Transcripts For CSPAN Hearing On Reproductive Health Care 20240713

Rep. Maloney the committee will now come to order. Good morning to everyone. The purpose of this hearing is to examine how state policies like those in missouri are impacting residents access to comprehensive Reproductive 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 i and State Governments e taking draconian steps to violate womens rights by restricting access to Reproductive Health Services Including abortion. These state actions include a burden,site undue 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 very good friend, congressman clay, for his leadership in requesting todays hearing. Missouri has taken some of the most extreme actions to limit access to Reproductive Health care. Missouri is one of six states with one remaining Abortion Provider. As we will hear today, it is at risk of having no providers at all. Missouris one remaining clinic is planned parenthood. We thank that clinics director, 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 Missouri State Health Department, ordered planned parenthood to perform medically unnecessary pelvic examinations on every single woman seeking abortion. This was an invasive statesponsored abuse of women seeking care. After significant public backlash, the state suspended this cruel practice. But dr. Williams also recently was forced to admit that he directed state employees to collect information about patients menstrual cycles to advance his ideological crusade. That is what they were spending taxpayers dollars on. I cannot begin to describe my disgust at these violations of privacy and breaches of trust by government officials. Sadly, missouris actions are not taking place in isolation. Other states have pushed for similar restrictions. I believe these states have been emboldened by the Trump 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. They did not invite one single woman to testify on that panel. Then they refused our request to have sandra fluke, a georgetown who was a Georgetown Law School student at the time, testify about the importance of Health Insurance coverage of contraceptives. They said she was not qualified. That iat that hearing asked in protest, where are the women . It is time to let women speak. It is time for everyone to listen. It is time for elected representatives in congress and in state houses across the country 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. But it is your decision and it doesnt belong to anyone else. I also want to thank Marcela Howell from in our own voice, which is part of the National Reproductive justice agenda. And fatima graves from the law center for all of her work and being here today and for helping the committee and me on this. Subject. I know recognize the Ranking Member jordan for his Opening Statement and i 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 placed what 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 , there was a common understanding about this fundamental principle. That life, in fact, is precious. Over the past few years, it seems our two sides have moved away from this basic understanding. Today, my colleagues on the other side of the aisle will charge me and republicans as being against women. Democrats will say, if youre not for them in this position, their position on this issue, then youre against all women. We want all people, including women and babies, to have access to worldclass health care. Statements to the contrary are simply false. And are meant to divide our country. Today, this congress is in the midst of an unprecedented impeachment inquiry against President Trump. I am proud that President Trump is one of the most 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. Second timothy 4 7, fight the 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 now yield one minute to the member from the great state of missouri, lacy clay, who requested this hearing. Rep. Clay thank you, madam chairwoman. I along with my constituents appreciate your calling this hearing today on an urgent issue that threatens the health and personal freedom of millions of american women. The assault against a 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 organizing of 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. Dr. Fox thank you, chairwoman maloney. I welcome you to your first hearing as acting chairwoman and look forward to continuing working together in your new role. We have had a productive working relationship over the years. I commit 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. However, law 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 now at a reflection point. After the governor of virginias horrific comments earlier this year there has been a national , outcry over the apathy shown by the proabortion Movement Towards babies that have been born after an abortion. This is an issue that 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 i can tell you exactly what would happen. The infant would be delivered. The infant would be kept comfortable. The infant would be resuscitated if that is what the mother and family desire. Then a discussion would ensure. Ensue between the physicians and the mother. Governor northam does not stand alone in this appalling stance. He echoes a planned parenthood lobbyist who expressed support for leaving an abortion survivor on the table to die, if that is what the patient and abortionist decided. In new york, the Reproductive Health act signed into law by Governor Andrew Cuomo removes protections for children born during an abortion attempt, leaving them at the mercy of the abortionist who just minutes earlier was trying to kill them. Illinois has also enacted a law that revealed the illinois partialbirth abortion ban act, removes licensing requirements for abortion facilities. Still, other states, notably massachusetts and virginia, having proposed legislation equally as alarming. Only two thirds of the state s have any laws to protect infants who survive abortion and positively enshrine their right to life into law. That is simply unacceptable. I hardly find anyone is losing access to anything, anyone save the defenseless, the unborn. The unborn are now even born alive. They are the ones having their rights deprived, and the American People find this intolerable. I find it to be an abomination. The pendulum in the states is not one swinging against women, not in the slightest. Some of my colleagues used to espouse the idea that abortion should be safe, legal, and rare. They espouse it no longer. Instead, on demand access to abortion up to and tragically even after birth is the new mantra. The fact that extremists wants are working to keep this everexpanding restriction on the right to life buttressed against the lives of babies born outside the womb, this should be a wakeup call to us all. Endll on Speaker Pelosi to her blockade against the bipartisan born alive survivors protection act. It would protect babies born alive in the jurisdictions that fail to do so. 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. , madam chairman. Thank you. Rep. Maloney i will briefly yield to congressman clay to introduce his constituent, dr. Nicholas. Rep. Clay thank you, i am happy to introduce to the committee one of my distinguished constituents, a highly skilled physician who has dedicated her life to providing Exceptional Health care for all women, the chief medical officer of planned parenthood of the st. Louis region in southwest missouri. She has also served as a 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. Dr. Mcnicholas performs her duties with skill and compassion. She is a compassionate healer who fiercely defends her patients rights and their privacy as well. Dr. Mcnicholas is a warrior for access to Quality Health care for women, not just in st. Louis, but across missouri and across the nation as well. Welcome, doctor. I yield back. Rep. Maloney thank you, congressman. Week are also joined by jennifer from st. Louis, missouri. She was holding that beautiful baby girl. Also, we are joined with fatima, president and chief executive officer of the National Womens law center. Texas, androm marcella howell, 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. And raise your right hand. Affirm ther to 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 that the witnesses answered in the affirmative. Thank you, and please be seated. The microphones are sensitive, so please speak directly into them. Without objection, your written statement will be made part of the record. With that, you are now recognized for your Opening Statement. Box good afternoon, acting chairwoman maloney, Ranking Member jordan, 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 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. Something i never imagined i 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 i learned my home state of missouri would insert itself in the middle of my grief. I searched for answers everywhere, yet we found no solace in them. Our daughter is not stillborn, would be born into a life of immediate and repeated invasive medical intervention. She would essentially have been born onto life support. With broken hearts, we knew 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 seek abortion are confronted with a litany of restrictions, including mandatory waiting periods, public and private bans, informed consent laws, 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 medical care i needed, my actual abortion procedure was the most everssionate care i have received from a physician. Jake and i left that day knowing we made the most merciful choice loving and 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 refer to women like me, women who had abortions later in pregnancy, as murderers. I never thought them to my governor would weaponize the Health Department to end safe and legal abortion in missouri. I did not anticipate they would enact an eight week abortion ban, a ban that would have made it impossible for me to make the best decision for our family. Let me be clear, my story does not give anyone the right to make judgments about good and reasons and bad reasons for abortion. A fetal diagnosis was my reason, but nobody should have to explain themselves or compare their stories to justify a deeply personal decision. I tell my story knowing i am a woman of privilege with means to and resources to access the care i needed, despite a complicated landscape of laws. Every day, women and people of color face racist and discriminatory policies carry the heaviest burdens when navigating Abortion Access. 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 her 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 simply begging lawmakers like you who have the power to create change 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 rose box. I have a rose tattoo above my heart so that she is with me every day. I am her mother. She is my daughter and will always be my daughter. I made decisions from day one as her mother. I made the most important decision of libbys life when we together with my husband we decided to terminate the pregnancy. It was a sacred, painful, personal decision. That is our story, unique to our family, and one that never should have included any politician. Thank you for your time. Rep. Maloney thank you for sharing your story. I will now call upon dr. Colleen mcnicholas. Mcnicholas. thank you active chairwoman maloney. Thank you for the kind introduction. My name is dr. Colleen mcnicholas. I am a practicing ob gyn in the state of missouri. I am the chief medical officer of planned parenthood in southwest missouri. For more than a decade, i have been honored with the trust of patients seeking a Broad Spectrum of Reproductive Health care 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 how we got here and the dangers we face when state officials abuse their power and disregard patients lives to pursue a political agenda. Despite the reality that abortion is safe, missouri politicians have put in restriction after restriction, ranging 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 just 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. Health officials admitted under oath they selected planned singled out planned parenthood for extra scrutiny. , including at the behest of antiabortion protesters. They came to our clinic five times in the first five months of this year. All while they conceded hospitals and Surgery Centers providing much riskier procedures went without a single inspection. During this inspection process, the Department Also admitted to keeping a spreadsheet of my 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 reinterpretation of a regulation which forced over patients to go 100 through multiple invasive pelvic exams. My colleagues and i in good conscience could not force patients to take their clothes off unnecessarily and injure endure a statemandated vaginal exam. Due to public outcry, the department relented, but that only confirms there was no real medical reason for the exam. Missourians want to believe that state officials charged with protecting Public Health have their best interests in mind. They want to trust that when they go to the doctor, their private medical information will not be mined Ready Department of health as part of a political fishing expedition. Governor parsons and director williams have repeatedly violated the trust of the community and compromise my safety 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 states 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. Despite this and many other serious Public Health crises, antiabortion politicians continue to divert precious resources to the overregulation of Abortion Providers. And targeting of Abortion Providers. In missouri, im happy to say that despite the unrelenting attempts on Reproductive Health care, our doors remain open, for now. Planned parenthood will continue the work of ensuring every patient that wants an abortion is able to access care with that care with dignity and respect consistent with their values, despite this possible impossible 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 put an end to this rampant abuse of power and keep abortion safe, legal, and accessible. Thank you. Rep. Maloney thank you for your work and testimony today. I am now going to recognize fatima graves. Ves thank you acting chairwoman maloney and members of the committee. Thank you for the invitation to testify today, especially on this first hearing following congressman cummings passing. He was a champion for justice on these issues. Goss graves. Tima 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 a persons liberty and equality and Economic Security, and everyone, no matter where they live, no matter their financial needs, should have access to abortion. Should they need it. As the Supreme Court sent, the 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 also know that legislation passing restrictions on abortion would limit lives. Rightsfacing the biggest invasion on the eve of the hundredth anniversary of the 19th amendment. , when women gained the right to vote. 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 regulatory and legislative efforts to shut down the states last abortion clinic. Missouri is not the only or even the first state to seek to end abortion, of course but what is , unique are the types of abortion bills being passed. Introduced and passed. Before this year, bans on abortion presented a direct challenge to roe, banning an abortion two weeks before and a missed period, were typically seen as too radical, even by many antiabortion advocates. What is also unique to this moment is the state legislatorss willingness to say why they are presenting these measures, giving the Supreme Court an opportunity to overturn or grossly undermine 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 that he would automatically overturn roe v. Wade. In the three years trump has been in power, he reshaped our federal judiciary in shocking terms to fulfill that promise. It is disturbing that earlier this year the district of health upheld a louisiana law similar to a law struck down in 2016. The Supreme Court has just agreed to review this decision. Term. This should be an easy decision. Nothing relevant has changed in the last three years, except the composition of the Supreme Court. But the law at issue in june does nothing to make abortion safer. Instead, such laws are intended to close clinics. They have done just that. The resulting shortage of Abortion Providers has led to longer waiting times for appointments increased travels to clinics, which result in increased costs, longdistance travel, hotel stays, additional childcare expenses, more time off work when people dont have it, and ultimately getting delays in the care they are seeking. These compound the other restrictions already in place, including restrictions on Insurance Coverage of abortion, all intended to make abortion unaffordable and therefore inaccessible. What these politicians are not representative of the will of the people. The public does not want the right to abortion overturned. In fact, 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 in our schools, work, health care, i have a birds eye view of how all of these fights are connected. The same misogyny that is 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. We think they can start by passing laws such as the Womens Health protection act. And teach women act. Each women act. Thank you. Rep. Maloney thank you so much. Ms. Stuckey id like to thank chairwoman maloney and ranking chair member jordan for the opportunity to appear before the committee. I am an author, a podcast host, 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 not dependent upon their humanity. I am here as a woman who believes female empowerment, equality, and freedom are not defined by her ability to terminate the life of a child. I am here as an american afraid for the fate of a country that no longer considers the right to life a prerequisite for the to liberty or the pursuit of happiness. I am here as a human being horrified by the violence and marginalization of a person based on where they died, in the womb. It is surreal to be here, and not because i am testifying before congress, but because of the subject at hand. It is incompressible to me that we are having a debate whether it is acceptable to kill a baby before they are born. Discuss i want to remind the committee of the true victims of radical legislation, preborn babies. There was a time when you could claim ignorance as the justification for allowing abortion. Only a few decades ago, we knew relatively little about preborn babies in early stages of development. It seems appropriate to some to deem abortion a privacy issue or an issue of bodily autonomy. Was safe, the motto legal, and rare. Proabortion advocates have abandoned these qualifications in favor of ondemand for any through all nine months for any reason. Barbaric laws in new york and virgina aim to codify unrestricted access to abortion until birth. Science and technology have advanced. We now know that a babys heart begins to beat as early as six weeks. The child can feel pain halfway as early as 20 weeks halfway , through the pregnancy. Babies born as early as 21 weeks gestation have survived outside of the womb. By 24 weeks, still only the second trimester, a fetus has a significant probability of surviving if born premature. Babies at this age have received lifesaving treatments for spina bifida. Any woman that has been pregnant or seen the child on the sonogram knows the undeniable humanity of their preborn babies. I was shocked to see my daughter in the womb at 11. 5 weeks, kicking, punching, flipping around. 11. 5 weeks is still the first trimester. Embryology tells us from conception onward a baby is a , human being with distinct dna, yet abortion advocates have doubled down on their efforts. Remarkably, many members of the socalled party of science insist upon referring to preborn children as cells. Clumps of cells. Speaking of abortion, as defenders ignore the existence of the child entirely, terms like reproductive freedom or autonomy and womens empowerment obscure 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 kind of deception would not be necessary. Abortion advocates know using accurate terminology is not to describe abortion is not effective pr, and does not make for a profitable business model. Lateterm abortions are performed by emptying the uterus of amniotic fluid. There are other cases of more grotesque methods utilized. Witnesses before congress have testified to congress about the neglect of babies who survived abortion. Many of whom die alone. Virginia Governor Ralph Northam the cleared earlier this year that a baby who survives an abortion would be delivered and resuscitated if that is what the mother and family desired. While tragic, prolifers should not be surprised by prochoice radicalism. This is the end of the logic of the proabortion case. There is no logical argument for abortion that does not apply to people who are born. America is included on the list of seven countries to allow including china and north korea 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. While i am thankful for this, i only wish the same basic compassion could be extended to the most vulnerable members of our own species. Thank you. Rep. Maloney thank you very much. Marcella howell. Howell acting chairwoman maloney, Ranking Member jordan, and honorable members of the committee, thank you for the opportunity to testify at todays hearing. I would like to take a moment to mourn the passing of chairman cummings, a fearless champion of human and civil rights. We promise to pick up his mental mantle and continue his fight for universal justice. Howell, founder and president of in her own voice womens reproduction agenda, a state partnership with eight 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 focus specifically on access rather than rights, asserting that the legal right to abortion is meaningless for pregnant people when they cannot access such care due to the cost, the distance to the nearest provider, or other obstacles. Across the country, we are faced with the ever complicated wave of abortion restrictions that continue to compound already existing barriers, making access to quality abortion care a privilege for the few rather than a human right for all. After the 1973 landmark roe v wade decision, the Supreme Court victory was immediately undermined and invalidated for people with low incomes with the passage of the hyde amendment. As one institute notes, because of social and economic inequality linked to systemic racism and discrimination, women of color are disproportionately likely to be insured through medicaid, therefore subject to the hyde amendments ban on Insurance Coverage of abortion. The decision of when and how to have a family or when to start or grow a family is a decision that should be made by a person pregnant 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 coercive mandated counseling, and mandated waiting periods, 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 abortions is because of the significant expense of having and raising another child, given that many are already parents. We cannot afford to endure another abortion ban, because we we are already battling discrimination, low wages, debilitating Childcare Costs and andtacks on immigrants, threats to our Voting Rights. These issues cannot be separated or siloed. Together, they are an attack to ability to live with full agency and raise our children with dignity. I thank the committee for its dedication to addressing these issues through a lens of justice and equity and valuing the experiences of underserved community, including black, latinx 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 full reproductive justice can be actualized. Thank you. Rep. Maloney thank you. I want to thank all the panelists for your important testimony. Without objection, the following members are authorized to participate in todays hearing. Congresswoman shupe. Congresswoman czajkowski. Congresswoman lee. I will now call on lacy clay to begin the questioning. He is the originator of this hearing. Chairwoman letm , me thank you for convening this hearing to call attention to the intrusive restrictions on the health and wellbeing of thousands of women in my Congressional District at home state. In missouri, we are down to one last abortion clinic. State Health Officials are doing everything in their power to try to shut the clinic down. They are trying to regulate missouris last clinic out of existence by imposing rules and regulations that are medically unnecessary, overly intrusive, or virtually impossible for any Health Care Provider to comply with. As you heard dr. Mcnicholas explain the Health Department , began enforcing a medically unnecessary requirement that women submit to an additional pelvic exam three days before being allowed to have an abortion. Dr. Mcnicholas, as a physician, is there any medical reason for such a requirement . Dr. Mcnicholas thank you for question, representative clay. As i previously stated, forcing women to undergo medically unnecessary pelvic exams shows clear disregard for the potential traumatic impact that that has. We are talking about a country where, every 73 seconds, an american is victimized with sexual assault. That rape is 12 times higher for rate 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 had never had a public exam before, who didnt even know what her parts were. As a reminder for those who of you who never had a pelvic exam, that means putting your fingers inside someones vagina, forcing somebody, this minor, never having had a pelvic exam, to have that invasive procedure when there was absolutely no medically relevant reason to do so, was traumatic for her, her mother, and for the physician who was required to do it. Rep. Clay how did that make you and your staff feel . Dr. Mcnicholas so i can tell you that in the times we had to comply with this regulation, im not sure who cried more, the physicians, the staff, the patients. We had patients apologizing to us that we were forced to do this to them. Our patients are accustomed to after hoopough hoops after ho p to get an abortion. They were resigned that this was part of the deal. It was traumatic to everyone. Lay if that was not outrageous enough just weeks , ago, we learned state staff were ordered to keep a spreadsheet tracking the menstrual cycles of women that who visited st. Louis planned parenthood clinic. Doctor, do you find the practice of tracking the dates of patients periods problematic . Dr. Mcnicholas i find it bizarre and a 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. Rep. Clay what do you make of the fact that a trained physician has imposed these medically unnecessary and intrusive requirements on providers and patients . Dr. Mcnicholas it is shocking our department of health is head by a physician, dr. Brenda williams, and more shocking is he is a ob gyn. He knows better, but instead of relying on the medical ethics he was taught and the many 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 what it is like to treat patients. Rep. Clay what would it mean for patients in missouri if your clinic closes . Dr. Mcnicholas the consequence of that is there are so many consequences to that. Certainly people will be forced , to carry pregnancies they cant, shouldnt, and dont want to, continuing the cycle of poverty for some. Many will be forced to travel long distances, expending resources they already dont have to access that care. Really 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. Thank the entire panel for being here today. Madam chair i yield back. , rep. Maloney i will now recognize representative roy. Name,oy i will take the clay. In 2015, i got a call from a young woman who was one of my dearest friends. She is like a little sister to me. She said the baby in her belly, her third, might be missing part of his brain. The part that connects the left and right hemispheres. She was terrified and couldnt ask questions fast enough. She had a monthly checkup with ob gyn the following week. 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 right after the appointment, understandably angry and terrified. Terminate . What . She asked the question with the same tone of ordering a copy at coffee 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 abortionegally have an 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. How did it all turn out . Her ultrasound was completely normal at 24 weeks. They just could not get a good read at her 20 week appointment. Her baby was born in may 2015 and completely healthy. It was a boy, by the way. None of us can imagine life without him. He is my godsend. In the winter of 1996, a couple went in for a checkup. They were excited. They had recently been informed they had twins. The doctor came in and performed more tests. Time passed by and the doctor returned. The doctor seemed concerned, as they believed the twins had cystic fibrosis. They would only survive for a few hours, they were told. I recommend termination, said the doctor. The couple said the first thing that came into their mind, no, and walked out. They chose life. Those twins grew up to become excellent men. I know this because jonah works for me. Right here. He is one of my staffers. Stuckey planned parenthood is not about health care, it is about abortion, no . Stuckey yes. Rep. Roy planned parenthood took in 1. 67 billion in revenue, a 14 increase the year before. Does that sound right to you . Yes. Rep. Roy government funded amount to 563 million. Planned parenthood received 60 million under title 10. In august, 2019, planned parenthood confirmed they would withdraw from title x funding rather than comply with the new rule. Does that sound right . Stuckey yes. Rep. Roy do we need planned parenthood for health care for women . Ms. Stuckey planned parenthood is not in the business of health care, they are in the business of abortion, by refusing title x care. They could have financially and physically separated their Abortion Services from the rest of their Health Care Services, but they refused. To do that. Isy have decided abortion central to their mission, whose which is why they fired the ceo, who was ousted because she did not prioritize abortion high enough. Rep. Roy in texas, we have 435 federally qualified Health Centers. 735 Health Clinics in total. 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 that number sound right to you . Yes. Trep. Roy rep. Roy does texas provide Health Care Solutions for women . Yes. I am from texas as well. Roy yes maam. The 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. Compared to the larger number and has only been in existence since 2016. Does that sound right to you . Yes. Rep. Roy my point is simply this, i cant speak to the other 49 states. We should create entities and allow the market to thrive. If we can get a Healthy Health care system, we can get more options. My time is running out. Could you please share your view of the ways in which we can provide Better Health care than allowing an organization like planned parenthood, which throws be er provision women already abortion is not health chair now recognizes congresswoman norton. Rep. Norton what kind of Health Services do you provide . Dr. Mcnicholas planned parenthood provides a Broad Spectrum of Reproductive Health care services, including cancer screenings, the full spectrum of Birth Control options, transgender care, primary care. Some planned parenthoods provide prenatal care. It looks like you provide the kind of acrosstheboard care that 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. 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 intrusions into health care, you will find that there are federal bans that include federal employees, federal prisoners. Included on this list are low income residents of the district of columbia. Our jurisdiction wants to provide on their own pay for Abortion Services for low income women the way almost 20 states already do. We are not demanding the federal government does this. My question is why we are finding that restrictions on coverage are related to economic mobility for women, on coverage for abortion and other such services. Apparently there is a on the level 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 most vulnerable of folks, the right to abortion does not feel time 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 in the district, in part because 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 no 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. Would you yield . I would be glad to yield. I just want to give dr. Mcnicholas an opportunity. We heard a stunning statement that planned parenthood is not in the Health Care Business or provide health care. I want to give you the opportunity to respond to that. Dr. Mcnicholas abortion is health care. I think the best way to demonstrate is to share the story of a patient who, when unable to express an abortion, died because of the complications she had prior to pregnancy. 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 why abortion is health care and is needed and necessary when they needed where they live. Rep. Maloney thank you very much. Thank you very much, chairwoman. Earlier this year, Governor Northam of virginia said if a mother is in labor i can tell you what would happen. The infant would be delivered, the infant would be resuscitated mother if that is what the family desired, then a discussion with ensue between the physicians and the mother. Do you support Governor Northams comments . Dr. Mcnicholas i cant speak for Governor Northam. What 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. Rep. Foxx so as a physician, what would be the harm in 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. The first is which using that language and perpetuating the notion that is a real thing is harmful in and of itself. It only serves two purposes. The first is to shame people that need lifesaving care in the second and trimesters of pregnancy. It also creates an environment in which Abortion Providers like myself and my colleagues are targeted and harassed. First and foremost, it is dangerous for those reasons. The second reason is because medicine is complicated. There really is no way for me to boil down more than a decade of education and practice to give you a single reason why doing such things is harmful to patients. Rep. Foxx the answer should have been either yes or no. Earlier this year 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 their 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, currently doesnt and never has. Rep. Foxx does planned parenthood v. Casey give states the authority to regulate abortion in accordance with the opinion of the respective constituencies . Dr. Mcnicholas i believe the most recent decision, and we have policy experts on the panel, the most recent decision in whole Womens Health set a precedent that restrictions must be based and grounded in science. That is what we are asking for, that abortion is treated to the medical standards and evidence and science. Rep. Foxx are there more federally qualified Health Centers than abortion clinics in 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 Health Care Centers 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. In 2005, a planned parenthood study found a baby would interfere with education and work, or would not want to be a single mother or have relationship problems. 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, are done on the basis of convenience. I dont see a logical or moral justification for killing an unborn child on the basis of simply not being wanted. Rep. Foxx thank you. Madam chair, earlier dr. Mcnicholas said dr. Williams had taken an ethics oath, and should know better than to do what he had done. I want to quote from the classic hippocratic 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. Mr. Roy asked me if i would enter into the record this article. Thank you, madam chair. I yield back. Rep. Maloney the chair now recognizes representative lynch. Rep. Lynch thank you for holding this hearing. And also to my friend and colleague the gentleman from , missouri, thank you for your leadership as well. I want to thank the witnesses here today, especially mrs. Fox, 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 recently adopted draconian measures on abortion. Alabama has banned abortion at any stage of pregnancy, apparently even in the case of rape or incest, while several other states have banned abortions as early as six weeks. Which 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 so restrictive that the basic core constitutional right to privacy would be effectively and totally eliminated. Meanwhile, other states are actively considering similar restrictive measures. This all occurs against a backdrop in which republicans in congress have repeatedly attempted to eliminate womens access to contraceptive Services Offered by groups such as planned parenthood. Ironically, even though those contraceptive services actually prevent unwanted pregnancies, and thereby reduce the number of unwanted pregnancies and abortions. Ironically, 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 health of pregnant women who are feeding in educating and housing children. Simply opposing abortion does not make you prolife. The Supreme Courts decision on reproductive rights have sought to acknowledge and 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. All of 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, obstructing contraceptive services, 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 counselor graves or miss howell. And thank you for your kind words regarding mr. Cummings. There are millions of women each year and miss mcnicholas, dr. Mcnicholas, you might have some input. Insight on this as well. If we have millions of women who come to planned parenthood and other providers and yet, the government steps in to deny funding, and this came to the floor. I spoke against this. This actually came to the floor when 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 produce unintended pregnancy 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. Secondly, it is providing them 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 . Many people actually go to planned parenthood for a number of different Health Care Services. They go not only for Birth Control, but also to have tests for diabetes, for mammogram screenings. A lot of the people we represent and we work with go to planned parenthood clinics as they are primary providers. To remove services they think are vital to them because people are opposed to the fact that some planned parenthoods also do abortions means that you are cutting off health care for people who most desperately need it. Thank you. The only thing i would add it is a Good Opportunity for me to correct something she said about planned parenthood. Planned parenthood did not want 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. I yield back. I have a unanimous consent request. I have a unanimous consent request. Thank you, madam chair. I want to clarify that the law according to what was identified by my colleague. I want the consent to be added into the record. This goes into the detail of the law that georgia would not imprison women who had an abortion. Thank you, madam chair. Dr. Mcnicholas, what is the medical consensus for age of viability of a fetus . I appreciate the question. Viability is a complicated medical construct. There is no particular gestational age. There are some pregnancies in which a fetus will never be viable. There are a number of factors we think about when considering 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 different services. I am not asking about the other services. I cant tell you how many his abortions i have done. I have had a long career of taking care of people. You manage a facility. Can you tell me or you are the medical overseer. Can you tell many how many abortions the facility in missouri performs each week . I can tell you i believe it is publicly available. I can give you a rest estimate rough estimate how many abortions we perform a year. Roughly around 3000. How do you dispose of 3000 fetuses . Missouri has a state law that requires we send the remains to pathology. What is the latest term abortion you have performed . Gestation period in weeks . My practice includes the provision of abortion up until the point of viability. Weve already had a discussion about 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 gestation period of the fetus you are aborting . My practice includes abortion care through the point of viability. As we discussed let me put it this way. Yes . 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 it would you abort a viable fetus . Again, every patient is different. I cant make any i am asking about a viable fetus. If the law didnt prevented 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 law preventing it . Again, given that the reality for people choosing abortion as that there are many reasons, there is not a single thing that defines somebodys choice. It is a reflection of their 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 here that you would abort a viable fetus for any reason if the law did not prevent it. Mr. Massey, abortion is moral it is important. It is health care. I support people being experts in their own lives in making decisions for themselves. It gives me some hope that you here understand that people do not support you when you would say you would abort a viable fetus for any reason. But given what you told us in your Opening Statement, and knowing what you have said, we know that you would. It does give me hope that you still know in your heart that is wrong. I am not sure can i respond to that . If you would answer my question, you could. You will not, so i will use my remaining time asking mrs. Stuckey, should any reason be a good reason for having a abortion . Absolutely not. It is a life in the womb from the point of conception onward. I am troubled by how flippantly she said there are 3000 abortions performed every year. Defenseless human beings. 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 . No, no. Finish your answer. Go ahead. I do not understand the illogic of saying that killing a child inside the womb is moral. It is health care. In what other situation besides when a child is defenseless do 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 for me. I recognize the gentlewoman from illinois for five minutes. Thank you mr. Chairman, and 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. Dr. Mcnichols i am interested in hearing your thoughts on this point. Thank you for that question. I think, as i previously alluded to, viability is not an easy thing to assess. It requires knowledge in multiple things about any individuals pregnancy. 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 parenthood in peoria. I am proud my state of illinois is an oasis in the sand. Very proud we are a shining light in the dark. Thi mrs. Stuckey you say you want to see the same basic compassion. You made that comment. I want 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 medicaid. 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 becomes 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. That is what i believe. 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 things are mutually exclusive. That we have to be on your side of the bait the debate. 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. We dont do anything about that. I reclaiming my time. In the wake of many draconian measures, my own state of illinois signed into law, the illinois Reproductive Health act ensures coverage for abortion care and updates clinic regulations to lift the burden from Abortion Providers. How does eliminating coverage bands improve access to abortion care for women who are working to make ends meet . It will mean the right to abortion will actually be a right that is accessible for women. For women no matter their income. Whether or not that right is accessible to you should not be depending on your financial means. That is not what the court says. Because 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. Whatever their political interests are. How will rolling back targets of abortions provide as improved access . Here is what we know. These targeted regulations of Abortion Providers are designed shut down clinics. There designed to shame patients. They are designed to confuse people and disrupt the doctorpatient relationship. All of that makes abortion less accessible. I have to say, the rhetoric that frictions and regulations make it so difficult for the people trying to live their lives to 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. They are 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 aisle refuse to recognize the baby as a baby. Refuse to recognize it is a person. There have been a lot of medical advances over the last several decades. Can you tell us about specific Scientific Evidence supporting the personhood, the humanity of the baby and the viability . Embryology tells us the child, from the moment of conception, has a separate dna. When we hear these euphemisms being thrown around like my body, my choice immediately obscuring the life of the child shows me the proabortion argument does not deal with fact. It deals with feeling. That is why we have had a hard time getting a a clear answer for what abortion is. What does it do . Talking about tearing a child apart limb by limb with forceps is not a very good pr 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 counsel women. They offer 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 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 beyond abortion in the womb. As we all were horrified, 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 like to act that this is not a thing. The cdc says at least 143 these babies were born alive and not attended to and 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. There is a logical and moral slope, and seems the proabortion side is sliding down quickly. I think it is an excellent point you brought forth that planned parenthood the majority of women have abortions because of convenience. How does that those findings from planned parenthood itself undermine the narrative, particularly about late term abortions, that it has something to do with the health of the mother . We can have conversations about the health of the mother in 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 heard the doctor 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 yield back. I recognize the gentlewoman from michigan. I am glad 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 to make such blatantly false claims. The young 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. 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 a number of times on this panel. The mistruths that are spoken about ripping fullsized babies out of wounds and killing them. That is not true. Selling of parts is not true. It just seems like it is enjoyed to say because it paints this horrific picture. We should say the truth. Statistics. I am so sorry to hear about the 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 passed in missouri would have 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 ban 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. We found out that before most 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 quiet. I was pregnant during the time the state legislature was enacting the ban. At our 20 week ultrasound, they could not get a couple views of the heart. Everything looked good. Physicians were not concerned. What should have been a happy day to know we were having a successful pregnancy because a pregnancy after a fetal diagnosis, ended with me being in the car sobbing hysterically 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. What i kept saying to my husband is, what if they find something devastating . I cannot protect my daughter. I understand that miss stuckey and i do not agree on things, that i would like you to remember that you are calling my husband and i murderers. I would ask for compassion and 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 that 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. Women, we are targeted. For us to have the same passion of a discussion about saving women who want to have their babies and this medical industry is failing us, we need to have the same passion. I yield back my time. Im going to say, we are sorry that 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 who 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 youd perform an abortion. Or lets say, ok. Someone came in with an eight 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 a pregnancy out of convenience. I have never in 10 years of taking care of in people have people reject a pregnancy because it just wasnt 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 . We talk to all of our 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. Do you make any efforts to report the person who is engaging 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 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 wants 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 experience in 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 toured 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 tissue . 20 years is a long time. But you back to the clinic. I absolutely 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. We did pass the 24 hour waiting period bill 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 . 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. I recognize the gentleman from california, mr. Connor, for five minutes. Thank you, representative clay, for convening this hearing. I would like to discuss state 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 patients . 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 may experience pregnancy. I have had the honor of taking care of many trans and nonbinary folks in my career. 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, fear 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 them unequivocally is that there 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 misgendering of the patient. I think it is important to remember that gay and lesbian folks also want to build families. They are parents. I myself have a wife and 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 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. Laws are regulations done by this government that allows other people to discriminate against them 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 laws. Representative cloud. 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 rights supersede. I do believe, while having compassion for anyone who has to go through a difficult situation, that the right to life supersedes the right to 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 . I appreciate your question. Abortion was around before the 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 pregnancy, 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 approach patients, i talk to them about what their options are for pregnancy termination. That depends on a variety of things including what stage of pregnancy theyre in, what other Health Problems they have, where there any particular instances could you describe what happens in the process of an abortion . Apparently, i am the only one 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 limb by limb 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 the womb. I also want to address miss box. I did not say the term murderers 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 womb and protecting babies unborn. I have very little time left now. Ms. Graves, you mentioned 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 a whole lot. Now, we know a baby can be viable at 20 weeks. We know a baby feels pain. I ask unanimous consent to submit this peer review on fetal 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 and the whole Womens Health decision consider 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. It became about a quest to end Abortion Access. No objection. We accept the entry. I now recognize congresswoman pressley 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 holding the line on this First Full Committee Hearing sent the transition from chairman cummings. We thank all of you for being here. We are going to leave this meeting for the house pro forma session. We will take you live to the house floor on cspan. I the house will be in order. The chair lays before the house a communication from the speaker. Rooms k the speakers washington, d. C. , november 29, 2019, i appoint the honorable Debbie Dingell to act as speaker pro tempore on this day. Signed nancy pelosi, speaker, house of representatives. I the prisoner will be offered by the guest chaplain, rabbi arnold e. Resnicoff, chaplain, washington, red, d. C. The chaplain god, we pri, reflect, meditate in different ways, but come together to give thanks. This thanksgiving week times are hard, hostility and tension fill our air waves and our lives, but thanksgiving ig a choice, give thanks, build on moments that give hope or give up to despair. On this house floor last week, congressman john lewis walked across the aisle honoring, embracing senator Johnny Isakson with simple but inspire words. I will come over to meet you, brother. When we see another not as other but instead as brother, sister, neighbor, that is cause for thanks. During holidays, some feast and some go hungry, not for bread alone but for kindness and hope. When words bridge a grap, when character and decency touch our hearts, that is cause for thanks. God, help us give thanks, celebrate good and hold on to faith that better times will come. Nd may we may, amen. I pursuant to section 2a of 71. E resolution the journal of the last days proceedings is approved. The chair will lead the house in the pledge of allegiance. I pledge allegiance to the flag of the United States of america and to the republic for which it stands, one nation under god, indivisible with liberty and justice for all. Pursuant to section 2b of House Resolution 713, the house stands adjourned until 2 00 p. M. On tuesday december 3, returns toe legislative hearing. You can watch live on cspan. These numbers are even worse for black and a native american woman. Maternal about the health care crisis. I would like to acknowledge this conversation being about compassion for the innocents. I rolled out the peoples justice guarantee, which calls for the abolishing of the death penalty. One in 25 are wrongfully convicted of innocence. 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. There is an additional stress as well. I want to give you some of the states that have some of the worst abortion bans, and some of the worst Maternal Mortality outcomes. Alabama, georgia, ohio, missouri, unfortunately, and a lot of the southern states. South carolina, texas. Those are the states that primarily have these outrageous abortion bans, which prevent people from accessing abortion care. Time is expiring. Would you please wind down . They also have the highest mortality 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. Thank you for being here today. As a mother, i have had the privilege to feel life quicken in my womb. As a grandmother, i know the joy of grandchildren. 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. But or unable but were unable to have children of their own. I have had friends and family who have been adopted, and they are very grateful. I have friends and family who have adopted children, and they are very grateful. They have brought such blessings to their family. However, i have become increasingly concerned as of late about the actions taken by my colleagues across the aisle. Washington democrats 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 utmost protection. Speaking of medical innovation, i think we can all agree that women having access to all health care is important. That being said, 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 . Yes, thank you for that question. First, i do want to address an issue i think we can all agree on that the Maternal Mortality rate in a developed country is way too high. I think the number is 3. 3 times higher for africanamerican women then it is for white 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 when we talk about the mortality rate is 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 if you want to collect antiabortion i am fine with that, too. Maybe even more so than ronald reagan. We 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 contraceptive care in order to receive title x funding. I heard earlier a comment about this gag rule. It actually is not a gag rule. It is you cannot encourage someone to get an abortion, but you can counsel them neutrally. It is not actually a gag rule. It is not a limit on free speech. President trump has insured that these policies can go forth. And of course given states the freedom to protect life inside the womb. For that, i am thankful. You might be familiar with efforts by House Republicans to protect babies who are born alive after an abortion attempt. Many argue the born alive act is unnecessary because doing so violates existing criminal law. Do you believe federal law should be clarified to ensure babies born alive after a failed abortion should receive critical medical care . Yes. It 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 further recognizes this childs personhood and says this is the medical treatment required. For a child outside the womb. We are not even talking inside the womb anymore. Democrats cannot even get on board with that. Theyre not any undue burdens or undue regulations. This is not preventing Abortion Providers from giving abortion. It is simply saying if a child survives an abortion, attend to the child. It should be really simple. If you really are prochoice and you are really not proabortion, as ive heard many times during the hearing, that should be a nobrainer. I understand a baby can survive as early as 23 years old. Can you elaborate on how age of viability has changed in recent years and what has made that possible . As technology and medicine advances, hospitals are able to give incredible prenatal care. As 21 weekss young has been known to survive outside of the womb. That is pretty early in the second trimester. That is only halfway through ass the pregnancy. 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 if she were to be born prematurely. 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, we are talking about mere location. On the one hand, we talk about them as if they are just these parasites to be discarded as remains of pregnancy, is what i think i heard the doctor say earlier. And then all of a sudden when theyre outside the womb, they are babies. As you have pointed out, even then, they do not seem to be respected by the proabortion side. Thank you. I yield back. Thank you. 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 answer them in writing. I thank you for your testimony. And i hope you do not miss your flight. Thank you. The next speaker will be Debbie Wasserman schultz. Thank you, madam chair. I have a question of you. I would like missed ducky to miss stuckey to hear my question. As you not want there to be an assumption that i was saying it while she was not in the room. I just want to clarify that miss stuckey is here expressing her own opinion exclusively and has no expertise in the subject matter whatsoever. Is that accurate . I wanted 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 one to give you specific reclaiming my time. Mike was 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 better access to prenatal care . How about the passage of the Affordable Care act to ensure it remains the law of the land to so that women are not considered preexisting conditions because of our existence as women. And the potential for us to be dropped or denied coverage because of our tendencies to get pregnant and have babies, which happened all the time 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. Provisions we advocate to make in fact, it is not a solution that we ever suggest to reduce the Maternal Mortality rate. It is a ridiculous edition. It is not a ridiculous suggestion. 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 florida. I have seen republicans in my state introduce bills that ban abortion after six weeks. Theyre fast tracking a proposed draconian parental consent law. We need to be unequivocal about calling them up for what they are, sinister attempts to interfere with womans right to make a choice on her own Health Choices, and steps in the larger political plan to ban all abortions. As we have heard, missouri has enacted so many restrictions on providing abortion care that only one clinic is left standing. Because my time is limited, i want to ask dr. Mcnicholas, the excuse 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 necessary patient delays would lead to women having leader abortions, which are more expensive and can pose a Higher Health risk . Thank you for the question and acknowledging the many intersecting realities people are navigating when trying to access basic care. For many of them, it means driving 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 pushed from seven weeks to 15 weeks after twovisit abortion became a fourvisit. 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 and your daughter that you brought with you. You received test results that revealed your daughter, libby, had a chromosomeal anomaly when you were around 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 . Revealed your daughter, libby, had a chromosomeal anomaly when you were 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 two different dnas. Theyd see two dnas, so theyd say its two people. My next question, a 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. 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 and ovum, where they combined a form to form a fertilized egg, was broken and thousands of these fertilized eggs were lost. I just want to ask people in the room whether or not they would agree with the headline in the newspaper the following day that said it was a human tragedy that these lives were lost. Just consider that. My next question, again, is back to you, dr. Mcnicholas. In regards to abo and rh incompatibility, why do i as an 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 n emergency medicine physician, patients whove come in bleeding from an abortion, and the unfortunate thing is the obstetrician u. S. Taken 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 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 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. You are the president of the National Womens law center. Presumably, you know something about the history of sterilization in our country. Where certainly tens of thousands of women, at least, were sterilized. If government has the power to prevent a woman from having an abortion against her will, 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 having 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 universal criminal mental background check on all gun purchases, at least for the witnesses who are still here. Would you reach across the aisle to the prolife witnesses to 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 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 under medically supervised conditions and are safe and allow women and families to have choices. The changes in title x are designed, again, to take away or limit choices. The attack on planned parenthood, insidious, designed to take away choices. And being willing to deny Women Health Care is the price you have to pay for their ideological stance. And miss 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, miss box, of 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. Are missouri affiliate sees 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 the risks of wisdom teeth, but having an abortion is safer than having your wisdom teeth removed. I think mischaracterizing abortion as anything other than safe, it is inappropriate. Its health care. Yes, unfortunate outcomes will happen for some people. But by and large, it is 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 x, dr. Mcnichols, planned parenthood decided to pull out of title x, even though it does not provide funding for abortions. Is that correct . Thats correct. Why did planned parenthood decide to leave title x . 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 x 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 x, but i think the point is well taken that with reduction of planned parenthood seeing title x patients, there will be a tremendous gap in services for patients, particularly who are low income or people of color. 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 ing 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. Mortality rates 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 from pregnancy complications than other women. Is that correct . Thats correct. Which 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 who has spent state on dollars enforcing unnecessary pelvic exams on women and tracking their menstrual cycles for planned parenthood patients, 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 addressing Maternal Mortality. The hypocrisy is so unjust and absurd. Ms. Howell, your organization did a phenomenal study finding that black women face greater barriers to access to Reproductive Health care and abortion care. What are some of the factors that are a factor with the discrepancy in Health Outcomes . Some of the factors are that that black women disproportionately get their Health Insurance from medicaid , which already then bans their access to abortion care and to get coverage. So what happens is that when they find they are pregnant and they decide they want to terminate a pregnancy, they have to go through a number of steps. 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 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 race, income, or zip code. Fighting for equitable access to 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 vs. Wade. I was a teenager, only 16 years old, and had to go to mexico for a gut wrenching back alley abortion. Again, before roe v. Wade. Abortions were not safe nor legal in my own country. So, i refuse to stand by and see even one more 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 having the each woman act. 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. 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 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. Thank you. I will now call on an incredible woman. A newly elected woman, ken dashcam kim 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 , supporting our efforts. I laugh because i thought you were going to talk about Ayanna Presley. A member of our freshman class. 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, 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 prevention. This is not, stop 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 legal procedure, something that one out of four women has before shes 45 years old. This is more common than a tonsillectomy. This is common. Chances are excellent. Pretty much 100 of the people in this room knows someone who has had an abortion. So i came to discuss those things. But then i heard all kinds of rhetoric. Youas a doctor, and thank for being here, i feel like i have to push back 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 is a philosophical and religious 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 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. 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 three years old, he had an injury. 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 rate of children in his condition was not 50 , it was not 98 , 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. We chose life. We chose hope and freddy started to recover. Even then, the doctors said he would have permanent brain damage and would not have a meaningful or full life. Im happy to say that today freddy has fully recovered. Freddys outcome was different. He graduated from college and now works for the hospital that saved his life. It was a different outcome than what doctors told us it would be. His accident is now a memory also an opportunity to learn about the value of human life. As this pertains to todays hearing, in this country, we have countless situations where people determine the value of an unborn human life. Abortions are sometimes planned and executed based upon diagnosis that have uncertain outcomes. Sometimes, as a result, babies are born. Theyre alive and they are killed as part of a planned abortion procedure. This should not only shock the conscience, but should make the American People sick. Im not asking for an answer to the next question im going to ask. Im just going leave it up to the people that are watching, but where does it stop when we have people determining the value of human life . I yield back. Would you yield to me . I yield to dr. Box. Thank you, mr. Keller. Mr. Keller, thank you for that moving story about freddy. I think you illustrated something very important to us. Doctors can make predictions, but theyre not god and they dont know whats going to happen. Weve heard a lot of things today, but i could not let this hearing close without saying that there are many things weve heard that should make us shudder, but i believe that what us intoer said leaves what i want to say next, but comparing killing a baby to removing wisdom teeth is absolutely beyond the pale, and when we have people as mr. Keller asked the question, where is this decision to kill innocent life going to take us in this country . To say its terminating a pregnancy and as miss stuckey said, never, ever facing up to what youre really doing is scary to me, and i want to say that miss lee said republicans characterize women who have had an abortion as evil. Ive never heard a republican say that. We grieve, and i said that at the beginning. We grieve for the women who find themselves making that decision. I cannot imagine that its never that it is ever easy. I hope that it is never easy for any woman to decide to kill her unborn child. I hope and pray that is not easy, and i would never characterize a woman who makes that decision as evil. Thank you, madam chair. I think the gentleman. She yields back. 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 am talking to an allmale panel. I usually have to ask, where are 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. Box. I believe your voice is the most 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 miss box, and i know its difficult to testify before congress on anything, but especially something that is so personal. How did it feel to hear officials in your state and across the country say hate all, say hateful, hateful rhetoric about the decision you are making. How did it feel . Its insulting, and i appreciate representative foxs sympathy. But i would like to say that while my particular reason for abortion of fetal diagnosis was sad for our family, most women, including myself, experience relief after having an abortion. I think when the answered a question, i said our abortion was the first day we began to heal from the grief of our diagnosis. I have cried a lot of tears about libby, but they have all been in grieving my daughter and never once as a regret to make a medical choice as her parent. I also wanted to say im 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. Dr. Mcnicholas, you have cared for hundreds of patients in ms. Box situation. What impacts have you seen on the patients you care for in missouri that 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, abortion bans 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 theorry that realization, the full realization that the people that are charged with protecting their health have completely abdicated their responsibility based on a ideological viewpoint. I support people who do not believe in abortion choosing not to have one, but i also think that it is right for every other individual to make that choice based on their values. I think you for the courage that all of you having your work and what you have done for other women and our country. I want to share that i have within my district two planned Parenthood Centers, and if you go to them, at the end of the day, when women are getting off 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. And planned Parenthood Centers provide primary and Preventative Health care to many who otherwise would have nowhere else to turn for care. And 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 parenthood is defunded, there is no other Health Facility that can address these needs and help these women. I cannot tell you how many women come to my office and tell me that at certain times in their life, the only place they could get health care was planned parenthood. I want to put that on the record, that i think it is a scandal that anyone would try to defund a service that is providing so much help to people that need it. This has been an important hearing to me, and i intend to continue working on this area and helping women receive the respect and health care deserve. I would like to call on my good friend, jackie speier, and give her five minutes and thank her for her relentless leadership in support of womens issues and women. Rep. Speier thank you, madam chair, and thank you for women. To the service of other women. Ms. Box, when you testified earlier, i was sitting here and i started to cry, because i share the same experience that i 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 came and picked her up and took her to another state to get the abortion. We cannot force women to have to jump through hoops and travel long distances to get the healthcare that they deserve and that is legal under the law in this country. And to see what missouri has done with their laws and how difficult they have made it is so repugnant to me and it should be repugnant to every woman in this country. Now, ms. Box, let me ask you the question that i think about a lot. When you were required to wait your 72 hours and received this counseling, what was the counseling that you had received . Ms. Box well, first i want to say that i thank you for sharing your story with me, and i am sorry for your loss. Rep. Speier thank you. Ms. Box i know how painful that is. I am not the legal expert, and we dont really have is it is it counseling . Rep. Speier you didnt recognize it as counseling. Ms. Box oh, ok. Yeah. Youre right. I didnt understand that was considered counseling. Rep. Speier what was it . Ms. Box so it is 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, with the doctor who works at 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 no judgment and counseled us and all of the thing available to us and gave us medically accurate, sciencebased information so that we could make a decision as parents that was informed and full of love. Rep. Speier thank you. Thank you again all of you. And i yield back. Rep. Maloney 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 and gynecologists, repro action, the guttmacher institute, and the American Civil Liberties union. These letters express grave concern over the packet the impact that state restrictions are having on the health and economic wellbeing of women and men in america and their families. I ask unanimous consent that these letters be entered into the official hearing record, and i so order. I like i would like now to thank our our incredible witnesses for fine for their testifying, and for their lifes work, and they 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, right and this hearing is now but before i conclude this hearing, i would like to thank in the powerful women of this committee, especially especially ms. Speier, ms. Presley, ms. Kelly, ms. Ocasiocortez for their leadership on this issue for encouraging the committee to examine it. I would also like to thank congresswoman judy chu, congresswoman jan schakowsky, congresswoman barbara lee, and congresswoman kim schrier for joining us this afternoon and for their tireless work to preserve access to abortion and Reproductive 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 we are going to continue on this issue. Thank you. 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