Amendment 67 and Pregnancy Complications

October 9th, 2014 | Posted by Atlee Breland in Colorado | Legislation | Pregnancy Issues - (Comments Off)

Per our earlier post about Amendment 67 and infertility treatment, we’ve also created an overview of Amendment 67 and Pregnancy Complications.

Again, the statutes referenced are Colorado-specific, but the general issues apply to all personhood amendments in all states. Hopefully this will help you understand exactly why the issues with pregnancy complications are very real for patients and doctors, not just a scare tactic.

Amendment 67 and IVF

October 9th, 2014 | Posted by Atlee Breland in Colorado | IVF | Legislation - (Comments Off)

As Colorado prepares to vote on Amendment 67, we’re putting together a number of new articles and updating our existing content to explain the key facts about this personhood amendment.

We’ve just published Amendment 67 and Infertility Treatment, which explains exactly how Amendment 67 would affect infertility physicians and patients, and why it would stop IVF and other common infertility treatments from being performed in Colorado.

While the statutes we discuss are obviously specific to Colorado, the basic concepts apply broadly to all personhood measures in all states, including North Dakota’s Measure 1. We hope this article will serve as a primer to help you understand why personhood and infertility treatment are simply and fundamentally incompatible.

On a personal note, it’s been more than eight years since my children were born, but I never forget the pain and uncertainty about whether I would ever become a mother. I remain profoundly outraged at the prospect that any state would forbid women like me from receiving the medical care we need to build our families. Infertility is hard enough without worrying about prosecution. This isn’t a “scare tactic” — it’s my real-life story, and the story of tens of thousands of couples every year just like me.

Before you take anyone’s word for it that Amendment 67 has nothing to do with IVF, I urge you to find out the REAL FACTS from the doctors and patients who know the most about infertility, not from special-interest groups which primarily focus on other political issues and which don’t truly understand IVF. If you understand the law and the medicine, the issue is clear.

Yes on 67: IUDs cause abortions

October 9th, 2014 | Posted by Atlee Breland in Birth Control | Colorado | Legislation - (Comments Off)

Personhood supporters, including Colorado’s Personhood USA, have long claimed that “personhood will not affect birth control, only abortion” and that questions about contraception are simply a “scare tactic”. That’s why we were surprised to see the Yes on 67 campaign Twitter account, which is run by Personhood USA to campaign for Colorado’s Amendment 67, openly discuss “abortion-causing IUDs”:

This is an elementary logic problem.
1) Personhood USA wants to pass personhood to ban abortion
2) Personhood USA considers IUD usage to be abortion
3) Therefore, Personhood USA wants to ban IUDs

IUDs are a class of birth control known as long-acting reversible contraception. They are among the most reliable methods, with over 99% effectiveness, and are used by 5-10% of American women who use birth control. It’s estimated that over 550,000 American women currently have IUDs implanted.

It’s time to stop asking whether personhood would impact contraception. It’s time to acknowledge that they do intend to ban at least some common methods of contraception. And it’s time to ask Personhood USA what they’d want to happen to those 550,000 women with IUDs if personhood were to pass.

That may be a scary idea, but Personhood USA’s own words show that it’s not a “scare tactic”.

ASRM opposes ND Measure 1

October 8th, 2014 | Posted by Atlee Breland in IVF | Legislation | North Dakota - (Comments Off)

This week, the American Society for Reproductive Medicine and the Society for Assisted Reproductive Technology issued a press release opposing North Dakota’s personhood Measure 1:

Charles Coddington, MD, President of SART said, “Measure One would insert the government into very personal medical decisions and ignore the individual choice of health care. In vitro fertilization procedures will not be possible because all fertilized eggs without regard to their viability, chromosomal abnormalities or carrier status for genetic disorders must be recognized and protected.”

ASRM and SART are the professional organizations for the doctors, nurses, and medical professionals who treat infertility. They are experts in both the medical and legal aspects of infertility treatment. They understand exactly what personhood would mean for infertility treatment, and they have strenuously opposed every personhood measure in every state from Mississippi to Colorado to Oklahoma.

ASRM understands infertility medicine and law better than anyone else, and they know that the threat of personhood is real, not just a “scare tactic”. When deciding how to vote this fall, we recommend that you trust the experts whose primary concern is helping infertility patients, rather than pro-life organizations who have a different focus and a questionable grasp of the medical realities.

ASRM urges North Dakota voters to vote No on Measure 1, and we are proud to stand with htem.

MS Personhood fails to gather signatures

May 14th, 2014 | Posted by Atlee Breland in Legislation | Mississippi - (Comments Off)

After the defeat of 2011′s Initiative 26, Personhood Mississippi announced plans to pursue a second initiative attempt. They filed paperwork in March 2013 for an attempt to reach the 2015 ballot, subsequently named Initiative 41.

Today is the official deadline for Initiative 41 to submit signatures to the Secretary of State, and it appears all but certain that organizers did not meet the signature requirements. In Mississippi, signatures must be turned in to county clerks for initial verification before they can be submitted to the Secretary of State. Since personhood supporters have not turned in any signatures to county clerks in any of the largest counties, it is no longer possible for them to reach the 2015 ballot.

When organizers filed Initiative 41, they claimed Mississippi voters were “confused” about Initiative 26, and that they only needed a few linguistic tweaks to ensure victory. However, the slightly-reworded language of Initiative 41 carried the same potential unintended consequences for infertility treatment, contraception, and life-threatening pregnancy complications. While Mississippians are generally pro-life, voters in 2011 felt that personhood simply went too far, and the new language did nothing to address voters’ concerns.

Today’s results continue to show that Mississippians were not confused at all when they voted 58-42 to defeat personhood in November 2011. A substantial majority of Mississippi voters put a great deal of thought and consideration into their vote on Initiative 26, and by declining to support Initiative 41, they have signaled that they regard personhood as a settled issue.

We are relieved that personhood will not appear on the 2015 ballot, and we hope that organizers will respect the opinions that Mississippians have now expressed twice over and decline to pursue future personhood efforts.

CO Senate candidate disavows personhood

March 25th, 2014 | Posted by Atlee Breland in Birth Control | Colorado | Uncategorized - (Comments Off)

Last week, Colorado Senate GOP candidate Rep. Cory Gardner announced to the Denver Post that he no longer supports personhood:

“This was a bad idea driven by good intentions,” he told The Denver Post. “I was not right. I can’t support personhood now. I can’t support personhood going forward. To do it again would be a mistake…. The fact that it restricts contraception, it was not the right position”

Gardner, who represents Colorado’s 4th District in the US House of Representatives, supported both the 2008 and 2010 personhood efforts. During his 2010 campaign, he stated during a debate that he had signed the petition himself and also collected signatures for it at his church. Additionally, Gardner co-sponsored personhood legislation in Congress as recently as July 2013, having signed as a co-sponsor of H.R. 374 in March 2012 and of H.R. 1091 in July 2013.

Gardner claims he now opposes personhood because he understands that it would potentially affect some forms of contraception. While we’re glad to see that Rep. Gardner now agrees that personhood carries serious unintended consequences, we wonder why it’s taken him over three years to figure this out. Contraception was a major topic of both the 2010 Colorado and 2011 Mississippi campaigns; while personhood advocates have always claimed this is a “scare tactic”, they have simultaneously been open in their opposition to emergency contraception, IUDs, and any other birth control which can potentially work after fertilization.

As recently as a month ago, Personhood USA was praising Rep. Gardner for his support of personhood, which they are predictably now criticizing as a “flip-flop”.

Gardner’s Democratic opponent, incumbent Sen. Mark Udall, is already running campaign commercials on personhood and hammering Gardner as an extremist, and it’s clear that the Gardner campaign understands that personhood is a political losing issue. This is a sharp departure from the early days of 2012, when Personhood USA sponsored presidential debates for the GOP primary candidates.

While personhood remains on the 2014 North Dakota and Colorado ballots and is gathering signatures in Mississippi, it appears to be notably less popular nationwide than in previous years. During the 2014 legislative session, far fewer states introduced personhood legislation than in past sessions, and no bills even made it out of committee. Is Rep. Gardner’s renunciation of personhood the recognition that it’s a losing strategy for the Republican party and the pro-life movement? We certainly hope so.

UPDATE 3/26/14: Personhood has now been rejected by a second Colorado congressman, Rep. Mike Coffman (R-CD6). Coffman supported the 2008 and 2010 measures, made no public comment on the 2012 effort, and now says it is “over-broad and full of unintended consequences”, according to Coffman’s campaign manager. Coffman faces a tight race for reelection against Democratic challenger Andrew Romanoff.

On personhood and miscarriage investigation

December 14th, 2013 | Posted by Atlee Breland in Legislation | Pregnancy Issues - (Comments Off)

We’re often asked if personhood would REALLY lead to investigations of women for having miscarriages, or alternately accused of “scare tactics” for discussing the possibility. A recent blog post from Personhood USA is representative:

This pro-abortion propaganda is clearly false because when abortion was illegal in the US, women weren’t investigated for miscarriages. Why? Because sadly the tragedy of miscarriage is common and therefore doesn’t provide reasonable suspicion of a crime

The first claim, that women weren’t investigated for miscarriages when abortion was illegal, is both misleading and inaccurate. It ignores the reality that, as pointed out by Americans United for Life, pre-Roe abortion law focused on prohibiting the act of abortion, rather than on using existing homicide statutes. Laws were specifically written to target the person performing the abortion, and often explicitly excluded pregnant women from prosecution. However, broadening existing homicide law to include embryos and fetuses rather than passing separate laws to regulate or prohibit abortion per se is the whole point of the personhood movement.

The case highlighted in Personhood USA’s post actually demonstrates the opposite of their claim that personhood would not require investigation of miscarriage. The reprehensible situation at issue here involves a Florida man who gave his girlfriend an abortion pill, pretending it was an “antibiotic”, and she subsequently had a miscarriage. John Welden pled guilty to product tampering and mail fraud, rather than to a fetal homicide charge prosecutors feared would be difficult to prove. The judge is currently working to decide how severe the corresponding sentence should be, since there is no scientific way to determine conclusively whether this particular miscarriage was directly caused by the medication, or if Ms. Lee was simply a coincidental part of the 20% of women who suffer early pregnancy loss.

Personhood USA claims that the judge’s indecision in this case demonstrates that miscarriage is so common that it of course would not be investigated, but in reality it proves the point. After all, here is a miscarriage which was then investigated to determine whether a crime occurred. There is suspicion in this case beyond the simple fact of the pregnancy loss, but it’s still an investigation, and it’s irrelevant whether the potential guilty party is the pregnant woman or another person. If personhood were to pass, other miscarriages might likewise give rise to suspicion that trigger law enforcement involvement.

Let’s flip the case around a little bit and suppose personhood were in effect. Ms. Lee has a spontaneous miscarriage which sends her to the hospital. Mr. Welden, who is unhappy with the relationship, tells the doctor that Ms. Lee was upset about the unplanned pregnancy, and that he heard her talking to a friend about “wanting to get rid of it”. At that point, if abortion is covered by the murder statutes, there is no way to avoid a legal investigation.

The doctor is a mandated reporter, who is required by law to contact the police and tell them there is reason to suspect a crime may have occurred, and to preserve evidence. The doctor would be obligated to preserve fetal tissue to see if there were a natural genetic anomaly that could explain the miscarriage. He would take blood samples in order to test for hormonal problems and to see whether Ms. Lee had taken misoprostol. He’d be obligated to perform another intrusive exam to see if there were pill residue from vaginal administration of Cytotec or physical evidence to show if she’d undergone an illegal D&C. The police would question Mr. Welden about what he heard, and Ms. Lee about the circumstances of the pregnancy and miscarriage. Ms. Lee’s medical records would be given to the police.

All that would occur on nothing more than Mr. Welden’s statement, and it would happen even if the miscarriage were ultimately determined to be spontaneous.The police can’t simply choose not to open an case, any more than they could ignore it if a person told them he’d overheard a widow talk about murdering her husband. They have no choice but to investigate and give the evidence to a prosecutor to determine whether charges should be brought. They might decide in the end that it’s ridiculously unfounded, but if they have a witness report of a potential crime, they have to take it seriously. After all, the Welden investigation was triggered by Ms. Lee’s witness report, and it would work just the same way if the two parties were reversed.

Nobody is claiming that personhood would require police investigations for every single miscarriage, just like police don’t get involved when elderly or sick people die in their sleep However, any questionable circumstances would definitely lead to investigations of SOME miscarriages. Since abortion often looks just like miscarriage, there’s no way to detect and prosecute illegal abortion without also investigating unusual miscarriages.

That’s why personhood laws in El Salvador result in hundreds of women being unjustly reported or imprisoned for having miscarriages. If Personhood USA wants to praise El Salvador’s personhood law and hold it up as a model for America, they’re going to have to explain why Americans wouldn’t suffer the same treatment as Salvadorans.

Personhood USA openly advocates prosecuting women who “take a pill or seek out a service like abortion that would kill their child”. If they really want those women to be prosecuted, there’s simply no way to do so without investigating miscarriages to determine which ones are spontaneous pregnancy losses and which ones are illegal abortions.

When we say that personhood could potentially affect many common birth control methods, including ordinary birth control pills and IUDs, personhood advocates commonly insist that this is just a “scare tactic”. A recent press release from Personhood USA reveals otherwise, by describing ordinary birth control as “chemical abortion”:

Planned Parenthood of the Rocky Mountains has announced their intentions to close two chemical abortion facilities in Colorado… Planned Parenthood Eastside and La Junta currently offer chemical abortions ranging in cost from $38 to $817, including the dangerous “Morning After Pill.”…. Mason continued, “I think most Colorado citizens would agree that fewer abortions in Colorado, whether chemical or referred surgical abortions, is a very small step in the right direction.”
– Personhood USA Press Release, 8/9/2013

The press release in question celebrates the closure of two Colorado Planned Parenthood facilities, neither of which offers surgical or medication abortions with RU-486. The only services the two facilities offer are standard birth control methods such as birth control pills and IUDs.

The Personhood USA press release specifically references “chemical abortions costing $817″, and directly links to the Planned Parenthood clinic’s list of available services. The only service with a cost of $817 on that list is the birth control implant, sold as brand name Implanon or Nexplanon. We must therefore assume that they consider Implanon to be “chemical abortion”.

Implanon is a long-acting reversible contraceptive which continuously releases low doses of contraceptive hormones for up to three years. The contraceptive hormones are identical to those used in progestin-only birth control pills, Depo-Provera shots, and the Mirena IUD, and work in exactly the same way by stopping ovulation and thickening cervical mucus. While people sometimes question whether intrauterine devices like Mirena can potentially prevent fertilized eggs from implanting, Implanon can’t directly affect implantation because it’s located under the skin of the upper arm rather than in the uterus. Its only effects are hormonal.

The other birth control methods provided by the Planned Parenthood locations in question include birth control pills, the birth control patch, the birth control shot (Depo-Provera), Mirena and copper IUDs, and NuvaRing. They also provide emergency contraception, also known as the morning-after pill or Plan B. It should be emphasized that the progestin-based morning-after pill is NOT an abortion pill and has no effect after implantation. The best scientific evidence suggests that emergency contraception also has no effect on preventing implantation and works exclusively prior to fertilization.

If Personhood USA wants to consider Implanon, IUDs, Depo-Provera, and birth control pills to be “chemical abortion”, and to describe birth control clinics as “chemical abortion facilities”, they’re allowed to believe whatever they want. However, we should remember that when they claim they only want to stop abortion and abolish “birth control that kills a person“, they’re really talking about ordinary birth control methods.

We’re glad to see that Personhood USA is finally being open and honest about its hostility to contraception, and that they’re publicly acknowledging that personhood would potentially impact the millions of American women who use ordinary birth control methods like the pill, the patch, Implanon, and IUDs. Now that they’ve put their views on contraception into the public record, we hope that they won’t attempt to argue that this vital and legitimate concern is just a “scare tactic”.

Yesterday, the Alaska Supreme Court issued a ruling in a lawsuit over a proposed initiative from 2011. Personhood activists had sought to place personhood on the 2011 ballot, but the initiative was rejected by Lt. Gov. Mead Treadwell on the grounds that Alaska does not permit clearly unconstitutional initiatives. Initiative sponsor Clinton Desjarlais appealed the ruling all the way to the Alaska Supreme Court, which yesterday ruled that the initiative was unconstitutional and cannot qualify for the ballot:

DesJarlais’s initiative would permit abortion only where dictated by “the law of
necessity,” in which case a defendant would still be subject to criminal prosecution.
Because DesJarlais’s initiative would prohibit abortion to an extent that the United States
Supreme Court has deemed unconstitutional, it is “clearly unconstitutional” under
controlling authority.

The logic of the Alaska Supreme Court’s decision was very similar to the 2012 initiative rejection by the Oklahoma Supreme Court. While Mr. Desjarlais could potentially continue the appeal to the US Supreme Court, it is doubtful he would fare better than the Oklahoma case, which the Supreme Court refused to hear in October 2012.

The Court’s ruling means that not only will Desjarlais’ measure not appear on the ballot, but that any similar measures filed in the future would also be denied. It likewise strongly suggests that any attempt by the Alaska Legislature would be struck down on similar grounds of constitutionality.

Infertility and personhood: listen to the scientists

May 2nd, 2013 | Posted by Atlee Breland in IVF | Legislation - (Comments Off)

Last week, I had the honor to be a panelist at the annual meeting of the Pacific Coast Reproductive Society, a medical society for infertility physicians and medical professionals. I was glad to have the opportunity to present to such a well-informed and interested audience, and to work with my co-panelists, Barb Collura of RESOLVE: The National Infertility Association and Sean Tipton of the American Society for Reproductive Medicine. Our talk focused on legal threats to infertility treatment, the same subject which Parents Against Personhood has been discussing for the last 18 months: that there is a fundamental conflict between infertility treatment and personhood.

I always enjoy speaking to other people about personhood, since it’s a passionate and personal subject for me. However, the PCRS Meeting offered me a chance to listen and learn as well as talk, because I was able to attend presentations on embryology, stem cell research, and clinical practice. As a layperson, I’m always working to improve my understanding of reproductive medicine, so that I can be an effective advocate and provide accurate factual information. These panels didn’t disappoint, and I’m grateful to PCRS for allowing me to learn about new directions in infertility treatment from some of the world’s foremost researchers.

The more I learn about the science and medicine behind infertility treatment, the more obvious it becomes that infertility physicians cannot practice under personhood. While some organizations like Personhood USA assert that IVF doesn’t ban personhood because embryo cryopreservation is unnecessary and we can simply freeze eggs, a thorough understanding of the science shows that this is a stunningly uninformed opinion.

A case in point was the embryology panel “Current Hot Topics in the Lab”, conducted by Dr. Peter Nagy of Reproductive Biology Associates and Dr. Catherine Racowsky of Brigham and Women’s and Harvard. One of the topics discussed at length is that new research suggests that embryo cryopreservation and frozen-embryo transfer may actually be more effective than fresh transfers. The idea is that the medications used in IVF to produce eggs may actually alter the uterine lining in a way that makes it harder for embryos to implant. By freezing the embryos and performing a frozen-embryo transfer in a later cycle, doctors can better prepare the uterus to receive embryos, and pregnancy rates increase. Traditionally, FETs have somewhat lower success rates than fresh cycles, but recent advances in cryopreservation mean that the benefits of improved endometrial conditions now outweigh those of using non-frozen embryos. Some clinics are now beginning to treat patients by freezing ALL embryos created and then transferring embryos the next month, after giving the patient a few weeks to recover and prepare a better uterine environment.

From the personhood perspective, this creates a catch-22 situation: If we agree that making it harder for an embryo to implant is the moral equivalent of abortion — and given that this is the core concept behind personhood advocates’ view of emergency contraception and IUDs as “causing abortion”, it’s hard to argue otherwise — then fresh embryo transfers clearly fall into this category, because it’s less likely that the embryos will implant and develop. Unlike the effect of the morning-after pill, this effect is not small or debatable; in the study I linked above, frozen embryos resulted in 63 live births compared to 37 for the fresh transfers.

However, as we have discussed before, freezing embryos is also not permissible, because the process of cryopreservation and thawing sometimes damages or destroys embryos. If we can’t freeze embryos for later transfer, and we can’t perform fresh transfers, there is no possible way to perform IVF. It’s logically impossible.

a person or entity performing in vitro fertilization shall limit the number of in vitro human embryos created in a single cycle to the number to be transferred in that cycle”

“Destructive research” means medical procedures, scientific or laboratory research, or other kinds of investigation that kill or injure the subject of such research.”
(Mississippi HB-819 and HB-937, 2013)

Another topic mentioned during this panel was that physicians don’t necessarily see the same success rates in the real world as in the research. In particular, oocyte cryopreservation (egg freezing) is a promising development, but physicians aren’t always seeing optimal results in practice. As the recent ASRM guidelines on oocyte cryopreservation note, small research studies may find good results, but large-scale observational studies show that “implantation and pregnancy rates may be lower when frozen oocytes are used compared with fresh or frozen embryos”. Several doctors at the panel discussed that this has been their experience with oocyte cryopreservation, and that they are seeing lower rates of successful fertilization, embryo quality, and pregnancy in their patients.

Again, this is a basic conflict with personhood. If freezing oocytes makes it less likely that those oocytes will fertilize correctly, implant, and develop into persons, personhood would obligate us not to perform a procedure which meets the medical definitions of “destructive research”. While oocytes are not persons, they would become persons at the instant that ICSI is performed to fertilize them. Any medical technique which impedes their later development and causes them to die in larger numbers would still be a potential violation of those embryos’ personhood rights. If individual physicians are seeing worse results in practice with frozen oocytes than fresh, legal and ethical constraints would prevent them from continuing to perform oocyte cryopreservation, and leave them open to allegations of malpractice or negligence.

Other subjects under discussion by the panelists and audience during this panel included Day 3 vs Day 5 cell biopsy, traditional ovarian stimulation versus newer low-stimulation techniques, and stimulation with FSH alone versus FSH-LH combination medications. In all of these cases, the question is which technique produces higher pregnancy rates — in other words, which technique damages or destroys fewer embryos. In every case, one technique will eventually be found have a higher success rate than another, meaning that in every case, the techniques we are using now may potentially be injuring embryos. If all embryos are people with a personhood-based right to life, we’re obligated not to perform medicine which we suspect may be increasing their risk of death, however inadvertent.

Ultimately, I left the PCRS Meeting with a much improved understanding of the latest scientific developments in reproductive medicine. In turn, that new knowledge clarified my existing awareness that the legal problems with infertility treatment and personhood are wide-ranging and basically impossible to reconcile. This wasn’t a surprise, as it’s why personhood is universally opposed by the medical professionals, researchers, and medical organizations who understand reproductive and infertility medicine. Still, there’s nothing to bring it home like listening to a room full of world experts talk about the science.

As always, I urge you to trust the judgment of physicians and medical organizations, not pro-life advocacy groups whose primary interest is abortion politics and who have little understanding of or interest in infertility treatment. That’s why I formed Parents Against Personhood in 2011, to help people understand the medical facts about infertility and personhood, and to encourage voters and legislators to listen to doctors and medical professionals. I thank the Pacific Coast Reproductive Society for the opportunity to continue my education in infertility medicine, and I hope I’ll have more chances in the future to share the latest knowledge with you.