Science
‘She was gasping for air.’ Abortion fight shifts to women who suffered under strict bans
During the five decades that followed Roe vs. Wade, lawsuit after lawsuit in states across the country chipped away at abortion rights. And again and again, the people who went to court to defend those rights were physicians who often spoke in clinical and abstract terms.
“The entirety of abortion rights history is a history of doctors appearing in court to represent their own interests and the interests of pregnant people,” said Elizabeth Sepper, a law professor at the University of Texas-Austin.
But in a Texas courtroom last month, the case for abortion was made by women themselves. They had been denied abortions and sued the state to clarify the exceptions to its ban, which makes it illegal to perform an abortion unless a patient is facing death or “substantial impairment of a major bodily function.”
The would-be mothers described in vivid, harrowing detail how the state’s abortion ban had endangered their health, traumatized them, and, in the case of Samantha Casiano, forced her to carry and give birth to a baby girl without a formed skull or brain only to watch her die a tortured death four hours later.
“She was gasping for air,” Casiano testified on the witness stand. She described how her baby turned purple and her eyeballs were bleeding. “I just kept telling myself and my baby that ‘I’m so sorry that this has happened to you.’ I felt so bad. She had no mercy. There was no mercy there for her.”
Casiano had been denied an abortion months earlier after she found out her baby had anencephaly, a fatal condition. She had wanted her daughter, whom she named Halo, to be spared from suffering and to “go to rest sooner.” She described abortion as an act of compassion, mercy and love.
For decades, Christian antiabortion groups have deployed ultrasound fetal images and grisly photos of what they say are aborted fetuses on highway billboards, protest signs and online ads to garner sympathy for “unborn children” and advance their religious and political aims. But for the first time since the early 1970s, according to legal scholars and historians, the Texas hearing trained the camera upward, away from the high-resolution fetal images to the faces of sympathetic women who say they suffered grievously under the state’s abortion ban.
Women have long shared abortion stories privately, and at public speak-outs, through #ShoutYourAbortion and the nonprofit group We Testify. But the formality of the Austin courtroom focused unblinking attention on their experiences. The black-robed judge and court stenographer leaned in to hear plaintiffs as their testimony under oath was recorded for a national television audience. It put antiabortion activists on the defensive.
“We’re in this moment where all of the stories are coming out and it’s raw,” said Greer Donley, an expert on abortion and the law at the University of Pittsburgh School of Law. “All of these secrets — abortion, miscarriage, the blurring of miscarriage and abortion — that’s something people viscerally appreciate now.”
Before the Supreme Court’s conservative majority eliminated a federal right to abortion in June 2022, polls showed that nationwide support for abortion care was “pathetically stagnant,” Donley said. Compare that stagnation, she said, with the support for same-sex marriage rights, which broadened as gay people and their families shared their stories publicly.
“Storytelling is the future,” Donley said. “That’s how you change hearts and minds.”
The pregnancy complications and medical emergencies described by the plaintiffs both “subvert ideas about motherhood” and “support ideas about motherhood,” said Mary Ziegler, a professor of law at UC Davis who has written books about the history of abortion.
Soon after the Supreme Court held that women had the right to abortion in 1973, the antiabortion movement began a concerted effort to narrow that newly established constitutional right. Movement leaders spoke in gruesome detail about abortions later in pregnancy, coining medically inaccurate phrases, such as “partial-birth abortion,” that infused the language of the abortion debate with emotional and provocative imagery.
“Usually, the story is women versus fetuses, and that people having abortions are selfish or don’t care,” Ziegler said. “But these women in court are saying, ‘What was best for my child was the abortion. I was denied that, but so was my child.’”
Some Catholics and conservative Christians who oppose abortion proffer the notion of “natural womanhood,” Ziegler said — the religious belief that God created women to complement men, and “that abortion is forcing women to be like men” and “disrupts nature.”
That belief was expressed by Dr. Ingrid Skop, a Texas OB-GYN who opposes abortion and testified last month as an expert witness for the state. When asked on the stand about Casiano’s description of watching her baby die, Skop said inducing a birth is “a much more holistic way to progress through the grieving process than to dismember your child and not have a way to grieve.”
Infant deaths have spiked in Texas since the government mandated births of nonviable pregnancies. In September 2021, Texas banned abortions after six weeks of pregnancy and then instituted a prohibition on all abortions from the moment of fertilization unless a woman was experiencing “a life-threatening physical condition aggravated by, caused by, or arising from a pregnancy.” The Texas law makes no exception for nonviable pregnancies.
In 2022, preliminary infant mortality data from the Texas Department of State Health Services, first obtained by CNN, showed a 21.6% increase in infant deaths caused by severe genetic and birth defects. That increase reversed a 15% decline in infant deaths from 2014 to 2021.
The case in Austin comes as abortion rights and civil liberties groups and state Democratic parties are mounting a series of legal and electoral challenges to the Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization, which overturned Roe last summer. In November, Ohio voters will take up a proposed constitutional amendment that would ensure “every individual has a right to make and carry out one’s reproductive decisions.” Litigation against abortion bans is ongoing in at least 17 states, according to KFF. (KFF Health News is a program of KFF.)
A new poll by the nonpartisan research firm PerryUndem that explored the impact of a “viability limit” on support for abortion ballot measures found that voters were 15 percentage points more likely to support ballot measures when they contained no government regulations on abortion over those that restricted abortion later in pregnancy.
The Texas lawsuit has highlighted the myriad reasons women and their families — at least two husbands were in the Austin courtroom — require abortion care throughout a pregnancy, Donley said.
In considering doing away with any limits on abortion, “we don’t have to trust that women are perfect, benevolent mothers,” Donley said. “We just have to believe they are rational actors.”
After 24 weeks, most abortions require induced birth, she added. “So, we’re imagining a person who, for no good reason, endured the burdens of pregnancy, watched her body change completely, and went through labor and delivery of a stillborn baby just because she couldn’t get around to an abortion earlier? People have abortions late because horrible things happen.”
Texas District Judge Jessica Mangrum on Friday ruled in favor of the plaintiffs, but the Texas attorney general has appealed the decision, blocking the order. The state’s assistant attorney general, Amy Pletscher, had asked the court to dismiss the case. She told Mangrum that the “plaintiffs sustained their alleged injuries as a direct result of their own medical providers failing them.”
But although the outcome of the case is uncertain, legal scholars said it marked the beginning of a new strategy for the abortion rights movement in the United States.
“We had a 50-year fight to get rid of Roe,” Ziegler said. “This is the beginning of the 50-year fight to get rid Dobbs.”
KFF Health News, formerly known as Kaiser Health News, is a national newsroom that produces in-depth journalism about health issues.
Science
Cluster of farmworkers diagnosed with rare animal-borne disease in Ventura County
A cluster of workers at Ventura County berry farms have been diagnosed with a rare disease often transmitted through sick animals’ urine, according to a public health advisory distributed to local doctors by county health officials Tuesday.
The bacterial infection, leptospirosis, has resulted in severe symptoms for some workers, including meningitis, an inflammation of the brain lining and spinal cord. Symptoms for mild cases included headaches and fevers.
The disease, which can be fatal, rarely spreads from human to human, according to the U.S. Centers for Disease Control and Prevention.
Ventura County Public Health has not given an official case count but said it had not identified any cases outside of the agriculture sector. The county’s agriculture commissioner was aware of 18 cases, the Ventura County Star reported.
The health department said it was first contacted by a local physician in October, who reported an unusual trend in symptoms among hospital patients.
After launching an investigation, the department identified leptospirosis as a probable cause of the illness and found most patients worked on caneberry farms that utilize hoop houses — greenhouse structures to shelter the crops.
As the investigation to identify any additional cases and the exact sources of exposure continues, Ventura County Public Health has asked healthcare providers to consider a leptospirosis diagnosis for sick agricultural workers, particularly berry harvesters.
Rodents are a common source and transmitter of disease, though other mammals — including livestock, cats and dogs — can transmit it as well.
The disease is spread through bodily fluids, such as urine, and is often contracted through cuts and abrasions that contact contaminated water and soil, where the bacteria can survive for months.
Humans can also contract the illness through contaminated food; however, the county health agency has found no known health risks to the general public, including through the contact or consumption of caneberries such as raspberries and blackberries.
Symptom onset typically occurs between two and 30 days after exposure, and symptoms can last for months if untreated, according to the CDC.
The illness often begins with mild symptoms, with fevers, chills, vomiting and headaches. Some cases can then enter a second, more severe phase that can result in kidney or liver failure.
Ventura County Public Health recommends agriculture and berry harvesters regularly rinse any cuts with soap and water and cover them with bandages. They also recommend wearing waterproof clothing and protection while working outdoors, including gloves and long-sleeve shirts and pants.
While there is no evidence of spread to the larger community, according to the department, residents should wash hands frequently and work to control rodents around their property if possible.
Pet owners can consult a veterinarian about leptospirosis vaccinations and should keep pets away from ponds, lakes and other natural bodies of water.
Science
Political stress: Can you stay engaged without sacrificing your mental health?
It’s been two weeks since Donald Trump won the presidential election, but Stacey Lamirand’s brain hasn’t stopped churning.
“I still think about the election all the time,” said the 60-year-old Bay Area resident, who wanted a Kamala Harris victory so badly that she flew to Pennsylvania and knocked on voters’ doors in the final days of the campaign. “I honestly don’t know what to do about that.”
Neither do the psychologists and political scientists who have been tracking the country’s slide toward toxic levels of partisanship.
Fully 69% of U.S. adults found the presidential election a significant source of stress in their lives, the American Psychological Assn. said in its latest Stress in America report.
The distress was present across the political spectrum, with 80% of Republicans, 79% of Democrats and 73% of independents surveyed saying they were stressed about the country’s future.
That’s unhealthy for the body politic — and for voters themselves. Stress can cause muscle tension, headaches, sleep problems and loss of appetite. Chronic stress can inflict more serious damage to the immune system and make people more vulnerable to heart attacks, strokes, diabetes, infertility, clinical anxiety, depression and other ailments.
In most circumstances, the sound medical advice is to disengage from the source of stress, therapists said. But when stress is coming from politics, that prescription pits the health of the individual against the health of the nation.
“I’m worried about people totally withdrawing from politics because it’s unpleasant,” said Aaron Weinschenk, a political scientist at the University of Wisconsin–Green Bay who studies political behavior and elections. “We don’t want them to do that. But we also don’t want them to feel sick.”
Modern life is full of stressors of all kinds: paying bills, pleasing difficult bosses, getting along with frenemies, caring for children or aging parents (or both).
The stress that stems from politics isn’t fundamentally different from other kinds of stress. What’s unique about it is the way it encompasses and enhances other sources of stress, said Brett Ford, a social psychologist at the University of Toronto who studies the link between emotions and political engagement.
For instance, she said, elections have the potential to make everyday stressors like money and health concerns more difficult to manage as candidates debate policies that could raise the price of gas or cut off access to certain kinds of medical care.
Layered on top of that is the fact that political disagreements have morphed into moral conflicts that are perceived as pitting good against evil.
“When someone comes into power who is not on the same page as you morally, that can hit very deeply,” Ford said.
Partisanship and polarization have raised the stakes as well. Voters who feel a strong connection to a political party become more invested in its success. That can make a loss at the ballot box feel like a personal defeat, she said.
There’s also the fact that we have limited control over the outcome of an election. A patient with heart disease can improve their prognosis by taking medicine, changing their diet, getting more exercise or quitting smoking. But a person with political stress is largely at the mercy of others.
“Politics is many forms of stress all rolled into one,” Ford said.
Weinschenk observed this firsthand the day after the election.
“I could feel it when I went into my classroom,” said the professor, whose research has found that people with political anxiety aren’t necessarily anxious in general. “I have a student who’s transgender and a couple of students who are gay. Their emotional state was so closed down.”
That’s almost to be expected in a place like Wisconsin, whose swing-state status caused residents to be bombarded with political messages. The more campaign ads a person is exposed to, the greater the risk of being diagnosed with anxiety, depression or another psychological ailment, according to a 2022 study in the journal PLOS One.
Political messages seem designed to keep voters “emotionally on edge,” said Vaile Wright, a licensed psychologist in Villa Park, Ill., and a member of the APA’s Stress in America team.
“It encourages emotion to drive our decision-making behavior, as opposed to logic,” Wright said. “When we’re really emotionally stimulated, it makes it so much more challenging to have civil conversation. For politicians, I think that’s powerful, because emotions can be very easily manipulated.”
Making voters feel anxious is a tried-and-true way to grab their attention, said Christopher Ojeda, a political scientist at UC Merced who studies mental health and politics.
“Feelings of anxiety can be mobilizing, definitely,” he said. “That’s why politicians make fear appeals — they want people to get engaged.”
On the other hand, “feelings of depression are demobilizing and take you out of the political system,” said Ojeda, author of “The Sad Citizen: How Politics is Depressing and Why it Matters.”
“What [these feelings] can tell you is, ‘Things aren’t going the way I want them to. Maybe I need to step back,’” he said.
Genessa Krasnow has been seeing a lot of that since the election.
The Seattle entrepreneur, who also campaigned for Harris, said it grates on her to see people laughing in restaurants “as if nothing had happened.” At a recent book club meeting, her fellow group members were willing to let her vent about politics for five minutes, but they weren’t interested in discussing ways they could counteract the incoming president.
“They’re in a state of disengagement,” said Krasnow, who is 56. She, meanwhile, is looking for new ways to reach young voters.
“I am exhausted. I am so sad,” she said. “But I don’t believe that disengaging is the answer.”
That’s the fundamental trade-off, Ojeda said, and there’s no one-size-fits-all solution.
“Everyone has to make a decision about how much engagement they can tolerate without undermining their psychological well-being,” he said.
Lamirand took steps to protect her mental health by cutting social media ties with people whose values aren’t aligned with hers. But she will remain politically active and expects to volunteer for phone-banking duty soon.
“Doing something is the only thing that allows me to feel better,” Lamirand said. “It allows me to feel some level of control.”
Ideally, Ford said, people would not have to choose between being politically active and preserving their mental health. She is investigating ways to help people feel hopeful, inspired and compassionate about political challenges, since these emotions can motivate action without triggering stress and anxiety.
“We want to counteract this pattern where the more involved you are, the worse you are,” Ford said.
The benefits would be felt across the political spectrum. In the APA survey, similar shares of Democrats, Republicans and independents agreed with statements like, “It causes me stress that politicians aren’t talking about the things that are most important to me,” and, “The political climate has caused strain between my family members and me.”
“Both sides are very invested in this country, and that is a good thing,” Wright said. “Antipathy and hopelessness really doesn’t serve us in the long run.”
Science
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