[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
                                 ------                                


                         C  O  N  T  E  N  T  S

                              ----------                              
                                                                   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

                              ----------                              


                      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.]

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