The Miscarriage Texts

The Miscarriage TextsWhat Fauci and Walensky discussed privately in January 2021, and what pregnant women were toldThis essay is written for both a general audience and expert scientists and physicians interested in this topic.  I have been trained as a pathologist and taught pathology (as well as molecular biology) to medical students for many years, and so it should be no surprise that some of the language is rather technical.For this, I apologize to and empathize with general-interest readers, and ask that you bear with me so I can communicate precisely with experts and policy specialists who may also read the essay.  Keep in mind that, until he left the federal government, even Fauci (or one of his minions) used to open and read some of our essays, and on occasion our essays reach and impact policymakers at the highest levels of government.In March 2026, a group at the University Hospital of Wuerzburg published what they had found in 106 term placentas collected between November 2020 and October 2022. Thirty-one were positive for SARS-CoV-2 spike protein by immunohistochemistry. The staining sat predominantly in Hofbauer cells, the fetal macrophages inside the chorionic villi, and in syncytiotrophoblast, with the trophoblast layer and the endothelium of villous capillaries also involved. Eleven of those positive placentas came from women who had been vaccinated and who reported no infection of any kind during the pregnancy.No viral RNA was detected in any sample tested. Vaccine RNA was. A Comirnaty probe lit up cells of the decidual surface in one placenta. A Spikevax probe lit up the endothelium of villous capillaries in another, from a woman whose last dose preceded her pregnancy (Bartmann et al. 2026).That study carries severe limits. It is descriptive work on fixed tissue and cannot establish mechanism. The cohort was drawn from uncomplicated births at term, and the authors state plainly that women with miscarriages were not included, so the study cannot speak to pregnancy loss at all. The RNA findings rest on two samples out of nine tested. And the literature is split: Santos and colleagues reported no spike glycoprotein in placentas after mRNA vaccination, and Prahl and colleagues excluded vaccine traces in twenty placentas by Western blot and PCR.The finding establishes that the question is real, answerable by experiment, and answerable in human tissue. The compartments where the staining appeared are the compartments that express ACE2, the receptor for the protein being stained. ACE2 is a carboxypeptidase. It degrades angiotensin II to angiotensin 1-7, and in the placenta that reaction governs vasodilation, oxidative balance, and the vascular remodeling on which perfusion depends.None of this was known when the federal government moved from telling pregnant women they could choose vaccination to telling them they should have it. Nor had anyone looked. The pivotal trials excluded pregnant women, the preclinical biodistribution work was done in nonpregnant rats, and the reproductive toxicity studies measured outcomes rather than tissue distribution.To be blunt, as a physician/scientist, experienced biological product development and clinical research specialist, I am shocked by this absence of critical data given the policy decisions that followed. This is an example of public health malpractice. <RWM>What did exist, in January 2021, was a conversation.On January 25, 2021, five days after the inauguration,Dr. Vivek Murthy, Biden’s nominee for Surgeon General and a senior adviser to the incoming administration’s COVID response, texted Anthony Fauci and newly installed CDC Director Rochelle Walensky. He asked whether any data or theoretical reason favored vaccinating early or late in pregnancy, and when more robust data on risk might arrive. He added that he had been telling pregnant women no concerning outcomes had appeared in the trials, while noting that the number of pregnant subjects was probably limited (The Hill 2026).Walensky answered first, describing a thin evidence base and pointing to the V-safe pregnancy registry, which by then had enrolled more than 15,000 pregnant women (Tampa Free Press 2026). Fauci replied that there were “no data or theoretical reason” to prefer early over late vaccination (The Hill 2026). He added that some people, including female health care professionals, were uneasy about a genetic vaccine early in pregnancy, and that the concern about effects on genes was a misperception.Roughly two hours later, he wrote again. He had asked around further, and another issue had come up that the others needed to know about. Because many people experience significant cytokine response and fever after the second dose, this “theoretically could be associated with miscarriage in the 1st trimester” (CNN 2026). Walensky replied that it was a good point, especially after dose two (Forbes 2026). The affirmative federal recommendation that pregnant women be vaccinated was issued on August 11, 2021. Nothing in that exchange, and no equivalent of it, reached the public in the intervening seven months.That is what makes these texts so consequential.The scandal is not that scientists discussed uncertainty privately.Scientists are supposed to discuss uncertainty.The scandal is that uncertainty may have disappeared not because the science had answered the question, but because they believed that the public-health message required certainty.Pregnant women deserved to know the difference.And they deserved to know itbefore they rolled up their sleeves.Thanks for reading Malone News! This post is public so feel free to share it.ShareWhat the public heard in the same weeksOn January 26, Murthy flagged the World Health Organization’s recommendation against routinely administering the Moderna vaccine to pregnant women. His stated concern, however, was not whether the WHO was correct. It was what the recommendation might do to pregnant women’s confidence in vaccination.Fauci’s answer set out the standard he was applying. Where data are lacking in pregnant women, one must weigh potential risks against benefits. COVID can be serious in pregnancy. More than 10,000 pregnant women had been vaccinated with no issues reported. FDA, the CDC advisory committee and the American College of Obstetricians and Gynecologists all left the decision to the individual (CBS News 2026).That position was defensible and it matched CDC’s clinical guidance, which held that a pregnant woman in an eligible group may choose vaccination. It is also not what he said in public a week later. Speaking with Howard Bauchner, then editor of JAMA, Fauci reported that FDA had found no red flags among the pregnant women vaccinated to that point, and said he would rather take his chances with the vaccine than with infection while pregnant (The Hill 2026).The private discussion included a plausible mechanism for harm, specific concern about the second dose, and an acknowledgment that the necessary data did not yet exist.The public discussion emphasized the absence of red flags and offered a personal endorsement.A week earlier, Fauci had privately identified a theoretical risk of miscarriage. When he spoke publicly, that part of the risk-benefit calculation was gone. The uncertainty had not disappeared. It had simply disappeared from the message.One mechanism, two registersFever is the clinical expression of cytokine release. The mechanism Fauci described privately in January was therefore not a private discovery, and that makes the sequence worse.CDC’s clinical guidance in December 2020 already advised that pregnant women who develop fever after vaccination may be counseled to take acetaminophen, on the stated ground that fever has been associated with adverse pregnancy outcomes (Newsweek 2020). The agency had accepted the causal premise in print before the first pregnant woman was vaccinated. Fauci’s January text restated the same pathway in mechanistic language and added two specifics: that the response concentrates after the second dose, and that the outcome at issue is loss in the first trimester.So the agency was not unaware. It published the countermeasure in December, discussed the mechanism privately in January, and by August had dropped the subject. The August 11 statement contained no fever caution of any kind.A risk that CDC had acknowledged in its own guidance eight months earlier stopped being mentioned precisely when its recommendation became universal.Evidence ran the other way too. The April 2021 registry analysis found that pregnant participants reported fever, chills, headache and myalgia less frequently than nonpregnant women of the same ages. Of the whole inflammatory pathway, reactogenicity was the one element CDC measured, and the measurement was reassuring. That finding belonged in the public conversation as much as the caution did, and neither appeared in August.Since these texts became public, the mechanism has been misdescribed in both directions. Post-vaccination fever is a finding consistent with a cytokine-mediated systemic response. In most recipients, that response is transient reactogenicity and nothing more, and anyone claiming these vaccines routinely produce cytokine storm is misusing a term that names a defined pathological syndrome.But a pathologist asks a different question, and that question does not appear to have been asked at all.Any biological insult applied across a large population produces a distribution of host responses. Clinically important events often occur in the tails of that distribution, not at its mean.A reassuring average therefore cannot, by itself, exclude an uncommon susceptible subgroup.The relevant question was not whether the average pregnant woman experienced a cytokine storm. She plainly did not. The question was whether the inflammatory response following vaccination could become sufficiently pronounced in some subset of pregnant women to alter pregnancy risk, particularly during the first trimester, and if so, whether those women could be identified.A woman with an underlying inflammatory or thrombophilic tendency, a history of recurrent pregnancy loss, or some other susceptibility is not the modal recipient. Her risk cannot be inferred simply from the modal result.That was the safety question hiding inside Fauci’s January text. And before the recommendation became universal, it was a question that deserved an answer.Why there were no dataPregnant women were excluded from the pivotal trials of both mRNA vaccines. That exclusion followed a convention in vaccine and drug development that long predated 2020. But its consequence was unavoidable: at the moment of authorization, there was no randomized evidence for pregnancy outcomes. And once mass vaccination began, that missing randomized evidence could not simply be recreated after the fact.What largely replaced it was V-safe, CDC’s voluntary smartphone-based surveillance system, with a pregnancy registry attached. Participants enrolled and reported their own outcomes. A registry of that design can be useful for detecting a large safety signal quickly. But it is not a randomized trial. It cannot by itself establish a population rate without an appropriate denominator, it has no contemporaneous unvaccinated control group, and it necessarily reflects the women who enroll and continue reporting.Those limitations do not make the data worthless. They define what conclusions the data can support.On August 11, CDC told pregnant women the vaccines were safe and recommended vaccination. Twelve days later, FDA approved Pfizer's vaccine while still requiring the company to conduct the pregnancy study necessary to characterize pregnancy and infant outcomes.And that distinction matters, because much of the reassurance offered about vaccination during pregnancy in the critical months between December 2020 and September 2021 rested on precisely this kind of observational surveillance.The government was not reassuring pregnant women on the basis of evidence generated in pregnant women before authorization. It was vaccinating them first and accumulating the pregnancy safety evidence afterward.By any recognizable standard of medical and research ethics, this is profoundly troubling. It runs directly against the Preles of informed consent and protection of human subjects embodied in the Nuremberg Code, the Declaration of Helsinki, and the Belmont Report.Suspending the defaultPregnancy medicine has traditionally operated from a precautionary default. When adequate evidence of safety is absent, exposure to a new drug or biological product is approached cautiously. Thalidomide and diethylstilbestrol helped build that posture, and modern federal labeling rules preserve the underlying principle by requiring labels to state when human pregnancy data are unavailable. The reason is obvious: pregnancy is precisely the circumstance in which controlled experimentation is difficult and the cost of guessing wrong may fall on someone who never consented.Fauci identified the principle that could override that default. Where data are lacking in pregnant women, he wrote on January 26, potential risks must be weighed against potential benefits.That is the correct standard.But performing such a calculation requires both sides of the equation.The harm term was largely unquantified because the pivotal trials had excluded pregnant women. The benefit term rested principally on the risk COVID posed to the mother, and CDC had attempted to measure that.Zambrano and colleagues, reporting in November 2020 on 409,462 symptomatic women aged 15 to 44, found that pregnant women were more likely than nonpregnant women to be admitted to intensive care, at 10.5 versus 3.9 per thousand; to receive extracorporeal membrane oxygenation, at 0.7 versus 0.3 per thousand; and to die, at 1.5 versus 1.2 per thousand. The adjusted risk ratios were 3.0, 2.4, and 1.7, respectively.Their own summary captured an important distinction: although theabsolute risks of severe outcomes were low, pregnant women were at increased relative risk for severe illness.Both statements were true.Only the second traveled.Consider mortality. The observed difference was 0.3 deaths per thousand symptomatic infections, or three additional deaths per 10,000. CDC’s earlier June 2020 analysis had found mortality among pregnant women statistically indistinguishable from nonpregnant women of the same ages, with an adjusted risk ratio of 0.9.The November report contained another comparison that received considerably less attention. Citing the 2009 H1N1 pandemic, its authors noted that the absolute risks of severe outcomes among pregnant women during H1N1 exceeded those then being observed with COVID-19.There was another curious feature in the COVID data.The relative risks diminished as the endpoints became harder: ICU admission carried an adjusted risk ratio of 3.0, ECMO 2.4, and death 1.7. In the earlier June analysis, death had carried a ratio of 0.9 and had not reached statistical significance.That pattern does not prove bias. But it should have raised an obvious question about how much of the apparent elevation reflected biology and how much reflected clinical decision-making.ICU admission is not purely a biological endpoint. It is also a clinical decision, and obstetrics has long maintained a lower threshold for escalating care because the physician is managing two patients and fetal monitoring may be easier at higher acuity.ECMO introduces another selection problem. Candidacy favors younger patients without major underlying disease, characteristics disproportionately represented among pregnant women. A higher rate of receiving ECMO therefore does not necessarily translate directly into an equivalent increase in underlying disease severity.The clinical environment could reinforce these effects. Throughout 2020 and 2021, physicians were repeatedly told that pregnancy was a high-risk condition for COVID-19, with these same surveillance figures offered as evidence. That creates the possibility of a feedback loop: clinicians expecting greater risk may admit or escalate pregnant patients sooner, and those admissions then enter surveillance datasets as evidence of greater risk.CDC acknowledged a version of this problem one level down. Its data could not reliably distinguish hospitalizationbecause of COVID deteriorationfrom hospitalization for another reason, including delivery.The COVID-NET hospitalization surveillance report from September 2020 illustrates the problem. Among 598 hospitalized pregnant women with laboratory-confirmed SARS-CoV-2 infection,54.5 percent were asymptomatic on admission. Many had entered the hospital for obstetric care and were discovered to be infected through testing.Two further limitations appear in the November report’s own footnotes. Death information was missing for 22.0 percent of pregnant women and 17.2 percent of nonpregnant women, with those missing outcomes assumed to represent survival. ECMO information was missing for roughly 78 percent of both groups, with missing values assumed to mean ECMO had not occurred. Importantly, the missingness on the mortality variable differed between the groups.None of this establishes that pregnancy carried no additional COVID risk.There were sound biological reasons to suspect that it might. Pregnancy reduces functional residual capacity, elevates the diaphragm, increases oxygen consumption, produces a hypercoagulable state, and alters immune function. Influenza had already demonstrated that respiratory infections can behave differently during pregnancy.Zambrano also restricted the analysis to symptomatic women, reducing part of the ascertainment problem.And the subsequent literature was not uniform. A prospective single-center comparison of obstetric and non-obstetric COVID cohorts in India found no difference in ICU admission, length of stay, or mortality, and significantly less need for ventilatory support among pregnant patients, although differences between the cohorts limit what can be inferred from that comparison (Kumari et al. 2022).The point is not that CDC had demonstrated there was no additional maternal risk.The point is that it had not measured that risk with anything approaching the precision implied by the public message.Its estimates were influenced by endpoints partly determined by clinical judgment, generated within a clinical environment already primed to regard pregnancy as high risk, and accompanied by important missing-data and ascertainment limitations.Yet those estimates supplied the benefit side of the calculation used to overcome the precautionary default.Those qualifications persisted into the September 2021 advisory. Its 161 deaths among more than 125,000 confirmed cases corresponds to roughly 1.3 deaths per thousand, broadly consistent with the absolute mortality Zambrano had reported a year earlier. Its more striking figure, that approximately 97 percent of hospitalized pregnant patients were unvaccinated, included hospitalization for COVID illnessor for labor and delivery, as the advisory itself acknowledged.What reached the public were principally the counts and relative risks. The absolute rates, uncertainties, endpoint problems, and confounders remained largely buried in the underlying literature.Meanwhile, the other side of Fauci’s equation remained poorly characterized.The mistake was not literally assigning vaccine risk a value of zero. It was allowingan absence of adequate evidence of harm to function, increasingly, as evidence of safety.That distinction is especially important in pregnancy.A risk-benefit calculation can tolerate uncertainty when uncertainty exists on both sides, but it cannot manufacture a missing quantity. If the potential benefit is estimated from imperfect observational evidence while the potential harm cannot yet be reliably measured, the result is not a conventional risk-benefit calculation. It is a decision made under profound uncertainty.And profound uncertainty is precisely why the precautionary default exists.Invoking risk-benefit analysis to override a precaution designed for circumstances in which one side of that analysis cannot yet be adequately measured turns the purpose of the precaution on its head.There is an uncomfortable parallel in Fauci’s own public assessment of COVID risk.On February 8, 2020, his diary recorded a denominator-adjusted case-fatality estimate of 0.2 to 0.3 percent. On February 28, writing with H. Clifford Lane and Robert Redfield in theNew England Journal of Medicine, he suggested that the overall clinical consequences of COVID-19 might ultimately resemble those of a severe seasonal influenza, with a case fatality rate perhaps near 0.1 percent.Less than two weeks later, on March 11, Fauci told the House Oversight Committee that COVID-19 mortality was approximately one percent and that the virus was therefore roughly ten times more lethal than seasonal influenza.The numbers were being generated from a rapidly evolving epidemic, with an uncertain denominator, so changing estimates were inevitable.But that is precisely the point.Uncertainty was treated as grounds for precaution when estimating the virus's danger.When estimating the danger of vaccination during pregnancy, uncertainty increasingly became a reason for reassurance.The paper, the denominator, and the correctionOn April 21, 2021, Shimabukuro and colleagues published preliminary V-safe pregnancy findings in theNew England Journal of Medicine. Among 827 participants whose pregnancies had reached a recorded outcome, 104 had experienced spontaneous abortion before 20 weeks. The paper presented that as12.6 percentand described the proportion as similar to the background rate in the general population. In the accompanying table, the authors placed a published incidence range of 10 to 26 percent beside it.There was a serious denominator problem.A footnote to the same table disclosed that700 of those 827 women had received their first eligible vaccine dose during the third trimester. By definition, those women had already passed 20 weeks of pregnancy and therefore were no longer at risk of an event defined as spontaneous abortion before 20 weeks.Including them in the denominator necessarily drives the apparent miscarriage proportion downward.Put simply, the calculation asked how often an event occurring before 20 weeks happened in a group dominated by women who were already beyond 20 weeks when they entered the analysis.The resulting 12.6 percent was therefore not a valid estimate of miscarriage risk following vaccination in early pregnancy.Hong Sun raised this objection in theAmerican Journal of Obstetrics and Gynecologyon August 3, 2021. On September 8, three of the CDC authors responded in theNew England Journal of Medicineand agreed with the essential point: 827 completed pregnancies was not an appropriate denominator for estimating the risk or rate of spontaneous abortion. Such an estimate needed to be based on women vaccinated before 20 weeks of gestation (Meaney-Delman, Ellington, and Shimabukuro 2021).On October 14, the journal formally corrected the article. The 10-to-26-percent background comparator beside the spontaneous-abortion figure was replaced with“Not applicable,”removing the comparison that had made the original 12.6-percent figure appear directly comparable with the expected population rate.There is an important arithmetic trap here, because the opposite error has circulated ever since.If the 700 third-trimester pregnancies are simply removed from 827, that leaves 127 completed pregnancies. Dividing 104 miscarriages by 127 produces approximately82 percent.That number is also invalid.It fails for the mirror-image reason. The March 30 cutoff preferentially captured early pregnancies that had already ended, while many women vaccinated early in pregnancy werestill pregnantand therefore had no completed outcome to enter the denominator. Miscarriages occur earlier than live births, so counting only pregnancies that had already finished at an early cutoff inevitably overrepresents losses.The original calculation diluted the numerator with women who could no longer miscarry. The 82-percent calculation does the opposite: it excludes many pregnancies that had not yet had time to reach a successful outcome.Neither 12.6 percent nor 82 percent is a valid miscarriage rate.The scientifically defensible conclusion from the April dataset was much simpler and much less reassuring than the headline number suggested:At that point, the registry did not yet contain enough appropriately followed early-pregnancy exposures to calculate a reliable miscarriage rate.August 11CDC announced its affirmative recommendation on August 11, 2021, under the headline“New CDC Data: COVID-19 Vaccination Safe for Pregnant People.”The agency cited an analysis of roughly 2,500 women who had received at least one vaccine dose before 20 weeks of pregnancy. It reported no increased risk of miscarriage, with a rate near 13 percent, within the expected background range.This was, in substance, the corrected calculation. It restricted the analysis to women who had actually been vaccinated during the period in which spontaneous abortion could occur, precisely the denominator problem critics had identified in the April paper.And its central finding has held up.Published as Zauche and colleagues on September 8, 2021, the analysis estimated a cumulative spontaneous-abortion risk of 14.1 percent, or 12.8 percent after age standardization, among 2,456 participants. Subsequent studies encompassing more than a million pregnancies have likewise found no overall increase in miscarriage following COVID-19 vaccination.That evidence matters. But so do the limits of what it established.The cohort underlying a universal recommendation is therefore worth examining. Of the 2,456 participants, 88.8 percent were health care personnel and 78.3 percent were non-Hispanic white. More than one quarter reported at least one previous spontaneous abortion. Thirty-five women who reported a loss before six completed weeks were excluded from the analysis. That is a methodologically defensible choice, given how frequently very early pregnancy losses go unrecognized in the general population, but it is still a choice that belongs in any description of what was measured.Composition determines more than whom a study represents. It also affects what the study is capable of detecting.A cohort composed overwhelmingly of working health care personnel is not necessarily representative of the entire pregnant population to whom a universal recommendation will apply. More importantly, a study of approximately 2,500 pregnancies can provide useful reassurance about a substantial increase inoverall miscarriage riskwhile remaining poorly equipped to identify a smaller increase confined to an uncommon susceptible subgroup.Those are different questions.The timing presents another problem. CDC announced the conclusionfour weeks before the analysis was published, meaning the public received the answer before outside scientists could examine the methods and data underlying it. The announcement also arrived while the AprilNew England Journal of Medicinepaper still stood uncorrected, with its inappropriate denominator and population comparator remaining in print until October 14.Walensky’s August 11 statement urged all pregnant people, those considering pregnancy, and those breastfeeding to be vaccinated, describing COVID-19 vaccines as safe and effective during the urgency of the Delta wave (CDC 2021a).But notice the distance between the evidence and the claim.The new analysis addressedone outcome: spontaneous abortion before 20 weeks, in one voluntary, self-reported surveillance cohort.The public conclusion was much broader:COVID-19 vaccination was safe in pregnancy.Those are not equivalent statements.On September 29 CDC followed with a health advisory, CDCHAN-00453, calling for urgent action. Its summary stated that CDC “strongly recommends COVID-19 vaccination either before or during pregnancy because the benefits of vaccination outweigh known or potential risks” (CDC 2021b).The advisory reported more than 125,000 laboratory-confirmed cases in pregnant people, more than 22,000 hospitalizations and 161 deaths as of September 27, with 22 of those deaths in August alone, and noted that roughly 97 percent of pregnant people hospitalized with confirmed infection were unvaccinated. Those figures are serious and they are the strongest part of the case CDC made. The advisory now carries a retired designation in the agency’s own document archive.The question that was not askedFauci’s concern ran from cytokine response and fever to first trimester loss. Fever in early pregnancy is a recognized risk, so the pathway is real, and it is the pathway an immunologist reaches for. It was also the only pathway anyone in that exchange raised.The antigen these vaccines instruct cells to produce carries biological activity of its own. Spike is a receptor-binding protein, and its receptor had already been mapped to the tissue at issue. Li and colleagues, publishing in PLOS ONE in April 2020 from a preprint that February, reanalyzed roughly 65,000 cells from placentae of six to fourteen weeks and found ACE2 expressed in decidual stromal cells, decidual perivascular cells, villous cytotrophoblast and syncytiotrophoblast. Ashary and colleagues reported that July that syncytiotrophoblast carried the highest proportion of ACE2-expressing cells in the first trimester placenta, and noted that extravillous trophoblast, which acquires ACE2 expression later, is the population that invades the maternal decidua and remodels the spiral arteries.That map was not new even then. Valdes and colleagues had localized ACE2 and angiotensin (1-7) to syncytiotrophoblast, cytotrophoblast, villous endothelium and vascular smooth muscle, and to invading trophoblast and decidual cells in the maternal stroma, in Placenta in 2006 (Valdes et al. 2006).The two-proline modification does not change any of this. The substitutions sit at the junction of heptad repeat 1 and the central helix, in the fusion machinery. The receptor-binding domain is untouched. What 2P prevents is the transition to the postfusion state, and receptor engagement occurs upstream of that transition. Wrapp and colleagues established the point in the paper that defined the antigen: their cryo-EM structure showed the predominant state of the stabilized trimer with one receptor-binding domain rotated up in a receptor-accessible conformation, and their surface plasmon resonance measured ACE2 binding at roughly 15 nanomolar, some 10 to 20 fold tighter than SARS-CoV spike (Wrapp et al. 2020). Both measurements were made on the 2P construct. Corbett and Graham of the NIAID Vaccine Research Center are authors on it. The canonical statement that this spike binds ACE2 with high affinity is a measurement of the vaccine antigen.Spike binding drives ACE2 into the endocytic pathway and lysosomal degradation, an effect mapped to both the receptor-binding domain and S2, and one that tracked with clinical severity across variants. A physiology review of ACE2 in pregnancy states the consequence directly: downregulation of placental ACE2, whether by inhibition or by spike protein binding, produces placental inflammation and oxidative stress, limits fetal growth, and generates the classical picture of preeclampsia.Whether the antigen reaches that tissue at concentrations approaching its affinity is the operative question, and the arithmetic constrains the argument. Ogata and colleagues measured circulating vaccine antigen after mRNA-1273 and found S1 detectable from day one, peaking on average near 68 picograms per millilitre (Ogata et al. 2022). At roughly 76 kilodaltons that is about 0.9 picomolar, some four orders of magnitude below the 15 nanomolar dissociation constant. In bulk plasma, receptor occupancy would be negligible. The question lives in local tissue concentration, not in blood.The Wuerzburg placentas are not the only place investigators have found the material since. A team at NYU Langone reported, in a research letter funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, vaccine mRNA in human placental tissue by in situ hybridization, with signal in the decidua and in the villi from recipients of both products (Lin et al. 2024). In pregnant mice given intramuscular mRNA-1273, the construct crossed the placenta within an hour, reached fetal circulation, accumulated in fetal tissue and was translated into spike protein there (Chen et al. 2025). Lipid nanoparticles resembling those in the vaccines transfect placental trophoblast, endothelium and immune cells, which is why an entire field now engineers them deliberately for placental delivery.The decidua and the villi are where the mRNA was found. They are also where ACE2 sits. What the antigen does to decidual stroma, decidual perivascular cells, villous cytotrophoblast and syncytiotrophoblast has not been characterized, and it was not characterized before pregnant women were told the vaccines were safe for them. The receptor map dated to 2006, the affinity measurement to February 2020 from the antigen’s own designers, and the experiment joining them to the tissue has still not been done.The same receptor distribution ties together presentations that were handled as separate topics. Decidual stromal and perivascular cells express ACE2. The decidua governs menstrual bleeding, sheds whole in decidual cast shedding, and fails in early pregnancy loss. Through the spring of 2021 women were reporting all three. Kate Clancy and Katharine Lee gathered roughly 130,000 accounts of menstrual disturbance in the same months the pregnancy registry was being assembled. The menstrual reports went to content moderation and to a survey run by two anthropologists. The pregnancy question went to a registry. No federal analysis treated them as observations on one organ.RedfieldRobert Redfield left the CDC directorship on January 20, 2021, five days before that text chain, and is not a participant in it. He is the third author on the February 2020 New England Journal editorial with Fauci and Lane, and he ran the agency when ACIP voted in December 2020 and when the permissive guidance issued.On August 11, 2026, responding to the released texts, he said he never thought pregnant women should be vaccinated, described it as a policy recommendation he had not favored, and called it an error in judgment (NewsNation 2026). He said he has seen no data establishing a link between the vaccine and miscarriage. His objection was to the risk-benefit reasoning and, more sharply, to the absence of the open discussion that would have let women decide for themselves.Redfield’s current positions on mRNA vaccines contradict the account that academic public health and the obstetric professional societies still promote, and that CDC and FDA officials promoted through 2024. Critics will use that to set him aside. What he said about the January 2021 posture is consistent with the guidance in force when he left.Just as importantly, Redfield didnotclaim that the vaccines had been shown to cause miscarriage. He said he had seen no data establishing such a link.His objection was different, and more fundamental.The evidence was inadequate to justify replacing individual risk-benefit judgment with a universal recommendation, and the uncertainties should have been discussed openly with the women being asked to make that decision.Redfield’s current views on mRNA vaccines diverge sharply from those still advanced by much of academic public health and the obstetric professional societies, and from positions maintained by CDC and FDA officials through 2024. That makes it easy for critics to dismiss his 2026 comments as retrospective dissent.But there is a contemporaneous record against which his claim can be tested.When Redfield left CDC on January 20, 2021, the agency he had been running did not recommend COVID vaccination for all pregnant women. It explicitly left the decision to them.Five days later, Fauci privately raised the theoretical possibility of first-trimester miscarriage.Seven months later, CDC recommended vaccination for every pregnant woman.What the record supportsNo one concealed a known harm.The mechanism Fauci raised has not been borne out as a miscarriage signal, and the large studies that followed have not found an overall increase in miscarriage after COVID-19 vaccination. That matters, and any honest account of this episode has to say so.But it does not dispose of what the documentary record shows.Three of the most influential officials shaping the federal COVID response privately acknowledged that pregnancy data were inadequate. Fauci raised a specific theoretical concern about first-trimester miscarriage following the inflammatory response to vaccination, particularly after the second dose. Walensky immediately recognized the point.That specific concern was not communicated to pregnant women.The reassurance offered in the months that followed initially rested in part on a miscarriage calculation that the agency’s own authors later acknowledged used an inappropriate denominator. The corrected analysis was considerably more reassuring, and its central finding has subsequently held. But CDC announced its affirmative recommendation four weeks before that analysis was published and therefore before independent scientists could examine it.And the headline went considerably further than the evidence beneath it.“New CDC Data: COVID-19 Vaccination Safe for Pregnant People.”The new data addressed one outcome, miscarriage before 20 weeks, in a voluntary surveillance registry heavily composed of health care personnel. It did not establish the absence of every potential pregnancy risk, nor could a cohort of that size exclude a risk concentrated in a small susceptible subgroup.Yet a limited and reassuring finding about one outcome became a categorical statement about safety in pregnancy.In fact, there have been very limited studies since then.The studies that were supposed to fill the evidentiary hole did not entirely fill it. Pfizer eventually completed a randomized pregnancy trial, but with 683 participants rather than the thousands originally planned, and vaccination began at 24 to 34 weeks, too late to test the first-trimester miscarriage concern Fauci had raised privately.Moderna's prospective pregnancy registry was supposed to enroll approximately 600 women. It enrolled twenty and was terminated for low enrollment. By then, of course, the policy decision had long since been made.Again, no data…It is unclear whether ACIP ever actually voted to recommend COVID-19 vaccination specifically for pregnant women in 2021. No corresponding 2021Morbidity and Mortality Weekly Reportrecommendation has been identified, and the pregnancy guidance instead appears in CDC’sInterim Clinical Considerations, a staff document that changed repeatedly over time.An inquiry is now with CDC, and the agency has said it is looking into the question.The answer matters.If ACIP did vote on the pregnancy recommendation, the record should be straightforward to produce: the meeting, the motion, the vote, the evidence presented, the conflicts disclosed, and the resulting recommendation.If it did not, then CDC appears to have moved from individual choice to a universal recommendation for a population excluded from the pivotal trialswithout a specific vote of the independent advisory committee normally expected to publicly examine vaccine recommendations.That would mean the most consequential change in pregnancy vaccine policy during the pandemic occurred without the public deliberation, recorded vote, conflict disclosures, and recusal procedures that the advisory process is designed to provide.Redfield identified the deeper failure correctly.Government scientists will discuss uncertainties privately. They should. Medicine advances because scientists argue about mechanisms, challenge assumptions, worry about signals, and ask questions for which they do not yet have answers.The ethical failure is not that Fauci had doubts. The ethical failure is that pregnant women were not permitted to share fully in those doubts while being asked to bear the consequences of the decision.They were entitled to know that the pregnancy data were limited. They were entitled to know what was reassuring. They were entitled to know what remained unknown. And they were entitled to know that the government’s own senior scientists had discussed a theoretical risk that had not yet been resolved.That is informed consent.It does not require government scientists to know every answer.It requires them to tell patients when they do not.RWM/JGMAn essay about undisclosed interests should disclose its own. Malone.News takes no advertising and no institutional sponsorship. It is paid for by its readers, and our own consulting and corporate roles are disclosed on the About page rather than buried. Everything above is cited so that you can go to the source and disagree with us from the documents. That is the whole point. If the work is worth continuing, a paid subscription is what continues it.ReferencesAshary, Nancy, Anshul Bhide, Priyanka Chakraborty, et al. 2020. “Single-Cell RNA-seq Identifies Cell Subsets in Human Placenta That Highly Expresses Factors Driving Pathogenesis of SARS-CoV-2.” Frontiers in Cell and Developmental Biology 8: 783.Bartmann, Catharina, Vanessa Schmidt, Michael Moerz, Michael Schwab, Monika Rehn, Bettina Blau-Schneider, Achim Woeckel, and Ulrike Kaemmerer. 2026. “Detection of Spike Protein in Term Placentas of COVID-19 Vaccinated and/or SARS-CoV-2 Infected Women.” PLOS ONE 21 (3): e0344185.CBS News. 2026. “Fauci Discussed Potential Risks, Benefits of COVID Vaccine for Pregnant Women in 2021 Texts Released by GOP Senators.” August 11.CDC. 2021a. “New CDC Data: COVID-19 Vaccination Safe for Pregnant People.” Media statement, August 11.CDC. 2021b. “COVID-19 Vaccination for Pregnant People to Prevent Serious Illness, Deaths, and Adverse Pregnancy Outcomes from COVID-19.” CDC Health Alert Network, CDCHAN-00453, September 29.Chen, J.-C., M.-H. Hsu, R.-L. Kuo, L.-T. Wang, M.-L. Kuo, L.-Y. Tseng, et al. 2025. “mRNA-1273 Is Placenta-Permeable and Immunogenic in the Fetus.” Molecular Therapy Nucleic Acids 36 (1): 102489.CNN. 2026. “Republican Senators Release Fauci’s Text Messages Discussing Safety of Covid Vaccine and Pregnancy.” August 11.Delahoy, Miranda J., Lindsay Whitaker, Alissa O’Halloran, et al. 2020. “Characteristics and Maternal and Birth Outcomes of Hospitalized Pregnant Women with Laboratory-Confirmed COVID-19, COVID-NET, 13 States, March 1 to August 22, 2020.” MMWR Morbidity and Mortality Weekly Report 69 (38): 1347-54.Ellington, Sascha, Penelope Strid, Van T. Tong, et al. 2020. “Characteristics of Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status, United States, January 22 to June 7, 2020.” MMWR Morbidity and Mortality Weekly Report 69 (25): 769-75.Forbes. 2026. “Republican Senators Release Fauci Texts on Safety of COVID-19 Vaccine for Pregnant Women.” August 11.Kumari, Anupama, Latika Chawla, Anissa Atif Mirza, et al. 2022. “Impact of Pregnancy on Susceptibility and Severity of COVID-19: A Hospital-Based Prospective Observational Study.” Cureus 14 (4).Li, Mengmeng, Lin Chen, Jing Zhang, Chunlin Xiong, and Xi Li. 2020. “The SARS-CoV-2 Receptor ACE2 Expression of Maternal-Fetal Interface and Fetal Organs by Single-Cell Transcriptome Study.” PLOS ONE 15 (4): e0230295.Lin, X., B. Botros, M. Hanna, E. Gurzenda, C. M. De Mejia, M. Chavez, et al. 2024. “Transplacental Transmission of the COVID-19 Vaccine Messenger RNA: Evidence from Placental, Maternal, and Cord Blood Analyses Postvaccination.” American Journal of Obstetrics and Gynecology 230 (6): e113-16.Meaney-Delman, Dana M., Sascha R. Ellington, and Tom T. Shimabukuro. 2021. Reply, “On Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons.” New England Journal of Medicine, September 8.NewsNation. 2026. “It Was a Mistake to Vaccinate Pregnant Women: Dr. Robert Redfield.” Katie Pavlich Tonight, August 11.Newsweek. 2020. “COVID Vaccine and Pregnancy: What You Need to Know.” December 17, quoting CDC clinical guidance then in force.Ogata, Alana F., Chi-An Cheng, Michael Desjardins, et al. 2022. “Circulating SARS-CoV-2 Vaccine Antigen Detected in the Plasma of mRNA-1273 Vaccine Recipients.” Clinical Infectious Diseases 74 (4): 715-18.Prahl, Mary, Yarden Golan, Arianna G. Cassidy, et al. 2022. “Evaluation of Transplacental Transfer of mRNA Vaccine Products and Functional Antibodies during Pregnancy and Infancy.” Nature Communications 13: 4422.Santos, Ana, Meredith Sauer, Alexander J. Neil, et al. 2022. “Absence of SARS-CoV-2 Spike Glycoprotein Expression in Placentas from Individuals after mRNA SARS-CoV-2 Vaccination.” Modern Pathology 35 (9): 1175-80.Shimabukuro, Tom T., Shin Y. Kim, Tanya R. Myers, et al. 2021. “Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons.” New England Journal of Medicine 384: 2273-82. Correction published October 14, 2021.Sun, Haiyan. 2021. “Adjustment Is Required to Calculate the Risk of Early Pregnancy Loss with COVID-19 Infection or Vaccination.” American Journal of Obstetrics and Gynecology, August 3.Tampa Free Press. 2026. “Newly Released Fauci Texts Reveal Internal Early Discussions on COVID Vaccines and Pregnancy.” August 11.The Hill. 2026. “Paul, Johnson Release Fauci Texts.” August 11.Zauche, Lauren H., Bailey Wallace, Ashley N. Smoots, et al. 2021. “Receipt of mRNA Covid-19 Vaccines and Risk of Spontaneous Abortion.” New England Journal of Medicine 385: 1533-35.Zambrano, Laura D., Sascha Ellington, Penelope Strid, et al. 2020. “Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status, United States, January 22 to October 3, 2020.” MMWR Morbidity and Mortality Weekly Report 69 (44): 1641-47.Valdes, Gloria, L. A. A. Neves, L. Anton, et al. 2006. “Distribution of Angiotensin-(1-7) and ACE2 in Human Placentas of Normal and Pathological Pregnancies.” Placenta 27 (2-3): 200-207.Wrapp, Daniel, Nianshuang Wang, Kizzmekia S. Corbett, et al. 2020. “Cryo-EM Structure of the 2019-nCoV Spike in the Prefusion Conformation.” Science 367 (6483): 1260-63.


Friday Funnies: Too “Far Right” to Run Against

This is personal!Nigel Farage beats the establishment. Again.There is something wonderfully British about the Nigel Farage situation.MP Farage recently resigned his Clacton seat, forcing a by-election and effectively asking voters to elect him all over again. Britain’s major political parties then faced the obvious question:Who were they going to put up against him?Their answer:Nobody.Labour, the Conservatives, Liberal Democrats and Greens all declined. Officially, they said that Farage had created a “farce,” a “circus,” a “vanity project,” and serious politicians simply wouldn’t dignify it.How terribly principled.There is another possibility:they were afraid he would beat the pants off them.Rather than send a candidate into the electoral woodchipper, Britain’s political establishment discovered a sudden respect for staying home.Farage, you see, is simplytoo far rightto run against.And what, precisely, makes Nigel Farage so terrifyingly “far right”? He thinks Britain should control its borders, British laws should ultimately be made in Britain, violent criminals should receive meaningful sentences, taxes and regulation should be lower, farmers and domestic industry should be protected, Net Zero mandates deserve reconsideration, free speech is worth defending, and British history need not be treated as a national embarrassment.He also supports keeping the NHS free at the point of use, which is presumably an especially cunning form of fascism.Apparently “far right” is now easier than actually arguing with Farage's policies. The particularly awkward problem for Britain's political establishment is that increasing numbers of British voters seem to agree with him.Perhaps the frightening thing about Farage isn't that he's far right.It's that he's far too popular.Apparently the proper way to defeat the dangerous far right is not to stand against it and persuade voters to reject it.It is to hide from it.Fortunately, democracy found someone much braver to run:Count Binface":Binface is a 5,900-year-old intergalactic space warrior who wears a rubbish bin on his head and campaigns to make 99 Flakes cost 99p and ban speakerphones in public.Compared with Westminster, something of a moderate.So Britain’s major political parties left the job of confronting Nigel Farage to a man dressed as household waste.Then it got better.Farage won with roughly 63 percent.Count Binface came second with about 27 percent. And yes,Binfacewas actually financed, backed and supported by the other major Parties and still roundly beaten."I've managed to beat the establishment candidate"Nigel FarageThe man wearing a rubbish bin was willing to do something Labour, the Conservatives, Lib Dems and Greens were not: stand against Nigel Farage. Perhaps the establishment isn’t frightened that Farage is too extreme. Perhaps it is frightened that he is too popular. So popular, that they could only put up a trash bin as a candidate.But Farage does seem extraordinarily unlucky around British institutions. First he wasdebanked by Coutts, the 300-year-old private bank synonymous with Britain's wealthy and well-connected establishment, producing a scandal serious enough that regulators had to “remind” banks not to discriminate on political grounds. But of course, charges against the bank were never brought.Now theMetropolitan Police are investigating Reform donations, while theParliamentary Commissioner for Standards resumed yet another investigation into Farageupon his return to Parliament. Sound familiar?Nothing seems to sharpen the institutional microscope quite like a conservative becoming inconveniently popular. Pure coincidence, naturally.Perhaps Farage should try wearing a rubbish bin on his head. It appears to attract considerably less institutional concern.Either way, British politics has achieved perfect symbolism:The establishment refused to take out the rubbish.So the rubbish took them out.Cheers!Jill and Robert with Nigel - at Palm Beach, Trump’s acceptance speech, 2024.(I can’t resist finishing this essay up with an old favorite!)Thanks for reading Malone News! This post is public so feel free to share it on social media, crosspost or email it to a friend!ShareSo, apparently my sense of humor belongs in the rubbish bin and my politics are “far right.” This may be particularly problematic since I am actually a dual U.S.-British citizen, although for reasons increasingly obvious, I have somehow neglected to renew my British passport.Subscribe nowIf my particular combination of politics, sarcasm and rubbish-bin humor appeals to you, please consider becoming a paid subscriber. Being this ridiculous every week takes considerably more time than you might imagine.JGMWOKE 1.0 VERsUS WOKE 2.0Woke 1.0: Change the CultureDEI everywhereCritical Race Theory“Equity” over equalityIdentity politicsIntersectionalityPronouns in the bioGender as self-identification“Latinx”Defund the PoliceAbolish the PoliceCancel cultureSafe spacesTrigger warningsMicroaggressionsSpeech is violenceSilence is violenceWords are violenceMen can get pregnantBiological sex is a spectrumDrag Queen Story HourRemove statuesRename schoolsRename military basesRewrite curriculaDecolonize everythingReparationsCorporate DEI departmentsRacial preferences in hiring/admissionsMandatory diversity trainingESG“Anti-racism”“White privilege”“Whiteness”“Heteronormativity”“Lived experience” over inconvenient statisticsCensorship rebranded as “content moderation”Disagreement rebranded as “hate”And, naturally, a land acknowledgment before the quarterly sales meeting, because apparently the entire United States is stolen land, private property is a colonial construct, and the rightful owners are whichever Indigenous people occupied it at the historically convenient moment.Woke 2.0: Change the SystemNow the ambitions get somewhat larger.Abolish ICEDecriminalize illegal border crossingSanctuary cities and statesMass amnesty / pathway to citizenshipExpand voting access to noncitizens in some local electionsAbolish the Electoral CollegeMake Washington, D.C. a stateMake Puerto Rico a stateExpand the Supreme CourtImpose Supreme Court term limitsRestrict presidential control over executive agenciesStrengthen the independence of the federal bureaucracyWeaken or eliminate the Senate filibusterAbolish the Senate, or radically restructure itReplace equal state representation with population-based representationLower the voting age to 16Expand federal voting-rights legislationUniversal voter registrationRestore voting rights to felonsReparations through government policyWealth taxesExpand federal administrative power over climate, labor and civil-rights policyNational gun-control measuresRestrict or eliminate qualified immunityFederalize abortion protectionsConstitutional amendments guaranteeing various positive rightsAnd when an inconvenient constitutional structure gets in the way, explain that the Constitution itself is the problem.Woke 1.0 wanted to change what you could say.Woke 2.0 wants to change the machinery that decides who governs.Or, put another way: the revolution has moved on from the HR department, to governance.Woke 1.0:Pronouns, bathrooms, statues and DEI.Woke 2.0:Borders, elections, courts, states, the presidency and the Senate.JGM

Summary: Nigel Farage and the Great Westminster Vanishing Act


Late-term Pregnancy Killings "Legal" in Massachusetts

Massachusetts has eliminated its statutory gestational limit on abortion and removed the specific conditions previously required for abortions at or after 24 weeks. Under the new law, an abortion may be performed at any gestational age based on the professional judgment of the physician.For purposes of this discussion, a late abortion means an abortion performed after fetal viability. In the case of a healthy mother carrying a healthy, viable fetus, the procedure is not simply a means of ending the pregnancy: delivery would also end the life of the unborn child. The distinguishing feature of abortion in that circumstance is that it is intended to end the pregnancy without a live birth.A labor and delivery nurse for over 30 years described it to me this way:After 24 weeks, it’s not an abortion. It’s a delivery. At that point, the safest option for the mother is delivery, not an abortion, and many OB/GYNs have said that. An abortion up to 40 weeks is not about the woman’s health or saving her life.After 24 weeks, they can deliver the baby, and that is the safest way to protect the mom. If she doesn’t want the baby, she can always give it up for adoption. You must have a lot of hate in you to do this. This isn’t about our president or women’s rights. This is about people trying to kill children.Another part of this story deserves considerably more attention.Supporters of the new Massachusetts law have emphasized the heartbreaking cases: a wanted pregnancy in which a catastrophic fetal abnormality is discovered late, or a woman who develops a serious medical complication after 24 weeks. These cases certainly exist. They are real, and they deserve compassionate discussion. But Massachusetts already had that law - this was amended to expand access to anyone who can get to the right clinic willing to perform the killing of a viable fetus.Massachusetts did not amend its statute merely to create a broader exception for catastrophic fetal abnormalities or serious threats to the mother’s health. Itremoved the statutory conditions governing abortion after 24 weeks altogether. The new standard is the “professional judgment of the physician.”That is a much larger change.And here we encounter a remarkably inconvenient problem:we do not actually have good statistics telling us what percentage of abortions performed after 24 weeks are performed because the mother’s life or physical health is threatened, because of a serious fetal abnormality, or for social, economic, or personal reasons.The CDC cannot answer that question. Its abortion surveillance system reports gestational age, but it does not provide a national breakdown ofwhyabortions are performed at advanced gestational ages. The most recent CDC surveillance data report that 1.1 percent of abortions for which gestational age was known occurred at 21 weeks or later. But “21 weeks or later” is one enormous bucket. It tells us neither whether an abortion occurred at 22 weeks or 32 weeks, nor why it was performed.The national figure also obscures an important distinction: the CDC aggregates data from states with very different abortion laws, including states where abortion after viability is generally prohibited and states where there is no statutory gestational limit.Consequently, the national percentage tells us very little about the frequency of abortions after 21 or 24 weeksin the states where they can legally be performed. And in some of those jurisdictions, the underlying data are particularly difficult to obtain.Colorado, for example, does not impose a gestational limit on abortion, yet its publicly reported abortion statistics do not provide the kind of detailed, procedure-by-procedure accounting of later abortions and their indications that would allow the public to determine how many were performed after viability or why.The result is a rather remarkable information gap: the states with some of the most permissive laws are not providing the data needed to determine how those laws are actually being used.  Which raises the issue of willful ignorance in data collection.That absence of data becomes particularly important when legislators justify eliminating a gestational restriction by invoking medical emergencies.I wrote about this issue in 2024, in an essay titledHuman Development and Abortion.At the time, I noted how extraordinarily difficult it was to determine how many later abortions were actually performed for medical reasons rather than social or economic ones. That remains true today.But absence of comprehensive statistics does not mean absence of evidence.One particularly interesting source comes from researchers who strongly support abortion access.In 2013, Diana Greene Foster and Katrina Kimport published a peer-reviewed study examining272 women who obtained abortions at or after 20 weeksat 16 facilities around the country.Here is the important part: the study was specifically examining women obtaining later abortionsfor reasons other than fetal anomaly or life endangerment.These women were numerous enough to allow the researchers to recruit hundreds of case studies.The researchers found that women obtaining later abortions frequently experienced delays associated with discovering the pregnancy late, difficulty deciding whether to have an abortion, difficulty finding a provider, raising money for the procedure and travel, relationship problems, and other circumstances. The authors identified several common profiles, including women raising children alone, women experiencing conflict with a male partner or domestic violence, women who had difficulty deciding and subsequently encountered access problems, and young women who had never given birth.Put more plainly, these were not all cases involving a dying mother or a fetus with a lethal abnormality. The researchers documented later abortions sought for reasons involving money, transportation, relationships, delayed recognition of pregnancy, difficulty deciding whether to keep the child, and difficulty obtaining the procedure earlier. By 24 weeks, we are talking about a fetus that is most likely viable; later still, the probability of survival outside the womb rises dramatically. The truth is that at this age, these are people who feel pain, cry, are conscious, can smile, and, in every aspect we consider human, are human beings. Premature infants born at this same gestational age are treated as patients in neonatal intensive-care units, where medical teams may fight desperately to keep them alive. In these cases, therefore, a medical team intentionally ended the life of a viable human for reasons that had nothing to do with the fetus being unable to survive or the mother’s life being in danger.A viable fetus is a child with an independent right to life; there is a much less clinical way to describe that.A living, viable child was killed because the mother discovered the pregnancy late, had difficulty making a decision, could not raise the money sooner, could not find a provider, or could not arrange transportation.Then came an even more directly relevant study.In 2022, Kimport publishedIs third-trimester abortion exceptional? Two pathways to abortion after 24 weeks of pregnancy in the United States.This time the threshold was not 20 weeks.It wasafter 24 weeks, precisely the gestational boundary Massachusetts has now removed.Kimport interviewed 28 women who had abortions between24 and 35 weeks of pregnancy. She identified two principal pathways to third-trimester abortion.The first was receiving “new information.” Sometimes that meant discovering a serious fetal abnormality. But new information could also mean something much simpler:the woman had only recently discovered that she was pregnant.The second pathway was encountering barriers that prevented an abortion from occurring earlier. These included the cost of the procedure, difficulty finding a provider, and stigmatization. Some women had wanted abortions earlier but did not obtain them until the pregnancy had progressed into the third trimester.This distinction matters enormously.A third-trimester abortion performed because a woman will otherwise die is one ethical and medical question.An abortion at 30 weeks because a lethal fetal abnormality was discovered at 29 weeks presents another terribly difficult question.But an abortion at 30 weeks because the pregnancy was discovered late, because money could not be raised earlier, or because the woman had difficulty finding an abortion provider presents an entirely different ethical question.Yet the Massachusetts statute does not distinguish among them by enumerating specific post-24-week conditions.This is precisely the uncomfortable issue I raised two years ago. The mainstream (liberal) rhetoric surrounding late abortion frequently creates the impression that these procedures overwhelmingly involve catastrophic medical circumstances. But the research literature itself documents third-trimester abortions occurring for reasons that are not maternal medical emergencies or lethal fetal abnormalities. What wecannot responsibly say, because the necessary reporting does not exist, is what percentage each category represents.That uncertainty should argue for better data, not for pretending that the inconvenient cases do not exist.There is another biological reality that makes the Massachusetts decision different from an argument about abortion at six or twelve weeks.At 24 weeks, we are no longer discussing an embryo or an early fetus.We are discussing a living human organism approaching, and in some circumstances already possessing, the capacity to survive outside the uterus.Neonatal medicine routinely attempts to save infants born around this stage of development. With every additional week, survival generally improves substantially. By the late second and third trimester, the central and peripheral nervous systems are extensively developed, the fetus responds to sensory stimuli, and the ethical questions become correspondingly harder.This is one of the points I tried to make in 2024. Whatever one’s position on abortion,human development does not stop because the subject makes us uncomfortable.Colorado has one of the broadest abortion laws in the United States. Under the state’sReproductive Health Equity Act (RHEA), enacted in 2022, abortion is a legally protected right, andColorado imposes no statutory gestational-age limiton when an abortion may be performed.That means Colorado law doesnotestablish a cutoff at 20, 24, 28, or even 36 weeks, nor does it impose a separate post-viability requirement that the mother’s life or health be threatened or that the fetus have a serious or lethal abnormality. The decision is left to the pregnant woman and her healthcare provider, subject to ordinary medical regulation. Colorado voters strengthened this protection in 2024 by placing a right to abortion in the state constitution.So what does that mean? Below are screenshots from just one Colorado clinic that appears to specialize in late-term abortions.  Note that there is absolutely no mention of these abortions being needed for the health of the mother, and in Colorado, minors do not need the consent of a parent, even in the case of a late-term abortion, where the killing of a grandchild is involved.As of 2026, KFF countednine states plus Washington, D.C.with no gestational limit.Those states are:AlaskaColoradoMarylandMichiganMinnesotaNew JerseyNew MexicoOregonVermontWashington, D.C.(not a state)AndMassachusetts is now effectively joining this group:There are over 54 million people living in these states. Using ChatGPT, we have dug into the actual numbers of late-term abortions in those states, but the states and the CDC have relentlessly hidden those statistics. After many attempts to locate the data, this is what Chat could come up with:“Extrapolating cautiously across the jurisdictions without statutory gestational limits suggests thatseveral thousand abortions may occur after 21 weeks each year, perhaps roughly 1,500–3,000 after 24 weeks, and potentially several hundred after 28 weeks.These are estimates, not reported national totals, for the simple reason that the government does not collect or publish sufficient data to calculate the actual numbers.And that is itself extraordinary. We are debating laws explicitly permitting abortion after fetal viability while lacking a national surveillance system capable of telling ushow many such abortions occur, at what gestational age, and why they are performed.” - Chat-GPTAnd that leads directly back to Massachusetts.If the purpose of changing the law was simply to protect physicians treating catastrophic maternal emergencies or pregnancies involving lethal fetal abnormalities, the legislature could have written those protections into the statute precisely. It could have broadened the medical exceptions. It could have defined circumstances in which a physician could act without fear of prosecution.Instead, Massachusetts removed the statutory post-24-week conditions and replaced them with the physician's professional judgment.It is entirely possible to believe that women facing catastrophic pregnancies deserve compassion, privacy and excellent medical care while simultaneously asking whether a viable fetus has any independent moral interest that the law should recognize.Those are not mutually exclusive positions.And perhaps the most revealing fact surrounding this debate is how little information government actually collects about the very abortions being used to justify the change.If abortions after 24 weeks are overwhelmingly performed because of catastrophic fetal abnormalities and genuine threats to maternal health, then collect the data and demonstrate it.If they are not, then the public deserves to know that too.Because once the legislature removes the gestational boundary altogether, the question is no longer merely whether a tragic medical exception should exist.The question becomeswhether there should be a boundary at all.There is one final aspect of this story that I find difficult to get past.They celebrated.Look at the photographs from the bill signing.Governor Maura Healey sits at her desk surrounded by legislators, physicians and abortion-rights advocates. They are smiling. They are applauding. They pose together for photographs commemorating the occasion.Massachusetts had not just increased funding for prenatal care. It had not expanded neonatal intensive-care units or created additional support for women facing catastrophic pregnancies.It had removed the state’s existing legal restrictions on abortion after 24 weeks.The previous law said that after 24 weeks an abortion could be performed when necessary to preserve the life or physical or mental health of the mother, or because of a lethal or grave fetal diagnosis incompatible with sustained life outside the uterus without extraordinary medical intervention.The new law deletes those requirements.In their place are twelve words:“an abortion may be performed when based upon the professional judgment of the physician.”That is what was signed.Healey herself described the cases used to justify the legislation as involving “devastating, heartbreaking” diagnoses. Advocates repeatedly presented the legislation through stories of parents discovering catastrophic abnormalities in desperately wanted pregnancies.If that were all this law did, perhaps the celebration could be understood as relief that families experiencing terrible medical tragedies would no longer have to leave Massachusetts for treatment.But that is not what the legislature wrote.It did not add another exception for fetal abnormalities.It did not broaden the definition of a maternal medical emergency.It did not create an expedited process for physicians confronted with catastrophic pregnancies.It removed the conditions.The organization that championed the legislation, Reproductive Equity Now, did not hide this. Its campaign was explicitly titled“Expanding Abortion Access Throughout Pregnancy.”It argued that Massachusetts should remove restrictions on abortion after 24 weeks and reported polling asking voters whether they supported abortion access “throughout pregnancy” based upon physician judgment.Those words matter.Because at 24 weeks we are no longer discussing an abstract possibility of human life sometime in the distant future. We are discussing a living, viable baby.  At the gestational ages permitted by this law, premature infants are simultaneously being treated in neonatal intensive-care units, where physicians and nurses employ extraordinary skill and enormous resources trying to keep them alive.That is what makes the photographs so unsettling.There is no requirement in the new statutory language that the fetus have a lethal abnormality. There is no requirement that the mother’s life be endangered. There is no statutory gestational ceiling at 28 weeks, 32 weeks or 36 weeks.And, as we have discovered while trying to answer the most basic questions for this article, Massachusetts cannot tell us how often abortions after viability involve healthy fetuses, because the surveillance data necessary to answer that question simply do not exist in adequate detail.Colorado offers some indication of why the question matters. In that state, where abortion likewise has no statutory gestational limit,137 abortions were reported at 28 weeks or later in 2023 alone.Clinics there openly advertise abortion well into the third trimester. And those clinics make it plain: no reason need be given.ShareThe government has removed the boundary of killing an innocent life - a person who feels pain, who can smile, who is fully human.And then there are those videos and photographs of Governor Healey signing the legislation.  The ghoulish nature is chilling.  These women look like they are having the best day of their lives.The smiles bother me.Where is the acknowledgment that at 28 or 30 weeks there may be a perfectly recognizable, potentially viable human being involved?None of that is in these photographs.There are politicians and activists grinning around a desk because Massachusetts has eliminated one of the last statutory boundaries regarding the termination of a human life, late in pregnancy.And this was no narrow, reluctant decision. The Massachusetts House voted119–33for the legislation, with roughly 78 percent of those voting supporting it; the Senate subsequently passed it without a recorded roll-call vote. Massachusetts legislators overwhelmingly chose to remove the specific statutory protections that had restricted abortion after 24 weeks, including the requirements involving maternal health and grave fetal diagnoses, and replace them with the professional judgment of the physician.Whatever euphemisms one prefers, the legislature knowingly voted for a legal framework that can permit the intentional killing of a viable, living fetus without a statutory requirement that the mother's life be endangered or the fetus be fatally impaired. That this passed overwhelmingly, rather than at the margins after anguished debate, says something deeply unsettling about how far Massachusetts politics has moved on the question of human life after viability.A civilized society might sometimes conclude that a terrible thing has just happened.What troubles me is not only the killing of a conscious human being, but the fact that the left actually celebrates that loss.JGM/RWMHow many abortions actually occur after viability? How many occur at 28 weeks or later? How many involve a serious threat to the mother’s health or a lethal fetal abnormality, and how many do not? These seem like rather basic questions to ask before eliminating the legal boundaries governing abortion late in pregnancy.Instead, we had to dig through CDC surveillance reports, individual state databases, medical literature, provider websites and abortion statistics just to begin assembling an answer.That is what independent journalism is supposed to do.If you value this kind of work, please consider becoming apaid subscriber. Your subscriptions allow us to spend the time following the data wherever they lead, asking questions that increasingly seem to make polite society uncomfortable, and publishing what we find without waiting for permission from an editor, advertiser or political party.Subscribe nowAnd, as always, thank you to those of you who already support our work. You make it possible.Please consider signingLifeSite’s petitionurging Archbishop Richard Henning to formally declare Gov. Healey of Massachusetts excommunicated for her signing of this bill into law:We must urge Archbishop Richard Henning to formally declare Gov. Healey excommunicated following her scandalous betrayal of God's law and His Church, knowing that such penalties exist to prompt the repentance of sinners and the salvation of souls who would otherwise partake in these crimes against God.

Summary: Innocent children will die