 Thank you all for coming. We're going to be talking about the impact of the DOB's decision on the delivery of health care to women. And I'm delighted to be joined by Lucy, the folks who are on the front lines here, of providing the health care that women need. Just a few comments. The DOB's decision is a shocking act of judicial vandalism by our Supreme Court. It's the first time I'm aware of where the Supreme Court has actually taken away a constitutional right that women in this country have protected for 50 years. And you're going to be speaking to us specifically about how that impacts your ability to provide health care to women, how it creates a lot of apprehension and fear. Just when I anecdote here, when I came home the day of that decision, there was a rally in Burlington, and there were many rallies around the state. And what I remember so vividly about that, it was different than other times when there's been citizen objection to something either Congress or the Supreme Court has done. And what I would see was anger. At this event, I saw a lot of fear. There were real, real world implications for people when they knew that. And I know you'll be able to speak to that. The second thing that I find extraordinary about this decision is how it's poor gasoline and let the match on the division we have in this country that is already too much. We need more unity. We need more mutual respect. We need more collaboration. And what this decision has done is exactly the opposite. Because we have peaceful coexistence. There are people in this country who do not believe in abortion. They're entitled to that point of view. But they're not entitled to impose that view on others. And what has happened here with this decision is that it's created a new political division within this country where folks who see the Dove's decision as justification for them to impose their will on others is, of course, creating a lot of conflict. And in the Senate, Mitch McConnell has indicated that he would favor a ban on abortion nationwide. Many states, of course, have already passed legislation that would do that. I'm very, very hopeful here in Vermont that we'll pass Proposition 5. Our legislature has approved that. Our governor said that he will support that. And it's great if in Vermont the citizens protect reproductive freedom for women by approving Proposition 5. And of course, in Congress, I voted for the Women's Health Protection Act. And that would get through the Senate, except for the filibuster. But as important as it is for us to pass Proposition 5 here in Vermont, when I talk to women in Vermont, they don't think reproductive freedom should be based on your zip code. And yes, we want to pass that here in Vermont. But Vermont women want the right of choice to be available to all women. And that's why the Supreme Court decision is so bad. So thank you so much for coming and for the work you do, but now we'll turn it over to Lucy. And it's great to be with you, and so admire the work you've done all these years. Thank you so much, Congressman Welch, for convening this roundtable. This is such an important moment in history. And also for your years of unwavering support for reproductive rights and human rights. So good morning, everyone. My name is Lucy LaRiche. I'm the vice president of Vermont Public Affairs for Planned Parenthood Northern New England, Vermont, and Planned Parenthood Vermont Action Fund. Thank you all for being here. I first want to stress that abortion is still legal, safe and legal in Vermont. Unfortunately, there are many places where this is not the case and where the threat looms very large. However, since the Supreme Court overturned Roe v. Wade, we continue to see the fallout of this devastating and cruel decision. Our patients are scared and they're confused. They want to know where they can still access a safe and legal abortion, what longer-term birth control options are available. And out of state callers want to know if they will face prosecution for coming to our area for care. In fact, anecdotally, we had a person call the health center and wanted to know if they could be prosecuted for an abortion that they had received years ago. So this is really creating chaos in the minds of people and around the country. At Planned Parenthood, we firmly believe that access to sexual and reproductive health care, including abortion, shouldn't depend on your zip code. We are committed to serving everyone who walks through our doors. We're also committed to protecting reproductive rights in Vermont long-term. In this November, Vermonters will vote on the Reproductive Liberty Amendment, or Article 22, previously known as Prop 5, which will protect every person's right to make their own reproductive decisions, like whether and when to become pregnant, use temporary or permanent birth control, or seek abortion care. Between now and election day, we'll work around the clock to make sure every Vermont voter has accurate information about the Reproductive Liberty Amendment so that they can make an informed decision when it comes time to cast their ballots. I'm now pleased to introduce Allie Stickney. Allie Stickney is the former CEO of Planned Parenthood, Northern New England, and she serves as chair of the board of the University of Vermont Health Network. So, Allie. Great, thank you, Lucy, very much, and thank you Congressman Welch for being here today and getting attention to this really very basic and important topic, so I appreciate that. I am here, I think, for a little historical perspective, I think. My work with Planned Parenthood started when abortion was illegal in Vermont, so in the early 1970s. So my first work, some of my first work, was staffing and chairing what we called the Problem Pregnancy Team that provided information to women about where they could get a safe abortion, not a legal abortion, but a safe abortion. And at that time, we referred women to Dr. Henry Morgantaler up in Montreal, because abortion was not legal in New York State then, either. And he was a physician who had abortion facilities and the government chose not to prosecute him, so he provided safe abortion. So I wanna draw a few threads from back then to today, as we see illegal abortion emerge again, because I think there are some important language that has resurfaced that I think is important to pay attention to, and some important situations where what might not be legal is still done and what might be legal is not done. So I'm gonna give some examples of that. So first of all, around language, a word that I am seeing surface again is the word elective abortion. We used to use that term back when only some kinds of abortions were allowed in the beginning days, and now I'm seeing reappear again, and I think one of the dangers of that is it implies that some women have valid reasons for seeking an abortion, and other women are seeking abortion only just they don't really need to, but they just want to. So I think we really need to be aware of that sort of language that puts women in a different categories, depending on their reason for seeking abortion. The question of things that are done when abortion is not legal, but is done, one example would be that telephone service we had, which was illegal by Vermont law, but we did it anyway, and I think we will see that happen again. I think we will begin to see people taking action that may not be legal, but they're going to do it. So I think that we're faced with that in this new day. The other thing to pay attention to is when things are legal, but nobody will provide it. So back when, in the early days of abortion provision, when abortion finally did become legal, there were many physicians in hospitals who did not want to perform abortions, so that's a reason that women's health centers came forward, Planned Parenthoods came forward. So I think that's a piece we have to pay attention to in our current situation where abortion may still be legal in Vermont, but we need to make sure that it continues to be available. And I'll close by giving one more example, which I think might sound far-fetched, but in today's environment isn't necessarily, and that's around contraception. So again, in an historical perspective, contraception was legal in the early 70s, but young women could not access it because there wasn't a provider who would provide contraception to women who weren't married and might be under the age of 21. So Planned Parenthood had an under 21 program when we made sure that unmarried women could have access to contraception. And I think we have to be aware of that in the days coming up too. Things may be legal, but some providers may choose because of political pressure, not to provide services to women and to young women. So those are some of the lessons learned from the early days, which I used to think were history, but now you can see some of them re-emerging. Yeah, thank you very much. I'm chilling to think about, thank you, Allie. So now I'm pleased to introduce Dr. Stephen Brown and OBGYN and geneticist, as well as an associate professor at UVM Medical Center. Dr. Brown. Oh, good morning. Yeah, I guess thank you for your comments about language. That's something I've struggled with myself over the years and what you're saying is correct. So I guess, you know, my own comments here have to do with the fact that for me abortion is something that is a practical matter. It needs to happen. There are patients who need it and who are going to get it one way or another. And, you know, we're fortunate to be here in Vermont where we're not restricted, at least not yet. And I feel badly for my colleagues around the country who can't offer care to patients who desperately need it. And, you know, to illustrate that, I can say that just since the time of the DOB's decision was made, I've had, you know, four patients with pregnancies with lethal abnormalities, a mother whose life was in danger from her pregnancy, as well as numerous other, you know, cases with extremely compelling reasons for termination of pregnancy. And I can only imagine that if that's happening here in our small state, it must be on a much huge scale in other places. I, you know, feel badly for those people. And I guess I'll just finish up by saying that I think that the idea of having a constitutional amendment here in Vermont to protect abortion rights is a very, very prudent idea that I'm hopeful to see pass in the fall and it gets voted on. Thank you. Thank you so much, Dr. Brown. I'd like to now turn it over to Tanya Sarota Winston, the director of clinical care at Planned Parenthood, Northern New England. Hi, thanks everybody for being in one of our health centers here. I would just share our perspective at Planned Parenthood where we have definitely already provided abortion care for people who have traveled great distances in this country. Since actually SB 8 in Texas, I myself helped provide abortion care to somebody from Texas two weeks after SB 8 was passed in our Rutland Health Center. So it is already happening that people are traveling great distances and sometimes finding their way to Vermont as their way to access their needed care. We certainly anticipate that to continue and to increase, unfortunately, in these times. Then there are the other impacts that we see already, as the congressman mentioned. Just that fear, like the number of phone calls that we've already received in our health centers of people local and from great distances calling with questions about how to access care, sort of reassessing their approach to their reproductive health care. We've seen a big upsurge in people seeking sterilization services, seeking long-acting reversible contraceptives, IUDs and implants. I've cared myself for people who are here for the summer in Vermont at home and feeling very worried about heading back to college in other states in this country and feeling a lot of need to receive services here in Vermont before they head back to college. So it is already having an impact in our health centers. We're super proud to be here to see those patients and to really show up for them. It certainly calls on us to do even more than we have before. But it really is already impacting providers in Vermont. Thank you. That's amazing. Within two weeks of the Texas decision, you had somebody from Texas here. Wow. Wow. Yeah, thank you, Tonya. There are states trying to make it illegal to travel, right? Now, which is scary. Yeah, I mean, that's the division I'm talking about because now there's been, it's unleashed that people who believe, they're opposed to abortion are now unleashed to impose that view on everyone else. And that's the fear that we see in our health centers. That's right. Yeah. Thank you. Yeah, thank you, Tonya. And I'm pleased to introduce to you here, Sydney Cordozo. She attends Lerner College of Medicine at UVM. Thank you for being here. Hi, thanks for having me. I'm also here with my friend and colleague, Brittany, who's second year at school with me as well. Your second year? I'm a third year. Third year? Second year, yes. Alright, seniority. Well, so it doesn't exist. Yeah, we just wanted to talk about the perspective of medical students, how this decision is affecting our education wellness and the overall impact on our health system. So to start, I guess with our education, we're very lucky here in Vermont at University of Vermont to have classes on termination of pregnancy in our pre-clerkship years, which are the first two years. And I'm currently in my OBGYN rotation right now. And I've actually been able to be, in a case with Dr. Brown, the one he was mentioning. The life-threatening one. And so we have access to these learning opportunities, which is imperative for our learning. And I guess the question is, are other students in other institutions getting the same education? And I think the answer to that is no, they're not. These procedures and these medical termination of pregnancy, those are on our exams, on our boards. It's pertinent to our education, and most importantly, it's pertinent to patient care. We're lucky in Vermont that we're receiving that. We're receiving that, but other places, I'm fearful that's not happening, as well as implications for residency training. I was with a fourth-year resident, in the case with Dr. Brown, who's interested in maternal fetal medicine, and she mentioned how imperative it is for her to be able to offer all therapeutic options to her patients. And she's training at Vermont, and she has the opportunity to learn about counseling and procedural techniques, but other institutions do not offer that. As far as medical student wellness goes, I think this is extremely distressing for students, especially even before getting to medical school. It's already a lucrative and challenging process to get in. And then you have to add it on challenge of deciding if you can be safe going somewhere in your education and your care. Because of the laws in that state. Yeah. And also, being medical students in residence, a lot of people will delay pregnancy because of the rigors of training. And as we know, as you get older, there are more complications with pregnancy. So it's another decision you have to make about where maybe you pursue residency training because you want access to care in case there's a pregnancy complication. There was this stat that Brittany and I were talking about where out of a survey of 629 female surgeons, 42% of them had pregnancy complications. Wow. And it's terrifying to think if you're training somewhere, you've gotten to some of the peak of your career in training. And if something were to happen, that could go away very quickly. So those are some of the things we wanted to bring up. Brittany, do you want to talk about anything? Yeah, so I'll just expand a little bit on your mention of the way that folks are delaying family building in their careers. On the flip of that, there's also the reality that folks who can become pregnant, including our trans and non-binary colleagues, may choose not to pursue specialties which are demanding of their time and their capacity. So, you know, a lot of what I've noticed as someone who's been in the medical field for a few years, even prior to entering medical school is the disparity in gender of the providers in certain specialties. And I think that this decision will only exacerbate that issue given that, you know, the folks who can become pregnant might be less likely to pursue a specialty that is going to require so much time of them that they won't be able to care for a child that they may have been forced to birth. Thank you. Thank you. Yeah, thank you, Sydney, and Whitney, for your perspective. And everyone, I mean, just like, underscoring that you really are the heroes here in this story. And Congressman Welch, you especially are wearing the cape today and every day trying to keep us in the fight. You're kind to do that. But, you know, this is a human-level issue. It's like women every day have to have confidence that they can make healthcare decisions and get the support they need to do it. And, you know, you've just addressed some of the life situations that so many people are in that now get complicated because this government's getting in the way. I mean, it's a staggering decision. And, you know, as I mentioned at the beginning, there's really two parts to this. One is the basic freedom of a woman to make her own decision. And that was protected by Roe for 50 years. And isn't that the right way that it would be? It's not a debate about abortion or not. It's about who makes the decision. And then in those situations where there's a medical complication and there are women speaking to people who dealt with this, Dr. Brown, I know you have, where the person who is pregnant has this whole vision of being a mom and maybe getting that room ready for the child. And then you have to give the news that there's a real lethal situation here and there's a heartbreaking decision that has to be made. Well, that has to be the woman and it has to be the doctor. And it can't be the government. It just can't be the government. These are hard, hard decisions, but government should not be getting in the way of the woman and the doctor who have to make this decision. And then what I've been so upset about too is reading about how doctors are now facing liability when they exercise judgment. You know, your job is to give the news, in your opinion, the best that can possibly be given to your patient. And if you now have people second-guessing you because they're there in the view against abortion and they're going to be second-guessing your medical judgment that you owe to your patient, that's a terrible situation to put that woman in that doctor. Any questions or anything? Can I just add one more thing? I think you bring up a good point on how it should be a decision between the patient and the physician. And Brittany and I were talking a lot how this decision often, in what times, affects those who are most vulnerable, so that will be our black and people of color, as well as our trans folks. So I think it's important to remember them in this conversation about how decisions like DOBS can lead to other adverse decisions like prevention of birth control and other hormone therapies, as well as just limiting safety and access. Yeah, thank you for that. Yeah, definitely. Any questions? Did you want to take questions? I think if you want to take questions. No, whatever. Any other process or questions? I have a quick question. Earlier this week, President Biden signed an executive order that would make it easier for states like Vermont that have not outlawed abortions to apply for Medicaid vouchers to help pay for procedures for people who might come from out of state here. Just how crucial is that to be able to get these Medicaid or to apply for the Medicaid vouchers to pay for the procedures? Yeah, whether it's Vermont or another state, it is incredibly important that we be providing resources to people who have really been disadvantaged and discriminated against based on where they live in regards to their ability to get healthcare. This is astounding to me that we live in a country where your human rights depend on what state you live in. It's a travesty. So we absolutely support the Biden administration and their efforts to make sure there are resources available to people to access critical fundamental healthcare. I don't know if anyone else wants to... It's really simple. This is a healthcare issue and in a society we should have healthcare access for everybody. And it's that simple. We should have privacy too. If we really had privacy we wouldn't even have to have this conversation. And Dr. Brown, unfortunately the DOB's decision opens the door for intrusion into privacy in other areas. Justice Thomas said that out loud that unless it was in the Constitution when it was written it is not entitled to constitutional protection, contraception, interracial marriage, gay marriage. A lot of the privacy issues... The hope of the Constitution, the aspiration of the Constitution is all men when it was written are created equal in the struggle that all of us have had in our country and we're all part of is to broaden that definition where the women and they're there now where African-Americans who are not included and the goal has been to to broaden the definition of the aspirational goal that we're all equal under the law we shall have equal opportunity and the Supreme Court in this decision is reversing that. The other thing, this conversation reinforces for me how quickly these issues have come up. So this is not some theoretical issue that we're talking about. So within weeks, the women are there with complications and issues. And you know with your history, because you saw this was happening when you started pre- you were there with Dr. Beecham, right? Yes, I was. God bless him. In Congress in America, I understand that there was a vote on the House floor around access to contraception and there were 195 people who voted against that. Well, that's right. Just for perspective here, for people who think the contraception is safe and that they will never do they'll never go after contraception that was really stunning. That never was really stunning to me. That's right. So I gotta say, you're on the front lines you know, sometimes people say my job is hard. It's got its challenges and I work with some of the best minds of the 16th century, you know. So... But you're on the front lines. You know, you're dealing in the real world with this woman who faces a lethal situation, a life-threatening situation in just the stress that that woman is under in the responsibility that you have to give your best advice and to be calm and comforting and supportive. That's hard and I just want to again say thank you for the work that you do. Question, if you're still taking question. Yeah, go ahead. When we're talking about the financial implications of this and Medicaid, what is it cost to get an abortion in Vermont? I know how much it costs at Planned Parenthood, but... Yeah, but that's the most important information. Yeah, so in Vermont we are fortunate in, unlike other states where there have been barriers to abortion access long before. You know, these most recent decisions where the Hyde Amendment prevented using federal dollars to cover abortion care. Private insurers could not cover abortion care. The actual financial barriers that people across this country have faced accessing abortion care have been real and present for a very long time. In Vermont, that situation has been different for most of our residents in that we haven't faced all of those challenges, but the Hyde Amendment has been a really large barrier for many people here as well. This is where, if you've heard about abortion funds across the country, they do incredible work and continue to do incredible work to overcome these financial barriers for people and are really stepping up in this moment to cover travel costs, child care costs. But, you know, anybody can call us, you know, at Plain Parenthood and get, like, a really clear answer about what their coverage is, how to access those abortion fund monies, you know, to help people sign up for state insurance programs. And so we're lucky here that the financial barriers to accessing the care are much less and very few people have to pay those out-of-pocket costs because of that and abortion funds. Do you know what percentage of patients seeking care are reliant or needing abortion funds? I do not have those numbers on the top of my tongue. I can say that the majority of our patients qualify for Medicaid insurance, so that we do, our patient base is primarily lower-income people. So I would guess that the people needing assistance at least mirrors that, but it's probably larger than that because we know that the cap on eligibility for Medicaid is still very, very low with regards to affordability. In other words, you can be making more than that Medicaid eligible amount and still not be able to afford healthcare. So we also have other sources of funds that we patch together to make sure that we can provide care no matter what. So we have a sliding fee scale. We make sure that we never turn patients away. All patients are welcome. We provide care to people no matter what. As it says there on the wall. There it is. That's great. I got a quick question that's okay. I guess for Congress and Walt given this Supreme Court decision, what are some concrete actions that you were trying to do in Congress to ensure that abortion access could be, you know, accessible in all across the nation? Well, you know, Congress can act. The Vermont Legislature can act. And we can pass legislation, the Women's Health Protection Act that codifies reproductive freedom as we have with Roe. We pass that in the House and it's only the filibuster in the Senate that's stopping us from passing that. So Congressional legislation could overturn the Dove's decision by providing legislative protection for all women across the country. And we could do that as we did for gay marriage. We did that in the House and there was support in the Senate for that. So this takes action by voters in all across the country to send to Congress representatives and senators who are going to stand up and restore the privacy protections that we enjoyed as a country and as citizens pre-dobs. So that's very much within the power of Congress to do if we can get the votes. And that's why elections matter. I am very fond of saying and reminding everyone, elections absolutely matter. We have basically two votes in the Senate that are preventing a lot of forward progress on many issues right now. You know, and I do want to say something about how divided the country is. We all know that. You know, January 6th happened. It's the first time in history of our country we've had violence a violent attack on the Capitol in an effort to stop the peaceful transfer of power. And what has happened with the Dove's decision is it is added to the division at a time when we absolutely need more unity. We need more collaboration. We need more mutual respect and acceptance. And when you have now intensified that division with the Dove's decision it's exactly the opposite of what we need in order to heal this country and to work together and to face some of the major challenges that affect all of us whether we are a Trump voter or a Biden voter. And that's the political implications here that are so bad. I mean I don't want to diminish because most important is the individual right of that woman to make her decision about what's best for her. But there's broad political implications that are intensifying this division that all of us know is really bad for our country. I have a question. You talked a little bit about how demand for reproductive healthcare has changed and I was curious if how the closure of four health centers in Vermont, one in New Hampshire in June has impacted that. Yeah, and if you could speak a little bit more about that. Yeah, I mean it's a complex healthcare landscape. I think you know as the congressman had mentioned it's a very divided country. We've had a lot of challenges as a country over these last couple of years and healthcare providers across the country separate from this have been called to respond to a global pandemic. We're now being called and in some ways sexual healthcare providers uniquely to yet another public health emergency this week. We're places like Planned Parenthood are on the front lines. It does take a lot of resources to provide a safe, medically accurate patient centered healthcare through all of this and you know we have fallen prey to some of those forces that the entire healthcare industry has at just the wrong time, right? So I can't sugarcoat it and say that access is the same in Vermont as it was before those closures. We have done our absolute best to continue to provide services our access to abortion care is completely unchanged. In fact we've been able to expand it and begin to offer telemedicine medication abortions during this time. Our telehealth program really expanded exponentially so that some of those people in impacted communities could access services but it is a very difficult time to be a healthcare provider and to be a reproductive healthcare provider. Thank you. Well thank you all. It's really wonderful to be with you. What a great last note there. Go Kansas! You know what I so admire is that the work needs to be done and figure out a way to do the work to get the work done. It's like the Vermont way. In Washington and the Supreme Court we should be making it easier to do a hard job. We can't make a hard job easy. But we can make a hard job harder. That's not what we should be doing. We should be making a hard job easier. I mean I think about the training you guys go through. You've gone through and what you've done and you have to deal with people in stressful situations. And I don't think any of us appreciate what it's like when that person comes in and is so vulnerable and is so unaware and they don't know what's involved. It's new for a lot of them and so it's a combination of your real medical skill and training with being caring and comforting and handling in a good way. And that's what I find so appalling about this decision. I mean who are these justices that don't have a clue about what the daily reality is for this vulnerable person who's a good person and wants a future and wants a family and wants to be part of the community. And then these barriers are set up where they're terrified and I just say thank you for the medical providers. You're doing God's work and I just think you're great. And I think it's precisely because you all do see the issues up close, up close and personal every day. That's why none of us is going away from this work. Yeah, so you get this court and it's all abstractions and you know this is real. So anyway, thank you. I think all of us in Vermont appreciate what you're doing. Thank you. Yeah, thank you so much Congressman Ross. We can't thank you enough for convening this conversation and you're continuing to lift this issue. I get embarrassed when you thank me because I'm just doing my job. I mean you have the hard job. But thank you.