Transcripts For CSPAN3 Senate 20240704

Allow abortion on demand up to the moment of birth. It takes all the state level protections and abolishes them. Bottom, line it doesnt codify roe, mr. Chairman, becomes one of the most extreme laws anywhere in the world. Colorado, new jersey, new mexico, oregon, vermont are passing laws with absolutely no restrictions. The democratic bill is in the same ilk with taxpayer funding. Lets take a look and see how that would put us as a nation regarding the rest of the world. As you see behind me, 47 of 50 European Union nations limit abortion at 15 weeks or below. France is at 14 weeks. China, north korea, iran and a few other nations allow abortion on demand up to the moment of birth. Your bill would put us in that category. 14 week limitations, france, belgium, germany, spain. 12 weeks, denmark and norway. My proposal is having a National Minimum standard of 15 weeks for exceptions for rape, incest, life of the mother, pregnancies. Why do we do this . By 15 weeks, and unborn child has teeth, fingers and toes. They begin sucking their thumb or making a fist. Each finger moves independently. Fingerprints have begun to develop. Fully formed organs and can feel pain. If you operate on a 15weekold unborn child, the standard practices to provide anesthesia because a baby can feel pain. Thats why 47 of 50 European Union nations prohibit abortion on demand after 15 weeks. 15 weeks or below. Your proposal, mister chairman, puts america in a category i think most americans reject. Abortion on demand up to the moment of birth, taxpayer funded. Which i believe is barbaric. What do we do . Were going to debate this, topic try to find consensus. But as for me, im going to lend my voice to the idea that america postdobbs should not be like north korea. And china. That america postdobbs should draw a line. States can take their own path up to a point. The line ive drawn it is 15 weeks. A line that puts you in association with the civilized world and rejects the barbaric practice of abortion on demand up to the moment of birth with taxpayer funding. Npr poll today said 66 of american support limiting abortion after 12 weeks. I dont know how long it will take but i do believe overtime in a postdobbs World Americans are going to come to consensus on this issue. The numbers are pretty compelling for early stage abortions. Most americans feel comfortable with a woman making that decision. But the more we learn about the unborn child, the more we understand how it develops. The more were going to have a consensus in this country that there needs to be a point in time, mister chairman, where we draw a line. Allowing abortion on demand up to the moment of birth with taxpayer funding doesnt make america a better place. It makes this an outlier in the civilized world. So, i welcome the debate. Its going to be part of the 2024 election cycle in beyond. I will close with this. This is a moment for america to have some self reflection on a very difficult topic. Why does most of the world, particularly europe, limit abortion at 15 weeks or under . And why would we choose to be north korea and china on this topic . It will be a debate worthy of a great nation. Thank you. Thank you, senator graham. I certainly respect your point of view but i want to respond to it, because youve made reference to a bill that i support. Here are the facts. According to the center for Disease Control, abortions after 21 weeks make up less than 1 of all abortions in the United States. One abortions later in a womans pregnancy happen, they can hardly be considered elective. There are three main reasons why women need access to an abortion late in pregnancy. Maternal health endangerment, diagnosis of severe fetal abnormalities which did not show up until late in the pregnancy, a restrictive state laws that made it difficult for a woman to get an abortion earlier in pregnancy. The exceptionally rare cases that incur after 24 weeks are often because a fetus has a condition that cannot be treated and will never be able to survive. Suchs and its definitely, where the fetus forms without a brain, complete brain or skull, or a limp body wall complex, where the organs develop outside the body cavity. I dont believe this is a nonchalant decision late in pregnancy. I believe this is a medical emergency in many cases. And at the situation, i think the analogy to other countries and their standards does not apply. Today, we welcome five witnesses. And i thank them for joining us. Before we swear the witnesses, and i will briefly introduce the democratic witnesses and turn to senator graham to introduce his witnesses. Our first witness is amanda zurawski. Mr. Of ski has joined us from texas, she is here to talk about her personal experience of being denied health care when her she needed it. Im grateful for your traveling here, this zurawksi. Michelle goodwin, chance was professor of law at university of california irvine. She also serves as the director for biotechnology and Global Health at ucla law. Welcome. Doctor nisha verma its an ob gyn in georgia, where she provides comprehensive Reproductive Health care. She also serves as a fellow with physicians for Reproductive Health. Thank you, dr. Verma. Now senator graham, your witnesses. Thank you, chairman. We have dr. Ingrid stop, is that right . She has been a present Board Certified ob gyn physician in San Antonio Texas for 27 years. She received her bachelor of science in physiology from Oklahoma State and her medical doctor from Washington University school of medicine. She completed a residency at the university of Texas Health Science center, san antonio. Shes a fellow of the American College of ob gyn physicians and a member of the American Association of pro life ob gyn specialists. She is currently practicing with b Hospital Group and is the Vice President of medical affairs for charlotte lausanne or institute. She currently serves as a medical director for anyone can pregnancy resource enter in san antonio, texas and on the medical Advisory Board of save the store. Dr. Monique pretty good . Pretty close . She is a Board Certified ob gyn specialist with over 20 years of experience in patient care. Teaching Research Health policy, Global Health and bio ethics. She graduated from Mount Holyoke college and received her medical degree from brown university, shared a medical degree from harvard and completed a residency at Yale New Haven Hospital and her post doctorate i ship center for Health Services research at the university of chapel hill. Shes a faculty member at the duke University School of medicine from 2003 to 2018. She subsequently served as Senior Deputy assistant administrator at the bureau for global at the United States agency for international development. Shes a Senior Research associate at the center for ethics and culture at the university of notre dame. Her Clinical Career has focused on caring for women in underserved and disadvantaged populations. Especially African Americans and native american communities. With a focus on womens medical, social and psychiatric problems. Thank you. Thank you, senator graham. Let me lay at the mechanics of todays hearing. After we swear in the witnesses, each witness will have five minutes for an opening statement. Then senators will have an opportunity to ask questions for up to five minutes. Can i ask the witnesses to please stand and raise the right hand . Do you swear and affirm the testimony you get before this testimony will be the truth, the whole truth and nothing but the truth, so help you god . Let the record reflect to the witnesses have all answered at the affirmative. Our first witness will be nice zurawksi. Chairman durbin, Ranking Member graham and members of the Senate Committee on the judiciary, thank you for the opportunity to testify before you today. My name is Amanda Zurawksi and im here to tell you a bit about my experience with the texas abortion bans. But eight months ago, i was thrilled to be cruising through the second trimester of my first pregnancy. Its carrying our daughter, willow, who had finally, blissfully been conceived after eight months of grueling fertility treatment. My husband josh and i were beyond thrilled. Then, on a sunny august day after i just finish to the invite list for the baby shower my sister was planning for me, everything changed. Some Unexpected Symptoms arrived and i contacted my obstetrician to be safe and was surprised when i was told to come in as soon as possible. After a brief examination, my husband and i received the harrowing news that i had dilated prematurely due to a condition known as cervical insufficiency. Soon, after my membranes ruptured and we are told by multiple doctors at the loss of our daughter was inevitable. It is clear that this was not a question of if we would lose our baby, there is a question of when. Asked what could be done to ensure the respectful passing of our baby and to protect me, now that my body was unprotected and vulnerable. I needed an abortion. I Health Care Team was anguished as they explained there was nothing they could do, because of texass anti abortion laws. The latest of which had taken effect two days after my water broke. It meant, but even though we would, with complete certainty, lose willow, my doctors didnt feel safe enough to intervene as long as her heart was beating or until i was sick enough for the ethics board at the hospital to consider my life at risk. I shouldnt have had to wait in anguish for days for the inescapable ill fate that awaited. But this was august, 2022 in the state of texas, where abortion is illegal unless the pregnant person is facing a lifethreatening physical condition aggravated by, caused by or arising from a pregnancy. People have asked biden travel to a state where the laws arent so restrictive, but we live in the middle of texas and the nearest sanctuary status at least an eight hour drive. Developing sepsis, a condition that can kill in under an hour in a car in the middle of the west texas desert or on an airplane is a death sentence. And its not a choice we should have even had to consider in the first place. How we could do was wait. I cannot adequately put the words the trauma and despair that comes with waiting to lose either your own life, your child or both. For days i was locked in this bizarre and avoidable. Would willows heart stop or what i deteriorate to the brink of death . Dancer arrived three long days later. In a matter of minutes, i went from being physically healthy to developing a raging fever and dangerously low blood pressure. My husband rushed me to the hospital, where we soon learned i wasnt septic shock. Made evident by my violent teeth chattering and in capacity to even respond to questions. Several hours later, after stabilizing just enough to deliver our stillborn daughter, my vitals crashed again. In the middle of the night, i was rapidly transferred to the icu, where i would stay for three days as medical professionals battled to save my life. What i needed was an abortion, a standard medical procedure. And abortion would have prevented the unnecessary harm and suffering that i endured. That only the psychological trauma that came with three days of waiting, but the physical harm my body suffered, the extent of which is still being determined. Two things i know for sure. The preventable harm inflicted on meat has already made it harder for me to get pregnant again. The barbaric restrictions that are being passed across the country are having real life implications on real people. I may have been one of the first two is affected by the overturning of roe in texas, but im certainly not the last. More people have been and will continue to be harmed until we do something about it. You have the power to fix this. You owe it to me and to willow and to every other person who may become pregnant in this country to protect our right to safe and Accessible Health care. Emergency or no emergency. No one should have to worry about the life of their loved ones simply because there was child. Your job is to protect the lives of the people who elected you. Not endanger them. Being pregnant is difficult and complicated enough, we do not need you to make it even more terrifying. And frankly downright dangerous to create life in this country. This has gone on long enough and its time now for you to do your job, your duty, and protect us. Thank you. Doctor skop, please proceed. Thank you, chairman durbin, Ranking Member graham and members of the committee. As you have heard, im doctor and grid skop, a Board Certified obstetrician practicing a texas for over 30 years. Today advocate for both of my patients, a woman and her unborn child. Every successful abortion and the life of one of my patients and often harms the other as well. In the coming legislative session, senator graham will likely reintroduce federal minimum protections limiting elective abortion after 15 weeks gestation. With exceptions for rape, incest and the life and health of the mother. Conversely, senator baldwin has reintroduced the Womens Health protection act, which ironically does nothing to protect the health of a pregnant woman from a dangerous abortion. The unburnt human life its never acknowledged and abortion is presented as procedurally and morally equivalent to a vasectomy or a colonoscopy. This proposed legislation insist there can be no common sense safeguards to protect a woman. The words choice, voluntary and consent are completely missing. Opening the door to others who will benefit from abortion. Sex traffickers, incestuous abusers and on whaling fathers. And provider is not required to be a physician or even medically licensed. Despite its euphemistic name, the Womens Health protection act prioritizes the death of the unborn human at the expense of the health or even the desires of a pregnant woman. A woman and her unborn child are not natural enemies. Most pregnancies ended delivery of a healthy baby to a healthy mother. Media sources have misinformed to the public, alleging that abortion limits will prevent an obstetrician from providing necessary medical care, increasing Maternal Mortality. This is not true. Every legal restriction protecting unborn life allows a physician to use his reasonable medical judgment. That is, to follow the standard of care to determine what to intervene in a medical emergency. Lets compare how second trimester regulations versus unlimited portion throughout pregnancy will actually impact american women. 90 of abortions in the second half of pregnancy are obtained for the same reasons as early abortions. Social and financial concerns. Additionally, there are other important factors. Coercion and a decision. Nine months is a long time for a woman who desires her child to say no to a coercive partner. Decisional uncertainty leaves a woman likely to regret aborting a baby whose kicks she can feel and with whom she has begun to bond. The physical risk of abortion increases as pregnancy progresses. The risk of Maternal Death to the 76 times higher in the second half of pregnancy compared to in early abortion. The dilation and evacuation procedure used for multiple most later abortions involves focusing organist wrong muscular cervix and blind insertion of sharp instruments to dismember and extract a struggling fetus and may cause hemorrhage, cervical damage, retain tissue and uterine preparation. Mental Health Complications including anxiety, depression, suicide and substance and alcohol abuse are higher after abortion. Particularly after late over coerced abortions or if there are preexisting Mental Health issues. European records linkage studies document a woman has six times the risk of suicide in the year following an abortion compared to childbirth. Unfortunately, the u. S. Centers for Disease Control does not even attempt to link Mental Health deaths to abortion in its dramatically incomplete Maternal Mortality data. Americans intuitively recognize these risks as three quarters support a limitation at 15 weeks and only one in ten support abortion without gestational limits. Extremely late abortions are sometimes perform by labor inducted because the fetus has grown too large to easily dismember. European studies document over half of babies survive induction abortion and 69 of u. S. Late term abortions in this report they do not routinely kill the fetus first, so it is likely that many babies survived late abortions and then our passively or actively killed. Infanticide used to be a red line, but no longer. As legislative protection for these unfortunate children has repeatedly been rejected. Fetal Neurological Research documents that the pathway is required for pain perception are in place by 15 weeks gestation. During an abortion, the fetus displays all the responses that we to it exhibit if we were torn limb from limb. Ive cared for many tiny babies, delivered at the edge of viability, around 22 weeks. Their precious faces express pain when theyre fragile bodies undergo therapeutic procedures. Fetal surgery as early as 15 weeks can be performed to reveal some neurological and vascular disorders before birth. Of course, these babies are always offered pain relief. How can we justify painful dismemberment of unborn babies of similar gestational age is just because we cannot hear their cries . Thank you. Professor goodwin . Committee chairman durbin, committee Ranking Member graham and distinguished members of the Senate Judiciary committee, my name is Michelle Goodwin and i am a chancellor professor at the university of irvine and the abraham penske visiting professor at harvard law school. In its 2021 2022 term, the United States Supreme Court decisively undercut stare decisis and the rule of law when it overturned roe v. Wade and planned parenthood v. Casey. In doing, so the Supreme Court unleashed a torrent of unnecessary uncertainty, fear that the future of the protections for Womens Health and their rights to life, liberty and safety. Justice thomass concurring opinion placed all privacy rights on highlight, save for interracial marriage, a status enjoyed by the justice himself. It for all other privacy rights, including marriage equality, access to contraception, freedom from state imposed sterilization and more, his concurrence remains a cause for serious alarm. Despite the promise protections articulated by the majority and justice kavanaugh, that freedom of travel would be preserved and that its dismantling of rome would return abortion rights to the states, today some legislatures are seeking to dispossess citizens of access to the ballot. Whether by enacting provisions making it more difficult to vote or engaging in efforts to rewrite states laws related to ballot and initiatives and referenda. There by introducing anti democratic principles into the democratic process itself. The postdobbs era expose it is not only a cruel disregard for the lives of those most affected but also a lack of regard for constitutional law and foundational principles and values. Such as freedom of movement, freedom of speech, freedom of association, privacy and separation of church and state. In the aftermath of dobbs, women, girls, people with the capacity of pregnancy are more at risk of state level, criminal surveillance and before. Whether in the effort to track their menstruation and travel. Bill of rights once proudly championed by our government because it protected speech, because it protected bodily privacy, because it protected freedom from government overreach including cruel and unusual punishment, it to now is vulnerable. Understandably, women and girls who do not wish to become pregnant are not prepared for motherhood or whose health is placed at risk by pregnancy and miscarriage are horrified, absolutely horrified, about credible, present dangers and those that lurk ahead. The United States bears the worry, worrying distinction as, quote, the deadliest nation in the industrialized or developed world to be pregnant. This is what barbarism looks like, this is what cruelty looks like. Nationwide, as noted by justice breyer, child birth is 14 times more likely than abortion to result in death. Ill repeat that. Childbirth is 14 times more likely to resulted in death than by abortion. As reported by nina martin and renee monte in, more american women are dying of pregnancy related complications than any other developed country. In fact, only in the u. S. Has the rate of women who die during pregnancy risen. As we heard from the Texas Observer shows, and my prior scholarship explains, this trend maps with the destructive antiabortion legislating and dismantling that has gone on in our doctor and its been exacerbated between 2010 and 2013. And now in just rapid exhilaration. More recently, data showed that the u. S. Maternal mortality crisis has worsened in the period overlapping with covid19 and as well in the period since dobbs itself. Today, you will hear more about these matters from me. Let me just say that, as i close, this period of time since dobbs has unleashed criminal actions against women and their doctors. It is also unleashed civil surveillance. The type of which includes, in nebraska, a mother and her daughter being criminally pursued. In texas, doctors facing 100,000 dollar fine in 99 years incarceration should they try to help a patient terminated pregnancy. In louisiana, a woman being forced to gestate a fetus that had no skill development. And wisconsin, a woman needing to bleed nearly to death before her doctors could intervene. And as you mentioned, senator durbin, right after dobbs, the case of a tenyearold girl having to flee ohio to get to the state of indiana in order to terminate a pregnancy due to rape. Thank you so much. Doctor wubbenhorst . Chair durbin, Ranking Member graham and members of the committee, thank you for your invitation and the opportunity to testify this hearing. My name is dr. Monique wubbenhorst, practice and Board Certified ob gyn with more than 30 Years Experience and patient care, teaching research, Health Policy and Global Health. Id like to begin by noting that the Dobbs Decision presents an opportunity to mitigate abortions many harms to women. On board, children families and community. Abortion not only post source to the, mother it is also by definition always lethal to an embryo or fetus and unborn child, it was a human being, a member of the human family. Not a clump of cells or potential child but a child assuming the human form. Abortions close to kill that human being and patriots or prevents any disease, therefore is not health care. This is reinforced by the fact that the majority of ob gyns do not perform abortions. Studies show that the percentage that do as declining and has been for decades from high 40 1985 to between seven and 24 at present. Given this, abortion cannot be considered essential health care for women. If abortions health care, my question is, what disease are you treating . Clinicians caring for pregnant women have two patients. Advancements in technology have allowed us to recognize that the fetus is a patient within the patient. If the unborn child was not, human disinvestment research and Clinical Care would not have occurred. But that view changes only if the same child as unwanted by his or her mother. The current emphasis on dilation and evacuation in the second trimester really arises from a eugenics view of abortion. Its a recognition admission that the fetus is not truly a human being and ignores the fact that fetuses do experience pain in earlier gestational stages. Most abortions are elective. The bar for safety should be very high and there is evidence of the safety of both medical and surgical abortion is overstated. As noted earlier by my colleague, the risks of abortion increased dramatically. Bartlett at all in 2004 found that the risk of a woman dying from abortion, not experiencing complications but the, i increased 38 for each week of gestational age. Abortions performed past 21 weeks had mortality rate 76 times greater than abortions done in the first trimester. Abortion does not prevent pregnancy complications or reduce Maternal Mortality. A womans individual risk for pregnancy complications such as diabetes, even mortality, its estimated but cannot be predicted with certainty. Theres no way to predict whether an individual woman and will suffer a pregnancy complication and any presumed effective abortion mortality is speculative and based on statistical sleight of hand. It does not address the causes of Maternal Mortality, in particular cardiovascular disease and infection. The women in the United States adverse pregnancy outcomes, for mostly African American women, are in fact from the eugenics you point to the unfit. The early eugenics it is made similar arguments proposing contraception is sterilization at solutions to medical and Public Health problems. Therefore, we must consider that the effect of Public Health measures and medical Treatment Patient education that are needed to improve maternal outcomes are the real answer to Maternal Mortality, not abortion. Four pregnancies for serious complications, occur league delivering of an unborn child may be necessary but such deliveries not an abortion because the schools to save the life of the mother in the life of the fetus if possible. This is ethically permissible. As a law, in medicine its paramount. Premature delivery is not induced abortion according to the American Association for prolife ob gyns. And the double declaration upholds of theres a fundamental difference between abortion and necessary medical Treatment Center carried out to save the life of the mother. Even if such treatments result in the loss of her unborn child. Since roe v. Wade, an estimated 17 million unborn African Americans have been boarded in the United States, which is more than the populations of the countries of senegal and cambodia respectively. And slightly less of the entire population of the netherlands. This means the deaths of not only 17 million black people who were aborted but all their descendants, families, hopes and dreams. Annually, approximately 300,000 black women undergo abortion every year. What 2021 there is approximately 518,000 births to black women. A number that continues to decline. We must ask ourselves, how is this destruction of innocent life reproductive justice . How does one defend the deliberate killing of the most vulnerable members of minority groups, especially in parts to that group that have been and continue to be in decline . Rather than black women achieving bottle autonomy and control of their fertility, rather their fertility is being controlled. There is substantial Racial Disparities and abortion, rates abortion mortality and non abortion related mortality between black women. A rate which is 2 to 3 times higher than white women, even though we comprise only 12 to 14 of the total u. S. Population. An estimated 684 black children are boarded every day. African american women also of the 2 to 3 times higher mortality from abortion compared with white women. Therefore, black women have the highest rates of abortion and the highest rates of Maternal Mortality. Both of these facts cannot be true if abortion reduces Maternal Mortality. In conclusion, the medical, Public Health and social landscape postdobbs offers many opportunities to help and support women to carry their unborn children to term. These include pregnancy resource, enters programs to improve maternal, Health Interventions to treat unborn children with disabilities as well as prenatal hospice and Stronger Civil Society engagement in the mission of strengthening families. The prolife message is one of profound hope and healing, of love and encouragement, of walking with women and parents and families through often difficult circumstances and helping them to thrive. Thank you for your invitation to this, hearing i look forward to your questions. Dr. Verma . Good morning, chairman durbin, Ranking Member graham and distinguished members of the Senate Judiciary committee. My name is dr. Nisha verma and im a Board Certified, fellowship trained obstetrician and gynecologist providing full spectrum Reproductive Health care. That means i do everything from cancer screenings to delivering babies to supporting people as they decide to continue or end a pregnancy. Im a fellow with physicians for Reproductive Health and i am also a proud southerner. I was born and raised in north carolina. I currently provide care in georgia and i have lived in the southeast for most of my life. I decided to stay in georgia after the Supreme Court overturned the constitutional right to abortion care. In georgia enacted a law that bans most abortions in our state last year. I decided tuesday knowing georges law threatened to make me a criminal for providing lifesaving care to my patients. Because i made a commitment when i became a doctor to serve my home and my community in the south. Every day, georges law forces me to grapple with impossible situations where state laws directly violate the medical expertise i gained through years of training and the oath i took to provide the best care to my patients. Because of a law that is not based in medicine or science, and forced to turn away patients that i know how to care for. Ive had adolescents with chronic medical conditions that make the pregnancy is very high risk, women with a regular period to dont realize theyre pregnant until after six weeks and couples with highly desired pregnancy who received a terrible diagnosis of a fetal anomaly, cry when they learned they cant receive their abortion in our state and begged me to help them. Imagine looking someone in the eye and saying, have all the skills and the tools to care for you but our states politicians have told me i cant. Imagine having to tell someone, you are sick, but not sick enough to receive care in our state based on our laws very narrow exceptions. Abortion is extremely safe and none of the arbitrary barriers imposed by politicians make it any safer. In fact, the National Academies of sciences, engineering and medicine published a comprehensive study for the safety of abortion and pointed out that the biggest threat to patients is medically unnecessary restrictions. One of my patients, ill call her am, gave me permission to share her story with you all today. Her experience brings the findings of the study to life. She studied with infertility and she and her husband were thrilled to see the positive pregnancy test after they transferred their final embryo. Then, at 17 weeks, when there is no chance of her baby ever developing longs that would allow it to live outside of her, her water broke. She went to the hospital but, because her baby still had a heartbeat, her doctors can do anything to help her. Instead, she had to wait to get sick. To start bleeding heavily or develop an infection of her uterus that could spread into her bloodstream. M shared with me that, to be denied the basic medical care i needed, to be told that i must first be at risk of dying, to be forced to relive the trauma of losing my baby every day for five days because of georgias law, the trauma of that on top of my losses devastating. Shes been her babys name was ezekiel charred walls, which means gods strength. And that she would miss him at every major milestone he would have had in his life. I stayed in georgia to provide care for people in my community but my heart breaks every day for my patients like m as i bear witness to the pain they have to carry because of these restrictions on Abortion Access. We know from recent data that already thousands of people have been forced to remain pregnant and have faced developing serious medical conditions as a result. We know the cities with higher numbers abortion restrictions are the same states with worse Maternal Health outcomes, where marginalized populations are facing the largest burden. Already the u. S. Has the highest Maternal Mortality rate of all high Income Countries in the world and data from the cdc shows us that this crisis is only worsening. I understand that abortion care can be a complicated issue for many people. Just like so many aspects of health care and life can be. I also know that abortion is necessary, compassionate, essential health care. And that my patients are capable of making complex, the awful decisions about their health and lives. No law should prevent them from doing so. Im unwavering in my commitment to support people in my home in the south. It shouldnt have to be this way. I urge you to listen to the stories of people who provide and access abortion care. I hope these stories help you understand that abortion care is not an isolated political issue. And to see how profoundly restrictions on Abortion Access harm all of our communities. Thank you for having me today, i look for it to your questions. Thank, you doctor verma. Thank you to all the witnesses. Miss zurawksi, a cant remember testimony as compelling or as forceful as yours. And i do this for a living. When i heard a story, as you present it, i thought for a moment, what would i feel like if you are my daughter . Going through this, the joy of a possible grandchild that has been erased and now youre struggling to live. An arbitrary political obstacle to saving your life. And some, point you had to be so sick and near death before they would finally agree to terminate the pregnancy. As you listen to the testimony from witnesses who share your feelings and dont, what was your reaction . Thats a good question. Its very complicated, as doctor verma said, everything abortion is complicated. I understand that. It gives me a lot of hope to know that there are people like you and like some of my fellow witnesses who are fighting for safe Successful Health care. But its also infuriating to know that there are people who think that what happened to me was okay. That it should have happened and that it should continue to happen. Once again, your answer is direct and has great meaning for me, personally. I hope for others. I would like to ask doctor skop a question. Based on your profession and medical expertise, with a reasonable degree of medical certainty, tell me when life begins. 96 of biologists agree, and i agree, this is scientifically proven, that life begins at the time the sperm fertilizer as an egg to create a zygote. Which is the first stage in the process of human life. The termination of a pregnancy is taking on life at any moment after the moment of conception . The Legal Definition of abortion is an action performed with the intent to and the unborn human life. As the answer in the affirmative . Yes, sir. Do you support senator grahams bill . Im here today in the capacity as a clinician and as a researcher. And as ive stated in my testimony, i think there are many reasons to support senator grahams bill based on the effects that late term abortions have on women. Which ive noted in my practice can be devastating. Particularly the case that many of these women are coerced into these abortions. Im not of that level, im trying to stick to the original question. But its my understanding that, if you believe an abortion occurs when pregnancy is ended after the moment of conception, then the notion of his bill limiting abortion to 15 weeks suggests that would be the taking of human life for 15 weeks after birth. Is that correct . I understand what youre saying. There is a difference between what is politically feasible and what is morally defensible. I think our country does need to have a conversation about the reasons that we are taking human life. In my mind, this gets to the heart of the issue in the debate. When does life begin . The debate has been going on for a long period of time. Maybe from the beginning of civilization. Im not sure i have the right answer, im not sure doctor skop has the right answer. Were trying to find a humane response. When i listen to this zurawksi, i understand, if you start for the moment of conception and says she asked whether what she did, literally at the brink of losing her life, before you could end that abortion, if you ask yourself, what about the life of the mother . Is that a critical element to . I think it is. Professor goodwin, youve talked about what women are going through now with data privacy and the possibility that they are going to be tracked as to whether they visit an Abortion Clinic and penalized by their home state. Its not a possibility . It is a possibility. Already in the state of idaho, there is legislation moving forward to track whether people would leave the state and travel. What we see is a dismantling, vulnerability of constitutional principles that date back centuries. And abortion is being used as a proxy to dismantle fundamental constitutional principles. Including the right to travel. Dr. Wubbenhorst makes a point about the number of African American women who are seeking abortions, would you like to respond to that . Yes, i would. Senator durbin, in the state of mississippi, a black woman as 118 times more likely to die by carrying a pregnancy to term than by having an abortion. The state of mississippi has notoriously been a death sentence for black women dating back to the time of slavery, through jim crow into the present. If we dont thread that needle together, then theres a lot that we are missing. Theres a reason why black women in mississippi have sought to be able to terminate pregnancies for their own bodily autonomy, for their own safety, for their own health. Mississippi is one of the deadliest places not just in the country to be pregnant, but one of the deadliest places in all of the industrialized world to be pregnant. And right, now as our antiabortion measures being spread through what was the u. S. Confederacy, what we see here the people who are most harmed where the people most harmed during american slavery and jim crow two. That happens to be black women. Think you, professor. Senator graham . Thank you. Three interesting discussion, i think we need to put it in context for the world is at. Doctor skop, skop, its that right . Are you from texas . Im from texas. Amandas situation is terrible. How does, what happened in texas . Amanda, i want to say, im so sorry at your loss of willow and im so sorry that your doctors its texas law. Ive heard you texas law of course because i practiced and i want to understand. As well as all the other laws in the state. Every single law allows an exclusion productivity is that a reasonable medical judgment to determine what to intervene and a medical emergency. Which is usually defined as a threat to the life of the mother or permanent irreversible damage to an organ or an organ system. None of the states have the terminology that the threat must be immediate. Doctors know, and obstetricians have always known, even prior to dobbs the Hyde Amendment has been in place since the late 70s. And the Hyde Amendment allowed and exclusion for life of the mother. So, doctors have been practicing and ive not changed my practice in any way since the Dobbs Decision. The American College of obstetrics and gynecology in regards to the horrible situation that amid defend herself in previable, pre rupture of the membrane where labor does not ensue and the baby is a long way from being able to live outside the mother. The American College acknowledges that the risk of infection is high, which can become sepsis, which can threaten the mothers life. But likelihood that the baby cant make it to an age in which he can live outside of the uterus is very low. And they tell us, and obstetricians do follow a cogs recommendations for the standard of care, they tell us at the time of diagnosis that we should offer immediate termination of pregnancy. Which they define as induction or dilation and evacuation abortion. Or expectant management. So, in a woman who is not currently infected and sick, ive had patients who have wanted to stay pregnant in hopes that they could get the baby to a gestational age where he could live. But it has always been the standard of care and continues to be the standard of care to offer delivery at that time. Most of my patients have opted for induction rather than dnd because they wanted to have a baby to mourn. But either one could have been offered thank you. 15 weeks, is it fair to say that the baby has a heart be a 15 weeks . Does anybody on the panel disagree with that . As a matter of fact, the baby has a heartbeat about two months before 15 weeks, is that right, dr. . 23 days after conception, there is a muscular chamber innervates by electrical impulses pumping blood cells, with sir oxygenated through the babys body. Does anybody disagree with what i said about the european standard that 47 of 50 years can nations limit elective abortion at 15 weeks or less . Does anybody disagree with that . Good. The bottom line is 55,000 babies are aborted after 15 weeks in the United States. Is that right, dr. Wubbenhorst . Most are elected. This will matter. So, i am for my bill, im not asking you to be, but im for it. Let me tell you i am for. I like america, at some point in time to say, 15 weeks is being pretty good to me, that the baby as well developed, can feel pain, you cant operate on the baby medically without anesthesia because the baby can feel pain there is nothing unreasonable about trying to draw a line at 15 weeks 1 47 of 50 european nations do that. With exceptions for rape, incest, life of the mother. Whats unreasonable is allowing up until the moment of birth, that is exactly what your bill does. Puts it in the category of china and north korea, i welcome this debate, we are not going to back off. We are going to try to have america and line with a civilized world, not north korea and china. Nothing good comes from will sell abortion on demand and 15 weeks on the baby can feel pain. Senator whitehouse . Thank you, chairman. Welcome to the ukraine and hold witnesses talks with all parties aimed at resolving the. One of the conflict. Things i this noticed phone conversation about the dobbs shows the great decision was importance to that in order to get had its 2 growing its where the relations with ukraine and justice is in favor of chinas willingness to that decision maintain the momentum of wanted to go, cooperation they had to in all change fields. The 2nd, since before Legal Standard escalation of the ukraine crisis, from china house a balancing of interests to irresponsible leadership country and history and a member of the u. S. Tradition security council, has been. In committed to promoting a balancing of peace talks in an interests, one of the objective and interests impartial manner, is the interest of the and has stayed in communication with woman relevant involved parties. In the well, lets talk to procedure our correspondent Shelby Wilder who is. In in kyiv. History and shelby, what more do tradition we know about, you go zelenskyys phone call back to ancient history with president xi, . Before women had rights, like the right to yes, well vote, ukrainian president like the right to Volodymyr Zelenskyy have credit said today that without the permission of their he believes that husband. Because of this phone call, and also the appointment of ukraines it looked like ambassador to china the rights announced of women today, were being that it would boost deliberately bilateral relations removed from the with beijing. Equation and as you by the mentioned, there was justices of the positive comments Supreme Court coming from the ukrainian president , and in that saying that his context, how did it feel to you . How did you feel your rights, your interest were being considered as he went through the experience that you had to . I felt i had absolutely no right to make a decision for my own body, for my own health, for the health of my child. You know, i thought about when my grandfather was in the hospital, similarly also had sepsis. And my dad and his siblings were making the decision on how he should receive health care and what kind of treatment he should receive. What i couldnt understand in those three days where i had to sit and wait to get health care is, how is it that my dad was able to make Health Care Decisions for his dad, but i couldnt make my own Health Care Decisions for myself and for the child that was inside me. I had no right, i had no opportunity, neither did my Health Care Team. In addition to changing the Legal Standard to get the result they wanted, the other thing that stuck out for me and that decision was Justice Alito s language that roe v. Wade, and i quote him here, was agreed just the wrong from the start. So, presumably, that means the start, back in 1973. Well, after that start, while roe was egregiously wrong, aledo came up for this committee, and he had the chance to tell us that he thought roe was a grievously wrong, make that observation about that case. Instead, he hid that sentiment, he said, instead, roe v. Wade is an important precedent of the Supreme Court, is decided in 1973. Its been on the books for a long time, its a precedent thats been on the books for several decades, it has been challenged, has been reaffirmed. No egregiously wrong, everything designed to reassure us that he was not going to overturn that decision. So, looking back, he looks a lot like a sleeper agent predetermined to attack roe, wouldnt disclose what he was up to go until he had the majority that he needed to change the Legal Standard and destroy the legal precedent. I think its a very unfortunate episode in the Supreme Courts history. Dr. Vermont, one of the groups ive heard the most from about this has been ob gyn doctors who expressed real or at what this means for their practice, particularly in circumstances where pregnancy has begun to go wrong. There are very difficult decisions that have to be made, that balance the life of one fetus against perhaps another, or if its risk to the mother and in that context, they view these laws as forcing decisions and disabling them from making decisions that are customary medical practice. Could you comment on that and what some of the circumstances are that you consider to be most dangerous . With regard to these laws. Absolutely, thank you for the question. I can tell you, as the ob gyn on this panel who provides a full spectrum caring, quoting labor and delivery and abortion care that these laws are creating huge amounts of confusion on the ground and preventing people from accessing the health care that they need. We train for years and years to be able to look at the person in front of us and to make the best Health Care Decisions with them and their families, and were seeing that many people with highrisk pregnancies are not able to get the abortion care that they need. Youve heard a couple of examples of people that break their water before the baby is able to survive outside of them. I also take care of people with medical conditions like high blood pressure, continuing the pregnancy puts them at risk for things like stroke and preeclampsia. We see people with perry pardoned cardiomyopathy where the pregnancy causes their heart to enlarge and weekend, and the risk of having that happen again in another pregnancy is quite high. For all of these people, were having to ask ourselves how sick do they have to get to be able to intervene . Instead of just being able to provide the best medical care for the person in front of us, we are having to figure out, can i do this under the law . And that is creating huge amounts of confusion and absolutely preventing people from getting the care that they need. Thank you. Mister chairman, i like statements from son of ob gyn doctors be admitted into the record. Without objection. Senator cornyn . Dr. Scope, if i understood you correctly, you said that in your medical opinion, the way amandas doctor handled her pregnancy was a deviation of the standard of care in similar cases. Did i understand you . [inaudible]. It tells us on when it is appropriate to offer delivery. Well, back many years ago, i used to handle medical malpractice cases. Usually, when a medical expert says that what a doctor did violated the standard of care, that gave rise to a cause of action for medical malpractice. I was just curious about that. So, this is an emotional and divisive issue. There is no doubt about it, thats a statement of the obvious. I appreciate dr. Scott, youre pointing to the difference between what is moral, which is an individual decision, people make about the appropriate conduct, and then what is possible when it comes to building consensus, either among the American People or the people in a given state, or in the legislative branch. But i can pretty much guarantee that post roe versus wade, now that that issue is back in the hands of the state legislatures, there is, its highly unlikely there will be a federal abortion standard, requires 60 votes in the United States senate, as you can see, this is a very divisive issue. I want to ask you, again, dr. Scott, im just going through the Womens Health protection act, this is what has been offered by senator baldwin and her democratic colleagues as an alternative to states determining what the abortion laws should be. First of all, and can you tell us who Kermit Gosnell was . Yes, kermit kozma was a obstetrician in intercity philadelphia who for 17 years, his clinic was never inspected by the Pennsylvania State department of health, he was allowed to perform very unsupervised late term abortions on unfortunate poor minority women and when it was actually, i believe it was a pill mill through which the state started investigating him. But it was determined that there were women who had died under his care, that his clinic was very squalid conditions. There was evidence that babies have been born alive and then he committed infanticide. Hes currently serving time in prison. He is an example of what happens if we allow politics to keep us from supervising abortion providers to make sure theyre performing adequate care. Unfortunately, under this legislation, we may see more providers like that. Well, there is a industry here in washington, d. C. , naming legislation in ways that are the opposite of how they actually function, im thinking of the inflation reduction act, which didnt actually reduce inflation. For example. But this legislation that senator durbin and others are proposing is called. If it were more accurately named, it seems to me might be the Kermit Gosnell tribute act. It would eliminate all restrictions at the state or federal level on access to abortion. The bill says it supersedes and applies to all federal and state laws, and that no law and conflict with this shall be enforced. It allows the access to abortion through all nine months of pregnancy, including late term abortions. It doesnt speak to infanticide, but we can imagine what would come next. The Hyde Amendment, which you alluded to, which has provided, for many years now, since the 70s, that no tax payer funds should be used, could be used to Fund Abortion would be overruled. All parental consent and parental notification laws if your child became, your adolescent child became pregnant, you would have no right to know of their seeking access to abortion or certainly no right to consent. If someone wanted to get an abortion because they had eight female baby and they wanted a male child, this law would, this proposed law would overrule that restriction and allow sex election abortion. I can go on and on and on, but i dont believe that the proposal that senator durbin and his democratic colleagues have made represents the consensus in this country. We all have a right to our own moral judgments, but when it comes to the laws of the land, no one has a right to impose their personal views on everyone else, which is what roe v. Wade did, the Supreme Court took that out of the discussion among the American People, or the halls of congress, the state legislators, said that you could not pass a lot, regardless of where the consensus was. Effectively allowing abortion on demand through, until the time of delivery. So, we need to solve this problem, were not gonna solve it in congress, this is now being debated, it should be debated and be resolved in the state legislatures around the country. Thank, you mister chairman. Senator from texas, i would like to make a point for the record. In 2013, doctor kermit gisela, physician in pennsylvania some guilty on three charges of infanticide. Murdering babies born alive in his clinic after botched late term abortions. Because not was also found guilty of Involuntary Manslaughter in the death of a woman who is undergoing an abortion in his care. He was sentenced to life in prison without the possibility of parole. I might remind the senator that this happened while roe v. Wade was the law of the land, suggesting that it somehow it absolve that kind of conduct is just plain wrong. Thank you, thank you, mister chairman. I dont need to remind me. Senator klobuchar. Miss zurawksi, thank you for sharing your difficult story with all of us today. As you know, nearly half of the states in the country have now enacted restrictions or are moving towards bends, 12 states are enforcing near total bans on abortion. In your testimony, you say that traveling to another state for care was not an option for you because you wouldve had to drive eight hours and risk what you call the death sentence of developing sepsis, which can kill quickly in the middle of the west texas desert or 30,000 feet above the ground. What do you want people to know about the risk that bans and restrictions placed on women experiencing miscarriages . Thank you for that question. So, first, i like to revisit something that senator cornyn brought up, and doctor scotts response. I would like to make it clear that dr. Scott is not my position, she has never been my position, she never treated me, she is not the night medical records. Quite frankly, my physician and my team of Health Care Professionals that i saw over the course of three days while i was repeatedly turned away from Health Care Access made the decision to not provide an abortion because thats what they felt they had to do under texass law. That will continue to happen, it is continuing to happen. And its not a result of misinterpretation, its a result of confusion. The confusion is because of the way the law is written. The language in the law is incredibly vague. It leaves doctors grappling with that they can and cannot do, what health care they can and cannot provide. And if they make the wrong decision, they face up to 99 years in prison and or losing their license. In my opinion, that was intentional because after the Dobbs Decision, the administration put out guidance for when an abortion can and cannot be, or should and should not be provided. The state attorney general in texas hated that so much that he sued the government to overturn those guidelines. So, what happened to me is exactly what he wanted to happen. And your point is that right now we have a patchwork of laws across this country, if we would enact some federal standards here and codify roe v. Wade into law, which was the law of land before this, this would not have happened to you. That is right. Okay, thank you. Dr. Verma, how do the medical consequences of delaying care impact women . The impact women significantly, were seeing, you know, im practicing in georgia, we have a sixweek ban in place. Were having to turn away patients for all kinds of reasons. People who have regular periods, dont realize theyre pregnant after six weeks, people that are diagnosed, their babies are diagnosed with terrible fetal anomalies on their 20 week ultra sound, people that develop worsening medical conditions during their pregnancies. And because they cant access their care in our state, even though their doctors are trained to provide that care, theyre having to figure out if they can go out of state, get the resources together, take time off work, figure out childcare. And what impact with a national ban on mifepristone have on your ability to care for your patients . It would have a devastating impact and our ability to care for patients. We know, based on decades of evidence, that mifepristone is incredibly safe and effective. It can be used in combination with me is a profitable for both medication abortion and management of miscarriages. Its an incredibly important treatment for our patients to have available to them. You, no sense dobbs, states like minnesota an illinois have become islands of care in the middle of the country. We are the states that are the islands of care. In 2022, colins health in minnesota and bloomington saw the percentage of out of state patients they treated increased more than double the numbers in 2019. Since dobbs, have you seen influxes and patients coming, going between states to access care . Absolutely, were seeing patients trying to get out of state to get the care they need. Although, wilson many people are not able to do that, theyre being forced to continue pregnancies, that puts their health at risk. Theyre being forced to deliver because they dont have the resources to get out of state. Okay, thank you. Can i just, im gonna ask one question in my remaining time of you, professor goodwin. One judge an amara low, and two on the fifth circuit, they wouldve entered an injunction setting limits, saying you cannot receive mifepristone by mail, you cannot get it over the counter in the pharmacy, theyre gonna have it be available up to ten weeks, but seven weeks instead. And as you know, thats currently on hold. One of the things that the Justice Department argued was that the doctors who brought this case, unlike the american medical association, thats made it very clear that this drug is safe and been used in 60 countries over 23 years in america, the department of justice, those few doctors that brought this case argued that the department of justice said they should not be able to sue because they hadnt been impacted by the approval of mifepristone. They were not going to be impacted in the future, unlike someone, say, that we just heard from, miss zurawksi. I thought this was interesting. As you know, Justice Scalia has made similar comments to this, where he rejected a lawsuit, saying it make a mockery of our prior cases, like, basically wouldnt have a standing to bring a case when you havent had harm or expect to have harm. Quickly, do you want to comment on that . What that standing really means . Why this case should fall in the standing of those who brought . It the case itself was absurdest, what the petitioners claims that the fda had rush to judgment with approving this drug. That drug spent over 54 months of review. 2000, it came into the marketplace. Other drugs that were approved in that same period had spent 15 months of review. What we know is that its safe, it is a drug that had already been used in europe. And in 23 years, since it was approved in the United States, we know that the safety of mifepristone, it is far safer than penicillin, tylenol, even biographer. The claims that somehow these petitioners, including a dentist, will somehow be overwhelmed with patients, who have use mifepristone, but who will seek their care, it is truly absurdest because in 23 years, that has not happened. That has not been the experience of the petitioners at all. It is worth noting that this was a form of Forum Shopping, looking for a very specific judge who had already articulated antiabortion views and put placing a petition before that specific judge. Thank you. Thank you, senator grassman . Dr. Wubbenhorst, can you explain how women can still receive compassionate and necessary medical treatment from pregnancy complications without performing an abortion . Yes, sir. Thank you for the question. I think that, as i said earlier in my testimony, when women experience complications, in my career of has literally hundreds of women, both here and in other countries, theyve had complications requiring delivery. When youre performing a procedure to save the life of the mother, its not really considered an abortion, therefore, it is ethically permissible. Compassionate care means that you consider the circumstances carefully, you act in the best interest for both patients. If the death of the unborn child is a result of your intervention, that is a tragic outcome, but nonetheless, our priority is to save the life of the mother and preserve her functioning. That can be accomplished without performing an abortion. Dr. Skop, theres been discussion of Long Term Health impacts, of complications from pregnancy, data suggests that both chemical and surgical abortions can cause adverse and lifethreatening Health Impacts. Can you briefly explain and discuss the possible complications an impact on health of women that can arrive from abortions, including surgical abortions are the use of the Abortion Pills . Yes, sir. Thank you for that question. So, in my 30 years practicing caring for women, ive cared for many women who have been harmed by abortion. Ive cared for a woman who died of a second trimester abortion from sepsis. I have, in my practice, another young girl died from sepsis after a first trimester surgical abortion, her uterus had been perforated. I cared for many women whove explained to me that their anxiety and depression is due to their unresolved guilt over an abortion. I trust those women to tell me what the cause of their concerns are. Ive seen women who self harm. I have seen women who turned to substance and alcohol use and abuse due to this guilt that they have. Regarding chemical abortion, and i would like to stay, so everyone is aware, the United States does not have any federal mandates to report any data about abortion. We do not know how many abortions occur, we do not know the complications, and we certainly dont know the deaths. As i reported, its wellknown that Mental Health desk and follow abortion, our cdc does not try to make that linkage at all. Countries that have made this linkage have documented far higher Mental Health deaths in the air falling abortion compared to childbirth, including six times as many suicides. But regarding chemical abortion, the industry tells us its safer than tylenol. Theyre comparing tylenol Overdose Deaths to the undercounted deaths from chemical abortion. There is no comparison. Women assume they mean normal tylenol use, they dont realize that theyre comparing it to deaths that happened from overdoses. The abortion industry tells us about the complications they know about. My experience has been, because the women have been assured it is so safe, when they have a complication, they do not return to the abortion provider, they come to me, as their gynecologist, or they come to the emergency room in distress. So, when we look at good quality records, linkage studies that the checked all chemical abortions and all subsequent events, we find five to 6 of these women present an emergency room within a month. Approximately the same number will require surgery because their bodies cannot evacuate all of the dead tissue. And im still caring for these complications in texas, even though weve had abortion limitations for quite some time. These drugs are circulating in the state to try to circumvent our state laws and provide abortions to these unfortunate women. Dr. Wubbenhorst, how can we approach reducing mortality rates from pregnant women . And you might also touch on the fact, why is on restricted abortion to this issue . Thank you for the question. The solution to internal mortality, evan working in this area globally and in the United States for many years, its to improve health care, health education, and to increase support to pregnant women. Abortion does nothing to address any of those issues. The main causes of Maternal Mortality have been four years, and the most recent cdc data in 2020, when cardiovascular causes, infection, analysts, so on and so forth. Abortion will not reduce those deaths. There is no argument and no paper anywhere that shows that abortion reduces Maternal Mortality. There are studies that report to do so, but when you look at the essence of the studies, what theyre saying is that, well, if you reduce the number of women at risk by performing abortions in them, that somehow reduces the number of mortalities. We cannot predict exactly who will have a poor outcome. We cannot predict who will have an adverse outcome. That asked the question, what percent of high risk pregnancies should we abort . 20 , 30 , 40 , i think the other issue, it really relates to community and Civil Society engagement in terms of helping women to have Better Outcomes for their pregnancies. Thank you, mister chairman. Thanks, mister chairman, thank you all for being here today. I want to begin by thanking miss particularly for your courage, sharing your story today. Also, doctor verma, to you and all the ob gyns, all of the Health Care Providers, the nurses, the escorts who are at clinics around the country, providing protection and care in the face of the danger, real, physical, as well as emotional, jeopardy inflicted on them. I think you are a profound as well. In connecticut, we now have laws, thanks to our state legislature that help to protect women in other states. Because we guarantee these rights and connecticut. But in other states, that come to connecticut to exercise reproductive rights, because of those dangers that you face every day in georgia, when i first introduced the Womens Health protection act ten years ago, the idea that roe v. Wade would be overruled, in fact, it was unthinkable. It was wellestablished precedent. It was long accepted, under the principle of stare decisis. Three nominees came to this room to be confirmed before our committee and agreed that it was long established precedent, and under that doctrine of stare decisis, they could not see how it would be over gold. They didnt refer to that case, it made no promises, but they lead us to believe that they believe the integrity of Supreme Court precedent should be respected. I think the best way to refer to their testimony here, and im talking about justices gorsuch, connie bera, and kavanaugh, is that it was disingenuous. I think a number of my colleagues would agree, senator whitehouse referred earlier to testimony from another justice who perhaps had in mind the same result, despite Supreme Court precedent, that is Justice Scalia. And theyre concluding, as they did in dobbs, that roe v. Wade was wrong. With barely a few years after they established their respect for it. I think it helped undermine the integrity and credibility of the court. I would like to ask you about, not the legal issues here, dr. Verma, but in hearing some of what has been said about the medicine, about the health care issues, whether he would like to correct some of what has been said here and just give you the opportunity to respond . I trust women to make these decisions, not politicians or judges or senators. And i want to know, what women should know from you in the face of what i think has been some disinformation. Absolutely. Thank you, senator, for that opportunity. I want to start by saying the American College of ob gyn, represents over 60,000 ob gyns across the country, along with over 75 other major science based medical societies have identified abortion care as incredibly safe essential health care, this is not one profession, this is not one society, this includes the american medical association, the American Academy of family physicians, surgery, anastasia, this is, the science on this is settled, abortion care is incredibly save essential health care. This is the consensus of the science based evidence based medical community. In addition, the american board of ob gyn, so the board that certifies all of us ob gyns at this table, theyve identified abortion care as incredibly safe essential health care with risk of serious major complications of less than 1 . And has actually said that misinformation about abortions, spreading misinformation about abortion as a medical unprofessionalism. In addition, we heard some people bring up kermit causal. What he did was terrible, to say that represents the about be of abortion care in this country as a disservice to me, my colleagues, my patients, i see my patients are facing abortion care from a place of compassion every day, compassion for themselves, their existing families, their children, when we see a patient we give them all over their options. That includes talking to them about adoption, continuing the pregnancy, and abortion. And confirmed that theyre completely sure before moving forward. We provide them with abortion care in a safe and compassionate way. If someone chooses to continue a pregnancy, im also very happy to support them in that and deliver their baby. I do all of ob gyn. I think that focusing on people having experience of regret, it does a disservice to our patients who are making these informed decisions about their health care lives and our experts on their own lives. We also have excellent data from the turn away study, followed 1000 women for over five years, and showed that the most common emotion after an abortion was relief. Thank you very much. Thank, you mister chairman. Thank, you senator blumenthal. Next is senator lee. From time to time the Supreme Court cracks prior errors. That happened with plus c versus ferguson, which is a bad decision. Weve all acknowledged that that, along with our bad decisions, i like it when the Supreme Court is able to correct prior errors. That is what occurred with dobbs. Dobbs corrected a prior error. Its difficult to injure hearing people say that they worry about the credibility of the court when sometimes those words are uttered by people who are themselves actively, willfully, deliberately attacking the credibility of the court. Sometimes as officers of the court. We are seeing this through an unfair attack on Justice Thomas and other members of the u. S. Supreme court. It has got to stop. Look, dobbs was right, as a matter of constitutional law, this is a matter not for this courts to decide, but from elected lawmakers, typically in state legislatures, not our national legislature. So, if you dont like the policy outcome, go to your state legislator, but this is not an issue in which the federal judiciary is somehow there is no reproductive rights cause of the u. S. Constitution. So, lets not pretend that were worried about the credibility of the court. If were simultaneously attacking the credibility of the court, and its ability to do its job. Now, a lot of these issues relate to this legislation thats been introduced. In the wake of the Dobbs Decision, which is itself way more radical, even then roe v. Wade was. And its way more radical than where americans are comfortable going. We, know 69 of americans are uncomfortable with abortion after the first trimester, 69 . You would never guess that from the way democrats and the United States senate float on these issues, essentially all of them, support or appear to be comfortable with second and third trimester abortions. In fact, all but i think to members of the Democratic Caucus and the United States senate voted against the abortion survivors act. So, this legislation would prohibit any state law from regulating abortion. Within states borders. Essentially ever, not to protect girls, not to protect women, not to protect health, safety, and welfare, not to protect the rights of a baby born alive. Putting aside for a moment the life of the child, when considering the Health Impact of abortion on women, i think there are important considerations to make. Dr. Skop, id like to start with you. What concerns do you have for the physical and Mental Wellbeing of women who have late term abortions . It is wellestablished that women of late term abortions are at much higher risk for mental Health Complications, as we mentioned, anxiety, depression, Substance Use and abuse, and Suicidal Ideation and self harm. Lets talk about suicide for a minute. Those who have second or third trimester abortions, late term abortions, do they have, what are their higher suicide look like . In the United States, we do not have data on this because, as i mentioned, backing up to Maternal Mortality, this is, the data is collected until a full year after the end of the pregnancy. And it is virtually impossible because the cdc mostly looks at death certificates. Its virtually impossible to link say it coerced abortion and a suicide six months later. I dont think there are many efforts to do this. By the way, how many abortions are medically indicated, medically necessary . He ising the definition that the intent is to kill the baby, i would say none. As we discussed earlier, occasionally, there is the need to do a separation of the mother in the baby, the intention that cases to save the mother. Sometimes the baby, regrettably dies. Even if you use that, you say, well, that counts as an abortion, it is still far less than 1 of the abortions in our country. Very good to know. Now, as youve noted, women are four times more likely to experience serious medical complications from a chemical abortion as a surgical abortion, why isnt the abortion industry pushing chemical abortion, does it have more to do with the fact that this is an industry that makes a lot of money off of a . Does it have more to do with the fact that dispenses with a lot of inconvenient things, like, the fact that we have planned parenthood clinics that have been caught on tape killing telling girls not to tell the age of the person having the abortion because than they would have a duty to report it, what is that . What is causing that . I think theres definitely advantages for the abortion industry to promote chemical abortions. They dont have to hire a surgeon paying for sterilization of instruments and the cost that go along with that. And the reality, i would like to acknowledge is that, again, about 90 of obstetricians to not perform abortions, and even obstetricians who claim to be poet choice, many of them will not perform surgical abortions. I think there is a staffing issue that began the promotion towards chemical abortion. There may be some advantages in terms of funding. Now that we see is there profit motive . There was a time the cost of a surgical abortion and chemical abortion were approximately the same, and average about 575. I think we also see, in light of states beginning to have prolife restrictions, this is a way to get around those restrictions and provide abortions in states that are trying to protect unborn life. Thank you. Thank, you mister chairman. Id say my time is expired. Senator thank, you mister chairman. Doctor scott says that miss zurawksi misinterpreted texas law, which criminalizes abortion. So, her doctors were acting under advice of the hospitals Ethics Committee, which includes lawyers. So, to suggest that doctors should ignore the advice and cautions of their own Ethics Committee is not realistic. So, professor goodwin and dr. Verma, wouldnt you agree the Dobbs Decision led to this kind of chaos has to appropriate care to be provided . Absolutely right, senator. The Dobbs Decision did unleash a torrent of uncertainty throughout the United States where doctors fear losing their medical license to practice if they intervene before the law says that they should. They also fear criminal punishment and civil fines, as i mentioned, in the state of texas, there can be criminal punishments up to 99 years, incarceration, finds up to 100,000. These are some of the considerations what doctors struggle with, including then losing their medical license to practice. Absolutely. Every individual person, pregnancy, and family is different. The reason we train for so long as doctors is to be able to look at the unique person and medical situation in front of us and make decisions with them about the best course of action. When we have to think about what the law says, and if a patient is sick enough for us to be able to legally provide them care without risking criminal prosecution or losing our livelihood, that delays carry, prevents people from getting the care that they need. To expect that doctors and Hospital Personnel will risk losing their license or being held criminally liable, that is something that is a risk i would say a lot of doctors and others wouldnt want to take. Professor goodwin, weve heard today that women are coerced to have abortions. Is that the data that women, not that women freely choose to have abortions, can you enlighten us . Sure, thank you so much for that question. The coercion is the coercion to be pregnant, to remain pregnant. States and acting coercive laws that force women, girls to injure pregnancies that they do not want pregnancies that may be the result of rape and incest, pregnancies that may threaten their health, this is what is actually taking shape by these laws. And its worth noting the historical arc of this. We cannot forget that forced pregnancy was also a feature of american slavery. We must remember that the effort to ratify the 13th amendment, which abolished slavery and involuntary servitude specifically related to the forced pregnancies that were placed upon black women and girls that they had to endure. These forced pregnancies were so normalized by advertisements in the 1718 hundreds tell us quite clearly what it was that they injured. And if you will, let me just read a couple of them to you, just so that we know exactly what the senators were trying to get rid of in american slavery. They included advertisements such as the following. Runaways, the knee grows around away or from me on friday. Last in the grow about 18 years of age, and her child named mary, about two years old, mary is a bright malott of child. From the republican 18, 11 eastern maryland. Five dollar reward runaway on tuesday the 13th, the subscribers girl named maria, with her female child, about nine months old, maria was lately the property of dr. Thomas mccaul, march 22nd, 1810, charleston south carolina. For a sailor exchange, a Young Healthy wench and child, it is not convenient to have a brooding lunch in the family. Virginia chronicle, march 9th, 1793, these kinds of advertisements where what senators read as they drank their Morning Coffee and orange juice. So, deeply troubling that baked into the story of american slavery and abolition is the story of sexual terrorism, inflicted on black girls and women, so troublingly normalized that the descriptors breeding when general otto child, simultaneously read as mundane Daily Affairs and horse. Thank you very much, professor for reminding us. There was a time when women did not own their own bodies. And that is exactly where we are today. As far as im concerned, that women in this country, persons are not able to make free choices about their bodies and what. To be forced to have a child is probably the most freedom taking thing that we can imposed on this country . Professor you also mentioned about judge shopping or foreign shopping. I think this is an issue that we need to base in this country also. It was very clear that in texas, which has 27 divisions, 20 of which has only one judge. It was so clear that there was judge shopping going on with that judge. Would you say that we should do something to prevent judge shopping . Well, the Forum Shopping that took place was quite clear in this case as judge kacsmaryk had in fact expressed antiabortion views and activism and, most recently, it has been disclosed closed that he removed his name from a law review article that was going to be published at that of texas that also further explained his antiabortion views. And that name was review removed before he became before the chambers were confirmation. So something does need to be done. Thank you for that. Thank you very much. Senator cruz. Thank you, mister chairman. There is probably nos issue in modern american politics that in genders sharper disagreement than the question of abortion i think everyone here agrees on that. It is a deeply moral issue, that reflects our values, who we are as a country. It is an emotional issue, it is a personal issue in which people feel very strongly. I believe the American People should decide abortion policy. Intire country, and if the voters disagree, the voters have no choice. And, look, the reason the democrats want this issue to be out of the hands of the voters is quite obvious. Because the modern Democrat Party is wildly out of step with the American People. On the question of abortion. The current position of virtually every democratic senator in this body is that abortion should be absolutely unlimited, available up until the moment of birth, and even shockingly in some instances after. That partial birth abortion should be fully legal. That there should be no parental notification and no parental consent no matter how young the girls who may be seeking an abortion. And that all of it should be funded by taxpayer money. Now, that is an extreme and radical view. How extreme and radical . Well, according to a Harvard Harris poll from last year. 10 of americans, only 10 , support abortion on demand up until the point of birth. That is the position, if you want to be a democrat in the senate, that is the position you have to embrace. Because that is where the money is. That is where the activists are, that is where the anger voices are that fuel a democrat campaign. But, 90 of americans look at that position, and say we disagree. And so, you understand now why my democrat colleagues dont want this decision decided by the voters. Because if 90 of the voters disagree with the extreme policy decision they have been praised, their position will not prevail at the ballot talks. And by the way, it is not just the voters in the United States who disagree with Senate Democrats on this. It is virtually every voter on planet earth. The United States is such an extreme outlier, out of the entire country there are only seven countries on earth and of the entire planet that allow abortion after 20 weeks. And yet, every one of my democrat colleagues wants to do so. Europe, virtually all of europe, including the left wing socialist, the greens there, they think the democrats in this body are looms on this issue. Sweden has an 18week limit on seeking an abortion. None of my democrat colleagues would vote for swedens law. France has a 14week limit. France. None of my colleagues would vote for francis law. Germany and luxembourg have 12 week limits. And the position of democratss 40 weeks. Up until the very moment of birth, no limits at all. That is a horrifying position. I suppose my democrat colleagues can comfort themselves with the company they are in. Communist china, iran, and north korea. And the national Democrat Party. They all have the same view. Those tyranny is that leads to explicit which is life has no value. And so they dont embrace any limits. And by the way, look, there is so much rhetoric on this issue. A skeptical listed there would be justified doubting what any of us are saying, but if you dont believe im saying, look to the votes. In the wake of the Supreme Court overturning roe and sending this decision back to that voters so the voters could decide, one of my colleagues in the senate you . Promptly voted on a bill that would strike down just about every reasonable restriction in the country that the voters have decided. To you legalize partial birth abortion, provide no protection for unborn children. Those are extreme positions. And, dr. Scope, i would like to ask you is. What are the consequences of unlimited abortion on demand . What does a 40week, or 36week unborn child who is enduring a partial birth abortion, what does that child experience if that procedure is allowed to happen . A partial a partial birth birth abortion abortion delivers delivers the baby intact. So, the very first thing that would happen is that the womens cervix must be aggressively dilated to a large dilation, that is very likely to damage her cervix and several high qualities systematic reviews have documented increased risk of pre term birth in the subsequent pregnancy after a procedure like that. Not only is that hurting her this time, it will lead to further complications, such a cervical incompetence. The baby generally is not killed first, as i reported, 70 of late term abortion providers say they do not routinely do this. These babies are highly likely to continue to live throughout the process of labor. Theyre delivered as a breach, and their head is crashed. So, that would be the point when they would die, when their head is crashed. Other late term abortion, i mean, blind procedures in many cases. So, the instruments could damage the uterus, they could puncture the uterus. There are a number of horrible consequences documented where adjacent foul has been disrupted, urinary tract injuries, hemorrhage, there is really no reason that an abortion needs to be done that late ever. Thank you. Senator booker . Thank you, mister chairman. I think all the witnesses for being here today. Miss goodwin, scholarship. And i want to ask you to maybe go a bit deeper with me when it comes to protecting women. The testimony by miss zurawksi and dr. Verma, we really compelling to me. But the data is really stunning. U. S. Women are more likely to die during her after pregnancy than anywhere else in the world, in the developed world, excuse me. And Public Health experts are predicting that this will get a lot worse. Right now, the United States is only one of 13 countries on the entire planet were more turtle mortality rates, deaths of women until one year postpartum is worse today, worse today than it was 25 years ago. We know that eat 2022 university of colorado study projected that in the first year following nationwide abortion bans, the number of Maternal Deaths would increase 13 . And in subsequent years, Maternal Death could increase 24 . And a commonwealth found, the common will fund found that states with heavily restricted Abortion Access in 2020 have Maternal Mortality deaths that were 62 higher than they were in states where Abortion Access was more accessible. I mean, these are stunning numbers when were talking about the health and wellbeing of women in this country. But you went one step further, and id like for maybe this to be the second layer of your response about this stunning realities for black women. Thats right, thank you so much, senator booker, for your question, also your commitment on these issues. For black women, its devastating. Nationally, three and a half times more likely than their white counterparts to die during or shortly after pregnancy. Thats nationally. When we go to certain counties and cities, it can be five times, ten times, 15 times more likely than their white counterparts for death. Id also like to correct the record here. Theres been much said about the history of eugenics being one of his portrayed on black women. To clarify, in 1927, the case, buck the bell, it is a case that introduces eugenics into the United States is the case that explicitly involved a poor white woman. This is important because its a commentary that Justice Thomas has made. We heard today that early eugenics was about black women. It was a horrific campaign that that was targeted at poor white people, like kari buck, and the state of virginia. And it was a law then, the eugenics laws that spread throughout the United States. That history is important because of an accurate conflation. It is true about later on during jim crow, when black women demanded more, such as voting rights, such as a quality, that the mississippi appendectomies, coercive sterilization, it was introduced. And its worth threading the needle because the person who helped us learn about that was fannie lou hamer. She threaded together the lack of bodily autonomy, the lack of voting rights, and especially as there are those that say take this to the democratic process, what does that mean in states where black people have historically been disenfranchised from voting, including mississippi, georgia, and other states with abortion bans. Thank you. Dr. Pharma, ive been working on Maternal Mortality issues that they came to the senate. Since i discovered how stunning the numbers are in our nation, relative to other countries, how many women are dying in childbirth. The fact that women, black women are three and half times more likely is stunning. And wondering the data that im looking at from, you know, nonpartisan, i should say, independent sciencebased research, the really predicting that these rates that are already horrific in our country are going to rise. Lee heard the testimony of doctor, excuse, me of miss zurawksi. Could you just give us, from your professional standpoint and understanding that, again, this hearing, theyre often set up to be about, something and then they get spinoff. This hearing is about the consequences for the health and wellbeing after the Dobbs Decision. These staggering numbers, some of which are read, what is your experience . How do you see the next months, if not years ahead . Absolutely. Thank you that questions. We have seen in the data that there is a link between stricter abortion restrictions and higher rates of mortality in the United States. Georgia has one of the highest Maternal Mortality rates in the country, and has very strict restrictions on abortion. And we have seen based on data out of places like texas, that even when these laws have exceptions for things like a medical emergency. We have heard about the confusion on the ground. And we have seen in the data that people with highrisk presidency still have a harder time getting the care that they need. And often are denied that care. And so we absolutely expect to see more people getting hurt because of these laws. I also want to just correct, so abortion care is again incredibly safe. We have heard a couple mentions of it being a blind procedure. As the one ob gyn on this panel that does to force full spectrum Reproductive Health care including abortion care, we do this procedure incredibly safely with ultrasound guidance. I also want to address that, again, what chairman durbin said earlier that in this country 90 of abortions occur in the first trimester. Less than 1 occur after 20 weeks, and when abortions do occur later in pregnancy, it is usually because something has gone terribly wrong with the patient or the pregnancy. Abortions up until the moment of birth simply do not happen. That does not reflect the reality of abortion care in this country. In addition, what the democrats are trying to do here is to allow people to make these important decisions without legislative interference. I perform abortions for grandmothers, for adolescents, for doctors, for people of faith, for people who thought they would never need an abortion. What each of my patients as, needs the ability to do is to make these important decisions themselves about their health care and their lives. Thank you, doctor. Thank you mister chairman. Thank you senator. Booker senators hills . Thank you, mister chair. Thanks to all the witnesses for being here today. Special thanks to dr. Goodman horse from my home state for being here. Dr. Women horse, just one point. I had somebody ask me what legislative measure i was most proud of when i was speaker of the house. I told him that it was compensation for eugenics victims in north carolina. First state to ever do it. And, professor goodwin, i would say a study the issue a lot to get support. And it is very clear that it was just proportionately racially mount evaded beginning with the late 50s on into the early 70s. When im not a victim of the mississippi appendectomies who its about my age you found out when she was trying to have a child, that she had been sterilized. Dr. Weve been north, ive noticed you during, i was here for all the tests testimony. I know she take a lot of notes. So the first question i have, i hate to be on the spot. Are there any points that have been made here that in the questions up to this point to the stage that you would like to either clarified or take a counter position from some of the other witnesses testimony . Sure, thank you very much for the chance to do that. I think that a couple of times people have mentioned the issue of Maternal Mortality being higher in states with restrictive abortion laws. I am very familiar with that literature. There are about seven papers. Every single one of the studies have does not have has a methodological flaw. The most important laws that none of the studies take into account issues like health workforce, distribution of health workforces, lack of karen rural areas, and economics. So, i feel that that literature is very flawed. It is not by any means definitive and cannot be stated to demonstrate that abortion restrictions lead to increased Maternal Mortality. On the contrary, there is a study that was done in mexico indicating that looking at all of these factors, and showing that the most powerful influence on Maternal Mortality was the availability of skilled help at birth, and the environmental situation. For example, did the household have Running Water and sewage and so on and so forth. I think some of your colleagues taking notes, so i will invite a member on the other side of the aisle to ask them if they would like to yield time for a rebuttal. But, i do you think if we are going to be instructed, if we are going to make a policy, here we have to be fully informed. And i believe that the factors that are leading to those mortality rates are not as simple as either extreme of the arguments presenting here. So that is not putting us in a good position to come up with reasonable policy. Dr. , im going to call you ingrid before i asked this question. Ive heard you referred to as coppins go. Which do you prefer . It is golf, but in greatest fine. Dr. Scott, you were, and mister chair i would like to see consent to put an article from detroit catholic where doctor scope is quoted into the record. Without objection. I have got this specific section of the texas law. Im not an attorney. But my attorney suggests that mr. Zurawski, could i pronounce that right . Situation that perhaps the doctor was given bad legal advice. It appears in a section under section one 78, dot o o that they could have had, knowing that the condition that mr. Roske had was likely and in viable fetus and going to threaten the health of the mother, and it within a few disease days you did experience obsess. It seems like to me maybe the doctor wasnt guilty malpractice but a Legal Adviser was guilty of malpractice. Would you agree with that . I think what is going on on the ground in texas, and i will agree with dr. Verma and mrs. Roske, there is confusion. Normally, doctors of course are not legally trained and normally they depend on advice from their professional societies to help them understand new laws. What has been noticeably absent in texas is any statement from the texas medical association, any statement from the texas board of medicine, board of pharmacy, board of nursing, hospital association. So, all of these organizations you can figure out why they might be silent, make your own conclusions. But they have been silent. And that is a reason for the confusion. And my read of it, i honestly, mr. Roske i am blessed with the granddaughter named willow, two and a half years old. If my daughter had, a hate. Im not im going to talk about it because i dont get through it. But if, this is illegal professional who is guilty of malpractice. And the Legal Advisers of the medical centers in the state of texas should be honest, set their political agendas aside, and give good legal advice of the doctors can provide care that i think, in mr. Roskes case she was entitled to. And instead, they letter get very sick. Thank you, mister chair. Senator tell us, i am going to give miss zirinsky a opportunity to respond. Although she was in an extreme situation in the icu when this happened, i know that her husband is with her today and im sure they both discussed some of the issues that have been raised about your care, whether there was medical malpractice or legal negligence of some sort. I want to give you a chance to respond if you can. Thank you for the opportunity. I am not a legal expert. Im not a doctor. I think that my doctors and buy Health Care Team are doing the best that they could with the information that they had, in the guidance that they were being given by the ethics board at the hospital. I know that they also consulted with colleagues at the hospital that i was out as well as outside of that hospital in texas. And they asked several times to several positions at several facilities whether i could be transferred, if there was Different Health care that could be provided somewhere else. If i couldve received an abortion somewhere else. And, across the board no matter who they asked, they were told time and time again that no. They would not have been able to provide an abortion. So it wasnt just my Health Care Team, it was everyone else though they consulted during the whole threeday ordeal, as well as afterwards. And, mr. , chair just to be clear on my position. I believe. I dont believe the doctor should be lawyers. Unless they have got a legal degree, and i dont think lawyers should be doctors unless they have a medical degree. My point was not about the doctor. They were in a difficult situation. They were trying to care for you. My question is, what the motivation was to not read the plain text of the statute that an attorney can read and understand that that should have been a legal basis for saying that they could proceed with the procedure that resulted in devastating consequences for the prospective family. Thank you mister chair. Well, im going to conclude if i might as sharon just say, the reason we are at this moment in history is because the Dobbs Decision decided we were going to redefine statebystate the access to abortion and to find the legal and medical circumstances. This is tricky territory. It is dangerous territory, as we have been told here. And that is why i think we have this hearing this morning. Senator padilla. Thank you, mister chair. I want to start by thanking you for holding this important hearing and thinking all the witnesses for joining us today. As we discussed the efforts that were undertaken to ensure a womans right to abortion care. It is not lost to me that this fight is actually larger than abortion care alone. As we work to address the unprecedented actions taken by the far right wing of the Supreme Court, it is not often us that, as they are working to strip away basic rights, they are also feeling to hold themselves accountable for some common sense ethical standards. So theres a lot going on here. I look forward to working with the chair to explore those greater issues, as well. To make sure that we can restore some Public Confidence into a coequal. They claim to be completely independent, but as a coequal branch of government as you work to protect the rights and protections that somebody americans will deer. Now, my first question deals with sort of the separation of power and world of courts question. It is clear that one troubling aspect of the recent fifth circuit position, which many scholars and fellow judges found legally unsound, was its attempt to intrude on decades old Public Safety driven decision by the fda. The fda, we all know who the fda is and what the fda does, but the fda is the agency that congress has interested with making scientific decisions relating to our health and safety. So, when the fda tests and approves a medication for use, people rely on that. They have trust in the testing and approval process. And so, when judges take it upon themselves to overstep the separation of powers, and intrude on the fdas Decision Making authority. The Authority Interested in it by congress, it leaves science no longer just to the scientists. And, senator tillis is talking about, i dont want doctors or practice law will save a lot degree. He doesnt want lawyers to Practice Medicine unless a medical degree. I dont want justices making scientific decisions unless they have that education and expertise. Dr. Ferments, something yes or no question, is regulated medical abortion in the United States safe . Yes, absolutely. So can you describe than the risks to patients when judges rather than scientists are making decisions about medicines that americans rely on . Absolutely, thank you for that question. So we know based on decades of data that medication abortion is incredibly safe and effective. By regulating a medication or taking a medication off the market that we know is safe and effective, we limit patients ability to get the care that they need. That includes care for people that need abortions, and for miscarriage management. Matthew preston is used very safely and effectively for management to push carriages. And shortens the amount of time to take someone to pass a pregnancy. A lot of people experiencing this carriages are already going through a traumatic event. And so to be able to offer them the most effective treatment option is incredibly important. Thank you. Now, despite the lack of attention that it gets in that press come coverage, we know that abortions are sometimes necessary to stabilize a womans condition. When a Womans Health or life is in danger, that becomes part of the. Should be more of the conversation that it is and our national discourse. Yet, it seems like so many states, post obvious are passing laws that are creating either unintentionally or sometimes very intentionally, conflicting laws leading to confusion. In possible decisions for decisions to make anyones notice. And exhibit a is your testimony, mr. Zurawski. First of, all let me thank you for being here. Thank you for your courage and your bravery to share your experience. Some people in the legal world saying, well theres a conflict between state and federal law. Well, theres a process for hashing that out through the courts. That takes a long time. In the meantime, we have women showing up in hospitals and Emergency Rooms that cant afford to wait. You described your experience from medical perspective. Just wondering if you take a minute to share what kind of mental anguish that experience was like while you are in the icu, and since then, and if you have a specific message for women living in states that are denied abortion care or access to the care that they need but live in a state that is clamping down on access and options for them . Absolutely, and thank you for the opportunity. Weve heard a lot today about the mental trauma and the negative harmful effects on a persons psychological wellbeing after they have an abortion supposedly. And i am curious why that is not relevant for me as well. Because i wasnt permitted to have an abortion, and the, trauma in the ptsd and the depression that i have dealt with in the eight months since this happened to me is paralyzing. On top of that, i am still struggling to have children. And i wanted to address my senators cruz and cornyn, neither of whom regrettably are in the room right now. I would like for them to know that what happened to me, i think most people would agree was horrific. But it is a direct result of the policies that they support. I nearly died on their watch. And further room, as a result of what happened to me, i may have been robbed of the opportunity to have children in the future. And it is because of the policies that they support. What happened to me was horrible, but i am one of many. And quite frankly, i am lucky. I am lucky that i have a husband who could take me to the hospital, i dont have other children that i had to worry about finding health care for. I have a job that was understanding that allowed me to grieve for three days as i waited to almost die. What about all of the women that dont have the same opportunities, that dont have access to health care, they dont have health insurance, that dont have a partner. What about them . Thank you. Senator kennedy. Thank you, mister chairman. Thank you all for being here today. Professor goodwin, help me understand your point to view. I think this is a yes or no question. Do you support it being legal to abort and unborn child up to the moment of birth. Senator kennedy, it is not a yes or no question. As supports women like miss seurat ski. Women across this country. No, maam. I think it is a yes or no question. No, well let me answer. If there were a lot. Im just trying to understand your perspective. And im not accusing you of this. Of course not. But people sort of talk around this issue. If there were a bill that said that a woman has an unfettered right to abort an unborn baby for any reason up to the moment of birth would you vote yes or would you vote no, senator kennedy i refused to be shackled by your question. What ive answered is that there are conditions. You dont know whether you would vote yes or . No they are conditions in pregnancy that mean after ten weeks, 14 weeks, 20 weeks, 24 weeks, conditions such as mrs. Roskes, that i would support her life. I would support her personhood. But you are advocating a law. I support her personhood. You are advocating a law that says an unborn baby can be aborted up to the moment of birth for any reason. Are you not . Let me clarify with the 14th amendment says in the first sentence. That citizens of this United States are individuals that are born. That is what our constitution says. Do you support our constitution . Why wont you answer the question, professor . Im not trying to argue, i just want to understand what your position is and i think youre afraid to say that you supported. If you supported, i think just for the purpose of and intellectual discussion, you want to just say so. For purposes of an intellectual discussion, i am happy to have that with you. But that is not could you answer my question. Do you support, please, i mean you teach. I am sure youve had students asked this question. Do you support making it legal to abort and unborn baby for any reason, any reason, up to the moment before birth . Senator, lets have that intellectual discussion that you want. Okay, we could start of you would answer my question. I cant go to my next question to answer that question. I want you to be able to go to your second, and your third questions. I do. But as i have explained, there are many different conditions during a pregnancy. No, no conditions. Im making it easy for. You well ive already shared with you, senator, that i support. I get. It i dont use all my time, youre not gonna answer my question. I would respect you more if you would just say, heres my answer. Im sorry that you dont respect me very. Much i do respect, you but i said i would respect you more if you just answer by. Question doctor, tell me how to say your last. Name miss dr. Ruben horse. Do you support a law that would allow for any reason, unfettered discretion, the abortion of an unborn child up until the moment of birth . No. You dont . Dr. Herman. So, senator kennedy, i am the one doctor in this room that does provide abortion care, and i can tell you that that does not reflect the reality of abortion care. It just simply doesnt happen. But do you support. It there are bills before congress that would allow that to happen. You dont support it . Are you gonna be . Youre not gonna answer my question. As the doctor in this room who does provide abortion care, that is not how abortion care in this country works. It is a hypothetical that does a disservice to our patients. But if i were to ask you, im gonna properly have a baby this week and i change my mind. And i would like you doctor to you aboard the child, would you do it . That is not how abortion care in this country works. But if a patient, did would you do . It my job as a doctors to look at each individual situation. But i have never. I dont mean to be, rude but i can tell neither you nor the professional led to my question, and you both have an opinion and i dont understand why you wont share it. I have provided. I provided care for a few years and i have never seen thats the situation. How about you, would you . I would not support unfettered abortion. And id like to point out that if a limited lifethreatening conditioning in pregnancy passed approximately 22 weeks, that baby can be delivered alive by induction or csection, and we can try to save that baby. The intent of abortion is a dead baby, and that is not necessary in that situation. I want you all to understand where im coming from. This is a tough issue. And it is a tough issue because theres some tough questions, we have got to answer. And when you wont answer the questions, when you are invited by my democratic friends, the majority, and you wont answer the most fundamental question, we have got a bill in front of us that will basically say a woman has the unfettered right to abortion at anytime for any reason up to the moment of birth. And that is a get check issue. And i would expect you as experts to answer that truthfully how you do it. Thank you, for your indulgence mister chair. Senator ossoff. Think you, mister chairman. And thank you to all of the witnesses for joining us and sharing your experiences and perspective. It has been tremendously impactful to hear from you. Mister chairman, i do want to note and acknowledge that we have a georgia physician with us, and dr. Pharma, thank you for your work. Providing health care for georgia women at a time with the provision of health care for georgia women is under attack by elected officials in georgia. As you noted in your opening remarks, where one of the most extreme laws in that country has been enacted, a sixweek ban on abortion, which takes effect before many women even know that theyre pregnant. In the midst of a Maternal Health crisis in our state. Mister chairman, i dont know if youve heard these statistics, but more than half of georgia counties have no ob gyn at all. No ob gyn in more than half of the counties in our state. We have one of the worst Maternal Mortality rates in the United States. Even worse, much worse for black women in georgia. And a shortage of qualified providers of ob gyn care. And so, dr. Verma, what i want to discuss with you as we consider the impact on human health of georgias extreme sixweek abortion ban, is how this risks were shoveling our shortage of qualified physicians. I am looking at data here from the association of the american medical colleges that new ob gyns are much less likely to apply into residency programs with extreme abortion bans like the sixweek ban in georgia. And i think we all recognize this but, dr. Verma, these physicians provide the full spectrum of paralegal care. So, what does the states ob gyn shortage mean for georgia women please doctor pharma, based on your professional experience . Thank you senator offensive, and thank you for all that you do for Health Care Providers in patients in georgia. So, i am very concerned that the law in georgia, the sixweek ban is going to make the Health Care Shortage worse. And affect providers wanting to go into ob gyn and provide in georgia. I have talked to multiple medical students and residents who say they arent going to stay in georgia because they dont want to be in an environment where they cant practice evidence based medicine, and have to worry about whether they are going to be criminally prosecuted, have that license removed, have their livelihood threatened. The same procedures that we use for abortion care are also used for miscarriage management. The same medications, the same procedures. And so i have talked to trainees who worry that if they stay in georgia, they wont get the training that they need to take care of someone who comes in that 14 weeks, bleeding heavily. That they wont be able to provide them with the Emergency Care that they meet. We know based on survey data that 90 of ob gyns have said that they have had a patient the last year that needed abortion care, and the vast majority have gotten that patient connected with the care that they need, even if they personally feel conflicted with abortion, even if they dont provide the care themselves. So, this is something that ob gyns support. They want patients to get the care that they need. And they are worried that they wont be able to practice evidence based medicine in georgia, and are leaving. Just to be clear, because i think it is vitally important that georgians understand this, and that the senate understand this. A sixweek abortion ban in georgia, backed by threats of criminal prosecution and imprisonment for physicians. And we see in the data that these laws are deterring ob gyns from pursuing residencies in states with laws like this. Absolutely. And youre absolutely right that then affects not just. Again, i am an ob gyn that does abortion care, but i also deliver babies, i do surgery, i do cancer screenings, i do full spectrum ob gyn as many ob gyns do. So this is not just going to affect ash access to abortion care, it is going to affect access to all care. All Reproductive Health care in our state. I practice in atlanta where we have already experienced the closure of a Major Medical program that is having devastating effects on access to care in our city. Youre absolutely right that have of counties in georgia have no ob gyn. I expect this is just going to get worse. Thank you, dr. Verma. Think you, mister chairman. Senator blackburn. Thank you mister chairman. Talk to very much, i have just. I want to ask you very quickly. You talk about evidence based medicine. Do you consider a heartbeat evidence based . Would you consider that a living being, if there is a heartbeat detected . Without the evidence enough that there is life . So, based on evidence based medicine, and i think we are trying to get at is that. No, i know what im trying to get out. Could you clarify what for me we are trying to get . That you talk about evidence based medicine. A beating heart is a sign of life. And, dr. Scott, earlier you said a heartbeat can be detected at 28 days, am i accurate . That i understand that . I was watching in my office . It is present at about 20 days after fertilization. Usually its about a week later before we can detective a ultrasound technology. So in 23 days. Thank you. I think that is evidence of life. So, i want to talk for just a moment. Dr. Reuben horsed, and dr. Skype. Late term abortions. When i am talking to women in tennessee, what i find is most people regardless of party affiliation, they are opposed to late term abortions. In the, from the work that i have done in the house and the senate, what i have found is that there seems to be dismemberment of the baby involved in these late term abortions. And many times there is an injection to stop that heart from beating. Is that accurate . Am i correct john . Okay, you all are nodding yes. And then, there are occasions during late term abortions when the baby survives that process, and then the baby is delivered alive. And i have talked to so many women who are so highly offended with Governor Northam a virginias remarks around that. I am just going to read these for the committee so that it is accurate. He said, if a mothers and labor, i can tell you exactly what would happen. And of course, he is referring to a mother in for an abortion, and she has gone into labor. He continues, the infant would be delivered. The infant would be kept comfortable. The infant would be resuscitated, if that is what the mother and the family desired, and then a discussion would ensue between the physicians and the mother. So, dr. Weve been worst, you have delivered a lot of babies. As someone who has done this, and who has personally cared for women, who suffered physically and emotionally from the complications of abortion, tell me how is there any way, any reason, anyone would think that statement from governor northridge was a compassionate caring statement . Yeah, i think it is very clear that it is not a compassionate statement. Because if you allow a child, and in fact, i think the Legal Framework in this country is that a child is neglected and allowed to die or killed, that is a fantasizing that is something that can be prosecuted. I think that the same situation, it is the same situation if a woman undergoes a late abortion. We know that passed 22, 23 weeks, we are able to resuscitate those children and they will live. So i think that it is morally inconsistent to, and this has happened in hospitals where i have worked. In one room you are fighting for the life of a child who is 22, 23, 24 weeks. And in another room you are boarding a child that is 28, 32 weeks. Yeah, and you know, visiting our nikkis and having friends and family that have had babies in the nick you, and you pray over these babies. For the continuation of their life and their health and their recovery. And then when you hear about the practice of late term abortion, it is just hard to square that up. I find it very difficult. Dr. Scott up, i want to talk to you for just a minute. And, i had talked with the doj about the attacks on Pregnancy Centers. There has not been a push forward to address these. But, there have been many cases. And we have had some in tennessee where they have gone after people that were across the street from the center on, and were going through protesting. I see my time has run out. But i do want to get this question in, and you can answer it for me. We will do this, mister chairman. I will take it from her. And in writing. I would like to know if you think doj and the Biden Administration is doing enough to protect the Pregnancy Centers. They are protecting abortion centers. And you can give me this and writing. I would like to get your read on what they are doing that protects the Pregnancy Centers and the health care that you are providing for expectant moms. Thank you, mister chairman. Senator, wells. Thank you, very much. I think the witnesses. Mister chairman, this hearing is extremely important. But i also think it is in the context of that conclusion that i am coming to you. And that is that we have a crisis on the Supreme Court. The United States Supreme Court has a duty to strengthen our democracy and strength and respect for the rule of law. Yet the United States Supreme Court, in many recent decisions has in my view become a threat to democracy. And it has profoundly eroded respect for the rule of law. It is not just pulls up the American People that show a record low respect for the court, confidence in the court. It is not a popularity contest, of course. But the court has been making decisions with outcomes that are very contrary to the public interest. That is a point of view. But, i think one that can be backed up with evidence. But it is also been using intellectual manipulation in reaching its decisions. And i think the public gets that. It is not on the level. Let me give three examples. We have a corrupt Campaign Finance system. And the Supreme Court and Citizens United an assertion of facts which i will talk about in a minute to justify unleashing Unlimited Money unaccountable money on disclosed money to pollute our political process. In the bruin decision, the United States Supreme Court came up with a framework of analysis, socalled historical analysis, which essentially made up a history of the way back to disregard the reality of today. And, in the Dobbs Decision the Supreme Court disregarded precedent and to csis in order to achieve an outcome that we are now living with. The Supreme Court itself has added claims to the fire when some of those justices were before this committee in this room, mister chairman. On this question of precedent, one justice told a committee in 2020, i will obey all of the rules of starting to csis and agree that roe was super precedent. In 2018, another justice told the committee that roe is an important precedent in the Supreme Court which has been reaffirmed many times. And in 2017, still another justice told the committee of roe quote, a good judge will consider precedent of the u. S. Supreme court as worthy of treatment like any other. And, of course we have also had recently the report to propublica about the ethical issues in the Supreme Court. So, i have two concerns. I dont know if i will have time. But one is, for professor goodwin about what i would regard as a departure from the doctrine of judicial restraint. To a doctrine of judicial flexibility. To achieve outcomes of the court. And the second is for ms. Zurawski who, thank you for being here. You have spoken about your own experience. But there are moms who have lost kids because we are not allowed to pass gun safety legislation that meets the Supreme Court master. There are citizens who are in the agony about their democracy being ruled by folks who can give multimillion dollar contributions. And there are women like you, who are suffering because they have lost access to the health care that they need. So i will start with you, professor goodwin. Thank you very much senator walsh for your question. As you mentioned, the outcome determinant of the Dobbs Decision, and youre absolutely right. One day before in the bruen decision, written by Justice Thomas. Justice thomas said that a prologue was necessary to understand the history of men and their bodily autonomy. Specifically black men. He spent five paragraphs on the bruin decision describing black men historically discrimination against them during slavery and jim crow and how their bodily autonomy matters and how gun safety, or having, guns was important to that. You will not find a prologue mentioning anything about women in the Dobbs Decision. Two words that you will not find in the Dobbs Decision, black women, or black women. Together you will not find five paragraphs that speak to the forced involuntary nature of reproduction of black women during slavery, being forced into pregnancies. You will not read anything about black Maternal Mortality in the Dobbs Decision. So, one day before five paragraphs devoted to it in the Dobbs Decision, absolutely nothing. And as we look at this kind of return to history as you mentioned, it is selective. It is opportunistic. It cherrypick through history. Let me just say this, roe v. Wade was a 7 to 2 decision. Five of those seven justices were republican appointed. Prescott bush, the father of each w bush was the treasurer planned parenthood. In the roe v. Wade decision, what Justice Blackman mentioned, and is absolutely right, abortion had not been criminalized in the United States. The pilgrims had performed abortions. So had additional people. When abortion becomes criminalized in this country, it was leading to and around the time of the civil war. And we see some of the same rhetoric today used then. The concern about the browning of the United States. And that was the impetus for early abortion laws during the time of the civil war. And we see the same kind of rhetoric today. Thank you. My time is up, but i dont know if we can allow mr. Roske just to speak briefly on behalf of essentially the federal damage of these decisions. Thank you, and thank you for the opportunity. I would like to address this repeated attempt by the republicans at a vulgar mischaracterization of whats someone who needs an abortion looks like. Frankly, it is stigmatizing, it is offensive, and it is unrealistic. And it does not reflect who needs an abortion or who wants an abortion in this country. And, quite frankly, health care should not be a meritocracy. You shouldnt have to deserve health care in order to access that in this country. And, what is going on is not an accident. As i mentioned, before. When dobbs first came down the Biden Administration put out guidance on who should and could receive an abortion. And in texas, in my home, state attorney general ken paxton sued over that guidance. And so, that guidance was revoked. So, as i said before, what happened to me was intentional. Thank you, mister chairman. Thanks, senator wells. I thank you to our witnesses. There are a few points i would like to make for the record as we close. Ones own clinic violence. I want to make it clear, i think we have made it clear but it bears repeating. There is no excuse, underline no, for violence on either side of this issue. None. And to harass physicians or those who have an opposite point of view is unacceptable from my point of view. And i hope the department of justice will treat offenders on both sides of that issue the same way. With force. To stop and protect those who have a point to be on this issue. Second thing that i want to say is, the argument that this is about states rights, what happened in amarillo . Was that about state rights . He was an effort to eliminate the use of a drug which is used for chemical abortions. Nationwide. Nationwide. And that is what this amarillo judge set out to do. So this is about more than state rights. It is about a point of view that goes much further. And finally, let me say. Im going to add into the record. I think it may have been in or already but a statement by the American College of obstetricians and gynecologists that is part of this hearing today. They went through a specific examples of some of the most outrageous cases you can imagine. Already under jobs. One i will read to you. And ob gyn who was contacted by a social worker by an 11 year old sex Trafficking Victim who was pregnant. Not only was the position unable to perform an abortion under state law, 11 years old. Unable to perform an abortion under state law, but the social workers were unable to help the child obtain it in another state without risking prosecution themselves. The ten year old in ohio, we have already made reference to. Come on. We are better than that as a nation that we would want and to have things to separate into this reality. The reality is that this shameful situation needs to be resolved. I dont know if it can be politically. But i hope that this hearing this is closer to that day. The Relentless Assault on reproductive rights has to come to an end soon. I am going to pledge to continue my efforts to this committee to make sure that the light is being shown on these issues, and work with my colleagues to enshrine protections for reproductive freedom. The Committee Sensitive arent