Starting with the 40th anniversary of Roe v. Wade this week, we got the welcome news that for the first time, the majority of Americans want abortion to be legal in all or most cases. As you can imagine, the sex-hating religious extremists are working to spin those results. And of course they continue to place every possible legal obstacle between women and an affordable, safe, legal abortion. (Hell, they even oppose contraception, which would seem to be the logical solution to their abortion qualms!)

But eventually that tide will change, just as is now happening with gay marriage. The most significant long-term news is this new study in the American Journal of Public Health, whose lead author was Tracy Weitz, associate professor and director of Advancing New Standards in Reproductive Health at UCSF.

This is significant because the shrinking number of abortion clinics (and more importantly, the declining number of physicians willing to perform abortions) has made the legal right to have an abortion an empty promise in many states. And many doctors now graduate medical school without ever learning how to perform an abortion.

The public health solution? The six-year study says that abortions performed by midwives, nurses and nurse practitioners are just as safe as those performed by doctors. We now know for a fact that there's no medical basis for requiring higher-paid doctors to provide first-term abortions, and that means eventually the policy will shift:

Currently in the United States, a patchwork of state regulations determines who can provide abortions, with several states specifically prohibiting non-physician clinicians from performing the procedure.

The new study was designed to evaluate the safety of early aspiration abortions when performed by nurse practitioners, physician assistants and certified nurse midwives trained in the procedure. The study was conducted under a legal waiver from the Health Workforce Pilot Projects Program, a division of the California Office of Statewide Health Planning and Development. California law requires a legal clarification about who can perform aspiration abortions.

The researchers report in their study that the results show the pool of abortion providers could be safely expanded beyond physicians to include other trained health care professionals. They found that:

• Nurse practitioners, certified nurse midwives and physician assistants can provide early abortion care that is clinically as safe as physicians;

• Outpatient abortion is very safe, whether it is provided by physicians or by nurse practitioners, certified nurse midwives or physician assistants.

Nationally, 92 percent of abortions take place in the first trimester but studies find that black, uninsured and low-income women continue to have less access to this care, according to the researchers.

In California, 13 percent of women using state Medicaid insurance obtain abortions after the first trimester. Because the average cost of a second trimester abortion is substantially higher than a first trimester procedure and abortion complications increase as the pregnancy advances, shifting the population distribution of abortions to earlier gestations may result in safer, less costly care, according to the research team.

“Increasing the types of health care professionals who can provide early aspiration abortion care is one way to reduce this health care disparity,’’ said lead author Tracy Weitz. “Policy makers can now feel confident that expanding access to care in this way is evidence-based and will promote women’s health.’’

Currently, non-physicians are allowed to perform aspiration abortions in four states: Montana, Oregon, New Hampshire and Vermont. In other states, non-physician clinicians are permitted to perform medication but not aspiration abortions. In recent years, in an effort to limit abortion availability, several states have put laws on the books to prohibit non-physician clinicians from performing abortions.

In the study, 40 nurse practitioners, certified nurse midwives and physician assistants from four Planned Parenthood affiliates and from Kaiser Permanente of Northern California were trained to perform aspiration abortions. They were compared to a group of nearly 100 physicians, who had a mean of 14 years of experience providing abortions.

Altogether, 5,675 abortions were performed in the study by nurse practitioners, certified nurse midwives and physician assistants, compared to 5,812 abortions by physicians. The abortions were performed between August 2007 and August 2011 at 22 clinical facilities in California.

And skilled abortion doctors can be reserved for the higher-risk second- and third-term abortions. It won't happen overnight (the Republicans still control too many state legislatures for that), but this is an important piece of science that will eventually make it easier and safer for women to have abortions.

The predictions about emboldened right-wing state legislatures after Wisconsin are coming true, with Michigan's legislature as one of the first testing grounds. Michigan, home to the auto industry and the likes of Betsy DeVos, has a legislature full of wingnuts.

This week, the Michigan House passed one of the most restrictive anti-abortion bills in the country. Via Jezebel:

The 60-page bill was introduced just last week by Republican Representative Bruce Rendon and contains all matter of horrors. For starters, all abortions after 20 weeks would be criminalized—no exceptions for victims of rape or if the fetus has a severe anomaly, like it is missing a brain or a spine. Wait? Oh, nevermind it's pointless to even try to understand how that is a good idea because it's not. There is a very narrow exception made if the mother's life is at risk, but simply her health and/or future fertility is not reason enough to allow an abortion. Well, how very pro-life indeed. Oh, it'd also make it a crime to coerce a woman into having an abortion. Geeze, make that definition vague enough and you might be able to start prosecuting doctors for being overly enthusiastic in telling patients that it's totally safe to get an abortion…

This lovely bill would also require that health centers that perform more than six abortions in a month be equipped with surgery rooms, even if they don't do surgical abortions. Just in case someone needs an emergency appendectomy while they're waiting, I guess? Makes TOTAL sense to spend a sh*t-ton of money you don't have to create a room filled with expensive equipment that you'll never use and have to jump through a bunch of hoops and pay to have the facility licensed.

There are also a number of provisions that can sadly now be described as typical: Women need to be screened to be sure there's no "coercion" going on. A doctor needs to be present for medication abortions, and no telemedicine is allowed, so doctors won't be able to use technology to prescribe medication abortions from afar or even prescribe the morning-after pill. And, just for good measure, the bill also puts in place elaborate new regulations for the disposal of fetal remains.

During the very heated debate on the bill, female representatives tried to introduce an amendment that would have the same rules apply to vasectomies, and Rep. Lisa Brown had this to say: "I'm flattered that you're all so concerned about my vagina. But no means no."

OH NOES!!!! Michigan men are just horrified that a woman said the word "vagina"!!!!! And "vasectomy"? Perish the thought. No, we don't say "vasectomy" in the hallowed halls of the Michigan house. Nay, nay, such heresies may not be uttered in the presence of delicate men.

And so, both representatives were banned from speaking the following day. Banned. As in, you may not speak at all. Period.

Ari Adler, spokesman for Bolger, said the women "will not be recognized to speak on the House floor today after being gaveled down for their comments and actions yesterday that failed to maintain the decorum of the House of Representatives."

Adler said the move was meant to ensure civility and maturity in the debate over the bills.

Excuse me while I recover from my paroxysm of involuntary hysterical laughter. HAHAHAHAHAHA -- Civility? Civility?

Hey, Michigan men. Here's uncivil. Uncivil is telling me you believe in small government while you authorize the government to attach themselves to the cold metal speculum crawling up my and my daughter's vagina to inspect. Uncivil is telling me I'm too stupid to actually, you know, make my own decisions. Uncivil is bullying your bullsh*t bill through the House of Representatives while treating women like they're half-citizens. That's uncivil. The words vagina and vasectomy? Not so much.

Say it with me. Va-gi-na. Vas-ect-omy. See? They sort of have an alliterative quality. There's nothing uncivil about those words, they're just actual terms for female anatomy and a medical procedure. There's nothing uncivil about them at all.

You guys crawling into my body? That's not only uncivil, it's disgusting.

Did every College Republican from the class of 2003 get elected in 2010 or what? I cannot recall a more childish or idiotic bunch of bone sacks holding office than in the past two years.

Update: In Mitt Romney lying liar fashion, House Speaker Jase Bolger's spokesman tells ABC News that gagging the opposition is "rather common practice." So I Googled to see if that was actually true, and behold! I'm having trouble finding even one article that actually confirms that claim.

Memo to ABC News: You too, can use the Google.

Here's the full statement made to MLive about why they gagged these two women:

It is the responsibility of the Majority Floor Leader, the presiding officer and every Representative to maintain the decorum of the House. Majority Floor Leader Jim Stamas has informed Minority Floor Leader Segal that Reps. Brown and Byrum will not be recognized to speak on the House floor today after being gaveled down for their comments and actions yesterday that failed to maintain the decorum of the House of Representatives. Under Rep. Stamas’ floor leadership, the House Republicans have allowed more debate on the House floor than ever seen in the past few sessions when House Democrats were in charge. House Republicans often go beyond simply allowing debate by welcoming open and passionate discussion of the issues before this chamber. The only way we can continue doing so, however, is to ensure that the proper level of maturity and civility are maintained on the House floor.

BWAHAHAHAHA. "Maturity and civility?" Check out the boys' reactions to the vajayjay word:

House Republicans didn’t take it well. “What she said was offensive,” said Rep. Mike Callton (R-Nashville). “It was so offensive, I don’t even want to say it in front of women. I would not say that in mixed company.”

Oh! His delicate wittle ears. He can't bear to say the word out loud. Personally, I think appropriate comeuppance in this case would be for him to name his firstborn Vagina. He'd come to love it. Really.

I was really surprised at this column by E.J. I was raised Catholic too, but I'm outraged at the Church's hostility towards contraception and I didn't think he bought into this narrative. And let's be honest E.J, many pro-lifers will not vote or support Obama anyway so why should this matter to him or any progressive Catholic? Why should the president do any more for them than the Democratic Party already has?

Obama’s breach of faith over contraceptive ruling

All religions live in the U.S. and must honor our laws. What's being offered is not illegal. How many times are women and progressives supposed to kowtow to the religious right? It's infuriating and I grew up Catholic.

Digby writes:

Tell me again why I'm supposed to care that "progressive" Catholics are unhappy that president Obama mandated that Catholic institutions that employ people who are not members of the faith have to provide birth control coverage under the health care law? I'm hearing they feel "betrayed."

Welcome to our world folks. Now you know what it felt like for the rest of us when the administration made a deal with the Church to give abortion coverage pariah status in the health care law and treat it as though it is something so dirty that decent people wouldn't even want their money to touch the money of those who bought this dirty coverage. It wasn't pleasant.

I don't pretend to understand why progressive Catholics, who I'm told practice birth control at similar rates to non-Catholics, are upset that the government is mandating low cost coverage for everyone—for something they personally practice. That sort of hypocrisy is simply beyond the ken of a heathen like myself. But as a political matter, the*President made the right decision. Pro-choice progressive women have been shafted over and over again on reproductive issues and to enable this growing anti-birth control crusade to gain traction at the hands of a Democratic president would have been a true betrayal of epic proportions. Keep in mind that Democratic women outnumber Democratic men by nearly 10 points.

I feel betrayed by a religion that taught me only how to be a better person when I attended in the '60s and '70s. I'm so sick and tired of these hypocrites telling women what they can and cannot do.

Today, 1 in 3 women has trouble affording birth control. The U.S. has one of the highest rates of unplanned pregnancies in the industrialized world, and studies show that women who plan their pregnancies are likely to be healthier, seek prenatal care, and have healthier children.

Given all of this, shouldn't the question be why a group of mostly men—bishops or otherwise—need an extra-extra special exemption from prioritizing the health of women? Sadly, this is no freak occurrence. When the Obama administration made the misguided decision not to allow Plan B to be sold over the counter, the debate focused exclusively on the way he—"as a father"—viewed the idea of 11-year-old girls getting Plan B with their pack of gum. The overwhelming majority of young women who were simply trying to avoid pregnancy or abortion, both far more risky than Plan B, were ignored. And when a collection of almost all men pushed the "Bart Stupak amendment," holding health reform they supposedly supported hostage for the sake of inroads on their anti-choice agenda, the actual impact their amendment would have on women was virtually absent, as news coverage lionized these men's dedication to their consciences.

Shouldn't we ask why women's health, our ability to control our lives and bodies and careers, is such a popular political football? Is it because the women who actually are affected have no voice in our political system?

Bart Stupak got run out of office for supporting these people. They are not interested in facts or freedoms. We do not live in a monarchy where men are the lords and women are the chamber maids. Dionne's instincts have been compromised by the same propaganda as so many Americans have been over the years. It's really sad.