long COVID and ME/CFS

One of the fears that I have about COVID is the risk of experiencing long COVID, where any number of a vast constellation of symptoms occurs for months/years after the acute infection phase.

The symptoms are very similar to those that characterize ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome). I have a family member with ME/CFS, so I am achingly familiar with the level of disability that can result. ME used to be referred to as fibromyalgia in the US, but now the ME designation is more common.

The October 5, 2022 edition of the (US) National Public Radio show On Point features an extensive discussion of long COVID and ME/CFS and how long COVID researchers and clinicians are learning from their peers who have been working for years on ME/CFS. All of these conditions are underdiagnosed and undertreated, so I wanted to share this with all of you. I believe this link will permanently take you to a recording of the episode. If the link breaks, you can try searching from the On Point link above or searching on your favorite podcast platform.

Anyone who has experienced these conditions or seen a loved one contend with them knows how difficult they can be. I want to raise awareness so that everyone affected can get the help they need. I also want everyone to realize that these conditions exist and are serious. Too often, affected people are dismissed and told their symptoms are “all in their heads.” While there is still much to learn, help is available, although it may be difficult to find, depending on the medical resources nearby. I hope we will all support research and treatment expansion so that the millions of people affected get the help they need.

A fairy tale wedding


A few days ago, spouse B, daughter T, and I attended the wedding of M and S. M is B’s and my niece and is the cousin closest in age to T.

M is also a big fan of Disney World. S chose to propose to M there and M planned their wedding and reception with a Cinderella theme, including the napkin above. There were castles and glass slippers and golden coaches incorporated into decorations, dancing into the night, a beautiful gown with yards of tulle.

Many echoes of a classic fairy tale.

But M and S don’t have an ordinary life. M is nurse with special training in emergency medicine who currently serves as a flight nurse, transporting critically ill or injured people to medical centers that can give them the best care possible. S is a state trooper, doing his best to keep people safe and assist them in emergencies.

They both do extraordinary things on a regular basis.

They also are facing an extraordinary challenge. Early in their courtship, M developed a serious medical issue but S stayed by her side, even when M tried to break up with him in order to protect him.

The strength of their bond in the face of adversity brought more than the usual number of tears at the wedding and during the toasts at the reception, where even the especially-stoic state troopers choked up over M and S’s love story.

Even at a fairy tale wedding, there are no guarantees of how long the “ever after” will be.

M and S showed us, though, that their love is strong and eternal, whatever obstacles are thrown in their path.

COVID bivalent boosters

As you may recall, spouse B, daughter T, and I were all participants in the Phase III clinical trial for the COVID-19 vaccine from Pfizer/BioNTech. We then all participated in a follow-on third dose trial. B and I left the trial this spring because we were eligible to receive a fourth dose and wanted the extra protection before travelling. T stayed in the trial until its end earlier this summer.

Here in the United States, a new booster was recently approved which combines the original formulation with a new one designed to better combat the Omicron BA.4 and BA.5 variants. BA.5 is the dominant variant currently in the US, accounting for about 88% of cases. About 11% are caused by BA.4. The new booster is expected to strengthen protection against serious illness/death and, one hopes, cut down on symptomatic infection somewhat, as well.

Given that I am still trying to remain COVID-free and that I have several trips coming this fall, I decided to receive one of the new boosters at my local pharmacy. I chose to receive the Pfizer formulation because all my others have been theirs, although there is a Moderna version which is also a fine choice. This was my first time receiving the vaccine in a pharmacy setting. My prior doses had all been in a medical office or a state vaccination site. I made an appointment online and everything was very fast and efficient.

Dr. Ashish Jha, who is the White House COVID-19 response coordinator, and Dr. Anthony Fauci, the long-time director of the National Institute of Allergy and Infectious Diseases, have said that it is possible that we may have reached a point where an annual booster will be enough to protect the vast majority of Americans from serious illness/death from COVID, similar to annual flu shots. Some people who are especially vulnerable due to age or medical condition might need more frequent boosters. The wild card, though, would be the emergence of a new strain that could evade our antibodies and current vaccines.

So, my message is to receive one of these new boosters as soon as they become available wherever you are. The US has been first to authorize them, but it seems they will become more widely available globally soon. Remember, though, that these are booster doses given to people who have already completed an initial vaccine series. If you haven’t completed an initial vaccine series, start NOW!

Meanwhile, here in Broome County, our community risk level is still medium. While I wait for the new booster to take full effect, I will still mask for indoor gatherings and shopping. I’ll be evaluating what to do after that, although these boosters are so new that data may be hard to come by.

I hope to stay well and hope that you do, too.

One-Liner Wednesday: still COVID

Another of my occasional reminders that COVID-19 is still with us.

Join us for Linda’s One-Liner Wednesdays, which I occasionally use to shamelessly promote another blog post. 😉 Learn more here: https://lindaghill.com/2022/08/24/one-liner-wednesday-upon-the-throne/

still COVID

I’m sad to report that the total death toll in the United States from COVID-19 is now over 1.04 million with over 93 million confirmed cases. The actual case count is no doubt higher, as some states have stopped reporting and many cases that are detected by at-home testing are not reported to health agencies at all. New cases are still occurring at a rate of 93,000 a day with 457 deaths (7-day rolling average on August 22, 2022).

It’s still heart-breaking.

And still considered by most experts a pandemic, although perhaps heading in the direction of being considered endemic in the United States soon, as influenza is.

Most cases in the US now are Omicron variants BA.4 or BA.5. There is some hope that new boosters that contain components targeted at Omicron variants might give some additional protection going into the fall and winter, especially against hospitalizations and deaths, but we will have to see if a) people actually get vaccinated and b) the vaccines do boost protection for any length of time.

And/or c) a new strain could develop that evades all prior immunity, is even more wildly contagious, doesn’t respond to current treatments, and/or causes more severe illness.

At home, B, T, and I all still remain uninfected to the best of our knowledge. It’s possible that one or more of us have had an asymptomatic case but there is no real way to know. Any time that we have had symptoms, we have tested, as we have also for travel and after known exposures. We also have had extra tests as part of our participation in the Pfizer/BioNTech vaccine trials. T remains a participant in the third shot trial; B and I exited the trial in order to receive a fourth dose before travelling to the UK this spring. I believe that our vaccination status has helped us to avoid infection and plan to receive one of the new booster shots this fall, if I’m eligible for what will be my fifth dose. T may be eligible for a booster after she finishes with her trial participation this fall if those boosters are available to people under 50.

Broome County, New York, managed to have only a few weeks in the Centers for Disease Control category of low community risk for transmission before going back up to medium. I’ve gone back to masking with a KF94 while shopping or in other indoor public places. I’m making determinations on small gatherings on a case by case basis. Other than church services, I’m avoiding large gatherings.

Some people think I’m being overly cautious at this point but I am still trying to avoid infection, if I can. At the very least, if I do become infected, I will know that I was doing everything I could to keep myself healthy so that I don’t suffer guilt on top of COVID. I am well aware that, even with multiple vaccine doses, masking, avoiding crowds, etc., Omicron, especially BA.5, has been quite successful at evading immunity and protections. I know from what the public health experts are saying and also anecdotally among my friends. There are very few left who have managed to stay COVID-free in recent months.

A large part of my motivation to keep from getting infected is fear of long COVID. While SARS-CoV -2 is too new a virus for researchers to fully understand, it’s possible that I may have some genetic risk factors that could come into play regarding long COVID. None of this is helped by the fact that the underlying medical conditions I have are themselves not well understood.

So, I’ll keep on doing the best I can to stay as healthy as possible.

Wish me luck.

I’m going to need it.

US environmental update

Trying to get the United States back to a better position regarding climate change and environmental issues in general has been a major task for the Biden administration. While some things were relatively straightforward, such as rejoining the Paris climate accords, others have been much more difficult.

Unwinding the changes that the prior administration had made to regulations was sometimes blocked by the courts. The biggest blow was the Supreme Court decision in West Virginia v. Environmental Protection Agency, in which a 6-3 majority found that the EPA can’t regulate emissions from coal-fired power plants unless they have been given specific direction by Congress. It was odd that the Supreme Court heard the case because it was brought against the Clean Power Plan, which was proposed by the Obama administration, but never enacted. The Biden administration had no intent to revive that plan, as circumstances have changed, so it appears that the conservative majority heard the case for the purpose of striking down the manner in which executive branch agencies and departments go about executing the laws that have been passed by Congress. This ruling could bog down not only EPA work but also the regulatory work of other Cabinet departments. [Please note that this is my layperson understanding of the case and its implications. There has been a lot of legal commentary which can be found in myriad places online, if you are interested.] An August 26 post with an update on the impact of this case can be found here.

Legislation to address the climate crisis was an important cornerstone of the Biden agenda. The House of Representatives passed a strong bill dealing with climate change and the care economy, including health care, universal education for three- and four-year-olds, provisions for child and elder care, permanent expansion of a fully refundable child tax credit, and other measures for social justice and equity. The bill was paid for by increasing taxes on wealthy individuals and corporations. Unfortunately, the 50-50 split in the Senate combined with Senate rules gave a couple of Democratic senators power over what was in the bill and they opposed some of the financial and energy provisions, so it looked as though it would not pass.

This was extremely discouraging to millions of people in the US, as well as to millions in the rest of the world who are depending on US action to cut carbon in the atmosphere and provide leadership for other countries to do the same.

And then, a surprise announcement that Senator Joe Manchin of West Virginia, who made his money from coal and had shot down prior versions of the bill, had reached an agreement with Senate Majority Leader Chuck Schumer on a version of the bill that he could support. Additional changes wound up being made to get Senator Kyrsten Sinema of Arizona on board. Senator Schumer kept the Senate in session in Washington into their August recess to pass the bill with Vice President Harris casting the tie-breaking vote. House Speaker Pelosi called the House back into session to pass the bill last Friday and President Biden will sign the bill into law this week.

While the Inflation Reduction Act is not as strong as the original legislation, I’m very happy that it will become law. It should bring down energy costs over time. It is projected to lower US greenhouse gas emissions by about 40% of 2005 levels by 2030; the United States goal in the Paris accord is a 50-52% reduction, so we hope that additional measures will be enacted to reach that goal. However, before this bill, we were on track for only a 25% reduction, so this is a major improvement. This article is a good summary of some of the main environmental/energy provisions of the bill.

I am grateful and still a bit shocked that this bill is about to become law. Yes, there is more to do, both on environmental and economic justice issues, but, at least, we have made a good start. This is important because people and the planet need this help and because it shows that the Democrats are actually serious about governing in a bipartisan way when it is possible, such as with the infrastructure law, and alone, if necessary. I hope that the progress in the last 18 months will encourage voters to keep the Democrats in the majority so more can get done in the next session. Perhaps, it will even give more Republican Congresspersons the impetus to support popular, commonsense measures that benefit the public. We have all witnessed past Republican majorities who were unable to pass much substantive legislation; for example, the Trump administration announced multiple “Infrastructure Weeks” but never got close to passing legislation. We have also, sadly, seen Republican minorities block action on legislation and appointments through the filibuster and other holds and delaying tactics. I think these need to be reformed so that the Congress is not bogged down and unable to do the work our country needs to function.

As the new programs ramp up, I encourage people in the US to be on the lookout for provisions that can help them make their lives greener, whether that is rebates on efficient electric appliances, incentives to buy used or new electric vehicles, or the opportunity to purchase renewable energy at lower than current rates. Support candidates who make the health and well-being of people and our environment their top priorities. We need representatives who are looking out for us, not just corporate profits and tax loopholes.

In my district, that means voting for the Democratic candidate. Make sure that you know the candidates’ positions in your area before casting your ballot.

the aftermath of Dobbs

When I wrote this post after the leak of US Supreme Court Justice Alito’s draft opinion on an abortion law in Mississippi, we weren’t sure if there would be changes before the decision was announced.

When the decision was announced on June 24, it was little changed from the draft. The majority signed on to the opinion that Roe v. Wade had been “wrongly decided” and threw the matter of the legality of abortion to each state’s legislature.

It’s not that long-standing Supreme Court precedents have never been overturned or declared “wrongly decided” – the Dred Scott decision springs to mind – but the Dobbs case was the first time that such a reversal came at the expense of a recognized right.

Many lawyers and Constitutional scholars have faulted the majority’s decision on historical and legal grounds, as Alito seems to cherry-pick sources in support of his view while ignoring the mainstream history and scholarship to the contrary. For example, while it is true that the Constitution does not specify a right to an abortion, it also never uses the word “woman” or “family.” There are many rights that have been recognized by the courts over the centuries that are not specifically cited in the Constitution under the Ninth Amendment which states “The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.” The right to privacy and to bodily autonomy belong to each person and should not be under the jurisdiction of the government at any level. The Alito opinion also seems to violate the Thirteenth Amendment against involuntary servitude and the Fourteenth Amendment which promises “equal protection of the laws.”

While Alito said that abortion was a unique situation in terms of privacy protections, Justice Clarence Thomas wrote a concurrence that openly questions other rulings, such as those allowing contraception and marriage equality in all states. Somehow, he didn’t suggest that the Loving case, which forced all states to allow interracial marriage, had been wrongly decided, one assumes because he is a partner in one.

It’s now a little less than a month since the decision was handed down and there is upheaval. There have been many protests and public demonstrations. Some states moved to ban all abortions or all after six weeks of pregnancy. Some states are even trying to prevent people from crossing state lines to receive care, as though being a resident of a state gave them ownership over you. While the House has passed legislation to codify abortion rights similarly to Roe and to allow interstate travel for medical care, the Senate Republicans have blocked both measures from coming to a vote.

Some states are protecting and codifying the Roe framework. My home state, New York, had done this previously and is now beginning the years-long process to amend the equal rights protections of the state constitution to include “sex, including sexual orientation, gender identity, gender expression, pregnancy, pregnancy outcomes, and reproductive health care and autonomy”. Bonus: this will protect marriage rights and stand against all gender-related discrimination, as well as returning reproductive health rights to each individual.

Before the decision was handed down, those of us warning of the dangers to the health and well-being of pregnant people were scolded for being alarmist, but we were being realistic. Every day, there are stories in the news of delayed care for miscarriages that threatens the health and life of the mother. There are stories of rape victims having to go to another state for an abortion. The most heart-breaking of these is the case of a ten-year-old rape victim who had to travel from Ohio to Indiana to receive an abortion at six and a half weeks pregnancy. This child has had to endure not only rape and the severe threat to her health that pregnancy at such a young age entails but also the trauma of some politicians and commentators questioning the veracity of her story.

These cases show the dangers of trying to legislate what should be private medical decisions. While some are contending that it’s not really an abortion if a child is pregnant and her life is endangered or if there is an ectopic pregnancy or if there is an incomplete miscarriage, medically speaking, all pregnancies end either in live birth or an abortion. Miscarriage is not a medical term; on medical records, it is termed a spontaneous abortion. Health care providers are being put in the impossible situation to provide the best care to their patients or to be forced by lawyers to wait until their patients are clearly dying themselves before intervening to remove a doomed fetus. When the federal government reminded hospital emergency rooms that they are required to treat any endangered pregnant person to save their life, the state of Texas filed suit, saying that their state law against abortion should take precedence.

Some states are making moves not only against abortion but also against contraceptives, even though these are not abortifacient. They are trying to prevent people from crossing state lines to receive care. As I mentioned previously, while the US House of Representatives has passed legislation to codify abortion rights and to affirm the right to interstate travel, the Senate is not taking these up because of obstruction by Republicans. Chillingly, there is talk of the Republicans passing a national abortion ban if they regain the Congressional majority. Meanwhile, Republicans fail to pass legislation that would uphold the health and dignity of each person, such as universal health care, living wages, social welfare support, etc.

As a Catholic woman, I knew this was coming. Alito was parroting the arguments that Catholic bishops have made against abortion and Thomas went even further down that road in his calls against contraception. I have struggled for years against a church that denies my full personhood as a woman, despite their lip service to the concept of human dignity. I did not expect my country to follow suit.

Like most women my age, I didn’t think we would still be fighting these kinds of equality battles, but we will. I can’t predict the manner or timing of victory, but we will not be demoted to second class citizenship by a skewed Supreme Court.

finally, but…

Broome County, New York, where I live, finally managed to get into the low community risk category on the CDC’s COVID map late last week, after many months in the high category with a few weeks of medium thrown in.

This is long hoped for news, but it is likely only a very temporary lull.

We had been high for so long due to our lower level of up-to-date vaccination and the fact that an Omicron subvariant that became dominant originated in central New York.

Unfortunately, another Omicron subvariant BA.5, is making its way into our area. BA.5 is already the most dominant strain in the US and carries the dubious distinction of being more contagious than other forms of Omicron. It may also have a tendency to more often affect the lower part of the respiratory tract, although this is still being researched; Omicron in general has been more likely to remain in the upper respiratory tract. It also appear to more easily infect people who are up-to-date on vaccination and those who have already had Omicron, even if the prior infection was only a few weeks ago. It’s difficult, though, to tease out which effects in the population are from the variant itself and which are from decreasing immunity that occurs over time.

It is also unfortunate that repeat infections increase the post-infection risk of stroke, heart attack, and other serious illnesses and bring the risk of long COVID.

Even with BA.5, though, being vaccinated and boosted is helpful. It lowers rates of severe disease, hospitalization, and death. Pfizer and Moderna are each developing vaccines/boosters that are more effective against Omicron that will be available in the fall. Of course, masking, avoiding crowds, and other public health measures are also helpful if transmission is high in your area.

Remember: the pandemic is still with us. Another new variant is spreading in India and several other countries and could cause another global wave of infections if it can out-compete BA.5. Stay alert and do what you can to take care of yourself, your family, and your community.

I’ll be doing that here. Even though our current infection rate is low, it has begun to creep up. I’ll be watchful.

COVID update

Remember the COVID-19 pandemic?

It’s still going on, even though most people here in the US are ignoring it. We crossed the one million death threshold in mid-May, although it is likely that the true number is higher as not all deaths caused by COVID are listed as such.

The good news in the US is that both the Moderna and Pfizer/BioNTech vaccines have been approved for children beginning at six months. It remains to be seen how many parents/caregivers decide to vaccinate their babies/toddlers/preschoolers. If it were me, I’d be first in line, but I expect we won’t see very high numbers. Only about 30% of 5-11-year-olds are fully vaccinated, despite availability since November, 2021. This boggles my mind, given that these same parents have vaccinated their children against a host of other serious diseases, yet have chosen to leave them unprotected against a disease that has sickened and killed so many here and around the world. It’s true that the vaccines are not a guarantee against infection but they prevent some infections and usually keep those that do occur from causing hospitalizations or deaths. From a public health standpoint, the more people who are vaccinated, the more likely it is that the pandemic will end and COVID-19 becomes endemic.

We are still far from that point, especially as new variants and subvariants are better at evading immunity, whether from vaccination or infection. The US right now is still dealing with Omicron subvariants. BA.2.12.1 is still responsible for the majority of cases here at about 56% but BA.4 and BA.5 are up to 35% of cases which is a large increase and a sign that they may out-compete the already wildly contagious BA.2.12.1.

Our county, which has been struggling with high infection rates for months, mostly due to BA.2 sub-variants that originated in central New York before causing misery more widely, is finally back in the “medium” risk category according to the CDC. It’s a bit discouraging in that Broome and our neighbor Tioga are the only two counties in all of upstate New York that haven’t dropped down into the “low” category. Maybe soon. Meanwhile, I’m continuing to avoid crowds and mask in public places like stores and church.

As you may recall, spouse B and I left the Pfizer/BioNTech COVID vaccine trial this spring in order to receive a fourth shot to boost our immunity before we travelled, but daughter T is still participating. Next month will be the one-year anniversary of her third dose, so she will be having an in-person visit for blood tests and such.

Pfizer and Moderna have both developed newer forms of their vaccines to better battle Omicron. The Food and Drug Administration scientists are meeting today to begin consideration of a new round of booster shots this fall to try to increase protection. It would be great if we can do so. I will definitely get another booster if it is offered, as I am still trying to keep from getting infected because I don’t want to be sick, especially with long COVID.

In the UK, where our daughter E and her family live, BA.4 and 5 are causing another spike in cases. Last week, it is estimated that 1 in 40 people in England and 1 in 20 in Scotland were currently infected. While the UK was initially slow to immunize children, earlier this year they began routine availability for COVID vaccination at age five. ABC’s recent fifth birthday came with the opportunity for her first Pfizer dose, for which we are grateful in the midst of the current wave. While it remains true that children have much lower rates of severe illness than adults, by not immunizing them you are allowing a large pool of little people to congregate, pass around germs, and spread them to their homes and communities. It’s one thing when we are talking about colds or even flu, but COVID-19 is a much more serious public health threat.

As usual, I renew my plea. Vaccinate if you are eligible and have access. Pay attention to infection rates in your area. Mask in indoor public places unless transmission rates are low. Avoid large crowds. Increase ventilation. Stay home if you are sick. Test and talk to your health care provider if you have symptoms. The SARS-CoV-2 virus has already caused immense suffering. Do everything you can to keep it from affecting you, your loved ones, and your community.

a fraught and complicated topic

Anyone in the US can probably guess from the title that this post is about abortion, which is all over the news right now, due to the publication of a first draft of an opinion by Justice Samuel Alito which would overturn the Supreme Court rulings in Roe v. Wade and Planned Parenthood v. Casey, ending the right to obtain a pre-viability abortion throughout the US after 49 years. If the final ruling follows this draft, each state would be free to adopt its own laws regarding abortion. While some states have already codified abortion laws in line with the Roe framework, other states have laws that would greatly restrict or totally ban abortion if Roe is struck down.

It’s been a political earthquake. It’s also being cast as yet another liberal versus conservative, blue versus red, pro-choice versus pro-life issue, but it is much more complicated than that.

Years ago, I started to draft a post called “shades of gray in a black-and-white world” that would have dealt with abortion as an example. I don’t tend to be an either/or person; everything to me is a complex web of concerns with many different aspects and perspectives to take into account. (You can blame my INFJ-ness or just Joanne being Joanne.) I’ll try to make myself as clear as I can in this post but my greater goal is to explore the varied factors that come into play.

At its root, I don’t think any branch of government should be dictating what a person who is pregnant does before the baby can survive on its own. I think that is a private medical and moral decision that belongs to the mother, her partner if they are available in a supportive way, her medical practitioner, and any advisors who can help.

I am Catholic and know that the Church currently teaches that life begins at conception but I think that is a problematic definition. Most fertilized eggs don’t implant in the uterus and it seems foolish to define all those as miscarriages. It’s tragic when an embryo implants elsewhere; if you have defined life as beginning at conception and prohibit all abortion, then an ectopic pregnancy couldn’t be treated until the embryo has died, by which point there will probably be life-threatening internal bleeding in the mother’s abdomen. Defining fertilized eggs as persons also gets problematic with frozen embryos used for assisted fertility treatment. I would certainly not be considered alive if I were placed in liquid nitrogen! (The Catholic Church opposes most fertility treatments, including in vitro fertilization, but it is germane because, of course, frozen embryos exist.) Other faiths believe personhood begins at different junctures, with many Muslims believing in ensoulment at 120 days after conception and many Jews marking birth as the beginning of full personhood. Because there is no consensus on when life begins among people, the government is overstepping its bounds to impose one.

The vast majority, about 92%, of abortions in the US are performed within the first 13 weeks gestation, or 15 weeks of pregnancy because weeks of pregnancy are, for some stupid reason, still counted from the date of the late menstrual period meaning you are considered two weeks pregnant at the time of conception. One of the very confusing things with laws in various states is referring to abortion bans at six weeks or fifteen weeks. It’s often referring to weeks of pregnancy, so we need to bear in mind that the gestational age is two weeks younger. 44% of abortion in 2019 were medical, using pills to cause a miscarriage early in the pregnancy, rather than surgical. Medical abortion can be used up to the tenth week of gestation.

Only 4% occur after 16 weeks gestation. These are most often done because of grave medical problems with either the mother or fetus. Sometimes, second trimester abortions are performed because of barriers of distance and/or cost to reach a provider. Rural women and people with low income/wealth often have this barrier, as do people without medical insurance or who have Medicaid because federal funds cannot be used for abortions.

The largest factor in choosing to have an abortion appears to be economic. 49% of people seeking abortion are living below the poverty level, with an additional 26% up to twice the poverty level. 60% already have at least one child. Unlike most modern democracies, the United States is not very supportive of families and children. I wonder how many would choose to raise the child rather than have an abortion if the US offered free or low-cost medical care, paid parental leave, guarantees of a living wage and/or subsidies for food, housing, day care/preschool, etc. that people in much of Europe have available to them.

Even the favorite alternative of those who oppose abortion, carrying the child to term and placing it for adoption, is expensive. If the mother is struggling financially and has other children to care for, she is literally faced with a choice between impending medical bills for delivering the new baby and feeding, clothing, and housing her present family. Abortion may be her most practical route to keeping her family afloat.

This brings me to one of the most troubling aspects of prohibiting abortion – forced childbearing. Carrying a child against one’s will is, to my mind, a form of involuntary servitude. I know from my own experiences with pregnancy that bearing a child is work which is physically, emotionally, and spiritually taxing. With my first pregnancy, which was planned and hoped for, I still experienced a lot of emotional upheaval, especially in the first trimester. I can only imagine what it would have been like if I had been without a partner, uninsured, living in poverty, unhealthy, in an abusive relationship, or a victim of sexual violence. Yet, some of the state laws restricting abortion carry no exceptions for rape and incest. Forcing a woman to bear a child that results from sexual violence or coercion magnifies the trauma. It’s especially dangerous if a tween or teen is involved.

Despite some progress, mothers in the United States bear a disproportionate amount of the labor and consequences of raising children. This is especially true if they are single parents. The poverty rate for single mothers is high. Often, the father doesn’t contribute substantially to the household finances. Many women who are unexpectedly pregnant face the loss of schooling, employment, and family support. It’s not just whether or not to have a baby or an abortion; it’s looking at 18+ years of raising a child without adequate support from the father, family, and community. While the stigma of single parenthood has lessened somewhat in my lifetime, it is still there, especially within certain religious communities. There is also still significant employment discrimination against women, in particular during pregnancy. Rolling back reproductive rights will likely worsen this.

While the leaked draft tries to say that the overturning of Roe v. Wade does not have legal implications beyond abortion, it’s unlikely that other private matters won’t be affected. The most obvious is access to contraception. It wasn’t until 1965 that the Supreme Court ruled that married couples must be allowed access to contraceptives and 1972 that any person could access them. I feel the right to use contraceptives is under particular threat because of the way the Catholic Church teaches about them and the fact that six of the current justices are Catholic, with an additional one who was raised Catholic. Only one of those seven is not in the conservative camp.

As a Catholic woman, I have been told that taking birth control pills is like having an abortion every month, ditto for morning after pills and IUDs. The fact that this is total garbage from a medical standpoint is apparently irrelevant to the Church. The Church also opposes surgical sterilization for males and females and privileges the life of the unborn over the mother. I, like millions of other Catholics, reject this teaching and follow my own conscience on these matters personally. I am fortunate that I never had to face a personal decision on abortion during my child-bearing years, but I do know that if I had had an ectopic pregnancy, I would not have hesitated to have surgery to save my life. I also probably would have had an abortion if we discovered that I was carrying a child who had problems that were “incompatible with life” as it is euphemistically termed. I don’t think I could have chosen to put myself and my child through the pain and trauma of birth, knowing that they would die soon after.

Other people might make other choices but that is the whole point. Each individual chooses what is right for them, within the realm of medical science and individual conscience. The government is not the entity doing the choosing.

Besides birth control, there are other issues that are considered privacy issues. Many people are concerned about the impact on marriage. The 2015 Obergefell case that established marriage equality throughout the US could be in danger. Some worry that even the 1967 Loving case that prohibited states from racial discrimination in granting marriage licenses could be at risk. Another ruling that could be in jeopardy is 2003 Lawrence v. Texas, which struck down the remaining state laws that prohibited same-sex relations.

By chance, I had had an opportunity to discuss a possible overturn of Roe v. Wade not too long before the leaked opinion draft. I sometimes do online surveys and had been invited by one of these polling organizations to participate in an online focus group about abortion. I admit that I was a bit of leery about it beforehand, but it was very interesting. Most of the group thought that Roe v. Wade was likely to be overturned soon, while I and a few others thought it would be a longer process. I had thought that the present case would uphold Mississippi’s 15-week ban, changing the timeframe of Roe without going so far as to say it was wrongly decided. I suppose this is still possible if Alito’s draft opinion didn’t draw the support of four other justices, though I feel that is unlikely at this point. In the focus group, we did view some short promotional videos that a client organization might use in the event of tightened abortion restrictions. I expect to see some of them debut after the Court formally announces its decision in June or early July.

There are already lots of marches and demonstrations going on and I expect more. There might be repercussions for the midterm elections in November but with the level of gerrymandering and voter suppression in the country already, it’s difficult to predict the outcome.

I also don’t know what reforms are possible. One of the reasons this ruling is possible is that the Republicans have interfered with the seating of federal judges and justices. Two of the justices likely voting in favor of this overturning of Roe were appointed by Donald Trump but those seats would have been made by Democratic presidents if the Senate confirmation process had not been co-opted by Senator Mitch McConnell. A few weeks before the 2020 election, I wrote a post about one possible approach to addressing this. And all of this is complicated by the structure of the US government that gives disproportionate power to less populous states through the Senate and the electoral college.

Thank you to any of you who have made it this far in a longer-than-usual post. I do not know what the coming weeks will bring with this latest addition to political tensions in the US. It’s hard to keep my fears in check.

Please, stay safe.

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