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Tag: pregnancy and childbirth

  • Police investigate death of Autumn Oxley, Virginia woman featured on ’16 and Pregnant’

    Police investigate death of Autumn Oxley, Virginia woman featured on ’16 and Pregnant’

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    Authorities in Virginia are investigating the death of Autumn Oxley, who appeared on the MTV reality show “16 and Pregnant” a decade ago and died over the weekend, police say.

    Police said they responded to a medical emergency shortly after 3:00 p.m. Saturday in Sandston, about 9 miles (14.5 kilometers) east of Richmond. Oxley, 27, was found unresponsive and pronounced dead at the scene.

    Authorities are still determining a cause of death, police said.

    Oxley was on the fifth season of “16 and Pregnant,” which aired in 2014. The episode followed her pregnancy and the birth of Oxley’s son, Drake.

    Officials urged people with information to contact Henrico County police.

    ___

    Olivia Diaz is a corps member for The Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues.

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  • Kansas won’t force providers to ask patients why they want abortions while a lawsuit proceeds

    Kansas won’t force providers to ask patients why they want abortions while a lawsuit proceeds

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    TOPEKA, Kan. (AP) — Kansas isn’t enforcing a new law requiring abortion providers to ask patients why they want to terminate their pregnancies, as a legal challenge against that rule and other older requirements makes its way through the courts.

    Attorneys for the state and for providers challenging the new law along with other requirements announced a deal Thursday. In return for not enforcing the law, the state will get another four months to develop its defense of the challenged restrictions ahead of a trial now delayed until late June 2025. The agreement was announced during a Zoom hearing in Johnson County District Court in the Kansas City area.

    Kansas doesn’t ban most abortions until the 22nd week of pregnancy. Its clinics now see thousands of patients from other states with near bans on abortion, most notably Missouri, Oklahoma and Texas.

    Last fall, District Judge K. Christopher Jayaram blocked enforcement of requirements that include rules spelling out what providers must tell their patients, and a longstanding requirement that patients wait 24 hours after consulting a provider to undergo a procedure. On July 1, he allowed the providers to add a challenge to the new reporting law to their existing lawsuit rather than making them file a separate case.

    The new law was supposed to take effect July 1 and would require providers to ask patients questions from a state script about their reasons for an abortion, although patients wouldn’t be forced to answer. Potential reasons include not being able to afford a child, not wanting a disabled child, not wanting to put schooling or a career on hold, and having an abusive spouse or partner. Clinics would be required to send data about patients’ answers to the state health department for a public report every six months.

    “We are relieved that this intrusive law will not take effect,” the Center for Reproductive Rights, the national organization for abortion provider Planned Parenthood and the regional Planned Parenthood affiliate said in a joint statement. “This law would have forced abortion providers to collect deeply personal information — an unjustifiable invasion of patient privacy that has nothing to do with people’s health.”

    Kansas already collects data about each abortion, such as the method and the week of pregnancy, but abortion opponents argue that having more information will aid in setting policies for helping pregnant women and new mothers. The Republican-controlled Legislature enacted the law over a veto from Democratic Gov. Laura Kelly.

    At least eight other states have such reporting requirements, but the Kansas Supreme Court declared in 2019 that the state constitution protects access to abortion as a part of a “fundamental” right to bodily autonomy. In August 2022, Kansas voters decisively rejected a proposed amendment to say that the constitution doesn’t grant any right to abortion access.

    The trial of the providers’ lawsuit had been set for late February 2025 before Jayaram delayed it in responded to the parties’ deal.

    “The state is prepared to accept an agreement not to enforce the new law until the final judgment, provided that we get a schedule that accommodates the record that we think we need to develop in this case,” said Lincoln Wilson, a senior counsel for the anti-abortion Alliance Defending Freedom, which is leading the state’s defense of its laws.

    Abortion providers suggested July 1 that the state wouldn’t enforce the new reporting requirement while the lawsuit proceeded, but the health department did not confirm that when reporters asked about it.

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  • Which states could have abortion on the ballot in 2024?

    Which states could have abortion on the ballot in 2024?

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    LITTLE ROCK, Ark. — Organizers of an effort to scale back Arkansas’ abortion ban face a Friday deadline to submit enough signatures to try to put their proposal before voters in November’s election.

    If they’re successful, Arkansas would be the sixth state where election officials are validating signatures on abortion measures. They are already on the ballot in another five, plus a proposed amendment in New York that would bar discrimination based on “pregnancy outcomes.”

    Supporters of other abortion measures in Arizona and Nebraska submitted petitions in their respective states on Wednesday.

    The fate of the measures could reshape or confirm the trendlines that have developed in the two years since the U.S. Supreme Court removed the nationwide right to abortion.

    Since the ruling, most Republican-controlled states have new abortion restrictions in effect, including 14 that ban it at every stage of pregnancy. Most Democratic-led states have laws or executive orders to protect access.

    Voters in all seven states that have had abortion questions before voters since 2022 have sided with abortion rights supporters, including California, Kansas, Kentucky, Michigan, Montana, Ohio and Vermont.

    Here’s a look at the abortion measures that could be on ballots in November:

    COLORADO

    Colorado’s top election official confirmed in May that a measure to enshrine abortion protections in the state constitution, including requirements that Medicaid and private health insurers cover it, made the ballot for the fall election.

    Supporters said they gathered more than 225,000 signatures, nearly double the requirement of over 124,000 signatures. Amending the state constitution requires the support of 55% of voters.

    Those backing a dueling measure — a law to ban abortion — did not submit signatures and the measure will not go before voters.

    Abortion is legal at all stages of pregnancy in Colorado.

    FLORIDA

    The state Supreme Court ruled in April that a ballot measure to legalize abortion until fetal viability could go on the ballot despite a legal challenge from state Attorney General Ashley Moody, who argued there are differing views on the meaning of “viability” and that some key terms in the proposed measure are not properly defined.

    Advocates collected nearly a million signatures to put a state constitutional amendment to legalize abortion until viability on the ballot, surpassing the nearly 892,000 required.

    To take effect, the measure would need agreement from at least 60% of voters.

    Abortion is currently illegal in Florida after the first six weeks of pregnancy, before many women know they are pregnant, under a law that took effect May 1.

    MARYLAND

    Voters also will be asked this year to enshrine the right to abortion in Maryland’s constitution. The state already protects the right to abortion under state law and Democrats outnumber Republicans 2-1. Abortion is allowed in Maryland until viability.

    NEVADA

    The Nevada Secretary of State ‘s office announced in June that a ballot question to enshrine abortion rights in the state constitution has met all of the requirements to appear in front of voters in November.

    Under the amendment, abortion access for the first 24 weeks of pregnancy, or later to protect the health of the pregnant person, would be enshrined. Such access already is ensured under a 1990 law.

    To change the constitution, voters would need to approve it in both 2024 and 2026.

    SOUTH DAKOTA

    South Dakota voters will vote this fall on a measure to ban any restrictions on abortion in the first trimester of pregnancy. It would allow the state, in the second trimester, to “regulate the pregnant woman’s abortion decision and its effectuation only in ways that are reasonably related to the physical health of the pregnant woman.”

    An abortion ban would be allowed in the third trimester, as long as it included exceptions for the life and health of the woman.

    The state’s top election official announced May 16 that about 85% of the more than 55,000 signatures submitted in support of the ballot initiative are valid, exceeding the required 35,017 signatures.

    Opponents have sued to try to take the initiative off the ballot.

    ARIZONA

    Abortion rights supporters submitted more than 823,000 signatures on Wednesday to put an abortion access measure before voters in November. That’s more than twice as many as required.

    Election officials still need to verify the signatures.

    Under the measure, the state would not be able to ban abortion until the fetus is viable, with later abortions allowed to protect a woman’s physical or mental health.

    Abortion is currently legal for the first 15 weeks of pregnancy in the state. The Arizona Supreme Court ruled in April that enforcement could begin soon for a near-total ban already on the books. The governor has since signed a bill repealing that law. It is still expected to be in effect for a time, however.

    ARKANSAS

    Proponents of an amendment to allow abortion in many cases must gather nearly 91,000 signatures by Friday for the measure to get on the Nov. 5 ballot. They also must submit a minimum number of signatures from 50 of 75 counties.

    Supporters said on Wednesday they were about 5,800 short of the requirement with two days left to circulate petitions.

    The measure would bar laws banning abortion in the first 20 weeks of gestation and allow abortion later in pregnancy in cases of rape, incest, threats to the woman’s health or life, or if the fetus would be unlikely to survive birth.

    Because it allows abortion to be banned 20 weeks into pregnancy, the proposal does not have the support of Planned Parenthood Great Plains, which includes Arkansas. The state currently bans abortion at all stages of pregnancy, with narrow exceptions.

    Anti-abortion groups in the predominantly Republican state also have campaigned heavily against the measure, and one group published the names and hometowns of canvassers gathering signatures for the proposal.

    MISSOURI

    Missouri abortion rights advocates turned in more than 380,000 signatures, more than twice the required 171,000, for a measure asking voters to approve a constitutional amendment to guarantee abortion until viability. Local election officials have until July 30 to verify the signatures, then it’s up to the secretary of state to declare whether there were enough.

    A group of moderate Republicans have for this year abandoned efforts for an alternate amendment that would have allowed abortion up to 12 weeks, with limited exceptions after that time.

    Abortion is currently banned in Missouri at all stages of pregnancy, with limited exceptions.

    MONTANA

    Abortion rights proponents in Montana have proposed a constitutional amendment that would bar the government from denying the right to abortion before viability or when it’s necessary to protect the life or health of the pregnant person.

    After a legal battle over the ballot language, the Montana Supreme Court in April wrote its version of the language that would appear on the ballot if enough valid signatures are certified. Sponsors were required to submit about 60,000 by June 21. They turned in about 117,000, nearly twice the amount needed.

    Counties have until July 19 to verify the signatures and the secretary of state would have until Aug. 22 to determine whether the amendment goes on the ballot.

    Abortion is legal until viability in Montana under a 1999 Montana Supreme Court opinion.

    NEBRASKA

    Competing abortion measures could come before voters in November after supporters of each said Wednesday they turned in far more signatures than the 123,000 required for ballot access.

    One would enshrine the right to abortion in the state constitution until viability. Supporters said they submitted more than 207,000 signatures.

    The other would write into the constitution the current law which bars abortions after the first 12 weeks of pregnancy, with some exceptions. Its backers said they submitted more than 205,000 signatures.

    Organizers for a third effort did not submit petitions. It would have defined embryos as people, thus barring abortion at all stages of pregnancy.

    Some efforts that sought to restrict or ban abortion also have failed to reach ballots. In Wisconsin, the House approved a measure asking voters to ban abortion after 14 weeks, but the legislative session ended without a vote from the state Senate.

    Likewise, Iowa lawmakers ended their session without approving a measure asking voters to find there is no constitutional right to abortion. Pennsylvania lawmakers previously pursued a similar amendment, but it’s not expected to be added to the ballot this year.

    A Louisiana measure to enshrine abortion rights in the state constitution died in committee, one in Maine effectively died when it fell short of receiving the approval of two-thirds of the House and a Minnesota measure was not passed by lawmakers.

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  • Many Florida women can’t get abortions past 6 weeks. Where else can they go?

    Many Florida women can’t get abortions past 6 weeks. Where else can they go?

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    RALEIGH, N.C. — When Florida enacted its six-week abortion ban last week, clinics in several other Southern and mid-Atlantic states sprang into action, knowing women would look to them for services no longer available where they live.

    Health care providers in North Carolina, three states to the north, are rushing to expand availability and decrease wait times.

    “We are already seeing appointments,” said Katherine Farris, chief medical officer of Planned Parenthood South Atlantic. “We have appointments on the books with patients who were unable to get in, in the last days of April in Florida.”

    Their reaction is part of a growing trend in the United States: Since the Supreme Court overturned Roe v. Wade, spurring more than 20 states to adopt laws banning or severely limiting abortions, states with looser restrictions have taken steps to welcome women who want or need to end their pregnancies.

    Since the court overturned Roe in June 2022, some Democratic-controlled states have made it easier for out-of-state women to obtain abortions. Several have adopted laws protecting in-state health care workers from being investigated for providing abortion to women from states with bans. Such measures have included allowing providers to prescribe abortion pills, the most common abortion method, via telehealth.

    Officials in California, New Mexico, Oregon and other states have used taxpayer money to increase abortion access.

    Florida recorded more than 84,000 abortions in 2023, a slight increase from 2022. As of April 1, the state reported approximately 14,700 abortions this year, potentially leaving a substantial number of women to consider going out of state.

    “Patients will travel when they’re desperate to get an abortion,” said Mara Buchbinder, a social medicine professor at University of North Carolina at Chapel Hill. “We know that.”

    At one point, Florida was a go-to state for women from other Southeastern states with restrictions, including neighboring Georgia and South Carolina, which both ban abortions around six weeks of gestation, before many women even know they are pregnant.

    Last year, about 7,700 abortions in Florida were for out-of-state patients, according to state data.

    But the state has steadily narrowed access. In anticipation of Roe being reversed, the Legislature passed a 15-week ban in April 2022 that took effect despite a court challenge. In 2023, it passed a six-week abortion ban that would take effect only if the earlier ban held up in court. The state Supreme Court upheld the ban last month, and the new law quickly went into effect.

    A referendum in November asking voters to codify abortion rights in Florida’s constitution could reverse the ban. But at least until then, Florida abortion advocacy groups will still need to organize many out-of-state trips.

    For women who are more than six weeks pregnant, South Florida is now the farthest from a legal provider of any highly populated area in the U.S. Subsequently, the average cost per abortion is expected to jump from $600 or $700 to as much as $1,800 or more, said Daniela Martins, a board member and caseworker team leader at the Women’s Emergency Network, a nonprofit organization that helps people in the region pay for abortion and other reproductive health care.

    Martins said her group anticipates helping women get to Virginia and places even farther north, such as Maryland and Washington, D.C. She said it is committed to not turning away clients in need, though raising enough money to honor that commitment could be challenging.

    “We’ve seen a lot of outpouring of support,” she said. “It’s nowhere near what we project we’ll need.”

    Another group, The Brigid Alliance, which provides travel and support across the country for women seeking abortions after 15 weeks of pregnancy, is preparing for more needs in the coming months.

    Serra Sippel, the group’s interim executive director, said the alliance is adding six new logistical coordinators, including four who speak Spanish, and is partnering with a clinic in Puerto Rico, an option particularly for Spanish-speaking people.

    One of the largest patient influxes is anticipated in North Carolina, where, even before Florida’s ban, 32% of abortions provided at the state’s Planned Parenthood clinics were for out-of-state patients, Farris said.

    But while it might be the most convenient place for Florida women given its geographical proximity, North Carolina is not without its own set of hurdles. The state’s 2023 law allows for abortions through 12 weeks of pregnancy, but requires two in-person visits to a provider 72 hours apart.

    Those extra steps can turn a single-day procedure into a weeklong affair, said Justine Orlovsky-Schnitzler, engagement director for Carolina Abortion Fund, a nonprofit in North Carolina and South Carolina that operates a helpline to assist callers with abortion care.

    Providers in North Carolina also fear the arrival of new patients will lengthen the wait time for an abortion, currently five to 20 days. Planned Parenthood South Atlantic, which serves North Carolina, South Carolina, Virginia and West Virginia, is trying to avoid that by rolling out seven additional days of abortion services and adjusting providers’ schedules at North Carolina clinics to expand availability, Farris said.

    “We are all willing to do the work,” she said. “Operationally, it is incredibly challenging, and I think it’s important to remember that this is a chaotic system.”

    Farris, who provides abortions in North Carolina, has to turn away patients who don’t qualify under the state’s law because they are more than 12 weeks along. She initially refers them to Virginia, which allows abortions until 24 weeks. If there are no appointments available, women can travel to Maryland, Washington or places farther north.

    Carolina Abortion Fund has six staff members and a volunteer network, but working there could often feel like having two full-time jobs even before Florida’s ban, Orlovsky-Schnitzler said.

    Volunteers have sometimes stayed up until midnight to help someone coordinate an emergency abortion, and there have been months in which the organization has received as many as 1,000 calls, she said. After Roe was overturned, calls rose by 400%.

    “That’s not an exaggeration,” she said.

    The center received 650 calls in April alone, according to data it provided.

    The organization often runs out of money, but Orlovsky-Schnitzler said that doesn’t stop workers from answering every call to get people the help they’re seeking.

    Staff at A Preferred Women’s Health Center in North Carolina, with clinics in Charlotte and Raleigh, are fielding about 4,000 calls weekly, most from women in Southern states, Executive Director Calla Hales said.

    Since Roe was overturned, about 70% of the clinics’ approximately 13,000 abortions each year have been with out-of-state patients, she said.

    The center also operates two clinics in Georgia under the state’s six-week ban. The clinics’ operations there may give a preview of what’s to come in Florida, Hales said.

    “As soon as they pee on a pregnancy stick, they’re running in,” she said.

    ___

    Associated Press writer Amanda Seitz in Washington, D.C., contributed to this report.

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  • Supreme Court to consider when doctors can provide emergency abortions in states with bans

    Supreme Court to consider when doctors can provide emergency abortions in states with bans

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    WASHINGTON — The Supreme Court will consider Wednesday when doctors can provide abortions during medical emergencies in states with bans enacted after the high court’s sweeping decision overturning Roe v. Wade.

    The case comes from Idaho, which is one of 14 states that now ban abortion at all stages of pregnancy with limited exceptions. It marks the first time the Supreme Court has considered a state ban since Roe was reversed.

    The Biden administration argues that even in states where abortion is banned, federal health care law says hospitals must be allowed to terminate pregnancies in rare emergencies where a patient’s life or health is at serious risk.

    Idaho contends its ban has exceptions for life-saving abortions but allowing it in more medical emergencies would turn hospitals into “abortion enclaves.” The state argues the administration is misusing a health care law that is meant to ensure patients aren’t turned away based on their ability to pay.

    The Supreme Court has allowed the Idaho law to go into effect, even during emergencies, as the case played out.

    Doctors have said Idaho’s abortion ban has already affected emergency care. More women whose conditions are typically treated with abortions must now be flown out of state for care, since doctors must wait until they are close to death to provide abortions within the bounds of state law.

    Meanwhile, complaints of pregnant women being turned away from U.S. emergency rooms spiked after the Supreme Court overturned Roe v. Wade, according to federal documents obtained by The Associated Press.

    Anti-abortion groups blame doctors for mishandling maternal emergency cases. Idaho argues the Biden administration overstates health care woes to undermine state abortion laws.

    The justices also heard another abortion case this term seeking to restrict access to abortion medication. It remains pending, though the justices overall seemed skeptical of the push.

    The Justice Department originally brought the case against Idaho, arguing the state’s abortion law conflicts with the 1986 Emergency Medical Treatment and Active Labor Act, known as EMTALA. It requires hospitals that accept Medicare to provide emergency care to any patient regardless of their ability to pay. Nearly all hospitals accept Medicare.

    A federal judge initially sided with the administration and ruled that abortions were legal in medical emergencies. After the state appealed, the Supreme Court allowed the law to go fully into effect in January.

    The Supreme Court is expected to rule by the end of June.

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  • Abortion returns to the spotlight in Italy 46 years after it was legalized

    Abortion returns to the spotlight in Italy 46 years after it was legalized

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    ROME — Italian Premier Giorgia Meloni’s far-right-led government wants to allow anti-abortion groups access to women considering ending their pregnancies, reviving tensions around abortion in Italy 46 years after it was legalized in the overwhelmingly Catholic country.

    The Senate on Tuesday was voting on legislation tied to European Union COVID-19 recovery funds that includes an amendment sponsored by Meloni’s Brothers of Italy party. The text, already passed by the lower Chamber of Deputies, allows regions to permit groups “with a qualified experience supporting motherhood” to have access to public support centers where women considering abortions go to receive counseling.

    For the right, the amendment merely fulfills the original intent of the 1978 law legalizing abortion, known as Law 194, which includes provisions to prevent the procedure and support motherhood.

    For the left-wing opposition, the amendment marks a chipping away of abortion rights that opponents warned would follow Meloni’s 2022 election.

    “The government should realize that they keep saying they absolutely do not want to boycott or touch Law 194, but the truth is that the right-wing opposes women’s reproductive autonomy, fears women’s choices regarding motherhood, sexuality, and abortion,” Cecilia D’Elia, a Democratic Party senator, said at a protest this week against the legislation.

    Under the 1978 law, Italy allows abortion on request in the first 12 weeks of pregnancy, or later if a woman’s health or life is endangered. It provides for publicly funded counseling centers to advise pregnant women of their rights and services offered if they want to terminate the pregnancies.

    But easy access to abortion isn’t always guaranteed. The law allows health care personnel to register as conscientious objectors and refuse to perform abortions, and many have, meaning women sometimes have to travel far to have the procedure.

    Meloni, who campaigned on a slogan of “God, fatherland and family,” has insisted she won’t roll back the 1978 law and merely wants to implement it fully. But she has also prioritized encouraging women to have babies to reverse Italy’s demographic crisis.

    Italy’s birthrate, already one of the lowest in the world, has been falling steadily for about 15 years and reached a record low last year with 379,000 babies born. Meloni’s conservative forces, backed strongly by the Vatican, have mounted a campaign to encourage at least 500,000 births annually by 2033, a rate that demographers say is necessary to prevent the economy from collapsing under the weight of Italy’s aging population.

    Meloni has called the left-wing opposition to the proposed amendment “fake news,” recalling that Law 194 provides for measures to prevent abortions, which would include counselling pregnant women about alternatives. The amendment specifically allows anti-abortion groups, or groups “supporting motherhood,” to be among the volunteer groups that can work in the counseling centers.

    “I think we have to guarantee a free choice,” Meloni said recently. “And to guarantee a free choice you have to have all information and opportunities available. And that’s what the Law 194 provides.”

    The new tensions over abortion in Italy come against the backdrop of developments elsewhere in Europe going somewhat in the opposite direction. France marked International Women’s Day by inscribing the guaranteed right to abortion into its constitution. Last year, overwhelmingly Catholic Malta voted to ease the strictest abortion laws in the EU. Polish lawmakers moved forward with proposals to lift a near-total ban on abortion enacted by the country’s previous right-wing government.

    At the same time, Italy’s left fears the country might go the way of the U.S., where states are restricting access after the U.S. Supreme Court struck down landmark legislation that had guaranteed access to abortion nationwide.

    Elly Schlein, head of Italy’s opposition Democratic Party, told a conference on women Tuesday that the country needs to establish an obligatory percentage of doctors willing to perform abortions in public hospitals, “otherwise these rights remain on paper only.”

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  • Morning sickness? Prenatal check-ups? What to know about new rights for pregnant workers

    Morning sickness? Prenatal check-ups? What to know about new rights for pregnant workers

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    Pregnant employees have the right to a wide range of accommodations under new federal regulations for enforcing the Pregnant Workers Fairness Act that supporters say could change workplace culture for millions of people.

    The Equal Employment Opportunity Commission, the agency in charge of enforcing the law, adopted an expansive view of conditions related to pregnancy and childbirth in its proposed regulations, including a controversial decision to include abortion, fertility treatment and birth control as medical issues requiring job protections.

    The rules, which were adopted on a 3-2 vote along partisan lines, were published Monday and offer extensive guidelines for addressing more routine difficulties of pregnancy, such as morning sickness, back pain and needing to avoid heavy lifting. Labor advocates say the law will be especially transformative for pregnant women in low-wage jobs, who are often denied simple requests like more bathroom breaks.

    Here’s what to know about the law and the EEOC regulations.

    Congress passed the law with bipartisan support in December 2022 following a decade-long campaign by women’s rights and labor advocates, who argued that the 1978 Pregnancy Discrimination Act did little to guarantee women would receive the accommodations they might need at work.

    The law stated only that pregnant workers should be treated the same as other employees, not that they deserved special consideration. To get their requests met, many pregnant workers therefore needed to demonstrate they had physical limitations covered under the Americans With Disabilities Act, often creating insurmountable hurdles.

    The new law treats pregnancy and related conditions as themselves deserving of “reasonable accommodations” and places the burden on employers to prove “undue hardships” for denying any requests.

    The law applies to employers of at least 15 workers. The EEOC estimates it will cover roughly 1.5 million pregnant workers in any given year. The EEOC regulations published April 15 are set to go into effect in June.

    The EEOC’s 400-page document encompasses a wide array of conditions and relevant advice for employers.

    It states that workers are entitled to unpaid time off for situations such as prenatal appointments, fertility treatments, abortion, miscarriage, postpartum depression and mastitis, an infection that arises from breastfeeding. This includes workers who are not covered by federal family leave laws and those who have not been on the job long enough to accrue time off.

    Workers can ask for flexible working arrangements to deal with morning sickness, such as a later start time, clearance to work from home or permission to carry snacks in workplaces where eating is typically prohibited. If they can’t sit or stand for extended periods due to sciatica, which is common in late pregnancy, they can request a schedule adjustment so their commutes happen during less crowded hours.

    The regulations also allow workers to be exempted from tasks such as climbing ladders or heavy lifting. If those duties are essential to their jobs, they can still request a temporary dispensation, according to the EEOC.

    Employers don’t have to accommodate workers exactly as requested but they must offer reasonable alternatives. They cannot deny a request without clearing a high bar to prove doing so would cause “undue hardships” for the organization’s finances or operations. They cannot force workers to take unpaid leave if a reasonable accommodation is available.

    The EEOC emphasizes that it “should not be complicated or difficult” for pregnant workers to request accommodations. Workers don’t have to make requests in writing, use specific words, cite any laws, or in most cases, provide documentation such as doctors’ notes. Employers must respond quickly and have a conversation about how to reasonably accommodate a worker’s needs.

    Still, legal experts advise both workers and employers to document the process. A Better Balance, the non-profit that spearheaded the 10-year campaign for the law’s passage, advises workers to familiarize themselves with their legal rights and be as specific as possible about their limitations and the changes they they need.

    Workers who believe a request was denied illegally can file a complaint with the EEOC. They have 180 days to do so, though the deadline can be extended in some states.

    The EEOC included abortion among the conditions covered under the law. The rules state, however, that employers are not obligated to cover expenses related to the procedure or to offer health insurance that does.

    The EEOC regulations argue that including abortion is consistent with the agency’s longstanding interpretation of other laws under Title VII of the 1964 Civil Rights Act, including the Pregnancy Discrimination Act.

    But the decision drew condemnation from Republican lawmakers who had championed the law’s passage. The five-member EEOC’s two Republican members voted against the regulations.

    In a statement explaining her dissent, Commissioner Andrea Lucas said the agency broadened the scope of the law “to reach virtually every condition, circumstance, or procedure that relates to any aspect of the female reproductive system” in ways that “cannot reasonably be reconciled with the text” of the law.

    Melissa Losch, a labor and employment attorney at the New Orleans-based firm McGlinchey Stafford, said she expects the regulations to give rise to further litigation. Losch cited the example of a worker living in a state with a restrictive abortion law requesting time off to undergo the procedure in another state. The EEOC rules provide “no good answer” about whether granting such a request would conflict with restrictive state abortion laws, she added.

    On February 27, a federal judge blocked enforcement of the Pregnant Workers Fairness Act for Texas state employees, a ruling that came in response to a lawsuit filed by Texas Attorney General Ken Paxton. Paxton argued the law was unconstitutional because it was part of a spending bill that passed in the House without a majority of members present, and the judge ruled in his favor.

    Gedmark, of A Better Balance, said she was optimistic the Biden administration would prevail in its expected appeal of the ruling. In the meantime, federal and private sectors workers in Texas are covered by the law.

    But in her dissenting statement, Lucas warned that if the Texas case or any future lawsuits succeed in overturning the law, the EEOC’s divisive rules have “all but extinguished” the chances of a bipartisan effort to reenact it.

    Employers have been obligated to abide by the Pregnant Workers Fairness Act since it took effect on June 27, 2023, though the EEOC regulations provided guidance on how to do so.

    The law swiftly made a difference to many low-wage workers, according to Gedmark.

    A Better Balance, which operates a helpline, has “heard an overwhelmingly positive experience from workers,” she said. Last summer, the organization worked with some women whose employers stopped resisting requests for accommodations as soon as the law took effect, Gedmark said.

    Some workers reported their employers were still operating under the old legal framework, handing them pages of disability paperwork to fill out in response to requests.

    The EEOC said it received almost 200 complaints alleging violations of the law by the time the fiscal year ended on Sept. 30, 2023.

    Gedmark said the success of the law will depend on enforcement and raising awareness.

    “If workers don’t know about the law and don’t know about their rights, then it really undermines the purpose of the law,” she said.

    ____

    The Associated Press’ women in the workforce and state government coverage receives financial support from Pivotal Ventures. AP is solely responsible for all content. Find AP’s standards for working with philanthropies, a list of supporters and funded coverage areas at AP.org.

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  • Woman with history of DUIs sentenced for crash that killed mom-to-be

    Woman with history of DUIs sentenced for crash that killed mom-to-be

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    SANTA ANA, Calif. — A Southern California woman with a history of convictions for driving under the influence has been sentenced to 15 years to life in prison for a crash that killed a 23-year-old pregnant woman and left her baby in critical condition.

    Courtney Pandolfi, 44, pleaded guilty to second degree murder earlier this year just as the case was headed for trial, the Orange County Register reported Friday.

    Prosecutors said Pandolfi was on a “drug cocktail” that included cocaine and methamphetamine in August 2020 when she drove her Jeep SUV onto a sidewalk in Anaheim. striking Yesenia Aguilar, who was eight months pregnant. Aguilar’s husband, James Alvarez, was walking with her but was not injured.

    Aguilar died, but her daughter was surgically delivered and survived. The girl, Adalyn Rose, is now 3 years old.

    Pandolfi, of Garden Grove, was convicted of driving under the influence of drugs in 2008, 2015 and 2016. As a result, she received a warning — known as a Watson advisement — that if she continued to drive under the influence and killed someone she could be charged with murder.

    Along with pleading guilty to the crash that killed Aguilar, Pandolfi also admitted to driving while on a combination of drugs, including methamphetamine and morphine, in November 2019. She also acknowledged possessing and using illegal drugs in jail while awaiting trial, the Register reported.

    Speaking after the sentencing, Alvarez held Adalyn Rose and said he believed his wife’s last thoughts were about their daughter.

    “She survived. I survived. So I was given a second chance in life, and I’m going to do something good out of it. I want to fight for those poor victims who lost someone in a tragic accident because of a drunk driver,” Alvarez said.

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  • Princess Catherine Fast Facts | CNN

    Princess Catherine Fast Facts | CNN

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    CNN
     — 

    Here is a look at the life of the Princess of Wales, the former Catherine (Kate) Middleton.

    Birth date: January 9, 1982

    Birth place: Reading, Berkshire, England

    Birth name: Catherine Elizabeth Middleton

    Father: Michael Middleton, former airline pilot, now mail-order business owner

    Mother: Carole (Goldsmith) Middleton, former flight attendant

    Marriage: Prince William, The Prince of Wales (April 29, 2011-present)

    Children: George Alexander Louis, Charlotte Elizabeth Diana and Louis Arthur Charles

    Education: University of St. Andrews, Fife, Scotland, 2005, MA, Art History

    Is the eldest of three children of self-made millionaires.

    Her engagement ring belonged to Princess Diana.

    2001 – Meets Prince William at University of St. Andrews.

    2002-2005 – Shares living quarters with William and several other college students.

    2003 – Begins dating Prince William around Christmas.

    April 1, 2004 – First public sighting of the couple, a ski trip in Switzerland, is reported.

    2006-2007 – Works as an accessories buyer for British ladies’ fashion chain store Jigsaw.

    March 2007 – Ends relationship with Prince William, but within months they are on again.

    October 2010 – Becomes engaged to Prince William during a trip to Kenya.

    November 16, 2010 – Prince Charles officially announces the engagement to the world.

    April 19, 2011 – The Middleton family coat of arms is unveiled.

    April 29, 2011 – Marries Prince William at Westminster Abbey and becomes Her Royal Highness the Duchess of Cambridge.

    June 2011 – The Duke and Duchess make an apartment on the grounds of Kensington Palace their London home.

    June 30-July 8, 2011 – The couple’s first official trip to a foreign country, Canada.

    July 8-10, 2011 – Visits Los Angeles, where she and William visit a job fair for veterans and an arts center in a low-income neighborhood. It is her first trip to the United States.

    July 22, 2011 – Her wedding dress is put on display at Buckingham Palace.

    January 5, 2012 – Announces the four charities she will support as a patron: the Art Room, which helps disadvantaged children express themselves through art; the National Portrait Gallery, which houses a famous collection of royal paintings and photographs; East Anglia’s Children’s Hospices, which helps children with life-threatening conditions; and Action on Addiction, which assists those with addiction issues.

    March 19, 2012 – Gives her first official public address at East Anglia’s Children’s Hospice facility in Ipswich, England.

    September 2012 – The French magazine Closer runs photographs of the Duchess privately sunbathing topless. The pictures also run in the Irish Daily Star newspaper.

    September 17, 2012 – The Duchess and William file a complaint in France against the photographer who took the topless sunbathing pictures. They are seeking damages and would like to prevent further publication of the photos. The French magazine Closer, the Irish Daily Star and the Italian magazine Chi have each published some of the topless photos.

    December 3, 2012 – The royal household announces that the Duchess is pregnant. According to the announcement, she is admitted to hospital with acute morning sickness.

    July 22, 2013 – The Duchess gives birth to the couple’s first child, a son weighing 8 lbs., 6 oz. The baby is named Prince George Alexander Louis of Cambridge.

    May 2, 2015 – The Duchess gives birth to the couple’s second child, a daughter weighing 8 lbs, 3 oz. The baby is named Princess Charlotte Elizabeth Diana of Cambridge.

    February 17, 2016 – Guest edits Huffington Post UK as part of her Young Minds Matter initiative.

    April 30, 2016 – As part of a partnership with the British National Portrait Gallery, the Duchess will appear on the cover of the centenary issue of fashion magazine British Vogue, and have two of her portraits hung in the gallery.

    September 4, 2017 – Kensington Palace issues a statement that the Duchess is pregnant. The baby will be her and Prince William’s third child.

    September 5, 2017 – A French court rules that the topless sunbathing pictures of the Duchess were an invasion of privacy, awarding her and William 100,000 euros (about $119,000) in damages.

    April 23, 2018 – The Duchess gives birth to the couple’s third child, a son weighing 8 lbs., 7 oz. The baby is named Prince Louis Arthur Charles of Cambridge.

    November 27, 2020 – The Duchess and the Royal Foundation release the findings of a study on how Covid-19 has impacted parents and caregivers of those raising children under the age of five. The study relied in part on a survey of more than half a million people about the early childhood years in the UK.

    June 18, 2021 – The Duchess launches The Royal Foundation Centre for Early Childhood. In a video announcing the center’s creation, the duchess says the goal is to “raise awareness of why the first five years of life are just so important for our future life outcomes.”

    September 8, 2022 – Queen Elizabeth II dies, and Charles ascends to the throne.

    September 10, 2022 – King Charles III announces William will be given the title Prince of Wales, making Catherine Princess of Wales.

    January 17, 2024 – Kensington Palace says the Princess of Wales will spend up to two weeks recovering in hospital after undergoing abdominal surgery.

    March 11, 2024 – Apologizes for an edited official photograph that was recalled by a number of international news agencies over concerns it had been manipulated. Catherine says she is sorry for “any confusion” caused by the image after her “experiment” with photo editing. The photograph, released to mark Mother’s Day in the UK, was the first official picture of Catherine since she underwent abdominal surgery in January.

    March 22, 2024 – Reveals she has been diagnosed with cancer and is in the “early stages” of treatment.

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  • How a medication abortion, also known as an ‘abortion pill,’ works | CNN

    How a medication abortion, also known as an ‘abortion pill,’ works | CNN

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    CNN
     — 

    While the fate of mifepristone, one of two drugs used for medication abortions, is in the hands of the US Supreme Court, the drug continues to be available in states where abortion is legal.

    “While many women obtain medication abortion from a clinic or their OB-GYN, others obtain the pills on their own to self-induce or self-manage their abortion,” said Dr. Daniel Grossman, a professor of obstetrics, gynecology and reproductive sciences at the University of California, San Francisco.

    “A growing body of research indicates that self-managed abortion is safe and effective,” he said.

    Mifepristone blocks the hormone progesterone, which is needed for a pregnancy to continue. The drug is approved to end a pregnancy through 10 weeks’ gestation, which is “70 days or less since the first day of the last menstrual period,” according to the FDA.

    In a medication abortion, a second drug, misoprostol, is taken within the next 24 to 48 hours. Misoprostol causes the uterus to contract, creating cramping and bleeding. Approved for use in other conditions, such as preventing stomach ulcers, the drug has been available at pharmacies for decades.

    Together, the two drugs are commonly known as the “abortion pill,” which is now used in more than half of the abortions in the United States, according to the Guttmacher Institute, a research group that supports abortion rights.

    “Some people do this because they cannot access a clinic — particularly in states with legal restrictions on abortion — or because they have a preference for self-care,” said Grossman, who is also the director of Advancing New Standards in Reproductive Health, a research group that evaluates the pros and cons of reproductive health policies and publishes studies on how abortion affects a woman’s health.

    READ MORE: With US Supreme Court abortion drug hearing looming, study shows how self-managed abortion became more common post-Dobbs

    What happens during a medication abortion? To find out, CNN spoke with Grossman. This conversation has been condensed and edited for clarity.

    CNN: What is the difference between a first-trimester medication abortion and a vacuum aspiration in terms of what a woman experiences?

    Dr. Daniel Grossman: A vacuum aspiration is most commonly performed under a combination of local anesthetic and oral pain medications or local anesthetic together with intravenous sedation, or what is called conscious sedation.

    An injection of local anesthetic is given to the area around the cervix, and the cervix is gently dilated or opened up. Once the cervix is opened, a small straw-like tube is inserted into the uterus, and a gentle vacuum is used to remove the pregnancy tissue. Contrary to what some say, if the procedure is done before nine weeks or so, there’s nothing in the tissue that would be recognizable as a part of an embryo.

    The aspiration procedure takes just a couple of minutes. Then the person is observed for one to two hours until any sedation has worn off. We also monitor each patient for very rare complications, such as heavy bleeding.

    A medication abortion is a more prolonged process. After taking the pills, bleeding and cramping can occur over a period of days. Bleeding is typically heaviest when the actual pregnancy is expelled, but that bleeding usually eases within a few hours. On average people continue to have some mild bleeding for about two weeks or so, which is a bit longer than after a vacuum aspiration.

    Nausea, vomiting, fever, chills, diarrhea and headache can occur after using the abortion pill, and everyone who has a successful medication abortion usually reports some pain.

    In fact, the pain of medication abortion can be quite intense. In the studies that have looked at it, the average maximum level of pain that people report is about a seven to eight out of 10, with 10 being the highest. However, people also say that the pain can be brief, peaking just as the pregnancy is being expelled.

    The level of cramping and pain can depend on the length of the pregnancy as well as whether or not someone has given birth before. For example, a medical abortion at six weeks or less gestation typically has less pain and cramping than one performed at nine weeks. People who have given birth generally have less pain.

    CNN: What can be done to help with the pain of a medication abortion?

    Grossman: There are definitely things that can be used to help with the pain. Research has shown that ibuprofen is better than acetaminophen for treating the pain of medication abortion. We typically advise people to take 600 milligrams every six hours or so as needed.

    Some people take tramadol, a narcotic analgesic, or Vicodin, which is a combination of acetaminophen and hydrocodone. Recent research I was involved in found medications like tramadol can be helpful if taken prophylactically before the pain starts.

    Another successful regimen that we studied combined ibuprofen with a nausea medicine called metoclopramide that also helped with pain. Other than ibuprofen, these medications require a prescription.

    Another study found that a TENS device, which stands for transcutaneous electrical nerve stimulator, helps with the pain of medication abortion. It works through pads put on the abdomen that stimulate the nerves through mild electrical shocks, thus interfering with the pain signals. That’s something people could get without a prescription.

    Pain can be an overlooked issue with medication abortion because, quite honestly, as clinicians, we’re not there with patients when they are in their homes going through this. But as we’ve been doing more research on people’s experiences with medication abortion, it’s become quite clear that pain control is really important. I think we need to do a better job of treating the pain and making these options available to patients.

    CNN: Are there health conditions that make the use of a medication abortion unwise?

    Grossman: Undergoing a medication abortion can be dangerous if the pregnancy is ectopic, meaning the embryo is developing outside of the uterus. It’s rare, happening in about two out of every 100 pregnancies — and it appears to be even rarer among people seeking medication abortion.

    People who have undergone previous pelvic, fallopian tube or abdominal surgery are at higher risk of an ectopic pregnancy, as are those with a history of pelvic inflammatory disease. Certain sexually transmitted infections can raise risk, as does smoking, a history of infertility and use of infertility treatments such as in vitro fertilization (IVF).

    If a person is on anticoagulant or blood thinning drugs or has a bleeding disorder, a medication abortion is not advised. The long-term use of steroids is another contraindication for using the abortion pill.

    Anyone using an intrauterine device, or IUD, must have it removed before taking mifepristone because it may be partially expelled during the process, which can be painful.

    People with chronic adrenal failure or who have inherited a rare disorder called porphyria are not good candidates.

    CNN: Are there any signs of trouble a woman should watch for after undergoing a medication abortion?

    Grossman: It can be common to have a low-grade fever in the first few hours after taking misoprostol, the second drug in a medication abortion. If someone has a low-grade fever — 100.4 degrees to 101 degrees Fahrenheit — that lasts more than four hours, or has a high fever of over 101 degrees Fahrenheit after taking the medications, they do need to be evaluated by a health care provider.

    Heavy bleeding, which would be soaking two or more thick full-size pads an hour for two consecutive hours, or a foul-smelling vaginal discharge should be evaluated as well.

    One of the warning signs of an ectopic pregnancy is severe pelvic pain, particularly on one side of the abdomen. The pain can also radiate to the back. Another sign is getting dizzy or fainting, which could indicate internal bleeding. These are all very rare complications, but it’s wise to be on the lookout.

    We usually recommend that someone having a medication abortion have someone with them during the first 24 hours after taking misoprostol or until the pregnancy has passed. Many people specifically choose to have a medication abortion because they can be surrounded by a partner, family or friends.

    Most people know that the abortion is complete because they stop feeling pregnant, and symptoms such as nausea and breast tenderness disappear, usually within a week of passing the pregnancy. A home urine pregnancy test may remain positive even four to five weeks after a successful medication abortion, just because it takes that long for the pregnancy hormone to disappear from the bloodstream.

    If someone still feels pregnant, isn’t sure if the pregnancy fully passed or has a positive pregnancy test five weeks after taking mifepristone, they need to be evaluated by a clinician.

    People should know that they can ovulate as soon as two weeks after a medication abortion. Most birth control options can be started immediately after a medication abortion.

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  • Heartbroken fiancee of Brit cop killed in ‘neck slice’ reveals she is pregnant

    Heartbroken fiancee of Brit cop killed in ‘neck slice’ reveals she is pregnant

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    THE heartbroken fiancee of a Brit cop who died after a freak fall at their engagement party has tragically revealed she is expecting their first child.

    Lilly Watts and police constable Liam Trimmer, 29, had gathered with friends and family to celebrate their engagement and announce she was 14 weeks pregnant in Western Australia.

    5

    Lilly Watts, the grieving fiancee of Brit cop Liam Trimmer, revealed she is pregnant with their first childCredit: 9News
    The police constable, 29, died on Sunday at the couple's engagement party

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    The police constable, 29, died on Sunday at the couple’s engagement partyCredit: 9News
    Lilly revealed she is 14 weeks pregnant

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    Lilly revealed she is 14 weeks pregnantCredit: Facebook

    But a freak fall during the celebrations on Sunday night saw the Brit officer cut the carotid artery in his neck, causing heavy bleeding.

    Lilly, who is a nurse, together with healthcare workers and police officers attending the bash, did everything they could to save Liam’s life, but his injuries were too severe.

    On Wednesday, the devastated lover opened up about her heartache, saying her fiancee was “truly excited to be a dad”.

    She told Daily Mail Australia: “I have never known a love like Liam’s and this heartbreak and emptiness is just so overwhelming.

    Read more about Australia

    “He will always be the love of my life and our baby will know the wonderful man he was.”

    Liam took part in the BBC series Wanted Down Under, giving a teenager advice on life in Australia before they migrated.

    However it appears his scenes were never used.

    He moved from the UK to Australia when he was still a teenager, later graduating from Joondalup Police Academy.

    The Brit then joined the gang crime squad and tactical response group, where he built his career as an exemplary officer.

    In 2017, Liam moved to Kalgoorlie – some 370 miles east of Perth – where he became a prominent member of the community while playing for the local rugby team.

    Lilly’s close pal Mel Kelly created a GoFundMe page earlier on Wednesday to raise money for the mum-to-be.

    She said Lilly had lost her “soulmate” and now might be raising her baby alone, while trying to make ends meet.

    The fundraiser read: “Lilly’s world was shattered by a freak accident that claimed the life of her beloved fiance.

    “The evening was meant to be a joyous celebration of Lilly and Liam’s recent engagement and announcing their pregnancy, a huge milestone in their journey together.

    “Friends and family gathered to share in their happiness. In a cruel twist of events, Liam’s life was cut short leaving behind a void that can never be filled.

    “Lilly, a dedicated Clinical Registered Nurse at Royal Perth Hospital, now finds herself navigating uncharted waters.

    “Not only has she lost her soulmate, but she also carries the precious gift of new life within her.

    “At almost 14 weeks pregnant, Lilly now faces the prospect of raising a child without her beloved partner, while also grappling with the financial responsibilities that come with homeownership.”

    Friends and colleagues have been taking to social media to pay tribute to Mr Trimmer in the days following his death.

    One pal described him as “possibly the fittest bloke” in a local trekking group.

    They wrote: “Great sense of humour with a passion to excel.

    “In my opinion, society can ill-afford to lose guys like Liam [who had] the courage to charge into the furnace on a daily basis, dealing with the ‘heavy duty side of policing.

    “The boys are hurting this week, but they have cracked on with major training exercises and domestic operations.”

    Another shared: “It has been a sad couple of days at the office.

    “Lots of hugs and lots of tears. But … the boys are getting on with it and getting stuck into their training. Hopefully it’s a good distraction.”

    A third friend commented: “He was like that from day one at the [police] academy – you couldn’t help but not like him.”

    He has been remembered by his colleagues at the WA Police Union as an “extraordinary officer” and a “valued member of the blue family”.

    Police Commissioner Col Blanch, for Western Australia Police Commissioner, said: “Everything was done to try and save him and it wasn’t to be, and I know everyone that was involved are really hurting.

    “I think they wish they could just wake up from this nightmare.”

    “This extraordinary officer loved helping the community and was a fine example of WA policing and it’s just such a tragedy,” Mr Blanch said.

    “[He was] a very, very confident, capable young man with his whole life ahead of him, and that’s how sad this is.

    “It’s important now for us to wrap around each other, to lean on each other.”

    The exact cause of the accident has not been confirmed.

    A report will be prepared for the coroner.

    Liam moved from the UK to Australia when he was still a teenager

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    Liam moved from the UK to Australia when he was still a teenagerCredit: 9News
    Liam's colleagues described him as an 'extraordinary officer'

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    Liam’s colleagues described him as an ‘extraordinary officer’

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    Juliana Cruz Lima

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  • Republicans push back on Biden plan to axe federal funds for anti-abortion counseling centers

    Republicans push back on Biden plan to axe federal funds for anti-abortion counseling centers

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    WASHINGTON — In a new twist to the fight over abortion access, congressional Republicans are trying to block a Biden administration spending rule that they say will cut off millions of dollars to anti-abortion counseling centers.

    The rule would prohibit states from sending federal funds earmarked for needy Americans to so-called “crisis pregnancy centers,” which counsel against abortions. At stake are millions of dollars in federal funds that currently flow to the organizations through the Temporary Assistance for Needy Families (TANF) program, a block grant program created in 1996 to give cash assistance to poor children and prevent out-of-wedlock pregnancies.

    “Programs that only or primarily provide pregnancy counseling to women only after they become pregnant likely do not meet the … standard,” the Health and Human Services agency said in its rule proposal released late last year.

    More than 7,000 comments have been submitted on the proposed rule, which includes a series of restrictions on how states would be able to spend TANF monies.

    The proposal limiting funds for anti-abortion counseling centers is the Biden administration’s latest attempt to introduce federal policies that expand abortion access. Conservative states, meanwhile, have severely restricted the care since the U.S. Supreme Court stripped women of their federal right to an abortion in 2022.

    Congressional Republicans this week introduced legislation that would block the Health and Human Services Agency from restricting the funds from the centers. The bill has no chance of becoming law this year.

    “Pregnancy centers are an important and vital alternative for expectant mothers,” Republican Rep. Darin LaHood of Illinois said Thursday during a House Ways and Means Committee hearing to mark up the legislation.

    The anti-abortion counseling centers have become an increasingly popular way for conservatives to sermonize against abortions, with an Associated Press investigation last year finding that states have been sending more and more money to the programs over the last decade. More than a dozen states have given the centers roughly $500 million in taxpayer dollars since 2010. Last year, Pennsylvania’s Democratic governor cut funding for all centers from the state budget.

    The centers’ mission is controversial not only because workers often advise pregnant patients against seeking an abortion, but, critics say, the organizations can provide some misleading information about abortion and contraception, like suggesting that abortion can cause breast cancer. Most centers are religiously affiliated and not licensed healthcare facilities. They typically offer pregnancy tests and some offer limited medical services such as ultrasounds.

    The Human Coalition, an anti-abortion organization that has locations in Georgia, Ohio, Pennsylvania, North Carolina and Texas, estimates it would lose millions of dollars in funds, said Chelsey Youman, the group’s national director of public policy. Plans to expand to Louisiana and Indiana could be put on hold if the rule goes through, she added.

    Youman argues that her organization helps connect women to social services, like Medicaid, while persuading them to continue with their pregnancy.

    “The work we do is truly compassionate and loving care for women who are facing sometimes the most difficult moment of their life,” Youman said.

    HHS is suggesting several tweaks that would change how states can use the $16.5 billion in block grants intended for the nation’s neediest families. The proposal comes on the heels of a high-profile corruption scandal in Mississippi, where $77 million in TANF funds were squandered over several years.

    The restrictions would limit how much of the money ends up benefitting middle- and high-income earners, with the agency saying that the percentage of impoverished families who get cash assistance has dropped from nearly 70% in 1996 to just over 21% in 2020. The plan would restrict how states use the money for college scholarships and child care, for example.

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  • Cesarean deliveries surge in Puerto Rico, reaching a record rate in the US territory, report says

    Cesarean deliveries surge in Puerto Rico, reaching a record rate in the US territory, report says

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    SAN JUAN, Puerto Rico — Cesareans are surging in the U.S. territory of Puerto Rico, which has one of the world’s highest rates with more than 50% of babies now delivered via surgery compared with only 32% on the U.S. mainland, according to a federal report released Wednesday.

    The rates of cesarean delivery on the island increased from 2018 to 2022 for each age group younger than 40 after remaining stable for nearly a decade, according to the U.S. Centers for Disease Control and Prevention.

    The report did not provide an explanation, but medical experts in Puerto Rico say reasons behind the surge vary and include the island’s crumbling health care system.

    “In general, hospitals have limited personnel and few economic resources,” said Dr. Carlos Díaz Vélez, president of Puerto Rico’s Association of Surgical Doctors.

    As a result, ob-gyns prefer to schedule a cesarean to ensure they will have all the medical personnel required for a birth, he said.

    “They prefer it be organized than improvised,” Díaz said. “It guarantees security.”

    More than a dozen delivery rooms have closed across Puerto Rico in the past decade because of doctors moving to the U.S. mainland and a record drop in births, with only 17,772 births reported last year. That’s the lowest since record keeping began in the late 1880s.

    Díaz said a spate of lawsuits against Puerto Rican ob-gyns in the previous decade that he described as “frivolous” also have prompted doctors to schedule cesareans to reduce risks.

    Women also prefer cesareans for aesthetic reasons or to avoid pain, since epidurals in Puerto Rico are routinely not covered by insurance companies, said Dr. Annette Pérez-Delboy, a maternal-fetal medicine specialist who specializes in high-risk pregnancies and previously worked in New York.

    “In Puerto Rico, women are afraid of vaginal birth,” she said.

    Pérez-Delboy coincided with Díaz that a lack of medical personnel also has contributed to a rise in cesareans. In addition, she noted that in vitro fertilizations have increased, leading to more twins being conceived, which leads to more cesareans to avoid risky births.

    Pérez-Delboy also said that up-and-coming doctors are not well-versed in using forceps or vacuums, and as a result opt for cesareans to avoid legal action.

    “For a doctor in Puerto Rico, it is better to do a cesarean section, since it pays more, you have it on time, it has less risk of litigation and the mother leaves happier,” she said, adding that doctors and patients are aware that vaginal births are better. “Everyone knows it, and everyone understands it, but you have to put yourself in the shoes of these doctors.”

    In recent years, cesarean deliveries in Puerto Rico increased by more than 10% in three of six municipalities that reported at least 1,000 births, according to the CDC report.

    The biggest increase occurred in mothers younger than 20, jumping from 37% to more than 42%, according to the report.

    Puerto Rico’s Health Department has said that more than half of all cesareans performed on the island were not medically justified, and that nearly 80% of women who underwent the surgery never presented risk factors.

    Heidi Anne Vera, a 47-year-old mother of two, is one of the few women who had a cesarean for medical reasons.

    “It was an emergency,” she said. “It was not planned.”

    She had worked with a doula and prepared to give birth at home, but her son was not in the correct position and her blood pressure began to spike.

    “That’s when we decided to go to a doctor,” she said.

    The World Health Organization recommends a cesarean rate of between 10% to 15%, noting that the average rate for the Americas is nearly 40%. Once the rate surpasses 10%, there is no evidence that mortality rates improve, according to the agency.

    “The sustained, unprecedented rise in caesarean section rates is a major public health concern,” the organization said in a 2018 report.

    Cesareans are considered a safe procedure, but the WHO noted that any surgery carries risks, and that cesareans could affect future pregnancies or put someone’s life at risk if performed in a place with limited resources.

    The organization said that factors contributing to the rise in cesareans are complex, adding that some of the most common reasons are fear of pain, the convenience of scheduling a birth and the perception that cesareans are less traumatic for a baby.

    For the U.S. as a whole, the cesarean delivery rate is much lower but also has been rising. After generally declining from 2009 to 2019, it inched up for three straight years, accounting for 32.2% of births in 2022, up slightly from 32.1% the year before.

    Data for 2023 has not yet been released.

    ___

    AP Medical Writer Mike Stobbe in New York contributed to this report.

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  • Prague gunman confessed to murders of baby and her dad in suicide note

    Prague gunman confessed to murders of baby and her dad in suicide note

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    A STUDENT who shot dead 14 people confessed in his suicide note to the earlier killings of a two-month-old baby and her father, police revealed.

    The woodland murders came six days before David Kozak, 24, went on the rampage at a Prague university on December 21 — the Czech Republic’s worst ever mass shooting.

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    Prague shooter David Kozak confessed to the earlier murder of two others, before his killing spree on December 21stCredit: czech police

    He injured a further 25 people while firing from a rooftop balcony in 30 minutes of terror — then shot himself as armed police closed in.

    Police said he had also killed his father, taking his total number of victims to 17.

    Investigators are yet to reveal his motives.

    But a police spokesman said: “I can confirm we secured a letter where the perpetrator wrote that he committed the murders. The contents of the document cannot be made public at this time due to the ongoing investigation.”

    READ MORE ON PRAGUE SHOOTING

    A terrifying video from the scene of the attack shows Kozak – a history student who fantasised about “becoming a maniac” – prowling around a rooftop at Charles University.

    Armed with an automatic rifle and dressed in black, the shooter is filmed calmly picking off his victims one by one.

    A brave man can then be heard screaming: “Hey you, shoot here f*****!” in a bid to halt Kozak’s bullet barrage and save the lives of others.

    Undeterred, the crazed gunman continued with his killing spree as he turned to aim at people on the ground and loud shots rung out.

    “He is shooting, get to cover,” the man shouted.

    He then desperately tried to alert police to the 24-year-old’s exact location to put an end to the bloodshed.

    The massacre began on Thursday afternoon at around 3pm when Kozak opened fire at the Faculty of Arts building in Jan Palach Square – an area popular with tourists and Christmas shoppers.

    And under a hour later, Kozak had committed the worst mass shooting in the Czech Republic’s history – leaving 14 dead and 25 injured, including 10 seriously.

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    Thomas Godfrey

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  • Bodies suspected to be pregnant woman and boyfriend were shot, police in Texas say

    Bodies suspected to be pregnant woman and boyfriend were shot, police in Texas say

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    SAN ANTONIO — The dead bodies that Texas investigators believe to have been a pregnant woman and her boyfriend were found with gunshot wounds days after they were reported missing, police said Wednesday.

    A medical examiner has yet to confirm that it was the bodies of Savanah Nicole Soto, 18, and Matthew Guerra, 22, that police found in a car parked outside a San Antonio apartment complex Tuesday. But the fact that they were shot offers the first indication of what may have happened at a crime scene that the city’s police chief described as “very, very perplexing.”

    Authorities have so far offered limited details on the case, which is being investigated as a capital-potential murder. A Wednesday statement from the San Antonio police department listed the victims as an 18-year-old woman, a 22-year-old man and an unborn child.

    Soto was a week overdue to deliver her baby and was scheduled to have an induced labor at a hospital last Saturday night, her family told KENS-TV. But her mother said she got no answer Saturday afternoon, when she knocked on the door of Soto’s apartment in the suburb of Leon Valley.

    The family spent Christmas night searching the area. On Monday, Leon Valley police issued a missing-person alert for Soto and later said Guerra also could not be found.

    San Antonio Police Chief William P. McManus said that the bodies found Tuesday were in a Kia Optima matching the description of one that belongs to Guerra. He said investigators believe them to be the missing couple but could not say for sure without confirmation from the medical examiner.

    “What we’re looking at right now is a very, very perplexing crime scene,” McManus said Tuesday night, without elaborating. He said he didn’t know whether a weapon had been found in the car, and police did not directly respond to that and other emailed questions Wednesday.

    Guerra and Soto were not among the dead listed in the Bexar County Medical Examiner’s Office’s online death records database on Wednesday afternoon.

    Guerra was arrested on Christmas of 2022 for assaulting Soto and sentenced to probation, according to court records obtained by WOAI-TV. A judge extended the sentence through February 2025 after Guerra later was arrested on other charges. The conditions of his probation barred him from possessing a weapon and from having “harmful or injurious” communication with Soto.

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  • Palestinian gives birth to quadruplets on Xmas Day as Gaza war rages around her

    Palestinian gives birth to quadruplets on Xmas Day as Gaza war rages around her

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    A PALESTINIAN woman gave birth to quadruplets on Christmas Day as the war in Gaza raged around her.

    Iman Al-Masri fled her home with her husband and five children while heavily pregnant.

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    Displaced Palestinian Iman Al-Masri gave birth to quadruplets as the war raged around herCredit: Rex
    All four of her babies are thought to be doing well

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    All four of her babies are thought to be doing wellCredit: Rex

    The family took shelter in a school in Deir Al-Balah city.

    And Iman, from the northern town of Beit Hanoun, gave birth on December 25, while the Israel Defence Forces continued its assault on the Gaza Strip.

    All four of her babies are thought to be doing well, although one is still receiving treatment in hospital.

    Unfortunately for Iman and her family, the war doesn’t look to be ending anytime soon as Benjamin Netanyahu promised to continue fighting until Hamas “is finished”.

    During his visit to the Norther Gaza, the prime minister was briefed by IDF commanders on the progress of the war.

    According to the press statement, the prime minister was told about the munitions IDF forces find in almost every building in the territory and on the extensive network of tunnels Hamas has built under Gaza “in the heart of civilian areas.”

    Netanyahu spoke to the soldiers and promised to “protect their lives”.

    He said: “I have two things to tell you: firstly we will do everything to protect your safety, your lives.

    “We want [to complete] this mission but we want to protect you as much as possible.

    “Secondly, we are not stopping. Anyone who talks about stopping — no. We’re not stopping.

    “This war is going to go until the end. Until we finish them. No less than that.”

    The family took shelter in a school in Deir Al-Balah city

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    The family took shelter in a school in Deir Al-Balah cityCredit: Rex

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    Robin Perrie

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  • North Dakota judge to decide whether to temporarily block part of abortion law that limits doctors

    North Dakota judge to decide whether to temporarily block part of abortion law that limits doctors

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    BISMARCK, N.D. — A North Dakota judge said Wednesday he will decide soon whether to temporarily block a part of the state’s revised abortion laws so doctors can perform the procedure to save a patient’s life or health.

    The request for a preliminary injunction asks state District Court Judge Bruce Romanick to bar the state from enforcing the law against physicians who use their “good-faith medical judgment” to perform an abortion because of pregnancy complications that could pose “a risk of infection, hemorrhage, high blood pressure, or which otherwise makes continuing a pregnancy unsafe.”

    North Dakota outlaws all abortions, except in cases where women could face death or a “serious health risk.” People who perform abortions could be charged with a felony under the law, but patients would not.

    Physicians, to mitigate risk of prosecution, “feel like they must delay offering abortions to their patients until the patients’ health has declined to the point where other physicians could not plausibly disagree that it was necessary to provide an abortion,” Center for Reproductive Rights attorney Meetra Mehdizadeh said.

    “Patients and physicians have experienced significant harm,” she said. “For patients, the denial of their constitutional rights and forced additional health risks; and for physicians, the harm of having the threat of criminal prosecution hanging over their head every time they treat a patient with a medical complication.”

    The state’s revised abortion laws also provide an exception for pregnancies caused by rape and incest, but only in the first six weeks, before many women know they are pregnant. It also allows for treatment of ectopic and molar pregnancies, which are nonviable situations.

    Special Assistant Attorney General Dan Gaustad cited the plaintiffs’ “seven-month delay” in seeking a preliminary injunction, and he disputed the “good-faith medical judgment” language. He told the judge the plaintiffs are asking him “to modify and rewrite the statute under the guise of a preliminary injunction.” The law uses ”reasonable medical judgment.”

    The Red River Women’s Clinic sued the state last year after the U.S. Supreme Court’s Dobbs decision, which overturned the court’s landmark 1973 Roe v. Wade ruling establishing a nationwide right to abortion. The lawsuit targeted the state’s since-repealed trigger ban — a ban designed to go into effect immediately if the court overturned Roe v. Wade — as unconstitutional. The clinic moved from Fargo to neighboring Moorhead, Minnesota, where abortion is legal.

    The judge granted a preliminary injunction blocking the ban from taking effect last year, which the state Supreme Court upheld in March.

    Chief Justice Jon Jensen wrote in the court’s March decision that “it is clear the citizens of North Dakota have a right to enjoy and defend life and a right to pursue and obtain safety, which necessarily includes a pregnant woman has a fundamental right to obtain an abortion to preserve her life or her health.”

    Soon afterward, North Dakota’s Republican-controlled Legislature passed a bill revising the state’s abortion laws, which Gov. Doug Burgum signed into effect in April.

    In June, the clinic filed an amended complaint, joined by several doctors in obstetrics, gynecology and maternal-fetal medicine. A jury trial is scheduled for August 2024.

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  • Some state abortion bans stir confusion, and it's uncertain if lawmakers will clarify them

    Some state abortion bans stir confusion, and it's uncertain if lawmakers will clarify them

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    Ever since the nation’s highest court ended abortion rights more than a year ago, vaguely worded bans enacted in some Republican-controlled states have caused bewilderment over how exceptions should be applied.

    Supporters have touted these exemptions, tucked inside statutes restricting abortion, as sufficient enough to protect the life of the woman. Yet repeatedly, when applied in heart-wrenching situations, the results are much murkier.

    “We have black and white laws on something that is almost always multiple shades of gray,” said Kaitlyn Kash, one of 20 Texas women denied abortion who are suing the state seeking clarification of the laws — one of a handful of similar lawsuits playing out across the country.

    State lawmakers there and elsewhere face growing pressure to answer these questions by amending laws in legislative sessions that start in most states next month. But it’s not certain how — or whether — they will.

    Before the Supreme Court overturned the 1973 Roe v. Wade decision in June 2022, nearly every state allowed abortion at least until a fetus would be viable outside the womb — around 24 weeks’ gestational age, or about 22 weeks after conception.

    Yet the new ruling cleared the way for states to impose tighter restrictions or bans; several had such laws already on the books in anticipation of the decision.

    Currently, 14 states are enforcing bans on abortion throughout pregnancy. Two more have such bans on hold due to court rulings. And another two have bans that take effect when cardiac activity can be detected, about six weeks into pregnancy — often before women know they’re pregnant.

    Each state ban has a provision that allows abortion under at least some circumstances to save the life of the mother. At least 11 — including three with the strictest bans — allow abortion because of fatal fetal anomalies, and some do when the pregnancy was the result of rape or incest.

    But a provision included in a law enacted by Congress in 1986 and signed by Republican President Ronald Reagan said abortion must be available when a pregnant woman’s life is at risk during a medical emergency.

    But a lack of clarity over how to apply that rule and other exceptions in state laws has escalated the trauma and heartache some women experience while facing serious medical issues but unable to access abortion in their home states.

    The case of Katie Cox, a Texas woman who sued for immediate access to abortion amid a fraught pregnancy and was denied by the state’s top court, received broad attention this month.

    Meanwhile, Jaci Statton filed a complaint in Oklahoma claiming the state violated the federal rule. She said in court documents that because her own life wasn’t found to be in immediate peril when doctors deemed her pregnancy nonviable, she was told to wait in a hospital parking lot until her conditioned worsened enough to qualify for life-saving care.

    In Tennessee, Nicole Blackmon told reporters that a 15-week ultrasound showed that several of her baby’s major organs were growing outside its stomach and it would likely not survive. Even so, her medical team told her she didn’t have the option to have an abortion. She eventually delivered a stillborn baby because she could not afford to travel out of state for an abortion.

    The vagueness surrounding the Volunteer State’s abortion ban has prompted Republican state Sen. Richard Briggs’ push to tweak the law during the upcoming 2024 legislative session. However, it’s unclear how far the measure will advance inside the GOP-controlled statehouse where many members are running for reelection.

    Republicans carved out an extremely narrow exception earlier this year, but Briggs, who is a doctor, said the statute still fails to properly help women and doctors. He wants the law to include a list diagnoses when abortion could be appropriate and protect women with pregnancy complications who may end up infertile if they don’t receive an abortion.

    Other states took steps in 2023 to address the confusion, but advocates say they didn’t fully accomplish the task.

    In Texas, lawmakers this year added a provision that offers doctors some legal protection when they end pregnancies in cases of premature rupture of membranes, commonly referred to as water breaking, or ectopic pregnancies. which can lead to dangerous internal bleeding.

    Across the country, advocates on both sides anticipate more legislatures will consider adding or clarifying abortion ban exceptions and definitions in 2024, though few, if any, such measures have been filed so far.

    “What is and is not an abortion, what is an abortion emergency?” said Denise Burke, senior counsel with Alliance Defending Freedom, a conservative Christian legal advocacy group that his behind many anti-abortion lawsuits. “That may need some clarification in some areas.”

    Meanwhile, in state where Democrats are in control, lawmakers are expected to push to loosen abortion restrictions and expand access.

    This year, Maine became the seventh state to have no specific limit on when during pregnancy an abortion can be obtained.

    Greer Donley, an associate professor at the University of Pittsburgh School of Law, who is an expert on abortion law, said there could be a push for more changes like that: “Many people are questioning whether a line should exist at all right now.”

    The line is stark in Texas, where changes are unlikely in 2024 because lawmakers aren’t scheduled to meet.

    In Texas, Kash and 19 other women who were denied abortions, plus two physicians, have a lawsuit before the state’s Supreme Court seeking to clarify when abortions should be allowed.

    Kash, who already had one child, was overjoyed at the thought of telling family and friends that she was expecting. But after a routine ultrasound 13 weeks into pregnancy, she learned that the baby had severe skeletal dysplasia – a condition affecting bone and cartilage growth. Her baby was unlikely to survive birth or likely to suffocate soon after being born.

    “Is this where we talk about termination?” Kash asked her doctor.

    “He told me to get a second opinion out of state,” she recalled.

    Her health wasn’t immediately at risk of failing, so she didn’t qualify for any of the narrow exceptions to allow her doctor to provide her abortion services. Instead, she went to another state to terminate her pregnancy legally.

    In the arguments on the case last month, a lawyer for the patients told the justices about the confusion.

    “While there is technically a medical exception to the ban,” Molly Duane, a Center for Reproductive Rights lawyer said, “no one knows what it means and the state won’t tell us.”

    Beth Klusmann, an assistant state attorney general, said that the law does include guidance: Doctors must use “reasonable medical judgment” when deciding whether a pregnant woman’s life is at risk.

    She added that “there are always going to be harder calls at the edge” of the lines of any abortion ban.

    Marc Hearron, a lawyer at the Center for Reproductive Rights who is leading the Texas case, said he does not have a lot of confidence in lawmakers across the U.S. to do it right generally.

    “Legislatures do not have a track record of listening to doctors,” he said. “We’re certainly not waiting on legislatures to do the right thing.”

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  • The Texas Supreme Court has paused an order that allowed a pregnant woman to have an abortion despite the state's ban

    The Texas Supreme Court has paused an order that allowed a pregnant woman to have an abortion despite the state's ban

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    The Texas Supreme Court has paused an order that allowed a pregnant woman to have an abortion despite the state’s ban

    ByThe Associated Press

    December 8, 2023, 10:45 PM

    AUSTIN, Texas — The Texas Supreme Court has paused an order that allowed a pregnant woman to have an abortion despite the state’s ban.

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  • Pregnant woman in Kentucky sues for the right to get an abortion

    Pregnant woman in Kentucky sues for the right to get an abortion

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    LOUISVILLE, Ky. — A pregnant woman in Kentucky filed a lawsuit Friday demanding the right to an abortion, the second legal challenge in days to sweeping abortion bans that have taken hold in more than a dozen U.S. states since Roe v. Wade was overturned last year.

    The suit, filed in state court in Louisville, says Kentucky’s near-total prohibition of abortion violates the plaintiff’s rights to privacy and self-determination under the state constitution.

    The plaintiff, identified as Jane Doe, is about eight weeks pregnant and she wants to have an abortion in Kentucky but cannot legally do so because of the state’s ban, the suit said. She is seeking class-action status to include other Kentuckians who are or will become pregnant and want to have an abortion.

    “I am a proud Kentuckian and I love the life my family and I have here, but I’m angry that now that I’m pregnant and do not want to be,” the plaintiff said in a statement released by the American Civil Liberties Union, one of the groups backing her challenge. “The government is interfering in my private matters and blocking me from having an abortion. This is my decision, not the government or any other person’s.”

    Republican state Attorney General Daniel Cameron’s office said it is reviewing the suit but offered no other comments. Cameron’s office has defended the state’s anti-abortion laws in other court proceedings.

    The filing in Kentucky comes a day after a judge in Texas gave a pregnant woman whose fetus has a fatal diagnosis permission to get an abortion. The temporary restraining order issued Thursday stops Texas from enforcing the state’s ban on the woman, who is 20 weeks pregnant, and lasts for 14 days. Her attorneys afterward spoke cautiously about any wider impacts, and Texas Attorney General Ken Paxton insisted that the order would not insulate any medical practitioners from any civil or criminal liability.

    Unlike the case in Texas, little is known about the Kentucky plaintiff or her pregnancy. Legal challenges currently taking place across the country have largely highlighted the stories from women who were denied abortions while facing harrowing pregnancy complications.

    But in Kentucky, the plaintiff’s attorneys insisted they would fiercely protect their client’s privacy, stressing that Jane Doe believes “everyone should have the right to make decisions privately and make decisions for their own families,” said Amber Duke, executive director for the ACLU of Kentucky.

    Earlier this year, Kentucky’s Supreme Court refused to halt the state’s near-total abortion ban and another outlawing abortion after the sixth week of pregnancy. The justices focused on narrow legal issues but didn’t resolve larger constitutional questions about whether access to abortion should be legal in the Bluegrass State.

    The ACLU, Planned Parenthood and other activists say they’ve been searching for a plaintiff ever since that February ruling. The suit filed Friday marks the launch of their new assault against the state’s abortion bans.

    “These bans have harmed countless Kentuckians since going into effect last year, and we are relieved to be back in court to try to restore abortion access in Kentucky,” Brigitte Amiri, deputy director of the ACLU Reproductive Freedom Project, said in the news release.

    The lawsuit says Kentucky woman are suffering “medical, constitutional and irreparable harm” by being denied the right to obtain an abortion.

    “Abortion is a critical component of reproductive healthcare and crucial to the ability of Kentuckians to control their lives,” the suit says.

    “Whether to take on the health risks and responsibilities of pregnancy and parenting is a personal and consequential decision that must be left to the individual to determine for herself without governmental interference,” it added.

    Kentucky voters last year rejected a ballot measure that would have denied any constitutional protections for abortion, but abortion rights supporters have made no inroads in the Republican-controlled Legislature in chipping away at the state’s anti-abortion laws.

    The legal challenge revolves around Kentucky’s near-total trigger law ban and a separate six-week ban — both passed by Republican lawmakers. The trigger law was passed in 2019 and took effect when Roe v. Wade was overturned in 2022. It bans abortions except when they’re carried out to save the life of the patient or to prevent disabling injury. It does not include exceptions for cases of rape or incest.

    ___

    Kruesi reported from Nashville, Tennessee.

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