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Time Magazine
24-06-2025
- Health
- Time Magazine
How the States We Govern Have Stepped Up Since Dobbs
Three years ago, when the U.S. Supreme Court decision in Dobbs v. Jackson Women's Health Organization overturned nearly 50 years of constitutional protection for abortion, states became the last line of defense in the fight for reproductive freedom. As governors, we've stepped up to respond to this new national reality. The Dobbs decision didn't end abortion in America. Instead, it's been rerouted to a few states now bearing the weight of a national need. States like ours—Illinois and New Mexico—have become what many call 'surge states,' where Americans facing extreme abortion restrictions in neighboring states turn for abortion care in record numbers. According to the Guttmacher Institute, last year, more than 155,000 Americans traveled out of state to access an abortion. Illinois has become the nation's leading provider of out-of-state care, providing more than 35,000 abortions to patients. In New Mexico, more than 70% of all abortions were provided to out-of-state residents. This surge has major implications for both clinicians and patients, and we've done everything we can to rise to the challenge with urgency and purpose. In 2024, the Chicago Abortion Fund received over 16,000 calls from people in 41 states — and didn't turn a single person away. To alleviate the pressure on clinics and organizations, Illinois launched the Complex Abortion Regional Line for Access (CARLA), a provider-to-provider scheduling and triage system to coordinate care and reduce hospital strain, facilitating 898 patient referrals from individuals across 23 states. New Mexico is also investing millions to build brick-and-mortar reproductive health clinics along the Texas border—where nearly 8,000 patients traveled for abortion care in the past year—and bolster its health care provider workforce. These are only a handful of the measures governors, clinics, and non-profit organizations have taken to ensure our states truly uphold reproductive freedom in a post-Dobbs America. But still, our systems are stretched. Even with public-private partnerships, clinics are full, providers increasingly fear for their safety, and care coordination grows more complex by the day. Read More: Abortions Keep Increasing in the U.S., Data Show In the meantime, anti-abortion forces are shifting their tactics to erode the infrastructure we're building to keep legal abortion accessible through federal rollbacks that compound the strain on states trying to hold the line. Just this month, the Trump administration rescinded Emergency Medical Treatment and Active Labor Act (EMTALA) guidelines that reaffirm federal protections for emergency abortion care when a patient's health or life is at risk. This guidance helped hospitals understand how to treat pregnant patients facing life-threatening complications, even in states with bans. Despite the fact that access to this care continues to be guaranteed in the law, revoking these guidelines creates dangerous confusion about how to treat medical emergencies, prompting hospitals to either wrongfully deny care or send pregnant patients across state lines, even in critical condition. That burden falls not just on our health systems, but on patients who may not survive the delay. Simultaneously, mifepristone—one of two medications used in medication abortion—is being politicized by the Food and Drug Administration (FDA), which is currently conducting a renewed review of its safety. This review follows years of coordinated attacks by anti-abortion activists who use junk science and political pressure to undermine public trust, despite mifepristone's decades-long safety record, as documented in more than 100 peer-reviewed studies. Medication abortion is a cornerstone of care, accounting for nearly two-thirds of all abortions in states without total bans. Losing access would require patients to rely on procedural abortions, necessitating more time, resources, and specialized care—further taxing our overburdened healthcare workforce and increasing wait times for patients who don't have the time to spare. We must recognize these attacks for what they are—a long-term strategy to chip away at reproductive rights across the U.S. If anti-abortion efforts targeting mifepristone and EMTALA succeed, the result won't just be increased suffering in states with bans— it will also undermine access in states where abortion is protected, stressing systems that are already struggling to meet overwhelming need. As 'surge states,' we know our role in this moment. The future of reproductive freedom in America will continue to be determined by state leaders who are prepared to do everything in their power to defend it. That means prioritizing reproductive health care in our policy agendas, defending it in our budgets, and building resilient legal and clinical infrastructure that can withstand the threats ahead. Dobbs didn't end the war on reproductive freedom; it just redrew the battle lines.
Yahoo
14-06-2025
- Health
- Yahoo
Our film imagined a post-Roe nightmare. Then it came true
When I first met Amy in the emergency room, she had a minor laceration on her finger. She claimed it was from an accident in the kitchen, but her cowering posture, downcast eyes and hesitant responses to basic questions suggested there was more to her visit than she was letting on. Amy reminds me of the girls I grew up with. Delicate, but exhausted and under pressure. She works long hours at a convenience store with a manager who offers no flexibility. Determined to save enough for college classes toward her degree, Amy has also shouldered the responsibility of supporting her mother, who has grown dependent on painkillers. She cleans homes to cover unexpected expenses, like becoming pregnant after a condom broke during sex, but she was unable to scrape together enough cash to purchase the morning-after pill. On June 3, the Trump administration revoked guidance that required hospitals to provide emergency abortions for patients in need. This national directive was issued in 2022 by the Biden administration, using the Emergency Medical Treatment and Active Labor Act (EMTALA), after the Supreme Court overturned Roe v. Wade, and it was intended to assist women facing medical emergencies and other serious complications. The Trump administration's action is just the latest salvo in an ongoing battle, one in which reproductive freedom seems to be losing ground every day. The mood, among both doctors and patients, is one of persistent uncertainty and fear. Here in the emergency room, Amy and I both feel it. The cut on Amy's finger was a ruse — a desperate act to access care. She is pregnant and doesn't want to be. But in our state, abortion is illegal. As an emergency physician, I tell her – quietly – that if she travels to another state, she can receive proper care. She'll need to budget a certain amount of cash for travel expenses. We keep this conversation between us. The possibility of this scene has become all too familiar a worry in real life, but the truth is that Amy isn't real. And I'm not really an emergency physician, I just play one in a movie. A few months after the Supreme Court overturned Roe v. Wade on June 24, 2022, while we were both still attending journalism school at New York University, my friend Nate Hilgartner approached me about a film he wanted to write and direct about the ethical implications of a post-Roe world. He had me in mind to play a doctor in a rural town torn between her duty to help her patient and the imperative to obey restrictive new laws. It would be an American horror story, he told me. At the time, it seemed prophetic but impossible, a bit of artful exaggeration to warn against a dystopian tendency. Today, it's our reality, and in some ways, things are worse. The consequences of a woman not receiving the reproductive healthcare of her choice could lead someone like our fictional protagonist to lose her ability to create a life on her own terms, trapping her in a cycle of poverty with a lack of education. In Georgia, a pregnant woman who has been declared brain-dead is being kept on life support until her baby can be delivered. Across the country, women have been turned away from emergency rooms after suffering ectopic pregnancies, which require an emergency abortion to prevent potentially fatal outcomes. Doctors have been reprimanded and fined, including Caitlin Bernard, an OB-GYN from Indiana, who performed an abortion on a 10-year-old rape victim denied an abortion in Ohio. Three years ago, all of this would have sounded like fiction, a fever-dream storyline out of The Handmaid's Tale. An investigation by ProPublica in December 2024 revealed that doctors in states with abortion bans often feel abandoned by lawyers and hospital leaders when seeking guidance on how to proceed with patients in emergencies. Since information about managing the bans in each state have been provided only on a 'need-to-know' basis, many doctors are left to navigate alternative options on their own, with some becoming too afraid to offer care, fearing professional and personal consequences. Sen. Ron Wyden (D-Oreg.) described the situation as doctors 'playing lawyer' and lawyers 'playing doctor,' leaving pregnant women facing life-or-death situations caught in the middle. Experts warn that the decision to eliminate access to emergency life-saving abortions will further exacerbate the crisis for doctors. The Trump administration's order to revoke emergency abortions sends a clear message to women who lack adequate resources to afford proper care. EMTALA, enacted in 1986, was designed to protect patients and ensure they receive stabilizing emergency care, regardless of their insurance status or ability to pay. While all pregnant women benefited from this law, it now appears that only those with sufficient health care and life circumstances will be able to survive potential emergencies. I am a writer and an actor, not a doctor. But for a time I imagined what it was like to be seated across from a woman scared and uncertain about the choices she could make about her body. Amy may not be real, but her plight is. Many of us may not admit it, but we've had our scares, moments where we've had to seriously consider the possibility of what we'd do if confronted with a pregnancy we weren't ready to have. At an age where I contemplate my own reproductive future, I am given pause: How can anyone assume there will never be complications in their pregnancy? Stories like Amy's aren't just about the right to make decisions about our bodies; they're also about the painful truth that those choices often come with a cost. When we set out to make this film, No Choice, we hoped to imagine a plausible future — not to prophesy our present reality. We could never have predicted just how quickly real-world headlines would not only validate our story, but outpace its darkest possibilities. Making a film was just one of many actions we hope other people will take to challenge the belief that a woman's body belongs to the state, not to herself. No Choice premieres in Los Angeles at the Dances With Films festival on June 23 — just one day shy of the third anniversary marking the fall of Roe v. Wade.
Yahoo
06-06-2025
- Health
- Yahoo
Who would want to have babies under a Trump administration? Not me.
Despite declarations that something needs to be done about the declining birth rate in the United States, neither President Donald Trump nor the Republican Party has the desire to protect pregnant people. If they did, the Trump administration wouldn't have made its latest move to restrict abortion nationwide. On Tuesday, June 3, the Centers for Medicare and Medicaid Services rescinded a Biden-era policy that directed hospitals to provide emergency abortions if it was needed to stabilize a pregnant patient. The guidance and communications on it apparently 'do not reflect the policy of this Administration.' I, like many people who support abortion rights, know what this will lead to. It means more pregnant people will die. Does that reflect the policy of the administration? The Biden policy was implemented in 2022, following the fall of Roe v. Wade, and argued that hospitals receiving Medicare funding had to comply with the Emergency Medical Treatment and Active Labor Act (EMTALA). The former administration argued that this included providing emergency abortions when they were needed to stabilize a patient, even in states that had severe abortion restrictions. Opinion: A brain dead pregnant Georgia woman is a horror story. It's Republicans' fault. This wasn't entirely a surprise. In 2024, the Supreme Court ruled that Texas could ban virtually all abortions in the state, including abortions that would have occurred under the old EMTALA guidelines. Still, it's terrifying to see this crucial policy eliminated. It's already dangerous to be pregnant in the United States. Our maternal mortality rate is much higher than in other wealthy countries. Same with our infant mortality rate. This will only exacerbate these tragedies. In states with abortion bans, the risks are even greater. A study from the Gender Equity Policy Institute found that people living in states with abortion bans were twice as likely to die during or shortly after childbirth. This is also backed by anecdotal evidence, including the 2022 deaths of two women in Georgia after the state passed a six-week ban. A different study found that infant mortality rates increased in states with severe restrictions on abortion, including an increase in deaths due to congenital anomalies. The Trump administration does not care about what is medically necessary to save someone's life. They don't care about whether the children supposedly saved by rescinding this policy will grow up without their mother. They care about their perceived moral superiority. They care about controlling women. Why would anybody want to have a child under that Republican way of thinking? Opinion: We're worrying about the wrong thing. Low birth rate isn't the crisis: Child care is. I want to say I'm surprised that the Trump administration would allow women in need of emergency care to die. Yet this is clearly aligned with the Republican stance on abortion, just like it's aligned with the actions that the party has taken to make it harder for women to access necessary care. Opinion alerts: Get columns from your favorite columnists + expert analysis on top issues, delivered straight to your device through the USA TODAY app. Don't have the app? Download it for free from your app store. Whether you like it or not, abortion is a necessary part of health care. It saves lives. Alexis McGill Johnson, the president and CEO of Planned Parenthood, laid it out plainly. 'Women have died because they couldn't get the lifesaving abortion care they needed,' she said in a statement. 'The Trump administration is willing to let pregnant people die, and that is exactly what we can expect." Again, this is the administration that wants young women like me to have children and improve the country's birth rate. This is an administration that claims to care about women and children. I know I wouldn't want to have a child while Trump continues to make it unsafe to be pregnant and give birth. I hate that this is the reality. Follow USA TODAY columnist Sara Pequeño on X, formerly Twitter, @sara__pequeno You can read diverse opinions from our USA TODAY columnists and other writers on the Opinion front page, on X, formerly Twitter, @usatodayopinion and in our Opinion newsletter. This article originally appeared on USA TODAY: Trump just made healthcare more dangerous for pregnant women | Opinion
USA Today
06-06-2025
- Health
- USA Today
Who would want to have babies under a Trump administration? Not me.
Who would want to have babies under a Trump administration? Not me. | Opinion The Trump administration does not care about what is medically necessary to save someone's life. They care about controlling women. Why would anybody want to have a child under that way of thinking? Show Caption Hide Caption Trump rescinds Biden-era emergency abortion care guidance The Trump administration rescinded guidance clarifying that hospitals in abortion-ban states must treat pregnant patients during medical emergencies. unbranded - Newsworthy Despite declarations that something needs to be done about the declining birth rate in the United States, neither President Donald Trump nor the Republican Party has the desire to protect pregnant people. If they did, the Trump administration wouldn't have made its latest move to restrict abortion nationwide. On Tuesday, June 3, the Centers for Medicare and Medicaid Services rescinded a Biden-era policy that directed hospitals to provide emergency abortions if it was needed to stabilize a pregnant patient. The guidance and communications on it apparently 'do not reflect the policy of this Administration.' I, like many people who support abortion rights, know what this will lead to. It means more pregnant people will die. Does that reflect the policy of the administration? Having a baby in America is dangerous. Republicans aren't helping. The Biden policy was implemented in 2022, following the fall of Roe v. Wade, and argued that hospitals receiving Medicare funding had to comply with the Emergency Medical Treatment and Active Labor Act (EMTALA). The former administration argued that this included providing emergency abortions when they were needed to stabilize a patient, even in states that had severe abortion restrictions. Opinion: A brain dead pregnant Georgia woman is a horror story. It's Republicans' fault. This wasn't entirely a surprise. In 2024, the Supreme Court ruled that Texas could ban virtually all abortions in the state, including abortions that would have occurred under the old EMTALA guidelines. Still, it's terrifying to see this crucial policy eliminated. It's already dangerous to be pregnant in the United States. Our maternal mortality rate is much higher than in other wealthy countries. Same with our infant mortality rate. This will only exacerbate these tragedies. In states with abortion bans, the risks are even greater. A study from the Gender Equity Policy Institute found that people living in states with abortion bans were twice as likely to die during or shortly after childbirth. This is also backed by anecdotal evidence, including the 2022 deaths of two women in Georgia after the state passed a six-week ban. A different study found that infant mortality rates increased in states with severe restrictions on abortion, including an increase in deaths due to congenital anomalies. The Trump administration does not care about what is medically necessary to save someone's life. They don't care about whether the children supposedly saved by rescinding this policy will grow up without their mother. They care about their perceived moral superiority. They care about controlling women. Why would anybody want to have a child under that Republican way of thinking? Opinion: We're worrying about the wrong thing. Low birth rate isn't the crisis: Child care is. None of this is surprising from Republicans. It's just sad. I want to say I'm surprised that the Trump administration would allow women in need of emergency care to die. Yet this is clearly aligned with the Republican stance on abortion, just like it's aligned with the actions that the party has taken to make it harder for women to access necessary care. Whether you like it or not, abortion is a necessary part of health care. It saves lives. Alexis McGill Johnson, the president and CEO of Planned Parenthood, laid it out plainly. 'Women have died because they couldn't get the lifesaving abortion care they needed,' she said in a statement. 'The Trump administration is willing to let pregnant people die, and that is exactly what we can expect." Again, this is the administration that wants young women like me to have children and improve the country's birth rate. This is an administration that claims to care about women and children. I know I wouldn't want to have a child while Trump continues to make it unsafe to be pregnant and give birth. I hate that this is the reality. Follow USA TODAY columnist Sara Pequeño on X, formerly Twitter, @sara__pequeno
Yahoo
06-06-2025
- Health
- Yahoo
Revoking EMTALA guidance on abortions will only further confuse doctors, experts say
In revoking federal guidance requiring emergency, life-saving abortions to protect the lives of pregnant women, the Trump Administration has added confusion to an already impossible situation for doctors, possibly putting women's lives at risk, experts told ABC News. "The rescission of this guidance is, contrary to its own statement, only further lending into the confusion that exists in emergency departments around the country, and it will put women's lives at risk," Alison Tanner, an attorney at the National Women's Law Center, told ABC News. "There have been countless stories of people across the country being denied emergency care, forced to wait in their cars in parking lots while they are actively bleeding, or being sent to different hospitals with a bucket and told to leave the state that they're in in order to get the care that they need," Tanner said. Earlier this week, the Trump administration revoked Biden-era federal guidance reminding hospitals that they are required to provide life-saving care, including abortions, in emergency situations under a federal law -- the Emergency Medical Treatment and Active Labor Act -- regardless of state law. The guidance was issued after Roe v. Wade was overturned in 2022, ending federal protections for abortion rights. At least 13 states have total abortion bans in effect, according to the Guttmacher Institute. As the administration rolled back the guidance this week, a government agency also found that a Texas hospital "failed to ensure ... [Kyleigh Thurman] received an appropriate medical screening," when she presented to the emergency department in early 2023, the Centers for Medicare and Medicaid Services said in a deficiency letter shared with ABC News. MORE: Trump administration rescinds Biden-era guidance requiring hospitals to perform emergency abortions Thurman ultimately needed to have a fallopian tube removed after it ruptured due to an ectopic pregnancy. Thurman said she was turned away twice from a local emergency room, without treatment. Another facility also denied her care twice, before her OB-GYN traveled to the hospital and convinced staff to end the pregnancy. She was rushed to surgery days later after the tube ruptured. Ectopic pregnancies are a dangerous complication that occurs when a fertilized egg implants and grows outside the uterus, in this case, in her fallopian tube. The treatment for an ectopic pregnancy is an abortion to prevent life-threatening complications. The hospital "did not appropriately screen [Thurman] for known risks associated with presenting signs, symptoms and test results including those which would constitute an [emergency medical condition], such as, but not limited to, ectopic pregnancy," the deficiency letter stated. "The hospital's failure to provide an appropriate medical screening examination, within the capability of the hospital's emergency department ... and consistent with the hospital's screening process, placed the patient at risk for deterioration of her health and wellbeing as a result of an untreated medical condition," the letter said. The determination was made after Thurman submitted an administrative complaint to the Centers for Medicare and Medicaid Services, an office within the Department of Health and Human Services, in August 2024. MORE: Meet 18 women who shared heartbreaking pregnancy journeys in post-Roe world "I know how incredibly horrible and how hard it was for me, and I didn't want anyone else to ever have to go through what I had to go through," Thurman told ABC News. Thurman said she did not know how Texas' near-total abortion ban could impact her health or even what an ectopic pregnancy is before she learned she was pregnant. "I never imagined myself being caught in the crosshairs, but I don't think that many people ever do. It only highlights how this can happen to anyone," Thurman said. "I really didn't have a thought on it, and it really didn't become evident to me how negatively [abortion bans] would impact women until it was impacting my life," Thurman said. "I didn't know what it all meant." Thurman said she wants to try for a family despite her experience. "A lot of people are like 'just move' and I'm like, 'it's not that simple when you have deep roots in a place.' This is my home. I am not leaving. I'd rather fight back than leave," Thurman said. The new guidance will only create more confusion around what is already "muddy and very confusing," Thurman said. It is now more of an environment where "mistakes can happen," Thurman said. Despite the rescinding of the guidance, hospitals and physicians are still required to provide stabilizing care, experts said. "EMTALA is still the law of the land. Hospitals and doctors must still comply with EMTALA," Astrid Ackerman, a staff attorney at the Center for Reproductive Rights who worked on filing EMTALA complaints, told ABC News. "What we're really concerned about is that this trend of that pregnant people cannot get the care that they need in this country, and more importantly, the care that hospitals and doctors want to provide," Ackerman said. Tanner said there is a real concern about whether the Trump administration will enforce EMTALA, especially after it dropped a federal lawsuit over Idaho's abortion ban, which does not allow abortions to save the life of the mother. An injunction in a separate EMTALA lawsuit by a hospital system in the state has blocked the ban. Doctors and hospitals are now stuck between "a rock and a hard place," trying to figure out what care they can provide, Tanner said. "Doctors and hospitals are being put in an untenable position. On the one hand, they are faced with state laws that would potentially impose severe criminal sanctions for providing necessary emergency abortion care," Tanner said. "And on the other hand, they have the federal law, EMTALA, which provides that both the federal government and individual patients can sue the hospital if they do not provide the necessary stabilizing care required under federal law," Tanner said. Revoking EMTALA guidance on abortions will only further confuse doctors, experts say originally appeared on
