ALABAMA REPRESENTATIVE PROPOSES THAT THE STATE REQUIRE ABORTION DOCTORS TO COMMIT MEDICAL MALPRACTICE

“We Dare Defend Our Rights”

Rep. Kerry Rich (R-Albertville) has no expertise in obstetrics, but that never stopped him from sponsoring anti-abortion bills which are unconstitutional and contrary to experts’ recommendations. In 2013, Rich was named “Legislator of the Year” by the Christian Coalition of Alabama, an extremist organization which does not represent the views of mainline Christian denominations and is intolerant of the views of other religious groups.

Alabama Rep. Kerry Rich (R-Albertville)

This session, Rep. Rich filed HB317 which seeks to regulate medication abortion. The bill appears to have been written without regard to the opinions of experts in the field of medication abortions. Lay terminology (“unborn child”) is used instead of correct scientific nomenclature (“embryo” or “fetus”).

Medication abortions are available up to 70 days after the first day of the last menstrual period. This is during the embryonic phase of gestation. Two drugs are used in a medication abortion: mifepristone and misoprostol. Women take the first drug in the clinic or at home. Mifepristone blocks progesterone needed to continue the pregnancy. The second drug, misoprostol, is taken 24 to 48 hours later to expel the embryo and placenta from the uterus.

Mifepristone and misoprostol combination pack.

Rep. Rich’s bill requires a physician to inform patients that medication abortion is reversible. This must be said in person, or by telephone (but not mail or email), prior to dispensing the medication. Written notification must be given again after dispensing the medication. That notice must say:

“Recent developing research has indicated that mifepristone alone is not always effective in ending a pregnancy. It may be possible to avoid, cease, or even reverse the intended effects of a chemical abortion using mifepristone if the second pill has not been taken. Please consult with a health care professional immediately.”

Opponents of legal abortion have claimed that women can take progesterone after the first medication to stop the abortion. Their evidence is anecdotal. No scientific studies support their claims. The American College of Obstetricians and Gynecologists and the American Medical Association have rejected claims that a medication abortion may be reversed.

In response to these claims, the University of California at Davis undertook a study in 2019 and published its findings in Obstetrics and Gynecology. Women who planned to have surgical abortions were enrolled in the study. All took 200 mg. of mifepristone. Twenty-four hours later they took either oral progesterone or a placebo. Follow up sonograms and blood tests were performed until the women had their surgical abortions, or earlier if the embryo had no cardiac activity or the gestational sac was expelled. After twelve patients were enrolled in the study, it was ended out of safety concerns for the patients. Three women had hemorrhaged. The scientists could not estimate the efficacy of progesterone to stop the effects of mifepristone. What was clear was that patients who use only mifepristone without misoprostol may be at high risk of significant hemorrhage.

Not only is the statement proposed by Rep. Rich inaccurate, it may endanger the lives of women who fail to take the second drug.

Bear in mind that patients seek, schedule, travel to, consent to, and pay for their medication abortions. As required by Alabama law, before an abortion of pregnancy can take place, patients must visit the clinic twice, and are given a copy of the Alabama “Women’s Right to Know” Act at least 48 hours before medication is given. Patients are advised how medication abortion works, what to expect, and the risks. Consent forms are signed. If a patient voices reluctance or doubts about her desire for an abortion, the medication will not be dispensed.

The proposed law states that if this procedure is not followed, the abortion provider may be prosecuted for a Class C felony. The penalty is a sentence of one year and one day to ten years imprisonment, and a fine up to $15,000. A felony conviction could cost a medical doctor her license.

There are other issues with Rep. Rich’s bill, but the scientific flaws should doom it. The State of Alabama will have to defend this law in court. As Alabama will not be able to produce any expert scientific testimony to support the law, it will be held unconstitutional. The state will be required to pay the plaintiffs attorneys’ fees and expenses.

Harassment of Doctors

A second portion of the bill creates a new civil suit which invites abuse of the judicial system. The patient, who signed a medical consent form for her medication abortion and whose pregnancy was safely aborted, may thereafter sue her doctor for failing to provide her with false and dangerous information. As she was not harmed, she won’t be able to prove damages.

Men who claim to have impregnated a patient, and in limited circumstances, the patient’s or the man’s parents, can file suit if the patient wasn’t twice told that her medication abortion could be reversed. None of these people would normally have a case. A man can’t successfully sue a doctor because he disapproves of a woman’s legal abortion. He has suffered no legal harm.

These suits will be brought solely to harass doctors who provide a needed, safe, and legal service to consenting patients. Doctors will win their cases, but at great expense, personally and financially. This bill does not provide for unsuccessful plaintiffs to pay the defendant’s attorneys’ fees and expenses, or intentional infliction of emotional distress.

Maybe that is the point of the bill.

Twitter @ALReproRightsAd Retired attorney in Alabama, women’s reproductive rights & ethical government advocate.

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