Health

Anti-Abortion Bill Would Force Doctors To Send Private Medical Records, Including Images, To The State

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A piece of anti-abortion legislation currently advancing in North Carolina contains an unusual provision that critics say could be used to intimidate doctors who provide abortion services after the first trimester.

Under HB 465, physicians would be required to report detailed information about miscarriages and abortions to North Carolina’s Department of Health and Human Services if their patient’s pregnancy ends after 18 weeks.

“A physician who advises, procures, or causes a miscarriage or abortion after the eighteenth week of a woman’s pregnancy shall record all of the following: the method used by the physician to determine the probable gestational age of the unborn child at the time the procedure is to be performed; the results of the methodology, including the measurements of the unborn child; and an ultrasound image of the unborn child that depicts the measurements,” the legislation stipulates.

Proponents of reproductive rights are worried that’s specifically designed to target abortion doctors, leaving them vulnerable to potential lawsuits from state officials who may allege they performed an abortion on a fetus that’s too far along. There’s also some concern that keeping a file of ultrasound images in the state health department would raise issues of privacy and doctor-patient confidentiality.

“When I first read the bill, this was the provision that frightened me the most,” North Carolina Sen. Terry Van Duyn (D), who’s currently the Democratic Whip, told ThinkProgress in an interview. “It seems to be all about intimidating physicians. The state legislature is setting them up for potential prosecution. I don’t care what it says about privacy in the bill — we know what the end game is.”

HB 465 also seeks to impose a 72-hour waiting period on patients seeking an abortion, which is the aspect of the bill that’s gotten the most media attention so far. The measure has been rapidly advancing through the legislature and is set to come up for debate in the state Senate this week.

Waiting period and ultrasound requirements have become widespread in states that are traditionally hostile to reproductive rights. Lawmakers in North Carolina, in fact, have already attempted to impose one of the most far-reaching ultrasound laws in the country, requiring doctors to describe the image in detail even if the patient chooses to close their eyes to avoid looking at it. That law was struck down last year for violating doctor’s First Amendment rights.

According to the Guttmacher Institute, a think tank that tracks state-level abortion legislation, it’s much more unusual for states to require abortion doctors to file patients’ ultrasound images with the health department. Just Oklahoma and Louisiana currently have this policy in place, and it’s unclear what medical purpose it intends to serve. Elizabeth Nash, the senior states issues associate at the Guttmacher Institute, told ThinkProgress via email that she’s not aware of “a single reason that would require a copy of the image to be sent to the state.”

“HB 465 goes too far in demanding that private images from women’s medical files be shared with the government,” Melissa Reed, the vice president of public policy at Planned Parenthood South Atlantic, told ThinkProgress via email. “There is no other law in North Carolina that requires health care providers to provide copies of any other type of medical image to the state, making it clear that the true intent of this measure is to allow the government to second-guess physicians’ medical determinations and shame women for their medical decisions.”

When state legislatures get involved in tightening the reporting requirements for abortions and miscarriages, there’s often some concern about whether that information will be used to criminalize pregnancy outcomes. As pregnant women and their doctors are turned into potential suspects in the eyes of the law, it gives state officials more power to scrutinize health outcomes — which can represent the first step toward prosecuting patients for allegedly illegally ending a pregnancy.

HB 465 originally included yet another potentially far-reaching provision. Last month, the bill sparked controversy for attempting to prevent teachers at the University of North Carolina at Chapel Hill — one of the top medical schools in the country — from training OB-GYN residents to provide abortion services. After significant pushback from the academic community, lawmakers in the House removed that part of the legislation, refocusing the conversation on the 72-hour wait.

Progressive groups in the state are pressuring Gov. Pat McCrory (R) to veto HB 465 if it gets to his desk, pointing out that the governor made a campaign promise to avoid enacting further restrictions on abortion. This week, they held a press conference in Charlotte in front of a large billboard imploring McCrory not to break that promise, the beginning of a state-wide campaign that will travel to seven additional locations.

“We find this to be medically unnecessary, we find this to be bad medicine, we find this to be bad law and bad for the people of North Carolina,” Shoshannah Sayers, the interim executive director of NARAL Pro-Choice North Carolina, said at that event.

Van Duyn told ThinkProgress she’s glad the legislation is getting coverage, but suspects the ultrasound reporting requirement may be slipping under the radar.

“The three-day waiting period is easier to talk about. But this, I think, is a little bit more subtle and something that the five o’clock news isn’t going to cover,” Van Duyn said.