The summary

• Two competing abortion-related measures are on the Nebraska ballot.

• This week, the state health department issued a notice to doctors suggesting that recent announcements about abortion restrictions in Nebraska had created “confusion.”

• Reproductive rights advocates and Nebraska obstetricians and gynecologists rejected the department’s message.

Just a week before an election in which Nebraska voters will decide on two competing ballot initiatives related to abortion rights, the state health department sent doctors an alert about what it called “misleading information” in health care ads. radio and television.

Nebraska Chief Medical Officer Dr. Timothy Tesmer wrote in the alert that recent ads had created confusion about Nebraska’s law restricting abortions after 12 weeks of gestation, although it did not specify which ads.

He listed some exceptions to the policy, including that Nebraska law does not prohibit the removal of an ectopic pregnancy. Abortions in the state are permitted in cases of rape or incest, according to the advisory, and when there is a threat to a woman’s life or a risk of irreversible damage to a major bodily function.

Nebraska’s two abortion-related ballot measures are called Initiative 439 and Initiative 434. Initiative 439 would allow abortions up to fetal viability (generally around 22 to 24 weeks, although it does not specify a gestational age) or when necessary to protect the life or life of a pregnant person. health.

Meanwhile, Initiative 434 would amend the state constitution to ban abortion in the second and third trimesters (in other words, after 12 weeks) with some exceptions. Is supported by Nebraska Right to Lifea group against abortion rights. Nebraska already bans most abortions after 12 weeks, so the measure wouldn’t cause major changes at the grassroots level. But if passed, it could make it more difficult to challenge the state’s abortion law and could open the door to greater restrictions.

Allie Berry, campaign director for Protect Our Rights, a campaign to vote “yes” on Initiative 439 and end Nebraska’s abortion ban, said she believes Initiative 434 is designed in part to sow confusion so that the people vote against 439.

Berry also suspects the health department’s notice was a response to her group’s ads, although the language did not describe a specific ad.

He said the health department and Gov. Jim Pillen, who held a news conference last week about what he called “misinformation” related to abortion, were “trying to camouflage that there is actually an abortion ban in Nebraska.” .

Pillen, a Republican, and Tesmer are “using their position of power to try to further confuse voters,” Berry said.

In response to a question, Pillen’s office noted a summary of his press conference last weekwhen she said she did not want “misinformation” to prevent women from seeking medical care for miscarriages and ectopic pregnancies. He said his concern was not related to Nebraska’s ballot initiatives.

Jeff Powell, director of communications for the Nebraska Department of Health and Human Services, said the intent of the health alert was to “clarify the current law.”

Berry’s group’s ads in support of Initiative 439 suggest that Nebraska’s abortion ban may threaten women’s lives, prevent doctors from properly treating patients and forcing women to have pregnancies with no chance of survival.

an advertisement features a woman named Kimberly Pasekawho shortly after the abortion ban went into effect last year learned she would lose her pregnancy. In the first trimester, the fetus was not developing properly and the heartbeat had slowed, but her doctor refused to intervene, Paseka told NBC News.

“As the law had just been passed, there was a lot of confusion because there was still cardiac activity,” he said. “So instead of doing anything, they sent me home for expectant management, which is basically waiting to have a miscarriage.”

Paseka said she suffered nausea and painful contractions while waiting for her miscarriage. He underwent more ultrasounds, which he described as “its own level of torture, just watching something you wanted so badly die.”

She finally miscarried at the end of her first trimester.

“I ended up passing our baby in the bathroom and it was just horrible and devastating,” Paseka said.

In response to the health department’s alert, two doctors in the state said there is no confusion among doctors about how to treat ectopic pregnancies or miscarriages.

But it can be difficult to determine what to do when a fetus still has a heartbeat, they said.

Nebraska’s abortion ban does not have an exception for fetal anomalies that prevent survival outside the womb, so if life-threatening abnormalities are detected after 12 weeks, “we can’t talk to you about terminating that pregnancy,” he said. Dr. Abigail Drucker, President. of the Nebraska chapter of the American College of Obstetricians and Gynecologists. Your organization opposes Initiative 434 and promotes 439.

Drucker said doctors are also confused about when it is legally permissible to intervene in certain cases where a patient’s amniotic sac ruptures prematurely, which could pose a risk of infection.

“These are the issues the governor didn’t talk about,” Drucker said. “Here in the state of Nebraska we are limited as to when and how to treat that patient because of the law.”

Dr. Mary Kinyoun, an obstetrician and gynecologist in Omaha, said recent comments from state officials downplay the burden doctors face as a result of the state’s abortion ban.

“It makes us villains as OB-GYNs in the community who fight for reproductive rights,” she said. “I’m concerned this will eat away at the trust of obstetricians and gynecologists in our community.”

Powell wrote in an email that it was not the health department’s “intent to villainize Nebraska obstetricians and gynecologists or any other medical professionals” and that “DHHS has great respect for both the medical profession and the physician relationship.” -patient”.

The back-and-forth in Nebraska is reminiscent of a similar controversy in Florida this month. Florida Department of Health sent cease and desist letters to multiple broadcast stations that aired an ad supporting a ballot measure on abortion rights. The attorney who wrote the letters on behalf of the department subsequently resigned.

The department threatened to file criminal charges against stations that would not stop playing the ad, but a federal judge ended the threats by issuing a temporary restraining order against the state’s Surgeon General, Joseph Ladapo. On Thursday, the judge extended the order for two weeks, until after the election or until the judge makes a decision on a request for a preliminary injunction to prohibit the health department from continuing to threaten television stations.