Thomas A. Glessner, J.D.
President, NIFLA

I. Review: The Key Provisions of Roe v. Wade, 410 U.S. 113 {1973)

A. States may not prohibit or restrict abortion even into the third trimester of pregnancy if the abortion is necessary to preserve the "health" of the mother. “For the stage subsequent to viability, the State in promoting its interest in the potentiality of human life may, if it chooses, regulate, and even proscribe, abortion except where it is necessary, in appropriate medical judgment, for the preservation of the life or health of the mother."
B. Companion case of Doe v. Bolton, 410 U.S. 179 {1973} defines "health" so broadly that virtually any stress upon a mother during her pregnancy justifies abortion for "health" reasons.
"The medical judgment may be exercised in the light of all factors -­
physical, emotional, psychological, familial, and the woman's age -­ relevant to the well-being of the patient. All these factors may relate to health."
C. The Court drew a line at viability when restrictions and prohibitions on abortion could happen (unless "health" reasons intervene) because that is when the unborn child (referred to as "potential life") has the "capability of meaningful life outside the womb." Viability, according to the Court, occurs between 24-28 weeks of pregnancy.
D. The unborn child, i.e., "potential life" is not a person under the Fourteenth Amendment to the U.S. Constitution. The Court said that there was no precedent in the law establishing personhood prenatally.

1. The Court ignored Blackstone's Commentaries on the Common law of England, and the famous AMA report of 1857, which set conception as the objective medically measurement of when human life begins.
2. The issue was not the humanity of the unborn child, i.e., "potential life", rather the legal recognition of personhood. (Quote the Court)

E. The Court stated that the right to an abortion was "fundamental" because it came from a previously recognized right of privacy. Hence, strict scrutiny became the legal standard to apply when reviewing any abortion restrictions.

Ill. Results of Roe:

A. A legal system which protects some human beings and not others.
B. A legal system which grants constitutional rights to some nonhumans, i.e., corporations, but not to other human beings, i.e., the unborn.
C. Over 63 million abortions have been performed and over 900,000 annually.

IV. Planned Parenthood v. Casey, 505 U.S. 893 {1992}:

A. Upheld by a 5-4 vote the "central premise" of Roe that recognizes a constitutional right to abortion.
B. Revised the standard of review from strict scrutiny to intermediate scrutiny - a lesser standard that does not require a compelling interest to uphold an abortion regulation, but rather requires that the regulation simply not be "unduly burdensome."
C. The unduly burdensome standard, theoretically, allows for more restrictions, but is subjective and gives no real guidelines for states and courts to determine what is and what is not an "unduly burdensome" unconstitutional regulation of abortion.

V. Dobbs v. Jackson Women's Health Center, 597 U.S. (2022):

A. There is no constitutional right to abortion. The decision to regulate abortion is left up to the "elected officials" of the people.
B. The decision is in line with the operations of a true Republic.
C. Federally elected officials have a role to play under Section Five of the Fourteenth Amendment, which says: "Congress shall have power to enforce, by appropriate legislation, the provisions of this article,"

1. The declarations of non-personhood by the Roe decision are no longer valid.
2. Hence, the issue of personhood is to be determined by the elected representatives of the people - including the Congress.


A. An abortion-free America is a nation where abortion is neither promoted or accepted across the country as an acceptable solution to an unwanted pregnancy. It is a nation where a culture of life permeates across the land, and every child is welcomed as valuable members of each community. It is a nation where the support for a mother in an unwanted pregnancy is so compelling that very few women choose abortion.

VII. Three elements that must come together to achieve an abortion-free America.

A. Legal Protection for mothers and their unborn children.

1. Political strategies will differ depending upon each state.
2. Red states are more promising than blue states, but all states must work to save lives.
Think of football strategy - a hail Mary pass virtually never works. Rather a winning strategy continues to push the ball down field until the goal is crossed.

B. Compelling alternative to abortion services in every community, which mean that very few mothers will choose abortion.

1. Expanded access to alternative to abortion services.
2. Chemical abortion must be effectively addressed and APR services implemented.
3. STI Testing and Treatment should be utilized.

C. A culture of life arises in every community in the nation.

1. Abortion must be seen as unthinkable and every child, no matter the circumstances of pregnancy and conception, will be welcomed into every community across the land.
2. Churches are responsible. When the spiritual leaders lead the people will follow.
3. Abortion in the church must be addressed.
4. Abortion by spiritual leaders must be dealt with.

VIII. The Year in Review

A. Illinois – SB1909

1. Based on a false premise - limited services pregnancy center use any deception, fraud, false pretense, false promise, or misrepresentation in advertising, soliciting, or otherwise offering pregnancy-related services; or in conducting, providing, or performing pregnancy-related services.
2. Penalty – Includes a preliminary or permanent injunction and a civil penalty not to exceed $50,000. Allows any party aggrieved by a violation of the Act to bring an action against any limited services pregnancy center that has committed such a violation, in which the court may award actual damages and any other relief the court deems proper. Effective immediately.
3. Rule 65 Preliminary Injunction Order
a. “Justice Scalia once said that he wished all federal judges were given a stamp that read ‘stupid but constitutional.’” Brown v. Chicago Bd. of Educ., 824 F.3d 713, 714 (7th Cir. 2016). SB 1909 is both stupid and very likely unconstitutional. It is stupid because its own supporter admitted it was unneeded and was unsupported by evidence when challenged. It is likely unconstitutional because it is a blatant example of government taking the side of whose speech is sanctionable and whose speech is immunized. SB 1909 is likely classic content and viewpoint discrimination prohibited by the First Amendment.

b. When seeking a preliminary injunction, it is the plaintiff’s burden to demonstrate standing, by showing (1) an injury in fact; (2) that the challenged conduct caused the injury; and (3) some likelihood that the court’s decision will remedy the injury. Id. An injury must be “concrete and particularized” and “actual or imminent, not conjectural or hypothetical.” Lujan v. Def. of Wildlife, 504 U.S. 555, 560 (1992).

B. Vermont – SB37

1. Suit filed by pro-life pregnancy services centers and their membership organization to a state law that unconstitutionally restricts the centers' speech and provision of services.
2. That law impedes the ability of pro-life pregnancy centers to continue providing help and support to Vermont women and families in two ways:
a. First, it censors the centers' ability to advertise their free services (Advertising Prohibition). Prohibition, 9 V.S.A. § 2493(a), regulates Plaintiffs' non-commercial speech.
b. Second, it precludes centers from offering non-medical services, information, and counseling unless provided by a licensed health care provider. The provider restriction does not define "health care services." However, the term is defined elsewhere in SB 37 as "services for the diagnosis, prevention, treatment, cure, or relief of a physical or mental health condition, including procedures, products, devices, and medications." 3 V.S.A. § 129a(f)(2)(B); 26 V.S.A. § 1354(d)(2)(B).
C. Ohio is likely to pass an initiative in November removing restrictions around the procedure until the point of fetal viability.

Legal Tips August 2023 IL Attachment


Kristen K. Waggoner, JD
CEO, President, and General Counsel
Alliance Defending Freedom

I. Introduction

A. Introduce Kristen and ADF
B. Briefly mention the Dobbs decision and ADF involvement
C. Connect the legal victories for life to Isaiah 42:9 (theme verse for National Leadership Summit)

II. Dobbs v. Jackson Women’s Health Organization

A. Discuss Supreme Court’s decision and ADF’s involvement in more detail.

1. The Gestational Age Act in Mississippi in 2018 limits abortions after 15 weeks of gestational age, permitting them only in medical emergencies or for severe fetal abnormality.
2. ADF worked with Mississippi lawmakers and Governor Bryant to draft and enact the Gestational Age Act in 2018, and they served on the Mississippi team defending the law at the Supreme Court as constitutional and fighting to have Roe and Casey overturned.
3. Fifth Circuit reversed, and the case was remanded for further proceedings.
4. A rational-basis review should be applied to state abortion regulations under constitutional challenge.
5. Regulation of abortion falls under the same level of scrutiny as other health and safety regulations by the states.
6. The history of criminalizing abortion by many states pre-Roe, and the lack of precedent for the court to establish a right not explicitly mentioned in the Constitution suggests the Fourteenth Amendment does not protect the right to abortion.
7. Roe and Casey determined the balance between the interest in what constitutes “potential life” and the interest of a woman wanting an abortion. Still, the states may evaluate these interests differently, and such differences do not disturb the order of “liberty.”
8. Roe imposed a precedent that looked too much like legislation and enforced an unjustified distinction between pre- and post-viability abortions, and Casey’s “undue burden” test fails the workability requirement.
9. If the Constitution does not ensure the right to abortion, then the power to regulate abortion must be returned to the states.
10. Roe and Casey overruled.

B. 32,000 babies were saved from abortion in the six months following Dobbs.
C. A little more than a year after Dobbs, fourteen States now have enforceable laws protecting unborn life at its earliest stages.
D. One State (Georgia) protects unborn life beginning at six weeks. And two more States protect unborn life beginning at twelve weeks. Two States protect unborn life beginning at 15 weeks, and one more (Utah) protects unborn life beginning at 18 weeks. Many other States protect life beginning around the time of viability with various exceptions.
E. In contrast, seven States have no gestational limits at all. And two States have enacted explicit constitutional protections for abortion.
F. Since Dobbs, eight state supreme courts have ruled on state constitutional rights to abortion.

1. Planned Parenthood Great Northwest v. State, 522 P.3d 1132 (Idaho 2023): The Idaho Supreme Court upheld three Idaho laws: (1) protecting unborn life from the outset of pregnancy, (2) protecting unborn life after a fetal heartbeat, and (3) imposing civil liability on abortion providers. The court held that the Idaho Constitution does not “guarantee” a fundamental right to abortion.” It further held that the Iowa Constitution contains “no explicit right of ‘privacy’” and upheld the laws under the rational basis test.
2. Members of Medical Licensing Board of Indiana v. Planned Parenthood Great Northwest, Hawai’i, Alaska, Indiana, Kentucky, Inc., 211 N.E.3d 1 (Ind. 2023): Several abortion providers challenged the enforcement of a bill prohibiting abortion in Indiana, except when necessary to preserve the life of the mother, as a violation of the Indiana Constitution and its protection of the right to abortion. The Indiana Supreme Court determined the Indiana Constitution does not contain a fundamental right to abortion, except when in the preservation of the life of the mother, even though there is no such text in the Indiana Constitution. The court then vacated the trial court’s injunction and declared the bill’s enforcement constitutional.
3. Planned Parenthood of the Heartland, Inc. v. Reynolds ex rel. State, 975 N.W.2d 710 (Iowa 2022): Shortly before Dobbs, the Iowa Supreme Court upheld an Iowa statute that required a 24-hour waiting period before an abortion procedure may be performed. The court held that the Iowa Constitution does not protect a right to abortion and that strict scrutiny does not apply, overturning a previous Iowa Supreme Court decision. The court denied rehearing following Dobbs.
4. Cameron v. EMW Women’s Surgical Ctr., 664 S.W.3d 633 (Ky. 2023): The Kentucky Supreme Court considered Kentucky’s trigger law and heartbeat law. However, the court avoided the constitutional issue, instead ruling that abortion providers did not have third-party standing to challenge the law on behalf of their patients. The trial court later dismissed the lawsuit entirely.
5. Weems v. State, 529 P.3d 798 (Mont. 2023): The Montana Supreme Court struck down a state law “restrict[ing] providers of abortion . . . to physicians and physician assistants.” Relying on a pre-Dobbs Montana Supreme Court case, the court held that the Montana Constitution “protects a woman's right of procreative autonomy . . . [that is] to seek and obtain a specific lawful medical procedure . . . from a health care provider of her choice.” It then held that the statute implicated that right and applied strict scrutiny.
6. Wrigley v. Romanick, 988 N.W.2d 231 (N.D. 2023): The North Dakota Supreme Court struck down a state law protecting unborn life from the beginning of pregnancy. The court held that the “North Dakota Constitution provides a fundamental right to receive an abortion to preserve a pregnant woman's life or health.” It then applied strict scrutiny, holding that the statute failed to survive strict scrutiny because it was not narrowly tailored to protect a woman’s health or unborn life.
7. Oklahoma Call for Reproductive Justice v. Drummond, 526 P.3d 1123 (Okla. 2023): Several Oklahoma abortion providers brought an original-jurisdiction action in the Oklahoma Supreme Court challenging both the State’s longstanding abortion prohibition, which traces back to 1890, and the State’s newer trigger law, which was scheduled to take effect in August 2022. The court held that “the Oklahoma Constitution creates an inherent right of a pregnant woman to terminate a pregnancy when necessary to preserve her life,” but “ma[d]e no ruling on whether the Oklahoma Constitution provides a right to an elective termination of a pregnancy.” Puzzlingly, the court held that the longstanding law’s life of the mother exception was sufficient but that the trigger law’s medical emergency exception was not.
8. Planned Parenthood South Atlantic v. State, 882 S.E.2d 770 (S.C. 2023): The South Carolina Supreme Court struck down a state law protecting life after the detection of a fetal heartbeat. It held that the state constitutional right to privacy extended to a woman’s decision to have an abortion and that the law failed strict scrutiny.

III. National Institute for Family and Life Advocates v. Becerra

A. NIFLA challenged a 2015 California law forcing pro-life pregnancy centers to point women toward abortion.
B. The so-called “FACT Act” regulated pregnancy centers in two ways:

1. First, it required medically licensed pregnancy centers to post a sign notifying women that California provides free or low-cost services, including abortions, and give them a phone number to call.
2. Second, it forced unlicensed pregnancy resource centers to post a sign informing women that California had not licensed the center to provide medical services.

C. Together, these requirements forced pro-life pregnancy centers to choose between expressing a message with which they disagree or suppressing their ability to serve women by advertising that they are not state-licensed clinics.
D. ADF brought a lawsuit on behalf of NIFLA, alleging that the Act violated the First Amendment by compelling speech and targeting the free exercise of religion.
E. The Southern District of California denied NIFLA’s motion for a preliminary injunction. Nat’l Inst. of Family & Life Advocates v. Harris, No. 15-cv-2277, 2016 WL 3627327 (S.D. Cal. Feb. 9, 2016).

1. The district court correctly recognized that NIFLA’s claims were ripe for adjudication.
2. On the merits, the court held that the notice for licensed clinics “is professional conduct subject to rational basis review” and that “[e]ven if speech is implicated . . . the Act regulates professional speech,” and that professional speech regulations are subject to intermediate scrutiny. It then held that “the Act survives intermediate scrutiny.”
3. The court also held that the disclosure for unlicensed clinics “withstands any level of constitutional scrutiny.”
4. Regarding NIFLA’s free exercise claim, the court held that “there [w]as no evidence to suggest the Act burdens only conduct motivated by religious belief” and that “the Act survives not only rational basis but strict scrutiny review.”

F. ADF appealed that ruling to the Ninth Circuit. The Ninth Circuit affirmed. Nat’l Inst. of Family & Life Advocates v. Harris, 839 F.3d 823 (9th Cir. 2016).

1. Like the district court, the Ninth Circuit held that NIFLA’s claims were constitutionally and prudentially ripe.
2. On the merits, the Ninth Circuit held that the Act was “content-based, but viewpoint neutral” and that strict scrutiny was “inappropriate” for content-based, but viewpoint neutral, “abortion-related disclosures.”
3. It then held that the licensed notice regulates “professional speech,” that “intermediate scrutiny should apply,” and that it “satisfies intermediate scrutiny.”
4. It further held that “abortion-related disclosures” in the licensed notice were subject to a lower level of constitutional scrutiny merely because they relate to the speech of licensed professionals.
5. Similarly, the Ninth Circuit held that the unlicensed notice “will survive even strict scrutiny.”
6. The court further held that “[t]he Act is facially neutral,” “operationally neutral,” and “generally applicable” under the Free Exercise Clause. It then explained that “the Act . . . survives rational basis review.”

G. Both the district court and Ninth Circuit decisions reflect the “abortion distortion,” or the tendency of federal (and sometimes state) courts to distort generally applicable legal rules if the subject matter of a case involves abortion. The Supreme Court later disavowed this distortion in Dobbs.
H. ADF petitioned for certiorari on both the free speech and free exercise issues. The Supreme Court granted cert on the free speech issue, and former ADF-CEO Michael Farris argued the case before the Court in March 2018.
I. In a 5–4 decision, the Court held that both the licensed and unlicensed notices compelled pregnancy centers’ speech in violation of the First Amendment. Nat’l Inst. for Family & Life Advocates v. Becerra, 138 S. Ct. 2361 (2018).

1. Majority Opinion (Justice Thomas):

a. Justice Thomas, writing for the majority, explained that the licensed notice was a content-based regulation of speech because it required clinics “to inform women how they can obtain state-subsidized abortions” and at the same time, they “try to dissuade women from choosing that option.”
b. The majority then rejected the Ninth Circuit’s lower level of protection for professional speech, explaining that constitutional free speech protection does not “turn[] on the fact that professionals [a]re speaking” and that the States do not have “unfettered power to reduce a group’s First Amendment rights simply by imposing a licensing requirement.”
c. The Court further explained that the licensed notice did not qualify for lower constitutional scrutiny because “it requires [pregnancy centers] to disclose information about state-sponsored services—including abortion, anything but an ‘uncontroversial’ topic” and because it “does not facilitate informed consent to a medical procedure.”
d. The majority held that the licensed notice could not survive even intermediate scrutiny.
e. It faulted the Act for being “wildly underinclusive” by exempting “nearly 1,000 community clinics” from its scope, which the Court said, “raises serious doubts about whether the government is, in fact, pursuing the interest it invokes.”
f. The Court further explained that California could inform low-income women about its services with a public-information campaign and that a “tepid response” to such a campaign could mean that women “do not want” the abortion “services” offered by the State but could not justify California’s attempt to “co-opt [pregnancy centers] to deliver its message for it.”
g. The Court then addressed the unlicensed notice, holding that it failed even the intermediate scrutiny test applicable to regulations of commercial speech.
h. The Court highlighted the facts that California could point to no evidence that women go into pregnancy centers not knowing what they are and that the services that triggered the unlicensed notice did not require a medical license.
i. It then faulted the unlicensed notice for covering “a curiously narrow subset of speakers,” suggesting that “the State ha[d] left unburdened those speakers whose messages are in accord with its views.”
j. The Court also criticized the length of the notice, explaining that it would require “a billboard for an unlicensed facility that says, ‘Choose Life’ to surround that two-word statement with a 29-word statement from the government, in as many as 13 different languages,” “drown[ing] out the facility’s message.”

2. Concurrence (Justice Kennedy):

i. Justice Kennedy, joined by Chief Justice Roberts, Justice Alito, and Justice Gorsuch, concurred with the majority opinion but wrote separately “to underscore the apparent viewpoint discrimination here is a matter of serious constitutional concern,” but that “[t]he Court . . . [wa]s corrects not to reach this question” because “[i]t was not sufficiently developed.”
ii. He explained that “[i]t does appear that viewpoint discrimination is inherent in the design and structure of this Act” because “the State requires primarily pro-life pregnancy centers to promote the State’s own preferred message advertising abortions.”
iii. He further noted that “the history of the Act’s passage and its underinclusive application suggest a real possibility that these individuals were targeted because of their beliefs.”

3. Dissent (Justice Breyer):

a. Justice Breyer, joined by Justices Ginsburg, Sotomayor, and Kagan, dissented from the opinion of the Court.
b. The dissent argued that the Act was not different than abortion informed consent under Casey, asking “[i]f a State can lawfully require a doctor to tell a woman seeking abortion about adoption services, why should it not be able, as here to require a medical counselor to tell a woman seeking prenatal care about childbirth and abortion services?”
c. But the dissent ignored the fact that the California law required pregnancy centers to post signs visible to all clients, regardless of whether those clients were seeking specific medical services or were even pregnant, not to relay certain information to women seeking “prenatal care.”
d. Instead, it would have expanded the Court’s informed consent doctrine far beyond requiring doctors to relay certain information to a woman before performing a specific medical procedure.

4. Bottom line: The Supreme Court confirmed that the First Amendment protects all Americans, including professionals, from being forced to speak a message contrary to our beliefs.

J. California agreed to a permanent injunction on remand.

IV. The Far Reach of the NIFLA Decision

A. In 2019, 2,700 U.S. pregnancy centers served roughly two million women, men, and youth, with services valued at over $266 million.
B. The role of pregnancy centers is even more important after Dobbs. Again, 32,000 lives were saved because of that decision and the work of thousands of PCCs.
C. NIFLA has also had a tremendous impact on the state of legal play, especially the standard of review for informed consent and compelled speech laws.

1. Brief Overview: Generally, courts apply a rational basis plus standard of review to examine the constitutionality of informed consent laws; that is, courts conduct a rational basis review combined with the analysis of an additional factor. Courts differ on the terminology of this additional factor; some require examining whether the compelled speech is ideological, while others require the speech to be truthful, non-misleading, and relevant. Regardless terminology, the factor is meant to determine that the compelled speech is factual and related to conduct instead of viewpoint-based or ideological.
2. While many courts use this rational basis plus standard, it is also notable that some other courts take a different approach and review informed consent regulations under intermediate scrutiny.
3. And when laws regulating physician-patient communications mandate compelled silence as opposed to compelled factual disclosures, most courts use heightened scrutiny.

D. Doctrine of Informed Consent Where It Came from and Where It Is Going.

1. Under common law, “informed consent is generally required for medical treatment . . . [t]he informed consent doctrine has become firmly entrenched in American tort law.” Cruzan v. Director, Mo. Dept. of Health, 497 U.S. 261, 269 (1990).
2. Thus, if a physician fails to obtain informed consent from their patient, they may be subject to tort or criminal liability. Cruzan, 497 U.S. at 269. In the 1914 case of Schloendorff v. Society of N.Y. Hospital, 105 N.E. 92, 93 (1914), the court noted: “[e]very human being of adult years and sound mind has a right to determine what shall be done with his own body; and a surgeon who operates without his patient’s consent commits an assault, for which he is liable in damages.”
3. In fact, in such circumstances, “[a]n action for failure to obtain informed consent may be brought under a theory of battery.’” NIFLA v Becerra, 138 S. Ct. 2361, 2373 (2018) (citing Cause of Action Against Physician for Negligence in Prescribing Drugs or Medicines, 9 Causes of Action 1 (2021)).
4. The doctrine of informed consent and attending liability has also been codified and particularized in various statutes. Looney v. Moore, 886 F.3d 1058, 1068–70 (11th Cir. 2018) (noting that the informed consent doctrine is codified in Alabama’s medical malpractice statute).
5. Importantly, courts have upheld informed consent statutes in the abortion context. For example, Texas Med. Providers Performing Abortion Services v. Lakey, 667 F.3d 570 (5th Cir. 2012) upheld a statute requiring the disclosure and explanation of a sonogram and fetal heartbeat to obtain informed consent for an abortion. And EMW Women’s Surgical Ctr., P.S.C. v. Beshear, 920 F.3d 421 (6th Cir. 2019) similarly upheld a statute requiring a physician to perform an ultrasound to obtain informed consent for an abortion.

B. What does informed consent require?
a. Under the doctrine of informed consent, a physician is required “to divulge in a reasonable manner . . . sufficient information to enable the patient to make an informed judgment.” Bradley v. Sugarbaker, 809 F.3d 8, 22 (1st Cir. 2015) (citing Harnish v. Children's Hosp. Med. Ctr., 439 N.E.2d 240, 242 (1982)).
b. What level of information is considered sufficient to inform the patient or what specific disclosures must be made largely depends on what the jurisdictional standard or the statutory scheme requires.
B. Informed Consent Regulations as Compelled Speech

1. While laws compelling speech are “presumptively unconstitutional and may be justified only if the government proves that they are narrowly tailored to serve compelling state interests,” NIFLA, 138 S. Ct. at 2371 (citing Reed v. Town of Gilbert, 135 S. Ct. 2218, 2226 (2015)), in the informed consent context, regulations compelling disclosures by doctors have not traditionally been reviewed under a strict scrutiny standard. Such laws usually pass constitutional muster under some form of rational basis review. Id. at 2373.
2. The Supreme Court has upheld laws compelling speech in the informed consent context as one of many “regulations of professional conduct that incidentally burden speech[,]” and explained that these regulations are “afforded less [First Amendment] protection.” Id. at 2372-73.
3. The Court has also explained that “[u]nder [its] precedents it is clear the State has a significant role to play in regulating the medical profession. See also Gonzales v. Carhart, 550 U.S. 124, 157 (2007).
4. As a result, because of the States’ traditional power to regulate the medical profession, states “may require doctors to provide information to their patients to ensure patients can give their informed consent for an abortion, like for any other medical procedure.” Beshear, 920 F.3d at 437.
5. The question in the informed consent context is whether informed consent laws are regulations of conduct that only incidentally burdens speech. If so, this justifies the Court’s different treatment of these compelled disclosure laws.
6. The Court explains that “[l]ongstanding torts for professional malpractice, for example, ‘fall within the traditional purview of state regulation of professional conduct’. . . [and that] [w]hile drawing the line between speech and conduct can be difficult, this Court's precedents have long drawn it.” NIFLA, 138 S. Ct. at 2373 (citing NAACP v. Button, 371 U.S. 415, 438 (1963)).

a. As discussed above, in NIFLA, the issue of regulating conduct was central to the Court’s holding. It notably found that the regulation at issue was not regulation of professional conduct and was thus subject to strict scrutiny, noting the “licensed notice at issue here is not an informed-consent requirement or any other regulation of professional conduct. The notice does not facilitate informed consent to a medical procedure. In fact, it is not tied to a procedure at all . . . The licensed notice regulates speech as speech.” Id. at 2373–74.
b. Professional Speech: Although the Supreme Court expressed deference to states regulating professional conduct that incidentally burdens speech, in NIFLA v. Becerra, the Court failed to adopt the reasoning of some lower courts that treated “professional speech” as a unique category of speech to be excepted from strict scrutiny review. NIFLA, 138 S. Ct. at 2371 (citing King v. Governor of New Jersey, 767 F.3d 216, 232 (3d Cir. 2014); Pickup v. Brown, 740 F.3d 1208, 1227–1229 (9th Cir. 2014).
c. These courts had developed a theory that professional speech received less protection in general (the professional speech doctrine) and that First Amendment protection of professional speech existed on a continuum. Pickup, 740 F.3d at 1227-28 (holding that First Amendment protection of professional speech existed on a continuum: the public dialogue of a professional received the highest protection, speech in the context of the professional relationship received less protection, and the state had the greatest power to regulate professional conduct that incidentally burdened speech).
d. The Court rejected this idea of professional speech, in general, receiving less First Amendment protection and specified that “outside of the context of disclosures under Zauderer [laws requiring professionals to disclose factual, noncontroversial information in a commercial context] and professional conduct—this Court's precedents have long protected the First Amendment rights of professionals.” NIFLA, 138 S. Ct. at 2374.
e. Yet, while the Supreme Court in NIFLA “recognize[d] that First Amendment heightened scrutiny does not apply,” Beshear, 920 F.3d at 429, to informed consent laws regulating professional conduct, it failed to articulate what specific level of scrutiny was to be used which has led to courts adopting different standards of review.
B. The Standards of Review for Informed Consent/Professional Conduct Regulations
1. In the Context of Abortion Regulations
i. Informed Consent disclosure regulations have been most heavily litigated in the abortion context, and due to this, much of the case law surrounding the standards of review of informed consent statutes reflects a combination of First Amendment Jurisprudence and language from the now-abrogated undue burden test from Planned Parenthood of Se. Pennsylvania v. Casey. However, it is very likely that these standards apply to informed consent regulations in all contexts and are not voided by Casey’s abrogation.
ii. In Casey, the Supreme Court held that an informed consent provision relating to an abortion procedure that required “the giving of truthful, non-misleading [and relevant] information . . . cannot be considered a substantial obstacle to obtaining an abortion, and . . . is no undue burden.” Planned Parenthood of Se. Pennsylvania v. Casey, 505 U.S. 833, 883 (1992), overruled by Dobbs v. Jackson Women's Health Org., 142 S. Ct. 2228 (2022). Subsequently, lower courts used this “truthful, non-misleading, [and relevant]” language as a standard to review whether an informed consent statute was constitutionally permissible.
iii. Casey additionally responded to a First Amendment challenge to the informed consent statute, noting “[t]o be sure, the physician's First Amendment rights not to speak are implicated . . . but only as part of the practice of medicine, subject to reasonable licensing and regulation by the State,” Casey, 505 U.S. at 884, which seemingly instructs a rational basis review. See Lakey, 667 F.3d at 575 (noting in Casey, “[t]he three sentences with which the Court disposed of the First Amendment claims are, if anything, the antithesis of strict scrutiny.”).

A. Rational Basis Plus Review

1. With Casey and NIFLA in mind, circuit courts have developed various standards of review to determine whether an informed consent statute is constitutional. The Fifth, Sixth, and Eighth Circuits have all in some way combined a variation of Casey’s “truthful non-misleading” language and rational basis review as a standard of review for informed consent laws.
2. The Fifth Circuit articulated a three-pronged standard of review explaining what informed consent laws are constitutionally permissible:
3. First, informed consent laws that do not impose an undue burden on the woman's right to have an abortion are permissible if they require truthful, non-misleading, and relevant disclosures. Second, such laws are part of the state's reasonable regulation of medical practice and do not fall under the rubric of compelling ‘ideological’ speech that triggers First Amendment strict scrutiny. Third, ‘relevant’ informed consent may entail not only the physical and psychological risks to the expectant mother . . . but also the state's legitimate interests in protecting the potential life within her. Lakey, 667 F.3d at 576 (quotations omitted).

B. Impact of NIFLA on the standard of review for informed consent and compelled speech laws.

a. The Sixth Circuit, when describing its standard, noted that “the [Supreme] Court clarified that the First Amendment has a limited role to play in allowing doctors to avoid making truthful mandated disclosures related to informed consent[,]” and thereby [u]nder the First Amendment, we will not highly scrutinize an informed-consent statute, including one involving informed consent to an abortion, so long as it meets these three requirements: (1) it must relate to a medical procedure; (2) it must be truthful and not misleading; and (3) it must be relevant to the patient's decision whether to undertake the procedure . . . Beshear, 920 F.3d at 428–29.
b. The Eighth Circuit, in Planned Parenthood Minnesota, et al. v. Rounds, had a very similar test holding that “with respect to First Amendment concerns, ‘while the State cannot compel an individual simply to speak the State's ideological message, it can use its regulatory authority to require a physician to provide truthful, non-misleading information relevant to a patient's decision to have an abortion, even if that information might also encourage the patient to choose childbirth . . .’” Planned Parenthood Minnesota, et al. v. Rounds, 686 F.3d 889, 893 (8th Cir. 2012) (en banc) (citing Planned Parenthood Minnesota, et al. v. Rounds, 530 F.3d 724, 734–35 (8th Cir. 2008)).
c. The Additional Factor While the Fifth and Eighth Circuits’ standards include the examination of whether the compelled speech is ideological as a factor, the Sixth’s does not, and the court explicitly opposed this component being part of the analysis. Beshear, 920 F.3d 421, 435–36 (6th Cir. 2019) (explaining that the ‘“ideological’ label has not been used by the Supreme Court as a reason to apply heightened scrutiny to mandated factual disclosures . . . what matters for First Amendment purposes is whether the disclosed facts are truthful, non-misleading, and relevant to the procedure, not whether they fall on one side of the debate . . .”). However, the Sixth Circuit’s disagreement with the non-ideological factor may be explained by its context: discussing a Fourth Circuit decision that found the use of ultrasound to be ideological speech that warranted intermediate scrutiny. Id. (citing Stuart v. Camnitz, 774 F.3d 238 (4th Cir. 2014).
d. The Fifth Circuit warned against broad readings of the definition of ideological that possibly made the Sixth Circuit Court so hesitant. It referenced Wooley v. Maynard, noting “that ‘ideological’ speech is speech which conveys a ‘point of view,”’ Lakey, 667 F.3d at 577 n. 4 (citing Wooley v. Maynard, 430 U.S. 705, 715 (1977), and “[t]he distinction the Court there sought to employ was between factual information and moral positions or arguments . . . surely a photograph and description of its features constitute the purest conceivable expression of ‘factual information.’” Id. Cf. Doe et. al. v Att'y Gen. of Indiana et. al., Case 1:20-cv-03247-RLY-MJD at *23-24 (S.D. Ind. Sept. 26, 2022)(holding a statute that required the remains of aborted children to be buried or cremated and the disclosure of such actions was “expressive conduct that receives First Amendment protection” and “. . . inherently conveys a message,” and thus was subject to strict scrutiny and not part of the professional regulation of conduct exception outlined by NIFLA).
e. Despite their different terminology, these three standards are arguably the same at their essence. The standards utilize rational basis review with an additional component to ensure that the compelled speech falls into the regulation of professional conduct exception outlined by the Supreme Court. Whether this component requires the speech to be truthful, non-misleading, and relevant, or non-ideological, the goal is to determine that the law regulates conduct and only incidentally burdens speech (as opposed to the State using its regulation to make a physician its ideological mouthpiece). Additionally, despite the adoption of the language from Casey, the use of this language functions differently; the language aims to limit informed consent disclosures to factual information related to a medical procedure (as opposed to preventing a regulation from being an undue burden), making it likely the standard applies beyond the abortion context as explained in depth infra.
a. Intermediate Scrutiny While the Fifth, Sixth, and Eighth Circuit Courts developed somewhat similar standards, the Fourth Circuit adopted an intermediate scrutiny test requiring the state to demonstrate that “the statute directly advances a substantial governmental interest and that the measure is drawn to achieve that interest.” Stuart, 774 F.3d at 249–50 (citing Sorrell v. IMS Health Inc., 131 S. Ct. 2653, 2667–68 (2011)).
b. The Fourth Circuit, addressing a statute that mandated the performance of ultrasound to obtain informed consent for an abortion, found that “[a] heightened intermediate level of scrutiny is thus consistent with Supreme Court precedent and appropriately recognizes the intersection here of regulation of speech and regulation of the medical profession. . .” Id. at 249–50.
c. This decision has since been undermined by NIFLA; the Sixth Circuit explained that:
d. Stuart's basis for applying heightened scrutiny is called into question by Supreme Court precedent . . . Stuart adopted a “sliding-scale” test first applied by the Ninth Circuit in Pickup v. Brown . . . the NIFLA Court, after citing the Ninth Circuit in Pickup . . . did not adopt any of the “different rules” applied in Pickup . . . as discussed, the Supreme Court explicitly carved out two exceptions to that general test that do not call for heightened scrutiny. Beshear, 920 F.3d at 435-36.
e. The Fourth Circuit, however, upheld this standard post-NIFLA in a case concerning the regulation of the legal profession. Capital Associated Indus. v. Stein, 922 F.3d 198, 209 (4th Cir. 2019) (holding that “intermediate scrutiny is the appropriate standard for reviewing conduct regulations that incidentally impact speech.”) The Fourth Circuit addressed NIFLA and noted that while the Court specified, strict scrutiny was not required, it did not specify which scrutiny was required; with this in mind, the Fourth Circuit found that “intermediate scrutiny strikes the appropriate balance between the state’s police powers and individual rights.” Id. See also Am. Med. Ass'n v. Stenehjem, 412 F. Supp. 3d 1134, 1149 (D.N.D. 2019) (adopting the Fourth Circuit’s intermediate scrutiny standard of review and describing the Rounds rational basis plus standard as an “abortion-specific standard.”).

B. These Standards likely apply outside the abortion context.

a. It should first be noted that since the Fourth Circuit has applied its intermediate scrutiny standard of review in other regulations of professional conduct, it is likely that it would apply this standard to other informed consent laws. Stein, 922 F.3d at 209.
b. While it has yet to be determined whether the standards of the Fifth, Sixth, and Eighth Circuits apply outside of the abortion context, the courts’ language in these cases suggests these standards would apply to informed consent regulations across the board.
c. The Sixth Circuit, in Beshear, was particularly emphatic in responding to an accusation from the dissent that the court was mixing its analysis with the undue burden test and focusing on the wrong provision of the Constitution; the court noted: indeed, we do address the relevant provision—the First Amendment. Casey and NIFLA recognize that First Amendment heightened scrutiny does not apply to incidental regulation of professional speech that . . . includes mandated informed-consent requirements, provided that the disclosures are truthful, non-misleading, and relevant . . . We, therefore, are applying Casey and NIFLA as they directly pertain to the First Amendment claim and not to any undue-burden claim under the Fourteenth Amendment. Beshear, 920 F.3d at 429.
f. The Sixth Circuit made clear that its analysis was solely that of a First Amendment inquiry. While it used the “truthful, non-misleading, and relevant” language of Casey, it was doing so in the context of a First Amendment analysis.
g. The Fifth Circuit standard pronounced in Lakey likewise was independent of an undue burden analysis and specifically articulated under the heading “First Amendment.” Lakey, 667 F.3d at 574. While the first prong of the Fifth Circuit’s standard references the undue burden law of Casey, it is merely a statement of fact recognized by Casey that “informed consent laws that do not impose an undue burden on the woman's right to have an abortion are permissible if they require truthful, non-misleading, and relevant disclosures.” Id. at 576. Moreover, the Fifth Circuit Court was not even addressing any challenge to the law as an undue burden but rather answering whether the sonogram disclosure law violated the First Amendment and whether the law was void for vagueness. Id.
h. The Eighth Circuit specifically prefaced its standard of review, stating, “Thus, with respect to First Amendment concerns,” Rounds, 686 F.3d at 893 (emphasis added), making clear it applies to a First Amendment analysis. While the court later noted that “to succeed on either its undue burden or compelled speech claims, Planned Parenthood must show that the disclosure at issue is either untruthful, misleading or not relevant to the patient's decision to have an abortion[,]” id. (Quotations omitted), in its decision, it conducted both analyses separately. First, the court articulated the Casey truthful non-misleading framework for the undue burden analysis; then, it separately articulated the First Amendment standard of review stated above. This clear articulation and separation make it again very likely that the Eight Circuit’s standard of review (like those of the Fifth and Sixth Circuits) applies outside the abortion context.

B. In other Contexts

a. An analysis of the standards of review for informed consent and professional conduct regulations in other contexts notably differ from the standards of the Lakey, Beshear, Rounds, and Stuart cases. The reason for the discrepancy in these other contexts is much of the litigation involves regulations requiring compelled silence by physicians which implicates different issues than compelled factual disclosures. Additionally, the affirmative disclosure regulations that have been litigated do not implicate informed consent in the physician-patient context.
b. Affirmative Disclosure Regulations
i. HIV Disclosures While not in the professional doctor-patient context, affirmative disclosures in the context of informed consent to conduct have been required for individuals with HIV. Most courts have upheld these laws as conduct regulations seemingly under a rational basis review.
ii. The Ohio Supreme Court upheld a law that “prohibit[ed] HIV positive individuals from engaging in sexual conduct without disclosing the HIV status prior to engaging in the conduct.” State v. Batista, 91 N.E.3d 724, 729 (2017). The court noted that “[t]he First Amendment does not prevent statutes regulating conduct from imposing incidental burdens on speech” and that “the disclosure is incidental to the statute's regulation of the targeted conduct. Thus, this statute regulates conduct, not speech, and does not violate the First Amendment right to free speech.” Id. at 728.
iii. The court was not exactly clear on what scrutiny it applied to the law in the First Amendment context and merely foreclosed the First Amendment challenge with its comments on conduct (suggesting rational basis review was used). However, the court upheld the statute under an equal protection challenge as well, and there explicitly used rational basis review, noting that the statute was “rationally related to the state's legitimate interest in preventing the transmission of HIV to sexual partners who may not be aware of the risk.” Id. at 730.
iv. Other courts have upheld similar laws that criminalized the intentional transmission of HIV and contained an affirmative defense for consent via disclosure. People v. Russell, 630 N.E.2d 794, 796 (1994) (citing (720 Ill. Comp. Stat. Ann. 5/12-16.2)); State v. S.F., 483 S.W.3d 385 (Mo.2016) (en banc). These courts similarly did not use intermediate or strict scrutiny signifying that rational basis review was used and was appropriate. Russell, 630 N.E.2d at 796 (holding that “the statute nor the cases before us have even the slightest connection with free speech . . . the statute in question is not violative of . . . the United States Constitution.”); S.F., 483 S.W.3d at 387-88 (holding the statute “does not regulate speech. It regulates conduct—specifically, conduct that exposes unknowing or nonconsenting individuals to HIV[,]” and “any speech compelled . . . is incidental to its regulation of the targeted conduct and does not constitute freedom of speech violation.”). However, an Iowa Supreme Court case is an outlier; while still upholding a similar HIV disclosure regulation, the court found the law content-based and subject to strict scrutiny. State v. Musser, 721 N.W.2d 734, 744 (Iowa 2006).
v. Affirmative Disclosures Required of Lawyers While most affirmative disclosures required by lawyers fit into the Zauderer commercial speech exception articulated in NIFLA, in Fox v. State, the Missouri Supreme Court addressed a statute that concerned the professional conduct exception. Fox v. State, 640 S.W.3d 744 (Mo. 2022). The statute at issue required attorneys (defense, prosecution, or otherwise) to inform sexual assault survivors of certain sexual assault survivors’ rights before commencing an interview. Id.
vi. The court found the statute was not a regulation of conduct incidentally burdening speech and applied strict scrutiny noting the statute “does not closely correspond to a preexisting professional requirement, and the compelled speech is more significant than the regulation of professional conduct.” Id. at 752. The court explained, “The regulations in Casey and NIFLA were tied to a preexisting professional requirement—obtaining informed consent before performing a procedure. . . As a result, the required speech—providing certain disclosures—was incidental to professional conduct—obtaining informed consent. The regulation here, though, does not . . .” Id. at 752.
vii. Prohibitionary Regulations Most courts apply heightened scrutiny to laws prohibiting physicians from speaking about certain topics.
viii. Inquiry about Firearms In one case, a law prohibited physicians from writing or speaking about firearms to their patients in certain circumstances. The Eleventh Circuit did not view this law as a regulation of professional conduct incidentally burdening speech but rather held that the law was a content-based regulation of speech and subject to heightened scrutiny (in this case, intermediate). Wollschlaeger v. Governor of Fla., 848 F.3d 1293, 1312 (11th Cir. 2017) (en banc).
ix. While the court noted that state officials argued that “the First Amendment is not implicated because any effect on speech is merely incidental to the regulation of professional conduct[,]” the court distinguished this prohibitionary regulation from a professional conduct regulation explaining that the provisions of the law “expressly limit the ability of certain speakers—doctors and medical professionals—to write and speak about a certain topic—the ownership of firearms—and thereby restrict their ability to communicate and/or convey a message. As a result, there can be no doubt that these provisions trigger First Amendment scrutiny.” Id. at 1307.
x. Medical Marijuana Another prohibitionary case involved a federal government policy that aimed to prohibit physicians from recommending marijuana in states where it had been decriminalized for medical purposes; the policy was to be enforced by revoking physicians’ licenses if they prescribed or recommended medical marijuana to their patients. Conant v. Walters, 309 F.3d 629, 632 (9th Cir. 2002). The Ninth Circuit enjoined the policy, finding it a content-based regulation of speech, and reviewed it with strict scrutiny. Id.
xi. The court stated that the policy punishes physicians “on the basis of the content of doctor-patient communications . . . [it] does not merely prohibit the discussion of marijuana; it condemns expression of a particular viewpoint, i.e., that medical marijuana would likely help a specific patient. Such condemnation of particular views is especially troubling in the First Amendment context.” Id. at 637. The court acknowledged that it had historically recognized legitimate regulations of the medical profession but that these regulations must be content-neutral and not attempt to “dictate the content of what is said in therapy.” Id. (citing NAAP v. California Bd. of Psychology, 228 F.3d 1043, 1055 (9th Cir.2000)).

B. Counseling Bans

a. In an Eleventh Circuit case, the court found that a statute banning “conversion therapy” was a content-based regulation of speech and subject to strict scrutiny. The court acknowledged that “States may regulate professional conduct, even though that conduct incidentally involves speech[,]” but noted that “[t]he government cannot regulate speech by relabeling it as conduct . . . What the governments call a ‘medical procedure’ consists—entirely—of words. As the district court itself recognized, plaintiffs’ therapy is not just carried out in part through speech: the treatment provided . . . is entirely speech.” Otto v. City of Boca Raton, Fla., 981 F.3d 854, 865 (11th Cir. 2020) (citing NIFLA, 138 S. Ct. at 2372) (quotations omitted).
b. The Ninth Circuit held the opposite in Pickup v Brown and Tingley v Ferguson, two cases that involved conversion therapy bans for minors. Pickup, which was decided pre-NIFLA (and articulated the professional speech doctrine and continuum theory), found that the ban was a regulation of conduct subject to rational basis review. Pickup, 740 F.3d at 1231.
c. In Tingley, the Ninth Circuit reviewed NIFLA as well as Pickup and found that the statute at issue fit into NIFLA’s “second exception . . . that ‘States may regulate professional conduct, even though that conduct incidentally involves speech.”’ Tingley v. Ferguson, 47 F.4th 1055, 1062 (9th Cir. 2022) (citing NIFLA,138 S. Ct. at 2372). While the court acknowledged NIFLA abrogated Pickup’s professional speech doctrine, it maintained that Pickup was not fully abrogated and that it was bound to follow Pickup’s continuum theory in terms of its review of professional conduct regulation. Id.
d. As Pickup had found the conversion therapy ban to be a regulation of conduct subject to the least First Amendment protection on the continuum, the court used a rational basis standard of review which it held the law satisfied, stating that “States do not lose the power to regulate the safety of medical treatments performed under the authority of a state license merely because those treatments are implemented through speech rather than through scalpel.” Id.
e. These decisions notably differed from the Ninth Circuit’s treatment of a prohibitionary regulation in Conant. The Ninth Circuit attempted to differentiate these decisions from Conant, arguing that a conversion therapy ban regulated treatment which was conduct, not speech. Id. The court explained that:
f. Unlike the law at issue in Conant that prohibited doctors from recommending the use of marijuana to patients, California's ban on practicing conversion therapy on minor patients still allowed therapists to discuss conversion therapy with patients, recommend that patients obtain it (from unlicensed counselors, from religious leaders, or out-of-state providers, or after they turn 18) . . . California's conversion therapy ban “regulate[d] only treatment” and “any effect it may have on free speech interests is merely incidental. Tingley, 47 F.4th at 1062 (citing Pickup 740 F.3d at 1231)
g. This reasoning was criticized in Pickup’s dissent, which argued the decision “ignores established free speech doctrine, misreads our cases, and thus insulates from First Amendment scrutiny California's prohibition—in the guise of a professional regulation—of politically unpopular expression;” in other words, the decision allows the state to “avoid First Amendment judicial scrutiny by defining disfavored talk as “conduct[.]” Pickup, 740 F.3d at 1215 (O’Scannlain, J., dissenting).
h. The Third Circuit similarly criticized the Pickup decision despite adopting its professional speech doctrine in King v. Governor of New Jersey. In King, the court addressed a conversion therapy ban and upheld it, but unlike the Ninth Circuit, held that conversion therapy “communications are “speech” for purposes of the First Amendment.” King, 767 F.3d at 224–25. The court criticized Pickup, stating, “the enterprise of labeling certain verbal or written communications “speech” and others “conduct” is unprincipled and susceptible to manipulation” and “speech is speech, and it must be analyzed as such for purposes of the First Amendment.” Id. at 228-29. With this in mind, the Third Circuit Court recognized the ban was a content-based restriction on speech and held it was subject to intermediate scrutiny (not strict scrutiny because of the now abrogated professional speech doctrine). Id. at 236-38.
i. Telemedicine One prohibitionary case prohibited a method of communication rather than a certain subject to be communicated. The case involved a law that required veterinarians to physically examine animals to lawfully practice veterinary medicine (and barred veterinarians from practicing by telemedicine alone). Hines v. Quillivan, No. 1:18-CV-155, 2021 WL 5833886 (S.D. Tex. Dec. 9, 2021). The court reviewed the law with strict scrutiny, finding the law was a content-based regulation of speech. Id. at *4. The court explained that the law as applied to the plaintiff did not fall into the regulation of professional conduct exception but targeted speech alone because “all of [the veterinarian’s] interactions with pet owners took the form of verbal and written communications.” Id. at *2.
i. Unauthorized Practice of Law While outside the medical context, unauthorized practice of law cases give some more insight into the court’s treatment of professional conduct regulations. As noted supra, the Fourth Circuit maintained its intermediate scrutiny standard in a case that involved a ban on corporations practicing law. Stein, 922 F.3d at 209. In this case, the court found the law to be one regulating professional conduct, noting that “North Carolina's ban on the practice of law by corporations fits within NIFLA’s exception for professional regulations that incidentally affect speech.” Id. at 207. The court further explained that the law was “part of a generally applicable licensing regime that restricts the practice of law to bar members and entities owned by bar members” and any effect on speech “is merely incidental to the primary objective of regulating the conduct of the profession.” Id. at 207-08.
j. In another case involving a “narrow and novel” as applied challenge to an unauthorized practice of law (UPL) statute, the court found that the statute was content-based and subject to strict scrutiny. Upsolve, Inc. v. James, 2022 WL 1639554, at *9-10 (S.D.N.Y. May 24, 2022). The UPL statute here defined the practice of law as the giving of legal advice (among other actions). Id. While the court noted that UPL statutes usually “regulate professional “conduct” and merely burden a non-lawyers speech incidentally[,]” it found that the restriction of the plaintiff giving legal advice alone was a restriction of speech itself. Id.
k. As demonstrated, in cases of prohibitionary regulations on physicians’ speech (that is, banning physicians from speaking about certain topics or in certain ways), most courts apply heightened scrutiny; Tingsley and Pickup are two notable exceptions to this rule.

B. A final word about the importance of NIFLA

a. In NIFLA v. Becerra, the Supreme Court made clear that while professional speech is not a unique category of speech to be excepted from strict scrutiny, regulations concerning professional conduct that incidentally burden or compel speech (like informed consent laws) are not subject to strict scrutiny review. The Court, however, failed to specify what scrutiny should be used to review these laws. Due to this, different standards have been used to review informed consent laws. In terms of the traditional informed consent regulations compelling affirmative factual disclosures, many courts have applied a rational basis plus review, while other courts have reviewed the laws with intermediate scrutiny. Outside of the physician-patient disclosure context, informed consent laws relating to HIV disclosure have also been upheld (in most cases under rational basis review) as regulations of conduct incidentally burdening speech.
b. In cases of prohibitionary laws regulating physicians’ speech, courts have consistently used heightened scrutiny (excepting the Ninth Circuit’s Tingley and Pickup). These laws differ significantly from the affirmative factual disclosure regulations because they are almost always content-based restrictions on speech.
c. As illustrated by the cases above, the professional conduct exception does not give states free reign over professionals’ speech. When regulating professional conduct that incidentally burdens speech, states are required to conform to certain restrictions; these laws must be tied to a preexisting professional duty/procedure (such as obtaining informed consent), Cf. Fox v. State, 640 S.W.3d 744 (Mo. 2022) (see supra) and cannot force the physician to become the state’s ideological mouthpiece.
d. As noted in NIFLA, the Supreme Court was very hesitant to reduce protection for professional speech in general. The Court specifically warned of the dangers of the state co-opting the medical profession, noting that “regulating the content of professionals' speech pose[s] the inherent risk that the Government seeks not to advance a legitimate regulatory goal, but to suppress unpopular ideas or information,” and “Throughout history, governments [including the Soviet government and Nazi Germany] have manipulat[ed] the content of doctor-patient discourse to increase state power and suppress minorities.” NIFLA, 138 S. Ct. at 2374 (quotations omitted).
e. In conclusion, given the analysis in the cases above, it is appropriate that informed consent factual disclosure laws are reviewed under a rational basis plus review. Traditionally, states have always been able to regulate the medical profession in this regard, and the rational basis plus standards ensure that these compelled disclosure laws do not go beyond the states’ authority. On the other hand, laws prohibiting physicians from speaking about certain topics—like counseling bans—are appropriately reviewed with heightened scrutiny because they almost always aim to suppress or discriminate against different viewpoints or certain conduct.

V. Events following Dobbs and NIFLA

A. Violence and vandalism toward pregnancy centers in the wake of Dobbs

1. Even before the Dobb’s opinion was officially released and the draft of the opinion was leaked, over 80 pro-life pregnancy centers around the U.S. were vandalized, most with threatening messages or set fire to.
2. The Department of Homeland Security was forced to issue a memo warning about domestic violence extremists who may retaliate to the decision to overturn Roe the same day Dobbs was released.
3. A group called Jane’s Revenge formed after Dobbs was released in 2022, a militant pro-abortion rights group responsible for attacks against pro-life pregnancy centers around the U.S.
4. Life Choices, a pregnancy center in Longmont, Colorado, was firebombed the day after Dobbs was released, forcing a yearlong renovation and preventing the center from providing their services.
5. Attorney General Ashley Moody of Florida filed a complaint against anti-abortion activist groups Jane’s Revenge and ANTIFA for vandalizing and setting fire to three crisis pregnancy center buildings. First Liberty Institute is filing a second suit on behalf of one of those clinics.
6. Recent Cases of Violence Against Reproductive Health Care Providers,

B. In 2023, at least fifteen States considered nearly twenty-seven measures attacking the life-affirming work of pregnancy centers.
C. Laws targeting pregnancy centers were enacted in Illinois, Colorado, and Vermont.

1. In Illinois, a 2016 law requires healthcare providers with conscience-based objections to abortion to inform patients of the supposed “benefits” of abortion and refer patients to a list of providers that offer abortion. ADF represents NIFLA and three Illinois pregnancy centers in a lawsuit challenging that statute.
2. In Colorado, the Becket Fund filed suit against a 2023 law making it illegal for pro-life pregnancy centers and medical clinics to offer or advertise abortion pill reversal.
3. And in Vermont, ADF recently filed suit against a 2023 law specifically targeting the speech of pro-life pregnancy centers.

D. These laws violate the Supreme Court’s decision in NIFLA, which prohibits “wildly underinclusive” laws that “disfavor[] a particular speaker or viewpoint.”
E. ADF is working with NIFLA to fight back against these laws.
F. In September of this year, ADF represented NIFLA at a federal trial in the Illinois case.

1. The Illinois law requires only those health care providers who have “conscience-based refusals” to provide particular medical treatments, including abortion, and requires those providers to violate their conscience by discussing the benefits of and referring for those treatments.
2. ADF argued at trial that the law unconstitutionally compels speech based on content and viewpoint and that it unconstitutionally targets religion by limiting its application to providers with conscience-based refusals.

G. In July of this year, ADF filed a lawsuit on behalf of NIFLA and two Vermont pregnancy centers against the Vermont pregnancy center law.

1. That law is facially viewpoint discriminatory because it applies only to those centers that do not provide or refer for abortion and “emergency contraception.”
2. ADF challenged two provisions of the law: (1) the Advertising Prohibition, which prevents pregnancy centers from advertising their services in a way that Vermont’s pro-abortion attorney general thinks is misleading, and (2) the Provider Restriction, which requires centers to hire licensed medical staff to provide broadly defined “services,” “information,” and “counseling.”
3. ADF’s complaint alleges that both provisions violate constitutionally restrict the centers’ free speech and are unconstitutionally vague.

H. Cases building on NIFLA

1. Gaspee Project v. Mederos, 13 F.4th 79 (1st Cir. 2021): The First Circuit upheld a Rhode Island law requiring “limited disclosure of funding sources responsible for certain independent expenditures and electioneering communications.” The Plaintiffs, two “not-for-profit organizations that engage in issue advocacy related to matters of public policy,” argued that the requirement compelled speech under NIFLA. The First Circuit rejected that argument, explaining that “on-ad disclaimer regimes concerning funding sources in election-related contexts are similarly not comparable to requiring pro-life clinics to explain to patients that they may seek free abortion services from the government.”
2. Brokamp v. James, 66 F.4th 374 (2d Cir. 2023): The Second Circuit upheld a New York licensing-scheme for mental health counselors. Applying NIFLA, the court first determined that the law “does not turn on the content of what a person says” but “only to speech having a particular purpose, focus, and circumstance.” It then applied intermediate scrutiny, holding that the law “addresses an important government” interest” in “promoting and protecting public health” and that it “does not burden more speech than necessary to allow the state to protect residents against incompetent and deceptive mental health counselors.”
3. Greater Phila. Chamber of Commerce v. City of Phila., 949 F.3d 116 (3rd Cir. 2020): The Third Circuit upheld “a Philadelphia Ordinance that prohibits employers from inquiring into a prospective employee’s wage history in setting or negotiating that employee’s wage.” Relying on NIFLA, the court held that the ordinance’s “effect on speech” was “incidental” and “d[id] not place the provision under First Amendment scrutiny.”
4. Recht v. Morrisey, 32 F.4th 398 (4th Cir. 2022): The Fourth Circuit upheld a West Virginia statute requiring attorneys to include certain disclosure in “advertisements made ‘in connection with a prescription drug or medical device approved by the [FDA].’” The court distinguished NIFLA on the grounds that “the disclosure requirements here are directly targeted at promoting the State’s interest ‘in dissipate[ing] the possibility of consumer confusion or deception’” and “they do so by providing information directly connected to the subject of the advertisement, rather than by compelling speech concerning unrelated or competing services.” It then applied the lower level of constitutional review for commercial speech, holding that unlike NIFLA, the State’s interest in “preventing deception of consumers is undeniably strong” and that the “disclosure requirements” are “no broader than reasonably necessary” because it requires only “two or three short sentences.”
5. Net Choice, LLC v. Paxton, 49 F.4th 439 (5th Cir. 2022): The Fifth Circuit considered a Texas statute that prevents social media platforms from engaging in “viewpoint-based censorship of users’ posts” requires platforms to “make certain disclosures” regarding their policies concerning “content-moderation.” The court first held that the censorship provision was a regulation of conduct, not speech, and passed intermediate scrutiny. It then applied the commercial speech doctrine to the disclosure requirements, distinguishing NIFLA on the grounds that the requirements did not “unduly burden (or ‘chill’) protected speech.” The court ultimately upheld both provisions. Plaintiff trade associations representing social media providers petitioned for cert in December 2022 and issued a CVSG order on January 23, 2023.
6. EMW Women’s Surgical Center, P.S.C. v. Beshear, 920 F.3d 421 (6th Cir. 2019): Kentucky’s Ultrasound Informed Consent Act required a doctor to show the pregnant mother an ultrasound while describing it to her and play the audio of the baby's heartbeat before providing an abortion. The Sixth Circuit held that the Act did not violate the First Amendment because NIFLA recognized “that First Amendment heightened scrutiny does not apply to incidental regulation of professional speech that is part of the practice of medicine and that such incidental regulation includes mandated informed-consent requirements, provided that the disclosures are truthful, non-misleading, and relevant.” Id. at 429. The Supreme Court denied cert.
7. Doe v. Rokita, 54 F.4th 518 (7th Cir. 2022): Indiana law requires “abortion providers to dispose of fetal remains by either burial or cremation” and to disclose to patients all statutory options for fetal disposition, including that “women may choose to take custody of the remains and dispose of them as they please.” Plaintiffs argued that the law violated abortion patients’ free exercise rights and abortion providers’ free speech rights. The Seventh Circuit rejected both challenges. Regarding the free exercise claim, the court explained that “Indiana does not require any woman who has obtained an abortion to violate any belief, religious or secular” because the law “applies only to hospitals and clinics.” And with regard to the free speech claim, the Seventh Circuit correctly held that Dobbs did not overrule Casey’s truthful and non-misleading test for informed consent laws, only Casey’s holding that “states may not substantially burden a woman’s ability to obtain an abortion before a fetus’s viability.” The Seventh Circuit correctly distinguished informed consent laws from the compelled speech law struck down in NIFLA, citing Casey’s holding that “a state may require medical professionals to provide information that facilitates patients’ choices directly linked to procedures that have been or may be performed.”
8. Tingley v. Ferguson, 47 F.4th 1055 (9th Cir. 2022): ADF represents a Christian therapist in a pre-enforcement challenge to Washington law banning “conversion therapy” for minors struggling with same-sex attraction. The district court dismissed ADF’s complaint, and ADF appealed. Relying on a case that the Supreme Court specifically abrogated in NIFLA, the Ninth Circuit distinguished NIFLA on the grounds that the law “is a regulation on conduct that incidentally burdens speech. The court then inexplicably applied the rational basis test, even though intermediate scrutiny is the usual constitutional test for such regulations. It then held that “[t]he Washington legislature acted rationally when it decided to protect the ‘physical and psychological well-being’ of its minors by preventing state-licensed health care providers form practicing conversion therapy on them.” The Ninth Circuit further distinguished NIFLA on the grounds that “some subcategories of speech by professionals are, in fact, excepted from heightened scrutiny and instead subject to less scrutiny. But rather than fitting the Washington law into the “commercial speech” or “informed consent” subcategories identified in NIFLA, the Ninth Circuit held that “[t]here is a long (if heretofore unrecognized) tradition of regulation governing the practice of those who provide health care within state borders.” The court did not attempt to explain why, if such a tradition exists, the Supreme Court would not have applied it in NIFLA, which also dealt with a statute regulating health care professionals. The court also rejected ADF’s free exercise claim. After the Ninth Circuit denied ADF’s petition for rehearing en banc, ADF petitioned for cert on both the free exercise and free speech claims. The Court set the case for a conference on September 26, 2023.
9. Animal Legal Defense Fund v. Kelly, 9 F. 4th 1219 (10th Cir. 2021): The Tenth Circuit struck down a Kansas statute preventing investigators from documenting and publicizing the abuse of animals. Applying NIFLA, the court held that the law was a regulation of speech that discriminated on the basis of viewpoint and content and that it failed strict scrutiny.
10. Otto v. City of Boca Raton, Fla., 981 F.3d 854 (11th Cir. 2020): The Eleventh Circuit struck down a Florida ordinance “prohibit[ing] therapists from engaging in counseling or any therapy with a goal of changing a minor’s sexual orientation[] . . . or changing a minor’s gender identity or expression.” Relying on NIFLA, the court rejected the City’s arguments that the content-based regulation was entitled to a lower level of review because it regulated professional speech or because it regulated conduct rather than speech. It also noted the NIFLA criticized cases upholding similar laws in other circuits. The court then applied strict scrutiny and struck down the ordinance.
11. NetChoice, LLC v. Attorney General, 34 F.4th 1196 (11th Cir. 2022): The Eleventh Circuit also considered a Florida law that prohibited social media platforms from moderating content in certain ways, required platforms to disclose their content-moderation policies, and allowed “deplatformed user[s] to ‘access or retrieve all of the user’s information, content, material, and data for at least 60 days.’” The court then rejected the argument that the entire statute was subject to strict scrutiny because it was viewpoint discriminatory under NIFLA. It then held that while the content-moderation requirements were content-based and subject to strict scrutiny, the disclosure requirements fell under NIFLA’s exception for “[l]aws that compel commercial disclosures.” The court ultimately struck down the content-moderation restrictions but upheld the disclosure requirements.

VI. Message of Hope

A. ADF will fight for your pregnancy centers against laws regulating centers’ speech and services.
B. Supreme Court’s decisions in Dobbs and NIFLA are proof that God has heard our prayers just as He heard the prayers of the Israelites who prayed for rescue from Babylon.
C. 14 States are currently enforcing laws protecting life at its earliest stages
D. Several more States have laws protecting life later in pregnancy
E. NIFLA has also been assisting ADF’s end-of-life cases
F. Call to prayer for ADF cases

VII. Conclusion

A. Our hope lies in God, not our own efforts, the government, the law, or the Supreme Court
B. God will be victorious
C. Connect everything back to Isaiah chapter 42


Kristi Hamrick
Vice President of Media & Policy
Chief Media & Policy Strategist
Students for Life of America


If you care about the issue of abortion, you need to care about chemical abortion pills. Surgical abortions as the leading cause of direct abortion deaths is over. Death by drugs is the present and future.


Even though we have no national abortion reporting law to verify abortion in America, the abortionists’ lobby at The Guttmacher Institute tells us that RIGHT NOW, more than half of all abortions are committed with deadly pills. It’s all trust, but NEVER verify with abortionists … and if anyone ever tells you abortion is safer than childbirth, call their bluff … That’s as accurate as comparing the number of unicorns to horse … one of those numbers don’t exist. Planned Parenthood has taken states to court for decades to stop reporting laws – It’s ‘Trust but Never Verify’ with them.

No National Reporting Law

In the U.S., it’s a two-pill cocktail used to cause preborn infant death, which was first known in the U.S. by the name RU-486. The first pill starved the baby and was created as a “non-pregnancy” pill … it blocks progesterone, the pregnancy hormone. The second pill causes contractions.

This deadly combination was developed by the French company Roussel Uclaf, which literally connected to the  Nazis, as detailed in a report in The Federalist.

On the Nazis (If we go that direction)

In the early to mid-20th century, the pharmaceutical holding company I.G. Farben Chemical Company controlled much of the German chemical industry. According to Encyclopedia Britannica, the infamous Auschwitz was one of I.G. Farben’s very own chemical plants, responsible for the slavery and deaths of more than a million people in World War II.  … “After the war, Western countries attempted to utterly splinter I.G. Farben’s industrial power but divided the holding company into three of its own industrial members, Hoechst, Bayer, and BASF.

“In 1974, the first of these three entities, Hoechst, gained a majority share of the holding company Chimio that controlled a French pharmaceutical company called Roussel Uclaf. By 1982, Roussel Uclaf had developed the RU-486 chemical abortion drug mifepristone.”  And Bill Clinton cut the deal with them to bring the pills to the U.S., detailed well in a 98-page Harvard University paper, The Life of the Abortion Pill in the United States.

The New York Times recently profiled the “father” of the abortion pill:  Dr. Étienne-Émile Baulieu.

His goal was ending life with pills – it wasn’t an accident or side effect; this wasn’t made as an arthritis or stomach pill … it was always about abortion. Dr. Baulieu made a faux progesterone, an impostor to latch onto progesterone receptors so the real hormone could not.


They can cost brick-and-mortar costs … personnel costs … testing costs … tissue disposal costs … outsource all problems to emergency rooms … and that’s what’s happening.

Given current trends, chemical abortion pills may soon cause more than 90 % of all abortions in the U.S.

  • Right now, the FDA says don’t use the pills past10 weeks.
  • Right now, Planned Parenthood says it’s safe to sell the pills to11 weeks.
  • Right now, there is a push to sell these drugs to 12weeks (and even beyond.)  The World Health Organization supports the pills to 12 weeks.
  • Right now, more than 9 in10 abortions (92.7%) take place by 12 weeks – that’s more than 90 % of all abortions.
  • Right now, three-quarters of abortions in Europeare committed with chemical abortion pills, according to the New York Times, and it can be more. As an NIH report notes that countries like Finland use chemical abortion pills 7% of the time, and in Sweden, the pills are used more than 96.4%.

Do we have the math of the number of abortions?

We have a book with women’s stories talking about the pain, the weeks of bleeding, the trauma of fully formed babies, sometimes born alive. One woman said: I wish they told me these pills wouldn’t end the baby’s life. It came out in the sack, with all the limbs and the eyes … heart still beating. If I knew that would be the outcome, I would’ve never done it.”

In the Washington Post, it was reported that one abortionist literally sends acid along to get rid of the babies’ bodies … this is an up close and horrifying event.

The health risks warning is one like the Surgeon General’s warning.

We know these pills are dangerous. They expose women to injury, infertility, and even death, as well as to abusers, using the pills without women’s knowledge or consent.

The FDA reports numerous side effects. Between 5 and 7 percent of women who take chemical-abortion pills will need a follow-up surgery to end the pregnancy. And an Australian study noted that up to 8 percent of women who took the pills in that country ended up in an emergency room. The abortion industry reported similar math.

An NIH-published study from Finland (because we don’t check on women’s health in the U.S. related to abortion)  titled: Immediate complications after medical compared with surgical termination of pregnancy found that the rate of complications was FOUR TIMES HIGHER, including things like hemorrhaging and incomplete abortions needing follow up care, like an abortion surgery.

Another NIH-published study titled Mifepristone-Misoprostol Medical Abortion Mortality reported that while they supported chemical abortion pills, those selling pills to women should “Inform them that the risk of death appears to be 10 times greater with medical abortion than with surgical abortion.”

Another issue for women is HOW MUCH BLOOD IS TOO MUCH BLOOD? (I’ve had bleeding in three of four pregnancies and each time sought help. There is NO SUCH THING as DIY, self-care abortions unless you’re also a DIY physician.

In a Charlotte Lozier study, they found that “(t)he rate of abortion-related emergency room visits following a chemical abortion increased over 500%from 2002 through 2015, according to an analysis of Medicaid claims data. Over the same period, chemical abortions within the study population increased from 4.4% to 34.1% of total abortions” ... and now it's more than HALF!

Many women don’t know how far they are in a pregnancy, and it matters. Chemical-abortion pills don’t work well later in pregnancy or when a woman has an ectopic pregnancy (one that takes place outside the womb), which affects up to 2 percent of women. Half of those experiencing that life-threatening condition will have no risk factors. The FDA also notes that such pills present a risk of death from internal bleeding caused by a ruptured ectopic pregnancy.

Without proper treatment, women also face an extreme risk of infertility after using chemical-abortion pills if they have an Rh-negative blood type, which includes 15 percent of the population. When a pregnant, Rh-negative woman experiences blood contact, such as in birth or abortion, she must urgently receive a shot of Rh immunoglobulin to neutralize deadly antibodies. Without that, miscarriages can bring future heartache as a mother’s body attacks future pregnancies.

Do we have an infertility one?

Women have died when chemical abortion pills were given later in pregnancy or to those with an ectopic pregnancy … If you cared to stop that, you would do an ultrasound beforehand for diagnosis … and after to ensure that nothing remained because that can lead to infection, which also has killed women.

If you cared to protect women’s future fertility, you would do a blood test and provide Rhogam to prevent the deadly antibodies from forming that can attack future pregnancies, leading to endless miscarriages. You must receive that shot fast – within 72 hours of a blood exchange through miscarriage, birth, or abortion. And you also get one during pregnancy.

… I’m Rh-negative and have received multiple shots of Rhogam, including when at 7 months along in one of my four pregnancies, I was rear-ended. They even gave me a shot then as a precaution. Shouldn’t caution with women’s health be the least we can expect?

If you cared about women, you wouldn’t create the sex trafficker’s and abuser’s dream drug. Women have been given chemical abortion pills without their knowledge or consent … something that could be prevented with an in-person consultation verifying that a pregnant mother wants the drugs and is not being coerced.

THEN WE GET TO ONLINE DISTRIBUTION THROUGH INTERNATIONAL ABORTION VENDORS AND AN EMERGING DRUG CARTEL. They often sell just ONE pill, something detailed by the Washington Post in an article titled Covert network provides pills for thousands of abortions in U.S. post-Roe

RECENTLY a study reported that the pills coming into the U.S. from some foreign outlets were just junk. Bloomberg Law reported that mega-donors like the Bill and Melinda Gates Foundation and DKT International had helped fund a chemical abortion pill manufacturer turning out garbage … “ But almost one-fifth of the 30 million products DKT distributes annually for abortions and postpartum hemorrhage prevention come from an Indian company with a record of making substandard medicine.”


(Possible sidenote – if the first pill knocked out by ADF/SFLA … will a protocol with the second work … NO)


As SFLA notes on our blog: The Charlotte Lozier Institute recently released a new report by Senior Fellow and Director of Medical Affairs Ingrid Skop (M.D., F.A.C.O.G.) which is entitled, “Induced Abortion with Misoprostol Alone.” The report detailed exactly why the one-pill Chemical Abortion regimen is such a killer for women, noting the abortion lobby’s disregard for women’s health, as well. (As a refresher, Misoprostol causes the body to go into labor to expel a preborn child. Mifepristone, the drug that is paired with it in the two-pill chemical abortion regimen, stops the production of the hormone progesterone, which ends up starving and killing a preborn baby.)  THIS ONE-PILL FORMAT FAILED ABOUT ONE IN FOUR TIMES … and yet, sales are booming, they say.

“Evidence from around the globe demonstrates that misoprostol alone is a poor abortifacient and very likely to cause injury to women…As an example of how poorly misoprostol alone functions to cause abortion, a 2010 study comparing standard mifepristone/misoprostol with misoprostol alone documented that using misoprostol only to induce an abortion led to a 23.8% failure rate requiring surgery. The embryo/fetus continued to survive in 16.6% of the pregnancies, and misoprostol is known to produce birth defects such as Moebius Sequence, associated with craniofacial and limb abnormalities, leaving these children at risk if the pregnancy continued to birth. In contrast, there were 3.5% failures and 1.5% continuing pregnancies in the mifepristone/misoprostol group.

“Similarly, a 2013 study demonstrated a failure rate of 38.8% when misoprostol alone was used vaginally and 29.8% when used sublingually (under the tongue). Finally, a worldwide systematic review of more than 12,000 misoprostol abortions performed by abortion advocacy researchers found 22% (nearly one in four) required surgical completion because misoprostol failed to completely empty the uterus of the remains of the child.”


What’s up in the Biden Administration?

But consider this -- Even during the height of the Supreme Court’s abortion decision Roe v. Wade that, now overturned, one means of abortion – partial birth abortion – was ended because of its barbaric nature and its harms to women. Gonzales v. Carhart made it clear that even among abortions, some are more horrific than others.


There is no social good in allowing women to be harmed to make it easier for abortionists to make a profit … which is what our current situation allows … Abortionists can cut cuts but cutting testing, staff, brick-and-mortar locations, disposal of the baby’s body, requirements, Rhogam … et al.

Chemical abortion pills are being handled in a negligent and dangerous way … thanks to the Administrations first of Bill Clinton, then Barack Obama, and now Joe Biden.

Dropping health and safety standards is a boon to abortionists and puts abortion in the back pocket of every teenager through their phone.

During the Covid-19 crisis, Planned Parenthood announced that it would have the capacity to do “telehealth services” in all 50 states … and they are not the only virtual abortion vendor.

Biden’s nefarious team … all those guys together.

The policies of the Biden Administration indicate that they don’t care who else is hurt if a preborn baby also dies.

Consider this … on the day that the FDA pulled a Johnson and Johnson COVID vaccine because ONE WOMAN had died, we learned they were dropping health and safety standards on chemical abortion pills even though now almost 30 women are confirmed dead by the FDA. (From the W. Times) In February 2022, the Food and Drug Administration (FDA) issued an official warning to consumers about Abbott brands of baby formula following a possible contamination at a factory that might have been linked to some illnesses or deaths – and suddenly no more baby food.

This summer, the FDA denied JUUL authorization to market e-cigarettes even though “the FDA has not received clinical information to suggest an immediate hazard.” The possibility of harm was enough justification to act… unless the concerns are about abortion.


I’ve been fighting against these pills for years, starting during the Clinton Administration. We’ve been fighting the expanded use of these pills at Students for Life since the state of California moved to force them onto all publicly funded college and university campuses … something that will start as early as this year.

It’s going to take all of us and a lot of tools to end this … At Students for Life of America/Students for Life Action, we have some innovative programming and a truly new idea:

We need outreach to the women being targeted … so we created the THIS IS CHEMICAL ABORTION website, with videos, educational tools and media campaigns.

We do outreach to women on campuses and through STANDING WITH YOU.

We’ve been working in legislatures at the state and federal levels to either limit the pills outright, just like we did with Partial Birth Abortion… or with the kind of regulation that will allow women a better survival rate.

But it’s going to take more … and we’re going to have to go to court, where the abortion lobby loves to play.



A very Erin Brockovich – Ben Stiller – Jack Black kind of tool.


In the comedy movie ENVY, two midlevel, bored employees – Black and Stiller – are best friends and neighbors. Jack Black invents a product called VA-POO-RIZE that makes dog poop disappears and becomes a billionaire … but it all falls apart when people start asking, Where does the poop go? It went into the ground and groundwater … as basically a poison … killing Jack Black’s horse, which Stiller buried in his pool … it’s a comedy.

That was fiction.

But in the movie on Erin Brockovich, a real-life story, a single mother uncovers corporate dumping that has been killing their employees and people in the community … leading to multi-million-dollar settlements … and again, the issue was what was in the water.

Those movies got me thinking about abortion ... and WHAT IS IN THE WATER? People have dealt with Infant Dignity Laws for years -- Indiana in particular fighting to the Supreme Court -- because we know human beings should not be treated as trash ... but what if they are flushed away?

We’ve had more than 30 years of corporate-sanctioned dumping and not a single U.S. government-sponsored test to check on whether chemical abortion pills are Harming aquatic life, animal life, and the environment.

The pills can harm people, animals, and the earth.

In 1996, the abortion zealot at the Population Council submitted a report saying there was no environmental impact to speak of unless you count a little littering.

The FDA rubber-stamped that, and it’s been “Don’t Ask, Don’t Tell” ever since.

Starting more than 6 years ago in California, which has some of the strictest water regulations in the country, the abortion extremists three times fought to get abortion pills on campus. Kristan Hawkins and others from SFLA raised the question then about the environmental impact – which the bill sponsor at the time ignored, saying basically, I’m sure the experts will figure that out.

Well, we can tell you, they haven’t … yet.

Now, I didn’t say there was NO EVIDENCE … I said that our government has not required full testing.


The ultrasound screenings et al. …gone … and now, we have government-sanctioned, corporate-dumping of medical waste into our water supply.

Despite the attacks on everything from cars to gas stoves, to lightbulbs .. all in the name of the environment ….

NEWSWEEK: Yet there is one industry that can enjoy government-sanctioned dumping of a potential hazard—and is often spared the requirements of state laws as "a judicially favored industry." That industry is corporate abortion, and the potential hazard is the chemically tainted blood, placenta tissue, and human remains resulting from the use of abortion pills that have been flushed into America's wastewater system for more than 20 years.

Given the necessity of protecting the nation's water from harmful pollutants, Students for Life of America has been filing a series of Citizen Petitions with the FDA, including calling for red bag medical waste disposal of human remains, which can be an issue when flushed away. That protocol requires that potentially harmful materials be collected and returned for disposal in accordance with state laws.

"Home-based health care can create medical waste, which can be hazardous if not disposed of properly. Inappropriate medical waste disposal can pose harmful environmental concerns and significant health risks to the public," says the American Academy of Family Physicians. "The importance of routine medical waste disposal and destruction practices should be stressed at all city and county levels of collection."

When then-President Bill Clinton forced chemical abortion pills onto the U.S. market, strong assurances were made about how the pills would be used and how they would impact both women and the environment. (Though little was said about the latter at that time.)  

Associated Press Article: FDA Approves Abortion Pill, Thursday, Sept. 28, 2000; 11:57 a.m. EDT, by AP Medical Writer Lauren Neergaard. The article includes many assurances and descriptions of health and safety standards that are all gone today.

Chemical abortion pills were politicized from day one, as our then president and so-called health experts and HHS and the FDA pressured a foreign company to bring deadly drugs to the U.S. when that company was reluctant.  

A 98-page Harvard University paper, The Life of the Abortion Pill in the United Statesdetails the political pathway that the drug combination used in chemical abortion pills took to arrive in the U.S., a path so complicated that in the end, the manufacturer of the drug “Roussel-Uclaf granted all of the pill’s patent rights and technology, for use in the United States, to the Population Council without remuneration. In return, Roussel-Uclaf rid itself of any liability from product liability claims.” This was accomplished by intense political pressure – not women’s need. In fact, “(a)lthough it took a long year of negotiations, President Clinton, the Department of Health and Human Services, and the FDA succeeded in their efforts to encourage Roussel-Uclaf to help make medical abortion with mifepristone a reality for American women.”

What you didn’t hear much about was how chemical abortion pills, along with the human remains and tissue flushed into our waterway systems, would impact the environment.  

At the time, the current scope of the chemical abortion pill market was not anticipated as “(t)he potential market, as compared to other drugs, was small, in the early nineties.”

In a 4-page summary report, with 2 pages being cover pages, the FDA noted “FINDING OF NO SIGNIFICANT IMPACT.”

In fact, the FDA did NOT even do its own homework on the Environment Impact – they took the word of the Abortion Industry’s Population Council that there was nothing to see here except maybe littering of the packaging. It was another Clinton “Don’t ask, don’t tell.”   

From the 1996 report: “The Food and Drug Administration, Center for Drug Evaluation and Research (CDER) has carefully considered the potential environmental impact of this action and has concluded that this action will not have a significant effect on the quality of the human environment and that an environmental impact statement, therefore will not be prepared.

“In support of their new drug application for Mifepristone tablets, The Population Council has prepared an environmental assessment in accordance with 21 CFR 25.3a (attached) which evaluates the potential environmental impacts of the manufacturer, use, and disposal of the product.

“Mifepristone is a synthetic drug which will be administered orally to provide a medical approach to the termination of early pregnancy. Mifepristone may enter the environment from the excretion by patients, from the disposal of pharmaceutical waste, or from emissions from manufacturing sites.  …. The Center for Drug Evaluation and Research has concluded that the product can be manufactured, used, and disposed of without any expected adverse environmental effects.”  

How did they conclude this? Where are the tests?

In 1996, the FDA Environmental Impact report said that there would be high standards for disposal, though the focus was primarily on the drug itself, not the human tissue and human remains, which are to be flushed into the wastewater system.  

From the 1996 FDA report on disposal locations, in accordance with the Center for Disease Control, guidelines for handling hazardous waste would be followed in clinics or healthcare provider offices. “The applicant will use a licensed incineration or grinding and landfill facility to dispose of this type of material.”  Emphasis added.

The chemical abortion pill market is exploding, resulting in medical waste in our water systems. This is a NATIONAL crisis as today, Corporate Abortion admits that more than half of all abortions are committed with chemical abortion pills.

  • The actual percentage of how many abortions are committed with chemical abortion pills is questionable as we don’t have a National Abortion Reporting law, so we are asked to take their word for it. States don’t report uniformly, and some report nothing at all. Then we have the chaos of online purchases, without real reporting, with chemical abortion pill vendors located internationally.
  • But consider this, given current trends, chemical abortion pills may soon cause more than 9 in 10 abortions.

Consider that the abortion industry’s advice on this is to allow the process of the pills to finish in the toilet … but it doesn’t disappear … it goes somewhere … into America’s Waste Water System. When you consider EPA standards for what not to flush, people seem like a logical thing to include.  

The only things you can safely flush are the 3 Ps: Pee, Poo, and Paper.  

In fact, “the U.S. Environmental Protection Agency (EPA) is encouraging all Americans to only flush toilet paper.”

The EPA is very direct on how to “protect local waterways” by not flushing the wrong things. “What happens to the treated water when it leaves the wastewater treatment plant? The treated wastewater is released into local waterways where it’s used again for any number of purposes, such as supplying drinking water, irrigating crops, and sustaining aquatic life.”

Medications & chemicals cause problems. The EPA notes that such things can impact the fertility of animals and fish.  As Students for Life of America, President Kristan Hawkins noted in a 2020 letter to then FDA Commissioner Stephen Hahn, a re-evaluation of the environmental impact of the volume of human remains is needed, given the current status. 

Hawkins wrote: “During the approval process for RU-486, an environmental impact study for the drugs focused on the impact of packaging for the drugs, rather than on the impact of human remains in our wastewater system and groundwater. Today, with so many lives ending by such chemical abortion pills, it’s vital to reopen an inquiry into the environmental impact on our water and land as so many human beings are being flushed away.

When you consider that the Environmental Protection Agency recommends against flushing tampons to preserve the environment and water safety, how much more significant is disposing of human remains through the wastewater systems across America?”

The need for safe drinking water, among other environmental priorities, impacts everyone, leading the United States to create agencies such as the Environmental Protection Agency (EPA) and the Food and Drug Administration (FDA). However, as the EPA notes, STATES lead the way.  

EPA: Who Regulates Medical Waste? Since the 1988 Medical Waste Tracking Act Expired in 1991, “Medical waste is primarily regulated by state environmental and health departments. EPA has not had authority, specifically for medical waste, since the Medical Waste Tracking Act (MWTA) of 1988 expired in 1991. It is important to contact your state environmental program first when disposing of medical waste. Contact your state environmental protection agency and your state health agency for more information regarding your state's regulations on medical waste.  

“Other federal agencies have regulations regarding medical waste. These agencies include the Centers for Disease Control (CDC), Occupational Safety and Health Administration (OSHA), U.S. Food and Drug Administration (FDA), and potentially others.”

Mishandling Human Remains and Medical Waste can lead to severe consequences. Those negative consequences can impact animals, fish, and people.   

The World Health Organization notes: “The disposal of untreated health care wastes in landfills can lead to the contamination of drinking, surface, and ground waters if those landfills are not properly constructed.”

The American Academy of Family Physicians, in discussing medical waste disposal in non-medical locations, notes: “Home-based health care can create medical waste which can be hazardous if not disposed of properly. Inappropriate medical waste disposal can pose harmful environmental concerns and significant health risks to the public, which include but are not limited to potential water contamination, inadvertent sharp-stick injuries, and toxic exposure to pharmaceutical products. The AAFP encourages practices to keep all medical and non-medical waste separate to avoid contamination and to facilitate the safe disposal of all medical waste. The importance of routine medical waste disposal and destruction practices should be stressed at all city and county levels of collection.”

In medical settings, the generator of medical waste is responsible for getting rid of human tissue or remains. Consider that if a limb were amputated, they don’t send you home with a leg in a bag to take care of elsewhere. The medical practitioner that began the chain of events leading to the tissue is responsible for its proper disposal.  

Medical waste, according to the EPA: “Medical waste is a subset of wastes generated at health care facilities, such as hospitals, physicians' offices, dental practices, blood banks, and veterinary hospitals/clinics, as well as medical research facilities and laboratories. Generally, medical waste is healthcare waste that may be contaminated by blood, body fluids, or other potentially infectious materials and is often referred to as regulated medical waste.”

The EPA notes in model guidelines that the generator of medical waste has responsibility for its disposal. Blood and human remains would usually be handled by incineration or a process of cleansing the material before disposal.

WHAT CAN WE DO: (this will change based on current events)

 SFLA has filed four citizen petitions with the FDA

  1. Red Bag Medical Waste
  2. REMS
  3. Endangered Species
  4. Clean Water Act – Recreational Water

Legislation: Red Bag Medical Waste/Protecting Life on College Campuses/Appropriations and the FDA re: evaluation … At the states, with Wyoming a great example … and WV/Idaho put forth Red Bag Medical Waste.

Wyoming: SFLAction’s cutting-edge legislation to combat the distribution of deadly Chemical Abortion Pills was signed into law, making it the first of its kind in the nation. The pills that are negatively impacting the preborn, women, and the environment are directly addressed through our bill with State Senator Tim Salazar. SF 109, “Prohibiting Chemical Abortions,” will be a deterrent for Wyoming physicians to prescribe the deadly pills as it imposes a heavy $9,000 fine or up to six months of jail time for violators.

Congress: FDA oversight … PROTECT THE COMSTOCK ACT.  Federal Protections … end payments of all kinds … (AG Bill)

AGs: Consumer Protection/Water Regs/etc.

Abortion On Demand and Without Apology:
How to Respond to Aggressive Abortion Advocacy

Dr. Marc Newman, President
Speaker for Life

I. Introduction: Where We Are Now

A. Senate Testimony
B. No longer “pro-choice” but “pro-abortion”
C. What is arrayed against the pro-life movement
D. Why pregnancy help centers and clinics are vital to victory
E. A word on public advocacy vs. counseling room conversations
F. It looks bad, but there is reason for hope

II. Pro-abortion Advocacy Strategies

A. Abortion Advocates for What is Good

1. “Abortion is Normal
2. “Abortion is Absolutely Health Care
3. “Abortion Access is Equity”

a. racial justice
b. unfair barriers to treatment
c. the magic of “agency”

4. “Abortion is Loving”

B. Pro-Life Advocacy is Built on Lies and Harm Women

1. The pro-life position is dangerous
2. The pro-life position is deceptive
3. The pro-life position is based on “misinformation”
4. The pro-life position is extreme

C. The Common Thread of Abortion Advocacy: The erasure of the unborn child as a target of abortion

D. Abortion Industry Strategies

1. Polarization
2. Aggressive marketing in pro-life states
3. Entrenching abortion in death states
4. Stockpiling abortion pills
5. Vetting doctors
6. Cross-border expansion into pro-life states

III. Responding to Abortion Arguments and Strategies

A. Words Matter: Abortion is not “good”

1. Clarifying what is meant by “abortion”

a. Why abandon the use of the broad term “abortion”?
b. Defining abortion: revealing the target
c. Contrast “elective” with “spontaneous”
d. Distinguishing “elective abortion” from “medical treatment”
e. Contrasting “normal” with “common”
f. Standing on The Syllogism

2. Clarifying “Heath” and “Care”
3. Exposing Assumptions About Access and Agency

a. Should we have access to everything? A thought experiment.
b. “Agency” is a meaningless term

4. Abortion is the opposite of loving

a. What is love?
b. Responding to Gov. Newsom’s Bible Billboards

B. Abortion Advocacy is Built on Lies and Harms Women

1. Abortion is dangerous

a. exposing the victims
b. a word on abortion access and maternal mortality

2. The abortion industry is purposefully deceptive

a. Over 70 years of abortion deception in print
b. The pro-life movement must guard against accusations of

3. Defining “misinformation” and who is guilty

a. Assertions and why pro-life advocates must not overclaim
b. Abortion industry assertions
c. The role of evidence
d. The right to choose life must be unburdened

4. On being extreme

a. Are rape and incest exceptions “extreme”?
b. Why the abortion industry cannot allow any exceptions
C. Counter-Strategies

1. Quick review
2. The abortion issue is absolutely polarizing\
3. Pro-life state counter-strike

a. Take the law as far as it is politically possible to go
b. Teach the rationale for state pro-life laws in schools
c. Inoculate students traveling to abortion states for sporting events
d. Eliminate abortion advocacy from the public school curriculum, except to contrast it with the science of embryology and moral reasoning.
e. Make it illegal to solicit abortion in advertising messages or “Can the Bunny Ranch advertise in Tennessee?”

D. A Regional Approach

1. Why state-by-state won’t work
2. Develop a strategic regional approach

E. The Limits of State Power and the Necessity of the Church

1. Why the drive to normalize abortion?
2. The limits of state power: they can only make abortion illegal
3. The internal stress that follows the passage of pro-life laws
4. The state can only punish
5. The church has the only answer to the distress of abortion
6. How to engage the church

IV. Concluding Remarks and Questions

Preventing Forced Abortion In The Post-Roe Era

Allan E. Parker
Jr. President, The Justice Foundation


Forcing a woman to have an abortion, including a minor, is illegal in all 50 states of the United States of America. The Justice Foundation’s Center Against Forced Abortions (CAFA) was created to provide educational resources to empower women who are being forced, unduly pressured, or coerced into an unwanted abortion. Any individual who attempts to use force or coercion could be subject to criminal or civil liability including child abuse, fetal homicide, domestic partner violence, etc.


  • The Center Against Forced Abortion is estimated to save 1,000 -2,000 babies
    lives annually.
  • 15,000+ lives have been saved since 2009.
  • A combined 30,000+ families have been saved.
  • Provides training and equips pregnancy resource centers, police, school guidance
    counselors, mental health professionals, and social workers.
  • CAFA has provided awareness and training to over 1,000 Texas police, schools,
    and child protective service agencies.
  • Over 3,000 Pregnancy Centers have been equipped, 600-700 pregnancy center
    workers trained in a 1-Hour training
  • CAFA partnered with Students For Life to raise awareness in college-aged
    students on the signs of forced abortion.


  • “Dear Client” Letter

A letter designed for pregnancy resource centers to inform their clients of their rights and remedies. Offers encouragement and resources. It explains that it is unlawful for anyone to force, coerce or unduly influence a woman to have an abortion. Provides training on how to empower women and training on how to avoid or resist coercion, undue pressure, or force to abort against their will.

  • "Dear Parent” Letter

The “Dear Parent Letter,” (in a friendly, helpful, and serious manner) informs the teen mother’s parents that they could be guilty of illegal actions if they force their daughter to have an abortion.

  • “Dear Father” Letter

The “Dear Father” Letter, (in a friendly, helpful, and serious manner) informs the father of the child that they could be guilty of illegal actions if they force the young girl to have an abortion.

  • “Fax” To Abortionists

Life Dynamics’s “Fax” to Abortionists, is a signed statement indicating the mother’s non-consent to an abortion, the two documents form a powerful legal defense that empowers the teen mother to stand for her child.

  • “Dear Counselor” Letter

The “Dear School Counselor” Letter advises school counselors and social workers that forced abortion is illegal and they can be liable for damages if they participate in forced abortion.

  • “Dear Police” Letter

The “Dear Police” Letter is a tool for informing police that they should help prevent forced abortion to avoid legal liability on their part.

  • “Dear Student” Letter

In collaboration with Students For Life, the “Dear Student” Letter informs college students of resources available to them. Informs the student that it is illegal for anyone, including parents, relatives, boyfriend, baby’s father, college, or employer to force, coerce, or unduly pressure them into having an abortion.


  • A legal mechanism in all 50 states in which a woman can safely relinquish her child at a designated place within a designated time after birth, and receive immunity from prosecution for criminal neglect or abandonment.
  • The law saves babies from unsafe abandonment. …Parents who do not harm their infant will not be prosecuted for abandonment if they relinquish or turn over their newborn to a Safe Haven location. It gives a desperate parent a responsible alternative. Depending on your state, the law tells you the locations of the acceptable places that you can leave your baby and up to what age, with no questions asked, as long as they are unharmed. – see


  • The Safe Haven Law time of relinquishing varies from state to state. The National
    Safe Haven Alliance website provides an interactive map of the United States with
    each individual state’s regulations.


  • In all fifty states, even extremely liberal states like California and New York, any woman can relinquish her baby anonymously at a hospital, fire station or other designated safe spot at birth, or within a set period of time after birth, at no cost, and be relieved of all parenting obligations.
  • Safe Haven is free, unlike abortion. It is equally available to the rich and the poor. It is much more widely accessible in many states than abortion. Most doctors don't want to kill the child, so abortionists are rare in some states. Now you do not have to find an abortionist. Hospitals and fire stations are everywhere.
  • Abortion is a Crime Against Humanity and most people know it in their hearts. Now each state can say to women "Don't kill the child. Don't hurt yourself. Give us your
    baby. We will help you.“
  • What will happen to those children? They will be given to the one to two million people in America waiting to adopt newborn children. This is a major evolution in American society and it is a win-win end to the abortion wars. See What Happens to the Baby Once Relinquished to a Safe Haven?
  • The baby is immediately taken to a hospital and examined to determine if the baby has been abused or neglected.
  • If abused or neglected, the baby will go into foster care. There will be an attempt to identify the baby’s biological parents to determine what, if any, consequences are
    appropriate for the abuse or neglect to the baby. The baby may be placed in a temporary placement to determine the outcome of the proceedings related to the abuse/neglect of the baby. The ultimate goal - placement with a loving, adoptive family. Through foster care, there is the potential of reunification with the baby’s
    biological parent(s).
  • If the baby has not been abused or neglected, the baby will go into a safe, loving placement. For some, this could be the permanent placement and the adoptive family.
    For others, this could be a temporary placement, allowing time to make sure the parent who placed the baby with the Safe Haven does not change his or her mind and to make sure the parent who didn’t cause the baby to be placed at the safe haven has a chance to express his or her desire to parent the baby. Once these time frames have
    passed, the baby could be placed in a permanent adoptive placement.
  • Ultimately, for every baby that is “safe-havened”, the goal is for the child to end up in a permanent, safe, loving home. This could be with a biological parent. Most likely,
    this will be with adoptive parents. How Does Safe Haven Compare, Legally, With Traditional Adoption – Open or Closed?
  • Some of this comparison will depend on whether the identity of the biological parents is known. If not known, clearly similar to a “closed” adoption – no contact with biological parents. If identity of at least one biological parent is known, there is the potential for an “open” adoption – some interaction with the biological parent. This could be through sending written updates, pictures on a periodic basis, e.g., yearly on the date of the child’s birth, to include a range of potential contacts.

How should Safe Haven be explained legally to women in unexpected or difficult pregnancies?

  • This is an additional method of being relieved of the burden of parenting.
  • Safe Haven gives the woman the maximum amount of time to decide what she wants to do, that includes up to the moment of birth and a designated time afterwards.
  • No pressure to be involved with an adoption agency. She doesn't have to think about it.
  • It’s free, unlike abortion, which may cost her something.
  • She can release her baby, anonymously.
  • Safe Haven can assist the woman in severing ties with an unsafe father of the child.

THE MORAL OUTCRY - What are the Five Reasons to Make Abortion Illegal in all 50 States?

  • The same reasons The Moral Outcry Petition used to ask the Supreme Court to reverse Roe, which the Court did in Dobbs on June 24, 2024, are the same reasons every state should make abortion illegal now:

1. Abortion is a Crime Against Humanity
2. Safe Haven Laws help women in an unexpected pregnancy by eliminating the
burden of parenting.
3. Abortion Hurts Women. Forced abortion is one-way women are hurt.
4. 1-2 Million People Want to Adopt Newborn Babies.
5. New science shows that life begins at conception, including IVF, DNA
testing and sonograms

Empowering Fatherhood and
Averting Baby Daddy Drama

Lynne Marie Kohm, JD
John Brown McCarty Professor of Family Law
Regent University School of Law
Peter Hunter, Regent, Law Student
Eduardo Navas, Regent, Law Student
Stormy Hatfield, Regent, Law Student
Courtney Massie, Regent, Law Student


Dads are far more than mere child supporters, or sperm donors, or adoption agree-ers.
The need for father empowerment is more important than ever. The objective of this session is to provide attendees with the law surrounding the rights of a father to empower dads to care for their children – expected or unexpected, and help lawyers, doctors, nurses, family members and pregnancy resource counselors to avert baby daddy drama.
Section I explains and covers all the laws on Putative Father Registries, the first step for rights assertion for a potential prospective dad. Then Section II examines who is a father, legally, and how that man can continue to assert his rights as a parent, from common law presumptions to constitutional standards. Finally, Section III examines legal conflicts between a child’s father and mother and how to deal with those conflicts legally. Providing the law surrounding fatherhood can work to empower fathers to make good choices not just for themselves but for their children first and foremost, which can not only avert baby daddy drama but can empower fathers in their roles as dads.

I. Putative Father Registry

A. Purpose: Gives putative (“possible”) fathers notice of a pending adoption to give them a chance to exercise their rights as fathers (Think Mamma Mia! but systematized) within a statutorily prescribed time.

1. Putative Father Registries by State:
2. Putative Father Registries to Encourage Adoption (?):

B. Effects:

1. Pros:

a. Preserves putative fathers’ right to participate in parenting their biological children.
b. Stabilizes the adoption process by eliminating the uncertainty of adoption contests.
c. Prescribed time means adopted children do not have an undetermined legal status for an unreasonable amount of time.

2. Cons:

a. Chaos. More likelihood of Baby Daddy Dramas. (Think Mamma Mia! but systematized)
Reason: Putative Fathers who need the registry probably have not gotten their name on their child’s birth certificate, sought a DNA test, nor have gone through other methods of establishing their paternity (cite e.g., various state codes). Thus, the system could have lots of potential for abuse and, therefore, more litigation. This doesn’t empower or encourage fatherhood.

b. Impracticable. The lack of a National Registry makes achieving the purpose of a registry hard, without interstate cooperation or integration. See Toward a National Putative Father Registry Database, 25 HARV. J.L. & PUB. POL'Y 1031.
Reason: If an adoption happens across state lines, and the putative father is not registered in that state, then the father will not be notified. This could result in a legislative nightmare.

3. How States differ: States adopt some, all, or none of the following features into their putative father State code or registry.

a. Impossibility Exception - Some states have established impossibility exceptions for the father whose efforts to parent the child were affirmatively thwarted.

i. where the father did not know the mother was pregnant.
ii. where the mother misrepresented the situation to the father such that she indicated falsely that she was not pregnant or that he was not the father.
iii. where the mother moved from the State of conception to a second State for delivery.

b. Sex as Notice - States have begun to assume the theory that sexual intercourse fairly serves as constructive notice of the possibility of a pregnancy, and some state statutes now provide that sexual intercourse serves as notice of a conception or the possibility thereof.
c. Prebirth Abandonment: Some state statutes, case law, and SCRUFNA provide that pre-birth abandonment is grounds to foreclose the father's rights. Others consider whether ignorance of the registry amounts to the same thing.
d. Notice time limit: States differ in how long the putative father must file, when he should start filing, and when the filing deadline occurs.

4. Control: Birth mothers, compared to “putative fathers,” exercise tremendous control in child custody proceedings today. While courts no longer apply the “tender years presumption,” the old presumption that mothers are somehow inherently better caregivers, putative fathers still face an uphill battle. Because even under the current “primary caregiver standard,” so-called “putative fathers” do not have a constitutionally protected fundamental liberty interest in the upbringing of their children.

5. Definitions: While domestic relations are primarily regulated under state law, many states do not define “fatherhood.” Yet, whatever fatherhood means, the Supreme Court has held that, unlike married fathers, “putative fathers” do not have a constitutionally protected right to direct the upbringing of their children; they must legitimize a child by establishing a “substantial relationship” with the child, DNA testing, and ultimately by convincing a court that recognition of their parental rights is in the best interest of the child.

6. Obstruction: Mothers may obstruct a putative father’s efforts to legitimize his child at every step. By proving delayed notice of birth or pregnancy to run the statutes of limitations on putative father registration, withholding consent to DNA testing, or allowing a spouse to adopt a child, mothers can prevent putative fathers from establishing the necessary substantial relationship and ultimately parenthood. Unless a birth mother marries her child’s birth father or otherwise assists in legitimizing, only through immediate and persistent legal action can a putative father preserve his fledgling rights.

II. Law Protecting Father’s Rights:

A. Who is a “father”?

1. Many state statutes do not define the term father.

a. Virginia
b. District of Columbia
c. North Carolina

2. West Virginia has five (5) definitions for “father.”

a. Birth Father - § 48-22-105
b. Determined Father - § 48-22-109
c. Legal Father - § 48-22-110
Marital presumption - at the time of conception or at the time of birth
d. Outsider Father - § 48-22-113
Man, with whom the mother conceives while married to another.
e. Putative Father - § 48-22-114
“[Any man named by the mother as a possible biological father of the child pursuant to the provisions of section 22-502, who is not a legal or determined father.”

B. Presumptions

1. Marital Paternity Presumption:

a. Most states acknowledge the statutory rebuttable presumption that a husband is the “father” of his wife’s child; “despite both biological parenthood and an established relationship with a young child, a father's due process liberty interest in maintaining some connection with that child [is] not [always] sufficiently powerful to overcome a state statutory presumption that the husband of the child's mother [is] the child's parent.” Troxel v. Granville, 530 U.S. 57, 87 (2000) (Stevens, J., dissenting) (citing Michael H. v. Gerald D., 491 U.S. 110 (1989)).
b. State Code
Example: The District of Columbia extends the paternal (parental) presumption to recent cohabitants and domestic partners. D.C. Code § 16-909.

a) No definition of “father.”
b) Complicated by same-sex couples.
c) “There shall be a presumption that a woman is the mother of a child if she and the child’s mother are or have been married, or in a domestic partnership, at the time of either conception or birth.” D.C. Code § 16-909 (A-1) (2).

2. Example: Maryland extends the paternal (parental) presumption to unmarried same-sex couples.

a. “There is a rebuttable presumption that a child born to parents who have not participated in a marriage ceremony with each other is the child of an individual who did not give birth to the child if the individual: (1) Has acknowledged himself or herself, in writing, to be a parent of the child...” Maryland Statutes Estates and Trusts § 1-208(C).

1) Maryland categorizes children and parentage as incidents of property.
2) Question: Does recognizing two mothers negate a father’s parental rights?

C. Judicial Determination

1. A court may determine that a putative father is a child’s father based on the alleged father’s acknowledgment of the child and has established a “substantial relationship” with the child. Caban v. Mohammed, 441 U.S. 380, 393 (1979).

b. But disinterested third parties (which putative fathers legally are until parenthood is established) cannot overcome the right of uncontested biological parents (mothers) to direct the upbringing of children. Troxel v. Granville, 530 U.S. 57 (2000).
Problem - Mothers can prevent putative fathers from establishing the “substantial relationship” necessary for judicial determination.

2. Putative Father Registries (provides notice only)

a. Provides notice to putative fathers when the suspected child is subject to court/adoption proceedings.
b. Must file with the registry within a specified number of days after the child’s birth (how does the father receive notice of child’s birth?)
c. Virginia requires filing within 10 days of the birth (unrealistic?).
d. “Discovery” of paternity standards would allow putative fathers an opportunity to establish a substantial relationship.

3. Paternity Acknowledged in Writing

a. In most states, there is a statutory rebuttable presumption that a putative father who acknowledges a child in writing is that child’s father.
b. Example: The District of Columbia requires the mother to also sign the paternal acknowledgment; the mother may refuse. D.C. Code § 16-909.03(D).

4. Conclusive Paternity Evidenced by DNA

a. Mothers may, with consequences, refuse DNA testing of children under their control.

5. Fit Parent Presumption

a. Fit parents presumptively act in the best interest of their children. Troxel v. Granville, 530 U.S. 57, 68, 120 S. Ct. 2054, 2061 (2000) (plurality) (citing Parham v. J. R., 442 U.S. 584, 602 (1979)).

D. Substantive Due Process Standard(s):

1. Fundamental Liberty Interest Standard

a. Fundamental rights are those (1) "deeply rooted in [the] Nation's history and tradition" and (2) "implicit in the concept of ordered liberty." Chavez v. Martinez, 538 U.S. 760, 775 (2003).
b. Government action interfering with fundamental rights must be “[1] narrowly tailored [2] to serve a compelling state interest” (strict scrutiny). Washington v. Glucksberg, 521 U.S. 702, 721 (1997).
c. Recognized Fundamental Rights

i. Only fit parents and guardians have a fundamental constitutional right “to direct the upbringing and education of children under their control. “Pierce v. Soc'y of Sisters, 268 U.S. 510, 534-535 (1925) (relying on Meyer v. Nebraska, 262 U.S. 390 (1923)).
ii. Caveat - Children have a liberty interest in familiar integrity; “just as parents possess a fundamental right with respect to their children, children also enjoy a ‘familial right to be raised and nurtured by their parents.’” D.B. v. Cardall, 826 F.3d 721, 740 (4th Cir. 2016); My Family Belongs to Me: A Child's Constitutional Right to Family Integrity, 56 HARV. C.R.-C.L. L. REV. 267, 268 (2021) (finding that the Second, Fourth, Fifth, Seventh, Ninth, and Tenth Circuits recognize a child’s right to family integrity).

2. Shocks the Conscience Standard

a. The government violates substantive due process when its deliberate actions are "arbitrary" and "unrestrained by the established principles of private right and distributive justice." Seegmiller v. Laverkin City, 528 F.3d 762, 767 (10th Cir. 2008) (citing County of Sacramento v. Lewis, 523 U.S. 833, 846 (1998)).

i. Problem - Setting aside a judicial determination that a parent is unfit requires a showing that the court’s action “shocks the conscience” (abuse of discretion); the right of parents to direct the upbringing of children must be balanced against “personal health and safety [of the children] and the state's interest as parens patriae in protecting that interest.” D.B. v. Cardall, 826 F.3d 721, 740 (4th Cir. 2016) (holding that government was justified in separating a child from a parent because the court first concluded the parent was unfit) (on remand to the trial court, the case was decided on procedural due process grounds. See Beltran v. Cardall, 222 F. Supp. 3d 476 (E.D. Va. 2016).
ii. Because “When a state's interference with parental control is predicated on a determination that the parent is unable to provide adequate care for a child, such interference does not contravene substantive due process, at least in the absence of governmental action that shocks the conscience.” Cardall, 826 F.3d at 740.

b. Once a court decides a parent is unfit, the court is likely shielded from any liability from resultant harm to the child; “government officials performing discretionary functions, generally are shielded from liability for civil damages insofar as their conduct does not violate established statutory or constitutional rights of which a reasonable person would have known.” Harlow v. Fitzgerald, 457 U.S. 800, 818 (1982).

3. Equal Protection Standard(s)

a. When an unwed mother dies, a putative father is entitled to the same due process rights as a married father before his child becomes a ward of the state. Stanley v. Ill., 405 U.S. 645 (1972). Unwed father are no longer “presumed unfit to raise their children,” and “it is necessary to hold individualized hearings to determine whether particular fathers are unfit parents before they are separated from their children.” Stanley, 405 U.S. at 647.
b. Problem - Putative fathers are not considered similarly situated as married/acknowledged fathers.

i. The Supreme Court has narrowly defined “father” to exclude putative fathers; putative fathers, therefore, do not have a fundamental right to direct the upbringing of their children. Michael H. v. Gerald D., 491 U.S. 110 (1989).
ii. In Quilloin v. Walcott, the Supreme Court held that a putative father’s “interests are readily distinguishable from those of a separated or divorced father” and that a “state could permissibly give [putative fathers] less veto authority [sic] than it provides to a married father” in adoption proceedings, 434 U.S. 246, 256 (1978).

E. Legal Conflicts

1. Tender Years Presumption (Stormy)

a. Definition: The tender years doctrine is a judicial presumption that operates in divorce cases to give custody of a young child to the mother.
b. Doing Away with the Tender Years Presumption:

i. Pre-Gender Equality mothers were presumptively awarded custody of children of a young age.
ii. The gender equality movement ushered a presumption for a custody award to the parent who was the primary caregiver to the child during the marriage.
iii. Most state statutes have done away with the presumption (eliminated), and some courts have held that the tender years doctrine violates the Equal Protection Clause of the 14th Amendment to the United States Constitution, because it discriminates based on sex.

c. Prevalence Today and Battling the Presumption:
Though courts are not supposed to give deference to tender years in court rulings, and though we may not see it mentioned on paper, there is a foul remanence of the presumption found in the application of our courts.

i. From a Tender Years Presumption to a Primary Parent Presumption
ii. Though gender-neutral on its face, the primary caregiver presumption is broadly seen as achieving the same maternal preference results as the tender years doctrine. In many states, identifying the child’s primary caregiver is a factor in the court’s custody determination, but it is not entitled to presumptive weight.

d. Today’s standard for child custody determinations is the “Best Interest of the Child.”

i. Some common factors courts weigh in determining the best interest of the child include (these are determined by common law or state statute):

• Age, sex, health of the child
• The continuity of care before the separation
• Who has been the child’s primary caregiver?
• The parent skills
• Each parent’s willingness and capacity to provide primary childcare
• Each parent’s employment and responsibilities to the employment
• It is one thing to look at people’s deployments or demanding jobs, and it’s another to see that the traditional caregiver will evidently have more time on their (her) hands
• Each parent’s age, physical and mental health
• Emotional ties between the parent and child
• The moral fitness of the parents
• The child’s ties to home, school, and community
• The child’s preference if the child is of sufficient age
• Normally 12 in the state of Mississippi (will vary by state)
• Each parent’s relative financial situation
• Differences in parents’ personal values and lifestyle
• The stability of each parent’s home environment
• Any other factors the court believes are relevant to the parent-child relationship.

• What is the mental and physical health of each parent?
• Who has historically been the primary caretaker?
• How demanding is a parent’s work schedule or other commitments outside the home?
• How willing is a parent to encourage a relationship between the child and the other parent?
• Can the parent provide a positive home environment?

ii. Statistics showing disparity:

a) According to a 2020 study conducted by the United States Census Bureau, as a national average, a female parent is granted around 65% of custody time whereas, the male parent receives around 35%.
b) According to a study conducted by the American Psychological Association, gender stereotypes may indeed play a role in custody decisions.

1) In this study, good mothers received greater custody allocations than good fathers in the United States.
2) Follow-up studies say this may be due to the propensity to prescribe warmth-related traits to women.
Which was the basis of the tender year’s presumption?

iii. Why it even matters:

a) Just like having a mom around is important for the child’s development and well-being, having a dad around also promotes development.
b) According to Psychology Today, a father’s involvement and caregiving can affect a child’s social competence, performance in school and emotion regulation.

i. Plain and simple, sometimes dad is a better option than mom even though she has been the primary care giver.
b. How do we battle this disguised tender years presumption?

1) Take out factors that weigh who the primary caregiver is.
2) Assess the effects rather than plain language of the statute’s factors.
3) Example primary caregiver is often the tender years presumption in disguise.
4) Take a holistic approach. We need to attack presumptions and stereotyping by implementing more policies geared towards shared parental leave and flexible work, part time employment options, gender neutral birth leave, etc.

2. Pre-birth Duties on Fathers Child support pre-birth

a. Child support pre-birth is a relatively new concept in which most states have discussed, yet only one has mandated.

i. Utah was the first state to require it in 2021, I can’t find any other state that has mandated it, but other states mimic Mississippi, or have some reference to supporting mom pre-birth such as Wisconsin and New York.

b. The process of gaining pre-birth rights is the same as post-birth. You should establish paternity by order of the court, DNA Testing, or affirmation by both parents.

i. You can prove this by multiple state statutes and general family law concepts.

c. Why it matters:

i. According to a study done in 2021 by Human Life International 96.5% of women get an abortion for social or economic reasons.
ii. How much does it cost to have a baby?

a) According to the Peterson-Kaiser Family Foundation $18,865 on average. This is often covered by health insurance, so parents only end up paying about $2000. However, women who don’t have insurance, or see $2000 as an unrealistic sum see this as the reason to terminate.
b) This cost can vary depending on the risk, type of birth, location and more.
c) If you don’t have health insurance the average cost of prenatal care according to WebMD is $2000.

iii. For women in financially dire situations, $2,000 to $19,000 is daunting to say the least. This is how pre-birth support can help solve some of the disparity for unwed mothers.

a) As of 2020, 86% of women who had an abortion were unmarried.

iv. Implied:


a) §93-9-7 Obligations of the Father

1) The father of a child which is or may be born out of lawful matrimony, whether the child is born alive, for the reasonable expenses of the mother’s pregnancy, confinement, and for the education, necessary support and maintenance, and medical and funeral expenses of the child. A child born out of lawful matrimony also includes a child born to a married woman by a man other than her lawful husband.

ii. Mandated:


a) 78B-12-105.1 Duty of Biological Father to Share Pregnancy Expenses

1) Except as otherwise provided in this section, a biological father of a child has a duty to pay 50% of the mother’s pregnancy expenses.
2) (a)If paternity is disputed a biological father owes no duty under this section until the biological father’s paternity is established. (b) Once paternity is established the biological father is subject to section (1).
3) (a) Any portion of a mother’s pregnancy expenses paid by the mother, or the biological father reduces that parent’s 50% share under Subsection (1), not the total amount of pregnancy expenses. (b) Subsection (3)(a) applies regardless of when the mother or biological father pays the pregnancy expense.
4) If a mother receives an abortion, as defined in Section 76-7-301, without the biological father’s consent, the biological father owes no duty under this section, unless:

(a) the abortion is necessary to avert the death of the mother; or
(b) the mother was pregnant as the result of:
(c) Rape, as described in section 76-5-402;
(d) Rape of a child, as described in section 76-5-402.1;
(e) Incest, as described in subsection 76-5-406(2)(j) or section 76-7-102.

b. Adoptive Couple v. Baby Girl, 570 U.S. 637 (2013).


1) The Indian Child Welfare Act (ICWA) does not protect the rights of a parent who has never had custody of the child.
2) With respect to adoptive placements for a Native American child, “a preference shall be given, in the absence of good cause to the contrary, to a placement with (1) a member of the child’s extended family, (2) other members of the Native American child’s tribe, or (3) other Native American families.”
3) To be a member of a Native American tribe for purposes of the ICWA one must register with the tribe.

c. Military dads –

1) Service Members Civil Relief Act
2) Family Care Plan
3) Altering Custody Agreements
4) Uniformed Deployed Parents Custody and Visitation Act
5) Virginia Military Parents Equal Protection Act
6) VA Code § 20-124.8
7) The Uniform Child Custody Jurisdiction and Enforcement Act/State Code
8) U.S. Military family benefits
a. Family Benefits
b. Housing Allowance
c. Health Care
9) Proving Parentage:

a. Genetic testing
b. Birth Certificate
c. Acknowledgement
d. Paternal Duties w/o Rights

1) Abortion
2) Adoption
3) Child Support (issue separate from visitation)

Conclusion: This outline projects not only the law surrounding father’s rights, but legal solutions that fathers can access to be empowered dads involved in their child’s life, for the best interests of that child. Here we have summarized the law and the legal conflicts which can indeed empower fatherhood and avert baby daddy drama.

The “FACE Act”
Freedom of Access to Clinic Entrances Act of 1994
18 U.S. Code § 248

309 West Washington Street Suite 1250
Chicago, IL 60606

Andrew Bath, JD
Executive Vice President
Thomas More Society, General Counsel


Following Roe v. Wade, 110 U.S. 113 (1973), pro-life advocates adopted a variety of approaches to protect the lives of the unborn as they worked to overturn the Roe decision. Early mainstream pro-life organizations like the National Right to Life Committee pursued public education and legislative change. One example of early legislation was the Hyde Amendment which limited public funding of abortion. See generally, Abolishing Abortion: The History of the Pro-Life Movement in America.
More activist pro-life groups sought to end abortion through public protest activities, including peaceful acts of “civil disobedience,” taking their cue from Dr. Martin Luther King’s espousal of “peaceable non-violent direct action” See, Letter from Birmingham Jail (April, 1963).

Instead of staging lunch counter sit-ins, which were a staple tactic of the late Fifties’ and Sixties’ civil rights protesters, the pro-lifers who opted for “direct action” began to block access to abortion providers by sitting in front of abortion facility entrances, singing hymns, chanting prayers and slogans, etc. Led by a young Evangelical preacher from Binghampton, New York, namely, Randall Terry, several large-scale demonstrations were staged in Cherry Hill, PA, New
York City, and elsewhere, under the banner of “Operation Rescue.”

These actions called “rescues” multiplied and began to proliferate throughout the country, sponsored by many different groups, including the Pro-Life Action League headed by Joseph Scheidler, often involving up to hundreds of activists blocking access to abortion facilities. The abortion industry struck back, filing a nationwide class action lawsuit, initially invoking the federal antitrust laws, charging that Joseph Scheidler’s organizing protesters on a national basis constituted an unreasonable and “anti-competitive” restraint of trade as he was trying to “shut down” the entire abortion industry. Later, the abortion forces added Randall Terry and his group called “Operation Rescue” as defendants, charging that Terry and Scheidler, were systematically staging acts of “extortion” – by taking “property” away from abortion providers by means of these clinic blockades, which allegedly involved physical “force and threats.” This “pattern” of “extortion” and other acts, the abortionists alleged, constituted a violation of the Racketeer Influenced & Corrupt Organizations Act or “RICO,” which was enacted in 1970. See 18 U.S.C. §§1961-1968.

This antitrust and RICO litigation, called NOW v. Scheidler, was filed in 1986, lasted 28 years, and went before the U.S. Supreme Court three times. Initially dismissed by lower courts on the ground that abortion protests were non-economic and political, the case was reinstated by a 9-0 ruling when the high Court held that non-economic “associations” could also be held violative of RICO equally as economically motivated groups. See NOW v. Scheidler, 510 U.S. 249 (1994)).
Later, in successive appeals that followed a long 1998 jury trial, the Supreme Court held 8-1 in 2003 that “rescues” did not constitute extortion as no “property” of the abortion providers was sought or “obtained” by the rescuers. Id., 537 U.S. 393.

A third appeal followed when the abortionists argued in the Seventh Circuit Court of Appeals that the Supreme Court had “overlooked” facts (four “acts of violence” unspecified as to time or place or identity of perpetrators) found by jurors at the 1998 trial that could be held by themselves to qualify as a pattern of “extortion” under an even broader reading of the federal extortion law (the Hobbs Act, 18 U.S.C. §1951) and RICO (18 U.S.C. §§ 1961–68).
But the Justices rebuffed the abortionists’ latest new extortion theory by 8-0 (O’Connor, J. having retired and Alito, J. not having heard the oral argument before his appointment to replace her.) Id., 547 U.S. 9 (2006).

Thus, the abortionists had failed in their effort to outlaw peaceful albeit aggressive acts of civil disobedience as either “antitrust violations” or as “extortionate” or “violent” acts of
“racketeering,” even though some pro-life leaders used especially aggressive rhetoric. For example, Terry was quoted as urging an end to abortion “through any means necessary.” And Scheidler said he didn’t weep when hearing that merely bricks and mortar used as an abortion clinic had been destroyed. But Scheidler qualified his comments by pointing out that every bombing or arson, even those done after midnight, put passersby, police, and firefighters at risk. For this reason, he opposed any form of violence as an appropriate pro-life tactic. And the courts in the RICO litigation, supra, specifically ruled against the abortionists’ claim that Scheidler himself was somehow personally guilty of, or an advocate for, any violence.

But during the 1980s, some purportedly “pro-life” extremists did turn to explicit advocacy of violence, calling it “justifiable homicide,” and in many cases acts of serious violence were committed. By 1994, over 100 abortion clinics were alleged to have been bombed or burned to the ground. There were also alleged to have been over 1,000 documented acts of violence against abortion facility staff. See, National Abortion Federation, NAF Violence and Disruption Statistics: Incidents of Violence and Disruption Against Abortion Providers in U.S. & Canada.

The murders of abortion providers Dr. George Tiller, Dr. Bernard Slepian, Dr. David Gunn and Dr. John Britton, as well as a clinic receptionist, and serious injury to an abortion nurse, gained national media attention. See, A look at fatal attacks in anti-abortion violence in the US | AP News.
It was against this backdrop that the FACE Act was passed in 1994.


A. What does the FACE Act protect?
It protects people, property, and facilities – including pregnancy resource centers and their staff.

1. People “obtaining or providing reproductive health services.” 18 U.S.C.

a) “The term ‘Reproductive health services’ means reproductive health services provided in a hospital, clinic, physician’s office, or other facility, and includes medical, surgical, counselling or referral services relating to the human reproductive system, including services relating to pregnancy or the termination of a pregnancy.” 18 U.S.C. §248(e)(5).

2. People exercising or seeking to exercise their religious freedom at a place of religious worship. 18 U.S.C. §248(a)(2).
3. Property of a place of religious worship. 18 U.S.C. §248(a)(4).
4. Facilities that provide reproductive health services. “Facility” includes a hospital, clinic, physician’s office, or other facility that provides reproductive health services, and includes the building or structure in which the facility is located. 18 U.S.C. §248(e)(1).

B. What does the FACE Act prohibit?
It prohibits three (3) things:

1. Using force, threat of force, or physical obstruction, to intentionally injure, intimidate, or interfere with (or attempt to do the same) any person because that person is or has been obtaining, seeking to obtain, or providing reproductive health services, or to intimidate such person from obtaining or providing the same. 18 U.S.C § 248 (a)(1).
2. Using force, threat of force, or physical obstruction to intentionally injure, intimidate or interfere with (or attempt to do the same) any person lawfully exercising or seeking to exercise the First Amendment right of religious freedom at a place of religious worship. 18 U.S.C. §248(a)(2). a) Definitions, 18 U.S.C. §§ 248(e)(2)-(4).

(2) “Interfere with” — to restrict a person’s freedom of movement.
(3) “Intimidate” — to place a person in reasonable apprehension of
bodily harm to him- or herself or to another.
(4) “Physical obstruction” —rendering impassable ingress to or egress from a facility that provides reproductive health services or to or from a place of religious worship or rendering passage to or from such a facility or place of religious worship unreasonably difficult or hazardous.

3. The intentional damaging or destruction of the property of a facility or attempting to do so because such facility provides reproductive health services or is a place of religious worship. 18 U.S.C. §248(a)(3). C. What does the FACE Act not prohibit?
It does not prohibit, “any expressive conduct (including peaceful picketing or other peaceful demonstration) protected from legal prohibition by the First Amendment to the Constitution.” 18 U.S.C. §§248(d)(1)-(2). D. How is the FACE Act enforced?

1. Criminal Prosecution

a) Who can prosecute?

(1) The U.S. Attorney General can enforce criminal violations of the FACE Act in federal court. 18 U.S.C. §248(a)(3).

b) What are the penalties for violating the FACE Act?
Penalties for violating the FACE Act include both fines and prison time, with penalties more severe if violence was used.

(1) First-time non-violent physical obstruction offense:

(a) Fine up to $10,000,
(b) Prison for up to six months, or both. 18 U.S.C. §248(b)(2)

(2) Second and every subsequent non-violent physical obstruction offense:

(a) Fine up to $25,000,
(b) Prison for up to 18 months, or both. 18 U.S.C. §248(b)(2).

(3) First-time violent offense:

(a) Fine up to $100,000, 18 U.S.C. §3571(b)(5), (b) Prison for up to a year, or both. 18 U.S.C. §248(b)(2).

(4) Second and every subsequent violent offense:

(a) Fine up to $250,000, 18 U.S.C. §3571(b)(3),
(b) Prison for up to 3 years, or both. 18 U.S.C. §248(b)(2).

(5) If bodily injury results from a violation, the length of imprisonment shall be up to 10 years. 18 U.S.C. §248(b)(2).

(6) If death results from a violation, the length of imprisonment shall be for any term of years or for life in prison. 18 U.S.C. §248(b)(2).

c) What must be proven?

(1) With respect to reproductive health services, the elements of intent and motive must both be proven.

(a) As to intent, the Act prohibits use of force, threat of force, or physical obstruction with the specific intent to injure, intimidate, or interfere with one obtaining or providing reproductive health services. Mere force or physical obstruction is not enough.
18 U.S.C. §§248(a)(1), (2), (3).
(b) As to motive, the conduct must occur “because” the person is obtaining or providing “reproductive health services,” or “in order to intimidate” someone from obtaining or providing “reproductive health services.” This means the alleged assailant must possess not only the intent to injure, etc., but also the specific motive of stopping someone from providing reproductive health services, or of physically obstructing them because they provide such services. In other words, the FACE Act requires that defendants have this specific motive in order to be guilty of the crime or liable in a civil lawsuit. Mere commission of physical obstruction, with intent to injure, etc., is not enough. 18 U.S.C.§§248(a)(1),(3).

For example, in United States v. Mark Houck, U.S. Dist. Ct. E.D. Pa, Case No. 22-cr-323, the federal district court judge instructed the jury on motive as follows:

In this context, the term “because” requires the
government to prove that the defendant would not have acted but for the fact that Mr. Love [the abortion clinic escort and alleged victim] was or had been providing reproductive health services. While you need not find it to be the sole motivation for the defendant’s actions, the government must prove that Mr. Love’s provision of reproductive health services was a determinative factor in the defendant’s decision to act. If you find that Mr. Love’s provision of reproductive health services was not a factor in the defendant’s conduct, or that the defendant’s conduct would have occurred regardless of whether Mr. Love was providing or had provided reproductive health services, then the government has not proven beyond a reasonable doubt that the defendant acted “because” Mr. Love was or had been providing reproductive health services.

2. Civil Enforcement

a) Who may sue?

(1) The U.S. Attorney General can enforce the FACE Act by filing civil lawsuits in Federal District Court, but only if he or she has reasonable cause to believe an injury has or may result from a violation of the FACE Act. 18 U.S.C. §248(c)(2).
(2) State Attorneys General can file civil lawsuits to enforce the FACE Act but only in federal court and only if they have reasonable cause to believe an injury has or may result from a violation of the FACE Act. 18 U.S.C. § 248(c)(3).
(3) Any person involved in providing or seeking to provide, or obtaining or seeking to obtain, services in a facility that provides reproductive health services who is “aggrieved” by one who, by force or threat of force or by physical obstruction, intentionally injures, intimidates or interferes with or attempts to injure, intimidate or interfere with any person because that person is or has been, or in order to intimidate such person or any other person or any class of persons from, obtaining or providing reproductive health services can file a civil lawsuit to enforce the FACE Act. 18 U.S.C. § 248(c)(1).
(4) Any person lawfully exercising or seeking to exercise the First Amendment right of religious freedom at a place of religious worship or the entity that owns or operates such place of religious worship if “aggrieved” by one who by force or threat of force or by physical obstruction, intentionally injures, intimidates or interferes with or attempts to injure, intimidate or interfere with any person lawfully exercising or seeking to exercise the First Amendment right of religious freedom at a place of religious worship can file a civil lawsuit to enforce the FACE Act. Id.

b) Who may not sue?
Clinic Escorts. The Act’s legislative history confirms that it never contemplated, and by its terms does not permit, lawsuits arising out of disputes between escorts and sidewalk advocates on the sidewalks, consistent with its express text. In particular, the FACE Act prohibits obstruction of “reproductive health services,” defined to mean relevant services provided “in a . . . facility.” 18 USC § 248(e)(5). The legislative history confirms that “in a facility” was intended to specifically prohibit escorts from bringing civil suits (and concomitantly, under the proper interpretation, from being the subject of a criminal prosecution) under the FACE Act. Senator Kennedy crafted the relevant language and declared that it meant “demonstrators, clinic defenders, escorts, and other persons not involved in obtaining or providing services in the facility may not bring such a cause of action.” See 18 USC § 248(c)(1)(a), regarding civil actions. The qualifier “in a facility” specifically means that “escorts” are excluded. The Act’s all-important definition of “reproductive health services” contains the same qualifier. Of course, violence against someone on the sidewalk could be prohibited if the motive is to intimidate someone,
e.g., an abortionist, from providing reproductive health services inside the facility, e.g., if violence was against the abortionist himself as he was walking from his car to the facility.

c) Available Civil Remedies.

(1) For all civil plaintiffs other than U.S. and States’ Attorneys General:

(a) Injunctive relief whether temporary, preliminary, or permanent, and either:
(b) Compensatory damages, or
(c) Statutory damages of $5,000 for each offense.
18 U.S.C. §248(c)(1)(B).

(2) For U.S. and States’ Attorneys General:
All the remedies available to all civil plaintiffs, plus:

(a) In lieu of actual damages, a civil penalty of up to $10,000 for firsttime nonviolent violators who physically obstruct,
(b) In lieu of actual damages, a civil penalty of up to $15,000 for other first-time violations,
(c) In lieu of actual damages, a civil penalty of up to $15,000 for a subsequent nonviolent physical obstruction violation, and
(d) In lieu of actual damages, a civil penalty of up to $25,000 for any other subsequent violation.
18 U.S.C. § 248(c)(2)(B).



A. United States of America v. Norman Weslin, 2007 WL 7121988 (D. Neb. 2007). Fr. Norman Weslin was praying outside the clinic of the notorious late term abortionist LeRoy Carhart on April 24, 2006, when the Spirit moved him to enter the clinic, drop to his knees and pray for those in the clinic. He also offered support to the women inside if they kept their babies and offered to help the clinic staff find other jobs. He was arrested and charged – not under state or local law for trespassing or disturbing the peace – but by the Federal DOJ for a felony violation of the FACE Act. Fr. Weslin’s testimony directly contradicted the testimony of the clinic workers who claimed that he blocked the door and obstructed their access. Fr. Weslin testified that he just knelt and prayed, moving out of the way whenever necessary to leave space for patients and clinic staff to walk around him. The jury deliberated for just over two hours before unanimously finding him not guilty.
B. United States v. Scott, Civil Action No. 11-cv-01430-PAB-MEH, (D. Colo. Jan.
25, 2012).
Ken Scott was (and still is) a sidewalk counselor who, at the time, offered pro-life literature, advice about nearby pregnancy resource centers, and other prolife counseling and advocacy to individuals patronizing the Planned Parenthood of the Rocky Mountains abortion facility in Denver. United States v. Scott was one of many FACE Act lawsuits brought by the Obama Administration and its
Attorney General, Eric Holder, against sidewalk counselors across the country. The AG’s primary legal theory was that a car that stops in a clinic’s driveway to speak to a sidewalk counselor constitutes a “physical obstruction” of access to an abortion facility and, by conversing with the driver, sidewalk counselors caused the obstruction and violated the FACE Act, exposing themselves to hefty fines and injunctions against sidewalk counseling at a particular facility. After hearing all the evidence, the judge ruled that the brief delays experienced by cars waiting for others who stopped to converse with Ken Scott were not “obstructions” of the clinic entrance, but instead were a product of Scott’s exercise of protected free speech rights on the public right of way. At the close of the Government’s case, the trial judge told the USDOJ prosecutors that if they had no further proof of obstruction and yet kept on with their prosecution through the rest of the trial, he would entertain a defense motion for sanctions. The USDOJ prosecutors thereupon dismissed the charge on their own motion.
C. Allentown Women's Ctr., Inc. v. Sulpizio, 403 F. Supp. 3d 461, 468 (E.D. Pa.
The Allentown Women’s Center abortion clinic filed a civil lawsuit under the FACE Act against three sidewalk counselors on April 11, 2019, in the United States District Court for the Eastern District of Pennsylvania, accusing the three of physically obstructing access to the clinic as well as “threatening, harassing, and insulting employees.” The allegations were supported by several abortionists and facility staff whose accusations were delivered while using pseudonyms – Dr.
Roe, Nurse Executive Doe, Employee Number 1, Escort Smith and Escort Stiles. The Allentown Women’s Center asked the court to impose a 25-foot buffer zone around each of the clinic's entrances. The clinic's theory was the same one the DOJ relied upon when prosecuting Ken Scott – that counselors obstructed the clinic entrance in violation of the FACE Act when they stood on the public sidewalk and induced drivers to stop on the driveway to roll their window down to converse and receive a pamphlet. The court properly rejected these arguments, recognizing that the defendants have a First Amendment right to be in the public right of way, and drivers have a right to stop if they wish to receive literature and engage in speech with them. The evidence showed that the defendants did not stand in front of vehicles or keep them from proceeding forward, in no way obstructed entry into the clinic and did not cause by their actions any unreasonably difficult or hazardous condition, meaning there was no basis to enjoin them or impose a buffer zone to keep them off the clinic entry way. After hearing testimony and viewing video of the defendants’ interactions with drivers, the judge concluded that “the Court does not find that the behavior evidenced on the videos constitutes physical obstruction under FACE.” Allentown Women’s Center, Inc. v. Sulpizio, 403 F. Supp. 3d. 461, 471 (E.D. Pa. 2019).
The Court further concluded, “The Court finds that none of the videos evidence either Defendant rendering ingress or egress to the AWC unreasonably difficult or hazardous. See 18 U.S.C. § 248(e)(4). The Court therefore finds that Plaintiff has failed to show a reasonable probability of eventual success in proving that Defendants physically obstructed the entrance of the AWC in violation of FACE.” Id. The judge noted a single instance in which, as shown on video, Sulpizio and an escort were “in each other's face, neither backing off” when fleeting physical contact occurred. Id. at 468.
Regarding the physical contact, the judge held:
Furthermore, even if the Court were to find that Sulpizio engaged in "force" against Escort Stiles, the video shows that Sulpizio did not use force because Escort Stiles was providing reproductive health services, but instead used force in connection with a mutual argument over Sulpizio's positioning and the time he was spending exercising what he believed to be his Constitutional rights. Therefore, the Court does not find that Plaintiff has shown a reasonable probability of eventual success in proving that Defendant Sulpizio violated FACE by using force to intentionally injure or intimidate or attempt to injure or intimidate a person because that person is providing reproductive health services. Id.
As for the clinic’s allegation that Sulpizio had used foul and insulting language that amounted to a threat of violence prohibited by the FACE Act, the judge held:
This contempt[i]ble language is irresponsible and repugnant. The Constitution anticipates that people will act responsibly, yet protects repugnant, repulsive, and irresponsible speech, as long as the speech does not involve force or threat of force. See [U.S. v.] Gregg, [226 F.3d 253] at 267-268 ("Activities that injure, threaten, or obstruct are not protected by the First Amendment, whether or not such conduct communicates a message.")
Because the Court does not find that these comments constitute threats of force, which, as stated previously, are a necessary precedent to "intimidat[ing]" a person in violation of FACE because that person is obtaining or providing reproductive health services, the Court concludes Plaintiff has failed to show a reasonable probability of eventual success on its claim against Sulpizio for threats of force in violation of FACE. Id. at 470.
The preliminary injunction was denied, and the case was ultimately dismissed.
D. People of the State of New York v. Griepp, 997 F.3d 1258 (2d Cir. 2021). Merle Hoffman, the “Millionaire Abortionist,” who is widely known as an outspoken public advocate for abortion rights in New York City and its environs, owns Choices, an abortion facility located in Jamaica, Queens, New York. Ms. Hoffman complained to, and worked with, New York’s Attorney General, who prosecuted a civil lawsuit under the FACE Act against a peaceful church group that prayed and counseled on the sidewalks outside Choices. Among the defendants were the senior Pastor, Ken Griepp, and nine other members of the very diverse and devout congregation of the Church@theRock in Brooklyn, New York. Since 2012, Griepp and his fellow believers have conducted a ministry on the public sidewalk outside of Choices, to offer support to desperate abortionminded women who want to keep their babies. Before going to Choices, the Church@theRock folks researched the law to try to ensure that their advocacy activities were lawful. Their activities include preaching, talking to patients, their companions, and escorts, handing out literature, and holding signs.
The AG and the facility set up a surveillance camera in June 2016 to surveil and record the Defendants’ sidewalk advocacy tactics. In addition, undercover AG investigators approached the facility, pretending to be patients and their companions, wearing hidden cameras recording video and audio. The AG did not call any of the investigators as witnesses and did not rely on any of the investigative reports in support of the AG’s claims. The AG also outfitted two Choices escorts with hidden recording devices on one or two occasions each. One of the escorts set up a fake Facebook account, pretending to be a pro-life activist named “Shelly Walker,” who “friended” some of the Defendants, thereby obtaining personal information and effectively cyber-stalking them. The escort shared with the AG information about Defendants that the escort obtained through the fake Facebook account. That escort and another also created a “protestor dossier” containing extensive personal information about each of the Defendants. The AG’s undercover and surveillance work was conducted pursuant to a “TAC
Plan,” written by the AG’s attorneys. In its list of supposed illegal activities, the TAC plan included: advocates simply being within 15 feet of the facility; following an individual up to the facility; and engaging in a demonstration within 15 feet of the facility.
After a year of surveilling and recording the pro-life advocates and working closely with and obtaining several additional years’ worth of surveillance from the facility, the AG opted not to file criminal charges. Instead, the AG filed a civil lawsuit alleging violations of the FACE Act, the New York Clinic Access Act, N.Y. Civ. Rights Law § 79-m, and the New York City Access to
Reproductive Health Care Facilities Act, N.Y.C. Admin. Code §§ 8-803 and 8-804. On the day when suit was filed, then-New York AG Eric Schneiderman held a press conference and, standing with Hoffman, the facility’s owner, and with the current New York AG Letitia James, stated that this is “not a nation where you can choose your point of view” and that pro-life “protestors… run their mouth” with “unlawful, un-American rhetoric.”
Before the hearing on the AG’s motion for preliminary injunction, the parties conducted extensive discovery, including exchanging documents and taking depositions. In February and March 2018, the district court held a 14-day hearing, and heard testimony from 17 witnesses, including the AG’s seven witnesses. The AG’s evidence included multiple terabytes of videos and photos. The video evidence included footage from six years of the facility’s surveillance, one year of the AG’s surveillance, and several videos taken by escorts, AG undercover investigators, and some Defendants. The photos included pictures taken by escorts and Defendants. The court also received pre- and posthearing briefing and heard oral argument from the parties.
Based on internal inconsistencies in their testimony, inconsistencies between their testimony and videos and photos, and/or their demeanor on the witness stand, the district court judged five of the AG’s primary witnesses to be “not entirely credible.” Id. at *6, 7, 8.
In July 2018, the District Court entered a 103-page detailed order and opinion denying the AG’s motion for preliminary injunction and including detailed Findings of Fact. People of New York v. Griepp, Case No. 17-cv-3706 (E.D. N.Y. July 20, 2018), 2018 WL 3518527. The court gave the video evidence “significant weight.” Id. at *5.
The AG appealed to the Second Circuit Court of Appeals, which initially vacated the District Court’s order (New York v. Griepp, 991 F.3d 81 (2nd Cir. 2021)), only to vacate its own order upon consideration of Defendants’ petition for rehearing en banc. New York v. Griepp, 11 F.4th 174 (2nd Cir. 2021). According to the Second Circuit Court of Appeals’ final order in the matter, the order of the District Court stands, and the lawsuit was dismissed leaving Church@theRock’s victory fully intact.
E. United States of America v. Mark Houck, Case No. 22-323 (E.D. Pa. 2023).
Mark Houck’s legal drama began in October 2021 when he was sidewalk counseling with his 12-year-old son outside an abortion clinic in Philadelphia. One of the clinic volunteers, Bruce Love, aggressively confronted Houck’s son multiple times, even after Houck told him to stop. Houck finally pushed him away because of his refusal to stop harassing and haranguing his son with obscenities. The local police were called and interviewed the witnesses, viewed the video of the encounter, and decided not to press charges. But almost a year later, on September 23, 2022, approximately 25 heavily armed FBI and other law enforcement agents raided the Houck home and made an early morning SWATstyle arrest, terrifying Houck’s wife and seven young children. Houck was arrested in this manner notwithstanding that Houck’s TMS attorney had written to the Justice Department’s prosecutor offering that, in the event the DOJ insisted on pressing charges, he and Houck would accept a summons and bring Mr. Houck in to surrender voluntarily and peaceably. Ignoring a reminder of the recent ruling of the district court just down the road from Philadelphia in Allentown, in the
Sulpizio case (supra), the DOJ charged Houck with two felony violations of the FACE Act, convictions on which would put him at risk of spending 11 years in a federal penitentiary. Having made its highly publicized “show arrest” of Houck, on the eve of the jury trial held in January 2023, the DOJ suddenly offered Houck a plea deal: no fine, no prison time, and no probation in exchange for a guilty plea. Houck refused and we took the case to a jury trial. The government failed to convince the jury that Houck was acting “because” Mr. Love was “providing reproductive health services” – rather than acting in defense of his young son – when he shoved away the aggressive escort. In fact, it took a Philadelphia jury less than an hour to unanimously find Houck “not guilty” on both counts.
F. United States of America v. Paul Vaughn, Case No. 3:22-CR-00327 (M.D.
On October 5, 2022, FBI agents swarmed Paul Vaughn’s Centerville, Tennessee farmhouse with guns drawn, terrified his wife and 11 children and dragged him away. The heavy-handed DOJ/FBI raid came less than two weeks after a similar strike force stormed the home of Mark Houck. Vaughn and ten others were charged with violating the FACE Act at an abortion facility in Mount Juliet, Tennessee in March of 2021 – over a year and a half prior to the arrest. Police responded to find a group of pro-life advocates sitting in a hallway in an office building outside of an abortion clinic singing Christian hymns, reading scripture, and praying. During the incident, Vaughn, who was never arrested by the local police, recorded the protest and served as a liaison between the pro-life advocates and the police to ensure the safety of all involved. No one was hurt and no property was damaged. The DOJ claimed that Vaughn, the President of Tennessee Personhood, violated the Ku Klux Klan Act (18 U.S.C. §241 (up to 10 years in prison if convicted)) by engaging in a “conspiracy against rights secured by the FACE Act” and violated the FACE Act itself, even though he never obstructed anyone. The U.S. Attorney’s Office indicted Vaughn and six others for conspiracy, and four other individuals for violations of the FACE Act. The case is pending. A trial date has not been set as of this writing.


CompassCare operates pregnancy resource centers in upstate New York and elsewhere.
One center is located in Amherst, New York, a suburb of Buffalo, and has an M.D. Medical Director who supervises the medical work of a number of RNs as well as other nurses. The nurses provide medical services to CompassCare’s clients, including pregnancy testing, ultrasound, STD testing and treatment, abortion pill reversal therapy, counselling regarding pregnancy options, counselling regarding abortion procedures, including its risks and side effects, as well as referrals for further medical care, social care and insurance. All services are provided for free.
CompassCare’s Amherst clinic was firebombed in the early morning hours of June 7, 2022. The fire and smoke caused extensive damage to the interior of the building, its door, its equipment and furnishings. Two large windows were broken, and two Molotov cocktails were found inside the building. Several fire departments and police were dispatched to fight the fire. Two firefighters were overcome while fighting the fire and were admitted to the hospital with minor injuries.
In addition, graffiti saying, “Jane was here” was spray painted on the exterior wall of the building. Authorities concluded that the fire and vandalism caused $150,000 of damage to the building and its contents.
Similar crimes against pregnancy resource centers bearing the hallmarks of Jane’s Revenge occurred in quick succession in cities all across the nation after the leak of the draft of the Dobbs decision. Those crimes also included an attack on the home of one of CompassCare’s attorneys, which resulted in destruction of property.
All these additional attacks were marked by graffiti including the name “Jane’s Revenge.” Many of the graffiti messages also included the ominous warning, “If abortions aren’t safe, then neither are you.” See generally, TRACKER: Pro-abortion attacks in the U.S. continue (updated) | Catholic News Agency

A. The FACE Act Protects Pregnancy Resource Centers.

A fundamental question regarding the application of the FACE Act to the attack on CompassCare is whether a PRC can qualify under the statutory definition of a protected “reproductive health care facility.” The FACE Act defines “facility” to include “a hospital, clinic, physician's office, or other facility that provides reproductive health services, and includes the building or structure in which the facility is located.” 18 U.S.C. § 248(e)(1). It defines “reproductive health services as “reproductive health services provided in a hospital, clinic, physician's office, or other facility, and includes medical, surgical, counseling or referral services relating to the human reproductive system, including services relating to pregnancy or the termination of a pregnancy.” 18 U.S.C. § 248(e)(5).
CompassCare, where nurses provide medical services to patients under the supervision of MDs, is a clinical setting. Even if not held to be a “clinic,”
CompassCare would still qualify as a “facility” under the catch-all provision
“other facility that provides reproductive health services,” so long as the services CompassCare provides meet the statutory definition of “reproductive health services.”
CompassCare’s provision of pregnancy tests, STD testing and treatment, ultrasounds, and abortion pill reversal therapy are undeniably medical services.
Further they are “related to the human reproductive system, including …. pregnancy or the termination of pregnancy.” Moreover, the counselling and referral services provided by CompassCare are pregnancy related.
B. The FACE Act Prohibits Attacks on Pregnancy Resource Centers.
Subsection (a)(1) of the FACE Act protects persons seeking to obtain or provide reproductive health care at health care facilities from force or threats of force intended to cause injury, intimidation or interference. In the context of the attack on CompassCare, this section means that one who uses force or the threat of force to intentionally intimidate any person because that person is or has been providing reproductive health services; or one who uses force or threat of force to intentionally intimidate any person from providing reproductive health services in the future, is subject to the civil remedies provided in subsection (c).
As previously noted, the vandalism perpetrated against CompassCare included the use of two Molotov cocktails that caused extensive fires in two areas of the building. Windows were smashed and an exterior door was badly damaged in an apparent attempt to pry it open. These actions evidence the use of force. Further, the graffiti (“Jane was here”) clearly constituted a threat of physical force and violence. Reference to “Jane” suggests that an extreme leftist group known as Jane’s Revenge was responsible for the attack. Jane’s Revenge issued a manifesto of sorts on March 30, 2022, calling for a “night of rage” on the day the Dobbs decision is handed down and declaring, “If abortion isn’t safe, you aren’t either.” On May 12, 2022, Jane’s Revenge issued a communique related to its arson and vandalism at a Madison, Wisconsin pro-life organization’s headquarters. The communique read in part:
As you continue to bomb clinics and assassinate doctors with impunity, so too shall we adopt increasingly extreme tactics to maintain freedom over our bodies. We are forced to adopt a minimum military requirement for a political struggle. Again, this was only a warning. Next time the infrastructure of the enslavers will not survive. Medical imperialism will not face a passive enemy.
By leaving behind the message, “Jane was here”, the CompassCare
arsonists expressed a thinly veiled threat of force and violence in line with the tactics suggested in Jane’s Revenge’s March 30 and May 12 published missives.
Those actors intended to intimidate (statutorily defined as creating “a reasonable apprehension of bodily harm”). 18 U.S.C. §248(e)(3). Again, by referring to Jane’s Revenge in their graffiti, the actors showed an intent to identify with the radical leftist group and its extreme rhetoric – a reference that was designed to instill fear. Further the use of Molotov cocktails indicates that the actors intended to seriously damage whatever (and whoever) was in the building. Two firefighters were, in fact, injured in the fire. These actions would cause a reasonable person to feel justifiably threatened about his or her physical safety.
Finally, Compass Care was targeted (as were many other PRCs) specifically because they provide pro-life reproductive health care services. This statutory motive requirement is met by the fact that Jane’s Revenge has a solitary purpose – to stop all anti-abortion efforts by any means necessary. The messages written on the walls of the other PRCs state their opposition to anti-abortion organizations and their championing of abortion at all costs (“If abortions aren’t safe then neither are you!”; and “You’re anti-choice not pro-life”; and “No forced births”). This vandalism was motivated by a desire to punish CompassCare for providing pro-life reproductive health services in the past and to prevent or at least deter CompassCare from providing pro-life reproductive health services in the future.
C. The Arson and Vandalism at CompassCare Are Precisely the Types of Threats and Property Damage that the FACE Act Prohibits.
18 U.S.C. § 248(a)(3) of the FACE Act addresses malicious property damage to reproductive health care facilities. It reads in pertinent part, “Whoever, intentionally damages or destroys the property of a facility because such facility provides reproductive health services … shall be subject to … the civil remedies provided in subsection (c)....” Id. As discussed above, there was extensive actual damage to the property of CompassCare (a reproductive health service facility) and because the fire was started by Molotov cocktails, the damage was clearly intentional. Also as previously discussed, CompassCare was selected as a target for vandalism specifically because it provided pro-life reproductive health services which was antithetical to Jane’s Revenge’s singular purpose of eliminating all opposition to abortion. Jane’s Revenge has been proudly public about its desire to destroy all pro-life organizations.
D. A Civil Action Can Be Brought Against Those Who Attacked CompassCare Even if The Federal Government and Local Prosecutors Take No Action.
Given that the attack on CompassCare meets the elements of both 18
U.S.C. §§ 248(a)(1) and (a)(3), a person involved in the provision of services at CompassCare who is aggrieved by the vandalism, threats, and physical damage may bring a private civil action if a proper defendant can be identified.
E. The Lack of Government Enforcement May Amount to Unconstitutional Viewpoint Discrimination.
Among the many ways that the FACE Act is currently being abused by government prosecutors is discriminatory enforcement – freely using FACE against pro-life protesters and counselors while largely failing to arrest or prosecute anti-PRC and anti-Church perpetrators of violence – thus engaging in impermissible as-applied viewpoint discrimination. Inexplicably, the USDOJ has engaged in many FACE Act prosecutions against pro-lifers, even after the Dobbs ruling reversing Roe v. Wade, while failing to arrest or prosecute the perpetrators of major violence against CompassCare, other pro-life PRCs, or churches.
While prosecutorial discretion serves an important function in our criminal justice system, established precedent is clear that where there is a pattern and practice of enforcement against only one of two or more opposing political viewpoints, the ordinary discretion accorded to prosecutors has exceeded its boundaries. At that point, the doctrine of prosecutorial discretion must cede and give way to the demands of the First Amendment, forbidding such blatant political discrimination and abuse of government power. See e.g., Foti v. City of Menlo, 146 F.3d 629, 635 (“[A] litigant may separately argue that discriminatory enforcement of a speech restriction amounts to viewpoint discrimination in violation of the First Amendment....”
At a hearing of the Senate Homeland Security and Governmental Affairs Committee held on November 17, 2022, FBI Director Christopher Wray testified that most cases of violence involving abortion are against pro-life organizations.
See, Pro-life centers targeted by 70% of abortion-related violent threats since
Dobbs decision: FBI | Fox News; User Clip: FBI Director Wray Admits Most
Abortion Violence Cases Are Against Pro-Life Orgs |
The Family Research Council produced a list of attacks against pro-life organizations, property and people that occurred between the leak of the Dobbs draft on May 2, 2022, and May 19, 2023, documenting 39 attacks against churches, 67 attacks against pro-life organizations/PRCs, and 24 other acts of violence or vandalism. (Attacks on Churches, Pro-Life Organizations, Property, and People Since the Dobbs Leak on May 2, 2022 See,
CompassCare made sharply worded public criticisms about the lack of government investigation or prosecution of crimes against PRCs and the Thomas More Society argued in its briefs in its FACE Act cases this point about USDOJ’s discriminatory failure to prosecute pro-abortion terrorists, while the FBI was aggressively investigating, and USDOJ was aggressively prosecuting, pro-life protesters until the FBI finally offered and publicized rewards for the apprehension of pro-abortion vandals and firebombers, etc., and USDOJ finally began to respond and bring FACE Act prosecutions against a few perpetrators of pro-abortion violence against pregnancy centers.
On January 24, 2023, Caleb Freestone and Amber Smith-Stewart, were charged under the FACE Act pursuant to the first ever FACE Act indictments of pro-abortion activists attacking pro-life pregnancy resource centers. (CV Update: FACE Act Indictments, Catholic Vote (Feb. 23, 2023)). On March 22, 2023, a
Superseding Indictment was filed adding two additional defendants: Annarella Rivera and Gabriella Victoria Oropesa. See, United States v. Freestone, 8:23-cr00025 –
And, on July 5, 2023, the DOJ charged a Bowling Green State University Student, Whitney Durant, with a misdemeanor violation of the FACE Act for defacing the building that houses HerChoice, a pregnancy care center located in Bowling Green, Ohio with spray paint because the clinic provides reproductive health services. Graffiti included “Liars,” “Fake Clinic,” ”Jane’s Revenge,” and
“Abort God.” See, Northern District of Ohio | Bowling Green State University
Student Charged with FACE Act Violation | United States Department of Justice.
Nonetheless, these few prosecutions of pro-abortion violence under the FACE Act, done only after and probably in response to our motions and briefing contending that the DOJ is engaged in impermissible as-applied viewpoint discrimination are not enough to rebut our assertion that the DOJ is discriminating when compared to the many aggressive prosecutions of pro-lifers whose conduct did not violate the FACE Act and the large number of pro-abortion FACE Act violations that have occurred, especially since the leak of the draft of the Dobbs Supreme Court opinion in May of 2022.

Although several federal courts of appeals have upheld the constitutionality of the FACE Act, the United States Supreme Court has never taken up the matter. E.g., United States v.
Weslin, 156 F.3d 292 (2d Cir. 1998), cert. denied, 525 U.S. 1071 (1999); Norton v. Ashcroft, 298
F.3d 546 (6th Cir. 2002), cert. denied, 537 U.S. 1172 (2003); United States v. Gregg, 226 F.3d 253 (3d Cir. 2000), cert. denied, 532 U.S. 971 (2001); United States v. Bird, 124 F.3d 667 (5th
Cir. 1997); Terry v. Reno, 101 F.3d 1412 (D.C.Cir.1996), cert. denied, 520 U.S. 1264 (1997);
United States v. Dinwiddie, 76 F.3d 913 (8th Cir.), cert. denied, 519 U.S. 1043 (1996); United
States v. Wilson, 73 F.3d 675 (7th Cir.1995), cert. denied, 519 U.S. 806 (1996); Cheffer v. Reno, 55 F.3d 1517 (11th Cir.1995); American Life League, Inc. v. Reno, 47 F.3d 642 (4th Cir.), cert. denied, 516 U.S. 809 (1995).
There is no general police power delegated to the federal government by the U.S. Constitution. In Section 2 of the FACE Act, 18 U.S.C § 248, Congress claimed it was given the power to enact the FACE Act’s prohibitions against violence, interference, and obstruction of reproductive health care facilities and churches by the U.S. Constitution's Commerce Clause and the Fourteenth Amendment’s Due Process Clause:
Freedom of Access to Clinic Entrances Act SEC. 2. PURPOSE.
Pursuant to the affirmative power of Congress to enact this legislation under section 8 of article I of the Constitution, as well as under section 5 of the fourteenth amendment to the Constitution, it is the purpose of this Act to protect and promote the public safety and health and activities affecting interstate commerce by establishing Federal criminal penalties and civil remedies for certain violent, threatening, obstructive and destructive conduct that is intended to injure, intimidate or interfere with persons seeking to obtain or provide reproductive health services. [Emphasis added.] 18 U.S.C § 248 sec. 2.
Section 8 of Article I of the Constitution contains the Commerce Clause, which provides:
Article I, Section 8, Clause 3:
[The Congress shall have Power . . .] To regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes….
[Emphasis added.] U.S. Const. art. I, § 8, cl.3.
Section 1 of the Fourteenth Amendment provides:
All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the state wherein they reside. No state shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any state deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws. [Emphasis added.] U.S. Const. amend. XIV, § 1.

Section 5 of the Fourteenth Amendment provides:
The Congress shall have the power to enforce, by appropriate legislation, the provisions of this article.
U.S. Const. amend. XIV, § 5.

But these two proffered predicates for Congressional power to regulate what have traditionally been state and local crimes are now newly vulnerable, and powerful new arguments are now available for challenging the constitutionality of the FACE Act and having it declared void and unenforceable. Here are several arguments that may be raised.

Susan B. Anthony: Pro-Life America

Autumn Christensen
Vice President of Public Policy, Her Plan

1. Intro

2. What did Dobbs do?

3. How did States Respond?

4. How did the Abortion Industry Respond?

a. Abortion Centers Reopen
b. Parking Lot Abortions
c. Mail-order Abortion
d. Ballot Initiatives

5. How many lives saved?

6. How do we save the rest?

a. National Discussion
b. National Protection
c. Common Questions

Speaking with Media,
Both Hostile and Friendly

Kristina Hernandez
Media Relations Specialist

I. Overview:

A. What to do when you’re contacted by a member of the media
B. How to prepare for an interview
C. Media lingo
D. How to interview with the press

II. Current news environment

III. The News Desk View

IV. What to do when contacted for an interview

V. Interview lingo and parameters

VI. Options - responding to media inquiries

VII. What to think about when deciding to do/not to do an interview

VIII. Examples of hostile media questions

IX. Interview basics

A. What to do before, during, and after the interview
B. Bridging phrases
C. What to say/not to say to a reporter
D. Tips for television, radio, and print interviews
E. Your rights as the subject of an interview
F. What to wear/not to wear during an interview

X. Practice interview

Mission Possible

Missy Clifton Ph.D.
Founder of Learning Is Created

1) Why is completing a security risk assessment important?

a) Required by HIPAA
b) Amendment to HITECH Act
c) American Data Privacy and Protection Act
d) Protecting Personal Health Data Act
e) My Body, My Data Act
f) Best practice

2) What is risk?

3) What is a risk assessment?

4) What is a SECURITY risk assessment (SRA)?

5) Preparing to conduct a security risk assessment: Questions to ask:

a) Who conducts a SRA?
b) What are your assets?
c) Who are your business associates?
d) Where are your documents?

6) Using the SRA Tool

a) Introduction
b) Demographics
c) Using your ingredients
d) Assessment

i) How the assessment is guided
ii) Sections
iii) Question structure and resources
iv) Vulnerabilities and subjectivity
v) How risk is calculated
vi) Likelihood, impact, and subjectivity
vii) Areas of success and Areas for review

7) Summary and Reports

a) Summary
b) Risk Report
c) Flagged Reports
8) Setting Goals
9) Downloading the SRA Tool
10) Question

The Abortion Wounded Church
Developing a culture of healing for the abortion wounded

Karen Ellison
Founder and President, Deeper Still

I. Why should you care? Even if abortion is not your story – It’s the story of someone you love.

II. Why is it Essential? Healing the Abortion Wounded Heart is not just a compassionate response; but an essential component to ending abortion.

A. My Background & Abortion Story
B. Abortion Wounded Christians & the Church
C. Letter to Your Pastor
D. Abortion Fatigue
E. The Challenge for Clergy
F. The Theology of Life & Healing
G. Let the Redeemed of the Lord say so
H. Across the Denominational Aisle
I. Developing an Isaiah 61 Faith Community
J. Action Steps