News Brief: Government Shutdown, Pompeo Speech, Miscarriage Treatment

Trump heads to McAllen, Texas, on the U.S.-Mexico border. Secretary of State Pompeo, who's in Egypt, speaks on U.S. policy in the region. A new treatment for miscarriage is mired in abortion debate.

DAVID GREENE, HOST:

Today, President Trump is heading to McAllen, Texas. This is a city right along the border with Mexico.

RACHEL MARTIN, HOST:

Right. It is one of dozens of towns on the nearly 2,000-mile stretch where the president hopes to build a wall or a barrier. The border wall is the reason the partial government shutdown is stretching into Day 20. And it's why negotiations broke down again yesterday between the White House and congressional Democrats. Vice President Mike Pence blamed Democrats.

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VICE PRESIDENT MIKE PENCE: Today, in this brief meeting, we heard once again that Democratic leaders are unwilling to even negotiate.

MARTIN: Meanwhile, Senate Minority Leader Chuck Schumer said it's the president who won't budge and the president who ended the meeting yesterday rather abruptly.

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CHUCK SCHUMER: Well, unfortunately, the president just got up and walked out.

GREENE: OK, well, let's bring in NPR White House correspondent Scott Horsley to talk about this moment. Good morning, Scott.

SCOTT HORSLEY, BYLINE: Good morning, David.

GREENE: OK, so no one is budging. This partial government shutdown, if it's not resolved by tomorrow, and there's no sign it will be, I mean, you're going to have hundreds of thousands of government workers missing their first paycheck. I mean, are you seeing any sides of the Democrats or Republicans cracking here?

HORSLEY: Not at the top, David. Democrats, led by House Speaker Nancy Pelosi and Chuck Schumer, the Senate minority leader, are not about to reward the president for shutting down parts of the government. They feel like that would just encourage him to resort to extortion whenever he doesn't get what he wants. And the president is reluctant to end the border shutdown without a wall because he feels like this is his, really, only point of leverage.

There have been some small cracks among rank-and-file Senate Republicans, especially a few who are up for re-election in two years, who have said they would like to see the shutdown ended while negotiations continue. But that only matters if the Senate Majority Leader Mitch McConnell is willing to go along. And so far, he's not.

GREENE: And Senate Republicans are critical - right? - because, I mean, the House, led by Democrats now, last night passed a bill to reopen parts of the government, but probably not going to go anywhere if you don't have leadership in the Senate actually saying, like, maybe we'll think about this.

HORSLEY: Nowhere except as a talking point and a way for Democrats to underscore their message that this shutdown is the responsibility of the president. Polls already suggest that most Americans blame President Trump for this shutdown. Not surprising since he's been pretty transparent about using it as a bargaining chip.

And, as you say, tomorrow is when this becomes very real in a financial way for those 800,000 federal workers who are supposed to get a paycheck and will miss one for the first time since this all began back before Christmas.

GREENE: OK, so President Trump - he walks out of a meeting with congressional leaders yesterday. That's the scene in Washington. Now he's shifting the backdrop. He's going to the border. I mean, beyond a scene change, what is the president hoping to accomplish here?

HORSLEY: This is sort of the field trip version of the speech he gave from the Oval Office on Tuesday night. It's an opportunity for him to try to paint this border situation as both a humanitarian and a national security crisis. He's going to visit a border patrol station. He's going to visit the Rio Grande river itself.

But, you know, the mayor of McAllen has been holding his own photo-ops and media interviews. On the one hand, he welcomes the president's visit. He welcomes some extra federal resources. But he's not thrilled about having his city, which he thinks is one of the safest in America, portrayed as some kind of desolate border badland of crime and drugs. So that's going to kind of undercut the president's message a little bit.

GREENE: All right. Scott Horsley, NPR's White House correspondent. Scott, thanks.

HORSLEY: Great to be with you, David.

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GREENE: We're going to turn now to Cairo, where Secretary of State Mike Pompeo is getting ready to give a big speech today.

MARTIN: Right. It was a decade ago that President Barack Obama went to Cairo to deliver a speech about his administration's foreign policy. Today, Mike Pompeo will give the Trump administration's version, and perhaps some clarity, after weeks of shifting positions, on Syria and other regional issues.

GREENE: And NPR's Michele Kelemen has been traveling with the secretary of state and joins us now from Cairo. And, Michele, you've been traveling a lot, right? Give us a sense of the ground Pompeo's covered.

MICHELE KELEMEN, BYLINE: Well, we're only just begun on this. We started in Jordan, a country that borders Syria and one of the many in this region that's nervous about the U.S. troop withdrawal from Syria. Pompeo then took a daytrip to Iraq, both Baghdad and up to Erbil in the mainly Kurdish north of the country.

And his message has been basically this - that the U.S. troop pullout is a tactical shift, not a change in the U.S. goals in the region. He says the U.S. is committed to defeating ISIS and pushing back on Iran. And he's trying to downplay all these mixed messages coming from the administration on the conditions and the pace of that Syria troop pullout and what it'll mean to Kurdish fighters who helped the U.S. in the fight against ISIS.

GREENE: OK, so now you're in Cairo, and it sounds like there are lots of people there with you covering this visit. I mean, what exactly is going to happen there?

KELEMEN: Yeah. We're busy here at the Foreign Ministry building. He's already met with the country's president, Abdel Fattah el-Sisi, who's been a big supporter of President Trump. Sisi has come under a lot of criticism from human rights groups for jailing thousands of activists. And while the State Department has raised some human rights concerns, it's also praising Sisi for his efforts to support Christians in Iraq. And that's something that Pompeo clearly appreciates. He's really put a priority on promoting religious freedom.

GREENE: And, Michele, this really is a moment to sort of take stock of U.S. policy in this region - right? - because, as Rachel said, I mean, it was a decade ago when President Obama gave this big speech there laying out his vision. I suppose this is really a chance for the Trump administration to use the same setting to lay out a vision that sounds like might be very different.

KELEMEN: Yeah. Well, you know, when Obama gave that speech in 2009, he was calling for a new beginning for U.S. relations with the Muslim world. He spoke at a very old university here. Pompeo is speaking at a different university, the American University of Cairo, and his message is likely to be far different. He's complained a lot, especially about Obama's approach to Iran, focusing on the nuclear deal and, as Pompeo says, ignoring all the rest of Iran's bad behavior in the region. The Trump administration has been trying to keep focused on that - on Iran and putting pressure on Iran.

GREENE: And then after the speech, where do you all go from Egypt?

KELEMEN: Oh, we have a big trip ahead. It's still Bahrain, UAE, Qatar, Saudi Arabia, Kuwait, Oman. Again, building up this coalition against Iran. He'll have to deal with the Saudi-Qatar split, which is ongoing - a diplomatic dispute that they've had, and his envoy on that quit this week.

GREENE: All right. Well, safe travels.

KELEMEN: Thank you.

GREENE: That's NPR's Michele Kelemen, who is traveling with Secretary of State Mike Pompeo in Egypt this morning.

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GREENE: All right. About 10 to 20 percent of known pregnancies end in a miscarriage. That is as many as one in five.

MARTIN: So a miscarriage is, obviously, an incredibly emotional experience. It's also a physically painful experience. And a woman often requires additional medical treatment to help her body clear the pregnancy.

There is a new treatment that can make that process easier, but getting access to it is not so easy. It involves a combination of drugs - one that's been used for miscarriages, and the other is known as the abortion pill. And regulations around abortions in the U.S. can make that second pill difficult, or even impossible, for some women to get.

GREENE: And we're joined in our studio this morning by Sarah McCammon, NPR correspondent. She's been reporting on this story. And she's been speaking to women in Canada, where the drugs are more available, and also in the United States, where they are less available. Sarah, thanks for being here.

SARAH MCCAMMON, BYLINE: Sure thing.

GREENE: So start with telling us how this treatment works exactly.

MCCAMMON: Well, it is important to understand that sometimes, a miscarriage happens on its own, completes naturally, but not always. Sometimes, to expel the fetal remains, a woman needs surgery. Sometimes she needs drugs to finish the process. And there are a couple of different drugs involved here, as we said. Doctors say the most effective protocol, they believe now, involves a drug called mifepristone, also known as the abortion pill.

So this is a little complicated. Stay with me. I'm going to explain the difference of these two drugs. There are actually two in the protocol. The first is called misoprostol, which has been used in abortions, but also for accelerating miscarriages for years. What's newer is using mifepristone with it. It was approved by the FDA in 2000 for use in medication abortions. But there's growing evidence that it's helpful for miscarriages, too. A recent article in the New England Journal of Medicine found that that combination of the drugs was faster and more effective than the old way, which was just misoprostol alone.

GREENE: OK, so mifepristone - this is the drug that is harder for women in the United States to access.

MCCAMMON: Exactly.

GREENE: Explain why that's the case.

MCCAMMON: Well, since it was approved for abortions, it's been heavily regulated. And unlike in Canada, where one woman I spoke to lives, it can't be stocked in pharmacies here in the U.S., and clinics that carry it have to apply for a special designation from the federal government. So some American doctors have said they've had trouble prescribing mifepristone for patients experiencing a miscarriage.

Here's Kristyn Brandi. She's an OB-GYN at Rutgers New Jersey Medical School, and she's had some difficulty prescribing this drug.

KRISTYN BRANDI: And it's been really frustrating to know that there's a medication out there that I can give to my patients that I don't physically have to give to them.

MCCAMMON: And I also talked to a woman in Canada. Her name was Kirstin Herbst. And she said, you know, she'd recently gone through a miscarriage, and the chance to take the pills and go through this process that was very difficult for her in the privacy of her own home was really invaluable.

GREENE: OK. So, Sarah, where is the opposition to this coming from?

MCCAMMON: Well, there's long been political debate around mifepristone in particular. Some anti-abortion groups say they have no problem using it just for miscarriage, but some have expressed safety concerns. One doctor I talked to who opposes abortion rights says she's mostly worried about safety, but she also worries that if regulations on mifepristone were relaxed, there would be more abortions.

It's worth noting that multiple medical groups, including the American College of Obstetricians and Gynecologists, or ACOG, are recommending this protocol and say it's safe and effective.

GREENE: Well, if that's the case, I mean, is there movement to make this drug easier to get here in the U.S.?

MCCAMMON: Well, there's at least one lawsuit not directly linked to miscarriage, but it's about easing restrictions about using the drug, in general, for abortion. And several medical groups, including ACOG and the American Medical Association, are asking the FDA to relax the regulations for use in miscarriage. The FDA has told NPR it believes the restrictions are necessary for patient safety.

GREENE: OK. That's NPR correspondent Sarah McCammon, who's in our studios in Washington this morning. Sarah, thanks.

MCCAMMON: Thank you.

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