 Good afternoon everyone and welcome to today's session post row today's abortion landscape. I'm Ziva Brandstetter. I'm a senior editor at ProPublica. Thank you so much for joining us. We are going to have a great panel today. We're going to wait for a few more people to join us before we get started. So just hang tight. I wanted to remind you all that closed captioning of the program is available today and can be enabled by clicking on the closed caption option on the bar bottom towards the bottom of your screen. And today we're going to be having a wide ranging discussion about some of the reporting we've done here at ProPublica. We're going to have two experts who are going to be joining us about this really important coverage that you know we all care about no matter what side of the political spectrum we're on. You know this is the third event in our three part virtual discussion series to bring this event to sort of our readers and our viewers and people who care about this issue and really bring clarity to the state of reproductive rights. So thank you so much for joining us we have quite a number of people signed up for this so I'm glad to see the numbers climbing here of people who are watching. And it looks like we have enough folks to on now so let's get started. If you're just joining us my name is Eva Branstetter and I'm a senior editor at ProPublica and I'll be your host today. I manage a team of reporters that cover this issue at ProPublica. But there are many people at other people at ProPublica covering this issue as well. And welcome to today's session post row today's abortion landscape. Again as I said closed captioning the program is available and can be enabled by clicking on the closed caption option at the bottom of your screen. And as an additional note today's session is being recorded and a link to the video will be emailed to everyone who is registered. You know for those of you who are new to us ProPublica is a nonprofit newsroom we're dedicated to investigator of journalism. You can find a link to our reproductive health care coverage in the chat. And we have a whole landing page where all of this coverage has been gathered we've done quite a few stories since the big discussion big decision from the Supreme Court of returning row the way that is the dobs decision. And today we had planned to talk to a few of our reporters who have been writing this coverage to review their their coverage and to review our coverage of maternal health and access to abortion. And unfortunately three of those reporters could not make it they had, you know emergencies come up which happens in life so we are here at any rate and we have another reporter with us who has written and a really fascinating story about privacy. And when then we have our two experts who will be joining us later in the program so I'm going to talk about the reporting that that reporters have done that I've edited and has raised some really important issues. And, you know, we may be wrapping up a little bit earlier today than planned but we're going to stay here as long as we can to answer the questions that you all have. To begin our presentation today I'd like to invite Jennifer Gullin to join us on screen. And while she's joining us, I am Hi Jennifer. I'm going to tell you a little bit about her and her story and then she and I going to talk about it. I'm an investigative reporter with the San Francisco Chronicle and Jennifer has reported on topics ranging from oil companies that dodge accountability for workers deaths to offenders who kill their intimate partners with guns that they possess illegally. And she recently published an investigation with ProPublica as a freelancer. So Jennifer, welcome to the program. Thank you very much. It's wonderful to be here. So I wanted to talk to you about, could you sort of sum up for our viewers, what you found when you were looking at the issue of people who are looking online for abortion medication, as you know, more than half of the people in America who do obtain abortions do so with medication versus surgical procedure so could you sum up what the reporting found that you did. Thank you. So we used a tool from the markup technology journalism website, which shows you which web trackers websites are using. And we took an in depth look at the online pharmacies that sell abortion pills to find out what kind of web trackers they're using and what kind of data is being shared with third parties including Google and other tech companies. What are the consequences of this type of data? I mean, we found that it was being shared and that most of the people who were visiting these websites, these pharmacy websites, we're not aware of that because of these trackers. What are the consequences of this type of data being shared with third parties? That's exactly right. So the kind of details that are being shared with these other third parties include things that people click on, the search terms they're using to find a website, the previous site that they had visited, their general location, information about the devices they're using, a laptop or a mobile device, a phone. And this information, while it helps these websites function, it also can potentially identify users. And the key here is that we found that with Google in particular, these websites were sharing a random number that was unique to users browsers. And why does it matter? Well, it can be then triangulated with other data that those tech companies are collecting to potentially identify users. So why might this be a problem? Well, prosecutors can then go get that data. You know, we found that law enforcement can use people's behaviors when visiting these websites that sell abortion pills to build cases against them to prosecute abortions. And there have been cases like this in places like Georgia, Idaho, and Indiana. Yeah, and obviously this issue is very important in the news, Wyoming became the latest state to pass legislation regarding abortion medication last week, specifically outlawing it. There's a big question as to whether states can even do this and what the rights are. There was a big sort of reaction to your story and I know that it had some impact and got picked up in a number of places. That's right. Popular science, Ms. Magazine, Washington Post and some other outlets picked up the piece and it was shared and viewed more than 25,000 times on social media. I think this has relevancy for people because of the important role that abortion pills play in our current debate. As we've seen, you know, it's now really the fulcrum of these political cross currents with the case in Texas that's pending and things like that. So, and it's such an important source of abortions for people, particularly in restrictive states. Right, right. I think this is going to be with the lawsuit, the case in Texas. Of course, I'm sure that most of our viewers are aware that a federal judge in Texas now is getting ready to decide whether the FDA had authority to give approval to one of those abortion drugs that is part of the two drug combination and that could have a sweeping national effect. So, I guess the sort of takeaway from your story is that people need to be aware of the tracking technology that a website could have on it and try to do the best that they can to make sure what information their computer is sharing with other websites that they visit. That's true. I think that was sort of one of the points that I learned in reporting this story. I assume that HIPAA might protect your information because it's medical. That's what I assumed. But what I came to learn through the reporting is that this privacy law does little to constrain the amount and type of data that tech companies can collect from consumers. So, Google and Facebook are generally not bound by HIPAA, which as you know limits the sort of certain healthcare providers and health plans from sharing patients' data. So, law enforcement can go and obtain this information from these tech companies. And that's why this matters. You know, Google from their latest numbers, while they require a court order or search warrant for law enforcement to obtain personal information like this, they receive more than 87,000 requests subpoenas and search warrants in the U.S. in the most recent year available in 2021. Right. And I should say that Google said that the company complies with all laws and requirements, but they did decline our request to give us specific information about whether any of those subpoenas had to do with these pharmacies and people ordering medication that we weren't able to get specific information about whether this information is sort of being gathered by subpoena. But Google did say it's complying with all laws. So, anything that I've missed there, Jennifer, or anything that you want to add, I guess, in summary? Well, for those who are looking to protect themselves and are concerned about their privacy, they can install a web browser such as Brave or Firefox that offers some sort of privacy protections. And, you know, these browser extensions are also available to block third-party trackers. They can adjust the privacy settings on their browsers. So all of that, I feel like, is worthwhile advice. And using Tor is another good option on top of that, to anonymize IP addresses. Right. We did have someone in the chat, Hope, was asking about how to protect herself or how can people protect themselves online? And so there are browsers that allow you to browse and access information without being tracked. So anti-tracking technology and browsers. You know, we're not IT specialists, so we're not here to give you advice on which ones you should choose, but Tor is an option. And there are definitely options where you can sort of have more privacy in your browsing habits. So consult your local IT specialist. In my case, that would be my husband. So. That's right. Your kid, whoever knows. Thank you. I really appreciate the story and would love to see you follow that up and any input that you have, you know, throughout the program, feel free to jump on and, you know, sort of answer questions that our audience has. Thank you so much. Thanks for your time, Jennifer. So I did also want to talk about some of the reporting that we have done at Republican that the reporters who couldn't be here today have done. The Vita Serana who was on my team has spent many months in Tennessee and that has the nation's most restrictive law. Basically, Tennessee's law, some of you may know, makes it a felony for a doctor to perform an abortion with a punishment up to 15 years in prison. There are no explicit exceptions in Tennessee's law. So essentially the doctor, if a if a doctor performs an abortion to save a mother's life, let's say he or she could be charged and then would have to go into court. It's called an affirmative defense and would have to essentially prove that that abortion was necessary. And again, risk prosecution. So the law is the strictest law in the nation. And in October, Kavita obtained a recording, sort of a strategy strategy session between anti abortion activists, both national and state based in Tennessee, and lawmakers that were preparing for the upcoming session. And so she was able to really show a very behind the scenes look at the advice that anti abortion activists were giving lawmakers there in that state which remind you already had the toughest law in the nation. And essentially the, the folks who were advising the lawmakers there and it helped them write the law in the first place we're telling them, not to create exceptions but to double down on the law and to sort of keep it in place. And there were some statements made during this. During the strategy session, reminding lawmakers that doctors could only perform an abortion in cases in which for example, to prevent an organ system from failing that was one of the actual quotes that was used during this strategy session. You know, the the anti abortion activists also coached lawmakers on messages aimed at swaying the larger public to be more accepting of these, these very strict law opinion polls show that roughly six in 10 Americans support generally supports the right to abortion with some limitations. So it is sort of the law in Tennessee does tend to go against the general public opinion. So they talked a little bit about that in the strategy session and can be the story reported that the anti abortion activists were advising lawmakers that to do things like hide behind the skirts of women who had maybe suffered a sexual assault, had a baby and had the exception was not needed in the law because their situation turned out okay. So it's a very interesting look into that specific group of folks who were fighting for not exceptions but for even tougher law, what was already the toughest law in the nation. And then Kavita wrote a second story that followed the months long sort of experience of a woman named Mayron Michelle Hollis and Mayron Michelle Hollis had her embryo had implanted in her cesarean scar tissue. So she had essentially what's like an ectopic pregnancy but it was a cesarean scar pregnancy. And because she had had a prior birth with a cesarean scar. Her doctors told her that her pregnancy could take her life, and she had other children. This is a woman who worked in selling insulation, working very hard and if you're family and so she could not travel to obtain an abortion and by the time she made her abortion, the law had already gone into effect in Tennessee, essentially banning abortion making abortion illegal. So, to be at the story, very sensitively from all sides of this issue. Talk to the doctors who had to make this decision, not to perform an abortion to talk to the woman herself who had to confront losing her fertility if she wanted any hope of, you know, an abortion but that was not even an option for her by the time this law passed and her decision was made. And it's a very complicated case so we were proud that we could bring that story to our readers, because it really people were shared with us that it was something that people on both sides of political spectrum could read and had an opinion about. So I would encourage you all to read it and think about your thoughts and where the story left you. It was, it sort of capture the nuances to this story which is not a black and white story, because these are real people's lives that are affected. And the busy press or story looked at believe it was in August looked at parental involvement laws which have been on the books for a long time in America and they require minors to either notify or get consent from their parents for an abortion. And these are very popular and many states across the country but if young people can't turn to their parents because maybe there's a situation with parental abuse. If they're vehemently anti abortion, maybe they're gone, or maybe their situation is otherwise unsafe. These young people have to go to a judge and prove that they're mature enough to end their pregnancies and so Lizzie story really dove into the experience of one young woman, and and looked at this procedure notice judicial bypass and notice and noted that these procedures are biased, and that judges delay or deny care in some cases to minors for subjective reasons. So we invite you to read the story of that young woman that Lizzie pressor told she was forced to carry her pregnancy to term, and and how a judge is ruling forever changed her life, and some of the children that are being brought into the world because of these decisions. And complicated stories right with no easy answers, but we appreciate your thoughts on on on these issues. And then the last story I was going to summarize just very briefly as we had a story by Megan Rose who looked at some of the laws that are being considered now for this next round of legislatures that are meeting the laws banning banning medication laws affirming the right for doctors to in states that are the allow abortions of form protecting doctors from laws that might punish them from other states. There's a lot of complicated interstate activity going on, and sort of looking at the new legal landscape in both blue states and red states, because this issue has been thrown to the states. So a very brief overview of some of the, some of the reporting we've done it's all on that landing page there which I think the link has been put into our chat. I encourage you to read, read it and we have a call out there as well. So the call out is for people to fill out and tell us their experiences. If some of you have had experiences that either yourself or people that you know that you think our reporters should be looking into. So regarding the impact of the of these abortion restrictions we would very much like to hear that we would like to know how to get in touch with the people that you think we should talk to. So now I'd like to introduce our special guest panelists and invite them to join us on screen. Now that you've heard about some of our reporting and you've heard about Jennifer's reporting. Yes, I'll just go ahead and give their, their, their impressive resumes to you. Mary Ziegler is the Martin Luther King Professor of law at University of California Davis. She is one of the leading historians of the US abortion debate and is the author of six books on the law, history and politics of reproduction in the United States. Dr. Dr. Nikki Z, did I say that right. Sorry, Zeit, as a Ziva I should have checked that with you beforehand. Dr. Nikki Zeit graduated from Northwestern University Medical School and she did her residency in OBGYN in Memphis, Tennessee at the University of Tennessee. She completed her complex family planning fellowship and MPH in Chicago and Nikki currently resides in Tennessee, where she is the professor and vice chair of education and advocacy in the, in the department of OBGYN at the University of Tennessee graduate school of medicine. Before jumping into today's conversation, I'd like to note that our guest speakers here are here today to represent their own personal perspectives and their thoughts are not a reflection of their institutions. So they're here to represent their experiences and their thoughts and that those are their own perspectives not of their institutions. So to be public, you know, we report on how issues like abortion impact and even harm the public in some cases. We don't take policy stance on these issues and themselves we don't write out tutorials we don't opine we don't contribute to organizations on either side, we try to bring you the truth. So that's sort of just wanted to set the table for our discussion. Mary so welcome to you both. Thank you. Thank you. Thank you guys. Mary I'm Friday Wyoming became the latest state to outlaw the use of abortion medication. How do you see the criminal legal landscape playing out like will women eventually be targeted for seeking an abortion that so far that's something that lawmakers have tried to narrowly avoid. So will women be targeted and if so what will that look like. I think it's unpredictable. We've seen a rising trend within the anti abortion movement of people who identify themselves as abolitionists. And they essentially argue that if the movement is serious that a fetus or unborn child is a rights holding person that it would be logical to punish women to right because if you a woman murdered a 10 year old or 20 year old or whatever we would prosecute them for murder. And that that movement is gained a foothold in in a lot of states the most recent manifestation that people may have heard was a South Carolina there were over 20 lawmakers sponsoring a bill that would treat abortion as murder and potentially subject women to the death penalty for having abortions getting the fact that that bill got 20 people sponsoring it was really striking to me and we've seen other kind of abolitionist bills emerging through committee in Louisiana. So on the one hand I think that's a trend we can't dismiss partially because I think it's very difficult. It may be very difficult unless the anti abortion movement is successful with some of its strategies to achieve a kind of backdoor national ban like the one you mentioned. That's happening in the federal court in Amarillo right now, or efforts to look to the the federal Comstock Act which is an anti vice law that was passed in the 19th century to essentially get in a de facto national ban. If that doesn't work then what's going to happen is that conservative states are going to have to try to find strategies that will allow them to prosecute doctors or other people are helping people get abortions in blue states or purple states and that's kind of constitutionally and legally uncharted territory. There's going to come a time I think where the abolitionists are going to be able to say look it's much much easier for us to prosecute women who are in our states right there's no question we have the ability to prosecute them. I think we've sort of seen set up a real conflict within the anti abortion movement and I think to some extent within the GOP to so far the kind of mainstream consensus within the movement that punishing women is a bad idea politically it's a bad idea morally is holding up but I think it's it's fragile. I think you can see I think even even in the mainstream movement some sense that the reason it's not okay to punish women right, the argument opposite suffered is that women don't know what they're choosing right they're being manipulated by abortion doctors by the abortion industry as the movement would put it. It leaves open the possibility that that what what if women know right what if women get it what if women know what they're choosing like then is then just punishment follow. So I think we're in a moment of tremendous uncertainty when it comes to that, and I think it, how much of a push we see to punish women will depend on whether other strategies that the movements pursuing right now succeed or not. And of course we have the case in Texas which is sort of walking up to that line in which you know people are allowed to sue other parties for help helping obtain an abortion and a man has sued three women who are, I think friends of his ex wife and so there are things like that that are happening that sort of walk up closely to that line. It's very interesting. Nikki could you tell us about your experience in Tennessee I talked about a reporting in Tennessee but I'm interested to know what have doctors in Tennessee be been seeing since the law went into effect there. I think you know of course there was the immediate intended consequence right abortion became illegal. And as you mentioned, the way our laws written, ending any pregnancy is illegal. So immediately our outpatient abortion clinics closed several of them, and that not only had the effect of making abortion more challenging to access for people who needed that care, but it also made it harder for those of us that teach abortion for the next generation of OBGYNs to be able to provide that care to not have that opportunity to teach in our state. And then we had all the unintended consequences, the cases like ectopic pregnancy that you mentioned the cases of inevitable but not complete miscarriage. The cases of pre viable P prom the cases of that ambiguous how close to death that she need to be for it to meet the standards of protecting or saving her life. And it became this, you know, complicated legal situation where physicians not only felt like they had to make medical decisions they then had to run it by hospital legal or, you know, a criminal attorney. We used to dealing with malpractice and having to practice the standard of care we are not used to being criminalized for practicing care. And all of us carry malpractice insurance but nobody carries felony insurance it doesn't exist. We lost a lot of scrambling and fear and, you know, frankly we lost a really great high risk or be doctor from Chattanooga to a permissive state we lost a complex family planning provider from Nashville to a permissive state. We lost all the amazing physicians that were working at our outpatient clinics providing abortion and other reproductive health care left the state. So we've lost a lot of physicians and we don't know the impact that it will have on trainees whether or not medical students will have to train in states where they're going to have restrictions on the type of care that they can learn and, frankly, most medical students are reproductive age. So they're going to have restrictions on their own care, and then residents and fellows. I mean if you want to train and high risk OB do you want to train somewhere where you can diagnose a problem but you can't treat it. Wow that's fascinating. Yeah I have been reading about this I guess you'd call it a brain drain of experts in this field who are leaving states like, you know, Wyoming like leaving the There's only a couple of OBGYNs in some of those states so if they leave you really have these OB deserts. Wow. Okay, well I think I'd love to circle back to that later this show but I'm Mary I wanted to ask you a little bit more you mentioned the fetal personhood laws. Does establishing fetal personhood make a pregnant person who has an abortion like a murderer under the law and like, you know the South Carolina legislature that you talked about they were considered this law and then I think they all of a sudden realized they all of a sudden said we didn't read it, which is a little frightening but I mean, how do you think that's going to play out legally. Yeah I mean it's really again hard to say because I think for a long time so fetal personhood isn't new one thing to be clear about like the anti abortion movements. The case of fetal personhood as a kind of constitutional argument started in the 60s. And then after Roe v. Wade it seemed to be off the table for the short term and instead what you saw was kind of ongoing. Talk about it within the movement within the Republican Party platform which has endorsed a human life amendment to the Constitution since the 80s, but not a whole lot of insight into what exactly it meant in concrete terms beyond the idea that abortion had to be illegal and and so that means that there are really deep differences of opinion on the right right now about what fetal personhood requires right so you'll see, you know, on the one hand, some people on the right saying well if if a fetus is a rights holding person or an unborn child is a rights holding person. That means we need to treat pregnant women a certain way during pregnancy right we need to let them drive in the HOV lane some of you've heard of that story from Texas we need to their proposals emerging on the right we need to make birth free we need to you know as Georgia has its anti abortion law requiring certain forms of child support during pregnancy. And then on the other hand you have people saying well if equal treatment is really the name of the game. And then that requires murder prosecutions for people who have abortions. And you have people I think in, I would say in the middle in the GOP who just don't want to get into what fetal personhood requires at all right who want to simply say, that fetal personhood is our rationale for criminalizing abortion but we don't need to really get into it beyond that we don't want to open that Pandora's box, and I think we're going to see that get contested to. But so far it's mostly been emerging in in state legislators up to a point although we haven't seen that many of them fully signing on to personhood. And I think it ended in the wrongful death lawsuit you mentioned. It, you know, one question you might have that is like why bother with a wrongful death lawsuit you have Texas's SBA you have criminal abortion laws literally multiple criminal abortion laws in Texas to choose from. Right. Why, why do this. And I think in part the answer is they wanted to say, you know, as the lawsuit says that if you provide someone else with abortion pills you're you're a murderer right you're an accomplished murderer you're a murderer and that's a personhood argument. So we're going to see it cropping up more in the courts and I think eventually the end game being a case brought up to the US Supreme Court which is not I don't think I'm going to be a favorable venue right now. But we're going to see those arguments, I think continue to filter up and whether they lead to, you know, again to prosecutions of women or just to, you know, nationwide abortion bands I think remains to be seen. I, there's some interesting mental gymnastics that folks are having to do to support some of these positions. I've noticed some of the legislation now is arguing that abortion is not medical care. Right. That it's because if you say it's a medical care then you have to do you have to treat it like all other medical care. I mean, so I think it's interesting to see where the logical conclusion is to these arguments. I mean, there's been again I think because the new paradigm on the right is a criminal paradigm right and so I think often what you'll see the argument is that abortion is only only takes place when there's a certain criminal intent in place right so you are performing a life saving procedure, or you know something that would qualify under a state with exceptions or affirmative defenses, you're going to see some people saying in the anti abortion movement well that's not done with a criminal intent to cause fetal demise so that's not an abortion. Of course, you know, for years for decades we've been talking about abortion is that medical termination of a pregnancy you'll see people use the term spontaneous abortion for miscarriage. And part of what feels so jarring I think is that you're seeing a kind of, you know, it's not just semantic but kind of beyond a semantic fight about what what what even defines abortion right is this really conversation about patients health and that's what matters or is this a comedy, compromise conversation about criminal law, in which case maybe we don't care about that and we're focusing on whether you had ill intentions and how much of an ill intention you had. Which leads us back to like communications and search warrants and you know data privacy there's a lot of questions that that raises. Nikki you've been part of working on a bill there in Tennessee, I believe to modify Tennessee's law to create clear exceptions are certainly you know about it from maternal health care. Can you tell us about that effort and where it stands now. Not in a good place unfortunately. So, it started out right after the dogs decision that myself and a couple of other physician advocates from Nashville wrote an open letter to the Tennessee General Assembly and we got over 1000 signatures from healthcare providers across the state. And that really got attention of the Tennessee Medical Association, the Tennessee ACOG and some other organizations that took the tenants in that of saying we need to clarify some things in this law first of all we've got to move away from the affirmative cases. No physician wants to practice in a guilty until proven innocent type situation. And that's why the, you know, I'm tell a DOJ case in Idaho, you know, put that case under injunction, but Tennessee is still in that situation. We needed to clarify that ectopic and miscarriage management was not part of the law. We needed to be able to take care of patients that were victims of rape or incest. We wanted to be able to take care of patients that were carrying non viable pregnancies. We were sticking with the things that as you mentioned, more of the voting population and more the people really truly felt were not controversial. And that was the things that we could all agree on. Now, you know, most of us, obviously feel like there is good medical and population health data to suggest that access to all abortion needs to be available in order to prevent healthcare and other issues, but we knew in Tennessee we couldn't get to that. So we were going to where we felt that we could get to and help as many people as possible. And so, Dr Briggs who a lot of Kavitha's story was about sponsored the bill that really asked for all those things, rape and incest was not included in that bill but it asked for all those things. So our high risk would be doctors, Dr Kimberly Fortner testified in front of the population health committee on Valentine's Day so some people will call this the love law. But it really asked for those things and had very good support from bipartisan support, and it was passed eight to two out of the population health committee, immediately the right to life went to work. They called all their members and got all their members to call all the legislators and started threatening the legislators with losing their ranking. And their ranking would be their ranking from what voters, yeah, I would look at to decide if they should vote for them or not. And, you know, they'd already stripped that from Dr Briggs when he came out and said he was going to sponsor this bill. So, unfortunately, we now have a very watered down amendment that they're claiming cleans things up, but it really doesn't. I don't think that physicians are going to feel that it gives them much more leeway to provide life saving care without being criminalized. And I don't think that it clarifies, you know, medical complexities or helps us take care of many more patients. The one thing it does do is say ectopic pregnancy is not part of this. I understand that that language is pretty restrictive and still is a very narrow needle the thread and that medical experts who looked at it said it's not going to be much help. Correct. I mean basically they asked us our opinion and then did not take it at all. Interesting. What are the problems with policymakers trying to determine what constitutes a medical emergency. Well, first of all, I think that the idea that it has to be a medical emergency is the first problem. We should be able to prevent an emergency, not just treat emergency and that came up in that, in that population health committee meeting where clearly the right to life wants it to be a true emergency. It's not a good use of health care resources if I'm already taking care of emergency putting a patient in the ICU using blood products, when I could have done the case two days before and it not be that serious her not have risk of heart failure kidney failure those things. It would have made a lot more sense to take care of her then, especially when the overwhelming evidence from most of these cases, which we have data out of Texas to show, it doesn't improve the outcome for the pregnancy. Staying pregnant if your water broke before 22 weeks does not lead to a better outcome for a baby. It just puts them on at risk. That's why laws for abortion have been liberalized in places like Poland and South and Central America and Ireland. Women died, because they were made to stay pregnant until there was no longer a heartbeat, and they got infected or bled. We don't want to go back to that in the United States, and legislators don't seem to understand that that's the inevitable outcome of what they're forcing us to do. I had a question about that as a journalist. I mean, I mean, how are we going to know if how many women are suffering, measurable harm, how are we going to know how many women might die or when or if a woman is going to die. And how long is it going to take us to get that data? I mean, when we look at the state maternal mortality reports, one, they're not always that accurate, you know, it takes the death reports at the end of the year and then the reviews. Usually we're two or three years behind. As a journalist, I can say that I think transparency is important in this area and having, you know, the data available to the public is very important. So if anyone out there listening to this is aware of any source of data that the public needs to have access to that might be able to measure the impact of these laws. We're certainly interested in that and knowing more about what data we what reports and records we can gather what sources of information experts like you or journalists like us should be looking at. In a timely fashion because these delays are only going to allow it to continue to happen for longer. Yeah, I mean these things are happening so I don't. And, you know, policymakers are pretty good at counting things and requiring reports and, you know, so was the medical community so it seems like a reasonable thing for data to be available to measure the impact of these of these laws. And I know that, you know, having information shouldn't be a shouldn't be a bad thing for the public. And I'm going to ask our experts one or two more questions here and then we're going to go to your questions. So Mary you recently wrote that the court does not get the final word even on the meeting of its own important decisions. Can can you talk about that it's a very interesting statement. Yeah, I mean I think what we've seen what we saw with row I mean if you look at the way that the papers of the judges who wrote row. They were settling this right and that row was going to mean that abortion was a thing between a doctor and a woman the doctor was just as much a stakeholder as the woman it wasn't a feminist thing. And everybody was just going to agree with that and move on. And of course they were wrong on both scores on row became a symbol of women's rights right I mean so much so that you'll see you know the women's march saying we're more than row like as if the women's movement was about row in the first place or was synonymous with row. You also see of course you know row did not obviously settle the abortion debate within the court outside of the court and so on and I think the court and Dobbs is sort of trying to say the same thing that we should be looking at what the Supreme Court defines as history and tradition in resolving our constitutional disputes and that history and tradition in the court's view probably not in the view of most historians would not have recognized right to abortion in the 19th century, and that that's kind of the end of it. And we're already seeing I think Dobbs emerging as a symbol of things the Supreme Court didn't want it to be right I mean we've seen a lot of documenting a really precipitous decline in trust of the Supreme Court and Dobbs being kind of the most visible symbol of that decline. And so I think the court often holds itself out as having the last word on these constitutional struggles. When it can't. And also, we've often seen Americans who are not lawyers help to define what these decisions stand for in our politics and I think we're seeing that happen with Dobbs and we definitely saw it happen with row. Fantastic thank you both so much for that so I want you to hang on, we're going to have q amp a from our audience and so leading up to this event registrants submitted over 100 questions to our panel. And we did our best to select the questions that were asked repeatedly by registrants so many of you out there will have questions that we're going to we're going to get to but you can also put questions in the chat. We'll be addressing a few of those as well as questions that are being submitted live during the program. And again if you'd like to ask a question, please click the q amp a button at the bottom of your screen and submit it to us. We have had a question regarding journalists and I'm going to read this and then I'm going to, I'm going to answer it so I have no prep here but I'm a journalist and have a question about covering abortion I think we can objectively describe the banning the banning and heavy restriction of abortion as a human rights issue. What are your thoughts, meaning, ProPublica and the journalists here and if banning abortion as a human rights violation, does it be who of us as journalists and necessarily include the voices of anti abortion lawmakers and activists to create a balance That's the sort of question that journalists also dealt with in some level on climate change issue. And where early on in reporting about climate change you would see journalists go to one or two sort of industry experts, you know and get the on the other hand perspective and you know that there's a notion of false balance and journalism and I think that we should and try to ensure that our stories, especially the stories about laws that are the most harmful appeal to people on all sides of this of the political spectrum, because it's important to educate people and to stick to the facts and so in our reporting we've tried to stick to the facts. But the facts are that this woman that we profiled in Tennessee had to be rushed to the hospital hemorrhaging and nearly died and delivered a baby at 26 weeks, which probably cost the taxpayers of Tennessee millions of dollars spent three months in the NICU had a helicopter flight probably will cost the taxpayers of Tennessee millions more dollars throughout its life, which is by the way going to be a very difficult life. And so we was brought into the world that a family wasn't ready for, and that now has to be cared for. And so that's a fact. And so I just think as journalists, we have to tell the facts, we're very interested in knowing about people on all sides of this issue, but I think we need to see how it's playing out on the ground as well. So I don't think we need to label it. I think readers can draw their own conclusions about about about abortion restrictions and and whether they're human rights issue or not. I think once you get into criminalizing people for for accessing the medical care system. That's a, that's a, that's a harm that I think as journalists we have responsibility to write about. So for our first submitted question to our experts. The person asked what can people in states that still protect the right to abortion due to safeguard maternal health for themselves, and for others in states that now ban the right to abortion. So, either of you can answer that I know, you know, it might, I don't want to put you in a situation of answering a question you don't know the answer to. Honestly, I think that. Oh, sorry, Mary. That's good. I'm feeling pretty discouraged in Tennessee, frankly, because we have a super majority of people who are very anti choice and are not shy about it and don't necessarily care to really try to live in the shoes of the physicians or the people who need this care. And so I honestly think it's going to take ballot initiatives and we don't have that option in Tennessee, we lost that option in 2014. But there are other states that do and, you know, even right now the Supreme Court case or sorry, Supreme Court election in Wisconsin, like I'm following that, because I see that that might have a big factor in the elections overall. And I really need something to happen at a federal level, because I don't know that it's going to happen, you know, normally you say state elections are important. Right. When they've been gerrymandered too much or they're too, it's going to take too long, like I don't see things getting better in Tennessee for decades. And I think I'm focusing at a federal level and I think, you know, I walk around with my voter registration card on my ID badge I walk around with a QR code for voters registration on my coffee mug and everywhere. Tennessee has a really, really poor voter turnout, really low engagement and we've got to fix that. Yeah, I mean, I think obviously there there have been some strategies developed. Well, I guess I would say to begin with, I don't I think it's, it's based on what's going on now in the federal courts if you're living in a state where abortion is legal you should not take for granted that that will remain the case there are I think the leading strategies on the anti abortion side now that they've they've accomplished a lot of what they want and in places like Tennessee has been to pivot to strategies that would eliminate access to abortion nationwide now that's not going to happen through Congress, we don't Republicans in Congress even if they control both houses of Congress on the White House. I don't think we're going to do that we've seen no sign of that happening. From the house Joe, GOP or otherwise, but there are legal strategies, both the Mipha Pristone case we've been talking about in Texas, which could, depending on how the FDA response make it impossible for people in a state like California to have a medication abortion the way the protocol or kind of standard of care is provided for a long time. And also the Comstock Act strategy which is in the Texas case and otherwise which essentially if a judge bought it and it went all the way up to the Supreme Court and was successful might mean that all abortions are criminal nationwide that's the interpretation of this old anti by slot that anti abortion attorneys are advancing. So I think a good first step is to realize how much 2024 is going to matter to that. The FDA has enforcement powers right and who is in the FDA which who's the president will define how much the FDA comes after people if a judge says hey Mipha Pristone no longer legal, whether the FDA uses a lot of time and energy to enforce that will depend on who is in the White House. Similarly, if a federal court comes along and says oh by the way the Comstock Act means you can't have an abortion anymore, who's in the Justice Department is going to have a lot to do with whether that's enforced so I think to begin with you shouldn't feel a false sense of security if you're living in a state where abortion is legal. I think in terms of, you know, pivot points, we're seeing a lot of energy being directed toward ballot initiatives and also kind of second order things related to this we've seen some Republican legislators essentially moving to make it harder to get ballot initiatives directly before voters so I think that's an area where you can pay attention. In a lot of I think contested states but also conservative states. There are some organizations forming in states like Tennessee that don't have ballot initiative options that are looking for kind of what would be arguments that appeal to conservatives on abortion for example. In Tennessee in Missouri, we've seen some voices emerging essentially saying look you know, even if you define yourself as pro life. Do you really want to spend a lot of taxpayer money enforcing criminal abortion laws because that's going to be really expensive, given the amount of resources it takes to uncover these things so we're starting to see some money and effort being directed into new messaging that might appeal to conservatives who have some qualms about how abortion laws are going to be implemented on the ground. State Supreme Courts are another big area of focus in terms of places you can invest your time and energy. State Supreme Court litigations already paid dividends in South Carolina, which essentially said the state six week ban is unconstitutional there and state Supreme Court elections are also moving target right I mean you state Supreme Court membership turns over a lot either through retention elections or direct elections so that's something that you can kind of in Wisconsin and elsewhere kind of keep a finger on the pulse of that going forward because it's not as if you know if things go well or badly depending on your point of view in a given state Supreme Court election that's not a forever thing it's not like when you get you know someone like Brett Kavanaugh or Katachi Brown Jackson confirmed to the US Supreme Court and that's pretty much the end of that for our lifetime. And that's an area where those same judges will be before voters again. So I think those are all areas that people can pay attention to if they're in progressive states but don't take your for granted that progressive states will remain able to do what they're doing now Very good insight. And we have this question for Jennifer, Colin. What outcomes do you see Jennifer in if legislators in states restricting abortion access get a hold of some of this data that let's say data of menstrual menstrual data from tracking apps or the form the pill ordering data that you talked about. Sure. Based on my understanding, it's actually a less of a concern the period tracking apps and more of a concern around the current information that law enforcement is collecting and buying. So, there's a great organization, the digital defense fund and I'll put that in the chat for everyone, and they make some recommendations in this area and consumer reports has also gone through and looked at these period tracking apps so I can also put that in the chat. Great. Thank you. So, let's see, we have a question for either either one of our experts what are individuals doing to reestablish the right of access to abortion in their home jurisdiction, where that access has been overturned or suspended I mean I think we've covered some of that you guys have covered anything else to add. They're trying to do ballot initiatives. They're, you know, I guess this kind of leads to the question of exceptions. And I think there's a notion out there that exceptions are good and exceptions allow people to have access to medical care. Nikki, can you talk about that a little bit. Is that a false sense of security that you know some of these people are sort of sending we can add exceptions. Yeah, I think it's complicated and I think it, you know, it's hard to understand, because I think that a lot of people think, Well, okay if we add an exception that's going to get access for some. But access for some is not actually helping the majority. You know, the type of care that I provide in a hospital setting is less than 1% of abortion care. And without abortion care we're going to see maternal mortality go up we're going to see, you know, people stay in abusive relationships and not be able to achieve their goals. All the things that we know from amazing studies like the turn away project and other work that if you don't have access to abortion, and it shouldn't be good abortion bad abortion it just has to be access to abortion, because everyone's reason for abortion is a legitimate reason for abortion. Right. It isn't something like what nine out of 10 abortions or, you know, the vast vast majority of abortions before, you know, before dogs were, you know, abortions in which people decided to have them and there wasn't like a medical emergency or there wasn't, you know, and most of them are early, if a patient or if a person has the, you know, privilege of being able to get a pregnancy test and know their body, they tend to want to end the pregnancy pregnancy if they know they want to end it. And it is safe with medication abortion and not have to have a procedure abortion or a later more challenging more complicated, more expensive procedure abortion. But the ones that we see that, you know, tend to seem more acceptable to people are the ones that are medical complications either something that's gone vastly wrong in a pregnancy like water breaking at 19 weeks, which a lot of people didn't realize, you know, there's the Chrissy Teigen story, like, you know, a year and a half after she had her miscarriage, she realized she really had an abortion. Because you know, she was bleeding, but there was still a heartbeat, and they had to end the pregnancy to save her life. That's an abortion. But that abortion care is a very minor number compared to the abortion access, you know, that we still need to protect people. And I think with exceptions to we've seen a lot of the history behind exceptions is designed to prevent people from using them as a quote unquote loophole right I think there's there's a lot of history of exceptions for example the height of this ban on Medicaid funding for abortion the anxiety there was always that if you had a broad health exception, that it would turn into allowing people to get abortions for any reason and that was more of a harm from the standpoint of a lot of conservative lawmakers than the risk to some patients if you drew exceptions to narrowly. The other dynamic I think that's influencing how ineffectual exceptions are now is that penalties are just much higher for violating these laws than they were before right so a lot of the times 19th century criminal abortion bans although there were some variations you know the average number of years people would theoretically spend in prison would be a few years they'd lose their medical licenses. Now we're talking in states like Texas about people facing up to 99 years in prison right so I think you're also putting doctors and and you're also in some instances having exceptions that are really hard to understand right Texas has multiple exceptions with slightly different exceptions in each one. So you're asking doctors to parse exceptions that are hard to understand, and then saying you know by the way if you get it wrong, you're going to prison for a really really long time. And it's hard to ask people to gamble that right so I think you also have to understand that the exceptions are kind of in this or in this dynamic with with penalties, and that influences people's access to I think inevitably. Fascinating discussion. I'm going to go ahead and have one more question for Nikki and then I think we're going to wrap it up this has been such a great discussion today. Dr. Zide how are medical schools deciding what procedures regarding ending a pregnancy. So purposely or otherwise how are they deciding what, what is taught and what is their legal standing especially Tennessee and Texas one of our person people wants to know. Yeah, well I mean currently about half of the residency training programs are in band states. And it is a requirement to graduate from residency and become a board certified OBGYN to be able to perform abortion care. Residency programs are required to have what's called apt out training so if a provider has a reason they do not want to get training they can opt out, but the training has to be part of residency. We've been struggling in Tennessee to figure out how we're going to get that training from our for our residents. We already struggled a little because our hospital had some barriers or residents, you know went off site to a free standing clinic to get some of their care and residents chose to go out of state to get more experience, even before dogs. But now we have no opportunity to get them training people are looking towards more stimulation, there are papaya and other fruit models there are clinics and other sessions that you know they can learn online, and then there are some programs in permissive states that are opening spots and opportunities. But this is something that is going to see how it plays out, because there are not enough sites to get everybody trained not everyone's going to be able to travel to get trained, and will it actually make it harder to become board certified. So if you have a real public health risk there that you have people leaving the states of their own volition, you have training that is very difficult to access and you have people who will be coming to emergency rooms who need abortion care because of the situation that I think is very poorly understood. I had a resident when I first got to the University of Tennessee that had opted out of all training. Before I arrived. And even cases where you know and and so fully you know no brain no kidneys, she just could not do a case if there was a heartbeat and that was her belief and we respect that belief and she did not get that training. About three months before she finished training we were called down to the trauma Bay, and a young woman who was about 16 weeks pregnant had been in a very bad car accident open pelvic fractures and her uterus was just full of blood. And there was still a heartbeat. Sometimes I really do not understand how these pregnancies try to continue. There was a heartbeat and I told the resident, you know, I need to go find the orthopedic surgeon, I need to empty her uterus before he starts pinning her pelvis together, because she's going to bleed to death. And the resident said, I'm coming with you. And I said, but there's a heartbeat and she said yeah but there's no way this is ending without her uterus being emptied. And the young woman, we did the case together and afterwards, she had this like crap moment of, I'm going to be on my own in three months. What happens if this patient comes in to my ER, and I don't know how to do this procedure because I opted out of this training, and I am the person who should be able to save her life. Wow. We need to train people to do these procedures. It's very profound that for everyone who's listening to this today, you know, I think both of our guests in our in our journalists have really illustrated the life and death issues that some people are facing that this, the privacy issues. The personal nature of these issues that are happening to millions and millions of people in our across the country. So I just really am very grateful for for your time. Mary, Nikki and Jennifer at talking to the people who joined us today. You know, I think it's really important that we continue these discussions so I really appreciate your time and helping us have an intelligent conversation. So that's our time for today. I wanted to say to everyone before you leave, please take our event survey, it only takes a few minutes it will help us do this better next time so click on the link in the chat and just fill that out and we really appreciate it. I want to thank Jennifer Golan and today's feature panelists for taking the time to bring clarity to today's abortion landscape and thank you to our audience for joining us and for your thoughtful questions. And again this event event has been recorded. So if you'll you'll receive an email with the full video of today's event and we'll be post posting the recording on ProPublica's YouTube channel. So please stay up to date on all of our programming and upcoming programs by visiting our event page which is ProPublica.org backslash events and we'll drop a link in the chat. And then, from all of us at ProPublica. Thank you so much for your time. Thank you to our guests for joining us. Have a great rest of your evening. See you next time.