Beyoncé takes part in a campaign rally focused on reproductive rights with the Democratic presidential candidate, U.S. Vice President Kamala Harris, at Shell Energy Stadium on Oct. 25, 2024 in Houston, Texas. (Photo by Justin Sullivan/Getty Images)

Democratic presidential nominee Kamala Harris appeared alongside superstar performer Beyoncé on Friday night to encourage voter turnout and reinforce the differences between the two parties on reproductive rights, with just days to go before voting ends.

The rally at Shell Energy Stadium in Houston, Texas, followed months of speculation about whether Beyoncé would support Vice President Harris publicly ahead of the Nov. 5 presidential election. The two-hour event featured other celebrities, including Willie Nelson and Jessica Alba, as well as women detailing being denied medical care for pregnancy complications in Texas after its abortion ban went into effect.

Beyoncé, who has won more than 30 Grammy Awards as well as hundreds of others throughout her career, said casting a vote is “one of the most valuable tools” that Americans have to decide the future of the country.

“We are at the precipice of an incredible shift, the brink of history,” Beyoncé said, adding that she wasn’t speaking at the rally as a celebrity or a politician.

“I’m here as a mother,” she said. “A mother who cares deeply about the world my children and all of our children live in. A world where we have the freedom to control our bodies.”

‘Horrific reality’

Harris, who is locked in an extremely close race with Republican presidential candidate Donald Trump, said abortion bans and restrictions implemented during the last two years have been “devastating.”

“We see the horrific reality that women and families face every single day,” Harris said. “The stories are vivid, they are difficult to hear, they are difficult to tell.”

Harris said there are also many stories that women and their families won’t discuss in public about challenges they’ve faced with access to medical care during pregnancy complications.

“An untold number of women and the people who love them, who are silently suffering — women who are being made to feel as though they did something wrong, as though they are criminals, as though they are alone,” Harris said. “And to those women. I say — and I think I speak on behalf of all of us — we see you and we are here with you.”

Harris said if voters give Trump another four years in the Oval Office, he will likely nominate more justices to the Supreme Court, which she argued would have a negative impact on the country.

“If he were reelected, he’d probably get to appoint one, if not two, members to the United States Supreme Court,” Harris said. “At which point Donald Trump will have packed the court with five out of nine justices … who will sit for lifetime appointments; shaping your lives and the lives of generations to come.”

Texas has one of the country’s most restrictive abortion laws, which has led to concerns about its OB-GYN workforce, how the state addresses maternal mortality and testimony before Congress about women having to leave the state to get care for pregnancy complications.

Texas is also where anti-abortion organizations decided to file a federal lawsuit in November 2022 challenging the U.S. Food and Drug Administration’s 2000 approval of medication abortion.

The two-drug regimen, consisting of mifepristone and misoprostol, is currently approved for up to 10 weeks gestation and is used in about 63% of abortions nationwide, according to data from the Guttmacher Institute.

The case made its way to the U.S. Supreme Court, which ruled earlier this year the organizations lacked standing to bring the lawsuit in the first place, but the justices didn’t address the merits of the anti-abortion groups’ arguments.

Speaking at ‘ground zero’

Harris told reporters on Friday before the rally began that Republican lawmakers in Texas have made the state “ground zero in this fundamental fight for the freedom of women to make decisions about their own body.”

Harris contended that access to reproductive rights, including abortion, is “not just a political debate” or “some theoretical concept.”

“Real harm has occurred in this country, real suffering has occurred,” Harris told reporters. “People die, and it is important to highlight this issue because this is among the most critical issues that the American people will address when they vote for who will be the next president of the United States.”

During Trump’s first term in office, he nominated three Supreme Court justices, who later joined with other conservatives to overturn the constitutional right to abortion established in the 1973 Roe v. Wade case.

The Supreme Court’s ruling two years ago sent “the authority to regulate abortion … to the people and their elected representatives.”

That has led to a hodgepodge of laws with 13 states banning abortion, six states restricting access between six and 12 weeks, five states setting a gestational limit between 15 and 22 weeks, 17 states restricting abortion access after viability and nine states not setting a gestational limit, according to KFF.

Polls find support for abortion access

Public support for abortion access has outpaced support for restricting access for decades, according to consistent polling from the Pew Research Center.

The most recent survey from May shows that about 63% of Americans want abortion to be legal in most or all cases, while 36% said they believe it should be illegal in most or all cases.

Additional surveying from Pew shows that 67% of Harris supporters believe abortion access is “very important — nearly double the share of Biden voters who said this four years ago, though somewhat lower than the share of midterm Democratic voters who said this in 2022 (74%).

“And about a third of Trump supporters (35%) now say abortion is very important to their vote — 11 points lower than in 2020.”

In addition to playing some role in the presidential election, voters in 10 states — Arizona, Colorado, Florida, Maryland, Missouri, Montana, Nebraska, Nevada, New York and South Dakota — will weigh in on abortion access directly through ballot questions.

Congress could supersede any protections or restrictions on abortion access established within states, if the House and Senate ever agree on legislation and a future president signs it into law.

Republicans are slightly favored to gain control of the Senate for the next two years following the election, while control of the House is considered a toss-up, as is the presidential race.

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Attorneys general from Idaho, Kansas and Missouri wrote in a 32-page brief that allowing the mailing of mifepristone “encouraged and enabled private parties to evade the states’ laws.” (Anna Moneymaker | Getty Images)

Missouri’s attorney general has renewed a push to restrict access to the abortion pill mifepristone, arguing in a lawsuit filed this month that its availability hurt the state by decreasing teenage pregnancy.

The revised lawsuit was filed by Missouri Attorney General Andrew Bailey, alongside GOP attorneys general in Kansas and Idaho. It asks a judge in Texas to order the Federal Drug Administration to reinstate restrictions on mifepristone, one of two medications prescribed to induce chemical abortions.

The trio of attorneys general were forced to refile the litigation after the U.S. Supreme Court rejected the original lawsuit after concluding the original plaintiffs — a group of anti-abortion doctors and medical organizations — did not have standing to sue because they couldn’t show they had been harmed.

In making the case that the states have standing this time, the attorneys general contend access to mifepristone has lowered “birth rates for teenaged mothers,” arguing it contributes to causing a population loss for the states along with “diminishment of political representation and loss of federal funds.”

“Younger women are more likely to navigate online abortion finders or websites ordering mail-order medication to self-manage abortions,” the filing argues.

Missouri’s teen pregnancy birth rate has steadily declined over the past several years, according to the Centers for Disease Control and Prevention, though it still remains among the highest in the country.

The lawsuit demands the federal government restore its previous restrictions on mifepristone by requiring three in-person doctor visits, reducing the gestational period during which the medication can be taken from 10 weeks to seven and rolling back recent federal policy that allowed for the mailing of mifepristone and allowed for prescriptions to be made online or through pharmacies.

In a statement to The Independent, Bailey framed the lawsuit as an attempt to ensure “long-standing safety requirements” for use of mifepristone are put back in place.

“We are moving forward undeterred for the safety of women across the country,” Bailey said.

Molly Meegan, chief legal officer and general counsel with the American College of Obstetricians and Gynecologists, said the latest legal attempt to reduce access to mifepristone is based on “out-of-date and unscientific federal restrictions.”

“Science has conclusively demonstrated that mifepristone is safe and effective, including when used as directed through telehealth, and that patients of any age who become pregnant and need medication abortion can safely use the combination regimen of mifepristone and misoprostol,” she said in a statement. ”Imposing needless barriers on mifepristone will make it harder for people to access this needed care—which of course is the point—and worsen existing health disparities.”

According to the FDA, mifepristone is safe to use if taken as directed. Cramping and bleeding are common side effects of the medication. Those prescribed mifepristone are urged to call their doctor if they experience heavy bleeding, abdominal pain or a fever. The same guidance applies to those who recently underwent surgical abortions, experienced miscarriages or delivered a baby.

Since the medication was approved for use 28 years ago, only 32 deaths have ever been reported associated with mifepristone, according to the FDA.

Bailey and his fellow GOP attorneys general, however, argue the drug is dangerous.

“The FDA has enabled online abortion providers to mail FDA-approved abortion drugs to women in states that regulate abortion — dispensing abortion drugs with no doctor care, no exam and no in-person follow-up care,” the attorneys general wrote in the amended lawsuit. “These dangerous drugs are now flooding states like Missouri and Idaho and sending women in these states to the emergency room.”

The filing also argues that the current regulations around mifepristone make it impossible to track and prevent medication abortions.

“All of this makes it difficult for state law enforcement to detect and deter state law violations and to give effect to state abortion laws,” the attorneys general wrote.

Lost revenue and fewer teen mothers

When the constitutional right to an abortion was overturned in June 2022, Missouri became the first state to enact a trigger law banning the procedure in all cases except for medical emergencies.

A decade ago, more than 5,000 abortions were performed in Missouri, according to data from the Missouri Department of Health and Senior Services. By 2020, that number dropped to 167 due to a series of “targeted regulation of abortion providers” laws enacted by the legislature, including a mandatory 72-hour waiting period between the initial appointment and a surgical abortion and mandatory pelvic exams for medication abortions.

Between June 2022 and March 2024, only 64 abortions were performed in Missouri under the state’s emergency exemption, according to health department data.

Despite these laws, thousands of Missourians have still accessed abortion in the past two years, either by driving to clinics in Illinois and Kansas or by ordering abortion medication through the mail.

In the six months after the Supreme Court’s abortion ruling, the number of self-managed medication abortions rose by more than 26,000 across the U.S. according to a study published in JAMA, the American Medical Association’s journal.

The attorneys general in their filing attempt to estimate how many people may have undergone medication abortions in each state, and how many may have been on Medicaid.

Between April 2018 and August 2023, there were 438 abortion complication reports — including 186 from medication abortions — filed with Missouri’s health department, according to the litigation.

Bailey’s office estimates that just shy of 400,000 women and girls of reproductive age are eligible for Missouri Medicaid, and that about 13% of those individuals are enrolled in Medicaid.

Bailey raised these data points in an attempt to estimate how much abortion medication costs the state, noting that under the Emergency Medical Treatment and Active Labor Act, public hospitals must treat anyone who comes in for emergency care, regardless of their ability to pay.

“If a public hospital provides medical services for complications stemming from chemical abortions,” the filing reads, “and the state’s Medicaid program does not cover the full portion of the bill, the outstanding balance is a loss to the public hospital, which is itself an instrumentality of the state.”

The attorney general’s office also noted the “loss of potential population” that resulted from an increase in access to medication abortions among Missourians.

“Reflecting the ease of driving to another state to receive abortion drugs, it is estimated that just 2.4%of abortion-minded women were prevented from getting abortions in Missouri after Dobbs,” the attorneys general write in the filing.

Fewer abortions would have occurred, the attorneys general argue, if the FDA’s previous requirements were still in place.

Bailey made a similar argument last year while attempting to inflate the estimated cost of an abortion-rights ballot measure, saying it would cost the state $6.9 trillion in lost revenue. A judge rejected his claim.

The filing also pointed to a November 2023 study that found abortion bans didn’t result in an increase in teenage pregnancies that ended in births for those between the ages of 15 and 19.

The study attributed this in part to young people’s ability to find online abortion medication providers.

“This study thus suggests that remote dispensing of abortion drugs by mail, common carrier, and interactive computer service is depressing expected birth rates for teenaged mothers in Plaintiff States, even if other overall birth rates may have been lower than otherwise was projected,” the attorneys general wrote.

Missouri Independent is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Missouri Independent maintains editorial independence. Contact Editor Jason Hancock for questions: info@missouriindependent.com. Follow Missouri Independent on Facebook and X.

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Medication abortion has become the most common method of abortion since the 2022 Dobbs decision ended the federal right to abortion. (Getty Images)

Researchers whose anti-abortion-funded studies were used to argue for restrictions on medication abortion — and then were retracted on methodological grounds — are now taking legal action against academic publisher Sage, which pulled their papers in February.

Represented by conservative law firms Consovoy McCarthy and Alliance Defending Freedom, the latter of which sued the Food and Drug Administration over abortion drugs in 2022, the researchers claim Sage’s retractions were unjustified and politically motivated and have led to “enormous and incalculable harm” to their reputations. They asked the Ventura County Superior Court in California to compel Sage to arbitrate with the researchers.

“Sage punished these highly respected and credentialed scientists simply because they believe in preserving life from conception to natural death. These actions have caused irreparable harm to the authors of these articles, and we are urging Sage to come to the arbitration table — as it is legally bound to do — rescind the retractions and remedy the reputational damage the researchers have suffered at the hands of abortion lobbyists,” said ADF senior counsel Phil Sechler in the recent announcement.

A representative for Sage declined to comment on the pending litigation.

A representative for the anti-abortion think tank Charlotte Lozier Institute, which employs the petitioning researchers, declined to comment. The nonprofit serves as the research arm of the influential Susan B. Anthony Pro-Life America, which works to elect federal and state anti-abortion lawmakers.

The three studies at the center of the dispute were published in the journal “Health Services Research and Managerial Epidemiology,” between 2019 and 2022. Two of them featured prominently in a federal lawsuit aimed at restricting abortion pills, which the U.S. Supreme Court rejected this summer but continues to make its way through the lower courts.

States Newsroom was the first to report last year that Sage had opened an investigation after pharmaceutical sciences professor Chris Adkins contacted the journal with concerns that the researchers had misrepresented their findings. In the 2021 paper, the researchers looked at Medicaid data in 17 states between 1999 and 2015 and tracked patients who had had a procedural or a medication abortion and counted each time they went to an emergency department in the 30 days following those abortions. Their finding that emergency room visits within 30 days following a medication abortion increased 500% from 2002 to 2015 was frequently cited by plaintiffs and judges in the FDA case and used to conclude that the abortion-inducing drug mifepristone is dangerous. But Adkins and other public health experts told States Newsroom that the researchers inflated their findings, and appeared to conflate all emergency department visits with adverse events.

These concerns prompted Sage to re-examine the peer review process and to identify that one of the initial peer reviewers was an associate scholar with the Charlotte Lozier Institute. The publisher then enlisted a statistician and two reproductive health experts to newly peer review all three articles.

“Following Committee on Publication Ethics (COPE) guidelines, we made this decision with the journal’s editor because of undeclared conflicts of interest and after expert reviewers found that the studies demonstrate a lack of scientific rigor that invalidates or renders unreliable the authors’ conclusions,” Sage said announcing the retractions, which notes that the experts found that the papers had “fundamental problems with the study design and methodology,” “unjustified or incorrect factual assumptions,” “material errors in the authors’ analysis of the data,” and “misleading presentations of the data.”

In a petition to compel arbitration filed late last week, the studies’ lead author James Studnicki and nine co-authors argue that Sage has delayed arbitration in violation of California contract law. They say they’ve had difficulty publishing new research since the retractions. As examples, the petition notes that in March a free online archive and distribution server for unpublished, non-peer-reviewed manuscripts refused to post one of the petitioners’ manuscripts and that in April a journal rejected the same manuscript, “citing similar pretextual reasons that HSRME used in its retraction.”

“These rejections are just the tip of the iceberg but reveal the enormous and incalculable harm that Sage’s retraction has inflicted on the Authors’ reputations and their ability to publish research and scholarship,” reads the court petition. “As scientists, the Authors’ credibility is their lifeblood, but Sage has destroyed the Authors’ hard-earned professional reputations.”

Studnicki, Charlotte Lozier’s vice president and director of data analytics, was on the editorial board of “Health Services Research and Managerial Epidemiology” until last fall, but the journal’s editor-in-chief dismissed him after the journal and Sage decided to retract the papers. The blog Retraction Watch reports that the journal is no longer accepting new submissions.

Medication abortion has become the most common method since the 2022 Dobbs decision ended the federal right to abortion.

Despite claims by the Charlotte Lozier Institute that medication abortion is unsafe, when administered at 9 weeks gestation or less, the FDA-approved regimen has a more than 99% completion rate, a 0.4% risk of major complications, and around 30 reported associated deaths over 22 years. Common symptoms include heavy bleeding and cramping, diarrhea, and nausea, and sometimes medical intervention is necessary to avoid infection. ProPublica recently reported on two women in Georgia who suffered rare complications of medication abortion, but whose deaths were ruled preventable and were attributed to the state’s near-total abortion ban.

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