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Sensemaker: Abortion – the future is already here

Sensemaker: Abortion – the future is already here

What just happened

Long stories short

  • President Biden will provide advanced long-range missiles as part of a $700 million weapons package to Ukraine, who promised they would not use them to strike inside Russia. 
  • Eurozone inflation hit 8.1 per cent in May, the highest rate since the creation of the euro in 1999. 
  • More than 200,000 local events and street parties are expected across the UK this weekend to celebrate the Queen’s Jubilee. 

Abortion – the future is already here

The US Supreme Court’s decision on whether to overturn Roe v Wade is still a few weeks away. But abortion providers and abortion access campaigners are mobilising as if it has already happened. 

To remind you: the Supreme Court is currently considering the case of Dobbs v Jackson Women’s Health Organization which could overturn the abortion rights set by Roe v Wade in 1973. For the first time in the court’s history, a draft opinion was leaked ahead of their decision which – strongly – indicates the court will overturn Roe. 

If that happens, what are the options when someone is pregnant in states likely to ban abortion?

Pills 

The Guttmacher Institute estimates 54 per cent of all abortions performed in the United States in 2020 were medication abortions. Mostly that means taking a combination of two drugs: mifepristone and misoprostol.

Taken together, the pills are 95 per cent effective at ending a pregnancy. The Food and Drug Administration approves their use before the 11th week of pregnancy, calculated from the last menstrual period. 

Pills are going to be an important means of abortion access post-Roe, but that doesn’t mean it will always be straightforward to get them. 

Pills by post 

The pandemic led the FDA to temporarily lift a requirement that mifepristone be dispensed in a doctor’s office, in person. Telemedicine providers began offering abortion pills delivered by post to be taken at home. In 2021, the in-office requirement was removed permanently.

Telemedicine makes it easier for people in remote, rural areas to access abortion care, and offers a convenient, private and discreet service. But it’s not accessible for everyone:

  • Patients in the US must have a credit card and an ID – and feel comfortable ordering the pills online knowing that data including search history and financial transactions could be used against them in a future prosecution.
  • According to the Kaiser Family Foundation, six states ban the use of telemedicine in abortion care. An additional 14 states require that the prescribing doctor is in the room when patients take the pills. 
  • It’s likely that the number of states where both telemedical abortion care and abortion pills aren’t available will increase post-Roe.  

Some patients are already crossing state lines to pick up pills they’ve ordered via telemedicine from mailing addresses, post offices or PO boxes.

Mail forwarding. Plan C, an organisation providing information about abortion pill access in the United States, describes how it works. A patient living in state like Texas where abortion is extremely restricted can set up a “virtual mailbox” in a state that allows telemedicine abortions and have the package forwarded on to their home address. 

Abortion access groups based outside of the US also offer abortion pill prescriptions. Austria-based group Aid Access connects American patients with doctors in Europe for telehealth appointments. Their prescription is then filled and posted by an international pharmacy. Aid Access works with pharmacies in India supplying generic pills not approved for import by the FDA.

In-person clinics. Clinics in states where abortion services will continue to be available are readying themselves for an influx of patients from out of state. 

Illinois will become a “haven state” for much of the midwest. Abortion providers there have been preparing for increased demand for years. In 2019, shortly after Missouri passed an eight-week abortion ban, Planned Parenthood opened an 18,000 square foot facility in an Illinois town 15 miles from the border with Missouri. The organisation is anticipating between 20,000 and 30,000 additional abortion patients per year across the state if Roe is overturned. 

Extreme measures. Some providers are looking to more extreme options: one organisation is fundraising for a fleet of vans to provide cross-border medical abortions; some women are being taught online how to provide manual-aspiration abortions outside medical settings; others on social media are advocating herbal and homeopathic remedies – which can be unsafe.

There are still barriers to post-Roe abortion provision: 

Funding. Abortion care costs money, sometimes more than $1,000. Likewise, travel costs, childcare, time off work, and accommodation are all barriers for people seeking abortions. Abortion access groups like the Midwest Access Coalition pay for or reimburse patient travel. Volunteers help drive patients to their appointments and – pre-pandemic – offered homestay accommodation. Other abortion funds help pay for procedures.

Criminalisation. Reproductive rights activist Susan Yanow told Sensemaker that groups are already moving to develop legal defence funds for people who might be criminalised for using pills without clinicians. 

Yanow also fears that if a fetus is declared a person and ending the life of the fetus becomes murder: “The states can’t maintain their services in the face of a change like that.”

Women have been already been prosecuted for self-managed abortions. In April, a 26-year old Lizelle Herrera was jailed for “death of an individual by self-induced abortion” in Texas after being reported at a hospital. Her case was dismissed after national campaigns for her release. 

Robin Marty, author of New Handbook for a Post-Roe America and operations director at West Alabama Women’s Center, is expecting a surge in miscarriages, which could mean criminal investigations if it’s unclear whether it was an abortion-attempt or poor-health outcome: “It’s essentially going to be this open season on any person who does not give a live birth”. 

Search engines. Appearing at the top of the list in search engines is a new battle for abortion providers and services set up by anti-abortion campaigners. There are 2,600 “crisis pregnancy centers” in the US, outnumbering abortion clinics three to one, set up with the goal of stopping abortions. It’s often hard to tell the difference between web pages of actual abortion clinics, and these centres. 

In summary: accessing abortion post-Roe will continue to be easy for some, a complicated game of logistics for many, and for others, impossible. 


CAPITAL ECONOMY, BUSINESS AND FINANCE

Greenwashing crimes
After accusations they were “greenwashing” their environmental, social and governance (ESG) strategy, German police raided the offices of DWS and its majority owner Deutsche Bank yesterday. BaFin, the German regulator, launched an investigation into DWS last year. The US Securities and Exchange Commission is also investigating the asset manager for similar claims. It’s a sign that ESG commitments are being taken seriously by regulators, but the “greenwashing” could have continued if it wasn’t for an act of whistle-blowing by former DWS executive Desiree Fixler. After being fired, she said the group made misleading statements in its 2020 annual report that over half their $900 billion in assets were invested using ESG criteria. The group CEO Asoka Woehrmann resigned hours after a raid telling staff the attacks on DWS, and his leadership, “however unfounded or undefendable… have left a mark”. DWS stocks were down 5.8 per cent when trading opened in Frankfurt this morning. 


CULTURE soCIETY, IDENTITY AND BELONGING

Ukraine on the pitch
Ukraine will play their first competitive football match since the Russian invasion this evening against Scotland in a World Cup qualifying semi-final play-off. If they win they will go on to play Wales on Sunday afternoon for the prize of a place in Qatar later this year. Around half of the Ukrainian squad play in their domestic league, which was abandoned following Russia’s invasion, and had been on its annual winter break – meaning many of their players have not played competitively since December. The Ukrainian-based players were given special dispensation to leave the country, and have set up their training camp in Slovenia, playing warm-up matches against German and Italian club sides. The winner of Sunday’s play-off final will enter England’s group in Qatar, alongside the USA and Iran. 


TECHNOLOGY AI, SCIENCE AND NEW THINGS

Texas free speech
The United States Supreme Court granted an emergency stay on a Texas law that would make it illegal for social media platforms to remove or restrict users – and the content they post – based on their political views. Both sides say the other is violating the First Amendment right to free speech: the tech companies say they have a right to decide what content can appear on their platforms; while the Texas policymakers say that they passed the law to counteract “a dangerous movement by social media companies to silence conservative viewpoints and ideas”. The case is currently pending at a federal appeals court, and the decision from the Supreme Court means the law can’t be enforced while the case is ongoing. 


The 100-year life health, education AND GOVERNMENT

Johnson’s jubilee
UK Prime minister Boris Johnson goes into the Jubilee weekend still trying to push away criticism of his conduct over law-breaking parties at Downing Street. The government’s ethics chief Lord Geidt threatened to quit unless Johnson explained publicly why he did not consider he had broken the ministerial code, a breach that would in normal times have led to the resignation. Dominic Raab, the deputy prime minister and justice secretary, did the broadcast rounds insisting Johnson had only “unintentionally” and “inadvertently” broken the law. In spite of forcing a reluctant letter out of Johnson, Geidt could still quit, which might add a few more Conservative MPs to the no-confidence spreadsheets being tallied in Westminster. And Conservative MPs back home in their constituencies this weekend might find the bunting and cupcakes come with an unfestive side of career-threatening vitriol aimed directly at them by once-loyal constituents.


Our planet CLIMATE AND geopolitics

Australian plant
We now have an answer to what happens when nature is left untouched by humans – the world’s largest plant can grow. Unusually for Australia, where the escalating degradation of the Great Barrier Reef because of rising sea temperatures is usually the dominating story, there is some good news on marine life. In Shark Bay, just off the country’s West coast, researchers have found a 4,500-year old seagrass that has spread over 200 sq km of underwater seafloor – roughly 20,000 football pitches across. And yes – it is all one plant. Its persistent growth in water that has high salinity and huge temperature variance is thought to be down to its inbuilt genetic diversity. Testing of the plant found it had all its ‘parents’ genes, rather than half from each. 

Thanks for reading. Please share this around and tell us what we’ve missed.

Sensemaker is taking a break for the Jubilee long weekend, but will be back on Monday morning. 

Phoebe Davis
@phoebe_ivy

Ella Hill
@_EllaHill

With additional reporting by Andrew Butler.

Photographs Getty Images


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