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A constitutional amendment to restore abortion rights in Missouri will move forward after a judge on Tuesday broke a standoff between two Republican officials that had halted the process. Cole County Presiding Judge Jon Beetem ordered Attorney General Andrew Bailey to approve fellow Republican Auditor Scott Fitzpatrick's estimated $51,000 price tag on the proposal within 24 hours. Bailey had refused to approve the price estimate, arguing that if the proposal were to succeed, it could cost the state as much as a million times more than that figure because of lost Medicaid funding or lost revenue that wouldn’t be collected from people who otherwise would be born. But Beetem said Bailey has “no authority to substitute his own judgment for that of the Auditor.” “There is an absolute absence of authority to conclude the Attorney General is permitted to send the Auditor’s fiscal note summary back to revision simply because he disagrees with the Auditor’s estimated cost or savings of a proposed measure,” Beetem wrote in his ruling. A spokesperson said the attorney general's office will appeal. If approved by voters, the proposal would enshrine in the constitution the individual right to make decisions about abortion, childbirth and birth control. Missouri's Republican-led Legislature and Republican governor banned nearly all abortions after the U.S. Supreme Court overturned Roe v. Wade last summer. The state now allows exceptions for medical emergencies, but not for cases of rape or incest. In Missouri, the auditor is required to calculate how much taxpayer money it could cost to implement ballot measures. The attorney general then reviews and approves the cost estimate in an administrative step that historically has been uneventful. Fitzpatrick’s office in March found that the proposal would have no known impact on state funds and an estimated cost of at least $51,000 annually in reduced local tax revenues, although “opponents estimate a potentially significant loss to state revenue.” Bailey said that cost estimate was so low it would bias voters and told Fitzpatrick to change it. Fitzpatrick refused, arguing that a multibillion-dollar projection for the initiative petition would be inaccurate, despite Fitzpatrick’s personal opposition to abortion. “As much as I would prefer to be able to say this IP would result in a loss to the state of Missouri of $12.5 billion in federal funds, it wouldn’t,” Fitzpatrick wrote in an April 21 letter to Bailey. “To submit a fiscal note summary that I know contains inaccurate information would violate my duty as State Auditor to produce an accurate fiscal note summary.” The standoff had blocked the secretary of state from allowing the pro-abortion rights campaign to start collecting signatures from voters. The campaign would need to collect signatures from 8% of legal voters in six of the state’s eight congressional districts in order to get the proposal on the 2024 ballot. ___ For more AP coverage of the abortion issue: https://apnews.com/hub/abortion Read More Ukraine war’s heaviest fight rages in east - follow live Charity boss speaks out over ‘traumatic’ encounter with royal aide Watch: Andrew Bailey questioned on BoE independence by House of Lords committee Missouri governor signs ban on transgender health care, school sports Hunter Biden reaches deal with DOJ to plead guilty to federal charges

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Women who smoke during pregnancy are 2.6 times more likely to give birth prematurely compared with non-smokers – more than double the previous estimate, new research suggests. The University of Cambridge study also found smoking meant the baby was four times more likely to be small for its gestational age, putting it at risk of potentially serious complications including breathing difficulties and infections. There was no evidence caffeine intake was linked to negative outcomes. We’ve known for a long time that smoking during pregnancy is not good for the baby, but our study shows that it’s potentially much worse than previously thought Professor Gordon Smith, University of Cambridge Professor Gordon Smith, head of the department of obstetrics and gynaecology at the University of Cambridge, said: “We’ve known for a long time that smoking during pregnancy is not good for the baby, but our study shows that it’s potentially much worse than previously thought. “It puts the baby at risk of potentially serious complications from growing too slowly in the womb or from being born too soon. “We hope this knowledge will help encourage pregnant mums and women planning pregnancy to access smoking-cessation services. “Pregnancy is a key time when women quit and if they can remain tobacco free after the birth there are lifelong benefits for them and their child.” The NHS recommends that women who are pregnant should stop smoking and limit their caffeine intake because of the risk of complications to the baby. When the toxins from smoke travel through the bloodstream to the baby, it struggles for oxygen. When this happens it affects their development, and is linked to premature birth and low birthweight, though it has also been linked to a reduced risk of pre-eclampsia (high blood pressure during pregnancy). High caffeine intake has also been linked to lower birthweight and possibly foetal growth restriction. But caffeine can be more difficult to avoid than cigarette smoke as, as well as being found in coffee and tea, it can be found in chocolate, energy drinks, soft drinks and certain medications. Researchers say studies looking at the links between smoking and caffeine and their impact on pregnancy tend to rely on people reporting how much they have consumed, or exposure to smoke, data which is not always reliable. Blood tests for metabolites – chemical by-products created when substances such as tobacco and caffeine are processed in the body – might be more accurate. Researchers at Cambridge and the Rosie Hospital, part of Cambridge University Hospitals NHS Foundation Trust, recruited more than 4,200 women who attended the hospital between 2008 and 2012 as part of the Pregnancy Outcome Prediction (POP) study. The team analysed blood samples taken from a group of these women four times during their pregnancies. To assess exposure to cigarette smoke, the team looked at levels of cotinine, which can be detected in blood, urine and saliva. Only two out of three women with detectable levels of cotinine in every blood sample were self-reported smokers, showing that this measure is a more objective way of assessing smoking behaviour, researchers say. A total of 914 women were included in the smoking analysis. Of these, 78.6% were classified as having no exposure to smoking while pregnant, 11.7% as having some exposure and 9.7% as having consistent exposure. The study, published in the International Journal of Epidemiology, found that compared with those without smoke exposure while pregnant, those with consistent exposure were 2.6 times more likely to experience spontaneous preterm birth. According to the researchers, this is more than double the previous estimate of 1.27 from an analysis of multiple studies. They were also 4.1 times as likely to experience foetal growth restriction. Additionally, babies born to smokers were found to be on average 387g lighter than babies born to non-smokers – that is, more than 10% smaller than the weight of an average newborn. This increases the risk that the baby will have a low birth weight (2.5kg or less), which in turn is linked to an increased risk of developmental problems as well as poorer health in later life. Unlike in previous studies, the team found no evidence that smoking reduced the risk of pre-eclampsia. To assess caffeine intake, researchers looked for the metabolite paraxanthine in 915 women. Of these women, 12.8% had low levels of paraxanthine throughout pregnancy (suggesting low caffeine intake), 74.0% had moderate levels and 13.2% had high levels. The researchers say there was little evidence of an association between caffeine intake and any of the negative outcomes. However, because the researchers did not study all possible adverse outcomes of pregnancy, and some of the outcomes not studied – such as stillbirth – have been associated with higher caffeine intake in previous studies, they cannot interpret the findings as indicating that current recommendations around caffeine intake should be changed. The work was supported by the National Institute for Health and Care Research (NIHR), Cambridge Biomedical Research Centre and the Medical Research Council. 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Russia launched overnight air attacks on Ukraine‘s south and east using drones and possibly ballistic missiles, Ukraine‘s Air Force and officials said early on Tuesday. A fire broke out at one of the “facilities” in the port of Mykolaiv late on Monday, the city mayor said. The port city provides Ukraine with access to the Black Sea. “It’s quite serious,” Mayor Oleksandr Senkevich said on the Telegram messaging app of the fire, adding that more detail will come in the morning. The southern port of Odesa and the Mykolaiv, Donetsk, Kherson, Zaporizhzhia and Dnipropetrovsk regions were under threat of Russian drone attacks, the Air Force said on the Telegram messaging app. It added that Russia may be using ballistic weaponry to attack the regions of Poltava, Cherkasy, Dnipropetrovsk, Kharkiv and Kirovohrad. It comes as Russian defence ministry said they repelled a Ukrainian drone attack on Crimea in the early hours of Tuesday - a day after an explosion on the bridge killed two people. The ministry said their air defences destroyed 17 drones and another 11 drones were intercepted by electronic warfare systems. Read More What the Crimea bridge attack means for Ukraine’s counteroffensive Why the Crimea bridge attack will get under Putin’s skin Russia stops crucial Ukraine grain export deal hours after attack on Crimea bridge Trump finally reveals how he thinks he could end Russia’s war in Ukraine in a day

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