Going the distance for abortion training

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Sep 06, 2024 View in browser   By Ben Leonard and Chelsea Cirruzzo Presented by  Driving The Day Some doctors in red states are going to great lengths to learn how to perform abortions to prepare for pregnancy complications and obstetric emergencies. | Frederic J. Brown/AFP via Getty Images ABORTION TRAINING POST-DOBBS — Abortion access has all but disappeared in much of the country since the Supreme Court overturned Roe v. Wade, and so has training for doctors performing the procedure. Many medical residents across the country working in states with bans are traveling to blue states for a crash course in abortion training — most of them OB-GYN residents who must have that experience but can’t get it at home, and others who have chosen to pursue it in addition to their required medical training. There is considerable agreement among leading medical groups, including the American College of Obstetricians and Gynecologists and the Association of American Medical Colleges, that the overturning of Roe has adversely affected medical education beyond abortion. POLITICO’s Alice Miranda Ollstein followed one doctor specializing in internal medicine and pediatrics who spent two years finding a clinic that would teach her to perform the procedure after her state implemented restrictions post-Dobbs that significantly reduced access to the training. Because abortions and miscarriages often require identical drugs and surgical procedures, she worried that failing to obtain the training would leave her unprepared to treat pregnancy complications and obstetric emergencies. “It felt like a moral imperative,” she said. The search: It took the doctor years to find, apply for and obtain grants and scholarships to pay for the month-long crash course she eventually took in Delaware, where the state’s Planned Parenthood affiliate provided hands-on instruction. POLITICO granted her anonymity because of her fear of professional repercussions and the threat of physical violence for seeking abortion training. The travel, living arrangements, malpractice insurance and other costs came to nearly $8,000. In April, she set off to Delaware, feeling as if she were entering a “political minefield” with no room for error. For most of the first week there, the doctor mainly watched other doctors perform the procedure and was struck by how safe and straightforward it seemed, given how hard the training was to obtain. “I’ve placed giant central intravenous catheters in the veins of people’s necks using an ultrasound, where there is a risk of puncture or collapsing a lung,” she said. “Although training is required, abortion seems much less technically complex.” By the end, she assisted in about a dozen surgical abortions and dispensed several dozen medication abortions — enough to give her a solid base of skills to build on in the future but not enough to reach full competency. When she returned home, the doctor gave a presentation about her experience to her fellow residents and encouraged them to pursue out-of-state abortion training. So far, none have taken her up on it. WELCOME TO FRIDAY PULSE. It’s never too early: Are you hearing any presidential transition rumblings? We want to hear from you. Send your tips, scoops and feedback to bleonard@politico.com and ccirruzzo@politico.com and follow along @_BenLeonard_ and @ChelseaCirruzzo.   A message from Tobacco-Free Kids Action Fund: E-cigarettes have gone from bad to worse. They come with fun flavors, more nicotine than ever and even built-in video games. Some vapes have as much nicotine as 20 packs of cigarettes. Almost all are illegal. To protect kids, the FDA and other federal agencies must act now. Learn more.   Abortion Former President Donald Trump's recent comments about abortion have some of his most ardent supporters, white evangelicals, concerned. | Rebecca Droke/AP ‘DISASTROUS’: KEY TRUMP BLOC WAVERS — Former President Donald Trump has been all over the map on abortion. White evangelicals now hope he doesn’t mean what he said, POLITICO’s Megan Messerly and Adam Wren report. Trump called himself “pro-choice” decades ago — then appointed the Supreme Court justices who sent abortion rights back to the states in overturning Roe v. Wade. But for anti-abortion activists, his shifting messaging in the past two weeks has been particularly fraught. The backstory: Trump said last week that he planned to vote against a ballot measure that would enshrine abortion rights in Florida’s constitution. That was a quick pivot after he left anti-abortion advocates in a panic when he suggested he might vote to undo Florida's six-week abortion ban. In recent days, he’s also said he would be “great for women and their reproductive rights” and pledged to require health insurers or the government to cover in vitro fertilization free of charge. Many anti-abortion advocates oppose IVF as currently practiced in the U.S. His shifting message reflects how Trump has struggled to navigate an issue that’s plagued the GOP since Roe’s demise. The reaction: It’s left some of his strongest supporters — white evangelicals — worried that some of their voters might stay home in November, giving Vice President Kamala Harris an edge in swing states and potentially handing her the keys to the White House. “It’s disastrous that he’s attempted to run against his own track record,” said Albert Mohler, a prominent evangelical and head of the Southern Baptist Theological Seminary. “There is a real danger to the Trump campaign that pro-life voters just don’t turn out for him with the intensity that he needs.” In Congress BAD NEWS FOR SVAC CHAIR — Sen. Jon Tester (D-Mont.), who chairs the Veterans’ Affairs Committee, is behind his GOP opponent by 8 points in a new independent poll of his state’s Senate race, POLITICO’s Ally Mutnick reports. Republican Tim Sheehy got 49 percent of the vote versus Tester’s 41 on a four-way ballot, according to the late-August poll of 600 likely voters commissioned by AARP. In a head-to-head contest, Sheehy bested Tester 51 to 45 percent. Former President Donald Trump’s popularity in the state helps Sheehy. Trump is ahead of Vice President Kamala Harris 56 to 41 percent, according to the poll. The bigger picture: The grim polling for Tester — well outside the margin of error of plus or minus 4 percentage points — indicates Democrats could have a hard time holding onto control of the chamber. They must win all the closest races to hold a 50-50 split, given the retirement of Sen. Joe Manchin (I-W.Va.). It also means Senate Democrats could have a race on their hands to chair the Veterans’ Affairs Committee, which could have a number of seats to fill, with Manchin and Sen. Kyrsten Sinema (I-Ariz.) not seeking reelection and Sen. Sherrod Brown (D-Ohio) in a tight race.   A message from Tobacco-Free Kids Action Fund:   Psychedelics LYKOS SHAKEUP — The CEO of Lykos Therapeutics, Amy Emerson, is headed for the exits after the FDA last month rejected the company’s application to offer MDMA, also known as ecstasy, as a treatment for post-traumatic stress disorder, POLITICO’s Erin Schumaker reports. Emerson had led the firm for nearly a decade. Emerson said in a statement that she was “deeply grateful” for the opportunity to lead Lykos’ effort to innovate in treating mental illness. “While we are not at the finish line, the past decade of progress has been monumental,” she said. Once in the pole position to get approval for a psychedelic drug to treat the disease, Lykos was rocked by the FDA’s move. Lykos cut 75 percent of its staff, and Rick Doblin, who had pioneered efforts to bring MDMA-assisted therapy to the public, departed its board. FDA outside advisers who evaluated Lykos’ plan cited concerns about missing safety data in Lykos’ trials, allegations of trial manipulation and the potential risk for misconduct among therapy practitioners. The journal Psychopharmacology delivered another blow, retracting three MDMA-assisted therapy papers by Lykos’ nonprofit arm, citing unethical conduct at a study site, which the papers’ authors hadn’t disclosed. Lykos said that corrections to the papers would have been enough and disagreed with the retraction. On the horizon: The FDA will hold a meeting today on treatments for PTSD, including psychedelics. Names in the News Katie Fitzwilliam has joined PhRMA as deputy vice president of public affairs, leading the group’s paid media and advertising team. She was previously vice president of advertising at Targeted Victory. Leslie Patterson Moore is joining the American Health Information Management Association as general counsel. She was most recently general counsel at the American College of Emergency Physicians. WHAT WE'RE READING POLITICO's Daniel Han reports on a New Jersey nursing home group suing the state’s Department of Health over its minimum staffing laws. Reuters reports on criminal groups forging batch numbers to spread fake versions of weight-loss drugs.   A message from Tobacco-Free Kids Action Fund: Parents pleading: the FDA must protect kids. E-cigarettes are more addictive and kid-friendly than ever. These products contain unprecedented levels of nicotine — some have as much nicotine as 20 packs of cigarettes. Over 1.6 million kids use e-cigarettes, and 88% use flavored products — almost all of which are illegal. Now, with students heading back to school, we are calling on FDA and other federal agencies to take action. It's time to protect kids and remove all illegal products from store shelves. Learn more.     Follow us on Twitter Dan Goldberg @dancgoldberg Chelsea Cirruzzo @chelseacirruzzo Lauren Gardner @Gardner_LM Sophie Gardner @sophie_gardnerj Kelly Hooper @kelhoops Robert King @rking_19 Ben Leonard @_BenLeonard_ David Lim @davidalim Megan Messerly @meganmesserly Alice Miranda Ollstein @aliceollstein Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker   Follow us

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