CONNECTICUT - TERMINATION OF PREGNANCY (ABORTION)

January 1, 2008

State laws and regulations that affect your medical practice

1. What are the restrictions on the performance of abortions by physicians?

(a) The decision to terminate a pregnancy prior to the viability of the fetus shall be solely that of the pregnant woman in consultation with her physician.

CT ADC § 19a-602(a)

CT ADC § 19-13-D54(a)

( c ) All induced abortions after the second trimester as verified by ultrasound, last menstrual period and pelvic exam, shall be done only in a licensed hospital with a department of obstetrics and gynecology and a department of anesthesiology.

CT ADC § 19-13-D54( c )

(d) No abortion may be performed upon a pregnant woman after viability of the fetus (i.e., during the third trimester of pregnancy), except when necessary to preserve the life or health of the pregnant woman.

C.G.S.A. § 19a-602(b)

2. What are the reporting requirements for abortions?

All induced abortions will be reported within seven days by the physician performing the procedure to the state commissioner of public health who will maintain such reports in a confidential file and use them only for statistical purposes except in cases involving licensure. Such reports will specify the date of abortion, place where performed, age of woman and town and state of residence, approximate duration of pregnancy, method of abortion, and explanation of any complications. The name of the woman will not be given. These records will be destroyed within two years after date of receipt.

CT ADC § 19-13-D54(b)

3. What are the requirements for outpatient clinics which offer abortion services?

Outpatient clinics which offer abortion services shall comply with the following provisions:

(a) Facilities, equipment and care shall be consistent with the national standards of the American College of Obstetrics and Gynecology.

(b) Any woman seeking an abortion shall be given:

(1) Verification of the diagnosis and duration of pregnancy, including preoperative history and physical examination;

(2) Information and an explanation of the procedure to be followed in accordance with subsection ( c ) of this section;

(3) Counseling about her decision;

(4) Laboratory tests, including blood grouping and Rh factor;

(5) Preventive therapy if at risk for Rh sensitization;

(6) Examination of tissue by a pathologist;

(7) Consultation as to the need for follow-up care;

(8) Information on family planning;

(9) A written discharge summary which indicates the patient's status and discharge plan, signed by both the patient and a licensed or certified health care provider, a copy of which shall be given to the patient and a copy shall be retained as part of the medical record; and

(10) Information regarding access to her medical record, which shall include a statement of patient confidentiality and the requirement for written consent for release of information to persons not otherwise authorized by law to access the record.

( c ) Prior to performing an abortion, a counselor shall obtain informed consent from the woman seeking to have the abortion. Informed consent shall exist only when a consent form is completed voluntarily and in accordance with the following provisions:

(1) An individual who obtains informed consent from a woman for an abortion procedure shall:

(i) Offer to answer any questions the patient may have concerning the procedure;

(ii) Provide a copy of the informed consent form to the patient;

(iii) Provide all of the following information orally to the patient:

(a) A thorough explanation of the procedures to be performed; and

(b) A full description of the discomforts and risks that may accompany or follow the performance of the procedure; and

(iv) Assure the patient that an interpreter is provided to assist the patient if she does not understand the language used on the consent form or the language used by the counselor obtaining consent.

(2) A consent form shall clearly spell out in language the patient can understand the nature and consequences of the procedure which shall be used.

(3) The consent form shall be signed and dated by:

(i) The patient;

(ii) The interpreter, if one is provided;

(iii) The counselor who obtains the consent; and

(iv) The physician who will perform the procedure.

(d) Staff qualifications:

(1) All counselors in an abortion clinic shall have background preparation in social work, psychology, counseling, nursing, or ministry. Such preparation shall have been obtained in formal course work or through in-service staff training.

(2) Those counselors who do not have a graduate degree in any of the above mentioned fields shall be supervised by a person with such a graduate degree. Such supervision shall consist of the direction, inspection, and on-site observation of the activities of the counselors in performance of their duties.

(e) All abortion clinics shall implement a written quality assurance and risk management program which shall include but not necessarily be limited to the following components:

(1) Annual program objectives and evaluation;

(2) Quarterly clinical record review;

(3) Annual documentation of clinical competence of professional staff; and

(4) Annual outcome audits.

(f) Each clinic shall formulate and implement when necessary a plan for the safety of the patients in the event of fire, natural and other disasters, and bomb threat.

(1) Fire: A written plan shall include but not necessarily be limited to:

(i) Posted fire evacuation plans in prominent areas showing two evacuation routes;

(ii) Fire drills conducted at unexpected times, at least quarterly on each shift;

(iii) A written record of each fire drill including date, time, personnel in attendance and evaluation;

(iv) Tasks and responsibilities assigned to all personnel; and

(v) An annual review and acceptance of the plan by the local fire marshal.

(2) Natural and other disasters: A written plan shall include but not necessarily be limited to:

(i) Policies for internal and external disasters;

(ii) Notification of designated persons;

(iii) Orderly patient removal and relocation if required;

(iv) Accountability of patients and staff during evacuation; and

(v) Patient notification in the event of an interruption in services.

(3) Bomb threat: A written plan shall include but not necessarily be limited to:

(i) Collection of all information from the caller by the recipient of the call;

(ii) Notification of emergency and administrative personnel;

(iii) Total communication and coordination between emergency and facility personnel;

(iv) Responsibilities of all staff during bomb threat;

(v) Orderly patient removal and relocation if required; and

(vi) Accountability of patients and staff during evacuation.

CT ADC § s 19a-116-1

4. May a physician refuse to perform an abortion?

Yes. No person shall be required to participate in any phase of an abortion that violates his or her judgment, philosophical, moral or religious beliefs.

CT ADC § s 19-13-D54(f)

5. What procedures must be followed if a newborn shows signs of life following an abortion?

If the newborn shows signs of life following an abortion, those measures used to support life in a premature infant shall be employed.

CT ADC § s 19-13-D54

6. What procedures must be followed for a minor seeking an abortion?

(a) Prior to the performance of an abortion upon a minor, a physician or counselor shall provide pregnancy information and counseling in accordance with this section in a manner and language that will be understood by the minor. The physician or counselor shall:

(1) Explain that the information being given to the minor is being given objectively and is not intended to coerce, persuade or induce the minor to choose to have an abortion or to carry the pregnancy to term;

(2) Explain that the minor may withdraw a decision to have an abortion at any time before the abortion is performed or may reconsider a decision not to have an abortion at any time within the time period during which an abortion may legally be performed;

(3) Explain to the minor the alternative choices available for managing the pregnancy, including: (a) carrying the pregnancy to term and keeping the child; (b) carrying the pregnancy to term and placing the child for adoption, placing the child with a relative or obtaining voluntary foster care for the child, and ( c ), having an abortion, and explain that public and private agencies are available to assist the minor with whichever alternative she chooses and that a list of these agencies and the services available from each will be provided if the minor requests;

(4) Explain that public and private agencies are available to provide birth control information and that a list of these agencies and the services available from each will be provided if the minor requests;

(5) Discuss the possibility of involving the minor's parents, guardian or other adult family members in the minor's decision-making concerning the pregnancy and whether the minor believes that involvement would be in the minor's best interests; and

(6) Provide adequate opportunity for the minor to ask any questions concerning the pregnancy, abortion, child care and adoption, and provide information the minor seeks or, if the person cannot provide the information, indicate where the minor can receive the information.

(b) After the person provides the information and counseling to a minor as required by this section, such person shall have the minor sign and date a form stating that:

(1) The minor has received information on alternatives to abortion and that there are agencies that will provide assistance and that a list of these agencies and the services available from each will be provided if the minor requests;

(2) The minor has received an explanation that the minor may withdraw an abortion decision or reconsider a decision to carry a pregnancy to term;

(3) The alternatives available for managing the pregnancy have been explained to the minor;

(4) The minor has received an explanation about agencies available to provide birth control information and that a list of these agencies and the services available from each will be provided if the minor requests;

(5) The minor has discussed with the person providing the information and counseling the possibility of involving the minor's parents, guardian or other adult family members in the minor's decision-making about the pregnancy;

(6) If applicable, the minor has determined that not involving the minor's parents, guardian or other adult family members is in the minor's best interests; and

(7) The minor has been given an adequate opportunity to ask questions.

( c ) The person providing the information and counseling shall also sign and date the form and shall include such person's business address and business telephone number. The person shall keep a copy for such minor's medical record and shall give the form to the minor or, if the minor requests and if such person is not the attending physician, transmit the form to the minor's attending physician. Such medical record shall be maintained as otherwise provided by law.

(d) The provision of pregnancy information and counseling by a physician or counselor which is evidenced in writing containing the information and statements provided in this section and which is signed by the minor shall be presumed to be evidence of compliance with the requirements of this section.

(e) The requirements of this section shall not apply when, in the best medical judgment of the physician based on the facts of the case before him, a medical emergency exists that so complicates the pregnancy or the health, safety or well-being of the minor as to require an immediate abortion. A physician who does not comply with the requirements of this section by reason of this exception shall state in the medical record of the abortion the medical indications on which his judgment was based.

C.G.S.A. § 19a-601

Copyright Kern Augustine Conroy and Schoppmann, P.C. Used with permission.