Health

(NEW YORK) — The past few years have seen a growing mental health crisis, prompting an increasing number of Americans to seek help through confidential telephone support lines.

But no two support lines are exactly the same. Crisis lines are intended for those undergoing an urgent mental health crisis and in imminent danger, like someone considering suicide. Helplines are designed for non-urgent needs, such as those seeking support and resources for depression, anxiety and other mental health disorders.

Experts said knowing the right one to call can help get you the specific help you need faster.

Everyone in the U.S. should feel empowered to call 911 if they experience distress, crisis or suicidal ideation, experts said. But for those experiencing suicidal thoughts, another option is 1-800-273-8255 [TALK], the National Suicide Prevention Lifeline, a crisis line that consists of a network of more than 200 crisis centers. In July, 988 will replace the 10-digit number as the new 24/7 Lifeline number.

“We are trained to de-escalate a situation,” Mary Givelber, executive director of Caring Contact, a member of the National Suicide Prevention Lifeline located in New Jersey, told ABC News.

She said that “we listen, we do not fix,” and volunteers “encourage them to take charge of where they are in that moment.”

However, if someone is in imminent danger, crisis lines can sometimes activate emergency services that send a mobile crisis unit or ambulance, but experts said this is rare.

“When police and ambulances show up and fire trucks often come out and the lights are on, this becomes a very traumatic experience for that individual,” Givelber said. “So we are trained to try and find the safest, least intrusive way of keeping somebody, we call it, ‘safe for now.’”

Additional resources are available for people who need help but are not experiencing an immediate crisis, such as suicidal thoughts.

Helplines offer information on where to find local mental health resources. One option is the National Alliance for Mental Illness (NAMI) HelpLine (1-800-950-6264), where volunteers are on standby to connect people to mental health services.

“The crisis call counselors can address the immediate crisis, but we want an individual to get well and stay well,” Hannah Wesolowski, chief advocacy officer for NAMI, told ABC News. “And so it’s those local call centers that can connect an individual to resources and services in their communities.”

The resources offered vary by location.

“There are some call centers that have the capacity to make same-day or next-day appointments with community mental health providers or refer them to services within the community,” Wesolowski said.

There are also helplines that focus on the needs of specific populations like the new National Maternal Mental Health Hotline launched this week by the U.S. Health and Human Services Department. It’s available by calling or texting 1-833-9-HELP4MOMS.

Then there are warm lines, a service growing in availability, which is a middle ground between crisis lines and helplines. People can call in to discuss non-urgent matters and are offered emotional support.

“The warm line is actually a phone line where they have volunteers, peer support volunteers, who will just talk to people. There’s no urgency around the conversation. They just get to listen reflectively and help people process and offer emotional support,” Dawn Brown, the national director of NAMI HelpLine Services, told ABC News.

Many call centers are staffed by volunteer peer-support specialists, “that means someone with a mental health condition and they’re now long into their recovery, or the family member supporting a loved one who’s in recovery,” said Brown.” Others are staffed by paid employees. Volunteers and employees undergo weeks of standardized training and quality assurance measures are in place.

What happens if you call the ‘wrong’ line?

In some states like New York and Georgia, one number serves not only as a crisis line, but also a helpline and warm line. But in locations where they are distinct, efforts will be made to direct you to the correct service.

For example, Brown explains at the NAMI HelpLine they “do a suicide risk assessment and if the person is deemed to be at imminent risk, we attempt what we call a warm transfer where we will keep the caller on the line and connect with the Lifeline to hand the person off to a crisis worker.”

But not all calls are transferred. If someone calls a crisis line and is specifically looking for resources, they may only be referred to a helpline.

Calling the appropriate line could help ease the burden on crisis centers. On average, 15% of calls to the National Suicide Prevention Lifeline don’t go through because of extended wait times, resulting in callers dropping the call.

According to Wesolowski, more federal funding is needed to increase staffing, “upgrade technology, data collection, developing training, and operating those back-up centers.”

“Time and time again, what we hear is thank you for listening to me. Thank you for hearing my story,” Givelber said.

If you are struggling with thoughts of suicide or worried about a friend or loved one, help is available. Call the National Suicide Prevention Lifeline at 1-800-273-8255 [TALK] for free, confidential emotional support 24 hours a day, seven days a week.

If you or someone you know needs help, contact NAMI HelpLine from 10 a.m. – 10 p.m. ET Monday to Friday at 1-800-950-NAMI [6264] or info@nami.org.

Adjoa Smalls-Mantey, M.D., D.Phil., is a psychiatrist, trained in immunology, and a contributor to the ABC News Medical Unit.

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(NEW YORK) — As a growing number of states continue to pass strict abortion laws, Americans are facing more barriers when it comes to accessing the procedure.

However, one of the greatest obstacles pregnant people are often met with is the cost of obtaining an abortion.

An abortion can cost anywhere from $0 to more than $1,000, and it’s not just the medical costs that patients face, according to a study from the Guttmacher Institute, a research group focusing on sexual and reproductive health.

Those seeking an abortion may also have out-of-pocket costs for traveling out of town — or, in some cases, out of state — as well as food, lodging, gas, coordinating child care and accessing medication.

Now, with the Supreme Court potentially set to overturn or severely gut Roe v. Wade, attention has turned to abortion funds, which can help arrange and pay for abortion care, as well as other costs associated with the procedure.

What is an abortion fund?

An abortion fund is a nonprofit organization that provides direct funding to those seeking an abortion who may not be able to afford it.

Some funds completely or partially cover the costs strictly related to the procedure, such as for pills for medication abortions — which make up more than half of all abortions in the U.S. — or for an in-office procedure.

“We also provide what we call practical support,” Chasity Wilson, executive director of the New Orleans Abortion Fund, which helps provide funding for people living in the Gulf South, told ABC News.

This includes surrounding costs such as transportation to and from abortion clinics, translation services, gas, lodging and child care — and emotional support.

In addition to local funds, there are 92 abortion funds — as of October 2021 — that are members of the National Network of Abortion Funds, which helps connect organizations across the country.

How do they work?

Some funds, such as the NOAF, allow women to call directly to ask for help paying for an abortion.

“The patient reaches out by calling our hotlines,” Wilson said. “Sometimes we also participate in solidarity funds when another fund that provides these services may reach out and say, ‘Hey, we have a person whose procedures cost $1,300 so we can spend $500, how much can you help?'”

Other funds, such as the Women’s Reproductive Rights Assistance Project — a nonprofit that helps provide funds to people seeking abortion services or emergency contraception — speak directly with clinics and providers.

“We have a network of over 700 clinics, doctors and hospitals that are networked with our fund that contact us on a daily basis to let us know that they have a patent in need of an abortion and that patient needs funding,” Sylvia Ghazarian, executive director of WRRAP, told ABC News. “When a clinic calls us, we return the call and make a pledge commitment to that clinic.”

Ghazarian said the fund will then receive the invoice from the clinic and cover the cost within the week.

WRRAP’s statistics from 2021 showed that 73% of the fund’s patients were people of color and 76% received public assistance. Additionally, NOAF’s 2021 report found that 71% of patients were Black or African American and about two-thirds were on Medicaid.

“A lot of these populations have traditionally less access to health care, but by no means does this mean these are the populations that receive abortions most frequently,” Wilson said.

Who can access them?

Some abortion funds have no requirements. Ghazarian said WRRAP helps provide funding for abortions across the U.S.

Other funds help specific groups of women based on where they live, their racial/ethnic makeup, or how far along they are in their pregnancies.

For example, the Midwest Access Coalition helps cover costs for people seeking abortions in the Midwest, while the Northwest Abortion Access Fund does the same for those living in Alaska, Idaho, Oregon and Washington.

Meanwhile, the Indigenous Women’s Fund provides support for Native or Indigenous Americans seeking to end their pregnancies.

Others, like the Brigid Alliance, help fund those who have to travel long distances to receive late-term abortions.

How do abortion funds get their funding?

Most abortion funds receive support through individual donations. Since the leak of the draft opinion, first reported by Politico, there has been a substantial increase in donations to abortion funds across the country.

The National Network of Abortion Funds told Good Morning America it received more than $1.5 million in donations within three days of the leak reporting.

Ghazarian said news of the leaked draft has left many patients confused. She said she spoke with an abortion clinic earlier in the week that was receiving calls from patients asking if their abortion appointments were still on.

Because of this, another part of WRRAP’s work is community outreach so people can know what the abortion laws are in the part of the country they live in.

“We’re trying to generate information out there not just to clinics but to communities, so that individuals know we’re still here and we will still support them no matter what,” Ghazarian said.

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(NEW YORK) — Last July, a tearful Felicia Croft sat in her car after a long shift in the COVID-19 intensive care unit, and expressed her deep despair about watching young patients die of the virus.

“People are younger and sicker, and we’re intubating and losing people that are my age and younger people with kids that are my kids’ age that are never going to see their kids graduate. They’re never gonna meet their grandkids,” the nurse from Willis-Knighton Medical Center, in Louisiana, told ABC News at the time.

With vaccination rates lagging in Louisiana — fewer than 40% then — Croft said she was frustrated to see preventable deaths occurring.

“We have seen people [in the hospital] that have been vaccinated, but they usually go home to raise their kids, and to hug their husband or their wife. I can’t explain the feeling of defeat. When you do everything you pour everything into a patient and it’s not enough,” Croft explained.

Now, as the nation mourns the loss of 1 million lives to COVID-19, Croft shared a new video diary reflecting on the milestone and the last two years, expressing her relief that fewer patients are dying of the virus at her hospital.

“Today, I am standing here, and I am doing an empty room, in our empty COVID Unit, at the hospital, which is really, really exciting,” Croft said.

Reflecting on earlier experiences caring for a dear family friend, Croft described the pain of seeing people steadily deteriorate as they were intubated, and terribly sick with COVID-19.

As she spoke to the mother of her friend on the phone, Croft recalled feeling helpless as she was not able to truly comfort to his family.

“I remember his mom crying, and me not being able to go to her, and not being able to just love on and comfort somebody that I love, because we’re trying to save another life. That was so difficult,” Croft said.

And although at Willis-Knighton, the need for COVID-19 related care has slowed, Croft said she and her colleagues are still mourning the losses of all of the patients, friends, and family members that died of COVID-19.

“COVID has thankfully dwindled down, but we are still mourning losses, and seeing the effects of just how it’s changed a lot of people, a lot of people’s long-term health, a lot of people’s outlook and it’s just very humbling. It’s been a very humbling experience,” Croft said.

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(NEW YORK) — Since Roe v. Wade legalized abortion nationwide, advocates and opponents of abortion rights have argued over how safe abortion is, how it’s performed and even where the public stands on whether it should be legal.

Now, the Supreme Court may be set to overturn the landmark 1973 decision, according to a leaked draft opinion initially reported by Politico last week.

Ahead of the final decision, which is expected in either June or July, ABC News spoke to public health experts about five common myths surrounding abortion and what the statistics actually show.

Myth: Most abortions happen in-office

Data from the Guttmacher Institute, a research group focusing on sexual and reproductive health, showed at-home medication abortions, not in-office procedures, make up most abortions in the U.S.

Drugs for medication abortions were first developed in the late 1970s as an alternative, non-surgical, form of abortion in which someone takes two pills to end a pregnancy.

The first pill is mifepristone, which was authorized by the U.S. Food and Drug Administration in 2000. It works by blocking the hormone progesterone, which the body needs to continue a pregnancy.

This causes the uterine lining to stop thickening and to break down, detaching the embryo. The second drug, misoprostol, taken 24 to 48 hours later, causes the uterus to contract and dilates the cervix, which will expel the embryo.

​​In the U.S., the drugs are approved up to 10 weeks’ gestation, although the World Health Organization says they can be taken up until the 12-week mark.

As of 2020, medical abortions account for 54% of abortions performed in the U.S., up from 24% a decade ago, according to the Guttmacher Institute.

Otherwise, patients can get an in-office procedure, including, in earlier pregnancy, one in which suction is used to empty the uterus. Contrary to beliefs that abortion is a prolonged procedure, most take less than 10 minutes, according to Planned Parenthood.

Patients may choose to have an in-office procedure rather than a medication abortion for many reasons, including the availability of abortion appointments, Dr. Evelyn Nicole Mitchell, an obstetrician and gynecologist with Keck Medicine of the University of Southern California, told ABC News.

“By the time [some women] see a provider, it’s past the nine- or 10-week mark, and the only option at that point is surgical abortion,” she said.

Myth: Many abortions happen in the second and third trimester

According to a Centers for Disease Control and Prevention report published in November 2021, 629,898 abortions occurred in the U.S. in 2019, the latest year for which data is available.

Of those abortions, the overwhelming majority occurred before 13 weeks’ gestation, which is the beginning of the second trimester.

The CDC report found 79.3% of abortions in 2019 were performed at 9 weeks’ gestation or earlier. What’s more, nearly all abortions in 2019 occurred at or before 13 weeks’ gestation, at 92.7%.

The report also showed from 2010 to 2019, abortions performed later than 13 weeks’ gestation was either at 9% or lower. Just 1% of abortions were performed after 20 weeks.

Public health experts told ABC News the majority of women who have abortions in the second trimester largely fall into one of two groups.

One group is made up of pregnant people who come from backgrounds with traditionally less access to health care, such as living in rural areas or being of lower socioeconomic status, according to Mitchell.

The other group is made up of those who choose to have an abortion because of diagnoses the fetus will be born with severe disabilities, or because their own health is in jeopardy.

“By the 15th week or so, many women are fully committed often to having that pregnancy,” said Dr. Paula Tavrow, a professor of community health sciences at the University of California, Los Angeles Fielding School of Public Health. “And then they may get dire news such as there are fetal abnormalities, or it might impair their health or well-being in some way to continue with the pregnancy.”

Myth: Abortions are more dangerous than childbirth

Two women died following complications from legal-induced abortions in the U.S. in 2018, the latest year for which data is available, according to the CDC’s Pregnancy Mortality Surveillance System.

Between 2013 and 2018, the CDC reported the national case-fatality rate was 0.41 abortion-related deaths per 100,000 legal abortions.

This represents a nearly 8-fold decrease from the case-fatality rate of 3.2 deaths per 100,000 legally induced abortions in 1972, the year before abortion was legalized nationwide, according to a CDC report at the time.

“​​So long as abortions are performed in a clean environment with properly trained people, they’re extremely safe,” said Tavrow.

By comparison, an analysis showed pregnancy and childbirth are far more dangerous in the U.S.

Over the same period, the mortality rate was 17.35 pregnancy-related deaths among mothers per 100,000 live births. Causes of death included cardiovascular conditions, sepsis, hemorrhaging and embolism.

“By the nature of getting pregnant, someone automatically puts themselves into a higher risk category,” said Dr. Deborah Bartz, an obstetrician-gynecologist at Brigham & Women’s Hospital in Boston. “It is absolutely false to claim it is equally safe or even more risky to have an abortion” than to continue with a pregnancy.

Experts said the risk with abortions occurs when they are performed unsafely, with the World Health Organization stating unsafe abortions are a “leading cause” of maternal deaths worldwide.

Myth: Abortions have only risen since Roe v. Wade was decided

Following the decision of Roe v. Wade, legal abortions in the U.S. did increase from a rate of 16.3 per 1,000 women, reaching its peak in the early 1980s before falling.

“Abortion temporality spiked because it was now safe, but the rate of abortion has really decreased,” said Tavrow.

As of 2017, the rate of legal abortions sits at 13.5 per 1,000 women, the lowest rate ever recorded, according to the Guttmacher Institute.

The experts said the rate has decreased due to several reasons, including greater access to contraceptives as well as more birth control methods with higher efficacy rates.

Additionally, the Guttmacher Institute noted, abortion rates have declined as births and pregnancies have fallen overall in the U.S.

Myth: Majority of Americans support the end of Roe v. Wade

Despite the Supreme Court being poised to overturn or severely gut Roe v. Wade, most Americans believe just the opposite should happen.

An ABC News/Washington Post poll conducted in advance of the leaked draft opinion found 58% of U.S. adults said abortion should be legal in either all or most cases.

By comparison, just 37% of adults said they believed abortion should be illegal in all or most cases.

What’s more, 70% of those polled said the decision on whether a woman can have an abortion should be left to the woman and her doctor while 24% said it should be regulated by law.

More than three-quarters of adults said abortion should be legal when the pregnancy is a result of rape or when a woman’s life is threatened by continuing the pregnancy.

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(NEW YORK) — Since the onset of the coronavirus pandemic over two years ago, people have reported lingering effects of COVID-19, including hair loss.

Dr. Jennifer Ashton, a board-certified OBGYN and ABC News’ chief medical correspondent, is among them, experiencing lingering hair loss after testing positive for COVID-19 in January.

“Now that it’s just over three months, roughly, later is really when I started to notice a major change,” Ashton said. “The two things that I noticed were loss of volume, really really like almost nothing for me to hold onto when I put my hair up in a ponytail, and then breakage.”

Ashton, who was vaccinated and boosted when she tested positive for COVID-19, has shared her hair loss journey on Instagram, where commenters thanked her for bringing awareness to the issue.

According to Ashton, it’s estimated that over 20% of people who have COVID-19 experience some form of hair loss.

Here are some questions answered about COVID-related hair loss, from why it happens to how it can be treated:

Why does COVID-19 hair loss happen?

It is not uncommon for people to experience noticeable hair loss a few months after recovering from a high fever or an illness, according to the American Academy of Dermatology (AAD).

While researchers are still looking into exactly how having COVID-19 can impact a person’s hair, the early research shows that the virus somehow infects and affects hair follicles, according to Ashton.

Hair follicles anchor hair into the skin, and each one goes through three phases: The anagen phase, when the hair grows; the catagen phase, when hair growth slows and the follicle shrinks; and the telogen, or shedding, phase, when old hair falls out and new hair begins to grow.

While most hair loss, or hair shedding, occurs in the telogen phase, COVID-19-related hair loss appears in the anagen phase, when the hair is beginning to grow, according to Ashton.

“This is relevant because it affects what the timeline is by which someone could start to notice hair loss following COVID-19,” Ashton said. “Hair loss after COVID can begin as early as 18 to 47 days after infection.”

With the more common type of hair shedding, telogen effluvium, most people start to see shedding two to three months after an illness, according to the AAD.

Is anyone more susceptible to COVID-19 hair loss?

The risk factors for COVID-19 hair loss are still unknown, and there is also no known way to specifically prevent this type of hair loss, according to Ashton.

“We don’t know yet who is more at risk,” she said. “It does appear that if you experienced more severe COVID-19, you are more likely to experience this, but you can experience this with mild COVID-19 illness as well.”

Does COVID-19 cause permanent hair loss?

Ashton said it remains to be seen whether hair loss due to COVID-19 is permanent.

She added that it looks “promising and encouraging” that most people will see hair regrowth and correction.

“We still don’t know what percentage breakdown will regain, or regrow, their hair, but the bottom line is it takes time,” Ashton said, noting that people should expect a timeline for regrowth of anywhere from three months to one year.

What are treatment options for COVID-19 hair loss?

While there are no known ways to prevent hair loss with COVID-19, there are many ways to treat it, according to Ashton.

She recommends first “resting your hair,” which means taking a break from stressors like heavy-handed brushing and pulling and not using tools like hair dryers and curling and straightening irons.

Ashton said that, for her, resting her hair also means wearing more hats and headscarves.

“I just think it’s super easy,” she said. “No one cares how dirty your hair is. No one cares what your hair looks like.”

Ashton also recommends limiting the use of hair products that contain alcohol as an ingredient because alcohol will dry out hair further. Instead, she recommends using a hair mask product, or going more natural by using coconut oil or olive oil to moisturize the hair.

Ashton has also been wearing hair extensions occasionally but stresses those can damage hair further.

“They can pull on your hair and actually forcibly detach your hair, so dermatologists are very kind of cautionary before they recommend that any woman use hair extensions,” she said. “I am experimenting with them, but we’ll see. I don’t foresee them as too heavy in my rotation.”

After her consulting with her dermatologist, Ashton said she began supplementing her diet with a protein powder to increase her daily protein intake, which will help lessen hair breakage.

While there are many supplements on the market promoting hair regrowth, Ashton said that, from a scientific standpoint, it’s unclear if those supplements get results any different than simply adding a daily prenatal vitamin or multivitamin to your diet.

And finally, Ashton stressed the importance of checking with a medical provider to rule out other medical causes of hair loss, like thyroid function.

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(WASHINGTON) — Amidst the nation’s latest resurgence in COVID-19 infections, new forecast models used by the CDC show that daily hospital admission levels and new virus-related deaths in the U.S. are projected to continue increasing over the next four weeks.

The forecast comes as a growing number of COVID-19 positive patients are entering hospitals and requiring care each day, according to data from the Centers for Disease Control and Prevention.

There are now more than 20,000 virus-positive Americans currently receiving care in the U.S., the data shows — the highest total number of patients hospitalized since mid-March. On average, more than 2,500 virus-positive Americans are entering the hospital each day — a total that has increased by 18.1% in the last week. This also marks the highest number of patients entering the hospital in nearly two months.

However, totals remain significantly lower than during other parts of the pandemic when there were more than 160,000 patients hospitalized with the virus in January.

The forecast also predicts that about 5,400 deaths will occur over the next two weeks. California, New York and Florida are projected to see the largest death tolls in the weeks to come.

A new ABC News analysis this week showed a growing proportion of COVID-19 deaths are occurring among the vaccinated. In August 2021, about 18.9% of COVID-19 deaths were occurring among the vaccinated. Six months later, in February 2022, that percent of deaths had increased to more than 40%.

Comparatively, in September 2021, just 1.1% of COVID-19 deaths were occurring among Americans who had been fully vaccinated and boosted with their first dose. By February 2022, that percent of deaths had increased to about 25%.

Health experts said vaccines and boosters continue to provide significant protection against severe disease. However, waning immunity re-emphasizes the urgency of boosting older Americans and high-risk Americans with additional doses.

During an interview with CBS News on Tuesday, Dr. Anthony Fauci acknowledged there has been an increase in the number of vaccinated people who are dying of COVID-19, many of whom are elderly, immunocompromised or have underlying conditions.

“As long as you have vulnerable people in the population, even though the unvaccinated are going to be much more at risk, even vaccinated with underlying conditions and a high degree of susceptibility to severe disease will account for those deaths,” he said.

The other group of Americans, who are becoming severely ill and dying, is still the unvaccinated, Fauci said. He stressed that a large proportion — about a third of Americans — have not been fully vaccinated, while about half of eligible Americans are still unboosted with their first dose.

Fauci said that in order for the U.S. to move into an endemic phase, the prevalence of the virus across the country has to come down.

“What we’re hoping for is that when the level comes down, it stays in a well-controlled level, and those people who’ve been vaccinated and boosted even though they might get infected, they won’t get a severe disease that would lead to hospitalization, and tragically in many cases, to deaths of individuals,” Fauci explained.

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(WASHINGTON) — A major producer of the abortion pill in the U.S. says it has ample supply if demand suddenly soars in the wake of a Supreme Court decision and that it’s working with federal regulators to make the drug available in pharmacies by the end of the year.

“We are prepared for any surge,” said the spokesperson for Danco Laboratories, which manufactures the brand-name drug Mifeprex.”Our supply is stable and plentiful.”

Mifeprex, along with its generic version, is quickly taking center stage in the abortion debate, as several states move to outlaw its use while others try to expand access.

Here’s what to know about the abortion bill:

What is Mifeprex?

A single 200-mg tablet, Mifeprex is the brand name for the drug mifepristone that is used to end a pregnancy up to 10 weeks. Packed in a blister foil pack inside an orange box, the single tablet induces an abortion by blocking the hormone progesterone.

The pill is typically taken with misoprostol, which causes cramping and bleeding to empty the uterus.

Medical experts say a doctor would not necessarily be able to tell if the woman took the drug or if she miscarried unless she told them.

Mifeprex has been on the market for 22 years, and the FDA regards it as a safe drug for most women. While the number of abortions has declined in recent decades, use of the drug has steadily increased. Now, about half of abortions in the U.S. are medication abortions, rather than a surgical abortion.

While opponents refer to mifepristone as a “chemical abortion,” doctors and drugmakers say that is not a term they use.

How do women get it?

To obtain the drug legally, a woman has to get a prescription from a certified provider.

It’s currently not available through U.S. pharmacies, although Danco Laboratories says it’s working with the Food and Drug Administration so that pharmacies would be allowed to carry the drug by year’s end.

The FDA allows the drug to be prescribed through a telehealth appointment and mailed to her home. However, at least 19 states have enacted laws requiring that the clinician be present physically when administering the drug.

The average cost for women is about $400-$500, a price that includes the consultation with a doctor and follow-up care. But the pill itself only costs about $50. It has a five-year shelf life before it expires.

Who makes it?

For nearly two decades, Danco Laboratories (pronounced DANK-oh) operated as the nation’s sole legal provider of abortion pills in the US, distributing its Mifeprex to all 50 states and territories.

In 2019, a generic version of the drug manufactured by a company called GenBioPro was approved by the FDA.

A third company, Corcept Therapeutics, uses mifepristone to produce an FDA-approved drug for patients with Cushing’s Syndrome. But that drug, called Korlym, which uses a much higher dose of the drug, is not prescribed for abortions.

Both Danco and GenBioPro withhold general information about their companies from the public, including the names of officials, where its facilities are located or production estimates. A spokesperson for GenBioPro could not be reached, while Danco said they do so for security reasons and to protect the privacy of their team members, as well as to safeguard proprietary information.

The FDA said it does not divulge this information either, citing laws aimed at protecting trade secrets and a concern for potential attacks on employees.

“The FDA concluded that there is a risk that individuals associated with the development, marketing and distribution of mifepristone for medical termination of early pregnancy may become the targets of threats of harm or violence,” the agency told ABC News in a statement. “Therefore, the agency does not disclose the names or locations of such individuals.”

Danco will only disclose that the company’s headquarters is located in New York City, while the drug itself is produced out of facilities in Europe that are inspected by U.S. federal officials.

The spokesperson described the company as modestly profitable and said it no longer needs to rely on private investors as it had early on in its tenure.

What happens if Roe v. Wade is overturned?

The Guttmacher Institute, which supports abortion rights, predicts that there are 26 states certain or likely to quickly ban abortion — including medication abortion — “to the fullest extent allowed” by the Supreme Court.

Abortion foes say their goal will be to ensure the drug doesn’t cross state lines.

Still, it’s not entirely clear how easy it will be for states to block a drug that can be obtained through a telehealth appointment and discretely mailed to someone’s home, including from online-based international organizations.

European-based Aid Access, for example, says it relies on a pharmacy in India to mail mifepristone to women in the US without approval by the FDA, despite warnings by the FDA that unregulated drugs can put women’s health at risk.

The result is an untested, complicated legal landscape.

“If there’s a telehealth abortion, that doctor could be in California. That doctor could be in the Netherlands. And in both of those cases, you’re going to have a very hard time getting that doctor into your courtroom,” said Mary Ziegler, a professor at Florida State University College of Law who specializes in the legal history of reproduction and abortion.

ABC News’ Devin Dwyer contributed to this report.

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(ATLANTA) — Parents are being asked to look out for symptoms of hepatitis in their kids as an unexplained outbreak of cases in children continues across the United States.

The Centers for Disease Control and Prevention (CDC) issued a health alert Tuesday aimed at educating parents on symptoms.

“Hearing about severe liver disease in children can be concerning. If you have any questions about your child’s health, call your child’s healthcare provider,” the CDC wrote, adding that parents should be aware of the symptoms associated with liver inflammation, including fever, fatigue, nausea, and jaundice, which is yellowing of the skin.

Hepatitis means inflammation of the liver. It can be caused by heavy alcohol use, toxins, some medications and medical conditions and is often caused by a virus, according to the CDC.

Here are five things to know about the CDC’s alert on hepatitis and kids and the outbreak.

1. The latest hepatitis outbreak in kids is global.

In April, researchers in the United States and Europe announced they were investigating small clusters of the cases emerging across the globe.

As of this week, the World Health Organization (WHO) says more than 340 probable cases of hepatitis in children have been reported in 20 countries.

In the U.S., there are at least 109 confirmed cases with five deaths in over 25 states and Puerto Rico, according to the CDC.

2. The cause of the outbreak remains unknown.

The cause of the reported cases of hepatitis in children in the U.S. remains unknown, according to the CDC.

“We do not know and are investigating what role other factors play in this illness, such exposure to toxins or other infections that the children might have,” the agency wrote in its latest health alert, also adding it is “not unusual” for the cause of hepatitis cases in children to remain unknown.

Some of the children who have had hepatitis also had adenovirus type 41, a type of virus that can cause severe stomach illness in kids, according to the CDC.

Adenoviruses are different types of viruses that can cause illnesses ranging from the common cold to acute bronchitis, pneumonia, pink eye and acute gastroenteritis, or inflammation of the stomach, according to the CDC.

3. The hepatitis vaccine is not protectant against this latest outbreak.

Hepatitis viruses are the most common cause of hepatitis in the world, including hepatitis A, B, and C, but they’ve been ruled out in the latest outbreak.

The strain of hepatitis seen in this vaccine is not one covered by the hepatitis vaccine that kids receive, according to Dr. Jennifer Ashton, ABC News chief medical correspondent.

“These cases of hepatitis are none of those [covered by the vaccine], so it’s really mystifying public health officials at this point,” Ashton said Wednesday on Good Morning America.

4. The hepatitis outbreak does not appear to be COVID-19-related.

Health officials do not believe the current outbreak in pediatric cases is linked to the novel coronavirus or the COVID-19 vaccine, according to Ashton.

“I just spoke to the CDC director, Dr. Rochelle Walensky, this morning,” Ashton said. “She wanted me to emphasize that the majority of these cases have been in children ages 2 to 5. These children, as we all know, are not eligible for the COVID vaccine, so this has nothing to do with the vaccine.”

5. Parents should call their pediatrician if symptoms appear.

The CDC has advised parents to be on the lookout for symptoms in their kids including fever and fatigue, nausea and vomiting, abdominal pain, joint pain, jaundice — a yellowing of the white part of the eyes or the skin — or a change in the color of urine or stool.

If any of those symptoms are present, parents should call their child’s pediatrician as quickly as possible, according to the CDC.

The agency also urges parents to make sure their child is up to date on all vaccinations and follow safety protocols, like washing hands often, avoiding people who are sick, covering their coughs and sneezes and avoiding touching the eyes, nose or mouth.

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(NEW YORK) — On wheels across the Mississippi Delta region, a group of three women is pulling up their sleeves and reaching underserved communities with free reproductive and sexual health care services.

Dr. Caroline Weinberg founded Plan A, a mobile health clinic, to offer free sexual and reproductive services, including mammograms, pap smears, contraception and STD testing, to patients regardless of insurance status, income or location. The first clinic opened in April 2021, providing health care services on wheels to the Mississippi Delta region.

“Something we have to accept [is] that we can’t solve every problem; like we can’t buy a mammogram machine, we can’t have a colonoscopy on-site, we can’t do surgery,” Weinberg said. “But we can add what we can, and if we’re able to get the resources to pull it off, then we just kind of expand whatever ways we can.”

The staff behind the clinic hopes to provide health care services to underserved communities across the area. By providing services around reproductive and sexual health care, Juliet Thomas, Plan A’s community health worker, hopes to destigmatize the conversation around those topics.

“It is [considered a taboo] when you talk about sex, birth control or anything like that’s really not talked about,” Thomas said.

Weinberg said she built the clinic on the belief that Roe v. Wade would one day be overturned. While the clinic does not offer abortions, Weinberg said they play a role by offering preventive measures to avoid pregnancies.

“I built the organization on the assumption that [Roe v. Wade] was kind of destined to be overturned,” she said. “Roe v. Wade being overturned in really any capacity doesn’t directly impact our day today, but it has an incredible impact on the community that we serve.

“As we seek to empower women and give them the options to kind of move forward with their reproductive health in whatever direction it is, that’s more challenging because their options are limited within the state.”

To fit the needs of the community, Plan A has expanded its operations to add primary care services like blood pressure screenings as well as COVID-19 vaccines. A 60-minute drive from where the mobile clinic is parked, Plan A has a brick-and-mortar clinic in Louise, Mississippi, to offer additional services to a broader community.

Mississippi is one of 12 states to not expand Medicaid since the passage of the Affordable Care Act in 2010 — a critical source of revenue for hospitals and a safety net for poor Americans. The federal government covers 90% of the costs for Medicaid, leaving 10% to be covered by the state.

Although at least eight expansion bills were proposed in the 2022 legislative session, not one was debated.

For Brock Slabach, chief operations officer of the National Rural Health Association, the issue with expanding Medicaid is around the arguments of federal involvement in state policy.

“The reason that they’ve given for their lack of participation in the costs that the federal government giveth and the federal government taketh away,” Slabach said. “At some point, if the federal government decided not to fund 90% of the cost of the expansion, then they would be stuck holding the bag in terms of the dollars it would cost to cover that expanded population.”

If expanded, the American Rescue Plan would provide an additional $600 million per year to the state and qualify more than 225,000 Mississippians.

The roadblocks, however, lie within its own government — with Gov. Tate Reeves and Speaker of the House Philip Gunn being two of Medicaid’s fiercest critics.

“I just don’t think Medicaid expansion is realistic, personally, I’m not for it,” Reeves said during a January interview with WAPT. “I don’t see that as a way forward in Mississippi. We need to be looking at ways to get people off Medicaid, not put them on Medicaid.”

But their stand on the issue is not what the majority population thinks. According to a Millsaps College and Chism Strategies poll, some 60% of voters believe that Medicaid should be expanded.

Patients like Lisa McCarty, who was formerly uninsured, sought the services of Plan A to access contraceptives.

The care and staff made McCarty a loyal patient. Without Plan A, McCarty told ABC News, she would be struggling with paying the doctor’s bill — or even have another child.

“Everyone knows each other and we’re so small here that it’s uncomfortable because you feel like, ‘OK, well, hey, this person may know what’s going on with me and I’m, you know, I don’t feel comfortable,’” McCarty said.

Now with insurance, McCarty said she will continue visiting Plan A, in part because of the wide variety of services outside reproductive health that are offered by the clinic.

As the clinic continues to expand, Desiree Norwood, Plan A program coordinator, hopes to reach more underserved communities across the state.

“I’m very excited because I know that there’s so much more great work that Plan A is going to do for the area, and I feel hopeful. Often the Mississippi Delta is looked at as one of the unhealthiest places, but we’re determined to change the narrative “

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(NEW YORK) — As the nation looks ahead to a possible post-Roe v. Wade world in which abortion is banned in multiple states, medical experts warn there could be wide-ranging health and financial complications for women.

As soon as next month, the Supreme Court’s conservative majority of justices is poised to overturn abortion rights established by Roe v. Wade, according to a draft opinion leaked to Politico.

If Roe is overturned, nearly half of the nation’s 50 states are prepared to ban or heavily restrict abortion, according to the Guttmacher Institute, a reproductive rights organization.

One of the most immediate impacts on women’s health would be maternal health, given that the United States already has one of the highest maternal mortality rates in the world, according to Dr. Ana Langer, director of the Women and Health Initiative and a professor of public health at the Harvard T.H. Chan School of Public Health.

According to Langer, for some women, “simply continuing a pregnancy is more risky than having a safe abortion.”

According to the Centers for Disease Control and Prevention (CDC), around 700 women die each year due to pregnancy or delivery complications within the first year after giving birth in the U.S., which continues to have the highest maternal mortality rate among developed nations.

Black women in the U.S. die of maternal causes at nearly three times the rate of white women, according to the CDC.

The disproportionate rate at which women of color are impacted by pregnancy complications is one reason abortion rights advocates say abortion bans disproportionately impact that population, many of whom are already impacted more greatly by poverty, lack of health care access and racism in the health care system.

“The same folks that are impacted by inequities in maternal health outcomes — Black women, indigenous folks, LGBTQ communities, young people, those living on low incomes — are the same ones that are going to be deeply impacted and more brutally enacted by restricting access to abortion care,” said Dr. Jamila Perritt, a board-certified OBGYN in Washington, D.C., and president and CEO of Physicians for Reproductive Health. “It’s a double hit.”

In 2018, the most recent data available, two people in the U.S. died due to abortion-related deaths, and both deaths were related to legal abortion, according to the CDC.

The American College of Obstetricians and Gynecologists (ACOG) calls abortion “an essential component of women’s health care.”

In instances of pregnancy complications like preeclampsia, placental abruption, placenta previa and cardiac conditions, abortion can often be the only measure to save the mother’s health, according to ACOG.

“There can be things that develop during a pregnancy that can be dangerous, and it can be dangerous for them to continue those pregnancies,” said Dr. Krishna Upadhya, vice president of quality care and health equity at Planned Parenthood. “Not having access to abortion means they will have to continue those pregnancies, no matter the consequences.”

Abortion is a common medical procedure that can be similar to the care a woman gets when she has had a miscarriage, according to Upadhya. She said limiting or banning access to abortion care could also complicate miscarriage care in legal and medical ways.

“When we ban abortion, that also means we prevent or we reduce the opportunities for doctors to know how to provide this care, and then that puts at risk people who need related care,” said Upadhya, adding, “I’m also concerned that people who experience a miscarriage or other pregnancy complication could be questioned about their pregnancy outcome with potential legal implications and that’s a whole other unnecessary problem that people could face as a result of overturning Roe.”

Medical experts including Upadhya and Langer say they also worry what the overturning of federal abortion rights by the Supreme Court could do for other aspects of women’s reproductive and overall health.

For many women, access to abortion care also means access to overall health care like well-woman exams, prenatal care, contraceptive care, treatment for sexually transmitted infections, HIV testing, Pap smears and screenings for breast and cervical cancers. At Planned Parenthood, for example, abortion care accounts for just 3% of the services they provide, according to the organization’s 2019 annual report.

“Planned Parenthood’s motto is care no matter what, so we provide a full range of sexual and reproductive health care,” said Upadhya. “We are doing everything we can to provide all of that care because we know people need that care.”

Another point of concern for women’s health advocates is what the fall of Roe v. Wade could mean for the future of birth control access.

Based on the leaked draft opinion, authored by Justice Samuel Alito, it’s not a far leap to imagine the Supreme Court taking on contraception, according to Kate Shaw, an ABC News contributor and constitutional law professor at Cardozo School of Law.

“A lot of the logic in this opinion suggests that other Supreme Court rulings are quite vulnerable to being revisited and possibly overturned by this Supreme Court that seems really emboldened to torch longstanding precedents because there are the votes to do it,” said Shaw, citing one of the cases as Griswold v. Connecticut, the Supreme Court ruling that invalidated a Connecticut law that made it illegal to use birth control devices or to advise about their use.

Experts say in addition to the immediate health complications for women, restricting access to abortion care has also been shown to have socioeconomic impacts on women, which can trickle down to, again, impact their health.

One frequently-cited study, The Turnaway Study, followed nearly 1,000 women who sought abortions in 21 states. The five-year study concluded that, “receiving an abortion does not harm the health and wellbeing of women, but in fact, being denied an abortion results in worse financial, health and family outcomes.”

Specifically, the study — led by researchers at Advancing New Standards in Reproductive Health (ANSIRH), based at the University of California San Francisco — found that women who were denied abortions were at nearly four times greater odds of a household income below the federal poverty line; had three times greater odds of being unemployed; had an increased likelihood of not being able to cover basic necessities like food and housing; and were more likely to stay with violent partners, putting themselves and their children at risk, according to the study brief.

The study also found women who were denied abortions were more likely to face greater mental health struggles and were less likely to complete advanced degrees.

“When we put restrictive laws in place like this, that ignore a person as a whole and ignore all of the complex decisions that go into deciding to become pregnant and parent,” said Dr. Jennifer Conti, a California-based OBGYN and abortion care provider. “We create dangerous situations where they have to choose between continuing a pregnancy and sometimes worsening their own medical conditions or worsening their own financial, economic decisions.”

In remarks Wednesday at a U.S. Senate hearing, Treasury Secretary Janet Yellen described how access to abortion can change the course of not only a woman’s life, but society’s circumstances, too.

“Roe v. Wade and access to reproductive health care, including abortion, helped lead to increased labor force participation,” she said. “It enabled many women to finish school. That increased their earning potential. It allowed women to plan and balance their families and careers, and research also shows that it had a favorable impact on the well being and earnings of children.”

If Roe v. Wade is overturned and, as a result, as many as two dozen states potentially ban or restrict abortion access, experts like Perritt, of Physicians for Reproductive Health, predict both the socioeconomic and health divides in this country will become even greater.

Already, in states like Texas, where abortion is heavily restricted, there are high rates of maternal and infant mortality and poverty, data shows.

And Texas’ ban on most abortion after six weeks of pregnancy, instituted last year, has not slowed the rate of abortions but rather has required people seeking abortion care to travel out of state, according to research from the University of Texas at Austin.

“We know what happens when you eliminate access to abortion at the state level. It means that people who have resources, people who have the ability, will travel to get care if they can, but most people cannot and will not,” said Perritt. “What we’ll be faced with is folks that are seeking care outside the formal medical system, and also folks who will be forced to carry pregnancies to term that they cannot and do not want to carry.”

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