Women’s Reproductive Rights

November 21, 2019
A New Anti-Abortion Bill Could Require Death Certificates for Fertilized Eggs

A Pennsylvania bill would redefine fetal death to mean at any point in pregnancy, starting at conception.

Anti-choice lawmakers in Pennsylvania have taken recent attempts to implement fetal personhood legislation to a new extreme: A new bill moving through the state legislature would redefine fetal death to mean death at any point in pregnancy, starting at conception, and require health providers to cremate or bury all fetal remains unless the pregnant person chooses to handle disposal on their own.

The bill is written in a way that it would require providers to obtain death certificates not just for miscarriages and abortions, but even for fertilized eggs that don’t implant in the uterus. It would subject anyone who fails to do so to a $50 to $300 fine, or up to 30 days in prison. Death certificates get filed to the state, though the bill says identifying information will remain confidential.

The “Pennsylvania Final Disposition of Fetal Remains Act,” or House Bill 1890, is modeled on legislation Vice President Mike Pence signed into law as Indiana governor in 2016, which requires miscarried or aborted fetuses to be buried or cremated. Fetal burial laws serve no medical purpose but add additional costs and regulations on abortion providers.

Yet in May, the U.S. Supreme Court upheld this provision of the Indiana law, which included several other restrictions on abortion, citing a precedent that granted state governments a “legitimate interest in proper disposal of fetal remains.”

The court’s ruling has given state lawmakers stronger grounds on which to argue for similar legislation—for instance, Texas attorneys recently asked an appeals court to review a ruling that blocked their fetal burial law—and, perhaps, encouragement to push the envelope.

The sponsor of the bill, Pennsylvania Rep. Francis Ryan, a Republican, maintains that the provisions in HB 1890 are “strictly voluntary for women” who want to be able to bury their own fetal remains, and don’t require a death certificate.

But reproductive health advocates say those claims are misleading. They argue that the language of the bill is deliberately vague, obfuscating an extreme proposal: that providers and hospitals treat fertilized eggs as they would the remains of pregnancies that end in the second trimester.

“The bill is written in a misleading way,” said Christine Castro, a staff attorney at the Pennsylvania-based Women’s Law Project. ”No, it does not explicitly mandate a death certificate. [But] it explicitly mandates a burial permit, and you need a death certificate to obtain a burial permit.”

“HB1890 is like a Russian doll,” she continued. “You have to keep unpacking it to see what’s really inside.”

To continue Castro’s metaphor, the smallest doll, nested within all of the others, might be the bill’s new definition of fetal death. Currently, Pennsylvania defines fetal death as the “expulsion or extraction” of a product of conception after 16 weeks’ gestation. Ryan’s legislation, however, gets rid of the 16-week threshold, proposing that fetal death be any “expulsion or extraction from its mother of a product of conception, which shows no evidence of life after the expulsion or extraction.” The absence of any time marker, Castro said, means that the legal definition of “fetal death” would include fertilized eggs that don’t implant if HB 1890 passed into law.

“‘Fetus’ is a word with a specific medical definition: It does not mean a blastocyst, or a two-week pregnancy,” Castro said. “It is not surprising that a bill that redefines a word to legally mean something it literally does not mean is also unclear about what it is seeking to accomplish.”

The medical reality of keeping track of—let alone disposing of—expelled fertilized eggs is dubious at best. According to expertsmore than half of fertilized eggs never fully implant, meaning they don’t result in a pregnancy. And most people won’t know if they’ve passed one, and if they did, it’s unlikely they would be at a clinic or doctor’s office when it occurred. Yet the proposed law would require that such tissue be cremated or buried.

“Typically, fertilized eggs that do not implant would not be expelled in a medical facility,” said Kavita Vinekar, a Pennsylvania-based OB/GYN and fellow at Physicians for Reproductive Health. “It is very unlikely that someone would know that has happened.” It’s also left unstated what would be required if someone miscarries at home—would the person need to preserve the remains to bury them?

It’s clear that the point of Ryan’s legislation isn’t to reflect accepted biological and medical facts, physicians say. Jennifer Conti, an OB/GYN in California, pointed out that the bill’s expanded definition of fetal death would also have implications for individuals and couples undergoing in-vitro fertilization, or IVF, which can involve several unsuccessful attempts to implant embryos in the process of getting pregnant.

“Anti-choice legislators are fools if they think science is selective,” Conti said. “You can’t arbitrarily choose when and when not to apply facts. Science is science and embryos are cells of potential, not definitive life.”

Ryan contends that his legislation gives women and their families “a voice” in the decision about what happens to aborted or miscarried fetal remains: When his wife had a miscarriage in the 1970s, he said he was upset the hospital disposed of the fetal remains without asking him, even though, currently, patients have the ability to make their own burial arrangements if a hospital doesn’t accommodate them. But critics of the legislation say that not everyone wishes to be involved in that decision-making process, especially if they have lost a pregnancy they intended to carry to term.

“We received heartfelt emails from women telling us about their early miscarriages, how difficult they were, and how much worse it would have been were they forced to get a death certificate for a pregnancy that they understood so differently,” Democratic Pennsylvania Rep. Dan Frankel told PennLive.com. “It’s simply wrong to tell women what a loss of pregnancy is supposed to mean to them.”

The Republican-controlled Pennsylvania House passed the bill in a 123-76 vote earlier this week, and with a majority-Republican state Senate, it is likely to go to Governor Tom Wolf’s desk. Though Wolf, a pro-choice Democrat, has vowed to veto the legislation, a group of anti-choice Democrats could help their Republican colleagues override Wolf’s veto.

Physicians worry that, beyond the mandates HB 1890 would place on their work, the consequences would be much graver for their patients, who may internalize the stigma they say is baked into Ryan’s legislation.

“For my patients … this question is about arriving at the decision that is best for their needs, their families, and their belief systems,” Vinekar said. “The patients I care for are strong, loving, and resilient. They navigate the ‘gray’ areas of life with courage. Legislating these nuanced and deeply personal decisions strips my patients of their most basic human rights, their dignity, and their health care—that is the ultimate violation of personhood.”   Source

May 16, 2019
News & Opinion

How Pennsylvania’s Latest Anti-Abortion Bill Fits Into Anti-Roe Strategy
The legislation, which just passed the state House, would forbid abortions based solely on a Down syndrome diagnosis — but opponents say it’s just one of many thinly veiled attempts to control women’s right to choose.

The justices of the U.S. Supreme Court gather for a formal group portrait on Nov. 30, 2018, to include new Associate Justice Brett M. Kavanaugh, top row, far right, at the Supreme Court Building in Washington. (AP Photo/J. Scott Applewhite)

Just one day before Alabama governor Kay Ivey signed the country’s strictest anti-abortion bill into law this week — bringing a fierce abortion rights debate to the forefront of the national conversation once again — legislators in the Pennsylvania House passed their own attempt to restrict women’s access to abortion.

The state House approved on Tuesday House Bill 321, a measure that would amend Pennsylvania’s Abortion Control Act to prohibit the abortion of any child due solely to a diagnosis of possible Down syndrome. With it, Pennsylvania joins a slate of states that have moved to challenge abortion rights in recent months.

Supporters of the bill compare it to an existing ban on abortions based on the sex of the child. In a memo, state Rep. Kate Klunk and Speaker of the House Mike Turzai claim that the abortion rate for children with Down syndrome is “too high” and that it’s “time to protect Down syndrome children in the womb.” (It’s worth noting that the state Department of Health does not collect statistics on abortion regarding Down syndrome or genetic anomalies.)

In a statement issued in March, Planned Parenthood Pennsylvania executive director Maggie Groff said the bill is “not about protecting individuals with Down syndrome and their families.”

“This bill is yet another unconstitutional attempt to ban safe, legal abortion in Pennsylvania,” Groff said. “Politicians need to stop wasting time with abortion ban legislation that has already failed. They need to introduce bills that ensure people with disabilities in our communities are treated equitably, free from discrimination, and that they and their families have access to the services and resources that they need.”

Groff and other opponents say the bill ultimately violates women’s right to make their own decisions about abortion — a right that, they argue, is currently under attack across the country, as seen in Alabama this week (and six other states this year).

Why are states like Pennsylvania passing such bills now? With Supreme Court Associate Justice Brett Kavanaugh’s confirmation last year, many abortion rights activists fear there is a likely 5-4 majority on the Court to overturn Roe V. Wade. Those against the precedent laid out in the case (which, of course, affords women across the country the right to abortion access) are enacting a broader movement to bring their arguments to the Supreme Court while they have a perceived opportunity to challenge it.

Several recent bills, including Alabama’s, seek to ban abortions after a fetal heartbeat is detected. That’s typically about six weeks into a pregnancy, before many women know they are pregnant. The legislation is contentious because Roe v. Wade allows women to get abortions up to the first 24 weeks of pregnancy.

Legislators in Pennsylvania have tried again and again to ban almost all abortions after 20 weeks. As it stands now, the bill that passed the state House this week would only apply to abortions sought solely because of a Down syndrome diagnosis — and wouldn’t affect the time frame during which women can seek abortions. But Sue Frietsche, a senior staff attorney at the Women’s Law Project, told 90.5 WESA that the bill could fit into a larger anti-abortion strategy to enact “series of incremental incursions on the abortion right … So chip away at Roe v. Wade.”

The just-passed bill offers an exception in cases of rape, incest, or endangerment to the mother, as required by the Abortion Control Act. An earlier version of the legislation passed the GOP-dominated House with a vote of 139-56 last year — but then died in the Senate (where this legislation will now head). Similar bills in Ohio and Indiana have been struck down in court.

Gov. Tom Wolf has said he would veto the bill if it were to reach his desk.   Source

May 15, 2019
Georgia ‘heartbeat’ bill will force a lot of men to pay, literally

Like most US laws about women’s reproductive choices, Georgia’s new “heartbeat bill” that bans abortion after six weeks will have a significant impact on men’s lives as well.

The new Georgia law, signed recently by governor Brian Kemp, essentially criminalizes abortion before many women, or their partners, are aware of a pregnancy, health care providers say, which could lead to an uptick in unplanned births in the state.

Although the Supreme Court’s landmark 1973 decision gives a woman the right to choose whether or not to terminate a pregnancy, men are frequently part of the decision-making process as well. Almost half of all US abortions involved couples either married or cohabitating. Overall, an estimated one in four men have “had” an abortion in America.  (The term “had” here to is used to describe a man involved in a pregnancy that results in a termination.)

Combined with Georgia’s existing state laws, the new law could mean many more men shouldering a hefty financial burden for years if they are involved in a pregnancy with a woman in the state, whether have an ongoing relationship with her or not.

Firstly, like most other US states, Georgia has relatively robust child support laws. A “non-custodial parent,” or the parent any child doesn’t live with (the man in about 80% of the cases in the US), is required to turn over a significant portion of his income in Georgia to the custodial parent until the child finishes high school, or is 20 years old, whichever comes first. That amount now depends on a calculation of both parents’ income and health care costs; 20% of gross pay was standard in Georgia in the past.

Georgia, like other states, uses DNA testing to establish paternity, and claims an excellent record of tracking down men who owe child support. Georgia’s department of health has established paternity in 97% of the cases it handles (pdf, pg. 12) and issued support orders in 90% of the cases. The state had 31 “parental accountability courts” across the state that can issue orders to pay child support, and was adding 11 more in fiscal year 2018.

In addition, men who impregnate a woman in Georgia are also likely to bear the cost of prenatal care and childbirth bills, based on state legal precedent. Georgia’s Supreme Court ruled in 1993 in favor of a mother who asked for $15,500 in pregnancy and birth-related expenses from the father of her child, stating that:

the duty to protect and maintain a child includes the duty to ensure that the child receives adequate medical care prior to and during birth. It cannot be disputed that the state has a significant interest in the health of its children which, we conclude, the legislature sought to further by this provision of the statute. Neither can it be successfully argued that a child’s prenatal care does not impact on postnatal health. Additionally, this is consistent with our holding that an unwed father’s constitutionally protected “opportunity interest to develop a relationship” with his child begins at conception.

Georgia’s rising childbirth costs may be borne by US taxpayers overall, too. About half of all births in Georgia are currently covered by Medicaid.

Men who don’t pay child support in Georgia can have their paychecks garnished, their drivers’ licenses suspended, and be referred to credit bureaus. In fiscal year 2017 (pdf, pg.5), Georgia’s Child Support Services had 555,000 children in its system who were distributed $745 million from 370,000 parents who owed support.

Governor Kemp’s office didn’t answer inquiries from Quartz on whether it had estimated how those figures might change after the new law goes into effect.    Source

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