WASHINGTON MAY 21: Pro-choice activists rally to stop states’ abortion bans in front of the Supreme Court in Washington, DC on May 21, 2019.

The Harms of Abortion Restrictions During the COVID-19 Pandemic

By Beatrice Brown

Several states, including Texas, Ohio, and Alabama, have dangerously and incorrectly deemed abortions a non-essential or elective procedure during the COVID-19 pandemic. The stated reason for these orders is to conserve personal protective equipment (PPE), a scarce, important resource for protecting health care workers treating COVID-19 patients.

However, these policies restricting abortion are unlikely to conserve PPE, and more importantly, they mischaracterize the nature and importance of abortions.

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woman with iv in her hand in hospital. Labor and delivery preparation. Intravenious therapy infusion. shallow depth of field. selective focus

Maternity Care Choices in the U.K. During the COVID-19 Pandemic

By John Tingle

One of many legal, ethical, and patient safety issues raised by the COVID-19 pandemic across the National Health Service (NHS) is that expectant mothers are considering freebirthing more after home births are cancelled.

The charity AIMS (Association for Improvements in the Maternity Services) states that while there is no specific definition of freebirthing, “…broadly speaking, a woman freebirths when she intentionally gives birth to her baby without a midwife or doctor present. Some women prefer to use the term ‘unassisted childbirth’ or UC to describe this.”

In The Guardian Hannah Summers recently wrote about this issue, which can carry major health risks. For example, if complications occur during a freebirth, professional clinical help will not be at hand to help.

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Histogram chart depicts the number of states that have passed restrictions, bans or protections for abortion in the United States in 2018 and 2019, as well as how court cases may have impacted the implementation of those laws.

Increased Restrictions and Court Activity for Reproductive Rights in the US in 2019

The landscape of abortion law in the United States saw increases in targeted restrictions in 2019, but also some efforts to protect access by state governments and courts, according to new data published this week to LawAtlas.org.

The data capture abortion-focused statutes and regulations (or amendments to existing laws) in effect between December 1, 2018 and December 1, 2019, as well as court cases that may impact the implementation of these laws.

Our research team noticed a few trends:

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Zoom in of a dashboard focusing on the "App Store" widget

Can Bedside Consent Apps Improve Informed Consent During Childbirth?

By Alexa Richardson

Informed consent in childbirth is under fire by advocates, who stress that there is a widespread absence of meaningful informed consent during birth. While informed consent in medical settings always poses challenges, informed consent in childbirth raises particular concerns. Labor unfolds in real-time, and people are heavily reliant on their provider for information during birth. Providers may not adequately seek informed consent out of a belief that they should make decisions in the fetal interest, rather than the parent. Furthermore, laboring people make choices that are more than medical: birth is a value-laden process entwined with beliefs about parenting, life-meaning, and fetal interests.  A new solution is on the table that could help improve the process of informed consent in childbirth: guided decision-making apps. This year, multiple mobile apps are in the works that would assist laboring people and clinicians in real-time decision-making during labor and birth.

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Illustration of a black woman nursing a swaddled baby

Policy Roundup: Improving Maternal Health Outcomes for Black Women

By Alexa Richardson

Data has long shown alarming rates of maternal mortality for black women in the United States, with deaths three to four times the rate for white women. Such deaths are not accounted for by differences in education or income, and systemic racism, including racial bias within the healthcare system, is believed to be a significant contributing factor to the problem. In the past year, this issue has finally made it into the policy arena, with a number of serious policy proposals put forth to try to reduce black maternal mortality.

In April, Congresswomen Lauren Underwood and Alma Adams formed the Black Maternal Health Caucus. Democratic primary candidates Senator Elizabeth Warren, Senator Kamala Harris, and Senator Cory Booker have all put forward proposals to address racial disparities in maternal mortality. And in October, California enacted legislation aimed at reducing racism and improving maternal health outcomes in obstetrics.

But what is the content of the policies being proposed? Are some better than others? This post surveys some of the biggest initiatives underway. It turns out that the measures being discussed vary widely–in approach, in scope, and in ambition. Read More

Pregnant woman sitting across desk from doctor wearing scrubs and holding a pen

Opioid Claims for Fetal Opioid Exposure Alarm Pregnancy Advocates

By Alexa Richardson

Lawyers calling themselves the “Opioid Justice Team” are pushing forward in their mission to certify babies exposed to opioids in utero, as well as “all women in the United States capable of becoming pregnant,” as distinct classes in the multi-district opioid litigation now unfolding in federal court in Ohio. Last week, lawyers filed an amended complaint on behalf of the legal guardians of individuals diagnosed with neonatal abstinence syndrome (NAS), and a list of “experts” with the court. Their claims misrepresent the science regarding fetal exposure to opioids and position fetal rights in opposition to those of pregnant people. National Advocates for Pregnant Women (NAPW) has issued a statement and fact sheet denouncing the claims.

In a series of court filings, sweeping claims about the impact of prescription opioid exposure on fetuses are being made. The lawyers falsely claim “[a]nything a pregnant woman ingests or breathes is transmitted to her baby by the placenta” and that “[i]n-utero opioid exposure leaves most children with physical, social, educational disabilities that require constant and regular interventions. Most of these disabilities are considered permanent.” In actuality, the American College of Obstetricians and Gynecologists states that the available data show “no significant differences” in long-term outcomes for individuals exposed to opioids in utero versus those who are not. The Centers for Disease Control (CDC) finds there may be early childhood impacts on cognitive or developmental abilities from prenatal opioid exposure. However, available studies struggle to separate the physical effects from environmental and social variables. There is not enough data to conclude whether any long-term consequences of fetal opioid exposure exist, the CDC finds.

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Photograph of a button pinned to a shirt. The button reads "Fuera el aborto de codigo penal."

Sexual and Reproductive Health and Rights: A Legal and Political Flashpoint in Today’s World

Friday, October 4, the Petrie-Flom Center will host “Abortion Battles in Mexico and Beyond: The Role of Law and the Courts,” from 8:30 AM to 12:30 PM. This event is free and open to the public, but registration is required. 

By Alicia Ely Yamin

Abortion Battles in Mexico and Beyond: The Role of Law and the Courts,” hosted by the Petrie-Flom Center on Friday, October 4th, provides a critical opportunity to reflect upon the progress that has been made with respect to recognizing sexual and reproductive health and rights (SRHR) as legally enforceable rights, and the role courts have played in Mexico and elsewhere.  The event could not be more timely, as the battle lines were evident at the UN General Assembly’s Universal Health Coverage (UHC) Summit and in negotiations over the “Political Declaration of the High-Level Meeting on Universal Health Coverage.” A group of countries led by the United States wanted to remove language of SRHR from the declaration and, in turn, the priorities for UHC. That effort was ultimately defeated but the debates showed the degree of contestation that these norms face in development paradigms, as well as international and national law.

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Illustration of a pregnant Muslim woman in a hijab sitting cross-legged in front of plants

Egg Freezing Permissible in Islam, According to Egypt’s Dar Al-Ifta

By Sarah Alawi

Dar Al-Ifta, Egypt’s Islamic body, issued a statement earlier this month on the legality of egg freezing under Islamic law following a controversial Facebook post by an Egyptian woman, Reem Mahana, on her decision to freeze her eggs.

Mahana said she froze her eggs for “the simple reason” that she wants to build a family when the time is right: “I cannot guarantee when exactly I will get married… I totally reject the idea of getting married to any man [only] to have a child.”

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Photograph of a woman lying in a hospital bed holding her newborn wrapped in a blanket

Where Are the Legal Protections for People Mistreated in Childbirth?

By Alexa Richardson

A new study indicates that 28.1% of women birthing in U.S. hospitals experienced mistreatment by providers during labor, with rates even higher for women of color. The multi-stakeholder study, convened in response to World Health Organization efforts to track maternal mistreatment, included more than 2,000 participants, and defined mistreatment as including one or more occurrences of: loss of autonomy; being shouted at, scolded, or threatened; or being ignored, refused, or receiving no response to requests for help. The study newly highlights the lack of legal protections available to for pregnant and birthing people who experience these kinds of mistreatment by providers.

Campaigns like Exposing the Silence have chronicled the outpouring of people’s harrowing birth stories, riddled with abuse and violations of consent. In one typical account, a user named Chastity explained:

I had a room full of student doctors, an OB I never met come in and forcibly give me extremely painful cervical exams while I screamed for them to stop and tried to get away. They had a nurse come and hold me down. There was at least 10 students practicing on me. I was a teen mom and my partner hadn’t gotten off work yet so I was all alone.

Another user named Abriana recounted:

As I was pushing, I got on my side and it was then that I started to feel pain much different from labor pains. I asked, ‘What is going on?’ The nurse replied, ‘I am doing a perineal rub.’ I immediately said, ‘Please stop doing that. You are hurting me.’ The nurse argued, ‘It will help you’ and didn’t move. I asked her again to please stop. I then yelled, while pushing, ‘Get your hands out of me!’ The nurse continued.

The traditional modes of seeking legal recourse have little to offer those who experience these kinds of mistreatment.

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Black and white photograph of adult holding a baby's hand

On the Tyranny of Partners in Posthumous Reproduction Cases

By Shelly Simana

The topic of posthumous reproduction has produced great interest globally due to the fundamental dilemmas it raises. The most controversial cases are the ones in which there is no explicit consent on behalf of the deceased person for using his or her gametes after death. In those cases, courts try to trace the presumed intentions of the deceased person, heavily relying on testimonies of the deceased’s family members and friends.

I recently published an article about this topic, in which I advocate for a more permissive approach toward posthumous reproduction. In this blog post, I would like to focus on a particular issue—the permission for the deceased’s partner, but not the parents, to engage in posthumous reproduction.

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