Abortion Laws by State — A Moving Target

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The Ever Changing Abortion Laws

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No matter where you stand on the issue, abortions are a medical procedure, so it’s under the purview of what it means to practice as a physician. Prior to even becoming a physician most medical school applicants will leap frog around state to state, with each state having it’s own politics, laws, and culture. This idea may sound odd for both US citizens who haven’t traveled much and my foreign readers. To put it bluntly, each state has its own constitution and bill of rights. Each state entered a binding agreement to join a union, hence the United part of the United States, and we are all binding together by federal law. In general, federal law trumps local state law — for example, it’s legal to buy 28 grams of marijuana if you of legal age in the states of Washington and Colorado, however it’s still against federal law so technically you can still be prosecuted by the district attorney representing the federal courts. This situation leads perplexing, and often conflicting laws that physicians must abide by that are state dependent. This is true as well for abortion, because despite a federal ruling (Roe v Wade) there’s still a contentious debate about the issue, and the results are disparate state laws.

Keeping track of the laws is a job within itself, however,  we should count ourselves lucky that Mr. Roberto Villalpando compiled a series of charts with “pretty colors”. But, remember that abortion legality and policy is a moving target so remember to check for applicable updates or revisions for your state of interest:

Temporal Allowance of Abortions: all states allowing for abortions have windows where abortions are allowed, there’s a wide spectrum in what’s considered a legal abortion.

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In some states abortions are requiring abortions to be performed at hospitals as opposed to out patient clinics — the grey states have no laws on the books specifying if they patient needs to be admitted into a hospital to have the procedure performed.

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Some states require a licensed physician to perform the abortion. States in the grey also allows for other health providers to perform abortions, for example in California both Physician Assistants and Nurse Practitioners may perform abortions without direct supervision of a licensed physician.

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Some states require a waiting period prior to abortions (typically around 24-hours). In some states this rule is waived if incest or rape occurs. These waiting periods are somewhat controversial, in some states pregnant mothers are mandated to receive “educational material” in an effort to get them to “rethink” their decision. A few states even mandate that at least two visits are required to receive an abortion. Whether you agree with the laws is a disparate issue, thus you should know that the laws exist whether you agree with them or not.

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A lot of premeds don’t know this, but in a lot of states the parents of a minor do not have to be informed that their child is receiving an abortion. Regardless of your personal beliefs do note that violating a minors privacy in some states may constitute a breach of patient rights.

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Other interesting notes on abortions laws:

* Most states have a provision allowing for a physician to refuse to give abortions due to their own personal beliefs in a life (maternal) threatening situation.

*I encourage you to become aware of your state’s law, whether you intend to stay local or travel for medical school and future potential residencies. http://www.guttmacher.org/statecenter/spibs/spib_MWPA.pdf

Source date May 1st 2014

Updates to end 2014

This year (2014) in Missouri, a bill being submitted to shape a law that would require written approval of the father consenting of the abortion to allow abortion, as stated in the bill:

 “No abortion shall be performed or induced unless and until the father of the unborn child provides written, notarized consent to the abortion.”

The bill does make one noteworthy loophole to gaining consent for women who become pregnant as the result of rape or incest: legitimate rape.As quoted in an interview, the Republican sponsor of the bill Rick Brattin defines the argument as such

“Just like any rape, you have to report it, and you have to prove it… So you couldn’t just go and say, ‘Oh yeah, I was raped’ and get an abortion. It has to be a legitimate rape.” — Rick Brattin

If you’re scratching your head about the term “legitimate rape”, you’re not alone as this author is also bewildered — I could digress into a whole other article on the term. Unfortunately for women public health and those perhaps not represented by such far-right conservative principles (especially as from 2014 until 2016 these parties will be in control of both the Senate and Congress), we should expect more laws created to chip away at Roe v. Wade in the years to come.

@doctororbust

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