over concerns the journal lacked editorial independence. The Royal College defended its decision not to retract in a 2023 statement, citing the “distance in time since the original article was published” and “the widely available public debate on the paper.”
Polis told States Newsroom the fear of lawsuits can deter retractions, a fear she understands firsthand. In 2020, the medical device company Valley Electronics of Zurich, Switzerland, sued Polis for defamation after she raised concerns about how their Daysy fertility tracker was being marketed as a contraceptive based on a paper that was ultimately retracted. The company lost the lawsuit.
“Editors, journals, and publishers have very little incentive to retract papers (and sometimes avoid retracting even when it really should be done),” Polis said in an email. Polis is an advocate for abortion access, but she said her research critiques have been based on concerns over methodology and not policy positions. She said this work analyzing and calling out flawed science has brought her into a community of scientists dealing with similar legal battles.
“In so many ways, people willing to do this kind of unappreciated, generally unrewarding, sometimes dangerous, and yet extremely critical scientific integrity work need more help and meaningful support,” Polis said.
Biggs told States Newsroom she doesn’t know where these new calls for retraction will lead. But she said she plans to continue pointing out the flaws in these studies, because their influence has had real-world impact.
“When we’re talking about these policies, they have real effects and can have the effects of denying someone a wanted abortion,” said Biggs, referencing the Turnaway Study she worked on, which found more negative short-term mental health outcomes for patients denied abortions, as well as more long-term health and socioeconomic outcomes. “It’s going to impact them. It’s going to impact their children and their families.”
WASHINGTON — The U.S. Supreme Court will hear oral arguments on March 26 in the case that could significantly curtail access to a prescription drug used for both abortions and miscarriage care.
The case centers on when and how patients can access mifepristone, a pharmaceutical the U.S. Food and Drug Administration originally approved in 2000.
Mifepristone is currently approved for use up to 10 weeks gestation and accounts for more than half of abortions in the United States when used in combination with a second pharmaceutical called misoprostol.
Doctors also often use the two-drug regimen to provide treatment following a miscarriage.
Lawsuit history
The original lawsuit, brought by the anti-abortion legal organization Alliance Defending Freedom, asked the U.S. District Court for the Northern District of Texas to overturn the FDA’s original approval of mifepristone.
If the judge didn’t agree to that, the organization requested the court revert prescribing and dosage of mifepristone to what was in place before the FDA began implementing changes in 2016.
Judge Matthew Joseph Kacsmaryk stayed the FDA’s original approval of mifepristone in an April 2023 ruling that was later put on hold by the U.S. Supreme Court pending appeal.
The 5th Circuit Court of Appeals heard oral arguments in May 2023 before issuing its ruling a few months later, in August.
That three-judge panel said that mifepristone could remain legal in the United States, but that prescribing and dosage guidelines should go back to what was used before changes began taking effect in 2016. That ruling is on hold pending the Supreme Court’s decision in this case.
That ruling, should it ever take effect, would lower the maximum gestational age from 10 weeks to seven weeks and remove the option for mifepristone to be prescribed via telehealth appointments and mailed to patients’ homes.
Patients would once again be required to attend three in-person doctor’s office visits to complete a medication abortion.
Only doctors would be able to prescribe mifepristone, instead of health care providers who are authorized to prescribe medications.
Dosage and timing of mifepristone and the second drug used in medication abortion, misoprostol, would need to be administered under guidelines that went out of use more than seven years ago.
Briefs filed
Dozens of medical organizations and pharmaceutical groups have filed briefs with the Supreme Court, urging it to decide one way or another.
The Pharmaceutical Research and Manufacturers of America wrote in its 28-page brief that if the 5th Circuit Court of Appeals ruling is left in place it “could invite boundless litigation to FDA drug approvals.”
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“Congress created an FDA approval process that is both rigorous and thorough, and pharmaceutical companies invest billions of dollars in research and development to meet FDA’s scientific standards,” they wrote.
If the appeals court’s ruling is allowed to take effect, they wrote, it “threatens to stifle pharmaceutical innovation by disrupting industry’s reasonable investment-backed expectations.”
Several medical organizations, including the American College of Obstetricians and Gynecologists and the American Medical Association, wrote in a 36-page brief to the Supreme Court that “[n]o patient should be denied treatment for miscarriage or other early pregnancy loss because of Respondents’ hypothetical fears or personal beliefs.”
When it comes to abortion access, they wrote that patients “in states where abortion remains legal and protected should not be denied the ability to safely and privately seek to exercise that right through safe and effective medication abortion.”
“Restricting access to mifepristone — the safety of which is proven by decades of rigorous scientific study and millions of uses — in ways that are not medically necessary or scientifically sound would seriously increase risk for hundreds of thousands of patients, while protecting none,” they wrote.
“For already vulnerable populations (particularly those living in areas with limited access to OB/GYN care) the rollback approved by the Fifth Circuit promises to be especially devastating and to further perpetuate racial and socioeconomic inequalities,” they added.
Alliance Defending Freedom Senior Counsel Erin Hawley said in a written statement released last week that she urged “the Supreme Court to hold the FDA accountable and require the agency to reinstate its safety standards.”
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Inside Missouri Republicans’ effort to curb direct democracy to stop vote on abortion
Just hours after a coalition of abortion rights groups launched a campaign to overturn Missouri’s near-total abortion ban at the ballot box, Republican senators called for action on the state Senate floor.
They were furious.
“This is life or death,” said Sen. Rick Brattin, a Harrisonville Republican. “Are we going to advance an initiative petition to solidify and protect that process to ensure that this evil, vile practice does not make its way into a constitution?”
“Many of us are pro-life in here,” said Sen. Denny Hoskins, a Warrensburg Republican. “We want to make sure that it is harder to get something passed in the Missouri Constitution.”
Brattin and Hoskins, in their speeches on the Senate floor in January, demanded their colleagues take up and pass legislation that would make it harder for Missourians to amend the state constitution through the state’s century-old initiative petition process — a stark acknowledgment that Republicans must weaken direct democracy in order to stymie the abortion rights campaign.
The GOP-controlled Missouri Senate later approved a version of the measure, which supporters call “initiative petition reform,” sending the legislation to the House. If passed by both chambers, voters would have the final say — either in November or at an earlier election, potentially in August, called by Republican Gov. Mike Parson.
The renewed effort to overhaul the state’s initiative petition process, which some Republicans have touted as a way to block the abortion rights campaign, has drawn intense scorn from Democrats, voting rights advocates and attorneys who have framed the legislation as a broader attack on democracy.
The Republican-led push has created a world in which Missourians across the state are gearing up for what could be two of the state’s most consequential statewide votes related to abortion access either directly, or by perception: a vote to overturn the state’s abortion ban and a vote on whether to overhaul the initiative petition process.
Some politicians and political observers on both sides of the abortion debate have raised questions about whether changes to the voter threshold, if approved by voters in August, would even impact the abortion rights vote if it were to reach the ballot in November.
But what’s clear from conversations inside the Missouri Capitol is that access to abortion will be a key message for both supporters and opponents of the state’s initiative petition process in the coming months.
House Minority Leader Crystal Quade, a Springfield Democrat, is embarking on a campaign for governor focused in large part on overturning the near-total ban in Missouri, which had for years whittled away at access to the procedure even before the ban went into effect in 2022.
The potential campaign against Republican efforts to make it harder for voters to amend the constitution will include the idea that Missourians should be able to have their voices heard on abortion, she said.
“They know Missourians want access to abortion and they know that when it makes it to the ballot box in the fall, that it’s going to pass,” Quade said of Republican lawmakers. “They have really pivoted their language towards, if we don’t get this done, then abortion is going to become the law of the land.”
But the debate over the state’s initiative petition process involves more than just abortion, Quade emphasized. Citizen-led campaigns have been utilized by voters of both parties to bypass the General Assembly and put measures to a statewide vote.
Republican criticism against the current process comes as voters have in recent years passed several progressive policies through initiative petitions, including marijuana legalization and Medicaid expansion.
While Rep. Brian Seitz, a Branson Republican, agreed that the initiative petition process and abortion are separate issues, he made the connection between the two efforts clear.
“We’re being extremely proactive to do everything that we can to make sure that abortion is not ensconced within our Missouri state Constitution,” he said. “We have to protect life in this state.”
The dueling efforts could mirror what happened in Ohio last year, in which Republican lawmakers put a measure on the ballot that would have increased the approval threshold for constitutional amendments from 50% to 60% in an attempt to thwart a campaign to enshrine abortion rights in the Ohio Constitution.
An overwhelming majority of voters in Ohio rejected the measure during an August special election. And then roughly the same percentage of voters, 57%, voted in favor of abortion rights in November.
Sam Lee, a longtime anti-abortion lobbyist in Jefferson City, said that, in practice, the two potential campaigns in Missouri will be linked together. But Lee, who supports making it harder to amend the constitution, signaled that’s not how he would like to see the two efforts framed, pointing to the votes in Ohio.
“Even though abortion wasn’t mentioned in that (Ohio) initiative petition, it was all about abortion. I mean, on both sides, they advertised on that,” he said. “Is that the way it should be? No, I think initiative petition reform is much broader than one particular issue.”
‘Last ditch effort’
Missouri Republicans have for years attacked the state’s initiative petition process, a more-than-100-year-old mechanism that requires an expensive and time-consuming signature-gathering campaign to get measures on a statewide ballot.
Republicans, for the most part, argue that it’s too easy for voters to change the constitution and the current process has allowed outside interest groups to influence elections.
But Republican messaging around the issue began to shift last year after abortion rights groups filed a series of petitions that would enshrine the right to an abortion in the state constitution.
House Speaker Dean Plocher, a St. Louis-area Republican, last year was one of the first prominent Missouri Republicans to directly connect abortion to the efforts to make it harder to change the constitution. He told reporters that he felt a majority of Missourians would vote to overturn the ban if the voter threshold was not increased.
“I think we all believe that an initiative petition will be brought forth to allow choice,” Plocher said at the end of last year’s legislative session in May. “I believe it will pass. Absolutely.”
Plocher’s office, in a recent written statement to The Star, however, downplayed the link between abortion and making it harder to amend the constitution, pointing to the fact that the abortion rights campaign has not yet qualified for the ballot. He instead touted the legislation as a way to prevent foreign countries from sponsoring ballot measures, a practice that is already illegal under federal law.
“I believe that Missouri voters will get to have a say on IP reform in November,” he said.
The measure passed by the Senate last month would require amendments to the state constitution be approved essentially twice, a majority vote in at least five of the state’s eight congressional districts and a majority vote statewide. Currently, constitutional amendments only need a majority vote statewide.
The change would effectively weaken the power of urban residents’ votes and empower the votes of rural residents in statewide elections on constitutional amendments. A coalition of rural congressional districts would be able to reject amendments even if they’re supported overwhelmingly in the state’s two biggest cities of Kansas City and St. Louis.
Maggie Olivia is the senior policy manager for Abortion Action Missouri, which is part of the coalition called Missourians for Constitutional Freedom that is seeking to overturn the state’s abortion ban.
Anti-abortion politicians are the same “anti-democracy” lawmakers who have been attacking the initiative petition process for years, Olivia said in an interview.
“This tie to the current abortion campaign in Missouri — it’s really just a last ditch effort by these anti-democracy politicians who know that they’re in a losing game,” she said. “They know that they’re not going to win unless they can get away with their dirty tricks.”
Supporters of the state’s initiative petition process and of overturning the abortion ban signaled in interviews that voters will be prepared for both issues if they reach the ballot. Many pointed to the votes in Ohio.
Voters want to have a say in their democracy and want to maintain and restore their rights, said Sen. Lauren Arthur, a Kansas City Democrat.
“I’m not concerned about either of those,” Arthur said of the two efforts. “There have been so many examples of times when voters have felt like they’re not being heard, their priorities are not being addressed by elected officials. And they’ve used the IP process as an important tool to make things happen in the state.”
In late January, Ashley Jaworski, a volunteer for the campaign to overturn the abortion ban, traveled to the Missouri Capitol from St. Louis to talk with Missourians about the importance of the state’s initiative petition process.
“They’re trying to change the rules out from under us because they know that this petition process works,” Jaworski said. “They’re scared of what real, everyday Missourians want. Missourians want to have their voices heard.”
But if either measure reaches the ballot this year, supporters of abortion rights will have to campaign in a state that has grown staunchly Republican over the last decade. Even before the abortion ban, anti-abortion officials had whittled down access to a single clinic in St. Louis.
The abortion rights campaign may also drive to the ballot box people such as Matthew Sheffer, who traveled to the Missouri Capitol last month from Fenton to push for criminal penalties against women who get abortions. Sheffer said in an interview that he wasn’t aware of the effort to change the initiative petition process.
But he had thoughts about the abortion rights campaign.
“It’s just more agreeing to shed innocent blood,” he said. “It’s just more consent to murder.”
Which election? It will be strategic
One of the biggest outstanding questions for both campaigns will be the timing of the elections.
If abortion rights supporters are able to garner roughly 171,000 signatures by May 5, the measure would go on the November ballot unless Parson, an anti-abortion Republican, calls a special election. The same goes for the initiative petition legislation if Missouri lawmakers successfully place it on the ballot.
Some abortion opponents may want to see the legislation raising the voter threshold placed on the August ballot so the changes, if approved, would be in place to block a potential vote on abortion in November.
But anti-abortion Republicans will also have to weigh another situation that could effectively cause their effort to backfire. If Missourians vote to raise the threshold for constitutional amendments and then vote to enshrine abortion rights, it would be much harder for abortion opponents to later strip legalized abortion from the state constitution.
Parson has given no indication of whether he might call a special election for changes to the initiative petition process, but he acknowledged during a news conference last month that it would be strategic.
“We’ll talk about that and we’ll see what the best strategy is for the state of Missouri,” the Republican governor told reporters.
There are some Missouri Republicans who don’t want to see either measure placed on the November ballot, fearing that the two measures would bring out Democratic voters in droves in a general election.
“They don’t want that to be the ‘get out the vote’ type of measure that’s on the ballot,” said Lee, the anti-abortion lobbyist.
Quade, the Springfield Democrat, said that Democrats will likely come out in force if either abortion rights or the initiative petition measure are on the ballot. But putting an abortion rights proposal on the August ballot could also affect the GOP primary for governor — a factor that Quade said Republicans will have to consider.
“If I’m the governor and I’m thinking about all of those things, I definitely think that that is also a factor in this decision,” she said.
Senate President Pro Tem Caleb Rowden, a Columbia Republican, said that the placement of either the initiative petition legislation, the abortion measure, or both, on the November ballot could have a significant effect on voter turnout.
“I don’t think it has a tremendous impact on statewide elections, because Missouri is a pretty bright red state,” Rowden told reporters. “But I certainly think it has a tremendous impact on the pivotal kind of swing elections in St. Louis County, Boone County, Greene County and some of the places that we know those swing districts are.”
Rowden also noted that there are differing legal opinions on whether changes to the voter threshold would affect the abortion rights vote. He told reporters he’s seen memos from at least two attorneys arguing that courts would probably allow the abortion rights campaign “to live under the old rules in November.”
Chuck Hatfield, a Jefferson City-based attorney who has worked on a slew of initiative petitions, said there is some indication of that from the courts. He pointed to a 2008 Missouri Supreme Court ruling that stated Missouri lawmakers could not “negate in advance an initiative petition that has been approved for circulation but prior to the time it is adopted by the people at an election.”
If voters approve changes to the voter threshold in August, Hatfield said he thinks there will be a lawsuit over when the changes take effect.
Since launching the effort in January, the abortion rights campaign has reported raising more than $4 million and thousands of people have signed up to collect signatures across the state.
At the same time, some Republican lawmakers have recently started to distance the effort to change the initiative petition process from the abortion rights campaign, including Sen. Mary Elizabeth Coleman, an Arnold Republican who sponsored the legislation.
“I don’t think that protecting the state’s constitution is about the abortion issue only,” said Coleman, who is running for Congress. “Certainly, I hope that people will decline to sign and that we won’t see that proposal put on the ballot. But this is about a number of different issues.”
‘No. 1 priority.’
With Missouri Republican lawmakers intent on passing some version of a plan to overhaul direct democracy in the state, access to abortion will almost certainly play a key role in the upcoming elections this year.
Messaging, whether it’s a need to stop the abortion rights push or that outside groups are influencing elections, will be crucial to persuading voters to weaken a tool utilized by both parties for more than a century.
Over the last several weeks, several Republicans have touted changes to the initiative petition process as the top issue they want to accomplish this year.
“Our entire Republican majority, 24 state senators, decided that this was our No 1. priority,” Hoskins, the Warrensburg Republican said on the Senate floor the morning the abortion rights campaign launched.
That acknowledgment was extremely telling, Senate Minority Leader John Rizzo, an Independence Democrat, told reporters.
“With all of the issues that are out there, the No. 1 priority of the Republican Party is to take people’s voice away at the ballot box,” Rizzo said. “That should tell you all you need to know about the Republican Party in the state of Missouri.”
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How Louisiana Has Become a Microcosm of the Abortion Access Fight
On a recent trip to Louisiana, I sat across the breakfast table from Dr. Nicole Freehill, an OB-GYN who has been practicing for more than a decade, as she explained how caring for her patients has changed since the state banned abortion in June 2022. She described the helplessness of telling a teenage survivor of sexual assault, pregnant and desperate not to be, that there was nothing she could do for her. “There are patients where you just know from the way they’re looking at you that traveling to another state is not an option,” Freehill said. “It’s untenable.”
Since the Supreme Court overturned Roe v. Wade, 14 states including Louisiana have banned abortion completely. What’s happening in Louisiana is a microcosm of what’s happening across America: the anguish of having a fundamental right stripped away and the resilience of people working tirelessly to help in the midst of a dire situation. Now, with the future of reproductive health care, including fertility treatment, hanging in the balance, the Supreme Court is preparing to decide the fate of one of the last remaining lifelines for people in states like Louisiana: abortion pills.
Even before Roe was overturned, pills were the most common form of abortion in the United States. A safe, effective, and FDA-approved method for ending pregnancy and treating miscarriages, abortion pills work best when taken within about the first 13 weeks. Pills can be prescribed remotely by licensed providers in the U.S. and sent through the mail without an in-person visit, which is crucial in rural areas and states that have banned or severely restricted abortion. Aid Access, an organization dedicated to providing abortion pills by mail, reports that they receive more requests from people in Louisiana than in any other state.
All of this is at stake right now, as the Supreme Court prepares to hear oral arguments in a case that could impose extreme and medically unnecessary restrictions on abortion pills. The case, brought not by medical experts but by anti-abortion activists, gives the Court a chance to override the FDA’s approval of mifepristone, one of two drugs used in medication abortion. All of this despite the fact that mifepristone has been used safely and effectively by more than 5 million people over the last two decades and rigorously tested in more than 100 scientific studies. It’s safer than Tylenol, Penicillin, or Viagra.
No matter where you live, this case should be on your radar. Restricting access to abortion pills would have sweeping implications for 65 million women of reproductive age living in the U.S.—not only in states with abortion bans, but in places like New York and California. This has nothing to do with science and everything to do with banning the most common method of abortion in the country. (In fact, in February 2024, an academic journal retracted two studies cited in a lower court ruling to restrict medication abortion, citing factual errors and “a lack of scientific rigor.”)
If the Supreme Court decides once again to advance a political agenda at the expense of people’s lives and access to essential health care, we don’t have to imagine what the consequences will be—we’re already living with them. Researchers estimate that, since Roe was overturned, there have been more than 64,500 pregnancies as a result of rape in states with abortion bans. (Louisiana, like many other states with total bans, provides no exceptions for rape and incest.) While some abortion bans include exceptions when the life of the pregnant person is at stake or the pregnancy is incompatible with life, experiences like Kate Cox’s in Texas and Nancy Davis’ in Louisiana illustrate the horrifying truth: In the moments when these exceptions are most urgently needed, they do not work.
In the last year and a half, Americans have been confronted again and again with the devastating impact of abortion bans. Brittany Watts in Ohio was brought up on charges and hauled before a grand jury for having a miscarriage. “Ashley,” a seventh-grader in Mississippi, became pregnant after being sexually assaulted by a stranger in her yard; unable to afford the nine-hour round trip to the closest abortion provider, she’s now a mom. In Texas, Yeniifer Alvarez-Glick died as a result of the state’s abortion law. Equally chilling are the stories we’ll never hear: In the first six months of 2023, there were an estimated 1,800 additional births in Louisiana, suggesting that many people who cannot access abortion in their community are left with no choice but to simply remain pregnant.
But abortion bans are just the beginning of efforts to restrict Americans’ reproductive decisions, not the end. After the Alabama Supreme Court ruled that frozen embryos had the legal status of children, several fertility clinics in the state paused treatment, devastating patients whose journeys to parenthood were abruptly put on hold. Anti-abortion groups have advocated for so-called “personhood” language—like the provision in Louisiana state law declaring that “every unborn child is a human being from the moment of conception and is, therefore, a legal person”— as a path to criminalize not only abortion, but everything from birth control to IVF.
Adding insult to injury is the fact that, in a country that is already home to the highest maternal mortality rate in the developed world, pregnancy care is suffering as a result of abortion restrictions. According to one study, women in states that banned abortion post-Roe were up to three times as likely to die during pregnancy, childbirth, or the postpartum period. Another study found that 93% of OB-GYNs in states that have banned or severely restricted abortion have been unable to follow standards of care because of abortion laws. Kaitlyn Joshua, a mom and community organizer from Baton Rouge, has described being turned away from not one but two emergency rooms while having a miscarriage. Terrified and bleeding through her jeans, Joshua was told by doctors that while a surgical procedure or pills could help with her pain and speed up the process, they could not treat her as a result of Louisiana’s abortion ban. “I was in total disbelief that I could live in a country that would put me in this predicament,” she said.
For Joshua, that was just the beginning. She shared her experience with a reporter and at a public forum held by the hospital. Messages poured in on social media from Louisianans denied care or told their only option would be to travel hundreds of miles to access abortion. When we met up at a coffee shop during a break in her Saturday errands, she bounced her four-month-old baby on her lap and told me she is determined to keep speaking out: about the devastating impact of abortion bans, about the barriers to care faced by Black women in the South, and about why anyone who can get pregnant should read up on abortion pills. “You never know when you might need them,” she said.
Spend any amount of time in Louisiana, or any state that has banned abortion, and the growing divide between the ideology of those in power and the will of the people they represent becomes painfully clear. A majority of Americans, including a majority of Louisianans, believe abortion should be legal. Two-thirds of Americans want abortion pills to remain accessible, including more than half of Republicans. A poll a year after Roe was overturned found that one in four Americans said state efforts to ban or severely restrict abortion have made them more supportive of abortion rights, not less. Every time voters have had the chance to decide on this issue, abortion rights have won.
When the Supreme Court overturned Roe, it was like a match on dry kindling. There were hundreds of protests in the weeks that followed; some called it “the summer of rage.” More than one pundit wondered whether women in America could possibly sustain that level of fury for the long-term. A year and a half later, it’s clear: We can and we will.
After all, it’s outrageous that nine unelected Supreme Court justices, not one of whom has spent a single day in medical school, are once again in a position to determine the rights and futures of millions of people. It’s infuriating that so many of the Republican politicians pushing for a national abortion ban—including likely presidential nominee Donald Trump—are permitted to spout myths and misinformation without ever having to answer for the cruelty inflicted on people all over this country. And it’s unconscionable that anyone who does not want to be pregnant or have a child—for any reason—would not have the freedom to make that decision on their own terms.
On a sunny Friday in January, Petrice Sams-Abiodun, Vice President of Strategic Partnerships for Planned Parenthood Gulf Coast, walked me through the beautiful New Orleans health center, newly opened in 2016. The waiting room was bright and airy, with private spaces for patients who need a few minutes to themselves and shelves of children’s books for anyone who shows up with a toddler in tow. She showed me the rows of exam rooms, the state-of-the-art lab for test results, the paintings by local artists on the walls—and the extra-wide hallways, surgical sinks, and restrooms built to exact specifications to comply with the state’s targeted restrictions on abortion providers. The state refused to grant Planned Parenthood’s license to provide abortions, and then Roe fell, and the point became temporarily moot. Sams-Abiodun pointed out the recovery room where patients could rest after an abortion, comfortable recliners still in boxes, dust gathering on the state-mandated nurse’s station. “This room makes me the proudest and the angriest,” she said.
The truth is, it’s not enough to stay angry. We need to channel our rage into action. And in Louisiana and across the country, Sams-Abiodun and so many others are doing exactly that. Abortion funds are gathering resources to help people travel out of state. Activist networks are helping connect people to care, including abortion pills by mail. Health care providers are sounding the alarm about the crisis unfolding before our eyes. Legal groups are litigating on behalf of abortion seekers. Organizers are working tirelessly to spread word about what’s happening, from state legislatures to the highest court in the land. People who have never considered themselves “political” are signing up to volunteer for candidates and campaigns. Local and national journalists are doing extraordinary, powerful reporting. Everywhere I go, people are sharing their own stories, and doing brave, important work in incredibly tough circumstances. Because when the alternative is giving up on entire swaths of the country, there’s really no alternative. “It’s like walking through the mud,” one clinic staff member told me. “It isn’t easy, but you just have to keep going.”
Cecile Richards is the co-founder of Charley, a chatbot that provides information about abortion options in every zip code in the U.S., and a co-chair of American Bridge 21st Century. She is the former president of Planned Parenthood Federation of America, New York Times bestselling author of Make Trouble, and a 2011 and 2012 TIME 100 Honoree.
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The vasectomy boom: After Dobbs, younger men are stepping up
On the last day of July in 2023, Planned Parenthood performed its final abortion in the state of Indiana. It was the day before the state would begin enforcing a near-total abortion ban, with very narrow exceptions, after a year of legal battles that followed the U.S. Supreme Court’s decision to end the constitutional right to abortion in the Dobbs v. Jackson Women's Health Organization case. Before the Dobbs decision, which effectively allowed every state to set its own abortion laws, four Planned Parenthood clinics in Indiana provided abortion services once a week. Today, abortions are no longer an option.
Deborah Nucatola, the chief medical officer of Planned Parenthood Great Northwest Hawai‘i, Alaska, Indiana, Kentucky, told Salon the abortion ban was especially devastating. Indiana had briefly served as a haven for out-of-state patients, such as those from Kentucky, whose access to abortion services was immediately restricted after Dobbs. Indiana became a “surge state,” serving many patients who were traveling from elsewhere, even while providers knew they would eventually had to cease their services.
That was extremely difficult, Nucatola said. “We went from feeling like we were helping so many people from so many places to feeling like our hands were tied, and there wasn't a lot we could do. So we’re constantly evaluating ways that we can help support patients, whether it's helping facilitate them getting abortion services in other places to providing services that can prevent undesired pregnancies.”
The next logical step, Indiana providers decided, was to focus on male reproductive health. In February, the Planned Parenthood affiliate announced it would offer vasectomy services at three locations across the state, including one in Fort Wayne, with plans to expand to Georgetown by late March. The affiliate also has plans to add additional vasectomy services in southern Indiana and Kentucky over the next six months. Nucatola said that by offering vasectomies, Planned Parenthood is adding to its contraceptive “toolbox” and offering more options to prevent unwanted pregnancies in a post-Dobbs world.
“It’s just adding to the list of contraceptive services that we provide,” she said. “It's a small but important option for folks to have.”
"We went from feeling like we were helping so many people from so many places to feeling like our hands were tied. So we’re constantly evaluating ways that we can help support patients [and] prevent undesired pregnancies."
After what she describes as a “very long year,” Nucatola said the expansion of vasectomy services has made the affiliate's staff feel as if they are better able to support Indiana families in making their own decisions about fertility and reproduction.
“It’s kind of a ray of light” in an otherwise darkening landscape, she added. “We're still seeing patients who are seeking abortion care, and we're helping them navigate to those services, but it's challenging not being able to provide them directly at our health centers.”
This expansion of vasectomy services in Indiana speaks to a nationwide increase in interest in the procedure following the Dobbs decision. Immediately after the Supreme Court overturned Roe v. Wade, Google saw the highest volume of searches for “vasectomy” in the past five years. Last year, preliminary data found a significant uptick in vasectomy consultations. According to the International Journal of Impotence Research, there was a 35 percent increase in vasectomy consultation requests and a 22.4 percent increase in actual vasectomy consultations after the Dobbs decision. Notably, the men seeking vasectomies were younger than before, and a higher number of men without children requested information about the procedure.
At the moment, vasectomies are the only FDA-approved birth control option for men, and are regarded as easy and safe surgical procedures. During the operation, a doctor cuts or seals the tubes that carry a male’s sperm, which can permanently prevent pregnancy. Usually the procedure can be carried out under local anesthetic, meaning the person is awake, and takes only about 15 minutes. At the Indiana Planned Parenthood clinics, the procedure costs $800 out of pocket — but can also be covered by Medicaid and many private insurance plans. The national average cost for a vasectomy is $1,000, but depending on insurance coverage and whether it's performed in a doctor’s office or surgical center, can cost up to $3,000.
Planned Parenthood clinics in Indiana are by no means alone in seeking to make vasectomies more accessible in light of widespread restrictions on abortion. Under a new California law that took effect in January, state residents covered by Medi-Cal can get vasectomies with no charge. There have also been smaller, more localized, efforts. A mobile Planned Parenthood clinic offered free vasectomies in Missouri last year. When a Planned Parenthood clinic in Oklahoma offered free vasectomies, all the available spots were filled in less than 48 hours.
Dr. Sarah Vij, co-author of the data study published in the International Journal of Impotence Research and an assistant professor of urology at Cleveland Clinic, told Salon that vasectomies are widely accessible, at least in states with reasonable health care options. In most cases, the procedure is covered by health insurance, although there are exceptions — some faith-based organizations object to the procedure and won’t pay it. Since access may vary greatly from state to state, she said, it makes sense for Planned Parenthood clinics to offer vasectomies more widely.
“Wherever there's demand, we need to be sure that we're offering it, and we need to be sure that patients are properly educated,” Vij said. For people who are "done" having children or don't want them, "it's a reasonable option," she continued. "It's not for everybody, but it's at least an option that everybody should know exists.”
Nucatola, from the Planned Parenthood clinic in Indiana, said that adding a new contraceptive method to a clinic's services amounts to providing more autonomy to the community it serves. “The more tools you have in your toolbox, the more you're able to help people choose what's best for them and their families to build the families that they want to build,” she said.
One benefit of making vasectomies more accessible is to ease the burden of birth control being placed on women. “Partners are realizing that women shouldn’t be the only ones with birth control in their cabinets, or in their bodies.”
Both doctors noted that one benefit of making vasectomies more accessible is to ease the burden of birth control being placed largely or entirely on women.
“Partners are realizing that women shouldn’t be the only ones with birth control in their cabinets, or in their bodies,” Rebecca Gibron, CEO of the Planned Parenthood affiliate that includes Indiana, said in a media statement. “Many men concerned for their partners’ reproductive rights and health are finding vasectomy as a solution."
Anecdotally, Vij told Salon this has been true in her own practice. She has personally seen an increased number of younger men without children seeking vasectomies. Before Dobbs, her typical patient was a man with kids who didn’t want more.
“Dobbs affected men and how they view reproduction,” Vij said. “I think the male is impacted, and I think that's often an ignored piece of this whole discussion when we talk about abortion care.
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