18 June 22
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“This,” of course, was any one of the antics or misdeeds that marked Trump’s time in office: the lies, the insults, the cruelty and the criminality. Imagine if Obama had gone out of his way to excuse the equivalent of a white supremacist mob; imagine if Obama had gone to the site of a natural disaster and tossed out paper towels like so many footballs; imagine if he had railed against “shithole countries” or tried to pressure a foreign leader into turning over information to undermine his political opponents.
Imagine what would have happened if Barack Obama had plotted to subvert and overturn a presidential election that he had lost.
Republicans would have lost their minds. Having whipped themselves into a lather over fake scandals and manufactured controversies during the actual Obama administration, they would have exploded into paroxysms of partisan rage over any one of these misdeeds. The Benghazi hearings would have looked like a sober-minded investigation compared with what Republicans would have unleashed if the shoe had been on the other foot.
The point of this mental exercise, for liberals, was to highlight the hypocrisy of the Republican Party under Trump. Tucked into this attempt to condemn Republican behavior, however, is an important observation about the value of political theater. All this conservative hysteria did not defeat Barack Obama at the ballot box, but it may have helped to put his party at a disadvantage.
The main effect of these years of Republican scandalmongering was to produce a cloud of suspicion and mistrust that helped to undermine Obama’s preferred successor, as well as to shield Trump, as the 2016 Republican nominee, from the kind of scrutiny that might have made him more vulnerable.
Democrats do not need to mimic Republican behavior in all of its deranged glory, but they would do well to heed the lesson that for many voters, where there is smoke, there must be fire.
It is with this knowledge in mind that Democrats in Washington should do something about Ginni Thomas, who has just been asked to testify before the House select committee investigating the attack on the Capitol. The reason is straightforward. Thomas, the wife of Supreme Court Justice Clarence Thomas, worked with allies of Donald Trump to try to overturn the 2020 presidential election. (Thomas quickly let it be known that she was looking “forward to talking to” the committee and couldn’t wait “to clear up misconceptions.”)
Earlier this year, we learned that Thomas exchanged text messages with Mark Meadows, the White House chief of staff, in the weeks and days before the Jan. 6 attack on the Capitol. We also learned, last month, that she urged Arizona Republicans to discard the results of the election and choose a “clean slate of electors” for Trump.
And we learned this week from the Jan. 6 committee that Thomas also sent messages directly to John Eastman, the conservative lawyer (and former law clerk for Justice Thomas) who essentially devised the plan to try to overturn the 2020 presidential results.
Eastman spoke at the Stop the Steal rally before the attack and even requested a pardon by way of Rudy Giuliani for his activities leading up to the insurrection: “I’ve decided that I should be on the pardon list, if that is still in the works.”
“Thomas’s efforts to overturn the election were more extensive than previously known,” The Washington Post reported on Wednesday. Eastman, for his part, claimed to have known of a “heated” dispute among the Supreme Court justices over whether to hear arguments about the 2020 election. “So the odds are not based on the legal merits but an assessment of the justices’ spines, and I understand that there is a heated fight underway,” he is said to have written in an email to another lawyer. (On Thursday, Eastman posted a rebuttal on Substack asserting that he’d heard about the “heated fight” from news reports and that he could “categorically confirm that at no time did I discuss with Mrs. Thomas or Justice Thomas any matters pending or likely to come before the court.”)
But if the first revelation, of Thomas’s correspondence with Meadows, was shocking, then the revelation of Thomas’s contact with Eastman is explosive. And it raises key questions, not just about what Ginni Thomas knew but about what Clarence Thomas knew as well. How, exactly, did Eastman know of tensions on the court? And why did he predict to Greg Jacob, the chief counsel to Vice President Mike Pence, that the Supreme Court would rule 7 to 2 against his legal theory about the Electoral College certification process before conceding that it would be 9 to 0?
So while the committee is rightly seeking testimony from Ginni Thomas, Democrats should say something, too. They shouldn’t just say something; they should scream something.
Not only did Ginni Thomas try to make herself a part of the effort to overthrow the government, but Justice Thomas was the only member of the court to vote in favor of Donald Trump’s attempt to shield his communications from congressional investigators — communications that would have included the messages between Mark Meadows and Ginni Thomas.
There is something suspect happening with the Supreme Court, and other constitutional officers have every right to criticize it. Democratic leaders in Congress should begin an investigation into Ginni Thomas’s activities and announce that they intend to speak to her husband as well. President Biden should tell the press that he supports that investigation and hopes to see answers. Rank-and-file Democrats should make a stink about potential corruption on the court whenever they have the opportunity. Impeachment should be on the table.
This probably won’t win votes. It could, however, capture the attention of the media and even put Republicans on the defensive. It is true that politics are unpredictable and that there’s no way to say exactly how a given choice will play out in the real world. But if the much maligned (and politically successful) investigations into Benghazi and Hillary Clinton’s emails are any indication, real pressure might turn additional revelations into genuine liabilities for the Republican Party.
The easiest thing for Democrats to do, of course, is nothing — to steer away from open conflict and leave the controversy (and the questions) to the select committee. But if Democrats choose instead to act as a political party should, they would do well to remember that if the tables were turned, their opponents would not hesitate to use every argument and every tool at their disposal.
Attorney General Merrick Garland. (photo: Susan Walsh/Press Pool)
‘I would like to see the justice department investigate any credible allegation of criminal activity on the part of Donald Trump,’ California Democrat says
During a press conference on gun violence on Monday, CNN Justice correspondent Evan Perez asked Mr Garland if he has had a chance to look at the hearings conducted by the House Select Committee investigating the Capitol riot and if he’s learned anything that could be useful for the Justice Department.
“I am watching and I will be watching all the hearings, although I may not be able to watch all of it live,” Mr Garland said. “I can assure you that the January 6th prosecutors are watching all the hearings as well.”
He added that he wouldn’t be able to say what his own “personal response” to the hearings would be.
“The Justice Department’s long-standing position is that we don’t comment on ongoing investigations,” Mr Garland said. “We do that both for the viability of our investigations and because it’s the right thing to do with respect to the civil liberties of people under investigation.”
“Our investigations generally proceed quietly and in secret so that we don’t tell witnesses where we are, we don’t want them to know, we want truthful answers. As we approach, we want to be able to do our subpoenas and search warrants without any risk,” Mr Garland said. “Eventually that information comes out ... in the form of our search warrants and affidavits, it comes out in our orders ... in our pleadings and eventually if there are charges.”
“But for our investigations to proceed in an efficient way, we have learned, over many, many years, that this is the way our investigations should go,” Mr Garland added.
“We have charged well over 800 people now in connection with January 6th, some of them have pled, but others are facing proceedings. And for us to comment about evidence, some of which regards them, some of which regards others, could affect their cases and could affect our ability to proceed in an effective way,” Mr Garland said, adding that the investigation isn’t constricted “in any way”.
Mr Garland’s refusal to comment on the investigation comes as members of the House Select Committee investigating the Capitol siege are pushing the department to pursue criminal charges.
“There are certain actions, parts of these different lines of effort to overturn the election, that I don’t see evidence the justice department is investigating,” Adam Schiff, a Democratic committee member from California, told ABC’s This Week on Sunday. “I would like to see the justice department investigate any credible allegation of criminal activity on the part of Donald Trump.”
Fellow committee member, Maryland Democrat Jamie Raskin, told CNN’s State of the Union that “one of the conventions that was crushed during the Trump administration was respect by politicians for the independence of the law enforcement function”.
“Attorney General Garland is my constituent, and I don’t browbeat my constituents [but] he knows, his staff knows, US attorneys know, what’s at stake here,” he added. “They know the importance of it, but I think they are rightfully paying close attention to precedent in history as well as the facts of this case.”
Ukrainian president Volodymyr Zelensky. (photo: Ronaldo Schemidt/Getty Images)
Commission also recommends candidate status for Moldova but gives more guarded response to Georgia
The EU executive also recommended candidate status for Moldova, another former Soviet state that launched an EU membership bid soon after Russia’s invasion of Ukraine. But it gave a more guarded response to Georgia, saying the country needed to carry out further anti-corruption and judicial reforms.
EU leaders will decide next week whether to grant the three states EU candidate status, although full membership would be likely to take years. The decision would be a historic step for Ukraine, where reformers have been seeking democratic change since the Maidan protests of 2014, events that were the prelude to Russia’s annexation of Crimea and war on its neighbour.
The European Commission president, Ursula von der Leyen, said Ukraine had made progress in the last eight years. She cited reforms to create a market economy, independent judiciary and to tackle corruption but said more needed to be done to allow Ukraine to progress in membership talks.
“Ukraine should be welcomed as a candidate country. This is on the understanding that good work has been done, but important work also remains to be done,” she told reporters. “The entire process is merit-based. So it goes by the book and therefore progress depends entirely on Ukraine. It is Ukraine that has it in their hands.”
“We all know that Ukrainians are ready to die for the European perspective. We want them to live with us, the European dream,” Von der Leyen added.
Zelenskiy, Ukraine’s president, said the EU proposal would “certainly bring our victory closer”.
The outcome for Ukraine to get candidate status looks positive, after a visit by four EU leaders to meet Zelenskiy on Thursday. “Ukraine belongs to the European family,” said the German chancellor, Olaf Scholz, at a press conference with France’s Emmanuel Macron, Italy’s Mario Draghi, Romania’s Klaus Iohannis and Zelenskiy.
Joining the EU could take years. Some EU countries have qualms about offering false hope to Ukraine in advance of demanding membership talks that Macron suggested may take decades to complete. The French president has called for the creation of a new European political community to allow prospective and former members to deepen ties on security, energy and movement of people.
While Paris insists this is not a substitute for EU enlargement, Kyiv is wary of anything that could slow down joining the bloc.
The decision to grant a country EU candidate status is a highly charged procedural step that usually takes years and paves the way for talks on aligning with EU law. Albania took more than five years to receive candidate status. North Macedonia became an EU candidate in 2005, but is still waiting to open membership talks.
Von der Leyen said the commission also wanted EU candidate status for Moldova, which declared independence from the collapsing Soviet Union in 1991 and is concerned about the spillover effect of the Ukraine conflict. Moldova, Von der Leyen said, was on “a real pro-reform, anti-corruption and European path for the first time since independence”. She said its economy and public administration still needed “major improvements”, but expressed confidence in the government.
Georgia, another post-Soviet state, ought to be granted “a European perspective”, a lower rung on the EU membership ladder than candidate status, the commission said.
Olivér Várhelyi, the EU enlargement commissioner, called for an end to Georgia’s political polarisation, as he listed a series of reforms Tbilisi needed to carry out to gain candidate status. These included judicial reforms, the creation of an independent anti-corruption agency, intensifying the fight against organised crime and greater protection of media freedom.
Pro-choice protesters march outside the Texas State Capitol in Austin. (photo: Sergio Flores/Getty Images)
The clinic, run by Planned Parenthood, is housed in a brick building surrounded by a tall metal fence. Anti-abortion protesters gather along the perimeter, attempting to stop people from driving in. Hanging from the side of the building is a sign with big block letters that reads “STILL HERE.”
Still being there, being open, is no small feat. For more than a decade, an increasingly conservative Missouri legislature has tried to legislate abortion out of existence. It passed a slew of draconian measures that led to the closure of the state’s other clinics. It passed a near total ban on abortion at eight weeks, a point at which many people don’t know they’re pregnant. To that measure, lawmakers affixed a so-called trigger law, which will outlaw abortion altogether when — imminently — the U.S. Supreme Court knocks down nearly a half-century of precedent acknowledging the right to terminate a pre-viability pregnancy. And although the eight-week ban was blocked by the federal courts as unconstitutional, at least by present standards, the state was undeterred, weaponizing its regulatory system in an attempt to revoke the clinic’s license.
“I describe practicing in Missouri as providing some of the most basic and not super-complicated health care with my hands behind my back, in handcuffs, and blindfolded,” said Dr. Colleen McNicholas, an OB-GYN and chief medical officer for Planned Parenthood of the St. Louis Region and Southwest Missouri. “And then tomorrow, I get to go provide the same health care in Illinois, where it is centered in science.”
While lawmakers in Missouri have worked furiously to constrict reproductive health care, politicians and providers in Illinois have been working to increase access. The state made birth control available over the counter, expanded Medicaid to include abortion coverage, repealed a parental notification requirement for minors seeking abortion, and enshrined reproductive freedom into state law. The abortion clinics on the Illinois side of the river — including an 18,000-square-foot facility in Fairview Heights operated by the same Planned Parenthood affiliate that runs the St. Louis clinic — have expanded capacity. Thousands of Missouri residents now make the trip across the river every year for services.
Simply living on the Illinois side of the river cuts a person’s likelihood of pregnancy-related death in half, notes Dr. Erin King, an OB-GYN who serves as executive director of the Hope Clinic for Women in Granite City, Illinois, also just across the border from Missouri.
With Roe about to fall, Illinois will be thrust into an even bigger role: 22 states are expected to swiftly outlaw abortion, a list that includes nearly every state in the South — and every one of Illinois’s neighbors. The state is poised to become an oasis of access in the heart of an abortion desert. In the first year post-Roe, the Fairview Heights clinic anticipates treating 14,000 additional patients; 15 miles away, the Hope Clinic estimates that its patient volume will nearly double.
Outlawing abortion won’t diminish the need for care, but it will make navigating access more complicated and costly and hit those with the least resources and mobility the hardest. Nationally, 60 percent of abortion patients are already parenting; nearly 50 percent live below the federal poverty line; a majority are patients of color. It was with this reality in mind — months before Politico published the leaked Supreme Court draft opinion that would eliminate abortion rights — that providers were joined by Illinois Gov. J.B. Pritzker in January as they unveiled their latest bid to help facilitate the looming exodus: the Regional Logistics Center.
A $10 million partnership between the Fairview Heights clinic and the Hope Clinic for Women, the RLC was designed as a one-stop shop for any patient traveling to Illinois. Patients calling for appointments at either facility are connected to the nation’s network of financial aid and practical support groups; case managers help arrange transportation and lodging or line up cash for food and child care. It is a first-of-its kind operation — and couldn’t come online a minute too soon.
“Today’s announcement is a shining example of what is possible when elected leaders like you work to shape policy that allows providers to center patients and not politics when delivering abortion care,” Yamelsie Rodriguez, CEO of the regional Planned Parenthood affiliate, said during an online ribbon-cutting ceremony. “Together we are breaking down the silos anti-abortion politicians created.”
The reproductive freedom tug-of-war that has been playing out across this stretch of the Mississippi River opens a window into what is to come after Roe falls: a jockeying for control among the states that will only intensify. As states like Illinois work to expand access for people across the country, others, like Missouri, will escalate their assault, attempting to bind residents to their anti-abortion laws.
There is a common anti-abortion talking point that claims returning control over abortion rights to the states will take the courts out of the mix — in other words, that “abortion law will become simpler,” note the authors of “The New Abortion Battleground,” a forthcoming article in the Columbia Law Review. But that, they write, is “woefully naïve.”
Missouri has already offered a potent example of what the future will look like. This spring, one lawmaker crafted a measure based on Texas’s notorious sue-thy-neighbor law that would allow lawsuits against anyone who helped a Missouri resident obtain care across state lines. While the legislation went nowhere, experts like David Cohen anticipate that measures like it are likely to become the norm.
“Thinking about Missouri is spot on,” said Cohen, a professor at Drexel University’s Kline School of Law and co-author of the new law review article. The state has regulated abortion so severely that there are already very few being performed. “Think of a state legislator in Missouri who, after Roe v. Wade is overturned, says, ‘OK, I have the green light to ban abortions.’ So they’re going to ban abortions,” he said. But if residents can leave the state, anti-abortion lawmakers haven’t really nailed their target. “Are they going to feel good about what they’ve done if they are a true pro-life believer? No, because it’s really kind of having no effect.”
So, he said, they’re going to pursue what will have an effect — and that is bound to unleash a new landscape of cross-border fights that will inevitably end up in the courts. “And those things are going to be the things that … involve interstate travel and crossing state lines or trying to prosecute someone for performing an abortion on a Missouri resident.”
Providers like McNicholas, King, and Rodriguez have long been readying for the fight ahead. “In our bi-state region,” Rodriguez said, “the post-Roe reality arrived years ago.”
Missouri’s Extreme Evolution
Growing up on Chicago’s South Side, McNicholas knew she wanted to be a doctor. Initially, the ambition was to be a forensic pathologist. She’d worked in the local coroner’s officer during college, “and I just loved it,” she said. It was more than medicine; it was also problem-solving. “That’s actually why I went to medical school,” she said. But that would soon change.
For med school, McNicholas landed in Kirksville, Missouri, a small, rural, conservative city roughly 40 miles from the Iowa state line. The culture shock was immediate: The traffic lights were only on for a few hours a day, she recalled, and there were deer running around town. “Honestly, I had never seen a deer in my whole life.” As she and her classmates settled in, they decided to start a chapter of Medical Students for Choice, an organization that promotes training in reproductive health, including family planning and abortion. “We thought that there would be some value in our medical school classmates having some exposure to just some more progressive or less judgy sexual reproductive health stuff,” she said. This is no small issue. Reproductive health education that includes abortion is not part of the curriculum in many U.S. medical schools, even for students training to become OB-GYNs.
McNicholas and her friends followed the school’s protocol for initiating the group. “We checked the boxes and we’re like, ‘OK, here we go,” she recalled. The reaction was not what she expected. In school meetings about whether the club should be allowed, “there were classmates crying about having to learn about abortion,” she said. “It was really quite shocking.” The lessons they’d planned were composed of basic stuff, like learning how to take a patient’s sexual history. “It wasn’t even about abortion.” And no one was required to participate. While the school eventually approved the chapter, “that was sort of like, maybe dead people is not the place where I’m going to be best using my talents and voice,” McNicholas said.
She reimagined herself as a “crunch-nugget” OB-GYN who would facilitate water births and provide abortion for her patients when they needed them. She did a residency at Washington University in St. Louis, the only program in the state to provide abortion training. It was there that she realized just how tricky abortion access in Missouri could be. “My training sort of collided with the really extreme evolution that was happening.”
It was the early 2000s, and legislatures across the country were beginning to ramp up their restrictions on abortion. There were laws creating waiting periods, which meant that getting an abortion would require multiple clinic trips. There were mandates for the provision of medically inaccurate “informed consent” materials designed to shame people seeking abortions. There were targeted restrictions of abortion providers, known as TRAP laws, which used safety as a pretext to shut down clinics. There were laws limiting health insurance coverage of abortion and access to medication abortion, which now accounts for more than half of all abortions in the country. Missouri would enact all these restrictions and more.
Amid the dimming landscape, McNicholas undertook research and policy work. She did media training. And she began to testify at the legislature. “If you think about it, the legislature generally doesn’t know anything about building railroads, right? So you would think if they were going to build a railroad, they would ask somebody about that,” she said. But they don’t do that where health care is concerned. “It’s both terrifying and disappointing,” she said. “More than anything, I think the thing that pushed the advocacy piece of my work was around feeling like I put all this time and money into learning how to take care of people, and this dude who has a farm — which, farming is important, great — but what do you know about what I do?”
Missouri politicians have displayed egregious ignorance concerning reproductive health issues. In the most recent legislative session, state Rep. Brian Seitz penned legislation that would ban the “trafficking” of medications or “instruments” used in abortion — the same medications used in miscarriage management and instruments used in routine gynecological procedures. The bill would also make it a felony punishable by life in prison to perform an abortion on a patient with an ectopic pregnancy, a nonviable, life-threatening condition. After public backlash, Seitz claimed the bill had been misrepresented. A subsequent version omitted the language about instruments and ectopic pregnancies.
In 2019, during the growing crisis of access, McNicholas decided to leave a faculty position at Washington University to become chief medical officer for the Planned Parenthood affiliate that operates the St. Louis clinic. That year, lawmakers passed the bill criminalizing abortion as early as eight weeks. Meanwhile, the state was simultaneously pursuing a regulatory strategy that nearly resulted in the clinic losing its license and Missouri becoming the first state in the country without a single abortion provider.
Under state law, the clinic is subject to inspection by Missouri’s Department of Health and Senior Services as part of its annual license renewal. Typically, these would be several-day affairs. But the inspection that year was protracted, spreading over several months. It seemed like the inspectors were on a “quest to find anything and everything,” McNicholas said. “Standing up on chairs and putting your finger across the ceiling tile to see if there is dust or trying to lift off the laminate of something because that could somehow be a violation.”
For the first time, the clinic was cited for not following a regulation regarding pelvic exams. According to the state, the clinic was required to provide an internal pelvic exam during the patient’s first visit — or 72 hours before the abortion would take place, thanks to Missouri’s mandated waiting period. Providers routinely conducted pelvic exams for patients receiving procedural abortions, but not three days ahead of time. Following the regulation meant patients would be subjected to an additional pelvic exam for no medical reason. The state was also imposing the same protocol for medication abortion, where a mandatory pelvic exam runs counter to best practices.
At first the clinic acquiesced, but the result was traumatic. “We explained to the patients that this was not our doing,” Kawanna Shannon, then-director of surgical services, later testified while fighting back tears. “We have patients who have been abused, raped, and you are putting them through an invasive, unnecessary pelvic exam … something they already have to do on procedure day. And you have patients apologizing to us saying, ‘I’m sorry you have to do that to me.’”
Planned Parenthood told the state that it would not comply. “We want Missourians to have access to abortion. But also, you’re not going to push us beyond our ethical boundaries,” McNicholas said. When clinic officials began to suspect that the state was plotting to revoke their license, they decided to be proactive and sued to prevent that from happening.
The state fired back in a press release suggesting the clinic had something to hide. Several weeks later, Dr. Randall Williams, then-head of the health department, told reporters that regulators had decided not to renew the clinic’s license. He said they had identified four patients who had “adverse outcomes” — including one who lost “half her blood” during an abortion — and accused the clinic of failing to file complication reports.
The whole matter ended up before the state’s administrative commission. Over the course of a multiday hearing, it became clear that Williams’s dire characterization was not supported by the evidence. And there were additional revelations, including that regulators had created a spreadsheet for tracking patients’ menstrual cycles in an effort to find failed abortions that the clinic hadn’t reported. The spreadsheet made national headlines. “Here’s the state digging into these people’s medical history trying to make something of nothing,” McNicholas recalled. “The whole picture is really disturbing on many levels.”
Ultimately, the administrative commission sided with Planned Parenthood. In an exhaustive opinion, Commissioner Sreenivasa Rao Dandamudi wrote that the clinic had “demonstrated that it provides safe and legal abortion care” and the state had not found anything amiss that would justify license revocation. Dandamudi ordered the state to pay the clinic’s legal fees. Three months later, Gov. Mike Parson replaced Dandamudi.
While the St. Louis clinic remains open, the heft of restrictions required to access abortion in Missouri have caused patient numbers to fall significantly. In 2015, the clinic provided a total of 4,647 abortions, including 1,177 medication abortions. In 2020, it provided just 51. Notably, none of those were medication abortions; the state refused to exempt them from the invasive pelvic exam requirement, so the clinic no longer provides them.
Meanwhile, just across the river in Illinois, abortion is available without restriction. As the Missouri numbers have dropped, the Illinois numbers have risen significantly. In 2020, the Fairview Heights clinic alone provided over 5,000 abortions — more than triple the previous year.
Illinois Is Right Here
Inside the Hope Clinic for Women in Granite City is a framed copy of Senate Bill 25, the Illinois Reproductive Health Act, and a pen Pritzker used to sign the legislation into law back in June 2019. King, the clinic’s executive director, was there behind the governor for the signing ceremony.
The RHA enshrines the right to reproductive freedom into state law and requires private insurers to cover abortion. “This act sets forth the fundamental rights of individuals to make autonomous decisions about one’s own reproductive health,” it reads, including “the fundamental right of an individual who becomes pregnant to continue the pregnancy and give birth to a child, or to have an abortion.”
As Missouri’s health department had the St. Louis clinic in its crosshairs, lawmakers from Georgia and Missouri had traveled to the Capitol in Springfield to urge their Illinois colleagues to pass the measure, which they said would send a positive message across state lines. “The idea of the … very last provider losing their license by the end of this week just really drives home the importance of what’s going on here in Illinois for people in the Midwest region,” then-Missouri Rep. Cora Faith Walker told Capitol News Illinois. “I want to let the people of Missouri know that Illinois is right here. There are people who are supportive of them and will help them if they need help.”
King, who practices medicine in both Illinois and Missouri, thinks the pleas from out-of-state legislators really resonated with their Illinois counterparts. She was out to dinner with her husband and father the night lawmakers were debating the bill and listened for updates through a single earbud. When it finally passed, she said, “There were tears streaming down my face.”
“I went into gynecology because I think reproductive health care is the most important public health measure you can pay attention to,” she said. “It’s actually a medical fact.” That’s because ready access to the full spectrum of reproductive health care — including birth control, prenatal and postpartum care, and abortion — leads to declines in troubling metrics like rates of maternal and infant mortality. This in turn strengthens families and the broader community, King said. “All sorts of things down the stream.”
Missouri has one of the highest maternal mortality rates in the country. In December, King took to the stage for a TEDx talk in St. Louis and laid it all out. “Simply by living in this state, your risk of dying from pregnancy is higher than in 42 other states,” she said. “This information is terrifying.”
The state had convened a multidisciplinary maternal mortality committee to address the problem and had issued two reports. But when you “apply the search terms of ‘contraception,’ ‘birth control,’ ‘abortion,’ or any family planning-related search term, there are no hits,” she told the audience. In states that have been successful in lowering their death rates, “their reports include family planning over and over and over again.”
“Missouri, ignoring this will continue to be our recipe for disaster,” she concluded.
As the state’s lawmakers have waged their war on abortion, they have also refused to exercise their power in ways that would support pregnant people and children. In the most recent legislative session, they failed to pass a measure that would expand postpartum Medicaid coverage to 12 months, for example, but included in the state’s budget an item that would bar low-income residents on Medicaid from receiving preventive reproductive health care — including cancer screenings and birth control — from Planned Parenthood.
King said it can be hard to connect her patients to the birth control they want or the postpartum care they need. “When I’m practicing in Missouri, I feel like I kind of bump up against all these different hurdles all the time,” she said. “It just reminds you every day about how reproductive health access can get chipped away so slowly, and no one really notices until it’s just not there.”
Of course, King, McNicholas, and Rodriguez did notice — they’d seen it happening for years as more and more patients were finding their way to Illinois. The Hope Clinic and the Fairview Heights Planned Parenthood had long been allies, but as their proportion of out-of-state patients increased, they wanted to see what more they could do. From that, the Regional Logistics Center was born.
Rodriguez came up with the idea about a decade ago, while working for another Planned Parenthood affiliate that runs clinics in the northern half of Illinois. Even though the state had scant abortion restrictions, surrounding states were ramping up theirs and Rodriguez regularly encountered patients who were struggling to access care. Since Roe was decided, states have passed more than 1,300 restrictions on abortion. For many people, the right to abortion conferred by Roe has long been out of reach.
“Everyday life poses challenges for people of color, people with low incomes,” Rodriguez said. “I would hear patients say something like, ‘Well, I’m going to have to figure out how do I pay my rent.’ People would say that they were trying to sell stuff in order to come up with the fees. Clearly, transportation has always been a challenge.”
Rodriguez thought there had to be a way to simplify things and hit on an idea: What if patients could make a single call to get an appointment and get hooked up with financial aid? What if the person on the other end of the line could arrange for transportation and lodging, or put money in the patient’s pocket for food and child care? “My goal was to become a connector of those services,” she said. “Not just health care appointment needs, but also all of the wraparound services and practical support that was going to enable them … to actually make it to that appointment.”
The idea didn’t get much traction at the time, but Rodriguez held on to it. By 2019, the clinics just over the river from Missouri were regularly seeing patients from at least seven states; the Supreme Court was changing; Missouri was continuing its relentless ambition to push abortion out of reach — which meant that area clinicians were already assisting patients with logistics. “I think that really helped us sort of move this vision of the Regional Logistics Center forward,” McNicholas said. “Acknowledging that there’s going to be a real problem with managing logistics when half the country … loses access.”
According to the Guttmacher Institute, 22 states are poised to ban abortion almost immediately after Roe falls. An additional four are likely to follow suit. Meanwhile, access to medication abortion — used up to about 10 weeks in pregnancy — is expected to become even more important, a fact hostile states have picked up on. Just this year, 117 restrictions on medication abortion have been introduced in 22 states, including seven that would ban medication abortion outright.
The southern Illinois providers hoped that the Regional Logistics Center could serve as an example for other parts of the country. They’d long heard from patients that “what they really needed was not necessarily another physical space,” McNicholas said. “Like, ‘Fine, if this is the physical space to get to in Illinois, or this is the physical space to get to in Colorado, I’ll get there. Help me get there.’”
King said they sat down and worked it all out. “It doesn’t sound like rocket science,” she said, “but it is a game-changer.”
Uncharted Legal Territory
The driveway of Planned Parenthood’s Fairview Heights clinic has a simple message painted in yellow block letters: DO NOT STOP. It’s a good reminder because the driveway is often flanked by individuals wearing colored vests, the kind usually worn by escorts at clinics across the country who help patients wade through anti-abortion protesters. The difference here is that the people wearing the vests are anti-abortion protesters.
Inside, Kawanna Shannon, sporting a leopard-print sweater and matching sneakers, is ready to give a tour. Shannon was previously director of surgical services for the St. Louis clinic. In Fairview Heights, she’s director of patient access and oversees the RLC.
Shannon’s phone rings day and night. It’s often patients looking for help to get to their appointments, but sometimes they just want to talk. “You build relationships,” she said. “They may just call and say hi. … They let you know they made it home safely.” One patient was undecided about whether she wanted an abortion. She called repeatedly to schedule and then cancel her appointment. I’m sorry I’m wasting your time, Shannon recalled the patient telling her. “You’re never wasting my time,” she replied.
Winding her way through the building, Shannon opens a door into a big room where staff, including Alexandria Ball, sit in front of computers wearing headsets. Behind Ball is a screen that shows incoming calls in real time, along with a rolling tally for the day. In front of her are two computer monitors. On one, she pulls up a spreadsheet with information about abortion funds and practical support organizations across the country. These are the funds that provide financial support for abortion itself — which can cost anywhere from several hundred to several thousand dollars, depending on the method — or money for other practical needs. Some, like Indigenous Women Rising, focus on specific populations, Ball noted. But like many others, it also offers “solidarity” funding, “which means you may not fit the bill for that particular funder, but they will help you anyway.” Ball matches individual patients to funding organizations. “That’s when I put on my little thinking cap and go to work,” she said.
Although the RLC was slated to open this summer — when the Supreme Court is expected to deliver Roe’s death blow — the clinics had to significantly accelerate their plans after Texas’s Senate Bill 8 took effect in September. Lawmakers sought to shield the six-week ban from legal challenge by outsourcing its enforcement, allowing private individuals to bring civil suits against health care providers or anyone else they believe may have aided a patient seeking an abortion in violation of the law.
After the U.S. Supreme Court shrugged its shoulders and declined to intervene, the law had an immediate impact, chilling abortion providers in Texas and emboldening other hostile states to follow suit. Patients who could afford to travel for care fled the state in droves. The Fairview Heights clinic saw a more than 50 percent increase in out-of-state patients after S.B. 8 took effect. In the first four months of 2022, the RLC provided funding and logistical support for nearly 1,000 patients.
Ball’s job also includes a significant amount of emotional labor, dealing with patients who are anxious, stressed out, or skeptical. She recalled a man from Texas who was trying to line up care for his partner. She told him the procedure would cost $3,600. He said they only had $500. “OK. You got $500. That’s great. I’ll take it. I can find the rest,” Ball responded. She told him she was going to go ahead and book a flight and hotel room. “And he was like, ‘Uh, so what’s the catch?’” There’s no catch, she replied. “And he was like, ‘Why are you doing this?’ And I was like, ‘Well, unfortunately, it shouldn’t be this hard to receive care. But unfortunately, it is, and we just want to make this as easy as possible.’”
Ball says she’s skeptical by nature, so she gets it: The patients scrambling to find a clinic are simultaneously waiting for the other shoe to drop. But the fact that her job is even necessary frustrates her. “People aren’t having abortions as some sort of righteous political act. They’re doing it because they need care,” she said. “No one is thinking, ‘I’m going to get pregnant so I can have an abortion. Really stick it to those legislators.’ No one’s thinking that.”
Conservative lawmakers, however, are trying to stick it to patients seeking abortions. Take Missouri state Rep. Mary Elizabeth Coleman, who offered a new spin on S.B. 8 with a measure that would unleash vigilantism on anyone who performs an abortion on a Missouri resident or helps them cross state lines for care. Coleman’s goal was for Missouri to own its residents. “If your neighboring state doesn’t have pro-life protections,” Coleman told the Washington Post, “it minimizes the ability to protect the unborn in your state.”
The measure would cast a wide net, targeting anyone providing financial support or even referrals for abortion care. That would include the abortion funds that help patients travel to Illinois, for example, and the staff of the RLC. It would also empower individuals to sue internet service providers and website hosts that “allow Missouri residents to access any website” that “encourages or facilitates efforts to obtain elective abortions.” And it declared medication abortion drugs “contraband” and would make it illegal to “mail, transport, or deliver” the pills to anybody in Missouri.
Coleman offered her measure as an amendment to several anti-abortion bills but found no takers. In fact, in an unusual turn, the Missouri legislature failed to pass any anti-abortion laws during their 2022 session — but this says less about policy priorities than it does about a legislature floundering under the weight of its own dysfunction.
Coleman has been ridiculed for what seems like blatant overreach. One advocate told the Washington Post her idea was “bonkers.” But Cohen, the Drexel law professor, says it’s precisely the kind of measure he expects will proliferate in the post-Roe landscape: “Missouri, and a lot of other states that are in similar positions, you’re going to see them getting very creative in approaches to try and limit or stop residents of their state from getting abortions elsewhere.”
To many, it’s an absurd idea that a state would have the power to control a resident’s actions beyond state lines. But whether that’s the case is a sort of gray area, says Cohen. “Most people think that if I travel across country, as long as I’m following the laws of the state where I am, then I’m doing the right thing,” he said, like a person buying marijuana in Colorado or gambling in Nevada. “Unfortunately, that sort of commonsense understanding is not reflected clearly in the case law.” Instead, he and his colleagues Greer Donley and Rachel Rebouché argue that there is enough debate about the contours of the law that “there’s an opening for an anti-abortion Supreme Court to sort of push the law in the direction of giving states broader authority … to control their citizens across state lines,” he said.
Even if, for example, Missouri can’t control a resident’s actions in Illinois, it could still say “at a minimum” that it can control those actions in Missouri. “So if you start doing things to travel out of state to get an abortion, you start that process in the state of Missouri,” he said.
Where limitations on access to medication abortion are concerned — like Coleman’s measure that would brand the medications as contraband — Cohen said he and his colleagues believe this should be preempted by federal law. “Because the federal FDA says that these are allowed and these are approved and safe, then states should not be able to act contrary to that,” he said. But that too “has not been tested in court yet.”
On the other side of the coin, a host of states are looking to insulate themselves from interstate overreach. To date, 19 measures to protect abortion have been passed in 11 states. California, Connecticut, New York, and Washington have passed laws or are considering measures that would shield doctors and patients from out-of-state interference. This too raises legal issues that will need to be sorted out.
In all, the demise of Roe is going to jumpstart an interstate power struggle that will see questions of abortion access dropped right back into the courts. “We’re entering a situation where states are going to start really taking extreme measures to ban abortion that threaten jurisdictional issues, and then other states are going to try and protect their abortion providers and patients, threatening classic expectations of cooperation,” Cohen said. “It’s this new territory that we’re going to enter.”
King says that even if a law like Coleman’s is unenforceable, it will nonetheless create uncertainty and intimidate people — which is what the myriad abortion restrictions across the country have already done. “When you’re confusing patients, you’re also confusing health care providers. So health care providers all of a sudden feel very uneasy in a state that has even proposed legislation like that. They feel very uneasy about talking about all options with a patient,” she said. “Which is really, really bad for health care in general: You’re not giving someone all the options because either you don’t understand it or you’re scared. And, obviously, that just limits patients’ access more.”
“I’m someone who is deeply immersed in abortion access,” she said. “I live in Missouri, I have a medical license in Missouri … and I’m still confused.”
Shannon has experienced the vast difference between providing health care in Missouri and Illinois. In Missouri, “It’s just so many unnecessary T’s and unnecessary I’s that you have to cross and dot,” she said. “Even before we’re talking about overturning Roe, these are struggles people have been going through for years, just trying to get basic health care.”
“It’s strenuous, and it is stressful on the patients unnecessarily. And it’s just the difference: You drive 15 minutes across that river, you’re just like, ‘Wow,’” she said. “Such a breath of fresh air and freedom for patients.”
Shannon says that she and her colleagues are determined to help people exercise their reproductive autonomy, free from government surveillance and overreach. Just making it across the river from Missouri into Illinois feels “like freedom. It’s really sad to say, but it is just like making it to a free land, where you’re able to make the choice that you want to make without being stressed out, ridiculed,” she said. “And it’s going to get down to the wire of the states that are left. And we will have to band together to help every other patient be seen.”
Activists rallying to defend DACA in Washington, D.C. (photo: Andrew Stefan/RSN)
After 10 years with DACA, recipients' futures remain uncertain.
"DACA gave me hope," program recipient Eddie Ramirez told ABC News. "And the biggest thing [DACA] gave me was a Social Security number with employment authorization, which allowed me to work to make money to pay for my schooling."
Ramirez was born in Jalisco, Mexico, and arrived in the U.S in 1994 at just 1 and a half years old. Ten years ago, in 2012, he received DACA status, ultimately enabling him to pursue his aspirations of becoming a dentist.
DACA students such as Ramirez are ineligible for federal aid, certain scholarships and internships. Limitations placed on DACA recipients drive various corporations and institutions to deny qualified individuals educational and employment opportunities due to their status.
"Not all institutions are friendly toward DACA," Ramirez said.
During his last year of dental school, the 2017 rescission of DACA went into effect, threatening Ramirez's citizenship status.
"It was this anxiety of am I going to be able to be a dentist," Ramirez said. "Am I going to be able to continue practicing dentistry, everything that I went to school for?"
Ramirez is now a practicing dentist in Hillsboro, Oregon, but the future of his reality, and the life he built for himself, hangs in the balance as legislators delay policy reform that impacts his stability.
DACA has promised security to over 835,000 recipients, according to the U.S. Citizenship and Immigration Services.
Over the past 10 years, DACA has faced many legislative challenges. Congress' latest response to the demands of DACA recipients was U.S. District Court Judge Andrew Hanen's ruling last July outlawing the DACA program and closing the door on all new applicants. The Department of Justice's appeal to that decision now makes its way to the 5th Circuit Court of Appeals. Meanwhile, immigration reform is stalled in the Senate.
Hundreds of DACA recipients and supporters rallied at the U.S. Capitol on Wednesday, calling on Congress to guarantee equal opportunity under DACA and the creation of a substantial pathway to citizenship. Though their backgrounds and languages vary, from Union Station to the Capitol, they walked together chanting the same message: "Sin papeles, Sin miedo" (without papers, without fear) and "Undocumented unafraid."
Dressed in her traditional African skirt and hair tie, Rugie Kamara Floyd, who is from Sierra Leone, West Africa, said she came to Wednesday's rally in support of all DACA recipients but more importantly, her nephew who was detained by ICE.
Floyd says her nephew was held for "two years for a crime he did not commit," and he is awaiting deportation.
"I'm here to support the movement because this movement is fighting for a pathway to citizenship for all immigrants," she said.
"My nephew is incarcerated ... two years for a crime he did not commit, now he is in detention by ICE awaiting deportation," she said. "Stop deportation and keep families united."
Ingrid Vaca, 59, from Bolivia, the mother of two dreamers, said she is waiting for laws to change for not only her family but also all families affected by DACA.
"I have two children who are dreamers. I am marching and fighting for the government to change this situation," she told ABC News.
"Our children are locked up in cages where they can't be with their families, nor can they go to their countries," she said, holding a "Sí se puede" (yes we can) sign. "DACA has been around for 10 years, but today is not an anniversary, it's something that is marking our lives."
One of those recipients is Greisa Martinez Rosas, executive director of immigrants' rights advocacy organization United We Dream.
"What we're seeking is permanent protection for us to be able to live without fear in our homes," Rosas told ABC News. "To be able to drive to work without the fear of being separated from our families and be able to make plans for the future."
Rosas met with Vice President Kamala Harris in January to stress the demands for permanent protection. She says that while "we felt heard and understood," no action was taken to fortify a certain future for recipients.
Thousands of qualified students are vulnerable to deportation. Caught in the crossfire of the remnants of the previous administration, which Rosas described as "vehemently anti-immigrant," and the current administration's efforts, the realities of undocumented people remain in limbo.
Although DACA does not provide a pathway to citizenship, the last line of defense in the fight for protection is the anticipated American Dream and Promise Act. If signed into law, the bill is set to provide an official pathway to citizenship by granting permanent resident status for 10 years to qualifying undocumented immigrants.
Jair Bolsonaro. (photo: Evaristo Sa/Getty Images)
Just weeks after disappearing, a journalist and human rights activist have been found murdered in the Amazon. Their shocking killings are a result of the pro-business, pro-extractivist agenda that Jair Bolsonaro has pushed to unprecedented extremes.
Phillips, a fifty-seven-year-old British journalist, was an experienced freelance writer who had frequently written about Brazil for the Guardian and the Washington Post. He was preparing a book on conservation efforts in the Amazon, a place he had covered extensively over the years. His travel companion was even more familiar with the region. A longtime employee of FUNAI (Fundação Nacional do Índio), the government entity tasked with overseeing relations between the Brazilian state and indigenous peoples, Pereira was a dogged advocate for the interests of natives deep in the rainforest.
On Wednesday, authorities announced that a suspect in custody, a local fisherman, had confessed to murdering Phillips and Pereira and burying their bodies in the jungle. The suspect led officials to the remains of both men. An intense search involving both armed forces and local brigades of indigenous volunteers thus confirmed the worst fears of everyone concerned about Phillips’s and Pereira’s safety.
Chico Mendes and Dorothy Stang
The murder of Phillips and Pereira is part of a longer history of violence against those who oppose the rapacious exploitation of the Amazon. The most prominent victims in this regard are Chico Mendes and Dorothy Stang.
Mendes was killed in 1988 by a lone shotgun blast outside his humble home in a remote Amazonian town three days before Christmas. A committed member of the leftist Workers’ Party in its early, most militant years, Mendes had achieved international prominence leading unionization efforts among rubber tappers and Brazil nut harvesters. He vigorously defended the rights of ordinary residents to make a living for themselves and their families in the face of ongoing efforts by major cattle ranchers to turn the rainforest into vast pastures, a process that has largely proceeded apace.
Mendes’s legacy is rooted in the collective organization of working people far from Brazil’s national centers of power. As James Brooke wrote in the New York Times in 1990, when “130 ranchers expelled an estimated 100,000 tappers from the forest, Mendes fought back, rallying families to stand in front of chain saws and bulldozers. In death, Mendes, an international eco-martyr, became the catalyst for popularizing the concept that the wealth of the Amazon resides in its profusion of plant and animal life, not in its thin, sandy soil.”
The fact that Mendes was well-known before his death meant that his murder garnered significant international attention (there was even a film made about his life starring Raul Julia). But powerful forces looking to profit from the Amazon have felled untold numbers of Brazilians whose names never made international headlines.
Dorothy Stang, a nun from Dayton, Ohio, was seventy-three when she was shot six times in 2005 in the the Brazilian state of Pará. Stang worked closely with the Pastoral Land Commission (Comissão Pastoral da Terra), an entity founded by Brazilian Catholic clergy in 1975 — the height of a brutal military dictatorship — to defend workers primarily in the Amazon laboring under conditions analogous to slavery.
When two men approached her at a farmers’ meeting in February 2005, according to an eyewitness, Stang read to them from scripture. “When asked if she was armed,” Folha de São Paulo reported, “she displayed the Bible and said it was her ‘only weapon.’” Shortly after, one of the men took a step back and opened fire.
The Role of Bolsonaro
The tragic deaths of Phillips and Pereira, then, are not unprecedented. But it is impossible to consider their murders apart from the calamitous presidency of Jair Bolsonaro, the far-right figure who won power in 2018. From the earliest reports that Phillips and Pereira had gone missing, Bolsonaro couched his dutiful lamentations in a condemnation of their supposed recklessness. “Really, just two people in a boat, in a region like that, completely wild, is an adventure that is not recommended for anyone. Anything can happen,” he said in a press conference last week.
Bolsonaro’s blasé comments triggered outraged responses from observers. Pedro Vaca, the Special Rapporteur for Freedom of Expression of the Inter-American Commission on Human Rights, asserted: “Dom Phillips and Bruno Pereira are not to blame for the violence they suffered in their journalistic and human rights work. Accountability for state efforts on the subject must be respectful and avoid re-victimization.” The Brazilian Association of Investigative Journalism called for an emergency meeting with the president to discuss rescue efforts after the federal government appeared to be dragging its feet.
And rightly so. The government conspicuously delayed its efforts to find both men, who went missing in a region where life and death can hang in the balance after mere hours. After the Federal Police — Brazil’s equivalent of the FBI — acknowledged that it was aware of Phillips and Pereira’s disappearance, the army released an awkward public statement stating that it would not be joining the search until it had received orders to do so from Brasília.
Why such orders stalled hasn’t yet been explained. The grim bigger picture, however, is that the current administration is intensely hostile to those who put themselves at risk to protect what is left of the world’s largest rainforest. Bolsonaro implicitly criticized Phillips, saying his reporting on illegal mining and other illicit activities in the Amazon had made him an unwelcome figure in the region. Pereira had previously been terminated from his government position by former justice minister Sergio Moro, the disgraced former judge who oversaw the conviction of ex-president Luiz Inácio Lula da Silva only to join the administration of Lula’s main electoral rival.
Righteous Anger
We will never know if Phillips and Pereira might have avoided their grim fates, about which much is still unknown, under a different administration. But it is certain that their deaths occurred under the most hostile government in at least fifty years for those reporting on and those resisting environmental degradation. And it is certain that such deaths will continue if they go unchallenged.
A renewed Brazilian left that takes seriously the need for a new environmental agenda — one that decarbonizes Petrobras, the national oil company, and cracks down on bad actors in remote regions of the Amazon — should draw upon the righteous anger aroused by this heartbreaking event.
The day after the deaths of Phillips and Pereira were officially confirmed, David Biller, the Brazil news director for the Associated Press, shared some of the final text messages he exchanged with Phillips. “There’s actually not that much of the Amazon that is untouched,” Phillips wrote. He added: “The Amazon is much less protected and pristine than most people think it is and much more threatened than people realize.”
May his and his colleague’s murders inspire the outrage necessary to prevent similar violence in the future.
"Imagining how our lives would change if we suddenly lost access to plastic can help us figure out how to forge a new, more sustainable relationship with it." (photo: Alamy)
Plastic has seeped into every aspect of our existence. Can we live without it?
But what if we could wave a magic wand and remove all plastics from our lives? For the sake of the planet, it would be a tempting prospect – but we'd quickly find out just how far plastic has seeped into every aspect of our existence. Is life as we know it even possible without plastic?
Humans have been using plastic-like materials, such as shellac – made from a resin secreted by lac insects – for thousands of years. But plastics as we know them today are a 20th Century invention: Bakelite, the first plastic made from fossil fuels, was invented in 1907. It wasn't until after World War Two that production of synthetic plastics for use outside the military really took off. Since then, plastic production has increased almost every year, from two million tonnes in 1950 to 380 million tonnes in 2015. If it continues at this rate, plastic could account for 20% of oil production by 2050.
Today, the packaging industry is by far the biggest user of virgin plastic. But we also use plastic in plenty of longer-lasting ways too: it's in our buildings, transport, and other vital infrastructure, not to mention our furniture, appliances, TVs, carpets, phones, clothes, and countless other everyday objects.
All this means a world entirely without plastic is unrealistic. But imagining how our lives would change if we suddenly lost access to plastic can help us figure out how to forge a new, more sustainable relationship with it.
In hospitals, the loss of plastic would be devastating. "Imagine trying to run a dialysis unit with no plastic," says Sharon George, senior lecturer in environmental sustainability and green technology at Keele University in the UK.
Plastic is used in gloves, tubing, syringes, blood bags, sample tubes and more. Since the discovery of variant Creutzfeldt–Jakob disease (vCJD) in 1996 – caused by misfolded proteins called prions that can survive normal hospital sterilisation processes – standard reusable surgical instruments have even been replaced by single-use versions for some operations. According to one study, a single tonsillectomy operation in a UK hospital can result in more than 100 separate pieces of plastic waste. While some surgeons have argued that single-use plastic is overused in hospitals, right now many plastic medical items are essential, and lives would be lost without them.
Some everyday plastic items are also vital for protecting health. Condoms and diaphragms are on the World Health Organization's list of essential medicines, and face masks – including plastic-based surgical masks and respirators, as well as reusable cloth masks – have helped slow the spread of the Covid-19 virus. "A mask that you have for Covid is related to our safety and the safety of others," says George. "The impact of taking that away could be loss of life, if you took it away on a big scale."
Our food system would also quickly unravel. We use packaging to protect food from damage in transit and preserve it long enough to reach supermarket shelves, but also for communication and marketing. "I cannot imagine how [plastic] would be replaced completely in our system," says Eleni Iacovidou, a lecturer in environmental management at Brunel University London.
It's not just consumers that would need to change their habits – supermarket supply chains are optimised for selling packaged produce, and would need overhauling. In the meantime, highly perishable goods with long journeys between farm and supermarket, such as asparagus, green beans, and berries, might end up left in fields, unpicked.
If we could solve those supply chain issues, fruit and vegetables could be sold loose, but we might need to shop more frequently. Research by UK waste reduction charity WRAP found that plastic packaging extended the shelf life of broccoli by a week when kept in the fridge, and bananas 1.8 days at room temperature – though for apples, cucumber, and potatoes, the plastic made no difference. In fact, the research found that food waste could even be reduced by selling fruit and veg loose, as it allowed people to buy only what they needed.
Even tins of tomatoes and beans would be out – they have an inner plastic coating to protect the food – so we'd have to buy dried pulses in paper bags and cook them at home instead. "People have relied too much on getting the thing they need in the most convenient and easy way," says Iacovidou. "I think we need to get a little bit uncomfortable."
Swapping out plastic packaging would have knock-on environmental effects. While glass has some advantages over plastic, such as being endlessly recyclable, a one litre glass bottle can weigh as much as 800g compared to a 40g plastic one. This results in glass bottles having a higher overall environmental impact compared to plastic containers for milk, fruit juice, and fizzy drinks, for example. When those heavier bottles and jars need to be transported over long distances, carbon emissions grow even more. And if the vehicles they're transported in don't contain plastic, they themselves will be heavier, which means even more emissions.
In some ways, though, changing food packaging would be the easy part. You might buy milk in a glass bottle, but plastic tubing is used in the dairy industry to get that milk from cow to bottle. Even if you buy vegetables loose, sheets of plastic mulch may have helped the farmer who grew them save water and keep away weeds. Without plastic, industrial agriculture as we know it would be impossible.
Instead, we'd need shorter food chains – think farm shops and community-supported agriculture. But with over half of the global population now living in cities, this would require huge changes in where and how we grow food. It wouldn't be an impossible task, says Iacovidou, but "we have to devote the time to do it, and we have to also cut the amount of things that we eat".
Living without plastic would also require a shift in how we dress. In 2018, 62% of the textile fibres produced worldwide were synthetic, made from petrochemicals. While cotton and other natural fibres like hemp would be good substitutes for some of our clothing, scaling up production to match current demand would come with a cost. Cotton already grows on 2.5% of arable land worldwide, but the crop accounts for 16% of insecticide use, risking the health of farmers and contaminating water supplies. Without plastic, we'd need to ditch fast fashion in favour of more durable items we can wear again and again.
We'd also quickly run out of shoes. Before widespread synthetic plastics came along, shoes were often made out of leather. But today there are many more people on Earth, and we get through many more pairs each: 20.5 billion pairs of footwear were manufactured in 2020. "We couldn't go to leather shoes for every person on the planet… that's just not feasible," says George.
There would be upsides to a world without plastic, though: we'd escape the harmful effects it has on our health.
Turning oil and gas into plastic releases toxic gases that pollute the air and impact local communities. What's more, chemicals added during the production of plastics can disrupt the endocrine system, which produces hormones that regulate our growth and development. Two of the most well-studied of these endocrine disrupting chemicals (EDCs) are phthalates, used to soften plastic but also found in many cosmetics, and bisphenol A (BPA), used to harden plastic and commonly used in the lining of tins.
"While these phthalates or BPA are important for the structure of the plastic, they are not chemically bound to it," says Shanna Swan, professor of environmental medicine and public health at the Icahn School of Medicine at Mount Sinai in New York. That means when these chemicals are used in food packaging, they can leach into the food itself – and end up in our bodies.
Some phthalates can lower testosterone production, reducing sperm counts and increasing fertility problems in men. BPA, on the other hand, mimics oestrogen and has been linked with an increased risk of reproductive problems in women. But the effects extend beyond fertility. "The breadth of the potentially disruptive influences of EDCs is striking," writes Swan in her book, Count Down. "They have been linked to numerous adverse health effects in almost all biological systems, not just the reproductive system but also the immunological, neurological, metabolic, and cardiovascular systems."
Exposure to EDCs during critical periods of foetal growth can have long-lasting effects. "If the mother is pregnant, and she is exposed to plastics or other chemicals that alter the development of her foetus, those changes are lifelong, irreversible changes," says Swan. This means that, while going cold turkey on plastics would reduce our exposure, their effects would still be felt for at least the next two generations. "Your grandmother's exposure is relevant to your reproductive health and your health in general," says Swan.
At some point, we'd want to address the plastic that's already in the oceans. Could we ever clean it all up? "You have some materials that are on the seafloor and they're not going to go anywhere, they're just part of the ecosystem," says Chelsea Rochman, assistant professor in the department of ecology and evolutionary biology at the University of Toronto. But with the floating plastics, she says, we have a fighting chance.
Researchers now think that most plastics floating in the ocean will eventually get washed up or buried along our shorelines. At the moment some of those shoreline plastics are removed with trash-traps and old fashioned beach cleans. Keeping that removal up would make a difference to marine wildlife. "You would have fewer animals washing up on the beach with plastics in their bellies, and less entanglement," says Rochman. "A lot of what's being ingested by animals is not the stuff that's in the deep sea, it's the coastal stuff."
Taking out bigger pieces of plastic waste would also stop them breaking up into microplastics. Most of the microplastics found away from coastlines are from the 1990s or earlier, suggesting that bigger pieces take decades to break down. That means if we simply stopped adding new plastic pollution to the oceans tomorrow, microplastics would continue to increase over the next decades – but by removing the existing debris as well, we could stop that surge. "Maybe we reach a time where every animal we pull out of the water doesn't have microplastics in it," says Rochman.
In a plastic-free world, making new kinds of plastic out of plants might start to look tempting.
Bio-based plastics that have many of the same qualities as petrochemical plastics are already in use. Corn starch-based polylactic acid (PLA), for example, is used to make straws are almost indistinguishable from their fossil fuel plastic counterparts – unlike paper straws that can end up soggy before you finish your drink. Bio-based plastics can be made from the edible parts of plants like sugar or corn, or from plant material that isn't fit for consumption, like bagasse, the pulp left over after crushing sugarcane. Some, but not all, bio-based plastics are biodegradable or compostable. But most of those plastics still need careful processing, often in industrial composting facilities, to ensure they don't persist in the environment – we can't just throw them into the sea and hope for the best.
Even if we did create the infrastructure to compost them, bio-based plastics might not be better for the environment – at least not right away. "I think initially we'd see all impacts increase," says Stuart Walker, a research fellow at the University of Exeter and author of a recent review looking at environmental impacts of bio-based and fossil fuel plastics.
Clearing land for crops would impact ecosystems and biodiversity. Fertilisers and pesticides come with carbon emissions attached and can pollute local rivers and lakes. One study found that replacing fossil fuel plastics with bio-based alternatives could require between 300 and 1650 billion cubic metres of water (300-1650 trillion litres) each year, which is between 3 and 18% of the global average water footprint. Food crops could end up being used to produce plastic instead, risking food security. Once they have been grown, crops need more refining to reach the bio-based equivalent of crude oil, which requires energy, resulting in carbon emissions.
But trying to compare the environmental impacts of bio-plastics with conventional ones is tricky, not least because fossil fuel-based plastics have a head start. "We've been making these things for so long at such scale that we're really good at it," says Walker. "In time it would shift and we'd see that with bioplastics, the emissions would reduce." As countries around the world decarbonise their electricity supplies, the carbon emissions from producing bio-based plastics would decrease further.
However, making plastic from plants wouldn't necessarily solve health problems stemming from the material. While research on the topic is scarce, it's likely that similar additives to those used in conventional plastics would also be used in bio-based alternatives, Iacovidou says. This is because the properties the materials need are the same. "The fate of the additives is what concerns me the most," she says. If bio-based plastics are mixed with food waste and composted, whatever is in the plastic enters our food system.
It's clear that replacing one material with another won't solve all our plastic problems.
There's already a push to figure out which plastics are unnecessary, avoidable, and problematic, with several countries, including the US, UK, Australia, New Zealand and the Pacific Islands region, aiming to phase these out. To go even further than that, we could decide to only use plastics that we really, truly need. In a recent book chapter, George describes a framework to help us figure out which plastics are vital. By considering whether the item fulfils an essential need – such as food, shelter, or medicine – and also whether reducing the amount of material, or replacing the plastic with something else, would affect its use, we can start to see which plastics we can and cannot live without.
But these essential plastics are context-specific and not set in stone. In some places, the only safe drinking water comes in plastic, for example. "That means we need to develop drinking water infrastructure there so that we don't have to rely on packaged water, but right now that [plastic] is necessary," says Jenna Jambeck, professor of environmental engineering at the University of Georgia.
Thinking through the whole life cycle of any new materials, including what we do with them when they no longer serve their purpose, would be essential. "We’ve kind of forgotten that recycling isn't the gold standard of what we can do with stuff when we’re finished with it," says Walker.
Along with colleagues at the University of Sheffield, he investigated the environmental impacts of disposable and reusable takeaway containers. They found that a durable plastic container would only need to be used between two and three times to be better, in terms of climate impact, than a single-use polypropylene one, even taking into account washing. Stainless steel containers reached the same break-even point after 13 uses – takeaways, thankfully, wouldn't need to be a thing of the past in a plastic-free world.
The biggest shift we'd face, then, would be re-evaluating our throwaway culture. We'd need to change not just how we consume items – from clothes and food to washing machines and phones – but how we produce them too. "We're too quick to buy something cheap and disposable, where we ought to be making things so they are compatible, and there's more standardisation, so things can be swapped out and mended," says George.
Without plastic, we might even have to change the way we talk about ourselves. "Consumer is inherently a single-use term," says Walker. In a world where packaging is reused and repurposed, not thrown out, we might become citizens instead.
Perhaps we'd also discover that, for all the genuine good plastic has done, not all of the lifestyle changes it has enabled have been positive. If it's plastic packaging that allows us to grab lunch to eat on the go, and plastic-heavy devices that mean we are always contactable, without it our schedules might need to be a little less frantic. "If that was all taken away, life would slow down," says Jambeck. "Would that be such a bad thing?"
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