June 29, 2015

Governor reviewing telemed abortion ruling before deciding on appeal

Governor Terry Branstad talks with reporters.

Governor Terry Branstad talks with reporters.

Governor Terry Branstad talked today about Friday’s Iowa Supreme Court ruling that allows so-called telemed abortions to continue.

“I was very disappointed in the court decision, and we are going to be reading and reviewing and analyzing that and determining what is the best course of action for us to take,” Branstad says.

Branstad says its’ too early to say if the state will appeal the ruling to the U.S. Supreme Court. “I do respect the fact that the courts are a separate branch of government from the executive branch of government. And I have not had the chance to review this in great detail. But I am disappointed in this decision,” Branstad says.

The Iowa Supreme Court said a rule created by the Board of Medicine requiring a doctor to be present for telemed abortions placed an undue burden on a woman’s right to terminate a pregnancy and was unconstitutional.

The governor made his remarks during his weekly meeting with reporters.


Telemed abortion ruling called ‘major victory’ and ‘devastating’

Suzanna de Baca

Suzanna de Baca of Planned Parenthood of the Heartland.

The Iowa Supreme Court’s decision today that a rule restricting telemed abortions is unconstitutional provided a dramatic turnaround of emotions from the district court decision that upheld the rule. Planned Parenthood of the Heartland saw the Supreme Court ruling go in its favor.

Suzanna de Baca is the President and CEO of the organization which sued to keep providing the telemed abortions. “Today’s Supreme Court ruling in our view is a major victory for the women of Iowa and for reproductive rights,” de Baca says. She says it is an important win in the overall abortion fight.

“This win is especially significant because the Board of Medicine’s case is part of a very disturbing trend really attacking access to safe and legal abortion for women. And because safe-legal abortion is a constitutional right, we found that trend disturbing,” according to de Bacca. “The fact that we won here says that the Iowa Supreme Court really looked at the evidence, they went beyond any kind of really political motivation and were really thinking about the health of Iowa women.”

Planned Parenthood has done 7,200 telemed abortions since 2008. “The medical evidence that we have certainly suggests, well it shows, that abortion –especially medication abortion — is a very safe procedure. Definitely this ruling I would say proves that in-person or telehealth are equally safe,” de Baca says.

A release sent out by Planned Parenthood says the ruling “sends out a strong and clear message to politicians across the country. Restrictions and bans on abortion are unconstitutional and deeply unpopular, and we will continue to fight them in every state in this country.”

De Baca would only say this about the case’s potential impact outside of Iowa. “Well, it’s difficult to tell what impact the decision will have, because this is very state-specific,” de Baca says. “But it’s a very notable court case, so the decision could certainly hold influence in abortion-related cases around the country.” As for other states, Minnesota has tried some telemed abortion services on a pilot basis and 18 states have passed laws banning the practice.

De Baca says there are no plans at this time to expand on the seven facilities that offer the telemed abortions in Iowa at this time. She was asked about the financial impact to the organization of providing telemed abortions. “I think the one thing that I would say is that we are a nonprofit organization, so our motive is really providing care to our patients –many of whom are low-income or who do not have an ability to pay. So, any claim that we have a profit motive, I think all anyone needs to do is look at our status as a non-profit to really know that that is not top of mind for us,” de Baca says.

Jennifer Bowen

Jennifer Bowen of Iowa Right to Life.

On the other side of the ruling, the Executive Director of Iowa Right to Life, Jennifer Bowen, says they felt the Supreme Court would uphold the ban after winning in the lower court.

“The news was devastating and it did come as a surprise,” Bowen says. “I was hopeful as one of the justices mentioned back in March when they were hearing oral arguments, one of the justices mentioned ‘we are not medical professionals here like the Iowa Board of Medicine, why should we rule against their decision here’?” She went on to say, “Disappointing and devastating would not be an over exaggeration of our feeling today.”

The Supreme Court ruling says telemedicine is being used for many medical procedures now and abortion should not be an exception. Bowen says a telemed abortion is not the same as having a doctor look at your toe, and there are much more serious concerns.

“Some women have lost their lives when they’ve had chemical abortions…and that was when they went into a hospital and other places when they saw a physician. And then when you add the component that these women are not even given the opportunity to meet with a physician at any point unless there is an emergency room visit, there’s huge, significant risks, and that has been well documented,” Bowen says.

She says the ruling is a setback for Iowans. “The decision today in no way safeguarded or protected Iowa women. And for that reason we are just absolutely devastated,” Bowen says. Bowen was asked if this is the final chapter in the fight against telemed abortions.

“It think that there are those who would like us to be done with this issue. But certainly back in 2010 when the then Iowa Board of Medicine ruled against us, we didn’t consider it over and done. We went out and we collected 31,000 signatures on both sides — both pro-lifers and pro-choicers who said ‘I’m not okay with this’ — who maybe didn’t know what webcam abortion was and after they learned, they signed our petition. We are going to keep going out there. We are going to keep going out into the grassroots of Iowa and make sure that Iowans know what is happening.”

Telemed abortions continued while the Supreme Court decided the case.


Iowa Supreme Court overturns rule blocking telemed abortions

Iowa Supreme Court building.

Iowa Supreme Court building.

The Iowa Supreme Court says so-called telemedicine abortions can continue in the state. The Supreme Court says the rule created by the Iowa Board of Medicine 2013 requiring a doctor to be on hand when women are given drugs to induce an abortion is unconstitutional. The rule effectively prevented Planned Parenthood from using webcams or teleconferencing to dispense abortion-inducing drugs to patients in remote locations.

The Board of Medicine said the rule was intended to protect the safety of women. Planned Parenthood sued, saying the rule was politically motivated by the board that was appointed by Governor Terry Branstad who opposes abortion. A Polk County judge upheld the rule and Planned Parenthood appealed.

The Iowa Supreme Court ruling says the rule has very limited health benefits and says while undoubtedly everyone would prefer to see a doctor in person every time they have a medical issue, the reality of modern medicine is otherwise.” The court says the telemedicine rule would make it more challenging for many women who wish to exercise their constitutional right to terminate a pregnancy.

Full ruling: Telemed abortion ruling PDF

 Related stories from Radio Iowa: 

Supreme Court hears arguments on telemed abortion rule

Both sides react to ruling upholding ban on telemed abortions



Iowa House passes bill requiring an ultrasound before an abortion

Joel Fry

Joel Fry

The Republican-led Iowa House has voted to require doctors to offer women seeking an abortion the opportunity to see an ultrasound image and hear the heartbeat of the fetus. The bill passed on a 57-39 vote after several hours of debate today.

“It is my belief that we are defending two lives here, both a mother and a child,” Representative Joel Fry, a Republican from Osceola, said to open the debate. “…It’s my attempt, my desire to bring to the forefront that one that is often not heard.”

Senator Sharon Steckman, a Democrat from Mason City, opposed the bill.

“I’m tired of the government thinking they need to tell the 1.5 million…Iowa women what to do,” Steckman said.

Representative Sandy Salmon, a Republican from Janesville, voted for the bill.

“The woman will have the opportunity to get more full knowledge about the reality of the unborn baby growing inside her,” Salmon said. “Our hope is that with this knowledge she will choose to honor that baby’s right to live.”

Representative Mary Mascher, a Democrat from Iowa City, argued expanding access to family planning services was a better answer.

“This proposed bill is just another effort by some lawmakers to shame a woman who has made a difficult decision to end her pregnancy,” Mascher said.

Representative Steven Holt, a Republican from Denison, said hearing the heartbeat and seeing the sonogram will help the woman make a “fully informed decision.”

“Movement stops. The heartbeat falls silent. The miracle ends,” Holt said. “Those are the consequences of abortion that should be demonstrated.”

Timi Brown-Powers

Timi Brown-Powers

Representative Timi Brown-Powers, a Democrat from Waterloo, responded: “We’re not the doctor. We’re not that patient. We don’t even know the circumstances. If a woman is raped, Representative Holt, is that really a miracle?”

Critics say the bill will force physicians to perform a more invasive ultrasound as most abortions occur in the early stages of a pregnancy when a traditional ultrasound image cannot be obtained.

The legislation is unlikely to be debated in the Iowa Senate, where Democrats control a majority of seats.

Supreme Court hears arguments on telemed abortion rule (audio)

Alice Clapman presents Planned Parenthood's case.

Alice Clapman presents Planned Parenthood’s case.

The Iowa Supreme Court heard arguments today over a rule created by the Iowa Board of Medicine that requires a doctor to be on hand when women are given drugs to induce an abortion. The rule effectively prevents the use of using webcams or teleconferencing to dispense abortion-inducing drugs to patients in remote locations. A district court ruling upheld the rule.

Planned Parenthood sued seeking to overturn the rule saying it is unconstitutional, and attorney Alice Clapman argued the rule creates several problems for women. “The health risks from a delayed abortion, the loss of autonomy that comes from being denied your only non-surgical abortion alternative, and being forced into an alternative between surgery or carrying your pregnancy to term,” Clapman says.

She was asked if this is simply an issue of cost for the women. “No, because the reality of these womens’ lives is they’re going to be delayed and medication abortion is only available in an extremely narrow window,” Clapman says. “To put this in context, it’s the first seven weeks of pregnancy measure from before pregnancy starts — measured from the last menstrual period. Most women when they discover they are pregnant have a few weeks at most in which they can have a medication abortion.”

Clapman was asked about the safety concerns of the telemed procedure. “Of the 7,000 patients who’ve had this service, there’s no evidence of any safety issues that have resulted. More importantly, this has actually improved public health and patient safety because it’s allowed women to have abortions earlier in their pregnancy when they are safer,” according to Clapman. Clapman says requiring a physician to see a woman before they can get the abortion pills is an undue burden on the women.

“The new telemedicine rules that we’ve directed this court’s attention to do not impose the standard on any other form of health care, even though it is clear that abortion is relatively safe and there are other forms of care that are being provided through telemedicine in Iowa that are equally or more risky,” Clapman explains.

Jefferey Thompson

Jefferey Thompson

Attorney Jeffery Thompson argued for the Iowa Board of Medicine. Thompson says the board was seeking to ensure the abortion pills are used safely and correctly. “What our board of medicine did was agree with you that there needs to be a standard of care decision, frankly in the face of prior complaint for discipline against somebody that alleged they weren’t following the standard of care,” Thompson says. “And they promulgated a standard of care that focused on safety and tried to resolve these questions, this uncertainty of safety, in favor of the woman.”

Thompson says Planned Parenthood’s own study goes against the claim that limiting telemedicine abortions keeps women from getting the abortions that want them. “They studied two years before they started telemed and two years after, and what it shows is there was no huge unmet need, number one. Patients didn’t drive shorter distances, number two. And in general, it had not real impact,” according to Thompson.

Justice David Wiggins questioned Thompson about the safety findings in the study. “And the study also shows, does it not, that the result of complications –whether by telemedicine or whether not by telemedicine — were exactly the same,” Wiggins asked. “They weren’t worse, but they weren’t better,” Thompson responded.

Thompson summed up his arguments by saying the Board of Medicine set up the rule to ensure the safety of the women who use the drug. “The role of standards of care and legislation is to resolve uncertainty. And that’s what this standard of care does, it’s necessary,” Thompson says. “You may not agree with it, I may not agree with it frankly, but it is within the Board of Medicine to do this, and it is absolutely constitutional.”

Telemedicine abortions are continuing until the Supreme Court rules on the issue. It is not know how long it will take for the ruling.

Audio: Supreme Court oral arguments on telemed abortions. 45:16

Bill requires doctors to offer to show, describe ultrasound to women seeking an abortion

Norm Pawlewski

Norm Pawlewski

A bill that would require doctors to perform an ultrasound and offer to both show and describe the image to a woman seeking an abortion has cleared a subcommittee in the Iowa House. Norm Pawlewski, a lobbyist for the Iowa Right to Life Committee and the Iowa Faith and Freedom Coalition, is the former director of the Iowa Department of Human Services. He calls it a “health care bill.”

“It not only protects the mother, but it protects the physician as well,” Pawlewski says, “makes sure that what they’re doing is appropriate for the age of the gestation of the child.”

Tom Chapman, a lobbyist for the Iowa Catholic Conference, says it will help a woman make an “informed” decision about an abortion.

“If there are bad actors who are not doing this sort of procedure before an abortion, I think this bill would help with that,” Chapman says.

Erin Davison-Rippey, a lobbyist for Planned Parenthood of the Heartland, says performing an ultrasound is already standard practice for doctors, but having legislators dictate the conversation a doctor has with a patient is a step too far.

“It feels like an effort to shame a woman who has made a decision to end her pregnancy,” Davison-Rippey says. “This bill sends the message that we don’t trust a woman to make decisions about her health care and that we don’t trust a physician to provide appropriate information.”

If the bill becomes law, doctors who fail to offer to show and describe the ultrasound to a woman seeking an abortion could be sentenced to up to five years in prison. Representative Beth Wessel-Kroeschell, a Democrat from Ames, says it’s “dangerous” for legislators to set that kind of precedent.

“This is moving us backwards to believing that women don’t understand what happens when they become pregnant,” she says. “…This is shaming and it’s demeaning.”

Joel Fry

Joel Fry

Representative Joel Fry, a Republican from Osceola, says a doctor is seeing “two patients” when a pregnant woman is in his office.

“I believe that child has, needs, deserves to have the opportunity to also have a voice in this medical arena,” Fry says.

The bill has a strong chance of passing the Republican-led House this year, but it’s unlikely to become law. Democrats control the debate agenda in the Iowa Senate and the bill is not likely to be considered there.

Group warns sex ed website now advertises porn

An Iowa pro-life group is issuing a warning about a website that once offered sex education information to parents and schools but which now directs computer users to pornography. Jennifer Bowen, executive director of Iowa Right to Life, says the website “teenwire-dot-com” had been run by Planned Parenthood but now advertises teen escorts, online sex and other X-rated content.

“We are very concerned for students in Iowa as well as nationally, anybody that uses any curriculum that advises from Planned Parenthood or from the Ellen Guttmacher Institute is very likely using curriculum that points teens to that website, teenwire.com,” Bowen says. Any outdated literature distributed to schools in the past few years, she says, still directs people to that website.

Bowen says her organization mobilized and contacted every school district in Iowa to give them a heads up about the website’s change. “Unfortunately, we only heard back from one and they were not inclined to believe that we were telling the truth,” Bowen says. “We are very concerned about the lack of response that we’ve had from the school districts.”

Bowen says the website, when run by Planned Parenthood, had used an Etch-A-Sketch in some of its videos months ago, so Iowa Right to Life contacted the makers of the toy in an effort to have the site shut down. “At that time, teenwire.com came down for a period of time,” Bowen says. “It went back briefly but then, apparently it came back down again at some point in the last year or two. Unbeknownst to us, it went right into the hands of the porn industry.”

Bowen says she’s been told the website is operating within the law so it won’t be forced to go dark.

By Karla James