An exchange between Dr Erica Schwartz and Senator Josh Hawley during her confirmation hearing is alarming
Robert F Kennedy Jr’s new cooking show isn’t the only big news out of the public health world this week. On Wednesday, Dr Erica Schwartz was confirmed by the US Senate as director of the Centers for Disease Control and Prevention (CDC), making her the first Black woman to hold the position. This is the first time in almost a year that the agency has had a permanent leader; the previous director, Susan Monarez, only lasted 29 days before she was ousted for butting heads with RFK about US vaccine policies. Translation: she was a little too keen on following accepted science for the Trump administration.
So is Schwartz an RFK-approved vaccine skeptic who thinks you can cure cancer by praying to trees? Surprisingly: no. Schwartz, who served as deputy surgeon general during Trump’s first term, actually has government experience and a public health background. During her confirmation hearing in July, she walked a careful tightrope when asked about her stance towards vaccines. Schwartz said she “will never betray the science” but also dodged questions about how she would handle pressure from Kennedy.
But don’t breathe a sigh of relief quite yet. During that same confirmation hearing, Schwartz made some chilling remarks about abortion surveillance when quizzed on the issue by Missouri senator Josh Hawley, an anti-abortion lawmaker who wants to ban the abortion pill mifepristone nationwide.
“The CDC collects data on abortions that are committed in the United States of America through a system called the Abortion Reporting System,” Hawley said when asking Schwartz whether she would commit to collecting detailed data on abortions. “This system is voluntary, and so a number of states, not coincidentally large blue states, do not turn over any data, so that it’s difficult to get a picture of just how many abortions and under what circumstances are committed in this country. We do know the numbers are going way up.”
“Senator, you have my commitment,” Schwartz replied. “Abortion surveillance is absolutely a critical component of what the CDC is currently doing.”
“I also want to make sure that certain states are not conflating emergency services and hiding abortions in that emergency services case definition,” she added. “We need to make sure we’re pulling out true abortions and making sure that we’re really having clear case definitions regarding abortions so the data is actually accurate.”
“Tremendous,” Hawley replied. He seemed very happy with her response.
If you are concerned about the growing criminalization of abortion and surveillance of pregnant women in the US, then absolutely nothing about this is tremendous. I’ve quoted the majority of the exchange between Hawley and Schwartz instead of paraphrasing it, because the choice of language is so alarming. First, look at the way in which Hawley frames the issue. He talks about abortions being committed: a loaded word which makes you think of murder. (Imagine it in another medical context: I’m having a mammogram committed tomorrow!) Then he insinuates that blue states are hiding abortion data for nefarious reasons. As it is, 44 states plus Washington DC have some form of mandated abortion reporting, according to the Guttmacher Institute, and there is no evidence that these states are hiding anything. New York is an outlier in that it only requires abortion reporting when a patient makes a request related to the disposition of the fetus’s remains. Which seems like a sensible policy that protects the privacy of people who have had abortions.
Now look at Schwartz’s reply. Why would abortion surveillance be “a critical component” of what the CDC is doing? Data collection around abortions can serve legitimate purposes, sure, but isn’t it rather more important for the CDC to be, I dunno, controlling and preventing diseases? Her reference to “true abortions” (as opposed to fake ones?) and to states “hiding abortions” is also worrying. Pregnant people are already dying preventable deaths because providers in states with abortion bans are terrified of treating them. This sort of language from the CDC director is going to make the situation even worse.
Donald Trump has called Schwartz “a STAR”. If her exchange with Hawley is anything to go by, however, she seems to be yet another stooge: happy to facilitate the Trump administration’s anti-abortion agenda and politicization of public health.
“Erica Schwartz’s testimony … should alarm everyone who believes private medical decisions belong to patients, not politicians,” Mini Timmaraju, the president and CEO of Reproductive Freedom for All, said in a statement. She added that, under the Trump administration, “abortion surveillance could be expanded or weaponized to collect more intrusive information, spread disinformation about reproductive health care, and support efforts to investigate or criminalize patients and providers”.
As activists and experts have repeatedly said, overturning Roe v Wade was just the beginning of the new war on reproductive rights in the US – a war facilitated by an unprecedented network of surveillance technology. The convicted felon in the White House seems intent on treating every pregnant woman as a potential criminal.
During a private call with religious groups, the acting attorney general, Todd Blanche, said efforts to reverse the Biden administration’s efforts to protect abortion were “taking longer than we want”. He seemed to suggest that the administration was working to restrict access to abortion pills and said: “We don’t have complete victory yet, but we will have victory, and victory will be soon, and it will be permanent.” Blanche has faced a rocky road to confirmation as attorney general. The bad news is that the government’s anti-abortion agenda will continue whether he gets the role or not.
That’s according to a new ruling by the state’s supreme court. No doubt they’ll soon be forced to report abortions, though!