Post-Election News Rundown

hangers-croppedIt would be an understatement to simply say we’re all reeling from last week’s election.

Ironically, in a nation where only 1.2 percent of the population are actual “real Americans” who are natives to this country, a swath of angry, non-native voters, with the intention of “taking their country back” (from whom is still a mystery) chose to pull the proverbial lever for a self-serving, authoritarian, demagogic, misogynistic, race-baiting, ego-maniacal, predatory, pathological liar.


Thanks to the 46,000 (and counting!) folks donating to Planned Parenthood in Mike Pence’s name.


The fact that hate speech and fear-mongering triumphed is truly frightening and demoralizing.

Most disappointing to many of us is the stunning betrayal we are realizing has been perpetrated by white female voters — 53 percent of whom voted for Donald Trump. #InsertFrownyFaceEmojiHere

Sorry to shatter your dream of a sisterhood! White ladies decided not to support a woman who has a long and storied history of advocating for children, affordable health care, equal pay, family leave, and women’s health and reproductive rights. Sadly, a majority of white women proved they would rather cast a vote for an openly cruel and vindictive man who doesn’t care about consent or gender equality, and publicly assigns and strips women of their value and humanity solely based on their appearance, and bullies female journalists and other women in the public sphere for his own entertainment.

Oh, and he blatantly and outlandishly lies about abortion. A procedure that one in three women has undergone.

Fairly certainly from a statistical standpoint, many of them were Trump voters.

I guess his statement that women who have abortions should be “punished” didn’t bother them.

In other harrowing news: Continue reading

Whole Woman’s Health v. Hellerstedt: Finally, Facts Matter

Tex-Supremes BlogOn Monday, June 27, 2016, the Supreme Court decided that Texas HB2 was unconstitutional, eliminating requirements for Texas doctors to have hospital admitting privileges near their clinics and for abortion clinics to become surgical facilities. Many fine summaries of this landmark decision popped up within hours of the decision. See Planned Parenthood’s press release and “The Court once again makes the ‘undue-burden’ test a referendum on the facts” on SCOTUS Blog.


On Monday, the Supreme Court demanded that laws be supported by facts.


What struck me most about the majority opinions written by Justices Breyer and Ginsburg was the lack of assertion and conjecture so often found in the court’s previous abortion case decisions. Recall Justice Kennedy’s 2007 Gonzales v. Carhart opinion upholding Congress’ Partial-Birth Abortion Act of 2003: “We find no reliable data” that abortion causes women emotional harm, but we find it nonetheless “self-evident” and “unexceptional to conclude” that “some women” who choose to terminate their pregnancies suffer “regret,” “severe depression,” “loss of esteem,” and other ills. “Some women”? Did we really uphold a law based upon this kind of neo-paternalistic, fuzzy thinking?

Not this time out. The Supreme Court put future litigants on notice: Facts matter, science matters, logic matters, common-sense inference matters. Unsupported assertions? Nah. Consultants parading as scientists? Not so much. In workmanlike fashion, dealing with abortion in a frank and unapologetic way, the majority read into law 15 separate District Court findings of fact gleaned from stipulations, depositions, and testimony. Further, the court chastised Texas for “attempting to label an opposing expert witness, Doctor Grossman, as irresponsible.” Breyer writes, “making a hypothesis — and then attempting to verify that hypothesis with further studies, as Dr. Grossman did — is not irresponsible. It is an essential element of the scientific method. The District Court’s decision to credit Dr. Grossman’s testimony was sound, particularly given that Texas provided no credible experts to rebut it.” Wow — The Supremes defend the scientific method. Color me happy.  Continue reading

Telling the Truth About Abortion Politics

Sens. Yee and Barto asked. We answered. It’s Our Turn to share the truth behind abortion politics. We have submitted the following op-ed to the Arizona Republic, but they have not (yet?) published it.

Thank You PP croppedAs a medical professional, I am dismayed at the recent “Our Turn” published in the Arizona Republic titled, “Make doctors tell the truth on abortion drug.” I would like to do just that — tell the truth and correct the record, because the opinion by legislators Barto and Yee was laden with revisionist history, misstatements of legal fact, and most important, non-medical junk science.

Doctors practice up-to-date, evidence-based medicine. I appreciate lawmakers repealing their intrusive foray into the practice of medicine, SB 1324. This law attempted to mandate how doctors dispense abortion medication according to an outdated, 16-year-old protocol contained in the original drug label. SB 1324 was an attempt to re-start a legal case that Arizona was losing. Despite the FDA’s update of the drug label to reflect current medical practice, policymakers and the governor stubbornly insisted on enacting SB 1324. Why, I cannot imagine. The repeal of this legislation was certainly welcome.

Real doctors reject junk science. More disturbing than the FDA label issue is Sens. Yee and Barto’s assertion that “at least 170 healthy babies have been born when medication abortions were reversed.” There is no scientific support for this assertion, just as there is no peer-reviewed medical evidence for the whole notion of “abortion reversal.” A handful of doctors with a moral agenda have attempted to use progesterone to “stop” a medication abortion. However, there is nothing in the literature to justify this practice, save for one report of six informal clinical anecdotes. No significant sample size, no control group, no oversight, no peer review. Regardless, last year these same legislators passed SB 1318, violating physicians’ and patients’ constitutional rights by forcing physicians to inform their patients that it is possible to reverse a medication abortion, which is untrue. Continue reading

Reproductive Justice?

President Bill Clinton stands by as Ruth Bader Ginsburg is sworn in as associate Supreme Court Justice in 1993

President Bill Clinton stands by as Ruth Bader Ginsburg is sworn in as associate Supreme Court justice in 1993

When Justice Antonin Scalia died on February 13, 2016, it was the death of more than just one man. For the first time in 20 years, the fairly reliable conservative tilt of the Supreme Court vanished. Now there were four generally liberal justices, three remaining consistently conservative justices, and Anthony Kennedy, a moderate who, though usually conservative, could move to the left, especially on social issues, as we saw in his eloquent opinion in support of same-sex marriage. If Kennedy voted with the conservatives, it would result in a tie, not a 5-4 decision. In case of a tied vote on the Supreme Court, the lower court ruling holds, and if there are conflicting rulings in different circuits, we continue with different law in different parts of the country.

Or the court could order a rehearing of a case once a new justice is seated.


The makeup of the Supreme Court is a glaring example of how much is at stake in presidential elections.


The political wheels started turning immediately. Senate Majority Leader Mitch McConnell almost immediately announced that Scalia’s seat should be filled after “the American people” weigh in during the presidential election — Republicans always seem to forget that the American people have already weighed in twice by making Barack Obama president. This categorical rejection of any Obama nominee, no matter who, is unprecedented. Scalia’s seat was apparently sacred, and could only fairly be filled by a Republican appointee. McConnell does not seem to consider that the next president might also be a Democrat.

The change in the balance of the court was apparent in the first of two cases concerning reproductive health that were scheduled to be heard this month. (The second case, Zubik v. Burwell, will be argued on March 23.) At SCOTUSblog, Lyle Denniston analyzed the oral arguments in Whole Woman’s Health v. Hellerstedt. It was always clear that the outcome would hinge on Justice Kennedy, and, before Scalia’s death, that in all likelihood the Texas law requiring abortion doctors to have admitting privileges at nearby hospitals, and abortion clinics to meet ambulatory surgical clinic requirements, would be upheld. Continue reading

Courting Women

Sotomayor, Ginsburg, and Kagan: Sitting Supreme Court Justices

Sotomayor, Ginsburg, and Kagan: Sitting Supreme Court Justices

“… [T]he difference of having three women on the Supreme Court. I think that all the justices obviously are important in that court, but it really makes a difference to begin to have a court that more reflects the diversity of this country, and I think women who can really speak from a woman’s point of view, just how impactful these kind of laws that specifically target women and women’s access to health care, how impactful they are. And I was really grateful to have the women’s voices in the room.”

Cecile Richards, Planned Parenthood president, March 2, 2016, commenting on that day’s oral arguments in Whole Woman’s Health v. Hellerstedt

Me, too, Cecile.

Courting women. Let’s snatch that phrase from the parlor in a Jane Austen novel and lob it into the Supreme Court chambers, making courting not the passive “pick me” word of yesteryear, but an assertive “empower me” word of today.

Power, judiciously applied, is what Ruth Bader Ginsburg, Sonia Sotomayor, and Elena Kagan demonstrated during oral arguments in Whole Woman’s Health v. Hellerstedt. They formed a tag team of relentless logic, assertiveness, and deep understanding of the predicament of women in Texas needing timely, accessible abortion care — and not getting it. The court was probing two provisions of Texas HB2, the law that requires that (1) physicians performing abortions must have admitting privileges at a hospital near their clinics and (2) all abortions must be performed in ambulatory surgical centers (ASCs, mini-hospitals). (See SCOTUSblog “Round Up” and Roe v. Wade: Texas Then and Now for additional background on this important case.)

Justices explored the elements that create an unconstitutional “undue burden” for women seeking an abortion by questioning attorney Stephanie Toti, representing Whole Woman’s Health, and Solicitor General Scott Keller, representing Texas. Here are some highlights: Continue reading

Roe v. Wade: Texas Then and Now

“Mr. Chief Justice, may it please the Court: It’s an old joke, but when a man argues against two beautiful ladies like this, they are going to have the last word.”

Supreme Court, 1973

Supreme Court, 1973

Thus Jay Floyd, Texas assistant attorney general, opened his December 1971 oral argument in Roe v. Wade, as his adversary attorneys Sarah Weddington and Linda Coffee sat nearby (no doubt dumbfounded) after Weddington had presented their argument for women’s abortion rights.

Wisely, the Texas reargument in 1972 opened with no attempt at humor. (When Roe was first argued, the Supreme Court consisted of only seven justices. Because the decision would be so historic, the Supreme Court decided to hear arguments a second time when all nine justices were in place the following year.) Then, on January 22, 1973, the Supreme Court decided that a woman’s right to an abortion was constitutionally protected and the 1854 Texas law at issue was struck down, along with abortion laws in 45 other states. (The Texas gentleman was right: The Texas ladies did have the last word.)


What will the Supreme Court bring us this year? “Don’t Mess with Texas” or “Don’t Mess with Women”?


So, as we approach the 43rd anniversary of Roe v. Wade this Friday, let’s mosey down memory lane. How did we get to that landmark decision, and where might we be going this year with a new Texas case testing abortion rights, Whole Woman’s Health v. Cole?

Throughout history, abortion has been a common practice. At the time of the adoption of the U.S. Constitution in 1787, abortion was legal in all states. Prior to the mid-1800s legal scholars were not proposing abortion laws, nor advocating “personhood” of an unborn child, nor asserting abortion control on medical safety or any other grounds. Continue reading

The Imaginarium of Doctor Delgado: The Make-Believe Medicine Behind SB 1318

pillDr. George Delgado, a gynecologist based in San Diego, is probably not likely to win the Nobel Prize in Medicine any time soon — or ever. Delgado’s dubious medical claims have been one of the driving forces behind a piece of legislation, Arizona Senate Bill 1318, that pushes what physician and state Rep. Randall Friese calls “fringe medicine.”

Delgado runs a website called Abortion Pill Reversal, offering 24-hour medical advice to women who have taken the abortion drug mifepristone and regret their decision. “There is an effective process for reversing the abortion pill, called ABORTION PILL REVERSAL, so call today!” the website cheers. Most people have probably never heard that a medication abortion — that is, an abortion performed by administering two pills — can be reversed. If this medical breakthrough sounds new, it’s because it doesn’t exist — at least not within any kind of evidence-based, established medical practice.


So-called abortion reversal is untested for safety or effectiveness.


Unsafe abortions have always been the consequence of the anti-abortion movement. Now unsafe abortion reversals can likely be added to that, thanks to the procedure Delgado has performed and promoted — in spite of scant evidence of its safety and effectiveness. In the two-step process of a medication abortion, a provider first administers a dose of mifepristone and then follows it with a dose of misoprostol. Delgado claims he can intervene in a medication abortion so that the patient’s pregnancy can continue. If patients change their minds after the first step, Delgado claims, they can counteract the initial drug with a dose of progesterone.

For published medical literature, Delgado can claim a 2012 article he co-wrote in the Annals of Pharmacotherapy. The article describes six abortion reversal patients, four of whom, he claims, remained pregnant. Though published in a legitimate medical journal, Delgado’s findings were from a small sample of patients, none of whom were compared in a controlled study to patients who did not undergo the progesterone treatment. Moreover, not everything that’s published in medical journals is well received by the medical community. Dr. David A. Grimes, a physician formerly with the Centers for Disease Control and Prevention, calls the article “an incompletely documented collection of anecdotes.” Continue reading