Texas Independent, April 18, 2012 by Mary Tuma
A proposed requirement by the state’s health services department would force doctors to collect detailed information about Texas women who seek abortions. Initially drawn up by Republican Rep. Bill Zedler during the 82nd legislative session, the new requirements would expand the scope of what a doctor must report to the state when performing an abortion. While health officials say the rules are important for demographic reasons, some pro-choice advocates and OB/GYNs argue the additional reports only serve to create a burdensome and intimidating climate for abortion-providing physicians.
Currently, doctors must disclose to the state information about the patient’s marital status, race, age and number of prior abortions and births. The “updated” requirements add data like the woman’s highest level of education, how she verified the pregnancy, the date of her last menstrual cycle, whether or not the woman viewed printed health materials (such as the controversial “Woman’s Right to Know” pamphlet) prior to the abortion and whether the ultrasound image of the fetus, a description of the image and an audible heartbeat were made available by the doctor.
Zedler’s original legislation, HB 1602, would have required the collection of even more granular details. The information was desired to maintain enough statistical data to, “aid in providing proper maternal health assistance, regulation, and education,” for women, according to the bill text. Zedler called for data on the age of the unborn child’s father, the method of contraception used that led to the pregnancy, why the woman chose to have an abortion (in checklist form), the number of miscarriages the woman has undergone and specific information regarding the woman’s educational background, among other particulars. The representative did not return calls for comment.
Zedler’s bill didn’t make it through a GOP super majority House last session, but is seeing new life through the Department of State Health Services (DSHS)–a move drawing criticism from abortion providers and pro-choice advocates who see the maneuver as both intrusive and a bypass of the legislative process, reproductive rights news site RH Reality Check recently reported.
During a DSHS stakeholder meeting earlier this month, the point of most concern among the groups was a requirement that forces doctors to report any complications caused by the procedure within 20 days. Since abortion facilities are already required to report such complications to the state department, meeting attendees called the new rule, “redundant and potentially intimidating.”
Dr. Curtis Boyd, a Texas-based abortion provider and OB/GYN, echoed these concerns. Boyd told the Texas Independent the proposed rule was not only repetitive but would exacerbate an increasingly hostile environment for the state’s abortion providers and their patients. While current requirements mandate facilities report information, the new rule would target individual, private-care doctors likely unfamiliar with the reporting process.
“This is going to discourage doctors from providing abortion services,” said Boyd. “There will be a fear that they may be identified and open to harassment, or penalized for not reporting certain information. Why aren’t they asking for additional reporting in other specialties? This is not about public health or patient health, this is about ensuring one legislator’s anti-abortion agenda is pushed through.”
Boyd pointed to the state’s recently enacted sonogram law–a requirement that forces abortion providers to show and describe the heartbeat of the fetus before the procedure–as evidence this new rule is just one more attempt to intimidate abortion physicians. Failure to comply with the law can result in criminal charges, a hefty fine and revocation of medical licenses. There is no warning, no caution, no inspection–the punishment is meant to intimidate the doctor, said Boyd.
“Like the sonogram law we’ve been dealing with as physicians, these rules are another way to shame and guilt women and their doctors,” he said. “It’s disrespectful to women. There is no doubt this is anti-abortion, anti-birth control and anti-woman.”
The most “disturbing” aspect, says Boyd, is that after failing to cull enough support during session, the bill language managed to evade the legislative process and debate and be sent directly to the state’s health department for rulemaking.
“Clearly this legislator has his own anti-abortion agenda and instead of using the democratic process he has gone around to the state and asked for a pass,” said Boyd. “Is this going to lead to other legislators pushing bills without going through the process?”
But Department of Health and Human Services (DSHS) spokesperson Carrie Williams said the course of action isn’t abnormal. During special session, the DSHS, along with the Health and Human Services Commission agreed to look at Zedler’s proposed additional requirements and figure out if they could possibly adopt some of those elements by rule, she said.
“It’s common for us to take stakeholder and legislative input at any point in time,” said Williams. “We are always in the rule writing process. We are required by law to make sure our rules are evolving and regulating the best interest of patients. Our goal is to make improvements based on public health expertise and regulatory function.”
As for concern over making sensitive patient information available for public view, the DSHS says the law is highly restrictive about what information can be provided. For instance, while data may be viewable online, the identity of the doctor, facility and patient is kept confidential.
Drafted language of the proposed rule was presented earlier this month. DSHS plans to present the final copy of the updated requirements to its decision-making committee on June 14. Williams says the new rule is a work in progress and the department is in the process of collecting feedback and taking comments under consideration. “It’s a launching off point. We are open for discussion and can make adjustments as we move forward,” she said.