[Senate Hearing 118-465]
[From the U.S. Government Publishing Office]
______
S. Hrg. 118-465
THE ASSAULT ON WOMEN'S FREEDOMS:
HOW ABORTION BANS HAVE CREATED
A HEALTH CARE NIGHTMARE
ACROSS AMERICA
=======================================================================
HEARING
OF THE
COMMITTEE ON HEALTH, EDUCATION,
LABOR, AND PENSIONS
UNITED STATES SENATE
ONE HUNDRED EIGHTEENTH CONGRESS
SECOND SESSION
ON
EXAMINING WOMEN'S FREEDOMS, FOCUSING ON ACCESS TO ABORTIONS ACROSS
AMERICA
__________
JUNE 4, 2024
__________
Printed for the use of the Committee on Health, Education, Labor, and
Pensions
GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT
Available via the World Wide Web: http://www.govinfo.gov
______
U.S. GOVERNMENT PUBLISHING OFFICE
57-241 PDF WASHINGTON : 2024
BERNIE SANDERS (I), Vermont, Chairman
PATTY MURRAY, Washington BILL CASSIDY, M.D., Louisiana,
ROBERT P. CASEY, JR., Pennsylvania Ranking Member
TAMMY BALDWIN, Wisconsin RAND PAUL, Kentucky
CHRISTOPHER S. MURPHY, Connecticut SUSAN M. COLLINS, Maine
TIM KAINE, Virginia LISA MURKOWSKI, Alaska
MAGGIE HASSAN, New Hampshire MIKE BRAUN, Indiana
TINA SMITH, Minnesota ROGER MARSHALL, M.D., Kansas
BEN RAY LUJAN, New Mexico MITT ROMNEY, Utah
JOHN HICKENLOOPER, Colorado TOMMY TUBERVILLE, Alabama
ED MARKEY, Massachusetts MARKWAYNE MULLIN, Oklahoma
TED BUDD, North Carolina
Warren Gunnels, Majority Staff Director
Bill Dauster, Majority Deputy Staff Director
Amanda Lincoln, Minority Staff Director
Danielle Janowski, Minority Deputy Staff Director
C O N T E N T S
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STATEMENTS
TUESDAY, JUNE 4, 2024
Page
Committee Members
Sanders, Hon. Bernie, Chairman, Committee on Health, Education,
Labor, and Pensions, Opening statement......................... 1
Murray, Hon. Patty, U.S. Senator from the State of Washington,
Opening statement.............................................. 2
Cassidy, Hon. Bill, Ranking Member, U.S. Senator from the State
of Louisiana, Opening statement................................ 5
Witnesses
Anderson, Madysyn, Abortion Patient, Houston, TX................. 8
Prepared statement........................................... 10
Summary statement............................................ 11
Verma, Nisha, M.D., MPH, Fellow, Physicians for Reproductive
Health, Atlanta, GA............................................ 11
Prepared statement........................................... 13
Lopez, Destiny, MPA, Acting co-CEO, Guttmacher Institute,
Washington, DC................................................. 15
Prepared statement........................................... 16
Summary statement............................................ 18
Linton, Allison, M.D., MPH, Chief Medical Officer, Planned
Parenthood of Wisconsin and Fellow, Physicians for Reproductive
Health, Milwaukee, WI.......................................... 18
Prepared statement........................................... 20
Summary statement............................................ 22
Francis, Christina, M.D., Chief Executive Officer, American
Association of Pro-Life Obstetricians and Gynecologists, Fort
Wayne, IN...................................................... 23
Prepared statement........................................... 25
Summary statement............................................ 36
Ohden, Melissa, MSW, Founder and Chief Executive Officer, The
Abortion Survivors Network, Kansas City, MO.................... 36
Prepared statement........................................... 38
Summary statement............................................ 47
ADDITIONAL MATERIAL
Statements, articles, publications, letters, etc.
Murray, Hon. Patty:
Clear and Growing Evidence That Dobbs Is Harming Reproductive
Health and Freedom, Guttmacher Institute................... 74
In Our Own Voice, National Black Women's Reproductive Justice
Agenda..................................................... 79
National Council of Jewish Women, Statement for the Record... 83
National Partnership for Women & Families, Statement for the
Record..................................................... 85
Power to Decide, Statement for the Record.................... 103
Reproductive Freedom for All, Statement for the Record....... 106
The American College of Obstetricians and Gynecologists,
Statement for the Record................................... 110
Cassidy, Hon. Bill:
Op-Ed written by Kelly Crawford, Founder & Executive Director
of Abel Speaks............................................. 114
THE ASSAULT ON WOMEN'S FREEDOMS:
HOW ABORTION BANS HAVE CREATED
A HEALTH CARE NIGHTMARE
ACROSS AMERICA
----------
Tuesday, June 4, 2024
U.S. Senate,
Committee on Health, Education, Labor, and Pensions,
Washington, DC.
The Committee met, pursuant to notice, at 10 a.m., in room
216, Hart Senate Office Building, Hon. Bernie Sanders, Chairman
of the Committee, presiding.
Present: Senators Sanders [presiding], Murray, Casey,
Baldwin, Murphy, Kaine, Hassan, Smith, Lujan, Hickenlooper,
Markey, Cassidy, Murkowski, Marshall, Tuberville, Mullin, and
Budd.
OPENING STATEMENT OF SENATOR SANDERS
The Chair. The Senate Committee on Health Education, Labor,
and Pensions will come to order. Two years ago, six Supreme
Court justices all nominated by Republican Presidents, decided
to overturn Roe v. Wade abolish the constitutional right for
women to have an abortion and to give politicians in state
government the right to control the bodies of women in state
after state.
This morning, we will be holding a hearing to take a hard
look at how this Supreme Court decision, the Dobbs decision,
has impacted women, physicians, and healthcare providers
throughout our Country.
In a few minutes, I am going to be handing the gavel as
Chair of the Committee to Senator Patty Murray, because given
the subject matter, I think it's appropriate for a woman to
Chair this important hearing. And this is an issue that Senator
Murray has been deeply and passionately involved in for many,
many years.
But before I hand the gavel over to Senator Murray, let me
say a few words on a subject I feel very, very strongly about.
It is no secret to anyone, that throughout our Country's
history, women have had to fight for their basic human rights
against all forms of patriarchy and sexism, no great secret.
Women had to struggle and some died in order to achieve the
right to vote, something which they did not receive until 1920.
Women had to struggle for the right to get the education that
they wanted. All over America, women wanted to go to this
school, wanted to do that, couldn't get into the door, because
they were women.
Women had to struggle to get banks to lend them the money
they needed to buy a car or start their own business. In fact,
up to 1974, banks in America could legally refuse to issue a
credit card to a woman simply because she was a woman.
Women struggled to get to choose the careers they wanted.
In the 1950's, it was legal for employers to fire women for the
crime of getting married, to get fired because she chose to get
married. Up until 1964 it was legal for employers in America to
reject a job applicant, simply because the applicant was a
woman.
The struggle for equal pay, for equal work, continues to
this day. In America today, women working full-time make just
84 cents on the dollar compared to men. And on and on it goes,
women struggling with their basic human rights.
Then on January 22nd, 1973, after decades and decades of
struggle, women in America finally won the right to control
their own bodies, as a result of the Supreme Court decision in
Roe v. Wade. No longer would state governments be able to tell
women what they could or could not do with their own bodies.
When we talk about the history of how all of these
happened, let's not ignore the lack of political representation
that women had.
In 1987, not so many, many years ago, there were 2 women in
the U.S. Senate and 98 men. Those are the folks all over this
country who are making the decision. The truth is that men
would not tolerate them being subject to government decisions
regarding how they can control their own bodies.
I am not aware of any state in this country that has ever
restricted the right of a man to get Viagra or any other
medication prescribed by a doctor. I'm not aware of any state
in this country that has prevented a man from getting a
vasectomy or any other medical procedure that men choose to get
that has been approved by a doctor.
We hear a lot of talk about freedom in this body, freedom
to do what you want to do, and yet right now we are living at a
time when half of our population or more has lost that freedom.
By the way, when I talk about the right of women to be able
to control their own bodies, it's not just me talking, it's
what the American people believe, in poll after poll, in state
election, after state election.
People are saying, we may disagree politically, we may
disagree on this or that issue, but very strongly, the American
people believe it is women, not the government that has a right
to control their own body.
Senator Murray, the gavel is yours.
OPENING STATEMENT OF SENATOR MURRAY
Senator Murray. [Presiding.] Chairman Sanders, thank you so
much for your statement, and thank you for letting me Chair
today's hearing on a topic that is deeply important to me. And
I want to thank all of our witnesses for joining us here today.
Today, we take a close accounting of the trauma Republicans
are inflicting on women and families across our Country, and
the damage they are doing to basic reproductive healthcare
through their horrific anti-abortion crusade. The issue here is
simple and it cuts to the core of American values. Freedom.
Many women every day experience the joy of becoming
pregnant and raising a family. They were able to make that
decision for themselves, but no woman, no one should be dragged
through a pregnancy against their will.
But right now, in America, more than a third of women of
reproductive age live in states where they essentially do not
have the choice to end a pregnancy if they need to.
Instead, Republicans have made the choice for them, with
extreme abortion bans and cruel restrictions on access to care.
With these policies, they have told women in no uncertain
terms, you don't control your body, we do. That is horrifying.
Think about what it means, what it really means to be told
someone else can decide you have to stay pregnant no matter the
circumstances.
Think about how little power that gives a woman over her
own life and her own health. And think about how much power
that gives, not just politicians, but any man who knows he can
get a woman pregnant, force her to stay pregnant so he can have
control over her or even get revenge for the rest of her life.
To every Republican who hopes this issue will go away or is
hoping the post Dobbs reality will become settled, status quo.
Listen, you never forget and you never just get used to someone
else taking control of your body, your medical decisions, your
plans for your family or your future.
You never forget a politician rescinding your right to make
decisions about something as personal as your own pregnancy,
and imposing his will instead, especially when you live with
the consequences every day. And the consequences of the post
Dobbs abortion bans are so much broader and so much more
devastating than any one story or hearing can ever do justice.
There are stories that get a lot of attention that are
shocking almost beyond belief. Stories of women denied care for
a miscarriage because of abortion bans. Women turned away from
hospitals because their doctor's hands were tied until they
lost over half of their blood, until their husband found them
unconscious, until the only option was an emergency
hysterectomy or tragically until it was simply too late.
Or stories of children, who can't get abortion care after
being raped. Some kids may be able to get across state lines to
get the care they need. Other children have been forced into
motherhood by Republican politicians. One teenager delivered a
baby while clutching a teddy bear.
These nightmares are happening across our Country as a
direct result of Republican abortion bans. And there are so
many other stories that go untold.
Women who do not want to be pregnant for whatever reason,
maybe they can't afford to have another child right now. Maybe
they are in an abusive relationship, maybe they just don't want
a kid right now, period. But they are told by politicians, they
have no say in the matter, not unless they have the time and
resources, often thousands of dollars to travel in some cases,
hundreds, and hundreds of miles.
It is harrowing to think that we live in a reality where
forced pregnancy has become so widespread and so rampant that
only the most dystopian stories get national attention. But the
stories of all the other women who were confronted by these
bans, their pain, their heartbreak, their anger, and fears are
also horrific, valid and an important part of the conversation.
A forced pregnancy does not have to make headlines to make
someone's life a living hell.
Let's be clear about a few more things before we get
started. Republican attacks are not only hurting people in the
states where they banned abortion. They're not only hurting
women who need an abortion, and their attacks on our rights are
not stopping at an abortion.
When it comes to states like mine where abortion is legal,
providers are being stretched beyond capacity by women in
desperate need of abortion care they can no longer get at their
home.
When it comes to women who aren't even seeking an abortion,
bans are hollowing out healthcare for women in general,
especially for those who already face some of the biggest
challenges getting care.
Women of color, Indigenous women, those in rural
communities, because in a surprise to no one, healthcare
providers do not want to work in states where politicians get
between a doctor and their patient and threaten providers with
jail time, and the loss of their medical license if they dare
to help patients get the care they need.
In states with extreme abortion bans, we are seeing
healthcare providers closing their doors and shutting down
their practices, new doctors staying away, and fewer options
for patients to get a whole range of necessary healthcare
services. The consequences extend far beyond abortion. And when
it comes to what is next, well, Republicans have already made
it painfully clear they want a national abortion plan.
No matter what they're saying now, we can just look at the
record. Look at how many Republicans have co-sponsored national
abortion bans. Look at the Life at Conception Act. That is a
bill that is supported by more than half of the House
Republican Conference that would enshrine fetal personhood
nationwide.
Let's be clear what that would mean. Not just an abortion
ban. It would mean that women and doctors will be charged with
murder for an abortion making them eligible for the death
penalty in their states. It would mean emergency contraception
like Plan B, outlawed. And it would mean IVF ripped away from
people who are trying to start a family.
This is not theoretical. We saw how much chaos this
dangerously extreme ideology already caused for families in
Alabama. And yet there are Republican states and Republican
Members of Congress, including the Speaker of the House, who
support making fetal personhood the law of the land. That is in
the extreme, but in the face of all this horror, we've also
seen an outcry from women and men who refuse to let Republicans
keep dragging our Nation backward and stripping away our basic
rights.
Every time abortion rights have been on the ballot, since
Dobbs, every single time, abortion rights have won. People are
standing up and they're speaking out and Democrats are proud to
stand with them.
Democrats are going to make sure women's voices are heard
in our Nation's capital, including at hearings like this one.
And we're going to keep fighting to pass the Women's Health
Protection Act and restore the basic and fundamental right of
women to control their own bodies.
While former President Trump continues to brag about how he
overturned Roe, and makes clear he will go even farther to
restrict and ban abortion if given the chance, Democrats have
been clear. With a pro-choice majority in the House and Senate
and Joe Biden in the White House, we will restore and protect
abortion rights for every woman in America. Thank you.
With that I look forward to hearing from all of our
witnesses, but first, I will turn it over to Senator Cassidy
for his opening statement.
OPENING STATEMENT OF SENATOR CASSIDY
Senator Cassidy. Thank you, Senator Murray.
Let's table-set. It's an election year in which a
Democratic incumbent President is running behind. So, a
decision has been made to raise abortion to a high profile to
change the setting, to invite a lot of folks to put us on TV.
It's partisan politics being played out in a Committee hearing,
but let me point out as well, it's not entirely partisan.
Louisiana's pro-life law was written by a female Democratic
State Senator and written and signed into law by a Democratic
Governor. And that female Democratic state senator was
reelected with wide margins. So, there is a breadth across the
political spectrum of people who have a different way of
framing this.
My Democratic colleagues want you to think that Republicans
believe terrible things, they'll attempt to normalize a
decision to abort a child. But a Republican would say that you
can't normalize a procedure, at least this Republican, in which
the intent is to end a life. Don't be misled. This is a life.
This is a life because can anyone say that child is not a life.
How could you not?
I'm a doctor. I see that you have to take care of that
mama. You have to take care of that mama, but you have to
recognize that there is another life there as well. This is not
just a collection of cells. This is a child that if delivered
will live, and maybe this one too, and that one as well. So,
let's have a national dialog. Let's actually explore this as
opposed to exploit it for political advantage.
In medical school, I was taught, to care for every patient
who walks in the door, and to recognize that when a woman is
pregnant, there are two patients there.
The second that baby gets there, it doesn't matter how
small and how vulnerable, how unsustainable, how weak. The
doctors, the nurses, the institution does everything they can
to save their life. And by golly, don't you want them to do
that? Don't you want the people who are entrusted with the
healthcare to have that ethic?
I believe that the responsibility to protect and say the
child shouldn't be determined by the arbitrary difference of
being inside or outside the womb. I'm unapologetically pro-
life. Scientifically and morally, there's no difference in the
value of a child, whether she is in her mother's arms or
whether she is in her mother's womb.
The science is clear. This is just not a clump of cells and
this is a difficult poster to look at. I can tell you it's
difficult. The reason it's difficult is because you recognize,
that by their policies, it should be legal to abort that child.
It is difficult, but let's frame it for what it is. How can we
dehumanize this? And yet this is what it's an attempt to do. At
what point do my Democratic colleagues believe that a child
deserves to live?
It does a disservice to the mother to dehumanize the unborn
child and discuss this issue as only the right to abort or not
to abort. This is one of the most significant decisions a woman
will ever make. We should not trivialize.
Now I understand and accept the need for exceptions, the
laws that regulate abortion under certain circumstances. But
unlike some of our testimony here, terminating life does not
spare a woman from potential grief. This should never be an
easy decision, if so, we've lost our moral compass.
I just want people to read the entire testimony of Dr.
Francis in which she refutes a lot of what was said, kind of
blithely, and she actually puts scientific data behind it.
As a physician, fear mongering, I find it infuriating. A
woman experiencing, the emotionally and physically painful
experience of miscarriage or an ectopic pregnancy is already
grappling with a loss of our unborn child, and yet this
Committee hearing would take this vulnerable moment of that
woman's life and misrepresented, and use it for political gain.
There is no law in any state preventing a doctor from
treating a patient going through a miscarriage or an ectopic
pregnancy or from preventing the saving of the life of a
mother. That is called healthcare. That is not an abortion.
One of the most inspirational medical professors said, that
in healthcare and medicine, our highest calling is truth. And
frankly, that's why I find it frustrating that fellow
physicians are misleading on these facts and corrupting truth
for political viewpoint.
While it's disappointing that my colleagues would say
things that are not true, deceiving Americans about Republicans
stand on the issue is also reprehensible that they mislead
Americans on the Democrats own extreme views.
Now, Democrats will say that they want to codify Roe v.
Wade. That's not true. The truth is, is that the democratic
policies go beyond Roe. Their marquee legislation will legalize
late term abortion and every state aborting this child, ban
states that prevent coerced abortion, allow strangers to
convince an underage child to get an abortion without notifying
the parents that she is pregnant.
Perhaps that pregnancy was due to abuse, shouldn't the
parents know? Why should the parents' rights be obligated and
eviscerate the conscience rights of healthcare professionals
who have moral or religious objections to abortion? Speak about
driving people out of the healthcare field.
Now, Senator Kaine has a bill that explicitly codifies Roe
into law. The only Democrats willing to co-sponsor are Senator
Sinema and Manchin, neither one of whom call themselves
Democrats by now. So, it begs the question, why does Senator
Kaine bill to codify Roe not have more Democratic support?
Well, it makes a good rallying cry, the policy of codifying Roe
is too conservative for the fringes that now define the debate
in the Democratic party.
There are nine states plus Washington DC, whose laws right
now allow, allow for abortion up to parturition. The child can
be ready to go through the birth canal and abortion is
legalized. Not because of the life of the mother, just to
legalize it. That is where the Democratic party has gone. That
should give us all a moral pause.
Now I ask my Democratic colleagues, can you designate a
point at which a pregnancy should not be terminated unless for
the life of the mother or instead of some extenuating
circumstances? Can you tell me if it's here or here or here? I
think that's a fair question. I invite everybody to be a doctor
who's trying to balance the needs of the unborn child with that
of the mom.
My Democratic colleagues may also claim that abortions are
low risk procedures, claiming that they're so safe, they can be
done without medical supervision. Not entirely accurate,
minimizing the potential complications. But that's the way you
can kind of feel better about this. And again, I refer people
once more to Dr. Francis' complete testimony, not just the 5-
minutes she'll give today.
Now, demagoguing and fear mongering on access to treatment
for miscarriages and ectopic pregnancies, cast in a decision to
abort or not to abort as an easy one, is a tremendous
disservice. I have supported postpartum coverage for women in
Medicaid. I've worked on serious legislation to advance
maternal health like the Connected Moms Act with Senator Maggie
Hassen, which lets physicians remotely monitor pregnant women
for potential complications.
From my practice in Louisiana, a woman who's eight and a
half months pregnant, using public transportation in August in
Louisiana, you can empathize for her and understand that if you
can remotely monitor her, her life is so much better. Senator
Bob Casey and I led legislation now law to ensure that pregnant
women are entitled to reasonable accommodations in the
workforce.
There is much more we can do to support the woman who's
pregnant, but we should debate and advance legislation so that
we are not leaving them without solutions when they're faced
with a very difficult, traumatic, and complex question.
We want women, moms to be healthy, successful, and
prosperous. And the human life inside a woman triggers the
double line--the human life, do a pregnancy test, those double
lines come up. Those double lines should not represent a burden
as the other side would like to cast. It should represent a
gift, but there's things that we can do to make her life
easier.
I'm open to the tough conversations. I think we should all
be, but we shouldn't minimize by dehumanizing. And it must be
with respect for both the mother and the defenseless and
voiceless unborn child that are participating in that debate.
This is too personal for too many Americans.
With that I yield.
Senator Murray. We will now introduce today's witnesses and
move to testimony. Today, we'll be hearing from Madysyn
Anderson. She's a young woman from Texas who was forced to
leave her state and travel hundreds of miles to get the
abortion care she needed after Texas passed its draconian
abortion ban.
Dr. Nisha Verma, an OB-GYN, an abortion provider in
Georgia, and a fellow with Physicians for Reproductive Health.
Destiny Lopez, acting CEO of the Guttmacher Institute. And Dr.
Allison Linton, Chief Medical Officer of Planned Parenthood of
Wisconsin. She's also an OB-GYN, an abortion provider, and a
fellow with Physicians for Reproductive Health. I will turn it
over to Ranking Member Cassidy to introduce his witnesses.
Senator Cassidy. Yes, I introduce Dr. Christina Francis.
She is a board-certified OB-GYN, working as OB-GYN hospitalist,
treating women with both high and low risk pregnancies who are
hospitalized. She is a board member of Indiana Right to Life.
And she is the CEO of the American Association of Pro-Life
Obstetricians and Gynecologists.
I'll also introduce Ms. Melissa Ohden. I have that right,
Ohden? Yes, who was the founder and Chief Executive Officer of
the Abortion Survivors Network. Melissa will tell us of her
story about surviving a failed saline infusion abortion in 1977
that was intended to end her life. We're fortunate that Melissa
has made this her life's work and runs the Abortion Survivors
Network, a group providing support to other abortion survivors
and mothers who have experienced a failed abortion. I look
forward to hearing from you today, Melissa, and thank you for
sharing your powerful story.
Senator Murray. Again, thank you to all of our witnesses.
We will begin with Ms. Anderson.
STATEMENT OF MADYSYN ANDERSON, ABORTION PATIENT, HOUSTON, TX
Ms. Anderson. Thank you, Senator Chair Sanders, Senator
Murray, Ranking Member Cassidy, and Members of the Committee.
My name is Madysyn Anderson, and I live in Houston, Texas.
Two years ago, during my senior year at the University of
Houston, I had just come out of a 2-year long relationship.
After a couple weeks of nausea, not sleeping or eating, I took
a pregnancy test. I called a friend to bring me more tests
because I was in disbelief. At one point. I had five tests in
front of me and there was no disputing I was pregnant.
This was just 2 weeks after the Texas abortion ban, known
as S.B 8, went into effect banning abortion after 6 weeks. I
knew almost immediately that abortion was the right choice for
me. I called and got an appointment at the local Planned
Parenthood just 5 minutes away from me for later that week. I
thought I was early enough to be able to get my abortion that
week, but at my appointment, my pregnancy measured 11 weeks.
I was shocked, I couldn't get an abortion in Texas. I
called 20 different clinics after my first visit. Yes, 20 I
called surrounding states and even as far as the Dakotas, no
one could see me right away. The earliest I could be seen was 2
weeks later at Jackson Women's Health Organization in
Mississippi. This was before the Dobbs v. Jackson Women's
Health decision that would take away the Federal constitutional
right for abortion, and before 20 more states would ban
abortion, and before wait times and states that didn't have
bans would stretch longer and longer.
My dad took off work, and we drove a total of 720 miles
round-trip, and spent 13 hours on the road. We spent 5 hours in
a hotel trying to sleep before my first appointment just to
turn right around and go back home.
Here's the thing. Because of unnecessary restrictions on
abortion care in Mississippi, I would have to make the trip all
over again. The state essentially puts patients in a timeout
because they don't trust people to know what is best for their
health or lives. When I got this news, I was angry, and sleep
deprived, and starving, and never more certain of my decision.
That certainty never faltered.
The following week, my mom was able to find us affordable
tickets, and we flew out to Jackson. The start of our day was
at 7am to make it to my 1.30pm appointment. After my procedure,
I went in the recovery room for about 20 minutes before having
to hop in the car and make my flight back home.
I want to talk for a minute about money. As a college
student who took out multiple student loans and was counting
every penny I had to pay for my first appointment in Houston,
my first appointment in Mississippi, and the abortion itself.
Then gas and a hotel for the first trip. And then flights for
the second trip. I missed 20 hours each of work and a mandatory
internship for my school, a total $2,850.
There is no dollar value I can put on the stress of
managing everything. The despair of having to go to such
lengths for basic healthcare that was legal just weeks before I
needed it.
The gut-wrenching reality of having to disclose something
so personal to my boss, professors, and anyone in a position of
authority for fear of losing my job, of failing every class
that semester due to all of the class time and assignments that
I was forced to miss.
I felt so much anger that the politicians in Austin thought
that they had the right to make this decision for me. I'm one
of thousands of people that have now gone through this. Every
day that we go without the right for abortion, there will be
more of us. More savings accounts drained, more classes and
shifts missed, more choices on which bills to skip paying.
If I had found out I was pregnant last year or last month,
Jackson Women's Health would not have been there for me. The
people who cared for me that day cannot care for abortion
patients today. I have to go to New Mexico, Kansas, or as far
as Illinois to make that decision.
Today, we talk about abortion and it is easy to get stuck
in theoreticals, but I am a real person. The lives of abortion
patients are not theoretical. People will continue to get
pregnant when they're not ready or just simply don't want to
be. We will always need abortions. This is simply no place for
a politician to decide for us. Thank you for inviting me here
today and letting me share my story with you.
[The prepared statement of Ms. Anderson follows.]
prepared statement of madysyn anderson
Chair Sanders, Senator Murray, Ranking Member Cassidy, Members of
the Committee:
My name is Mady Anderson, and I live in Houston, Texas.
Two years ago, during my senior year at the University of Houston,
I had just come out of a 2-year relationship. After a couple weeks of
nausea and not sleeping or eating, I took a pregnancy test.
I called my friends to bring me more tests because I was in
disbelief. At one point I had five positive tests in front of me.
I was pregnant.
This was just 2 weeks after Texas's abortion ban, known as S.B. 8,
went into effect, banning abortion after 6 weeks.
I knew almost immediately that abortion was the right decision for
me.
I called and got an appointment for the following week at my local
Planned Parenthood, 5 minutes away. I thought I was early enough to be
able to get my abortion that week. But at my appointment my pregnancy
measured at 11 weeks.
I was shocked. I couldn't get an abortion in Texas.
I called 20 different clinics after that first visit. Yes, you
heard correct. 20.
I called surrounding states and even as far as the Dakotas; no one
could see me right away. The earliest I could be seen was 2 weeks
later, at Jackson Women's Health Organization in Mississippi.
This was before the Dobbs v. Jackson Women's Health decision that
would take away the Federal constitutional right to abortion. Before 20
more states would ban abortion. Before wait times in states without
bans grew longer and longer.
My dad took off from work, and we drove a total of 720 miles
roundtrip, and spent 13 hours on the road. We spent 5 hours in a hotel
trying to sleep, before going to my first appointment--just to turn
right around and head back home.
Here's the thing: Because of medically unnecessary restrictions on
abortion care in Mississippi, I would have to make the trip all over
again. The state, essentially, put patients in a time-out because they
don't trust people to know what is best for our own health and lives.
When I got this news, I was angry, sleep-deprived, and starving--and as
certain as I ever was that I wanted an abortion. That certainty never
faltered.
The following week my mom was able to find us affordable tickets,
and we flew back to Jackson. We started our day at 7 a.m. for my 1:30
p.m. appointment. After my procedure, I waited in the recovery room for
about 20 minutes, before hopping in a car to make my flight back home.
I want to talk for a moment about money. As a college student who
took out multiple student loans, I was counting every penny.
I had to pay for the appointment in Houston.
Then gas and hotel for the first trip to Mississippi.
Then the first appointment in Mississippi.
Then plane tickets for the second trip to
Mississippi.
Then the abortion itself.
Then I missed 20 hours of work.
And 20 hours of my mandatory internship program.
The total? $2,850.
There is no dollar value I can put on the stress of managing all of
this. The despair of having to go to such lengths for basic, safe
health care that was legal just weeks before I needed it. The gut-
wrenching reality of having to disclose this deeply personal thing that
should be private to professors, my boss, and anyone else in a position
of authority over me for fear of not only losing my job but also
failing out of all my classes due to all the classes and assignments I
missed.
I felt so much anger that politicians in Austin thought they had
the right to make this decision for me.
I am one of thousands of people who have now gone through this.
Every day, every month we go without a Federal right to abortion, there
will be more of us. More savings accounts drained, more classes and
shifts missed, more choices about which bill to skip paying.
If I had found out I was pregnant last year or last month, Jackson
Women's Health wouldn't have been there for me. The people who cared
for me that day cannot care for abortion patients in Mississippi. I
would have had to go to New Mexico, Kansas, or as far as Illinois.
When we talk about abortion, it's easy to get stuck talking in
theoreticals.
But I am a real person.
The lives of abortion patients are not theoretical. People will
continue to get pregnant when we don't want to be. We will always need
abortions.
There is simply no place for politicians to decide for us.
Thank you for inviting me here today and letting me share my story.
______
[summary statement of madysyn anderson]
My name is Mady Anderson, and I live in Houston, Texas. Two years
ago, during my senior year at the University of Houston, I had just
come out of a 2-year relationship. After a couple weeks of nausea and
not sleeping or eating, I took a pregnancy test. I was pregnant.
This was just 2 weeks after Texas's abortion ban, known as S.B. 8,
went into effect, banning abortion after 6 weeks.
I knew almost immediately that abortion was the right decision for
me. I called and got an appointment for the following week at my local
Planned Parenthood, 5 minutes away. I thought I was early enough to be
able to get my abortion that week. But at my appointment my pregnancy
measured at 11 weeks. I couldn't get an abortion in Texas.
The earliest I could be seen was 2 weeks later, at Jackson Women's
Health Organization in Mississippi. This was before the Dobbs v.
Jackson Women's Health decision that would take away the Federal
constitutional right to abortion. Before 20 more states would ban
abortion.
My dad took off from work, and we drove a total of 720 miles
roundtrip, and spent 13 hours on the road. Because of medically
unnecessary restrictions on abortion care in Mississippi, I would have
to make the trip all over again.
The following week my mom was able to find us affordable tickets,
and we flew back to Jackson. We started our day at 7 a.m. for my 1:30
p.m. appointment. After my procedure, I waited in the recovery room for
about 20 minutes, before hopping in a car to make my flight back home.
As a college student who took out multiple student loans, I was
counting every penny. I had to pay for the appointment in Houston. Then
gas and hotel for the first trip to Mississippi. Then the first
appointment in Mississippi. Then plane tickets for the second trip to
Mississippi. Then the abortion itself. Then I missed 20 hours of work.
And 20 hours of my mandatory internship program. The total? $2,850.
There is no dollar value I can put on the stress of managing all of
this.
I am one of thousands of people who have now gone through this.
Every day, every month we go without a Federal right to abortion, there
will be more of us. More savings accounts drained, more classes and
shifts missed, more choices about which bill to skip paying. The lives
of abortion patients are not theoretical. People will continue to get
pregnant when we don't want to be. We will always need abortions. There
is simply no place for politicians to decide for us.
______
Senator Murray. Thank you very much.
Dr. Verma.
STATEMENT OF NISHA VERMA, M.D., MPH, FELLOW, PHYSICIANS FOR
REPRODUCTIVE HEALTH, ATLANTA, GA
Dr. Verma. Good morning, Chair Sanders, Senator Murray,
Ranking Member Cassidy, and distinguished Members of the Senate
HELP Committee. My name is Dr. Nisha Verma, and I'm a board-
certified, fellowship-trained obstetrician and gynecologist,
providing full spectrum reproductive healthcare. I'm a fellow
with Physicians for Reproductive Health, and I'm also a proud
Southerner.
I was born and raised in North Carolina. I currently
provide care in Georgia, and I've lived in the southeast for
most of my life. I made a commitment when I became a doctor to
care for people without judgment throughout their lives. For
me, that commitment holds whether I'm talking a young person
through a first pap smear, delivering a couple's highly
anticipated third child, or supporting a patient and her family
as they decide to continue or end a pregnancy.
However, after the Supreme Court's Dobbs decision, with
Georgia enacting a law that bans most abortions in our state
very early in pregnancy, I struggle every day to provide
necessary lifesaving medical care. I've seen young moms with
worsening medical conditions that make their pregnancies very
high risk, and couples whose deeply desired pregnancies are in
the process of miscarrying, be turned away or forced to leave
their communities to access needed healthcare.
As a doctor, I have the immense privilege of sitting with
patients and learning about their lives. For me, these patient
stories are a powerful reminder that abortion is not an
isolated political issue, and today I want to provide a glimpse
of what access to abortion care means for real people.
Shortly after Georgia's 6-week abortion ban went into
effect in 2022, I saw a young woman who had just started her
junior year of high school, and despite using her birth control
correctly, realized after missing her period that she might be
pregnant.
She called to make a clinic appointment for an abortion
right away, but when she came to see me, she unfortunately was
just a couple days past George's arbitrary cutoff, which bans
most abortions after just 2 weeks from the first missed period.
I had to tell her that even though I have the skills to
help her, I can no longer perform her abortion in our state.
She returned to rural Georgia where she lives and I didn't see
her again until a few weeks ago. At our most recent visit, she
told me that she was unable to find the resources and support
to get out of state for abortion care.
She also couldn't find a doctor in her part of the state
that took her insurance Medicaid for many months, and so even
though she was forced to continue her pregnancy against her
will, she couldn't get prenatal care. After delivering her
baby, she struggled with postpartum depression and had to move
out of her home, drop out of school and work a minimum wage job
to try to make ends meet.
She told me that she loves her son, but this is not the
life she wanted or planned for herself. I have thought about
this patient every day since she came back to my clinic. I know
it was Georgia's laws that prevented me from providing her with
the medical care she needed and deserved, but I still feel like
as her doctor, I failed her.
This patient's story, while heartbreaking, is not unique.
We know that bans and restrictions have forced many people to
stay pregnant, and we know the harm that people experience when
they're unable to get this care. They're more likely to face
long-lasting economic hardship, to stay in contact with a
violent partner and to develop serious health problems.
Mental health conditions like the postpartum depression
that my patient experienced, are the leading cause of pregnancy
related deaths in this country.
We also know that abortion care is incredibly safe. In
fact, in 2022, over 75 major professional societies
representing the overwhelming consensus of the science-based
medical community came together to reaffirm that abortion is
safe, essential healthcare.
As patients face a growing wave of abortion restrictions,
many describe feeling betrayed by a government and healthcare
system that is supposed to serve and protect them. Doctors too
feel betrayed by our government. Many of my colleagues are
overwhelmed by laws that threaten to make us criminals for
providing evidence-based, life-saving care to our patients, and
are leaving their states. And places like Georgia, where
already over 50 percent of counties have no OB-GYNs, these
worsening workforce shortages are devastating for all aspects
of reproductive healthcare.
I understand that abortion care can be a complicated issue
for many people, just like so many aspects of healthcare and
life can be. I also know that abortion is necessary
compassionate essential healthcare, and that patients are
capable of making complex, thoughtful decisions about their
health and lives. No law should prevent them from doing so.
I urge you to listen to the stories of people who provide
and access abortion care. I hope these stories help you 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.
[The prepared statement of Dr. Verma follows.]
prepared statement of nisha verma
Good morning Chair Sanders, Senator Murray, Ranking Member Cassidy,
and distinguished Members of the Senate HELP Committee. My name is Dr.
Nisha Verma, I use she/her pronouns, and I am a board-certified,
fellowship trained, obstetrician and gynecologist providing full-
spectrum reproductive health care. I am a fellow with Physicians for
Reproductive Health, and 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.
I made a commitment when I became a doctor to care for people,
without judgment, throughout their lives. For me, that commitment holds
whether I am talking a young person through a first pap smear,
delivering a couple's highly anticipated third child, or supporting a
patient and her family as they decide to continue or end a pregnancy.
However, after the Supreme Court's Dobbs decision, with Georgia
enacting a law that bans most abortions in our state very early in
pregnancy, I struggle every day to provide necessary, life-saving
medical care. I've seen young moms with worsening medical conditions
that make their pregnancies very high risk and couples whose deeply
desired pregnancies are in the process of miscarrying, be turned away
or forced to leave their communities to access needed health care.
As a doctor, I have the immense privilege of sitting with patients
and learning about their lives. For me, these patients' stories are a
powerful reminder that abortion is not an isolated political issue, and
today, I want to provide a glimpse of what access to abortion care
means for real people.
Shortly after Georgia's 6-week abortion ban went into effect in
2022, I saw a young woman who had just started her junior year of high
school, and despite using her birth control correctly, realized after
missing her period that she might be pregnant. She called to make a
clinic appointment for an abortion right away, but when she came to see
me, she unfortunately was just a couple days past Georgia's arbitrary
cutoff, which bans most abortions after just 2 weeks from the first
missed period. I had to tell her that, even though I have the skills to
help her, I could no longer perform her abortion in our state. She
returned to rural Georgia, where she lives, and I didn't see her again
until a few weeks ago. At our most recent visit, she told me that she
was unable to find the resources and support to get out of state for
abortion care. She also couldn't find a doctor in her part of the state
that took her insurance, Medicaid, for many months, and so even though
she was forced to continue her pregnancy against her will, she couldn't
get prenatal care. After delivering her baby, she struggled with
postpartum depression and had to move-out of her home, drop out of
school, and work a minimum wage job to try to make ends meet. She told
me that she loves her son, but this is not the life she wanted or
planned for herself.
I have thought about this patient every day since she came back to
my clinic. I know it was Georgia's laws that prevented me from
providing her with the medical care she needed and deserved, but I
still feel like, as her doctor, I failed her.
This patient's story, while heartbreaking, is not unique. We know
that bans and restrictions have forced many people to stay pregnant.
\1\ And we know the harm that people experience when they are unable to
get this care--they are more likely to face long-lasting economic
hardship, to stay in contact with a violent partner, and to develop
serious health problems. \2\ Mental health conditions, like the
postpartum depression my patient experienced, are the leading cause of
pregnancy-related deaths in this country. We also know that abortion
care is incredibly safe--in fact, in 2022, over 75 major professional
societies representing the overwhelming consensus of the science-based
medical community, came together to reaffirm that abortion is safe,
essential health care. \3\
\1\ See #WeCount Report, SOC. OF FAM. PLANNING (May 14, 2024),
https://societyfp.org/wp-content/uploads/2024/05/WeCount-report-6-May-
2024-Dec-2023-data-Final.pdf.
\2\ See See Diana Greene Foster, Turnaway Study: Ten Years, A
Thousand Women, and the Consequences of Having or Being Denied an
Abortion, ANSIRH (2020), https://www.ansirh.org/research/turnaway-
study.
\3\ More than 75 Health Care Organizations Release Joint Statement
in Opposition to Legislative Interference, AM. COLL. OF OBSTETRICIANS
AND GYNECOLOGISTS (July 7, 2022), https://www.acog.org/news/news-
releases/2022/07/more-than75-health-care-organizations-release-joint-
statement-in-opposition-to-legislative-interference.
As patients face a growing wave of abortion restrictions, many
describe feeling betrayed by a government and health care system that
is supposed to serve and protect them. Doctors, too, feel betrayed by
our government. Many of my colleagues, overwhelmed by laws that
threaten to make us criminals for providing evidence-based, life-saving
care to our patients, are leaving their states. In places like Georgia,
where already over 50 percent of counties have no OB/GYNs, these
worsening workforce shortages are devastating for all aspects of
reproductive health care. \4\
---------------------------------------------------------------------------
\4\ See Stephanie Colombini, Turning Away Patients Every Day:
Georgia OB-GYN on the Effects of Abortion Bans, HEALTH NEWS FL (May 16,
2024), https://health.wusf.usf.edu/health-news-florida/20240516/
turning-away-patients-every-day-georgia-ob-gyn-on-the-effects-of-
abortion-bans; Adrienne D. Zertuche, Georgia's Obstetric Crisis:
Origins, Consequences, and Potential Solutions, GA. SENATE STUDY CMTE
ON WOMEN'S ADEQUATE HEALTHCARE (Oct. 26, 2015), https://
www.senate.ga.gov/committees/Documents/
Oct%2026%20Ga%20Maternal%20Health%20%20Infant%20Research%20Group%20-
%20Dr%20Zertuche.pdf.
I understand that abortion care can be a complicated issue for many
people, just like so many aspects of health care and life can be. I
also know that abortion is necessary, compassionate, essential health
care, and that patients are capable of making complex, thoughtful
decisions about their health and lives--no law should prevent them from
---------------------------------------------------------------------------
doing so.
I am unwavering in my commitment to support people in my home in
the South. It shouldn't have to be this way. I urge you to listen to
the stories of people who provide and access abortion care. I hope
these stories help you to see how profoundly restrictions on abortion
access harm all of our communities.
Thank you for having me today, I look forward to your questions.
______
Senator Murray. Thank you.
Ms. Lopez.
STATEMENT OF DESTINY LOPEZ, MPA, ACTING CO-CEO GUTTMACHER
INSTITUTE, WASHINGTON, DC
Ms. Lopez. Thank you, Chair Sanders, Ranking Member
Cassidy, Senator Murray, and the distinguished Members of the
Committee for the opportunity to highlight the clear and
growing evidence that the Dobbs decision is harming
reproductive health and freedom.
My name is Destiny Lopez, and I am the acting co-CEO of the
Guttmacher Institute, a leading research and policy
organization committed to advancing sexual and reproductive
health and rights worldwide.
For decades following the 1973 Roe v. Wade decision, anti-
abortion advocates worked strategically to make abortion harder
to get and highly stigmatized. Public support for abortion's
legality has remained high and consistent. But the sheer number
of state-level abortion restrictions ensured that abortion
became inaccessible for many, even with Roe in place.
The Dobbs v. Jackson Women's Health Organization decision
was an inflection point, unleashing chaos and fear across the
Nation. Our experts are constantly assessing this changing
landscape and the increasingly robust body of evidence that
illustrates the harms caused and exacerbated by Dobbs decision.
Two years after the decision, here is what we know: Access
to abortion care is severely restricted in many parts of the
country. 14 states are now enforcing total abortion bans with
very limited exceptions, and many more have other new
restrictions in place. The total number of brick-and-mortar
clinics providing abortion care in the U.S. declined by more
than 40 between 2020 and early 2024.
Banning abortion does not stop the need for abortion
access. Which is why many people seeking abortions post-Dobbs
must overcome huge financial and logistical barriers to get
care, especially those in states with total or early
gestational bans.
The number of Americans traveling out of state for
abortions doubled from 81,000 in 2020 to more than 170,000 in
2023. States that border states with total abortion bans saw
the sharpest increases in out-of-state patients.
No one should have to travel to another state to access
basic healthcare. And in fact, those who can't overcome the
burdens of traveling for care, which for some might mean
crossing multiple state lines, may be forced to stay pregnant
against their will. Others may decide to self-manage their
abortion.
Decades of research have documented that the majority of
people obtaining abortions have few financial resources, are
people of color, and are already parenting. They are the ones
most harshly impacted by bans and restrictions.
We also know that providers are resilient and adapting to
meet patient needs. While brick-and mortar facilities provide
more than three-quarters of all abortions, online clinics are
expanding care options by offering medication abortion services
via telehealth. Research by the Society for Family Planning
shows that virtual-only telehealth abortions accounted for
almost one in five abortions from October to December 2023.
There are many other important ways Dobbs is interfering
with reproductive health care across the Nation that I don't
have time to discuss in detail today, from current and future
OB-GYNs not wanting to practice in ban states to impacts on
maternal health and people facing obstetric emergencies.
What does all this mean? Overturning Roe did not resolve
the debates on abortion that have characterized U.S. politics
for the past 50 years. Instead, it enabled policies that have
significantly worsened the harms faced by individuals who are
most marginalized in our health care system.
Still, despite these immense hardships and many people
being denied care, there were more than one million clinician-
provided abortions in 2023, a 10 percent increase from 2020.
This is a testament to the heroic efforts of providers,
abortion funds and other support networks, to the resilience
and determination of people seeking care, and to the centrality
of abortion in peoples' lives. And it explains why the anti-
abortion movement and their political allies are doubling down
on even more repressive policies.
For instance, this year, four states introduced legislation
and one passed a law criminalizing adults who support
adolescents seeking abortion care in another state. Earlier in
the year, the Alabama Supreme Court's decision to classify
frozen embryos as ``children'', wreaked havoc on fertility
treatment services while advancing the anti-abortion movement's
long-term goal to enshrine fetal personhood in both law and
policy.
These attacks on bodily autonomy, coupled with two major
abortion cases currently before the Supreme Court, signal that
the policy and legal landscape will continue to shift.
The full damage caused by Dobbs will not be clear for years
to come, but the evidence suggests it will not be easy to
repair. That's why it is imperative that policymakers at all
levels of government champion a bold vision of abortion care
that goes beyond what Roe promised.
Only policies rooted in evidence and human rights will
guarantee that all people have meaningful access to high-
quality, affordable abortion care where they live and via the
method they choose. Thank you.
[The prepared statement of Ms. Lopez follows.]
prepared statement of destiny lopez
Thank you, Chair Sanders, Ranking Member Cassidy, Senator Murray
and the Members of the Committee for the opportunity to highlight the
clear and growing evidence that the Dobbs decision is harming
reproductive health and freedom. My name is Destiny Lopez, and I am the
acting co-CEO of the Guttmacher Institute, a leading research and
policy organization committed to advancing sexual and reproductive
health and rights worldwide.
For decades following the 1973 Roe v. Wade decision, anti-abortion
advocates worked strategically to make abortion harder to get and
highly stigmatized. Public support for abortion's legality has remained
high and consistent. But the sheer number of state-level abortion
restrictions ensured that abortion became inaccessible for many--even
with Roe in place.
The Dobbs v. Jackson Women's Health Organization decision was an
inflection point, unleashing chaos and fear across the Nation. Our
experts are constantly assessing this changing landscape and the
increasingly robust body of evidence that illustrates the harms caused
and exacerbated by Dobbs. Two years after the decision, here is what we
know. \1\
---------------------------------------------------------------------------
\1\ Information throughout this testimony is referenced here:
Baden K, Dreweke J and Gibson C. Clear and Growing Evidence That Dobbs
Is Harming Reproductive Health and Freedom, Guttmacher Institute, 2024,
https://www.guttmacher.org/2024/05/clear-and-growing-evidence-dobbs-
harming-reproductive-health-and-freedom.
Access to abortion care is severely restricted in many parts of the
country. Fourteen states are now enforcing total abortion bans with
very limited exceptions, and many more have other new restrictions in
place. The total number of brick-and-mortar clinics providing abortion
---------------------------------------------------------------------------
care in the U.S. declined by more than 40 between 2020 and early 2024.
Banning abortion does not stop the need for abortion access. Which
is why many people seeking abortions post-Dobbs must overcome huge
financial and logistical barriers to get care, especially those in
states with total or early gestational bans. The number of Americans
traveling out of state for abortions doubled from 81,000 in 2020 to
more than 170,000 in 2023. States that border states with total
abortion bans saw the sharpest increases in out-of-state patients.
No one should have to travel to another state to access basic
healthcare. And in fact, those who can't overcome the burdens of
traveling for care, which for some might mean crossing multiple state
lines, may be forced to stay pregnant against their will. Others may
decide to self-manage their abortion. Decades of research have
documented that the majority of people obtaining abortions have few
financial resources, are people of color, and are already parenting.
They are the ones most harshly impacted by bans and restrictions.
We also know that providers are resilient and adapting to meet
patient needs. While brick-and-mortar facilities provide more than
three-quarters of all abortions, online clinics are expanding care
options by offering medication abortion services via telehealth.
Research by the Society for Family Planning shows that virtual-only
telehealth abortions accounted for almost one in five abortions from
October to December 2023.
There are many other important ways Dobbs is interfering with
reproductive health care across the Nation that I don't have time to
discuss in detail today, from current and future OB-GYNs not wanting to
practice in ban states to impacts on maternal health and people facing
obstetric emergencies.
What does all this mean? Overturning Roe did not resolve the
debates on abortion that have characterized U.S. politics for the past
50 years. Instead, it enabled policies that have significantly worsened
the harms faced by individuals who are most marginalized in our health
care system.
Still, despite these immense hardships and many people being denied
care, there were more than one million clinician-provided abortions in
2023--a 10 percent increase from 2020. This is a testament to the
heroic efforts of providers, abortion funds and other support networks,
to the resilience and determination of people seeking care, and to the
centrality of abortion in peoples' lives. And it explains why the anti-
abortion movement and their political allies are doubling down on even
more repressive policies.
For instance, this year four states introduced legislation--and one
passed a law--criminalizing adults who support adolescents seeking
abortion care in another state. Earlier in the year, the Alabama
Supreme Court's decision to classify frozen embryos as ``children''
wreaked havoc on fertility treatment services while advancing the anti-
abortion movement's long-term goal to enshrine fetal personhood in both
law and policy. These attacks on bodily autonomy, coupled with two
major abortion cases currently before the Supreme Court, signal that
the policy and legal landscape will continue to shift.
The full damage caused by Dobbs will not be clear for years to
come, but the evidence suggests it will not be easy to repair. That's
why it is imperative that policymakers at all levels of government
champion a bold vision of abortion care that goes beyond what Roe
promised.
Only policies rooted in evidence and human rights will guarantee
that all people have meaningful access to high-quality, affordable
abortion care where they live and via the method they choose.
Thank you.
______
[summary statement of destiny lopez]
Destiny Lopez is the acting co-CEO of the Guttmacher Institute. Her
testimony will focus on what the research tells us about the impact of
Dobbs, 2 years after Roe was overturned. Ms. Lopez will share the state
policy landscape as it relates to abortion access, including that 14
states are now enforcing total abortion bans. Her testimony will
include data about people traveling out of state for abortion care and
why the lack of abortion access in communities exacerbates inequities
and falls hardest on certain groups. Ms. Lopez's testimony emphasizes
the resilience of providers, support networks and patients in finding
ways to provide and access care--including the increased use of
telehealth to access medication abortion, but makes clear that the
landscape is fraught with chaos, hardships and many people being denied
abortion care. She also notes that the policy and legal landscape
continue to shift--with attacks on IVF and two abortion-related cases
before the Supreme Court--as the anti-abortion movement doubles down on
more repressive policies.
______
Senator Murray. Dr. Linton.
STATEMENT OF ALLISON LINTON, M.D., MPH, CHIEF MEDICAL OFFICER,
PLANNED PARENTHOOD OF WISCONSIN, FELLOW, PHYSICIANS FOR
REPRODUCTIVE HEALTH, MILWAUKEE, WI
Dr. Linton. Chair Sanders, Senator Murray, Ranking Member
Cassidy, Members of the Committee, my name is Dr. Allison
Linton. I'm a board-certified obstetrician and gynecologist as
well as a board-certified complex family planning specialist.
I completed my medical school training, a residency in
obstetrics and gynecology, a complex Family Planning fellowship
and a master's of public health at Northwestern University. I'm
now an assistant professor of Obstetrics and Gynecology in
Milwaukee, as well as Chief Medical Officer of Planned
Parenthood in Wisconsin and a fellow at Physicians for
Reproductive Health.
I have spent my life learning how to provide the highest
standard of care possible to my patients, but because of
decisions made by people in power in rooms similar to this in
Washington and across the country, my colleagues and I can no
longer provide the care we know our patients need.
For the past 711 days since the Supreme Court took away the
constitutional right to abortion, my patients and my colleagues
have been existing in a state of chaos, confusion, and fear.
In my home State of Wisconsin, a statute from 1849 remained
on our books that seemed to ban abortion from the moment of
conception. A law written before the Civil War in the abolition
of slavery, before women had the right to vote, before the
discovery of penicillin.
We had questions about the enforceability of the law, but
without Federal protections, the penalties a $10,000 fine and 6
years in prison were too severe to risk.
All providers in Wisconsin stopped providing abortions
immediately after the Dobbs decision, with the exception of if
an abortion ``is necessary'' or is advised by two other
physicians is necessary to save the life of the mother per the
statute.
For those who have no understanding of the complexities of
the human body or the perils of pregnancy, this exception might
seem self-explanatory. I'm here to inform you Members of the
Committee that it is not.
On one hand, we risk medical malpractice and harming a
patient if we don't act soon enough. And on the other, we risk
criminal prosecution, if a prosecutor feels that we acted too
early. What about a patient with a newly diagnosed breast
cancer at 8 weeks of pregnancy, who cannot start chemotherapy
or radiation while she is pregnant. Is delaying her treatment
until after delivery a risk to her life?
What about a patient with a blood clotting disorder where
pregnancy will further increase their risk of a pulmonary
embolism or stroke. Is the risk of a blood clot enough or do I
have to wait until the actual stroke occurs? What about a 13-
year-old who's the victim of incest. Is the psychological and
physical trauma of carrying a child in her barely pubescent
body enough to justify ending her pregnancy?
What about a mother of three who cannot emotionally or
financially support another child? She is making a loving
decision for the children she already has. Shouldn't she have
just as much right to and control over her body and future as
any other person who needs an abortion?
Regardless of the reason, these are not rhetorical
questions. These are real patients that I encountered and tried
to care for in Wisconsin. In reality, any law that tries to
delineate when an abortion is or is not permitted will never be
able to fully account for the complexities of our patient's
health and our patient's lives.
Each patient's situation is unique and regardless of their
reason for needing an abortion, they deserve healthcare. Since
June 24th, 2022, pregnancy in the United States is far more
dangerous for patients with medical complexities, yes, but also
for people with abusive partners, for people who may not
understand what is happening to their bodies.
For Black women who die from pregnancy and childbirth,
three times as often as white women. And it will only get more
dangerous. The fear of not being able to provide care for
patients as leading practitioners, to move away from states
with abortion bans and restrictions, or to stop treating
pregnant patients.
It's made recruiting providers more difficult. I have had
students request transfer to another state to finish their
training. This means that there is less sexual and reproductive
healthcare where it is most desperately needed.
After a ruling from a state judge on our 1849 law, we
started providing abortion again in Wisconsin in late 2023, but
we still work under medically unnecessary restrictions. These
restrictions include a 24-hour waiting period, a same provider
requirement and a ban on telemedicine abortion. They do nothing
but make it harder for patients to get the care they need,
especially those that live in rural areas of the state.
Abortion bans mean that there is no longer a standard of
care for pregnant patients. They are getting the care based on
the state that they live in, in the wealthiest country in the
world, this is what we're subjecting pregnant people to: chaos,
confusion and fear. My patients deserve so much better. Thank
you.
[The prepared statement of Dr. Linton follows.]
prepared statement of allison linton
Chair Sanders, Senator Murray, Ranking Member Cassidy, Members of
the Committee:
My name is Dr. Allison Linton. I am a board certified obstetrician
and gynecologist as well as a board certified complex family planning
specialist.
I completed my medical school training, a residency in obstetrics
and gynecology, and Complex Family Planning fellowship and Masters of
Public Health at Northwestern University in Chicago, Illinois. I
subsequently moved to Milwaukee, Wisconsin, where I am an Assistant
Professor of obstetrics in gynecology, as well as the Chief Medical
Officer of Planned Parenthood of Wisconsin, and Fellow at Physicians
for Reproductive Health.
I have had the opportunity to teach dozens of ob-gyn residents and
hundreds of medical students over the past 7 years. I have had the
opportunity to work with community partners, expanding access to
contraception and sexually transmitted infection testing and treatment
in multiple Milwaukee health departments. I have given lectures and
trainings across the Midwest in both academic and community settings.
But most of all, I have been honored to take care of patients. I
see them annually for Pap tests and breast cancer screening exams,
catching up on their new jobs, where their kids are going to college,
or what vacation they have coming up. I see them as adolescents when
they have questions about how their body is changing. I see them for
STI testing, discussions of birth control, irregular periods, and
chronic pain symptoms. I sit with them for hours on labor and delivery
as they push to bring a new baby into the world. And I cry with them
when something changes in their life or a new diagnosis is made and
they are forced to make decisions they never thought they would have
to.
Sometimes they come alone. Sometimes with a partner or a friend.
But we are always with them. Their doctors, their nurses, their health
care teams--we support them in every situation, giving them all the
information we can, and trusting them to make the decision that is best
for them.
Unfortunately, our ability to do our job changed 2 years ago. On
June 24, 2022 at 9:10 a.m. Central Time, the Dobbs v. Jackson Women's
Health Organization ruling sent reproductive health care into a
tailspin. For the past 711 days, my patients and my colleagues have
been existing in a state of chaos, confusion and fear.
In my home state of Wisconsin, a statute from 1849 remained on our
books, which seemed to ban abortion from the moment of conception. A
law written before the Civil War and the abolition of slavery, before
women had the right to vote, before the discovery of penicillin. While
there were certainly questions about the enforceability of this law,
due to the harsh penalties associated with violating it--$10,000 fine
and 6 years in prison--all abortions in the state were immediately
ceased. There was only a narrow exception for an abortion that ``is
necessary, or is advised by 2 other physicians as necessary, to save
the life of the mother.'' No exceptions for rape or incest. No further
language to help clarify. Just that one sentence.
For those who have no understanding of the complexities of the
human body or the perils of pregnancy, this exception may seem self-
explanatory. I have heard some say that physicians should know which
cases meet this exception and which don't. That it is up to our best
medical judgment and it's the physician's fault if a patient suffers
from not receiving appropriate care.
As a practicing physician, I can tell you this is NOT self
explanatory. Deciding whether something is or is not necessary to
``save the life of the mother'' is not clear. Phrases like ``threat to
maternal life'' are not a medical diagnosis, and adding phases like
``imminent death'' or ``direct threat'' do not help to clarify.
Medicine is complex and rapidly changing. It is an art where physicians
must take all the information presented and try to predict a prognosis
or outcome. And we are not infallible. Our tools are not infallible.
Telling a physician to ``do our best'' under threat of felony charges
if someone doesn't agree with our best medical judgment is not fair and
it is not appropriate.
As physicians, we are trained to make decisions based on the
medical evidence in front of us. We are taught to minimize risk to our
patients, discuss all medically appropriate options, including their
relevant risks and benefits, and honor patient autonomy when they
choose the treatment that is best for them. As of June 24, 2022 at 9:10
a.m. Central, we were no longer able to do this.
When would an abortion be necessary ``to save the life of the
mother''?
What about a patient who presents with heavy bleeding in the first
trimester, but there is still fetal cardiac activity on ultrasound--can
I remove the pregnancy to stop her bleeding? Do I have to wait for a
certain amount of blood loss? Do I have to wait for her vital signs to
change, or until she needs a blood transfusion, or until she bleeds so
much that she can no longer clot her own blood?
What about a pregnancy affected by a lethal fetal diagnosis such as
anencephaly where the top of the fetal head fails to develop or renal
agenesis where the fetus's lungs cannot develop. Continuation of
pregnancy will never lead to a live child, so is the risk of pregnancy
without any potential benefit enough to justify an abortion?
What about when the bag of water breaks before the fetus can
survive outside the womb? Or a pregnant patient with unresolved
congestive heart failure from her last pregnancy that puts her at a
higher risk of dying in this pregnancy--what percent chance of death
does she need?
What about a patient with newly diagnosed breast cancer at 8 weeks
of pregnancy who cannot start chemotherapy or radiation while she is
pregnant? Is delaying her treatment until after delivery a risk to her
life?
What about a patient with a blood clotting disorder where pregnancy
will further increase their risk of a pulmonary embolism or stroke? Is
the risk of a blood clot enough, or do I have to wait until the actual
stroke occurs?
What about a 13 year old who is the victim of incest? Is the
psychological and physical trauma of carrying a child in her barely
pubescent body enough to justify ending the pregnancy?
What about a mother of three who cannot emotionally or financially
support another child? She is making a loving decision for the children
she already has. She should have just as much control over her body and
future as any other person who needs an abortion, for any reason.
These are not rhetorical questions. They are real patients that my
colleagues and I have encountered and tried to care for in Wisconsin.
In reality, any law that tries to delineate when an abortion is or
is not permitted will never be able to fully account for the
complexities of our patients' health and their lives. Each patient's
situation is unique, and regardless of their reason for needing an
abortion, they deserve health care. These decisions are deeply
personal, and my job is to make sure my patients have all the
information they need to make the best decision for themselves, their
families, and their futures.
Under the 1849 law, instead of being able to follow the medicine--
offering patients all their options and letting them choose--we would
call additional colleagues asking their opinions, we would discuss
cases with our hospital's lawyers. And far too often, we would have to
look our patients in the eye and tell them that despite having the
medical training to help them and knowing that an abortion was a safe
and medically appropriate option, we couldn't help them in their home
state due to a law written over 170 years ago by legislators who likely
had no medical training and certainly had no understanding of modern
medicine.
The consequences of this confusion and fear went beyond what many
would typically consider abortion-related. I received calls from
colleagues asking if they could provide care for a patient who had
experienced a miscarriage. I received calls from colleagues in Illinois
and Minnesota who were seeing patients with ectopic pregnancies who had
been told they could not receive care in Wisconsin.
Of course my first thought was frustration and concern for patients
that were not receiving the standard of care due to fear and
misunderstanding. But you must remember we are physicians--not lawyers.
These physicians were afraid, trying to interpret an archaic, non-
medical law through a modern medical lens. They feared a threat of
prosecution, loss of their medical license, loss of their livelihood
and career. You cannot blame physicians for being afraid when you have
forced them to go against the core tenants of their medical training.
Shortly after the Dobbs decision, my partners and I discussed our
concerns of covering labor and delivery due to fear of what clinical
scenarios may present. We feared being forced to go against our medical
training of providing the standard of care OR providing the standard of
care and putting ourselves at risk of criminal prosecution. I had
similar discussions with my colleagues in the Emergency Department and
institutions across the state. We all felt we were left with an
impossible choice--risk of malpractice and harming a patient or risk of
criminal prosecution?
Since June 24, 2022, pregnancy in the United States is far more
dangerous. For patients with medical complications, yes, but also for
people with abusive partners. For people who may not understand what is
happening to their bodies. For Black women, who die from pregnancy and
childbirth three times as often as white women.
It will only get more dangerous: The fear of not being able to
adequately care for patients has led some practitioners to choose to
move out of their home states or to stop caring for pregnant patients.
It has also made it more difficult to recruit new providers to move
into states where they may face criminal prosecution for providing the
standard of care. In many areas of the country with maternity care
deserts, including Wisconsin, this difficulty retaining and recruiting
providers will only worsen our maternal health crisis. There is less
sexual and reproductive health care where it is most desperately
needed.
In the wake of Dobbs, I learned of several residents and medical
students inquiring about transferring to another state for the
remainder of their training. Speaking to one student, they voiced
concerns not just about not being able to receive adequate training to
provide comprehensive care to their patients after graduation, but
given that they too were of reproductive age, they worried about their
health if they or their partner were to experience a medical
complication during pregnancy.
Unfortunately, confusion and fear was not isolated to physicians
and health care providers. While Wisconsin's 1849 law only threatened
prosecution of the person who performed an abortion and not the patient
themselves, patients were still afraid. I met with patients who told me
they were afraid to come to the emergency room when they were
experiencing medical complications in early pregnancy, concerned they
would be denied care or accused of doing something to themselves to
harm the pregnancy. I spoke with a patient who told me she thought she
wasn't allowed to discuss her thoughts about terminating her pregnancy
with her own family, being under the impression that they could be
charged with a crime if they knew what she was considering. Despite
trying our best as a medical community to reassure patients that they
could trust their health care team and should feel safe seeking help, I
have no doubt that many patients did not receive the care they deserved
due to confusion and fear stopping them from disclosing information to
their providers.
After a ruling from a state judge on our 1849 law, we started
providing abortion again in Wisconsin in late 2023. Now, the lower
court's ruling is making its way through the appeals process. Because
we don't have any affirmative state-wide protection, there is
uncertainty about the future of abortion access in Wisconsin. And we
still work under medically unnecessary restrictions. These
restrictions, including a mandatory 24-hour waiting period, with a
same-provider requirement for medication abortion, and a ban on
telemedicine abortion, do nothing but make it harder for patients to
get the care they need--especially those who live in rural areas of the
state.
I'm glad to see the Senate taking action, from Senator Baldwin's
legislation to help restore the Federal right to abortion, to moving to
pass the Right to Contraception Act and ensuring the right to IVF. All
of this will not fix what has been broken by the Dobbs decision, but it
is a step in the right direction.
Abortion bans mean there is no longer a standard of care for
pregnant patients--they're getting care based on the state they live
in. In the wealthiest country in the world, this is what we're
subjecting pregnant people to: chaos, confusion, and fear.
My patients deserve so much better.
______
[summary statement of allison linton]
My name is Dr. Allison Linton. I am a board certified obstetrician
and gynecologist as well as a board certified complex family planning
specialist.
I completed my medical school training, a residency in obstetrics
and gynecology, and Complex Family Planning fellowship and Masters of
Public Health at Northwestern University in Chicago, Illinois. I
subsequently moved to Milwaukee, Wisconsin, where I am an Assistant
Professor of obstetrics in gynecology, as well as the Chief Medical
Officer of Planned Parenthood of Wisconsin and Fellow at Physicians for
Reproductive Health.
As physicians, we are trained to make decisions based on the
medical evidence in front of us. We are taught to minimize risk to our
patients, discuss all medically appropriate options, including their
relevant risks and benefits, and honor patient autonomy when they
choose the treatment that is best for them. As of June 24, 2022 at 9:10
a.m., we were no longer able to do this. For the past 711 days, my
patients and my colleagues have been existing in a state of chaos,
confusion and fear.
In my home state of Wisconsin, a statute from 1849 remained on our
books, which seemed to ban abortion from the moment of conception. A
law written before the Civil War and the abolition of slavery, before
women had the right to vote, before the discovery of penicillin. While
there were certainly questions about the enforceability of this law,
due to the harsh penalties associated with violating it--$10,000 fine
and 6 years in prison--all abortions in the state were immediately
ceased with the exception of if an abortion ``is necessary, or is
advised by 2 other physicians as necessary, to save the life of the
mother.''
For those who have no understanding of the complexities of the
human body or the perils of pregnancy, this exception may seem self-
explanatory. As a practicing physician, I can tell you this is NOT self
explanatory. Telling a physician to ``do our best'' under threat of
felony charges if someone doesn't agree with our best medical judgment
is not fair and it is not appropriate.
In reality, any law that tries to delineate when an abortion is or
is not permitted will never be able to fully account for the
complexities of our patients' health and their lives. Each patient's
situation is unique, and regardless of their reason for needing an
abortion, they deserve health care. These decisions are deeply
personal, and my job is to make sure my patients have all the
information they need to make the best decision for themselves, their
families, and their futures.
After a ruling from a state judge on our 1849 law, we started
providing abortion again in Wisconsin in late 2023. But we still work
under medically unnecessary restrictions, and we don't have any
affirmative state-wide protection.
Abortion bans mean there is no longer a standard of care for
pregnant patients--they're getting care based on the state they live
in. In the wealthiest country in the world, this is what we're
subjecting pregnant people to: chaos, confusion, and fear.
______
Senator Murray. Dr. Francis.
STATEMENT OF CHRISTINA FRANCIS, M.D., CHIEF EXECUTIVE OFFICER,
AMERICAN ASSOCIATION OF PRO-LIFE OBSTETRICIANS AND
GYNECOLOGISTS, FORT WAYNE, IN
Dr. Francis. Thank you. Chairman Sanders, Ranking Member
Cassidy, and Senator Murray, and Members of the Committee.
Thank you so much for the opportunity to speak to you today. As
a board-certified OB-GYN hospitalist, who manages both high and
low risk pregnancies and has delivered thousands of babies, I
really do have the best job in the world.
Not only do I have the distinct honor and privilege to be
with women and their families during the most exciting,
challenging, and sometimes heartbreaking times of their lives.
Not only do I get to help usher little lives into the outside
world for the first time, but I also serve as an advocate for
both my maternal and fetal patients.
One of the reasons those of us at this table likely chose
the specialty of obstetrics was because of the challenge of
taking care of two patients at once. Induced abortion, which
intentionally ends the life of one of those patients is not
healthcare. It is not performed by the vast majority of OB-GYNs
and it actively harms our patients.
Thankfully, in most circumstances, the lives of our two
patients benefit one another and our mantra of healthy mom,
healthy baby, is a reality. There are, however, still
situations in which a pregnancy complication can endanger the
mother's life. While these most often occur after the point of
fetal viability, currently approximately 22 weeks of pregnancy,
they can occur before this point.
The decision to intervene in these situations is extremely
difficult, and not one that any of us take lightly. I have sat
on the edge of my patient's bed crying with her as we discussed
why we couldn't wait even one or two more weeks when her baby
might survive to deliver her. In these discussions, we
recognize that our intent in intervening is to save the
mother's life, with the unintended consequence of our fetal
patient losing his or her life.
An induced abortion occurs when the goal is to end our
fetal patient's life. In my nearly two decades of practice, I
have never performed an induced abortion, and have also seen
most of my colleagues provide excellent care to women even in
difficult circumstances without abortion as well.
There's been a lot of false information being spread that
laws limiting abortion will prevent these lifesaving
treatments. But honestly, this is absurd. Not only do no state
laws prohibit these treatments, but even state laws restricting
abortion before Roe allowed for them.
There are more than 7,000 members of AAPLOG, along with the
remainder of the 93 percent of OB-GYNs who do not perform
abortions, know that induced abortion does not need to be legal
in order to ensure we can provide our patients with excellent
healthcare. Women deserve fully informed consent and ongoing
medical care. This is yet another point of agreement we should
have at this table.
However, the same abortion advocates who are positing that
women will die from ectopic pregnancies if states restrict
abortion, are the people who have for the last several years,
been advocating for women to receive abortion drugs without
first being seen by a physician. Which is critical to ensure
they do not have an ectopic pregnancy, which occur in one in 50
pregnancies and are the leading cause of maternal mortality in
the first trimester.
This is not good medical care and women seeking abortions
deserve the same level of healthcare as any other woman.
Induced abortion has no health benefits to our patients. It
ends the life of one and often causes significant harm to the
other.
For example, there are more than 160 studies that show an
increased risk of preterm birth in future pregnancies after
surgical abortions. Having sat with a patient during the loss
of her fifth child, due to extreme prematurity after having
surgical abortions with her first two pregnancies, I can tell
you that this is devastating for women and their families.
Abortion also leads to a significant increased risk of
adverse mental health outcomes. The vast majority of the
literature on this issue shows long lasting mental health
effects from abortion, including depression, anxiety, drug
abuse, and suicide for at least 20 to 30 percent of women.
When our Country is already facing a mental health crisis,
we should be minimizing things that contribute to this, not
encouraging them. As OB-GYNs, we love caring for both our
patients. We all desire for women to have the best possible
healthcare and for them and their children to have the best
chance to pursue their goals and dreams.
Pro-life laws have not created a women's healthcare
nightmare. The idea that induced abortion is the only way women
can be successful or healthy has. We now have the opportunity
to change course.
I invite my colleagues at the table, the thousands of OB-
GYNs across this country and you Senators, to lead the way as
we empower women with accurate information as exceptional
healthcare and better solutions for our maternal patients than
ending the lives of their own children.
[The prepared statement of Dr. Francis follows.]
prepared statement of christina francis
GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT
[summary statement of christina francis]
As a board-certified OB/GYN Hospitalist who manages both high-and
low-risk pregnancies and has delivered thousands of babies, I have the
distinct privilege to be with women and their families during the most
exciting, challenging, and sometimes heartbreaking times of their
lives. I am also here as an advocate for my patients.
With the advancements in medical technology and understanding over
the last 50+ years, it is now undisputed fact that, at the moment of
fertilization, a distinct, living and whole human being comes into
existence.
While most pregnancy complications threatening the mother's life
occur after the point of fetal viability (currently approximately 22
weeks of pregnancy), they can occur before this point. The decision to
intervene in these situations, especially preterm, is extremely
difficult and not one that I take lightly. These interventions are not
induced abortions.
There has been a lot of false information being spread that laws
limiting abortion will prevent these life-saving treatments, but this
is simply untrue. Not only do NO state laws currently on the books
prohibit these treatments, but even state laws restricting abortion
pre-Roe allowed for them. The more than 7,000 members of AAPLOG, the
American Association of Prolife OB/GYNs, along with the remainder of
the 76-93 percent of OB/GYNs who do not perform abortions, know that
induced abortion does not need to be legal in order to ensure we can
provide our patients with excellent healthcare.
In fact, excellent healthcare does not include induced abortion at
all. Induced abortion has no health benefits to my patients--it ends
the life of one and often causes significant harm to the other. For
instance, there are more than 160 studies that show an increased risk
of preterm birth in future pregnancies after surgical abortion.
Abortion also leads to a significant increased risk of adverse
mental health outcomes. The vast majority of the literature on this
issue shows long-lasting mental health effects from abortion including
depression, anxiety, drug abuse and suicide for at least 20-30 percent
of women. One large study showed that women who had abortions had a 7x
increased risk of suicide compared to women who carried their
pregnancies to term.
The other witnesses and I have something essential in common. I
assume we all desire for women to have the best possible healthcare and
for them and their children. Prolife laws have not created a women's
healthcare ``nightmare''--the idea that induced abortion is the only
way women can be successful or healthy has. We now have the opportunity
to change course--and tens of thousands of physicians across the
country who do not perform induced abortions are ready to lead the way
as we empower women with accurate information and excellent healthcare.
______
Senator Murray. Ms. Ohden.
STATEMENT OF MELISSA OHDEN, MSW, FOUNDER AND CHIEF EXECUTIVE
OFFICER, THE ABORTION SURVIVORS NETWORK, KANSAS CITY, MI
Ms. Ohden. Chairman Sanders, Ranking Member Cassidy, and
Members of the Committee, thank you for inviting me to today's
hearing. I am Melissa Ohden, the survivor of a failed saline
infusion abortion, and the founder and CEO of the Abortion
Survivors Network.
Babies survived abortions before Roe v. Wade. We survived
during Roe v. Wade, and babies are still surviving abortions no
matter where or how the abortion is performed. These
experiences highlight the fundamental and undeniable humanity
of the pre-born and the needs, fears, and experiences of their
mothers. I appreciate this opportunity to have a serious
conversation about this issue and for stories that highlight
the impact of abortion to be told.
Earlier this year, The Washington Post wrote a story about
a woman named Evelyn that I want to share with you today.
Evelyn's trips to abortion clinics ended differently than
expected. Two separate attempts where medication abortion
failed, and she was found to be too far along to abort a third
time. If we're going to talk about women's experiences with
abortion, then we need to include these stories in this
discussion as well.
I empathize with Evelyn, shocked at discovering that her
first medication abortion failed. As directly quoted, she
fainted when she saw that there was a heartbeat on the
ultrasound and was in and out of consciousness for about 5
minutes.
As a journalist Amber Ferguson wrote with an honesty I
appreciate, ``Evelyn says she didn't know that the pills
sometimes didn't work''. She later learned that 3 percent of
medication abortions fail when the gestation reaches 70 days or
10 weeks according to the American College of Obstetricians and
Gynecologists.
I can tell you that the Abortion Survivors Network hears
these stories from women time and again. They're shocked to
discover they're still pregnant with the baby they attempted to
abort. They try to keep it a secret and often navigate it
alone.
Whether they continue the pregnancy or attempt another
abortion or multiple abortions as Evelyn did. As directly
quoted, desperate Evelyn found a website aid access that
shipped abortion medication across the country.
After speaking with a doctor by phone and paying $150, she
waited for pills that were being mailed from India. This second
course of abortion drugs also failed to end her pregnancy.
Evelyn's story and her daughter's life wasn't over yet. As the
article continues, she found a clinic in Albuquerque that
offered second trimester abortions. She was approaching the
third trimester.
The clinic staff warned about the health risks of having a
surgical abortion so late in her pregnancy, but helped connect
her to two abortion organizations that covered the cost of her
plane ticket, hotel food, and the $12,000 procedure. We need to
pause here and truly consider Evelyn and her daughter.
The support she was offered after the failure of two
medication abortions was to pay for a plane ticket, lodging,
food, and a $12,000 abortion that posed risks to her health.
This is an abysmal response to Evelyn and her baby. Evelyn
needed emotional support, medical and mental healthcare,
financial assistance. Evelyn's baby like me, deserved more than
to be subjected to yet another attempt to end her life.
Could you imagine a child in your own life being subjected
to so-called medical interventions intended to weaken, starve,
burn, or dismember them limb by limb until they die? This is
the reality of abortion and we should be ashamed of it. Evelyn
was found to be 32 weeks pregnant.
According to Southwestern Women's Options, the clinic's
doctors aren't trained to perform abortions after 24 weeks.
Evelyn soon thereafter gave birth to her daughter and she made
an adoption plan, an option they both can live with.
The nightmare here is not abortion bans. The nightmare is
that abortion continues to be aggressively promoted, so that it
is seen as the only option, like a plane ticket and $12,000 for
a late-term abortion.
I ask each of you to consider how different women's and
children's lives, families, our society could be, if just as
much money was spent to provide financial assistance, housing,
education, and employment support, childcare, medical, and
mental health care. This would lead to a new era of women's
empowerment that ends the generational trauma of abortion. This
doesn't have to be a dream. We can make it a reality.
[The prepared statement of Ms. Ohden follows.]
prepared statement of melissa ohden
Chairman Sanders, Ranking Member Cassidy, and Members of the
Committee, thank you for inviting me to today's hearing.
I am a survivor of a failed saline infusion abortion and the
Founder and CEO of The Abortion Survivors Network, which has connected
with over 700 survivors of abortion procedures. Babies survived
abortions before Roe vs. Wade, we survived during Roe vs. Wade, and
babies are still surviving abortions, no matter where or how the
abortion is performed, as I'll be sharing today. These experiences
highlight the fundamental and undeniable humanity of the preborn and
the needs, fears, and experiences of their mothers.
I appreciate the opportunity to have a serious conversation about
this issue and for stories that highlight the impact of abortion to be
told. My hope is that today's discussion is the catalyst for
intellectual honesty, deeper conversations and understanding, and
collective support across the aisle for women, children, and families.
Earlier this year, the Washington Post wrote a story about a woman
named Evelyn. Evelyn was young and pregnant, and the article chronicled
her decision to obtain an abortion and end her pregnancy. This is a
common and familiar story, but this story had a plot twist. Her first
abortion failed, her second also failed, but she persevered and sought
a late-term abortion but was denied it. This, too, may be part of the
familiar narratives. However, the redemption in her story is evident,
as she decided to place her child for adoption and now has a
relationship with her daughter and the woman who raises her. \1\ Her
story is one of a failed abortion, one that I am very familiar with but
many try to deny or hide. When the term ``abortion survivor'' is
dismissed as ``fake news,'' women like Evelyn and my birth mother,
Ruth, are also being dismissed, their experience erased and denied with
the experiences of those who survived--like Evelyn's daughter and me.
---------------------------------------------------------------------------
\1\ Ferguson, Amber. ``After abortion attempts, two women now
bound by child.'' Apri l6 2024. The Washington Post.
If we are going to talk about women's experiences with abortion and
the nightmare of abortion, then we need to include these stories in the
---------------------------------------------------------------------------
discussion, as well.
While Evelyn's trips to abortion clinics ended differently than
expected--two separate attempts with medication abortion failed, and
she was found to be too far along to abort a third time--they stand as
proof that a pregnancy can continue after an abortion. Some of the most
powerful words in this article came from the journalist, who expanded
on and called attention to women's healthcare in America. Let me be
clear: Women in America and around the world deserve better than
abortion.
I empathize with Evelyn's shock at discovering that her first
medication abortion failed. When a family friend and nurse arranged for
bloodwork and an ultrasound at a hospital after months passed without
her menstrual cycle returning, as directly quoted, she ``fainted when
she saw that there was a heartbeat, and was in and out of consciousness
for about 5 minutes'' (1).
As the journalist Amber Ferguson wrote with an honesty I
appreciate,``Evelyn says she didn't know the pills sometimes didn't
work. It is a rare occurrence, but she later learned that 3 percent of
medication abortions fail when gestation reaches 70 days, or 10 weeks,
according to the American College of Obstetricians and Gynecologists.
The odds of failure increase if the patient waits longer than
prescribed to take the second dose of the medication, several medical
experts said'' (1).
Abortion bans have not ended abortion--we've merely seen a shift to
abortion pills. These pills have a lower success rate and result in
women becoming their own DIY abortionist. The results of this access to
abortion are staggering, nearly 1-8 percent of abortion pills fail,
which means that women are still facing the same challenges as before,
and put themselves and their child at risk for repeat abortion attempts
(2345).
How could Evelyn know this when women aren't told this information?
The Abortion Survivors Network hears these stories from women time and
time again--they are shocked to discover they are still pregnant with
the baby they attempted to abort. They are unaware that abortion
procedures, including medication abortion, can fail. They feel shame
and guilt, uncertainty and fear about their baby's future. They try to
keep this a secret and often navigate it alone--whether they continue
the pregnancy or attempt another abortion--or multiple abortions--as
Evelyn did.
Women nationwide could identify with Evelyn's experience because it
weaves several threads of an abortion experience. ``Desperate, Evelyn
found a website, Aid Access, that shipped abortion medication across
the country. After speaking with a doctor by phone and paying $150, she
waited for pills that were being mailed from India. Evelyn had told the
doctor she wasn't sure the date of her last period'' (1).
Shocking as it was for Evelyn, this second course of abortion drugs
also failed to end her pregnancy.
This was not what Evelyn was told would happen. It must have been
agonizing when she realized that not one, but now two medication
abortions failed to end her pregnancy. But her story, and her
daughter's story--her daughter's life--wasn't over yet.
As the article continues, ``She found a clinic in Albuquerque that
offered second-trimester abortions. She was past the halfway point in
her pregnancy and approaching the third trimester, but she still had
time, Evelyn told herself. The clinic staff warned about the health
risks of having a surgical abortion so late in her pregnancy but helped
connect her to two abortion organizations that covered the cost of her
plane ticket, hotel, food and the $12,000 procedure . . . '' (1).
We need to pause here and truly consider Evelyn and her daughter.
The support she was offered after the failure of two medication
abortions was to pay for her plane ticket, lodging, food, and the
$12,000 abortion that posed risks to her health.
This is an abysmal response to Evelyn and her baby. Evelyn needed
emotional support, medical and mental health care, financial
assistance, and answers to the questions she had about the impact
medication abortion attempts had on her developing baby. Evelyn's baby
deserved more than to be subjected to yet another attempt to end her
life. Can you imagine a child in your own life subjected to so called
``medical treatments'' intended to weaken, starve, burn or dismember
them limb by limb until they die?
This is the reality of abortion. And we should be ashamed of it.
Yet this story did not end in an abortion clinic. `I'm so sorry,'
Evelyn remembers the nurse telling her, looking at the screen.`You are
too far along, 32 weeks pregnant,' she said, pausing before adding, `We
can't help you.' The clinic's doctors aren't trained to perform
abortions after 24 weeks, according to Southwestern Women's Options.
``Suddenly out of options for ending the pregnancy, Evelyn began to
consider a future that had once seemed impossible. She would be giving
birth'' (1).
In Deaths and severe adverse events after the use of mifepristone
as an abortifacient, \2\ the researchers found that in 452 patients
with ongoing pregnancy after the use of mifepristone--102 (22.57
percent) chose to continue the pregnancy, 148 (32.74 percent)
terminated again, one miscarried and 201 (44.7 percent) had unknown
outcomes. Although there are a number of ways to interpret these
statistics, for today's hearing to I want to emphasize the researchers'
concluding concern:
---------------------------------------------------------------------------
\2\ Aultman, Kathi et al. ``Deaths and Severe Adverse Events after
the use of Mifepristoneas an Abortifacient from September 2000 to
February 2019.'' Issues in law & medicine vol. 36,1(2021):3-26.
``The significant number of women who chose to continue their
pregnancy after initially choosing termination raises concerns
regarding pre-abortion counseling and informed consent they
received . . . Additionally, the high percentage of women with
ongoing pregnancies for whom there is no follow-up or known
outcome is concerning. As health care providers, we are to
continue to care for our patients and manage any complications
yet in the AER's (Adverse Event Reports) we reviewed this was
not the case for the abortion provider. Furthermore a Federal
directory of known outcomes and birth defects is imperative''
---------------------------------------------------------------------------
(2).
This hearing purports that abortion bans have caused a nightmare
for pregnant women who are facing an unplanned, unwanted, or a
complicated pregnancy. I want to correct that false narrative and
remind you all that the nightmare existed before any bans took effect.
The nightmare is that women have been made to believe that pregnancy is
a problem. The nightmare is that women are told abortion will solve
that problem.
The nightmare is that this ``solution'' continues to be
aggressively promoted so that it is seen as the only solution--like a
plane ticket and $12,000 for a late-term abortion. I ask you to
consider how different women's lives, children's lives, families, our
society could be if just as much money was spent to provide financial
assistance, housing, education and employment support, childcare, and
medical and mental health care. This would lead to a new era of women's
empowerment,that ends the generational trauma of abortion--if that too
pricey, then perhaps, we are spending too much money helping women get
abortions.
When women know there is support available to them outside of
seeking an abortion, then they are empowered and will make choices that
everyone can live with. Evelyn's story proves this can happen. My
story, and countless others, are proof this is an attainable reality in
America, it is not just a dream.
GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT
______
[summary statement of melissa ohden]
Babies survived abortions before Roe vs. Wade, we survived during
Roe vs. Wade, and babies are still surviving abortions, no matter where
or how the abortion is performed. These experiences highlight the
fundamental and undeniable humanity of the preborn and the needs,
fears, and experiences of their mothers.
Earlier this year, the Washington Post wrote a story about a woman
named Evelyn. Evelyn was young and pregnant, and the article chronicled
her decision to obtain an abortion and end her pregnancy. Her first
abortion failed, her second also failed, but she persevered and sought
a late-term abortion but was denied it. If we are going to talk about
women's experiences with abortion and the nightmare of abortion, then
we need to include these stories in the discussion, as well.
Abortion bans have not ended abortion--we've merely seen a shift to
medication abortion. These pills have a lower success rate and result
in women becoming their own DIY abortionist. The results of this access
to abortion are staggering, nearly 1-8 percent of abortion pills fail,
which means that women are still facing the same challenges as before,
and put themselves and their child at risk for repeat abortion
attempts.
This hearing purports that abortion bans have caused a nightmare
for pregnant women who are facing an unplanned, unwanted, or a
complicated pregnancy. The nightmare is that women are told abortion
will solve that problem. The nightmare is that this ``solution''
continues to be aggressively promoted so that it is seen as the only
solution--like a plane ticket and $12,000 for a late-term abortion.
______
Senator Murray. Thank you to all of our witnesses. We will
now begin a round of 5-minute questions and I'll ask my
colleagues to keep track of your clock and stay within those 5
minutes.
Mady, I want to start with you. First off, thank you so
much for being here today, telling your story. I know it is not
easy and it takes a lot of courage to be here in front of all
these people to talk about something so personal to you. We
really appreciate it.
You touched upon in your remarks many hoops that you had to
jump through just to be able to get your abortion, including
traveling, I think you said, over 700 miles round trip away
from your home in Texas to Mississippi. Talk a little bit about
how you felt when you were forced to drive 13 hours, out of
state, to get care. What was going through your head?
Ms. Anderson. Thank you so much for that question, Senator.
There was a lot going through my mind when I was having to go
through the travel. Like I said in my testimony, I was
extremely anxious and sleep deprived, so a little bit delirious
in the part of just wanting to sleep and feel relaxed. I felt
very on edge, constantly fearing what would be thrown at me
next.
Senator Murray. How'd you feel after receiving care in
Mississippi, on the way back home?
Ms. Anderson. When I was able to get my abortion and
receive care, that was the first time I was able to sleep more
than 3 hours and I woke up and I looked at my mom and I started
crying. Because I was like, I got to sleep, I can finally
breathe, and this huge weight just lifted off my chest.
Senator Murray. It's your life and your choice.
Ms. Anderson. Absolutely.
Senator Murray. Dr. Francis, I have a question for you and
I want a simple yes or no. Do you believe that women should
have access to plan B? Yes, or no?
Dr. Francis. I believe women deserve to have accurate
information about their healthcare.
Senator Murray. I'm not asking you that question. Do you
believe that women should have access to plan B?
Dr. Francis. I think that women should be given any
medication under the supervision of a physician.
Senator Murray. You support access to plan B?
Dr. Francis. I support women having access to accurate
information and care from a physician.
Senator Murray. Do you believe that women should have
access to medication abortion? Just yes or no.
Dr. Francis. Chemical abortion are dangerous high-risk
drugs.
Senator Murray. No. Do you believe women should have access
to IUDs? Yes, or no?
Dr. Francis. I believe that again, women should receive
comprehensive healthcare access under the direction of a
physician.
Senator Murray. Access to IUDs. Do you believe women should
have access to IUDs? Yes, or no?
Dr. Francis. I believe that women should have access to OB-
GYN physicians who can counsel them about all of their options.
Senator Murray. I take that as a no. And I want to ask you
for the record today, do you think that IUDs and emergency
contraceptives are abortifacients? Yes, or no?
Dr. Francis. If you look at the package inserts for such as
the copper IUD, it actually clearly states that they do prevent
implantation, even if fertilization has occurred, which would
classify that as an abortive for patients--per the package
insert.
Senator Murray. Okay. I just want to, for the record, Dr.
Francis, your organization has taken the mind-boggling position
in defiance of nearly all medical experts that abortion is
never necessary to save a woman's life. According to resources
that were put out by your organization, you recommend that in
cases of dangerous pregnancy complications, like a massive
placental abruption, women should be forced to labor for 24
hours, even if that means being treated with blood transfusions
in intensive care, and even if their pregnancy is non-viable in
the first place, just so they can deliver an ``intact'' fetus.
It has also been well-documented how your organization is
working behind the scenes with Republican lawmakers to redefine
certain kinds of contraceptives as abortions, so you can
ultimately ban those types of contraception. I think that is
incredibly alarming.
It's really important for people to understand the
Republican minority has specifically invited you to this
hearing today, despite those dangerous positions.
For the information of all Senators, we are going to be
voting this week on the right to contraception. And I hope
everyone truly thinks about what that means for women and how
it would change our entire country and our women's rights
moving forward across the board. So, I just wanted to make that
very clear.
I just have a few seconds left, Dr. Verma really quickly.
Many states, yours included, require many, a lot of time, a lot
of consulting, a lot of multiple trips to doctors. How does
that affect the healthcare system in general?
Dr. Verma. It immensely affects the healthcare system to
make basic medical decisions about whether we can provide care
to a patient in front of us. We're often having to involve
legal representatives, hospital administration, that creates
delays in care instead of just being able to provide the care
that we know is right for the patient sitting in front of us.
Senator Murray. Thank you. And I am out of time, so I will
turn it to Senator Cassidy.
Senator Cassidy. I'll defer to Senator Mullin.
Senator Mullin. Thank you. And thank you, Chairwoman. I
just want to actually commend everybody for actually having a
good conversation here. I expected this to actually be pretty
rambunctious, and so for that, I'm probably going to leave a
lot of my questions out because I came here to be punchy.
[Laughter.]
Senator Mullin. I think it's important that I share a
story. And then I do have a couple of questions too, because I
do appreciate everybody's opinion. And that's what this is
about, is about having a conversation. And I think put in a
context of why I'm so pro-life may help a little bit of the
understand our positions, right?
I've been married for 27 years. I got married when I was
19. My wife was 18. First question my father-in-law asked me
when I asked to marry my wife, Christie is, is she pregnant?
I was like, no, I don't think so. And at 7 years later, we
were still trying to have kids. And my wife had endometriosis,
and it took a long time to have kids. We went through
everything you can think of in vitro, through shots, through
you can imagine. And then she got pregnant, and that was my
Christmas gift, 1 year I got out of my stocking.
It was quite an exciting time and we went through the
pregnancy and we went to the first doctor visit and how excited
it was. And then we went later on and we heard the heartbeat
the first time. And I'm going to tell you, that was a child to
me. I mean, I was so excited. We were thinking them names. We
were going through the whole process. And man, I can't tell you
the excitement I had.
I literally, I'm not even a crier at that time. Now, I talk
about my kids, I cry all the time. But I remember getting
emotional for the first time and I was thinking, what is this
inside of me, a tear about to drop out of my eyes.
But then while through the pregnancy, she went back in and
she had a miscarriage. That was a death to us, hundred percent
death to us, so no one will say that wasn't a death. That was a
child when I heard the heartbeat, and it was a death when we
didn't hear the heartbeat. And it was extremely difficult for
my wife and I.
Fortunately, literally, the month that child was due to be
born, we found out we were pregnant again. And his name is Jim
Martin Mullin, and after my dad.
15 months later, we had another one because people that
tell you, you can't get pregnant when breastfeeding, lies,
because you can. And his name is Andrew Daniel Mullin.
Three years later, after the doctor said she couldn't get
pregnant anymore, and she was going to have to have a
hysterectomy, we had another one. And her name is Larra, and
she's 15, Larra Mullin, and lord, she's 15. And love her to
death.
Then my wife and I decided we were not going to have kids
anymore, and I got a vasectomy and she got an ablation. And yet
we still collected three more kids. Because there were three
kids that deserved a home and two mothers that loved those
children so much instead of aborting them, they were brave
enough to carry them.
Gave Christie and I an opportunity to love these three
wonderful kids, two twins named Ivy and Lynette that we'd
adopted when they were 2 years old, and now they're 13. And
Jace, who is wrestling at Oklahoma State as we speak, I was in
Ohio with him this week. And his mother was just barely 20
years old. And the twins' mother was 15 when she got pregnant.
I thank God every day, literally every day that those
mothers gave Christie and I an opportunity to be blessed and be
loved by these three kids.
There's options. What's sad is when you look at
statistically speaking is that, over 50 percent of the
pregnancies inside the United States is unplanned, but 50
percent of all pregnancies also end in abortion. That's sad. I
mean, you're lucky to be born right now, and inside DC its 51.5
percent of all pregnancies, meaning we end more pregnancies
here in Washington DC than we actually have. Something's wrong.
Abortion has become almost a point of convenience. While we
understand it's unplanned, but that child deserves an
opportunity to be in a loving home, just like my three kids
are. I tell everybody we had three, we got stuck with, and
three we chose. Which ones do you think we love the most?
I'm blessed, Christy and I are blessed, but we got to talk
about the reality here. And we're not talking about rape and
incest and high-risk births. Those account for less than 9.5
percent of all births out there. 8 percent are high risk, 1
percent are rape, point less than 0.5 percent of from incest.
We're not talking about those abortions; we're talking about
others.
Guys, we can do better as a country. And that's what this
conversation is about. We have to talk about it. Just give
these kids an opportunity to live. They'll bless somebody,
because Our kids bless us every single day. With that I yield
back.
Senator Murray. Senator Sanders.
The Chair. Let me thank all of the panelists for their
testimony. I think we can all agree that the issue we're
discussing today is an emotional issue. It is a difficult
issue. And sincerely people have different points of view on
the issue.
I would like to direct my questioning to doctors Verma and
Linton, and ask them this. No doubt you have experienced women
and their partners who have jumped for joy when they learned
that they were pregnant and that you did everything you could
to make sure that the pregnancy was successful.
I suspect you have also met with many women who, for a
variety of reasons, whatever they may be, health reasons,
economic reasons did not jump for joy when they learned that
they were pregnant.
My question to you is a pretty simple one. I'm assuming
that you have worked with people in all walks of life, all the
economic levels, races, so forth. Who do you think is best
prepared to make the decision about the future of that
pregnancy? Is it people in a legislature, generally speaking
often dominated by men, or would it be the people who are
feeling the impact of that pregnancy?
Understanding, I would suspect you've never told anybody
they should not have an abortion, right? We respect people's
different points of view. Who should make that decision based
on your experience? Dr. Verma.
Dr. Verma. Yes. Thank you for that question. Based on my
experience, people are the experts in their own lives and are
able to make these really complicated decisions about their own
lives.
I want to say I appreciate Senator Mullin sharing that
story. I, myself have struggled with infertility, and I've
experienced a first trimester miscarriage that I found
devastating. And so, I am not at all saying that pregnancies
don't have value. That value is different for different people,
and the way that people connect with their pregnancies is
different.
Each person is capable of making these really important,
sometimes complex, sometimes difficult decisions about their
healthcare and their life. Even if that sometimes means ending
a pregnancy.
The Chair. Dr. Linton on this enormously personal decision,
should it be a state legislature that makes it for every woman
in the state, or should it be the woman herself?
Dr. Linton. I agree wholeheartedly with Dr. Verma. I think
this is a decision that only the patient can make. Every single
patient situation is unique. Our patients live very complicated
lives. And I think that we have to trust them.
Our job as physicians is to meet patients where they are,
provide them the information that they need, and then support
them in whatever decision they make for themselves and for
their futures.
The Chair. All right, let me ask the doctors again. If you
were a young physician wanting to practice medicine, would you
gravitate to a state which has a harsh anti-abortion law?
Dr. Verma. Thank you. This is really difficult for me. I'm
from the south. I love the south. It is my home, and it has
been really hard to grapple with wanting to serve my community,
but being in an environment where I have to face threats of
criminal prosecution, of having my license removed for simply
providing medicine.
I have had thoughts about leaving, even though I love my
home and my community, and I talk to medical students and
residents every day who are in that same position. They love
the south, they're from the south, but are choosing to leave
because they can't get the training and they can't practice in
the way that they want to.
The Chair. A time when there is already a shortage of
physicians in that area. Correct?
Dr. Verma. Yes. And in Georgia, 50 percent of counties do
not have an OB-GYN. And as doctors leave, that doesn't just
affect access to abortion care, it affects access to all types
of care, to prenatal care, to miscarriage management.
Already at the hospital I work at, I see patients coming to
labor and delivery who have received no prenatal care because
they haven't had access to that care that's just going to get
worse and worse and make pregnancy riskier and more dangerous.
The Chair. Excellent. Your experience regarding that?
Dr. Linton. I would agree. I think that the concerns that I
hear from trainees are sort of twofold. The first is similar to
what Dr. Verma was speaking about, wanting to make sure they
receive that comprehensive training. They want to be able to go
into practice and feel prepared that they can provide whatever
care is necessary to serve their patients.
But I think it's also important to remember most of our
trainees are of reproductive age, and they also need to think
about what would happen if they experienced an unintended
pregnancy or an unexpected health outcome. So, yes, I have
heard from many of my trainees concerns about staying in state
or certainly about thinking about these restrictions when
deciding where they aim to practice in the future.
The Chair. Thank you.
Senator Murray. Senator Cassidy.
Senator Cassidy. Thank you, Madam Chair. Ms. Ohden, thank
you for sharing your story. Thank you all. This is a very
difficult topic and this is part of that dialog and so, so
thank you all. Ms. Ohden, I understand that you have a child
with special needs. Can you relate the counseling you received
where you suggested that you get an abortion or how can you
relate that?
Ms. Ohden. I do appreciate everyone sharing such personal
stories. I think this is part of what we need to do is share
our stories more, but listen more as well. No matter what side
of the aisle we're sitting on.
Not only am I someone who survived an attempt to end my
life at approximately 31 weeks gestation by a saline infusion
abortion, I'm also a woman who has had a first trimester
miscarriage and have felt that pain. And not just myself, my
husband as well. I remember his pain so distinctly.
I also have a child who was born with complex medical
needs. I was 36 years old, fast approaching 37. And so even
prior to finding out that my daughter had a prenatal diagnosis,
I was being pressured time and time again with conversations
about abortion because of my advanced maternal age at 36.
To the point that even prior to my 20-week ultrasound, I
had to call up the OB-GYN's office and let them know that I
found it so offensive for them to continue to state abortion
time and time again based on my own personal history that I was
asking, they not do it again, or I would need to go to another
practice.
I can tell you my daughter is almost 10. She is an
incredible young woman who has overcome a lot. And as she is
raised, to know that she has the same dignity and value as
everyone else in the room. That everyone is made differently.
And yes, some of us see different doctors for different health
issues at different times, but she is someone who experiences
incredible joy and is living a great life.
Senator Cassidy. Thank you. Dr. Francis, I think that
Senator Murray was suggesting that you were trying to duck her
question when you said that people needed to be counseled, but
your testimony is very nuanced.
Now, some of the testimony we've heard has suggested
somehow that women, particularly minority women, particularly
African American women, and their long-term health outcome is
hurt by not having ready access to abortion.
Yet you quote data, and I just compliment you on just how
this is chockfull of references and studies, it's like a white
paper. Can you give a little bit more nuance about how someone
should be counseled that abortion does not necessarily save a
life? In some ways, it brings further complications.
Dr. Francis. Yes, absolutely. Thank you, Senator Cassidy,
for that question. As you said, we do see disparate health
outcomes in this country, unfortunately especially in minority
women. But we also see that Black women have a much higher rate
of abortion than do white women.
This has not improved their health outcomes. In fact, their
maternal mortality rates are worse. Their preterm birth rates
are worse. And, as I stated, there are more than 160 studies
that show a link between surgical abortions and preterm birth.
In fact, the patient whose story between----
Senator Cassidy. Wait, surgical abortion and preterm birth?
Dr. Francis. Yes, preterm birth in future pregnancies. In
fact, the Institute of Medicine has acknowledged that surgical
induced abortions are an immutable risk factor for preterm
birth in future pregnancies.
Senator Cassidy. The increased loss of unborn or
miscarriage children in some, may be, you're saying there may
be a causation associated with their previous history of
abortion.
Dr. Francis. Correct. That's what the studies suggest.
Senator Cassidy. Is there academic literature supporting
that?
Dr. Francis. 100 percent. There are very large systematic
reviews, and as I said, the Institute of Medicine has
acknowledged this as well.
Senator Cassidy. When you say in response to Senator Murray
that someone should be counseled, they should be counseled!
Dr. Francis. Absolutely. In fact, that patient that I sat
with who had lost her fifth child due to a condition called
cervical insufficiency, where her uterus literally could not
hold a baby in, to the point of viability anymore. One of the
things I thought about is, let me just----
Senator Cassidy. Just because we have limited time, and you
also quote data showing that in countries that have prohibited
abortion after previously not allowing it, maternal mortality
has not worsened. Suggesting that this kind of idea that
abortion saves women's lives has not been borne out by empiric
experience.
Dr. Francis. Correct.
Senator Cassidy. Dr. Linton. In your testimony, you say
something along the lines that suggesting that there shouldn't
be any restriction, but I go back to that child. Now we know
it's rare for someone late term without a reason to have a
child like this aborted, but it does occur. And in nine states
plus a city in which we are currently, it's allowed.
Does this child really have no rights whatsoever? I mean,
should that child, knowing I'm giving you the hypothesis, the
mama does not have a risk, this is just a decision to abort.
Is there no consideration to be given of this? Because I
have to understand, we have to have a dialog, but I'm seeing if
there's actually a common ground here. Your mic, please.
Dr. Linton. Thank you, Senator Cassidy for that question. I
think that these sorts of extreme hypotheticals really give
no----
Senator Cassidy. No, these occur and it's legal. And this
side, the Democratic aisle actually wants that to be the law of
the land.
Dr. Linton. I think what you are describing is----
Senator Cassidy. My question is--because now I'm going to
just say Senator Murray thought Dr. Francis was trying to duck.
Maybe it's a yes or no. If it's not for the health of the mama,
the life of the mama, et cetera, should this child have no
rights in the decision to abort at week 40 when otherwise if
the child was delivered, the child would be alive.
Dr. Linton. Senator Cassidy, respectfully, I don't think
this is a question that we can whittle down to a yes or no. I
think pregnancy is much more complicated than that.
Senator Cassidy. Do they have a right?
Dr. Linton. I would say that every situation is unique. And
when a patient presents----
Senator Cassidy. I will say at this point, the inability to
answer that is troubling. And with that I yield, because I'm a
minute over. I'm sorry.
Senator Murray. Senator Casey.
Senator Casey. I was going to ask a question to Dr. Verma.
Dr. Linton, anything else you wanted to say in response?
Dr. Linton. Thank you, Senator. No, I was simply going to
say that I think every situation is unique and our job as
physicians is to take all of the information that a patient
provides us and give them the option to decide what is best for
themselves and for their bodies. Thank you.
Senator Casey. Thank you. And I'll start with Dr. Verma. I
want to go to Dr. Verma in page one of your testimony, you say,
and I quote, I've seen young moms with worsening medical
conditions that make their pregnancies very high risk. And
couples whose deeply desired pregnancies are in the process of
miscarrying, be turned away or forced to leave their
communities to access needed healthcare.
Tell me how that reality that has surfaced most recently.
Tell me how that reality has affected your ability to care for
your patients, No. 1. And No. 2, how has your relationship with
those patients changed?
Dr. Verma. Thank you for that question. It has been
devastating to have to look at patients and say, I can't help
you. I can't provide this care, or I have to wait for you to
get sicker before I can potentially provide this care.
It creates a huge amount of mistrust that patients have for
both the healthcare system and the government. There is not a
line in the sand where someone goes from being totally fine to
acutely dying. It's often a continuum. And even when state laws
like Georgia's have exceptions for things like medical
emergency, it's unclear to us as the doctors when we can
intervene.
If I could just take a second to go back to Dr. Cassidy's
point here. I just really want to highlight that the situation
of doing an abortion at the moment of birth doesn't happen. As
a doctor who provides full spectrum reproductive healthcare,
including OB care, I love taking care of people on labor and
delivery. I provide abortion care. That doesn't happen.
It is a false hypothetical that is meant to create
additional stigma around abortion care. If a patient comes in
at 40 weeks, their options are a C-section and a vaginal
delivery. And this misinformation is really dangerous to our
patients.
I also just want to highlight that 90 percent of abortions
in this country occur in the first trimester, and less than 1
percent are occurring after 20 weeks, when in most cases,
something has gone terribly wrong with the patient or the
pregnancy. And that person really needs that care for some
reason.
Senator Casey. Doctor, thank you. And I want to turn to Dr.
Linton for her to make reference to her testimony. I'm looking
at both pages. The bottom of page 2 and the top of page 3. On
page 2, you pose this question, ``When would an abortion be
necessary, quote, to save the life of the mother?''
You point to a couple of examples. ``What about a patient
who presents with heavy bleeding in the first trimester, but
there is still fetal cardiac activity on ultrasound. Can I
remove the pregnancy to stop the bleeding? Do I have to wait
for a certain amount of blood loss?''
Then you continue at the top of the page with a few more
examples. ``A pregnant patient with unresolved congestive heart
failure from her last pregnancy that puts her at higher risk of
dying in this pregnancy. What percent chance of death does she
need?''
Next question. ``What about a patient with a newly
diagnosed breast cancer at 8 weeks of pregnancy who cannot
start chemotherapy or radiation while she's pregnant, is
delaying her treatment until after delivery a risk to her
life?''
Finally, at least of the examples I'm pointing out, ``What
about a patient with a blood clotting disorder where pregnancy
will further increase the risk of a pulmonary embolism or
stroke? Is the risk of a blood clot enough, or do I have to
wait until the actual stroke occurs?''
You go on from there with other examples and you say,
``These are real patients that my colleagues and I have
encountered.'' I'd ask you the same question. How has that
reality since the Dobbs decision changed your ability to care
for your patients and your relationship with your patients?
Dr. Linton. Thank you for that. I think I would go back to
that same idea of this culture now of confusion and fear. All
of those cases that I mentioned in my oral and written
testimony, those are real patients that I have encountered,
that my partners and I debated, did we meet this, arbitrary
phrase from an 1849 law or not? Do we need to call lawyers? Do
we have to consult other physicians?
We were not able to just follow the medicine in these
cases, and adding words such as imminent death or immediate
death, that doesn't help clarify anything further. So, I would
reiterate what Dr. Verma said. These are impacting our ability
to care for the patients in front of us in a timely and
appropriate way.
Senator Casey. Thank you.
[Technical problems]
Senator Murkowski. I want to thank you all for being here
for your testimony and for sharing deeply personal stories. As
has been repeated here, and we know to be true, access to, to
reproductive care, the issue of abortion itself, decision to
terminate a pregnancy is deeply, deeply personal. It's
complicated.
Clearly there are views that Americans have on this issue
that present deep and conflicting convictions. And so just the
ability, the opportunity to have true discussion and
conversation about it, I think is important.
I have been pretty clear where I stand on this issue. I
think the choice to have an abortion should ultimately be in
the hands of the woman, of the individual, not the government.
But I also believe that it's reasonable not to require those
who are firmly opposed to abortion to support it with their
income tax dollars, and that providers who do not wish to be
involved in abortion should not be forced to do so.
That's why I've worked with several other colleagues here.
Senator Collins, Kaine, Sinema, and I have this bipartisan
legislation to ensure that the rights that women have relied on
for the past 50-some-odd years, those that were set out Roe and
in Griswold are protected. I think that they should be
protected.
We establish a Federal right to choose and reaffirm the
right to contraceptive access without raising concerns about
religious freedom and provider conscience protections. So, my
position on this is clear, but I'm also pretty clear-eyed in
recognizing that it's unlikely that the Congress is going to
pass legislation that would establish clearly that right to
abortion, certainly in this Congress.
But I will tell you, I continue to hear from so many in my
state, women in Alaska who are concerned about access to
abortion, access to reproductive services, even while we are a
state where we have included in our state's constitution, a
right to privacy that protects that access to abortion.
But what we have seen from decisions across the country in
the lower 48, is a ripple effect that has come all the way up
to the North. Planned Parenthood in South Soldotna Alaska
location closed in anticipation of the trigger laws that were
coming online that would require more resources in other
states.
We think that we are far enough that we're protected, that
access is protected, but there are implications that move
beyond those state boundaries. And so women are asking me about
access. We are a very, very rural state in the first place.
Access to providers is limited in the first place. And
certainly, access to abortion has also been limited.
I am going to throw this out to anybody on the panel. What
can we do practically, right now, to help ameliorate some of
what we are seeing with the impact of the Dobbs decision to
ensure that women do have access to the care that they need
now.
I wasn't here when you presented your testimony Ms.
Anderson, but I can't imagine how difficult, when you're
already in a very stressful situation, the thought that I might
have to travel hundreds of miles, extraordinary expenses to
travel, but the access to care is so limited. I've given you no
time to answer, but does anybody have anything, Ms. Lopez, go
ahead.
Ms. Lopez. I'm happy to answer. Thank you for the question
and for the describing the experience in Alaska. I mean, I
think one of the things we can do, Senator, is ensure that we
can maintain access to medication abortion, right? Medication,
abortion now accounts for two-thirds of all abortions in this
country as of 2023.
In rural areas like yours, it's incredibly important to
have that option via telehealth for folks who can't reach a
provider or when they live in communities as the doctor said,
that don't have providers given the limited access to providers
that they have. And so maintaining access to a method that we
know is safe and effective based on decades of widespread use
and study I think becomes critically important.
Senator Murkowski. Thank you for saying that. I absolutely
agree. Thank you, Mr. Chairman. Thank you.
Senator Murray. Thank you.
Senator Murphy.
Senator Murphy. Thank you, Senator Murray. Thank you all
for being here today for your testimony. In Connecticut we
often hear from our physicians that we should not labor under
the belief that there are safe states, right? Connecticut is a
state today that protects the right to full reproductive
healthcare for women, for families.
But we know what the agenda is. We know that the agenda of
Republicans in the Senate and Congress is to pass a national
abortion ban, and we are potentially months or years away from
losing those protections in Connecticut.
But the doctors in my state tell me that this myth of the
safe state is also due to the fact that the bans that are being
passed in states that aren't Connecticut are fundamentally
changing the practice of medicine and medical knowledge in the
United States. And so, Senator Sanders started to explore, I
think this really important issue, but I wanted to build on his
questioning. I think I have two questions to ask, and maybe
I'll pose the first one to Dr. Verma and Dr. Linton.
What does it mean that we now have a growing number of
states that are not training physicians in the suite of
services related to pregnancy loss?
What does it mean that we have physicians today that are
emerging from education in those states that potentially do not
have the full scope of training on how to manage medical
challenges like miscarriages or complications such as
infections or hemorrhaging that could stem from pregnancy loss?
This seems like a significant challenge for our Country.
How is medical education changing when you have so many
residents and medical students who are simply not getting the
same kind of comprehensive education around reproductive
healthcare?
Dr. Verma. Thank you for that question. Over 50 percent of
OB-GYN residencies are in states that have enacted bans or very
restrictive abortion laws, and that's absolutely affecting
resident training and medical student training. I think it's
important to highlight here that it's the same procedures, the
same medications that we use when we're providing abortion care
that we also use when someone comes in experiencing a
miscarriage or experiencing a pregnancy loss.
It's very concerning that more and more doctors are not
going to be able to provide all options for care to someone who
comes in, for example, at 14 weeks bleeding after breaking
their water and is sick and needs care.
I absolutely think this is going to affect the ability for
people to get all types of care across the country. It's
particularly going to affect women in rural areas in certain
parts of the country. And I think that's really devastating
when we're already experiencing such a healthcare crisis and
maternal mortality crisis.
Senator Murphy. Dr. Linton.
Dr. Linton. I agree with Dr. Verma, I will say immediately
after the Dobbs decision, there are certain requirements that
trainees have to achieve or things that they have to learn in
order to satisfy the requirements of residency training,
specifically in OB-GYN.
I can tell you that in the immediate after fact of
aftermath of Dobbs, trying to find places for those learners to
go and receive that training was incredibly difficult. As you
mentioned, one of the safe states or haven states not only are
these states being asked to take care of an influx of patients,
we are also asking them to take care of an influx of learners.
And all of that is just being compounded and compounded.
I agree with Dr. Verma. I am concerned about the future of
our ability of our workforce to be able to care for patients in
a variety of settings.
Senator Murphy. Well, Ms. Lopez, let me ask you that
question about the broader workforce challenge, because our
state reports that we are seeing an influx of individuals for
training, but what we also know is that in states that have
passed these abortion bans, they have seen a 10 percent decline
in applications for OB-GYN residencies.
We're not seeing a 10 percent increase in our states, in
part because we have a set number of residency slots that's not
going to change overnight. And so, the net effect here at a
moment when we were already desperate for more individuals to
go into this care, seems to be a doubling down of a workforce
crisis that is going to affect every woman and every family
across this country, no matter which state you live in.
Ms. Lopez. Absolutely. Thanks, Senator, for that question.
Absolutely. And these folks are not just providing abortion
care, right? They're providing the full range of reproductive
care, which means that if you are seeking prenatal care or
contraception or IVF or any of the number of reproductive care
options, you will not have those providers available.
We already have maternity care deserts around this country.
Those will only increase as well. And I think it also forces
doctors to think about, do they want to risk criminalization
for providing this standard medical care, this basic medical
care.
Senator Murray. Thank you.
Senator Budd.
Senator Budd. Thank you, Madam Chair. Thank the panel and
for your stories and testimoneys. So, after the Biden
administration's FDA, it ended in-person dispensing
requirements. As I understand, chemical drugs are now routinely
available without any medical supervision.
Dr. Francis, can you tell us about abortion reversal pills
and why it's important for states to make sure that pregnant
women have access to information about these pills?
Particularly those women who are considering abortion? Dr.
Francis.
Dr. Francis. Thank you, Senator Budd, for your question. If
I can first just highlight the dangers of the, the FDA's
decision to lift that in-person dispensing requirement, because
that will tie into abortion pill reversal as well.
What that removes from women is any kind of medical
oversight. It removes the opportunity to document how far along
in their pregnancy they are. Many women are wrong about how far
along in their pregnancy they are. And we know that the farther
along in pregnancy a woman takes those drugs, the higher the
risk of complications.
It also removes the possibility of adequately screening for
ectopic pregnancy. And it also removes the real possibility for
a woman to receive fully informed consent. That's a really
important part of ensuring that before a woman takes these
drugs, that she is in fact not only sure of her decision, but
aware of the potential risks that she's facing by taking those
drugs.
We know that now women are receiving less counseling, more
and more women are deciding after taking that first drug, the
mifepristone pill, that they regret their decision and they
desire to save their child's life.
I know this because I'm a member of the Abortion Pill
Reversal Network. I'm a provider of that treatment, which
involves giving a woman natural progesterone, which can
counteract the effects of the first mifepristone.
It's essential that women are aware of this, not only
because they're not receiving adequate counseling now before
they receive these drugs, but so that they know if they make
the choice, if we really are supportive of women having
choices, we should support their choice if they decide that
they regret their abortion and, and would like to save their
child's life.
Senator Budd. Thank you. So, you're saying that there's
more dangerous health outcomes with the lifting of the medical
supervision, correct?
Dr. Francis. Absolutely. So, even according to the FDA's
own data, 1 in 25 women who take these drugs even with medical
supervision, will end up in the emergency room. But I can tell
you, having gone down to the emergency room in my own hospital
many times to care for women who are facing life-threatening
complications after taking these drugs, it is more common now
that they're not being seen in person first.
Senator Budd. What's the window of time from taking the
chemical abortion drugs to the reversal?
Dr. Francis. It's most effective if it's taken within the
first 72 hours, but especially within the first 24 hours. So,
it's imperative that women have this information so that they
know if they change their mind that there is a treatment that
they can access.
Senator Budd. In light of FDA ending in-person dispensing
requirements for these drugs, could you talk about how human
traffickers are exploiting the lack of protections that used to
exist for women?
Dr. Francis. Well we certainly know that there's a link
between human trafficking and forced abortions that's been
shown very clearly. And it's also been shown that one of the
main points of contact for a trafficking victim to get help is
actually with a medical professional.
What we've done now is we have removed that point of help
for a woman, and we've also allowed for traffickers, a way for
them to be able to access these drugs online. It's been well
documented that women who are not pregnant are receiving these
drugs after going online and ordering them.
I personally talked with a woman who is in her sixties who
got these drugs. She just wanted to see if she was able to get
it, and she was able to get these drugs. So, it is now possible
for anyone to go online, get these drugs. Traffickers could
stockpile them so that they could force them on their victims,
to force abortions as they have in the past.
Senator Budd. Can you walk me through some of the
ramifications of S. 4381 given that it waives protections from
the Religious Freedom Restoration Act? This is the
Contraception Legislation that's before us right now. So, I
believe it's S. 4381 and it waives protections from the
Religious Freedom Restoration Act.
Dr. Francis. Thank you for the opportunity to also clarify,
I think one misunderstanding of my organization's position on
contraception. So, we actually don't take an official position
on contraception.
However, we would support the right of any physician to
abstain from prescribing any medication or participating in any
procedure that violated either their religious beliefs or
violated their own conscience. And if they feel that it
violates the oath that they took as a physician, then we would
support the right for any physician to be able to abstain from
prescribing those medications.
Senator Budd. Thank you, thank you panel.
Senator Murray. Senator Hassan.
Senator Hassan. Well, thank you very much, Senator Murray,
and to the Chair, and Ranking Member Cassidy. Thank you for
this hearing, and to all of the witnesses, thank you for being
here today. I've received thousands of messages from
constituents in New Hampshire urging me to protect reproductive
freedom since the Supreme Court overturned Roe v. Wade.
On that day, the women of America lost a fundamental
freedom. Every woman should have the right to control her own
life, and that includes the right to make her own healthcare
decisions. And with deep respect for my colleagues on the other
side of the dais, women know what a pregnancy is.
I too in response to Senator Mullin, I had a miscarriage at
12 weeks in a pregnancy between the birth of my son and the
birth of my daughter. It was as devastating for me and my
husband and our family as Senator Mullin described the
devastation that he and his family experienced.
Right now, though, women are facing a danger in our Country
that is real and it is grave. And that includes women like one
of my constituents, who was carrying twins and discovered in
the third trimester that one of the twins could prove fatal to
the other.
Now, think about the decision that she and her physicians
had to make as they grappled with this very rare, very
difficult medical challenge and the impact of the abortion ban
in New Hampshire on her and her physician as they tried to
figure out what to do.
A few questions. Dr. Linton, abortion bans are impacting
multiple facets of women's healthcare. Miscarriage is common,
and as we've just talked about, it can be devastating. One in
five pregnancies in the United States results in miscarriage.
In places where abortion bans are in place, some women
experiencing miscarriages who need immediate medical attention
are being denied the healthcare that they need because doctors
fear criminal penalties if they treat these women.
Can you discuss how abortion bans are jeopardizing the
health of women who are having miscarriages?
Dr. Linton. Thank you for that question. Yes. I think that
it goes back again to this idea of confusion. These laws are
not written by physicians. Many of them are written before the
era of modern medicine, before we had ultrasounds and modern
diagnoses that we use today. So, asking a physician to
interpret a law, not only through a medical lens, but through a
modern lens, can be very difficult.
We are physicians. We are not lawyers. We did not go to
medical school to make very intricate legal decisions. And so
as much as sometimes I obviously--my biggest concern is for the
patient in that situation. And yet at the same time, I can't
necessarily blame the physician for having this fear over
confusion of whether or not they can provide care. We need to
focus on letting physicians make medical decisions to be able
to care for the patients in front of them.
Senator Hassan. Thank you. Dr. Verma, abortion bans and
restrictions are even making it harder for women to get
prenatal care that supports the wellbeing of women and their
babies. It's harder than ever to recruit obstetricians, as you
all have talked about and, gynecologists, to practice in rural
areas across the country, especially once you factor in
abortion bans, including those that could put doctors and their
patients in jail.
Dr. Verma, what is the impact of abortion bans on doctors
who are trying to do their jobs? In particular, how are these
bans limiting women's access to care in rural areas?
Dr. Verma. Absolutely. Thank you for that question. Even
pre--Dobbs I was seeing patients in Georgia that were traveling
significant distances to get to a hospital where they could get
prenatal care to get to a doctor who took Medicaid, if that is
their insurance.
There are multiple barriers that women are already facing.
What we're seeing is as more doctors leave these states because
of abortion bans, those distances that patients are having to
travel are getting further and further.
Patients are also scared. One of the things I do in my
practice is I do preconception counseling visits where I sit
down with a patient who wants to get pregnant and talk to them
about how to optimize that pregnancy. So, starting a prenatal
vitamin, getting off any medications that are dangerous for the
pregnancy.
Since Dobbs, I'm hearing again and again, patients are
asking, what happens if I get pregnant and something goes
wrong? And these are patients with desired pregnancies. They
are so afraid that something is going to go wrong and they
won't be able to get the care that they need. And it's
affecting people's decisions about whether to expand their
family, even if that's something they want.
Senator Hassan. Absolutely. Thank you. I am almost out of
time. So, a quick question for Ms. Lopez. Since Roe v. Wade was
overturned, it's more critical now than ever that women can
access contraception. Most forms of health insurance cover
birth control.
However, there are nearly 1 million women of reproductive
age who are enrolled in Medicare because of a disability, and
they don't have guaranteed access to contraception. I'm working
on a bill that will close this contraception coverage gap by
requiring Medicare to cover all forms of contraception,
allowing women with disabilities to get the type of
contraception they want and need. Can you speak to the
importance of requiring Medicare to cover contraception?
Ms. Lopez. Thank you. And thank you for your championship
of that legislation. Yes. It's critical for all people who can
become pregnant to have access to contraception, so that, they
can plan their families appropriately. So, that they can
determine if, when, and how they want to start a family. And
that includes folks on the margins, including disabled people.
So, thank you again.
Senator Hassan. Thank you very much. Thank you.
Senator Murray. Thank you.
Senator Marshall.
Senator Marshall. Thank you, Madam Chair. Dr. Linton, how
many babies have you delivered in the past month or two?
Dr. Linton. I would say probably in the tens to twenties.
Okay.
Senator Marshall. Dr. Verma, how many babies have you
delivered in the past month or two?
Dr. Verma. That's a good question. I'm terrible at
estimating, but over my career, thousands.
Senator Marshall. You're still active, you're still
actively delivering babies.
Dr. Verma. Oh, yes, yes, I do labor and delivery shifts
every week.
Senator Marshall. How often or what type of range would you
do sonograms on a pregnant woman, let's say before their fourth
month or pregnancy, hardly ever, a lot, sometimes?
Dr. Verma. Yes, I see patients with all kinds of
pregnancies. Sure. And usually when a patient comes in and is
has a positive pregnancy test, I talk to patients that want to
continue this pregnancy----
Senator Marshall. Like, my question is, how often do you
use sonograms on your routine prenatal visits? Before 16, 8
weeks or so?
Dr. Verma. We usually do an initial ultrasound to confirm
that the pregnancy is there.
Senator Marshall. Prenatal pregnancy, first visit, usually
you're doing a sonogram to confirm the pregnancy. Dr. Linton,
how often are you doing sonograms in the first, trimester or
early second on a routine OB situation?
Dr. Linton. To be very clear, I work on labor and delivery
and I deliver babies, but I do not provide prenatal care.
Senator Marshall. Thank you. So then, Dr. Linton, do you
deliver a 23-24-week baby, I'm sure before?
Dr. Linton. Yes.
Senator Marshall. When that baby's delivered, you call in
anesthesia, you call the NICU, you call everybody you can in to
help that baby, right?
Dr. Linton. It depends on the clinical scenario. But yes,
if it's a desired pregnancy and the patient has voiced the
desire for resuscitation, then we have NICU present at that
delivery.
Senator Marshall. You've also done abortions at 23, 24
weeks as well?
Dr. Linton. In my training, I provide the standard of care
in line with medical law.
Senator Marshall. I'm just asking that. I'm not sure.
You're not ashamed of it. You've done abortions with the baby's
23, 24 weeks.
Dr. Linton. I provide the care that I'm trained to do based
on the state laws where I live in.
Senator Marshall. Dr. Verma, you've done abortions and
you've delivered babies at 23, 24 weeks, full resuscitation, at
the same time you've done abortions on those as well.
Dr. Verma. I think what you're highlighting here is the
complexity of what we do.
Senator Marshall. No, that's not my question. I get to ask
the question here. I'm not asking for a lecture. Is there any
distress in your mind or your heart after doing an abortion? On
the one hand, you're delivering a baby at 23 weeks and--all out
resuscitate the baby, you feel horrible. It doesn't make it,
then you do an abortion on that same--how does that make you
feel?
Dr. Verma. I appreciate the question. I think it's a great
question. And again, like I was saying, this is why this is so
complicated. I feel that complexity, like I said, I've
experienced a first trimester loss myself, and I found that
loss devastating. So, this is complicated, but I also know that
my patients are able to make these really complicated decisions
about their health and lives.
Senator Marshall. Thank you very much. Dr. Linton, what
pregnancy category of drug is mifepristone?
Dr. Linton. I'm sorry, Senator. Off the top of my head, I
can't tell you the class.
Senator Marshall. Dr. Verma, do you know what type of
pregnancy category drug mifepristone is?
Dr. Verma. I know mifepristone is incredibly safe based on
decades of data about----
Senator Marshall. Do you know that what category of drug
that is in pregnancy?
Dr. Linton. I can tell you we use Misoprostol for a variety
of reasons, including for desired pregnancies, on labor and
delivery every day.
Senator Marshall. They're both category X drugs. Okay. I'm
going to tell you the answer. They're both categories. So, you-
all are prescribing these drugs and you don't know what
category of drug it is. And why is it a category X drug?
Because it causes fetal malformations, right? So, it causes
fetal malformations.
Dr. Verma. Those categories that you're describing are
actually based on politics. The mifepristone is safer than
Tylenol and Viagra.
Senator Marshall. You're saying that FDA is based upon
politics. The FDA is saying this is a category X drug. Would
you agree with me that these abortion pills are less effective
at 14 weeks as opposed to 8 weeks? Dr. Linton.
Dr. Linton. Yes. I would say that our data does support
with increasing gestational ages, that sometimes we have to
modify the protocol, but generally they're more effective at
earlier gestational ages, depending on the protocol you use.
Senator Marshall. What I'm confused about is, and I've
never prescribed this drug, I've taken care of lots of patients
that have complications from these drugs.
I'm confused why you do a sonogram in a routine pregnancy
to establish gestational age. That's the only main reason
you're doing pregnancies in the first trimester, early second
trimester. Because the spine is not developed, the heart is not
developed. So, you're basically doing it for gestational age.
You're recognizing that so many women come in and they're a
month off of their gestational age. So, why wouldn't you want
to do a sonogram on every person you see before you prescribe
this drug, realizing that it has decreased effectiveness at 14
weeks than at 10 weeks, so therefore, you're prescribing a
category X drug to a pregnancy that has a possibility of not
being aborted.
You're increasing the risk of fetal anomalies. It just
doesn't add up to me. Why are you scared to do a sonogram?
Wouldn't you think if you were doing an abortion procedure on a
12-weeker versus a baby, that's actually 20 weeks that it would
change everything? I'm just appalled that why you all are so
afraid of doing sonograms. Thank you so much. And I yield back.
Senator Murray. I'll allow you time to answer that
question, Dr. Verma.
Dr. Verma. Thank you. And I will say, as a doctor who
actually does provide this care to patients and is currently
practicing, we actually often do sonograms if there's any
questions.
When we see a patient and we're providing medication
abortion via telemedicine, we go through screening
questionnaires, and if there's any concern, we absolutely do a
sonogram. So, that isn't really an accurate representation of
how this practice of medicine works.
Senator Murray. Thank you.
Senator Smith.
Senator Smith. Thank you so much. Welcome everybody. I'm
appreciating very much all of you being here. I want to just
follow-up a little bit on the question about medication
abortion. So, mifepristone has been lawfully prescribed to
patients since 2000. I'll just ask Dr. Verma, how safe is
medication abortion and how effective is it?
Dr. Verma. Thank you for that question. Medication abortion
is incredibly safe and effective. In a recent study of 20,000
patients that have undergone medication abortion, the rate of
adverse events was 0.38 percent. So, very, very low. Only about
1 percent of those patients came to the emergency room after
the process. And of those people, about 40 percent didn't need
any treatment.
We know that medication abortion is incredibly safe and
effective. And I also want to highlight how dangerous
misinformation about the practice of medicine is for our
patients, for physicians.
The American Board of OB-GYNs, which is the board that
certifies all of us OB-GYNs at this table, has asserted that
abortion care is safe, is effective, that medication abortion
is safe, that abortion reversal is not something that we can,
in good faith offer to our patients because it can cause
serious risks of bleeding and hemorrhage.
That abortion care does not cause preterm birth. And so I
just want to highlight some of that misinformation that we've
heard today because it can be very dangerous and contradicts
what the American Board of OB-GYNs and American College of OB-
GYNs asserts.
Senator Smith. We've heard a few things also today about
abortion reversal drugs, saline abortions, is there any
misinformation that you'd like to clear up there as well?
Dr. Verma. Yes, thank you for that question. Saline
abortions is not something that is done in the practice of
modern medicine. I have been practicing for about a decade,
have never seen or heard of it. So, that is not a practice that
is done.
For abortion reversal, my colleagues and I actually studied
whether this is a treatment that we could offer to our
patients, because if it was a safe treatment and a patient
wanted it, I'd be happy to offer it. I am happy to support my
patients who want to continue a pregnancy, end, a pregnancy,
whatever is right for them.
We found we had to stop that study early because people
were experiencing significant bleeding and were at risk. And
so, it is not a safe treatment that is available to patients,
that is misinformation.
Senator Smith. Thank you. And maybe I'll ask Dr. Linton
this. I'd like to ask you this question about whether
telemedicine for medication abortion is also safe and
effective.
Dr. Linton. Thank you for that. I would reiterate what Dr.
Verma said. When we are thinking about providing medication
abortion via telemedicine, we have screening questions. And if
there are any red flags, if someone does not have a regular
menstrual cycle, if somebody is concerned about bleeding or
cramping, then they are not eligible for a medication abortion
via telemedicine.
Of course, our utmost priority in every single patient
encounter is patient safety.
Senator Smith. Thank you. Ms. Lopez, thank you so much for
being here. As you all know, Louisiana recently enacted a law
that adds mifepristone and misoprostol, which is another drug
used to manage abortion to the state's controlled substances
list.
This law would criminalize anyone who possesses the drug
without a valid prescription, and it puts it in the same
category as opioids.
[Laughter.]
Senator Smith. I'm just wondering, is there any reason, I
mean, what do you make of that? And do you believe that
medication abortion should be put in the same classification as
other dangerous controlled substances?
Ms. Lopez. The easy answer is no. And I think my colleagues
have really reiterated how safe and effective medication
abortion is. We have two decades of widespread use of study of
this drug. So, we know that it is safe and effective both here
and globally.
It has also become an incredibly important option for folks
to access abortion care. Two-thirds of abortions are now via
medication abortion. And so any effort to restrict it further
is simply an effort to make abortion more difficult to obtain.
Senator Smith. What impact does that have on women, for
example, living in rural communities, people who struggle
already to get access to care, including women who are
marginalized in so many other ways and don't get access to
care?
Ms. Lopez. Yes. The folks who are most impacted by all of
these abortion restrictions are folks who are already
marginalized by our healthcare system. So, folks of color, the
underinsured young folks, LGBTQ folks and folks who, as you
said, Senator, live in rural communities. And so it makes it
harder to get.
We know now that one in five abortion seekers, is traveling
out of state to get care. So, it means they're leaving their
home communities at significant financial, logistical, and
emotional cost to themselves and their families.
Senator Smith. Thank you, Chair Murray.
Senator Murray. Well, as Senator Baldwin is settling in, I
just want to ask unanimous consent to enter into the record
seven statements in support of abortion access and reproductive
freedom. Without objection.
[The following information can be found on page 74 in
Additional Material:]
Senator Murray. Senator Baldwin.
Senator Baldwin. Thank you. I want to thank you, Senator
Murray, and Chairman Sanders, for holding this hearing. Because
in the wake of the overturning of Roe, I think we must keep
drawing attention to the dire consequences on women's health
across this country, and particularly in my home state, States
like Wisconsin.
Before the Supreme Court overturned Roe v. Wade,
generations of women in this country had only known a country
with the right to abortion care. And they only knew a country
where every woman had the freedom to make their own choices
about if and when to start a family. But when those freedoms
were stripped away, Wisconsinites were sent back to the year
1849. They live under a pre-Civil war criminal ban on abortion
care.
I've heard such horrifying stories since that ban went into
effect, about women bleeding out, about contracting life-
threatening infections before receiving care, about women
forced to travel hours and hours away from their families and
support systems to receive care for an unviable pregnancy.
Thankfully, more recently Wisconsin has been able to take
important steps to restore abortion services in three
communities, three counties. We have 72 counties. However,
without access to care statewide, too many Wisconsinites must
still drive hours, take time off work, arrange for childcare
and face medically unnecessary barriers before getting the
healthcare they need. And while some people, say it should be
the state or the Federal Government who should decide abortion
rights, I believe it's women who should decide about these
issues.
That's why we must pass the Women's Health Protection Act
which I author, ensuring that women have the right to make
healthcare decisions and freedom to access abortion care no
matter where they live. Dr. Linton, and I'm so glad that you
are here today to share your experience about providing care in
Wisconsin.
Your testimony highlights the impossible landscape that you
and other providers have been forced to navigate in the wake of
the Dobbs decision and the effects on real patients in the
State of Wisconsin. These stories aren't hypotheticals. They're
about real people, and I wanted you to tell us a little bit
more about how patients in Wisconsin were affected immediately
after Dobbs.
How was the Dobbs decision and Wisconsin's archaic 1849
law, and how that has harmed Wisconsinites? And I imagine there
were people who had appointments for care on the day that the
Dobbs decision came out.
Dr. Linton. Absolutely. Thank you, Senator Baldwin. So,
yes, you're exactly right. Because of the 1849 law, this was
not a law that if Dobbs was passed, then we had 30 days or 90
days or whatever. It was of course, as we've mentioned a couple
times, there have been questions about the enforceability, but
because of the risks of $10,000 fines in 6 years in prison that
went into effect for us immediately.
At 9:10 am, on the 24th of June, we ceased providing care
at that moment. We had patients in our clinic, we had patients
scheduled the next day, and staff members had to go out into
the lobby and tell them, because of something that just
happened states away, you cannot receive care here today. And
it was, it was incredibly difficult for patients and staff to
try to figure out next steps to help them get healthcare.
Senator Baldwin. Thank you. I've introduced legislation
that I just described, the Women's Health Protection Act. This
bill would guarantee that doctors have the freedom to provide
abortion care and give patients the ability to receive the care
they need nationwide. How would passage of that act impact in
Wisconsin and improve care for patients right now?
Dr. Linton. Thank you. And as a Wisconsinite, I do want to
thank you very much for your leadership on this issue. As I
mentioned, we have and as you mentioned, we've resumed abortion
care in Wisconsin, but the future of abortion access in
Wisconsin is anything but clear.
Even as we are providing abortion care right now, we are
still practicing under medically unnecessary restrictions,
including 24 hour waiting periods, ban on telemedicine,
parental consent law, mandatory ultrasounds, et cetera.
As a physician who sees the impact of these restrictions
every single day, I can tell you that Federal protections for
abortion access will only improve the care that we can provide
our patients in Wisconsin.
Senator Baldwin. Thank you. And what do you want us to know
about the current state of--tell us how these barriers that you
just described that are in part of state law, how do they
affect patients that you see?
Dr. Linton. I think first and foremost, they delay care. We
know, as you mentioned, abortion is only accessible in
Wisconsin right now in three counties. Our state is a lot
bigger than three counties, so patients are already having to
travel long distances.
We know that 24-hour bans are often not 24 hours. We have a
same physician law in the State of Wisconsin. So, the patient
has to see the same physician for a counseling appointment, to
receive their medication abortion. So, oftentimes between those
two appointments, it can be a week or plus before they can come
back. And abortion is an incredibly time sensitive procedure.
All of these additional restrictions are creating hoops and
barriers for patients to receive routine or what should be
routine healthcare.
Senator Baldwin. Thank you.
Senator Murray. Thank you.
Senator Kaine.
Senator Kaine. Thank you. Well, like many who spoke of
today, I think the Dobbs decision was a disaster, both in terms
of the human consequences of it, but also the radical nature of
undoing not just 50 years of Roe v. Wade, but a hundred years
of 14th Amendment precedent, that began with cases like whether
parents should be able to make their own choices about whether
their kids go to parochial schools or not, should parents be
able to make their own choices about educating their children
to speak German, should people be able to marry who they want.
And the Supreme Court's decision to cast out, not just Roe, but
then jeopardize all of these other rights that we've taken for
granted for a century, has had just a set of horrible
consequences.
I think we need a national protection. I have a bipartisan
bill that would protect both Griswold and Roe and restore to
where we are, pre-Dobbs, and make plain, that your rights
shouldn't depend on what zip code you live in. Your rights
shouldn't depend on who your state legislature is.
The notion in Dobbs at the Supreme Court said, but don't
worry, you can go to your state legislature, when most of the
state legislatures in the country, I mean, look at Congress,
that's 26 percent women. That's called comfort, to say women's
rights, well you can just count on the legislature to do it
right, when women are so underrepresented in most of our
legislatures, and that's why we have a constitution.
The Constitution and the Bill of Rights is designed to
protect core freedoms. Even if the majority is against you,
there's something that you should get living in this country,
even if you're just one person that the majority can't trample
upon.
Virginia, thank goodness, is one of the few states that
essentially still follow Roe. There was the basic framework
established by Roe, minimal regulation of abortion, pre
viability, some more significant regulation, post-viability.
That's where Virginia is. Not everybody likes that. For some
it's not enough, for some, it's too much.
But Virginia has basically done that, and that has put
Virginia in an unusual position because we're the last state in
the South that really still provides women and all the rights
that Roe guaranteed to them for half a century.
Ms. Lopez, you alluded to this in your testimony, but
there's an unusual burden in these instances where states like
Virginia are protecting reproductive freedom, but surrounded by
others that aren't.
There was a story in the Washington Post recently, and I
mean, here's an example. A woman drove from Houston, Texas to
Fort Lauderdale, an 18-hour drive to access reproductive care.
She hadn't heard that the Florida 6-week ban had gone into
effect, so with no other option and 9 weeks pregnant, she then
drove an additional 12 hours to Virginia to receive care.
After she legally was able to terminate her pregnancy at 9
weeks, she then had a 17-hour drive home back to Texas. I think
it's just outrageous that we're making people do that. But talk
a little bit about the burden with this patchwork of some
states protecting women's reproductive freedom and many states
not.
Ms. Lopez. Yes. Thank you, Senator, for the question. And
as I stated in my testimony now one in five abortion seekers
are traveling outside of their state to places like Virginia to
seek care, which----
Senator Kaine. You said it was 160,000. 80,000 before
Dobbs, 160,000 since.
Ms. Lopez. Yes. And what we know is that increases in
places like your state, and for our providers, that increases
the number of patients they're getting. So, both the residents
that they're serving within their own state, and now this
influx of patients, which means that there's going to be an
increased waiting time.
If you think about all of the barriers, that someone having
to leave their home community, figure out how they're going to
pay for the procedure, take off work, find childcare, because
most people who seek abortion are also parents themselves. Go
to an unfamiliar place probably have to wait. And then also
have costs on the ground, the financial, logistical, and
ultimately the emotional barriers are ridiculous and sometimes
insurmountable, and ultimately could be forcing some people to
carry pregnancies to term.
Senator Kaine. Then finally, this is a hearing that is
about how abortion bans have created a health care nightmare.
That's the title of the hearing. But the Dobbs decision also
impacted a whole lot of other rights.
Again, this whole 14th amendment jurisprudence since the
mid 19-teens, including the right to contraception in Virginia,
because of the logic of the opinion Virginia legislators see a
price. And Ghazala Hashmi, two friends of mine in the Virginia
General Assembly introduced a contraception protection in
Virginia law that was passed overwhelmingly by the legislature,
but our Governor vetoed it.
Are you seeing other states taking the green light of
Dobbs, to put into question contraception, in vitro and other
important health care services?
Ms. Lopez. Absolutely. Senator, not just contraception, but
efforts to defund Planned Parenthood continue, to limit or
defund Title X, access to contraception for everyone, other
restrictions on minors' access to care, IVF.
Then we're also seeing kind of similar efforts around
transgender and gender affirming care. Those are all
interrelated and all efforts to limit access to basic
reproductive healthcare.
Senator Kaine. Well, just as I conclude, to my colleagues,
Elizabeth Carr, the first child born via IVF in the United
States was born in Virginia in 1981. And I had her as my guest
at the State of Union. And she said, when the Alabama Supreme
Court rendered the ruling that then led the Alabama health care
providers to stop IVF, she said, for the first time in my life,
I felt like an endangered species. No one should be made to
feel that way.
Thank you. I yield back.
Senator Murray. Thank you. That will conclude our hearing
for today. I will give you a closing statement. I want to thank
everybody who's joined us in this discussion. Senator Cassidy,
I'll allow you the closing remarks, and I have not yet voted,
so keep it short.
Senator Cassidy. First, I'd like to ask unanimous consent
to enter into the record an Op-ed written by Kelly Crawford,
founder and executive director of Abel Speaks, an organization,
created in memory of her son who was diagnosed with Trisomy 18.
The organization supports families. I think they would feel,
just as Senator Kaine, they feel as if the children who were
born with trisomy 18, are being selectively aborted. And that,
of course, makes them feel like their lives are threatened.
[The following information can be found on page 114 in
Additional Material:]
Dr. Verma, just a quick question. You rightly point out
that rarely is this done. Would you agree, therefore, that it
would be reasonable to restrict late term abortions?
Dr. Verma. First, late term abortion is not a medical term.
We tend to say abortion later in pregnancy.
Senator Cassidy. Just this, would you find it reasonable
that after some week, that it would be reasonable to restrict
an abortion after a certain period of week, given that it saves
life the mother and such like that. Because I think that's
really the crux.
Is there any kind of limit that will be placed, if you say,
this hardly ever happens or never happens, I think was your
words. Would it be reasonable then to restrict when this would
occur?
Dr. Verma. When I provide abortion care later in pregnancy,
I want you to envision a patient who has a nursery designed, a
name picked out, who Is diagnosed with a terrible fetal anomaly
or a worsening health condition----
Senator Cassidy. This is not a theoretical, I'm just saying
if the child is otherwise well, and the mother's health is
well, since you are saying this hardly ever happens, is it
reasonable to have----
Dr. Verma. I would say abortion at the moment of birth does
not happen. I also take care of patients who need abortion care
later in pregnancy for many different reasons----
Senator Cassidy. I respected, by the way, I really did
respect you speaking of that tension between the week 23 that
you would abort and the week 23 threes that you would
resuscitate. I don't mean to be confrontative, but you're
avoiding the dialog here.
Dr. Verma. No, no, I totally hear you. And I'm not trying
to be confrontational. I'm just trying to highlight what these
situations actually look like. So, for example, getting an
abortion care later in pregnancy for someone----
Senator Cassidy. I'm sorry. I'm not going to get an answer
that. Dr. Francis, will you just finish up on that question,
please?
Dr. Francis. Absolutely. Well I think certainly beyond the
point where a child can survive outside of his or her mother,
there would never be a reason you would need to intentionally
end that child's life. You would simply deliver that baby,
you'd take care of mom, and you'd take care of baby in an
appropriate way. And I think that's something that I would hope
that all of us at this table could agree upon.
Senator Cassidy. With that I yield. Thank you.
The Chair. Let me just give Dr. Verma, I don't think that
Senator Cassidy gave you the opportunity to respond
effectively. Take 2 minutes to respond and say what you wanted
to say.
Dr. Verma. I appreciate it. I was just trying to paint a
picture as a doctor who's actually sitting with these patients
and providing this full spectrum of care, what this care
actually looks like. So, when I'm providing care for a patient,
for example, that comes in later in pregnancy, a lot of times
that's a patient who's received a terrible fetal diagnosis and
is having to make that difficult, difficult decision. They have
a nursery set up, they have a name picked out, and what they
need from me as their doctor is support.
I have some patients that choose to continue that pregnancy
and deliver at term and other patients who say, that's too
traumatic. I can't do that. And my job is to support them in
both of those situations with whatever is right in their life.
I think as doctors, we all recognize that providing
lifesaving care sometimes means ending a pregnancy. And to call
that care something besides an abortion is an issue of
semantics to further a political agenda.
The care that we're referring to that sometimes means
ending a pregnancy, that is abortion care, and that is what we
are talking about here. And is sometimes necessary lifesaving
care for our patients who come in needing this care for a
variety of reasons.
Senator Murray. Thank you for that comment. And I'll just
say that as Dr. Verma said, abortion up until the moment of
birth doesn't happen. Abortions that are later in pregnancy are
extraordinarily rare, and they occur essentially only when a
pregnancy is non-viable and the mother risks severe injury or
death by remaining pregnant.
The Democratic position on abortion is simple and
mainstream. We want to ensure that every woman has the right to
receive abortion care, should she need it. The decision to have
an abortion is extremely personal, and that should be made in
every instant by the patient and their doctor, not by
politicians. That is our position.
With that, I just want to end this hearing by saying that
this is the truth. This is a topic that is absolutely not going
to go away, because women are going to continue suffering under
Republican's extreme abortion bans. They're going to continue
to have to travel, thousands of miles, and scrape together
thousands of dollars to get the care when they need an
abortion.
Pregnant women are experiencing health emergencies and will
continue being turned away from hospitals because politicians
have made doctors wait until women get sicker and sicker before
they're allowed to treat them.
More and more women will continue being forced to stay
pregnant, forced into motherhood against their will. This is
not something you forget. It's not a reality that you ignore.
It's not a status quo you get used to. And make no mistake,
women are standing up, they are speaking out, and they're
fighting back to defend their rights that have been ripped
away.
Democrats are going to continue to stand with women, lift
their voices up like today, and push with everything we've got,
to restore every woman's right to access abortion care in this
country.
With that, for any Senators who wish to ask additional
questions, questions for the record will be due in 10 business
days, June 18th, by 5 p.m.
Senator Murray. The Committee stands adjourned.
Thank you.
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[Whereupon, at 12:16 p.m., the hearing was adjourned.]