Bill Text: IN HB1210 | 2011 | Regular Session | Engrossed
Bill Title: Abortion matters.
Spectrum: Moderate Partisan Bill (Republican 49-6)
Status: (Passed) 2011-05-16 - SECTIONS 2 through 16 effective 07/01/2011 [HB1210 Detail]
Download: Indiana-2011-HB1210-Engrossed.html
Citations Affected: IC 16-18; IC 16-34.
Effective: July 1, 2011.
Wolkins, Yarde
(SENATE SPONSORS _ MILLER, WALKER, BANKS, SCHNEIDER, YODER)
January 12, 2011, read first time and referred to Committee on Public Health.
February 3, 2011, reassigned to Committee on Public Policy.
February 17, 2011, amended, reported _ Do Pass.
March 28, 2011, read second time; call withdrawn.
March 29, 2011, re-read second time, amended, ordered engrossed.
March 30, 2011, engrossed. Read third time, passed. Yeas 72, nays 23.
March 31, 2011, read first time and referred to Committee on Health and Provider Services.
April 14, 2011, amended, reported favorably _ Do Pass.
Digest Continued
a fetus feeling pain and a compelling state interest in protecting the fetus. Sets requirements for performing an abortion after the first trimester but before the earlier of viability of the fetus or 20 weeks of postfertilization age of the fetus (current law requirements are based on viability of the fetus). Requires that a physician determine the postfertilization age of a fetus before performing an abortion, and allows for the discipline of a physician who fails to do this in certain circumstances. Adds information that a pregnant woman must be informed of orally and in writing (current law requires that the information be given only orally) before an abortion may be performed concerning the physician, risks involved, information concerning the fetus, available assistance, and existing law. Requires a pregnant woman seeking an abortion to view fetal ultrasound imaging unless the pregnant woman states in writing that the pregnant woman does not want to view the fetal ultrasound imaging. Requires a physician who performs an abortion to: (1) have admitting privileges at a hospital in the county or in a contiguous county to the county where the abortion is performed; or (2) enter into an agreement with a physician who has admitting privileges in the county or contiguous county; and notify the patient of the hospital location where the patient can receive follow-up care by the physician. Requires the state department of health to post Internet website links on the state department's web site to materials setting forth certain information concerning a fetus and abortion.
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A BILL FOR AN ACT to amend the Indiana Code concerning
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(1) There is substantial medical evidence that a fetus at twenty (20) weeks of postfertilization age has the physical structures necessary to experience pain.
(2) There is substantial medical evidence that a fetus of at least twenty (20) weeks of postfertilization age seeks to evade certain stimuli in a manner similar to an infant's or adult's response to pain.
(3) Anesthesia is routinely administered to a fetus of at least twenty (20) weeks of postfertilization age when prenatal surgery is performed.
(4) A fetus has been observed to exhibit hormonal stress responses to painful stimuli earlier than at twenty (20) weeks of postfertilization age.
(b) Indiana asserts a compelling state interest in protecting the life of a fetus from the state at which substantial medical evidence indicates that the fetus is capable of feeling pain.
(1) During the first trimester of pregnancy for reasons based upon the professional, medical judgment of the pregnant woman's physician if:
(A) the abortion is performed by the physician;
(B) the woman submitting to the abortion has filed her consent with her physician. However, if in the judgment of the physician the abortion is necessary to preserve the life of the woman, her consent is not required; and
(C) the woman submitting to the abortion has filed with her physician the written consent of her parent or legal guardian if required under section 4 of this chapter.
(2) After the first trimester of pregnancy and before the earlier of viability of the fetus or twenty (20) weeks of postfertilization age, for reasons based upon the professional, medical judgment
of the pregnant woman's physician if:
(A) all the circumstances and provisions required for legal
abortion during the first trimester are present and adhered to;
and
(B) the abortion is performed in a hospital or ambulatory
outpatient surgical center (as defined in IC 16-18-2-14).
(3) Except as provided in subsection (b), at the earlier of
viability of the fetus or twenty (20) weeks of postfertilization
age and any time after, viability of the fetus, for reasons based
upon the professional, medical judgment of the pregnant woman's
physician if:
(A) all the circumstances and provisions required for legal
abortion before the earlier of viability of the fetus or twenty
(20) weeks of postfertilization age are present and adhered
to;
(B) the abortion is performed in compliance with section 3 of
this chapter; and
(C) before the abortion the attending physician shall certify in
writing to the hospital in which the abortion is to be
performed, that in the attending physician's professional,
medical judgment, after proper examination and review of the
woman's history, the abortion is necessary to prevent a
substantial permanent impairment of the life or physical health
of the pregnant woman. All facts and reasons supporting the
certification shall be set forth by the physician in writing and
attached to the certificate.
(b) A person may not knowingly or intentionally perform a partial
birth abortion unless a physician reasonably believes that:
(1) performing the partial birth abortion is necessary to save the
mother's life; and
(2) no other medical procedure is sufficient to save the mother's
life.
(1) At least eighteen (18) hours before the abortion and in the presence of the pregnant woman, the physician who is to perform the abortion, the referring physician or a physician assistant (as
defined in IC 25-27.5-2-10), an advanced practice nurse (as
defined in IC 25-23-1-1(b)), or a midwife (as defined in
IC 34-18-2-19) to whom the responsibility has been delegated by
the physician who is to perform the abortion or the referring
physician has orally informed the pregnant woman orally and in
writing of the following:
(A) The name of the physician performing the abortion, the
physician's medical license number, and an emergency
telephone number where the physician or the physician's
designee may be contacted on a twenty-four (24) hour a
day, seven (7) day a week basis.
(B) That follow-up care by the physician or the physician's
designee (if the designee is licensed under IC 25-22.5) and
is available on an appropriate and timely basis when
clinically necessary.
(B) (C) The nature of the proposed procedure. or treatment.
(C) (D) The objective scientific evidence of the risks of and
alternatives to the procedure, or treatment. including:
(i) the risk of infection and hemorrhage;
(ii) the potential danger to a subsequent pregnancy; and
(iii) the potential danger of infertility.
(E) That human physical life begins when a human ovum
is fertilized by a human sperm.
(D) (F) The probable gestational age of the fetus at the time
the abortion is to be performed, including: an offer to
provide:
(i) a picture or drawing of a fetus;
(ii) the dimensions of a fetus; and
(iii) relevant information on the potential survival of an
unborn fetus;
at this stage of development.
(G) That objective scientific medical evidence shows that
a fetus can feel pain at or before twenty (20) weeks of
postfertilization age.
(E) (H) The medical risks associated with carrying the fetus to
term.
(F) (I) The availability of fetal ultrasound imaging and
auscultation of fetal heart tone services to enable the pregnant
woman to view the image and hear the heartbeat of the fetus
and how to obtain access to these services.
(J) That the pregnancy of a child less than fifteen (15)
years of age may constitute child abuse under Indiana law
and must be reported to the department of child services
or the local law enforcement agency under IC 31-33-5.
(2) At least eighteen (18) hours before the abortion, the pregnant
woman will be orally informed orally and in writing of the
following:
(A) That medical assistance benefits may be available for
prenatal care, childbirth, and neonatal care from the county
office of the division of family resources.
(B) That the father of the unborn fetus is legally required to
assist in the support of the child. In the case of rape, the
information required under this clause may be omitted.
(C) That adoption alternatives are available and that adoptive
parents may legally pay the costs of prenatal care, childbirth,
and neonatal care.
(D) That there are physical risks to the pregnant woman in
having an abortion, both during the abortion procedure
and after.
(E) That Indiana has enacted the safe haven law under
IC 31-34-2.5.
(F) That materials developed by the state department in
section 1.5 of this chapter:
(i) will be provided to the pregnant woman by the
physician providing the abortion as a hard copy;
(ii) are available on the state department's Internet web
site;
(iii) provide objective scientific information about the
unborn child; and
(iv) list agencies in the area that offer alternatives to
abortion, including agencies that offer alternatives to
abortion at no cost to the pregnant woman.
(3) The pregnant woman certifies in writing, before the abortion
is performed, that:
(A) the information required by subdivisions (1) and (2) has
been provided to the pregnant woman;
(B) the pregnant woman has been offered the opportunity
to view the fetal ultrasound imaging and hear the
auscultation of the fetal heart tone if the fetal heart tone is
audible and that the woman has:
(i) viewed or refused to view the offered fetal ultrasound
imaging; and
(ii) listened to or refused to listen to the offered
auscultation of the fetal heart tone if the fetal heart tone
is audible; and
(C) the pregnant woman has been given a written copy of
the printed materials described in section 1.5 of this
chapter.
(b) Before an abortion is performed, the pregnant woman may, upon
the pregnant woman's request, shall view the fetal ultrasound imaging
and hear the auscultation of the fetal heart tone if the fetal heart tone is
audible unless the pregnant woman certifies in writing, before the
abortion is performed, that the pregnant woman does not want to
view the fetal ultrasound imaging.
(b) The state department shall post Internet web site links relating to materials that include the following:
(1) Objective scientific information concerning the probable anatomical and physiological characteristics of a fetus every two (2) weeks of gestational age, including the following:
(A) Realistic pictures in color for each age of the fetus, including the dimensions of the fetus.
(B) Whether there is any possibility of the fetus surviving outside the womb.
(2) Objective scientific information concerning the medical risks associated with each abortion procedure, including the following when medically accurate:
(A) The risks of infection and hemorrhaging.
(B) The potential danger:
(i) to a subsequent pregnancy; or
(ii) of infertility.
(3) Information concerning the medical risks associated with carrying the child to term.
(4) Information that medical assistance benefits may be available for prenatal care, childbirth, and neonatal care.
(5) Information that the biological father is liable for assistance in support of the child, regardless of whether the biological father has offered to pay for an abortion.
(6) Information regarding telephone 211 dialing code services for accessing human services as described in IC 8-1-19.5, and the types of services that are available through this service.
(c) In complying with subsection (b)(6), the state department
shall consult with the recognized 211 service providers and the
Indiana utility regulatory commission as required by IC 8-1-19.5-9.
(1) Determine in accordance with accepted medical standards the postfertilization age of the fetus and which trimester the pregnant woman receiving the abortion is in.
(2) Determine whether the fetus is viable.
(3) Certify that determination as part of any written reports required of the attending physician by the state department or the facility in which the abortion is performed.
(b) In making a determination under this section of the postfertilization age of the fetus, the attending physician shall do the following:
(1) Question the patient concerning the date of fertilization.
(2) Perform or cause to be performed medical examinations and tests that a reasonably prudent physician would conduct to accurately diagnose the postfertilization age of the fetus.
(c) Except in the case of a medical emergency (as described in section 0.5 of this chapter), a physician that violates this section is subject to disciplinary action under IC 25-1-9.
(1) governed by section 1(a)(3) and 1(b) of this chapter;
(2) performed in a hospital having premature birth intensive care units, unless compliance with this requirement would result in an increased risk to the life or health of the mother; and
(3) performed in the presence of a second physician as provided in subsection (b).
(b) An abortion may be performed after the earlier of the time a fetus is viable or the time the postfertilization age of the fetus is at least twenty (20) weeks only if there is in attendance a physician, other than the physician performing the abortion, who shall take control of and provide immediate care for a child born alive as a result of the abortion. During the performance of the abortion, the physician performing the abortion, and after the abortion, the physician required by this subsection to be in attendance, shall take all reasonable steps in
keeping with good medical practice, consistent with the procedure
used, to preserve the life and health of the viable unborn child.
However, this subsection does not apply if compliance would result in
an increased risk to the life or health of the mother.
(c) Any fetus born alive shall be treated as a person under the law,
and a birth certificate shall be issued certifying the child's birth even
though the child may subsequently die, in which event a death
certificate shall be issued. Failure to take all reasonable steps, in
keeping with good medical practice, to preserve the life and health of
the live born person shall subject the responsible persons to Indiana
laws governing homicide, manslaughter, and civil liability for wrongful
death and medical malpractice.
(d) If, before the abortion, the mother, and if married, her husband,
has or have stated in writing that she does or they do not wish to keep
the child in the event that the abortion results in a live birth, and this
writing is not retracted before the abortion, the child, if born alive, shall
immediately upon birth become a ward of the department of child
services.
(b) A minor:
(1) who objects to having to obtain the written consent of her parent or legal guardian under this section; or
(2) whose parent or legal guardian refuses to consent to an abortion;
may petition, on her own behalf or by next friend, the juvenile court in the county in which the pregnant woman resides or in which the abortion is to be performed, for a waiver of the parental consent requirement under subsection (a). A next friend may not be a physician or provider of abortion services, representative of the physician or provider, or other person that may receive a direct financial benefit from the performance of an abortion.
(c) A physician who feels that compliance with the parental consent requirement in subsection (a) would have an adverse effect on the welfare of the pregnant minor or on her pregnancy may petition the juvenile court within twenty-four (24) hours of the abortion request for a waiver of the parental consent requirement under subsection (a).
(d) The juvenile court must rule on a petition filed by a pregnant
minor under subsection (b) or by her physician under subsection (c)
within forty-eight (48) hours of the filing of the petition. Before ruling
on the petition, the court shall consider the concerns expressed by the
pregnant minor and her physician. The requirement of parental consent
under this section shall be waived by the juvenile court if the court
finds that the minor is mature enough to make the abortion decision
independently or that an abortion would be in the minor's best interests.
(e) Unless the juvenile court finds that the pregnant minor is already
represented by an attorney, the juvenile court shall appoint an attorney
to represent the pregnant minor in a waiver proceeding brought by the
minor under subsection (b) and on any appeals. The cost of legal
representation appointed for the minor under this section shall be paid
by the county.
(f) A minor or her physician who desires to appeal an adverse
judgment of the juvenile court in a waiver proceeding under subsection
(b) or (c) is entitled to an expedited appeal, under rules to be adopted
by the supreme court.
(g) All records of the juvenile court and of the supreme court or the
court of appeals that are made as a result of proceedings conducted
under this section are confidential.
(h) A minor who initiates legal proceedings under this section is
exempt from the payment of filing fees.
(i) This section shall not apply where there is an emergency need for
a medical procedure to be performed such that continuation of the
pregnancy provides an immediate threat and grave risk to the life or
health of the pregnant woman and the attending physician so certifies
in writing.
(1) has admitting privileges at a hospital located in the county where abortions are provided or a contiguous county; or
(2) has entered into an agreement with a physician who has admitting privileges at a hospital in the county or contiguous county concerning the management of possible complications of the services provided.
(b) A physician who performs an abortion shall notify the patient of the location of the hospital at which the physician or a physician with whom the physician has entered into an agreement under subsection (a)(2) has admitting privileges and where the patient may receive follow-up care by the physician if
complications arise.
(1) The age of the woman who is aborted.
(2) The place where the abortion is performed.
(3) The full name and address of the physicians performing the abortion.
(4) The name of the father if known.
(5) The postfertilization age of the fetus, the manner in which the postfertilization age was determined, and if after the earlier of the time the fetus obtains viability or the time the postfertilization age of the fetus is at least twenty (20) weeks, the medical reason for the abortion.
(6) The medical procedure employed to administer the abortion, and if the medical procedure performed on a fetus who is viable or has a postfertilization age of at least twenty (20) weeks:
(A) whether the method of abortion used was a method, that in the reasonable judgment of a physician, would provide the best opportunity for the fetus to survive; and
(B) the basis for the determination that the pregnant woman had a condition described in this chapter that required the abortion to avert the death of or serious impairment to the pregnant woman.
(7) The mother's obstetrical history, including dates of other abortions, if any.
(8) The results of pathological examinations if performed.
(9) Information as to whether the fetus was delivered alive.
(10) Records of all maternal deaths occurring within the health facility where the abortion was performed.
(b) The form provided for in subsection (a) shall be completed by the physician performing the abortion and shall be transmitted to the state department not later than July 30 for each abortion performed in the first six (6) months of that year and not later than January 30 for
each abortion performed for the last six (6) months of the preceding
year. Each failure to file the form on time as required is a Class B
misdemeanor.
(c) Not later than June 30 of each year, the state department
shall compile a public report providing the following:
(1) Statistics for the previous calendar year from the
information submitted under this section.
(2) Statistics for previous calendar years compiled by the state
department under this subsection, with updated information
for the calendar year that was submitted to the state
department after the compilation of the statistics.
The state department shall ensure that no identifying information
of a pregnant woman is contained in the report.
