Current Text for HB360

149586-1:n:02/28/2013:DSM*/th LRS2013-1112




HB360
By Representative Rich
RFD Health
Rd 1 28-FEB-13


SYNOPSIS:Under existing law, abortion can be performed with the consent of a pregnant woman.
 This bill would redefine certain terms in the chapter relating to abortion and add new terms.
 This bill would require disclosure of additional information prior to the performance of an abortion.

A BILL
TO BE ENTITLED
AN ACT

Relating to abortion; to amend Sections 26-23A-3, 26-23A-4, and 26-23A-5, Code of Alabama 1975, to redefine abortion and medical emergency; to add new terms; and to require additional information be provided prior to an abortion procedure.

BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:

Section 1. Sections 26-23A-3, 26-23A-4, and 26-23A-5, Code of Alabama 1975, are amended to read as follows:

§26-23A-3.

"For the purposes of this chapter, the following terms have the following meanings:

"(1) ABORTION. The use or prescription of any instrument, medicine, drug, or any other substance or device with the intent to kill the unborn child of a woman known to be pregnant or with the intent to prematurely terminate the pregnancy of a woman known to be pregnant. Such use or prescription is not an abortion if done with the intent to save the life or preserve the health of an unborn child, remove a dead unborn child, or to deliver an unborn child prematurely in order to preserve the health of both the mother (pregnant woman) and her unborn child.

"(2) CONCEPTION. The fusion of a human spermatozoon with a human ovum.

"(3) EMANCIPATED MINOR. Any minor who is or has been married or has by court order otherwise been legally freed from the care, custody, and control of her parents.

"(4) GESTATIONAL AGE. The time that has elapsed since the first day of the woman's last menstrual period.

"(5) MEDICAL EMERGENCY. That condition which, on the basis of the physician's good faith clinical judgment in reasonable medical judgment, so complicates the medical condition of a pregnant woman as to necessitate the immediate abortion of her pregnancy to avert her death or in which a delay will create serious risk of substantial and irreversible impairment of a major bodily function will create serious risk of substantial and irreversible physical impairment of a major bodily function, not including psychological or emotional conditions. No condition shall be deemed a medical emergency if based on a claim or diagnosis that the woman will engage in conduct which she intends to result in her death or in substantial and irreversible physical impairment of a major bodily function.

"(6) MINOR. Any person under the age of 18 years.

"(7) PHYSICIAN. Any person licensed to practice medicine in this state. The term includes medical doctors and doctors of osteopathy.

"(8) PREGNANT or PREGNANCY. The female reproductive condition of having an unborn child in the mother's (woman's) body.

"(9) QUALIFIED PERSON. An agent of the physician who is a psychologist, licensed social worker, licensed professional counselor, registered nurse, or physician.

"(10) QUALIFIED TECHNICIAN. A registered diagnostic medical sonographer who is certified in obstetrics and gynecology by the American Registry for Diagnostic Sonography (ARDMS) or a nurse midwife or advance practice nurse practitioner in obstetrics with certification in obstetrical ultrasonography.

"(10)(11) UNBORN CHILD. The offspring of any human person from conception until birth.

"(12) STABLE INTERNET WEBSITE. A website that, to the extent reasonably practicable, is safeguarded from having its content altered other than by the Department of Public Health.

"(11)(13) VIABLE. That stage of fetal development when the life of the unborn child may be continued indefinitely outside the womb by natural or artificial life-supportive systems.

"(12)(14) WOMAN. Any female person.

§26-23A-4.

"Except in the case of a medical emergency, no abortion shall be performed or induced without the voluntary and informed consent of the woman upon whom the abortion is to be performed or induced. Except in the case of a medical emergency, consent to an abortion is voluntary and informed if and only if:

"(a) At least 24 hours before the abortion, the physician who is to perform the abortion, the referring physician, or a qualified person has informed and provided the woman in person, or at least by 48 hours before the abortion by return receipt certified mail restricted delivery, and if by mail, again in person prior to the abortion, a copy of the printed materials in Section 26-23A-5 which list agencies that offer assistance, adoption agencies, development of the unborn child, methods and risks of abortion and childbirth, father's obligations, and alternatives to abortion, and informed the woman that she has the right to review the printed materials described in Section 26-23A-5, that these materials are available on a state-sponsored website, and what the website address is. The physician or a qualified person shall orally inform the female that the materials have been provided by the State of Alabama and that they describe the unborn child and list agencies which offer alternatives to abortion. Mailing of the materials in Section 26-23A-5 may be arranged by telephone.

"(b) Prior to an abortion, the physician who is to perform the abortion, the referring physician, or a qualified person has informed the woman in person:

"(1) The name of the physician who will perform the abortion in writing or a on a printed business card.

"(2) The nature of the proposed abortion method and associated risks and alternatives that a reasonable patient would consider material to the decision of whether or not to undergo the abortion.

"(3) The probable gestational age of the unborn child at the time the abortion is to be performed, and the probable anatomical and physiological characteristics of the unborn child at the time the abortion is to be performed. If the unborn child is viable or has reached a gestational age of more than 19 weeks, that:

"a. The unborn child may be able to survive outside the womb.

"b. The woman has the right to request the physician to use the method of abortion that is most likely to preserve the life of the unborn child, provided such abortion is not otherwise prohibited by law.

"c. If the unborn child is born alive, the attending physician has the legal obligation to take all reasonable steps necessary to maintain the life and health of the child.

"(4) The physician who is to perform the abortion or the referring physician is required to perform an ultrasound on the unborn child before the abortion. The woman has a right to view the ultrasound before an abortion. The woman shall complete a required form to acknowledge that she either saw the ultrasound image of her unborn child or that she was offered the opportunity and rejected it chose not to look at the displayed images.

"(5) She has the right to view the videotape and ultrasound of her unborn child as described in Section 26-23A-6.

"(6) Any need for anti-Rh immune globulin therapy, and if she is Rh negative, the likely consequences of refusing such therapy and the cost of the therapy.

"(7) She cannot be forced or required by anyone to have an abortion. She is free to withhold or withdraw her consent for an abortion without affecting her right to future care or treatment and without the loss of any state or federally funded benefits to which she might otherwise be entitled.

"(8) That she has the right to request a comprehensive list, compiled by the Department of Public Health, of health care providers, facilities, and clinics that offer to have ultrasounds performed by a person at least as qualified as a registered nurse licensed under the Uniform Credentialing Act, including and specifying those that offer to perform such ultrasounds free of charge. The list shall be arranged geographically and shall include the name, address, hours of operation, and telephone number of each entity. If requested by the woman, the physician who is to perform the abortion, the referring physician, or his or her agent, shall provide such a list as compiled by the department.

"(9) The abortion provider who is to perform or induce the abortion, a certified technician, or another agent of the abortion provider shall make the embryonic or fetal heartbeat of the unborn child audible for the pregnant woman to hear the heartbeat as described in Section 3 of the act adding this amendatory language.

"(c) The woman shall complete and sign a form that she has received the information of subsections (a) and (b), and does provide her informed consent for an abortion on her unborn child.

"(d) Prior to the performance of an abortion, the physician who is to perform the abortion or his or her agent shall receive the signed receipt of the certified mail dated 24 hours before the abortion, if mailed, and the signed forms that she has received the information of subsections (a) and (b) before the abortion, had the opportunity to view the video and the ultrasound of her unborn child, and provided her informed consent for an abortion. The abortion facility shall retain the signed receipt, signed forms, and the ultrasound in the woman's medical file for the time required by law, but not less than four years.

§26-23A-5.

"(a) The Department of Public Health shall publish within 180 days after October 14, 2002, and shall update on an annual basis, the following easily comprehensible printed materials:

"(1) Geographically indexed printed materials designed to inform the woman of public and private agencies and services available to provide medical and financial assistance to a woman through pregnancy, prenatal care, upon childbirth, and while her child is dependent. The materials shall include a comprehensive list of the agencies, a description of the services offered, and the telephone numbers and addresses of the agencies.

"(2) The printed materials shall include a list of adoption agencies geographically indexed and that the law permits adoptive parents to pay the cost of prenatal care, childbirth, and neonatal care.

"(3) Printed materials that inform the pregnant woman of the probable anatomical and physiological characteristics of the unborn child at two-week gestational increments from fertilization to full term. It shall include color photographs of the developing child at each of the two-week gestational increments, a clear description of the unborn child's development, any relevant information on the possibility of the unborn child's survival, and dimensions of the unborn child. The materials shall be realistic, clear, objective, non-judgmental, and designed to convey only accurate scientific information about the unborn child at the various gestational ages.

"(4) The materials shall contain objective information describing the methods of abortion procedures commonly employed and the medical risks of each, and the medical risks associated with carrying a child to term.

"(5) The printed materials shall list the support obligations of the father of a child who is born alive.

"(6) The printed materials shall state that it is unlawful for any individual to coerce a woman to undergo an abortion, that any physician who performs an abortion upon a woman without her informed consent may be liable to her for damages in a civil action at law.

"(7) The material shall include the following statement: "There are many public and private agencies willing and able to help you to carry your child to term, and to assist you and your child after your child is born, whether you choose to keep your child or place him or her for adoption. The State of Alabama strongly urges you to contact those agencies before making a final decision about abortion. The law requires that your physician or his or her agent give you the opportunity to call agencies like these before you undergo an abortion."

"(8) The material shall include the following statements: "Your chances of getting breast cancer are affected by your pregnancy history. If you have carried a pregnancy to term as a young woman, you may be less likely to get breast cancer in the future. However, you do not get the same protective effect if your pregnancy is ended by an abortion. The risk may be higher if your first pregnancy is aborted." and " If you have a family history of breast cancer or clinical findings of breast disease, you should seek medical advice from your physician before deciding whether to remain pregnant or have an abortion. It is always important to tell your doctor about your complete pregnancy history."

"(9) The materials shall include a comprehensive list of health care providers, facilities, and clinics that offer to have ultrasounds performed by a person at least as qualified as a registered nurse licensed under the Uniform Credentialing Act, including and specifying those that offer to perform such ultrasounds free of charge. The list shall be arranged geographically and shall include the name, address, hours of operation, and telephone number of each entity.

"(10) The material shall include the following statement: "Abortion terminates the life of a whole, separate, unique, living human being."

"(b) The materials in subsection (a) shall be in a bound booklet, shall contain large clear photographs, and shall be printed in a typeface large enough to be clearly legible.

"(c) The materials required under this section and the videotape described in Section 26-23A-6 shall be available to the general public, from the Department of Public Health upon request, and appropriate number to any person, facility, or hospital. The department may charge a reasonable fee based on the cost of producing the materials and videotape.

"(d) The Department of Public Health shall develop and maintain a stable Internet website to provide the information described under Section 26-23A-5. No information regarding who uses the website shall be collected or maintained. The Department of Public Health shall monitor the website on a daily basis to prevent and correct tampering."

Section 2. (a) In order for the pregnant woman to make an informed decision, at least two hours prior to a woman having any part of an abortion performed or induced, and prior to the administration of any anesthesia or medication in preparation for the abortion on the female, the physician who is to perform the abortion, or qualified technician working in conjunction with the physician, shall do the following:

(1) Provide a simultaneous explanation of what the ultrasound that is required in Section 26-23A-6(b), Code of Alabama 1975, is depicting, which shall include the presence and location of the unborn child within the uterus and the number of unborn children depicted. If the ultrasound image indicates that fetal demise has occurred, the woman shall be informed of that fact.

(2) Simultaneously display the ultrasound images so that the pregnant woman may view them.

(3) Provide a medical description of the ultrasound images, which shall include the dimensions of the embryo or fetus and the presence of external members and internal organs, if present and viewable.

(4) The specific type of ultrasound procedure used shall be determined with the consent of the woman.

(b) Nothing in this section shall be construed to prevent a pregnant woman from averting her eyes from the ultrasound images required to be provided to and reviewed with her. Neither the physician nor the pregnant woman shall be subject to any penalty if she refuses to look at the presented ultrasound images.

Section 3. (a) Prior to a woman having any part of an abortion performed or induced, and prior to the administration of any anesthesia or medication in preparation for the abortion on the female, the physician who is to perform the abortion, or qualified technician working in conjunction with the physician, if the pregnancy is at least eight weeks after fertilization, 10 weeks from the first day of the last menstrual period, shall offer the woman an opportunity to hear her unborn child's heartbeat. If the woman indicates that she would like to hear the heartbeat, it shall be made audible by using a handheld Doppler fetal monitor.

(b) If the woman has indicated that she would like to hear the unborn child's heartbeat, the physician who is to perform the abortion or the referring physician or a qualified technician working in conjunction with the physician shall not be in violation of subsection (2) if:

(1) The physician who is to perform the abortion or the referring physician or a qualified technician working in conjunction with the physician has attempted, consistent with standard medical practice, to make the embryonic or fetal heartbeat of the unborn child audible for the pregnant woman to hear using a handheld Doppler fetal monitor.

(2) That attempt does not result in the heartbeat audible.

(3) The provider has offered to attempt to make the heartbeat audible at a subsequent date.

(c) Nothing in this section shall be construed to prevent the pregnant woman from not listening to the sounds detected by the handheld Doppler fetal monitor.

Section 4. This act shall become effective on the first day of the third month following its passage and approval by the Governor, or its otherwise becoming law.


Health
Abortion
Women
Physicians
Code Amended