Health

(WASHINGTON) — The Biden administration’s stark warning last week that as many as 100 million Americans could be infected during a COVID-19 wave in the fall and winter came as a shock to many in the country.

After all, 70.5% of the eligible U.S. population aged 5 and older are fully vaccinated and 47.8% of those aged 12 and older are boosted, according to the Centers for Disease Control and Prevention.

What’s more, a recent CDC analysis estimated at least three out of every five Americans have antibodies that indicate being previously infected with COVID-19, meaning most people in the U.S. have natural immunity.

So with such high levels of protection, why would up to 30% of the population be infected during a potential new wave?

Scientists and public health experts said the 100 million estimate — based on mathematical models — does not surprise them and that as immunity wanes and people move indoors due to cold weather, cases will inevitably rise.

“Certainly we’re capable of sustaining 100 million infections this winter,” Dr. Shira Doron, an infectious disease physician and hospital epidemiologist at Tufts Medical Center in Boston, told ABC News. “The model doesn’t mean that there will be 100 million cases, but there is the potential for a lot of infections. It doesn’t mean everyone should panic.”

Doron explained that even with the high rates of vaccination in the U.S., immunity diminishes over time and COVID-19’s ability to mutate has helped it evade — at least partially — the protection offered by vaccines.

“Being vaccinated does protect you from serious illness, but it does not [fully] protect you from infection,” she said.

She said when the vaccines first rolled out in the winter of 2020-21, they were based on the original strain of the virus. Because of this, they were protective against infection, severe disease and death.

However, as the virus mutated, those vaccines became less effective at preventing infection while still being highly effective at protecting against the most serious effects of the disease.

“These vaccines are great, but they’re not perfect,” Dr. William Schaffner, a professor of preventive medicine and infectious diseases at Vanderbilt University in Nashville, Tennessee, told ABC News. “They can’t prevent widespread, mild infections. We haven’t got a vaccine that could turn off COVID like a light switch.”

This means it’s possible for Americans who are fully vaccinated and boosted to test positive for COVID-19, but it’s unlikely this group will get severely ill or die.

Another reason the U.S. could see such a high number of infections is because as temperatures drop, people will move indoors, which increases the risk of transmission.

“The weather will get colder, and we’ll start to go indoors again, and we had increased transmission during the last winter season and we may have increases again on the basis of seasonality,” Schaffner said.

The prediction comes as the Biden administration asks Congress for $22.5 billion in funding for testing, vaccines and treatments.

If the funding is secured, a senior administration official told reporters Friday that the country will be better prepared to blunt the effects of the surge and keep hospitalization and death rates low.

If Congress rejects the funding, “the consequences of those 100 million being infected will be higher,” Doron said.

Cuts to funding will decrease testing, leading to COVID-19 infections being spread undetected, and fewer treatments for those at high risk of severe disease, which could lead to hospitalization, she said.

Dr. Peter Chin-Hong, an infectious diseases specialist at the University of California, San Francisco, added this will also limit the number of people who access vaccines, treatments or tests.

“Some vulnerable folks who probably need additional doses will not get it if they have to pay out of pocket for a vaccine or not have it covered,” he told ABC News. “When people are not sure if they will be saddled with a bill, they’ll stay away from accessing care.”

The experts said the best way people can protect themselves ahead of a surge is to make sure they are up to date on their booster shots, whether they are eligible for one or two doses and to follow the advice of public health experts.

“There may be a call to get another dose of vaccine or in specific locations, people may have to wear masks again,” Schaffner said. “Please be open to this. … Be prepared, keep listening and reading updates on the virus in your area.”

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(NEW YORK) — The bombshell leak of a draft Supreme Court decision that could overturn Roe v. Wade was disheartening but not surprising to many abortion providers, who have been preparing for the possible end of legal abortion for years.

Whole Woman’s Health operates abortion clinics in Virginia, Maryland, Minnesota, Indiana and Texas. For Marva Sadler, the senior director of clinical services for the abortion provider, recent restrictions on abortion access in Texas offer a hint of what’s to come if Roe is overturned this year.

After Texas’ near-total ban on abortions, SB8, went into effect last year, the number of patients seeking abortions at Whole Woman’s Health’s Texas clinics declined by upward of 50%, Sadler said. Meanwhile, Texas patients have traveled as far as Virginia to obtain an abortion due to waits at closer clinics. Whole Woman’s Health’s Minnesota clinic has seen a 30% increase in the number of patients from Texas since SB8 went into effect, Sadler said.

“Unfortunately, Texas has given us great insight in exactly what we’ll see happening on a much bigger, larger scale,” Sadler told ABC News.

Preparing for an influx

The leak of the Supreme Court draft opinion is not a final decision in the case of Dobbs v. Jackson Women’s Health Organization, which involves a ban on abortions in Mississippi after 15 weeks of pregnancy — before the fetal viability line established by Roe.

The Mississippi law remains under review by the Supreme Court, but 26 states are certain or likely to prohibit abortions if Roe is overturned, according to the Guttmacher Institute, a reproductive health policy research organization.

That includes every state that borders Illinois. Planned Parenthood of Illinois expects between 20,000 to 30,000 more patients would travel to the state each year for abortion care if Roe falls.

“We really do anticipate that that’s going to happen,” Jennifer Welch, president and CEO of Planned Parenthood of Illinois, told ABC News. “And what we have been doing is preparing for a number of years for this eventuality.”

Preparations include expanding the sizes of its health centers, opening two new clinics on the Indiana and Wisconsin borders, launching telehealth services for medical abortions and working with partners like abortion funds and other affiliates “to make sure that there’s a navigation program in place so patients can get the care they need here in Illinois,” Welch said.

Whole Woman’s Health has been assessing the needs at its clinics for years, as abortion access has changed in the states it covers and their neighbors. The organization has already started the process of readjusting its staffing needs should Roe be overturned “to make sure that we are well aware of how far we can expand … and what we need to obtain to move forward,” Sadler said.

Responding to evolving needs

In the wake of SB8, which bans abortions after about six weeks of pregnancy, Whole Woman’s Health has helped women get abortion care out of state if they are unable to in Texas. It launched its Abortion Wayfinder Program, which refers patients to a Whole Woman’s Health clinic in a haven state like Maryland, Minnesota or Virginia, as well as connects them to other ally organizations and funding support. So far, the program has helped over 85 women access or obtain abortion care outside of Texas, Sadler said.

“That program has grown so fast that we’ve not been able to keep up,” she said.

If Roe is overturned, Sadler anticipates its clinics will reassess the needs of the communities they serve in order to continue to provide reproductive health care, such as by continuing to help patients access abortion care outside of Texas.

“Texas will absolutely be one of the states where abortion will become illegal very shortly after and if Roe falls, and so we do have to be prepared and are prepared for what does that post-Roe atmosphere look like for our Texas clinics,” Sadler said. “We’re going to do whatever we possibly could do to see as many patients as we possibly can — where we can, while we can. And in the event that we cannot, then we’ll reassess what those patients in those communities need and how we can be of assistance to them.”

Expanding in safe havens

Some abortion clinics are anticipating opening new facilities in states that are less likely to enact sweeping bans should Roe be overturned.

Shannon Brewer, the director of Mississippi’s only abortion clinic, Jackson Women’s Health, told ABC News’ podcast “Start Here” last week that she’s seeking to open a new location in New Mexico.

“This is not something that is going to just affect Mississippi within the year. This is going to affect upwards of 25 to 26 states, which is half of the United States,” said Brewer.

Sadler said that opening more clinics is “absolutely part of the conversation” at Whole Woman’s Health.

“If women are going to have to make a mass exodus outside of the state to go to where they need to go, we definitely need to pay attention and are paying attention to where those safe havens are, what the current situation can hold and who can hold the influx and where the need may arise in the near future,” Sadler said.

Welch said Planned Parenthood of Illinois is considering opening a new location in southern Illinois.

“We need to know that we have a location that is safe and appropriate for our patients and our staff,” she said. “That would be a while down the road, so we’re so focused on the other ways that we can welcome 20[,000] to 30,000 additional patients into Illinois per year when the Supreme Court overrules Roe.”

‘We’re not leaving these communities’

Trust Women operates abortion clinics in Oklahoma City and Wichita, Kansas. Both have seen an influx of patients since SB8 went into effect; patient volume at the Oklahoma City clinic has doubled since September, with a majority of patients now coming from Texas, according to communications director Zack Gingrich-Gaylord.

The Texas ban has increased waits for care at both clinics. With the Oklahoma governor signing a six-week abortion ban similar to the one in Texas last week, the abortion provider expects delays at its Kansas clinic to get even worse.

Trust Women has been working to increase capacity at its Kansas facility by bringing on additional doctors and increasing the number of clinic days. It also is looking to bring over its Oklahoma staff in the wake of the state’s new restrictions.

If Roe falls, Oklahoma’s trigger law would ban abortion in the state, placing further demand on independent abortion clinics in Kansas, Gingrich-Gaylord told ABC News.

“As more states fall off and access becomes even more limited, then people will not be able to see doctors in clinics,” he said. “There are much better medicines and ways to self-manage abortion now and it’s very safe to do so. But even that still will be out of reach for some people.”

As abortion clinics await the Supreme Court’s decision, Trust Women is working to protect abortion rights in Kansas ahead of an upcoming ballot measure in the August primary that could overturn the constitutional protection for abortion access in the state.

“If Roe falls, Kansas will be the closest legal abortion provider for 7.7 million people across the region,” Gingrich-Gaylord said. “So Kansas’ constitutional protection for abortion matters.”

Though there are challenges to abortion access in Oklahoma and Kansas, Gingrich-Gaylord said Trust Women doesn’t have any plans to leave the states and open clinics elsewhere.

“Our plans are to remain in our communities,” he said. “We may adjust how we do some things, but we’re not leaving these communities and our clinics will stay open and provide some service going forward. We’re not going anywhere.”

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(NEW YORK) — At least 109 children have been sickened — including five who have died — from mysterious cases of hepatitis with an unknown cause, officials from the Centers for Disease Control and Prevention said Friday.

Reports of the cases, which have been identified in 25 states and territories over the past seven months, come days after officials from the World Health Organization said that they were investigating similar cases around the globe.

Overall, more than 90% of these patients under investigation in the U.S. were hospitalized, 14% received liver transplants and more than half had a confirmed infection from adenovirus, common viruses that can cause a variety of illness. The majority of these children have fully recovered, officials said.

Officials acknowledged that the increase in cases may be alarming, but overall, the rate of severe pediatric hepatitis cases is still quite rare.

“We know this update may be of concern especially to parents and guardians of young children,” said Dr. Jay Butler, deputy director for infectious diseases for the CDC, told reporters during a phone briefing on Friday. “It’s important to remember that severe hepatitis in children is rare, even with the potential increase in cases that we’re reporting today,”

Officials stressed that this is an evolving situation, and investigators are “casting a wide net” to help determine the cause of these outbreaks.

“Although rare, children can have serious hepatitis, and it’s not uncommon for the cause to be unknown. The 109 patients under investigation were identified as having been all within the past seven months. Not all the cases are recent, and some may of them may ultimately wind up not being linked to the current investigation,” Butler said.

Officials reported that they are working closely with public health experts around the world to understand the global outbreak of cases. Globally, around 278 cases have been identified, according to World Health Organization officials, with many of the sick children under the age of 10.

Thus far, none of the common hepatitis viruses (A, B, C, delta and E) can be traced to the cases and officials do not believe there is any connection to the COVID-19 vaccination, as many children had either not been vaccinated or were not yet eligible to be vaccinated.

Officials repeatedly stressed it is still unknown what is behind this concerning outbreak.

It’s not clear what role other factors may play, such as environmental exposure — including animals, medications, or other infections that the children might have, Butler said.

“Investigators both here and abroad and around the globe are working hard to determine the cause,” Butler said.

A potential connection to adenovirus remains “top of the list” for viruses of interest, and one of the leading hypotheses by investigators for what could be causing the outbreak.

Although there has been no known connection to COVID-19, specifically among the nine cases of severe hepatitis among children in Alabama, Butler said overall, a potential link to COVID-19 is still under investigation.

Health experts recommend that parents be aware of any concerning symptoms that could be linked to hepatitis, including vomiting, dark urine, light colored stools, and yellowing of the skin. Officials encouraged parents to contact their child’s health care provider with any concerns, should any concerning symptoms emerge.

Parents should also take every-day preventative actions to protect against infections, including regular handwashing, avoiding people who are sick, covering coughs and sneezes, and avoiding the touching of the eyes, nose or mouth.

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(NEW YORK) — Former NASCAR driver Danica Patrick revealed she had her breast implants removed after suffering medical complications she believes were caused by the implants.

Patrick, who turned 40 in March, shared in an Instagram post that she had her implants removed this month, nearly eight years after undergoing breast augmentation surgery.

“I thought to myself, I want to share this if it makes a difference,” Patrick told ABC News’ Kayna Whitworth in an interview that aired Friday on Good Morning America. “Because I’ve tried so many different things to feel better to look better, all the things, and nothing worked.”

Patrick said she got her silicone implants in 2014, when she was 32-years-old.

“I did it because I wanted to be more perfect,” she said. “I wanted the whole package … I felt like I was very fit and I thought, well, but I just don’t have boobs.”

Four years later, in 2018, Patrick said she started experiencing health concerns, and spent the next four years seeking answers for symptoms including weight gain, inflammation, leaky gut, menstrual changes, heavy metal toxicity and thinning hair.

Patrick said she went to multiple doctors, took thyroid medications, tried a 90-day protocol to heal her gut and at one point was taking “up to 30 pills a day” to improve her health, all to no avail.

Ultimately, Patrick said she came to the conclusion that she had breast implant illness, a term coined by clinicians and patients to describe symptoms reported by women after breast reconstruction or augmentation using implants, according to the Food and Drug Administration.

Dr. Shaun Parson, the Arizona-based plastic surgeon who performed Patrick’s removal surgery, said breast implants can sometimes prompt a “chronic inflammatory response” in the body.

“It’s usually that their bodies have this kind of chronic inflammatory response to this thing, this implant, so your body’s fighting something just like if it had an infection,” said Parson, a board-certified plastic surgeon. “I have seen too many times people get better after you remove their implants, and I think we have work to do to try to figure out why.”

One week after having her implants removed, Patrick said she feels “amazing.”

She said she plans to continue to share her journey with the hope of helping other people.

“My journey is not even over. This is week one,” said Patrick. “There’s going to be tons of testing that still happens. There are going to be physical changes on the inside and outside that I’m happy to share.”

What to know about breast implant illness

Breast implant illness is not yet a recognized medical term but is described by experts as a “diagnosis by exclusion,” according to Diana Zuckerman, Ph.D., president of the National Center for Health Research, who has studied the health impact of breast implants for over 30 years.

“Diagnosis by exclusion means that there is no test for it, but there are tests for other things that have the same symptoms or similar symptoms,” Zuckerman said. “And if there is no other reason for this array of symptoms, then there are doctors who will call it breast implant illness.”

There are as many as 40 symptoms of breast implant illness, but the most common symptoms include joint and muscle pain, fatigue, memory problems or brain fog, hair loss and difficulty breathing, according to Zuckerman.

She said Patrick’s story of taking years to get to a diagnosis is not uncommon for women who suffer health complications due to breast implants.

It can take years for breast implants to start causing complications, which makes it more difficult to link complications back to breast implants, according to Zuckerman, who was not involved in Patrick’s care. She also noted that many of the symptoms of breast implant illness can, and are, attributed to other things.

“When [women] go to the doctor and say, ‘I have joint pain. I’m really tired,’ the doctor will say things like, ‘No wonder you’re tired, you have a young child,’ or, ‘No wonder you’re tired, you’re 45 years old. You’re not 25 years old anymore,” said Zuckerman.

“So there’s been this, some might call it gaslighting, but this sense that these are common symptoms and they could be anything,” she said. “But, what is distinct about them is there are so many women who are experiencing them, and there are very good studies showing when women have these symptoms and they have their breast implants taken out, almost all of them get better.”

Breast implant surgery is considered an elective procedure that is done not only for cosmetic reasons but also for women undergoing breast reconstruction after a medical procedure such as a mastectomy.

Saline-filled and silicone gel-filled are the two types of breast implants approved for use in the United States, according to the FDA.

Breast implants may cause damage if they leak in the body, or because they can cause scar tissue to build in the body, according to Zuckerman.

“When women have a breast implant, their body almost always forms a scar tissue capsule around the implant,” she said. “The body is basically protecting itself by surrounding this foreign body, this breast implant, with scar tissue, and that scar tissue can get very thick and can get very hard and be a bad symptom in that it can be painful.”

Zuckerman said that the popularization of social media has helped women with similar symptoms connect and share their experiences, leading to greater awareness and more diagnoses of breast implant illness.

Patrick wrote on Instagram that she watched “over 100 stories on YouTube” of women with breast implant complications.

“Social media has really made the big difference here,” Zuckerman said. “It wasn’t until Facebook and other social media options became available that women could really share their stories.”

“We’ve certainly known women who’ve spent tens of thousands of dollars on tests and specialists, and nothing helped and then they went online and found a Facebook page or some other social media, and they started reading these stories of other women that sounded just like them,” she said.

In October, the FDA released new guidelines on breast implants, adding a black box warning and a checklist for doctors and patients about potential side effects.

“The patient must be given the opportunity to initial and sign the patient decision checklist and it must be signed by the physician implanting the device,” the FDA noted in its guidelines.

Zuckerman, a member of the working group that advised the FDA on implant safety, said she advises women who are thinking of getting implants to make sure they also have the resources to get them removed later on if needed.

“Don’t get them unless you can afford to have them taken out,” she said. “A lot of women spend all this money getting them put in, and then when they get sick, they don’t have the money to get them taken out. It costs just as much, sometimes more, to have them taken out.”

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(WASHINGTON) — Inclined sleepers for babies and crib bumper pads will be banned from being sold under legislation passed Wednesday by Congress.

The bill, known as the Safe Sleep for Babies Act, will now go to the White House for President Joe Biden to sign.

Among the advocates calling on Biden to sign the legislation quickly into law is Erika Richter, whose 2-week-old daughter, Emma, died while using a Fisher-Price Rock ‘n Play sleeper, a type of incline sleeper that would be banned under the new legislation.

“For this bill to be passed, it’s a huge win, and for it to have bipartisan support just highlights that this change was long overdue and undeniably necessary,” Richter, of Portland, Oregon, told Good Morning America. “There are 4.7 million of these products sold.”

Richter has been a vocal advocate for change since the death of Emma, her only child, in August 2018.

In 2020, Richter filed a lawsuit against Fisher-Price for wrongful death and gross negligence. The case is ongoing in Los Angeles County Superior Court and Richter declined to provide details on her daughter’s cause of death due to the litigation.

In its answer to the lawsuit, Fisher-Price has denied all of the allegations and specifically denied “that because of an act or omission by them, their agents, or independent contractors, Plaintiffs were injured or damaged in any sum, or at all.”

It was only after Emma’s death that Richter said she learned about reports of other infant deaths associated with Rock ‘n Play sleepers, which were recalled in 2019 by the Consumer Product and Safety Commission (SCPC) after being linked to over 30 deaths.

“I thought to myself, ‘If I had just known sooner,'” said Richter. “I wish that somebody had done what I’m doing and what some of the other mothers are doing more publicly around the time that I had Emma.”

Last June, Richter shared her story publicly for the first time at a congressional hearing that followed up on a report from the House Committee on Oversight and Reform. The report found Fisher-Price ignored repeated warnings that its Rock ‘n Play sleeper was dangerous before the device was recalled.

The report found more than 50 infant deaths were linked to the sleeper, which puts infants at a 30-degree incline.

The cause of death for some of the babies was asphyxia, or the inability to breathe, due to the child’s position, the report said.

“We trusted a name brand, and we were wrong,” Richter said in her testimony, holding up baby clothes as a reminder of what she has left to remember her daughter.

When Richter first shared her story publicly last June, a spokesperson for Mattel, the parent company of Fisher-Price, told ABC News in a statement there “is nothing more important” to the company than the safety of its products and that its “hearts go out to every family who has suffered a loss.”

“The Rock ‘n Play sleeper was designed and developed following extensive research, medical advice, safety analysis and more than a year of testing and review,” a spokesperson said, adding that independent medical and other expert analyses verified that the sleeper was safe when used in accordance with its instructions and warning. “It met or exceeded all applicable regulatory standards. As recently as 2017, the U.S. Consumer Product Safety Commission (CPSC) proposed to adopt the ASTM voluntary standard for a 30-degree angled inclined sleeper as federal law.”

A Mattel spokesperson confirmed to ABC News Thursday the Rock ’n Play Sleeper is no longer on the market, noting it, “was sold from its introduction in 2009 up until its voluntary recall in April 2019.”

Guidelines from both the CPSC and the American Academy of Pediatrics (AAP) say caregivers should always place infants to sleep on their backs on a firm, flat surface and should never add “blankets, pillows, padded crib bumpers, or other items to an infant’s sleeping environment.”

In addition, caregivers should not use infant sleep products with inclined seat backs of more than 10 degrees, and should not use infant car seats, bouncers and other inclined products for sleep, according to the guidelines.

Around 3,400 babies in the U.S. die each year while sleeping, in sudden and unexpected deaths, according to the AAP, which issued a statement Wednesday applauding the passage of the Safe Sleep for Babies Act.

“The message from pediatricians has long been clear: the safest sleep environment for babies is a firm, flat, bare surface,” AAP’s president, Dr. Moira Szilagyi, said in a statement. “Despite what the science shows, crib bumpers and inclined sleepers have remained on the market and store shelves, misleading parents into thinking they are safe and leading to dozens of preventable infant deaths.”

Experts say that padded crib bumpers, which are also banned under the new legislation, pose a particular potential danger because babies may turn their faces into the bumper’s padding, raising the risk of suffocation, may become entrapped underneath or around the bumper, or may become entangled in the bumper’s ties, increasing the risk of strangulation.

Even when federal crib standards changed in 2011, mandating a smaller distance between crib slats so babies would not get their heads stuck between them, crib bumpers — which arguably had lessened that risk — became unnecessary, but they remained on the market, despite the safety risk, according to Dr. Ben Hoffman, a professor of pediatrics at Oregon Health & Science University and chairman of the AAP’s Council on Injury, Violence, and Poison Prevention.

“There is an assumption that [products] are safe until they are proven dangerous, as opposed to what I think the public believes, which is if something is sold, it is safe,” Hoffman told ABC News last year.

Richter said she too has learned from her advocacy work since Emma’s death that parents need to be cautious consumers when it comes to the products they use with their kids.

“I have learned that we have a long way to go when it comes to consumer protections, and that legacy brands do not equal trust,” she said. “People die because they make assumptions that the brands themselves are doing their due diligence, and you cannot put that type of control in the hands of profit maker or profit owner.”

Richter said she plans to continue to push for more consumer controls, including calling on Congress to repeal a provision, 6B, in the Consumer Product Safety Act that she claims allows companies to “self-regulate” when it comes to product safety.

Richter said she also plans to keep speaking out to raise awareness and make sure banned infant sleep products don’t end up in the hands of other mothers.

“I’m still a mom. I’m still Emma’s mom. I still have that responsibility, and I still think like a mom and I still want to protect other moms and other children,” she said. “That is so important to me.”

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(NEW YORK) — As abortion rights increasingly come under threat across the country — with states like Oklahoma enacting “copycat” bills of sweeping Texas legislation that criminalizes abortion and with the Supreme Court poised to overturn abortion protections — advocates anticipate that women seeking abortion options will look outside the traditional health care system more and more.

For many women, that may mean pursuing a so-called medication abortion.

Medication abortions rely on pills, rather than surgery, to terminate the pregnancy. Usually two drugs — mifepristone and misoprostol — are used in combination to induce the abortion. In 2020, the number of medication abortions exceeded the number of surgical abortions for the first time, according to the Guttmacher Institute, a reproductive health policy research organization.

In “self-managed” cases, women do not undergo their abortions in a formal health care setting, according to the Guttmacher Institute.

That’s in contrast with “supervised” cases where women undergo their abortions under the watchful eye of supervising clinicians. Currently, 19 states require clinicians to be physically present when the medication is administered, according to the Guttmacher Institute.

But since the Texas law and its copycats place health care providers who facilitate pregnancies at legal risk — including telehealth clinicians who support the process virtually — supervising health providers could be held legally liable, Elizabeth Sepper, a professor of law at the University of Texas at Austin, told ABC News.

For example, the recently passed Oklahoma legislation could hold any individual — doctors, nurses, pharmacists — that “aids or abets the performance or inducement of an abortion” legally liable. This raises the concern that — to avoid liability — those individuals might turn away women seeking abortions, Sepper told ABC News.

As a result, pursuing a medication abortion increasingly means self-managing the process without medical supervision, Alina Salganicoff, director of women’s health policy at the Kaiser Family Foundation, told ABC News.

Sometimes, that’s meant crossing international borders into Mexico or Canada to obtain pills.

“I think there’s no question that people seeking abortions will look into any option,” Salganicoff told ABC News, “just because you ban an abortion doesn’t mean women won’t continue to seek them.”

More often, that’s meant turning to the postal service.

In July 2020, following a suit by the American Civil Liberties Union, the Food and Drug Administration temporarily suspended restrictions allowing mifepristone to be delivered by mail. Last December, the FDA permanently lifted those restrictions.

There are now numerous companies and international pharmacies devoted to shipping pills, according to Plan C, an information portal for self-managed abortion services. Some companies even ship to a handful of states — like Arizona and Texas — where mailing abortion pills is illegal.

The number of pills currently being sent through the mail is difficult to track, Abigail Aiken, an associate professor in health policy at the University of Texas at Austin, told ABC News.

But requests for the medicines by mail have skyrocketed in Texas since the legislation: one study found that, after the passage of the law, requests sent to Aid Access — the country’s largest telehealth abortion provider — leapt 10-fold in the week after it was enacted. Daily requests remained twice as high as the pre-legislation baseline over the next three months, after which point the researchers stopped tracking.

“I think we can see that making abortion illegal doesn’t limit the need for abortion,” Abigail Aiken, who is also the lead investigator on the study, told ABC News, “it just shifts where individuals can find care.”

Data on information seeking for self-managed abortions acquired by ABC News suggests these patterns in Texas may foreshadow broader trends across the country.

In the week after the Supreme Court’s draft decision leaked to the press, page views and overall users on Plan C’s website increased seven-fold. The number coming from states with Texas copycat laws leapt further still: page views from users in Idaho increased 23-times, and page views from those in Oklahoma increased 18-times, according to Elisa Wells, co-director of Plan C.

The good news about self-managed medication abortions, Aiken told ABC News, is that they appear safe and effective for most women who use them early in pregnancy. Recent U.S.-based studies have reported that up to 96% of women undergoing self-managed medication abortions before 10 weeks of gestation successfully terminated their pregnancy.

But doctors fear that the success rates will likely be lower in women who turn to the medications in lieu of other options who are further along in their pregnancy. The later the pregnancy, the higher risk that something will go wrong for women attempting self-managed medication abortions – including blood infections that can be life-threatening without urgent medical care, experts said.

“I have some concern that … regardless of whether their self-assessment [for gestational age] says they’re eligible, they’ll use the pills — because they’re desperate,” Daniel Grossman, professor of obstetrics and gynecology at the University of California San Francisco, told ABC News.

Then there’s the legal risk. In Texas, women like Lizelle Herrera have already been arrested under murder charges after their abortions came to light. Seeking medical care could similarly leave them vulnerable to criminal prosecution, Sepper told ABC News, which would further discourage them from seeking care.

If women with abortions who need care avoid it out of concern for legal consequences, it could endanger their health, Grossman told ABC News.

Despite all the potential upsides of medication abortions, the risk of undue death is what advocates fear most. Especially, since abortion seekers are disproportionately from groups that already face the highest rates of maternal death, including communities of color.

“We know that when abortion is illegal, it doesn’t make it less common, it just makes it less safe,” Danika Severino Wynn, vice president of abortion access at Planned Parenthood, told ABC News.

“When we push people further into the shadows, it means we are undoubtedly making their care more dangerous,” Wynn said.

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(NEW YORK) — People of color will face the brunt of the impact if Roe v. Wade is overturned by the Supreme Court, abortion rights advocates warn.

The landmark decision that protected a person’s right to have an abortion is in danger of being overturned by the high court’s conservative majority, according to a draft court opinion leaked this week to Politico.

Activists who work in Black and brown communities fear the socioeconomic effects of this potential decision from the highest court in the country. Abortion rights, they say, are an economic and health justice issue.

Abortion rights advocates say there are several factors that may go into a person’s decision to seek an abortion, including health care access and quality, financial support and willingness to be pregnant.

“This is not something where it’s either: make a choice to choose to be a parent or not to choose to be a parent,” said Oriaku Njoku, co-founder and executive director of ARC-Southeast, an abortion fund in Georgia that serves six states across the Southeast region. “There’s so many things like access to food, access to a living wage, access to insurance, your race, your gender, your ability to make money for your family.”

She says that not just the right to have an abortion, but also the right to access an abortion has long been threatened and that many people are struggling with the multifaceted injustices in poverty, health care and stability.

The demographics of abortion patients

In the most recent data from the CDC in 2019, Black women had the highest rate of abortions with 23.8 abortions per 1,000 women.

Hispanic women had 11.7 abortions per 1,000 women, according to the CDC. White women had the lowest rate: 6.6 abortions per 1,000 women. The majority of these women — 56.9% — were in their 20s, according to the data.

The country’s most marginalized will be affected by looming abortion bans: people already impacted by poverty, lack of healthcare access and racism in the healthcare system, advocates say.

“This fight for abortion access that we’re in right now is a fight against white supremacy in this country,” said Monica Raye Simpson, the executive director of the Southern-based reproductive justice group SisterSong.

“When we live in a world in a country where access to health care is already extremely limited to people of color … that is a problem,” said Simpson.

She continued, “To think about what it would mean to take care of themselves, accepting themselves as a family, like all of these are parts of a decision that one has to think about when thinking about creating a family.”

Health care challenges for people of color

Research has shown that racial and ethnic minorities often receive lower-quality health care than white people.

Even when factors like income, age, condition, and insurance are comparable, research has shown that Black and brown people are still failed by the health care system.

These poor health systems contribute to worse health conditions: Black people are at higher risk for heart diseases, stroke, cancer, asthma, diabetes, according to the Department for Health and Human Services.

Experts say America’s poor systems of health make abortions a vital part of health care for people of color.

Black and Hispanic women are more likely than white women to experience health complications during pregnancy and childbirth, according to Blue Cross Blue Shield Association.

A recent report from the Centers for Disease Control and Prevention also found that Black women died of maternal causes at nearly three times the rate of white women in 2020.

The rate for Black women was 55.3 deaths per 100,000 in 2020 and the rate for white women was 19.1 deaths per 100,000, according to the CDC. For Black women, the rate increased nearly 26% from the year prior.

Being pregnant presents some kind of risk. And unintended pregnancies increase the risk for poor maternal and infant outcomes, the CDC reports.

“The real issue is the historic and ongoing disparities and access to quality health care, and sexual and reproductive health information in Black and brown communities,” Njoku told ABC News. “This is denying the next generation a better future. Improving access to health care, education, family planning; I feel like those are better ways to reduce unintended pregnancies than trying to restrict abortion.”

For others, terminating unintended pregnancies can be a financial decision.

The financial implications of pregnancy

Activists say an abortion ban will only push pregnant people into poverty or into debt. Pregnancy and childbirth alone can cost thousands of dollars.

Black and Hispanic people are 1.8 and 1.5 times as likely to be in poverty than white people, according to 2019 census data.

The Economic Policy Institute also found that Latinas earn 57 cents and Black women earn 65 cents for every dollar earned by white, non-Hispanic men.

“When there are barriers placed on someone’s ability to access abortion care, it pushes them farther into pregnancy, and has pretty devastating financial implications for folks who have to pay out of pocket if their insurance doesn’t cover abortion care,” said Morgan Hopkins, the executive director of campaigns and strategies for abortion rights group All* Above All.

“It only gets more expensive the further into pregnancy you go,” Hopkins said.

However, many reproductive rights activists say that even while Roe is the law of the land, abortion is still hard to access for many across the country.

“Codifying Roe is not going to make abortion more accessible,” said Njoku. “It’s not going to change the fact that we live in places where there are abortion deserts … it’s not going to change the fact that people are crossing state lines to get abortions.”

According to reproductive care researchers at the Guttmacher Institute, abortion access has long been limited for those in states with stronger abortion restrictions, that already push people to travel out of state.

In states with anti-abortion rights legislation, the organization found a high correlation between the “proportion of women whose nearest provider was in another state and the proportion who obtained out-of-state care not found in a state with supportive abortion policies.”

For some, it can be an expensive but necessary task.

“If this leaked draft becomes final, it will be earth-shattering and felt hardest for those same communities that are already being disproportionately impacted,” Hopkins said.

“If someone is forced to carry a pregnancy to term, it impacts their economic security and their ability to live the life that they want and raise the family that they maybe already have,” Hopkins said. “The impact will be devastating.”

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(NEW YORK) — As states across the country have passed bans against abortion, more women have had to spend time and money heading across state lines to get the legal procedure.

And with the Supreme Court poised to roll back Roe v. Wade, abortion rights activists told ABC News they fear that it will become near impossible for women in the South and Midwest to get a legal and safe procedure.

Two women who recently had to travel hundreds of miles to get an abortion allowed “Nightline,” to accompany them through the process in hopes that people, including policymakers, can see just how devastating those laws will be to other women in the same situation.

“I feel like people need to know and need to know our side of the story,” said “Marie,” a 31-year-old Texas woman who got an abortion in Tulsa, Oklahoma last month and asked ABC News not to reveal her real name. “We’re not evil. We’re not baby killers.”

After Texas passed its ban on abortions following six weeks in the fall, Marie had to look for health care centers in nearby Oklahoma. The state’s Planned Parenthood centers saw a 2,500% jump in patients from Texas following the ban, according to the non-profit.

Marie told ABC News she had to wait more than a month for an open appointment, had to take a week vacation from her job and had to drive 14 hours straight to the Planned Parenthood center in Tulsa.

“In the car by myself for 14 hours, you definitely have a lot of time to think,” she said. “It’s been really, really hard.”

Marie said she felt more nervous because of news reports of copycat abortion bans that made its way through the Oklahoma State Legislature. Marie was able to get her procedure done before Gov. Kevin Sitt signed a copycat bill into law on May. 3.

“How dare you try and force people to do things the way you want them to do them. It’s our bodies. I feel like women will be desperate, harm themselves,” Marie said.

Nicole, a 39-year-old mother of two who recently traveled to Kansas to get an abortion, also shared that sentiment with “Nightline.” Nicole said that even though she has a full time job and loves being a mom. But she and her partner could not afford to have another child.

Her situation is common among abortion patients, according to health data. The U.S. Centers for Disease Control and Prevention said about 60% of patients who have had an abortion have at least one child.

“I wanted to give a voice to the older women- [who] already have kids, and I want to give an opportunity for the government to see how it affects us,” Nicole told “Nightline” about why she wanted to tell her story.

Nicole was early enough in her pregnancy that she could have a medication abortion, but due to a backlog in Oklahoma she had to drive to Kansas to get the pills. She told “Nightline” that she had to pay for travel, find childcare for her two boys and drive back and forth to the clinic.

Nicole said the experience backed up her concerns about raising another child.

“If I struggle to pay $800, $900 to take care of something like this, how would I be able to take the money, the time, and everything, and take care of a child?” she said.

Kansas could become another state to ban abortions. The right to an abortion is currently protected by the state constitution but the public could vote to restrict it through a ballot initiative scheduled for Aug. 2.

Nicole and Marie told “Nightline” that they are upset that lawmakers aren’t considering the circumstances that women are in when they make decisions regarding abortion rights.

Marie added that her experience has made her want to speak out more.

“I feel like it’s going to affect my life now forever because I’m going to fight more for women in this situation that don’t have any other choices,” she said.

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(WASHINGTON) — The Food and Drug Administration has put limits on the Johnson & Johnson COVID-19 vaccine due to the rare risk of blood clots.

“Today, the U.S. Food and Drug Administration has limited the authorized use of the Janssen COVID-19 Vaccine to individuals 18 years of age and older for whom other authorized or approved COVID-19 vaccines are not accessible or clinically appropriate, and to individuals 18 years of age and older who elect to receive the Janssen COVID-19 vaccine because they would otherwise not receive a COVID-19 vaccine,” the FDA said in a statement Thursday.

The announcement follows a recommendation from the Centers for Disease Control and Prevention late last year to opt for either Pfizer or Moderna, over the single-shot J&J vaccine after a review of new CDC data on rare blood clots linked to J&J.

This is a developing story. Please check back for updates.

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(NEW YORK) — Pink is marking Mental Health Awareness Month and sharing her story about suffering from “pretty awful panic attacks” when she was in her early 20s.

“I didn’t know what was happening. I didn’t have anybody to talk to about it and I didn’t know what to do,” the “Just Like Fire” singer admitted in a new Instagram video.

She said her attacks felt “like I was having strokes, like, stroke symptoms. It was terrifying.”

When she went to the hospital for help during the attacks, Pink said she was always told, “You’re fine. There’s nothing wrong. You’re imagining it all. It’s all in your head.”

The “Try” singer said she didn’t take that as a final answer and sought a therapist to help figure out what was causing her issues.

“I started learning all these steps on how to take care of myself,” she said. “I’d never been taught how to take care of myself.”

Pink said she turned to meditating, healthy eating, surrounding herself with the right people and using a “spiritual toolbox” that she keeps under her bed to help manage the panic attacks.

What has helped the most, she noted, is music: “Writing songs is probably the thing that has saved my life.”

“I will tell you – from being a very, very afraid seven-, eight-, 13-, 23-, 31- and now 42-year-old woman – it does get better and there are beautiful moments waiting for you,” she said. “And there are beautiful people waiting to love you, and one of those people is yourself.”

Pink is partnering with the nonprofit Child Mind Institute to promote its “Dare to Share” campaign, which encourages children to be open about their own mental health.

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