NH abortion stats (and lack thereof) in the news

A front-page news item in one of New Hampshire’s best-known media outlets underscores something readers of this blog have known all along: reliable, objective abortion statistics are hard to come by in the Granite State.

The New Hampshire Sunday News for July 31 had a front-page article by Michael Cousineau headlined “NH clinics, foes weigh impact of Roe v. Wade reversal.” (The full article is available online but might be paywalled.) In the course of writing the piece, the reporter prefaced information supplied by New Hampshire abortion providers with a necessary qualifier: “Getting information on the number of abortions in New Hampshire and demographics about those patients is difficult. New Hampshire is one of only three states (along with California and Maryland) that don’t compile and report such statistics to the U.S. Centers for Disease Control and Prevention.”

He quoted Jason Hennessey of New Hampshire Right to Life. “It’s a vital statistic, just like births and deaths. It’s a number we should be keeping track of like 47 other states do.”

This is one policy initiative that needs to keep coming back to the General Court until legislators finally get it right. With or without Dobbs and Roe, the collection of objective abortion statistics and distribution of aggregated data is essential as a matter of public health. Women’s health. Self-reporting by abortion providers is a lousy basis for public policy.

I think we’re up to nine stats bills that have failed in New Hampshire since 2002. Any policymaker who wants to look at past efforts should start with the best one, HB 629 from 2015-16, when the study committee headed by Rep. Bill Nelson did the deepest dive to date on the technical aspects of stats collection. That bill got past the House on a voice vote but died on a tie vote in the Senate; I reported at the time on that disappointment.

Enough already. Let’s get a stats law.

Welcome a new women’s health care practice to N.H.

Dr. Sarah Bascle (CMC photo)

This is good news, and it’s a long time coming: Catholic Medical Center in Manchester, NH is welcoming Sarah Bascle, M.D., to its Women’s Wellness & Fertility Center of New England. The public is invited to an Open House on March 14 to meet Dr. Bascle and tour the new practice.

This won’t be just an abortion-free practice. It’ll be a practice staffed by professionals who know that fertility is understandable and manageable, it’s not a disease, and women don’t need to be “fixed.” The Open House is a good opportunity to learn more about NaPro Technology and restorative reproductive medicine, among the other specialties of the new OB/GYN practice.

When a woman in New Hampshire wants to find an obstetrician or gynecologist who neither performs nor refers for abortion, it’s an uphill battle. Harder still – impossible, in my experience – is finding a provider who isn’t fully invested in providing and promoting contraception.

My use of natural family planning was tolerated with some amusement by my longtime primary care provider. When she retired a few years ago, after we had known each other for a quarter of a century, she remarked that I was the only patient she had ever known who had used NFP and who understood her own body so well. (There’s a connection there.)

I welcome CMC’s work in expanding life-affirming options in New Hampshire, and I look forward to meeting Dr. Bascle.


Unfinished business

Two years ago today, I posted “N.H. Stats Study Committee Recommends ‘Future Legislation'”.

The future brought legislation, but it did not pass.

From my 2014 post:

The interim study committee examining House Bill 1502 from the 2014 New Hampshire House session issued its brief report on November 14. Representative Laurie Harding (D-Lebanon) wrote on behalf of her colleagues on the Health, Human Services and Elderly Affairs Committee:

“The committee voted in favor of future legislation that is focused on meaningful, confidential collection of abortion statistics only for the purpose of public health analysis and intervention. The data would be summarized and made public in an aggregated form. The committee supported the motion to recommend future legislation only if the data collection is guaranteed to protect the anonymity of the provider and patient and the appropriate resources are available.” (Vote: 16-1)

The ensuing bill, HB 629, was introduced in January 2015, retained and studied all year, brought back in January 2016, passed the House on a voice vote, and was finally tabled in the Senate after passage there failed on a tie vote.

Planned Parenthood of Northern New England and the New Hampshire Department of Health and Human Services withdrew their support for the bill in 2016, after cooperating in the study committee that led to HB 629’s introduction.

Something else from Leaven’s 2014 post:

New Hampshire public health authorities have no official idea how many abortion providers work in New Hampshire, or how many women and girls get abortions, or how many of those abortions are late-term surgical or early-term chemical. Any effort to fill in those gaps will be a public health boon. Let’s take it further and pass a law that tracks how women fare after abortions, at least to the extent that a provider who consistently had awful outcomes could be identified and stopped.

There has just been an election in New Hampshire. Five of the state senators who voted against HB 629 are no longer in the Senate. Nine House members have filed a request for a new stats bill to be introduced in January.

Do you suppose that an abortion statistics bill might finally pass in 2017?

Deal with it: life after the Court’s latest misstep

I have a constitutional right to substandard care, as long as abortion’s involved. At least that’s what U.S. Supreme Court Justice Breyer and four of his colleagues think. All women, pro-choice and pro-life alike, have reason to choke on that.

In Whole Woman’s Health v. Hellerstedt, the Court tossed out hospital admitting requirements for abortion providers and requirements that abortion facilities meet the same standards as ambulatory surgical centers. Gosnell must be loving this.

I’m not. I was discouraged for about forty-five minutes, then I got angry. The decision stinks. Even so, I have to deal with it.

I’ll deal with it like this.

  • Witness. Recommit to 40 Days for Life with its peaceful and decidedly un-political witness to clients and workers at abortion facilities.
  • Demonstrate. Marches for Life in Washington and in my state capital next January, rallies at the State House:  simple ways to remind the Justices and their abettors that they haven’t settled anything.
  • Demand stats. Keep working for an abortion statistics law. Without reliable stats, people like Justice Ginsburg can chant about how “safe” abortion is.  There are no reliable uniformly-collected nationwide public health statistics to back that up. Ask the Centers for Disease Control. Its abortion surveillance reports are full of footnotes about the different figures kept by different states, and about the lack of information from several states including my own.
  • Protect whistleblowers. If a worker at an abortion facility goes public with concerns about facility conditions, is the worker protected from reprisals? Time to find out.
  • Remember Gosnell, from grand jury report to verdict.  Breyer mentioned the Gosnell scandal in the Whole Woman’s Health decision, only to dismiss its relevance. He has the devil’s own nerve being so cavalier about women’s health.
  • Fight public funding of abortion providers who with their support of Whole Woman’s Health are in favor of making substandard care a Constitutional right.  

A tall order, all that – until I’m reminded that five Supreme Court Justices, including three women,  consider women’s health to be less important than the business interests of abortion providers.

That’s unacceptable. Pushback starts now.

New Hampshire Senate tables abortion statistics bill

The New Hampshire Senate on May 5 shot down an abortion statistics bill, tabling it after passage failed on a 12-12 vote. The failure of HB 629 capped a seventeen-month effort to craft a law that would permit collection of abortion statistics while protecting the privacy of all parties involved in an abortion.

Supporting HB 629 were twelve Republicans: Senators Forrester, Bradley, Cataldo, Sanborn, Daniels, Avard, Carson, Boutin, Reagan, Birdsell, Morse and Prescott.

Opposing HB 629 were ten Democrats and two Republicans: Senators Woodburn (d), Watters (d), Pierce (d), Hosmer (d), Little (r), Kelly (d), Lasky (d), Feltes (d), Soucy (d), D’Allesandro (d), Fuller Clark (d) and Stiles (r).

Why fight stats collection?

The full debate should be available on the Senate web site shortly. Look for the recording from May 5; the debate began early in the afternoon session.

Senator Kevin Avard presented the “ought to pass” committee recommendation for the bill. Opponents then launched into objections, which I paraphrase thus – and anyone who wants to listen to the original statements may do so via the link in the preceding paragraph:

  • The bill calls for a $135,000 expenditure to set up the stats-gathering program, and there was no proper fiscal note to the bill.
  • A woman has a constitutional right to abortion and therefore gathering statistics is an intrusive no-no. I’m not sure the senator making that claim would argue the same way about Second Amendment rights, but I frankly don’t follow 2A bills closely enough to know.
  • Gathering stats would violate a woman’s privacy. That ignored the fact that the committee that crafted HB 629 was concerned about privacy from the outset, and the resulting legislation called for release of aggregate data with no personally-identifying information.
  • No other medical procedure (“and abortion IS a medical procedure,” Senator Kelly admonished her colleagues), and certainly nothing that would apply to men, is subject to the statistics-gathering requirements of this bill, and therefore collecting abortion statistics is discriminatory.
  • There is no “compelling need” to gather this information, since “abortion is a safe procedure.” The senator making that claim did not point out that there are no New Hampshire statistics to buttress the safety claim.

And so on.  A woman has a right to abort, and in New Hampshire she has no corresponding right to any data about the safety of the procedure she seeks. Public health  officials have no right to information on maternal morbidity following abortion, never mind if there are providers responsible for any untoward outcomes.

What the Centers for Disease Control says

When HB 629 was introduced in January 2015, New Hampshire was one of only three states not reporting abortion data to the federal Centers for Disease Control, which monitors abortion as a matter of public health.

From the CDC web site:

“CDC began abortion surveillance in 1969 to document the number and characteristics of women obtaining legal induced abortions. Many states and reporting areas (New York City and the District of Columbia) conduct abortion surveillance. CDC compiles the information these reporting areas collect to produce national estimates. CDC’s surveillance system compiles information on legal induced abortions only….[S]tates and areas voluntarily report data to CDC…

“This report is used for many purposes in the field of public health. In the past, it has been used to:

-Identify characteristics of women who are at high risk of unintended pregnancy.

-Evaluate the effectiveness of programs for reducing teen pregnancies and unintended pregnancies among women of all ages.

-Calculate pregnancy rates, on the basis of the number of pregnancies ending in abortion, in conjunction with birth data and pregnancy loss estimates.

-Monitor changes in clinical practice patterns related to abortion, such as changes in the types of procedures used, and weeks of gestation at the time of abortion. This information is needed to calculate the mortality rate of specific abortion procedures.

“Surveillance systems, such as this one, continue to provide data necessary to examine trends in public health.” [emphasis added]

The painstaking development of the bill

HB 629 was introduced in January 2015 and was retained a month later for further study, with the results to be presented to the House in January 2016.

I was present for most of the study meetings on this bill; the full docket is included as an image below. Participants in the study included legislators from the House Health Human Services and Elderly Affairs Committee, along with representatives of the state Department of Health and Human Services and the Department of Vital Records.

Also welcomed at the table were a representative of Planned Parenthood of Northern New England, and myself. Early in the process, I was representing Cornerstone Action, a policy group. After I left Cornerstone, the committee members continued to welcome my participation in the discussions. All meetings were posted in advance and open to the public.

Planned Parenthood had never supported a stats bill in New Hampshire before, and it was the hope of the HB 629’s sponsors that a variety of voices in the discussion could yield a workable bill.

All of us – regardless of party or any other affiliation – agreed from day one that patient privacy was critical to any statistics-gathering effort. Rep. Kathleen Souza, chief sponsor of HB 629, looked at what states with abortion statistics laws have done, and members of the study committee had access to that information.

When HB 629 returned to the House in January of this year, it did so in a version amended to incorporate the findings and concerns that came up in the study process. The Health Human Services & Elderly Affairs committee voted 12-1 to recommend “ought to pass” on the amended bill. It passed the House on a voice vote on January 6. The committee report to the full House contained this statement: “All stakeholders agreed to the final version of the bill.”

And then two “stakeholders” deserted. Planned Parenthood reverted to type. The other entity to drop its support was the state Department of Health and Human Services, now headed by a commissioner recently appointed by Governor Hassan.

Nothing in the bill changed between House passage and Senate consideration. The only change was in the political winds. Against those, public health didn’t stand a chance.

Status Quo

With the tabling of HB 629, New Hampshire public health officials will continue to rely on self-reporting by a few abortion providers.

Since there is no restriction in New Hampshire on who may perform abortions, public health officials will continue to be ignorant about who’s providing them and therefore will have no way of knowing if a provider has a history of harming women.

Information on pregnancy rates – legitimate public-health data, in the CDC’s view – will remain in by-guess-and-by-golly territory, with no reliable induced-abortion information to factor into the rate.

At what point in pregnancy are abortions being performed in New Hampshire? Surgical or chemical (“medical”) abortions? Complication rates? All remain unknown to public health officials and to women seeking abortion in New Hampshire.

The reason for New Hampshire’s willed ignorance is a mystery. Statistics are collected in nearly every other state, with women’s privacy protected and abortion in no way restricted by statistics laws. Statistics laws simply do not affect abortion rights or availability. Stats are a matter of women’s health.

On a 12-12 vote on May 5, women’s health got thumbs-down in the New Hampshire Senate.