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TimesLIVE
21-05-2025
- Health
- TimesLIVE
Family powerless as brain-dead pregnant woman is kept alive
A 30-year-old woman declared brain-dead in Georgia is being kept on life support against her family's wishes because she is pregnant. This complex and painful situation is because of one of the strictest abortion laws in the US. Adriana Smith was nine weeks pregnant when she began experiencing severe headaches in February. According to her mother, April Newkirk, Smith sought medical help at a hospital but was allegedly sent home with medication and no further testing. 'They gave us some medication. But they didn't do any tests. Didn't do any CAT scans. If they did, they would have caught it,' Newkirk told NBC News. The next morning, Adriana's boyfriend realised something was terribly wrong as she was gasping for air and appeared to be choking, likely on blood. She was rushed to Emory Decatur Hospital and later transferred to the facility where she worked as a registered nurse. Doctors there discovered extensive blood clots in her brain. 'They did a CAT scan and she had blood clots in her head. They asked if they could do a procedure to relieve them, and I said yes. Then they called me back and said they couldn't do it,' said Newkirk said. Shortly afterward, Adriana was declared brain-dead. Despite her condition, Georgia's 'heartbeat' abortion law requires that she remain on life support to carry the foetus, now around 22 weeks, to term. The law which was signed by governor Brian Kemp in 2019, bans abortion after a heartbeat is detected, typically around six weeks and well before many women even realise they are pregnant. While the law includes limited exceptions for rape, incest and medical emergencies, it does not explicitly address scenarios where the mother is already legally brain-dead. 'It's torture for me. I come here and I see my daughter breathing on the ventilator. She's not there, and I'm touching her,' said Newkirk. Newkirk said she continues to bring Adriana's young son to visit her. Newkirk voiced concern about the baby's future health, as doctors warn that the foetus may suffer severe complications due to Adriana's condition and the lack of oxygen during the trauma. 'She's pregnant with my grandson, but my grandson may be blind, may not be able to walk, may be wheelchair bound. We don't know if he'll live once she has him,' she said. For Newkirk, the most heartbreaking part is not just her daughter's condition but the loss of agency over Adriana's care. 'It should have been left up to the family. I'm in my 50s. Her dad is in his 50s. We're going to have the responsibility with her partner to raise her sons,' she said. 'I'm not saying that we would have chosen to terminate her pregnancy. What I'm saying is we should have had a choice,' she said. Georgia is one of several states that enacted restrictive abortion bans after the US Supreme Court's 2022 decision to overturn Roe v Wade. The state has at least 11 abortion providers, according to the National Abortion Federation. Similar 'heartbeat bills' have been passed in Mississippi, Kentucky, and Ohio. This case has ignited renewed debate over abortion rights, patient autonomy and how states interpret medical decisions in cases involving brain death and pregnancy. Advocates warn that laws like Georgia's fail to account for the complexities of real-life medical crises.
The Guardian
20-04-2025
- Health
- The Guardian
New figures shed light on US abortion travel as Trump cuts tracking research
For the second year in a row, abortion providers performed more than 1m abortions in the United States in 2024. About 155,000 people crossed state lines for abortions – roughly double the number of patients who did so in 2020, before the US supreme court overturned Roe v Wade and paved the way for more than a dozen state-level abortion bans to take effect. These numbers, released earlier this week by the abortion rights-supporting Guttmacher Institute, have not changed much since 2023, when the US also performed more than 1m abortions and 169,000 people traveled for the procedure. This lack of change masks a deep geographical divide in the US, as a handful of states have now become major hubs for people seeking abortions. In 2024, Illinois provided roughly 35,000 abortions to out-of-state patients, while North Carolina provided 16,700. Kansas and New Mexico, which neighbor anti-abortion Texas, provided 16,100 and 12,800 abortions – the vast majority of which were to out-of-state patients. 'Travel is so incredibly costly, both for patients and for the broader support network of funds, practical support organizations and providers,' said Isaac Maddow-Zimet, a Guttmacher data scientist. The sheer magnitude of the travel, he said, is 'testament to the great efforts that a lot of people are taking in order to make sure that people could access care that really they should be able to access within their own community – without necessarily expending this enormous financial and logistical cost'. As the Guttmacher report focuses on abortions provided through the formal healthcare system, it does not count self-managed abortions, which appear to be on the rise post-Roe. (Medical experts widely agree that individuals can safely end their own first-trimester pregnancies using abortion pills.) The report also does not track abortions provided to people living in states with total abortion bans, even though providers living in blue states sometimes mail abortion pills across state lines – a practice that, in recent months, has sparked heated litigation. This does not mean, researchers warned, that everybody who wants a post-Roe abortion is still able to get one. Caitlin Myers, a Middlebury College economics professor who has researched the impact of abortion bans, estimated that about 20-25% of people who want abortions are blocked from getting them by bans. The Guttmacher report arrived days after the Trump administration effectively demolished the CDC team responsible for government reports on abortion provision in the United States, which are known as 'abortion surveillance' reports. These cuts have alarmed researchers. 'If we can't measure outcomes, we can't do science,' Myers said. 'My concern is that this work fundamentally relies on the ability to track public health outcomes, and if we aren't tracking them, we don't know what's happening to people. We don't know what's happening in their lives. We don't know the effect of policies and interventions.' In addition to the CDC and Guttmacher, just one other group – #WeCount, a research project by the Society of Family Planning – regularly collects nationwide data on abortion incidence. The groups use different methods to collect data, so the CDC's annual report on the topic has long been less comprehensive than the post-Roe reports issued by Guttmacher and #WeCount. A number of states – including California, a haven for abortion rights – do not provide information to the federal government about the abortions performed within their borders. The CDC report also lags behind the Guttmacher and #WeCount reports; its most recent report, issued in November, counted abortions performed in 2022. The CDC report does include information about abortion patients' demographic backgrounds and the gestational age of their pregnancies, which can serve as a critical fact-check in heated debates around abortion. Anti-abortion activists, for example, often condemn abortions that take place later on in pregnancy, but the 2022 CDC report found that only about 1.1% of all abortions take place at or after 21 weeks' gestation. 'Abortion surveillance can be used to asses changes in clinical practice patterns over time,' a former employee from the CDC's Division of Reproductive Health said in a text. 'Without this report, we are losing the ability to track these changes.' Notably, the move to ax the researchers behind the CDC report appears to run counter to Project 2025, a famous playbook of conservative policies. Project 2025 urged the federal government to dramatically expand the CDC's 'abortion surveillance' by cutting funds to states that did not provide the CDC with information about 'exactly how many abortions take place within its borders, at what gestational age of the child, for what reason, the mother's state of residence, and by what method'. It also suggested that the CDC collect statistics on miscarriages, stillbirths and 'treatments that incidentally result in the death of a child (such as chemotherapy)'. These proposals alarmed researchers and raised concerns about patients' data privacy, especially given the fact that abortion remains a deeply controversial procedure. But given the turbulence of the Trump administration, experts are not sure whether another agency will ultimately take up Project 2025's recommendations. Maddow-Zimet said he doesn't 'think that we're necessarily any less concerned than we were before about the possibility of these kind of data mandates going into effect and/or using the data in appropriate ways to either make providers ask patients questions they wouldn't have otherwise asked, that are very stigmatizing, or potentially put providers at risk'.
The Guardian
09-04-2025
- Health
- The Guardian
‘A skill you need to save a life': the US doctors traveling to Mexico for abortion training
On paper, it should not be difficult for Dr Sebastian Ramos to learn to perform abortions. As a family medicine doctor, Ramos works in a specialty that frequently provides the procedure. He lives in deep-blue California, where it is still allowed. And the administrators running Ramos's residency program – a kind of apprenticeship that US doctors must undergo to become full-fledged physicians – support Ramos's desire to learn how to do it. But over the course of his three-year-long residency, Ramos is guaranteed just three days' worth of training at Planned Parenthood. Residents get to participate in only a handful of abortions. 'That's just not enough if you want to practice abortion care,' said Ramos, who asked to go by a shortened version of his last name to protect his privacy. 'I knew that if I wanted to do this, I needed more experience.' That's why, earlier this month, Ramos traveled to a clinic in Mexico City for two weeks' worth of training in abortion provision. During his first week at the clinic, which is run by the global organization MSI Reproductive Choices and its Mexican arm Fundación MSI, Ramos performed roughly 60 abortions. In the years since the US supreme court overturned Roe v Wade, paving the way for more than a dozen states to ban virtually all abortions, a small but growing number of would-be abortion providers have begun to leave the country in search of an education. In 2023, MSI trained nine American doctors to perform abortions at clinics in Mexico. In 2024, it trained 27. So far this year, it is on track to double that number. 'On one hand, it's a tremendous relief to know that medical students and residents aren't going to have to forego this very important part of their training in their education,' said Pamela Merritt, executive director of Medical Students for Choice. Last year, Merritt's organization helped eight medical students and residents receive abortion training in Mexico and the UK. Merritt continued: 'It's also incredibly sad that in the United States, we are failing to train people even to the standard of care indicated by abortion bans.' Every abortion ban in the US permits abortions to save a patient's life. But without adequate training, doctors may not be skilled enough to perform abortions even in those dire circumstances. Medical schools and residency programs are run by massive hospitals that are heavily dependent on public funding; such institutions tend to be, by nature, leery of anything as controversial as abortion. The Accreditation Council for Graduate Medical Education (ACGME) has required OB-GYN residencies to teach doctors how to perform abortions since the 1990s, but rather than offer training in-house, hospitals have often farmed their residents out to freestanding abortion clinics for training. Even before Roe fell, this system was faulty: a 2019 study found that, despite the ACGME requirement, just 64% of OB-GYN residency programs offered 'routine training with dedicated time' for abortions. Family medicine residents who want to learn to perform abortions face a greater disadvantage, since the ACGME does not require their residency programs to offer any kind of abortion training. Even most OB-GYN residents, program directors reported in the 2019 study, did not achieve what doctors call 'competency' when it came to abortion. Without competency – a qualification that's measured through a melange of doctors' knowledge, skills and attitudes – doctors may not be able to safely perform abortions on their own. Abortion training and competency is now even harder to come by. Since Roe's collapse, more than 100 abortion clinics have shuttered. Those that are left are often besieged by patients fleeing abortion bans, leaving them without the time and space to teach everybody who wants to learn. If an OB-GYN residency program is located in a state that bans abortion, ACGME rules currently dictate that the residency 'must provide access to this clinical experience in a different jurisdiction where it is lawful'. The ACGME declined to respond to a request for information about how many residency programs are currently compliant with its abortion-training requirement, although records show that no OB-GYN programs have lost their accreditation status in the last year. Patricia Lohr serves as the director of research and innovation for the British Pregnancy Advisory Service (Bpas), a UK nonprofit that provides abortions up until about 24 weeks of pregnancy. Lohr trained to become an OB-GYN in the US. 'Having been a resident and a medical student in the United States, I could really see the importance of having access to abortion education that wasn't entirely reliant on what was being delivered within academic training programs,' Lohr said. 'Because often, abortions weren't being provided in those academic hospitals.' When Lohr moved to the UK, she quickly moved to create a two-week training program at Bpas where medical students could learn about abortions and observe – but not perform – the procedure. In the years since Roe fell, that training program has received a surge of applications from American medical students and residents. 'It's a shame that people would have to travel to learn a basic part of women's health care,' Lohr said. 'There are many trainees out there at the moment who would like to obtain abortion skills, but cannot get it locally, and so they get diverted into doing something else.' Lauren Wiener, a New Jersey medical student, had originally planned to travel to Arizona in summer 2022 to learn how to provide abortions. But when Roe's fall led Arizona abortion providers to temporarily stop working, Wiener had to cancel her trip. Instead, she ended up undergoing a week-long training at Bpas last fall. 'It is something that you need to know how to do, because there are emergency situations,' Wiener said of abortions. 'You might not want to electively perform an abortion at 24 weeks, but if someone comes in and they're miscarrying, you need to know how to evacuate that uterus. It's a skill you need to have to save a life.' While training in the US dwindles, the country's increasingly conservative approach to abortion has also put it at odds with much of the rest of the world. Only four countries – including the US – have tightened their abortion laws over the last 30 years, while more than 60 countries and territories have loosened theirs, according to a tally by the Center for Reproductive Rights. Mexico is one of them. In 2023, its supreme court decriminalized abortion nationwide; the procedure is now available in about half of all Mexican states. And providers aren't the only people taking advantage of Mexico's liberalized abortion laws: last year, Fundación MSI provided first-trimester abortions to 62 women from the United States. 'Training, training, training – it is key, to have less danger for actual patients,' said Araceli Lopez-Nava, managing director of MSI Latin America. 'We understand how difficult the situation is becoming in the US, so we're happy to help.' The organization has the capacity to train up to 300 doctors a year to perform abortions, Lopez-Nava estimated. MSI is not, however, a solution for everybody. Would-be trainees need to speak Spanish. And although the organization has in past years trained medical students, MSI's Mexico clinics have started focusing on teaching residents who have already performed 20 abortions. Because residents have already chosen their specialties and secured berths in residency programs – which can be highly competitive – they are more likely to become abortion providers. Training in Mexico can also be pricy, especially since the program does not pay for travel and lodging. Ramos's entire trip cost about $5,000, although a scholarship helped him cover most of the costs. 'It's a way, at least for me, to be exposed to a different medical system, learn from different providers from a different country, exchange knowledge,' Ramos said. 'I feel like I'm being adequately prepared to meet the needs of my patients in the US.'
Associated Press
08-04-2025
- Politics
- Associated Press
California man arrested near Justice Kavanaugh's home with a gun pleads guilty to attempted murder
GREENBELT, Md. (AP) — A California man pleaded guilty on Tuesday to trying to kill U.S. Supreme Court Justice Brett Kavanaugh at his home in a suburb of Washington, D.C., nearly three years ago. Nicholas John Roske was arrested near Kavanaugh's home in Chevy Chase, Maryland, in June 2022. Roske was armed with a gun and a knife, was carrying zip ties and was dressed in black when he arrived in the neighborhood by taxi just after 1 a.m., authorities said. U.S. District Judge Deborah Boardman is scheduled to sentence Roske on Oct. 3. Prosecutors say federal sentencing guidelines call for a term of 30 years to life in prison Roske, 29, of Simi Valley, California, pleaded guilty to attempting to murder a justice of the United States without reaching a plea agreement with federal prosecutors. A trial for Roske had been scheduled to start on June 9. After his arrest, Roske told a police detective that he was upset about a leaked draft opinion suggesting the Supreme Court intended to overrule Roe v. Wade, the landmark abortion case, according to an FBI agent's affidavit. Killing one judge could change the decisions of the nine-member court 'for decades to come,' Roske wrote over an encrypted messaging platform to another user in May 2022. Roske added, 'I am shooting for 3.' The leaked opinion draft led to protests at several of the justices' homes. Roske's arrest spurred the House to approve a bill expanding around-the-clock security protection to the justices' families. Roske also said he was upset over the school massacre in Uvalde, Texas, and believed that Kavanaugh would vote to loosen gun control laws, the affidavit said. Roske was apprehended after he called 911 and told a police dispatcher that he was near Kavanaugh's home and was having suicidal and homicidal thoughts. He was spotted by two U.S. marshals who were part of 24-hour security provided to the justices. In a court filing last Thursday, Justice Department prosecutors laid out Roske's planning for his trip to Kavanaugh's neighborhood: Roske searched the internet for justices' home addresses and other information, including techniques for breaking into homes and quietly killing somebody. He also wrote about killing judges in encrypted messages sent to another user, who isn't named in the filing. 'The thought of Roe v Wade and gay marriage both being repealed has me furious,' Roske wrote. In late May 2022, Roske purchased tactical gear, a lock pick, black face paint, a glass cutter, a suction cup and other items that he took to Maryland. On June 2, 2022, Roske bought a Glock 9 mm pistol from a gun store in Camarillo, California. The following day, he practiced firing the pistol at a Simi Valley shooting range, where he also purchased pepper spray. Two days later, Roske booked a one-way flight from Los Angeles to Dulles International Airport in northern Virginia. 'Roske also saved a map on his Google account that contained location pins marking the residential addresses of Associate Justices in Maryland and northern Virginia,' prosecutors wrote. After arriving at Dulles on June 7, 2022, he took a taxi directly to Kavanaugh's home. He texted his sister on the way, telling her that he loved her. Roske was still on the phone with the police dispatcher when officers arrested him and seized his backpack and suitcase. He later told investigators that he was thinking about how to give his life 'a purpose' when he decided to kill Kavanaugh.
The Guardian
17-03-2025
- Health
- The Guardian
Texas midwife arrested for allegedly providing abortions amid state's near-total ban
A Texas midwife has been arrested over accusations that she performed abortions in defiance of the state's near-total abortion ban, Texas attorney general Ken Paxton announced on Monday. Maria Margarita Rojas has been charged with the illegal performance of an abortion and with practicing medicine without a license, according to a press release from Paxton's office. Under Texas law, the illegal performance of an abortion is considered a second-degree felony. If convicted, Rojas could face decades in prison. Rojas' arrest is believed to be the first criminal arrest under Texas's abortion ban. Last year, Paxton's office sued Dr Margaret Carpenter, a New York-based abortion provider, for allegedly mailing abortion pills to a Texan. 'In Texas, life is sacred. I will always do everything in my power to protect the unborn, defend our state's pro-life laws, and work to ensure that unlicensed individuals endangering the lives of women by performing illegal abortions are fully prosecuted,' Paxton said in a statement accompanying the news of Rojas' arrest. 'Texas law protecting life is clear, and we will hold those who violate it accountable.' In the years since the US supreme court overturned Roe v Wade, enabling Texas and more than a dozen other states to ban almost all abortions, anti-abortion activists have grown increasingly fed up with the lack of prosecutions of abortion providers. In Texas, advocates have increasingly encouraged men whose partners have had abortions to strike back with legal action. Rojas, 48, operated a network of three clinics in the Houston area, according to Paxton's office. These clinics, his office said, 'unlawfully employed unlicensed individuals who falsely presented themselves as licensed medical professionals to provide medical treatment'. Sign up to Headlines US Get the most important US headlines and highlights emailed direct to you every morning after newsletter promotion Requests for comment from Rojas' clinics were not immediately returned. However, Holly Shearman, a midwife who runs a birthing center where Rojas sometimes worked, told the Texas Tribune that she did not believe the allegations. 'I've known her for eight years and I've never heard her talk about anything like that,' said Shearman, who said Rojas is a devout Catholic who often works with Spanish-speaking, low-income individuals. 'I just can't picture Maria being involved in something like this.' Midwives – in particular, midwives of color – have long been a target of US anti-abortion activism. As abortion bans spread across the country in the 19th century, midwives were often driven out of work or faced criminal consequences, which in turn led white, male doctors to siphon up their patients and dominate the medical field.
