Transcripts For CSPAN Hearing On Reproductive Health Care 20240713

The committee will now come to order. Good morning. To rest of this hearing is examine how state policies like those in missouri are impacting residents access to comprehensive Reproductive Health Care Services including abortion. Without objections the chair is authorized to declare a recess of the committee at any time. For audience purposes we welcome you and respect your interest in being here. In turn we request and we ask you to respect the proceedings as we go forward in todays hearings. With that i will recognize myself to give an Opening Statement. I would like to begin by acknowledging that this is the First Full Committee Hearing we have held since our friend, our colleague and our beloved chairman Elijah Cummings passed away. Chairman cummings spent his entire life fighting for justice and equality for everyone. He was a fierce champion for womens access to health care. Across the country, extreme forces and State Governments are taking draconian steps to violate womens rights by restricting access to Reproductive Health Services Including abortion. Ae state actions include ,rerequisite on do burden restrictions and outrageously invasive procedures for patients seeking abortions. Let me be clear about what these restrictions are. They are a denial of basic Health Care Services women have a right to receive, no matter where they live. I want to thank my good friend for his leadership in requesting todays hearing. Missouri has taken some of the most extreme actions to limit access to Reproductive Health care. Withy is one of six states one remaining Abortion Provider. As we will here today, it is at risk of having no providers at all. Clinicis one remaining is planned parenthood. Director,hat clinics dr. Nicholas, for testifying here today, and for her brave service to the women in her Community Every single day. Earlier this year, dr. Randall williams, director of the misery state Health Department, ordered planned parenthood to perform medically unnecessary pelvic examinations on every single woman seeking abortion. Invasivean statesponsored abuse of women seeking care. After significant public backlash, the state suspended cruel practice. But dr. Williams also recently was forced to admit that he directed state employees to collect information about patients menstrual cycles to advance his ideological crusade. That is what they were spending taxpayers dollars on. I cant begin to describe my discussed at these violations of privacy and breaches of trust by government officials. Actions are not taking place in isolation. Other states have pushed for similar restrictions. I believe these states have been emboldened by the Trump Administrationa systemic administrations systemic attacks and general disregard for women. Our former chairman darrell issa held a hearing in this room with an allmale panel of religious leaders who were trying to take away contraceptive coverage for women. One singlet invite woman to testify on that panel. Ton they refused our request have sandra fluke, a Georgetown Law School student at the time, testify about the importance of Health Insurance coverage of contraceptives. They said she was not qualified. I asked in protest, where are the women . It is time to let women speak and time for everyone to listen. It is time for elected representatives in congress and in state houses to protect the right to privacy and a womans right to Abortion Services rather than attack it, undermine it and try to eliminate it. I want to thank jennifer box for sharing her family story with us. No one should ever have to make the heartbreaking decision you and your husband had to make. It is your decision and it doesnt belong to anyone else. Thank Marcela Howell from in our own voice, part of the National Reproductive agenda. The lawma graves from center for all of her work and being here today and for helping the committee and me on this. I know recognize the Ranking Member jordan for his Opening Statement and i yield back area yield back. Rep. Jordan thank you madam , chair. I want to thank our witnesses for being here today. In the declaration of independent signed 243 years ago our Founding Fathers enshrines the principle that life, liberty and the pursuit of happiness are inalienable for everyone. I think it is always interesting to note the order of the rights they chose to mention. Can you really pursue happiness . Can you chase down your goals and dreams if you first dont have freedom . If you first dont have liberty . And do you ever enjoy true liberty, true freedom if government wont protect your most fundamental right, your right to live, your right to life . Life is precious. Its a sacred gift from god. During an earlier time here in congress, whatever disagreements that we had, colleagues who didnt share those beliefs there was a common understanding about this fundamental principle. That life, in fact, is precious. Over the past few years, it seems our two sides have moved away from this basic understanding. Today my colleagues on the other side of the aisle will charge me and republicans as being against women. Today this congress is in the midst of an unprecedented impeachment inquiry against President Trump. I am proud that President Trump is one of the most prolife president s to ever lead our nation. President trump has taken bold steps to stop federal funding of abortions and enabled better Legal Protections for Health Care Workers who are opposed to providing, assisting or participating in these procedures. The hearing today is an attack on that prolife record. Todays culture, standing for life, its not easy. Im always guided by one of my favorite scripture verses. 7 fight thehy 4 , good fight. Finish the course. Keep the faith. Thats what we have to do. Keep the faith in those basic principles outlined in that document that started our nation over 200 years ago. We came to this congress to fight for the right of all americans to have life, liberty and pursue happiness. I yield back. Rep. Maloney i will i will now yield one minute to the member from the great state of missouri, lacy clay, who requested this hearing. You madam thank , chairwoman. I along with my constituents appreciate your calling this hearing today on an urgent issue that threatens the health and personal freedom of millions of american women. The assault against a womans right to make their own Health Care Decisions is an insult to the basic values of individual freedom and limited government. Nowhere in the nation is that assault more urgent than in my home state of missouri, specifically in the city of st. Louis which i am so proud to represent. Planned parenthood of st. Louis is the last remaining Womens Health care clinic in the entire state of missouri that also provides Abortion Services. I visited the clinic staff and physicians this past june as the battle was elevating, and i wanted to lend my support and voice to their efforts. As a husband, father, and brother, i support and trust the private personal Health Choices of women. I am truly amazed that the Missouri Department of health went along with efforts to shut down the clinic, intimidate patients and threaten providers, and would allegedly and bizarrely track womens menstrual periods on spreadsheets to determine if they had had an abortion. No woman should be subjected to this violation of their personhood. This is america. Its her body. Its her health care and its her decision. I stand with planned parenthood because they are truly on the front lines of defending Womens Health care across america. Madam chairwoman, i would also like to introduce into the record a personal statement by ms. Meevie mead, the director of policy and planned parenthood advocates in missouri. Rep. Maloney without objection. So ordered. Rep. Clay thank you. I yield back. Rep. Maloney and i will now yield time to the member from the great state of north carolina, dr. Fox. I welcome you to your first hearing as active chairwoman, and look forward to working with you and your new role. I committed to continuing in that spirit. I want to save my sympathy goes out to any woman who feels she must seek an abortion. It must be a horrible situation to be in. I will admit i am perplexed by the scope of the hearing. My colleagues on the other side are quick to assert that roe v. Wade is the law of the land. Allows states to implement abortion restrictions, even ones that apply during the first trimester. States are grappling with issues of how to defend and preserve lives and support standards for Womens Health care. As states continue to explore ways to do so, in recent years, we are at a reflection point. After the governor of virginias horrific comments, there has been a National Outcry over the apathy shown by the proabortion Movement Towards babies that have been born after an abortion. This issue has been close to my heart and the hearts of millions of americans. I am going to quote the governor. If a mother is in labor, the infant would be kept comfortable. The infant would be resuscitated if that is what the mother and family desire. Then a discussion would ensure. Governor northam does not stand alone in this appalling stance. He echoes a planned parenthood support who expressed for leaving a abortion survivor on the table to die, if that is what is decided. In new york, the Reproductive Health act removes protections for children born during an abortion attempt, leaving them at the mercy of the abortionist who just minutes earlier was trying to kill them. Illinois has enacted a law that revealed the illinois partial ban act, removes licensing requirements for abortion facilities. Other states, massachusetts and virginia, having proposed legislation equally as alarming. Only two thirds of the state have any laws to protect infants who survive abortion and enshrined there right to life into law enshrine their right to life into law. I hardly find anyone is losing access to anything, anyone save the unborn. They are the ones having their rights deprived, and the American People find this intolerable. I find it to be an abomination. The pendulum in the states is not swinging against women, not in the slightest. Some of my colleagues used to espouse the idea that abortion should be safe, legal, and rare. They espouse it no longer. Instead, on demand access to abortion after birth is the new mantra. The fact that extremists wants to keep this everexpanding restriction on the right to life buttressed against babies born outside the womb, this should be a wakeup cal. Wakeup call. I call on Speaker Pelosi against the to support the born alive babies protection act. Life is sacred. The regard with which we hold it is what defines who we are as a society. We live in a society that mistakes choice for liberty and denies the dignity of unborn life. The beauty of living in a free country is we can use our liberty for love. We must put love into action every day, affirming the value of life at all stages, no matter the difficulties it presents. Starting to love daily is not easy, yet it is the greatest exercise of our freedom, and there is no life unworthy of that love. I yield back. Thank you. I will briefly yield to congressman clay to introduce his constituent. Rep. Clay i am happy to introduce to the committee one of my distinguished constituents, a highly skilled position who has dedicated her life to providing Exceptional Health care for all women, the chief medical officer of planned parenthood of the st. Louis region in southwest missouri. As aas also served distinguished assistant professor of obstetrics and gynecology at Washington University of medicine in st. Louis. The doctor is also a champion for Closing Health care disparities like high maternal and infant mortality rates that affect minority and low income patients, most because of a lack of access to basic medical care. The doctor performs her duties with skill and compassion. She is a compassionate healer who fiercely defends her patients rights, and their privacy as well. She is a warrior for access to Quality Health care for women, not just in st. Louis, but across missouri and across the nation as well. Welcome, doctor. I peeled back. Yield back. We are also joined by jennifer from st. Louis, missouri. She was holding that beautiful baby girl. Andre joined by president chief executive officer of the National Womens law center. And founder and president , chief executive officer in our own voice, National Black womens reproductive justice agenda. If you would all please rise and raise your right hand, i will begin to swear you in. Raise your right hand. Do you swear to a firm the testimony you are about to get is the truth, the whole truth, and nothing but the truth, so help you god . Let the record show the witnesses answered in the affirmative. Thank you, and please be seated. The microphones are sensitive, so please speak directly into them. Without objection, your written statement will be made part of the record. You are recognized for your Opening Statement. Good afternoon acting chairwoman maloney and members of this committee. I am a mother of three living children, and i am here today with my three month old and husband. I am a Small Business owner, a white, and missouri a wife, and a missourian. I am here to share with you as someone in need of an abortion how difficult my home state of missouri makes it for pregnant people to access abortion. Imagined i never would have to navigate when learning the most devastating news of our life. It was in the same breath i learned my pregnancy had a fatal fetal diagnosis, that my home state of missouri would insert itself in the middle of my grief. I searched for answers everywhere, yet we found no solace. Stillborn,r is not would be born into a life of immediate and repeated invasive medical intervention. She would have essentially have been born onto life support. With broken hearts, we knew the greatest act of love that we could undertake as her parents would be to suffer ourselves instead, to end the pregnancy, grant her peace, and spare her tiny broken body a short life full of pain. We had made our decision, and we are still grappling with the reality of it. There was little time to spare. Missourians like me who speak for abortion are confronted with a litany of restrictions, including waiting periods, public and private insurance bans and more. This means i move at the direction of the government. My doctors Catholic Hospital where i delivered my two older children refused me care. We had to pay thousands of dollars out of pocket because of the states insurance ban against abortion coverage. Perhaps most surprising, our procedure was rushed due to the states consent and mandatory delay laws. Despite how difficult it was to access the care i needed, my actual abortion procedure was the most Compassionate Care i received from a physician. Jake and i left that day knowing we made the most merciful choice for our daughter. I thought after the procedure, my family could begin to heal privately. I never imagined watching the state of the union and hearing the president referred to women like me, women who had abortions later in pregnancy, as programmers. As murderers. I never found the government the governor would weaponize this issue. My story doesr, not give anyone the right to make judgments about good and bad reasons for abortion. A fetal diagnosis was my reason, but nobody should have to explain themselves or compare their stories to justify a deeply personal decision. I tell my story knowing i am a woman of privilege with means to access the care i needed, despite a complicated landscape of laws. Women of color face racist and discriminatory policies carry the heaviest burdens. Politicians like Governor Parson are focused on finishing off what remains of Reproductive Health care in my state. Members of congress, i urge you to remember who you represent. I am the one in four women who will have an abortion in their lifetime. You have the power to change a broken system working against us. I ask you work in our best interests. I am not asking you to condone my choice. I am begging lawmakers like you to allow families to make the choice for themselves. I speak for libby. It is an honor to share her name with this committee and the country today. Libby. I have a rose tattoo above my heart so that she was with me every day. I am her mother. She is my daughter and will always be my daughter. I make decisions from day one as her mother. I made the most important decision of libbys life when we decided to terminate the pregnancy. It was a sacred, painful, personal decision. That is our story, unique to our family, and one that never should have included any politician. Thank you for your time. Thank you for sharing your story. Thinking active chairwoman thank you active chairwoman maloney. Thank you for the kind introduction. Ob gyn incticing missouri. Chief acting officer of planned parenthood in missouri. For more than a decade, i have been honored with the trust of patients seeking a Broad Spectrum of reproductive services, including abortion. There is only one Health Center left in missouri that provides abortion to meet the needs of 1. 1 million women of reproductive age in my state. Planned parenthoods Reproductive Health services in st. Louis. I am here today because if Governor Parson and Health Director williams get their way, missouri could soon become the first state since roe v. Wade without a single Health Center that provides abortion care. I want to tell you the dangers we face when state officials abuse their power and disregard patients lives to pursue a physical agenda patients lives to pursue a political agenda. Restriction after restriction range from long waiting periods to insurance bans in an deliberate attempt to end Abortion Access. Over the last 30 years, missouri has gone from nearly 30 clinics to one clinic today. Earlier this year, Governor Parsons signed one of the most restrictive abortion bans in the country, banning abortion as early as eight weeks, and altogether if roe were overruled. Fortunately that ban, for now, is blocked in the courts. Unable to get the job done through legislation, the Parsons Administration weaponize the process with an iced the process weaponized the process. Officials admitted under oath they selected planned parenthood for extra scrutiny. They came to our clinic five times in the first five months of this year. Theye htey can conceded hospitals performing much riskier procedures went without a single inspection. The Department Also admitted to keeping a spreadsheet of my patients menstrual cycles, a misuse of data motivated by an agenda to find something, anything they could use to justify further scrutiny. As shocking as that sounds, more egregious was director william interpretation that forced patients to go through multiple pelvic exams. My colleagues could not force patients to take their clothes off unnecessarily and injure and endure a statemandated vaginal exam. The department relented due to public outcry. That confirms there was no real medical reason for the exam. Missourians want to believe state officials charged with protecting Public Health have the best interests in mind. They want to trust that when they go to the doctor, their private medical information will not be mined as part of a political fishing expedition. Governor parsons and director theiams repeatedly violated trust of the community to push a political agenda. It is not just missouri. Antiabortion politicians in other states refuse to license abortion facilities, simply because they do not agree with the health care that is provided there. This year alone, 12 states have enacted 25 different abortion bans. That is on top of the nearly 500 abortion restrictions enacted in the state since 2011. This obsession with abortion has not only proved detrimental to our patients, but has lasting effects on health of an entire community. While missouri goes to incredible lengths to ban abortion, Maternal Mortality is rising. Black women are dying in pregnancy at three times the rate of white women. Displaying this and other serious Public Health crises, antiabortion politicians continue to divert precious resources to the overregulation of Abortion Providers. In missouri, despite the unrelenting attempts on Reproductive Health care, our doors remain open, for now. Planned parenthood will continue to work of ensuring every patient that wants an abortion is able to access care with dignity and respect consistent with their values, despite this possible landscape. In my exam room, abortion is not political, it is simply health care. It is time we listen to the majority of americans and end this rampant abuse of power and keep abortion safe, legal, and accessible. Rep. Maloney thank you for your work and testimony today. I am now going to recognize fatima. Thank you acting chairwoman maloney and members of the committee. Thank you for the invitation to testify today, especially on this first hearing following congressmen coming congressman cummings passing. I am president and ceo at the National Womens law center. We know access to abortion is vital to gender justice. Access to abortion is a key part of the persons liberty and Economic Security, and everyone, no matter where they live or financial needs, should have access to abortion. Sent, thereme court ability of women to participate in the economic and social life of this nation has been facilitated by their ability to control their reproductive lives. We note legislation passion now legislation k passing restrictions on abortion would limit we are on the eve of the hundredth anniversary of the 19th amendment. The fight to secure the vote was symbolic of a broad societal change regarding womens ability to be politically equal and make politically independent decisions. Now there is a Broader Movement in this country that will transform the relationship between gender and power. It is against this backdrop we must view missouris legislative efforts to shut down the states last abortion clinic. Missouri is not the only or even the first state to speak to end abortion, but what is unique are the types of abortion bills being passed. Before this year, bans on abortion presented a direct challenge to roe, banning an abortion two weeks before and missed period, were typically seen as too radical, even by many antiabortion advocates. What is unique is the state sayslatures willingness to why they are presenting these measures, giving the Supreme Court an opportunity to overturn roe v. Wade. These legislators believe between President Trump and Vice President pence and the newly constituted Supreme Court, that their goal will be realized. During his first campaign, President Trump promised some form of punishment for women who have abortions, and he would automatically overturn roe v. Wade. In the three years trump has been in power, he reshaped our judiciary in shocking terms. It i disturbings that earlier this year the district of health a louisiana upheld a lawsiana law similar to a struck down in 2016. Courtremee the supreme just agreed to review this decision. This should be an easy decision. Nothing relevant has changed in the last three years, except the composition of the Supreme Court. It does nothing to make abortion safer. Intendedsuch laws are to close clinics. They have done just that. The resulting shortage of Abortion Providers has led to longer waiting times, increased travels to clinics, which result in increased costs, hotel stays, additional childcare expenses, more time off work when people dont have it, and getting delays in the care they are seeking. These compound the other restrictions already in place, including restrictions on Insurance Coverage of abortion, intended to make abortion and accessible. These politicians are not representative of the will of the people. In the wake of these extreme abortion bans, public sentiment showed people flooded the streets this past summer to protest these laws in the middle of the week. As president of an organization that fights for gender justice care, ils, work, health have a birds eye view of how these fights are connected. The same misogyny driving these abortion bans drives much of the opposition we are seeing in other gender justice battles. That is why at this moment of reckoning on the constitutional right to abortion, we need congress to lead. They can start by passing laws such as the Womens Health protection act. Thank you. Rep. Maloney thank you so much. Thank chairwoman maloney and ranking chair member jordan for the opportunity to appear before the committee. Podcast host, a a wife, and a mom. I spent the last few years studying the proabortion movement, showing the radicalization and speaking out of the injustice occurring on the state and federal levels against preborn children and their mothers. Im here today as a mom fighting for a future for their kids in which rights are dependent upon their humanity. I believe female empowerment, equality, and freedom are not defined by her ability to terminate the life of a child. I am here afraid for the fate of a country that no longer considers the right to life a prerequisite for the pursuit of happiness. It is surreal to be here, and not because i am testifying before congress, but because of the subject at hand. It is incumbent principal we are having a debate whether is incomprehensible that we are having a debate whether it is ok to kill a baby before they are born. I want to remind the committee of the true victims of radical legislation, preborn babies. There was a time when you could claim ignorance at the justification for allowing abortion. Only a few decades ago, we knew little about preborn babies in early stages of development. It seems appropriate to some to deem abortion an issue of bodily autonomy. Even then the model was safe, legal, and rare. Proabortion advocates have abandoned these qualifications in favor of ondemand for any reason. Barbaric laws in new york and virginia aim to codify that codify unrestricted access to abortion. Science and technology have advanced. We know that a babys heart begins to beat as early as six weeks. The child can feel pain halfway through the pregnancy. Babies born as early as 21 weeks gestation have survived outside of the womb. By 24 weeks, a fetus has a significant probability of surviving if born premature. Babies at this age have received lifesaving treatments for spina bifida. Any woman that has been pregnant knows the undeniable humanity of their preborn babies. I was shocked to see my daughter in the womb at 11. 5 weeks, kicking and flipping around. 11. 5 weeks is still the first trimester. Embryology tells us from conception a baby is a human being with distinct dna, yet abortion advocates have doubled down on their efforts. Many members of the socalled party of science insist on referring to preborn children as cells. Speaking of abortion, as defenders ignore the existence of the child entirely, terms like autonomy and womens empowerment of scare the reality that the life inside the moms body is a human, her baby. If abortion were a truly winning issue for women, a moral good, this deception would not be necessary. Abortion advocates know using accurate terminology is not effective pr, and does not make for a profitable business model. Lateterm abortions are performed by acting the uterus of emptying the uterus of amniotic fluid. There are other more grotesque methods utilized. Members have testified to congress about the neglect of babies who survived abortion. Virginia Governor Ralph Northam declared a baby who survives an abortion would be delivered and resuscitated if that is what the mother and family desired. Tragic, prolifers should not be surprised by prochoice radicalism. This is the end of the logic of the proabortion case. There is no argument for abortion that does not apply to people that are born. America is included on the list of seven countries to allow abortion after 20 weeks gestation. The same legislators who are proabortion were happy to vote yes on the bill criminalizing animal cruelty on the federal level. I wish the same basic compassion could be extended to the most vulnerable members of our own species. Thank you. Rep. Maloney thank you very much. Honorable members of the committee, thank you for the opportunity to testify at todays hearing. I would like to take a moment to mour the passing ofn chairman cummings, a fearless champion of civil rights. We promise to pick up his mental and continue his fight for universal justice. I am founder and president of in her own voice womens reproduction agenda, a state partnership with black womens reproductive justice organizations. Black women for wellness, black Womens Health imperative, new voices for reproductive justice, sister love, sister reach, spark reproductive justice now, and women with a vision. Reproductive justice is a human right to control our bodies, our sexuality, our gender, our work, and our reproduction. That right can only be achieved when all people have the complete economic, social, political power and resources to make healthy decisions about our bodies and families and communities. This includes the right to choose if, when, and how to start a family. When it comes to abortion, we focused specifically on access rather than rights, asserting the legal right to abortion is meaningless for pregnant people when they cannot access such care due to the cost, distance to the nearest provider, or other obstacles. Faced the country, we are with the ever complicated wave of abortion restrictions that continue to compound already existing barriers, making access to quality abortion care a privilege for the few rather than a human right for all. After the 1973 landmark roe v wade decision, the Supreme Court victory was immediately undermined and invalidated for people with low incomes with the passage of the height amendment. Hyde amendment. Because of social and economic inequality linked to systemic racism and discrimination, women of color are disproportionately likely to be injured through medicaid. Be insured through medicaid, therefore subject to the hyde amendments ban on abortion. The decision when to start or grow a family is a decision that should be made by a person and those they trust, not politicians. Over the last decades, Abortion Access in the u. S. Has become increasingly fraught with restrictive laws. Such abortion restrictions include everything from parental consent laws for individuals under 18, often course is mandated counseling coercive mandated counseling, and burdensome regulations on providers and clinics. This web of restrictions and bans ultimately created an unjust landscape. As the country grapples with the Maternal Mortality crisis, one that disproportionately impacts black women, research has found that the states with the higher numbers of abortion restrictions are the exact same states that have poorer Maternal Health outcomes. That is not a coincidence. Reproductive justice is economic justice. One reason People Choose to have an abortion is because of the significant expense of having and raising another child, given that many are already apparents. Already parents. We cannot afford to injure to endure another abortion ban, because we experience discrimination, low wages, debilitating Childcare Costs and threats to our Voting Rights. These issues cannot be separated. Together, they are an attack to live with full agency and raise our children with dignity. I thank the committee for its dedication to addressing these and valuing the experiences of underserved communities, pacific islanders, transgender nonbinary people, lgbtq people, people with low income, people in rural communities, those with disabilities, youth, and immigrants. I explicitly name us all, because all of our struggles are tied together. Many of us live at the margins of multiple oppressed identities. I urge the committee to address these abortion restrictions with urgency as we collectively work toward bodily autonomy and a world where for reproductive justice can be actualized. Full reproductive justice can be actualized. Rep. Maloney without objection, the following numbers are me mbers are authorized to participate in todays hearing. Now call to begin the questioning. He is the originator of this hearing. You fory let me thank convening this hearing to call attention to the obtrusive restrictions on the wellbeing of thousands of women in my congressional district. In missouri, we are down to one last abortion clinic. State Health Officials are doing everything in their power to try to shut the clinic down. They are trying to regulate missouris last clinic out of existence by proposing regulations that are medically unnecessary, overly intrusive, or virtually impossible for any Health Care Provider to comply with. Doctorheard the explained, the Health Department begin enforcing a medically unnecessary requirement that women submit to an additional pelvic exam three days before allowing before being allowed to have an abortion. Any physician, is there medical reason fo suchr a requirement . Thank you for the question. Forcingviously stated, women to undergo medically unnecessary pelvic exams shows clear disregard for the potential traumatic impact that has. We are talking about a country where, every 73 seconds, an american is victimized with sexual assault. That rape is 12 times higher for women with intellectual disabilities. Within days of having to comply with the mandate, we saw a minor accompanied by her mom who was a victim of sexual assault, who has never had a public exam before, who didnt even know what her parts were. As a reminder for those who never had a pelvic exam, that means putting your fingers inside someones vagina, forcing someone this minor, never having had a pelvic exam, to have that invasive procedure when there was no medically relevant reason to do so, was traumatic for her, her mother, and for the physician required to do it. Clay how did that make you and your staff feel . In the times we had to comply, im not sure who cried staff,he physicians, the the patients. We had patients apologizing to us that we were forced to do this to them. Our patients are accustomed to jump into to get an abortion. To get through hoops an abortion. They were resigned that this was part of the deal. Rep. Clay just weeks ago, we learned state staff were ordered to keep a spreadsheet tracking the menstrual cycles of women that visited st. Louiss planned parenthood clinic. Doctor, do you find the practice of tracking the dates of patients periods problematic . I find it bizarre and a violation of the trust the community puts in the Public Health department. It was clearly part of an orchestrated attack on planned parenthood, and really demonstrates an abuse of power and misuse of data. What do you make of the fact that a trained physician has imposed these intrusive requirements on providers and patients . It is shocking our department of health is head by a physician, and more shocking is he is a ob gyn. He knows better, but instead of relying on the medical ethics he was taught and Patient Experiences over his career, he instead decided his job was to act on the behest of the politician to end abortion as part of a political agenda and forgetting to treat patients. Rep. Clay what would it mean for patients in missouri if your clinic closes . Dr. Mcnicholas the consequence people will be forced to carry pregnancies they shouldnt and dont want to, continuing the cycle of poverty for some. Many will be forced to travel forced to travel long distances, expending resources they dont have to access that care. People will have lost the trust they have in the state of missouri, who have been advocated its sensitivity to providing basic health care. Rep. Clay thank you for your response. I thank the panel for being here today. I yield back. Rep. Maloney i will now recognize representative roy. Roy in 2015, i got a call from a young woman who was one of my dearest friends. She said the baby in her belly, her third, might be missing part of his brain. She was terrified and couldnt ask questions fast enough. Her husband had to work, but she took her two boys with her. The checkups were usually routine. She went into the appointment expecting her doctor to reassure her. The doctor looked her straight in the eye and asked if she wanted to terminate the pregnancy. She called us after the appointment, terrified. Terminate . The question with the same tone of ordering a copy at starbucks. She asked without her husband there. It was cold. The doctor told her she had to decide quickly, because she was approaching 22 weeks, which is as long as you can take legally in virginia. She told us she almost laughed and publicly responded termination was not an option. She walked out of the Doctors Office and never returned. Her ultrasound was completely normal at 24 weeks. They could not get a good read at her 20 week appointment. 15r baby was born in may 20 and was healthy. He is my godsend. In the winter of 1996, a couple went in for a checkup. They were informed they had twins. The doctor performed more tests. The doctor returned. The doctor seemed concerned, as they believe the twins had cystic fibrosis. They would only survive for a few hours, they were told. The couple said the first thing that came into their mind, no, and walked out. They chose life. Those twins grew up to become excellent men. I know this because jonah works for me. He is one of my staffers. Planned parenthood is not about health care, it is about abortion, no . Planned parenthood took in 1. 67 billion in revenue, a 14 increase the year before. Does that sound right to you . Yes. Togovernment funded amount 563 million. Planned parenthood received 60 million under title 10. 2019, planned parenthood confirmed they would withdraw from title x funding rather than comply with the new rule. Does that sound right . Yes. Do we need planned parenthood for health care for women . Planned parenthood is not in the business of health care, they are in the business of abortion, by refusing title x cap. They could have financially and physically separated their Abortion Services from the rest of their Health Care Services, but they refused. They decided abortionists whosel to their mission, ceo was ousted because she did not prioritize abortion high enough. 5 in texas, we have 43 federally qualified Health Centers. There are 327 Pregnancy Centers, 130 of which are medical Pregnancy Centers. According to the planned parenthood website, there are 40 planned Parenthood Centers in texas. Does texas provide Health Care Solutions for women . Yes. I am from texas as well. Texas program was established in 2016 helping women in texas with more providers and planned parenthood. In fy 2018, helping women served 172,000 clients. In 2018, planned parenthood served only 83,000 patients. Does that sound right . Yes. I my point is simply this, cant speak to the other 49 create we should entities and allow the market to thrive. If we can get a Healthy Health care system, we can get more options. Could you please share your view of the ways in which we can provide Better Health care than allowing planned parenthood, which throws babies in garbage bags, to be the center of health care for women . Abortion is not health care. That is all i have time for. Rep. Maloney chernow recognizes chair now recognizes congresswoman norton. Norton what kind of Health Services do you provide . Dr. Mcnicholas planned parenthood provides a Broad Spectrum of Reproductive Health Care Services, including cancer l spectrum ofhe ful Birth Control options, transgender care, primary care. Some planned parenthoods provide prenatal care. Provide thelike you kind of acrosstheboard care. Hat a young woman may need one stop fits all. Dr. Mcnicholas the goal is to meet the patients needs and the Community Needs and to make sure it is accessible to them. Rep. Norton i have a question. Perhaps i should start with ms. Graves. I represent 700,000 residents. They pay the highest federal taxes, a littleknown fact. Highest federal taxes per capita in the United States. We are trying to make the district of columbia the 51st state. When you look at where there are care, you into health will find that there are federal bans that include federal employees, federal prisoners. Included on thisincluded on thiw income residents of the district of columbia. Our jurisdiction wants to provide on their own pay for Abortion Services for low income women the way almost 20 states already do. We are not demanding the federal government does this. Question is why we are finding that restrictions on coverage are related to economic mobility for women, on coverage for abortion and other such services. Apparently there is a correlation not only for women generally, but especially for women of color. So why do restrictions on abortion relate to economic mobility . Why are they correlated in that way . Dr. Mcnicholas i very much appreciate you raising the issue as a resident of the district that lacks the Voting Rights you describe. Often times there is a deep focus on the levels of restrictions in places like missouri, but even in the district, because of restrictions on insurance. For low income women in particular, what that means is that abortion is inaccessible and unavailable, and having to scrap together the money to be able to afford it is not possible. What it also means is for the lks, thenerable of fo right to abortion does not feel meaningful. That connection between the ability to have Economic Security for yourself and for your family is deeply tied to your ability to access the health care you need. This is a travesty that is deeply felt by people who live part becauseict, in of restrictions on medicaid, but you also see it show up in medical insurance. So many people here are also working for the federal government. Rep. Norton you can see there are many reasons why the district of columbia wants to become the 51st state. I want to say to my republican colleagues, whose mantra is we want government out of our business my friends on the other side of the aisle vote against government doing things which the American People want government to do. All the district of columbia is asking is you get out of their business so that we can deal with our business alone. I yield back. The chair recognizes my friend yields her 20 seconds. Norton . Would you yield . I just want to give dr. Mcnic holas an opportunity. It is a stunning statement that planned parenthood is not in the business of health care. Dr. Mcnicholas abortion is health care. The best way to demonstrate is to share the story of a patient unable tohen when express an abortion, died because conditions worsened. A patient from outofstate visited my clinic for a consultation after understanding that her current medical condition would worsen with pregnancy. She returned to her outofstate home, having to wait the mandated amount of time between those visits before she can receive that care. When she didnt return and we called to follow up, we were later told she passed away from competitions of her prepregnancy medical condition. This is the definition of why abortion is needed and necessary when they need it aware people live. Rep. Maloney thank you very much. Earlier this year, governor Northern Virginia said if a mother is in labor, the infant would be delivered, the infant would be kept comfortable, the infant would be resuscitated if that is what the family desired, then a discussion with ensue. Do you support governor northerns comments . Dr. Mcnicholas i cant speak for governor northam. I can say there is no way to oversimplify the medical conditions in which people present in the second trimester that i think he was referring to. So as a physician int would be the harm legislation such as the born alive abortion survivors act to make sure a child born alive would not be put to death . Dr. Mcnicholas there are several harms. Using that line which and percussion reading the notion that is a real thing and perpetuating the notion that is a real thing only serves two purposes. One is to shame people that need lifesaving care in the trimesters of pregnancy. It also creates an environment in which Abortion Providers like myself are targeted and harassed. First and foremost, it is dangerous for those reasons. The second is because medicine is complicated. There really is no way for me to boil down more than a decade of education and practice to give you a single reason why doing such things is harmful to patients. Rep. Foxx the answer should have been yes or no. Thousands of fetal remains were found in the home of a deceased abortionist. Do you believe that all fetal remains should be disposed of in a manner that treats them with dignity and respect . Dr. Mcnicholas just like i believe patients are capable of making a decision to continue their pregnancy or not, i believe patients are capable of deciding what happens to the remains of the pregnancy. Rep. Foxx is it ok for those fetal remains to be sold for profit by planned parenthood . Dr. Mcnicholas planned parenthood has never sold fetal tissue and never has. Rep. Foxx does planned parenthood give states the authority to regulate abortion in accordance with the opinion of the respective constituencies . Dr. Mcnicholas i believe the wholeecent decision in Womens Health set a precedent that restrictions must be grounded in science. That is what we are asking for, that abortion is treated to the medical standards and evidence in science. Rep. Foxx are there more federally qualified health inters than abortion clinics the United States . Yes. The ratio is 26 to 1 of Health Care Centers federally funded to planned parenthoods. Rep. Foxx which offers more comprehensive services to women . The ones that are not planned parenthood. Rep. Foxx if we want access to comprehensive Health Services for women, would we be better off supporting abortion clinics or federally qualified Health Care Centers . Federally qualified Health Care Centers. Rep. Foxx thank you. A planneda 2005, parenthood study found a baby would interfere with education and work, or would not want to be a single mother what are your thoughts on the findings of this study . It belies this notion that abortion is used only in extreme cases, that extreme rare cases are typically used to cast prolifers into an extremist radical misogynist light, which is not accurate. The majority of abortions, according to planned parenthood, is done on the basis of convenience. I dont see a logical justification for killing an unborn child on the basis of simply not being wanted. Rep. Foxx thank you. Mcnicchair, earlier dr. Holas said director williams had taken an ethics oath, and should know to do better. I want to quote from the classic hippocratic of. Oath. I will use the regimes that benefit my patients and i will do no harm or injustice to them. I will not give a lethal drug to anyone if i am asked, nor will i advised such a plan, and i will not cause an abortion. Did you swear a hippocratic oath . Dr. Mcnicholas i did, and i continue to live that every day. Rep. Foxx amazing. I would like to enter into the record this article. I yield back. Rep. Maloney the chair now recognizes representative lynch. Lynch thank you for holding this hearing. To the gentleman from missouri, thank you for your leadership. I want to thank the women here today for your willingness and your courage to come before this committee to share your own experience, and all of you for sharing your perspectives. As i noted in my oped in the boston globe when this state legislation arose, in missouri, alabama, georgia, legislatures have adopted draconian measures on abortion. Alabama has banned abortion at any stage of pregnancy, apparently even in the case of rape or interest, while several other states have banned abortions as early as six weeks , which has some witnesses noted, is often before many women know they are pregnant. In georgia, a woman terminating a pregnancy after six weeks could be charged with homicide. These laws are far more punitive than those in place before the roe v. Wade decision. They are so intrusive and restrictive that the core constitutional right to privacy be effectively and totally eliminated. Meanwhile, other states are actively considering similar restrictive measures. This all occurs against a backdrop in which republicans in congress have repeatedly attempted to eliminate womens access to contraceptive services, often by groups such as planned parenthood. Ironically, even though those contraceptive services actually prevent unwanted pregnancies, and thereby reduce the number of unwanted pregnancies and abortions. They would also be cutting off expectant mothers, especially those in low income areas who rely on these services for the prenatal and postnatal care to have safe and healthy pregnancies. It is to be noted that to be prolife includes supporting the life of another women. Simply opposing abortion does not make you prolife. The Supreme Courts decision on reproductive rights have sought to balance the constitutional interests at stake on this issue. While critics abound, the number of abortions that are performed in the United States each year has dropped dramatically. That is largely due to the impact of effective and widely available contraception, Family Planning, and education. Women are and should be in charge of the Reproductive Health, and their efforts to reduce unwanted pregnancies are actually working, on which leads many to believe the timing of this multistate Campaign Reveal a purely political strategy to energize and motivate the religious right. That is truly shameful. While i am personally informed by my faith, my actions as a legislator must be in support of and defense of the constitution. That is the oath that i took, and i stand by it. As i said in may, if these recent developments, closing all clinics, obstruction, denying women every option, denying women every option in Health Care Decisions, if this defines the new prolife movement, you can count me out. I have one question for either counsel grades or miss howell. Thank you for your kind words regarding mr. Cummings. There are millions of women each year and miss mcnicholas, dr. Missed dr. Mcnicholas, you might have some input. If we have millions of women who come to planned parenthood and yet, theviders and government steps in test to deny funding, and this came to the floor this actually came to the floor and the republicans were in control of the house. They proposed to zero out any federal funding for planned parenthood to carry on its contraceptive services. What would the impact on the abortion rate be the rate of unwanted pregnancies and the abortion rate if the measure had been implemented . So i think you raise a very important point, which is, one of the best strategies we have to reduce unintended poignancy is actually multilayered. It is first, improving the sexual education we provide to our young children. Helping them know how their body works, and being very positive about understanding how sex works and how you get pregnant. Themdly, it is providing access to the available contraceptive method of their choice when they need it and without barriers. Included going to a clinic in their neighborhood, making sure it is affordable for them, and making sure they can change that method as often as they need to when their history or preference changes. Do you want to add to that . Actually go to planned parenthood for a number of different Health Care Services. They go not only for birth testsl, but also to have for diabetes, for mammogram screenings. A lot of the people we represent and we work with go to planned parenthood clinics as they are primary providers. They thinkervices are vital to them because people are opposed to the fact that some planned parenthoods also do abortions means that you are cutting off health care for people who most desperately need it. Thank you. The only thing i would add it is a Good Opportunity for me to correct something she said about planned parenthood. Wanted parenthood did not to do right by its patients. It was not going to lie to them. It was not going to misinform them. The idea we are now in a situation where providers are being forced to make that decision about whether or not they can continue to serve the lowest income population in communities is really terrible. Patients are going to suffer for it. Thank you very much. The yield back. I yield back. That the georgie harpy bo would not imprison women who had an abortion. Thank you, madam chair. Dr. Mcnicholas, what is the medical consensus for age of viability for a fetus . Viability is a complicated medical construct. There is no particular gestational age. There is some princis in which a fetus will never be viable. There are a number of factors we are taking about when we consider if a pregnancy is or is not viable. Is there a legal consensus on the age of viability . Not to my understanding. I am a physician. Not a lawyer. In your 10 years as a doctor, how many abortions have you performed . I provide a variety of services. You not providing i have had a long career of taking care of people. Or you aretell me the medical overseer. Can you tell many how many abortions the facility in missouri performs each week . I believe it is publicly available i can give. You a rough. Estimate how many abortions we perform a year. Roughly around 3000. Have you dispose of 3000 fetus is . State law that a requires we send the remains to pathology. What is the latest term abortion you have performed . My practice includes the provision of abortion up until the point of viability. Give me the number in weeks. I do not know. You do not remember the number of weeks . That is correct. What about size of the unborn baby . Do you know the largest baby you have aborted . I am not sure how i would even quantify that . If i use the word fetus you have no idea the age or of the fetusiod you are aborting . My practice includes abortion care through the point of viability. As we discussed let me put it this way. Is there any point of gestation beyond which you personally would not abort a fetus . Medicine is not black and white. I recognize in my 10 years of practice informs this opinion that pregnancy can be really complicated. Given there are pregnancies for which a fetus may never be viable, i think it is important we allow physicians and patients to have every medical resource to make decisions that are appropriate for them. In the absence of a law preventing, would you probe or a would you abort a viable fetus . Every patient is different. I am asking about a viable fetus. Would you consider it a limitation morally for you to abort a viable fetus . I think you are forgetting there are number of reasons. At your clinic, does it matter what the reason is . At my clinic, i trust that women have a valid reason, every reason they have is valid. Given that you think every reason is valid, would you abort a viable fetus if there was not a low preventing it . Reality, given that the for people choosing abortion as there are many reasons, there is not a single thing that defined somebodys choice. You seem to have a hard time saying this. This tells me you have a heart or you know that people watching this have a heart. They would be concerned if you would just admit, which you will not admit, that you would abort a viable fetus for any reason if the law did not prevent it. Abortion is moral it is important. It is health care. I support people being experts in their own lives in making decisions for themselves. That gives me some hope here understand that people do not support you if you would say you would abort a viable fetus for any reason. Given what you told us in your Opening Statement, and knowing what you have said, we know that you would. It does give me hope that you still know in your heart that is wrong. Can i respond to that . If you would answer my question, you could. My will not, so i will use remaining time asking mr. Stuckey, should any reason asking mr. Stuckey, should any reason be a good reason for having a abortion . From is a life in the womb any point. I am troubled by her saying there are 3000 abortions performed every year. The remark that abortion is moral time has expired. The time has expired. I recognize you gave the others over two minutes over, mr. Chairman. We need to be fair on both sides of the aisle. You want to finish . Inish your answer go ahead. I do not understand the illogic of saying that killing a child inside the womb is moral. In what other situation besides when a child is defenseless we call killing Someone Health care or moral . Can anyone on the proabortion side a situation outside of the defenseless child inside the womb in which it is morally justifiable to kill someone because they are not wanted . That is the answer i would like. That is the question i have. I do not think anyone is able to answer it. I recognize the gentlewoman from illinois for five minutes. Thank you for this hearing. Our republican colleagues have suggested earlier restrictions on abortion have become necessary because advances in medicine are moving the point of viability earlier. I am interested in hearing your thoughts on this point. , as i previously alluded to, viability is not an easy thing to assess. Inrequires knowledge multiple things about any individuals painted teaching thank you for clarifying. I want to thank the witnesses for being here. Thank you for sharing your story with us. I want to let you know i was a proud board member of planned member planned parenthood in pay area. Of illinoisy state is an oasis in the sand. You say you want to see the same basic compassion. I wanted to see the same basic compassion for Maternal Mortality. I had to water down the bill i had because the compassionate republicans, not one, would sign onto the bill to extend the decayed. We have not been able to get a gun violence prevention bill passed because we do not have the same basic compassion once the unborn fetus comes a baby and they grow up. We do not seem to have compassion in the area. We do not have the same compassion when it comes to feeding our young people. We do not seem to care about that. We are looking at cutting back so 500,000 people do not have the food they had. Where is the compassion once you are born . That is the question i have. Thank you for bringing up these points because i agree we should have compassion from the womb to the tomb. It is not there. I do not necessarily agree with all of your legislative solutions. I do believe the private sector does a much better job. Your premise is that these is that these things are mutually exclusive. You never heard me. I am just saying you are saying we are violently murdering, but there are a lot of kids being murdered every day. Why cant we hear about both . Reclaiming my time. Of manager county and measures of Truck Company in the illinois Reproductive Health act ensures coverage for abortion care and updates clinic regulations to lift the abortion provided. How does limiting coverage bands improve access to abortion care for women who are working to make ends meet . Will mean the right to abortion will actually be a right that is accessible for women. Income. R their whether or not that right is accessible to you should not be depending on your financial means. That is not what the court says. The other thing we never talk about is, wealthier women who tend not to be women of color, they have been having abortions for a long time whether they are in red states or blue states or however they vote. Of will rolling back targets abortions provide as improved access . Here is what we know. These targeted regulations of Abortion Providers are designed shutdown clinics. There designed to shame patients. They are designed to confuse people and disrupt the doctorpatient relationship. All of that makes abortion less accessible. Rhetoric that the is surrounding it on top of the sorts of regulations and restrictions have made all of this so difficult for people who are just trying to live their lives and get the health care they need. I know from a lot of College Students they are not going to planned parenthood to get an abortion. There going for health. That is the place of choice to get health care and not for abortions. Planned parenthood is very proud to be able to provide services to people who are financially insecure and to do that in a way that serves their needs and respects their dignity. Thank you. The gentleman from georgia is recognized for five minutes. A lot of this debate and argument centers around whether or not the baby is a person or fetus. I recognize many on the others the aisle refused to recognize the baby as a baby. Refused to recognize it is a person. Been a lot of medical advances over the last several decades. Specificell us about Scientific Evidence supporting the personhood, the humanity of the baby and the viability . Childryology tells us the , from the moment of conception, as a separate dna. When we hear these euphemisms being thrown around like my body, my choice, a shows me the proabortion argument does not deal with fact. It deals with feeling. That is why we have had a hard a clearting a answer for what abortion is. Talking about tearing a child apart them by limb with forceps is not a beer is apr strategy. All i am trying to do is remind us when we are having this conversation that there are two people. I do not believe we have to pit a mother against her child for a woman to be successful. We talked about legislative solutions and showing compassion for children after they are born. I believe in that. Every prolife Pregnancy Center i have been a part of, they do not just councilwomen. They of her parenting classes. They offer help from abusive situations. They are offering programs for young women to get affordable baby clothes and things like that. Every prolife denies asian es about children in the every prolife organization cares about children. Lets not ignore the scientific reality that a baby is a baby. It is deserving of the right to life. And the way this is going on abortion in the womb. Horrified,ere virginia Governor Ralph Northam in his description of however they could be described as a post birth abortion, one of the most horrifying things i have heard in my life where the baby would sit there on the table, and we would decide what to do with it. How do you respond to this . Unfortunately, this has been a reality across the country. We do not we like to act that this is not a thing. The cdc says at least 143 these were born alive and not attended to are cared for. Only six states requires reporting. The number 143 is probably a lot higher. This is not just a degradation of children inside the womb. It is a degradation of babies in general. It is a degradation of life based on whether or not the child is wanted. In what other state of life do we decide someone gets to die because they are not wanted . Not to provoke a slippery slope fallacy, but what we have seen from governor northams statements and other statements is that it is a slope. And moral logical slope, and seems the proabortion side is sliding down quickly. It was an excellent point you brought forth that planned parenthood the majority of women have abortions because of convenience. That those findings from planned parenthood itself undermined, particularly about late term abortions, that it has something to do with the health of the mother . We can have conversations about the health of the mother in those where circumstances those rare circumstances. The vast majority of cases are for any reason whatsoever, including not wanting the child, wanting to finish school. If the proabortion side were honest, they are fine with that. They are completely open to the normalization their organizations exist to normalize abortion and destigmatize abortion. That means they believe abortion to be not only normal, but good. We are the doctors say she believes abortion is good. If you believe that a more that abortion is morally good, of course, you do not think it should be limited to the life of the mother. It is all nine months, on demand, without apology. That is the new motto. And the fact that the baby is a person. How can it be moral to kill it . I do not know what else it is if it is not a person. I recognize the gentlewoman from michigan. To be here for this hearing. This hearing should be a substantive discussion on how to expand access to care for women. I am disappointed in my republican colleagues who are using this hearing as to make such blatantly false claims. Lady who speaks in generalization, and for the record, while one side calls itself prolife, there is not a person i know who says they are proabortion. They are prochoice. Abortion are not abortions are not that is not how abortion works. This type of deceptive rhetoric is another attempt to distract from efforts to make abortion out of the reach for women and to shut down clinics. I constantly have had this debate and number of times on this panel. Spokentruths that are fullsized babies out of wounds and killing them. That is not true. Selling parts is not true. Enjoyedseems like it is to say because it paints this horrific picture. We should say the truth. Statistics. About therry to hear pain you and your family had to suffer. Thank you for bringing the beautiful baby in the room. Have you considered whether this law, that is being proposed or haved in missouri would prevented you from having an abortion if it existed two years ago . Thank you. It absolutely would have prevented me from having an abortion. At eight weeks, which is when the band that my state legislature passed, it is impossible to know of the chromosomal abnormalities. I am not the doctor here today. We did the early genetic testing because i am of advanced maternal age. Another one of my not favorite terms. Before most that women and families would find out. We found out earlier because of that. Most people would not find out until the 20 week anatomy scan. I was able to successfully get pregnant again as evidenced by my beautiful daughter who is now being quite gin being quiet. I was pregnant during the time the state legislature was enacting the ban. Ultrasound, they could not get a couple views of the heart. Physicians were not concerned. What should have been a happy day to know we were having a successful day because a poignancy is a stressful pregnancy after a field diagnosis, ended with me being hystericallybbing because they would not see me again until i was 24 weeks along. Because they were not worried. That was my next regularly scheduled appointment. In missouri, that would have been too late. But i kept saying to my husband is, what if they find something devastating . I cannot protect my daughter. I understand this is stuckey and i do not agree misses stuckey and i do not agree on things, that i would like you to remember that you are calling my husband and i mutters. Anduld ask for compassion respect when you speak about these decisions. Americans make these decisions that are difficult and personal. We deserve to be treated with respect to whether or not you condone our choice. I do not need your approval, but i would ask for your respect. I appreciate what you are saying. In the few minutes i have left, i would like to bring another issue to the table. We in this country have the highest Maternal Mortality rate of any civilized country in the world. For women to be dying to give birth in america is unacceptable. With the same energy we are making Health Decisions and decisions about our bodies, and we should, as women in america, have the same choices and have without men have without the government telling them what to do. I used a comparison because now there is discussion about Birth Control. I would love to have a debate about viagra and whether the government should regulate or restrict viagra for men. That has never been on the table. We are targeted. For us to have the same passion on a discussion about saving women who want to have their babies and this medical industry is failing us, we need to have the same passion. I yield back my time. Im going to say, we are sorry u. N. Your family had to experience you and your family had to experience what you did. Im going to recognize mr. Grossman for five minutes. A couple quick questions for dr. Mcnicholas. If someone came to you it was eight months pregnant with a healthy baby girl and said they wanted to have an abortion because they did not want another girl, would you perform that abortion . That sensationalized hypothetical is not real, and i have never had that happen. You said you perform an abortion. Or lets say, ok. Someone came in within a month pregnancy and wanted to have an abortion because they did not feel they had the time to care for the baby. I first want to reject the notion that people make decisions of continuing princi out of convenience. I have never in 10 years of taking care of in people have people reject a pregnancy because it was convenient. People presumably come to planned parenthood for contraceptive care as well. If a 14yearold or 13yearold came to you, would you give them the contraceptives . All of ourto patients about the availability of all of their contraceptive methods. Particularly for young people, we would have an indepth discussion about healthy behaviors, prevention of sexually transmitted infections, the importance of making informed decisions. If a 13yearold is sexually active, that is a serious sexual assault. You make any efforts to report the person who is engaging illegal in illegal activity with the young lady . We at planned parenthood follow all the rules and laws, so if by law, we are required to do it, we would do it. Would you make any efforts . If we are required to do it, we would do it. If you would not if you are not required to do, you would not . Talking to young people about their Sexual Health i will ask you another question. If someone comes in as a 13yearold girl and was to have an abortion, which means certainly, something illegal was done, would you probe into the anymore, or would you just do the abortion . One of the most impactful times i have with patient is discussing around issues of sexual assault. We to provide our patients the space to discuss what happened if they want to discuss that. Recognizing a can be incredibly traumatic to discuss the in. Rience. Any Health Situation i would respect whatever is comfortable for her. I will give you another question. If someone comes in and does not have the money for an abortion and says they are broke, but i went and abortion, you perform the abortion . We make every effort to take care of patients every needs regardless of their financial insecurities. As i understand it, talking to people in your industry, you will find a way to do an abortion whether the government is paying or nobody is paying, you will find the money to do the abortion. To set the record straight, government does not pay for abortions. People are navigating the complexity of paying for basic health care because the government has abdicated its responsibility. You do not turn people down. We do not turn people away. I have toward some abortion clinics. One thing that struck me it has been 20 years since i toward them they never use the word abortion. They always use the words, procedure and tissue. Do you still follow the policy in which we try to avoid using the word fetus and abortion and use the words procedure and fetus . 20 years is a long time. But you back to the clinic. Use the word fetus and abortion. I take the direction from my patients, who absolutely understand the potential life that is in their uterus. Most patients who have abortions are parents. They are well aware of the fact that what would happen if they did not have abortion, is that they would have a baby. We are out of time. Did pass the 24 hour waiting time in wisconsin. You have one in missouri . We have 72 hours. The question i have for you. It came out as part of a lawsuit in madison, wisconsin. About 10 of the women who came in the first time around did not come back a second time. It would indicate they are on the fence. Given more time, they decided not to have the abortion. Percentagewise, what percent do not come back a second time in missouri yucca i think he made an assumption about what that 10 means. My informed assessment of that would be those 10 of women really struggled to figure out a way to get back because they did not have the financial means, the secure transportation needs, the ability to navigate additional time off of work, or find somebody to watch their children while they were trying to access the care. The gentlemans time has expired. Recognize the gentleman from california, mr. Connor, for five minutes. Thank you, representative clay, for convening this hearing. Stated like to discuss and federal restrictions to Abortion Access and the disproportionate impact they have on lgbtq plus patients. Dr. Mcnicholas, a few questions for you. First, could you briefly describe the need for abortion care among the lgbtq plus community . Thank you for your question. The most basic thing people forget is that your Sexual Orientation does not define who you are having sex with. People in all of those communities they experience pregnancy may experience pregnancy. I have had the honor of taking care of many trans and career. Ry folks in my as long as you have a uterus, you have the capability of getting pregnant. If you think that accessing abortion care is stigmatizing when you present as a woman, imagine what it is as you are presenting as your male self. I appreciate you mentioning there are transgender men and nonbinary individuals who rely on Abortion Services. In 2015 when the National Center for transit Quality Survey transgender americans, 23 of respondents did not see a doctor when they needed to because of,. Ear of being mistreated as a transgender person as a doctor, can you describe sound of the challenges gender diverse patients face in accessing health care and abortion care . I have had the honor of taking care of many specifically transmitted seeking hysterectomies in their transformation process. One of the things i hear from therenequivocally is that have been tremendous delays in accessing basic care because they are afraid they will not be treated with deity or respect. The second because that is their lived experience. They have been turned down by many physicians and have been intentionally degraded with, for example, use of intentional miss jen during of the patient gendering of the patient. It is important to remember that gay and lesbian folks also want to build families. They are parents. I myself have a wife and child. I fit into that group as well. It is important they are able to access that care in a place where they feel respected and dignified. Planned parenthood is happy to be one of those places. Thank you for speaking to those issues. Turning to you, transgender people are four times more likely than the general population to live below the poverty line. Close to one in four lesbian and bisexual women in the United States live in property. Current laws prevent federal medicaid dollars from being used to cover. Abortion services out of these restrictions overlap with identity to make abortion even less accessible for the lgbtq plus community . The discrimination that people go toward, and because they are either trans or changed trans or gender nonbinary or lgbtq, really does hit them harder because as was mentioned, they are afraid to go get services. When they go to get services, they find that current regulations allow people to discriminate against them. They find they do not have any access to getting good Reproductive Health services, much less regular Health Care Services. Our organization does believe all people have the right to get Reproductive Health services regardless of whether they identify as lgbtq, whether they are trans, whether they are low income, all of these factors should be taken into account to allow them to get the kind of services they deserve. Regulations done by this government that allows other people to discriminate against them push them at higher risk. Puts them at higher risk. Those are the laws we fight against. Thank you. For your advocacy for some of the most vulnerable populations. I believe we have to consider their access to health care as we craft these levels. Cloud. Esentative thank you for being here. I appreciate you all coming to take part in discussion that is emotionally charged with deeply held beliefs of conscience on both sides of the issue. For me, the most difficult decisions we have to make as lawmakers are those in which individual rights are in conflict with each other. For me on this issue or i come down is to the whole life, liberty, and pursuit of happiness. Which rates supersede. I do believe, while having compassion for anyone who has to go through a difficult situation, that the right to toe supersedes the right liberty and the pursuit of happiness. In that context, i approach this conversation. Can you describe what happens in the process of an abortion to the baby yucca i appreciate your of an abortion to the baby . Thebortion was around for concept of life, liberty, and pursuit of happiness. The abortion procedure depends on the clinical situation. When i speak to patients about their option for terminating a painted tea, i start with, where are we in pregnancy . Can you speak to the process please . I realize it is difficult, but in medicine, things are not short. There are 100 shades of gray. It is impossible for me to take what is a 50 minute conversation with a patient and answer it in 30 seconds for you. As i approached patients, i talk to them about what their options are for princi termination. That depends on a variety of things including what stage of poignancy they are in, what have,health problems they where there any particular instances could you describe what happens in the process of an abortion . The only one, i am willing to talk about specifics. This is free online. Even planned parenthoods website describes what a dnc abortion is, which is taking out the amniotic fluid, drying it out of the fetus. Dismembering the baby them by them with forceps. Ms. Lawrence spoke to that being deceitful or hyperbolic. It is not at all. Look online, and you can see what an abortion is. We see it is not me speaking in generalities. It is the proabortion side speaking in generalities because they know the grotesque nature of what an abortion is. You do not have to be an Abortion Provider to know what an abortion is. That is why im here, to talk about the brutality of the killing of life inside a worm. I also want to address miss box. Murdererssay the term to my recollection. I do not think that me being passionate about the subject means that i disrespect you. I think we can agree or disagree even passionately without taking that as a personal slight. I did not mean it that way. I just care about life inside the room inside the womb. I have very little time left now. Mentioned, you nothing has changed since roe v. Wade besides the makeup of the Supreme Court. I want to correct you because i was talking about the Womens Health decision, which was three years ago. The case that is going to be before the court but a lot has changed. Science has developed a whole lot. Back in the 1970s, it was rare for a woman to have an ultrasound. Now, we know i hold up. We know abb can be viable at 20 weeks. We know a baby feels pain. I ask unanimous consent to fetal this peer review on pain that a baby feels during abortion. There is a lot that has happened. The scientific advances merits us looking at this. The Supreme Court did three years ago considered you mentioned a number of health inspections. Were you aware of the history of Health Violations at your clinic before you took over . Our clinic has been subject to repeated inspections every year, which we have passed. With a single inspection every year up until this year when clearly, it was no longer about ensuring the safety of patients. Ut a quest to end Abortion Access. I ask request to submit to the record. Objection. We accept the entry no objection. We accept the entry. I know recognize congresswoman presley for her questioning. She has been a tireless advocate for these issues on this committee. Thank you for your leadership. Thank you, acting chair for your for holding the line on this first full committee ition fromnt the trans chairman cummings. We thank all of you for being here. Elijah cummings often reminded us we are to be an efficient and effective pursuit of the truth. We are still trying to arrive at that it seems, today. This conversation could not be more timely as we bear witness to an experience this administrations calculated and systemic attacks on our constitutional and rights of freedom. The right to determine our own Economic Future and the audacity to determine our own fate and the freedom to determine when, if eddo, to have a child. Even in states like the commonwealth of massachusetts, individuals with low income and young people and black and brown folks continue to encounter barriers in accessing Reproductive Health care. Let me be care. Health care is abortion care. We have seen states pass restrictions that hinder access to abortion, endangering lives and criminalizing individuals for decisions that should be kept between themselves and their doctor. As chair of the abortion rights and Access Task Force of this firstever prochoice majority in the history of congress, i would be remiss if i did not shed light on the impact that federal coverage bands are voting on our vulnerable communities. Current law restricts medicaid funds from covering abortion care for women in communities across the state. The good mocker institute, restrictions on medicaid coverage for abortion covered forces one in four women to carry unwanted trinities to turn. S lure coverage ban individuals to poverty . For some women, what is the hardest time in their life, they are now in a situation where, because they are on medicaid or because they are on a federal health plan or other federal restrictions, they no longer have or are in a situation where there health care can be covered by insurance like the rest of their health care. All of a sudden, youre having to scrap together money on top of a range of other barriers. Those barriers may look like having to travel long distances. Those barriers may look like having to pay for childcare because of multiday waiting periods. It is not only the restrictions on coverage. You have these other costs. Further right to abortion count for the right to abortion, which has been legal for almost 50 years and reaffirmed again and again by the Supreme Court, most recently, just three years ago. That right is not just for those who are affluent. It is not just for those who happen to live in a state or the state is trying to make up the serious gaps in federal coverage. That right is a fundamental right. Tois a right that is tied your ability to have dignity in this country. It is tied to your ability to have freedom in this country. It is fundamental to your Economic Security. Thank you. I would be remiss if i did not acknowledge sitting next to me, a champion in the efforts to repeal hide. My physician physicians in service. Thank you for being here. The u. S. , 700 women in are likely to die during childbirth. These numbers are worse for a and native american women. Could you speak to your report recently issued connecting the . Mpacts of abortion bans there was this conversation about compassion for the innocent kid earlier today, i rode out the peoples just as guarantee, which calls for the abolishing of the death penalty. One in 25 or wrongly convicted or innocent. I look forward to my colleagues the other side of the aisle signing onto my legislation. The report that you referred to looks at the correlation between Maternal Mortality and states that have placed these bans against abortion. What we know is that if you decide you need to terminate a pregnancy, and you are denied that care, it puts additional stress on you. We also know that women who are denied abortion care tend to delay prenatal care. Asre is an additional stress well. I want to give you some of the states that have some of the , and sometion bans of the worst Maternal Mortality outcomes. Alabama, georgia, ohio, missouri, unfortunately, and a lot of the southern states. South carolina, texas. Those are the states that primarily have these outrageous which prevent people from accessing abortion care. Would you please climb down . Please wind down . They also have the highest hotel at he rates. We have to look at those things together in terms of what it means to access good Reproductive Health care for people. Thank you, madam chair. The chair recognizes representative miller. Thank you. You for being here today. As a mother, i have had the quickene to feel life in my room in my womb. Joy grandmother, i know the of grandchildren. Ive gotten to experience endless joy having grandchildren because it is unconditional love. I have had family members and friends who have yearned to be parents. The run able to have children of their own. I have had friends and family who have been adopted, and they are very grateful. I have friends and family who have adopted children, and they are very grateful. They have brought such blessings to their family. However, i have become increasingly concerned as of late about the actions taken by my colleagues across the aisle. Washington democrats refused to protect babies, even after they are born alive after an abortion attempt. It is so heartbreaking. Our most vulnerable and youngest citizens deserve our most protection. Speaking of medical innovation, i think we can all agree that women having access to all health care is important to that not every planned parenthood provides comprehensive Womens Health care. Can you elaborate on the positive steps Trump Administration has done to not only protect life, but to ensure women have better access to health care through federally qualified Health Care Center . First, i do want to address an issue i think we can all agree on, Maternal Mortality rate in a developed country is way too high. The number is 3. 3 times higher for africanamerican women than it is for what women. I fully believe we need to address that. I would encourage the Trump Administration to address that. I do not understand why the exclusive solution we discussed his abortion. Why is that the only solution we discussed. Can we not come together and talk about how we can best care for a woman and her child . Why do we have to sacrifice the child for the health of the mother when it is not necessary . President trump has been the most prolife, most antiabortion. I am fine with that too. Maybe even more so than ronald reagan. Know, enacting the final role for title x that says you have to physically and financially separate your Abortion Services from the rest of your controversial for the rest of your contraceptive care. I heard earlier a comment about this gag rule. Someone toencourage get an abortion, but you can counsel them neutrally. It is not actually a gag rule. President trump has insured that these policies can go forth. Given states the freedom to protect life inside the womb. For that, i am thankful. May be familiar with efforts by House Republicans to protect babies who are born alive after an abortion attempt. Isy argue the born alive act necessary because doing so violates existing criminal law. You believe federal law should be clarified to ensure babies born alive after a failed abortion should receive critical medical care . Needs to be clarified. This new law the democrats have tried to blockade criminalizes the neglect of an Abortion Provider to attend to the medical needs of a child who survives an abortion, for the recognizes the childs personhood and says this is the medical treatment required. We are not even talking inside the womb anymore. Democrats cannot even get on board with that. Theyre not any undue burdens or regulations. It is not preventing Abortion Providers from giving abortion. It is saying if a child survives an abortion, attend to the child. It should be really simple. If you really are prochoice and abortion, that should be a nobrainer. I understand a baby can survive as early as 23 years old. Can you elaborate on how viability has changed in recent years . Medicinehnology and advances, hospitals are able to prenatal care. That is pretty early in the second trimester. But it only halfway through the printed t. At 24 weeks, that is tenderly accepted as the age of viability. That means that child has a really good chance to live outside the womb. She would spend some time in nicu, but she would grow up if everything went well, and she was healthy, into a normal functioning child. You would not be able to tell the child was premature. When we are talking about these children as if they are not babies, on the one hand, we talk about them as if they are just these parasites to be discarded. Remains of princi is what i heard the doctor say earlier. Remains of pregnancy is what i heard the doctor say earlier. As you have pointed out, even then, they do not seem to be respected by the proabortion side. Yield back. D i i understand the witness has a flight she needs to catch. I will dismiss her, noting there may be other additional questions. I request she answered them in writing. I thank you for your testimony. I hope you do not miss your flight. The next speaker will be Debbie Wasserman schultz. Bottom chair, i have a question of you. I would like missed ducky to hear my question miss stuckey to hear my question. Clarify that miss stuckey is here expressing her own opinion and has no expertise in the subject matter whatsoever. Is that accurate . I want to ask you from what your knowledge of her is. That is my understanding. Thank you. I just wanted to clarify that fact. I think the witness should answer in all fairness. I think it says something when i, the one without the scientific or medical background, and the only want reclaiming my time. Canuestion was not a view not of you. You have acknowledged you here expressing an opinion, which we appreciate. The other thing i wanted to point out is that no one here today has said abortion is the only solution to address the Maternal Mortality rate. How about access to prenatal care . How about the passage of the Affordable Care act to ensure it remains the law of the land to that women are not considered preexisting conditions because of our existence as women. All the timed before the Affordable Care act was the law of the land. I can go on with many other provisions we advocate to make sure we can reduce the Maternal Mortality rate. Certainly, abortion is not the only thing we suggest. It is not a solution that we ever suggest to reduce the Maternal Mortality rate. It is a ridiculous edition. What is not a ridiculous edition is the discussion to become a parent is one of the most important and most personal life decisions we make. Watching the expansion of state laws that limit a womans autonomy to make this choice is troubling. The fight for reproductive freedom is when we are all too familiar with in 40. I have seen republicans in my state introduce bills that ban abortion after six weeks. Theyre fast tracking a proposed consent law. We need to be unequivocal about calling the load out for what they are, sinister attempts to interfere with womans right to make a choice on her own Health Choices. Missouri hasard, enacted semi restrictions on providing abortion care that only one clinic is left standing. Because my time is limited, i , theto ask dr. Mcnicholas excuse a patient can drive to another state to receive medical care, is that an acceptable rationale for any other type of medical service, and is it accurate to say that requiring wouldary patient delays lead to women having leader abortions, which are more expensive and compose a Higher Health risk . Thank you for the thank you for the question and acknowledging the sort of many intersecting realities that people are navigating when theyre trying to access basic care, and in missouri, for many of them that means driving hundreds of miles multiple times. Im reminded, actually, of a patient i took care of recently in the second trimester who actually was able to get to the clinic the first time very early at six weeks of pregnancy. She went home and scheduled her clinic procedural date for about a week and a half later, but unfortunately, was in a car accident on the way to that appointment. Because missouris law not only requires a waiting period, but requires it to be with the same physician who will ultimately perform your procedure, she was then her twovisit abortion became a fourvisit appointment visit, and she was pushed from seven weeks to 15 weeks. This is exactly what happens when there is no context and no medical or scientific grounding in abortion restrictions. Patients are pushed to later and later in pregnancy, which is quite ironic for a cohort of folks who want to limit abortion later in pregnancy. Thank you. Ms. Box, i want to end with you. And im so sorry for your loss, but i know youre overjoyed and that your daughter that you and your daughter that you brought with you. You received test results that revealed your daughter, libby, had a chromosomeal anomaly when you were andround 13 weeks pregnant. If the missouri law that would ban abortion after eight weeks had been the law in the state of missouri at that time, would you have considered leaving the state to have an abortion . How difficult would it have been for you and your family if you had needed to travel out of state to obtain your abortion care . So, the answer is, yes, i would have looked at how i could have protected my daughter, regardless of what regulations the state tried to interfere with. The truth is, even though abortion the ban had not come into effect yet, the eightweek ban, we did look at leaving missouri and going to representative kellys state of illinois, because the restrictions there are fewer. The gentlewomans time has expired. If you could please wrap up real quick. Yep. So, yes, we would have done whatever we could to protect our daughter, regardless of governmental intrusion. Thank you for sharing your personal story. And i yield back the balance of my time. I now recognize representative green. Thank you, madam chairwoman. My first question is for dr. Mcnicholas. Am i pronounceing that correctly . Yeah. If the dna from a fetus and a mother were found at, say, a crime scene, say its two blood samples, take fetal blood, take mothers blood, we put them at the crime scene, the investigators know nothing, they find two samples, would the investigators see these as two separate people . I have no idea. Of course, they would. The answer is, yes. You know as a physician, its two different dnas. Theyd see two different dnas. Theyd see two dnas, so theyd say its two people. My next question, question for you as well, recently in california, a mother was charged for killing her unborn baby by excessive methamphetamine usage. If the mother had just gotten an abortion and killed the baby, that way, she wouldnt have been charged. And killed the baby that way, she wouldnt have been charged. Do you see the hypocrisy in this . I think its tragic that were criminalizing people who need basic health care and treatment for their drug addiction problem. Thats what i think is a problem in this country. Absolutely. Someone who uses methamphetamines should get help. Theres no doubt about it. And she was charged with a crime for the death that she caused of her baby with methamphetamine use. The child was stillborn. I just i find that hypocritical, that if she had just gone a week prior to planned parenthood and gotten an abortion, she wouldnt be charged. You know, im going to transition a little bit here. I want people to make their own choices. Im for freedom, but when one persons freedom impinges on the freedom of another, and, for example, if someone in this room yelled fire, thatd be against the law, because potentially, a stampede could occur and people would be hurt. Abortion is a decision where one person makes it, and it leads to the death of another person. So thats thats something to take into consideration. My next question, i was going to actually ask ms. Stuckey, but shes gone. Ill just read the question and let the audience and others consider it. A few years ago, a freezer unit protecting previously fertilized human eggs, meaning a sperm, ovum, where they combined a form of fertilized egg, was broken and thousands of these fertilized eggs were lost. I just want to ask people in the room to whether or not they would agree with the headline in the newspaper the following day that said it was a human tragedy that these lives were lost. Just consider that. My next question, again, is back to you, dr. Mcnicholas. In regards to abo and rh incompatibility, why do i as an e. R. Physician have to treat the mothers with rogam to prevent her antibodies from attacking the blood supply of the baby . Oh, so two minutes for this. No, you got 30 seconds. Oh. Or i can do it because, i do it i treat these patients all the time. Go ahead. Sure. So, in the instance in which the fetus has a different blood type than mom, there are occasions where mom can create her own defense mechanism to that situation, which would in a subsequent pregnancy, attack a subsequent pregnancy and have some serious conditions for the fetus. That was pretty good. I mean, you did it in about 30 seconds, but shes absolutely correct. Basically, the mothers immune system sees that second child as foreign, and attacks it because its got a different blood type than the mother. Lets see. I also want to share a few quick observations in a little bit of time that i have left as an e. R. Physician. I know that there are a lot of statements about the safety of abortion. I just want to tell you that i have treated many, many patients in the Emergency Department where the abortion hasnt gone as intended. Where products of conception, the medical term, or baby parts, are left inside the mother, and sepsis results and those patients come to us and we take care of them in the Emergency Department, we save their life from that infection. I also want to say, ive taken care of many over the years as a emergency medicine physician, patients whove come in bleeding from an abortion, and the unfortunate thing is, the obstetrician who has to take care of that patient didnt do the abortion. So he doesnt know the patients history, and theyre rushing them into surgery to stop the bleeding and save the patients life. That does happen. And it happens more frequently than many people would want you to know. But it is a reality, and i just want to say, thats why i support Abortion Providers having credentials at a hospital where they can treat the complications of the surgical procedure of an abortion that results when they do that. Oh, am i out . Thank you, madam chairman. Chairwoman. Thank you. Id now like to recognize congressman raskin. Madam chair, thank you and thank you for calling this important hearing. Big brother seems to have come to missouri. And all of our colleagues who like to strike a libertarian note when it comes to people possessing ar15s ar15s and militarystyle assault weapons, the kinds that are wreaking havoc across the land, suddenly become the champions of leviathan, big brother, gilead, and the allpowerful state. Politicians making Health Care Choices for our people. Ms. Gossgraves, let me start you with you. Presumably, you know something about the history of sterilization in our country. Where certainly tens of thousands of women, at least, were sterilized. If government has the power to prevent a woman from having an abortion against her will, wont government also have the power to sterilize women against their will . Which was so much a part of our history. You know, i think its important to put the right to abortion, which is so core and fundamental, in the context of a range of rights. The right to abortion is in the context of the right to make Reproductive Health care decisions broadly, including contraception, including around sterilization, and not having forced sterilization, but it is also among the set of rights around the right to be intimate. The right to marry. All of those things follow a long line of decisions that animate from the 14th amendments guarantee around liberty and around our your ability to sort of live with dignity. Dr. Mcnicholas, officials in missouri, including dr. Randall williams, the director of the department of health, senior services, and Governor Parsons, have reaserted the restrictions adopted in missouri are necessary for the health and safety of people seeking abortions. In your opinion, is the requirement that a physician have admitting privileges at a local hospital necessary for the health or safety of a woman seeking an abortion . So the short answer is no, and the longer answer is, its not my opinion. It is what science and fact and the most recent publication out of the National Academies of science has told us. What about this 72hour waiting period between a woman seeking an abortion and being able to get one . And then also, i understand they adopted a provision for two pelvic exams during that time. Is that necessary for the health and safety of women in missouri . None of those are required to maintain health and safety. How do you know that . Science. There is plenty of published literature supported by the American College of obgyn, again, supported by the national academys publication, that has demonstrated not only are they not medically relevant or necessary, but they actually cause harm. Well, what about from the standpoint of the patient . Ms. Box, let me come to you. Did you feel that any of the procedural hurdles and hoops that were set up in missouri and you were forced to jump through were necessary for your health and safety . No, i found them insulting. They presumed that my husband and i didnt have the ability to make a decision for ourselves. The waiting period that dr. Mcnicholas was talking about and the mandatory samephysician rule meant that my abortion, which happened at around 15 weeks, had i not been able to do the available date that the physician had, i actually would have been outside of when the legal timeframe in missouri, and i was well short of it. I would have had to reconsent, been given another booklet of medically inaccurate information, which my husband and i refer to as the book of shame, and that all of that presumes that i think what i find most insulting as a patient is that i didnt have the ability to think for myself. That i needed my State Government to put that time in for me. I thank you for that really important insight when you talk about this book of shame. I think you started your testimony by saying that one quarter of american women will have an abortion over the course of their lifetime. Most of them, also mothers, as you are. You have, how many kids . Two kids . I have three living children. You have three living children. Okay. Well, they want to throw the book of shame at tens of millions of american women. How does that feel to you as a citizen in missouri . That you get hit by the book of shame . I mean, its its devastating. I mean, in our particular case, we are in the middle of a very grief griefstricken process. We were in a crisis. And to have confusing and misleading information when youre trying to make a medical decision is horrifying that we would ever allow patients to get mischaracterization and misinformation and hope they can make the best decision for themselves. Okay. And finally, i wanted to ask this question while all the witnesses were there. I was thinking we could make history by getting the prochoice witnesses and the antichoice witnesses to agree on a Prolife Program which is a on a Prolife Program, which is a universal criminal mental background check on all gun purchases, at least for the witnesses who are still leer. Still here. Would you reach across the aisle to the prolife witnesses to stay you would stand for that . Say you would stand for that . Id let the record reflect i think they all nodded their heads, madam chair. Congressman conley. Thank you, madam chairman. Thank you for holding this hear hearing. Thank you, mr. Clay, for being our inspiration in highlighting and highlighting whats happening in your state. I think we need to be honest here. Everything designed to make your very difficult decision, personal decision, not a state decision, ms. Box, was designed to take away your choice. What mr. Green described was insidious logic. Because there might have been complications from some abortions, all abortions should be eliminated. Even though the overwhelming majority of legal abortions, because of roe v. Wade, are done medically supervised conditions and are safe and allow women and families to have choices. The changes in title 10 are designed, again, to take awooiay take away or limit choices. The attack on planned parenthood, designed to take away choices. And being willing to deny Women Health Care is the price you have to pay for their ideological stance. And the stuckeys misguided moral absolutism for all the rest of us. And, of course, the sacrifice of science, as you point out, dr. Mcnicholas. That has to be in there, too, because science is an inconvenient source of information and truth. I, again, denied you and your family, ms. Box, in a critical moment in a decision you had to make. Go ahead. I thought you wanted to comment. Dr. Mcnichols, how many women, patients, does planned parenthood see every year . The planned parenthood in the st. Louis region no, no, nationwide. Oh, i dont know. All right. St. Louis. Missouri affiliate says more 50,000. How many . 50,000. Would you guess thats a lot more than dr. Green sees in a year . It is. I would actually like to highlight to dr. Greens point about safety that i have yet to see an oral surgeon brought before congress to talk about having wisdom teeth removed. Mischaracterizing abortion as anything other than safe is in inappropriate. Its health care. Yes, unfortunate outcomes will happen for some people. By in large its safer than colonoscopy, wisdom teeth and will also mention its far safer than carrying a pregnancy to term. And its safe because roe v. Wade made one law for the whole United States including missouri. Is that correct . We have lots of examples internationally to show legalization of abortion is one of the most important Public Health and lifesaving interventions for women. Would it be fair to say that absent roe v. Wade, its not that abortion will disappear, it is that people will be forced once again to go into the shadows to secure those services, to make those decisions, or go to states that do protect it legally. Is that a fair statement . So as i mentioned before, abortion was around before the constitution, and it will not go anywhere if we remove those barriers. Right. So our choices make it safe, hopefully its rare, because contraception is available, Family Planning is available, but it has to be an option, as ms. Boxs personal experience tells us. Its a health decision, a hard one, a heartbreaking one for many people. But to deny them access to it because youve decided on the morality of it, or youve made up science to justify your own personal beliefs, is to impose your will on the majority of americans, including women who are affected by this choice. Title 10, dr. Mcnichols, planned parenthood decided to pull out of title 10 even though it does not provide funding for abortions. Is that correct . Thats correct. Why did planned parenthood decide to leave title 10 . I think as was previously mentioned by ms. Gossgraves, theres a really fundamental issue for planned parenthood, which is that the new rule would force us to lie to patients and intentionally exclude information that could be important and life saving for them. And real quickly, because title 10 provides other health care for women, theyre now going to be denied that coverage because of planned parenthoods being forced out of the program, is that correct . We are going to try our very best to meet all the needs of our patients, including those who were previously receiving title 10, but i think the point is well taken that with reduction of planned parenthood seeing title 10 patients, there will be a tremendous gap in services for patients, particularly who are low income or people of color. My time is expired. I thank you all for being here and for the courage of sharing, especially you, ms. Box. To recognize congresswoman tlaib. Sorry, i didnt know i was next. Thank you so much. It really is incredibly important that you all are here to talk about this particular issue, especially as a woman serving the United States congress, i just want to personally thank you for defend defending my right to choose. One of the things i want to discuss is the impact of politically motivated restrictions of abortion that weve been talking about, access to Maternal Health, but even more even around infant mortality. When i served six years in the Michigan State legislature, i was always taken aback by so much time and effort in debate and conversation around the right to choose versus infant mortality. You know, Maternal Health. All of those things that i think are interconnected with some of the, you know, reasoning behind folks that want to support life. Right . And theres an issue that is deeply, you know, concerning to me, is that parts of my home district have among the highest Maternal Mortality rates in the iterates in the country. In 2014, a woman giving birth in detroit was three times more likely to die in child birth than the rest of the country. Infant mortality in detroit is double the National Rate in the country, and it just goes on and on. And so dr. Mcnichols, missouri has the highest rates of Maternal Mortality in the country, and it continues to rise, especially among women of color. In fact, black women in missouri are three times more likely to die with pregnancy complications die from pregnancy complications than other women. Is that correct . Thats correct. What state official again is responsible for addressing Maternal Mortality in missouri . That would be the director of Public Health, dr. Williams. Dr. Williams is the same official on enforcing unnecessary pelvic exams on women and tracking their menstrual cycles at planned parenthood, correct . Yes. How do you think that he should be spending time . What do you think he should be doing right now and again, around the same ideals, right . That theyre supporting this. They wont support the women that are having children. Yeah. You raise a great point. Under dr. Williams, missouri went from 42nd in the country to 44th in the country with Maternal Mortality. While hes spending his time visiting his time and resources on visiting planned parenthood multiple times, he could be focusing on things like addressing Maternal Mortality, addressing the systemic and institutional racism that is ingrained in that rate of three times higher for black women. He could be working on improving access particularly for our rural women. Missouri is one of the states that because we havent expanded medicaid, thats another thing he can do. We have rural hospitals closing at alarming rates. So if you want to continue your pregnancy, your chance of having a healthy pregnancy is sabotaged by the fact that theres no hospital that you can go to to get care during that pregnancy. There are a number of things that he could be doing with Maternal Mortality. The hypocrisy is so unjust and absurd. The hypocrisy is so unjust and absurd. Ms. Howell, your organization did a phenomenal study finding that black women face greater barriers to Reproductive Health reproductiveto health care and abortion care. What are some of the factors that are with the discrepancy in Health Outcomes . Some of the factors are that black women are disproportionately get their that black women get disproportionately get their Health Insurance from medicaid which already then bans their access to abortion care and to get coverage. So what happens is that when they find they are pregnant and they decide they want to terminate a pregnancy, they have to go through a number of steps. Theyve got to figure out how to afford it, how they can take off work, how they can get child care. How far they have to travel. One of the things that we did was we asked black women in a poll, what are the factors that you take into account when deciding whether or not to have a child . And it wasnt just about having money. It was also about having a neighborhood where Neighborhood Services were happening. It was about being able to get quality food sources. It was about clean water. There were a number of factors, and if you are a woman of low income and you get your healthcare from medicaid, you also have all these other factors that come in, too. And thats why when we were talking about no one knowing how to decide to terminate a pregnancy, our organization trusts black women to make those personal decisions that are best for themselves and their families, and the other side clearly does not trust us to make those decisions. No. They want to control us. Thank you so much, and i yield the rest of my time. I thank my friend from michigan for her powerful voice for her state, and i now call upon one of congress most outstanding leaders. My good friend and colleague, barbara lee, and i want to publicly thank her for her tireless work and for being such a powerful advocate for progress, gender, justice, and equality. Thank you for sitting here all day long. Shes not even a member of the committee, so i appreciate you being here, and i appreciate your voice. Thank you, chairwoman maloney, for holding this and this hearing and for your tremendous work and leadership, and for allowing me to sit through this very, very important hearing. And i want to thank our prochoice caucus and the congresswoman Ayanna Presley and judy chu, who have been such clearthinking and passionate leaders on so many issues since they have been here in the house of representatives. First, let me just and throughout their life, quite frankly. Let me start by stating a couple of statistics, banning access to safe legal abortion is not what the majority of this country wants. According to recent polling published in september, 77 of americans support access to abortion, and we know and we see how many of these restrictions disproportionately, as we talked about, impact women of color and lowincome women. Access to the full range of Reproductive Health care should be accessible to all and not based on ones rashgs income or ones race, income, or zip code. Accessg for equitable for abortion is deeply personal for me, and i do, and its hard to talk about this, but today ill mention it again. I remember the days of back alley abortions before roe versus wade. I was a teenager only 16 years old and had to go to mexico for a gut wrenching back alley abortion. Abortions were not safe nor legal in my own country. So, i refuse to stand by and see even one more womans life put in danger because of lack of access to safe and legal abortions. Many of my republican colleagues here today, and the minority witness, they want to portray women who have had abortions as evil, or as murderers, but im here today with several of my sisters, several, who have personally had an abortion, and when you say these comments, they also say them to me. They say them to you, and were not going to stand for it. Many, and i serve on the appropriations committee, and let me tell you what i see. Many of our republican colleagues, they oppose teen pregnancy prevention programs. They oppose comprehensive sex education, they oppose Family Planning. They oppose contraception and they oppose abortions, and i see these budgets zeroing out funding for Health Care Programs that would prevent pregnancies, prevent pregnancies. Also, i see budget cuts every day to child care, snap benefit, nutrition, Early Childhood education, everything that would help raise families and children in a way that they deserve to be raised. So i want to just ask you your feedback. Maybe, miss howell, we know that these programs are disproportionately impacting women of color. How do you see this whole movement now and what were seeing . I still call it a war on Womens Health, because when you look at the comprehensive nature of these cuts and the policies and the restrictions, what else is it . What are we to do as women in this country . I think that one of the things that we have weve seen over the last couple of years is women taking back their rights, and its not just women. Its people. Its lgbtq people, its trans people, basically standing up and saying, we wont allow this to happen anymore, and we saw it in the 2018 election. We saw it where women of color, for instance, came out and voted to change the house of representatives, voted very strongly, and one of those issues that they voted on was hyde, eliminating hyde, and they and having the each woman at. They were very clear on what they were looking for and the right to make decisions for themselves without political interference, and i think that thats critical. Thank you. I want to thank ms. Box for your being here today and your stories and for being so brave in terms of given the real deal about what women go through as a result of trying to exercise their constitutional rights, so thank you. Ms. Grace . I just want to add that it is true that people are outraged and rising up against the bans that are sweeping this country, but this is a dangerous time. It is dangerous to ban abortion. It is dangerous to have states where people think they cant get care even though abortion is legal in every state of this country, and it is dangerous the rhetoric that we heard in this room today and that we hear outside of this ream that demonizes patients, that demonizes women and that goes sort of to the core of who we are as a country. This today has reminded me how dangerous these are. These times are. Thank you. Thank you, madam chair, very much. I want to thank my friend barbara lee for sharing really one of the most personal and heartbreaking events of her life. Shes sharing it not only with this hearing, but with the whole world, and barbara lee, your courage has made us stronger and your leadership. I will now call on an incredible woman. A newly elected woman, ken schryer, from the state of washington, a powerful advocate for science or women across this country. Thank you for being here. Shes not a member of this committee, but she wanted to be here and to speak out, and i thank you for being here all day and in supporting our efforts. I laugh because i thought you were going to talk about Ayanna Presley. I already talked about her. I came here today to talk about these unnecessary restrictions on a womans access to full reproductive care, access to abortion, and we have heard about a million ways that local governments and State Governments are trying to restrict a womans access to a safe and legal medical procedure. And every one of these unnecessary ultrasounds, bogus scripts, hallway size, admitting privileges at local hospitals and second pelvic exams, even first pelvic exams, admitting privileges i mentioned and even waiting periods and all of those are unnecessary. They make it harder for women. They especially make it harder for women who are poor. Who would have to take additional time off work and who would have to travel great distances. These do not stop abortions. If you want that as your goal, you should be doubling down on funding for planned parenthood for pregnancy. For pregnancy prevention. Abortions, they make them later and they make them less safe. Theyre totally inappropriate. I came to talk about that and i want to enforce that this is a safe and illegal procedure, something that one out of four women has before shes 45 years old. This is more common than eight tonsillectomy. A tonsillectomy. Which is very common, pretty much 100 knows someone who has one. So i came to discuss those things. All that those kinds of rhetoric. Backl like i have to push on comments. Pseudoscience, total baloney. I dont feel like i can let those things just stand. Everything from not understanding a difference between an embryo and a baby, which by the way, if she believes they are the same, that and religiousical decision, it is not a medical distinction or Something Congress should be involved in or something she should have any say over any other womans decision. But there are other things that she talks about, like 20 weeks in pain, totally unproven, bogus. She talked about the gag rule not being a gag rule. It is when a physician cannot mention that one option for her patient is abortion, that is a gag rule, and by the way, its a dangerous gag rule, because if a woman is diagnosed with pregnancy and Cervical Cancer in the exact same visit, an abortion would save her life. Lets be clear. The other one she mentioned was she painted a very happy picture of a 23week microprimie. Im a pediatrician, and ive spent a lot of time in nicus. The real picture is you have a 5050 shot at survival. And if you do survive, you have a high likelihood of having consequences down the line. That doesnt mean i didnt resuscitate those babies and take care of them in the nicu, but it does mean that she is not giving you the full, correct picture of the situation. But the most egregious one is this discussion that somehow, you could pull a baby out three days before the delivery and call that an abortion. We call that an induced delivery. That is a baby who is pulled out and handed to their mother or taken to the nicu, where a doctor like me would take care of them if they are in trouble or in distress. If you want to have a conversation about pregnancies and abortions, later in reg later in pregnancy, lets have a real discussion about it. About 1 of abortions happen after 20 weeks, and none of these is because a woman just decided one woman i dont want to be pregnant anymore. That does not happen. These are all for a reason. Some devastating turn something devastating has taken a turn in a pregnancy. Something has happened either with the health of the mother or the health of the pregnancy, and it is so important that congress not get into that discussion. This is a decision between a woman and her god and her doctor and her life, and only she knows how to make that decision and there is absolutely no place for me or anybody in congress to get in that discussion. What we owe that woman is a little grace and a little trust to make the best decision about her body. I will end there. Thank you. I am sorry that you had to put up with such harassment today. Thank you for your services. I now recognize mr. Keller. Thank you, madam chair. What i want to start with is, i heard testimony about the viability of the pregnancy being difficult to determine because theyre all based on a different diagnosis and different situation. Ill get to that later in my comments. I just want to start out with knowing that, and it was just mentioned that some babies have a 50 50 shot at survival and dr. Schryer mentioned that. I just want to say this, every life has opportunity and hope, and sometimes doctors, despite their best effort, do not calculate the appropriate outcome for their diagnosis. Ive had a personal experience with this. When my son, freddy, was 3 years old, he had an injury, result resulting it led to a devastating head injury and the doctors despite their best efforts thought fred was not going to live. He was put on life support and as we waited and prayed the doctors prognosis was that the mortal iterate of children in his condition was not 50 . It was not 98 , but we were told it was 100 . He was not going to live. They even tried to convince us to disconnect life support, and end his treatments, since they did not believe he was going to live. He was on a vent for 28 days. I hope and pray that is not easy, and i would never characterize a woman who makes that decision as people. Evil. I yield myself five minutes. This hearing is very important to me and very meaningful, because usually when i am attending a hearing on Womens Health care and womens needs, i panel. Ing to an allmale , where areave to ask the women . Especially on the hearings that affect their wellbeing and health care. It is personally thrilling and inspiring to me to see a panel made entirely of womens voices and america should listen to womens voices. I want to thank all of the panelists, but i particularly want to thank ms. His box. Is the mostur voice important of all the voices we have heard today, because to me you represent every person who has been shamed and judged for making a deeply personal decision about their own body and their own health care, and for them wanting to access the very best health care that they need to take care of themselves and their families. I just want to ask you, ms. His box, and i know its difficult before congress on anything, but especially something that is so personal. To hearit feel officials in your state and across the country say hate all, about theetoric decision you are making. How did it feel . Its insulting, and i appreciate representative foxs sympathy. While my feeble diagnosis was sad for our family, most women, including myself, experience relief after having an abortion. Our abortion was the first day we began to heal from the grief of our diagnosis. I have cried a lot of t ears about it, but they have all been grieving my daughter rather than regret. Imwanted to say sorry, sir, i cant say your name, but i am really glad your son had a positive outcome, and i believe in supporting parents and making the best decisions for their family and their children. Thats what my husband and i did for libby. Thank you for sharing your experience. You have cared for hundreds of patients in ms. Box situation. What impact have you seen on the patients you care for in missouri has these restrictive laws are enacted and enforced upon them . I think first and foremost the outright confusion that people have about what is happening in terms of their access to abortion and reproductive care more broadly is important to lift up. As abortion bands are passed, whether they are active or not, patients think that means they cant access abortion. We have done a tremendous work in making sure the country knows that abortion is still legal in every state in this country. What are you most worried about for your patience . They have theied full realization that people who are charged with protecting their health have completely abdicated their responsibility based on an ideological viewpoint. 100 , people who dont believe in abortion, choosing not to have one, but i believe it is also the right of every other individual to make that choice based on their values. I thank you for the courage yourall of you have in work for other women and your country. I have in my district two planned Parenthood Centers. When women are getting off work, women are lined up through the halls of the building, outside, to the sidewalk, down the street, into the next block, waiting to get basic Health Care Services. Planned Parenthood Centers provide primary and Preventative Health care to many who would otherwise have nowhere else to turn for care. I want to point out that 54 of planned Parenthood Centers are in areas where there is health care shortages, and we have heard testimony from medical experts that if planned , there is is defunded no other Health Facility that can address these needs and help these women. I cannot tell you how many women come to my office and tell me that at certain times in their life, the only place they could get health care was planned parenthood. Recordto put that on the , that i think it is a scandal that anyone would try to defund soervice that is providing much help to people that needed. This has been an important hearing to me, and i intend to continue working on this area thehelping women receive respect and health care deserve. I would like to call on my good friend jackie spier. Give her five minutes and thank her for her relentless leadership in womens issues. Aspire r rep providing a panel of committed women to the service of other women. Ms. Box, when you testified earlier, i was sitting here and started to cry, because i share the same experience that youve had. I lost a child, a fetus when i was 17 weeks, and i told my story on the house floor in part because i sat there and listened to such false information coming from my colleagues on the other side of the aisle, that it outraged me so much that i said you have no idea what youre talking about. You have not lived through this kind of experience, and to hear you talk about libby rose and keep her on your chest is just very powerful because it underscores what we all go through when we lose a fetus at late term. It is never by choice, and i find it so offensive that we continue to have members here in congress think that they can somehow take hold of our bodies and tell us what we can do. So thank you. Thank you for your presence here, for your new infants presence here. Having the gurgling of your child was just music to all of our ears. And thank you to all of you, as well. Im going to share one story, though, that relates to missouri. My daughter went to the university of missouri and graduated there. She had a girlfriend who became pregnant, who then drove an hour and a half to st. Louis to be seen, and then was told that she had to wait three days and so then she had to drive an hour and a half back and then, of course, she couldnt get the abortion in three days because there was such a long waiting list. Now, this friend of my daughters then finally called her mother, who lived in another state, who was not prochoice, and her mother picked her up and took her to another state to get the abortion. We cannot force women to have to jump through hoops and travel long distances to get the healthcare that they deserve and is legal under the law in this country. Is legal urn the law in this country, and to see what missouri has done with their laws and how difficult they have made it is so repugnant to me and it should be repugnant to every woman in this country. Now, ms. Box, let me ask you the question that i i think about a lot. When you were required to wait your 72 hours and received this counseling, what was the counseling that you had received . Well, first i want to say that i thank you for sharing your story with me, and i am sorry for your loss. I know how painful that is. Thank you. Am not the legal expert and we dont really have is it is it counseling . You didnt recognize it as counseling. Oh, okay. Yeah. Youre right. I didnt understand that was considered counseling. What was it . Its a booklet that has so the consent process is i apologize. They had to go over this information and they provided me with a booklet that is written by the state that has medically inaccurate information in an attempt to help me make an informed decision which just doesnt make sense to me, but what i will say is that how it works in missouri currently is you have to consent with the provider who will perform the abortion. So my consent and my counseling, the book, like i said earlier, i call book of shame, but my conversation with the provider and the doctor who works at mapped parenthood mapped planned parenthood was the most Compassionate Care id ever received. She took something that was the worst experience of my husband and my life and showed us love and showed no judgment and counselled us and all of the thing available to us and gave us accurate, sciencebased information so that we could make a decision as parents that was informed and full of love. Thank you. Thank you again all of you and i yield back. Thank you. Thank you so much. I would like to enter into the record a series of letters that the committee has received in recent days from organizations, including the American College of obstetricians anyd and gynecologists and repro action and the good mocker institute and the american with the American Civil Liberties union. These letters express grave concern on restrictions are having on the health and economic wellbeing of women in america and their families. I ask unanimous consent that these letters be entered into the official hearing record, and i so order. I would like now to thank our incredible witnesses for testifying, and for their lifes work, and without objection, all members will have five legislative days within which to submit additional written questions for the witnesses to the chair, which will be forwarded to the witnesses for their response. I ask our witnesses to please respond as promptly as possible and this hearing is now but before i conclude this hearing, i would like to thank the powerful women of this committee especially especially miss speier, miss presley, miss kelly, miss ocasiocortez for their leadership on this issue and her encouraging the committee to examine it. I would also like to thank congresswoman judy chu, congresswoman barbara lee, and congresswoman kim schryer for joining us this afternoon and for their tireless work to preserve access to abortion and Reproductive Health care for women across this nation, and i would also like to thank lacy clay, who has worked with me on this hearing, and for his leadership on this issue. This hearing is adjourned, but were going to continue on this issue. Thank you. [captions Copyright National cable satellite corp. 2019] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. Visit ncicap. Org] announcer the House Intelligence Committee and terroristin and care adam schiff continue testimony on cspan2 with testimony marie why dont y. Marie we have more on our cspan website, cspan. Org impeachment. Listen live forever you are with this free dish with the free cspan radio app. Announcer cspans washington journal live every day with news and policy issues that impact you. Coming up friday morning, Michigan Democratic congresswoman dan k. Discusses the latest on the impeachment inquiry. Columnist and colder talks about dacan coulter talks about and impeachment. Be sure to watch cspans washington journal live at 7 00 eastern friday morning. Join the discussion. Theuncer live friday on cspan network, the house returns for work on a bill to reauthorize the u. S. Export cspan. Anks on on cspan2, the second day of public impeachment hearings at 9 00 a. M. Yovn ill hear from marie anovich. 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