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July 24, 2014

PRESS RELEASE: Florida Hospital Says It Will Force Pregnant Woman to Have Cesarean Surgery

July 25, 2014

Contact: Farah Diaz-Tello
(212) 255-9252; (347) 829-4226

Florida Hospital Says It Will Force Pregnant Woman to Have Cesarean Surgery
Federal Court Won’t Issue Emergency Order to Prevent Forced Surgery

Ft. Myers, FL – A Florida hospital has threatened to force a pregnant patient to have cesarean surgery against her will and to report her to child welfare authorities for exercising her right to medical decision-making. The threats were made in a July 10th, 2014 letter from the Chief Financial Officer of Bayfront Health Port Charlotte to Jennifer Goodall, a Cape Coral, FL mother of three who was nearly 39 weeks pregnant. The letter informed her that because she decided to have a trial of labor before agreeing to cesarean surgery, her prenatal care providers intended to report her to the Department of Children and Family Services, seek a court order to perform surgery, and to perform cesarean surgery on her “with or without [her] consent” if she came to the hospital.

Ms. Goodall had three previous cesarean surgeries, and based on that experience and careful informed consideration, seeks to avoid additional surgery if possible and to allow labor to proceed in hopes of having a vaginal birth after cesarean (VBAC). According to medical research, both VBAC and repeat cesarean surgery carry risks. The risk of uterine rupture increases for women who labor after having had previous cesarean surgeries, but the risks associated with another surgery also increase. In fact, undergoing a cesarean surgery for the fourth time carries a 1 in 8 chance of major complications. The American College of Obstetricians and Gynecologists indicates that 60-80% of women who attempt VBAC are successful. “I would definitely consent to surgery if there were any indication during labor that it is necessary,” Goodall emphasized, “I am trying to make the decision that will be safest for both me and my baby, and give me the greatest chance at being able to heal quickly after my child is born so I can care for my newborn and my three other children.”

National Advocates for Pregnant Women (NAPW), with Florida attorney Patricia E. Kahn, filed a complaint on behalf of Ms. Goodall in federal court on Friday seeking a temporary restraining order preventing the hospital from carrying out its threats. Federal District Judge John E. Steele denied the request, stating, in part, that Ms. Goodall has no “right to compel a physician or medical facility to perform a medical procedure in the manner she wishes against their best medical judgment.” Farah Diaz-Tello, Staff Attorney for NAPW, expressed disappointment in the ruling: “The process of labor and delivery isn’t a procedure; our client is the one trying to avoid a compelled medical procedure. Deciding whether and when to consent to surgery is a constitutionally protected right.” Ms. Diaz-Tello explained that every appellate court to rule on this issue on a full record has held that pregnant women retain their constitutional rights, including rights to medical decision-making and bodily-integrity. “No woman should fear that because she’s pregnant, she can be threatened, coerced, or deprived of her constitutional rights.”

According to declarations of medical experts filed with the lawsuit, the hospital’s actions violate medical ethics. Mary Faith Marshall, PhD, Director of the Center for Biomedical Ethics & Humanities at the University of Virginia School of Medicine called the hospital’s actions “troubling. Given the clear statements from ACOG’s Committee on Ethics and other professional groups that coerced or court-ordered medical procedures are not ethically justified, it is stunning that a hospital would threaten such an action.”

Diaz-Tello acknowledged the hospital’s concerns about malpractice liability, but noted that there is no legal or ethical authority that supports managing liability concerns by forcibly performing unwanted surgery. “The Florida Supreme Court has said health care providers are protected from liability when they respect and follow the decisions of a competent and informed patient to delay or refuse a proposed treatment, even when there are risks involved. Ms. Goodall has explicitly and carefully documented her informed decision to proceed with a trial of labor; there is no justification for forcing her, or any person, to have unwanted surgery to protect a hospital’s bottom line.”

The following statement can be attributed to Jennifer Goodall:

My decision to allow labor to proceed before consenting to a surgical intervention is based on years of research, careful consideration of the risks to me and my baby, and my family’s needs. All I want is to be able to go to the hospital when I’m in labor and have my medical decisions respected - and my decision is to proceed with a trial of labor and not have cesarean surgery unless some medical complication arises that makes cesarean surgery necessary for my or my baby’s health. Instead of respecting my wishes like they would for any other patient, my health care providers have made me fear for my safety and custody of my children. The people who are supposed to be caring for me and my baby have put me into an even more dangerous situation. I know I’m not the only one to go through this; I’m speaking out because pregnant women deserve better.


July 17, 2014

PRESS RELEASE: Leading Experts & Organizations Challenge Tennessee Medical Association's Role in New Pregnancy Criminalization Law

JULY 17, 2014

CONTACT: ALEX WALDEN: (202) 587-2868


National Advocates for Pregnant Women and More Than 70 Organizations and Medical and Ethics Professionals, Express Concern in Open Letter, Call on TMA to Join Efforts to Repeal the Law and Prioritize Confidential and Compassionate Health Care

New York, NY – National Advocates for Pregnant Women (NAPW), along with more than 70 leading Tennessee, national, and international medial and ethics professionals, and other organizations, released a letter to policymakers and media calling attention to the Tennessee Medical Association’s (TMA) support for a radical new law allowing the arrest of women who become pregnant.

The new Tennessee law that went into effect on July 1 permits arrests of pregnant women for the crime of fetal assault, with special focus on the “illegal use” of “narcotics” by pregnant women. Tennessee is the first state, through legislative action to make pregnant women criminally liable for the outcomes of their pregnancies.

In response to the TMA’s outspoken defense of the law and its role in helping to draft and enact it, National Advocates for Pregnant Women, American Association for the Treatment of Opioid Dependence, Healthy and Free Tennessee, International Doctors for Healthy Drug Policies, Global Lawyers and Physicians, SisterReach, and other organizations, and medical and ethics experts sent an open letter today to the TMA to address the Association’s misleading claims about the law in general and the effects of prenatal exposure to opioids, in particular. The letter also corrects the assertion that the law will increase access to methadone and other recommended medication-assisted treatment.

Lynn Paltrow, Executive Director of National Advocates for Pregnant Women, said, “Because Tennessee’s law undermines maternal, fetal, and child health – the signatories hope that the TMA will join efforts to educate health care providers, policymakers, judges, and the public about the value of medication-assisted treatment” and work vigorously to repeal the law. Paltrow added, “The TMA should reaffirm its commitment to confidential and compassionate health care – not punishment – for all pregnant women and new mothers.”

Many state legislatures have considered and rejected similar laws. There has been overwhelming, consistent opposition to such laws from national and state based medical groups and leaders. Unlike the medical associations and experts in other states, the TMA worked with politicians to develop this punitive law.

Ruth R. Faden, PhD, MPH, Director of the Johns Hopkins Berman Institute of Bioethics and signatory to this letter said, “The TMA’s participation in the development of a law that criminalizes patients in this way is radically out of step with the mainstream medical community and bioethics standards.” She explained, “The role of medical providers is not to negotiate lesser criminal penalties for pregnant patients and new mothers but to advocate for policies that promote the health and well-being of women and their babies.”

As a result of the Tennessee law, on July 10th, Mallory Loyola was charged with assault after she tested positive for a non-narcotic drug and gave birth to a newborn who also tested positive but is not reported as experiencing any injury. She is the first mother to be charged under this law.


July 15, 2014

PRESS RELEASE: Guadalupe County Jail Releases Pregnant Woman

July 15, 2014

CONTACT: Kylee Sunderlin

Guadalupe County Jail Responds to National Outcry
Releases Pregnant Woman, Facilitates Methadone Treatment

Seguin, TX - On July 14, 2014, Jessica DeSamito, a Navy Veteran who was taken into custody on a technical parole violation and denied methadone treatment at 24 weeks of pregnancy, was released from Guadalupe County Jail. She is now under electronic monitoring at home, where she will continue to receive medical care that is essential to her health, and to the health of her pregnancy.

Ms. DeSamito was incarcerated on July 7th, pending a decision on the status of her parole. She courageously advocated for herself and her future child at the initial parole revocation hearing. Despite her efforts, as well as two expert affidavits explaining the medicals risks and legal violations of denying her medical treatment while incarcerated, she was detained at the Guadalupe County Jail and was completely denied her medication for days. This denial of essential medical care not only caused her immense stress and suffering, it also increased the risk of stillbirth.

As a result of ongoing legal advocacy by National Advocates for Pregnant Women (NAPW) and local counsel, human rights lawyer Alicia Perez, public outrage through a nationwide campaign "Justice for Jessica," and a storm of media attention, the jail began providing Ms. DeSamito with Methadone Maintenance Treatment -- a treatment that is recommended for people who are opioid dependent, and prioritized for pregnant women. Yesterday, the parole board decided to release her with continued electronic monitoring.

Upon her arrival home, Ms. DeSamito said: "I am so grateful for all of the people who took the time to reach out and help me. I've never felt so cared for and supported. I also hope that the state of Texas will learn from my experience and will start treating all pregnant women with dignity and respect."

"While NAPW is extremely pleased that Ms. DeSamito can now obtain the medical care she needs, we know that her case is not unique," explained NAPW's Soros Justice Fellow, Kylee Sunderlin. She added, "Due to rampant stigma and medical misinformation, jails and prisons, drug courts, parole and probation departments, and child welfare agencies throughout the country have dangerously restricted pregnant women and parents from receiving medication assisted treatment."


Arresting Developments (and some Victories) for Pregnant Women in the US

Arresting Developments (and some Victories) for Pregnant Women in the US

As if the recent Supreme Court decisions were not enough, the last few weeks have been a frightening reminder that it is not just women's rights to abortion and contraception that are at stake, but also their right to be free from arrests, prosecutions, and cruel and inhumane punishment.

Last week, the first woman was arrested under Tennessee's new law that makes the crime of fetal assault applicable to pregnant women in relationship to the eggs, embryos, and fetuses they carry. As NAPW and its coalition allies have explained, the first arrest proved that the law is not limited to women who "illegally use narcotics," is not limited to situations in which a newborn is injured, and is not about increasing access to treatment. NAPW is exposing the injustice of this new law, and has already reached out to help in her defense. We are also ready to challenge a federal court ruling in Tennessee if, as we fear, a judge sentences a woman to significantly more time in prison because she was pregnant at the time she committed the crime.

And state officials in Texas made clear that pregnant women who are incarcerated will be deprived of critical medical care. In early July, Jessica DeSamito, who was 24 weeks pregnant and receiving methadone treatment, contacted NAPW for help. She was on parole and terrified that it would be revoked because she had committed the technical violation of testing positive for opioids during the time she was struggling to gain entry to a methadone treatment program. She knew that if her parole were revoked, she would be jailed and denied the treatment necessary for her health and for the health of her pregnancy. Despite NAPW's efforts, Ms. DeSamito was in fact jailed and cruelly denied medical care. Neither Ms. DeSamito nor NAPW gave up. With the invaluable help of local counsel Alicia Perez, exceptional media coverage, such as "Texas Jailers Deny Pregnant Navy Vet Medication Needed to Continue Her Pregnancy" and "Rick Perry's 'pro-life' hypocrisy: How Texas puts pregnant women at risk," and the public outcry that resulted, Ms. DeSamito is now out of jail and receiving the health care she needs.

But it is not only cases involving drugs where pregnant women are being targeted for arrest: women have also been arrested for ending a pregnancy. On July 18, the Ninth Circuit Court of Appeals will hear oral argument in a case brought by Jennie McCormack, an Idaho mother of three who was arrested and charged with having an illegal abortion after she terminated a pregnancy using medication she obtained online.

This Feminist Wire commentary: "Feminism and the Prison Industrial Complex: Why 'Add Incarceration And Stir' Doesn't Cut It" by NAPW's Board President, Jeanne Flavin, and NAPW Research & Program Associate, Laura Huss, makes clear how these seemingly diverse cases all come together and that intersectional work is needed to ensure Reproductive Justice for all. NAPW is committed to doing that work. For example, we are looking forward to participating in the Standing Our Ground: Raising Our Voices Against Reproductive Oppression and Violence Against Women (#StandingOurGround) Reproductive Justice weekend.

Please help NAPW continue our vital work.

July 11, 2014

First Arrest Demonstrates Failure of Tennessee's Fetal Assault Law

Cherisse Scott, SisterReach, Healthy and Free Tennessee, 901-310-5488
Farah Diaz-Tello, National Advocates for Pregnant Women, 212-255-9252
Micaela Cadena, Young Women United, 575-644-5830

The following statement can be attributed to Healthcare Not Handcuffs:

As yesterday’s arrest of an East Tennessee mother makes clear, the state’s newly expanded fetal assault law is designed to humiliate and punish, not treat or protect.

This is a law that makes going to term and giving birth the basis for criminal investigation, arrest and public humiliation: local news outlets report that this mother “gave birth to a baby girl on Sunday” and two days later “was arrested and charged with simple assault.”

We believe that it is immoral to treat childbirth as an element of criminal activity. As predicted, we are already receiving reports of women who are paralyzed with fear about whether to seek prenatal care, and seeking out non-licensed drug treatment providers to avoid having a medical record and risking arrest.

Significantly, this first arrest exceeds the scope of the plain language of the law. Proponents of the law claimed its purpose was to address Neonatal Abstinence Syndrome (NAS) and illegal use of “narcotics” by pregnant women. However, the drug this mother is accused of using is not a narcotic, and there is no NAS that results from exposure to this drug.

In addition, the simple assault law requires that a person cause “bodily injury to another.” According to the news reports there is evidence of exposure to a drug, but absolutely no mention is made of injury to the child. There are many substances and environmental exposures that present risks to pregnant women and the fertilized eggs, embryos and fetuses they carry and sustain. While newborns may test positive for those substances, it does not mean they have suffered bodily injury as a result of that exposure.

The law’s supporters also claimed that the fetal assault law would somehow increase access to treatment. There is no indication that any treatment was available or offered in this woman’s case but state money has already been spent arresting, booking and incarcerating her.

As is sadly typical, little has been reported about the life or circumstances of the woman at the center of this story or the suffering her children will experience as a result of this punitive, costly and counterproductive prosecution. We do not believe that addiction defines her or any other person.

This very first application of the law makes clear that it must be repealed.

Women and families who enter into health care at the University of Tennessee Medical Center or any other medical setting should not leave as criminals.

# # #

Healthcare Not Handcuffs is a coalition of organizations (including Healthy and Free Tennessee, SisterReach, National Advocates for Pregnant Women and Young Women United) and individuals dedicated to advancing policies that support, rather than punish, pregnant women and their families.

July 8, 2014

Guadalupe County Jail Denies Medical Treatment to Pregnant Woman: Creates Serious Risk of Stillbirth

July 8, 2014

Contact: Kylee Sunderlin
(212) 255-9252

Guadalupe County Jail Denies Medical Treatment to Pregnant Woman:
Creates Serious Risk of Stillbirth

Seguin, TX – Yesterday, a parole panel at the Guadalupe County Jail incarcerated Jessica De Samito, a 24-week pregnant woman, and is denying her medical care essential to her health and the health of her unborn baby. As a result of her incarceration, she is being denied methadone treatment, a medically approved care deemed by health experts, public health organizations, and U.S. state and federal governments as the gold standard of care for pregnant women who are opioid dependent.

Jessica De Samito is a U.S. military veteran who suffers from PTSD and an anxiety/panic disorder. In May of 2011, Ms. De Samito was charged with possession of a controlled substance and later convicted. Ms. De Samito was released on parole on February 7, 2014. Following her release, she started self-medicating with opiates—a response to her ongoing PTSD.

When Ms. De Samito became pregnant this last spring, she began a desperate search for appropriate treatment. She finally found a local methadone treatment provider that recognized her situation as an emergency and prioritized her enrollment, consistent with federal recommendations that establish priorities for treating pregnant women.

In June, Ms. De Samito contacted National Advocates for Pregnant Women (NAPW), explaining that she was 24 weeks pregnant, receiving methadone treatment, and facing a Parole Revocation Hearing as the result of a positive urine drug screen in May before she was able to access treatment. She was terrified that, if detained, she would be denied treatment and her baby's health would be placed at risk.

On July 7th, Ms. De Samito appeared at her Parole Revocation Hearing at the Guadalupe County Jail. At that hearing, Ms. De Samito did not have counsel, but she did submit two expert affidavits to the Parole Panel—one from Dr. Robert Newman, a nationally and internationally recognized expert in methadone treatment, addressing the danger of abrupt detoxification during pregnancy, and the other from Kylee Sunderlin, an NAPW Legal Fellow, explaining the numerous laws violated and implicated by the denial of methadone treatment, including the Texas Prenatal Protection Act. Ms. De Samito’s Parole Panel advised her that it would take 2-3 weeks to issue a decision. In the meantime, she was immediately taken into custody and incarcerated in the Guadalupe County Jail, which refuses to provide her with methadone treatment despite the fact that doing so creates a serious risk for stillbirth. A 2009 lawsuit against a Montana Jail that similarly refused to provide a pregnant woman with methadone treatment resulted in a settlement agreement that ensures the provision of medication-assisted treatment for pregnant inmates with opioid dependency.

Kylee Sunderlin said: “No woman should be punished with the denial of health care and the threat of stillbirth.” She added, “Forced sudden withdrawal is not only dangerous to Ms. De Samito and her pregnancy, but has been condemned as ‘tantamount to torture or cruel, inhuman or degrading treatment’ by a 2013 U.N. human rights report.”

Ms. De Samito is seeking the immediate provision of methadone treatment.


July 2, 2014

The Supreme Court Denies Contraceptive Supplies: We Say Organize!

In the abortion clinic access decision last week, and again on June 30, the U.S. Supreme Court reminded us that all women, including pregnant women and their families, must continue to fight for our human rights to health, living wage work, and to be recognized as full and equal members of society. Yesterday's two 5-4 decisions show that women's full personhood has not yet been realized as a matter of U.S. law, and we still must work to secure the rights of all women to the resources they need to support their families and determine the course of their own lives.

The Burwell v. Hobby Lobby decision involves the Affordable Care Act's birth control mandate, an important step in ensuring that women employees are not discriminated against when they seek the health care they need. In this case, for-profit companies used the Religious Freedom Restoration Act to challenge the birth control requirement, arguing that their free exercise rights were violated by the rule. The purpose of RFRA, however, is to protect people from substantial and unjustifiable burdens on their religious practice. The Supreme Court's decision that RFRA allows these corporations to refuse to cover contraception permits private employers to substantially and unjustifiably burden women. In Harris v. Quinn, the Supreme Court issued an opinion that undermined unions working on behalf of Illinois home health care workers - workers who are mostly women, and generally paid extremely low wages for the essential caring work they provide.

In both opinions, the majority of the Court ignored the ways in which women are relegated to second-class status. In Hobby Lobby, five justices agreed that religious for-profit companies (notably, NOT "people," despite the "legal fiction" the Court resorted to yesterday) are burdened when their employees' insurance plan covers important contraceptives like Plan B, ella, and the IUD. There is no question, however, that women and their families (real, not fictional people) experience real burdens on their bodies, health, and lives when they cannot access the reproductive health care they need.

The birth control that Hobby Lobby doesn't like helps prevent pregnancies as a result of sexual assault, birth control failure, or unprotected sex. As Justice Ginsburg recognized in her dissent, unintended pregnancy and its consequences harm women, their loved ones, and the children they already have. This is the real burden that the Affordable Care Act's birth control mandate was intended to alleviate.

Allowing employers to decide which contraceptives, if any, its women employees should get demeans women and puts their health at risk. (NAPW has previously noted that despite its objection to its participation in an insurance plan that includes coverage for contraception, Hobby Lobby carries knitting needles, that women in the past and once again may use to end pregnancies that they could not prevent in the first place.)

If there is a silver lining to Justice Alito's opinion, it is this suggested solution to the problem: full government funding for contraception. Putting aside the current political situation in Congress that makes such funding improbable, the decision does suggest the real solution demanded not by RFRA but by human rights: a system of universal health care that includes everyone and covers all women and all of their health care needs.

So let us summarize:

In the guise of
free exercise
the Supreme Court denies
contraceptive supplies
women's ability to unionize
while affirming the
right to terrorize
women who seek to exercise
their reproductive rights and lives.

We say Organize!

We call on Congress to correct the Court's overreach into the lives of women workers, whose bodies, health, and lives are at stake. We call on those states with contraceptive equity laws to continue to prioritize women's health over politics. We call on all in the U.S. to work together for universal health care and women's equality. We call on you, NAPW supporters, to help us continue to organize, litigate, and make positive change on behalf of pregnant women and their families.

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