▶ 0:16:01Sen. Cassidy: The senate committee on health, education, labor, and pensions will please come to order. I am a doctor. When you are a doctor, you are supposed to take care of your patient. When someone is pregnant, there are two patients. Both must be considered with absolute care and concern. Scientifically and morally, there is no different in the value of a child whether she is in her mothers arms or she is in her mother's womb.
▶ 0:16:32Sen. Cassidy: And the science is clear. Life begins at conception, and abortion ends that life. Now, we cannot dehumanize the conversation, and we should not normalize the ending of that life. Not normalizing a procedure whose intent is to end a life. I want to highlight the march for life next week in washington around the country.
▶ 0:16:56Sen. Cassidy: For decades, every january thousands of americans very young and old begin the new year by joining together to march and peacefully call attention to the sanctity and inherent value of every single life. And so for those of you who will march in the weeks ahead, thank you. We are here to represent your passion and your action to protect women and their unborn child. We will hear testimony today about the dangers of the chemical abortion drug.
▶ 0:17:26Sen. Cassidy: These drugs are not safe run-of-the-mill drugs. They are certainly not safe for the unborn child, but there can also be potential complications for the mother. You are the facts. One study showed nine in 10 women who take a chemical abortion drug described their pain is moderate to severe, and half of women say the experience was with an expected -- worse than expected.
▶ 0:17:49Sen. Cassidy: Half of women who took mifepristone suffered serious adverse events including hemorrhaging, bleeding, sepsis, overwhelming infection, or just kind of infection but less overwhelming. These are not about statistics. It is about real women with real stories when you dehumanize this.
▶ 0:18:10Sen. Cassidy: A woman described feeling like her insides were being "torn and sliced apart." and "seeing blood all over my legs." like many, she regretted her abortion, saying "I saw the most heartbreaking thing that I have seen in my entire life. I saw my child. And it was at that moment that it sunk in that I really had been pregnant. I had been carrying the life that I created inside of me until that very moment.
▶ 0:18:41Sen. Cassidy: I could not believe what I was looking at. It was the most beautiful thing that I have ever created, and I destroyed it." another woman described the cramps as unbearable, saying it "felt like somebody stabbing me in my stomach." she ended up going into sepsis because the abortion drugs left some of the unborn child's remains inside of her. After two months of hospitalization and a partial hysterectomy she had to relearn how to walk and perform normal everyday activities.
▶ 0:19:10Sen. Cassidy: So how do we get here to the point where abortion pills can be ordered online, mail, taken with no medical supervision come and we have no safeguards against coercion? This started when the obamas ministrations fda pursued an agenda, removed requirements to report nonfatal adverse events effectively no longer wanted to bring the drug's safety. Now, who could be opposed to making sure that adverse events are important to the fda?
▶ 0:19:41Sen. Cassidy: We make so much out of somebody getting a vaccine and having a sore arm that lasts for a day where they got the shot, but we are not reporting that someone had sepsis? Then the biden administration removed the in person dispensing requirement. Which protected women having abortions from serious medical complications.
▶ 0:20:03Sen. Cassidy: It is only through a proper medical exam that a doctor can determine the baby's gestational age, ensure the woman does not have an ectopic pregnancy, and ensure the abortion will not jeopardize future fertility. Now, I am a doc. The first rule is do no harm. The way things are working here today, it has a lot of potential to do a lot of harm. The impotent requirement I feel passionate about.
▶ 0:20:28Sen. Cassidy: Again, prescribing a drug with potential complications with no in person requirement. It means that a medical professional who is trained to spot abuse, to protect the woman from being coerced can actually interview the patient and find out if she really willingly wishes to take this.
▶ 0:20:51Sen. Cassidy: Now, under the current situation, and we will hear these stories today, someone can order the pill and coerce the pregnant woman into taking them. Straight to the mailbox, no questions asked, and then they coerce the women to take it. That is wrong. We should all be concerned about that whether you are pro-life or pro-choice. Think of the women, the girls in abusive relationships being trafficked whose voices are being silented. It just struck me.
▶ 0:21:20Sen. Cassidy: I was in a southwest airline bathroom. I am a gastroenterologist. Sometimes I go there in my thoughts. As I look at the sign on the door of the bathroom, it read if you are being trafficked, tell a traffic attendant or call this number. Tip of the hat to southwest. And maybe the other airlines but I never noticed the sign before forget it they know that someone may be traveling to some place a super bowl to get trafficked.
▶ 0:21:48Sen. Cassidy: And yet we make these appropriate, appropriate efforts to protect the young person in this situation, but we do not require the in patient interview in which a physician can ask the young person, wait a second, do you really want this or not? And if you don't, tell me about it. You are being trafficked? We are calling the police. Why do we have it on the inside of a bathroom on an airplane but not as a requirement for something which is mailed?
▶ 0:22:23Sen. Cassidy: As chairman of the health committee, I urge the commissioner to complete the safety review of mifepristone that they both promised us during their confirmation hearings. Republican members of this committee and many other senators expect an answer. At an absolute winner mom, the previous in person safeguards should be restored and should be done immediately. By the way, it is not just republicans who say this.
▶ 0:22:51Sen. Cassidy: A recent poll showed 71 percent of americans including 67% of those who identify as pro-choice, support requiring a visit for the chemical abortion drug to be prescribed. Louisiana attorney general liz murrill will share real-life stories of women and girls coerced with the drug a portion -- coerced or drugged with the abortion pill. She is working to protect these women. Dr.
▶ 0:23:19Sen. Cassidy: Monique wubbenhorst will provide medical expertise and further insight into the dangers that abortion pill's pose to these women and will dispel the false narrative that triggers the miscarriage, stillbirth, and ectopic pregnancy is the same as an abortion. It is an honor to convene the health committee for the first hearing of the year to discuss such an important topic. Women, families, and unborn children deserve nothing less. With that, I recognize ranking member sanders.
▶ 0:23:45Sen. Sanders: Thank you, Mr. chairman. In a few minutes, I will hand the mic over to senator patty murray, who has been a national leader on the subject. But first, let me be as clear as I can be. This hearing is not about the safety and effectiveness of mifepristone. It is not about protecting the health and well-being of women. The overwhelming evidence from the scientific and medical community is clear, and it is unambiguous. Mifepristone is safe.
▶ 0:24:16Sen. Sanders: It is effective. And not only has it been proven to safely end the pregnancy has been used by women throughout this country and the world to effectively manage a miscarriage. That is not what bernie sanders's position is. That is 100s of clinical trials and studies in prominent medical journals have found for nearly three decades.
▶ 0:24:42Sen. Sanders: That is what the american college of obstetricians and gynecologists, the longest organizations of ob/gyns in america, have found. It is not my view, not patty murray's view. That is their view. That is what the american medical association representing over 270,000 doctors have found. That is what the fda has found for more than a quarter of a century after it approved mifepristone in the year 2000.
▶ 0:25:14Sen. Sanders: Let's be clear what this hearing is about. It is not the safety of a drug. It is about the ongoing effort of my friends in the republican party to deny the women of this country the basic right to control their own bodies. That is what this hearing is about. Four years ago, six supreme court justice is, all nominated by republican presidents, decided to overturn roe v.
▶ 0:25:40Sen. Sanders: Wade, abolish the constitutional right for women to have an abortion, and give politicians and state governments all over this country the right to control a woman's body. Since this disastrous supreme court decision, 13 states have enacted a total abortion ban, and 28 states have restricted access to mifepristone. That is what this hearing is about.
▶ 0:26:08Sen. Sanders: It is whether in the year 2026 we are going to fight to make sure that women have a right to control their bodies when the politicians take away those rights. Senator murray?
▶ 0:26:18Sen. Murray: Thank you very much, Mr. chairman, ranking member sanders, about an issue I care deeply about. The fact of the matter is medication abortion is safe and effective, and we have known that for a very long time. Fda had the data to show this when they first approved mifepristone 25 years ago. And if safety was reaffirmed when fda approved a generic version of this last fall.
▶ 0:26:46Sen. Murray: We have a tremendous amount of data showing how safe this medication is. More than 160 high-quality studies have been conducted. And billions of women around the world use mifepristone safely every year. With fewer complications, by the way, than viagra or penicillin. The fact of the matter is mifepristone is one of the most of the medications we have.
▶ 0:27:12Sen. Murray: In fact, in october, a federal court ruled that fda's current restrictions on mifepristone are in logical and unsupported by the evidence. The only reason mifepristone is regulated as heavily as it already is is because of antiabortion politics, not because of science.
▶ 0:27:31Sen. Murray: And now republicans are holding this hearing to peddle debunked junk studies by antiabortion organizations which have no could ability and have been forcefully condemned by actual medical organizations to justify reinstating more burdensome requirements and ultimately ripping medication abortion off the shelves entirely. We all know this hearing is not about the actual science or the facts, and it is certainly not about what is best for women's health.
▶ 0:28:00Sen. Murray: This hearing really is about the fact that truck and his antiabortion allies want to ban abortion nationwide and medication abortion is the most common method of abortion in the U.S. republicans are furious that despite their extreme abortion bans, some women are still finding ways to get the care that they need, and they want to put a stop to it, whatever it takes.
▶ 0:28:26Sen. Murray: Of course, the overwhelming majority of people in this country do not want medication abortion ripped away, and they do not want republicans legislating their pregnancies. And I think most people are going to see right through the other b.s. That is being staged here today. I also have to say I am stunned that republicans found time to hold this sham hearing when they have yet to have held any sort of hearing holding rfk jr.
▶ 0:28:50Sen. Murray: To account for undermining access to safe and effective vaccines and letting deadly diseases like measles and whooping cup ripped through our communities. Wasn't he supposed to be here quarterly? Wasn't he supposed to lead the vaccine desk leave the vaccine schedule alone? Isn't this committee supposed to be conducting oversight? It seems we will have a hearing on literally anything but that. Mr.
▶ 0:29:19Sen. Murray: Chair, I want to ask inanimate consent to enter into the record egg statements from leading organizations on the safety of mifepristone and a letter sent by every single senate democrat last fall pressing fda for answers on this new so-called safety refute of mifepristone. We have not yet received an answer to that letter.
▶ 0:29:36Sen. Cassidy: Without objection. It is my pleasure now to introduce louisiana attorney general liz murrill. Attorney general murrill has a distinguished career in public service, has been at the forefront of defending louisiana's strong pro-life laws, and protecting women and unborn children. She will be testifying today about how the removal of the in person dispensary of mifepristone led to horrific instances of coercion and health risks for women.
▶ 0:30:09Sen. Cassidy: She will walk us through the actions she is taking hold those looking to circumvent the louisiana's laws equitable. Attorney general murrill, louisiana is lucky to have you as our top law-enforcement officer. I look forward to hearing your testimony. But before you begin, I would like to ask unit must consent to enter into the record 17 letters from attorney generals in support of attorney general murrill's testimony.
▶ 0:30:36Sen. Cassidy: Without objection, is approved -- it is approved. Miss murrill.
▶ 0:30:43A.G. Murrill: Thank you. The united states supreme court returned the issue of abortion to the people's elected representatives in dobbs versus jackson women's health organization. That landmark decision empowered louisiana and every other state to decide how to address the issue of abortion. Louisiana made its overwhelmingly bipartisan decision and reaffirmed its long-standing policy to the right to life of every child, born and unborn.
▶ 0:31:15A.G. Murrill: Louisiana's protections include a prohibition on abortion by means of an abortion inducing drug, and it likewise prohibits aiding and abetting and facilitating in the procurement, disturbing, or use of such drugs. That should have been the end of it. But the biden administration and is pro-abortion partners had long been planning to circumvent dobbs.
▶ 0:31:36A.G. Murrill: After dobbs, the biden fda promptly announced it would remove the in person dispensing requirement for abortion pill's, thereby authorizing mifepristone to be shipped nationwide by mail. This was not a medically informed decision but a purely political one. It was not even a legal one because federal law prohibits distribution by mail. President biden recommitted to "doing everything in his power to protect access to abortion.
▶ 0:32:08A.G. Murrill: To that end, he issued ultimately as ignoring federal law, directed the hhs secretary becerra to identify "ways to ensure mifepristone is as widely accessible as possible, including one prescribed by telehealth and through mail." this thremoving data-driven restrictions that previously
▶ 0:32:39A.G. Murrill: Required in person dispensing, which for health and safety reasons mandated mifepristone be dispensed only in certain health care settings specifically clinics, medical offices, and hospitals. Its illumination facilitated widespread dispensing of mifepristone through the mail. This is medically dangerous, unethical, and illegal in the louisiana and many states as well as federal law.
▶ 0:33:06A.G. Murrill: The biden revision worked as planned. Aid access perhaps most well-known among the illegal abortion pill distribution facilitators unabashedly credits removal of the in person dispensing for its ability to mail fda approved abortion drugs "two people in all 50 states, even those that have banned it." to be clear, removing these protections could not and would
▶ 0:33:37A.G. Murrill: Not legalize distribution of these pills by mail, so the biden administration's objectives as directly stated by the president were to facilitate illegal drug distribution. Indeed, abortions have tragically increased in the louisiana and other pro-life states since dobbs because of the biden administration's actions. Data from pro-abortion groups indicate 900 illegal abortions occurred per month in the louisiana and 2025.
▶ 0:34:09A.G. Murrill: That trend coincides with national reported data. Behind these statistics is a woman or girl injured by this dangerous, illegal, and medically unsupervised distribution and use of abortion pills a few.
▶ 0:34:25A.G. Murrill: Examples from louisiana include a woman who was coerced into losing her baby, a pregnant woman who took pills that margaret carpenter from new york mailed to her at 20 weeks gestation and ended up in the emergency room while her baby was left in a dumpster. Another 20 week old pregnancy, the baby was found recovered in a toilet. Activists have created and organized a dangerous scheme of drug dealing protected by politicians.
▶ 0:34:56A.G. Murrill: These are not medical standards. There are no medical standards in any state that sanction such irresponsible actions by a medical professional. And political preferences do not justify placing women at such medical risk. These are not medical professionals, and this is not health care. Shield laws in some states protect providers from liability and effectively nullified laws in our states.
▶ 0:35:27A.G. Murrill: Their purpose is to make it more difficult to sue or prosecute individuals in those states where abortion drugs are prohibited. They also make it more difficult for women coerced into abortion, taking abortion drugs to bring their abusers to justice. The biden fda is removal of in person dispensing requirements had its intended effect. But for the 2023 rounds, activists could not blanket our states like louisiana with mifepristone by mail.
▶ 0:35:58A.G. Murrill: The 2023 rounds must be vacated. Until then, louisiana's efforts to protect mothers and their unborn children and to hold out-of-state abortion pill traffickers accountable for the harm they inflict will be all but futile. Thank you, Mr. chairman.
▶ 0:36:18Sen. Cassidy: Before introducing Dr. wubbenhorst, who will get the award for the most interesting name this entire year, I ask unanimous consent to enter into the record letters from the louisiana family forum and the louisiana right to life. Both letters further underscore attorney general murrill's testimony about the harms that unfettered access to mail order chemical abortion drugs cause women in our state. I now turn to senator banks to introduce Dr. wubbenhorst.
▶ 0:36:47Sen. Banks: Thank you. It is my honor to introduce a practicing board-certified ob/gyn with more than 30 years of experience in patient care, teaching, research, health policy, and global health. Dr. wubbenhorst is a senior fellow with the center for ethics and culture at notre dame and an adjunct professor at the indiana university school of medicine. She also cares for patients at two indian hospitals. In her medical practice, Dr.
▶ 0:37:19Sen. Banks: Wubbenhorst is focused on providing ob/gyn to impoverished women at home and abroad. She has also authored over 20 peer-reviewed articles and has served on review boards for peer-reviewed medical journals. Dr. wubbenhorst, thank you for being here today. And I look forward to hearing your testimony on the dangers that chemical abortion pills pose to women especially. It is great to have a hoosier here was such a staunch defender for the unborn and for women. Thank you, Mr.
▶ 0:37:49Sen. Banks: Chairman, for holding this hearing. I think it is really important. I am glad you called this hearing. I appreciate your leadership. With that, I yelled back -- I yield back.
▶ 0:38:01Dr. Wubbenhorst: Thank you, senator banks. I am more excited about indiana football. Go hoosiers. Good morning. Excuse me. Good morning, chairman cassidy, ranking number sanders.
▶ 0:38:14Sen. Cassidy: Can you pull the microphone a little closer to your mouth?
▶ 0:38:17Dr. Wubbenhorst: How is that?
▶ 0:38:19Sen. Cassidy: Wonderful.
▶ 0:38:21Dr. Wubbenhorst: Thank you for the opportunity to be here. It is an honor. Abortion is some trick in so we need to give grave consideration to its risks and benefits. Mifepristone is now the dominant method for abortion, accounting for almost 60% of abortions. We have data to document and examine negative outcomes associated with the use of mifepristone.
▶ 0:38:47Dr. Wubbenhorst: We all know the regiment includes both mifepristone and mesoprostol. This is a section with short and long-term physical and mental harms to women. These are document and by international studies as well as studies in the united states, including studies in scandinavian countries which are not pro-life countries. The different risks that are associated are bleeding, infection, hemorrhage, need for transfusion, and perforation.
▶ 0:39:15Dr. Wubbenhorst: Operation is not a risk for chemical abortion alone, an estimated 6% or one and 70 women will require surgical intervention, and these women are exposed to both the risks of chemical and surgical abortion. In the u.k., an estimated 10,000 women per year were treated in emergency rooms in 2022 and 2023 for complications arising from abortion.
▶ 0:39:39Dr. Wubbenhorst: There have recently been documented deaths from chemical abortions. Abortion in general is associated with serious psychological and physical harms for women. A study in canada found that markedly increase the risk for inpatient psychiatric admission, the most severe diagnosed forms of mental health. It is also associated with sex trafficking, child sex abuse, and arresting violence.
▶ 0:40:10Dr. Wubbenhorst: I am aware of a case of a young girl who is age 16 who came in with severe sepsis to the emergency room. When queried about what was the cause of her missed abortion, it turned out she had been given abortion bills by her teacher who gave them to her and skipped town presumably to do the same thing to another one of his students.
▶ 0:40:33Dr. Wubbenhorst: Abusers have been known to force abortion bills down women stones, put them in their drinks, and earn certain them -- and insert them into their bodies. Mifepristone is not safer than tylenol and should not be made available over-the-counter. Tylenol is an over-the-counter medication. It does not have a black box warning. Most problems with tylenol are associated with accidental delivery overdose. Mifepristone associated with routine.
▶ 0:41:10Dr. Wubbenhorst: Elected abortion is fetal side, not the same as in utero demise with the fetus is already demised, and not the same as care for miscarriage. Abortion and african american women is a pervasive problem. There is a racial disparity in abortion rates between african-american european women and many states. In particular, in some states approximately the rates are three to five times abortion in black women compared with white women.
▶ 0:41:42Dr. Wubbenhorst: The practice of standard telemedicine is highly regulated and therefore the prescribing of drugs virtually should not be legitimized by calling it telemedicine. This is more properly called remote abortion. In these cases, a woman cannot have her pregnancy accurately dated. A woman cannot be assessed medically. Sorry.
▶ 0:42:03Dr. Wubbenhorst: I would like to conclude by stating that our concern is for the woman and access to any medical intervention should never come at the expense of safety. Authorities should continue to help decrease chemical abortion harms to women including existing regulations. Thank you very much.
▶ 0:42:24Sen. Cassidy: Thank you, Dr. wubbenhorst. Senator sanders will now introduce his witness.
▶ 0:42:29Sen. Sanders: Thank you. I would like to introduce Dr. nisha verma, who is an obstetrician and gynecologist and fellow of physicians for reproductive health. Dr. verma practices in massachusetts and georgia and has conducted research on the impacts of abortion restrictions on women with high-risk pregnancies. Dr. verma, thanks very much for being with us today.
▶ 0:42:51Dr. Verma: Good morning, chair cassidy, ranking member sanders, and distinguished members of the senate health committee. My name is Dr. nisha verma, and I am a double board-certified fellowship trained obstetrician and gynecologist and father with physicians for reproductive health. I provide full-spectrum care in georgia and massachusetts.
▶ 0:43:12Dr. Verma: That means I provide everything from pap smears and cancer screenings to delivering babies to supporting people postpartum to providing contraception, abortion, and miscarriage care. As a doctor, I know that abortion care can be complicated for many people. I sit with that complicity every day as do so many of my patients and their families. Holding complexity is important.
▶ 0:43:38Dr. Verma: But discomfort with abortion cannot be used as an excuse to distort facts. So let's talk about the facts. The fact is the science on mifepristone's safety and effectiveness is long-standing and settled. Over the past 25 years from medication abortion using mifepristone and misoprostol has been rigorously studied and proven safe and effective in over 100 high quality peer-reviewed studies.
▶ 0:44:07Dr. Verma: Extensive data show that medication abortion through telehealth is equally safe and effective and provides vital access for those who live in rural areas and in the growing number of maternity care deserts in the country. Medication abortion is now the most common method of abortion care in the united states, used by more than 7.5 million people since its fda approval in 2000. The small number of studies that contradict this track record of safety are deeply flawed.
▶ 0:44:35Dr. Verma: In fact, two of the less than 10 have been retracted. When we looked at the full body of high-quality evidence, it is clear that the safety and effectiveness of mifepristone and misoprostol is not a matter of opinion or debate. It is the clear consensus of the evidence-based medical community. Both here in the united states and globally.
▶ 0:45:01Dr. Verma: Leading professional organizations including the american college of ob/gyn's and american medical association affirmed this fact, as does the national academies of sciences, engineering, and medicine. Globally, the world health organization classifies mifepristone and misoprostol as essential medications, among the safest and most effective treatments that should always be available. In my practice, I regularly prescribe mifepristone and misoprostol because I know they are safe and allow.
▶ 0:45:35Dr. Verma: When I prescribe these medications, I counsel my patients, ensure they understand their options, review potential side effects and risks, just as I would with any treatment, and support them in making decisions that are right for them. Miscarriages occur in 10% to 26% of all pregnancies, and I often care for women and families spritzing the loss of a highly desired pregnancy who wish to treat their miscarriage with medication.
▶ 0:46:00Dr. Verma: For these patients, mifepristone along with misoprostol speeds up the process, reduces pain, and decreases the need for additional treatments. Knowing that mifepristone and misoprostol are safe and effective for miscarriage management, I took these medications myself a few months ago after my husband and I experienced a devastating pregnancy loss.
▶ 0:46:26Dr. Verma: Luckily, in massachusetts we were able to obtain these medications from our local pharmacy and completeness emotionally difficult process safely, privately, and at home.unfortunately for many people, unnecessary restrictions on mifepristone make this evidence-based care unavailable and force them to undergo additional hardship during already heartbreaking experiences. Mifepristone and misoprostol are safe. However, my patients do face many real well-documented threats to their health, well-being, and lives.
▶ 0:46:58Dr. Verma: My patients are at risk because of restrictions on abortion care and cuts to medicaid. They are at risk because of decreased funding to clinics that provide preventative care and cancer screenings and fears about whether they can safely go to the hospital based on their immigration status. They are at risk because of the ever-increasing crisis presence of maternal mortality, widespread misinformation about vaccines, and disregard of science and evidence.
▶ 0:47:23Dr. Verma: As a doctor, I have the immense privilege of sitting with patients and their families and learning about their lives. My patients remind me every day that abortion care, pregnancy, and medicine are not isolated political issues, and I chose to be here in this room today, as challenging as it might be more for them. I hope moving forward this committee will focus on addressing the many real documented dangers patients face rather than restricting access to safe evidence-based care.
▶ 0:47:54Dr. Verma: Thank you for having me, and I look forward to your questions.
▶ 0:47:57Sen. Cassidy: Thank you. I shall begin with questions. Doctors, thank you very much for seeing patients. I appreciate that. Dr. verma, you mentioned not restricting access to safe evidence-based care. Would you prescribe these drugs for someone in week 20 of her pregnancy?
▶ 0:48:16Dr. Verma: Thank you for that question. What we are seeing --
▶ 0:48:20Sen. Cassidy: No. It is only fda approved up until week 10. Would you prescribe these drugs for someone who is at week 20 of her pregnancy?
▶ 0:48:31Dr. Verma: I would not prescribe them in the way you are describing.
▶ 0:48:34Sen. Cassidy: Please.
▶ 0:48:37Sen. Sanders: Letter answer the question.
▶ 0:48:38Sen. Cassidy: No, she answered the question. It is not here to go beyond entering the question, bernie. Next, attorney general murrill, you spoke of in your testimony two women who prescribed this medicine, taking it after week 20. Did I hear that correctly? Your microphone, please.
▶ 0:49:03A.G. Murrill: The gestational age as determined by the doctors at the emergency room that treated these women said that the babies were approximately 20 weeks. So, yes.
▶ 0:49:13Sen. Cassidy: Dr. verma suggested telehealth is an appropriate way to prescribe this but if I listen to your testimony carefully, I did, you don't have to have a telehealth visit. I think you spoke about filling out a form online without history.
▶ 0:49:34A.G. Murrill: That is correct. There is a form you fill out online. No human contact at all. No human contact. The paperwork that comes with the pills, and we know this because we conducted a controlled file of these pills through the process. We also know this through one of the cases.
▶ 0:49:53Sen. Cassidy: We know this.
▶ 0:49:55A.G. Murrill: We know this.
▶ 0:49:56Sen. Cassidy: There is actually some common ground here. After verma suggested -- Dr. verma suggested it should be evidence-based and some sort of human contact is applied and what I am hearing from you is it is being prescribed according to the physician actually examined the patient post a loss of the child at gestational week 20, and there had been no contact necessarily.
▶ 0:50:18Attorney General Murrill: That is correct. There is no human contact in this process.
▶ 0:50:22Sen. Cassidy: Dr. wubbenhorst, is that standard of care? No human contact prescribe this?
▶ 0:50:30Dr. Wubbenhorst: I would say it is not only standard of care, but it is a response will. If I had a pregnant woman who came in with a bladder infection and I just talked to her on the phone and prescribed an antibiotic, that would be malpractice.
▶ 0:50:42Sen. Cassidy: Ok. Dr. wubbenhorst, attorney general murrill very disturbingly spoke about women being coerced to take these pills. You mentioned it too. Can you comment further on that?
▶ 0:50:59Dr. Wubbenhorst: Yes, there is substantial evidence in the medical literature that many abortions are coerced. In addition to that, there are published -- yes, I would say published 19 cases where as I mentioned in my testimony boyfriends, abusers forced women to have an abortion. That is just the tip of the iceberg.
▶ 0:51:25Sen. Cassidy: Attorney general murrill, clayton, the district attorney in a parish, can you describe the case? I think it was a mother that forced the young lady to take the pill and there was a complication.
▶ 0:51:39Attorney General Murrill: Her mother. She was 16 years old, and her mother who had a documented history of severe physical abuse of that same child coerced her into taking the pills because she did not want the burden of an added baby. The little girl, the young women have been planning a gender of your party.
▶ 0:51:59Attorney General Murrill: And instead of having a gender of your party, she was undergoing an abortion after her mother supervised her pills and forced her to abandon the baby alone. She panicked and called 911. She testified and the mother was indicted in the clinic was indicted and the doctor has been indicted and governor kathy hochul has blocked our tradition of the doctor to hold the doctor accountable for giving the pills f to the mother who coerced her daughter to have the unwanted abortion.
▶ 0:52:30Sen. Cassidy: Dr. wubbenhorst, you and Dr. verma spoke about in person interview as the opportunities to make sure the person understood the imposition of taking these pills and to make sure they are not being abused. If that young lady had had an in person interview, would you have been able to see it was her mother dictating her course of action and she was being coerced?
▶ 0:52:52Dr. Wubbenhorst: Yes. One of the things we try to do what we have these inpatient interviews is to sit down with the women alone, apart from her mother or boyfriend, ever maybe trying to abuse her and to ask these questions. What I have done this, when women are in an abusive relationship or trafficking, they would say you are the first person who has ever asked me about this, and they will disclose.
▶ 0:53:14Sen. Cassidy: Thank you. Senator sanders.
▶ 0:53:17Sen. Sanders: Thank you. Let me ask Dr. verma a simple question. Who do you think is best prepared to determine whether mifepristone is safe and effective? Do you think it is members of a state legislature? Do you think it is you do you think it is y united states senators?
▶ 0:53:40Sen. Sanders: Or do you think it should be organizations like the american medical association by the american college of obstetricians and gynecologists, and doctors and scientists who for decades have studied the issue?
▶ 0:53:50Dr. Verma: Thank you for the question. As a doctor, I know that people are capable of making these decisions for themselves. They are the experts on their own lives and can make these decisions guided by evidence, science, and what is happening in their own lives.
▶ 0:54:04Sen. Sanders: Let me ask you another question. I was interested in what the attorney general said. Very simple question. We live in a society where everybody here talks about freedom. Right? We all believe in freedom. Who should make the decision regarding her own body? Should it be a woman? Should it be the united states senate, attorney generals? Who should make that decision?
▶ 0:54:34Dr. Verma: People should be able to make decisions by themselves, guided by their families, evidence, and science. I want to highlight some misinformation we have been hearing around the source of some of the harm that we are seeing right now. A lot of the cases we are hearing about are a direct result of abortion bands and restrictions. People are desperate because they cannot get the care that they need in their communities with their trusted clinicians.
▶ 0:55:04Dr. Verma: And people in their communities and the way that they need. That is why we are seeing these cases come up. It is a direct result of abortion bans and restrictions. Access makes people safer.
▶ 0:55:14Sen. Sanders: Dr. verma, can you speak for a moment about what happens when states limit access to mifepristone? Can you talk about what a state like louisiana and many others if women for whatever reason want to terminate a pregnancy and have no other option's?
▶ 0:55:41Dr. Verma: Absolutely, limiting access to medications we know are safe and effective takes important evidence-based treatments away from people. You mentioned louisiana. We are seeing louisiana has now made these medications controlled substances, and we are seeing the dramatic impact that is having on people that need abortion care, that are experiencing miscarriage, and people having postpartum hemorrhage is.
▶ 0:56:06Dr. Verma: I have heard from my colleagues in the state and heard from, for example, the department of public health in new orleans has said this is very much harming people in the state. So, for example, when you have a patient having a postpartum hemorrhage, I have been in many of these situations as a doctor that provides care on labor and delivery. I need access to those medications right away. That is a life-threatening emergency. It is one of the leading causes of maternal mortality.
▶ 0:56:32Dr. Verma: I need to be able to access safe medications right away to save the patient's life, so we are seeing the impact of these restrictions and things limiting access to mifepristone and misoprostol not just on patients in abortion care but in a whole range of care that is lifesaving for them.
▶ 0:56:50Sen. Sanders: If I could ask the attorney general murrill a brief question, if I understood you correctly, you said that over 900 women a month are turning to mifepristone. Was I correct in hearing that? In the louisiana.
▶ 0:57:06Attorney General Murrill: Yes, those are statistics from a pro-abortion advocacy group.
▶ 0:57:10Sen. Sanders: But you kind of indicated that might be in the ballpark.
▶ 0:57:13Attorney General Murrill: It is the only data we have.
▶ 0:57:15Sen. Sanders: All right. If a woman in louisiana turns to mifepristone because she has no other option and that is her choice, that is 10,000 women in louisiana a year. What do you tell those women who for whatever reason, you may agree with it, I may agree with it, we may not, make a decision that for their lives they want to terminate a pregnancy? What do you say to 10,000 women in the cna here? You think they have a right to make that choice or do they not?
▶ 0:57:46Sen. Sanders: Senator sanders, the policy decision of the overwhelmingly bipartisan legislature in louisiana has enacted laws to protect women of the louisiana. And I think the issue here that you and maybe other people don't want to talk about is that we live in a land of the rule of law and that is the law of louisiana. So if they can seek that care in another state.
▶ 0:58:11Sen. Sanders: Sorry to cut you short here, but I just have a few seconds. In other words, essentially what you are saying, 10,000 women a year in the louisiana make a decision, and that decision is overwritten by the state legislature rather than their own choice. I think it is unfortunate.
▶ 0:58:30Sen. Sanders: Senator sanders, I would also continue to say that it is illegal, it is unethical, and it is immoral for them, for anyone to send pills to someone with no medical supervision and then tell them to lie at the hospital.
▶ 0:58:45Sen. Sanders: That happens because of the laws of your state.
▶ 0:58:47Attorney General Murrill: No. It happens because people from outside of our state are sending them to our state to nullify our state laws. That is why it happens.
▶ 0:58:58Sen. Marshall: Thank you. Dr. verma, do you not have other drugs to treat? Is that the only drug out there that works?
▶ 0:59:09Dr. Verma: We have a few medications to treat postpartum hemorrhage. When I am in situations --
▶ 0:59:15Sen. Marshall: I delivered a baby for 30 years. I know your situation but there are other alternatives out there. No one has tried to take those away. These abortion drugs, I know category a drugs are safe, b, probably safe, c -- what are the drugs you are trying to prescribe?
▶ 0:59:37Dr. Verma: In louisiana now they have been made controlled substances. Yes, there are other medications.
▶ 0:59:43Sen. Marshall: We will let you answer that later on someone else's time but you would agree that these are category x drugs. The answer is yes, they are category x drugs. Ok. Dr. wubbenhorst. Did I get that right? Ok. Like you, I delivered a baby nearly everyday of my life for 30 years. A woman comes in for her first visit and tells you what her last menstrual cycle was.
▶ 1:00:11Sen. Marshall: It is pretty common for them to be off and in fact it is common for them to be off a month. It would not be unusual. Would you agree with that?
▶ 1:00:19Dr. Wubbenhorst: Yes, Dr. marshall. Actually, I would add to that I recently had a woman come in because she was having some bleeding and abdominal pain and she was 23 weeks and did not know.
▶ 1:00:31Sen. Marshall: Very common. Abdominal pain five minutes apart and they are getting way to do an appendicitis and, oh my gosh, she is having a baby. I think he would also agree with me that the failure rate of these abortion drugs is probably around 5% at less than 10 weeks. But the failure rate of giving it to a 14 week person over the phone, the failure rate is 10%. Failure meaning it does not work.
▶ 1:01:00Sen. Marshall: Not only seeing the patient in person but having an ultrasound at your helmet at your helme there impact your decision-making. You and I don't prescribe the abortion drugs but you and I have taken care of thousands of miscarriages. Would you add any color to that?
▶ 1:01:20Dr. Wubbenhorst: Yes, I would say that would be a change because once you get into the second trimester, the risk of hemorrhage increases dramatically.
▶ 1:01:24Sen. Marshall: Yeah, so my point is you do this visit over the phone. The young lady think she is eight weeks. I have so much compassion for these young ladies. They are scared and they need help, and that is why I opened up my practice regardless of your ability to pay to say, look -- I had more than one patient come to my office say they had been to planned parenthood and were coerced into an abortion. They say, do I have to have an abortion?
▶ 1:01:54Sen. Marshall: We will take care of you, get you hooked up with catholic social services, get you a card, do whatever it takes. That thmy point is this, that same patient goes to the pharmacy and picks this drug. They think they are 10 weeks but they are actually 14 weeks.
▶ 1:02:13Sen. Marshall: There is a 10% chance of this drug not working, and the risk factors associated with this x rated drug, I will have to read them because I did not realize this. 5% of the babies that go on to deliver that took this drug, 5% of them have a major, major fetal malformation, living deformity like they are missing fingers, missing digits. Cranial nerve policies cranial nerve pol.
▶ 1:02:45Sen. Marshall: Think like bell's palsy, you cannot open your eyelids, cannot smile, craniofacial defects, and of course premature birth. Doctor, I will come back to you. Do you think an ultrasound, seeing the patient is beneficial, and not doing so is below the standard of care?
▶ 1:03:02Dr. Wubbenhorst: I would agree with that. And any pregnancy that is not dated by ultrasound is suboptimally dated.
▶ 1:03:11Sen. Marshall: Dr. verma, you take care of ladies with miscarriage, and I am sorry for your loss as well. It is one of my worst days, taking care of a woman with a miscarriage. Do you do ultrasounds typically when a person comes to office for a miscarriage?
▶ 1:03:26Dr. Verma: I do ultrasounds and a lot of different settings including when a patient is unsure of their last menstrual period.
▶ 1:03:34Sen. Marshall: I'm sorry. I know you have been kind of coach to go off-line here but you do an ultrasound on every patient that comes to your office with a friend miscarriage to see how far along they are?
▶ 1:03:44Dr. Verma: I do ultrasounds again in many different situations. I think the misinformation here is when a patient --
▶ 1:03:51Sen. Marshall: Do you do ultrasounds with patients that come to your office with a threat of miscarriage?
▶ 1:03:56Dr. Wubbenhorst: Yes, sir.
▶ 1:03:59Sen. Marshall: When an ultrasound and a patient being seen in person help you in making the decision to prescribe these abortion post?
▶ 1:04:10Dr. Verma: When a patient is unsure about her last period. What is limiting them from getting the ultrasound is abortion bans in their communities.
▶ 1:04:19Sen. Marshall: You don't have an ultrasound in your office? Do you have an ultrasound in your office?
▶ 1:04:27Dr. Verma: You are talking about telehealth care.
▶ 1:04:28Sen. Marshall: The answer is yes. Telehealth, taking care of ectopic pregnancy pregnancies, threatened miscarriages, prescribing abortion bills is below the standard of care. You are putting women's lives in danger.
▶ 1:04:40Sen. Cassidy: Senator murray.
▶ 1:04:41Sen. Murray: Dr. verma, do you want to finish or enter?
▶ 1:04:48Dr. Verma: Absolutely. I want to talk about telehealth care which is an important way for people to get health care in abusive relationships. We have data that for people in these abusive relationships telehealth is a critical tool that helps them get the care that they need. And actually when we are doing telehealth, we have very strict screening processes so if there are signs of an ectopic pregnancy, we would connect them with further care.
▶ 1:05:16Dr. Verma: If we are unsure or they are unsure about their last menstrual period, we would recommend an ultrasound. And I really want to highlight here what is limiting people's ability to get that additional care is abortion bans and restrictions. That is why we are seeing these cases, because people cannot get that in their that in care and their committees. They are scared of going to the hospital for fear of being criminalized. That is what is making care and safe.
▶ 1:05:43Dr. Verma: We have strict policies that guide our telehealth care like our inputs and care.
▶ 1:05:48Sen. Murray: Thank you very much for that spot. One thing we hear has to do with the word coercion, the current regulations allowing telemedicine prescribing and dispensing somehow empower abusers. As opposed to empowering save you hundreds of thousands of women who seek out care every year. Dr. verma, which is the problem in this scenario? Is it the availability of a safe and effective drug for abortion care, or is the people who abuse or coerce women?
▶ 1:06:18Dr. Verma: Thank you for that question. I oppose reproductive coercion and abuse in any form, any type of reproductive coercion is wrong. And it is something I have spent a lot of my career fighting against. I scream my patients. I find real solutions to support them. We know that abortion care and telehealth care actually helps protect people. Having all of their options helps protect people.
▶ 1:06:47Dr. Verma: Have seen in the data that the people that are in abusive relationships that are denied needed abortions, they are more likely to stay in those abusive relationships and put themselves and their families and children at risk. What we need here is real solutions to support people in these relationships and people that are being coerced, restricting care further is not a real solution. It is a distraction.
▶ 1:07:12Sen. Murray: Thank you for that response. I just have to say I am tired of republicans pretending they care about protecting women when all they mean is taking away women's ability to make decisions about their own bodies. If they really cared about protecting women, they would care about the fact that this administration refused to release epstein files without an act of congress or they would not cut grants for victim services for survivors of domestic violence and sexual assault.
▶ 1:07:41Sen. Murray: They would actually care about the fact that this administration has elevated people who shield a budget sex traffickers like andrew tate. And they certainly would not be trying to force rape victims to remain pregnant. I have a question for you, Dr. wubbenhorst.
▶ 1:08:00Sen. Murray: Antiabortion folks have shown time and time again they will try anything to report way access to medication abortion, including actually in recent years pushing this absurd lie that mifepristone is somehow "poisoning our water supply." they absurdly claim that when people self manage abortions at home, they are somehow contaminating the environment. This is crazy.
▶ 1:08:23Sen. Murray: The head of policy for the antiabortion group students for life told politico last year "people need to understand they are likely drinking other people's abortions." Dr. wubbenhorst, do you agree that that is the case?
▶ 1:08:37Dr. Wubbenhorst: Thank you for the question, senator murray. Although I take the way you are -- although I take exception with the way you are characterizing antiabortion groups. I do not feel qualified to speak on this issue because I do think there are other products that are disposed of in wastewater. Miscarriages or menstrual hygiene products -- miscarriages are. Menstrual hygiene product are.
▶ 1:09:06Dr. Wubbenhorst: I think it is probable that a woman who delivers her baby in the toilet, in her dorm room, on the floor of the shower, wherever.
▶ 1:09:14Sen. Murray: Let me just tell you that is insane. That comment is insane. We know the used to push environmental laws on mifepristone is not the problem. The student literally described it as using the devil's own tools against them.
▶ 1:09:32Sen. Murray: People need to understand that right now, antiabortion groups are pushing invasive and dehumanizing laws to block women in states where abortion is legal from getting the care in the privacy of their own home. The public's need to stop this. And I am just appalled that this is where they are going. Thank you.
▶ 1:09:50Sen. Cassidy: Senator banks.
▶ 1:09:52Sen. Banks: Thank you, Mr. chairman, again for holding this hearing. Biden administration made a reckless decision to allow online pharmacies to prescribe dangerous chemical abortion drugs intellect mail order pharmacies ship them directly to women without a real consultation with a doctor. However, Mr. chairman, I am disappointed the fda under Dr. makary's leadership has not moved faster to remove the in person dispensary requirement.
▶ 1:10:25Sen. Banks: I hope the rumors are false. Some of them are in print that the agency is intentionally slow walking its study on the mifepristone health risk. I really hope that is not the case. I was really hoping Dr. makary would be here today so we could ask him some of these questions directly and clear up those rumors. This is for protecting women from dangerous and even life-threatening drugs and their side effects. Mr. chairman, I hope Dr. makary and the fda will address this issue without further delay.
▶ 1:10:55Sen. Banks: With that, I will begin my questions. Dr. wubbenhorst, the 2016 obama fda stopped requiring reporting of nonfatal complications from abortion drugs like mifepristone . Then in 2023, the biden administration weakened the program for mifepristone and allowed it to be prescribed online and through the mail. Can you tell us very quickly why that combination of decisions are so dangerous?
▶ 1:11:25Dr. Wubbenhorst: I think those decisions were dangerous because, number one, we are only focusing on death. We are missing all the other outcomes. And we can assent to have been collecting data that we need. As I mentioned in both the U.S. and internationally, there are studies indicating that mifepristone and misoprostol used for abortion are associate with significant side effects and risks and harms to women. In addition to that.
▶ 1:11:58Dr. Wubbenhorst: , the lack of data on mifepristone and misoprostol leads us to come to the conclusions about its safety. Mifepristone, the requirement is for prescribers of mifepristone and drug companies to report, but there is no mandatory requirement for hospitals and medical providers. There is no mandatory reporting, so we are really not seeing a huge number of those complications being reported. And this is putting women at harm.
▶ 1:12:25Sen. Banks: Dr., this is the fda label for mifepristone. It is dated january 2023. That was during the biden administration when they started weakening the safeguards, and the label has not changed since then. Mifepristone has a black box warning, and I am wondering if you can tell us, what does a black box warning mean?
▶ 1:12:47Dr. Wubbenhorst: Right, so black box warnings exist to warn patients and subscribers of serious and sometimes fatal competitions that are associated with the use of the drug. Example, chemotherapy drugs typically have a black box warning associated with them. This is why the comparison with viagra and tylenol is not correct because viagra does not have a black box warning, tylenol does not have a black box warning.
▶ 1:13:11Sen. Banks: The label says doctors need to inform patients mifepristone about mifepristone -- patients about mifepristone's risks. They need to know who to call and what to do with extreme fever, abdominal pain, prolonged heavy bleeding, or fainting. Are online pharmacies and telehealth websites doing that?
▶ 1:13:31Dr. Wubbenhorst: No, they are not good I have actually visited these. Of course, I have not bought anything, but I have visited these and they do not say anything about the black box warning or the serious side effects.
▶ 1:13:42Sen. Banks: So do you think that any drug with a black box warning should be prescribed online?
▶ 1:13:47Dr. Wubbenhorst: Never. It should not be prescribed over-the-counter either.
▶ 1:13:51Sen. Banks: The fda label also says "serious and sometimes fatal infections and bleeding occur very rarely following spontaneous surgical and medical abortions. Including following mifepristone use. Doctor, based on all the data in the studies we have seen, how often is "very rarely?"
▶ 1:14:15Dr. Wubbenhorst: Well, one of the studies I reviewed recently from one of the scandinavian countries shown in infection rate of approximately 2%. So if you consider the number of millions of abortions -- I'm sorry, about 60% of abortions are being done, close to one million abortions every year, 2% infection rate, that is not rare.
▶ 1:14:37Sen. Banks: Can you quantify that any further?
▶ 1:14:40Dr. Wubbenhorst: In terms of numbers of women?
▶ 1:14:42Sen. Banks: How many women are impacted?
▶ 1:14:46Dr. Wubbenhorst: How the women are impacted?
▶ 1:14:47Sen. Banks: How many? Can you take an estimate? That is so significant. We are not acting quickly enough and I hope we do something about this.
▶ 1:15:06Chair Cassidy: To my colleagues, as regarding the commissioner mean present, we hope to have the commissioner before the committee very soon and will be speaking with the fda to facilitate discussion of this and other issues. As regards secretary chemic -- secretary kennedy, he did promise to come back. That was something senator murray mentioned. And so now, senator baldwin?
▶ 1:15:37Sen. Baldwin: This hearing is allegedly about protecting women, but what we are really talking about here is a republican effort for a national abortion ban by any means necessary. Frankly, if my republican colleagues truly cared about protecting women, they would ensure that women have the right to make decisions about their own bodies. An access to comprehensive and affordable health care.
▶ 1:16:11Sen. Baldwin: We are currently facing an ongoing health care crisis in this country. President trump and congressional republicans' big ugly bill will result in 15 million americans losing their health insurance, and because 200 planned parenthood clinics to close, cutting off access to cancer screenings and reproductive health care.
▶ 1:16:38Sen. Baldwin: The 24 million americans who rely on the affordable care act marketplace are facing drastically increased costs, fueled by the exploration of enhanced premium tax credits. And numbers released yesterday by cms show that the affordable care act enrollment is declining as a result. Dr.
▶ 1:17:03Sen. Baldwin: Verma, you touched on this in your testimony, but how did these republican actions to limit women's access to health care generally, and reproductive health care specifically -- how does that affect the patients that you see?
▶ 1:17:19Dr. Verma: Thank you for that question. It dramatically impacts the patients that I see. In georgia, we have a huge network of maternity care deserts, about 40% of our counties. Many of those patients cannot get easy access to their prenatal care, there cancer screenings. I often see women who come in to deliver their babies who have not been able to get any prenatal care.
▶ 1:17:49Dr. Verma: These cuts are making that much worse. We are creating a world where women can't get access to the abortion care they need. They also, when they wish to parent, cannot safely continue their pregnancies and deliver, because they can't get the health care that they need.
▶ 1:18:07Sen. Baldwin: We have heard a lot to date of things that are not based in evidence. Here are the facts. Mifepristone has been fda approved for nearly 25 years. More than 100 peer-reviewed, robust clinical studies have confirmed its safety. 99% of patients who took the abortion pill had no complications.
▶ 1:18:37Sen. Baldwin: My republican colleagues are citing studies that simply don't pass muster. These studies may not be peer-reviewed, or even published in medical journals. So, Dr. verma, could you show the difference between the over 100 studies affirming the safety of mifepristone and the so-called studies are republican colleagues have chosen to highlight at this hearing?
▶ 1:19:03Dr. Verma: Thank you for that question. Absolutely. As you have mentioned, we have over a hundred high quality peer-reviewed studies showing mifepristone's safety and effectiveness. To have been retracted. Less than 10 suggest that mifepristone is not safe.
▶ 1:19:26Dr. Verma: Even the ceo of the association of pro-life ob/gyn's admitted the paper is not a study in the traditional sense and is not proof of anything. It was a policy paper that was a self-published, that mislabeled serious adverse events. It included routine care as serious adverse events, and falsely -- really falsely made claims about everything it was saying.
▶ 1:19:53Dr. Verma: So yes, the science on this is more than settled. Which really does beg the question of what are we doing here today, right? The science is settled. Any person in science can compare these over a hundred studies to the less than 10, to have been retracted, all of which were deeply flawed if you look at them as a person of science. Any person can say the science is settled. Again, what are we doing here today?
▶ 1:20:23Dr. Verma: It may be that we are here today because people in this room feel uncomfortable with abortion, and that is ok, and we can talk about that, and we can have an honest conversation about that, the complexity, and the reasons that my patients need abortion care. But we should not pretend this is an issue of the science.
▶ 1:20:40Chair Cassidy: I think Dr. marshall is a practicing ob know something about science.
▶ 1:20:50Sen. Houston: In preparation for today's hearing, I had a lot of reflection. I started out in foster care. Was adopted. And know that my birth mother was under a lot of pressure to have an abortion. And thankfully for me, she didn't.
▶ 1:21:21Sen. Houston: I know that my biological father had pressured her to do so, and she chose an adoption. So, I fast-forward and think about the world we live in today, with drugs like mifepristone, and wonder, if it had existed then, with the outcome for me have been different?
▶ 1:21:48Sen. Houston: I would like to think that my birth mother would have still chosen to have an adoption. But I have seen some of the horrors of men who are trying to use the drug in pregnancies against the will of the woman that they give the drug too. I'm going to go through a couple of examples to prove that this is a real life situation. Example one, according to a criminal complaint filed in U.S.
▶ 1:22:19Sen. Houston: District court in the southern district of texas, a man murdered his next-door neighbor's unborn child, and he obtained mifepristone via an online pharmacy. He gave her these drugs without her knowledge by lacing it in her hot chocolate. Example two, from my own state of ohio.
▶ 1:22:40Sen. Houston: According to the ohio state medical board, hussein obtained mifepristone and myth a postal -- and another medication by out-of-state providers come up by providing the telemedicine that form the name of his experienced -- estranged wife. He obtained the prescription with the intent to secretly terminate the pregnancy of a woman with whom he had engaged in a sexual relationship.
▶ 1:23:10Sen. Houston: Public reporting alleges he spiked the beverage with the abortion drug without the woman's knowledge, but she did not consume the beverage. Later, the men waited until she was asleep, held her down, and forced her to consume the drug. That is not the choice of a woman. This is not the choice of a woman controlling her own body.
▶ 1:23:35Sen. Houston: This is how an easily obtained drug that can terminate the life of an unborn child can be used to and that life without an individual -- the woman -- consenting to it. So I just ask the question -- I will start with you, attorney general murrill. How do we stop this?
▶ 1:24:03Sen. Houston: It seems to me that just requiring an in person visit before dispensing the drug would stop this. I want your thought on that.
▶ 1:24:18Ms. Murrill: Thank you, general. It is stories like yours that have caused the overwhelming bipartisan decision of our state legislature to protect life both for the born and unborn children . That is an overwhelming policy decision in our legislature that is supported by the overwhelming majority of people in our state. Appreciate you sharing your story.
▶ 1:24:45Ms. Murrill: We absolutely believe that putting the in person dispensing requirement back in place would substantially protect women, and we do have additional evidence -- more stories like yours. A state senator's sister testified in her legislature about her estranged husband poisoning her food to get rid of a pregnancy he did not want. Fortunately, her baby was born. She suffered some complications from that assault on her.
▶ 1:25:16Ms. Murrill: But this is why louisiana put those drugs on the state controlled substances list, so we can track who is prescribing them and make sure they are being -- there is some accountability for the use of these medications. The in person requirement provides that accountability, and still does not interfere with those states who wish to adopt a different policy provision.
▶ 1:25:39Sen. Sheehy: Said -- Sen. hus
▶ 1:25:45Ted: How do we stop this from happening?
▶ 1:25:46Ms. Murrill: We prosecute those people.
▶ 1:25:49Dr. Wubbenhorst: I think we reinstate and enforce the comstock act. Those of the two most effective things to stop telemedicine abortion.
▶ 1:26:01Dr. Verma: Thank you for sharing your story. I do want to assure you that I talk to all my patients about adoption. I think we stop this by making sure that people can get the care they need in their communities and are able to get support when they need it.
▶ 1:26:19Sen. Husted: Thank you, Mr. chairman.
▶ 1:26:23Chair Cassidy: Senator kennedy? I'm sorry, senator hassan? I can't even read.
▶ 1:26:34Sen. Hassan: Thank you, senator. That is very kind. Welcome to our witnesses and thank you for being here. You know, I have to say, Mr. chair, this hearing has just struck me as gas lighting at the highest level. I have some questions for Dr. verma. I will get to them in just a second. But let me be clear.
▶ 1:27:05Sen. Hassan: There is bipartisan work that we have all done together to combat sex trafficking. Those signs you saw in the southwest airlines plane -- that's because we passed a law that said they have to go up in airports and on planes. That was bipartisan work we all did. The truth of the matter is that women have been coerced before mifepristone, and they have been coerced since mifepristone.
▶ 1:27:31Sen. Hassan: The murder rate, the assault rate on pregnant women by their partners, to end a pregnancy, has been a long-standing part of human history. So to blame it on mifepristone misses the point. To say that women shouldn't be able to get this medication through the mail misses the point that abortion bans have created reproductive health deserts in this country so when
▶ 1:28:01Sen. Hassan: You say a woman should consult with her physician, there are women who would have to travel hours, miss work, find a babysitter, if they have a car to begin with, in order to do that, because of policies that have banned abortion and have cut medicaid in particular. That is what we are facing. There is bipartisan concern that women be able to access health care.
▶ 1:28:28Sen. Hassan: There is a bipartisan understanding that reproductive care, to Dr. verma's point, is complex. When I had a miscarriage at 12 weeks, it was painful, and it was hard, and it was emotional, and mifepristone had nothing to do with it, and I did not use mifepristone. I had to have a dnc. The gas lighting here is extraordinary. Let's talk about the real issues. Dr.
▶ 1:28:54Sen. Hassan: Verma, planned parenthood provides life-saving health care for millions of women. I recently heard from a constituent, trisha, in new hampshire, who went to plant parenthood to get basic health care after she left the military. Tricia shared that without planned parenthood's sliding fee scale based on income, she would not have been able to see an ob/gyn at all.
▶ 1:29:21Sen. Hassan: During one of her appointments, tricia was tested and treated for a reproductive health condition that, if left untreated, could have led her to have serious health complications down the road. President trump and congressional republicans stripped planned parenthood of critical funding last year, taking lifesaving preventive care and screenings away from women like tricia. What long-term health impacts could women like tricia face as a result of president trump defunding planned parenthood?
▶ 1:29:49Dr. Verma: Thank you for that question and for sharing your story. I see patients like this all the time. Planned parenthood plays a critical role in their health care access for things like cancer screenings, infection screenings, in addition to abortion care and reproductive management.
▶ 1:30:10Dr. Verma: Not having that access point will have devastating effects on the visibility to detect signs of cervical cancer or precancer early, to have conditions treated, to have a lot of the preventive care that people need to stay healthy.
▶ 1:30:26Sen. Hassan: Thank you. I have heard from granite stators who took mifepristone after the loss of a much wanted pregnancy. I understand there are serious health risks for women if they have a miscarriage that goes untreated. When a state restricts access to mifepristone, what are the effects of experiencing miscarriage?
▶ 1:30:47Dr. Verma: Thank you for that question. We know based on the data that mifepristone combined with another medication for women who want medication management of their miscarriage, is the ideal option. Already because of restrictions, many women cannot get that standard of care treatment that speeds up the process, reduces pain, and decreases their need to have to have a procedure if that is something they don't want it.
▶ 1:31:17Sen. Hassan: Last question. Millions of women live in maternal care deserts, where the nearest ob/gyn is sometimes hours away, as I referenced in my initial comments. Women who don't have access to a specialist can access safe abortion by getting mifepristone and follow-up care through telehealth. How has telehealth changed access to safe reproductive care in rural areas?
▶ 1:31:41Dr. Verma: Thank you. It has made it more accessible. Like I emphasized earlier, there is a process for telehealth. There are regulations. There are strict screenings that happen. What is really the issue is that people who need additional care cannot get it in their communities without being criminalized.
▶ 1:32:01Chair Cassidy: Senator moody?
▶ 1:32:04Sen. Moody: Thank you for convening this important hearing. As one of only a few mothers of school children in the senate, the safety and well-being of women and children is very important to me.
▶ 1:32:22Sen. Moody: I was disheartened to hear, after this brave story of my colleagues sharing that he was indeed adopted and of his birth mother pressured to get an abortion, and she bravely refused and carried him to term and gave him up for adoption, that that was referred to as gas lighting.
▶ 1:32:41Sen. Moody: It is very hard for me also to sit here, as someone who has been in the legal world and seen the horrific stories that have come to light about coercive abortions, that that is gas lighting.
▶ 1:32:59Sen. Moody: I would ask my colleagues on the other side of the aisle to refrain from using that language, because there have been very serious incidents where women and their children were harmed, and that is not gas lighting. That is fact.
▶ 1:33:14Sen. Moody: And I am also disheartened that we heard, as we bring up the instance of men or even some women crushing of these abortion drugs and giving them to people surreptitiously, in order to end a life, that we should tolerate this new trend in crime, in murder, because, as one of my democratic colleagues just put it, after referring to these instances as gas lighting,
▶ 1:33:46Sen. Moody: Because, and I'm quoting my democratic colleague, coercion of abortions is a long-standing part of human history. That is unacceptable. And in fact, when I was attorney general in florida, just a year or so ago, a woman in florida got an abortion drug from out of state as part of a plot to kill her ex-boyfriend's new girlfriend's child in the womb. I mean, this stuff is not made up.
▶ 1:34:16Sen. Moody: When I was a judge in florida back before I was the attorney general, in my hometown, a guy got an abortion drug, put a different label on the bottle, labeled it as an antibiotic, and gave it to his former girlfriend and said you need to take this, and she did, and she had to testify at trial with a picture of a sonogram of that child. This is not gas lighting. This is happening.
▶ 1:34:46Sen. Moody: And as states are trying, after dobbs, to come up with, as a people, what their laws are going to be, we here in washington have to make sure that those laws that they come up with to prevent this kind of thing, to protect their people, are not circumvented. Ms. verma, can men get pregnant?
▶ 1:35:12Dr. Verma: Dr. verma. I want to make sure.
▶ 1:35:20Sen. Moody: In your opinion as a doctor, can men get pregnant? I will move onto the next one. Dr., can men get pregnant?
▶ 1:35:31Dr. Wubbenhorst: No.
▶ 1:35:34Ms. Murrill: No.
▶ 1:35:38Sen. Moody: Is there any reason why men should get their hands on the abortion drug?
▶ 1:35:41Dr. Wubbenhorst: None.
▶ 1:35:45Sen. Moody: And are they getting their hands on the abortion drugs through the mail across state lines? They are.
▶ 1:35:53Sen. Moody: Even when it is illegal and people have decided within states that they want to prevent that?
▶ 1:35:57Ms. Murrill: They are, and I would add that that is because there is a concerted effort to prevent any accountability in any human context, so they go to anybody who asks for them. They do not identify now, in many states, the prescriber, the pharmacy, or the recipient. So this is very dangerous. It is, by design, created that way, in order to circumvent dobbs.
▶ 1:36:25Sen. Moody: Is it easy for men to get abortion drugs across state lines?
▶ 1:36:28Ms. Murrill: Extraordinarily.
▶ 1:36:32Sen. Moody: I had a members who said my name is michael. How can I get abortion drugs? Would it surprise you there are many organizations ready to satisfy that whim of a man?
▶ 1:36:41Ms. Murrill: It does not surprise me.
▶ 1:36:45Sen. Moody: I know from working with you as fellow attorneys general -- I know that you value life and you want to protect life. But in your role as a prosecutor that is protecting people -- it is your job to enforce the people's laws to protect people. Our men getting these drugs and using them to surreptitiously end life in their girlfriends, wives, lovers, etc.?
▶ 1:37:07Ms. Murrill: They are. And sometimes parents and women. In two of the cases that we are in fact prosecuting, shield laws are blocking our ability to do that. I cannot understand why any governor would refuse our extradition papers so we can prosecute someone who coerced their child to have an abortion.
▶ 1:37:32Sen. Moody: I see my time has expired. I appreciate you for placing this issue head-on. Thank you, sir.
▶ 1:37:38Chair Cassidy: Senator kim?
▶ 1:37:41Sen. Kim: Thank you to the three of you for showing up here. Dr. verma, I'd like to start with you. There is a phrase you mentioned and some of my colleagues have, but I would like to dive in deeper, which is about these maternal care deserts. If you can just explain to us, explained to the american people, the challenge we are facing with maternal care deserts.
▶ 1:38:04Dr. Verma: Absolutely. Thank you for that question. We have seen that hospitals and clinics are closing because of many of the changes we are seeing with cuts to medicaid making it harder for hospitals to stay open, clinics to stay open. And it is increasing the distances that people have to travel to get to ob/gyn's. There are some women in rural parts of the country that have to travel over a hundred miles to get to the closest ob/gyn.
▶ 1:38:34Sen. Kim: These are counties where there are no hospitals that offer birth centers? No obstetricians, gynecologists, certified nurse midwives? Do you know how many counties there are?
▶ 1:38:48Dr. Verma: In the united states it is about 35% of counties. In some states like georgia, it is more.
▶ 1:38:57Sen. Kim: It is exactly right. 36%. I was calculating it. Over 1100 counties in the united states. For me, I'm grateful that in new jersey we have greater density and more access to this. But I'm trying to think through what is needed around the entire country. I'm thinking about millions of women of childbearing age that do not have this type of access, and then the conversation we are having here. I keep thinking about -- I hope we have a hearing on this.
▶ 1:39:27Sen. Kim: I hope we have a hearing on just the challenges that so many women are facing, and the difficulty, going forward. As you were saying, and -- am I correct that it seems like this is getting worse right now in terms of the lack of access and hospitals closing and other issues?
▶ 1:39:43Dr. Verma: Absolutely. It is getting worse. I took care of a patient recently, a young woman. Came to see me. Chose to continue her pregnancy. Wanted to support her in that. But she said I can't get to an ob/gyn. I do not know how I am going to get prenatal care. That makes people less safe.
▶ 1:40:04Sen. Kim: And even within these areas, who are the types of women that would have the greatest struggle within these deserts, people that may not have access to transportation, other things like that, that I'm sure you have come across.
▶ 1:40:16Dr. Verma: It's people already facing burdens to access the health care system, people that don't have insurance, or have medicaid that is getting additionally cut, young people, people from marginalized communities that are already facing barriers. This is just exacerbating this situation for them.
▶ 1:40:35Sen. Kim: It is something I think we, as a committee, need to commit ourselves toward. If we are talking about care for women, obviously a lot of disagreements on very important issues, but I hope we can all agree upon the need for greater access to be able to reverse this trend of growing maternal care deserts.
▶ 1:40:56Sen. Kim: One other implication I just wanted to throw into the mix here is just the question that comes with this undermining of fda and the trust that I think is being eroded with these types of challenges that we are facing.
▶ 1:41:13Sen. Kim: I wanted to ask you your thoughts of what would happen when it comes to whether drug developers and others that are seeking and closely watching this hearing right now -- what happens if the american people lose trust in the fda, if we lose trust in the fda's ability to follow science and approved drugs based on safety and efficacy?
▶ 1:41:33Dr. Verma: Thank you for that question. You are right. This has implications for a whole range of things. Science and evidence need to guide medicine, not politics. What we are seeing is a political agenda that is dictating what options are available for patients, and that is not just going to affect access to abortion care, care management. It has implications for birth control, vaccines. We are already seeing the impact on vaccines.
▶ 1:42:03Dr. Verma: This is far-reaching when we start to let politics dictate medicine.
▶ 1:42:07Sen. Kim: The amount of outreach that I got regarding this hearing across the board from well beyond issues related to these types of medications -- just about the issues about where our country is heading towards when it comes to trust in medicine and development. I just want to point that out, because the ramifications are very far-reaching, and ones that could very well affect many, many other drugs. With that, I will yield back.
▶ 1:42:33Chair Cassidy: Senator hawley? I think it has been established that men cannot have babies. Don't worry about it. I'm joking with senator moody.
▶ 1:42:49Sen. Hawley: Since you bring it up, why don't we start there. I was not sure I understood your answer to senator moody a moment ago. Do you think men can get pregnant?
▶ 1:42:57Dr. Verma: I hesitated there because I was not sure where the conversation was going or what the goal was. I do take care of patients with different identities. I take care of men and women. I take care of people with different identities. That is where I paused. I was not sure where you were going with that.
▶ 1:43:17Sen. Hawley: The goal is just the truth. Can men get pregnant?
▶ 1:43:20Dr. Verma: Again, the reason I paused there is I am not sure the goal of the question.
▶ 1:43:28Sen. Hawley: The goal is to establish a biological reality. You said science and evidence should control, so let's test that proposition. Can men get pregnant?
▶ 1:43:36Dr. Verma: I take care of people with many identities. Women that can get pregnant, I do take care of people who do not identify as women. Again, as I am saying --
▶ 1:43:51Sen. Hawley: Let me remind that you testified a moment ago that science and evidence should control, not politics. Can men get pregnant? You are a doctor.
▶ 1:44:00Dr. Verma: I totally agree science and evidence should guide medicine.
▶ 1:44:07Sen. Hawley: Biological men, can they get pregnant?
▶ 1:44:10Dr. Verma: I think yes/no questions like this are a political tool.
▶ 1:44:16Sen. Hawley: Let's not make a mockery of this proceeding. This is about science and evidence. The U.S. supreme court heard arguments yesterday at great length on this question. This is not a hypothetical question. It is not theoretical. It affects real people in their real lives. You are here as an expert, called by the other side as an expert, and you have been telling us that you follow -- you are a doctor, and you follow the science and the evidence. I want to know, based on the science, can men get pregnant? That is a yes or no question.
▶ 1:44:46Sen. Hawley: It really is.
▶ 1:44:47Dr. Verma: I think you are trying to reduce the complexity of the language.
▶ 1:44:53Sen. Hawley: It's not complex. I'm trying to get to an answer and trying to test, frankly, your veracity, as a medical professional and as a scientist.
▶ 1:45:02Dr. Verma: I think you are also conflating mail with --
▶ 1:45:08Sen. Hawley: They are two different things. There is biological men ■and there are biological women, and I want to know, can men get pregnant?
▶ 1:45:16Dr. Verma: What you are talking about is biological males?
▶ 1:45:22Sen. Hawley: This is not hard, doctor. Can men get pregnant, yes or no.
▶ 1:45:27Dr. Verma: I would be more than happy to have a conversation with you that is not coming from a place of trying to be polarized and push me.
▶ 1:45:37Sen. Hawley: I'm not trying to be polarized. I think it is extraordinary that we are here in a hearing about science and about women, and for the record, it is women who get pregnant, not men. We are here about the safety of women, and science that shows that this abortion drug causes adverse health events in 11% of cases.
▶ 1:46:02Sen. Hawley: That is 22 times greater than the fda label, another fact you have not acknowledged, and yet you won't even acknowledge the basic reality that biological men don't get pregnant. There is a difference between biological men and biological women. I just don't know how we can take you seriously in your claims to be a person of science if you won't level with us on this basic issue. I thought we were passed all of this, frankly. I can't believe we are still here, talking about this.
▶ 1:46:31Dr. Verma: I am a person of science and I am also someone here who knows the complex experiences of my patients, and I don't think polarized language and question serve that goal. I don't think they serve the american people.
▶ 1:46:48Sen. Hawley: It is not polarizing to say that there is a scientific difference between men and women and I want this to be clear and for the record! It is not polarizing to say that women are a biological reality and should be treated and protected as such. That is not polarizing. It is truth. It is also, by the way, the united states constitution, which offers unique protections to women in a variety of circumstances, as women.
▶ 1:47:12Sen. Hawley: And your refusal to recognize women as women and men as men is deeply corrosive to science, to public trust, and yes, to constitutional protections for women as women. And I think it is extraordinary that you would sit here and advance a political agenda that has been thoroughly discredited and rejected by the american people in this forum. I'm glad we had this exchange because this is exceptionally clarifying. It is also in many ways quite depressing.
▶ 1:47:40Sen. Hawley: I see that my time has nearly expired. I want to thank the other witnesses for being here. Thank you for protecting women and children. Thank you for your valiant efforts. Thank you for following the science. Thank you, Mr. chairman.
▶ 1:47:52Chair Cassidy: Sen. alsobrooks:.
▶ 1:47:58Sen. Alsobrooks: I heard my colleague very passionately talk about the fact that this is about the safety of women. I want to make it clear that this administration and this secretary could care less about women, men, or children. In fact, they don't care about humans. I want to be very clear. I could delineate how that is true. But that is not the subject of today's hearing.
▶ 1:48:18Sen. Alsobrooks: But for the past year we have all watched secretary kennedy and this administration peddle conspiracy theories and junk science to dismantle public health structures in this country. So I don't want anyone lecturing about the safety of women. These people don't care about humans.
▶ 1:48:34Sen. Alsobrooks: Last week, in fact, we saw the latest example, with kennedy recklessly eliminating the cdc's recommendation for a number of critical childhood vaccinations, very alarmingly, including the flu shot in the midst of a flu surge and a super flu. This is the moment that this man decides to eliminate the flu shot for children as a recommendation.
▶ 1:49:00Sen. Alsobrooks: Just like with the pediatric vaccine schedule, changing the rules on fda approved drugs without scientific input, legitimate evidence on safety risk, or transparency -- it will cause unnecessary fear for patients. Rfk's same playbook is being used to target mifepristone, a safe and effective medication that has been approved by the fda for over 25 years.
▶ 1:49:26Sen. Alsobrooks: Take all of the fear mongering and mistruths that rfk spewed earlier last year about measles, mumps, rubella vaccines, and take the fact that rfk agreed to reopen the case on mifepristone this fall, conducting his own very fake review of the evidence of safety and efficacy of this drug. That review was based in part on a study released last summer by the ethics and public policy center.
▶ 1:49:56Sen. Alsobrooks: As a practicing physician, I would imagine that you read peer-reviewed research and journals fairly regularly. Is that correct?
▶ 1:50:03Dr. Verma: Yes, I do.
▶ 1:50:08Sen. Alsobrooks: Is the ethics and public policy center a peer-reviewed or rigorous medical journal?
▶ 1:50:12Dr. Verma: It is not. That is a policy paper you are referring to.
▶ 1:50:19Sen. Alsobrooks: : their own stated mission is to apply the riches of the jewish and christian traditions to contemporary questions of law, culture, and politics, in pursuit of america's continued civic and cultural renewal.
▶ 1:50:33Sen. Alsobrooks: Some of the recent publications include a post entitled "good riddance, governor walz." another is "liberal women have abandoned marriage." another 1 -- "ending mail order abortion would fulfill three trump campaign promises." and "the rights of women -- a natural law approach." this is not science.
▶ 1:50:56Sen. Alsobrooks: But an organization with a political agenda, one based on promoting the idea that women are in their view inferior and should submit to men. And yet their work is being cited by state attorneys general and members of this committee to rollback access to a drug that millions of women have used safely for decades. Was the mifepristone study peer-reviewed?
▶ 1:51:20Dr. Verma: It was not.
▶ 1:51:24Sen. Alsobrooks: Ended the study mixing data from miscarriage management and iud insertion procedures that have nothing to do with abortion care question mark -- care?
▶ 1:51:35Dr. Verma: It did makes in a lot of things that were not directly related and they were not transparent about their methods, so it was hard to figure out what exactly happened. Any peer review study needs to reveal their methods, their data sources. They did not do that. So it is very unclear the specifics.
▶ 1:51:54Dr. Verma: But we can tell that patients that were coming to the emergency room, for example, for routine care, because they could not get care otherwise in their communities, or patients with completely unrelated conditions, were counted.
▶ 1:52:10Sen. Alsobrooks: So this study included completely unrelated conditions as complications of mifepristone, right? How would the inclusion of this data undermine outcomes?
▶ 1:52:20Dr. Verma: It's significantly over exaggerates complication rates by, again, counting things that are not actually complications of mifepristone.
▶ 1:52:33Sen. Alsobrooks: Let me ask you one other question. In contrast to this sham study, can you describe the body of evidence of medical reviews and published clinical trials that reviewed the safety and efficacy of mifepristone -- sorry. It is hard to say.
▶ 1:52:49Dr. Verma: Absolutely. We have over 100 years of high quality peer-reviewed data from multiple journals, multiple researchers, and based on that data, I want to highlight one thing quickly about the fda label that was strategically left out. The label specifically says there has been no causal relationship between the use of mifepristone and myth possible -- and the other medication and the convocations listed.
▶ 1:53:18Sen. Alsobrooks: And this study from this conservative think tank is not, in rfk's words, gold standard science. It is self published, lacks transparency, cannot be replicated, has conflict of interest, and includes flawed data.
▶ 1:53:31Chair Cassidy: Sen. markey:?
▶ 1:53:35Sen. Markey: It is very difficult for me to ignore the irony and the hypocrisy of my colleagues on the other side organizing this hearing today while my republican colleagues frame today's hearing on "protecting women. -- women." they don't appear to have cared about protecting women and families when they strip health care from millions of people last year.
▶ 1:54:05Sen. Markey: Democrats warned that blocking the extension of the aca premium tax credits would lead to skyrocketing premiums for 22 million americans and their families, and that nearly 5 million people, particularly women and people of color, would lose their health insurance. But republicans did nothing to protect women then.
▶ 1:54:28Sen. Markey: When republicans and trump added restrictions and paperwork requirements to medicaid, democrats warned that could cause millions to lose their health insurance, including 2 million young women. But republicans did nothing to protect those young women.
▶ 1:54:44Sen. Markey: When republicans and trump cut almost $1 trillion from medicaid to fund tax breaks for billionaires and ceo's, I warned in my study then that those cuts would put 300 rural hospitals at risk of closure, by having to cut services like labor and delivery, making childbirth more dangerous for women in our country. But republicans did not care about women then either.
▶ 1:55:14Sen. Markey: Now, my republican colleagues have spent all morning spreading dangerous lies about a medication that we have known is safe for over a quarter of a century. And why are they doing that? Because this was never about protecting women. It is about controlling women. Republicans have shown us that they will not stop until there is a national ban on abortion.
▶ 1:55:41Sen. Markey: And today's attacks are just another step toward that national ban. I'm proud that massachusetts has some of the strongest abortion protections in the nation. I heard from some patients who traveled to massachusetts for treatment. Their stories are a testament to the need for abortion protections nationwide. One said she did not want to risk another pregnancy after experiencing complications during her last pregnancy.
▶ 1:56:08Sen. Markey: Another said she was trying to escape a violent relationship, and pregnancy would make it harder for her to leave. Another said she had been raped. People should not have to travel out of state to get basic health care. So Dr. verma, can you speak to how abortion bands impact how soon people can get care, both in states with bands and states with protections?
▶ 1:56:31Dr. Verma: Thank you for that question. We know overall in the united states about 90% of abortion care is happening in the first trimester, but that is being pushed later into pregnancy because of abortion bans and restrictions and patients not able to get care in their communities in a timely manner because of abortion bans and restrictions.
▶ 1:56:59Dr. Verma: They are having to figure out how to get transportation and resources together to get to a place where they can get the care they need.
▶ 1:57:06Sen. Markey: What are the harms to people who have to travel long distances?
▶ 1:57:10Dr. Verma: It is a huge burden on many people, particularly people already facing challenges accessing the health care system. This adds additional burdens for them and adds additional time before they can get the care they need.
▶ 1:57:24Sen. Markey: Let me be clear. This debate is not just about mifepristone and medication. This is about health and freedom , and all of the health care system we put together to protect women -- freedom to live your life with dignity, autonomy, control over your future.
▶ 1:57:47Sen. Markey: And it is absolutely imperative that we continue to fight for abortion rights to give women the ability to make the key decisions for their own health, for their own future, and that is really what is the subject of this hearing today. Thank you.
▶ 1:58:04Chair Cassidy: Senator kaine?
▶ 1:58:08Sen. Kaine: You gave me the opportunity to cut in a long time ago, but I want to wait my turn. This is a very important hearing. Dr. woman horst -- subbenhorst, your opening line was something similar to what Dr. verma said. Abortion is an important subject of debate among the people in the united states. You both talked about it as important and complicated.
▶ 1:58:35Sen. Kaine: It is an issue on which people have very strong feelings, and one in which the stories, those that have been shared today by many, are important to hear. But I do agree with my colleagues that the hearing really is about a national abortion ban. Sharing stories is important, but this committee is a committee with a huge jurisdiction, and there are a million hearings we could have, and many I wish we were having.
▶ 1:59:03Sen. Kaine: But we are having this hearing because of the desire of many in the senate majority to do a national abortion ban. The effort to overturn roe v. Wade was successful in the supreme court, and that has led many states like louisiana and others to put very strict bands on abortion in their state laws. You talked about a bipartisan consensus in louisiana. Virginia has reached a different bipartisan consensus.
▶ 1:59:33Sen. Kaine: I know the louisiana legislature in the house, 27 percent female, and in the senate 12% female. And I'm not bragging about congress being only 28% female. But the decision that this will be returned to elected representatives is cold comfort to a lot of women who don't see themselves represented in the legislature, the legislative bodies. But it is what it is. States can make their own decision.
▶ 2:00:00Sen. Kaine: But that is not enough for advocates and that is not enough for many of my colleagues. The fact that states, many states all over this country, are either banning or significantly restricting abortion rights is not enough. Now let's go after the primary method that is being used by women even in states like virginia that have said we trust women to make these decisions for themselves.
▶ 2:00:26Sen. Kaine: So again, every story is an important one to think about, but in a committee like this that could be having hearings on a million things, the fact that we are having this hearing in the aftermath of dobbs essentially, with state legislatures wiping out abortion in many areas of the country -- now let's go after the chief methods in states where abortion is lawful.
▶ 2:00:58Sen. Kaine: Deciding to terminate a pregnancy -- I just see that agenda. The other thing I notice as we talk about stories is that there are a lot of stories about coercion. Portion is awful. Portions should be prosecuted, as the attorney general says. We ought to. But it seems to me that the opposite of coercion is choice. If we are against portion, why would we be anti-choice? I think these are words called antonyms. They are opposites.
▶ 2:01:26Sen. Kaine: If coercion is a problem -- and I credit that it is. I credit the stories that have been told. If they are true, they ought to be prosecuted. But it does not seem to me that the response to coercion is to more tightly control the choices women make about their own lives. Mr.
▶ 2:01:45Sen. Kaine: Chairman, I would like to introduce come up with respect to the science -- there was an amicus brief submitted to the supreme court in a case following the fifth circuit court of appeals decision and alliance for hippocratic medicine versus fda, and it is an amicus brief. The title is brief of over 300 reproductive health researchers in support of petitioners about the scientific studies on mifepristone. I would like to introduce that into the record.
▶ 2:02:12Chair Cassidy: Without objection.
▶ 2:02:17Sen. Kaine: And I would like to introduce something else in the record. Dr. wubbenhorst, I read the beginning of your first line in your testimony, and now I'm going to read the full line. Abortion is a subject of intense interest today and legislative action among the people of the united states and their elected representatives. That's the part I read. The remainder of the sentence is this. And due consideration should be given to its risks and purported benefits. Not to its risks and benefits.
▶ 2:02:48Sen. Kaine: Not to its purported risks and purported benefits. To its risks and purported benefits. So you tell us right at the beginning that you will be in a camp that would be against abortion under any circumstances. And just on the topic of risks and purported benefits, let me introduce a second item into the record that I am just going to read and then I will conclude, published today in pro public.
▶ 2:03:16Sen. Kaine: A pregnant woman at risk of heart failure could not get urgent treatment. She died waiting for an abortion. When she visited a cardiologist on november 14, 2020 three, her heart was pounding at 192 beats per minute, a rate healthy people reached during the peak of a sprint. She was having another episode of a fed, rapid irregular heartbeat. The 34-year-old police officer was at risk of a stroke or heart failure.
▶ 2:03:44Sen. Kaine: In the past, doctors had always been able to shock her heart back into rhythm with the procedure called a cardioversion. This time, the treatment was out of reach after a pregnancy test came back positive. The cardiologist did not offer to shock her. Graham texted a friend about the cardiologist, and said she could not get the cardi overt being pregnant.
▶ 2:04:07Sen. Kaine: She died of heart failure, leaving a two-year-old, because she lived in a state that would not give her cardiovascular care because she was pregnant and would not allow her to end the pregnancy so she could remain being a mother to her two-year-old son. These stories are really important, and I think women can make these decisions for themselves. Thank you, Mr. chair. I yelled back. I would like to introduce that article for the record.
▶ 2:04:34Chair Cassidy: Without objection. There was an implication that louisiana's law was somehow influenced because of the gender makeup of our legislature. I will note the woman that the democratic state senator, who wrote the law, was katrina jackson, and she was the driving force behind the law. The democrat and for what it's worth african-american. So just to stipulate that for the record.
▶ 2:05:02Chair Cassidy: And also, the health of the mother is an exception to our abortion restrictions in louisiana, and I'm sure it's elsewhere. So in this particular case, I'm not sure of the physician, what the thinking was. I just say that for the record.
▶ 2:05:21Sen. Kaine: It was a story from north carolina and you are right about louisiana. Rape and incest is not an exception, but the death of the mother would be an exception in louisiana.
▶ 2:05:32Chair Cassidy: Senator hickenlooper?
▶ 2:05:37Sen. Hickenlooper: I would like to start just for the record -- I would like to ask unanimous consent to enter into the record letters from board-certified physicians and the american college of obstetricians and gynecologists in colorado.
▶ 2:05:51Chair Cassidy: Without objection.
▶ 2:05:55Sen. Hickenlooper: Thank you all for being here. This is a hard issue, obviously, in the recent we say health care decision should be between a woman and her doctor, or so many of us say that, is because so often these are deeply painful, challenging, personal circumstances. Roughly 10% to 20% of clinically recognized pregnancies unfortunately end up in miscarriage.
▶ 2:06:27Sen. Hickenlooper: Mifepristone, along with the other drug, our gold standard interventions to manage early pregnancy loss. You have been through this. You have some experience of this. Are you worried that the constant attacks on this medication will leave millions of people who are losing a wanted pregnancy, but they won't have -- they will be denied options. Please tell your own story, if you can.
▶ 2:06:56Dr. Verma: Absolutely. We know that mifepristone combined with meza postel -- misaprostil is the most effective treatment option for many people in the country. That option is not available because of restrictions and bans on these medications. I was lucky when I had my experience to be in massachusetts, where I could access these medications. But for many people in the country, that is not the case.
▶ 2:07:27Dr. Verma: For example, in louisiana, with the controlled substance laws, people can't get either of these medications when they are experiencing miscarriages. I also want to go back to one thing. I want to thank both of you for recognizing -- senator kaine -- that this is complicated.
▶ 2:07:44Dr. Verma: As a woman myself and someone who takes care of many women in addition to people who don't identify as women, exchanges like the very polarized one that you saw really do a disservice to complexity and to people's lives. And I just wanted to say that I'm very happy to have these nuanced, productive conversations with anyone.
▶ 2:08:04Dr. Verma: I really do think that serves the american people better, because this is complicated, and we really need to honor that for our patients and for our fellow americans.
▶ 2:08:16Sen. Hickenlooper: Building on that, I want to reflect back on when I was governor in colorado. We got a grant for a five-year very ambitious statewide effort to as much is universally possible vastly expand long-acting reversible contraception, to as many young women that wanted it. And over an eight year period, we reduced unintended pregnancy by almost 60%.
▶ 2:08:48Sen. Hickenlooper: So this is not only a major step forward to expand more access to all forms of reproductive care, reduce teen pregnancy and reduce teen abortion, but it also saved 67 million dollars over that whole process, because so often those teenage pregnancies are not well -- they don't get sufficient medical attention and they end up with premature births, very expensive
▶ 2:09:19Sen. Hickenlooper: Situations. How can comprehensive reproductive health, reproductive health care education and planning, such as what we did in colorado -- how can that help increase access for all women to their rights?
▶ 2:09:33Dr. Verma: Thank you for that question. I absolutely support people having access to whatever birth control options are right for them, and having access to the full range of health care helps make people healthier. I think this also ties into a lot that we have heard about reproductive coercion. We have heard stories that are terrible.
▶ 2:09:58Dr. Verma: I have also seen many patients who can't access birth control, can't access abortion care, and end up having to stay in abusive relationships for that reason. I could tell you many stories, which is why the issue of reproductive coercion is so important to me. And I strongly believe that making sure health care -- all health care -- is more accessible to people is one of the solutions, in addition to figuring out how else we can better support people.
▶ 2:10:29Sen. Hickenlooper: Thank you. I will leave us with the thought that just last week the wyoming state supreme court found unconstitutional their extreme bans on abortion violated their own constitution, because after the affordable care act was passed, there was a statewide initiative to say that they viewed that affordable care act as infringing on their right
▶ 2:10:59Sen. Hickenlooper: To decide their own health care. And now that has been reversed, obviously. The sentiment has changed. As the wyoming state supreme court noted last week, the abortion bans do directly violate an individual's abilities to make their own decisions regarding health. That is a big issue here, is whether people have that right to make their own decisions. I yield.
▶ 2:11:27Chair Cassidy: Senator murray?
▶ 2:11:34Sen. Murray: Thank you very much, Mr. chairman, and thank you to all of our witnesses. Look, it is really clear to me that this hearing is not about science and it is certainly not about women's health. I know folks would like to try to pretend otherwise, but that is about as convincing as saying rfk jr. Saying he is not against vaccines. Republicans can throw a lot of rhetoric around here, but their long antiabortion track record is too painfully clear to hide.
▶ 2:12:02Sen. Murray: We all know the real motivation behind this hearing -- republicans don't like abortion. They want to ban abortion nationwide. But they know that is not popular. They know the american people won't stand for that. So republicans are doing the next worst thing and chipping away at abortion access with every tool they can arm, in every way they can think of, and hoping americans won't notice. But you know what? People tend to notice when the rights go away.
▶ 2:12:31Sen. Murray: People tend to notice when politicians force them to stay pregnant. And people tend to notice when you turn your life upside down. So we are not going to let these attacks on abortion slide. Not a single one of them. We are going to call them out for what they are, and we are going to keep fighting for women's reproductive freedom every single time.
▶ 2:12:51Chair Cassidy: Thank you, senator murray. Just a few things to clean up. My staff was able to confirm that in north carolina the health of the mother is an exception in which abortion would be allowed. So just to say that. Secondly, Dr. verma suggested that in louisiana if someone is having a miscarriage, if they do not have access to these drugs -- that is incorrect.
▶ 2:13:17Chair Cassidy: Specifically it says if somebody is having a miscarriage, there is access to the legitimate use of these drugs in compliance with the law. So that is incorrect. Also, by the way, there is some common ground here. There was a lot of criticism of what Dr. su what Dr. swubbenhorst was quoting, but I think both sides want a safety review. If the issue is this is not accurate, then let's do the safety review.
▶ 2:13:45Chair Cassidy: I think there is common ground there. I think there is common ground on a couple other things, believe it or not. Specifically, it was mentioned that telemedicine would be important, but the attorney general says this is not telemedicine. These are people filling out forms online, and implicitly we would agree that is not appropriate.
▶ 2:14:09Chair Cassidy: I gather it most obs, it is standard of care to do an ultrasound if there is an issue of a miscarriage, and so that should be done. There should be some information. And I was impressed with what Dr. marshall said about the inaccuracy of the report. The statement online -- that seems unlikely. Secondly, next, there was also standard of care as regards the need to have medical records. M Dr.
▶ 2:14:39Chair Cassidy: Verma mentioned how important it was. But the attorney general pointed out that the doctor in california was coaching the patient on how to deny that she had been given her medication.
▶ 2:14:53Ms. Murrill: The paperwork says that to everyone. And there is a whole paragraph in it that says lie to the hospital if you need help.
▶ 2:15:05Step Up -- Chair Cassidy: They should not be telling patients to lie to their doctor. That is not good. That said, I have no illusions that we will find common ground on everything. But if our common ground turns out to be that there should be telemedicine, actual human contact, and that people should not be told to lie to their doctors, then maybe something will come out of this despite the polarization.
▶ 2:15:28Step Up -- Chair Cassidy: With that, I ask unanimous consent to enter into the record statements and letters from live action, the U.S. conference of catholic bishops, students for life, the restoration of america foundation, liberty counsel action, and the american association of pro-life ob/gyn's, expressing concern about the harmful effects of chemical abortions. Unanimous consent requested and granted.
▶ 2:15:56Step Up -- Chair Cassidy: For any senator whisking 2 -- wishing to ask additional questions, questions for the record will be due 5:00 p.m. January 28. Thank you all for being here. And the committee stands adjourned.