[House Hearing, 116 Congress]
[From the U.S. Government Publishing Office]
EXAMINING STATE EFFORTS
TO UNDERMINE ACCESS
TO REPRODUCTIVE HEALTH CARE
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HEARING
BEFORE THE
COMMITTEE ON
OVERSIGHT AND REFORM
HOUSE OF REPRESENTATIVES
ONE HUNDRED SIXTEENTH CONGRESS
FIRST SESSION
__________
NOVEMBER 14, 2019
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Serial No. 116-71
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Printed for the use of the Committee on Oversight and Reform
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Available on: http://www.govinfo.gov
http://www.oversight.house.gov
http://www.docs.house.gov
__________
U.S. GOVERNMENT PUBLISHING OFFICE
38-554 PDF WASHINGTON : 2020
__________
COMMITTEE ON OVERSIGHT AND REFORM
CAROLYN B. MALONEY, New York, Acting Chairwoman
Eleanor Holmes Norton, District of Jim Jordan, Ohio, Ranking Minority
Columbia Member
Wm. Lacy Clay, Missouri Paul A. Gosar, Arizona
Stephen F. Lynch, Massachusetts Virginia Foxx, North Carolina
Jim Cooper, Tennessee Thomas Massie, Kentucky
Gerald E. Connolly, Virginia Mark Meadows, North Carolina
Raja Krishnamoorthi, Illinois Jody B. Hice, Georgia
Jamie Raskin, Maryland Glenn Grothman, Wisconsin
Harley Rouda, California James Comer, Kentucky
Katie Hill, California Michael Cloud, Texas
Debbie Wasserman Schultz, Florida Bob Gibbs, Ohio
John P. Sarbanes, Maryland Ralph Norman, South Carolina
Peter Welch, Vermont Clay Higgins, Louisiana
Jackie Speier, California Chip Roy, Texas
Robin L. Kelly, Illinois Carol D. Miller, West Virginia
Mark DeSaulnier, California Mark E. Green, Tennessee
Brenda L. Lawrence, Michigan Kelly Armstrong, North Dakota
Stacey E. Plaskett, Virgin Islands W. Gregory Steube, Florida
Ro Khanna, California Frank Keller, Pennsylvania
Jimmy Gomez, California
Alexandria Ocasio-Cortez, New York
Ayanna Pressley, Massachusetts
Rashida Tlaib, Michigan
David Rapallo, Staff Director
Miles Lichtman, Professional Staff Member
Jennifer Gasper, Counsel
Joshua Zucker, Clerk
Christopher Hixon, Minority Staff Director
Contact Number: 202-225-5051
C O N T E N T S
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Page
Hearing held on November 14, 2019................................ 1
Witnesses
Jennifer Box, St. Louis, Missouri
Oral Statement............................................... 6
Dr. Colleen McNicholas, OB/GYN, Chief Medical Officer, Planned
Parenthood of the St. Louis Region and Southwest Missouri
Oral Statement............................................... 7
Fatima Goss Graves, President and Chief Executive Officer,
National Women's Law Center
Oral Statement............................................... 9
Allie Stuckey (minority witness), Carrollton, Texas
Oral Statement............................................... 10
Marcela Howell, Founder and President/Chief Executive Officer, In
Our Own Voice: National Black Women's Reproductive Justice
Agenda
Oral Statement............................................... 12
Written opening statements and witness' written statements are
available at the U.S. House of Representatives Repository:
https://docs.house.gov.
----------
The documents listed below are available at: https://
docs.house.gov.
* Letter from Ms. M'Evie Mead, Director of Policy and
Organization, Planned Parenthood Advocates in Missouri;
submitted by Rep. Clay.
* ``A Mother's Love and the March that Matters,'' article;
submitted by Rep. Foxx.
* ``No, Georgia's Heartbeat Bill Won't Imprison Women Who Have
Abortions,'' article; submitted by Rep. Hice.
* Violations at Abortion Clinics in Several States; submitted
by Rep. Cloud.
* Letter from the American College of Obstetricians and
Gynocologists; submitted by Acting Chairwoman Maloney.
* Letter from Reproaction; submitted by Acting Chairwoman
Maloney.
* Letter from the Guttmacher Institute; submitted by Acting
Chairwoman Maloney.
* Letter from the American Civil Liberties Union; submitted by
Acting Chairwoman Maloney.
EXAMINING STATE EFFORTS
TO UNDERMINE ACCESS
TO REPRODUCTIVE HEALTHCARE
Thursday, November 14, 2019
House of Representatives
Committee on Oversight and Reform
Washington, D.C.
The committee met, pursuant to notice, at 2:19 p.m., in
room 2154, Rayburn Office Building, Hon. Carolyn Maloney,
presiding.
Present: Representatives Maloney, Norton, Clay, Lynch,
Connolly, Krishnamoorthi, Raskin, Rouda, Wasserman Schultz,
Sarbanes, Speier, Kelly, DeSaulnier, Lawrence, Khanna, Gomez,
Pressley, Tlaib, Jordan, Foxx, Massie, Hice, Grothman, Cloud,
Roy, Miller, Green, Armstrong, Steube, Keller, and Norman.
Also present: Representatives Chu, Schakowsky, Schrier, and
Lee.
Chairwoman Maloney. The committee will now come to order.
Good morning to everyone. The purpose of this hearing is to
examine how state policies, like those in Missouri, are
impacting residents' access to comprehensive reproductive
healthcare services, including abortion.
Without objection, the chair is authorized to declare a
recess of the committee at any time.
For audience purposes, we welcome you and respect your
interest in being here. In turn, we request and we ask you to
respect the proceedings as we go forward in today's hearings.
With that, I will now recognize myself to give an opening
statement.
I would like to begin by acknowledging that this is the
first full committee hearing we have held since our friend, our
colleague, and our beloved chairman, Elijah Cummings, passed
away. Chairman Cummings spent his entire life fighting for
justice and equality for everyone, and he was a fierce champion
for women's access to healthcare.
Across the country extreme forces in some state governments
are taking draconian steps to violate women's rights by
restricting access to reproductive health services, including
abortion. These state actions include prerequisite undue
burdens, restrictions, and outrageously invasive procedures for
patients seeking abortions. Let me be clear about what these
restrictions are. They are a denial of basic healthcare
services that women have a right to receive no matter where
they live.
I want to thank my very good friend, Congressman Clay, for
his leadership in requesting today's hearing. Missouri has
taken some of the most extreme actions to limit access to
reproductive healthcare. Missouri is one of six states with
only one remaining abortion provider, and as we will hear
today, it is at risk of having no providers at all. Missouri's
one remaining clinic is Planned Parenthood, and we thank that
clinic's director, Dr. McNicholas, for testifying here today
and for her brave service to the women in her community every
single day.
Earlier this year, Dr. Randall Williams, the director of
the Missouri State Health Department, ordered Planned
Parenthood to perform medically unnecessary pelvic examinations
on every single woman seeking an abortion. This was an invasive
state-sponsored abuse of women seeking care. After significant
public backlash, the State suspended this cruel practice. But
Dr. Williams also recently was forced to admit that he directed
state employees to collect information about patients'
menstrual cycles to advance his ideological crusade. That is
what they were spending taxpayers' dollars on.
I cannot begin to describe my disgust at these violations
of privacy and breaches of trust by government officials. Sadly
Missouri's actions are not taking place in isolation. Other
states have pushed for similar restrictions. I believe these
states have been emboldened by the Trump Administration's
systemic attacks on reproductive healthcare and general
disrespect for women.
In 2012, our former chairman, Darrell Issa, held a hearing
in this room in this committee with an all-male panel of
religious leaders who were trying to take away contraceptive
coverage for women. They did not invite one single woman to
testify on that panel. Then they refused our request to have
Sandra Fluke, who was a Georgetown law school student at the
time, testify about the importance of health insurance coverage
of contraceptives. They said she was, and I quote, ``not
qualified.'' It was at that hearing that I asked in protest,
where are the women. It is time to let women speak, and it is
time for everyone to listen. It is time for elected
representatives here in Congress and in state houses across the
country to protect the right to privacy and a woman's right to
abortion services rather than attack it, undermine it, and try
to eliminate it.
I want to thank Jennifer Box for sharing her family's story
with us. No one should ever have to make the heartbreaking
decision that you and your husband had to make, but it is your
decision and it does not belong to anyone else. I also want to
thank Marcela Howell from In Our Own Voice, which is part of
the National Black Women's Reproductive Justice Agenda, and
Fatima Goss Graves from the Women's National Law Center, for
all their work and for being here today, and for helping the
committee and me on this subject.
I now recognize the Ranking Member Jordan for his opening
statement, and I yield back.
Mr. Jordan. Thank you, Mr. Chair. I want to thank our
witnesses for being here today. In the Declaration of
Independence, signed 243 years ago, our Founding Fathers
enshrined the principle that life, liberty, and the pursuit of
happiness are unalienable for everyone. I think it is always
interesting to note the order the founders placed the rights
they chose to mention. Can you really pursue happiness, can you
chase down your goals and dreams if you first don't have
freedom, if you first don't have liberty? Do you ever enjoy
true liberty, true freedom if government won't protect your
most fundamental right, your right to live, your right to life?
Life is precious. It is a sacred gift from God.
During an earlier time here in Congress, whatever
disagreements that we had, colleagues who didn't share those
beliefs, there was a common understanding about this
fundamental principle, that life, in fact, is precious. Over
the past few years, it seems our two sides have moved away from
this basic understanding. Today my colleagues on the other side
of the aisle will charge me and Republicans as being against
women. Democrats will say if you are not for them and this
position and their position on this issue, then you are against
all women. We want all people, including women and babies, to
have access to world-class healthcare. Statements to the
contrary are simply false and are meant to divide our country.
Today, this Congress is in the midst of an unprecedented
impeachment inquiry against President Trump. I am proud that
President Trump is one of the most pro-life presidents to ever
lead our Nation. President Trump has taken bold steps to stop
Federal funding of abortions and enable better legal
protections for healthcare workers who are opposed to
providing, assisting, or participating in these procedures. The
hearing today is an attack on that pro-life record.
Today's culture, standing for life, is not easy. I am
always guided by one of my favorite Scripture verses, II
Timothy 4:7, ``Fight the good fight, finish the course, keep
the faith,'' and that is what we have to do, keep the faith in
those basic principles outlined in that document that started
our Nation over 200 years ago. We came to this Congress to
fight for the right of all Americans to have life, liberty, and
pursue happiness. I yield back.
Chairwoman Maloney. I will now yield one minute to the
member from the great state of Missouri, Lacy Clay, who
requested this hearing.
Mr. Clay. Thank you, Madam Chairwoman. I along with my
constituents appreciate your calling this hearing today on an
urgent issue that threatens the health and personal freedom of
millions of American women. The assault against a woman's right
to make their own healthcare decisions is an insult to the
basic values of individual freedom and limited government.
Nowhere in the Nation is that assault more urgent than in my
home state of Missouri, specifically in the city of St. Louis,
which I am so proud to represent.
Planned Parenthood of St. Louis is the last remaining
women's healthcare clinic in the entire state of Missouri that
also provides abortion services. I visited the clinic staff and
physicians this past June as the battle was elevating, and I
wanted to lend my support and voice to their efforts. As a
husband, father, and brother, I support and trust the private
personal health choices of women. I am truly amazed at the
Missouri Department of Health would, along with efforts to shut
down the clinic, intimidate patients and threaten providers,
and would allegedly and bizarrely track women's menstrual
periods on spreadsheets to determine if they had had an
abortion. No woman should be subjected to this violation of
their personhood. This is America, it is her body, it is her
healthcare, and it is her decision.
I stand with Planned Parenthood because they are truly on
the front lines of defending women's healthcare across America.
Madam Chairwoman, I would also like to introduce into the
record a personal statement by Ms. M'Evie Mead, the director of
policy and organizing of Planned Parent Parenthood advocates in
Missouri.
Chairwoman Maloney. Without objection, so ordered.
Mr. Clay. Thank you. I yield back.
Chairwoman Maloney. I will now yield time to the member
from the great state of North Carolina, Dr. Foxx.
Ms. Foxx. Thank you, Chairwoman Maloney. I welcome you to
your first hearing as acting chairwoman and look forward to
continuing working together in your new role. We have had a
productive working relationship over the years, and I commit to
continuing in that spirit.
I want to say that my sympathy goes out to any woman who
feels she must seek an abortion. It must be a horrible
situation to be in, but I will admit that I am perplexed by the
scope of the hearing. After all, my colleagues on the other
side are quick to assert that Roe v. Wade is ``the law of the
land. However, Planned Parenthood V Casey clearly allows states
to implement abortion restrictions, even ones that apply during
the first trimester of pregnancy. States are grappling with
issues of how to defend and preserve life and support high
standards for women's healthcare. As states continue to explore
ways to do so in recent years, we are now at a reflection
point.
After the Governor of Virginia's horrific comments earlier
this year, there has been a national outcry over the apathy
shown by the pro-abortion movement toward babies that have been
born after an abortion. This is an issue that is very close to
my heart and the hearts of millions of Americans. I am going to
quote the Governor: ``If a mother is in labor, I can tell you
exactly what would happen. The infant would be delivered. The
infant would be kept comfortable. The infant would be
resuscitated if that is what the mother and the family desired,
and a discussion would ensue between the physicians and the
mother. Governor Northam unfortunately does not stand alone in
this appalling stance. He echoes Planned Parenthood's
lobbyists, who during testimony on Florida's Born Alive Bill,
expressed support for leaving an abortion survivor on the table
to die, if that is what the patient and abortionist decided.
In New York, the Reproductive Health Act signed into law by
Governor Andrew Cuomo removes protections for children born
alive during abortion attempts, leaving them at the mercy of
the abortionist who just minutes earlier was trying to kill
them. Illinois has also enacted a law that repeals the Illinois
Partial Birth Abortion ban Act, and removes licensing
requirements for abortion facilities. Still other states,
notably, Massachusetts and Virginia, having proposed
legislation equally as alarming. Only two-thirds of the states
have any laws to protect infants who survived abortion and that
positively enshrine their right to life into law. That is
simply unacceptable.
Madam Chairwoman, respectfully, in light of these events, I
hardly find that anyone is losing access to anything, anyone
save the defenseless, the unborn, and now even the born alive.
They are the ones having their rights deprived, and the
American people find this intolerable. I find it to be an
abomination. The pendulum in the states is not one that
swinging against women, not in the slightest. Some of my
colleagues used to espouse the idea that abortion should be
safe, legal, and rare. They espouse it no longer. Instead, on-
demand access to abortion up to and, tragically, even after
birth is the new mantra. And the fact that extremists are
working to keep this ever-expanding restriction on the right to
life buttressed against the lives of babies born outside the
womb, this should be a wake-up call to us all.
I call on Speaker Pelosi to end her blockade against the
bipartisan Born Alive Survivors Protection Act. This bill would
protect babies born alive in the remaining one-third of state
jurisdictions that fail to do so. Life is sacred, and the
regard with which we hold it is what defines who we are as a
society. We live in a society that mistakes choice for liberty
and denies the dignity of unborn life. But the beauty of living
in a free country is that we can use our liberty for love. We
must put love into action every day, affirming the value of
life at all stages, no matter the difficulties it presents.
Striving to love daily is not easy, yet it is the greatest
exercise of our freedom, and there is no life unworthy of that
love. I yield back, Madam Chairwoman. Thank you.
Chairwoman Maloney. I will now briefly yield to Congressman
Clay to introduce his constituent, Dr. McNicholas.
Mr. Clay. Thank you, Madam Chair, and I am happy to
introduce to the committee one of my distinguished
constituents, a highly skilled physician, who has dedicated her
life to providing exceptional healthcare for all women, the
chief medical officer of Planned Parenthood of the St. Louis
Region in Southwest Missouri, Dr. Colleen McNicholas. Dr.
McNicholas has also served as a distinguished assistant
professor of obstetrics and gynecology at Washington University
of Medicine in St. Louis, and Dr. McNicholas is also a champion
for closing healthcare disparities, like high maternal and
infant mortality rates, that affect minority and low-income
patients, mostly because of a lack of access to basic medical
care.
Dr. McNicholas performs her duties with skill and
compassion. She is a compassionate healer who fiercely defends
her patients' rights and their privacy as well. Dr. McNicholas
is a warrior for access to quality healthcare for women, not
just in St. Louis, but across Missouri and across the Nation as
well. Welcome, Doctor, and I yield back.
Chairwoman Maloney. Thank you, Congressman. We are also
joined by Jennifer Box from St. Louis, Missouri, and she was
holding that beautiful baby girl. Also we are joined with
Fatima Goss Graves, president and chief executive officer of
the National Women's Law Center, and Allie Stuckey, from
Carrollton, Texas, and Marcela Howell, founder and president,
chief executive officer, In Our Own Voice: National Black
Women's Reproductive Justice Agenda.
If you would all please rise and raise your right hand, I
will begin to swear you in, and raise your right hand.
Do you swear to affirm that the testimony you are about to
give is the truth, the whole truth, and nothing but the truth,
so help you God?
[A chorus of ayes.]
Chairwoman Maloney. Let the record show that the witnesses
answered in the affirmative. Thank you, and please be seated.
The microphones are sensitive, so please speak directly
into them. Without objection, your written statement will be
made part of the record. With that, Ms. Box, you are now
recognized for your opening statement.
STATEMENT OF JENNIFER BOX, ST. LOUIS, MISSOURI
Ms. Box. Good afternoon, Acting Chairwoman Maloney, Ranking
Member Jordan, and members of this committee. My name is
Jennifer Box. I am a mother of three living children, and, as
you saw, I am here today with my three-month-old, Astrid, and
my husband, Jake. I am a small business owner, a wife, and a
Missourian.
I am here today to tell you the story of our daughter,
Libby. I am also here to share with you as someone who was in
need of an abortion, how difficult my home state of Missouri
makes it for pregnant people to access abortion. Libby's story
is heartbreakingly linked with the political landscape in
Missouri, something I never imagined I would have to navigate
when the learning the most devastating news of our lives.
It was almost in the same breath that I learned my
pregnancy had a fatal fetal diagnosis that I learned my home
state of Missouri would insert itself in the middle of my
grief. I searched for answers everywhere, and yet we found no
solace in them. Our daughter, if not stillborn, would be born
into a life of immediate and repeated invasive medical
intervention. She would essentially have been born onto life
support. With broken hearts, we knew that the greatest act of
love that we could undertake as her parents would be to suffer
ourselves instead, to end the pregnancy, grant Libby peace, and
spare her tiny, broken body a short life full of pain.
We had made our decision and were still grappling with the
reality of it, but there was little time to spare. Missourians
like me who seek abortion are confronted with a litany of
onerous restrictions, including mandatory waiting periods,
private and public insurance bans, informed consent laws, and
more. This means that I moved at the direction of the
government. For example, my doctor's Catholic hospital, where I
delivered my two older children, refused me care. We had to pay
thousands of dollars out of pocket because of the state's
insurance bans against abortion coverage. And perhaps most
surprising, our procedure was rushed due to the state's consent
and mandatory delay laws.
Despite how difficult it was to access the medical care I
needed, my actual abortion procedure was the most compassionate
care I have ever received from a physician. Jake and I left
that day knowing that we had made the most loving and merciful
choice for our daughter.
I thought after the procedure was over my family could
begin to heal privately. I never imagined watching the State of
the Union and hearing the President refer to women like me,
women who have had abortions later in pregnancy, as murderers.
I never fathomed my Governor would weaponize the health
department in an attempt to end safe, legal abortion in
Missouri. I did not anticipate my state legislature enacting an
eight-week abortion ban that would have made it impossible for
me to make the best decision for our family.
And let me be clear. My story does not give anyone the
right to make judgments about good reasons and bad reasons for
abortion. A fetal diagnosis was my reason, but nobody should
have to explain themselves or compare their stories to justify
a deeply personal decision. I tell my story knowing I am a
woman of privilege with means and resources to access the care
I needed despite a complicated landscape of laws. Every day
women and people of color who fear racist and discriminatory
policies carry the heaviest burdens when navigating abortion
access.
Politicians like Governor Parson are hellbent on finishing
off what little remains of the reproductive healthcare in my
State. Members of Congress, I urge you to remember who you
represent. I am the one in four women who will have an abortion
in her lifetime. You have the power to change a broken system
working against us, and I ask that you work in our best
interest. I am not asking you to condone my choice. I am simply
begging lawmakers like you, who have the power to create
change, to allow families to make that choice for themselves.
I speak for Libby. It is an honor to share her name with
this committee and the country today. Libby Rose Box. I have a
rose tattoo above my heart so that she is with me every day. I
am her mother, and she is my daughter and will always be my
daughter. I made decisions from day one as her mother, and I
made the most important decision of Libby's life, when together
with my husband we decided to terminate the pregnancy. It was a
sacred, painful, personal decision. That is our story unique to
our family, and one that never should have included any
politicians. Thank you for your time.
Chairwoman Maloney. And thank you for sharing your story. I
will now call upon Dr. Colleen McNicholas.
STATEMENT OF COLLEEN MCNICHOLAS, M.D., OB/GYN, CHIEF MEDICAL
OFFICER, PLANNED PARENTHOOD OF THE ST. LOUIS REGION AND
SOUTHWEST MISSOURI
Dr. McNicholas. Thank you, Acting Chairwoman Maloney,
Ranking Member Jordan, and members of the committee. Special
thanks to Representative Clay for that very kind introduction.
My name is Dr. Colleen McNicholas, and I am a practicing
OB/GYN in the state of Missouri. And as you heard, I am the
chief medical officer of Planned Parenthood of the St. Louis
Region in Southwest Missouri. For more than a decade, I have
been honored with the trust of patients seeking a broad
spectrum of reproductive healthcare services, including
abortion.
As you may know, there is only one health center left in
Missouri that provides abortion to meet the needs of more than
1.1 million women of reproductive age in my state, Planned
Parenthood's Reproductive Health Services in St. Louis. I am
here today because if Governor Parson and Health Director
Williams get their way, Missouri could soon become the first
state since Roe v. Wade without a single health center that
provides abortion care.
I want to tell you how we got here and the dangers that we
face when state officials abuse their power and disregard
patients' lives to pursue a political agenda. Despite the
reality that abortion is safe, Missouri politicians have
layered restriction upon restriction, ranging from long waiting
periods to insurance coverage bans, in a deliberate attempt to
end abortion access. Over the last 30 years, Missouri has gone
from nearly 30 clinics to just one clinic today.
Earlier this year, Governor Parson signed one of the most
restrictive abortion bans in the country, banning abortion as
early as eight weeks, and all together if Roe were overruled.
Fortunately, that ban for now is blocked in the courts. Unable
to get the job done through legislation, though, Parson's
administration weaponized the licensure process to deny our
abortion facility license. Health officials admitted under oath
that they singled out Planned Parenthood for extra inspections,
additional scrutiny, including at the behest of anti-abortion
protestors and legislators.
They came to our clinic five times in the first five months
of this year, all while they conceded that hospitals and
surgery centers providing much riskier procedures went years
without a single inspection. During this year's inspection
process, the department also admitted to keeping a spreadsheet
of my patients' menstrual cycles, a brazen abuse of power and
misuse of data motivated by an agenda to find something,
anything, that they could use to justify further scrutiny. As
shocking as that sounds, more egregious was Director Williams'
reinterpretation of a 1988 regulation which forced over 100
patients to undergo multiple invasive pelvic exams. My
colleagues and I could not in good conscience force patients to
take their clothes off unnecessarily and endure and extra
state-mandated vaginal exam. Due to public outcry, the
department relented, but that only confirms that there was no
real medical reason for that exam.
Missourians want to believe that state officials charged
with protecting public health have their best interests in
mind. They want to trust that when they go to the doctor, their
private medical information will not be mined by the department
of health as part of a political fishing expedition. Governor
Parson and Director Williams have repeatedly violated the trust
of our community and compromised my patients' safety, all to
push a political agenda.
And it is not just Missouri. Anti-abortion politicians in
other states, including Louisiana, refuse to license abortion
facilities simply because they do not agree with the healthcare
that is provided there. This year alone, 12 states have enacted
25 different abortion bans, and that is on top of the nearly
500 abortion restrictions enacted in the states since 2011.
This obsession with abortion has not only proven detrimental to
our patients, but it has lasting effects on the health of an
entire community. While Missouri goes to incredible lengths to
ban abortion, maternal mortality is rising, and black women are
dying in pregnancy at three times the rate of white women.
Despite this and many other serious public health crises anti-
abortion politicians continue to divert precious resources to
the overregulation and targeting of abortion providers.
In Missouri, I am happy to say that despite the unrelenting
attacks on reproductive healthcare, our doors remain open for
now. Planned Parenthood will continue the work of ensuring that
every patient who needs and wants an abortion is able to access
that care with dignity and respect, and consistent with their
values in spite of this impossible landscape. In my exam room,
abortion is not political. It is simply healthcare, and it is
time we listened to the majority of Americans and put an end to
this rampant abuse of power, and do what is necessary to keep
abortion safe, legal, and accessible. Thank you.
Chairwoman Maloney. Thank you. Thank you for your work and
for your testimony today. I am now going to recognize Fatima
Goss Graves.
STATEMENT OF FATIMA GOSS GRAVES, PRESIDENT AND CHIEF EXECUTIVE
OFFICER, NATIONAL WOMEN'S LAW CENTER
Ms. Goss Graves. Thank you, Acting Chairwoman Maloney, and
Ranking Member Jordan, and members of the committee. Thank you
for the invitation to testify today, and especially on this
first hearing following Congressman Cummings' passing. He was a
champion for justice and on these issues.
My name is Fatima Goss Graves. I am president and CEO at
the National Women's Law Center. At the Law Center, we know
that access to reproductive healthcare, including abortion, is
vital to gender justice. Access to abortion is a key part of a
person's liberty and equality and economic security, and
everyone, no matter where they live, no matter their financial
means should have access to abortion when they need it.
As the Supreme Court said in Planned Parenthood v. Casey,
the ability of women to participate equally in the economic and
social life of this Nation has been facilitated by their
ability to control their reproductive lives. We also know that
legislators passing restrictions on abortion want to control
the lives and futures of women. And it is not lost on me that
we are facing the biggest threat to the right to abortion on
the eve of the 100th anniversary of the Nineteenth Amendment
when some women first gained the right to vote. The fight to
secure the vote was symbolic of a broader societal change
regarding women's ability and right to be politically equal and
make politically independent decisions. Now, too, there is a
broader movement in this country that will transform the
relationship between gender and power. And it is against this
backdrop that we must view Missouri's regulatory and
legislative efforts to shut down the state's last abortion
clinic.
Missouri is not the only or even the first state to seek to
end abortion in this country, of course, but what is unique in
this moment are the types of abortion bills that are being
introduced and passed, before this year, bans on abortion that
represented direct challenge to Roe. For example, banning
abortion two weeks after a missed period before most people
would even know that they are pregnant, were typically seen as
too radical, even by many anti-abortion advocates.
What is also unique to this moment is state legislators'
willingness to express up front why they are pushing these
extreme measures. Their goal is to propel a case that presents
the Supreme Court an opportunity to overturn or to grossly
undermine Roe v. Wade. These legislators believe that between
President Trump, Vice President Pence, and the newly
constituted Supreme Court, that their goal will be realized.
During his first campaign, President Trump even promised some
form of punishment for women who have abortions, and that he
would automatically overturn Roe v. Wade. In the three years
that Trump has been in power, he has reshaped our Federal
judiciary in shocking terms to fulfill that promise.
It is disturbing then that earlier this year, the Fifth
Circuit upheld a Louisiana law that is identical to a Texas law
struck down by the Supreme Court in Whole Woman's Health v.
Hellerstedt in 2016. The Supreme Court has just agreed to
review this rogue decision this term in June Medical Services
v. Gee. This should be an easy decision. Nothing relevant has
changed in the last three years except for the composition of
the Supreme Court, but the law at issue in June also does
nothing to make abortion, an already extremely safe procedure,
safer. Instead, such laws are intended to close clinics, and
they have done just that.
The resulting shortage of abortion providers has led to
longer waiting times for appointments, increased travel to
clinics which often result in increased costs, long distance
travel, hotel stays in different cities, additional childcare
expenses, more time off work when people don't have it, and
ultimately delays in getting the care that they are seeking.
These costs compound the other restrictions that are already in
place, including restrictions on insurance coverage of
abortion, all intended to make abortion unaffordable and,
therefore, inaccessible. What these politicians are doing is
not representative of the will of the people. The public
doesn't want the right to abortion overturned. In fact, in the
wake of these extreme abortion bans, the public sentiment
showed its strength as people flooded the streets this past
summer to protest these laws in the middle of the week.
As president of an organization that fights for gender
justice in our schools, in work, in healthcare, and improving
income security for women in their families, I have a bird's
eye view of how all of these fights are connected. The same
misogyny that is driving these abortion bans drives much of the
opposition that we are seeing in other gender justice battles.
That is why at this moment of reckoning on the constitutional
right to abortion, we need Congress to lead. We think they can
start with passing laws, such as the Each Women Act and the
Women's Health Protection Act. Thank you.
Chairwoman Maloney. Thank you so much. Allie Stuckey.
STATEMENT OF ALLIE STUCKEY, CARROLLTON, TEXAS
Ms. Stuckey. I would like to thank Chairwoman Maloney, and
Ranking Member Jordan, and the rest of the committee for the
opportunity to appear before the committee today. My name is
Allie Stuckey. I am an author, a podcast host, a commentator, a
wife, and a mom. I have spent the last few years studying the
pro-abortion movement, observing the growing radicalism of the
abortion agenda, and speaking out about the injustice occurring
on the state and Federal [level] against preborn children and
their mothers.
I am here today as a mom fighting for a future for her kids
in which rights are not dependent on whether a person is
wanted, but upon their humanity. I am here as a woman who
believes that female empowerment, equality, and freedom are not
defined by her ability to terminate the life of her child. I am
here as an American, afraid for the fate of a country that no
longer considers the right to life a prerequisite to liberty
and the pursuit of happiness. I am here as a human being
horrified by the violence, the oppression, and marginalization
of a defenseless people group based solely on where they
reside, in the womb.
It's surreal to be here, and not because I'm testifying
before Congress, but because of the subject at hand. It is
incomprehensible to me that we are having a debate over whether
or not it is acceptable to kill a baby before they are born.
And while we discussed Democrats' concerns about abortion
restrictions today, I want to remind the committee of the true
victims of radical legislation, and that is preborn babies.
There was a time perhaps when we could claim ignorance as
our justification for allowing and approving of abortion. Only
a few decades ago, we knew relatively little about preborn
babies in early stages of development. It seemed appropriate to
some to deem abortion a privacy issue or an issue of bodily
autonomy. Even then the motto was ``safe, legal, and rare.''
Pro-abortion advocates have abandoned these three
qualifications in favor of on-demand through all nine months
for any reason.
Barbaric laws, like those of New York, Illinois, and a bill
in Virginia, aim to codify what Roe and its companion cases
allow, the virtually unrestricted access to abortion until the
point of birth. As its defendants' position on abortion has
radicalized, science and technology have advanced. We now know
that a baby's heart begins to beat as early as six weeks. The
child can feel pain as early as 20 weeks, only halfway through
the pregnancy. Babies born as early as 21 weeks' gestation have
survived outside of the womb. By 24 weeks, still only the
second trimester, a fetus has a significant probability of
surviving if born premature. Babies at this age have also
received lifesaving procedures to treat diseases like spina
bifida.
Any woman who has been pregnant or has seen her child on an
ultrasound knows the undeniable humanity of their preborn
babies. Even as someone who is pro-life, I was shocked to see
my daughter in the womb at just 11-and-a-half weeks kicking,
punching, flipping around. Eleven-and-a-half weeks is still the
first trimester. Embryology tells us that at the moment of
conception onward, a baby is a living human being with a
distinct DNA, and yet the abortion advocates have doubled down
on their dehumanizing rhetoric and legislative efforts.
Remarkably many members of the so-called party of science
insist upon referring to preborn children as no more than
clumps of cells.
In speaking of abortion, its defenders ignore the existence
of the child entirely. Terms like ``reproductive freedom'' or
``bodily autonomy,'' ``women's empowerment'' are used as
euphemisms to obscure the reality that the life inside the
mom's body is a human, a baby, her baby. If abortion were truly
a winning issue for women, if it were, as an article in New
York Magazine recently argued, a moral good, this kind of
deception wouldn't be necessary. But abortion advocates know
that using accurate terminology to describe abortion is
ineffective PR, and, therefore, it doesn't make for a
profitable business model.
Late-term abortions are typically performed, of course, by
emptying the uterus of amniotic fluid, then dismembering the
baby with forceps. There are other cases of more grotesque
methods utilized, like with Kermit Gosnell. Witnesses before
Congress have testified to the neglect of babies who survived
abortions, many of whom were reportedly left to die alone.
Virginia Governor, Ralph Northam, declared earlier this year
that a baby who survives an abortion would be delivered, kept
comfortable, and resuscitated if that is what the mother and
the family desired.
While tragic, pro-lifers shouldn't be surprised by pro-
choice radicalism. This is the end of the logic of the pro-
abortion case. There is no logical argument for abortion that
doesn't also apply to people who are born. America is included
on a list of only seven countries, including China and North
Korea, to allow abortion after 20 weeks' gestation. The same
legislators who are pro-abortion were happy to vote ``yes'' on
the bill criminalizing animal cruelty on the Federal level. And
while I'm am thankful for this, I only wish the same basic
compassion could be extended to the most vulnerable members of
our own species. Thank you.
Chairwoman Maloney. Thank you very much. And Marcela
Howell.
STATEMENT OF MARCELA HOWELL, FOUNDER AND PRESIDENT,CHIEF
EXECUTIVE OFFICER, IN OUR OWN VOICE: NATIONAL BLACK WOMEN'S
REPRODUCTIVE JUSTICE AGENDA
Ms. Howell. Acting Chairwoman Maloney, Ranking Member
Jordan, and honorable members of the committee, thank you for
the opportunity to testify at today's hearing. I would like to
take a moment first to mourn the passing of Chairman Cummings,
a fearless champion of human and civil rights. We promise to
pick up his mantle and continue his fight for universal
justice.
I am Marcela Howell, founder and president of In Our Own
Voice: National Black Women's Reproductive Justice Agenda, a
national state partnership with eight black women's
reproductive justice organizations: Black Women for Wellness,
Black Women's Health Imperative, New Voices for Reproductive
Justice, SisterLove, Sister Reach, SPARK Reproductive Justice
NOW!, the Afiya Center, and Women With a Vision.
Reproductive justice is the human right to control our
bodies, our sexuality, our gender, our work, and our
reproduction. That right can only be achieved when all people
have the complete economic, social, political power and
resources to make healthy decisions about our bodies, our
families, and our communities in all areas of our lives. This
includes the right to choose if, when, and how to start a
family.
When it comes to abortion, we focus specifically on access
rather than rights, asserting that the legal right to abortion
is meaningless for pregnant people when they cannot access such
care due to the cost, the distance to the nearest provider, or
other obstacles. Across the country, we are faced with the
ever-complicated wave of abortion restrictions that continue to
compound already existing barriers making access to quality
abortion care a privilege for the few rather than a human right
for all.
After the 1973 landmark Roe v. Wade decision, the Supreme
Court victory was immediately undermined and invalidated for
people with low incomes with the passage of the Hyde Amendment.
As the Guttmacher Institute notes, ``Because of social and
economic inequality linked to systemic racism and
discrimination, women of color are disproportionately likely to
be insured through Medicaid, therefore subject to the Hyde
Amendment's cruel ban on insurance coverage of abortion.'' The
decision of when and how to have a family or when to start or
grow a family is a decision that should be made by a pregnant
person and those they trust, not politicians.
Over the last decade, abortion access in the U.S. has
become increasingly fraught with restrictive laws. Such
abortion restrictions include everything from parental consent
laws for individuals under 18, often coercive mandated
counseling, mandated waiting periods, and unnecessary and
burdensome regulations on providers and clinics. This web of
restrictions and bans has ultimately created an unjust
landscape. As the country grapples with the maternal mortality
crisis, one that disproportionately impacts black women,
research has found that the states with the higher numbers of
abortion restrictions are the exact same states that have poor
maternal health outcomes. That is not a coincidence.
Reproductive justice is economic justice. One reason people
choose to have abortions is because of the significant expense
of having and raising another child given that many are already
parents. We cannot afford to endure another abortion ban
because we are already battling discrimination in healthcare,
wages too low to put food on the table, debilitating childcare
costs, attacks on immigrants, and threats to our voting rights.
These issues cannot be separated or siloed. Together, they are
an attack on our ability to live with full agency over our
lives and to raise our children with dignity.
I thank the committee for its dedication to addressing
these issues through a lens of justice and equity, and
centering the valued, lived experiences of marginalized
communities, including black, Latinx, Asian-American/Pacific
Islanders, and Native and indigenous women, transgender and
gender non-binary people, LGBT people, people with low income,
people in rural communities, those with disabilities, youth,
and immigrants. I explicitly name us all because all of our
struggles are tied together, and many of us live at the margins
of multiple oppressed identities.
I urge the committee to address these abortion restrictions
with urgency as we collectively work toward bodily autonomy and
a world where full reproductive justice can be actualized.
Thank you.
Chairwoman Maloney. Thank you. I want to thank all of the
panelists for your important testimony.
Without objection, the following members are authorized to
participate in today's hearing: Congresswoman Chu,
Congresswoman Schakowsky, Congresswoman Schrier, and
Congresswoman Lee.
I will now call on Lacy Clay to begin the questioning. He
is the originator of this hearing.
Mr. Clay. Madam Chairwoman, let me thank you again for
convening this hearing to call attention to the intrusive
restrictions that are threatening the health and well-being of
thousands of women in my congressional district and home State.
In Missouri, we are down to one last abortion clinic. State
health officials are doing everything in their power to try to
shut that clinic down. They are trying to regulate Missouri's
last clinic out of existence by imposing rules and regulations
that are medically unnecessary, overtly intrusive, or virtually
impossible for any healthcare provider to comply with.
And as you heard Dr. McNicholas explain, the health
department began enforcing a medically unnecessary requirement
that women submit to an additional pelvic exam three days
before being allowed to have an abortion. Dr. McNicholas, as a
physician, is there any medical reason for such a requirement?
Dr. McNicholas. Thank you for the question, Representative
Clay. So as I previously stated, and I think you noted as well,
forcing women to undergo medically unnecessary pelvic exams
shows clear disregard for the potential traumatic impact that
that has. We are talking about a country where every 73 seconds
an American is victimized with sexual assault, and that rate is
12 times higher for women with intellectual disabilities.
Within days of having to comply with that mandate, we saw a
patient, a minor accompanied by her mom, who was a victim of
sexual assault, who had never had a pelvic exam before, who
didn't even know what her parts were.
And as a reminder for those of you who have never had a
pelvic exam in this room, that means putting your fingers
inside someone's vagina. Forcing somebody, this minor, never
having had a pelvic exam, to have that invasive procedure when
there was absolutely no medically relevant reason to do so, was
traumatic for her, for her mother, and for the physician who
was required to do it.
Mr. Clay. How did that make you and your staff feel?
Dr. McNicholas. So I can tell you that in the times when we
had to comply with this regulation, I am not sure who cried
more, the physicians, the staff, the patients. We had patients
apologizing to us that we were forced to do this to them. Our
patients are accustomed to jumping through hoop after hoop to
get an abortion, so when told they had to do this, too, they
were resigned to the fact that that was just part of the deal.
But it was traumatic for everyone.
Mr. Clay. And if that wasn't outrageous enough, just weeks
ago we learned that the state staff were ordered to keep
spreadsheets tracking the menstrual cycles of women who visited
St. Louis' Planned Parenthood Clinic. Doctor, do you find the
practice of tracking the dates of patients' periods
problematic?
Dr. McNicholas. I find it bizarre and a complete violation
of the trust that the community puts in the public health
department, and the trust that our patients put in us. It was
clearly part of an orchestrated attack on Planned Parenthood,
and really demonstrates an abuse of power in misuse of data.
Mr. Clay. And what do you make of the fact that a trained
physician has imposed these medically unnecessary and intrusive
requirements on providers and patients?
Dr. McNicholas. So it is shocking that our department of
health is headed by a physician, Dr. Randall Williams, and more
shocking is that he is an OB/GYN. He knows better. But instead
of relying on the medical ethics that he was taught and the
many patient experiences that he has had over the course of his
career, he instead decided that his job was to act at the
behest of a politician to end abortion as part of a political
agenda, and forgetting what it is like to treat patients.
Mr. Clay. What would it mean for patients in Missouri if
your clinic closes?
Dr. McNicholas. You know, the consequence of that, there
are so many consequences to that. Certainly people will be
forced to carry pregnancies that they can't and shouldn't and
don't want to, continuing the cycle of poverty for some. Many
will be forced to travel long distances, expending resources
they already don't have to access that care. And people will
have really lost the trust that they have in the state of
Missouri who would then have abdicated its responsibility to
providing very basic healthcare.
Mr. Clay. I thank you for your responses. I thank the
entire panel for being here today. And, Madam Chair, I yield
back.
Chairwoman Maloney. I will now recognize Clay Roy.
Representative Roy?
Mr. Roy. I will take the name ``Clay.'' It is all right.
Chairwoman Maloney. Okay.
Mr. Roy. Thank you. Thank you, Madam Chairwoman. In 2015, I
got a call from a young woman who is one of my dearest friends.
She is like a little sister to me. She said that the baby that
was in her belly, her third, might be missing part of his
brain, the part that connects the left and right hemispheres.
She was terrified and couldn't ask questions fast enough. She
had a monthly checkup with her OB/GYN the following week. Her
husband had to work, but she took her two boys with her. They
liked going to hear the baby's heartbeat, and the checkups were
usually routine and quick.
She went into the appointment expecting her doctor would
reassure her and, in her answer, review the file. Then the
doctor looked our friend straight in the eye and asked her if
she wanted to terminate the pregnancy. She called us right
after that appointment, understandably angry and terrified.
Terminate? What? She explained the doctor had asked the
question in the same tone as she might have used when ordering
coffee at Starbucks. She didn't blink an eye. She asked it in
front of her two little boys. She asked without her husband
there. She offered no explanation or comfort. It was cold.
The doctor told her she had to decide quickly because she
was approaching 22 weeks, which is as long as you can legally
wait to have an abortion in Virginia. Our friend's response was
such a source of pride for us. She told us she almost laughed,
and then politely responded that termination was not an option.
She walked out of that doctor's office and never returned.
So how did it all turn out? Her ultrasound was completely
normal at 24 weeks. They just couldn't get a good read at her
20-week appointment. Her baby was born in May 2015 and is
completely healthy. It was a boy, by the way. None of us, but
particularly his loving and courageous mother, can imagine life
without him. He is my godson.
In the winter of 1996, a couple went in for a checkup. They
were excited. They had recently been informed they had twins.
The doctor came in and performed more tests. Time passed by and
the doctor returned. The doctor seemed concerned as they
believed the twins had cystic fibrosis. If they were born, they
would only survive for a few hours, they were told, if that.
``I recommend termination,'' said the doctor. The couple said
the first thing that came into their mind, no, and walked out.
They chose life. Those twins would grow up to become excellent
men. I know this because Jonah works for me right here. He's
one of my staffers.
Ms. Stuckey, Planned Parenthood is not about healthcare. It
is about abortion, no?
Ms. Stuckey. Yes.
Mr. Roy. Planned Parenthood that took in $1.67 billion in
total revenues, a 14 percent increase over the year before.
Private donations totaled $630 million. Does that sound right
to you?
Ms. Stuckey. Yes.
Mr. Roy. Government funding amount to $563 million of that
amount. Does that sound right to you?
Ms. Stuckey. Yes.
Mr. Roy. Planned Parenthood received nearly $60 million
dollars annually under Title X under the Protect Life Rule,
which ensures compliance with statutory prohibition against
using Title X funds for programs where abortion is a method of
family planning. In August 2019, Planned Parenthood confirmed
they would withdraw from Title 10 funding rather than comply
with the new rule. Does that sound right to you?
Ms. Stuckey. Yes.
Mr. Roy. Do we need Planned Parenthood for healthcare for
women?
Ms. Stuckey. Planned Parenthood is not in the business of
healthcare. They are in the business of abortion as they
demonstrated by refusing Title X care. They could have
financially and physically separated their abortion services
from the rest of their healthcare services, but they refused to
do that. They have decided that abortion is central to their
mission, which is exactly why they fired CEO Leana Wen, who, in
her words, was ousted because she didn't prioritize abortion
high enough.
Mr. Roy. That is right, and if I might direct you to the
chart behind me, in Texas we have 301 rural health clinics in
Texas, 434 federally qualified health centers, to total 735
federally funded community health clinics. There are 327
pregnancy centers, 130 of which are medical pregnancy centers.
And according to the Planned Parenthood website, there are 40
Planned Parenthood centers in Texas. Does that number sound
right to you?
Ms. Stuckey. Yes.
Mr. Roy. Does Texas, at least in the state which I
represent, provide healthcare solutions for women throughout
the state of Texas.
Ms. Stuckey. Yes, they do. I am from Texas as well.
Mr. Roy. Yes, ma'am. Texas's Program, Healthy Texas Women,
was established in 2016, has been helping women in Texas with
services and with more providers than Planned Parenthood. Does
that sound right to you?
Ms. Stuckey. Yes.
Mr. Roy. In Fiscal Year 2018, Healthy Texas Women served
172,000 clients. According to the Planned Parenthood website of
Greater Texas, in 2018 Planned Parenthood served only 83,000
patients compared to that larger number, and it has only been
in existence since 2016. Does that sound right to you?
Ms. Stuckey. Yes.
Mr. Roy. My point is simply this. The state of Texas I can
speak to. I can't speak to the other 49 states. We take women's
health very seriously, and we should. We should entities and we
should allow the market to thrive, and, frankly, if we could
get some of the regulations out of the way of a healthy
healthcare system, we could have more options. But could you
please, as my time is running out, please share your view of
the ways in which we can provide healthcare and better ways
than allowing an organization like Planned Parenthood, which
takes unborn babies, puts them in plastic bags, and throws them
in garbage bins, to be the center of healthcare provision for
women? Thank you.
Ms. Stuckey. Abortion is not healthcare. I think that's all
I have time for.
Chairwoman Maloney. The chair now recognizes Congresswoman
Norton.
Ms. Norton. I thank you very much, Madam Chair. Dr.
McNicholas, just to follow up here. What kind of health
services do you provide?
Dr. McNicholas. I appreciate that question, Ms. Norton. So
Planned Parenthood provides a broad spectrum of reproductive
healthcare services, including well people care, cancer
screenings, the full spectrum of birth control options,
transgender care, primary care. Some Planned Parenthoods also
provide prenatal care, and the list goes on.
Ms. Norton. So it look like you provide the kind of across-
the-board care that a young woman may need. You go in this one
stop fits all.
Dr. McNicholas. The goal is to meet our patients' needs
both in the clinical services that they need and require and
that the community needs, and also to make sure that it is
accessible for them.
Ms. Norton. And abortion would be only one of those
services.
Dr. McNicholas. That is correct.
Ms. Norton. I have a question. Perhaps I should start with
Ms. Graves or perhaps also Dr. McNicholas. I represent 700,000
residents. They pay the highest Federal taxes-this is a little-
known fact-highest Federal taxes per capita in the United
States. We are trying to make the District of Columbia the 51st
state, but when look at where there are intrusions into
healthcare, you will find that they are all Federal bans that
include Federal employees, Federal prisoners who are included
in this list, low-income residents of the District of Columbia.
Our jurisdiction wants to provide on their own, pay for
abortion services for low-income women the way almost 20 states
already do. We are not demanding that the Federal Government
does this. My question is, why we are finding that restrictions
on coverage are related to economic mobility for women on
coverage for abortion and others such as services? And
apparently there is a correlation here for not only for women
generally, but especially for women of color. So why do
restrictions on abortion relate to economic mobility? Why are
they correlated in that way?
Ms. Goss Graves. Well, I very much appreciate you raising
that issue also as a resident of the District that lacks the
range of voting rights that you described. And oftentimes there
has been a deep focus on the levels of restrictions that are in
places like Missouri. But even in the District, because of
restrictions on insurance, for low-income women, in particular,
what that means is that abortion is inaccessible and
unavailable, and having to scrap together the money to be able
to afford it is not possible.
And what it also means is that for the most vulnerable of
folks, the right to abortion does not feel very meaningful. And
that connection between the ability to have economic security
for yourself and for your family is deeply tied to your ability
to access the healthcare you need. This is a travesty that is
deeply felt by people who live in the District, in part
because, you not only have the restrictions on like Medicaid.
You also see them show up in Federal health insurance, and so
many people who live here are also working for the Federal
Government.
Ms. Norton. So you can see that there are many reasons why
the District of Columbia wants to become the 51st state. I just
want to say to my Republican colleagues, you know, whose mantra
is we want government out of our business, my friends on the
other side of the aisle vote against the government doing
things which the American people want government to do. All the
District of Columbia is asking is that you get out of their
business so that we can deal with our business alone.
Thank you very much, and I yield back.
Chairwoman Maloney. The chair recognizes--
Mr. Connolly. Might I just yield to her 20 seconds? Ms.
Norton, would you yield?
Ms. Norton. I will be glad to yield.
Mr. Connolly. I thank my friend. I just wanted to give Dr.
McNichols an opportunity. We just heard a stunning statement
that Planned Parenthood is not in the health care business,
doesn't provide health care. I want to give you the opportunity
to respond to that. Thank you.
Dr. McNicholas. I appreciate the question. Abortion is
health care, and I think the best way to demonstrate that is to
share a story about a patient who, when unable to access her
abortion, died, because her comorbidities and the complications
she had prior to pregnancy worsened during that.
A patient from out of state visited my clinic for a
consultation after understanding that her current medical
condition would worsen with pregnancy. She returned to her out-
of-state home, having to wait the mandated amount of time
between those visits before she can receive that care. When she
didn't return and we called to followup we were later told that
she passed away from complications of her pre-pregnancy medical
condition.
This is the very definition of why abortion is health care
and is needed and is necessary, when people need it, where they
live.
Chairwoman Maloney. Thank you very much. Dr. Foxx.
Ms. Foxx. Thank you very much, Chairwoman.
Dr. McNicholas, earlier this year, Governor Northam of
Virginia said, ``If a mother is in labor I can tell you exactly
what would happen. The infant would be delivered, the infant
would be kept comfortable, the infant would be resuscitated, if
that is what the mother and the family desired, and then a
discussion would ensue between the physicians and the mother.''
Do you support Governor Northam's comments?
Dr. McNicholas. So I can't speak for Governor Northam, but
what I can say is that there is no way to oversimplify the-
sort of the medical conditions in which people present in the
second trimester, that I think that he was referring to.
Ms. Foxx. So as a physician, then, what would be the harm
in legislation such as the Born Alive Abortion Survivors Act,
to make sure that a child born alive would not be put to death?
Dr. McNicholas. So there are several harms. The first is
which, using that language and perpetuating the notion that
that is actually a real thing is harmful in and of itself, and
it only serves two purposes. The first is to shame people, like
Jennie, who need life-saving care in the second and third
trimesters of pregnancy. It also creates an environment in
which abortion providers like myself and my colleagues are
targeted and harassed. So first and foremost, it is dangerous
for those reasons.
The second reason is because medicine is complicated. There
really is no way for me to boil down more than a decade of
education and practice to give you a single reason why doing
such things is harmful to patients.
Ms. Foxx. The answer should have been either yes or no.
Earlier this year, thousands of fetal remains were found in
the home of deceased abortionist, Ulrich Klopfer. Who do you
believe- do you believe that all fetal remains should be
disposed of in a manner that treats them with dignity and
respect?
Dr. McNicholas. Just like I believe that patients are
capable of making a decision to continue their pregnancy or
not, to expand their family or not, I believe that patients are
capable of deciding what should happen to the remains of their
pregnancy.
Ms. Foxx. So is it okay for those fetal remains to be sold
for profit by Planned Parenthood?
Dr. McNicholas. Planned Parenthood has never sold fetal
tissue, and current doesn't, and never has.
Ms. Foxx. Does Planned Parenthood v. Casey give states the
authority to regulate abortion in accordance with the opinions
of their respective constituencies?
Dr. McNicholas. I believe that the most recent decision,
and we have some policy experts on the panel who can speak more
to this, but the more recent decision in Whole Women's Health
set a precedent that restrictions must be based and grounded in
science, and that is all we are asking for is that abortion is
treated to the current standards of medical evidence and
science.
Ms. Foxx. Ms. Stuckey, thank you very much for being here.
Are there more federally qualified health centers than abortion
clinics in the United States?
Ms. Stuckey. Thank you for the question. Yes, the ratio is
about 26 to one of health care centers that are federally
funded, to Planned Parenthoods.
Ms. Foxx. And which offers more comprehensive health
services to women?
Ms. Stuckey. Of course, the health care centers that are
not Planned Parenthood.
Ms. Foxx. So if we wanted to support access to
comprehensive health care services for women, would we be
better off supporting abortion clinics or federally qualified
health care centers?
Ms. Stuckey. The federally qualified health care centers.
Ms. Foxx. Thank you. In 2005, a Planned Parenthood-funded
study found a majority of women seeking an abortion did so
because having a baby would interfere with education and work,
cost too much, or they did not want to be a single mother or
having relationship problems. What are your thoughts on the
findings of this study?
Ms. Stuckey. It shows that- it belies this notion that
abortion is only used in very extreme cases. The extreme, rare
cases are typically used to cast pro-lifers into a negative,
extremist, radical, misogynous light, which is just not
accurate. The majority of abortions, according to Planned
Parenthood's own research, are done on the basis of
convenience, and I just don't see a logical or moral
justification for killing an unborn child on the basis of
simply not being wanted.
Ms. Foxx. Thank you. Madam Chair, earlier Dr. McNicholas
said that Dr. Williams was a physician and had taken an ethics
oath and show know better than to do what he had done. I just
want to quote from the classic Hippocratic Oath: ``I will use
those regimes which will benefit my patients according to my
greatest ability and judgment, and I will do no harm or
injustice to them. I will not give a lethal drug to anyone if I
am asked, nor will I advise such a plan, and similarly, I will
not give a woman a pessary to cause an abortion.''
Dr. McNicholas, did you swear a Hippocratic Oath when you
were licensed?
Dr. McNicholas. I did, and I continue to live that every
single day.
Ms. Foxx. Amazing.
Madam Chair, Mr. Roy asked me if I would enter into the
record this article.
Chairwoman Maloney. Without objection.
Ms. Foxx. Thank you, Madam Chair. I yield back.
Chairwoman Maloney. The chair now recognizes Representative
Lynch.
Mr. Lynch. Thank you, Madam Chair. I want to thank you for
holding this hearing, and also to my friend and colleague, the
gentleman from Missouri, Mr. Clay, thank you for your
leadership as well.
I want to thank all the witnesses here today, especially
Ms. Box- Mrs. Box, for your willingness and your courage to
come before this committee to share our own experience, and all
of you for sharing your perspectives.
As I noted in my op-ed in the Boston Globe back in May,
when this onslaught of state legislation arose, in Missouri,
Alabama, Ohio, and Georgia, the legislatures have recently
adopted draconian measures on abortion. Alabama has banned
abortion at any stage of pregnancy, apparently even in the case
of rape or incest, while several other states have banned
abortions as early as six weeks, which, as some of our
witnesses have noted, is often before many women would even
know they are pregnant. In Georgia, a woman terminating a
pregnancy after six weeks could be charged with homicide.
These laws are far more punitive than those in place before
the Roe v. Wade decision. They are so intrusive and so
restrictive that the basic core constitutional right to privacy
and protection from government intrusion into health care
decisions would be effectively and totally eliminated.
Meanwhile, other states are actively considering similar
restrictive measures.
This all occurs against a backdrop in which Republicans in
Congress have repeatedly attempted to eliminate women's access
to contraceptive services offered by groups such as Planned
Parenthood, ironically, even though those contraceptive
services actually prevent unwanted pregnancies, and thereby
reduce the number of unwanted pregnancies and abortions.
Ironically, and seeking to shutter many of these clinics, they
would also be cutting off expectant mothers, especially in
those low-income areas, who rely on their services for the
prenatal and postnatal care they need to ensure that they have
safe and healthy pregnancies.
It is to be noted that to be pro-life includes supporting
the health of pregnant women. It includes feeding and educating
and housing children. Simply opposing abortion does not make
you pro-life.
The Supreme Court's decision on reproductive rights, as
controversial as they may be in our country, have sought to
acknowledge and balance the constitutional interests that are
at stake on this issue. And while critics are bound, even
without the onslaught of restrictive state legislation, the
number of abortions that are performed in the United States
each year has dropped dramatically, and that is largely due to
the impact of effective and widely available contraception,
family planning, and education.
Women are and should be in charge of their reproductive
health, and their efforts to reduce unwanted pregnancies are
actually working, all of which leads many to believe that the
timing and the similarities of this multistate campaign reveal
a purely political strategy to energize and motivate the
religious right, and that is truly shameful.
While I am personally informed by my faith, my actions as a
legislator must be in support of, in defense of the
Constitution. That is the oath that I took and I stand by it.
And as I said back in May, if these recent developments,
closing all clinics, obstructing contraceptive services,
denying women every option in their health care decisions, if
this defines the new pro-life movement then you can count me
out.
I have one question for either Counselor Graves or Ms.
Howell, and thank you for your kind words regarding Mr.
Cummings. So there are millions of women each year- and Ms.
McNicholas, you might have some - Dr. McNicholas, you might
have some input on this as well - if we have millions of women
who come to Planned Parenthood and other contraceptive services
providers, and yet the government steps in to deny funding- and
this came to the floor. I spoke against it. This actually came
to the floor when the Republicans were in control of the House,
and they proposed to zero out- zero out- any Federal funding
for Planned Parenthood to carry on its contraceptive services.
What would the impact on the abortion rate be, the rate of
unwanted pregnancies and the abortion rate, if that measure had
been implemented?
Dr. McNicholas. So I think you raised a very important
point, which is one of the strategies- one of the best
strategies we have to reduce unintended pregnancy is- it is
actually multilayered. It is, first, improving the sexual
education that we provide to our young children, helping them
know how their body works and being very positive about
understanding how sex works and how you get pregnant.
Second, it is providing them access to the available
contraceptive method of their choice when they need it, and
without barrier, including going to a clinic in their
neighborhood, making sure that it is affordable for them, and
making sure that they can change that method as often as they
need to, when their history or their preference changes.
Mr. Lynch. Counselor Graves, on this, do you want to add to
that?
Ms. Howell. Many people actually go to Planned Parenthood
for a number of different health care services. They go not
only for birth control but also to have tests for diabetes, for
mammogram screenings. A lot of the people that we represent,
and that we work with, go to Planned Parenthood clinics as
their primary provider. And so to remove services that they
think are vital to them, because people are opposed to the fact
that some Planned Parenthoods also do abortions, means that you
are cutting off health care for people who most desperately
need it.
Mr. Lynch. Thank you.
Ms. Goss Graves. The only thing I would add, it is a good
opportunity for me to correct something Ms. Stuckey said about
Planned Parenthood. We should be really clear about what
happened with this gag rule that the Administration put out.
Planned Parenthood wanted to do right by its patients. It
was not going to lie to them. It was not going to misinform
them. And the idea that we are now in a situation where
providers are being forced to make that sort of decision about
whether or not they can continue to serve the lowest income
population in communities is really, really terrible, and
patients are going to suffer for it.
Mr. Lynch. Thank you very much. Madam Chair, I yield back.
Mr. Hice. Madam Chair, I have a unanimous consent request.
I have a unanimous consent request.
Okay. Thank you, Madam Chair. Being from Georgia I just
want to clarify that the law is not according to what was just
identified by my colleague, and I would like to ask unanimous
consent to be added into the record an article by David French
that goes into the details of the law that the Georgia
Heartbeat Bill would not imprison women who have an abortion.
Chairwoman Maloney. Without objection.
Chairwoman Maloney. I now recognize Mr. Massie.
Mr. Massie. Thank you, Madam Chair.
Dr. McNicholas, what is the medical consensus for age of
viability of a fetus?
Dr. McNicholas. I appreciate the question. So viability is
a complicated medical construct. There is no particular
gestational age. There are some pregnancies in which a fetus
will never be viable. There are a number of different factors
that we think about when we are considering if a pregnancy is
or is not viable.
Mr. Massie. So is there a legal consensus on the age of
viability?
Dr. McNicholas. Not to my understanding, but I am a
physician, not a lawyer.
Mr. Massie. In your 10 years as a doctor, how many
abortions have you performed?
Dr. McNicholas. So I provide a variety of different
services, and as you--
Mr. Massie. I am not asking about the other services.
Dr. McNicholas. Right.
Mr. Massie. How many abortions have you performed?
Dr. McNicholas. So I can't tell you how many hysterectomies
I have done and I can't tell you how many abortions I have
done. I have had a long career taking care of people for a
variety of things.
Mr. Massie. So you manage a facility. Can you tell me- or
you are the medical overseer- can you tell me how many
abortions the facility in Missouri performs each week?
Dr. McNicholas. I can tell you- I believe it is probably
available, so I can give you a rough estimate of how many
abortions we perform per year, which is, I think roughly around
3,000.
Mr. Massie. How do you dispose of 3,000 fetuses every year?
Dr. McNicholas. So Missouri has a state law that requires
that we send all of the remains of pregnancy to pathology.
Mr. Massie. What is the latest-term abortion that you have
performed, like gestation period, in weeks?
Dr. McNicholas. So my practice includes the provision of
abortion up until the point of viability, and again, we already
had a discussion about viability not being----
Mr. Massie. So just give me the number in weeks them.
Dr. McNicholas. I don't know.
Mr. Massie. You don't remember the number of weeks?
Dr. McNicholas. That is correct. So I--
Mr. Massie. What about size of the unborn baby? Do you know
the largest baby that you have aborted?
Dr. McNicholas. I am not sure how I would even quantify
that.
Mr. Massie. If I use the word fetus could you- do you know?
You have no idea the age or gestational period of the fetuses
that you are aborting.
Dr. McNicholas. So again, as I said, my practice includes
abortion care through the point of viability, and as we
previously discussed, that could be--
Mr. Massie. Let me put it this way.
Dr. McNicholas [continuing]. at any point, yes.
Mr. Massie. Is there any point of gestation beyond which
you personally would not abort a fetus?
Dr. McNicholas. You know, medicine is not black and white.
I recognize, in my 10 years of practice, informs this opinion,
that pregnancy can be really complicated, and given that there
are pregnancies for which a fetus may never be viable, I think
it is really important that we allow physicians and patients to
have every medical resources to make decisions that are
appropriate for them and their health.
Mr. Massie. In the absence of a law preventing it, would
you abort a viable fetus?
Dr. McNicholas. Again, every patient is different and I
can't make any--
Mr. Massie. I am just asking about a viable fetus. If the
law didn't prevent it, would you consider it a limitation,
morally, for you to abort a viable fetus?
Dr. McNicholas. So I think you are forgetting that there a
number of reasons that go into a patient's--
Mr. Massie. If the reason--
Dr. McNicholas [continuing]. choice.
Mr. Massie. At your clinic, does it matter what the reason
is for the abortion?
Dr. McNicholas. At my clinic, I trust that women have a
valid reason. Every reason that they have is valid.
Mr. Massie. Okay. So given that you think that every reason
is valid, would you abort a viable fetus, if there was not a
law preventing it?
Dr. McNicholas. Again, given that the reality for people
choosing abortion is that there are many reasons, there isn't a
single thing that defines somebody's choice.
Mr. Massie. You seem to have a--
Dr. McNicholas. It is a reflection of their--
Mr. Massie [continuing]. hard time- you seem to have a hard
time saying this. This tells me you have a heart, or at least
you know that people watching this have a heart, and they would
be concerned if you would just admit, but you won't admit here,
that you would abort a viable fetus for any reason if the law
did not prevent it.
Dr. McNicholas. Mr. Massie, abortion is moral. It is
important. It is health care. And I support people being the
experts in their own lives and making decisions for themselves.
Mr. Massie. It gives me some hope that you here understand
that people do not support you when you abort- when you say- or
if you would say that you would abort a viable fetus for any
reason. But given what you told us in your opening statement,
and knowing what you have said, we know that you would. But it
does give me hope that you still know, in your heart, that is
wrong.
Mrs. Stuckey--
Dr. McNicholas. I am not sure- can I respond to that really
quickly?
Mr. Massie. If you would answer my question you could, but
you won't, so I am going to use my remaining time asking Mrs.
Stuckey, should any reason be a good reason for having an
abortion?
Ms. Stuckey. Absolutely not. It is a child. It is a life
inside the womb from the moment of conception onward. And I am
very troubled by how flippantly she said that there are 3,000
abortions performed every year, of defenseless human beings,
and the remark that abortion is moral--
Mr. Clay.
[Presiding.] The time has expired.
Ms. Stuckey. You cannot have that kind of logic--your
lifestyle.
Mr. Clay. No. The time has expired. I recognize--
Mr. Hice. You gave the others over two minutes, Mr.
Chairman. Mr. Chairman, we need to be fair on both sides of the
aisle, please.
Mr. Clay. You want to finish your answer?
Mr. Massie. Please. I would like for her--
Mr. Clay. No, no. Finish your answer. Go ahead.
Ms. Stuckey. I don't quite understand the illogic of saying
that killing a child inside the womb for any reason whatsoever
is moral, it is health care. In what other situation, besides
when a child is defenseless in the womb, do we call killing
someone health care, do we call killing someone moral? Can
anyone on the pro-abortion side tell me a situation, outside of
a defenseless child inside the womb, in which it is morally
justifiable to kill someone simply because they are not wanted?
That is the answer that I would like. That is the question
that I have. I, unfortunately, don't think anyone is able to
answer it for me.
Mr. Clay. I recognize the gentlewoman from Illinois, Ms.
Kelly, for five minutes.
Ms. Kelly. Thank you, Mr. Chair, and thank you for this
hearing.
My Republican colleagues have suggested that earlier
restrictions on abortion have become necessary because advances
in medicine are moving the point of viability earlier and
earlier. Dr. McNicholas, I am interested in hearing your
thoughts on this point.
Dr. McNicholas. Thank you for the question. So I think, as
I previously alluded to, viability isn't an easy thing to
assess. It requires--
Ms. Kelly. It is different with every pregnancy.
Dr. McNicholas. That is exactly right. It requires
knowledge of multiple things about any individual's pregnancy.
Ms. Kelly. Thank you for clarifying. First of all I want to
thank the witnesses for being here. Thank you for sharing your
story with us. And I want to let you know that I was a proud
board member of Planned Parenthood in Peoria, and I am very
proud that my state of Illinois is an oasis in the sand, very
proud that we are a shining light in the dark.
And, Mrs. Stuckey, you said you want to see the same basic
compassion. You made that comment. Well, I wanted to see the
same basic compassion for maternal mortality. I had to water
down the bill I had because the compassionate Republicans, not
one would sign onto the bill to extend Medicaid.
We have not been able to get a gun violence prevention bill
passed because we don't have the same basic compassion once the
unborn fetus becomes a baby, and they grow up. We don't seem to
have compassion in that area. We don't have the same compassion
when it comes to feeding our young people. We don't seem to
care about that. We are looking at cutting that, so 500,000
people don't have the food they have.
So where is the compassion once you are born? That is the
question I have?
Ms. Stuckey. Well, Ms. Kelly, thank you so much for
bringing up these points, because I agree that we should have
compassion from the womb to the tomb. That is what I believe. I
don't necessarily--
Ms. Kelly. It is not fair.
Ms. Stuckey [continuing]. I don't necessarily agree with
all of your legislative solutions to that. I do believe the
private sector does a much better job. But your premise is that
these things are mutually exclusive, that we either have to be
on your side of the debate, and for violently murdering
children inside the womb--
Ms. Kelly. No, you never heard me--
Ms. Stuckey [continuing]. or we are not--
Ms. Kelly [continuing]. no, I am just saying--
Ms. Stuckey. They are not mutually exclusive.
Ms. Kelly [continuing]. you are saying we are violently
murdering, but there is a lot of kids being murdered every
day--
Ms. Stuckey. And why can't we care about--
Ms. Kelly [continuing]. and we don't do anything about
that. I am reclaiming my time. Reclaiming my time.
In the wake of many draconian measures, my own state of
Illinois recently signed into a law a bill to protect abortion
access for our residents. The Illinois Reproductive Health Act
ensures coverage for abortion care and updates clinic
regulations to lift that burden from abortion providers.
Ms. Goss Graves, how does eliminating coverage bans improve
access to abortion care for women who are working to make ends
meet?
Ms. Goss Graves. It will mean that the right to abortion,
which has been legal for almost 50 years, will actually be a
right that is accessible for women, for women no matter their
income. Whether or not that right is accessible to you should
not be depending on your financial means. That is not what the
court said.
Ms. Kelly. Because the other thing we never talk about is,
you know, wealthier women who tend not to be women of color,
they have been having abortions for a long time, whether they
are in red states or blue states, or however they vote--
Ms. Goss Graves. That is right.
Ms. Kelly [continuing]. or whatever their political
interests are. And how will rolling back targeted regulations
of abortion providers improve access?
Ms. Goss Graves. Here is what we know. These targeted
regulations of abortion providers are designed really to shut
down clinics. They are designed to shame patients. They are
designed to confuse people and disrupt the doctor-patient
relationship. All of that makes abortion less accessible. And
all of that- I mean, listening--I have to say, the rhetoric
that is surround it, on top of the sorts of regulations and
restrictions, have made all of this so difficult for people who
are just trying to live their lives and get the health care
that they need.
Ms. Kelly. And I know from a lot of college students that
they are not going to Planned Parenthood to get an abortion.
They are going for health. That is their place of choice to get
health care, not for abortions.
Dr. McNicholas. Yes. Planned Parenthood is very proud to be
able to provide services to people who are financially
insecure, and to do that in a way that serves their needs and
respects their dignity.
Ms. Kelly. Thank you, and I yield back my time.
Mr. Clay. The gentleman from Georgia, Mr. Hice, is
recognized for five minutes.
Mr. Hice. Thank you, Mr. Chairman. It seems to me that a
lot of this debate and argument centers around whether or not
the baby is a person or a fetus, and I recognize that many on
the other side of the aisle refuse to recognize the baby as a
baby, refuse to recognize it is a person, it is humanity.
Ms. Stuckey, there have been a lot of medical advances,
certainly, over the last several decades. Can you tell us about
some specific scientific evidence supporting the personhood,
the humanity of the baby, and the viability?
Ms. Stuckey. Well, embryology tells us- thank you for your
question, first of all- embryology tells us that the child,
from the moment of conception, has a separate DNA, and so when
we hear these euphemisms thrown around, like my body, my
choice, immediately obscuring the life of the child, it shows
me that the pro-abortion argument doesn't deal with fact. It
deals with feeling, which is exactly why we have had such a
hard time getting any kind of clear answer from any of the
panelists of what abortion actually is. What does it do?
Because, talking about tearing a child apart, limb by limb,
with forceps just isn't a very good P.R. strategy for Planned
Parenthood or the abortion industry.
All I am trying to do is to remind us, when we are having
this conversion, that there are two people. There are two
people. And I don't believe we have to pit a mother against her
child in order for a woman to be successful.
We talked about, you know, legislative solutions and
showing compassion for children after they are born. I
absolutely believe in that. Every pro-life pregnancy center
that I have ever been a part of, that I have ever donated to,
they don't just counsel women. They also offer parenting
classes. They are also offering help from abusive situations.
They are offering programs for these young women to be able to
get affordable baby clothes and baby products and things like
that.
Every pro-life organization I know cares about children, in
the womb, after they are born, and the mother, who is pregnant
with these children. That is what I am trying to argue, that
let's not ignore the scientific reality that a baby is a baby,
and, therefore, in my opinion, is deserving of the right to
life.
Mr. Hice. In a way this is even going beyond abortion in
the womb. As we all were horrified, many of us, Virginia
Governor Ralph Northam, and his description of however it could
possibly be described as a post-birth abortion, one of the most
horrifying things I have ever heard in my life, where the baby
would just sit there on the table and we would decide what to
do with it. How do you respond to this?
Ms. Stuckey. Yes. That is a great point that you bring up.
Unfortunately, this has been a reality in other places across
the country. We like to act like this is not a thing. The CDC
itself says that over a span of 11 years, at least 143 babies
were born alive and then not resuscitated, or born alive and
not attended to and cared for. Only six states actually require
this kind of reporting, so the number of 143 is probably a lot
higher than that.
So what we see, that this is not just a degradation of
children inside the womb. It is a degradation of babies, in
general. It is a degradation of life based on whether or not
this child is wanted by the mother. And again, I ask, in what
other context, in what other stage of life do we decide that
someone gets to die simply because they are not wanted? And not
provoke a slippery-slope fallacy, but truly, what we have seen
from Governor Northam's statements and from other statements
that we have heard, is that it truly is a slope. There is a
logical and a moral slope to this, and it seems like the pro-
abortion side is sliding down very quickly.
Mr. Hice. Well, and to that point- and I think it is,
likewise, an excellent point you brought forth a while ago,
Planned Parenthood's own study, that the majority of women have
abortions not because of their own personal health but because
of convenience sake, whether it be a job or whatever it may be.
How does those findings from Planned Parenthood itself
undermine the narrative, particularly about late-term
abortions, that it has something to do with the health of the
mother?
Ms. Stuckey. Yes, and we can have conversations about the
health of the mother in those very rare circumstances. But as
you mentioned, and that Planned Parenthood has noted the vast
majority of cases are for any reason whatsoever, including just
not wanting a child, it not being convenient, wanting to finish
school. And if the pro-abortion side were honest, they are
completely fine with that. They are completely open to the
normalization- there are organizations now that exist to
normalize abortion, to destigmatize abortion. That means that
they believe abortion to be not only normal but good.
Actually, we heard the doctor say that she believes that
abortion is good. If you believe that abortion is morally good,
of course you don't think it should be limited to the life of
the mother or any of those very rare circumstances. It is all
nine months, on demand, without apology. That is the new motto
of the pro-abortion side.
Mr. Hice. And the fact is the baby is a person, and for
that reason how could it be moral to kill it?
Ms. Stuckey. I don't know what else it is if it is not a
person.
Mr. Hice. Thank you. I yield back.
Mr. Clay. The gentleman yields back. I recognize the
gentlewoman from Michigan, Mrs. Lawrence, for five minutes.
Mrs. Lawrence. Thank you, Mr. Chairman, and I am glad to be
here for this hearing. This hearing should be substantive
discussion on how to expand access to care for women. I am
disappointed that my Republican colleagues are using this
hearing to make such blatantly false claims, the young lady who
speaks in generalization. And for the record, while one side
calls themselves pro-life, there is not a person I know that
says they are pro-abortion. They are pro-choice.
So abortions are not infanticide. That is not how abortion
works, and this type of deceptive rhetoric is yet another
attempt to distract from efforts to make abortion out of the
reach for women, to shut down clinics.
And just constantly I have had this debate a number of
times on this panel. The mistruths that are spoken about,
ripping full-sized babies out of wombs and killing them, that
is not true. Selling of parts is not true. And it just seems
like it is enjoyed to say, because it paints this horrific
picture, and we should say the truth, statistics.
Mrs. Box, I am so sorry to hear about the pain your family
had to suffer, and thank you for bringing your beautiful baby
in the room. Have you considered whether this law that is being
proposed or passed in Missouri would have prevented you from
having an abortion if it had existed two years ago?
Ms. Box. Thank you. It absolutely would have prevented me
from having an abortion. At eight weeks, which is when the ban
that my state legislature passed, it is impossible to know of
the chromosomal abnormalities, as far as my understanding. I am
not the doctor here today. We did the early genetic testing
because I am of advanced maternal age- another one of my not-
favorite terms--
Mrs. Lawrence. Yes.
Ms. Box [continuing]. and so believe that we found out
before most women and families would find out, because we found
out earlier. Most people would not find out until the 20-week
anatomy scan. And I can say that after Libby I was obviously
able to successfully get pregnant again, as evidenced by
beautiful daughter, who is now being quiet, thankfully. So I
was pregnant during the time that the state legislature was
enacting this ban and that Governor Parsons signed this into
law.
And at our 20-week ultrasound for Astrid they couldn't get
a couple of views of the heart. Everything looked good.
Physicians weren't concerned. But what should have been a happy
day, to know that we were having a successful pregnancy-
because a pregnancy after a fetal diagnosis is a very stressful
pregnancy- ended with me being in the car, my husband and I
walking out of the appointment, and me being in the car sobbing
hysterically, because they wouldn't see me again until I was 24
weeks along, and in Missouri- because they weren't worried,
right? That was my next regularly scheduled appointment. And in
Missouri, that would have been too late. And what I kept saying
to Jake, to my husband, is, ``What if they find something
devastating now? I can't protect my daughter.''
And I understand that Mrs. Stuckey and I don't agree on
things, but I would like to ask you to remember that you are
calling me and my husband murderers, and you believe in
compassion and love, and I would ask for compassion and
respect, ma'am, when you speak about these decisions, because
Americans make these decisions that are difficult and personal,
and we deserve to be treated with respect, whether or not you
condone our choice. I don't need your approval, Mrs. Stuckey,
but I would ask for your respect.
Mrs. Lawrence. I appreciate what you are saying. In the few
minutes I have left I just want to bring another issue to the
table. We, in this country, have the highest maternal mortality
rate of any civilized country in the world, and for women to be
dying to give birth in America is unacceptable. And with the
same energy that we are making health decisions and decisions
about our bodies, and we should, as women in America, have the
same choices that men have, without the government telling them
what to do.
I often use the comparison because now there is discussion
about birth control. I would love to have a debate about Viagra
and whether the government should regulate or restrict Viagra
for me. That has never been on the table.
And so women, we are targeted, and for us to have the same
passion of a discussion about saving women who want to have
their babies, and this medical industry is failing us, we need
to have the same passion.
I yield back my time.
Mr. Clay. The gentlewoman's time has expired. I want to say
to Ms. Box, we are sorry that you and your family had to
experience what you did.
And now I recognize the gentleman, Mr. Grothman, for five
minutes.
Mr. Grothman. Correct. A couple of quick questions for Dr.
McNicholas. If someone came to you who is eight months pregnant
with a healthy baby girl and said they wanted to have an
abortion because they didn't want another girl, would you
perform that abortion?
Dr. McNicholas. So that sensationalized hypothetical isn't
real and I have never had that happen before.
Mr. Grothman. Well, you said you performed an abortion- you
know, it is up to- I am just giving you an example. Well, let's
say, okay, someone came in with an eight-month pregnancy and
just wanted to have an abortion because they didn't feel they
had time to care for a baby. Would you do the abortion then?
Dr. McNicholas. So I first want to reject the notion that
people make decisions about continuing their pregnancy out of
convenience. I have never, in 10 years of taking care of
pregnant people, had somebody request an abortion because it
just wasn't convenient.
Mr. Grothman. Okay. Do you report- people presumably come
to Planned Parenthood for contraceptive care as well. If a 14-
year-old or 13-year-old came to you, would you give them the
contraceptives?
Dr. McNicholas. So we talk to all of our patients about the
availability of all of their contraceptive methods.
Mr. Grothman. Right--
Dr. McNicholas. And particularly for young people we would
have an in-depth discussion about--
Mr. Grothman. Okay.
Dr. McNicholas [continuing]. healthy behaviors, prevention
of sexually transmitted infection, the importance of making
informed decisions.
Mr. Grothman. What I will say is, if a 13-year-old is
sexually active, by definition that is a serious sexual
assault. Do you make any efforts to report the person who is
engaging in illegal activity with the young lady?
Dr. McNicholas. So we at Planned Parenthood follow all the
rules and laws, and so we would--if, by law, we were required
to do it, we would do it.
Mr. Grothman. Would make any efforts--
Dr. McNicholas. If we are required to do it--
Mr. Grothman [continuing]. any efforts to--
Dr. McNicholas [continuing]. we would do it.
Mr. Grothman. If you weren't required to do it, you
wouldn't do it.
Dr. McNicholas. You know, talking to young people about
their sexual health can be a--
Mr. Grothman. I will ask you another question. If someone
comes in, is a 13-year-old girl, and wants to have an abortion,
would you- which means, inevitably, or almost certainly
something illegal was done, a serious sexual assault--would you
probe into that anymore, or would you just do the abortion and
not worry?
Dr. McNicholas. So one of the most impactful times I have
with patients is discussing particularly around issues of
sexual assault. We provide our patients with the space to
discuss what happened, if they want to discuss that,
recognizing that it can be incredibly traumatic to discuss that
experience in any single health situation. And so I would
respect whatever is comfortable for her.
Mr. Grothman. I will give you another question. If someone
comes in and doesn't have the money for an abortion, says they
are broke but ``I want an abortion,'' maybe seven or eight
weeks pregnant, do you perform the abortion, or do you say that
``we don't do the abortion''?
Dr. McNicholas. We make every effort to take care of
patients' every needs, regardless of their financial
insecurities.
Mr. Grothman. So as I understand it, talking to people in
your industry, you will find a way to do an abortion, whether
the government is paying for it or nobody is paying for it.
Somehow you will find the money to do that abortion. Correct?
Dr. McNicholas. So to set the record straight, the
government does not pay for abortions. People are navigating
the complexity of paying for basic health care because the
government has abdicated its responsibility to pay for that.
Mr. Grothman. So you don't turn people down. That is what I
want to know.
Dr. McNicholas. We do not turn people away.
Mr. Grothman. Correct.
I have toured some abortion clinics, and one thing that
struck me about the abortion clinics, at least- and this was
like 20 years now since I toured them--is they never used the
word ``abortion'' and they never used the word ``fetus.'' They
always used the words ``procedure'' and ``tissue.'' Do you
still follow that policy, in which we try to avoid using the
words ``fetus'' and ``abortion'' and use the words
``procedure'' and ``tissue''?
Dr. McNicholas. Twenty years is a long time. I invite you
back to our clinic to see what happens there. And I absolutely
use the words ``fetus'' and ``abortion.'' And, actually, I take
the direction from my patients, who absolutely understand the
potential life that is in their uterus. Most patients who have
abortions are parents. They are well- aware of the fact that
what would happen if they didn't have an abortion is that they
would have a baby.
Mr. Grothman. We- I am running out of time here. We did
pass a 24-hour waiting period bill in Wisconsin. Do you have a
similar bill in Missouri?
Dr. McNicholas. We have one of the most restrictive waiting
period bans in Missouri.
Mr. Grothman. Okay.
Dr. McNicholas. It is 72 hours, and requires the same
physician.
Mr. Grothman. Okay. The question I have for you, it came
out as part of a lawsuit, in Madison, Wisconsin. Because of the
waiting period bill, about 10 percent of the women who came in
the first time around, I believe, and gave an amount of money,
did not come back the second time, which would indicate they
were very much on the fence, and given some more time to think
about it they decided not to have the abortion.
Percentage-wise, of all the women who come in to see you
the first time, what percent don't come back the second time,
in Missouri?
Dr. McNicholas. I think you made an assumption about what
that 10 percent means. My informed assessment of that would be
that those 10 percent of women really struggled to figure out a
way to get back, because they didn't have the financial means,
the secure transportation needs, the ability to navigate
additional time off of work or find somebody to watch their
children while they were trying to access that care.
Mr. Grothman. So you are not going to answer my question.
Mr. Clay. The gentleman's time has expired.
Mr. Grothman. Thank you for being so--
Mr. Clay. I recognize the gentleman from California, Mr.
Khanna, for five minutes.
Mr. Khanna. Thank you, Representative Clay. Thank you for
your leadership in convening this hearing.
I would like to discuss state and Federal restrictions to
abortion access and the disproportionate impact that they have
on LGBTQ patients.
Dr. McNicholas, a few questions for you. First, could you
briefly describe the need for abortion care among the LGBTQ+
community?
Dr. McNicholas. Absolutely. Thank you for your question. I
think the first, most basic thing that most people forget is
that your sexual orientation does not define who you are having
sex with, and so people in all of those communities may
experience pregnancy.
Similarly- and I have had the honor of taking care of many
trans and non-binary folks in my career- so long as you have a
uterus you have the capability of getting pregnant, and if you
think that accessing abortion care is stigmatizing when you
present as a woman, imagine what it is when you are presenting
as your authentic male self.
Mr. Khanna. I appreciate you mentioning that there are
transgender men and non-binary individuals who rely on
reproductive health services and abortion services.
In 2015, when the National Center for Trans Equality
surveyed transgender Americans, 23 percent of respondents did
not see a doctor when they needed to because of, quote, ``fear
of being mistreated as a transgender person.''
As a doctor, can you describe some of the challenges
gender-diverse patients face in accessing health care, and
abortion care, specifically?
Dr. McNicholas. So in my practice I have, again, had the
great honor of taking care of many specifically trans men
seeking hysterectomies in their transformation process, and one
of the things I hear from them, unequivocally, each one of
them, is that there have been tremendous delays in accessing
very basic care, one, because they are afraid that they won't
be treated with dignity and respect, and the second is because
that is their lived experience. They have been turned down by
many patients- excuse me, physicians- and have been
intentionally degraded with, for example, use of intentional
misgendering of the patient in front of them.
Mr. Khanna. And can you also describe some of the specific
challenges that gay, lesbian, and bisexual patients may face in
abortion care, specifically?
Dr. McNicholas. Sure. So I think it is important to
remember that gay and lesbian folks also want to build
families. They are parents. I, myself, have a wife and a child,
so I fit into that group as well. It is important that they are
able to access that care in a place where they feel respected
and dignified, and Planned Parenthood is happy to be one of
those places.
Mr. Khanna. Thank you so much for speaking to those issues.
Turning to you, Ms. Howell, transgender people are four
times more likely than the general population to live below the
poverty line, and close to one in four lesbian bisexual women
in the United States live in poverty. Yet current laws prevent
Federal Medicaid dollars from being used to cover abortion
services.
How do these funding restrictions overlap with identity to
make abortion even less accessible for the LGBTQ communities?
Ms. Howell. The discrimination that people go toward,
because they are either trans or gender nonbinary or LGBTQ, it
really does hit them harder because, as was already mentioned,
they are afraid to go and get services, and when they go to get
services they find that some of the current regulations allow
people to discriminate against them, and that they then find
that they don't have any access to getting good reproductive
health services, much less regular health care services.
Our organization does believe that all people have the
right to get reproductive health services, regardless of
whether they identify as LGBTQ, whether they are trans, whether
they are low income. All of these factors should be taken into
account to allow them to get the kind of services that they
deserve. And so laws or regulations that allow--that have been
done by this government that allow other people to discriminate
against them puts them at higher risk, and those are the kind
of laws and regulations that we fight against.
Mr. Khanna. Well, thank you, Ms. Howell. Thank you, Dr.
McNicholas, for your advocacy for some of the most vulnerable
populations, and I believe we need to really consider their
access to health care as we craft these laws.
I yield back my time.
Chairwoman Maloney.[Presiding.] Thank you. Representative
Cloud.
Mr. Cloud. Thank you all for being here. I appreciate you
all coming to take part in a discussion that is, no doubt, very
emotionally charged with very deeply held beliefs of conscious
on both sides of the issue.
For me, the most difficult decisions we have to make as
lawmakers are those in which individual rights are in conflict
with each other. And so for me, on this issue, where I come
down, is to the whole life living in pursuit of happiness,
where which rights supersede. And I do believe that while
having compassion for anyone who has to go through a difficult
situation that the right to life is more- supersedes the right
to liberty and the pursuit of happiness.
So in that context I approach this conversation.
Dr. McNicholas, could you describe what happens in the
process of an abortion, to the baby?
Dr. McNicholas. So I appreciate your question and I want to
first note that abortion was around before there was any
concept of life, liberty--
Mr. Cloud. Answer the question.
Dr. McNicholas [continuing]. and the pursuit of happiness.
Mr. Cloud. I have only five minutes.
Dr. McNicholas. The abortion procedure really depends on
the clinical situation. When I speak to patients about their
options for terminating a pregnancy I start with where are we
in pregnancy.
Mr. Cloud. I only have five minutes. Could you speak to the
process please?
Dr. McNicholas. So I realize it is difficult, but in
medicine things aren't short. There are 100 shades of gray. So
it is impossible for me to take what is often a 50-minute
conversation with a patient and answer it in 30 seconds for
you.
As I approach patients, I talk to them about what their
options are for pregnancy termination, and that really depends
on a variety of things, including what stage of pregnancy they
are in, what are their other medical comorbidities or health
problems that they have, whether any particular instances in
previous pregnancies, for example--
Mr. Cloud. Okay. I am going to have to--
Ms. Stuckey, could you describe what happens in the process
of an abortion?
Ms. Stuckey. Well, apparently I am the only one willing to
talk about specifics, and this is free online. Anyone can go
look. Even Planned Parenthood's website describes pretty
clearly what, for example, a D&C abortion is, which is taking
out of the amniotic fluid, drying that up from the uterus,
which is what, of course, the fetus, the baby, needs to
survive, and then dismembering the baby, limb by limb, with
forceps. And Ms. Lawrence spoke to that being deceitful or
hyperbolic. It is not at all. Please, go look online and you
can see what an abortion actually is.
But again we see that it is not me that is speaking in
generalities. It is the pro-abortion side that is speaking in
generalities, because they know the grotesque nature of what an
abortion procedure is. You don't have to be an abortion
provider to know what an abortion is. That is exactly why I am
here, to talk about the absolute brutality of the killing of
life inside the womb.
And I also want to address Ms. Box, who I have the utmost
compassion for. One, I actually did not say the term
``murderers,'' to my recollection, and I don't think me being
passionate about this subject we do disagree on means that I
disrespect you. I think that we can agree, or disagree, even
passionately, without taking that as a personal slight, and I
certainly didn't mean it that way. I just care about life
inside the womb and protecting babies unborn.
Mr. Cloud. Okay. I have very little time left now, but, Ms.
Graves, you mentioned that nothing has changed since Roe v.
Wade except for the makeup of the Supreme Court. The reality
is--
Ms. Goss Graves. I actually said- I just want to correct
you, because I was talking about the whole women's health
decision, which was three years ago--
Mr. Cloud. Okay.
Ms. Goss Graves.--and the case that is going to be before
the court this term, the June Medical Services--
Mr. Cloud. But a lot has changed. We- science has developed
a whole lot. Back in the 1970's, it was rare for an ultrasound-
for a woman to have an ultrasound. Isn't that correct? Now we
know a whole lot. We know that a baby can be viable at 20
weeks. We know that a baby feels pain.
I ask unanimous consent to submit this peer-reviewed
scientific article on fetal pain that a baby feels during
abortion.
There is a lot that has happened since this is- and
certainly I think the scientific advances merit us relooking at
this.
Ms. Goss Graves. The Supreme Court did, three years ago, in
the Whole Women's Health decision, it considered--
Mr. Cloud. Dr. McNicholas, you mentioned a number of health
inspections at your abortion clinic when you just took over.
Were you aware of the history of health violations at your
clinic before you took over?
Dr. McNicholas. So our clinic has been subject to repeated
inspections every year, which we have passed, with a single
inspection every single year, up until this year when clearly
it became- it was no longer about ensuring the safety of
patients and it became about a quest to end abortion access.
Mr. Cloud. Okay. Well, I ask unanimous consent to submit to
the record. This is only seven states, the violations at
abortion clinics from a--
Chairwoman Maloney. No objection. We accept this entry.
Thank you.
Chairwoman Maloney. And your time has expired.
Mr. Cloud. Unfortunately, my time is up.
Chairwoman Maloney. Okay. I now recognize Congresswoman
Pressley, for her questioning. She has been a tireless advocate
for these issues on this committee, so thank you for your
leadership.
Ms. Pressley. Thank you, Acting Chair Maloney, for holding
the line on this full committee hearing since the transition of
Chairman Cummings. Thank you, Ms. Box, for modeling that which
he spoke of often, which is turning your pain into purpose. We
thank all of you for being here.
Elijah Cummings often reminded us that we are to be in
efficient and effective pursuit of the truth, and so we are
still trying to arrive at that, it seems, today.
This conversation cannot be more timely, as we bear witness
to and experience this Administration's calculated and systemic
attacks on our constitutional rights and freedoms. The right to
determine our own economic future and the audacity to determine
our own fate, and the freedom to determine when, if at all, to
have a child.
Even in states like the Commonwealth of Massachusetts,
which I represent, individuals, particularly low-income and
young people, LGBTQ and black and brown folks, continue to face
barriers in accessing comprehensive reproductive health care.
And let me be clear, health care is abortion care.
But in these times, we have seen many states emboldened by
this Administration pass additional restrictions that further
hinder individuals' access to abortion, endangering lives and
criminalizing individuals for decisions that should be kept
between themselves and their doctor.
It is important to discuss these draconian state
restrictions, but as chair of the Abortion Rights and Access
Task Force of this first-ever pro-choice majority in this
history of Congress, I would be remiss if I didn't also shed
light on the impact that Federal coverage bans are posing on
our most vulnerable communities.
Current law restricts Medicaid funds from covering abortion
care for women in communities across the United States. To be
clear, the Hyde Amendment functioned as the original abortion
ban for low-income individuals.
According to the Guttmacher Institute, restrictions on
Medicaid coverage for abortion services force one in four low-
income women to carry unwanted pregnancies to term.
Ms. Goss Graves, how do coverage bans like the Hyde
Amendment force low-income individuals further into poverty?
Ms. Goss Graves. So just at, for some women, is the hardest
time in their life, you know, around being pregnant, they are
now in a situation where they, because they are on Medicaid or
because they are on a Federal health plan or other Federal
restrictions, they no longer have, or are in a situation where
their health care can be covered by insurance, like the rest of
their health care. So all of a sudden you are having to scrap
together money, on top of a range of other barriers. Those
barriers may look like having to travel long distances. Those
barriers may look like having to pay for child care because of
multi-day waiting periods. So it is not only the restrictions
on coverage. You also have these other costs.
And for the right to abortion, which has been legal for 50
years almost, and reaffirmed again and again and again by the
Supreme Court, most recently just three years ago, that right
is not just for those who are affluent. That right is not just
for those who happen to live in a state where the state is
trying to make up for the very serious gaps in Federal
coverage. That right is a fundamental right. It is a right that
is tied to your ability to have dignity in this country, it is
a right that is tied to your ability to have freedom in this
country, and it is fundamental to your economic security.
Ms. Pressley. Thank you. I would be remiss if I did not
acknowledge, sitting next to me, a champion in the efforts for
decades now to repeal Hyde. I want to acknowledge my other
sisters in service from our Pro-Choice Caucus were waived on
today, Representatives Chu and Schakowsky, respectfully. Thank
you for being here.
Each year, 700 women in the U.S. are likely to die during
childbirth. These numbers are even worse for black and Native
American women. Ms. Howell, could you speak to your report
recently issued connecting the impacts of abortion bans on the
maternal health crisis?
And I would be remiss- I just wanted to acknowledge, since
there was this conversation about compassion for the innocence-
earlier today I rolled out the People's Justice Guarantee,
which calls for the abolishing of the death penalty, and, in
fact, 1 in 25 are wrongfully convicted and innocent. So I look
forward to my colleagues on the other side of the aisle signing
on to my legislation.
Ms. Howell?
Ms. Howell. The report that you refer to looks at the
correlation between maternal mortality and states that have
placed these bans against abortion. And what we know is that
trying to- if you decide that you need to terminate a pregnancy
and you are denied that care, it puts additional stress on you.
We also know that women who are denied abortion care tend
to delay prenatal care. So, again, there is an additional
stress as well.
And I might add, I want to give you some of the states that
have some of the worst abortion bans and also some of the worst
maternal mortality outcomes. Alabama, Georgia, Ohio, Missouri,
unfortunately, and a lot of the Southern states- South
Carolina, Texas. Those are the states that primarily have these
outrageous abortion bans that prevent people from actually
accessing abortion care, but they also have--
Chairwoman Maloney. The gentlelady's time has expired.
Ms. Howell [continuing]. the highest mortality--
Chairwoman Maloney. Could you please wind down?
Ms. Howell. They also have some of the highest mortality
rates for maternal mortality. So we have to look at both of
those things together in terms of what it means to access good
reproductive healthcare for people.
Ms. Pressley. Thank you, Ms. Howell.
Ms. Howell. Thank you.
Ms. Pressley. Thank you, Madam Chair.
Chairwoman Maloney. Thank you. The chair recognizes
Representative Miller.
Mrs. Miller. Thank you, Madam Chairman and Ranking Member
Green, and thank you all for being here today.
As a mother, I have had the privilege to feel life quicken
in my womb. As a grandmother, I know the joy of grandchildren.
I have gotten to experience endless joy having grandchildren
because it is just unconditional love.
I have had family members and friends who have yearned to
be parents but were unable to have children of their own. I
have had friends and family who have been adopted, and they are
very grateful. I have friends and family who have adopted
children, and they are very grateful. They have brought such
blessings to their family.
However, I have become increasingly concerned as of late
about the actions taken by my colleagues across the aisle.
Washington Democrats refuse to protect babies even after they
are born alive after an abortion attempt, and it is so
heartbreaking. Our most vulnerable and youngest citizens
deserve our utmost protection.
Ms. Stuckey, speaking of medical innovation, I think we can
all agree that women having access to all healthcare is
important. That being said, not every Planned Parenthood
provides comprehensive women's healthcare. Can you elaborate on
the positive steps that the Trump administration has done to
not only protect life, but to ensure that women have better
access to healthcare through federally Qualified Health
Centers?
Ms. Stuckey. Yes, thank you for that question.
First, I do want to address an issue that I think that we
can all say- all agree on, that the maternal mortality rate in
this country, in a developed country, is way too high. And it
is, I think the number is 3.3 times higher for African-American
women than it is for white women, and I fully believe that we
need to address that. And I would encourage the Trump
administration to address that.
I don't understand why the exclusive solution that we
discuss when we talk about the maternal mortality rate is
abortion. Why is that the only solution that we discuss? Can we
not come together and talk about how can we best care for a
woman and her child? Why do we have to sacrifice the child for
the health of the mother when it is not medically necessary?
President Trump has been the most pro-life, most- if you
want to call it anti-abortion, I am fine with that, too- anti-
abortion administration since Ronald Reagan, maybe even more so
than Ronald Reagan, with the Mexico City policy. And of course,
we know enacting the final rule for Title X that says you have
to physically and finally separate your abortion services from
the rest of your contraceptive care in order to receive Title X
funding.
I heard earlier a comment about this gag rule. Well, it is
actually not a gag rule that the Trump administration enacted.
It is you cannot encourage someone to get an abortion, but you
can counsel them neutrally. So that is not actually a gag rule.
It is not a limit on free speech.
President Trump has ensured that these policies can go
forth and, of course, given states the freedom to protect life
inside the womb. And for that, I am very thankful.
Mrs. Miller. You might be familiar with efforts by House
Republicans to protect babies who are born alive after an
abortion attempt. Many argue that the Born Alive Act is
unnecessary because doing so violates existing criminal law.
Do you believe Federal law should be clarified to ensure
babies born alive after a failed abortion should receive
critical medical care?
Ms. Stuckey. Yes. It needs to be clarified. So this new law
the Democrats have tried so hard to blockade simply
criminalizes the neglect of an abortion provider to attend to
the medical needs of a child who survives an abortion, further
recognizes this child's personhood, and says this is the
medical treatment that is required for a child outside the
womb. We are not even talking inside the womb anymore.
And unfortunately, Democrats cannot even get onboard with
that. There are not any undue burdens, undue regulations. This
is not preventing abortion providers from even giving
abortions. It is simply saying if a child survives an abortion,
attend to that child.
It should be really simple. If you really are pro-choice
and you are really not pro-abortion, as I have heard many times
during this hearing, that should be a no-brainer.
Mrs. Miller. I understand a baby can survive as early as 23
weeks old. Can you elaborate on how age of viability has
changed in the recent years, and what has made that possible?
Ms. Stuckey. Well, as technology and medicine advances,
thankfully, hospitals are able to give incredible perinatal
care, so that a child as young as 21 weeks actually has been
known to survive outside of the womb. I mean, that is pretty
early in the second trimester. That is only halfway through the
pregnancy.
At 24 weeks, that is generally accepted as the age of
viability. What that means is that that child has a really good
chance, if she were to be born prematurely, to live outside the
womb, to grow. She would spend some time in NICU, but she would
grow up, you know, if everything went well and she was healthy,
into a normal functioning child. You wouldn't even be able to
look back and tell that the child was premature.
So when we are talking about these children as if they are
not children, as if they are not babies, we are talking about
mere location. I mean, on the one hand, we talk about them as
if they are just these parasites to be discarded as these
remains of pregnancy, I think is what I heard the doctor say
earlier.
And then a second later, when they are outside of the womb,
they are all of a sudden babies. Although, unfortunately, as
you pointed out and other congresspeople have pointed out, even
then, even then they don't seem to be respected by the pro-
abortion side.
Mrs. Miller. Thank you. I yield back.
Chairwoman Maloney. Thank you.
I understand that the witness, Ms. Stuckey, has a flight
she has to catch. So I will dismiss her, noting that there may
be other additional questions that I request that she answer
them in writing.
And thank you for your testimony, and I hope you don't miss
your flight.
Ms. Stuckey. Thank you.
Chairwoman Maloney. So the next speaker will be Debbie
Wasserman Schultz from Florida. Congresswoman Schultz?
Ms. Wasserman Schultz. Thank you, Madam Chair.
Madam Chair, I have a question of you, and in fairness, I
would like Ms. Stuckey to hear my question because I wouldn't
want there to be any assumption that I was saying it as she was
no longer in the room.
I just want to clarify that Ms. Stuckey is here expressing
her own opinion exclusively and has no scientific or particular
expertise in this subject matter whatsoever. Is that accurate?
No, I want to ask you, from what your knowledge of her
experience is in the description of the witness's experience.
Chairwoman Maloney. That is my understanding.
Ms. Wasserman Schultz. Thank you. I just wanted to clarify
that particular fact.
Chairwoman Maloney. But I think the witness should answer,
in all fairness, as she is here.
Ms. Stuckey. I think it says something that when I, the one
without the scientific or medical background, am the only one
to give you specifics on what is--
Ms. Wasserman Schultz. Reclaiming my- reclaiming my time.
My question--
Ms. Stuckey [continuing]. what an abortion procedure
actually is. Ask the doctor for yourself.
Ms. Wasserman Schultz. Reclaiming my time, Ms. Stuckey, my
question was not of you, and you have essentially acknowledged
that you are here expressing your own opinion, which we
appreciate.
So the other thing I wanted to point out was that no one
here today has said that abortion is the only solution to
address the maternal mortality rate. How about access to-
better access to prenatal care? How about the passage of the
Affordable Care Act and making sure that it remains the law of
the land so that women are no longer considered preexisting
conditions just because of our existence as women and the
potential for us to be dropped or denied coverage because of
our propensity to get pregnant and have babies, which happened
all the time before the Affordable Care Act was the law of the
land.
I could go on with many other provisions that we advocate
to make sure that we can reduce the maternal mortality rate.
Certainly, abortion is not the only thing we suggest and, in
fact, is not a solution that we ever suggest to reduce the
maternal mortality rate. It is a ridiculous suggestion.
What isn't a ridiculous suggestion is that the decision to
become a parent is one of the most important and most personal
life decisions that we make. Watching the rapid expansion of
state laws that limit a woman's autonomy to make this personal
choice for herself is deeply troubling.
This fight for reproductive freedom is one that we are all
too familiar with in Florida. I have seen Republicans in my
home state in the legislature introduce bills that ban abortion
after six weeks, ban abortions that are based on certain
medical diagnoses, and right now are fast-tracking a proposed
Draconian parental consent law.
We need to be unequivocal about calling these laws out for
what they are, sinister attempts to interfere with a woman's
right to make her own personal health choices and decisions and
obvious steps in a larger political plan to ban all abortions.
As we have heard, Missouri has enacted so many restrictions on
providing abortion care that only one clinic is left standing.
Because my time is limited, I want to ask Dr. McNicholas,
the excuse that a patient can just drive to another state to
receive medical care, is that an acceptable rationale for any
other type of medical service? And is it accurate to say that
requiring medically unnecessary patient delays, whether that is
to gather travel funds or make lodging and caregiving
arrangements, would lead to women having later abortions, which
were more expensive and can pose a higher health risk?
Dr. McNicholas. Thank you for the question and
acknowledging the sort of many intersecting realities that
people are navigating when they are trying to access basic
care. And in Missouri, for many of them, that means driving
hundreds of miles multiple times.
I am reminded, actually, of a patient I took care of
recently in the second trimester, who actually was able to get
to the clinic the first time very early at six weeks of
pregnancy. She went home and scheduled her clinic procedural
date for about a week and a half later but, unfortunately, was
in a car accident on the way to that appointment.
Because Missouri's law not only requires a waiting period,
but requires it to be with the same physician who will
ultimately perform your procedure, she was then- her two-visit
abortion became a four-visit appointment visit, and she was
pushed from seven weeks to 15 weeks. This is exactly what
happens when there is no context and no medical or scientific
grounding in abortion restrictions. Patients are pushed to
later and later in pregnancy, which is quite ironic for a
cohort of folks who want to limit abortion later in pregnancy.
Ms. Wasserman Schultz. Thank you.
Ms. Box, I want to end with you, and I am so sorry for your
loss. But I know you are overjoyed in your daughter that you
brought with you.
You received test results that revealed your daughter Libby
had a chromosomal anomaly when you were around 13 weeks
pregnant. But if H.B. 126, the Missouri law that would ban
abortion after about eight weeks, had been the law in the state
of Missouri at that time, would you have considered leaving the
state to have an abortion? How difficult would have it have
been for you and your family if you had needed to travel out of
state to obtain your abortion care?
Ms. Box. So the answer is, yes, I would have looked at how
I could have protected my daughter, regardless of what
regulations the state tried to interfere with. The truth is,
even though abortion, the ban had not come into effect yet, the
eight-week ban, we did look at leaving Missouri and going to
Representative Kelly's state of Illinois because the
restrictions there are fewer. There is an opportunity for--
Chairwoman Maloney. The gentlewoman's time has expired. If
you could please wrap up real quick?
Ms. Box. Yes. So, yes, we would have done whatever we could
to protect our daughter, regardless of governmental intrusion.
Ms. Wasserman Schultz. Thank you for sharing your personal
story, and I yield back the balance of my time.
Chairwoman Maloney. I now recognize Representative Green.
Mr. Green. Thank you, Madam Chairwoman.
My first question is for Dr. McNicholas. Am I pronouncing
that correctly? Yes. If the DNA from a fetus and a mother were
found at, say, a crime scene, say it is two blood samples. We
take fetal blood. We take mother's blood. We put them at the
crime scene. The investigators know nothing. They find two
samples. Would the investigators see these as two separate
people?
Dr. McNicholas. I have no idea.
Mr. Green. Of course, they would. The answer is yes. You
know, as a physician, it is two different DNAs, and they would
see two DNAs, and so they would say it is two people.
My next question, question for you as well. Recently, in
California, a mother was charged for killing her unborn baby by
excessive methamphetamine usage. If the mother had just gotten
an abortion and killed the baby that way, she wouldn't have
been charged. Do you see the hypocrisy in this?
Dr. McNicholas. I think it is tragic that we are
criminalizing people who need basic healthcare and treatment
for their drug addiction problem. That is what I think is a
problem in this country.
Mr. Green. Absolutely. Someone who uses methamphetamine
should get help. There is no doubt about it. And she was
charged with a crime for the death that she caused of her baby
with methamphetamine use. The child was stillborn.
I just- I find that hypocritical that if she had just gone
a week prior to Planned Parenthood and gotten an abortion, she
wouldn't be charged.
You know, I am going to transition a little bit here. I
want people to make their own choices. I am for freedom. But
when one person's freedom impinges on the freedom of another,
and for example, if someone in this room yelled ``fire,'' that
would be against the law because, potentially, a stampede could
occur, and people would be hurt.
Abortion is a decision where one person makes it, and it
leads to the death of another person. So that is something to
take into consideration.
My next question I was going to actually ask of Ms.
Stuckey, but she is gone. I will just read the question and let
the audience and others consider it.
A few years ago, a freezer unit protecting previously
fertilized human eggs, meaning a sperm and ovum where they had
combined to form a fertilized egg, was broken. And thousands of
these fertilized eggs were lost. I just want to ask people in
the room whether or not they would agree with the headline in
the newspaper the following day that said it was a human
tragedy that these lives were lost. Just consider that.
My next question again is back to you, Dr. McNicholas. In
regards to ABO and Rh incompatibility, why do I, as an ER
physician, have to treat the mothers with RhoGAM to prevent her
antibodies from attacking the blood supply of the baby?
Dr. McNicholas. Oh, so two minutes for this?
Mr. Green. No, you got 30 seconds.
Dr. McNicholas. Oh.
Mr. Green. Or I can do it because I do it all- I treat
these patients all the time. Go ahead.
Dr. McNicholas. Sure. So in the instance in which the fetus
has a different type than mom, there are occasions where mom
can create her own defense mechanism to that situation, which
would in a subsequent pregnancy attack a subsequent pregnancy
and have some serious conditions for the fetus.
Mr. Green. That was pretty good, and I mean, you did it in
about 30 seconds. But she is absolutely correct. Basically, the
mother's immune system sees that second child as foreign and
attacks it because it has got a different blood type than the
mother.
Let us see, I also want to share a few quick observations,
in the little bit of time that I have left, as an ER physician.
I know that there are a lot of statements about the safety of
abortion. I just want to tell you that I have treated many,
many patients in the emergency department where the abortion
hasn't gone as intended, where products of conception, the
medical term- or baby parts- are left inside the mother, and
sepsis results.
Those patients come to us, and we take care of them in the
emergency department. We save their life from that infection.
I also want to say that I have taken care of many, over the
years as an emergency medicine physician, patients who have
come in bleeding from an abortion. And the unfortunate thing is
that the obstetrician who has to take care of that patient
didn't do the abortion. So he doesn't know the patient's
history, and they are rushing them into surgery to stop the
bleeding and save the patient's life. That does happen.
And it happens more frequently than many people would want
you to know, but it is a reality. And I just want to say that
is why I support abortion providers having credentials at a
hospital where they can treat the complications of the surgical
procedure of an abortion that they- that results when they do
that.
Chairwoman Maloney. The gentleman's time has expired.
Mr. Green. Oh, am I out? Okay, thank you, Madam Chairwoman.
Thank you.
Chairwoman Maloney. Thank you. I would now like to
recognize Congressman Raskin.
Mr. Raskin. Madam Chair, thank you. And thank you for
calling this important hearing.
Big Brother seems to have come to Missouri, the Leviathan
state has arrived in Missouri, and all of our colleagues who
like to strike a libertarian note when it comes to people
possessing AR- 15s and military-style assault weapons, the
kinds that are wreaking havoc across the land, suddenly become
the champions of Leviathan, Big Brother, Gilead, and the all-
powerful state. Politicians making healthcare choices for our
people.
Ms. Goss Graves, let me start with you. You are the
president of the National Women's Law Center. Presumably, you
know something about the history of sterilization in our
country, where certainly tens of thousands of women at least
were sterilized. If Government has the power to prevent a woman
from having an abortion against her will, won't Government also
have the power to sterilize women against their will, which was
so much a part of our history?
Ms. Goss Graves. You know, I think it is important to put
the right to abortion, which is so core and fundamental, in the
context of a range of rights. The right to abortion is in the
context of the right to make reproductive healthcare decisions
broadly, including contraception, including around
sterilization and not having forced sterilization. But it is
also among the set of rights around the right to be intimate,
the right to marry.
All of those things follow a long line of decisions that
emanate from the Fourteenth Amendment's guarantee around
liberty and around your ability to sort of live with dignity.
Mr. Raskin. Thank you.
Dr. McNicholas, officials in Missouri, including Dr.
Randall Williams, the Director of the Department of Health and
Senior Services, and Governor Parsons, have asserted that the
restrictions adopted in Missouri are necessary for the health
and safety of people seeking abortions. In your opinion, is the
requirement that a physician have admitting privileges at a
local hospital necessary for the health or safety of a woman
seeking an abortion?
Dr. McNicholas. So the short answer is no, and the longer
answer is it is not my opinion. It is what science and fact and
ACOG and the most recent publication out of the National
Academies of Science has told us.
Mr. Raskin. Well, what about this 72-hour waiting period
between a woman seeking an abortion and being able to get one?
And then also I understand they adopted a provision for two
pelvic exams during that time. Is that necessary for the health
and safety of women in Missouri?
Dr. McNicholas. None of those are required to maintain
health and safety.
Mr. Raskin. But how do you know that?
Dr. McNicholas. Science. There is plenty of published
literature supported by the American College of OB/GYN, again
supported by the National Academies publication that has
demonstration that not only are they not medically relevant or
necessary, but they actually cause harm.
Mr. Raskin. Well, what about from the standpoint of the
patient? Ms. Box, let me come to you. Did you feel that any of
the procedural hurdles and hoops that were set up in Missouri
and you were forced to jump through were necessary for your
health and safety?
Ms. Box. No. I found them insulting. They presumed that my
husband and I didn't have the ability to make a decision for
ourselves. The waiting period that Dr. McNicholas was talking
about and the mandatory same physician rule meant that my
abortion, which happened at around 15 weeks, had I not been
able to do the available date that the physician had, I
actually would have been outside of when is the legal timeframe
in Missouri.
And I was well short of it. I would have had to reconsent,
been given another booklet of medically inaccurate information,
which my husband and I refer to as the ``book of shame,'' and
that- all of that presumes that- and I think what I find most
insulting as a patient is that I didn't have the ability to
think for myself, that I needed my state government to put that
time in for me.
Mr. Raskin. I thank you for that really important insight.
You talk about this ``book of shame.'' I think you started your
testimony by saying that one quarter of American women will
have an abortion over the course of their lifetime, most of
them also mothers, as you are. You have how many kids? Two
kids?
Ms. Box. I have three living children.
Mr. Raskin. You have three living children. Okay. Well,
they want to throw the ``book of shame'' at tens of millions of
American women. How does that feel to you as a citizen in
Missouri? That you get hit by the ``book of shame''?
Ms. Box. I mean, it is devastating. I mean, in our
particular case, we were in the middle of a very grief-stricken
process, and we were in a crisis. And to have confusing and
misleading information when you are trying to make a medical
decision is horrifying that we would ever allow patients to get
mischaracterization and misinformation and hope they can make
the best decision for themselves.
Mr. Raskin. Okay. And finally, I wanted to ask this
question while all the witnesses were there. I was thinking we
could make history by getting the pro-choice witnesses and the
anti-choice witnesses to agree on a pro-life program, which is
a universal criminal and mental background check on all gun
purchases.
At least for the witnesses who are still here, would you
reach across the aisle to the pro-life witnesses to say you
would stand for that?
[Response.]
Chairwoman Maloney. The gentleman's time has expired.
Mr. Raskin. I would let the record reflect I think they all
nodded their heads, Madam Chair.
Chairwoman Maloney. Congressman Connolly?
Mr. Connolly. Thank you, Madam Chairman. And thank you for
holding this hearing.
And thank you, Mr. Clay, for being our inspiration in
highlighting what is happening in your state.
I think we need to be honest here. Everything designed to
make your very difficult decision, personal decision--not a
state decision, Ms. Box--was designed to take away your choice.
What Mr. Green described was insidious logic. Because there
might have been complications from some abortions, all
abortions should be eliminated.
Even though the overwhelming majority of legal abortions,
because of Roe v. Wade, they are done under medically
supervised conditions and are safe and allow women and families
to have choices. The changes in Title X are designed, again, to
take away or limit choices. The attack on Planned Parenthood
insidious, designed to take away choices and being willing to
deny women healthcare as the price you have to pay for their
ideological stance.
And Ms. Stuckey's misguided moral absolutism for all the
rest of us. And of course, the sacrifice of science, as you
point out, Dr. McNicholas, that has to be in there, too,
because science is an inconvenient source of information and
truth, again denied you and your family, Ms. Box, at a critical
moment in the decision you had to make. Go ahead.
I thought you wanted to comment.
All right. Dr. McNicholas, how many women patients does
Planned Parenthood see every year?
Dr. McNicholas. The Planned Parenthood of the St. Louis
region, so--
Mr. Connolly. No, no. Nationwide?
Dr. McNicholas. Oh, I don't know.
Mr. Connolly. All right. St. Louis?
Dr. McNicholas. Our Missouri- our Missouri affiliates see
more than about 50,000 women a year.
Mr. Connolly. How many?
Dr. McNicholas. Fifty thousand.
Mr. Connolly. Would you guess that is a lot more than Dr.
Green sees in a year?
Dr. McNicholas. It is. And I would actually like to
highlight, to Dr. Green's point about safety, that I have yet
to see an oral surgeon be brought in front of Congress to talk
about the risks of wisdom teeth, but having an abortion is
safer than having your wisdom teeth removed.
So I think mischaracterizing abortion as anything other
than safe is inappropriate. It is healthcare. So, yes,
unfortunate outcomes will happen for some people, but by and
large, it is safer than colonoscopy, wisdom teeth, and I will
also mention it is far safer than carrying a pregnancy to term.
Mr. Connolly. And it is safe because Roe v. Wade made one
law for the whole United States, including Missouri. Is that
correct?
Dr. McNicholas. We have lots of examples internationally to
show that legalization of abortion is one of the most important
public health and lifesaving interventions for women.
Mr. Connolly. And would it be fair to say that absent Roe
v. Wade, it is not that abortion will disappear, it is that
people will be forced once again to go into the shadows to
secure those services, to make those decisions, or go to states
that do protect it legally? Is that a fair statement?
Dr. McNicholas. So as I mentioned before, abortion was
around before the Constitution, and it will not go anywhere if
we remove those barriers.
Mr. Connolly. So our choices make it safe. Hopefully, it is
rare because contraception is available. Family planning is
available, but it has to be an option. As Ms. Box's personal
experience tells us, it is a health decision, a hard one, a
heartbreaking one for many people.
But to deny them access to it because you have decided on
the morality of it or you have made up science to justify your
own personal belief is to impose your will on the majority of
Americans, including women who are affected by this choice.
Title X, Dr. McNicholas, Planned Parenthood decided to pull
out of Title X, even though it does not provide funding for
abortions. Is that correct?
Dr. McNicholas. That is correct.
Mr. Connolly. Why did Planned Parenthood decide to leave
Title X?
Dr. McNicholas. I think, as was previously mentioned by Ms.
Goss Graves, there is a really fundamental issue for Planned
Parenthood, which is that the new rule would force us to lie to
patients and intentionally exclude information that could be
important and lifesaving for them.
Mr. Connolly. And real quickly, because Title X provides
other healthcare for women, they are now going to be denied
that coverage because of Planned Parenthood's being forced out
of the program. Is that correct?
Dr. McNicholas. We are going to try our very best to meet
all of the needs of our patients, including those who were
previously receiving Title X, but I think the point is well
taken that with reduction of Planned Parenthood seeing Title X
patients, there will be a tremendous gap in services for
patients, particularly who are low-income or people of color.
Mr. Connolly. My time has expired, but I thank you all for
being here and for the courage of sharing, especially you, Ms.
Box.
Chairwoman Maloney. I would now like to recognize
Congresswoman Tlaib.
Ms. Tlaib. Sorry. I didn't know I was next.
Thank you so much. It really is incredibly important that
you all are here to talk about this particular issue.
Especially as a woman serving in the U.S. Congress, I just want
to personally thank you for defending my right to choose.
One of the things I want to discuss is the impact of
politically motivated restrictions of abortion that we have
been talking about, access to maternal health. But even more,
even around infant mortality.
When I served six years in the Michigan state legislature,
I was always taken aback by so much time and effort and debate
and conversation around the right to choose versus infant
mortality, you know, maternal health. All of those things that
I think are interconnected with some of the, you know,
reasoning behind folks that want to support life, right?
And there is an issue that is particularly concerning to me
is that parts of my home district have among the highest
maternal mortality rates in the country. In 2014, a woman
giving birth in Detroit was three times more likely to die in
childbirth than the rest of the country. Infant mortality in
Detroit is double the national rate in the country, and it just
goes on and on.
Dr. McNicholas, you know, Missouri was one of the highest
rates--has the highest rates of maternal mortality in the
country, and that continues to rise, especially among women of
color. In fact, black women in Missouri are three times more
likely to die from pregnancy complications than other women. Is
that correct?
Dr. McNicholas. That is correct.
Ms. Tlaib. Which state official again is responsible for
addressing maternal mortality in Missouri?
Dr. McNicholas. That would be the Director of our
Department of Public Health, Dr. Randall Williams.
Ms. Tlaib. So Dr. Williams is, in fact, the same official
that has spent state dollars on enforcing unnecessary pelvic
exams on women and tracking their menstrual cycles of Planned
Parenthood patients. Correct?
Dr. McNicholas. Yes.
Ms. Tlaib. How do you think that he should be spending
time? I mean, what do you think he should be doing right now?
And again, around the same ideals, right, that they are
supporting this, they won't support the women that are having
children.
Dr. McNicholas. Yes, you raise a great point. Under Dr.
Williams, Missouri went from 42nd in the country to 44th in the
country in maternal mortality. And while he is spending his
time visiting- his time and resources on visiting Planned
Parenthood multiple times, he could be focusing on things like
addressing maternal mortality, addressing the systemic and
institutional racism that is engrained in that rate of three
times higher for black women.
He could be working on improving access, particularly for
our rural women. You know, Missouri is one of the states who,
because we haven't expanded Medicaid--hey, that is another
thing he could do- we have rural hospitals closing at alarming
rates. So if you want to continue your pregnancy, your chance
of having a healthy pregnancy is sabotaged by the fact that
there is no hospital that you can go to to get care during that
pregnancy.
There are a number of things that he could be doing to
address maternal mortality.
Ms. Tlaib. I know, and the hypocrisy is so unjust and
absurd.
Ms. Howell, your organization did a phenomenal study,
finding that black women face greater barriers to access to
reproductive healthcare, including abortion care. What are some
of the factors that you think account for the discrepancy in
health outcomes?
Ms. Howell. Some of the factors are that black women
disproportionately get their health insurance from Medicaid,
which already then bans their access to abortion care and to
get coverage. So what happens is that when they find they are
pregnant and they decide they want to terminate a pregnancy,
they have to go through a number of steps. They have got to
figure out how to afford it, how they can take off work, how
they can get childcare, how far they have to travel.
One of the things that we did is we asked black women in a
poll what are all the factors you take into account when you
are deciding whether or not to have a child? And it wasn't just
about having money. It was also about having a neighborhood
where neighborhood services were happening. It was about being
able to get quality food sources. It was about clean water.
There were a number of factors.
And if you are a woman of low income and you get your
healthcare from Medicaid, you also have all these other factors
that come into it. And that is why when we were talking about
no one knowing all the reasons why someone might decide to
terminate a pregnancy, our organization trusts black women to
make those personal decisions that are best for themselves and
their families. And the other side clearly does not trust us to
make those decisions.
Ms. Tlaib. No, they want to control us.
Thank you so much, and I yield the rest of my time.
Chairwoman Maloney. I thank my friend from Michigan for her
powerful voice for her state, and I now call upon one of
Congress' most outstanding leaders, my good friend and
colleague Barbara Lee, for her- and I want to publicly thank
her for her tireless and for being such a powerful advocate for
progress, gender justice, and equality.
Thank you for sitting here all day long. She is not even a
member of the committee. So I really appreciate your being
here, and I appreciate your voice.
Ms. Lee. Well, thank you, Chairwoman Maloney, for holding
this hearing and for your tremendous work and leadership and
also for allowing me to sit through this very, very important
hearing.
I also want to thank my colleagues from the Pro-Choice
Caucus, especially our chairs of our task forces, Congresswoman
Ayanna Pressley and Congresswoman Judy Chu, who have been such
clear-thinking and passionate leaders on so many issues since
they have been here in the House of Representatives.
First, let me just- and throughout their lives, quite
frankly. Let me start by just stating a couple of statistics.
Banning access to safe, legal abortion is not what the
majority of this country wants. According to recent polling
published in September, 77 percent of Americans support access
to abortion. And we know and we see how many of these
restrictions disproportionately, which we have talked about,
impact women of color and low-income women.
Access to the full range of reproductive healthcare should
be accessible to all and not based on one's race, income, or
zip code.
Now fighting for equitable access to abortion is deeply
personal for me, and I do, and it is hard to talk about this,
but I think today, you know, I will mention it again. I
remember very clearly the days of back alley abortions before
Roe v. Wade. I was a teenager, only 16 years old, and had to go
to Mexico for a gut-wrenching back alley abortion.
Again, before Roe v. Wade, abortions were not safe nor
legal in my own country. So I refuse to stand by and see even
one more woman's life put in danger because of lack of access
to safe and legal abortion.
Now many of my Republican colleagues here today and the
minority witness, they want to portray women who have had
abortions as evil or as murderers. But I am here today with
several of my sisters, several who have personally had an
abortion. And when you say these comments, they also say them
to me, they say them to you, and we are not going to stand for
it.
Many- and I serve on the Appropriations Committee, and let
me tell you what I see. Many of our Republican colleagues, they
opposed teen pregnancy prevention programs. They oppose
comprehensive sex education. They oppose family planning. They
oppose contraception. They oppose abortions.
Again, as an appropriator, I see these budgets zeroing out
funding for healthcare programs that would prevent pregnancies,
prevent pregnancies. Also I see budget cuts every day to
childcare, SNAP benefits, nutrition, early childhood education,
everything that would help raise families and children in a way
that they deserve to be raised.
So I want to just ask you your feedback, maybe Ms. Howell,
could you just- we know that these programs are
disproportionately impacting women of color, and how do you see
this whole movement now, what we are seeing? I still call it a
war on women's health because when you look at the
comprehensive nature of these cuts and the policies and the
restrictions, what else is it? What are we to do as women in
this country?
Ms. Howell. I think that one of the things that we have--we
have seen over the last couple of years is women taking back
their rights, and it is not just women. It is people. It is
LGBTQ people. It is trans people. Basically, standing up and
saying we won't allow this to happen anymore.
And we saw it in the 2018 election. We saw it where women
of color, for instance, came out and voted to change the House
of Representatives. Voted very strongly. And one of those
issues that they voted on was Hyde, eliminating Hyde and having
the EACH Woman Act.
So they were very clear about what they were looking for
and the right to make decisions for themselves without
political interference. And I think that that is critical.
Ms. Lee. Thank you.
Ms. Graves, would you like to comment? We have just a few
more seconds. I want to thank Ms. Box for your being here today
and your stories and for being so brave in terms of giving the
real deal about what women go through as a result of trying to
exercise their constitutional right.
So thank you. Ms. Graves?
Ms. Goss Graves. I just want to add that it is true that
people are outraged and are rising up against the bans that are
sweeping this country, but this is a dangerous time. It is
dangerous to ban abortion. It is dangerous to have states where
people think they can't get care, even though abortion is legal
in every state of this country.
And it is dangerous, the rhetoric that we heard in this
room today and that we hear outside of this room that demonizes
patients, that demonizes women, and that goes sort of to the
core of who we are as a country. This is- today has reminded me
how dangerous these times are.
Ms. Lee. Thank you.
Thank you, Madam Chair, very much.
Chairwoman Maloney. I want to thank my friend Barbara Lee
for sharing really one of the most personal and heartbreaking
events of her life. She is sharing it not only at this hearing,
but with the whole world, and Barbara Lee, your courage has
made us all stronger.
Thank you. And your leadership.
I now call on an incredible woman, a newly elected woman to
our Congress, Congresswoman Kim Schrier. She is from the great
state of Washington. She is a physician and a powerful advocate
for science and women across this country.
Thank you for being here. She is not a member of this
committee, but she wanted to be here and to speak out, and I
thank you for being here all day, supporting our efforts.
Thank you. Dr. Schrier?
Ms. Schrier. Thank you, Madam Chair. I laughed because I
thought you were going to talk about Ayanna Pressley, who is a
member of our freshman class.
[Laughter.]
Chairwoman Maloney. I already talked about her.
Ms. Schrier. I came here today to talk about these
unnecessary restrictions on a woman's access to full
reproductive care, access to abortion. And we have heard about
a million ways that local governments and state governments are
trying to restrict a woman's access to a safe and legal medical
procedure.
And every one of these unnecessary ultrasounds, bogus
scripts, hallway signs, admitting privileges at local
hospitals, second pelvic exams, even first pelvic exams,
admitting privileges I mentioned, and even waiting periods, all
of those are unnecessary. They make it harder for women. They
especially make it harder for women who are poor, who would
have to take additional time off work, who would have to travel
great distances.
These do not stop abortions. If you want--that is your
goal, you should be doubling down on funding for Planned
Parenthood for pregnancy prevention. These do not stop
abortions. They make them later. They delay them, or they make
them less safe. They are totally inappropriate.
Now I came to talk about that, and I want to reinforce that
this is a safe and legal procedure. It is something that 1 out
of 4 women have before she is 45 years old. This is more common
than a tonsillectomy. This is common. Chances are excellent,
pretty much 100 percent, that everybody in this room knows
somebody who has an abortion. That is how common it is.
So I came to discuss those things, but then I heard all
kinds of rhetoric, all kinds of rhetoric. And as a doctor, and
thank you all for being here, I really feel like I need to push
back on a lot of Ms. Stuckey's comments. Pseudoscience, total
baloney, and I don't feel like I can let those things just
stand.
I mean, it is everything from not understanding a
difference between an embryo and a baby, which, by the way, if
she believes they are the same, that is a personal
philosophical and religious decision. That is not a medical
distinction, and that is not something that Congress should be
involved in. It is not something that she should have any say
over any other woman's decision.
But there are other things that she talked about, like 20
weeks in pain. Totally unproven, bogus. She talked about the
gag rule not being a gag rule. It is. When a physician cannot
mention that one option for her patient is abortion, that is a
gag rule. And by the way, it is a dangerous gag rule because if
a woman is diagnosed with pregnancy and cervical cancer at the
exact same visit, an abortion would save her life. Let us be
clear.
The other one she mentioned was she painted a very happy
picture of a 23-week micro preemie. I am a pediatrician. I
spend a lot of time in NICUs. Let me tell you what the real
picture is. The real picture is that you have got about a 50/50
shot at survival. And you have got, if you do survive, a very
high likelihood of having consequences later down the line.
Now that doesn't mean that I didn't resuscitate those
babies and take care of them and take care of them in the NICU,
but it does mean that she is not giving you the full correct
picture of the situation.
But the most egregious one is this discussion that somehow
you could pull a baby out 3 days before delivery and call that
an abortion. We call that an induced delivery. That is a baby
who is pulled out and handed to their mother or taken to the
NICU, where a doctor like me would take care of them if they
are in trouble or in distress.
If you want to have a conversation about pregnancies and
abortions later in pregnancy, let us have a really honest
discussion about it. About 1 percent of abortions happen after
20 weeks, and none of these are because a woman just decided
one morning I don't want to be pregnant anymore. That does not
happen.
These are all for a reason. Some devastating turn,
something devastating has taken a turn in a pregnancy.
Something has happened, either with the health of the mother or
the health of the pregnancy, and it is so important that
Congress not get into that discussion.
This is a decision between a woman and her God and her
doctor and her life, and only she knows how to make this
decision, and there is absolutely no place for me or anybody in
Congress to get into that discussion. What we owe that woman is
a little grace and a little trust to make the best decision
about her body.
I will end there. Thank you. And I am sorry that you had to
put up with such harassment today. Thank you for your services.
Chairwoman Maloney. Thank you. I now recognize Mr. Keller.
Mr. Keller. Thank you, Madam Chair.
What I want to start out with is I heard some testimony
during today's hearing about the viability of a pregnancy being
difficult to determine because they are all based on a
different diagnosis, different situation. And I will get to
that later in my comments.
I just want to start out with knowing that, and I know that
it was just mentioned that some babies have a 50/50 shot at
survival. You know, Dr. Schrier mentioned that. I just want to
say this. Every life has opportunity and hope. And sometimes
doctors, despite their best efforts, do not calculate the
appropriate outcome for their diagnosis.
I have had personal experience with this. When my son
Freddy was three years old, he had an injury resulted in a- led
to a devastating head injury. He had an accident. The doctors,
despite their best efforts, thought Freddy was not going to
live.
He was put on life support. As we waited and prayed, the
doctor's prognosis was that the mortality rate of children in
his condition was not 50 percent, was not 98 percent, but we
were told was 100 percent. He was not going to live.
They even tried to convince us to disconnect life support
and end his treatment since they did not believe he was going
to live. He was on a vent for 28 days. We chose life. We chose
hope. And Freddy started to recovery.
Even then, the doctors said he would have permanent brain
damage and would not have a meaningful or full life. I am happy
to say that today Freddy has fully recovered. Freddy's outcome
was different.
He graduated from college and now works for the hospital
that saved his life. It was a different outcome than what the
doctors told us it would be. His accident is now a memory, but
also an opportunity to learn about the value of human life.
As this pertains to today's hearing, in this country, we
have countless situations where people determine the value of
an unborn human life. Abortions are sometimes planned and
executed based upon diagnoses that have uncertain outcomes.
Sometimes as a result, babies are born. They are alive, and
they are killed as part of a planned abortion procedure. This
should not only shock the conscience, but should make the
American people sick.
I am not asking for an answer to the next question I am
going to ask. I am just going to leave it up to the people that
are watching. But where does it stop when we have people
determining the value of human life?
I yield back.
Ms. Foxx. Mr. Keller, would you yield to me?
Mr. Keller. I yield to Dr. Foxx.
Ms. Foxx. Thank you, Mr. Keller.
Mr. Keller, thank you for that moving story about Freddy. I
think you illustrated something very important to us. Doctors
can make predictions, but they are not God, and they don't know
what is going to happen.
We have heard a lot of things here today, but I could not
let this hearing close without saying that there are many
things we have heard that should make us shudder, but I believe
that what Mr. Keller said leads us into what I want to say
next.
But comparing killing a baby to removing wisdom teeth is
absolutely beyond the pale. And when we have people, as Mr.
Keller asked the question, where is this decision to kill
innocent life going to take us in this country?
To say it is terminating a pregnancy, and as Ms. Stuckey
said, never, ever facing up to what you are really doing, is
scary to me. And I want to say that Ms. Lee said that
Republicans characterize women who have had an abortion as
evil. I have never heard a Republican say that.
We grieve- and I said that at the beginning. We grieve for
the women who find themselves making that decision. I cannot
imagine that it is ever easy. I hope it is never easy for any
woman to decide to kill her unborn child. I hope and pray that
is not easy, and I would never characterize a woman who is
faced with that decision and makes that decision as evil.
Thank you, Madam Chair.
Chairwoman Maloney. I thank the gentlewoman. She yields
back.
And I yield myself five minutes.
And this hearing is very important to me and very
meaningful because usually when I am attending a hearing on
women's healthcare and women's needs, I am talking to an all-
male panel and usually have to ask ``Where are the women?''
especially on hearings that affect their well-being and their
healthcare. It is personally thrilling and inspiring to me to
see a panel made entirely of women's voices, and America should
listen to women's voices.
I want to thank all of the panelists, but I particularly
want to thank Mrs. Box. I believe that your voice is the most
important of all the important voices that we have heard today.
Because to me, you represent every person who has been shamed
and judged for making a deeply personal decision about their
own body and their own healthcare and for them wanting to
access the very best healthcare that they need to take care of
themselves and their families.
I just want to ask you, Mrs. Box, and I know it is
difficult to testify before Congress on anything, but
especially something that has been so personal, how did it feel
to hear officials in your state and across the country say
hateful, hateful rhetoric about the decision that you were
making, your own personal decision? How did it feel?
Ms. Box. It is insulting, and I appreciate Representative
Foxx's sympathy for me, but I would like to say that while my
particular reason for abortion of fetal diagnosis was sad for
our family, most women, including myself- not all, but most-
experience relief after having an abortion.
And I said in my- I think when I answered a question that
our abortion, it was the first day that we began to heal from
the grief of our diagnosis. I have cried a lot of tears about
Libby, but they have all been in grieving my daughter and never
once in regret for my decision to make a medical choice for her
as her parent.
And you know, I also wanted to say- I am sorry, sir. I
can't see your name. But I am really glad that your son had a
positive outcome, and I believe in supporting parents in making
the best decisions for their family and their children, and
that is what my husband and I did for Libby.
Chairwoman Maloney. Thank you. Thank you for sharing your
experience.
Dr. McNicholas, you cared for hundreds of patients in Mrs.
Box's situation. What impacts have you seen on the patients you
care for in Missouri, as these restrictive laws are enacted and
forced upon them?
Dr. McNicholas. So I think, first and foremost, the
outright confusion that people have about what is happening in
terms of their access to abortion, and reproductive care more
broadly, is really important to lift up.
As abortion bans are passed, whether they are enacted or
not, patients automatically think that means they can't access
abortion. So we have done a tremendous amount of work in
patient reassurance, in making sure that the country knows that
abortion is still legal in every single state in this country.
Chairwoman Maloney. What are you most worried about for
your patients?
Dr. McNicholas. I worry that they have the realization, the
full realization that the people who are charged with
protecting their health have completely abdicated their
responsibility based on an ideologic viewpoint.
I 100 percent people who don't believe in abortion choosing
not to have one. But I also think it is the right of every
other individual to make that choice based on their values.
Chairwoman Maloney. I thank you really for the--
Mr. Clay. Madam Chair?
Chairwoman Maloney.- courage that all of you have in your
work and what you have done for other women and for our
country.
I want to share that I have within my district two Planned
Parenthood centers, and if you go to them at the end of the
day, when women are getting off of work, women are lined up
through the halls of the building, outside to the sidewalk,
down the street into the next block, waiting to get basic
healthcare services. And Planned Parenthood centers provide
primary and preventive healthcare to many who otherwise would
have nowhere else to turn for care.
And I want to point out that 54 percent of Planned
Parenthood centers are in areas where there is healthcare
shortages, and we have heard testimony from medical experts
that if Planned Parenthood is defunded, there is no other
health facility that can address these needs and help these
women. I cannot tell you how many women come to my office and
tell me that at certain times in their life, the only place
they could get healthcare was Planned Parenthood. And I want to
put that on the record that I think it is a scandal that anyone
would ever try to defund a service that is providing so much
help to people that need it.
This has been an important hearing to me, and I intend to
continue working on this area and helping women receive the
respect and the healthcare they deserve. I would now like to
call on my good friend Jackie Speier and give her five minutes
and thank her for her relentless leadership in support of
women's issues and women.
Ms. Speier. Thank you, Madam Chair.
And thank you to a remarkable panel of very persuasive and
committed women to the service of other women.
Ms. Box, when you testified earlier, I was sitting here,
and I started to cry because I share the same experience that
you have had. I lost a child, a fetus, when I was 17 weeks, and
I told my story on the House floor in part because I sat there
and listened to such false information coming from my
colleagues on the other side of the aisle that it outraged me
so much that I said you have no idea what you are talking
about. You have not lived through this kind of experience.
And to hear you talk about Libby Rose and keep her on your
chest is just very powerful because it underscores what we all
go through when we lose a fetus at late term. It is never by
choice. And I find it so offensive that we continue to have
Members here in Congress think that they can somehow take hold
of our bodies and tell us what we can do.
So thank you. Thank you for your presence here, for your
new infant's presence here. Having the gurgling of your child
was just music to all of our ears.
And thank you to all of you as well.
I am going to share one story, though, that relates to
Missouri. My daughter went to the University of Missouri and
graduated there. She had a girlfriend who became pregnant, who
then drove an hour and a half to St. Louis to be seen and then
was told that she had to wait three days. And so then she had
to drive an hour and a half back. And then, of course, she
couldn't get the abortion in three days because there was such
a long waiting list.
Now this friend of my daughter's then finally called her
mother, who lived in another state, who was not pro-choice. And
her mother came and picked her up and took her to another state
to get the abortion.
We cannot force women to have to jump through hoops and
travel long distances to get the healthcare that they deserve
and that is legal under the law in this country. And to see
what Missouri has done with their laws and how difficult they
have made it is so repugnant to me and should be repugnant to
every woman in this country.
Now, Ms. Box, let me ask you the question that I think
about a lot. When you were required to wait your 72 hours and
received this counseling, what was the counseling that you
received?
Ms. Box. Well, first, I want to say that I thank you for
sharing your story with me, and I am sorry for your loss. I
know how painful that is.
I am not the legal expert, but you don't really have is it
counseling?
Ms. Speier. You didn't recognize it as counseling.
Ms. Box. Oh, the book? Oh. Okay. I am sorry. Yes, you are
right. I didn't understand that was considered counseling.
Ms. Speier. What was it?
Ms. Box. It is a booklet that has- so the consent process,
I guess, is that- I apologize. So they had to go over this
information, and they provided me with a booklet that is
written by the state that has medically inaccurate information
in an attempt to help me make an informed decision, which just
doesn't make sense to me.
But what I will say is that how it works in Missouri
currently is that you have to consent with the provider who
will perform the abortion. So my consent and my counseling, the
book, like I said earlier, I called ``book of shame.'' But my
conversation with the provider, with the doctor who works at
Planned Parenthood, was the most compassionate care I have ever
received.
She took something that was the worst experience of my
husband and my life and showed us love and no judgment and
counseled us in all of the options available to us, and gave us
medically accurate, science-based information so that we could
make a decision as parents that was informed and full of love.
Ms. Speier. Thank you. Thank you again, all of you, and I
yield back.
Chairwoman Maloney. Thank you. Thank you so much.
I would like to enter into the record a series of letters
the committee has received in recent days from organizations,
including the American College of Obstetricians and
Gynecologists, Reproaction, the Guttmacher Institute, and the
American Civil Liberties Union. These letters express grave
concern over the impact that state restrictions on abortion
access are having on the health, economic well-being of women
in America and their families.
I ask unanimous consent that these letters be entered into
the official hearing record, and I so order.
Chairwoman Maloney. I would like now to thank our
incredible witnesses for testifying and for their life's work.
And without objection, all Members will have five
legislative days within which to submit additional written
questions for the witnesses to the chair, which will be
forwarded to the witnesses for their response.
I ask our witnesses to please respond as promptly as
possible, and this hearing is now--
But before I conclude this hearing, I would like to thank
the powerful women of this committee, especially Ms. Speier,
Ms. Pressley, Ms. Kelly, Ms. Ocasio-Cortez, for their
leadership on this issue and for encouraging the committee to
examine it.
I would also like to thank Congresswoman Judy Chu,
Congresswoman Jan Schakowsky, Congresswoman Barbara Lee, and
Congresswoman Kim Schrier, for joining us this afternoon and
for their tireless work to preserve access to abortion and
reproductive healthcare for women across this Nation.
And I would also like to thank Lacy Clay, who has worked
with me on this hearing and for his leadership on this issue.
This hearing is adjourned, but we are going to continue on
this issue.
Thank you.
[Whereupon, at 5:24 p.m., the committee was adjourned.]
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