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American College of Obstetricians and Gynecologists

Emergency miscarriage care

Jan 19th, 2023
by Charles Kuffner.
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Here’s another thing most of us have not had to think much about in the past when abortion was generally legal.

[A uterine aspiration (also commonly known as a D&C) or the removal of tissue from the uterus via suction] is a standard method for treatment of miscarriage and can be a life-saving intervention if a woman is hemorrhaging. But uterine aspiration is also routinely used to perform early abortions, and that’s one reason many emergency departments have historically resisted efforts to make the option available to patients who come in for miscarriage-related care.

That care already accounts for more than 900,000 emergency room visits every year, according to the most recent estimates. Now, as states move to restrict access to abortion in the wake of the Supreme Court’s decision in June to overturn Roe v. Wade, experts say that number is likely to surge even higher.

“Fewer abortions will mean more pregnancies, and more pregnancies will mean more miscarriages,” said Dr. Sarah Prager, a professor of obstetrics and gynecology at the University of Washington and a co-author of the guidelines on miscarriage management for the American College of Obstetricians and Gynecologists.

Around 15% of known pregnancies end in miscarriage, and the first medical professional many of those patients see will be in an emergency room. Yet, by and large, she says, “emergency medicine physicians aren’t trained in managing miscarriage and don’t see it as something they should own.”

For more than a decade, Prager has been trying to change that through her work with the TEAMM Project, the nonprofit she co-founded on the premise that “many people experience miscarriage before they’re established with an OB-GYN.” Short for Training, Education and Advocacy in Miscarriage Management, TEAMM has conducted in-person workshops for clinicians at more than 100 sites in 19 states on all aspects of miscarriage care — everything from the use of ultrasound to diagnose fetal death to the three treatment options miscarrying patients should be offered when they come in for care.

A uterine aspiration is recommended when patients are bleeding heavily, are anemic, or are medically fragile, and many patients prefer the procedure because it can resolve a miscarriage most quickly. Another option is medication — usually mifepristone followed by misoprostol — which can help the body expel pregnancy tissue in a matter of hours. And the third is “expectant management”: waiting for the tissue to pass on its own. The latter can take several weeks and is unsuccessful for about 20% of patients, who remain at risk for hemorrhage and have to return to the hospital for surgery or medication.

In many emergency departments, expectant management has long been the only option made available. But now, amid the legal uncertainty unleashed by the fall of Roe, Prager and colleagues say they’ve been inundated with inquiries from emergency departments across the country. Doctors in states that have since criminalized abortion face stiff penalties, including felony charges, prison time, and the loss of their medical license and livelihoods.

“I think they’re scared,” says Prager. “They want to be able to know, with 100% certainty, that a pregnancy is no longer viable.”

This is why I say it’s just a matter of time before some nice white suburban lady who already has kids dies because she isn’t treated for a pregnancy-related emergency in a timely fashion. The corollary to this is that some doctor who performs a life-saving D&C on a patient will be arrested and charged with murder for it. I don’t want to see these things happen. It’s just that the conditions in our state, and in too many other states, are absolutely ripe for it. I really hope I’m wrong.

More on our future doctor shortage

Jan 16th, 2023
by Charles Kuffner.
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This is unsustainable.

Abortion restrictions have forced Texas obstetrician-gynecology residency programs to send young doctors out of the state to learn about pregnancy termination, a burdensome process educators say is another example of abortion bans undermining reproductive health care.

At least one Houston-area program, the University of Texas Medical Branch, began sending residents out of state this year, to a partner institution in Oregon. Two other local programs, Baylor College of Medicine and Houston Methodist, said they still are working out arrangements for their own out-of-state rotations. McGovern Medical School at UTHealth Houston declined to comment on its plans.

The changes follow revised requirements from the Accreditation Council for Graduate Medical Education, the standard-bearer for residency programs, which maintains that abortion training is essential for providing comprehensive reproductive health care. Requirements updated in September say OB-GYN programs in states that ban the procedure “must provide access to this clinical experience in a different jurisdiction where it is lawful,” with exceptions for residents who choose to opt out.

Experts, however, say it takes month of coordination to arrange a temporary rotation in another state, leaving some inexperienced physicians with few options.

“There is no question that the restrictions in place following the Dobbs decision pose a risk to the training of up to 45 percent of OB-GYN residents who are training in states where abortion care is restricted,” said Dr. AnnaMarie Connolly, chief of education and academic affairs at the American College of Obstetricians and Gynecologists. “The joint efforts of ACOG … and countless residencies in protected states are directly addressing this risk to medical education and training.”

[…]

Arranging an out-of-state rotation is a logistical feat, Steinauer said, as it takes up to nine months to develop a plan for housing, airfare, training permits and other needs.

The university also takes on additional costs. To send two UTMB residents to Oregon for two weeks, it costs $5,216 for housing, $1,689 for airfare and airport transportation, $240 for parking and $370 for training permits, according to documents obtained through an open records request. The Ryan program is paying $1,500 for each resident, while the university picks up the remaining expenses, documents show.

There also is a strain on the host institution, said Dr. Aileen Gariepy, director of complex family planning at Weill Cornell Medicine in New York City. Some programs that offer abortion care may only have the capacity to accommodate their own residents. With a small number of programs left to take on a crush of new learners, “we may be doing a disservice to the training needs of all of our trainees,” she said.

She noted that Weill Cornell does not have the space yet to take on residents from its affiliate institution, Houston Methodist, which has approached the school about an out-of-state rotation.

“This kind of legislative interference in medical care is unprecedented,” she said. “We didn’t have a plan for that.”

[…]

Beyond the immediate challenge of meeting accreditation requirements, some educators publicly have expressed concern that abortion laws will make it harder for Texas to attract and retain OB-GYNs.

Out of nine publicly funded OB-GYN residency programs in Texas, six saw a drop in applicants from 2020 to 2021, the year SB8 was enacted, according to documents obtained by the Chronicle. Seven of those programs saw a drop in applicants in 2022.

Experts caution against drawing conclusions based on those trends. Yaklic noted that the number of graduates interested in OB-GYN programs often fluctuates, and recent changes to the application process may have influenced the data.

Still, at UTMB, many applicants have asked about abortion training during interviews, he said. Even before the Dobbs decision, earlier abortion restrictions caused medical school graduates to favor states that allow the procedure.

See here for some background. It’s certainly possible that we’ll more or less get acclimated to how things are now and the system will limp along as degraded but basically functional, with the bulk of the cost being borne by the people with the least power and fewest resources. It’s also possible, as noted in the comments, that the Lege could pass a bill to outlaw out-of-state abortion training for medical students in Texas, and then we’ll see how bad things can get. All I’m saying is that our state’s forced-birth laws are going to have a negative effect on overall health care, and we are already starting to see it happen.

Quantifying the abortion ban harm

Dec 2nd, 2022
by Charles Kuffner.
1 comment

These stories will keep on coming.

Usually, articles in medical journals are about science; they bring data to their readers, who can use them to provide evidence-based care to their patients.

But sometimes, evidence is an expression of grief or even rage. A recent journal article, “Maternal Morbidity and Fetal Outcomes Among Pregnant Women at 22 Weeks’ Gestation or Less with Complications in 2 Texas Hospitals After Legislation on Abortion,” contains such evidence.

To understand this article, you need to know that any number of complications can threaten a pregnancy, such as rupture of the bag of water around the baby, preterm labor, or heavy bleeding. When those complications arise before 22 weeks of gestation— before the age of viability when a fetus can live outside of a uterus—the standard of medical care is to offer a patient termination of pregnancy as an option. Women who continue pregnancy in these situations take on significant risks to their own health, and because of the early gestation, the chance for a healthy baby is very, very low.

However, in September 2021, Texas adopted two measures, S.B. 4 and S.B. 8, which instituted punitive actions against anyone providing abortion. These laws took effect before the Supreme Court decision ended Roe v. Wade. And all of a sudden, termination of pregnancy became impossible in Texas unless and until there was an “immediate threat to maternal life.”

The journal article, published in the American Journal of Obstetrics and Gynecology, describes the experience of two large Texas hospitals over a period of eight months following that legislation. The authors, who care for patients at those hospitals, describe how their hospitals managed 28 women who presented at less than 22 weeks’ gestation with serious complications following the ban on abortion.

Without the ability to offer abortion to their patients, all 28 women were managed expectantly. This is a medical way of saying that they waited for something terrible to happen. That wait lasted, on average, nine days.

During that nine days of waiting, here is what was achieved for the babies: 27 of the patients had loss of the fetus in utero or the death of the infant shortly after delivery. Of the entire cohort, one baby remained alive, still in the NICU at time of the journal article’s publication, with a long list of complications from extreme prematurity, including bleeding in the brain, brain swelling, damage to intestines, chronic lung disease. and liver dysfunction. If a baby survives these complications, they often result in permanent, lifelong illnesses.

During those nine days of waiting for an immediate threat to maternal life, here is what happened to the women of that cohort: Most of them went into labor, or had a stillbirth, which meant the medical team could then legally intervene and empty the uterus. Fifty-seven percent of those pregnant women had some sort of complication, and for about a third of them, it was serious enough to require intensive-care admission, surgery, or a second admission to the hospital. One of the 28 patients ended up with a hysterectomy, which means she will never carry a pregnancy again. The authors of the article estimate, based on their pre-September practice, that about half of those maternal complications would have been avoided if immediate abortion had been offered as a choice. But of course, post-September in Texas, these women didn’t get a choice.

I’ll say again, it’s just a matter of time before some nice white suburban lady who already has kids dies as a result of not being able to get proper medical care following a similar instance. I’d love to tell the woman who was forced to have a hysterectomy to sue the state of Texas for that, but I don’t know that any deserving target of such a lawsuit would be allowed to be named as a defendant. You know what the refrain is for this song.

Brief abortion news roundup

Jul 10th, 2022
by Charles Kuffner.
1 comment

Too much news, etc etc etc. You know the drill.

Houston crisis pregnancy centers, labeled ‘deceptive’ by experts, find new spotlight after Roe ruling.

Since 2011, pregnant Houstonians seeking abortions at the Planned Parenthood clinic off the Gulf Freeway have encountered a large blue bus parked outside the entrance, offering “free and confidential pregnancy services” and “real choices.”

But those choices do not include abortion.

In fact, the bus, run by the nonprofit Houston Coalition for Life, is one of 22 crisis pregnancy centers in the Houston area that seek to deter patients from terminating a pregnancy, often with medically unreliable advice.

They are not licensed clinics and are usually run by religious organizations. Supporters say their services — free ultrasounds, parenting classes and baby items — help low-income, expectant mothers who may feel they have no options outside of abortion. One Houston center, run by Catholic Charities, also connects new refugee parents with rent and utility assistance. But when it comes to health care, the American Medical Association says they should be considered sources of “propaganda” and “misinformation” that undermine women’s health.

While the medical community has criticized the centers for years, last month’s overturning of Roe v. Wade puts them in a new spotlight. Abortion rights advocates and healthcare providers worry their advertising methods — using neutral language that gives the impression of a clinic — will absorb a rush of abortion-seeking patients who misunderstand the centers’ mission in states that offer no other alternative.

“As states move to ban and criminalize abortion care, it is critical that people who need abortions are able to access evidence-based, non-judgmental health information from qualified professionals, not crisis pregnancy centers that use deceptive advertising and misinformation to spread their ideology,” American College of Obstetricians and Gynecologists President Dr. Iffath Abbasi Hoskins said in a statement supporting new federal legislation that would crack down on abortion-related disinformation.

These things have been a plague for a long time. Fun fact, a few years ago SCOTUS ruled unconstitutional a California law that required “crisis pregnancy centers” to display a sign that stated truthfully that they were not a licensed medical facility on the grounds that the law impeded their free speech rights, even though SCOTUS has previously upheld state laws requiring doctors to give out misleading information about abortion, on the grounds that such laws did not impede the doctors’ free speech rights. So they’re a plague that has the protection of our lawless and radical Supreme Court.

Biden pushes to protect inter-state abortion access amid Texas crackdown.

President Joe Biden signed an executive order Friday to bolster access to abortion and other reproductive health services after the U.S. Supreme Court’s decision to overturn Roe v. Wade.

In his most pointed remarks since the ruling last month, Biden said he was outraged by the court’s decision and would take every step within his power to curb the damage. But he said he has limited ability to prevent Texas and other states from cracking down.

“The most extreme Republican governors and state legislatures have taken the court’s decision as a green light to impose some of the harshest and most restrictive laws seen in this country in a long time,” Biden said. “What we’re witnessing is a giant step backwards in much of our country.”

The directive instructs federal health officials to push back against state-led efforts to cut off access to federally approved abortion pills and out-of-state abortion services. It also calls for protecting privileged patient information around abortion and the privacy of those seeking information about reproductive care online.

But the order stopped short of more forceful responses that some fellow Democrats have pushed for in recent weeks, such as declaring a public health emergency and authorizing abortion care on federal lands in states with abortion bans.

The reaction I’ve seen online from reproductive rights activists is that this executive order was not expansive enough. Some of the things that President Biden did not include, like authorizing abortion care on federal lands in states with abortion bans, would be challenged in court and very likely knocked down by SCOTUS when it got to them. On the one hand, it’s almost certainly better politics to be caught trying to do as much as you can, and for sure the base really wants and needs to see a higher level of commitment not just from the President but from other Democratic leaders as well. Let SCOTUS continue to be the villain here, that’s a net positive for us. On the other hand, inviting them to make more rulings on the subject could result in firmer and more extensive restrictions or evisceration of existing rights. I don’t know how to evaluate the risks here, but in the absence of further information I side with those who pushed for more. There’s nothing to prevent the President from issuing another EO, so maybe this isn’t the end. Also, never forget that the stated goal of the forced birth radicals in the Legislature is to outlaw travel to other states to get abortions, and in keeping with SB8 to make it a crime for anyone to assist in that in any way. The stakes are already higher than you think.

Houston urologists say ‘tremendous’ uptick in vasectomies after Roe v. Wade ruling.

Houston urologist Russel Williams typically performed about 10 vasectomies a day. Since the Supreme Court overturned Roe V. Wade, it’s already up to 15.

Houston urologists are seeing an increase in vasectomies, mirroring national trends, as Texas prepares to ban most abortions, following the Supreme Court decision.

Dr. Williams, who runs The Y Factor and its six urology and fertility clinics that dot the Greater Houston area, said there has been “a tremendous increase” in patients getting the procedure at his offices.

“We’re pretty busy, which is the new normal in our office,” said Stephanie Alvarado, the surgery coordinator at The Y Factor.

[…]

Houston Metro Urology, which staffs 19 urologists has seen similar trends at its facility in the Galleria area.

“It’s definitely something we’ve taken notice of and have tried to accommodate,” chief operating officer Nancy Nicolovski said.

Although her office is well staffed to handle the surge, she said, Nikolovski has considered expanding its operating hours to meet the demand. HMU was also already working on opening a vasectomy-only clinic on Saturdays before the Supreme Court’s ruling, but talks have accelerated and will likely open in the next few months, because she expects the trend to keep up through the end of the year.

“Vasectomy has always been a very popular procedure, anyway, but the changes in our landscape has prompted people who have been discussing it to just do it,” she said.

I mean, yeah. What did you think would happen?

If we can’t ban it, we’ll BS about it

Jul 29th, 2016
by Charles Kuffner.
Comments are off for this post

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

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

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

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

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

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

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

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

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

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

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

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

Apr 11th, 2014
by Charles Kuffner.
1 comment

From the inbox:

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

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

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

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

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

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

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

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

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

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

Jul 11th, 2013
by Charles Kuffner.
4 comments

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

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

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

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

[…]

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

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

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

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

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

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

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

3. Prepare for the inevitable litigation.

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

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

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

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

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

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

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

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

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

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

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

Ultrabad

Mar 18th, 2009
by Charles Kuffner.
Comments are off for this post

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