[House Hearing, 117 Congress]
[From the U.S. Government Publishing Office]
EXAMINING THE HARM TO PATIENTS
FROM ABORTION RESTRICTIONS AND THE
THREAT OF A NATIONAL ABORTION BAN
=======================================================================
HEARING
BEFORE THE
COMMITTEE ON
OVERSIGHT AND REFORM
HOUSE OF REPRESENTATIVES
ONE HUNDRED SEVENTEENTH CONGRESS
SECOND SESSION
__________
SEPTEMBER 29, 2022
__________
Serial No. 117-107
__________
Printed for the use of the Committee on Oversight and Reform
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
Available on: govinfo.gov,
oversight.house.gov or
docs.house.gov
___________
U.S. GOVERNMENT PUBLISHING OFFICE
48-804 PDF WASHINGTON : 2022
COMMITTEE ON OVERSIGHT AND REFORM
CAROLYN B. MALONEY, New York, Chairwoman
Eleanor Holmes Norton, District of James Comer, Kentucky, Ranking
Columbia Minority Member
Stephen F. Lynch, Massachusetts Jim Jordan, Ohio
Jim Cooper, Tennessee Virginia Foxx, North Carolina
Gerald E. Connolly, Virginia Jody B. Hice, Georgia
Raja Krishnamoorthi, Illinois Glenn Grothman, Wisconsin
Jamie Raskin, Maryland Michael Cloud, Texas
Ro Khanna, California Bob Gibbs, Ohio
Kweisi Mfume, Maryland Clay Higgins, Louisiana
Alexandria Ocasio-Cortez, New York Ralph Norman, South Carolina
Rashida Tlaib, Michigan Pete Sessions, Texas
Katie Porter, California Fred Keller, Pennsylvania
Cori Bush, Missouri Andy Biggs, Arizona
Shontel M. Brown, Ohio Andrew Clyde, Georgia
Danny K. Davis, Illinois Nancy Mace, South Carolina
Debbie Wasserman Schultz, Florida Scott Franklin, Florida
Peter Welch, Vermont Jake LaTurner, Kansas
Henry C. ``Hank'' Johnson, Jr., Pat Fallon, Texas
Georgia Yvette Herrell, New Mexico
John P. Sarbanes, Maryland Byron Donalds, Florida
Jackie Speier, California Mike Flood, Nebraska
Robin L. Kelly, Illinois
Brenda L. Lawrence, Michigan
Mark DeSaulnier, California
Jimmy Gomez, California
Ayanna Pressley, Massachusetts
Russ Anello, Staff Director
Erinn Sauer, Team Lead
Elisa LaNier, Chief Clerk (Full Committee)
Contact Number: 202-225-5051
Mark Marin, Minority Staff Director
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C O N T E N T S
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Page
Hearing held on September 29, 2022............................... 1
Witnesses
Kelsey Leigh, Pittsburgh, Pennsylvania
Oral Statement............................................... 5
Nisha Verma, MD, MPH, FACOG, Fellow, Physicians for Reproductive
Health
Oral Statement............................................... 6
Monique Wubbenhorst, MD, MPH, FACOG, FAHA, Senior Research
Associate, University of Notre Dame
Oral Statement............................................... 8
Bhavi Kumar, MD, MPH, Medical Director for Primary and Trans
Care Planned Parenthood Gulf Coast
Oral Statement............................................... 10
Jocelyn Frye, President, National Partnership for Women &
Families
Oral Statement............................................... 12
Opening statements and the prepared statements for the witnesses
are available in the U.S. House of Representatives Repository
at: docs.house.gov.
INDEX OF DOCUMENTS
----------
The documents listed below are available at: docs.house.gov.
* List of Democrats that support expanding the court; submitted
by Rep. Biggs.
* Foxx News, article, ``Goldberg dehumanizes nonviable unborn
children as `toxic thing' in mother's womb, denies fetal
heartbeat;'' submitted by Rep. Biggs.
* The Daily Signal, article, ``Fact Check: `There Is No Such
Thing as a Heartbeat at 6 Weeks,' Says Stacey Abrams; submitted
by Rep. Biggs.
* An amicus brief by Dr. Wubbenhorst; submitted by Rep. Biggs.
* Article from Abortion Survivors Network; submitted by Rep.
Cloud.
* Ultrasonography, research study, ``Role of Ultrasound in the
Evaluation of First Trimester Pregnancies in the Acute
Setting;'' submitted by Rep. Clyde.
* The U.S. Constitution and the Declaration of Independence;
submitted by Rep. Clyde.
* Prolife fact page from The Turnaway Survey; submitted by Rep.
Norman.
* Statement from Americans United for Life; submitted by Rep.
Cloud.
* Statement from American College of Obstetricians and
Gynecologists; submitted by Chairwoman Maloney.
EXAMINING THE HARM TO PATIENTS
FROM ABORTION RESTRICTIONS AND THE
THREAT OF A NATIONAL ABORTION BAN
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Thursday, September 29, 2022
House of Representatives,
Committee on Oversight and Reform,
Washington, D.C.
The committee met, pursuant to notice, at 10:08 a.m., in
room 2154, Rayburn House Office Building, and via Zoom; Hon.
Carolyn B. Maloney [chairwoman of the committee] presiding.
Present: Representatives Maloney, Norton, Lynch, Connolly,
Krishnamoorthi, Raskin, Khanna, Ocasio-Cortez, Tlaib, Porter,
Brown, Wasserman Schultz, Welch, Sarbanes, Kelly, DeSaulnier,
Schrier, Jordan, Foxx, Hice, Grothman, Cloud, Higgins, Norman,
Sessions, Keller, Biggs, Clyde, LaTurner, and Flood.
Also present: Representative Schrier.
Chairwoman Maloney. The meeting will come to order.
Without objection, the chair is authorized to declare a
recess of the committee at any time.
I now recognize myself for an opening statement.
Let me begin by taking a moment to acknowledge the ongoing
devastation caused by Hurricane Ian. My thoughts are with the
people of Florida and the surrounding communities being
affected by this terrible storm. I hope that everyone impacted
will stay safe and quickly receive the resources they need. I
am grateful to all the first responders, the local, state, and
Federal officials who are working around the clock to respond
to this natural disaster. The President is very engaged, and we
are all hopeful.
Today's hearing is the fourth I have held to examine the
decade's-long effort by Republican politicians to bulldoze
abortion rights straight into the ground. Since the Supreme
Court's decision in Dobbs v. Jackson, Republican-led states
have pushed to impose draconian abortion bans that take away
freedom and the right of women to make choices about their
healthcare, including their own reproductive healthcare, and
with more bans taking effect almost every single week.
Just last Friday, a judge reinstated an abortion ban in
Arizona that was originally passed in 1901.
Let that sink in. A law banning abortion for more than a
century ago, before women won the right to vote, is now back in
effect.
Republicans are turning back the clock on women's rights,
back to a time when women were not viewed as equal citizens,
and when they had no control over their own bodies.
More than 33 million women of reproductive age live in
states hostile to abortion. In most of these states, abortion
is now severely restricted or outright banned. This means that
roughly half of the women in America live in states that rob
them of their fundamental freedom to make decisions about their
bodies.
This stands in stark contrast to other countries and the
world community, like Ireland, Argentina, New Zealand, and
Mexico, all of which are expanding women's rights to an
abortion.
Today, we will hear directly from a patient and doctors who
will share their firsthand accounts of accessing abortion care,
the barriers being erected in their states, and the harms
caused by taking away this fundamental right.
We will hear that abortion bans prevent doctors from
exercising their professional judgment about what their
patients need out of fear of being charged with a crime. Some
doctors have reported having to wait until their patients are
close to death before they can provide emergency care.
For example, one woman in Texas who suffered a miscarriage,
was forced to carry fetal remains for two weeks because doctors
denied her care due to Texas' abortion ban. Another Texas woman
had to prove that an infection was killing her before doctors
would agree she was in enough danger to terminate her lethal
pregnancy.
This is horrifying, and Republicans are not done yet,
because it turns out Republicans aren't satisfied with states
banning abortion; they want to ban abortion nationwide.
Earlier this month, Senator Lindsey Graham introduced a
bill to ban abortion anywhere in the United States after 15
weeks and imprison doctors and nurses who provide abortion
care. In the House, nearly 100 Republicans, including the
ranking member and many of the Republicans on this committee,
have cosponsored this extreme bill. And a new memo released by
the committee today reveals that, during just this Congress
alone, congressional Republicans have introduced more than 50
separate measures to ban or restrict abortions.
So, you see where their priorities are, right here with
these 50 different bills. You know, some of them put doctors in
prison. Some of them ban travel from state to state if you're
seeking abortion. Some are just outright bans, but there are 50
different measures to restrict abortion.
Republicans are showing us the America that they envision.
It is a place that limits women's freedom and imposes
government control over our bodies and our choices. It is an
America where a politician can force a woman to give birth
against her will, regardless of the consequences for her
health, for the woman, and for her family.
This chilling Republican vision is not what the American
people want. The majority of the people in the United States
support a woman's right to choose. They support abortion
rights. That support has only grown stronger since the
extremist, dangerous Supreme Court decision in Dobbs.
While Republicans are pushing to criminalize abortions
nationwide, Democrats--the Democrats are fighting to protect
the freedom of every person to make their own medical decisions
without interference from the state, and to protect the
patient's and doctor's personal relationship.
That's why Democrats passed the Women's Health Protection
Act, which would establish a Federal right to abortion, and the
Ensuring Access to Abortion Act, which would safeguard a
patient's right to travel across state lines to obtain abortion
care. Unfortunately, Republicans overwhelmingly oppose both
bills.
Democrats in Congress stand with the American people. We
stand with women who want the autonomy to make their own
healthcare decisions about their bodies. Abortion is necessary
healthcare, and it must be accessible to all. We will not stand
by while that freedom is stripped away from us.
I want to thank each and every one of our witnesses for
sharing their stories and for their bravery in coming before
the committee today. They are doing a tremendous service to
their communities and to the Nation.
I now yield to Representative Hice, who is representing
Ranking Member Comer for this hearing, for his opening
statement.
Mr. Hice. Thank you very much, Madam Chair.
I thank each of our witnesses for being here this morning,
and I would like to begin by echoing the Chairwoman's thoughts
and concerns for those in harm's way in Florida and South
Carolina and elsewhere with the hurricane. Truly, when one
state in this country suffers, we all suffer with them. Our
prayers, our concern, and our aid certainly are with those who
have been affected.
Fifty years ago, in Roe v. Wade, the Supreme Court
tragically strayed from the text of the Constitution and took
away from the American people the power to decide the question
of abortion for themselves. This constitutionally illiterate
decision resulted in the death of over 63 million unborn
Americans.
As Justice Byron White wrote in his dissent, quote, ``This
issue, for the most part, should be left with the people and to
the political processes the people have devised to govern their
affairs,'' end quote.
This summer, the Supreme Court heeded the wisdom of Justice
White and returned that moral decision to the American people
and to the democratic process through the Dobbs decision.
I would underscore the word ``moral decision.'' This is a
moral, spiritual, and religious issue for countless millions of
Americans who hold to a Biblical world view on life. Those who
hold that life is precious, that it is created by God--and I
certainly count myself among that number of millions of
Americans. In fact, the Bible mentioned multiple instances
where individuals were known in the womb before they were born,
people like Jacob and Esau; Samson; Isaiah; Jeremiah; King
David; the apostle, Paul; John the Baptist. All the Scripture
references were known in the womb before they were born.
For us or companies to have policies, laws, or requirements
to force people to violate their deeply held religious
convictions is just wrong, whether it be forcing them to use
their tax dollars to pay for abortions, or whether it be
forcing individuals in the medical industry to assist in
abortions when it goes against their religious beliefs or be
fired if they don't do so. It's wrong for us to go down that
path.
But, putting that aside, this hearing today, rather than
engage honestly on the merits of politics and law and science,
Democrats are fear-mongering and spreading misinformation. In
fact, The New York Times published a piece encouraging
Democrats to, quote, ``lean into the politics of fear,'' end
quote.
Instead of following the science, Democrats are trying to
ignore it or spin it for political purposes. If we are
following the science, then modern medical advances make it
clear that unborn babies are just that, precious human lives
that we must protect.
The 4D ultrasound provides the means to understand more
about unborn babies than at any other point in history, and
here's just a few examples: Within the first four weeks of
pregnancy, the baby develops a heartbeat, despite, by the way,
claims of my home state's gubernatorial candidate, Stacey
Abrams. This is not merely a manufactured sound. It's an
ultrasound. Referring to an unborn baby's heartbeat as mere
cardiac activity does not change the fact. It's another attempt
to simply deny what we are talking about, and that is a human
life.
As early as 12 weeks, a baby can feel pain, which is
exactly why anesthesia is administered to a baby during fetal
surgery. In fact, the only cases that anesthesia is not
administered is during an abortion.
By 15 weeks, all of a baby's major organs are formed, and
the circulatory system is pumping approximately 26 quarts of
blood per day.
Babies that are born as early as 22 weeks and receive
hospital treatment survive at rates at nearly 60 percent.
Just recently, scientists recorded evidence that unborn
babies respond with facial reactions to flavor of foods eaten
by their mothers. It's fascinating.
Over the past several decades, scientific advancements have
provided us with amazing insights into the development of a
human baby in its mother's womb. Unfortunately Democrats
outright deny the science and spin false narratives to avoid
one unmistakable fact: Unborn babies are human beings, and they
deserve the right to life.
Thankfully, the American people do not support the
Democrats' radical legislation, like H.R. 8296, the Abortion on
Demand Until Birth Act. Every Democrat on this committee voted
for legislation that would allow abortion up to the moment of
birth. This is a radical position. It is so extreme that it
puts the Democrats on par with authoritarian dictatorships like
North Korea and China. Even France prohibits abortions after
week 14.
Polling conducted after the Dobbs decision found that 72
percent of Americans, including 75 percent of women, oppose
abortion after 15 weeks of pregnancy. That's why Republicans
are fighting for the will of the American people.
Let's call this hearing today what it really is. It's
nothing other than a desperate political ploy. It's a ploy to
distract the American people, No. 1, from issues they're
facing, like skyrocketing inflation, skyrocketing crime, the
border crisis, students' learning loss from school closures,
the fentanyl crisis, and we can go on.
This hearing today is a ploy to distract from that, but it
is also an attempt to continue fear-mongering against policies
for life and to distract what this issue of abortion versus
life is really all about, yet Democrats continue to distract
from the reality that they have created that the American
people across this country are suffering from.
Fortunately, this political ploy, I believe, will join a
long list of Democrat failures. It's time today in this
hearing, however, to stop denying science. Unborn children are
human beings, and they deserve the right to live.
With that, Madam Speaker, I yield back. Thank you.
Chairwoman Maloney. The gentleman yields back.
Now we will introduce our witnesses.
First, we will hear from Kelsey Leigh. Then we will hear
from Dr. Nisha Verma, a fellow at Physicians for Reproductive
Health. Then we will hear from Dr. Wubbenhorst. Then we will
hear from Dr. Kumar, medical director for primary and trans
care at Planned Parenthood Gulf Coast. Finally, we will hear
from Jocelyn Frye, president of the National Partnership for
Women & Families.
The witnesses will be unmuted so that we may swear you in.
Will you please raise your right hand.
Do you swear or affirm that you're about to give the truth,
the whole truth, and nothing but the truth so help you God?
Let the record reflect that they answered in the
affirmative.
Thank you, and, without objection, your written statements
will be made part of the permanent record of Congress.
With that, Ms. Leigh, you are now recognized for your
testimony.
STATEMENT OF KELSEY LEIGH, PITTSBURGH, PA
Ms. Leigh. Thank you, Chairwoman Maloney and members of the
committee, for inviting me to speak to you today.
My name is Kelsey Leigh, and I came from Pittsburgh to tell
you about the abortion that I had 22 weeks into a very wanted
pregnancy.
I had baby names on a short list. I had a Pinterest board
full of ideas on how my two children, my three-year-old and my
future baby, could share a room in our cozy century-old house.
At every appointment, it seemed my pregnancy was healthy
and progressing. But when I saw him on ultrasound for the first
time at 20 weeks, six days into my pregnancy, what I saw was
not compatible with life, life as I define it--healthy,
quality, free of suffering.
He wasn't moving. His limbs and neck were deformed. His
umbilical cord had a structural anomaly. If my pregnancy
continued, he likely wouldn't have had the ability to swallow.
He may not have been able to breathe, and his bones would have
broken during delivery, no matter the method.
So I did what I knew was right for my son, myself, and my
family. I chose to end my pregnancy. I could not and would not
carry my son for four more months to give birth to him knowing
his life would be filled with pain and suffering.
Pennsylvania's law allows abortions until 23 weeks, six
days into pregnancy, so I was able to access comprehensive,
compassionate abortion care within the legal window at a
hospital just 10 minutes from my home.
Just six weeks later, while I was still grieving and
healing, I stood before a bank of cameras and pled with the
Pennsylvania Legislature not to pass a bill that would ban
abortion at 20 weeks, a bill that would have banned my abortion
and stripped me of my privacy in my most vulnerable moments.
We stopped that legislation in its tracks. A year later,
when the bill came up again, I went from office to office in
Harrisburg, asking lawmakers to support people like me. Enough
lawmakers listened and understood the gravity of their
responsibility that we stopped that bill from becoming a law.
Pennsylvania's abortion laws are far from perfect. The
state puts patients in a 24-hour timeout after trying to shame
them out of getting an abortion with biased information. Among
the demeaning questions I was subjected to was an offer to mail
me a week-by-week fetal development guide. You can imagine how
difficult that was for me to hear.
But, because lawmakers listened to their constituents, in
this new reality the Supreme Court created, Pennsylvania is a
beacon for patients in other states. I now work at Allegheny
Reproductive Health Center, where we are proud to provide
abortion care. I schedule appointments and find patients the
resources they need to travel to Pittsburgh and pay for their
care.
Two-thirds of the calls I field in a given day are from
patients who live in other states because the abortion bans
going into effect across this country cannot and will not stop
anyone from needing an abortion.
No one calling owes me a justification for why they need
their care. No one has to convince me or anyone else at our
clinic of their worthiness of an abortion. They are each a
human being, and they each have the right to control their own
body. Never--not once--in my years of advocating for abortion
access, have I talked to someone who deserved their abortion
less than I did.
The people you each represent do not want abortion to be
illegal. Your constituents are mothers like me, are young
people with dreams and plans, and we're all citizens who should
be allowed to make our own decisions about our health, our
bodies, and our futures.
So, in this moment where you, as lawmakers, have been given
the green light to take away our power of our most personal
decisions, I want to close by asking you this question: Who are
you going to be? Will you sit in judgment of people who are
pregnant without knowing them or their circumstances, or will
you listen to me, to us, and be the compassion that our country
so desperately needs right now?
Thank you.
Chairwoman Maloney. Thank you very much.
Dr. Verma, you are now recognized for your testimony, and
you are now recognized.
STATEMENT OF NISHA VERMA, M.D., MPH, FACOG, FELLOW, PHYSICIANS
FOR REPRODUCTIVE HEALTH
Dr. Verma. Thank you.
Good morning, Chairwoman Maloney, Ranking Member Comer, and
distinguished members of the committee.
My name is Dr. Nisha Verma, and I use she/her pronouns. I'm
a board-certified, fellowship-trained obstetrician and
gynecologist who provides full-spectrum reproductive
healthcare. I'm a fellow with Physicians for Reproductive
Health, a network of physicians across the country working to
improve access to comprehensive reproductive healthcare.
I am also a proud southerner. I was born and raised in
North Carolina. I currently provide care in Georgia, and I have
lived in the southeast for most of my life.
Growing up, I saw firsthand the devastating impacts of
restrictions on contraception and abortion care in the lives of
real people, my friends, family, and people in my community.
They are the reason I'm here before you today.
I became a doctor and OB/GYN because of my drive to take
care of people without judgment throughout the course of their
lives, regardless of their healthcare needs. For me, that
commitment includes talking people through their first pap
smears, delivering their babies, and supporting them as they
decide to continue or to end a pregnancy.
Whether I'm caring for someone who is ready to build a
family, already parenting, or focused on their education or
career, all my patients have something in common: They are
making thoughtful decisions about their health and well-being
and deserve high-quality care, including abortion care,
regardless of who they are or where they live.
The Supreme Court's decision to overturn the constitutional
right to abortion care has wreaked havoc across this country as
states, including Georgia, have enacted severe abortion bans
and restrictions.
Right now, I am terrified for my communities in Georgia,
where most abortions have been banned very early in pregnancy,
at approximately six weeks. This is before some people know
they are pregnant, and long before many of my patients receive
diagnoses of dangerous medical decisions or fetal anomalies
that complicate their pregnancies and endanger their health.
Because of a law that is not based in medicine or science,
I am forced to turn away patients that I know how to care for.
Imagine looking someone in the eye and saying, I have all the
skills and the tools to help you, but our state's politicians
have told me I can't. Imagine having to tell someone, you are
sick, but not sick enough to receive care in our state based on
their law's very narrow exceptions.
As a doctor in Georgia, I am being forced to grapple with
these impossible situations more and more, situations where the
laws of my state directly violate the medical expertise I
gained through years of training and the oath I took to provide
the best care to my patients.
I have also practiced in Massachusetts and Delaware and
have seen how dramatically the care I am able to provide and
that the people I care for are able to receive varies based on
the laws of the state. In these states, when I don't have to
deal with medically unnecessary restrictions on abortion
access, I can focus on doing what I'm trained to do--providing
safe, compassionate, evidence-based care.
I understand that abortion care can be a complicated issue
for many people, just like so many aspects of healthcare and
life can be. But I'm here today to tell you that abortion is
necessary, compassionate, essential healthcare. It should not
be singled out for exclusion or have additional administrative
or financial burdens placed upon it.
Bans and restrictions on abortion care have far-reaching
consequences, both deepening existing inequities and worsening
health outcomes. When abortion is difficult or impossible to
access, complicated health conditions can worsen, and even
result in death. We have already seen that abortion bans impact
access to other types of essential healthcare, like miscarriage
management, harming the overall health and well-being of people
across the country.
The reality is, as a provider of comprehensive reproductive
healthcare, I know people are capable of making complex,
thoughtful decisions about their health and lives. It is
indefensible that any politician would try to prevent them from
doing so.
Despite the Supreme Court's decision and efforts by
politicians to create an unjust patchwork of abortion bans and
restrictions, I am unwavering in my commitment to support
people in my home and community in the South in whatever way I
can. It shouldn't have to be this way. People should be able to
get care in their own communities in a manner that is best for
them, with people they trust.
I urge you to listen to the stories of people who provide
and access abortion care. I hope these stories help you
understand that abortion care is not an isolated political
issue and to see how profoundly restrictions on abortion access
harm all of our communities.
Thank you for having me today, and I look forward to your
questions.
Chairwoman Maloney. Thank you.
Dr. Wubbenhorst, you are now recognized.
STATEMENT OF MONIQUE CHIREAU WUBBENHORST, (MINORITY WITNESS)
Dr. Wubbenhorst. Thank you.
Chair Maloney, Ranking Member Comer, and members of the
committee, thank you for the opportunity to testify at this
hearing, and good morning.
My name is Dr. Monique Chireau Wubbenhorst, and I am a
board-certified obstetrician-gynecologist. I have over 30
years' experience in patient care, teaching research, health
policy, and global health. In my clinical career, I focused on
providing obstetric and gynecologic care for underserved and
disadvantaged populations in both domestic and international
settings, and for those with--for women with limited access to
care in such places as rural North Carolina, inner-city Boston,
Native-American reservations, as well as in India, Nepal, the
Philippines, and other countries.
I'd like to discuss abortion's harms to women and their
children. The Dobbs decision, which returns the decisionmaking
on abortion legislation to the states and Federal elected
officials, presents an opportunity to mitigate abortion's many
harms to women in communities and to urban born human beings.
Abortion not only poses risks to the mother; it is always
lethal to an unborn child. It is my opinion that abortion is
not healthcare. Abortion is defined by CDC as an intervention
that is intended to terminate a suspected intrauterine
pregnancy and does not result in a live birth. The goal of any
abortion is, therefore, to kill the embryo or fetus, which is a
human being.
There are, of course, different types of healthcare, and
it's my opinion that abortion either prevents, treats, or
palliates any disease. It has, instead, as its goal, the death
of a human being. It is, therefore, not healthcare for the
mother or her fetus.
Research confirms this because the majority of OB/GYNs do
not do abortions. In 1985, 40 percent of OB/GYNs surveyed
performed abortions, in a study by Orr, et al. In a 2018
survey, only seven percent of private practice OB/GYNs
performed abortions. In another survey in 2019, 23 percent of
OB/GYNs performed abortions, but only 30--but 30 to 40 percent
performed fewer than eight abortions per year.
I'd like to now talk about the fact that clinicians caring
for pregnant women have two patients, the mother and her unborn
child, because the fetus is, indeed, a patient, and
advancements in technology have enabled us to recognize that.
Many fetal conditions can prevent--be prevented or treated
in utero. Open fetal surgery, as we heard earlier, can be
performed as early as 15 weeks gestation. Science also shows
that an unborn child is able to feel pain much earlier than
previously thought. In addition to that, anesthesia is
routinely provided at 15 weeks in order to ameliorate the pain
from these procedures.
I would also like to discuss briefly the epidemiology of
abortion, because we know that the abortion statistic
collection is extremely flawed. In 2019, in fact, reporting
to--the CDC's abortion surveillance report stated that because
reporting to CDC is voluntary and reporting requirements vary,
CDC is unable to report the total number of abortions performed
in the United States. This probably is not just limited to
number of abortions, but also to abortion complications.
For many years, there has been an assertion that abortion
is safer than childbirth, and this has been used to defend the
right to abortion. Because of the incompleteness of data, it is
not possible to make this assertion with any certainty. Indeed,
there are some studies that suggest that abortion-related
mortality is equal to, or almost equal to maternal mortality
when abortion is conducted at later gestational ages.
I'd like to briefly mention that the fetal heartbeat is an
important measure and a useful measure of fetal health. In my
experience, physicians use ultrasound to detect it, and the
fetal heart develops over the course of gestation with the
heartbeat being able to be detected sometimes as early as six
weeks, but often later.
But the point that I would like to make is that the
heartbeat is there whether we detect it or not. We are simply
observing it, and observing the heartbeat is an important part
of assessing fetal health. Studies show that the presence of a
heartbeat at 10 weeks is associated with a greater than 90
percent likelihood that that pregnancy will carry to term.
I'd like to close by briefly discussing racial disparities.
Since Roe v. Wade, an estimated 17 million unborn African-
Americans have been aborted in the United States. That's more
than the populations of the countries of Senegal and Cambodia.
Those abortions mean not only the deaths of the 17 million
Black people who are aborted, but all of their families and
descendants. In addition, there are substantial racial
disparities in abortion and its complications. Black women
undergo 38 percent of abortions, even though we comprise only
12 to 14 percent of the total population, and these statistics
are likely underestimates.
More than one-third of second trimester abortions are
performed in Black women. And it--it seems to me to be
difficult to reconcile the fact that Black women have the
highest rates of maternal mortality and the highest rates of
abortion at the same time. Both cannot be true.
Thank you very much.
Chairwoman Maloney. Thank you.
Dr. Kumar, you're now recognized for five minutes.
STATEMENT OF BHAVIK KUMAR, M.D., MPH, MEDICAL DIRECTOR FOR
PRIMARY AND TRANS CARE, PLANNED PARENTHOOD GULF COAST
Dr. Kumar. Thank you. Chairwoman Maloney, Representative
Comer, thank you for the opportunity to----
Mr. Hice. You need your microphone.
Chairwoman Maloney. Microphone. Your microphone.
Dr. Kumar. Thank you.
Chairwoman Maloney, Representative Comer, thank you for the
opportunity to appear before the committee today.
My name is Dr. Bhavik Kumar, and I use he/him pronouns. I
grew up in Corsicana, Texas, where my family moved when I was
10. I know what it's like to be undocumented, a person of
color, gay, and governed by White supremacist laws that burden
our families and communities.
I decided to become a doctor because I believe that
everyone deserves quality healthcare. As I've provided abortion
care in Texas for over seven years, I've witnessed the steady
erosion of our rights and freedoms at the hands of anti-
abortion politicians.
On September 1, 2021, S.B. 8 banned abortion in Texas at
about six weeks, before many people even know they're pregnant.
Less than a year later, the Supreme Court overturned Roe v.
Wade, allowing states like Texas to completely outlaw abortion.
At this moment, America is effectively two countries--one
where people can control their own bodies, and another where
politicians have decided for them. I've met, sat with, and
cared for thousands of people who know it's not the right time
for them to be pregnant. Unlike the people who pass abortion
bans or uphold them in court, I actually have to face those who
are harmed. I have to look my patients in their eyes, listen to
them beg for help, and tell them I'm not legally allowed to
take care of them.
These are real people with real lives and real stories.
It's an honor and a privilege to hear them. As lawmakers, it's
your obligation to reckon with the devastating consequences of
abortion bans for my patients and your constituents. It's your
duty to hear their stories, too.
Before Roe was overturned, when we were still providing
abortion care under S.B. 8, I saw a patient who was afraid her
abusive partner would find out she was pregnant. She was sure
she'd made it to the clinic in time to get an abortion. She
hadn't. She barely made it to the clinic that day without her
partner finding out. Going out of state was unthinkable. She
sobbed so loudly; people could hear her in the waiting room.
Her fate was sealed. She was sentenced by the state to carry
that pregnancy to term, tethered to her abusive partner to
likely endure more abuse.
These stories are endless--rape, incest, young girls still
learning about their bodies, mothers struggling multiple jobs
and kids, college students with their whole lives ahead of
them, trans folks who thought they couldn't get pregnant,
people with wanted pregnancies where something went gravely
wrong, people extremely sick from pregnancy who came in
clutching IV polls, and on and on and on.
Over and over again, we are forced to violate our
conscience and our training to turn away patients who need us.
There is nothing more inhumane, cruel, or unethical than having
to deny people the essential healthcare they seek in their time
of need.
Now, as providers in Texas, our scope of practice is
limited by the law. Texas has three overlapping abortion bans
that carry severe punishments for providers like me, including
life in prison, unless it's a medical emergency, something the
law fails to adequately define because it was written by
politicians and not doctors.
Doctors have to wait to intervene. People have already been
denied the care they need, even for early pregnancy laws,
commonly known as miscarriage, because they weren't sick enough
yet not bleeding enough yet not miscarrying enough yet, all
this in a state with extremely high maternal mortality rates,
especially for Black women, who were already three times more
likely to die during childbirth.
Abortion bans are inherently racist, inherently classist,
and fundamentally part of the White supremacy agenda.
We don't have to imagine a world where people face the
deadly consequences of being denied essential medical care.
It's here, and we should be ashamed. But it doesn't have to be
this way. You are all in a position to act. Please be creative,
be bold, and do something. Act like people's lives depend on
you, because they do.
I will never stop fighting for my patients, for their right
to control their own bodies without political interference, and
for my ability to provide them with the best medical care I
can. I will show up for them with the dignity and respect that
they deserve and that their government has denied them.
I welcome your questions. Thank you.
Chairwoman Maloney. Thank you.
Now we will hear from Ms. Frye. You are recognized for your
testimony.
STATEMENT OF JOCELYN FRYE, PRESIDENT, NATIONAL PARTNERSHIP FOR
WOMEN & FAMILIES
Ms. Frye. Thank you, Chairwoman Maloney and Ranking Member
Comer in his absence, and Congressman Grothman, and all the
members of the committee. I am grateful for the chance to be
here with you today.
Before I start, I do want to say to you, Madam Chair, that
I just want to express my appreciation to you on behalf of the
Partnership. Your extraordinary legacy that you've built over
the years is one that we have depended on. You have been a
powerful voice for women's rights, and I'm sure you will
continue to do so into the future.
The National Partnership is a policy and legal advocacy
organization that strives to advance healthcare, civil rights,
and economic justice for women and families in America. Our
mission is to help ensure that women and people of all genders
live in a society free of barriers and biases, in a society
where we can all reach our full potential.
We believe that every person should be able to enjoy the
fundamental human right to live with dignity and autonomy, to
determine the course of their own destiny. This is particularly
true for women. Women's progress has been inextricably linked
with the freedom to control our own bodies, and to decide for
ourselves when or if to start a family, which is one of life's
most personal choices.
The decision to have a child shapes every aspect of
someone's life, from their physical health and their family
well-being, from their economic security to the trajectory of
their future. Access to abortion has been pivotal for women,
and for all those who give birth, to secure their own health
and to take charge of their own lives.
The evidence is clear, and it is compelling. Research
consistently proves restricting abortion access undermines the
health, safety, and well-being of those who are pregnant. Women
who give birth after being denied abortions are more likely to
endure life-threatening complications during and after
pregnancy. America has already the dubious distinction of one
of the worst records on maternal health in the developed world.
A national abortion ban could increase our maternal
mortality rate by as high as 24 percent. The dangers are
especially acute for Black and indigenous women. Black women
are three times more likely to die during pregnancy or
childbirth than White women. Further restraints on
comprehensive reproductive healthcare will only make this
crisis worse.
Limiting reproductive freedom imposes economic hardships as
well. Women who seek but are denied abortions are more likely
to amass debt, fall into poverty, and suffer an eviction. Roe
v. Wade was a landmark victory, because it established a firm
constitutional foundation upon which women, and, indeed, all
people could rely on. It made clear that the right to privacy
afforded essential protections, which place critical health
decisions in the hands of the people most affected, not in the
hands of politicians or judges.
Dobbs v. Jackson eliminated this fundamental right which
people have depended on for decades, creating chaos in too many
communities. As of today, 26 states have enacted or are likely
to enact partial or complete bans on abortion. The National
Partnership estimates that these bans would restrict the
freedom of 36 million women of reproductive age. These women
include 15 million women of color, nearly 13 million women who
are economically insecure, and 3 million women with
disabilities.
These bans inflict the greatest harm upon communities who
already confront the steepest hurdles in accessing healthcare
and economic opportunity. People with the lowest incomes and
people of color, especially Black and indigenous people, often
face the harshest health risks and are most likely to die from
causes related to pregnancy.
To make matters worse, the states that have passed the
strictest abortion laws are the same places where families have
the hardest time securing affordable healthcare, childcare, and
paid family leave. They are also the same places that have
deployed other restrictive laws, such as those that make it
harder to vote, further deepening the inequities confronting,
in particular, Black, and Brown people. We must ensure that
access to comprehensive, quality reproductive healthcare is
available to every person. We must meet this moment with the
urgency that it deserves.
A national abortion ban would make America's families
poorer. It would set women back and deny them the freedom to
control their own bodies, and it would put the lives of those
who are pregnant at enormous risk.
The ability to access an abortion is a human right. It is
fundamental to women's equality and the opportunity for women
to participate fully in our society.
I appreciate the chance to speak with you today about the
magnitude of the moment, and I look forward to answering your
questions.
Chairwoman Maloney. Thank you so much for your testimony. I
thank all of the panelists for your bravery, for your
testimony.
I now recognize myself for questions.
The fall of Roe v. Wade was the culmination of a decades-
long effort by Republican politicians and, I would say, right-
wing judges to take away the constitutional right to abortion
that has been recognized for half a century in this country.
Earlier this month, Senator Lindsey Graham introduced a
nationwide criminal ban on abortion, one that would imprison
doctors and nurses who perform abortions.
Dr. Kumar, you have treated patients in Texas where the
right to have an abortion was taken away from women for more
than a year ago by a law called S.B. 8. From what you have seen
on the ground, in Texas, what would a national abortion ban
mean for patients who need abortion care throughout our
country?
Dr. Kumar. Thank you for your question.
I think a national ban would be very concerning. Like you
said, it's been about a little bit over a year in Texas since
we've had a ban close to six weeks, and that lasted for about
10 months until we had an outright ban. What we know throughout
time is that people have always sought ways to end their
pregnancies, and even with a ban in Texas, people continue to
find or need abortion care, and we would continue to have
people calling us, people coming to our clinic asking us for
care.
Six weeks is certainly a very difficult time period to get
into care. Most people don't even know that they're pregnant at
that point. But what I find with all bans on abortion, whether
it's at six weeks or 15 weeks, is that they're very arbitrary.
When I'm looking at a patient and they say that they can't be
pregnant, they're telling me exactly why they can't continue
that pregnancy. They don't care whether they were 16 weeks or
15 weeks. They know that they can't be pregnant, they need
care, and they'll go to whatever lengths that they can to get
that care. That's what we saw. Many people left Texas to get
the care that they needed.
Chairwoman Maloney. Thank you.
Ms. Leigh, you made the personal choice to have an abortion
under very heartbreaking circumstances, and you used your own
judgment to decide what was best for you and your family.
What would you say to the Republican politicians here in
Washington who think they know better about what is right for
you and your family?
Ms. Leigh. Thank you for the question.
I like to remind people that, as Americans, we all have the
core value of self-determination, bodily autonomy, and to
determine our futures for ourselves and our families. I like to
ground people in that, because we all want that for ourselves.
I was privileged enough to have that, and that's what I
want for anyone seeking an abortion in this country. I made the
right choice that I could, just like you would want to do if it
was yourself, a family member, or a loved one.
Chairwoman Maloney. And how does it make you feel that
politicians are inserting themselves into one of your most
personal and painful decisions that you've ever made?
Ms. Leigh. So the hardest day of my life was having my
ultrasound with my son and finding out that what I thought was
a healthy pregnancy was indeed not. The second hardest day of
my life was finding out that the Pennsylvania Legislature was
fast-tracking a 20-week ban without any public hearings or
input from doctors to ban abortion at 20 weeks.
So I've lived that experience, where if that ban had been
moving a few weeks earlier or my pregnancy had been timed
differently, I would have been legislated about without ever
being talked to, without a single abortion patient ever being
asked, or, you know, physicians or leading scientific groups on
these things. It's unthinkable. We don't do this on any other
issue, and we need to stop doing it on abortion.
Abortion seekers are moral people. Abortion providers are
my heroes. We are capable of making these decisions, and we do
not want the government in our body and in our private
decisions.
Chairwoman Maloney. I want to thank you for your bravery
and for coming before the committee today.
My Republican colleagues believe that politicians in
Washington should have the power to force a woman in Kentucky,
New York, Arizona, Pennsylvania, any state in our country, to
give birth, even if the fetus is incompatible with life, as
your fetus was.
They don't trust women to make the best decisions for
themselves, for their families, for their healthcare, for their
lives. Their end game is a nationwide abortion ban that will
rip away freedoms for millions of women and put our Nation's
healthcare providers at risk of imprisonment, and they will
stop at nothing to pass it.
We must not let them have their way.
I want to thank all of the witnesses for being here.
With that, I recognize the gentlelady from North Carolina,
Ms. Foxx.
Representative Foxx, you're now recognized.
Ms. Foxx. Thank you, Madam Chairman, and thanks to our
witnesses for being here.
Dr. Wubbenhorst, thank you for your service to our Nation
as a practicing OB/GYN and working with USAID during the Trump
administration. It's always great to have fellow North
Carolinians here.
Democrats have the distinction of holding the truly extreme
position on abortion today. Twice during the 117th Congress,
nearly every single Democrat voted in favor of the so-called
Women's Health Protection Act, which should be called the
Abortion on Demand Until Birth Act. This bill reveals their
agenda for the United States: Abortion on demand, until birth,
in every state.
Dr. Wubbenhorst, in your understanding, would this bill
even abolish laws that prevent aborting a baby just because of
a Down syndrome diagnosis or because of the sex of the baby?
Dr. Wubbenhorst. Yes. Thank you, Congresswoman, Dr. Foxx.
Yes, I believe that this bill would go very far toward
abolishing any protective laws for disabled fetuses.
Ms. Foxx. But it would be protecting those babies that have
Down syndrome or because of their sex, correct?
Dr. Wubbenhorst. The law would be?
Ms. Foxx. Yes.
Dr. Wubbenhorst. Yes.
Ms. Foxx. So this extreme bill, the extreme bill, that
Women's Health Protection Act, would, in fact, place the United
States back in the company of countries such as China and North
Korea?
Dr. Wubbenhorst. That's correct.
Ms. Foxx. Right. And, again, it--the Women's Health Act
would not protect babies from being aborted because of their
sex?
Dr. Wubbenhorst. Yes. I think that that's an important
point. If we look at the coercive abortion practices in many
countries--in particular, China and--I would also add to that
countries in sub-Saharan Africa where foreign aid has been tied
to abortion, or to our promotion of abortion. I think that
that's an important consideration, yes.
Ms. Foxx. Thank you for giving an example of other
countries and what that--what company that puts us in.
A Harvard University poll from June 2022 showed that 90
percent of Americans believe that there should be some legal
limits on abortion. Is that correct?
Dr. Wubbenhorst. Yes.
Ms. Foxx. Is it also correct that this poll showed that a
majority of Democrats in this poll supported protections for
the unborn after 15 weeks?
Dr. Wubbenhorst. Yes.
Ms. Foxx. I believe this constitutes a majority of all
Americans. It seems to me that it is the Democrats who hold the
extreme positions on abortion, and they hold the views contrary
to the will of most Americans. And I find it really interesting
that there are people who say this is an act of self-
determination.
It is one thing to be determining what happens in your own
body. It's another thing to be determining the life of a--of an
unborn child that you are carrying. And I'm often reminded of
the Merchants of Venice, where--in the Merchant of Venice,
there was a deal made that, if a man could not pay his debt, he
would give a pound of his flesh. And, in court, the defense
lawyer said: You may have your pound of flesh, but you may not
take a drop of blood.
And it seems to me that elective abortion should be
compared to that, because you may be self-determining for your
body, but what are you doing to the body--to the child in your
own body?
Dr. Wubbenhorst, is there anything you've heard today you'd
like to respond to or correct for the record?
Dr. Wubbenhorst. Well, I do think, as I said earlier, that
abortion is not healthcare. I--it's also very important to
point out that there are no data to support the assertion that
increasing rates of abortion or, in fact, that abortion at all
has any effect on maternal mortality. Again, you would have to
reconcile the fact that African-American women have the highest
rates of maternal mortality and the highest rates of abortion,
and both of those cannot be true if it's the case that abortion
has an effect on maternal mortality.
I would also like to add that the questions regarding
miscarriage and care and ectopic pregnancy care have been
frequently misrepresented in the media, and it's important to
set the record straight. Miscarriage--treatment of a
miscarriage is not an abortion. The treatment of an ectopic
pregnancy is not an abortion.
Ms. Foxx. Thank you very much. I yield back.
Chairwoman Maloney. Your time has expired.
We now recognize the gentleman from Massachusetts, Mr.
Lynch. You are now recognized for five minutes.
Mr. Lynch. Thank you, Madam Chair.
In face of the charges of radicalism, I just think it's
important to remember that, since it was decided in 1973, Roe
v. Wade had been cited in more than 4,500 cases as precedent
for privacy and for other rights as well, including more than
140 Supreme Court cases, more than 2,600 Federal court cases,
and nearly 2,000 state court cases.
And, for quite nearly 50 years, Roe and its progeny have
stood as the law of the land, reflecting a delicately
determined legal balance between the fundamental right of a
woman to make a decision about her reproductive rights and
health, free of unnecessary governmental interference and the
legitimate interests of the state.
I think it's important to note as well that Roe also
affirmed and solidified the broader individual right to privacy
of every American as derived from the due process clause of the
14th Amendment. And, indeed, according to the court, this
constitutional guarantee to personal privacy includes personal
rights that can be deemed fundamental are implicit in the
concept of ordered liberty.
Unfortunately, today, we have 15 states--15 states that ban
abortion. And, in my mind, I cannot recall a moment in our
country's history, other than prior to the Civil War, where
people in this country had to flee their home state to go to
another state in order to have their rights recognized. I
speak, of course, of slavery, when--when human beings had to
flee their home state in order to have their rights as human
beings and as people recognized in other states that would do
so.
So, right now, we have a situation where women have to flee
their state and go to another safe harbor in order to have
their health needs addressed and their full rights as citizens
recognized. That--that itself is telling. That itself is
telling.
What's troubling as well here is that, here in Congress,
congressional Republicans have introduced at least five bills
that would ban abortion nationwide, and implement a nationwide
limitation based on gestational age or abortion method.
Congressional Republicans have also introduced at least four
bills targeting a personal--a person's ability to travel to
obtain an abortion. So that, in itself--that travel would also
be made illegal.
Ms. Frye, you represent a national organization, and you
have a national perspective on how this is all happening. Can
you--can you shed some light on the situation that is happening
from state to state and what impact this is happening--this is
having on women who happen to be unfortunately living in
jurisdictions where the state legislature has banned abortion
and what they're dealing with?
Ms. Frye. Well, thank you, Congressman, for the question.
I mean, I think the short answer is that it's been chaotic
for people on the ground, and your point is well-taken that
this is what happens when you eliminate a fundamental right
that is rooted in the Constitution, and you decide that
anything goes, and any state can do whatever they want.
It is unsettling and unnerving for people, and it is
devastating to not have access to the--the protections of the
Constitution that they rightly deserve, and that people have
depended on for years. And what we are seeing across the
country is as you described--people moving from state to state
to try to get basic healthcare and being able to make the
decisions that make sense for them.
And it's unacceptable. We can do better.
Mr. Lynch. May I ask you: As an attorney, if the
relationship between a woman and her doctor is not within that
sphere of privacy, can you think of any other right that might
be?
Ms. Frye. Well, I think that that's the concern, is that,
you know, clearly, that relationship should be within the right
to privacy. But the court recognized the right to privacy
before Roe. It related to contraception. It now relates to
things like access to LGBTQ rights. It is extensive. The
ability for people to be able to make personal choices and
decisions about themselves is critical.
So this is devastating for folks.
Chairwoman Maloney. The gentleman's time has expired.
Mr. Lynch. Thank you, Madam Chair. My time has expired. I
yield back. Thank you.
Chairwoman Maloney. The gentleman yields back, and I grant
Mr. Grothman additional time, too, as they went over just a
little bit.
Mr. Grothman. OK.
Chairwoman Maloney. Thank you.
Mr. Grothman. Dr. Wubbenhorst, thanks for coming here
today, the belly of the beast.
So, first of all, just a general comment. I'm from
Wisconsin. There was a law passed banning abortion in Wisconsin
around 1849 and was in effect until Roe. I think the idea that
there is a constitutional right to abortion is obviously shown
not to be true for the fact that abortion was illegal in this
country. I think, in 1973, there were only two or three states
that were widespread proabortion states.
You know, you have to really stretch. We have an era in
which judges go to law school and find ways to get around the
Constitution, but obviously this was not a constitutional
right.
Mr. Grothman. Now when I look around the world, the United
States, under a bill that was recently passed or recently
passed the House of Representatives, would make abortion
illegal or legal--I'm sorry--all the way until birth.
And when I look around the world at other more civilized
countries, we see limits on that, you know: Sweden, 18 weeks.
It seems the consensus is normally 12 weeks, 10 weeks, a
variety of European countries.
I believe there are still many what used to be referred to
as Third World countries in which abortion is still legal. And
I've heard complaints from representatives of those countries
that the heavy-handed United States of America is trying to
throw around their weight and force them to change their laws
against their will, kind of the ultimate of the ugly American.
Could you indicate--well, there are only two countries, I
think, three countries, four countries, that have no
restrictions: North Korea, which I think is usually referred to
as the most repressive country in the world; Red China, of
course, still which has not just disavowed the previous leaders
they've had killing tens of millions of people who were not
babies; and, sadly, under Justin Trudeau, Canada.
But why do you think these other countries would not think
of allowing abortions past 10 or 12 weeks?
Dr. Wubbenhorst. Thank you, Mr. Grothman, for the
opportunity to speak.
I think there are a couple of reasons. In most European
countries there is a recognition that the risks of abortion
increase dramatically from the first to the second trimester.
And so they recognize that that there's a need to regulate
abortion because it's inherently a much less safe procedure.
There's quite a bit of data on this. There's a specifically
a study by Barrett and colleagues from 2004 that showed that
the risks of death, not just complications, but the risk of
death from abortion increase exponentially by 38 percent for
every additional week of gestation. That's No. 1.
No. 2, in some countries that have slightly later, I'm
thinking in particular of the Scandinavian countries, that have
slightly later restrictions on abortions, one of their
rationales is that they do not want to be allowing abortion
anywhere near viability. And the reason for that is actually
quite interesting. It's because the standard for viability is
constantly being pushed back, currently around 21 weeks.
And so their thought is that, if a pregnancy is misstated
or it takes some time to have an abortion, that they are going
to be then up against that viability standard.
But, above and beyond that, I think it's simply a
recognition that late second trimester abortion is wrong. And I
do think that, again, if you look at elective abortion as wrong
and I think if you do look at the history of abortion, regimes
that permit abortion at later gestational ages, you see these
human rights abuses. And I appreciate very much your notation
about countries feeling strong-armed. This was a constant
issue, especially in sub-Saharan Africa, especially some
countries in Asia, because, in those countries, the culture is
very much pro-life. They do not want abortion.
And so I do think that that's a very important point
related to that.
Mr. Grothman. Everybody should be ashamed of America that
we use our great reputation to muscle countries in Africa and
Latin America to become pro-abortion.
What percentage of OB/GYNs perform abortions, you think,
about? I know they have a hard time sometimes finding doctors
to do this in abortion clinics.
Dr. Wubbenhorst. No, I think there's very good data, and I
alluded to some of it earlier. It's interesting that the
percent of OB/GYNs willing to do abortions has declined
dramatically from about 46 percent in the mid-1980's.
Currently, among private practice OB/GYNs, it's about 7
percent, and about 20 to 23 percent for all practitioners.
Mr. Grothman. Seven percent. Why did the other 93 percent
not perform abortions?
Dr. Wubbenhorst. Because I think inherently people feel
that abortion is morally wrong, and they won't perform it.
They'll refer for it, but they won't perform it.
Mr. Grothman. OK. As an obstetrician, you're taught that
the mother and the fetus are two separate patients, correct?
Dr. Wubbenhorst. The patient within the patient is the
fetus.
Chairwoman Maloney. The gentleman's time has expired.
You may answer his question.
Mr. Grothman. OK. Well, I'll just make one pitch here on
the way out. I'll recommend people go to the website of the
American Association of Pro-Life Obstetricians and
Gynecologists. There's really good stuff on there. And if----
Chairwoman Maloney. OK. The gentleman's time has expired.
Mr. Grothman [continuing]. You want to know more about the
topic, it's a good place to find it.
Chairwoman Maloney. The gentleman from Virginia, Mr.
Connolly, is recognized for five minutes.
Mr. Connolly. Thank you, Madam Chairwoman.
One does not know where to begin. As we speak, women all
over Iran are protesting against the suppression of their
rights under the regime of the ayatollah. And here we are
debating how much we should suppress women's rights. What an
irony.
When we adopted the Bill of Rights, we didn't make a moral
statement. Take the First Amendment. The fact that I believe in
broad freedom of speech does not mean I approve of every form
of speech. It's not a moral statement. It's a legal statement
that recognizes a pluralistic society in which choices are
complex, and it's not our role to judge and restrict the rights
of the American people, including more than half of them,
women.
It's complicated. It's not as simple as you would have us
believe, Dr. Wubbenhorst. And for you to say as an OB/GYN this
is not a healthcare issue is an astounding statement and would
come as news to most OB/GYNs in this country, many of whom, as
Dr. Kumar pointed out, in states that have banned abortion, are
wrestling with the provision of healthcare, many of them not
wanting any longer to serve in those states because they're at
legal jeopardy, choosing between the healthcare they provide
their patients and what they--what their lawyers are telling
them is or is not legal.
And this is not theoretical. In South Carolina, a 19-year-
old came to the emergency room after her water broke, after
just 15 weeks of pregnancy. Once the hospital attorneys
intervened, they informed the doctors they'd be legally at risk
if they extracted the fetus, exposing this woman to a greater
than 50-percent chance she'd lose her uterus and a 10-percent
chance she'd develop sepsis and possibly die.
In Nebraska, a 34-year-old woman's water broke before the
fetus developed lungs. Despite her and her husband's desire to
end an unviable pregnancy, the doctor informed her that he had
no choice but to deliver the fetus. Weeks later, the woman went
into labor. Fifteen minutes after that delivery, both parents
were in deep mourning.
I'd ask people to pay attention to a video from Ms. Weller
of Texas, if you could play the video.
[Video shown.]
Mr. Connolly. Thank you.
Dr. Verma, are these three examples I gave--and there are
so many more--are they unusual? They're not really, you know,
uncommon.
Dr. Verma. Thank you for that question.
We are absolutely seeing these situations come up day after
day. We're seeing people that are diagnosed with terrible
medical conditions during their pregnancy that can't access the
abortion care that they need. We are----
Mr. Connolly. So I'm going--I'm going to interrupt you
because my time's going to run out, and I want to ask you one
more question.
But so it's not as simple as Dr. Wubbenhorst would have us
believe, that it's simple termination of life, that's all it
is.
Dr. Verma. No, we're often running into these situations
where we need to provide this care to protect the health and
well-being of our patients, the pregnant person in front of us.
Mr. Connolly. And let me just ask you, as an OB/GYN, in
your view, is this a healthcare issue?
Dr. Verma. Absolutely. And that is the overwhelming
consensus of the medical community, including the American
Board of OB/GYNs that certifies all of us OB/GYNs at this table
and the American College of OB/GYNs. So this is the
overwhelming consensus of the scientific medical community is
that abortion is absolutely healthcare.
Mr. Connolly. I thank you.
And I yield back, Madam Chairwoman.
Chairwoman Maloney. I thank you.
The gentleman yields back.
The gentleman from Georgia, Mr. Hice, you're now
recognized.
Mr. Hice. Thank you, Madam Chair.
You know, this hearing is about examining the harm to
patients from abortion restrictions. And I would just contend
that the primary patient in abortion is the baby, and the harm
done to the baby is permanent; it is death.
Dr. Wubbenhorst, let me come to you. Pro-abortionists want
to convince the public that, in the abortion debate, we are
talking about anything but a human life.
Recently a prominent Democrat, who I referred to earlier,
Stacey Abrams, said, quote: There is no such thing as heartbeat
at six weeks. It is a manufactured sound designed to convince
people that men have the right to take control of a woman's
body away from her, end quote.
How do you respond that?
Dr. Wubbenhorst. I would just--thank you for the question,
Congressman Hice.
I would respond to that by saying that, as I mentioned a
bit ago, there's a fetal heartbeat whether we hear it or not.
And we use instruments to amplify that sound. The fetal
heartbeat is detectable initially as a twinkling typically
around, between possibly as early as five weeks. We know that
many of the major structures of the fetal heart are complete
between the fifth and the sixth week.
And so there's no question that this is just not a--that
the fetal heartbeat is a random contraction of cells. There's
coordinated movement. That's well-documented. It's documented
in the radiology literature. It's documented in the obstetrical
literature.
And so I think that the question as to whether this is a
manufactured sound, again, as I said, the fetal heart is
beating early in pregnancy.
And the other point that I think is very important to make
is that we rely on assessments of the fetal heart rate,
presence or absence of the fetal heartbeat in order to assess
fetal health and provide reassurance to parents.
One of the most exciting things that can happen for parents
is hearing their baby's heartbeat for the first time.
Mr. Hice. I would think that most doctors involved in this
whole process for one way or the other understand that the baby
is a patient.
Dr. Wubbenhorst. Yes, sir.
Mr. Hice. And so the claim that the overwhelming consensus
is that abortion is healthcare, would you agree with that?
Dr. Wubbenhorst. No, I don't agree. And I, as I said
earlier, I respectfully disagree with assertions to the
contrary simply because, as I've said, internists don't perform
abortions. And most obstetrician-gynecologists don't provide
abortions. If abortion was essential healthcare, why is it that
greater than 85 percent of us don't do it?
Mr. Hice. Yes. Exactly. That was the point I was hoping you
would bring out.
That does not sound like a consensus at all. In fact, it
sounds like more misinformation to pretend that the consensus
of doctors in this field believe that abortion is healthcare.
Another deceptive tactic by pro-abortionists is to say
abortion restrictions will somehow deprive women of treatments
for miscarriages and ectopic pregnancies.
How do you respond to that?
Dr. Wubbenhorst. Miscarriage treatment is not an abortion.
Again, abortion is a procedure which ends an intrauterine
pregnancy, which is living, whereas a miscarriage is
typically--not typically. A miscarriage has occurred when there
has been a demised fetus, and, therefore, you are not
proceeding with the intent to kill or take a human life.
For an ectopic pregnancy, which is extrauterine or perhaps
in parts of the uterus, fallopian tubes, or in the body of the
uterus, these pregnancies, if not attended to, can result in
devastating consequences. But performing a procedure or
administrating medication to terminate an ectopic pregnancy is
not an abortion.
Mr. Hice. Thank you very much.
Final question. Pro-abortionists also claim that abortion
is necessary for women due to high rates of maternal mortality.
Would you agree with that? What's your reaction to that
comment?
Dr. Wubbenhorst. It's not true based on any science. There
are no studies that show that increasing rates of abortion
decrease maternal mortality.
In fact, until recently, countries that--where abortion was
criminalized and prohibited--and I'm thinking particularly of
Chile and Ireland, and I think Cyprus--had the lowest rates of
maternal mortality in the world. For several years
consecutively, Ireland had zero maternal mortality at a time
when abortion was completely illegal.
Mr. Hice. Thank you very much. I found your written
statement to be fascinating, and the research there that you
provided was incredible. Thank you very much.
And I yield back.
Dr. Wubbenhorst. You're welcome, sir.
Chairwoman Maloney. The gentleman yields back.
The gentleman from Maryland, Mr. Raskin, is recognized for
five minutes.
Mr. Raskin. Thank you, Madam Chair.
I've heard our GOP colleagues for many years now saying
essentially what the ranking member said when we started this
morning, that fetuses are human beings and deserve the right to
life.
The necessary implication is the position that the anti-
abortion movement has taken aggressively for decades, which is
that there should be a total ban on abortion rights in America
without any exception for rape or incest. After all, as they
always point out, the fetus is still a human being, even if it
is conceived as the result of a gang rape of a 13-year-old girl
or an incestuous rape of a teenager.
The most intellectually consistent Republicans, like the
GOP candidate for Governor of Pennsylvania, have said that
women themselves should be charged with murder for having an
abortion at 10 weeks, for example, which is what the
Pennsylvania Republican gubernatorial candidate said.
Now they've grown a little more reticent and evasive about
voicing their determination to ban all abortions everywhere in
the country since the people of Kansas, by 20 points, massively
repudiated the dangerous extremism of the Republican position.
So we don't hear as much these days the rhetoric of
``abortion is murder'' and ``women are murderers if they have
an abortion'' and ``this is worse than the Holocaust'' and the
normal fare of the anti-abortion movement.
It seems like the cat's got their tongue now that they have
struck the rock, and the rock is the women of America who are
standing up for their freedom as first-class citizens of the
United States of America.
But don't be deceived by their newfound silence and
evasiveness. Just look at what's happening in America. From
2017 to 2021, GOP legislatures enacted 127 laws restricting
abortion, nullifying the rights of 31 million American women.
Categorical abortion bans are in effect in 15 states.
Since 2021, Republicans in Congress have introduced 52
bills to ban or restrict abortion nationwide, including 16
calling for criminal prosecution of doctors and nurses and 4
targeting a woman's ability to travel across state lines for
purposes of accessing perfectly lawful healthcare in the
designation jurisdiction.
But that's all they've been able to do so far. Their
proposal to ban abortion nationwide would strip reproductive
freedom from nearly 64 million American women. Let's look at a
map of where we are now in terms of their ability to take
abortion rights away from women, if we could put up that up
first map.
So, if you look at the dark red, the maroon states, those
are states where the dangerous extremists in the Republican
Party, who are now running the party, have gotten their way,
and they've been able to completely ban women's rights.
Now what would happen if Senator Rand Paul and
Representative Alex Mooney's legislation, which is endorsed by
the vast majority of the Republican Caucus in the House, were
to pass? They would define personhood as beginning at
conception, banning in effect all abortions, and certain type
of birth control, too, by the way, such as IUDs.
What would happen? Put up that second map, if you could put
up the next one. Then abortion would be banned all over
America.
Ms. Frye--actually, Dr. Verma first. If they pass this
legislation, if they're able to enact a nationwide ban on
abortion, what would the effect be on the healthcare provided
to America's women?
Dr. Verma. Thank you for that question.
We are already seeing a devastating healthcare crisis in
this country, and it's hard for me to even fathom how much
worse things are going to get in the setting of the national
abortion ban.
I have patients that seek abortion for all kinds of
different reasons. We heard a beautiful story today of people
that are diagnosed with terrible fetal anomalies and seek
abortion out of love for that future child or that pregnancy.
I have people that are diagnosed with terrible medical
conditions, people that seek abortion for all kinds of reasons.
Mr. Raskin. So essentially these state legislators and all
the busybody theocrats in Congress who think they know better
than the women of America are going to usurp that very private
medical decision for women and for their families.
Ms. Frye, what would a nationwide ban on abortion rights
mean for the social and economic status of women in America?
Will they be equal citizens under such a situation?
Ms. Frye. Well, I think not, because they won't have the
ability to control their bodies and their futures, and what we
know is that access to abortion has been critical in the
ability of women to make decisions about their lives and decide
when they want to have a family and ensure their own economic
stability and security.
Mr. Raskin. Madam Chair, let's not go down----
Chairwoman Maloney. The gentleman's time----
Mr. Raskin [continuing]. The road of Saudi Arabia and Iran.
Chairwoman Maloney. The gentleman's----
Mr. Raskin. Let's be America.
I yield back.
Chairwoman Maloney. The gentleman's time has expired.
The gentleman from Pennsylvania, Mr. Keller, is now
recognized.
Mr. Keller. Thank you.
Let's be very clear about what today's hearing is actually
about. It's not about advocating for the best interests of the
unborn or women. It's an attempt by Democrats on this committee
to justify their radical pro-abortion agenda and efforts to
establish a system of taxpayer-funded abortion on demand. I'm
not exaggerating.
Democrats passed legislation last year that would allow for
unrestricted access to abortions to take place up until a baby
is born.
And they do so under the guise of hearings like this one
being held right now using titles like ``Examining Harm to
Patients from Abortion Restrictions and the Threat of a
National Abortion Ban'' to perpetrate fear and achieve their
far-left agenda.
How many times have we heard Democrats say, and I'll quote,
``trust the science,'' until it has to do with acknowledging an
unborn baby is a life?
I guess I've heard about healthcare. And I have to--you
know, Dr. Wubbenhorst, if there was a--if two lives go into a
facility for medical care and only one comes out, half the
patients only come out, is that successful healthcare?
Dr. Wubbenhorst. Yes, sir. Thank you for your question.
I would say that is not successful healthcare.
Mr. Keller. Right. And that's what happens. You have two
lives that go into this setting. They have what the Democrats
are calling a medical procedure, and it is. But then only one
life comes out. I don't call that success, and I don't think
anybody--and it's not radical to defend life. That's in our
founding documents: life, liberty and the pursuit of happiness.
You can't have liberty and pursue happiness if you're not born,
you're not life.
Dr. Wubbenhorst, after conception, what can you tell us
about the development of an unborn baby at I'll say some
milestones, you know, 10 weeks? I have a pin that says, at 10
weeks, a baby's feet are this big. What other milestones might
you see for development of the baby after conception?
Dr. Wubbenhorst. Sure. So I think there are a number of
important milestones even beginning very early,
postfertilization. Postfertilization--and actually at the time
of fertilization, there's actually a zinc spark that's emitted.
And we know that the question as to whether the embryo, the
zygote, is human is simply reflected in the fact that this
individual has human DNA. It came of human parents. He or she
came of human parents.
Subsequently, the zygote develops into a blastocyst which
implants. That implantation process is accompanied by the start
of the development of the placenta. That's when hCG is
released. And then, as time goes along, you have very early
milestones. You know, primordial cells begin to develop in the
heart as early as four weeks. But, even before that, the embryo
is already organizing himself or herself into different layers,
different cell layers which will give rise to different types
of tissues.
So, by about six to seven weeks, the central nervous system
is already well along in development. The spinal cord begins to
truly be developed. Fingerprints are already starting to form
at 7, 8, 9 weeks. The fetal brain has already begun. And
actually EEG activity, electrical activity in the brain, can be
detected as early as nine weeks and possibly earlier as well.
And so you have a number of these processes that are
occurring in very, very early stages of pregnancy around the
time that these unborn children are being aborted.
We know, as I said earlier, and I just want to emphasize
this, the fetal is a human being. It is not a dog. It is not a
salamander. It is a human being. It is a human being that is
achieving through development the completed form of the adult.
Mr. Keller. If I can ask a question, at what point in time
can an unborn baby feel pain? How many weeks after conception?
Dr. Wubbenhorst. Sure. So there's very excellent evidence
that, by 15 weeks, the mechanisms--and I don't want to get too
technical here but the----
Mr. Keller. So at 15 weeks I guess would be a point where
they could start to feel pain?
Dr. Wubbenhorst. Say it again, sir?
Mr. Keller. They could feel pain around 15 weeks?
Ms. Wubbenhorst. Yes, there's very good evidence because,
again, pain is a subjective phenomenon. But there's very good
evidence that the structures that can perceive pain are already
in place. And this is recent research. People used to think the
lower structures weren't really in place until 24 weeks. But,
in fact, they are present earlier, the thalamus, the peripheral
nervous system, and the early stages of the cortex, which is
the brain stem.
Mr. Keller. We tend to evolve through our entire life, and
it starts at conception. I remember when I was in 9th grade
biology class, and I remember our biology teacher writing on
the board. And it said: Sperm plus egg equals baby. I mean,
that put it pretty simply.
And I think that, when we're talking in the United States
of America, depriving life, if we're not going to protect
someone's life, we're not protecting anyone else of theirs. And
I think it starts right here in what we recognize as life, and
it begins at conception.
Thank you.
And I yield back.
Dr. Wubbenhorst. Thank you, sir.
Chairwoman Maloney. The gentlewoman from the District of
Columbia, Ms. Norton, is now recognized.
Ms. Norton. Thank you, Madam Chair, for this very important
hearing.
After decades of claiming that questions of whether
abortion is legal should be left to the states, Republicans
have revealed their true intentions, a nationwide abortion ban.
It's unsurprising that Republicans are seeking to impose a
Federal ban that would override state abortion laws because
Republicans have long tried and sometimes succeeded in
overturning the abortion laws of the District of Columbia.
The previous--they have previously tried to ban abortion
after 20 weeks in the District. And, since 1988, with few
exceptions, Congress has prohibited D.C. from using its local
funds on abortions. If Republicans do not succeed with a
national abortion ban, they will try to ban abortions in D.C.
Ms. Frye, how would Federal abortion ban override state
initiatives to protect and enshrine abortion rights and access?
Ms. Frye. Well, I think that--thank you, first off, for the
question.
You know, I think the challenge here is that those abortion
bans would be devastating for folks who need access to quality
reproductive healthcare. What we know is when they don't--
people don't have access to abortion, they have limited ability
sometimes to control their futures and their economic lives. We
know that from studies and ample research around poor economic
outcomes, poor health outcomes, not only for women and people
who give birth themselves but also their children. So, you
know, the harm is far-reaching.
But, most importantly, Congresswoman, I think it's just the
impact on denying women and anybody who gives birth the ability
to make the health decisions that make sense for them. That
harm is overwhelming, I think, for a lot of people.
Ms. Norton. Well, thank you, Ms. Frye.
Republicans in Congress have proposed, Ms. Leigh, Federal
bans as early as six weeks into pregnancy.
As we have heard throughout this hearing, many people do
not experience pregnancy complications until they are much
further along.
So, Ms. Leigh, what would have happened to you if a second
trimester Federal abortion ban had been in place at the time of
your pregnancy?
Ms. Leigh. Thank you, Representative, for the question.
As I said before, I don't have to imagine very hard because
Pennsylvania tried to do that just a few weeks after my own
abortion, when I was still grieving my son and physically
healing from my procedure.
And you make a great point about fetal anomaly often not
being detected until about 20 weeks. I'm not a clinician, and
Dr. Verma and Dr. Kumar can speak to that.
But what I do know is the counseling that I received about,
if I wanted to get pregnant again and try again, what would we
look for early on in the pregnancy, because I had full genetic
testing done, and it was inconclusive, because the vast
majority of fetal anomalies aren't yet detectable by genetic
testing.
And what--that doesn't change what my son's prognosis would
have been. And so, if I had chosen to go on to have another
pregnancy, I may have had one earlier ultrasound. But what we
saw isn't detectable until about 18 or 20 weeks. So, even in a
patient like myself who we perhaps would be--maybe I'd get some
extra vigilance because of my history, even in me it would not
have been detected again before 18 to 20 weeks.
Ms. Norton. Well, Ms. Frye, in addition to outright
abortion bans, Republicans in Congress have introduced over 20
bills that would impose severe medically unnecessary
restrictions on access to abortions, potentially nullifying
abortion access in states that have acted to safeguard abortion
rights.
Ms. Frye, how would placing restrictions on abortion access
at the Federal level hurt people in states even where abortion
is legal?
Ms. Frye. Well, I think it broadens across the country the
impact of denying people the basic ability to make decisions
about their own health and well-being.
You know, that's what Roe did is that it enabled folks to
bypass individual state preferences and ensure that every
person had the ability to make those choices and that it was
rooted in the Constitution.
Chairwoman Maloney. Your time has expired.
The gentleman from Arizona, Mr. Biggs, you're now
recognized for five minutes.
Mr. Biggs.
Mr. Biggs. I thank the chair.
You know, the Delegate from D.C. has been crabbing here
about various proposals by Republicans to pass some kind of
national abortion law to supersede states' laws. That's kind of
odd because that's exactly what Roe v. Wade did, and they're
embracing Roe v. Wade.
In fact, the radical Democrats on this committee just a
year ago voted lockstep to pass the most, the most radical ever
abortion bill, lifting any restrictions on abortions
whatsoever. That was the Women's Health Protection Act.
Everybody here, every Democrat in Congress did in the House,
except for one, Representative Cuellar, but it failed in the
Senate.
I just think it's interesting. That's why I bring it up. It
wasn't in my notes. But, I mean, the fact that you're sitting
here, saying, ``Wait a second, wait a second, there's state
laws that might conflict with what we believe, the new
orthodoxy,'' but that's exactly what Roe v. Wade did.
You know, I didn't hear any Republicans or Conservatives or
pro-life advocates saying, ``Hey, let's pack the court.'' Sure
hear it now.
In fact, that's one of the articles I'm going to submit for
the record, Madam Chair, is the list of Democrats who've called
for packing the court because they don't like the Dobbs
decision.
We heard just a minute ago the gentleman from Maryland say:
Hey, let's not go down the way of Saudi Arabia and Iran.
Apparently, he'd rather go down the way of China and North
Korea, because that's what the bill that he voted for did. It
took away all restrictions on abortion whatsoever.
Yes, that's--that's pretty doggone radical if you ask me.
And that's why it isn't so brave to have to come into this
committee, because the chair and everybody in the majority, in
fact, every witness but one agrees with that radical position.
So the real person who's exhibiting bravery today--and I
want to thank you for coming in--is Dr. Wubbenhorst. Thanks for
being here, coming into the belly of the beast, as Mr. Grothman
said.
By six weeks, medicine has found that an unborn baby's
heart is beating. And that's a medical milestone echoed by
popular websites like whattoexpect.com, babycenter.com, which
even tells mothers: You may hear the sound this week if you
have an early ultrasound.
But recently you had a prominent Democrat running for
statewide office in Georgia say, quote: ``There's no such thing
as a heartbeat at six weeks. It is a manufactured sound
designed to convince people that men have the right to take
control of a woman's body away from her, close quote.''
That's from Stacey Abrams.
And I want to say, Dr. Wubbenhorst, I really appreciate
what you've said in your testimony, both written and oral
today. The fact that we don't detect it doesn't mean it's not
there. Please expand on that.
Dr. Wubbenhorst. Well, I think that it's, especially
regarding the fetal heartbeat and, indeed, almost any
developmental milestone, but especially the heartbeat as an
indicator of fetal health and well-being and also reassurance
to physicians and--I wish I understood why this mic--
reassurance to physicians and patients that, again, it's
similar to the phenomenon of fetal pain. We can't appreciate
whether the fetus experiences pain or not. Pain is a subjective
phenomenon, but we can observe that it exists. It probably
exists based on the evidence.
Similarly, with the fetal heartbeat, we know that, based on
embryological studies and anatomical studies, we know that
these structures are present. People have followed the
development of the fetal heart, the development as it--not just
in its primordial and its primitive state but as valves and
chambers form and that that pattern its laid down, as I said,
pretty much by about 7 to 8 weeks.
So it's really at that point almost in miniature. And there
are, of course, other anatomical differences.
And so I do think that it's important to keep in mind that
these--being able to see and detect these phenomena or, for
example, the fetal heartbeat does not negate the fact that the
fetus is a human being and that the heartbeat is present.
Mr. Biggs. So a prominent Democrat speaking on the podcast
of a disgraced former CNN anchor claimed that the Supreme
Court's Dobbs v. Jackson decision forces mothers to carry a,
quote, ``toxic thing,'' close quote, inside them.
Would you tell us whether you believe that a fetus is a
toxic thing inside a woman's body?
Dr. Wubbenhorst. I don't believe that a fetus is a toxic
thing inside a woman's body because women want to be pregnant.
They want to have families. And, if you look at very well-
established data on why women have abortions, it is because
they have no one to support them through pregnancy.
I've talked to women repeatedly, especially in work with a
crisis pregnancy center. And they said: If I just knew that
someone would walk with me through this pregnancy, I would not
abort.
And that's basically somewhere between 60 and 80 percent.
So really what could you look at with a lot of women who are
choosing to abort is a subtle form of coercion. And that's----
Chairwoman Maloney. The gentleman's time has expired.
Mr. Biggs. My time has expired.
Madam Chair, I do have three documents for the record, one
called ``Fact Check: `There Is No Such Thing as a Heartbeat,'
says Stacey Abrams''; ``Goldberg dehumanizes nonviable unborn
children as `toxic thing'"; and also Dr. Wubbenhorst's amicus
brief to the Dobbs decision.
I'd to submit those for the record.
Chairwoman Maloney. Without objection.
Mr. Biggs. Thank you very much.
Chairwoman Maloney. The gentleman from California, Mr.
Khanna, is recognized.
Mr. Khanna. Thank you, Madam Chair.
It's very disappointing that this Supreme Court has put
ideology and politics over the rule of law to take away
fundamental freedoms and rights from women across America.
You know, it's not just me who is perplexed, frustrated,
outraged that the Supreme Court would actually take away rights
in our country at this time. It's the American people who are
outraged. The Supreme Court approvals ratings have never been
lower. Gallup did a poll today. Forty percent approve. Most
Americans understand what's going on. They understand that this
was an ideological political decision, and they disapprove, and
the Supreme Court is losing the respect of the American people
at large.
The decision to take away women's fundamental rights, the
decision to take away women's rights to choose and make
decisions about their own healthcare has affected different
districts across America differently.
In my district, we have gone out of our way with many
leaders and civic leaders to stand up for women's decision to
do what they think is appropriate with their bodies and their
reproductive decisions.
But, Ms. Frye, in the wake of Dobbs v. Jackson, could you
briefly touch upon how the experience of seeking reproductive
care, whether it's getting contraception or getting an
abortion, may look different for a patient in rural America
than a patient in an urban area?
Ms. Frye. Well, yes, Congressman, I think you're absolutely
right that the experiences are quite different, depending on
whether or not it's one of the 26 states that now either ban or
are likely to ban abortion.
For folks in those states, they have to look elsewhere.
There are economic costs if they have to travel. They may or
may not be able to get the prenatal care that they need. Many
of those folks are already, we know from the pandemic, living
in areas where there have been persistent health inequities for
decades that have led to the racial and ethnic disparities
experienced by many Black and Brown women in particular.
And so now, you know, they have no choice maybe to go to
other states. But it is a cost. And it, really, it's a
situation that shouldn't be the case. People should be able to
access the healthcare they need, and it shouldn't be determined
by their ZIP Code.
Mr. Khanna. Thank you, Ms. Frye.
Ms. Leigh, could you expand on that and just talk about how
a patient in a rural community might be impacted if she cannot
afford to travel across state lines to obtain abortion care?
Ms. Leigh. Yes. Thank you for the question, Representative.
I can speak--I--while I only speak for myself, I'm here
representing the hundreds of other patients that I've met in my
years of advocating and storytelling and now the patients that
I work with day in and day out.
And we don't have to guess in western Pennsylvania. We are
living it. We have two clinics that perform abortions in
Pittsburgh. And the next closest clinic, even within our own
state, is over three hours away. We are the closest clinic for
70 percent of Ohio.
Two-thirds of the people I talk to every day are from Ohio
and West Virginia who are traveling hours in each direction,
organizing rides, getting childcare because they have to--they
live in urban centers. I talk to people from Columbus and
Cincinnati and Akron.
Mr. Khanna. Ms. Leigh, I appreciate your mentioning
Columbus because I was there with the President recently where
they're opening up this new Intel facility, all these jobs. The
Governor's there.
And, you know, obviously the right to abortion is a
fundamental human right. But, beyond that, it's impacting the
ability to bring manufacturing jobs because Intel and others
are saying: We can't recruit to get people to go there. We
can't get people to go to the colleges or have women come in to
work here, given the uncertainty.
Can you talk about how this is hurting states that want
manufacturing jobs and want an economy to actually be able to
do that?
Ms. Leigh. You know, I can only speak on behalf of myself.
I'm not an economist or a policy expert. But what I can tell
you for myself is, after living through my second pregnancy and
needing an abortion and accessing that care, that I want to
live somewhere--I want this whole country to be a place where
people can access that care. And I can imagine that folks
wouldn't want to settle anywhere where they couldn't access a
basic human right, because abortion is self-determination, and
it is our right as Americans.
Mr. Khanna. Thank you.
Chairwoman Maloney. OK. The gentleman from Texas, Mr.
Cloud, you're now recognized.
Mr. Cloud. Thank, Madam Chair.
Our founding documents guarantee us the right to life,
liberty, and the pursuit of happiness. And, of course, you have
to start with life and the guarantee of life.
And there's been a lot of discussion, of course, especially
since the Dobbs decision and a lot of, frankly, misinformation
that's come out and a lot of fearmongering. I imagine, you
know, as we lead up to an election, unfortunately, that
happens.
You know, we've heard things like this is the end of
democracy and all those sorts of things when actually what the
Dobbs decision did was basically say that Roe got it wrong in
that there's not a constitutional right to an abortion, which
is a pretty accurate statement.
And, as far as the end of democracy, it returned the issues
to the states where people can actually vote on it and have
differing ideas in differing states.
And so it's important we look at this right. And,
obviously, we know a lot more now than we did even in the
seventies when Row v. Wade was passed. At the time, it was
called a clump of tissues, and we've had a lot of scientific
development to know that that is hardly the case at all.
Dr. Wubbenhorst, could you speak to some of the
technological advancements and what we now know that we didn't
know back then?
Dr. Wubbenhorst. Yes, I think that it's one of the most
amazing things that, even since I've been involved in medicine
since the 1980's, to see the explosion of knowledge and care
that's gone on, specifically that not only are we now able to
visualize living fetuses with a degree of precision that was
simply not available in the--when I was training--ultrasounds
were these huge, bulky machines and there was grainy image,
and, well, maybe I see it, maybe I don't--to now having 3D and
4D renderings where we can see the expressions on these unborn
children's faces.
So what that is, I think, has helped us to do is to real--
--
Mr. Cloud [continuing]. Emotion, you mean, like----
Dr. Wubbenhorst. Yes.
Mr. Cloud. Yes.
Dr. Wubbenhorst. Emotion, right?
Mr. Cloud. Responding to----
Dr. Wubbenhorst. To stimuli.
Mr. Cloud. Yes.
Dr. Wubbenhorst. To stimuli, and there's been this
incredibly fascinating study that came out recently showing
that, when the mother would eat certain foods, within a period
of time, the fetus would respond.
Now we had an inkling of that because sometimes we'll say:
If a baby's not moving a lot, OK, give the mom something to
eat. And, in a few minutes, the baby will sort of perk up.
Mr. Cloud. Right.
Dr. Wubbenhorst. But to actually be able to see that shows
us the humanity of a fetus in a totally different dimension.
And, in addition, we have other technological advances that
allow us to intervene when fetuses are ill or struggling or
have difficult medical problems. We're able to transfuse
fetuses. We're able to do samplings, surgery on the bladder,
surgery on the heart, surgery on the lungs with previously
lethal diagnoses.
And so I think that there's a huge opportunity there that
we have to recognize that opens up a whole new way of looking
at the fetus as a patient.
Mr. Cloud. Now one of the big issues, too, has been some of
the messaging dealing in what states are doing across the
state. There's been a lot of fearmongering about just what's
going on with what states are doing to go after women and the
like. There's no state laws that do that currently.
Dr. Wubbenhorst. That's correct, yes.
Mr. Cloud. OK. Just checking.
I wanted to submit for the record as well, if I can, a
couple of statements that have been presented. One is from
Americans United for Life, if I may.
Chairwoman Maloney. No objection.
Mr. Cloud. And then another one, and this is interesting,
because part of the discussion today has been to do with--with
the reason that some would have for aborting someone because
there's some sort of issue during the pregnancy.
And this so--this is from the Abortion Survivors Network.
And it's interesting to hear from them as they watch this
dialog happening, people who are living and have a valuable
life now who see this discussion in a whole different light and
feel completely devalued in the process.
So if I could submit that for the record----
Chairwoman Maloney. Without objection.
Mr. Cloud [continuing]. As well, I would appreciate that.
There was also an interesting topic on crisis pregnancies
just a second ago and what we see happening there. And there's
really been oddly an attack against crisis pregnancy centers in
the fallout of this. And that's interesting because we used to
hear from the left that abortions should be safe, legal, and
rare. And so you would think that crisis pregnancies would be a
place that we could all agree on was a good thing. But now the
dialog seems to be we should have--more abortions, the better,
you know. It's been odd. Dr. Kumar even mentioned that this is
a racist thing when--for working in an organization that was
started by Margaret Sanger is a very odd statement to make, a
racist eugenicist.
Could you speak to some of the good work that's done at
crisis pregnancy centers?
Dr. Wubbenhorst. I've worked very closely with them in the
past, and what I've found is that they're able to provide that
support. A moment ago I talked about the difficulties that
women face in their decision to abort.
One of the reasons they are successful in convincing women
not to abort is that they offer their support to walk with her
through pregnancy, to get resources that she needs and not
just--it's not just: Oh, you had your baby; you're done. We
don't care about you.
This continues post-pregnancy.
And, with new models that are being proposed, maternity
waiting homes, being able to live in a waiting home even after
you've had your baby, they're doing tremendous work.
Chairwoman Maloney. The gentleman's time has expired.
The gentlewoman from Ohio, Ms. Brown, you are now
recognized.
Ms. Brown. Thank you, Chairwoman Maloney and Ranking Member
Comer, for holding this hearing today.
Draconian abortion bans and restrictions that force people
to remain pregnant further exacerbate racial health
disparities. In places like Ohio, a six-week abortion ban was
slated to take effect following the Supreme Court's Dobbs
decision due the passage of Ohio Senate bill 23 in 2019.
Luckily, in Ohio, a judge temporarily blocked the state law and
restored the right for Ohioans to an abortion.
If this statewide ban were to go into effect, certain
communities, especially those that have experienced generations
of disinvestment, would suffer the most.
So, Ms. Frye, when it comes to assessing reproductive
healthcare, how do abortion bans and restrictions
disproportionately impact communities of color that have been
often left behind?
Ms. Frye. Thank you, Congresswoman.
I think what we have to remember is that the status quo is
not OK. The status quo is one where inequity has resulted in,
as you point out, decades of disinvestment and lack of access
to quality healthcare.
And what we really want is the ability of every person,
particularly Black women, indigenous women, Brown women, and
people of color to have access to quality healthcare, the
healthcare that they need.
And what happens with abortion bans is that it takes the
decisions out of their hands. It forces them to look elsewhere
and rely on systems that have perpetuated disparities for
decades. This is--bans that deny Black and Brown women the
ability to control their own bodies and instead have to go to
state legislatures in order to figure out what healthcare they
need is simply a step backward. It will do little to address
persistent inequity.
And this is particularly a problem, as you know, with Black
maternal health disparities. We have a crisis in this country.
Black women are three times more likely to die than White
women. We need to do more and not less. And more means making
sure that they have access to the healthcare that they need,
that they have access to doctors who can give them sound advice
and not advice that is edited by politicians. That's what folks
need.
And that's what--you know, the abortion bans will do great
harm to folks who really are trying to correct these persistent
disparities across the country.
Ms. Brown. Thank you.
So, when we discuss the health impacts of abortion
restrictions, we must also recognize and discuss the structural
racism faced by people of color in our medical system. Across
the United States, communities of color experience systematic
health disparities, including higher rates of insurance,
stigma, and the strain caused by racism.
A national ban on abortion is likely to increase maternal
deaths by 24 percent and increase maternal deaths of Black
women by 39 percent. These numbers alone should scare all of
us.
Ms. Leigh, I understand that, following your own abortion,
you began volunteering at an abortion clinic in Pennsylvania.
Have you seen the increase in patients coming into Pennsylvania
for abortion care?
Ms. Leigh. Thank you, Representative.
Yes, I actually now work full time at the independent
abortion clinic in Pittsburgh, Allegheny Reproductive Health,
and I'm proud to work there alongside my colleagues.
I answer the phones. And so I talk to--I'm one of the first
people patients are talking to when they're calling to inquire
about abortions and to schedule their appointments.
And about two-thirds of the patients in any given day I
talk to are from Ohio, West Virginia, Kentucky. We've had a
patient from Mississippi, from Texas, and even a patient who
drove overnight from Indiana.
And so we, as I said before, are only one two of clinics
all of western PA. And so we are providing coverage for a lot
of rural areas in Pennsylvania, as well as beyond. We're now
the closest clinic for 70 percent of your state.
Ms. Brown. Thank you.
It is also important to note for people with less income
the cost associated with abortion care, which includes the cost
of the procedure itself, as you pointed out, transportation
costs, childcare, and taking days off from work, they all pose
significant barriers to receiving care. State restrictions that
force people to travel longer distances to see a provider make
abortion care even more unaffordable.
Dr. Kumar, you treat patients in Texas where the right to
abortion was eliminated by Republicans more than a year ago.
What has that impact been on the people of color who already
experience disproportionate barriers?
And I see that my time has expired. So----
Chairwoman Maloney. If you could answer the question, her
time has expired.
Dr. Kumar. Sure.
Ms. Brown. Thank you, Chair.
Dr. Kumar. I would say abortion is an economic issue. Folks
that I see often cite economic issues for needing access to
that care. And when we're denying that care, we're forcing them
to stay in poverty. That means that children they're forced to
have, as well as the children that are already at home.
Chairwoman Maloney. OK. Thank you.
The gentleman from Texas, Mr. Session, is now recognized.
Mr. Sessions. Madam Chairwoman, thank you very much.
Madam Chairman, today's activities are designed to divide
Congress, to divide the American people, and not to bring us
together.
Today our country is going through a tremendous storm that
is happening across our South and East Coast, and I know that
we need to be at a time where we're thoughtful about so many
Americans that are facing difficulty.
I'd like to talk about this issue in a different way. I
know that it's been pitched as a battleground, a battle of
choice versus the rights of people. I know it's being pitched
as a nationwide ban that Republicans want.
Well, in fact, the Supreme Court ruled that it's not a
constitutional issue. It's states' rights issue. And whether I
agree with it or not, I think it's important that we recognize
that's the law of the land.
I have a little bit different take on this. Perhaps might
be informational to some that are listening, perhaps not. I
have a Down syndrome son who is 28 years old. And Alex is a
young man, Alexander Sessions. Alex is a young man who faced
some difficulties early in his life with medical issues.
Otherwise, he was a normal baby boy who was born.
But Alex turned into the kind of person who has made a lot
of his life. Alex has a big brother, who is also a medical
doctor, who is also an Eagle Scout, who is also a young man,
both of them, the way they were raised, they get up, and they
enjoy the day. They see a mission in front of them.
And, while Alex, as a Down syndrome man, has what might be
called an intellectual disability, he has been able, through
the grace of what I will say God, because God helped create
Alex, and Alex has been nothing but a positive person to
thousands of people who have known him. He is an inspiration,
not just with his life but the way he greets people. He was a
regular visitor here in Congress, would come to the floor. He
made friends. Alex is a person and a young man who had a desire
to make something of himself, and others have fully accepted
that.
And so, if I can give a story to those who might consider
perhaps their ideas about what a Down syndrome person might
mean, might be in their life, I'd like to say it's a positive,
positive, thoughtful experience. And Alex at his church or his
Sunday school or his Scout troop or--he works at Home Depot
now. And he works at Home Depot because Home Depot recognizes
that people who might not have all the necessary, I would use
the term ``abilities,'' they still have lots of abilities, and
they're an asset to their business model. They're an asset
whether he's pushing carts to clean a parking lot or whether
he's in just greeting people, that it's a tender side of life.
And we were chosen for this. We did not--you know, when we
necessarily conceived Alex, we did not have to sit back and
say, what do we want? This is not like shopping at a grocery
store or going online to Amazon. It is something that you are
participatory with.
I do recognize not everybody agrees with this issue. I do
recognize that it can be a very difficult circumstance. But
what I would say is let's--let's not beat up this issue with
what I believe is hyperbole to just beat the issue up and talk
about nationwide ban is what Republicans want to do and they
want to take away all these rights and obligations.
Well, it is an issue that is going to be solved on a state-
by-state basis. It will not be, in my opinion, decided in the
near term, because we have a President who's been duly elected,
who would not sign that legislation. So it will be at its
appropriate time. If it's going to be a national issue, it will
be available to the voters in two years.
So, I'd really like for us, if we could, between maybe now
and then to talk about this issue in a way that is balanced.
And that is the Supreme Court has made a decision. And the
country will deal with that as they have made many other
difficult decisions, some that I agree with, some that I
disagree with.
But it's law of the land, and I thank each of you for being
here today and would tell my fellow colleagues that I think
that this issue should be one that we deal with very carefully
and thoughtfully because we're dealing with the essence of
life.
Thank you.
Chairwoman Maloney. The gentleman yields back.
The gentlelady from Florida, Ms. Wasserman Schultz, is now
recognized.
Ms. Wasserman Schultz. Thank you, Madam Chair, and I
appreciate the opportunity to talk about this really critical
issue in this hearing.
The gentleman from Texas said something, I think, that
really gets to the crux of the matter that we're dealing with
here today when he referenced that the Supreme Court has made
the decision. That is--that is really what the problem is here,
is that there is a question that needs to be answered, and that
is: Who gets to decide? Does the government get to decide
whether or not--whether and when a woman can be pregnant, or is
that a decision--a personal healthcare decision that is--should
be made and left to the woman, her family, her faith, and her
doctor?
And Republicans have clearly answered that question because
they've introduced 52 bills to restrict abortion access in this
Congress alone, directly contradicting what is the will of the
American people, because the truth is, is that abortion access
is popular. Most Americans absolutely do not want governments
forcing women into pregnancy. In my home state, Florida,
Governor Ron DeSantis and extremist Republicans passed a 15-
week abortion ban, which a recent survey showed that 60 percent
of Floridians oppose. Polls show that same sentiment across
America.
Ms. Leigh, if I can start with you. You had an abortion at
22 weeks after receiving a devastating fetal diagnosis, but you
also work with patients with vastly different experiences and
reasons for seeking an abortion. So, in your experience, why do
most Americans staunchly support abortion access no matter
their age, their gender, or ethnic background?
Ms. Leigh. Thank you for the question.
As I've said before, it's my honor to have witnessed so
many stories of folks seeking abortion through volunteering,
storytelling, and now through my job. And what I can tell you
to be true among all abortion seekers or folks considering them
are that they're moral people who are just trying to make the
best next right decision for their life. A lot of the people I
talk with are already parents. I often can hear their toddlers
giggling in the background, and they express having their hands
full.
I have talked with folks who have been in abusive
situations, people who were on birth control and it failed. And
what I've learned through this time is that no one has a good
or a bad abortion. There are no right reasons or wrong reasons
to have an abortion. There are just people trying to make the
best next right choice for themselves, and no one is more or
less worthy of seeking an abortion than another.
Ms. Wasserman Schultz. Thank you.
Just last month, Kansans voted by a landslide to protect
abortion rights, and the Florida judge who denied a 17-year-
old--a 17-year-old--an abortion based on her school grades was
booted out of office by voters. Smart Republicans clearly know
this is a barbaric policy, so they obfuscate, they waffle, they
hide their true position, and they say the Supreme Court didn't
outlaw abortion, like my colleague just said. They just want it
left to the states.
Yet, in state after state, radical Republicans keep passing
extreme laws opposed by their citizens, or they make it harder
for voters to protect abortion rights themselves.
In Michigan, Arkansas, Florida, and other states, extremist
Republicans are trying to block or make it harder for abortion
rights ballot initiatives from ever reaching voters. Why?
Because voters favor abortion rights, and only extremists want
to enforce government-mandated pregnancies and put doctors into
jail.
Ms. Frye, how can valid measures like the one in Kansas
subvert extremist laws and protect abortion rights?
Ms. Frye. Well, I think that they can play a critical role
in doing exactly what you said, making it clear that--from
voters that the right to access abortion is one that enjoys
wide support, and one that people expect to be able to access
in every state, and it's unfortunate that people have to resort
to those ballot measures.
You know, that is what--why Roe was so important, is that
it secured a right for every person. But I think it's really
critical at this moment for folks in states across the country
to speak up and speak out.
Ms. Wasserman Schultz. Absolutely.
Look, Republicans know that abortion restrictions are a
losing issue. Some, like Governor DeSantis, cravenly skirt the
harsher laws and brush them under the rug and pretend they're
not going to pursue them when they can, and that's because
people across the country want the freedom to make their own
decisions about their own bodies. So extremist Republicans know
that, if they want to enact these draconian laws, they have to
defy the will of the people. And that means avoiding or
undermining the accountability of democracy at all costs.
No one should be able to take that freedom away, and, if
they do, they must be held to account at the ballot box.
Madam Chair, thank you. I yield back the balance of my
time.
Chairwoman Maloney. The gentlelady yields back.
The gentleman from Louisiana, Mr. Higgins, you are now
recognized for five minutes.
Mr. Higgins. Thank you, Madam Chair.
To my colleague's point from Florida, some of us don't care
at all about the politics of this. Some of us don't even like
politicians. We have our own core principles. We make no
apologies for those principles.
I'm the seventh of eight children. I have six sisters and
one brother. We were greatly outnumbered. I was raised as a
Southern gentleman in a Catholic family. I support life from
conception to natural death, and I make no apologies for that.
This is a deeply divisive issue in America, because it's a
deeply personal concern.
On May 1, 1990, my daughter, Daniela, was born. I recall
when my wife realized she was pregnant and the joy that we
felt. It wasn't long, just a few months later, that Daniela was
born by emergency c-section, almost three months early. She
weighed 1.5 pounds.
My wife and I devoted ourselves as best we could to our
daughter, struggling there for life, for many months. It tore
our very soul. But our daughter, Daniela, breathed life into
us. Her hand would wrap itself around my little finger and
couldn't reach. She touched every life that she gazed upon. She
had a particular calmness of spirit.
And, regardless of what she was going through and the pain
that we felt, that I felt as her father, the guilt that we
felt, my wife and I; had we done something wrong during the
pregnancy? No matter the sorrow that we bore, Daniela would
look at us with this beautiful gaze as if to tell us, It's OK.
Everything's going to be all right.
We weren't sure what that meant. But, on November 10, 1990,
Daniela died, having touched hundreds of lives with her little
soul. She touched so many lives that, when the hospital built a
new facility for neonatal care, they named that facility after
my daughter.
So America does know that this is a conflicting issue, I
say respectfully to my colleagues across the aisle. But America
knows that life is more than flesh. My living children, for 30
years now, have always known their sister, Daniela, countless
trips to the graveyard, birthdays celebrated. Every Christmas,
Daniela's stocking hangs upon the mantle with the others.
My wife had a friend who had an abortion that I didn't know
for years what they discussed. It was a private matter between
my wife and her friend. But after many, many years, my wife
shared with me that her friend had had an abortion long before,
and she was haunted by that. She would have nightmares of
little hands, tiny, little hands. And I was familiar with those
tiny, little hands, because my own daughter's would wrap around
my finger just barely.
So this is a painful and deeply personal discussion. I'm
hopeful that my colleagues will communicate across the aisle,
and let's deal with this honestly.
Madam Chair, I yield.
Chairwoman Maloney. The gentleman yields back.
The gentleman from Vermont, Mr. Welch, you're now
recognized for five minutes.
Mr. Welch. Thank you. Thank you, my colleague from
Louisiana.
This question, in my view, and most of us, I think, should
be decided by a woman, not by politicians. In Vermont, we have
significant support for reproductive choice and freedom for
women. But there's two things that are happening as I see it. I
want to ask a few questions about this.
One is, now that there are abortion bans, it's not a
question of I accept your decision on how you want to decide,
and you accept mine. There has really been a lot of
divisiveness injected into this because there are folks who
think it is not only their right to decide, but their right to
decide for you. And I disagree with that.
But the second thing that's really happening with some
states allowing for reproductive freedom and others not, it's
putting a real strain on the healthcare system. We had a
roundtable in Vermont with providers, and they were describing
how this is creating additional stress on the healthcare
system. It's been under immense stress due to COVID and other
things. So I want to ask a little bit about that.
Dr. Kumar, are you seeing increases in patients traveling
to other states to receive abortion care?
Dr. Kumar. Yes. Absolutely.
So, since June 24, when the Dobbs decision came out, we
haven't provided any abortion care in Texas. So everyone that's
called us or sought care with us has had to travel out of
state. Of course some people can't make that trip, but that's
the only option that we can give them.
Mr. Welch. So if--it's a little different for you, but you
talk to colleagues in some of those receiving states, and how
does a deeply short-staffed environment affect physicians like
you and the care that you provide? Not just you, but your--the
nursing staff, the frontline providers?
Dr. Kumar. Sure. We're certainly seeing an influx of people
seeking care in other states, and, of course, they're already
taking care of people that are living in that state, and the
infrastructure is already having a hard time keeping up. We're
seeing wait times of several weeks, sometimes up to 3 or 4
weeks. Some clinics are so booked up that they're setting a
limit on how far out they can book and having people call back.
So the infrastructure is strained.
Mr. Welch. Thank you.
Ms. Leigh, thank you so much for sharing your story. You
know, these additional hoops that patients have to jump
through, you know, any time you have a health event, you're
really vulnerable, right? You're dependent. You're nervous.
You're apprehensive. And you're also nervous about what the
expenses are and how you're going to do it, and the logistics,
and what it does to your employment, what it does to your
family.
Can the average--the average patient who is living week to
week, paycheck to paycheck, who doesn't have a lot of
flexibility in schedule, who has a lot of pressures and demands
that take up an immense amount of time every single day, can
the average patient jump through these hoops of traveling out
of state, finding a provider to receive abortion care?
Ms. Leigh. Thank you for the question.
It is my honor to be able to represent all of those
patients that we are seeing in Pittsburgh who are traveling.
Certainly I only talk to the patients who know they can travel
out of state. There is a lot of misinformation out of there
that people don't think they can travel. And when I do, you
know, patients will often say, well, do you think, actually,
you could see me next week? Could I come in in two weeks,
because I should have enough time to save the money?
And that is a heartbreaking thing to hear. That is a
reality in our country. We don't actually take insurance
because the vast majority of insurance plans are not allowed
and don't cover abortion.
But one of the real things that gives me hope and is a
reminder to all of us that the actions and choices we take
right now are creating the post-Roe world that we're living in,
is that we are able to provide significant financial assistance
to patients because of the generosity of fellow Americans who
believe that we each have this right and that $250, $400 should
not make the difference between if you can elect to have an
abortion or not.
And I am not exaggerating when I say myself and my
colleagues on the phones scheduling these appointments cry with
patients at least once a day when they hear their relief when I
say----
Mr. Welch. Wow.
Ms. Leigh [continuing]. Don't worry about it. You don't
have to bring a dime. And it can move me to tears now----
Mr. Welch. Yes.
Ms. Leigh [continuing]. Because it's how we're showing up
for each other. We're supporting that cause.
It--I paid for my abortion out of pocket without a second
thought, because I'm lucky and privileged, and it's my honor to
pass along that support to these patients----
Mr. Welch. Uh-huh.
Ms. Leigh [continuing]. Who otherwise would be making this
life-altering decision of parenting over $50, $200. It's
unconscionable.
Mr. Welch. Thank you very much. I yield back.
Chairwoman Maloney. Gentleman's time has expired.
The gentleman from Georgia, Mr. Clyde, you're now
recognized.
Mr. Clyde. Thank you, Madam Chairwoman.
Again, we are here today because of the Supreme Court's
landmark and life-saving decision in the Dobbs v. Jackson case.
But the truth behind why we are really here is the Democrats
want one more opportunity to place the issue of abortion front
and center in the news before the November 8 elections.
They somehow believe that saving innocent, unborn lives is
a problem, and they want to use this last session week before
the elections as an opportunity to campaign on killing
innocent, unborn children.
Dr. Verma, I see you are a fellow Georgian. Recently,
gubernatorial nominee Stacey Abrams from our great state of
Georgia stated, and I quote, ``There is no such thing as a
heartbeat at six weeks. It is a manufactured sound.''
So let me ask you: Is a heartbeat at six weeks a
manufactured sound? A yes or no will suffice.
Dr. Verma. So I want to start by just saying that----
Mr. Clyde. A yes or no will suffice, ma'am. Is--is----
Dr. Verma. So----
Mr. Clyde. Do I need to repeat the question?
Dr. Verma. I'd love to answer your question, but, like so
many things in medicine, it's complex. I think that what we are
discussing today----
Mr. Clyde. I don't believe it's complex, ma'am. It's a
pretty simple question. Is a heartbeat at six weeks a
manufactured sound? Yes, or no?
Dr. Verma. Again, I'd love to answer your question. I need
a little bit of time to do so, because----
Mr. Clyde. OK. All right. It----
Dr. Verma [continuing]. There are so many, like----
Mr. Clyde. I just need a yes or no.
Dr. Verma [continuing]. Questions on privacy----
Mr. Clyde. Is it, or is it not?
Dr. Verma. It is complicated.
Mr. Clyde. OK. You're not going to answer my question. All
right.
Dr. Verma. I do provide comprehensive reproductive
healthcare, so I take care of people----
Mr. Clyde. Madam Chair, I'd like to ask for unanimous
consent to submit for the record this study titled ``Role of
Ultrasound in the Evaluation of First Trimester Pregnancies in
the Acute Setting,'' which was published in Ultrasonography in
2019, in which it finds that in normal fetal development, a
heartbeat is expected at or around six weeks.
Chairwoman Maloney. Without objection.
Mr. Clyde. Thank you.
And, while we're talking about science, let's talk about
biology. And let's just keep it real simple. Just two yes or no
questions, and this is for Dr. Kumar.
Dr. Kumar, can biological men become pregnant and give
birth?
Dr. Kumar. So men can have pregnancies, especially trans
men.
Mr. Clyde. So can biological men become pregnant and give
birth? So are you saying that a biological female who
identifies as a man and, therefore, becomes pregnant is, quote,
``a man''? Is that what you're saying?
Dr. Kumar. These questions about who can become pregnant
are really missing the point. I'm here to talk about----
Mr. Clyde. No, no, no, no, no.
Dr. Kumar [continuing]. What's happening in states.
Somebody----
Mr. Clyde. This is me asking a question.
Dr. Kumar. I'm answering the question.
Mr. Clyde. I'm asking the question, sir, not you.
Dr. Kumar. Right. And I'm answering the question. Somebody
with a uterus may have the capability of becoming pregnant,
whether they're a woman or a man. That doesn't mean that----
Mr. Clyde. OK. We're done. Not--we're done.
Dr. Kumar [continuing]. Someone who has a uterus----
Mr. Clyde. This isn't complicated.
Dr. Kumar [continuing]. Has the ability to become pregnant.
Mr. Clyde. Let me tell you, if a person has a uterus----
Dr. Kumar. This is medicine.
Mr. Clyde [continuing]. And is born as a--is born female,
they are a woman. That is not a man, and the vast majority of
the world considers that to be a woman, because there are
biological differences between men and women.
I mean, clearly, any high school biology class teaches that
men and women have different chromosomes. Females are XX
chromosome, and male are XY chromosome. I can't believe it's
necessary to say this, but men cannot get pregnant and cannot
get birth--give birth, regardless of how they identify
themselves.
Why in the world would Democrats have brought in a person
whose title is director of trans care for an abortion hearing
when only biological women can become pregnant?
Dr. Kumar, in your opening statement, you said, quote,
``Abortion bans are inherently racist, inherently classist, and
fundamentally part of White''--``of the White supremacy
agenda.''
How do you rationalize working for Planned Parenthood, an
organization founded by Margaret Sanger, someone who associated
with White supremacist groups and eugenics? Margaret Sanger's
entire focus was to decimate communities of color through
abortion to eliminate their future generations.
Dr. Kumar. You know, I----
Mr. Clyde. I'm--how many abortions have you performed in
your lifetime?
Dr. Kumar. If I can answer your question----
Mr. Clyde. No, no, no. How many abortions have you
performed in your lifetime?
Dr. Kumar. Likely thousands.
Mr. Clyde. Likely thousands. OK. So, as a doctor yourself,
do you believe you have terminated enough unborn babies to
justify Margaret Sanger's beliefs and your continuance of her
legacy? This is unconscionable. This is inexcusable. I'm
thankful it is now criminal, and I look forward to the day when
life is again respected across our entire Nation.
In closing, I'd like to ask for unanimous consent to submit
for the record a copy of the United States Constitution, which,
despite my Democrat colleagues' absurd claims, does not--and I
repeat--does not include a right--a constitutional right to
abortion. The word abortion doesn't even exist in it.
And I would also like to ask unanimous consent to submit
for the record the Declaration of Independence, which
highlights the inalienable right to life.
Chairwoman Maloney. So--so ordered.
Mr. Clyde. Thank you, and I yield back.
Chairwoman Maloney. Committee members are reminded to treat
all witnesses with civility and respect.
The gentleman from Illinois, Mr. Krishnamoorthi, is
recognized for five minutes.
Mr. Krishnamoorthi. Thank you, Madam Chair.
Dr. Kumar, would you like to answer the question?
Dr. Kumar. Thank you. Yes.
So I was going to say that I find it bewildering and,
actually, I'm flabbergasted at the fact that we have 17 states
with abortion bans. I'm here to talk about what's going on in
Texas. And I was very surprised to hear a question about
Margaret Sanger.
I also want to say that, at Planned Parenthood, we do not
stand for racism. We're happy to serve our clients that are
Black and Brown, and we're actually proud to do that.
Mr. Krishnamoorthi. Thank you, Dr. Kumar.
I just want to turn your attention to this 15-week
nationwide abortion ban which Senator Lindsey Graham first
talked about. But it turns out on June 24 of this year, Mr.
McCarthy, the House minority leader, actually said he supported
that.
So this is not some kind of a--an abstract concept. It's
very clear that if Mr. McCarthy were to somehow become Speaker
of the House, he would put the 15-week abortion ban on the
floor, and it would likely pass if it had a majority of
Republicans supporting it, which it currently does.
Here is my question, which is: This nationwide abortion
ban--15-week nationwide abortion ban, Dr. Kumar, a 2021 study
predicted a 21 percent increase in pregnancy related deaths if
an abortion ban were imposed, with Black women facing a
predicted increase of 33 percent.
Can you explain to us why there would be an increase in
pregnancy-related deaths as well as more Black women--a 33
percent increase in Black women dying as well?
Dr. Kumar. Sure. Thank you for that question.
What I would point to, first, is a recent CDC report that
looked at maternal mortality in our country and actually found
that four out of five of those deaths are preventable. Some of
the top conditions that they talked about were mental health
conditions, such as suicidality or depression; excessive
bleeding, referred to as hemorrhage; cardiac conditions, which
are highest among Black women; and also hypertension-related
conditions. All of these things are preventable.
When we look at today's landscape of abortion access and we
talk about a 15-week ban, we can look at Florida, for example,
of what's happening today with a natural disaster, Hurricane
Ian. As that state has a 15-week ban and we think about what's
happening to families, what's happening to their homes, folks
that may be 13 weeks pregnant or even 10 weeks pregnant, as
they deal with the things that they're having to deal with in
their life, they're being pushed further and further into
pregnancy.
When we look at the landscape around accessing abortion and
the limited number of clinics that are still available in haven
states and how long people are waiting, sometimes several
weeks, that's also pushing them further into pregnancy.
So these impacts are always felt disproportionately by
people of color, especially low-income folks, and also Black
folks, and that's what we'll continue to see, but it will only
worsen from here.
Mr. Krishnamoorthi. So basically what I'm hearing you say
is that, if you have this 15-week abortion ban and you have all
these people who are already--are lacking maternal healthcare,
and, of course, access to reproductive healthcare, that they
were--they're likely going to go past that 15-week mark, and
then they get pushed into pregnancy, whether or not they like
it.
Now, tell me--walk us through why that relates--results in
death.
Dr. Kumar. Yes. That's a great question, and I think we can
look to The Turnaway Study, where what we find--and The
Turnaway Study looked at folks that were able to access an
abortion and compared them to folks that weren't able to access
an abortion, which is exactly what you're looking at. And these
folks had less access to prenatal care. We found that they had
worse outcomes, including things like eclampsia. And, in the
study, also, two women died in the group that were denied
access to abortion.
We also saw worse outcomes for the children that they were
forced to have, as well as the children that they had at home.
So these impacts are faced by the people that are denied
abortion care that are not able to get the care, as well as the
children that they're being forced to have, and it causes
generational harm.
Mr. Krishnamoorthi. Tell us about the children that are
born in those situations. Tell us about their health as they
kind of emerge into the world.
Dr. Kumar. Yep. So, again, from this study, they showed
that the folks that were denied abortion access had lower birth
weight children and that there was poor maternal bonding. And
it's understandable, as people are making decisions about their
pregnancies and what to do in their life, know that they can't
be pregnant, when they're denied that care, it's difficult for
them to come up suddenly with the means to stay pregnant, to
parent children appropriately, and to have the resources.
The other thing I would mention is that states that are
most restrictive of abortion access also tend to be the states
that lack appropriate maternal care.
Mr. Krishnamoorthi. Dr. Verma, I want to ask you a
question. Sometimes my colleagues like to create this exception
for life of the mother, not health of the mother. And you've
probably heard of this particular exception.
I guess, tell us a little bit about what that practically
means for a physician who is then forced to decide whether the
life of the mother is in jeopardy, as opposed to trying to save
the person's health and whether this person escalates to a
point where their life becomes endangered, and they die?
Chairwoman Maloney. Your time has expired, but she may
answer the question.
Dr. Verma. Thank you for that question.
It's often unclear to us as doctors who are practicing on
the ground what these exceptions mean when we can actually
intervene and take care of the person in front of us. How sick
is sick enough? How much bleeding is too much bleeding? And
it's completely counterintuitive to us in our training as
doctors to have to wait for someone to get sicker before we can
actually take care of them.
I do just want to point out, as a doctor, we practice in
these really complex environments. Medicine, people's lives,
health are complex. And we do a disservice to our patients by
trying to put things into neat little boxes or narrow
definitions, as we've heard politicians try to do today. That's
just not how medicine works.
Chairwoman Maloney. Your time has expired.
Mr. Krishnamoorthi. Thank you.
Chairwoman Maloney. The gentleman from Kansas, Mr.
LaTurner, you're now recognized.
Mr. LaTurner. Thank you, Madam Chairwoman.
Today, the Oversight Committee is convening to talk about
abortion for the third time this year. We could be conducting
government oversight on the actions this administration has
taken that have shattered our economy. Constituents in my
district are shifting money away from their monthly grocery
bill to pay their rent and utility bills. People in lower-
income communities are effectively choosing between eating and
living in their homes as runaway inflation continues to impact
everyday lives.
We could be conducting oversight on this administration's
energy policies and its agencies' rulemaking that has hindered
domestic oil and gas production, compromising our national
security in the midst of a global conflict where energy is the
key bargaining chip, or we could conduct oversight on the
policies that led to the current border crisis and the ensuing
fentanyl crisis. Last year, our Nation recorded the most
overdose deaths in its history.
Only a couple months ago, I've talked to law enforcement
officers in my district who were trying to outpace the massive
amounts of fentanyl flooding into midwestern communities, over
80 percent of which comes into our country via the southern
border.
Sellers of this drug are lacing it into other drugs,
designing it to look like candy and targeting children as
potential buyers through social media and messaging apps. But
this committee is holding a hearing about abortion, just two
months ago--after a previous hearing on abortion. The Supreme
Court's June decision on Dobbs sparked important conversations,
but it also gave rise to rampant misinformation and fear-
mongering promulgated by Democrats.
I'd like to use the remainder of my time today to get
clarity around some questions on women's health and expose some
untruths coming from the other side of the aisle.
Dr. Wubbenhorst, one assertion that we've heard in the wake
of the Dobbs decision is that abortion access is a fundamental
component of women's health outcomes. We hear that restricted
access to abortion disproportionately affects minority women,
poorer communities where women already struggle with accessing
health services. But even abortion advocates won't refute that
abortion procedures come with some risks and potential
carryover effects on future pregnancies.
In fact, in Finland, where the maternal mortality rate is
significantly lower, the risk of death from lethal-induced
abortions is four times greater than the risk of death for
childbirth. In the United States, the death rate from abortion
is double the death rate from natural childbirth.
Based on your experience, is abortion a positive
contributor to women's health outcomes?
Dr. Wubbenhorst. No. Abortion is not a positive contributor
to women's health outcomes and is especially not a positive
contributor to the outcome of Black women. Black women
disproportionately undergo abortions. Black women
disproportionately undergo mid-trimester abortions, which are
inherently riskier. The death rate--not the complication rate--
for abortion for Black women is two to three times that of
other women.
And the--in my opinion, my clinical opinion, one of the
great burdens that we don't talk about at all is the--the
crisis--the epidemic of preterm birth in African American
women. African American women, as I've noted, have higher rates
of abortion, and abortion is causally associated with the risk
for preterm birth, especially abortions that are performed at
later gestational ages.
Mr. LaTurner. How do you respond when people argue that
abortions are safer than childbirth?
Dr. Wubbenhorst. I think that that particular question
rests on a series of flawed papers by Dr. Grimes, et al. I knew
Dr. Grimes when he was at the University of North Carolina.
And, with all due respect, those papers conflate denominators.
They use different data sources which are not compatible, and
they arrive at a conclusion which really is not tenable based
on the data.
In spite of that, these particular statistics and that
particular claim has been relentlessly--relentlessly echoed
over and over again when there is absolutely no basis for it.
And, in countries--as you mentioned, Finland, which I think
is an excellent example--countries where we have complete
ascertainment of maternal mortality, complete ascertainment of
abortion-related mortality, we can see that that is not the
case.
Our abortion statistics in the United States are flawed.
Our maternal mortality statistics are flawed as well. So,
therefore, we cannot come to any reasonable conclusions except
by extrapolation. I mentioned the Barrett study earlier from
2004 that showed a 38 percent exponential increase in risk for
death from abortion with every gestational--every week of
gestational age, but we simply don't have the data to come to
that kind of conclusion.
Mr. LaTurner. And why is that? Why don't we have more data
on maternal mortality and the adverse health effects relating
to abortion?
Dr. Wubbenhorst. I think collection of data on maternal
mortality is necessarily somewhat complex. If you look at the
latest statistics which came out last week from CDC, they show
some very interesting trends.
One is that you don't have a lot of--you have deaths in
early pregnancy, presumably from things like ectopic pregnancy,
and then, of course, deaths around and after postpartum. But
the problem is that some women die in pregnancy, but not from
pregnancy-related causes. And that's actually a substantial
number of those women.
And so I think that we really need to push for both better
abortion mortality collection, better basic data collection on
how many abortions we have in the United States, and maternal
mortality data collection.
Chairwoman Maloney. OK. The gentlewoman's time has expired.
Mr. LaTurner. Thank you, Madam Chairwoman.
Chairwoman Maloney. The gentlewoman from New York, Ms.
Ocasio-Cortez, is now recognized.
Ms. Ocasio-Cortez. Thank you very much, Madam Chair.
And I think, briefly, I'd like to address some of the prior
claims that--and prior--several prior media claims, one being
that abortion is not an economic issue and that we should be
focused on economic issues.
And I also, you know--I think it's important to state
that--that abortion is an economic issue. Forcing poor and
working-class people to give birth against their will, against
their consent, against their ability to provide for themselves
or a child is a profound economic issue, and it's certainly a
way to keep a work force basically conscripted to large-scale
employers and to employers to be--to work more against their
will, to take second and third jobs against their desire and
their own autonomy.
And so, the idea that abortion and access to abortion is
somehow not a profound and central economic and class issue and
class struggle is certainly something that I think a person who
has never had to contend with the ability to carry a child--you
know, it belies that perspective. And it's disappointing to
see.
But second, I think another thing that I'd like to address
is that the same folks who tell us and told us that COVID's
just a flu, that climate change isn't real, that January 6th
was nothing, but a tourist visit, are the same--are now trying
to tell us that transgender people are not real. And I would
say that their claim is probably just as legitimate as all
their others, which is to say not very much at all.
But, moving forward, Dr. Kumar, are you able to tell me
what methotrexate and what conditions that methotrexate is
routinely prescribed for?
Dr. Kumar. Sure. Methotrexate has a number of different
uses. It can be used to treat ectopic pregnancies, atopic
dermatitis, lupus. And there are several other conditions that
it can be used for.
Ms. Ocasio-Cortez. Uh-huh. Yes. I believe it's--can also be
used to treat cancer. Is that correct?
Dr. Kumar. That's correct.
Ms. Ocasio-Cortez. I believe you said rheumatoid
arthritis----
Dr. Kumar. Uh-huh.
Ms. Ocasio-Cortez.--as well?
Dr. Kumar. Yes.
Ms. Ocasio-Cortez. And they can also be prescribed in the
event of an abortion, correct?
Dr. Kumar. Right. It can be used for ectopic pregnancies.
It has been used in the past for intrauterine pregnancies, even
though that's rare now.
Ms. Ocasio-Cortez. Uh-huh. And so, I mean, what we see here
is that this is one drug that has many different applications
depending on the condition, which is common for many other
medications as well. High blood pressure can also treat other--
you know, medications for high blood pressure can also treat
other conditions as well.
And so what we're seeing here is that many of these
abortion--these anti-abortion laws, these forced-birth laws,
are written by legislators that really have very little clue
into the nuances of medical care.
In fact, Texas has designated methotrexate as an abortion-
inducing drug, and now the same people who have cancer,
arthritis, and lupus have to prove that they are not using
those medications for abortion, which then, of course, delves
into gross violation of privacy issues that create real
conflicts for people.
Is this something that you are seeing, Dr. Kumar?
Dr. Kumar. Yes, certainly. I've heard from people in Texas
who have been using methotrexate for other medical conditions,
and they are not able to access it at the pharmacy. Some people
have also----
Ms. Ocasio-Cortez. Uh-huh.
Dr. Kumar [continuing]. Gone to the pharmacy to get their
medication and been asked about pregnancy tests or about if
they're using any kind of contraception, which, again, is a
violation of their privacy and shouldn't be asked. They've been
getting these medications----
Ms. Ocasio-Cortez. Thank you.
Dr. Kumar [continuing]. For some time.
Ms. Ocasio-Cortez. Thank you.
And, you know, I think--I'd like to walk through a little
bit of a thought experiment or even a scenario in the small
amount of time that I have left.
I, for example--you know, since Republicans are forcing
this conversation in uncomfortable ways, then I will meet them
to it. I have an IUD. I've had one for years. Now, IUDs--if an
IUD fails and results in an ectopic pregnancy, which has about
a 50 percent chance, I believe, of an ectopic pregnancy
emerging with an IUD, does that--would that mean that if I were
hospitalized in these states, you would have to wait until I
was in the process potentially of actively dying before you
could effectively treat me and save my, or anyone in our
position's life?
Speaker. I just talked to him----
Dr. Kumar. So thank you for that question. I think this
came up earlier around ectopic pregnancies.
To date and to my knowledge, there are no laws that outlaw
care for ectopic pregnancies. However, what we've seen in
Texas, because these laws are written by politicians and
sometimes don't make sense and are difficult to grapple with
and understand by physicians who are practicing medicine, we
have seen people denied access to that care and eventually seen
somebody in Texas who left the state to get care for her
ectopic pregnancies.
So it's very possible. It depends on which healthcare
provider you see, which clinic or hospital you may go to,
because we're interpreting these laws in real time by
physicians.
Ms. Ocasio-Cortez. And that's exactly the problem, right,
is that doctors----
Chairwoman Maloney. The gentlelady's time has expired.
Ms. Ocasio-Cortez.--are now having to intercept law?
Dr. Kumar. That's correct.
Ms. Ocasio-Cortez. Thank you.
Chairwoman Maloney. Thank you. The gentlelady yields back.
Mr. Flood is recognized for five minutes.
Mr. Flood. Thank you, Madam Chair.
Good public policy is based on facts. We must understand
the issues in order to draft strong, effective legislation.
That's the whole reason we came to work here in Washington
and--to hold hearings, to meet with our constituents, to pass
legislation, to serve our communities back home.
Unfortunately this hearing today has nothing to do with
finding facts or crafting strong legislation. It's merely a
messaging tactic by my colleagues across the aisle to create a
false narrative about Republicans and to drum up votes before
the midterm elections. The left knows they're losing, and this
hearing is purely a last-ditch effort to save their sinking
ship. So let's talk about facts.
I support commonsense abortion regulation. That's why, in
2011, as the speaker of the Nebraska state legislature, I
introduced and passed the Nation's first 20-week abortion ban.
Out of 49 state senators in our unique unicameral, I got 44
votes for this legislation. That included over 10 Democrats. It
was truly a bipartisan bill that set the stage for a similar
20-week ban in many states.
And, right now, Democrats in my state are telling me
they're comfortable with the 20 weeks. I truly believe a great
number of Americans and Nebraskans support these commonsense
regulations. And I believe it's important that these
conversations need to happen in the state legislature. That's
what we did in Nebraska. That's what the Dobbs decision meant
and will benefit us as Nebraskans and Americans from having
these conversations.
So I have a question for Dr. Chireau Wubbenhorst. Nebraska
state law bans abortions at 20 weeks of pregnancy. Can you
explain where a child is developmentally at this point during
the mother's pregnancy?
Dr. Wubbenhorst. Well, I think it's an excellent question.
And, actually, the 20 weeks, children are fairly well-
developed. If you remember--if we can remember that previously
viability was defined somewhere around 28 weeks, that number
has been pushed relentlessly back by the neonatologists. So now
we're at a point where, around 21 or 22 weeks, children who are
born at that gestational age have a reasonable chance of
survival.
At that gestational age, typically children's eyelids may
be fused. They usually are fused. But, in terms of their
ability to move, their ability to perceive pain, their
ability--their bodily functions, they're well on the way to
being at the age of viability. And as I said, that's really
only one or two more weeks past that particular time of 20
weeks.
Mr. Flood. Many on the left, pro-abortion activists, they
support late-term abortion and abortion even up until birth.
Can you explain where a child is developmentally at seven
months into the child's, or to the mother's pregnancy.
Dr. Wubbenhorst. So by seven months, the baby's lungs are
actually extremely well-developed, and those infants have,
again, at this point in time, a fairly high rate of success in
terms of being able to transition to extrauterine life. By that
point, as I said, their lungs are developed, though still
immature. Their brains are developed, though still immature.
They're able to interact with the environment.
And, while they definitely suffer from certain GI problems
like colitis, occasionally because of their prematurity, they
are really very much along the lines of--very close to being,
with proper care, able to survive and do extremely well.
Mr. Flood. Thank you very much, Doctor.
I think it's important to note, and people ask me this all
the time, they say, Nebraska was the first state in the Nation
to do this. How did this get passed?
And I think it has more to do with the fact that our
technology has come so far----
Dr. Wubbenhorst. Uh-huh.
Mr. Flood [continuing]. That you can see an ultrasound of a
child and you can see the fingers and the toes and the legs and
the head, and you can say to yourself, I've created a life
here.
Dr. Wubbenhorst. That's right.
Mr. Flood. What's the impact of the technology and the
ultrasound and the 3D imaging? When you work with patients,
when you talk to patients, have you seen a change over the
last--during your practice with the benefits of technology?
Dr. Wubbenhorst. Oh, a tremendous change. Tremendous change
in virtually every area related to neonatology.
And, as far as imaging is concerned, again, early in my
training, you know, ultrasound was grainy. It was a difficult--
had low resolution. And, very often, it was a question as to
whether it was actually a helpful--helpful technology. And,
again, now we are at the point of being able to see these
three-dimensional and four-dimensional renderings.
I think the other point that you brought up earlier,
though, in talking about what's going on at, you know, 20 weeks
and 28 weeks, those infants now are able to survive with
assistance, with Surfactin and our other technologies. So to
abort that infant or to allow it to be born and then neglect it
so that it dies is very problematic for me. If you have an
infant that is able to survive, that is able to be cared for
appropriately, then, essentially, you're making a decision that
amounts to infanticide.
Mr. Flood. Thank you for your testimony.
I yield back.
Chairwoman Maloney. OK. All right.
The gentleman from Maryland, Mr. Sarbanes, you're now
recognized.
Mr. Sarbanes. Thank you, Madam Chair.
I just want to make the observation that Democrats don't
have to convince anybody that the Republicans have an extreme
agenda when it comes to these abortion bans. People are seeing
that themselves. The polling indicates that a majority of
Americans don't agree with that agenda. We're just trying to
bring attention to what's happening.
And, as Republicans have moved to implement these extreme
abortion bans across the country, providers in states like
Maryland that I represent, that protects abortion rights, have
seen an influx, as can you imagine, of out-of-state patients
seeking abortion care.
Last year, Maryland enacted a new law that will allow more
qualified and specially trained medical professionals to
provide abortions, and several local jurisdictions have
committed significant funds to increase the availability of
comprehensive reproductive health services in Maryland.
But, even with these resources, providers have faced new
challenges and have had to work overtime to meet the need.
Dr. Verma, you provided abortion care in Georgia until the
state implemented its ban earlier this summer. How did an
increased number of patients from states, like Texas, where
abortion was no longer accessible previous to that, impact your
practice before this most recent Supreme Court decision?
Dr. Verma. Thank you for that question and for the efforts
happening in Maryland. We've absolutely seen this unjust
patchwork of abortion bans forcing people to leave their
communities and travel for care instead of being able to get
that care in their own communities.
And we're also seeing that that's delaying when they can
get their abortion. So, in the United States, 90 percent of
abortions happen in the first trimester, and less than 1
percent happen after 20 weeks.
What delays people in getting the care that they need is
when we have these abortion bans forcing people out of their
communities, when people end up thinking that they're going to
a health center, but end up at a crisis pregnancy center that's
using deceptive practices, that's lying to them about how far
along in pregnancy they are, that's tricking them into delaying
that care, and then they're not able to get the care they need
in a timely manner. And we've absolutely seen that.
Mr. Sarbanes. I appreciate that insight. That's very, very
helpful.
The other thing I think it's important to highlight is that
these abortion bans don't just impact reproductive healthcare
delivery. They also impact doctors' ability to provide other
essential healthcare. For example, in Texas, some oncologists
have been forced to deny radiation or other treatments to
pregnant women with cancer until they become even sicker,
because the standard of care would then include an abortion.
Dr. Kumar, what implications does this have for women's
health and the healthcare system as a whole?
Dr. Kumar. Thank you for that question.
Yes, abortion care is part of a spectrum of care when it
comes to reproductive healthcare, and it's a critical part of
that.
I've also seen patients that have had a recent diagnosis of
cancer, whether it's breast cancer or colon cancer, who are
waiting to undergo treatment and are coming in for care before.
Like you mentioned, their oncologist has told them that it's
best for them not to be pregnant before they continue with
care.
I've also seen patients that have children that are
undergoing care and have come in to have an abortion so that
they can take care of their child, or folks that already have
children in the hospital, and they need to be present for them.
You mentioned that this has an effect on many people
throughout the healthcare system. That also includes emergency-
room physicians that may see increased visits from people who
haven't been able to access that care, and so many other folks
throughout the entire healthcare system.
Mr. Sarbanes. Thank you.
Besides increasing the health risks for patients, these
bans interfere with the doctor-patient relationship and the
integrity of the medical profession. I mean, it's really an
affront to the medical profession.
Dr. Verma, what has it meant for you to be forced to base
some of your medical decisions not on the clinical needs of
your patients, but on the ever-changing legal situation?
Dr. Verma. Yes, absolutely.
So we train for years and years to be able to provide
evidence-based care to our patients and to be able to adjust
that care to the needs of the particular person in front of us.
And now, we're being forced to practice in situations where the
laws of our state are based on politics, not science, and are
at complete odds with the practice of medicine.
So, instead of just being able to do what's best for the
person in front of us, we're having to think about whether
we're going to be criminalized, whether our licenses are going
to be taken away. We're thinking about our livelihoods, just
for providing evidence-based care. And that's absolutely having
a chilling effect on the medical profession. And it's not what
people want. People want their doctors to be able to provide
them the care they need without us having to think about
whether our licenses will be removed.
Mr. Sarbanes. Thank you very much. Powerful statement.
I yield back, Madam Chair.
Chairwoman Maloney. Thank you. Gentleman yields back.
And the gentleman from South Carolina, Mr. Norman, you're
now recognized.
Mr. Norman. Thank you, Madam Chair.
I ask for unanimous consent to enter a pro-life fact page
on The Turnaway Survey, if I might?
Chairwoman Maloney. Without objection.
Mr. Norman. Well, you know, here we go again, Madam
Chairman. The country is suffering the--is suffering
dramatically at every level, inflation, gas prices, crime,
supply chain issues. And here we are going--discussing, I
guess, a--getting a panel that wants to bash Roe--the
abolishment of Roe v. Wade and put it back to the states where
it should be. It just shows you how disconnected this
administration is on solving real problems of this country.
The last panel we had of pro-choice advocates, I asked a
very simple question: Do you agree with the killing of a child,
infanticide at birth, a perfectly live, healthy child at birth?
They couldn't answer it.
So I said, Well, that's your decision. You agree with that.
So I won't bother asking y'all that question. I will tell
you I'm a grandfather. My daughter had a 25-week-old child. It
was this big. It was a child that could--you see pain. He was
moving in the womb, perfectly healthy child now. Didn't make
the choice to kill it, had it at term. Perfect three-years-old.
So--but, you know, what's amazing to me is the distortion
that this administration is using. I'll just name a few that
really is sad to see--and it has to do with the Dobbs decision.
The myth that state abortions restrictions will not allow a
physician to care for a woman if her pregnancy poses a serious
risk to her life. All state--the fact: All state abortion laws
currently in effect have exemptions to save the life of the
mother.
The myth that state abortions restrictions means a woman
with an ectopic pregnancy must choose between jail or death,
even Planned Parenthood admits that treating an ectopic
pregnancy isn't the same as getting an abortion.
Myth being put out by the left: State abortion restrictions
will prevent physicians from treating miscarriages. Fact: Pro-
life legislation will not prevent any woman from getting care
during the heartbreak of a miscarriage.
Myth: Abortion has no adverse mental health effects. I will
tell you I've talked to a lot of ladies that talked about
having an abortion. Tears came to their eyes, men as well.
Don't tell me that it's no mental effect. It is a mental
effect. And the fact that you're putting out that it doesn't,
it just simply is not true.
Abortion contributes to--the facts are abortions
contributes to increased rates of mental health disorders among
women, including anxiety, depression, substance abuse,
excessive risk-taking, self-harm, and suicide.
And finally, the myth that overturning Roe threatens dozens
of other precedents founded on privacy rights, such as gay
marriage and contraception, the Dobbs decision clarifies that
the opinion only impacts abortion and argues that abortion is
fundamentally different from other privacy issues, such as
contraception and marriage, because it destroys the life of a
distinct human being.
These are all myths that the American people are fed up
with, and these are the myths that it's not going to sell this
time.
Ms. Wubbenhorst, I understand that, following the Dobbs
decision, 27 states have few or no limits on abortion. Doesn't
that mean that, in these states, our abortion--our Nation
allows one of the most extreme policies on abortions in the
world?
Dr. Wubbenhorst. Yes, sir. I'm aware that and agree with
you that 27 states do allow it, and I think that, where
abortion--abortion laws permit abortion up to and including the
time of birth, when that child's birthday would have been, that
that is an extreme position as compared to the rest of the
world. There is no question about it. And, as we've talked
about earlier, it's only Canada, China----
Mr. Norman. North Korea?
Dr. Wubbenhorst [continuing]. And North Korea that have a
similar----
Mr. Norman. We joined North Korea in that distinct--this
blows my mind how that happens.
Anyone--Ms. Frye, you want to comment on that? Dr. Kumar?
Ms. Leigh, any of you want to contact on that? I've got 27
seconds. Real quick.
Ms. Frye. Most Black women don't live in China or North
Korea.
Mr. Norman. I'm not talking about Black or White women. It
has nothing to do with Black----
Ms. Frye. I'm concerned about them having access to
healthcare here----
Mr. Norman. No, you're not going to blame----
Ms. Frye [continuing]. In this the United States.
Mr. Norman. Abortion affects--doesn't matter the color.
Dr. Kumar?
Dr. Kumar. Well, I did want to respond to your first
comment about infanticide. Nobody on this panel, I think,
stands for infanticide. I think that a suggestion that we would
support that is inflammatory, especially given the amount of
violence and harassment that abortion providers face.
Mr. Norman. It wasn't inflammatory with the group that I
had previously.
Chairwoman Maloney. The gentleman's time has expired.
The gentlelady from Michigan, Ms. Tlaib, is recognized.
Ms. Tlaib. I want to pause a little bit, because I know
that's intense. And I do appreciate you all being here, because
there are so many women and those that can be pregnant can't be
here, and you all are speaking for them, and I really do
appreciate that.
You know, when I served in state legislature, I just wish
my colleagues were as obsessed with handling infant mortality
as environmental racism that gives so many folks, you know,
preexisting conditions and so much more. In the 13 District
Strong that I represent, because I grew up in the most
beautiful, Blackest city in the country, the city of Detroit,
where, unfortunately, because of systematic racism, we see
poverty at higher levels, we see preexisting conditions because
environmental racism exists, and so much more. We are ranked in
the city of Detroit with one of the worst asthma rates in the
Nation. We have the worst--one of the worst infant mortalities
in the Nation.
Just a few weeks ago, Chairman Khanna and I held an
Environmental Subcommittee field hearing in my district about
frontline communities facing high rates of pollution and so
forth. At that hearing--I don't know if the chairwoman knows--
it was incredible to hear folks from those that live in the
shadows of Stellantis, U.S. Ecology, that are--continue to
pollute in communities that feel like they're sacrifice zones.
One of the biggest health issues they raised was pregnancy
complications, loss of pregnancy, difficult having children. I
just even heard it from a dear friend who did environmental
justice work, losing a child, thinking, is it because I live
here?
You know, Dr. Verma, one of the things I wish folks would
understand, and maybe you--but addressing infant mortality and
offering prenatal care, would that save lives?
Dr. Verma. Yes, that would absolutely save lives. And what
we're saying here today--so I provide comprehensive
reproductive healthcare. I support my patients who need
abortion care and who decide they want to continue the
pregnancies. And I support them in trying to access health
insurance in trying to get prenatal care. But there are huge
limitations when it comes to that.
And so, when we're talking about people's access, it's also
important that we pursue policies that allow people to have
healthy pregnancies and parent in healthy ways. But we are--
support all of that. I want people who need abortion care to
get that care. I also want people who want to continue their
pregnancies to be able to do so in a healthy way.
Ms. Tlaib. Yes. You know, Ms. Leigh, I cannot thank you
enough for providing your testimony today, but I don't know.
You know, as a woman in our country right now, I just--I feel
like we're not as obsessed with the children that are among us
living in poverty, that are going to schools with, you know,
lead in the walls, where most of my schools right now don't
even have access to clean water. They're literally--their
fountains are shut down.
I--I mean, why is abortion bans so dangerous for patients
and families with stories like yours?
Ms. Leigh. I appreciate the question, Representative.
And that question reminds me that as I've sat here when
Representative Flood and other members who have now left the
room so they can't hear this correction, have sat here to use
their five minutes to tell us about how eyelids are developed
and fingerprints and heartbeats--it's demeaning, and it's
insulting to insinuate that that's what I need to hear, to know
that my son and that his life mattered. It's insulting to all
pregnant people everywhere.
The rhetoric and the sentinelization creates stigma and
shame, and it's wrong. And it's really difficult to sit here
and to hear that, and then not actually be looked in the eye
and asked about my experience, not being asked a single
question while I have to sit here.
And I have the privilege and honor of sitting here and
representing so many people--my friends, Karen and Whitney and
Erica, who also had to say good-bye to babies before they ever
held them in their arms.
Mr. Higgins, your story was beautiful, and I share your
grief as a parent.
No one needs to be reminded of the sanctity of life. We
need to be reminded that this is a nuanced, complex decision
that is never going to be answered by a binary yes or no
question or the amount of weeks that my ultrasound shows. We
need to leave people alone to make these decisions for
themselves and their families and the betterment of our
communities.
Ms. Tlaib. Thank you, Ms. Leigh.
You deserve a lot more time. And I just want you to know,
even though you may not have felt seen and heard here, I see
and hear you.
With that, I yield, Madam Chair.
Chairwoman Maloney. The gentlelady yields back.
And I now ask unanimous consent that Representative Dr. Kim
Schrier be allowed to participate in today's hearing.
Without objection, so ordered.
She's now recognized for five minutes.
Thank for joining us.
Ms. Schrier. Thank you, Madam Chair.
And thank you to our witnesses. And I have met several of
you but not all of you, and I would like to introduce myself by
saying that I'm the first ever pediatrician in Congress. So I
have worked in the neonatal intensive care unit. I've attended
high-risk deliveries. I have seen families in my office up
close, either, you know, a teenage girl facing an unplanned
pregnancy or a mother who is so excited about a pregnancy and
then finds out something is devastatingly wrong.
And that is why, as I just heard from Ms. Leigh, this is a
nuanced question. And this--these are questions that should be
left between doctors and patients and that the government
really has no role making such a personal decision.
I'm the only pro-choice woman doctor in all of Congress,
and so I'm really honored to be here. Mainly, I want to set the
record straight on several things that I've heard today.
You know, the first is just can we talk about ectopic
pregnancies for a second.
Dr. Verma, what is the treatment for an ectopic pregnancy?
Dr. Verma. The treatment is either a medication,
methotrexate, or a surgery.
Ms. Schrier. And either way, this would be considered an
abortion. Is that correct?
Dr. Verma. There are--so there are some distinctions
present. But we are absolutely seeing that--again, there are
gray areas, and we are seeing that these abortion bans
definitely affect people that have ectopic pregnancies. The
most common types of ectopic pregnancies are in the tubes and
are treated in those two ways.
There are types of ectopic pregnancies in the cervix or in
the C-section scar that are treated very similarly in the way
that we do abortion, and we're seeing that there's all this
confusion because politicians who are making these laws don't
actually understand the medicine and the science. And these
laws are absolutely affecting people that are having ectopic
pregnancies.
Ms. Schrier. That's right. Thank you for pointing out,
politicians making medical decisions.
I wanted to also ask you about miscarriage because that
word gets thrown around a lot. A miscarriage is the natural
loss of a pregnancy. Can you tell us about an incomplete
miscarriage--at least that's what it has traditionally been
called; you can correct my language if you'd like--and what the
treatment for that is?
Dr. Verma. Absolutely.
So we often see patients that are in the process of passing
a pregnancy. So they're experiencing bleeding and cramping.
Their cervix is open, but part of the pregnancy is still
present in the uterus.
And, again, there's a lot of uncertainty. I've seen this in
Georgia about whether doctors can intervene in those situations
and provide the care that patients need. And patients are
experiencing delays in care, because of this uncertainty,
because of these abortion bans.
Ms. Schrier. That's right.
And it's putting doctors in a really untenable and really
inappropriate position of having to call an ethics board or to
call their lawyer before they can treat their patient with the
standard medical care.
I had another question for you. I'll just throw this to
you, Dr. Verma. We just heard mental health. I hear this thrown
around a lot. Can you tell me what the overwhelming mental
health response of women who get abortions is? I don't believe
that it is any of the things the Republicans are pointing out.
I believe it is relief. Can you either confirm that or say
otherwise?
Dr. Verma. Yes. So the Turnaway Study that followed many,
many women who had abortions and were turned away from
abortions found that the most common emotion was relief.
And I appreciate you pointing out the amount of
misinformation we've heard today. I want to reemphasize that
the overwhelming consensus of the medical society, which
includes over 75 major medical societies across all
specialties, have come together and have established that
abortion care is essential, necessary healthcare and that
abortion restrictions harm our patients.
Anything can be misrepresented for a political or personal
agenda, but the science is not up for debate. And the
overwhelming consensus of the medical community, which includes
OB/GYNs, surgeons, the American Medical Association,
pediatrics, the consensus is clear and the American Board----
Ms. Schrier. Thank you.
Dr. Verma [continuing]. Of OB/GYN----
Ms. Schrier. I--And I hate to interrupt, but I have a quick
another question for you, because another big source of
misinformation that we hear from some of my colleagues is a
real focus on abortions late in pregnancy.
Since about 95 percent of abortions occur very early in
pregnancy, in your experience, have you ever had a patient--do
patients come in at 8 or 9 months and just decide that they no
longer want a pregnancy? Or can you clarify that these are for
extraordinary circumstances that no politician should be
deciding for a woman?
Dr. Verma. Yes, thank you for that question.
That's absolute that is just not reflective of the reality
of abortion care that people are coming in right before birth
and having abortions. Ninety percent of abortions are occurring
in the first trimester. In the 1 percent that occur after 20
weeks, in the majority of cases, something has gone terribly
wrong with the patient or pregnancy.
And so it--this is a lot of misinformation again that we're
hearing today about abortions later in pregnancy.
Ms. Schrier. Thank you for clarifying and setting the
record straight.
I yield back.
Chairwoman Maloney. Thank you, Doctor and Representative.
I would like to introduce this document into the record.
It's a statement from the American College of Obstetricians and
Gynecologists, which represents and trains more than 57,000 OB/
GYNs across America, that affirms what we've heard from Drs.
Verma and Dr. Kumar.
It says, quote: Abortion is an essential component of
women's healthcare, end quote.
It also says quote: Personal decisionmaking by women and
their doctors should not be replaced by political ideology.
And I agree. Republicans need to stop interfering with
women's personal healthcare decisions, and I would like to
place this in the record.
Without objection.
Chairwoman Maloney. I have--the gentleman does not care for
a closing statement, but I would like to give one briefly.
To all of our witnesses who shared your expertise and your
personal stories of abortion today, I want to thank you very,
very much for all that we've learned from you.
And, as the witnesses at today's hearing made painfully
clear, Republican abortion bans and restrictions are already
taking away rights and jeopardizing the health of more than 30
million women across our country.
And, as the memo we released today shows very clearly,
Republicans are now intent on banning abortion nationwide and
putting doctors and nurses in prison for providing abortion
care. If Republicans succeed, they will strip reproductive
freedoms from nearly 64 million women in America. And that is
horrifying.
And Republicans are not telling the truth about their
national abortion ban. They claim today that they want to
protect women's health, but the truth is a national ban will
increase maternal deaths. A recent analysis estimates we could
see an increase in maternal deaths of nearly 30 percent in the
first year of a national ban.
They claim today that they don't want to, quote, ``force,''
end quote, people to support abortion. But their national
abortion ban would force women to give birth against their
will, even if the fetus is totally incompatible with life, as
Ms. Leigh's experience was, simply because Republican
politicians say so.
Today we heard exactly how devastating this would be. We
heard today how a national ban would roll back the clock on
women's rights and economic advances in this country and would
have a profound impact on entire families, and that is simply
unacceptable.
Democrats in Congress understand that the right to control
our reproductive futures is essential for our democracy. I
would say there is no democracy if women cannot make decisions
about their own healthcare, including reproductive healthcare.
And this is why Democrats continue to fight to protect
abortion rights. We have already passed bills in the House to
protect this right, and we will not stop until we ensure that
everyone has the freedom to make their own healthcare
decisions.
With that, I yield back.
The meeting--whoops.
I was swept away with the emotion of today's hearing, and I
must make this closing.
I want to thank our panelists for their remarks, and I want
to commend my colleagues for participating in this important
hearing and conversation.
And without--with that and without objection, all members
have five legislative days within which to submit extraneous
materials and to submit additional written questions for the
witnesses to the chair, which will be forwarded to the
witnesses for their prompt response.
I ask our witnesses to please respond as promptly as you
are able.
This hearing is now adjourned.
[Whereupon, at 1:18 p.m., the committee was adjourned.]
[all]