WASHINGTON — The national debate over whether laws or patients should decide access to abortion dominated a U.S. Senate committee hearing Tuesday, where a panel of six experts testified about the complicated nature of treating pregnancies and miscarriages.
The two-hour hearing in the Health, Education, Labor and Pensions Committee was at times heartfelt and heartfelt, but at other times it revolved around arguments that Democrats and Republicans have repeated over and over since the U.S. Supreme Court struck down the constitutional right to abortion two years ago.
The Hear was just part of Democrats’ increasing focus on reproductive rights, including access to abortion, contraception and in vitro fertilization, ahead of the November election. On Wednesday, senators will vote on whether to advance a contraceptive rights bill.
Democratic Senator from Washington Patty Murray said during the hearing that in some states, restrictions and bans on access to abortion have deprived women of the ability to make private decisions about their medical care and the size of their family.
“With this policy they have said to women in no uncertain terms: ‘You are not in control of your bodies, we are.’ That is appalling,” Murray said.
“Think about what it means, what it really means, to be told that someone else can decide that you have to stay pregnant no matter what the circumstances,” Murray said. “Think about how little power that gives a woman over her own life and her own health.”
Republican Senator Bill Cassidy of Louisiana, the ranking committee member, argued that the hearing was about highlighting the differences between the Republican Party and the Democrats in a presidential election year, rather than about showing a genuine interest in the state of reproductive health care.
“So let’s set the table: It’s an election year with a Democratic incumbent president trailing, so the decision was made to bring the abortion issue to the forefront, change the frame and invite a lot of people to show us on television,” he said. “This is partisan politics being played out in a committee hearing.”
Doctors or politicians?
Dr. Nisha Verma of Physicians for Reproductive Health in Atlanta said that because of their complicated nature, pregnancies — including those that end in miscarriage, threaten the woman’s life or health, or involve a diagnosis of a fatal fetal abnormality — must be managed by doctors, not politicians.
“I myself have struggled with infertility and suffered a miscarriage in the first trimester, which I found devastating, so I am by no means saying that pregnancies are worthless,” she said.
“That value is different for different people. And the way people deal with their pregnancy is different,” Verma said. “And every person is capable of making these really important, sometimes complex, sometimes difficult decisions about their health care and their life – even if that sometimes means terminating a pregnancy.”
Verma sought to dispel misinformation about when and how abortions are performed in the United States after comments from some people at the hearing criticizing abortions that are performed later in pregnancy.
She pointed out that for a patient in the 40th week of pregnancy, the only options are a cesarean section or a vaginal delivery, not an abortion.
“I would also like to point out that 90% of abortions in this country occur in the first trimester and less than 1% occur after 20 weeks, even though in most cases something has gone terribly wrong with the patient or the pregnancy,” Verma testified. “And that person really needs this care.”
In such a case, says Verma, patients need the support of their doctor and should not be told that she cannot offer them any treatment options.
“Some of my patients choose to continue the pregnancy and deliver at term, and other patients say, ‘It’s too traumatic, I can’t do that,'” she said.
“I think as doctors we all know that life-saving procedures sometimes mean terminating a pregnancy,” Verma said. “And calling these procedures anything other than abortion is a matter of semantics and different political agendas.”
Dr. Christina Francis, executive director of the American Association of Pro-Life Obstetricians and Gynecologists in Fort Wayne, Indiana, had a very different answer to the question of when and how doctors should perform abortions.
“I think, apart from the point at which a child can survive outside its mother, there is certainly no reason to intentionally end a child’s life,” Francis said, referring to viability, which usually occurs between 22 and 24 weeks of pregnancy.
“You would simply deliver the baby,” Francis added. “You would take care of the mother and you would take appropriate care of the baby. And I think that’s something that I hope we all agree on around this table.”
During the hearing, Francis did not elaborate on her views on abortion before viability is determined.
Access to abortion in Alaska
Alaska Republican Senator Lisa Murkowski reiterated her longstanding position that abortion decisions should be left to women and their doctors, not the government.
“I also believe that it is reasonable not to require strict anti-abortion groups to support them with their tax dollars, and that providers who do not want to be involved in abortion should not be forced to do so,” Murkowski said.
Women in Alaska, Murkowski said, continue to raise concerns with her about access to abortion, especially given the rural location of some areas of the state.
“I continue to hear from so many women in my state, from women in Alaska, who are concerned about access to abortion and access to reproductive services; even though we are a state that has a right to privacy enshrined in the Constitution that protects that access to abortion,” Murkowski said. “But what we’ve seen in decisions across the country, in the lower 48 states, is a ripple effect that reaches all the way up north.”
Virginia Democratic Senator Tim Kaine rejected the idea that state legislatures are best placed to decide abortion access.
“Your rights should not depend on the zip code you live in, your rights should not depend on who your state legislator is,” Kaine said.
Dr. Allison Linton, chief medical officer at Planned Parenthood of Wisconsin, said one problem with lawmakers implementing restrictions or bans on abortion access is the complicated range of problems that can arise during a pregnancy.
Linton then detailed the patients’ stories and rhetorically asked the committee whether these people should have had access to abortion.
“What about a patient diagnosed with breast cancer at eight weeks’ gestation who cannot begin chemotherapy or radiation during pregnancy?” asked Linton. “Is it a risk to her life to delay her treatment until after delivery?”
“What about a patient with a bleeding disorder where pregnancy further increases the risk of pulmonary embolism or stroke?” Linton continued. “Is the risk of a blood clot sufficient or do I have to wait until the actual stroke occurs?”
“What about a 13-year-old who is the victim of incest?” Linton asked. “Is the psychological and physical trauma of carrying a child in her barely pubescent body sufficient to justify terminating her pregnancy?”
Vote on contraception is imminent
Another focus for members of Congress this week is access to contraception.
Senators should vote Wednesday on a bill sponsored by 49 Democrats and independents. 12-page invoice is intended to ensure access to contraceptives, regardless of future decisions of the Supreme Court.
The constitutional right to contraception is currently enshrined in two U.S. Supreme Court decisions: Griswold v. Connecticut, a 1965 case that held that married couples had a right to privacy to make decisions about contraception, and the 1972 Eisenstadt v. Baird decision, in which the justices declared that this right also applied to unmarried people.
But Democrats and reproductive rights advocates fear the Supreme Court could overturn those two cases in the same way it overturned Roe v. Wade.
Iowa Republican Senator Joni Ernst this week introduced her own four-page bill to protect access to contraception, rejecting her Democratic colleagues’ proposal.
“In the face of Democrats’ radical abortion push, I am proud to provide women with greater access to safe and effective contraception,” Ernst wrote in a statement. “My bill will increase over-the-counter contraceptive options while providing much-needed transparency and accountability to ensure the government is using taxpayer dollars to support families.”
Almost two years ago Ernst blocked Democrats from passing their bill on access to contraception using the fast-track procedure known as unanimous consent, in which any senator can object to the passage. This procedure does not involve a roll call vote.
Measure by the Democrats in the House of Representatives
House Democrats also presented their version of the Senate Democrats’ bill on access to contraception at a press conference on Tuesday.
North Carolina Democratic Representative Kathy Manning called on the House Republican leadership to bring the bill to a vote, a request that is unlikely to be met.
“This law ensures that individuals have the right to obtain contraception and that health care providers have the corresponding right to provide it,” Manning said. “It also protects a full range of contraceptive methods, devices and medications, including birth control pills, IUDs, emergency contraception and Plan B.”
Senate Majority Leader Chuck Schumer said during a press conference that Democrats will “put reproductive freedom and women’s rights front and center” in the Senate in the coming weeks.
Part of this initiative will be the “very soon” vote on a bill to improve access to in vitro fertilization, said the New York Democrat.
“Millions of Americans have relied on IVF to have children,” Schumer said. “But after a stunningly radical decision by the Alabama Supreme Court that threatens access to IVF, families are rightly concerned that this option could be taken away from them.”
