seat to democracy. tonight on c-span, a look at reproductive health care and streamlining cybersecurity for businesses with assistant national cyber director. and the successful launch of the boeing star liner coming up tonight on c-span. >> a senate health committee hearing on how the supreme court's decision overturning roe v. wade affects reproductive care. lawmakers hear testimony from both sides. this is over two hours and 15 minutes.

>> the senate committee will

come to order. two years ago, six supreme court justices nominated by republicans decided to overturn roe v. wade. abolish the constitutional right for women, to give politicians in the state government the right to control the bodies of women. in state after state. this morning, we will hold a hearing to take a hard look at how the supreme court decision has impacted women, decisions in health care providers throughout our country. it is no secret to anyone that throughout our country's history, women have had to fight for their basic human rights. against all forms of patriarchy

and sexism, no great secret. women had to struggle and some died to achieve the right to vote, something they did not receive until 1920. women struggled to get the education they wanted all over america. they could not get through the door because they were women. women had to struggle to get banks to lend them the money to buy a car or start their own business.

it was legal to fire women because they decided to get married. or reject an applicant because they were a woman. the struggle for equal pay for equal work continues and women working full-time make $.84 on the dollar compared to men. and on and on it goes. women struggling for their basic rights. then on january 22, 1973, after decades of struggle, women finally win the right to control their own bodies as a result of roe v. wade. no longer would state governments tell women what they could or could not do with their

own bodies. when we talk about the history, let's not ignore the lack of representation women have. in 19 87, not many years ago, there were two women in the senate and 98 men. folks all over this country making decisions. the truth is that men, men would not tolerate them being subject to government decisions regarding how they control their own bodies. i am not aware of any state that has restricted the right of a man to get viagra or any other medication. no state has prevented a man from getting a vast ectomy or

procedure that men choose to get. we hear a lot of talk about freedom in this body, freedom to do what you want to do. we are living at a time when half of our population or more has lost that freedom and when i talk about the right of women to control their bodies, it is what the american people believe in state election after state election. people saying we may disagree politically on this or that, but it is women, not the government that have the right to control her body. senator murray, the gavel is yours. senator murray: thank you so much for your statement and

letting me share the hearing on a topic that is important to me. i want to thank witnesses for joining me. today we take a close accounting of the trauma republicans inflict on women and families across the country and the damage they are doing to basic health care through their antiabortion crusade. the issue is simple and cuts to the core of american values, freedom. many women experience the joy of raising a family, they made that decision for themselves. no one, no one, should be dragged through a pregnancy against their will. right now in america more than one third of women live in states where they essentially do not have the choice to end a pregnancy if they need to.

republicans have made the choice for them with extreme abortion bands and cruel restrictions on access to care. they have told women you do not control your body, we do. think how much power that gives to a man. to every republican who hopes this issue will go away for this will become status quo, listen.

you never forget or get use to someone else taking control of your body, medical decisions, plans for your family for you church. you never forget a politician rescinding your rights to make decisions about some thing as personal as your pregnancy and imposing his will, especially when you live with the consequences every day and the consequences of the ban are so much broader and more devastating than anyone story or hearing can ever do justice. there are stories that getting a lot of attention, shocking beyond belief. stories of women denied care for a miscarriage, women turned away from hospitals because doctors hands were tied until they lost over half their blood, until their husband found them unconscious, until the only

option was an emergency hysterectomy or it was too late. stories of children who cannot get abortion care after being raped. some may be able to go across state lines, others were forced into motherhood by republican politicians. when teenager delivered a baby while clutching a teddy bear. these nightmares are happening across our country as a result of republican abortion bands and there are so many other stories that the one told. women do not want to -- women who do not want to be pregnant, maybe they cannot afford a child, maybe they are in an abusive relationship, maybe they just don't want a kid, but they are told they have no say in the matter. not unless they have the time and resources costing thousands of dollars to travel and in some

cases, hundreds of miles. it is harrowing to consider. so i it is harrowing to think that we live in a reality where forced pregnancy has become so widespread and ran that only the most dystopian stories get national attention, but the stories of all the other women confronted by these bands, there fears are horrific, growling and an important part of the conversation. a forced pregnancy does not have to make headlines to make

someone's life a living hell and let's be clear before we get started, republican attacks are not only hurting people in the states where they banned abortion, not only women who need abortions, their attacks are not stopping abortion. when it comes to states like mine where abortion is, providers are stretched beyond capacity by women in desperate need of abortion care they can no longer get. when it comes to women who are not seeking version, they are hollowing out health care for women in general, especially those who face the biggest challenges getting care. women of color, indigenous women, rural communities. health care providers do not want to work in states where politicians get between a doctor and patient and threatened jail time and the loss of licenses if they dare.

in states with extreme abortion bans health, care providers are shutting down practices. doctors are staying away and fewer options to get necessary health care services. the consequences extend beyond abortion. republicans want a national abortion plan. we can look at the record, look at how many have cosponsored national abortion bans. one bill would enshrine fetal personhood nationwide. it would mean women and doctors would be charged for murder for

an abortion, making them eligible or the death penalty. emergency contraception like plan b would be outlawed and ibf would be the way from people trying to start a family. this is not theoretical. we saw how much chaos this caused for families in alabama. there are republican members in congress including the speaker of the house, who support making fetal personhood the law of the land. that is extremely in the extreme. in the face of this horror we have seen an outcry from women and men who refuse to let republicans drag our nation backwards and strip away our basic rights. every time abortion rights have been on the ballot, every single time, abortion rights win. people are standing up and

speaking out and democrats are proud to stand with them. democrats will make sure women's voices are heard in our nations capital, including hearings like this one and we will keep fighting to have the women's health protection act and restore the fundamental rights of women to control their bodies. former president trump continues to brag about how he overturned roe v. wade and made clear he would go farther if given the chance, democrats have been clear. with a pro-choice majority in the house and senate and joe biden, we will detect abortion rights for every woman in america, thank you. with that, i look forward to hearing number witnesses, but first i will turn it over to senator cassidy. senator cassidy: it's an election year in which the democratic incumbent president

is running behind. they are raising abortion to invite folks to put us on tv. it is partisan politics. let me point out as well, it is not partisan. louisiana's law was written by a female senator and signed by a democratic governor and a female state senator was reelected with wide margins. there is a breath across the political spectrum of people who have a different way of framing this. my colleagues want you to think republicans believe terrible things. they will attempt to normalize a decision to abort a child. republicans say you cannot normalize the intent of ending a life. don't be misled. this is a life, this is a life.

does anyone think that child is not a life. how could you not? six i'm a doctor, i see that you have to take care of that mom, take care of that mom. but you have to recognize there is another life as well. this is not a collection of cells, this is a child that if delivered will live. and this one too and that one as well, so let's have a national dialogue and explore this. in medical school i was taught to care for every patient and recognize when a woman is pregnant there are two patients. the second that baby gets here it does not matter how small, how unsustainable, the doctors, nurses, institutions do what they can to save their life and by golly, don't you want them to do that? don't you want the people to

have that philosophy? there is a response ability to protect and save a child that should not be determined by the difference of being inside or outside the womb. i am unapologetically pro-life. scientifically and morally, there is no difference in the value of a child whether she is in her mother's child -- arms or womb. the science is clear, this is a difficult post, it's difficult because you recognize that by their policies it should be legal to abort the child. it is difficult, but let's frame it for what it is. how can we dehumanize this and yet this is an attempt to do that. at what point do democrats

believe that a child deserves to live? it does a disservice to the mother to dehumanize the unborn child and discuss this as the right to abort or not. this is one of the most significant decisions a woman will make. we should not trivialize. i understand the need to regulate abortion but unlike our testimony, determining a life does not spare a woman from grief. this should never be an easy decision and i want people to read the entire testimony in which dr. francis refutes what is said and puts scientific data behind it. as a physician i find fear mongering infuriating. a woman experiencing miscarriage

or ectopic pregnancy is grappling with the loss of an unborn child and this committee hearing would misrepresent it and use it for political gain. there is no law preventing a doctor from treating a patient going through a miscarriage or preventing the saving of the life of a mother, that is called health care, that is not an abortion. one of the most inspirational medical professors said in health care and medicine our highest calling is truth and that's why find it frustrating that physicians are misleading, corrupting the truth. it is disappointing that colleagues say things that are

untrue. deceiving americans is reprehensible, they mislead americans on the democrats views. democrats want to codify roe v. wade, that is not true. democratic policies go beyond, they are marking legalized late-term abortions in every state aborting this child. bans allow strangers to convince a child to get an abortion without notifying the parent child hi child, shouldn't the parents know? why should parents rights be aggregated? speak about driving people out of health care.

senator kaine has a bill that codifies roe v. wade and the only democrats are senators cinema and mansion who do not call themselves democrats now. why does the bill not have more democratic support? it makes a good rallying cry. the policy of codifying roe v. wade is too conservative for the fringes in the democratic party. there are nine states and washington dc whose laws right now allow for abortion up to -- the child can be ready to go through the birth canal and abortion is legalized. not because of the life of the mother, just to legalize it. that is where the democratic party has gone, that -- that

should give everyone a moral cause. that should give us all a moral cause. now i ask my democratic colleagues can you designate a point at which a pregnant she should not be terminated? my think that is a fair question, i invite everyone to be a doctor who is trying to balance the needs of the unborn child and mom. democratic colleagues claim abortions are low risk, so safe they can be done without medical supervision. not entirely accurate, minimizing complications, but that is the way we feel better about this and i refer people to dr. francis complete testimony, not the five minutes she will give today.

now fear mongering access to treatment and the decision to abort or not abort as an easy one is a disservice. i've supported postpartum coverage for women in medicaid, work to advance maternal health by the connected moms act which lets physicians remotely monitor pregnant women. a woman who is eight and a half months pregnant using public transportation in august, you understand if you could remotely monitor her her life is so much better. bob casey made a law to ensure pregnant women are entitled to reasonable accommodations. there is more we can do to support a pregnant woman, but we should advance legislation so we are not leaving them without

solutions when faced with a difficult question. we want moms to be healthy and prosperous and that human life triggers the human life, those double lines are not a burden as the other side would like to cast, it should represent a gift. there are things we can do to make life easier. i think we should all be open to tough conversations, but not demise and it must be with respect for the mother and the voiceless unborn child. they are participating in the debate. this is too personal for many americans, i yield. >> we will now move to testimony. we will hear from madison anderson, a young woman oars to leave her state and travel

hundreds of miles to get abortion care after taxes past a draconian abortion ban. an ob/gyn abortion provider and a fellow with physicians for reproductive health. the acting ceo of the guttmacher institute and planned parenthood of wisconsin ob/gyn abortion provider and a fellow with physicians for reproductive health. >> i introduce christina francis, a board certified ob/gyn with high and low risk presidencies -- pregnancies. she is a board member of indiana right to life and the ceo of the american association of pro-life gynecologists. i will introduce melissa bowden,

i have that correct? yes. who is a founder and chief executive officer of the abortion survivors network and she will tell us her story about a failed abortion in 1977 intended to end her life. she's made this our life's work and runs the survivors network providing support to survivors who have experienced a failed abortion. thank you for sharing your powerful story. >> thank you to all of our witnesses, we begin with ms. anderson. ms. anderson: thank you, senator. ranking member cassidy and members of the committee, i live in houston texas. during my junior year at university of houston i came out

of a two-year relationship after nausea, not sleeping or eating, i took a pregnancy test. i called a friend to bring me more tests. at one point, i have five tests in front of me and there was no disputing that i was pregnant. this was two weeks after the texas abortion ban went into effect, banning abortion after six weeks. i knew immediately that abortion was the right choice for me. i got an appointment at planned parenthood five minutes from me for later that week. i thought it was early enough to get my abortion, but at my appointment, my pregnancy measured 11 weeks. i was shocked, i could not get an abortion. i called 20 different clinics, yes, 20.

i called surrounding states as far as the dakotas, no one could see me. the earliest was two weeks later in mississippi before the women's health decision that would take away the federal right for abortion and before 20 more states would ban abortion and wait times in states without bands stretch longer and longer. we drove 720 miles round-trip and spent 13 hours on the road. five hours in a hotel before my first appointment, just to turn around and go home. here is the thing, because of unnecessary restrictions, i would have to make the trip all over again. the state puts patients in a timeout because they don't trust people to know what is best for their health or their lives. i was angry, sleep deprived,

starving and never more certain of my decision. certainty never faltered. my mom found us affordable tickets and we flew to jackson. we made it to my appointment and i was in the recovery room for about 20 minutes before my flight back home. i want to talk about money. as a college student who took out multiple student loans and was counting every penny i had to pay for my first appointment in houston, and my appointment in mississippi and the abortion. then gas and a hotel for the first trip and flights for the second drug. i missed 20 hours each of work and a mandatory internship for my school. $2850. there is no dollar value i can

put on the stress of managing everything, having to go to such lengths or basic health care that was legal weeks before. the reality of disclosing something so personal to my boss, my professor and anyone in a position of authority for fear of losing my job, failing every class due to the assignments i was forced to miss. i felt anger that politicians thought they had the right to make this decision for me. i am one of thousands who have gone through this. every day without the right for abortion there will more. more accounts drained, more choices on which bills to skip paying. if i found out last year or last

month, jackson's women health would not have been there for me. they cannot care for abortion patients today. i have to go to new mexico, kansas or illinois to make that decision today. we talked about abortion and it is easy to get stuck in theoretical's, but i am real. the lines are not theoretical, people will get pregnant when they do not want to be. we will always need abortion, this is no place for a politician to decide, thank you for inviting me and letting me share my story. >> thank you very much. dr.: good morning chair sanders, distinguished members of the house committee. i am a board certified

fellowship trained gynecologists . a fellow with visions for reproductive health and a proud southerner born and raised in north carolina. i've lived in the southeast most of my life. i made a commitment to care for people without judgment throughout their lives. for me that holds whether i am talking a young person through a pap smear, delivering a third child or supporting a patient and her family as they after the supreme court's dobbs decision with georgia enacting a ban on abortions very early, i struggle every day to abide necessary medical care. i've seen young moms with worsening medical conditions that make nancy's high risk in couples who desire pregnancies

and are in the process of miscarrying, forced to leave their communities to access health care. as a doctor, i had the privilege of sitting with patients and learning about their lives. for me these patient stories are a powerful reminder that abortion is not isolated. today i want to provide a glimpse of what access to abortion means. shortly after the six week abortion ban in 2022, i saw a young woman who started her junior year of high school and despite using birth control realized that she might be pregnant. she called to make a clinic appointment right away and when she came to see me, she was a couple days past the cutoff which bands most abortion after two weeks of a missed period. i had to say i could no longer

perform her abortion. she returned to georgia and i did not see her again until a few weeks ago. she told me she was unable to find resources to get abortion care and could not find a doctor for many months so even though she was forced to continue her pregnancy she could not get care. after delivering her baby she struggled and had to move, work a minimum wage job. she loves her son but this is not the life that she wanted or planned. i thought about this patient every day, i know it was george's laws that prevented from providing her with the care she deserved, but i feel like i failed. this patient's story is not

unique. we know bands and restrictions have forced many to stay pregnant and the harm people experience. they are more likely to face economic hardship, stay in contact with violent partners and develop health problems. postpartum depression is the leading cause of pregnancy related deaths. we know abortion care is safe. in 2022, 75 professional societies and the overwhelming consensus of the science based community affirmed abortion is safe. many patients feel betrayed by a government and health care system that is supposed to serve and protect them. doctors feel betrayed. many colleagues overwhelmed by

laws that threatened to make us criminals for providing life-saving care are leaving their states. in places like georgia where 50% of counties have no ob/gyn, this is devastating. i understand abortion can be a complicated issue, just like many aspects of health care and life. i know abortion is necessary and compassionate health and patients can make complex decisions about their health and their lives. no law should prevent that. i urge you to listen to the stories of people who provide abortion care. i hope they help you to see how restrictive abortion access harms communities. thank you for having me. i look forward to your question.

>> thank you. for the opportunity to highlight growing evidence that the dobbs decision is harming reproductive health. my name is destiny lopez from the guttmacher institute. for decades following the roe v. wade decision, antiabortion advocates make abortion highly stigmatized. public support has remained high and the sheer number of state abortion restrictions assures it is it accessible. the decision was an inflection point, unleashing chaos and fear. experts constantly assess the landscape and the robust

evidence that illustrates the harms caused and exacerbated by the decision. here is what we know. access to abortion care is restricted. 14 states are enforcing total bands with limited exceptions and others have new restrictions in place. the total number of clinics in the u.s. declined by more than 40 between 2020 and 2024. fitting abortion does not stop the need for access which is why many people must overcome financial and logistical barriers, especially total or early bands. the number of americans traveling double from it he 1000 to more than 170,000. states with total bans saw the

sharpest increase in out-of-state patients. no one should have to travel to another state for basic health care and those who cannot overcome the burdens of traveling which might mean crossing state lines may be forced to stay pregnant. others decide to self manage. decades of research documented the majority of people had financial resources, they're the most partially impacted. we know providers are resilient in adapting to patient needs. brick and mortars provide more than three quarters of abortions. research shows virtual only abortions accounted for one in five abortions from october to december 2023. there are many other ways it is

interfering across the nation with health care that i don't have time to discuss from current and future guidance to impacts on health and people facing emergencies. what does this mean? overturning roe v. wade did not resolve abortion debates. it enabled policies that worsen the harm on marginalized individuals. despite these hardships and people being denied care, there are more than one million abortions in 2023, a 10% increase. this is a testament to providers of abortion funds and other support networks to the resilience of people and to the centrality of abortion. antiabortion political allies are doubling down. in four states, they

criminalized adult to support adolescents seeking care in other states. the alabama supreme court wreaked havoc on fertility treatment services and advance the long-term goal to enshrine fetal personhood in law and policy. these attacks coupled with two major abortion cases signal the legal landscape will shift. the damage will not be clear for years. evidence suggests it will not be easy to repair. it's imperative that policymakers champion abortion care beyond what roe v. wade promised. only policies rooted in ethics will guarantee people have access to affordable care act where they live via the method they choose, thank you. >> doctor?

dr.: members of the committee, my name is dr. allison, a board-certified obstetrician and gynecologist and complex family-planning specialist. i completed a residency in gynecology, a complex family-planning fellowship. i'm an assistant professor in milwaukee as well as chief medical officer in wisconsin. i've spent my life learning how to provide the highest standard of care. because of decisions made in washington and across the country, my colleagues and i can no longer provide the care patients need. for the past 700 11 days since the supreme court took away the right to abortion, my patients

and colleagues have existed in chaos, confusion and fear. and in wisconsin, a statue from 1849 remained on our books that they and abortion from the moment of conception. a log written before the civil war, abolition of slavery, before women had the right to vote or the discovery of penicillin. get questions about enforceability but without federal protections, a $10,000 fine and six years in is and were too severe. all providers stop providing abortions after the decision with the exception of if and abortion is necessary or advised by two other physicians as necessary to save the life of a mother per the statute. for those with no understanding of the complexities of the human body or the perils of pregnancy, this exception might seem tough explanatory i'm here to inform that this is not. on one hand we risk malpractice

and harming a patient if we do not act and on the other, we risk criminal prosecution if a prosecutor feels reacted to early. what about a newly diagnosed breast cancer who cannot start chemotherapy while pregnant? is delaying her treatment until after delivery a risk to her life? what about a blood clot in disorder where pregnancy will increase the risk of pulmonary embolism or stroke? is the risk enough or do i have two wait until a stroke occurs? what about a 13-year-old who was the victim of incest, psychological physical trauma of carrying a trauma in her barely pubescent body enough to justify ending pregnancy? what about a mother of three who cannot emotionally or financially support another child. she is making a loving decision for children she already has. shouldn't she have the right to be in control over her body as

any other person? regardless of the reason? these are not rhetorical questions, these are real patients that i encountered and tried to care for it wisconsin. in reality, any law that tries to delineate when an abortion is or is not permitted will never fully account for the complexities of health and lives. they deserve health care. it is far more important for people who die from pregnancy and childbirth s often -- three times more often. and not being able to provide care or stop treating pregnant

patients. it has made recruiting providers more difficult. i've had providers request transfer. there is less reproductive health care where it is desperately needed. after a grilling from the state judge we started providing abortion in late 2023. we still work on their a 24 hour waiting pe and a banriod -- period and a band, making it hard to get the care they need. it means there is no longer a standard of care for pregnant patient. they had getting the care they need based on chaos, confusion and fear. my patients deserve better. thank you.

dr. francis: thank you chairman sanders, dr. cassidy, senator murray and members of the committee, thank you for the opportunity to speak. as a board-certified ob/gyn at a hospital that manages high and low risk pregnancies and has delivered thousands of babies i have the best job in the world. not only do i have the honor and privilege to be with women and families during the most exciting, challenging and heartbreaking times of their lives, not only do i get to usher little lives into the world, i served as an advocate for maternal and fetal patients. another reason i chose the specialty was the challenge of taking care of two patients at once. induced abortion, which ends the life of one of those patients, is not health care. it is not performed by the vast

majority of ob/gyn's and it harms our patients. thankfully in most circumstances, the lives of our two patients benefit one another and our mantra of healthy mom, healthy baby is a reality. there are however situations in which a pregnancy complication can enjoy the mother's life. while these incur after viability, 22 weeks of pregnancy, they can occur before this point. the decision to intervene is extremely difficult. and not one that any of us take lightly. i have sat on the edge of my patient's bed, crying with her as we discussed why we could not wait even one or two more weeks when her baby might survive to deliver her. in these discussions we recognize our intent in intervening is to save the mother's life with the unintended consequence of fetal patients losing his or her life. induced abortion occurs when the goal is to end our fetal

patients life. in my two decades i have never performed an induced abortion and have seen most of my colleagues provide excellent care in difficult circumstances without abortion. there has been a lot of false information spread that laws limiting abortion will prevent life-saving treatments. this is absurd. not only do you know state laws prohibit these treatments, even laws restricting abortion allowed for them. the remainder of the 93% of ob/gyn's who do not perform abortion no induced abortion does not need to be legal to provide patient excellent health care. this is yet another point of agreement we should have, but the same advocates who posit woman will die from ectopic

pregnancies if states strict abortion are the people who have been advocating for women to receive abortion drugs without being seen by a physician, which is critical to ensure they do not have ectopic pregnancy which occurs in one and 50 pregnancies and are the leading cause of eternal mortality in the first trimester. this is not good medical care. women seeking abortions deserve the same health care as any other woman. induced abortion has no benefit to the patient, for example, there are more than 160 studies that show increased risk of preterm birth after surgical abortion. having sat with a patient after the loss of her fifth child after surgical abortions, i can tell you this is devastating.

abortion that leads to a significant increase of adverse mental health outcomes. the vast majority of literature shows long-lasting effects from abortion including depression, anxiety, drug abuse, and suicide for 20 or 30% of women. we should be minimizing things that contribute, not encouraging them. as ob/gyn's we love caring for patients and we desire women to have the best possible health care for them and their children to pursue goals and dreams. pro-life laws have not created a health care nightmare. the idea that induced abortion is the only way women can be successful or healthy -- we have the opportunity to change course and i invite my colleagues and you to lead the way as we empower women with accurate information, sectional health care and better solutions for

maternal patients than ending the lives of their children. thank you. >> miss ogden: chairman sanders thank you for inviting me to today's hearing. i am a survivor of a failed abortion and the founder and coo of the abortion survivors network. babies who survived abortions, we survive during roe v. wade and babies are still surviving, no matter where or how the abortion was performed. this highlights the fundamental humanity of the pre-born and the fears and experiences of their mothers. i appreciate the opportunity to have a serious conversation and for stories that highlight the importance. washington post shared a story of a woman named evelyn whose trip to an abortion clinic ended

. she was found to be too far along to abort a third time. if her going to talk about women's experiences, we need to include these stories as well. i empathize with her shock at discovering her first medical abortion failed. she fainted when she saw a heartbeat on the ultrasound and was in and out of consciousness for five minutes. as a journalist wrote, evelyn did not know the pills sometimes did not work. she learned that 3% of abortions fail when the gestation reaches 10 weeks. i can tell you the abortion survivors network use these stories time and again, they are shocked to discover they are still pregnant, they try to keep it a secret and navigate it alone. whether they continue or attempt

another or multiple abortions as evelyn did. as directly quoted, she found a website that shipped abortion occasion across the country. after speaking with a doctor and paying $100 she waited for wills mailed from india. this second course failed to end her pregnancy. her story and her daughter's story, her daughter's life was not over yet. as the article continues, she found a clinic that offers second trimester abortions. she was approaching the third trimester. staff warned about the health risks of a surgical abortion, but they helped to connect her to abortion services that covered her costs. including a $12,000 procedure. we need to pause and consider evelyn and her daughter. support she was offered after the failure of abortions was a

plane ticket, lodging, and a $12,000 abortion that pose risks to her health. this is an abysmal response to evelyn and her baby. she needed emotional support, health care, financial assistance. evelyn's baby, like me, deserve more than to be subjected to another attempts to enter life. imagine a child in your own life being subjected to medical intervention intended to weaken, starve, burn or dismember them until they die? this is the reality. we should be ashamed. evelyn was found to be 32 weeks pregnant. according to southwestern women's options, doctors are not trained reform abortions after 24 weeks and she gave birth to her daughter and made an adoption plan. an option they can both live with.

the nightmare is not abortion, the nightmare that it is aggressively promoted so it is seen as the option, like a plane ticket and $12,000 for a late term abortion. i asked each of you to consider how different women and children's lives, families and society could be if just as much money was spent to provide housing, education, childcare that an health care. this would lead to a new era of women's power meant that ends interracial trauma of abortion. this does not have to be a dream. we can make it a reality >> thank you. we will not begin a round of questions and i will ask my colleagues to track and stay within those five minutes. thank you so much for being here

today and telling your story. i know it is not easy and it takes a lot of courage to talk about something so personal to you. the appreciate it. you touched upon in your remarks many hoops you had to jump through to get your abortion, including traveling over 700 miles away from your home to mississippi. talk about how you felt when you were forced to drive 13 hours out-of-state, what was going through your head? madden: thank you so much for that question. there was a lot going through my mind when i was having to go through the travel. like i said in my testimony, i was extremely anxious and sleep deprived. a little bit delirious in the first part, just wanting to sleep and feel relaxed. i felt very on edge constantly.

fearing what would be thrown at me next. >> how did you feel after receiving care on the way back home? madison: when i was able to get my abortion and receive care, that was the first time i was able to sleep more than three hours. and i will go and i look to my mom and i started crying, because i was like i got to sleep. i can finally breathe. and this huge weight just lifted off my chest. >> dr. francis, i have a question for you and i want a simple yes or no. do you believe women should have access to plan b? >> i believe that women deserve to have accurate information -- >> do you believe women should have access to plan b?

>> women should be given any medication under supervision. i support women having access to accurate information. >> do you believe women should have access? yes or no? >> abortions are dangerous high-risk drugs. >> do you believe women should have access to iud's? >> i believe women should receive comprehensive health care under the direction of a physician. i want to ask you for the record, do you think that iud's and emergency contraceptives are abortive agents? >> if you look at the cover it does say that they do prevent

implantation even if fertilization has occurred, per the package insert. >> i want to say for the record that your organization, dr. francis, has taken the mind-boggling position in contrast to all medical experts that abortion is never necessary to save a life. according to documentation by your organization you say that in the case of emergency pregnancy complications, women should be forced to labor for 24 hours even if that means being treated with blood transfusions and intensive care, even if there pregnancy is nonviable in the first place, just so they can deliver an "intact fetus." it is also mind-boggling how your organization has been working with republican lawmakers to redefine certain contraceptives as abortion so you can ultimately ban them. i think that is incredibly alarming.

it is important for people to understand that the republican minority has specifically invited you to this hearing today despite those dangerous positions. for the information of all senators we will be voting this week on the right to contraception and i hope everyone truly thinks about what this means for women and how it would change this entire country and our women's rights moving forward across the board. i wanted to make that very clear. it required a lot of time and consulting and multiple trips to doctors. how does it affect the health care system in general? >> it immensely affects the health care system about whether we can provide care to a patient in front of us or to have to involve legal representatives and hospital administration. it creates delays in care

instead of being able to provide the care that we know is right for the patient sitting in front of us. >> i will dessert -- defer to senator mullin. i would like to commend everybody for having a good conversation. i expected this to be rambunctious. i will leave my questions out. i came here to be punchy. i think it is important that i share a story and that then i have a couple of questions. i appreciate everybody's opinion. that is what this is about. putting it in the context of why i am so pro-life might help you to understand our positions. i have been married for 27 years. the question my father-in-law asked me when i asked to marry my wife was is she pregnant? i said i don't think so.

seven years later we were still trying to have kids. my wife had endometriosis and we went through a lot to have kids from in vitro to shots. you can imagine and then she got pregnant. that was my christmas gift one year. it was an exciting time. we went to the first doctor visit and we heard the heartbeat and that was a child to me. i was so excited. we were thinking of names and going through the whole process. i cannot tell you the excitement i heard. i was not a crier at that time but i remember getting emotional for the first time. then through the pregnancy she went back in and she had a miscarriage. that was a death to us.

that was a child when i heard the heartbeat and it was a death when we did not hear the heartbeat. it was extremely difficult for my wife and i. fortunately the month that that child was due to be born, we found out we were pregnant again. his name is jim martin mullen. 15 months later we had another one. people will tell you you cannot get pregnant when breast-feeding, lies, because u can and his name is andrew daniel mullen. three years later after the doctor said she could not get pregnant anymore, we had another one. her name is lara and she is 15. my wife and i decided we were not going to have kids anymore and i got a vasectomy and she got an ablation and yet we still collected three more kids.

there were three kids that deserved a home and two mothers who loved those children sothatm they were brave enough to carry them and gave christie and i an opportunity to love these three wonderful kids. two twins named iv and lynette. we adopted them when they were 13. and jace who is wrestling at oklahoma state as we speak. his mother was barely 20 years old. the twins mother was 15 when she got pregnant. i thank god every day that those mothers gave kristi and i an opportunity to be blessed and be loved by these three kids. there are options. what is sad is statistically speaking over 50% of pregnancies inside the united states are unplanned.

15% of all pregnancies end in sad.ion. you are lucky to be born right now. d.c. it is 51.5% of all pregnancies. meeting we end more pregnancies in washington, d.c. then we have. something is wrong. abortion has become almost a point of convenience. that child deserves an opportunity to be in a loving home. which one of our kids do you think we love the most? we are blessed. we have to talk about the reality here.

we are not talking about rape and incest and high risk briths. those account for less than 9.5%. 8% are high risk, 1% are rape, less than 0.5% are incest. we can do better as a country. we have to talk about it. give these kids an opportunity to live. they will bless somebody. our kids bless us every day. >> senator sanders. sen. sanders: let me think the panelists for their testimony. we can all agree the issue we are discussing today is emotional. it is a difficult issue. people have different points of view on the issue. i would like to direct my questioning to dr. virma and

dr. linton. no doubt you have experienced women and their partners who have jumped for joy when they learned that they were pregnant and you did everything u sure s successful. i'm sure you have also met with a variety of women who for a variety of reasons did not jump for joy when they learned they were pregnant. my question for you is simple. i am assuming that you have worked with people in all walks of life of all economic levels, who do you think is best prepared to make the decision about the future of their pregnancy? is it people in the legislature, often dominated by men? or could it be the people who

are feeling the impact of that pregnancy? understanding -- i would suspect you have never told anybody they shouldn't not have an abortion. who should make that decision based on your experience? >> thank you for that question. based on my experience people are the experts in their own lives and are able to make these complicated decisions about their own lives. i appreciate senator mullin's sharing that story. i struggled with infertility and i experienced a first trimester miscarriage that i found devastating. i'm not saying that pregnancies don't have value. that value is different for different people. the way that people connect with pregnancy is different. each person is capable of making these important sometimes complex and sometimes difficult decisions about their health care. even if it sometimes means

ending a pregnancy. sen. sanders: dr. linton on this and normally personal decision, should it be the state or the woman herself? >> i agree wholeheartedly with dr. verma. every situation is unique. our patients live complicated lives. our job as physicians is to meet the patient where they are, provide the information they need, and to support them in whatever decision they make. sen. sanders: let me askhe physn wanting to practice medicine, could you gravitate to a state which has a harsh antiabortion law? >> this is difficult for me. i am from the south and i love the south. it is my home and it has been really hard to grapple with

wanting to serve my community but being in an environment where i have to face threats of criminal prosecution or having my license removed for providing medicine. i have had thoughts about leaving even though i love my home and my community. i talked to residents every day who are in that same position. who are choosing to leave because they cannot get the training and cannot practice -- sen. sanders: at a time there is already a shortage of physicians? >> yes, in georgia 50% of counties don't have an active ob/gyn. as doctors leave affects access not just to abortion care but prenatal care, miscarriage management. i often already see patients coming to labor and delivery who have received no prenatal care because they have not had access. it's just going to get worse and make pregnancy riskier and more dangerous.

sen. sanders: is that your experience? >> the concerns i hear from trainees are two fold. dr. verma was talking about wanting to make sure they receive that comprehensive training. they want to go to practice to feel that they can provide whatever care is necessary to serve patients. most of our trainees are of reproductive age. they also need to think about what would happen if they experience an unintended pregnant c or unexpected health outcome. i have seen many of my trainees concerns about staying in the state or thinking about these restrictions for the future. sen. sanders: thank you. >> madam chair. thank you for sharing your story, thank you all. it is a difficult topic and this is part of that dialogue. i understand that you have a child with special needs. can you relate to counsel, were

you suggested toeti do appreciae sharing such personal stories. this is part of what we need to do. share our stories more but listen more as well no matter which side of the aisle. not only am i someone who survived an attempt to end my life by a saline infusion abortion, but i am a woman who has had a first trimester miscarriage. i felt that pain. my husband as well. i also have a child who is born with complex medical needs. i was 36 years old fast approaching 37. finding out that my daughter had a prenatal diagnosis, i was pressured with conversations about abortion because of my advanced maternal age. to the point that prior to my 20

week ultrasound i had to call the ob/gyn's office and let them know that i found it so offensive for them to continue to state abortion based on my own personal history that i was asking that they would not do it again or i would go to another practice. i can tell you that my doctor is almost 10. she is an incredible young woman who has overcome a lot. she is raised to know that she has the same dignity and value as everyone in the room. that everyone is made differently and some of us need different doctors for different health issues at different times. she is someone who experiences incredible joy and is living a great life. >> dr. francis. ■qi think that the senator was suggesting you were trying to duck her question when he suggested people should be counseled but your testimony is nuanced.

some of the testimony has suggested that some women particularly minority or african-american women, their long-term health is hurt by not having access to abortion. you quote data that is chock-full of references and studies, like a white paper. can you give testimony on how someone should be counseled that abortion does not necessarily save a life and can bring further complications? >> yes thank you for the question. we do see disparate health outcomes in this country. especially in minority women unfortunately. we also see that black women have a much higher rate of abortion than white women. this has not improved their health outcomes. their maternal mortality rates are worse, their preterm birth rates are worth. there are more than 160 studies that show a link between

surgical abortions in preterm birth in future pregnancies. the institute of medicine has acknowledged that surgically induced abortions are in a mutable risk factor for preterm birth in future pregnancy. >> the increased loss of unborn or miscarried children -- there may be an association with their previous history of abortion. that there is academic literature supporting that? >> there are large systematic reviews of the institution of medicine has acknowledged this. >> when you say that someone should be counseled, they should be counseled. >> absolutely. that patient i sat with who lost their fifth child due to■ú a condition called cervical insufficiency where the uterus could not hold the baby into the point of viability, one of the things i thought about -- sen. cassidy: just because we have limited time.

you also look at how countries that prohibited abortion after previously not allowing it maternal mortality has not worsened. this idea that abortion saves women's lives has not been borne out by empiric experience? >> correct. sen. cassidy: dr. linton, you say something along the lines that there should not be any restriction. i go back to that child. we know it is rare for someone late term without a like this a, but it does occur. there are nine states plus the city in which we are currently, it is allowed. does this child really have no rights? i'm giving you the hypothesis. the ththis. is a decision to abort. is there no consideration? i understand we is a common ground. >> thank you, senator cassidy.

i think these extreme hypotheticals -- sen. cassidy: this is legal and the democratic side would like that to be the law of the land. i will just say maybe it is yes or no. if it is not for the health of the mother, should this child have no rights in the decision to abort at week 40 when otherwise if the child was delivered the child would be alive? >> this is a question we can whittle down to a yes or a no. sen. cassidy: so do they have rights? >> i would say every situation is unique. sen. cassidy: the inability to answer that is troubling. i yield because i am a minute over. >> senator casey. sen. casey: dr. linton, anything

else you wanted to say? >> i was simply going to say that every situation is unique. our job is to takeinformation ts and give them the option to decide what is best for themselves. sen. casey: i will start with dr. verma. in page one of your testimony you say, and i quote, i have seen youngom with worsening medical conditions that make their pregnancies very high risk and couples whose deeply desired pregnancies are in the process of miscarrying be turned away or forced to leave their communities to access needed health care. tell me how that reality that has surfaced most recently, how that reality has affected your ability to care for your patients, and how is your

relationship with your patients changed? >> thank you for that question. it has been devastating to look at patients to say that i cannot help you, i cannot provide this care, or have to wait for you to get sicker before i can provide this care. it creates a huge amount of missed rest that patients have for the health care system and the government. not a line in the sand were someone goes from being totally fine to acutely dying. it is often in a continuum. even state laws like georgia where they have exceptions for medical emergency it is unclear to us as doctors when we can intervene. if i could take a second to go back to dr. cassidy's point, i want to highlight that the situation of doing an abortion at the moment of birth does not happen. as a doctor who provides full

spectrum reproductive health care, i love taking care of people in labor and delivery, i provide abortive care, but does not happen. it is a false hypothetical that is meant to create additional stigma around abortion care. if a patient comes in at 40 weeks their options are a c-sectiothis information is reay dangerous to our patients. 90% of abortions in this country occur in the first trimester. less than 1% occur after 20 weeks when in most cases something has gone terribly wrong with the patient or the pregnancy and that person really needs that care for some reason. sen. casey: thank you. i want to turn to dr. linton to make reference to her testimony. i'm looking at both pages, the two and the top of page three.

on page two, you posed this question. when would an abortion be necessary to save the life of the mother? you point to a couple examples. what about a patient who presents with heavy bleeding in the first trimester but there is still fetal cardiac activity on ulasound? can i remove the pregnancy to stop the bleeding? do i have to wait for a certain amount of blood loss? you continue at the top of the page with more examples. the pregnant patient with unresolved congestive heart failure from her last pregnancy that puts her at higher risk of dying in this pregnancy. what percent chance of death does she need? what about a patient with a duly -- newly diagnosed breast cancer at eight weeks of pgnancy who cannot start chemotherapy or radiation? is delaying her treatment until

the end of her pregnancy risk to her life? what about a patient with a blood clotting disorder where pregnancy will further increase the risk of the pulmonary embolism or stroke. is the risk of a blood clot enough or do i have to wait until the actual stroke occurs? you go on from their with other examples. these are real patients that i have encountered, yosa how has that reality since the dobbs decision changed your ability to care for your patients and your relationship with your patients? >> i would go back to that same idea of this culture of confusion and fear. all of those cases i mentioned are real patients that i have encountered that my partners and i debated. we need this arbitrary phrase

from an 1849 law, do we have to call lawyers or consult other physicians. we were not able to just follow the medicine. adding words such as imminent death or immediate death does not clarify things further. these are impacting our ability to care for the patients in front of us in a timely and appropriate way. [inaudible] >> thank you all for being here for your testimony and for sharing. deeply personal stories. as has been repeated here, and we know to be true, access to reproductive care, the issue of

abortion itself, and the decision to terminate a pregnancy is deeply personal and complicated. clearly there are views that americans have on this iue that present deep and conflicting convictions. the opportunity to have true discussion and conversation about it is important. i have been clear where i stand on this issue. i think the choice to have an abortion should ultimately be in the hands of the woman, of the individual, not the government. i believe it is reasonable not to require those who are firmly posed to abortion to support it with tax dollars and that providers who do not wish to be involved in abortion should not

be forced to do so. that is why i worked with several other colleagues. senator collins, cain, synema and i have this bipartisan legislation to ensure that the rights that we women have relied on in the past 54 years, those set out in ro and griswold are protected. we establish a federal right to choose and reaffirm the right to contraceptive access without raising concerns about rigious freedom and provider conscience protection. my position on this is clear. i am pretty clear ride in recognizing that it is unlikely that the congress is going to pass legislation that would establish clearly that right to abortion. certainly in this congress. i will tell■f you, i continue to

hear from so many in my state, women in alaska who are concerned about access to abortion, access to reproductive services. we are including in our state constitution the right to privacy. that protects that access to abortion. what we have seen from decisions across the country in the lower 48 is a ripple effect that has come all the way up to the north. in alaska, closed in anticipation of the trigger laws that were coming online, that would require more resources in

other states. we think they are far enough away that that access is protected but there are implications. women are asking me about access. access to providers is limited in the first place. certainly access to abortion. access has been limited. i will throw this to anybody on the panel. what can we do practically right now to help ameliorate some of what we are seeing with the impact of the dobbs decision to ensure that women do have access to the care that they need now. i was not here when you presented your testimony, but i

cannot imagine how difficult when the eu are already in a stressful situation, the thought that i might have to travel hundreds of miles, incur extraordinary expenses to travel, but the access to care is so limited. i have given you no time to answer. >> i am happy to answer. thank you for the question in describing the experience in alaska. one of the things we can do is make sure we to medication abortion. it accounts for two thirds of abortions in this country and in rural areas like yours it is incredibly important t via teler folks who cannot reach a provider. maintaining access to a method

that we know is safe and effective based on decades of widespread use and study is critically important. sen. murkowski: thank you for saying that. >> thank you for being here today and for your testimony. in connecticut we often hear from our physicians that we should not labor under the belief that there are safe states. connecticut is a state today that protects the right to full reproductive health care for women, for families. we know what the agenda is. we know the agenda of republicans in congress is to pass national abortion bands and we are or years from losing those protections in connecticut. the doctors in my state tell me that this myth of the safe state

is also due to the fact that the bands that are being passed in states that are not connecticut are fundamentally changing the practice of medicine. and the medical knowledge in the united states. senator sanders started to explore this important issue. i think i have two questions to ask and i will pose the first one to dr. verma. what does it mean that we now have a growing number of states that are not training physicians in the suite of services related to pregnancy loss? what does it mean that we have physicians today emerging in those states that potentially do

not have the full scope of training on how to manage medical challenges like miscarriages or complications or infections or hemorrhaging that could stem from pregnancy loss. this seems like a significant challenge for our country. how is medical education changing when you have so many residents and medical students who are simply not getting the same kind of comprehensive education around reproductive health care? >> thank you for the question. over 50% of obgyn residencies are in states that have enacted bands or restrictive abortion laws and that is absolutely affecting resident training and medical student training. it is important to highlight here that it is the same procedures and same medications that we use providing abortion care that we also use when

someone comes in experiencing a miscarriage or a pregnancy loss. it is concerning that more and more doctors are not going to be able to provide all options for care to someone who comes in at 14 weeks bleeding after breaking their water care. i think this is going to affect the ability to get all types of care across the country. it is particularly going to affect women in rural areas and certain parts of the country and that is really when we are already experiencing such a health care crisis and maternal mortality crisis. >> i agree with dr. verma. immediately after the dobbs decision there were certain requirements that trainees have to achieve, things that they have to learn to satisfy the requirements of residency training specifically in ob/gyn. i can tell you the immediate aftermath of dobbs, trying to

find places for those learners to go receive that was dramatically difficult. as you said the safe states or haven states, not only are they asked to take care of an influx of patients but an influx of learners. all of that is compounded. i agree with dr. verma. i am concerned about theuture of our ability of our work force to be able to care for patients in a variety of settings. >> let me ask you that question about the broader workforce our state reports that we are seeing an influx of individuals for training. what we also know is that in ]states that pass these abortion bands, they have seen a 10% decline in applications for ob/gyn residencies. seeing a 10% increase in our states. in part because we have a set number of residency slots. the net effect here at a moment

when we were already desperate for more individuals to go into this care seems to be a doubling down of a workforce crisis that is going to affect everyone and every family across this country no matter which state you live in. >> absolutely, senator. these folks are not just providing abortion care but a full range of reproductive care. if you are seeking prenatal care or contraception or ivf, or any number of repructive care options, you will not have those providers available. we already have maternity care deserts around this country. those will only increase. it forces doctors to think do they want to risk criminalization for providing the standard basic medical care. >> senator becker. >> sen. beck: as i

understand, cmical drugs are routinely available. can you tell us about abortion reversal pills and why it is important to make her pregnant women have access to information about these pills, particularly those who are considering abortion. >> if i can first highlight the dangers of the decision to lift that requirement, it will tie into abortion pill reversal, what that removes from women is any kind of medical oversight. it removes the opportunity to document how far apregnancy the. many women are wrong. in pregnancy a woman takes those drugs the higher the risk of complication. it removes the possibility of adequately screening for ectopic pregnancy and the real possibility for a woman to

receive fully informed consent. that is a really important part of ensuring that before a woman takes these drugs that she is ensuring that she is not only sure of this decision but is aware of the potential risks to safety. we know that now women are receiving less counseling, more women are deciding after taking the method per stone -- mefepri stone pill, that they regret that decision. i am a member of the abortion pill reversal network and i'm a provider of that treatment which involves giving a woman natural progesterone which can counteract the effects of the first drug. it is essential that women are aware of this so that they know that if they make the choice, if we are supportive of women having choices, that we should support their choice that if they decide they regr their abortion and would like to save a child's life. >> you are saying there are more

dangerous health outcomes with the lifting of the medical supervision? >> absolutely. according to the fda's ■own data one and 25 women who take this drug will end up in the emergency room. having gone to the emergency room and my own hospital many times to care for women facing it is more common now that they are not being seen in person first. >> what is the window of time from taking the chemical to the reversal? ? >> it is most effective if it is taken within the first 72 hours but better the first 24. it is important they have this information so that they know if they change their mind there is treatment that they can access. >> in light of the fda ending in person requirements for these drugs, can you talk about how human traffickers are exploiting this lack of protection? >> we know that there is a link

between human it has also been e of the main points of contact for a trafficking victim to get help is with a medical professional. what we have done is removed that point of help for woman and have allowed for traffickers they have a way to access these drugs online. it has been well documented that women who are not pregnant have going online and ordering them. i personally talked with a woman who was in her 60's who got these trucks because she wanted to if she we are able. it is now possible for anyone to go online and get these drugs. traffickers could stockpile them to force them on their victims to force abortions. sen. murphy: can you walk me through some of the!&> complications of s41 and the ligious freedom restoration act? this is the contraception

legislation before us right now. s4381. it waives religious protections. >> thank yofor the opportunity to clarify one misunderstanding of my organizations position on contraception. we don't take an official position on contraception but we would support the right of any position to abstain from prescribing any medication or participating in any procedure that violated their religious beliefs or their own conscience. if they feel that it violates the oath that they took of his -- as a physician, we feel any physician should be able to abstain from prescribing those. sen. hassan: thank you very much. thank you for this hearing and to all of the witnesses, thank you for being here. i have received thousands of

messages from constituents in new hampshire urging me to protect reproductive freedom since the supreme court overturned roe v. wade. on that day the women lost a fundamental freedom. every woman should have the right to control their own life which includes the right to make their own health care decisions. with deep respect for my colleagues on the other side of the break us, women know what a -- on the others of the dais. women know what a pregnancy is. like senator mullin i too had a miscarriage. it was devastating for me and my family. senator mullin described the devastation that he and his family experienced.right now woa danger in our country that is real and grave. that includes women like one of my constituents who was carrying twins and discovered in the

third trimester that one of the twins could prove fatal to e other. think about the decision that she and her physicn■ had to make as they grappled with this very rare medical challenge. the impact of the abortion ban in new hampshire on her and her physician as they tried to figure out what to do. a few questions. abortion bans are impacting multiple facets of women's health care. miscarriage is common and it can be devastating. one in five pregnancies in the united states resulted miscarriage. where abortion bans are in place some women experience miscarriages need immediate medical attention are being denied the health care they need because doctors are fearing criminal penalties if they treat these women. can you discuss how abortion bans are jeopardizing the health of women having miscarriages? >> yes.

it goes back to this idea of confusion. these laws are not written by physicians. many of them were written before the eraultrasounds in the modern diagnoses that we use. asking a physician to interpret a law three medical lands in a modern lens can be difficult. we are physicians not lawyers. we did not go to medical school to medical school to make intricate legal decisions. as much as my biggest concern is for the patient, at the same time i cannot blame the physician for having this fear over confusion of whether or not they can provide care. we need to focus on leading providers make medical to care for the patient in front of them. sen. hassan: abortion bans are making it harder for women to get prenatal care that supports the health of the women and their babies. it makes it harder for obstetricians to practice in rural areas across the country

especially when you factor in abortion bans including putting the doctor and patient in jail. what is the impact of abortion bans on doctors trying to do their job? how are these bands limiting access to care in rural areas? >> even pre i was traveling sigt distances to get to a half to get -- to get to a doctor to get prenatal care. @2there are multiple barriers women are already facing. what we are seeing is as more doctors leave these states because of abortion bans, those distances that patients have to travel are getting further. patients are scared. one of the things i is preconcen counseling visits. i sit with a patient who would like to get pregnant and talk about how to optimize that pregnancy.

starting prenatal vitamins, getting off medications dangerous for thprsince dobbs 'n and happens if i get pregnant and something goes long? these are patients who desire pregnancies. they are so afraid something it is affecting decisions about whether or not to expand their families even if it is something they want. sen. hassan: i am almost out of time. quick question for miss lopez. since roe v. wade was overturned it is more critical now than ever that women access contraception. most forms of health insurance cover birth control but there are nearly one million women of reproductive age enrolled in medicare because of a disability and they don't have guaranteed access to contraception. i am working on a bill that will close contraception coverage gaps by requiring medicare to cover all forms of contraception allowing women with disabilities to get the typesthey need.

can you speak to the importance of requiring medicare to cover contraception? legislation. and for it is critical that all people have access to contraception to determine their pregnancies appropriately so they can determine how and when to start a family. thank you again. sen. hassan: thank you. senator murray. sen. murray: how many have you delivered in the past two months? >> 10 to 20. >> and dr. vera? >> i'm terrible at estimating that over my career thousands. sen. murphy: but you are still active? >> yes. at what type of range would you do pregnancy or sonogram --

>> i see patients with all kinds of pregnancies and usually when a patient comes in and has a positive pregnancy test -- sen. marshall: my question is how often do you use sonograms on routine prenatal visits before eight weeks? >> we usually do an initial ultrasound pregnancy is there. sen. marshall: so in the first trimester or early second on a routine ob situation? >> to be clear i work on labor and delivery. i do not provide prenatal care. >> dr. linton, you delivered a 24 week baby before i'm sure? >> yes. >> when that baby is delivered, =oyou call in anesthesia, the nicu, everybody>> it depends onl

scenario. if it is a desired pregnancy and the patient has voiced the desire for resuscitation, we call nicu. >> and you have also done abortions at 23 weeks? >> in my training and provide the standard of care and lined with medical guidelines. sen. marshall: you have done abortions at 24 weeks? >> i provide the care i am trained to do based on the state laws were a live. sen. marshall: and dr. verma you have done abortions at 24 weeks? i think what you are highly -- >> i think what you are highlighting is the complexity of care. sen. marshall: i'm not asking for a lecture. is there any concern in your heart or your mind that the baby

at 24 weeks who does not make it and you do in abortion on the same time, how does it make you feel? >> i think it is a great question. this is why it is so complicated. i feel that have experienced a t trimester lost myself and i found it devastating. my patients are able to make these complicated decisions about their health and lives. sen. marshall: web pregnancy category of drug is mifepristone? >> i cannot tell you what the top of my head. sen. marshall: do you know, dr. virma? >> i know it is incredibly safe based on decades of data. sen. marshall: do you know what category it is? they are both category extracts. your prescribing these drugs and you don't know what category drug it is. why is it a category x drug?

because it causes fetal malformations. >> those categories you're describing are based on politics. mifepristone is safer than tylenol, viagra. sen. marshall: the fda saying this is a category x drug. would you agree with me that these abortion pills are less effective at 14 weeks as opposed to eight weeks? >> yes. i would say that our data does increase with gestational ages. sometimes we have to modify the protocol. generally less effective at higher gestational ages. sen. marshall: i have never prescribed this drug. i've taken care of a lot of patients who hadomplications from these drugs. i'm confused why you do a sonogram and a routine pregnancy to establish gestational age.

■&the main reason you to it in e first trimester -- the spine is not developed, the heart is not developed. you are doing it for gestational age. recognizing that so many women come in and are a month off with the gestational age. why wouldn't you do a sonogram on every person you see before you prescribe this drug realizing it has■ decreasing effectiveness at 14 weeks or 10 weeks? your prescribing a category x drug on a patient that has the possibility of not being aborted. you are increasing the risk of fetal anomalies. why are you scared to do a sonogram? if you are doing it on that 12 weeks versus 20 weeks that it would change everything? i am appalled why you are so afraid of doing sonograms? i yield back. >> i will allow you time to answer that question. >> thank you. as a doctor who does provide this care and is currently

practicing, we often do sonograms if there is any question. when we see a patient and we are providing medication abortion via telemedicine, we go through screening questionnaires. if there is any concern we absolutely do a sonogram. that isn't really an accurate representation of how this practice of medicine works. >> thank you. senator smith. sen. smith: i appreciate all of you being here. i want to follow on this question about medication abortion. mifepristone has been lawfully prescribed to patients since 2000. dr. virma, how safe is it and how effective is it? >> thank you. medication abortion is incredibly safe and effective. in a recent study of 20,000 patients that have undergone medication abortions the rate of adverse events is 0.83%.

only about 1% of those patients came to the emergency room after the process. of those people about 40% did not need any treatment. we know that medication abortion is incredibly safe and effective. dangerous misinformation about the practice of medicine is for our patients, for physicians. the american board of ob/gyns, the board that certifies all of us at this t, has asserted that abortion care is safe, effective, and medication abortion is safe and the reversal i can offer to ourients because it can cause serious risk of bleeding and hemorrhage and abortion care does not cause preterm birth. i want to highlight the misinformation we have heard today because it can be very dangerous and contradict what the american board of ob/gyn and

american college of ob/gyns assert. >> we have heard a few things about abortion reversal drugs and saline abortions. is there any misinformation you would like to clear up? >> saline abortions are not something done in the practice of modern medicine. i have been practicing for a decade and i've never seen or heard it. that is not a practice that is done. for aborti and i studied whether to our patients because if it was a safe treatment and a patient wanted it i would be happy to offer it. i'm happy to support patits who want to continue a pregnancy or end of pregnancy. we had to stop that study early because people were experiencing significant bleeding and were at risk. it is not■v ae treatment available to patients. that is misinformation. >> and dr. linton, i would like

to ask you about this question of whether telemedicine for medication abortion is also safe and effective? >> i would reiterate what dr. virma said. we have screening questions. if there are any red flags, if someone does not have a regular menstrual cycle, if someone is concerned about bleeding or cramping, they are not eligible for a medication abortion via telemedicine. the■g utmost priority in every encounter is patient safety. sen. smith: louisiana recently enacted a law that adds mifepristone and mifepristol to the states controlled substances list. it would criminalize anybody who possesses it without a valid prescription and puts it on a category that is in the same as opioids.

i'm wondering, is there any reason -- what do you make of that? do you believe medication abortion should be put in the same class as these other substances? >> the easy answer is no. my colleagues havreally reiterated how effective it is. we know that it its safe and effective here and globally. an increfor folks to access abon care. two thirds of abortion care is medication abortion. any effort to restrict it further is an effort to make abortion more difficult to obtain. sen. smith: what impact does that have oniving in rural communities, people who struggle to get access to care includin■3■7 women who are marginalized in so many other ways? >> the ones impacted by all of these restrictions are those already marginalized. patients of color, the under or

uninsured, folks who live in rural communities. it makes it harder to get. )íwe know that one in five abortion seekers is traveling out of state to get care. they are leaving their home communities at significant financial much emotional and logistical costs to themselves. >> i want to ask unanimous consent to enter into the record seven statements in support of abortion access and reproductive freedom? senator baldwin. sen. baldwin: i want to thank you senator murray and chairman sanders for holding this hearing. in the wake of the overturning of roe, we are drawing attention to the dire consequences on women's health across this country. home state. before the supreme court overturned roe v. wade,

generations of women in this country had only known a country with a country with the right to abortion care. knew a country where every woman had the freedom to make their own choices about if and enwhen those freedoms were stripped away. wisconsinites were sent back to the year 1849. they live under a pre-civil war criminal ban on abortion care. i have heard such horrifying story since the ban went into effect, worrying about bleeding out or contracting life-threatening infections before receiving care, women forced to travel hours from families and support systems to receive care for an unviable pregnancy. thankfully more recently wisconsin has been able to take important steps to restore abortion services in three communities.

three counties. access to care statewide, drive hours, take time off work, arrange for child care, and face medically unnecessary barriers. while some people debate whether it should be the state or the federal government who should decide abortion rights, i believe it is the women who should decide about these issues. that is why we must pass the women's health protection act which i authored ensuring that women have the right to make health care i'm so glad you're here today to share your spirit about providing care in wisconsin. your testimony highlights the impossible landscape that you and other providers have been

forced in every. these stories aren't hypothetical. they are about real people. i wanted you to tell us a little more about how patients in wionsin were affected immediately after dog. how was the dobbs decision -- how has that harmed wisconsin? did i mention there are people who had apartment for care on the day that the decision came out? quick you are exactly right. this is not -- there is question about the enforceability. there will go into effect frozen mealy.

9:00 a.m. on the 24th of june. we cease providing care that moment. we had patients in our clinic, we had patient scheduled the next day and staff members had to go out into the lobby and tell them because of something that just happened, you cannot receive care here today. it wasn't currently difficult for patients and staff to try to figure out the next up south of get health care. correct thank you. i've introduced legislation that i could describe. this bill would guarantee doctors have to freedom to provide abortion care and give patients the ability to have care they need nationwide. how would passage of that act improve care for patients right now? >> thank you. i do want to thank you very much for your leadership on this issue. as you mentioned, we resumed abortion care.

even as we are providing abortion care right now. the been on telemedicine, as a physician who sees theç impact everything that, i can tell you that abortion access will only improve the care we provide. >> thank you. what you want us to know about the current state of -- tell us how these vaous you justdescrib. how do they affect the patients care. abortion is only accessible in wisconsin right now in three counties. her state is a lot bigger than three counties. the patients are already having to travel long distances.

we know our bands are often not one for hours. we have the same positional in the state of wisconsin. this is to receive their medication abortion. often times between those two appointment it can be a week or plus. all of these additional restrictions are creating barriers for patients to receive what should be routine health care. >> thank you. any who spoke today, i think the dobbs decision was a disaster. also the radical nature of undoing roe v. wade but 100 years of 14th amendment -- should people be able to marry who they want in the spring

course decision, they cast out not just roper then jeopardize all these other rights we have taken for granted for just horr. i think we need a national protection. i have a bipartisan bill that would protect both griswold and roe and restore where we are pre-dobbs had made plain that you're right should not depend on the zip code you live in. ■x■kthe super court said you cao to your state legislature when both of the state legislatures and country look at congress as 26% women. or they seek a e legislature to do it when women are so unrepresented is -- and most of our legislators. we have a constitution. it is designed to protect even if the majoritis against you, there is something you should get in this country even if you're just one person majority

can't trample upon. virginia is one of the states -- few states that essentially -- there was the basic framework established biro, memo regulation of abortion pre-liability so significant regulation. that is where the journey is, not everybody likes that. it is not pursuant to much. virginia has basically done that and that has put virginia in an unusual position. we are thought estate in the south that really still provides women at all the rights that grow guaranteed to them for half a century. as lopez,■ you alluded to this into tess mata but there is unusual burden in these instances where states like virginia are protecting reproductive freedom but surrounded by others. n drove from houston texas.

some states protecting women's reproductive freedoms.

someone leaving the home community, figure out how we're going to pay for the procedure. we will probably have to wait. and then also have cost on the ground. vcthis is ridiculous and sometis insurmountable. this is a hearing that is about how abortion bans have created a health care nightmare. impacts a whole lot of other rights. including the right to contraception in virginia because of the logic of the

opinion, virginia legislators see a price in the general assembly. evers to defund planned parenthood continue to limit or defund title, everyone, other restrictions on access to care, ibm and then we are also seeing similar efforts around transgender and gender from care. that is all that is related and all efforts to limit access to basic reproductive health care. question is i conclude my colleagues, the idf in united

states was born in 1991 and i had her as my guest during the state of the union and she said when they render the ruling that led the alabama health care providers to stop this for the first time in our life-like and endangered species. no one should be made to fl that way. i go back. quick that will conclude our hearing for today. i was a think everyone who's joined us in this discussion. senator cassidy, i will allow you causing the box. >> i would like to ask unanimous consent enter into the record, in organization that was diagnosed with the organization they feel as though the children to our board with this are being selectively aborted and that mr. fillet their lives are threatened.

just a quick question. you rightly point out that really is thisone -- would you agree that it would be reasonable to restrict late-term abortions? >> late-term abortion is not a medical term. >> would you be reasonable that after some week that would be reasonable to restrict and abortion after a certain. of weeks? i think that is really the crux. ■■5if you say this hardly ever happens, would be reasonable to restrict when this would occur? >> or two to envision the nursery design. they are diagnosed with a terrible fetal anomaly. >> this is not a theoretical. if the child is otherwise well and the mother's health as well

because he said this on the child ever happens, is it reasonable? >> abortion at the moment of birth does not happen. i also to mean abortion care later. >> and a respecter by the way. i really do respect to speaking of that tension between the week when three will report in the week 23 you would resuscitate. i don't mean to be comforted but your aborted the dialogue here. because i'm not trying to become rotation, i'm just trying to highlight what the situations actually look like. >> dr. francis, would you just finish up the question please? absolutely. i think certainly beyond the point where a child can survive outside of his or her mother, they would bit -- never be a reason you would need to intentionally edit that childlike. you would simply deliver the baby and take care of mom and

baby inappropriate way. i think that something i would help all of us at this table could creep on. ■=>> with that i yield. thank you. >> senator cassidy give you the opportunity to respond effectively. take two minutes to respond and say what you want to say. >> i was just pitting a picture of a doctor who was just sitting with his patients and providing a full special meth care, what this actually looks like. a lot of times a terrible diagnosis. they have a nursery set up, they ve me as their doctor to support. i have some patients that choose to continue their pregnancy and delivery are term and other patients who say that is too dramatic, i can't do that and my job is to support them in both of those situations with

whatever is right in their life. i think as doctors we all recognize that providing left in care sometimes means ending a pregnancy and that this is an issue of semantics to further a political agenda. what we are referring to -- that is abortion care and that is 're talking about here. it is sometimes necessary lifesaving care for patients that come in eating this care forat comment. i'll decide this. abortion up until the moment of birth doesn't happen. abortions that are later in pregnancy are extraordinary rare and they occur essentially only one pregnancy is nonviable and the mother risks severe injury or death by being pregnant.

pregnant women urge spiritually health emergencies. politicians have made doctors wait until women get sicker and sicker before they are allowed to treat.

victims to, women are standing up. questions for the record will be due in 10 business days june 18 by 5:00 p.m..

click to spaz washington journal

ally form involving you to discuss the latest issues in government, politics and public policy from washington dc to across the country. coming up thursday morning, the 80th anniversary of d-day, we will get your reaction by taking your calls, text and facebook messages throughout the morning. and then talking about the birth of the american superpower. she spaz washington journal, joining the conversation live at 7:00 p.m.morning on c-span, c-sr online at c-span.org. crises that is your unfiltered view of government. we are funded by these television companies and more including mediacom. >> at mediacom, you should have access to fast and reliable

internet.