Hi Rulers! I’m Sydney Gold, one of the POLITICO magazine interns. I’m excited to be helping out today to discuss two Houston doctors fighting to clarify abortion law in post-Dobbs Texas. (Thanks to Sophie Gardner for her help putting together this newsletter!)

Last year, Dr. Judy Levison, an OBGYN in Houston, was offering routine counseling to a pregnant patient about screenings, explaining how she could check for spinal cord or chromosomal abnormalities in the fetus. She told her patient that while not everyone wants to know about abnormalities in their pregnancy, others do in case they’ll need to prepare for any health issues or, depending on the prognosis, even end the pregnancy.

“As I got to the word ‘abortion,’ you know, ending a pregnancy, I suddenly stopped and said, ‘Oh my, I can’t offer abortion anymore, and my patients tend to be low income, and going out of state is really not an option,’” said Levison. “I suddenly felt like somebody had literally tied my hands behind my back.” Levison ultimately decided to stop seeing patients after nearly 40 years in practice, citing Dobbs as a contributing factor.

Levison, along with six other plaintiffs, is suing Texas, one of 12 states with a near total abortion ban. She and Dr. Damla Karsan, a fellow OB/GYN, are joining the suit with five women who were initially denied abortion services despite life threatening complications in their pregnancies. (Most ended up having to leave the state to get care.) The Texas ban does allow for an exception when the mother’s life is at risk, but doctors like Levison and Karsan argue the law is too vague and creates uncertainty about when they can legally terminate a pregnancy in an emergency. Their goal is not to overturn the ban, but to clarify the language in the law, which doesn’t include medical terminology.

“What percentage of ‘dying’ do you have to have, and how do you quantify that before it qualifies?” said Dr. Karsan. “We’re waiting until the risk increases to the point where people feel comfortable that there’s no denying that her life is in danger, which is ludicrous.”

The abortion bans coincide with climbing maternal mortality rates in the United States. The CDC recently released a report showing maternal mortality rates hit a 65 year high in 2020, making the United States the most dangerous high-income country for childbirth. The risk is particularly high for Black women, who had a rate of death three times higher than non-Hispanic white women.

With the Texas case, five of the plaintiffs are women who endured the circumstances Dr. Levison and Dr. Karsan described: They needed medical care they weren’t allowed to receive in their state — and they needed to get worse before they could get better. One plaintiff, Anna Zargarian, was forced to travel out of state after her water broke at 19 weeks to receive an abortion that would save her life. Another, Amanda Zurawski, was diagnosed with preterm pre-labor rupture of membranes, a condition which meant her fetus would not survive birth. Despite the diagnosis, Zurawski couldn’t receive abortion care until she developed sepsis – the infection damaged one of her fallopian tubes, which could impact her ability to become pregnant again in the future.

“There’s no list long enough that would include all of the possible complications. There’s always some twist in real life, and I think that that needs to be recognized,” Levison said. “We need to be able to practice the best medicine that we’ve been trained to practice, and right now we can’t without great hesitation.”

In Texas, the penalty for offering abortion services can be up to life in prison. Karsan says she gets a pit in her stomach when the conversation turns to jail time and punishments.

“I mean the other day there was some mention of criminal charges, and I just thought, ‘Oh my God, they’re going to come arrest me at the office today,’” Karan said. Regardless, Karsan, a former Planned Parenthood provider, said she’s always been outspoken – “I think that’s part of why I got approached” by the lawyers, she joked – and felt an obligation to represent her colleagues in the lawsuit. Levison echoed her sentiment.

“We’re really the voices of so many of our colleagues who are younger, who have young families, who cannot afford life imprisonment, losing their licenses,” said Levison. “I think we both said the identical phrase, which was: ‘if not me, who?’”

The lead attorney for the case, Molly Duane, is a senior staff attorney at the Center for Reproductive Rights. She recognizes this instinct in many of her post-Dobbs clients, who seem more eager than ever to speak out.

“What is different now is that women do want to tell their stories. They want to be public about it. They want to use their names and their faces, despite the grave risks to themselves,” said Duane.

Duane is girding herself for more battles on the abortion front. Since Zurawski v. The State of Texas was filed less than two weeks ago, a Texas man filed a wrongful death suit against three women who helped his ex-wife acquire abortion pills, another first-of-its-kind suit. Earlier this week, another Texas judge heard a case attempting to overturn FDA approval for an abortion pill, mifepristone.

“Dobbs was the first time in the history of this country that the Supreme Court took away a constitutional right. It’s never happened before,” said Duane. “One of my colleagues always says, ‘How can we know what to expect? Roe has never been overturned before.’”

POLITICO Special Report

“The Sharp-Witted Representative Who Opened the Doors of Congress to Young Moms,” by Joanna Weiss for POLITICO Magazine: Schroeder would wind up serving 12 terms in Congress, cementing herself not just as a trailblazer — she and Abzug were among only 14 women in the House when she was elected — but a symbol of what can happen when people, and particularly women, in the thick of life experience get a seat at the table of power.

“Why New York’s cannabis equity program is stranding women entrepreneurs,” by Mona Zhang for POLITICO: “Since launching the program in August, New York regulators have awarded dozens of licenses to entrepreneurs who had an immediate family member convicted on marijuana charges or have a record themselves. While those priorities were written into the program to make up for decades of disproportionate criminal enforcement, particularly in communities of color, the rules are having the unintended consequence of leaving women entrepreneurs out.

“Across two rounds of licensing, 7 percent in the first round were women, while women made up just 14 percent of winners in the second.”

“Why Ursula von der Leyen matters to Biden,” by Suzanne Lynch for POLITICO.

Number of the Week

Read more here.

MUST READS

“S.C. Republicans propose bill that could subject women who have abortions to the death penalty,” by Rebecca Shabad for CBS News: “The South Carolina Prenatal Equal Protection Act would ‘ensure that an unborn child who is a victim of homicide is afforded equal protection under the homicide laws of the state.’ The bill would define a ‘person’ as an ‘unborn child at every stage of development from fertilization until birth.’

“Under South Carolina law, people convicted of murder can face the death penalty or a minimum of 30 years in prison.”

“Covid Worsened a Health Crisis Among Pregnant Women,” by Roni Caryn Rabinfor the New York Times.

“Ukraine’s older women share tales of heartbreak and resilience,” by Ivana Kottasová, Yulia Kesaieva and the Visuals team for CNN: “Ukraine has a large population of older people — one in four of its residents is over the age of 60 — and most of them are women. Some lived through World War II as children, only to see their lives disrupted again in 2014 when Russia annexed Crimea and the conflict in eastern Ukraine began.

“When Russia then launched its full-scale invasion last February, many of these women were unable or unwilling to leave. Of the 4.8 million Ukrainians who have registered in other European countries as refugees since the war began, most are younger women and children.”

“Her Doctor Said Her Illness Was All in Her Head. This Scientist Was Determined to Find the Truth.” by Alice Callahan for the New York Times.

Quote of the Week

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Transitions

Maureen Tkacik will be investigations editor at The American Prospect. She currently is a senior fellow at the American Economic Liberties Project, an affiliation she’ll keep. …

Olivia Coleman is now press secretary for the House Select Subcommittee on the Coronavirus Pandemic. She previously was deputy press secretary for Sen. Ron Johnson (R-Wis.). … Charyssa Parent is now comms director for Sen. Roger Marshall (R-Kan.). She previously was deputy comms director for the House Republican Conference. … Megan Shea is now scheduler for Rep. Jill Tokuda (D-Hawaii). She most recently was government relations manager at the News/Media Alliance. …

Rachel Thomas is moving into a new role as a senior adviser for comms around implementing the Biden administration’s legislative wins (BIL, IRA, CHIPS, ARP, PACT). She is an Education Department and Biden campaign alum. …

Stacy McBride is joining Husch Blackwell Strategies’ federal team as a principal. She previously was chief of staff and committee staff director for Sen. Roy Blunt (R-Mo.). …

Pia Carusone is joining SKDK as president of SKDK Political. She most recently led Sen. Mark Kelly’s (D-Ariz.) reelection campaign. (h/t Playbook)

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