WASHINGTON — Tuesday’s Senate Finance Committee hearing on how the Dobbs decision affected women’s access to care featured arguments over everything — including the title of the event.
“The Senate Finance Committee has never had a non-sitting president’s name in its hearing title, which should tell us all we need to know about the reason for this hearing,” said Sen. Mike Crapo (R-Idaho), the committee’s ranking member. The hearing was titled, “Chaos and Control: How Trump Criminalized Women’s Health Care.”
Sen. Ron Johnson (R-Wis.) agreed. “Listening to the testimony here, it’s like there are two totally different realities,” he said, noting that some witnesses were describing a “torrent of pandemonium” with women “bleeding out in parking lots” in the wake of the Dobbs decision, which returned control over abortion laws from the federal government to the states.
If women are afraid to seek care, “maybe it’s because here in the … Finance Committee, we’re holding a hearing that says women’s healthcare now is criminalized,” he said. “Maybe a title like that is causing the chaos.”
But others contended that the hearing was aptly named. “The legal, social, and moral chaos of the Supreme Court’s Dobbs decision has brought about a torrent of pandemonium, fomenting havoc for medical providers and hospitals,” said Michele Goodwin, professor of constitutional law and global health policy at Georgetown University, in Washington. “It has exacerbated and caused the closure of clinics that provided the only healthcare services for tens and even hundreds of miles for economically disenfranchised women and families. These closures, which were foreseeable, place the lives of women and girls at risk.”
The Supreme Court’s Role Questioned
Sen. Ron Wyden (D-Ore.), the committee’s chair, argued that the three Supreme Court justices appointed by former president Donald Trump were to blame for the current situation, in which women in states with abortion bans who need abortions in order to save their lives or protect their health are afraid to seek care, and doctors are afraid to provide needed care for fear of imprisonment or loss of licensure.
“Each one of [the three Trump appointees] swore up and down that Roe was settled law, that there was no threat to any facet of reproductive freedom,” Wyden said, referring to Roe v. Wade, the 1973 Supreme Court ruling that legalized abortion nationwide. But “every single one of those justices threw the pledges they took under Senate oath into the trash can and gutted Roe at the very first opportunity.”
“The consequences of that decision, while predictable, are gut-wrenching,” he continued. “Women are miscarrying, suffering life-threatening blood loss, losing their ability to bear future children, or dying because they were denied the emergency medical care they needed. Doctors are being targeted or forced to relocate to states where they can practice basic medicine without fear of a legal witch hunt.”
Is Misinformation to Blame?
Republicans on the committee had another explanation: misleading information from pro-choice advocates regarding state abortion bans that were passed or re-activated in the wake of the Dobbs decision, which invalidated Roe. “Unfortunately, there have been widespread and misleading claims suggesting that these laws require physicians to wait until a woman is on the verge of death or severe and irreversible harm before they can intervene,” said Sen. Marsha Blackburn (R-Tenn.). “No law in this country mandates that a physician ignore the needs of pregnant women in medical emergencies.”
Christina Francis, MD, the CEO of the American Association of Pro-Life Obstetricians and Gynecologists and an ob/gyn from Fort Wayne, Indiana, agreed. “I, like every other physician in the state of Indiana, intervene when I have a woman in front of me who’s facing an emergency,” she said. “I don’t send her out to her car. I don’t send her home and tell her to come back when she’s more sick.”
The pandemonium that others are describing “is not the fault of the state law,” she added. “Every state law provides clear exceptions for physicians to have a wide latitude to intervene in an emergency. If they are withholding treatment and they’re not intervening, it is coming from a lack of understanding.” Francis faulted various organizations, including some state medical associations, for not properly explaining the law.
Senators also heard from Kaitlyn Joshua of Baton Rouge, Louisiana, who was refused care by two different hospital emergency rooms even as she was bleeding and cramping. “Louisiana’s new abortion ban affected my pregnancy from the very start, when I called to schedule my first prenatal appointment,” she noted. “I was told I have to wait until I was 12 weeks pregnant — a month longer than my first pregnancy.”
When she asked the scheduler if this was because of the abortion ban, “the young lady … said yes, because of the abortion ban, prenatal appointments were purposely scheduled weeks later than normal, delayed further into pregnancy when miscarriages are less common, so as to avoid potential legal and criminal liability for medical providers,” said Joshua. Eventually, “I had to pass the pregnancy at home without care, and I was terrified,” Joshua said. “I’ve received hundreds of letters from women across Louisiana who’ve had similar experiences.”
An Ob/Gyn’s Decision to Leave Idaho
Amelia Huntsberger, MD, an ob/gyn, explained to the committee why her family ended up leaving Sandpoint, Idaho, the small town where she and her husband had practiced for 11 years. “Idaho has enacted some of the strictest abortion restrictions in the country, without exceptions to allow doctors to act to preserve a pregnant patient’s health, not even to prevent harm to organs or functions like fertility, unless an abortion is necessary to prevent death,” she said.
Once the laws went into effect, Idaho “no longer felt like a safe place to practice medicine,” said Huntsberger. “The risk of criminal prosecution and civil penalties immediately felt very real for my husband, who is an emergency medicine physician, and for me as an ob/gyn … These laws forced us to consider what would happen to our children if both of their parents went to jail.” They eventually ended up moving to Oregon.
Sen. Maggie Hassan (D-N.H.) asked Huntsberger what the effects of laws like Idaho’s had been on physician training. “It’s huge,” Huntsberger said. “Medical students deciding whether or not to come to Idaho for family medicine — many are deciding not to apply or not to go there as a result of the bans and the negative effect on their medical education. We’re seeing this not just in Idaho; it’s happening across the country, with specific impacts on ob/gyn and family medicine, but it affects all specialties.”
Senators on both sides of the issue also discussed the case of two Georgia residents, Amber Thurman and Candi Miller, who both died following incomplete medication abortions. Thurman waited 20 hours for emergency care. “The irony is that these tragedies would have never occurred if the FDA had kept the safety precautions for chemical abortions — including the in-person dispensing requirement and the follow-up visit with a medical provider — in place,” said Sen. Steve Daines (R-Mont.). “They’re blaming the deaths of these women on Georgia law. That is a lie.”
But the Democrats disagreed. “What we’re seeing is Republican politicians who pass these medically unsound and dangerous laws that end up intimidating and confusing physicians who are just trying to provide care,” said Sen. Elizabeth Warren (D-Mass.). “Amber and Candi should be alive today.”
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