NEW JERSEY - TERMINATION OF PREGNANCY (ABORTION)

January 1, 2008

New Jersey state laws and regulations that affect your medical practice

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

The termination of pregnancy at any stage of gestation is a procedure which may be performed only by a physician licensed to practice medicine and surgery in the State of New Jersey. Any reference to the stage of pregnancy shall be in terms of weeks from start of last menstrual period, or "weeks LMP."

(N.J.A.C. 13:35-4.2)

After 14 weeks LMP
Any termination procedure, other than dilation and evacuation ("D & E"), shall be performed only in a licensed hospital.

15 weeks - 18 weeks LMP
A D & E procedure may be performed either in a licensed hospital or in a licensed ambulatory care facility ("LACF") authorized by the Department of Health ("DOH") to perform surgical procedures.

The LACF, to be eligible, must have a Medical Director who shall chair a Credentials Committee. This Committee shall grant practice privileges relating to the complexity of the procedure and commensurate with an assessment of the training, experience and skills of each physician for the health, safety and welfare of the public. A list of the privileges of each physician must contain the effective date of each privilege conferred, must be reviewed at least biennially, and must be preserved in the files in the LACF.

19 weeks - 20 weeks LMP
A physician planning to perform a D & E procedure after 18 weeks LMP and through 20 weeks LMP in an LACF shall first file with the Board of Medical Examiners a certification signed by the Medical Director that the physician meets the eligibility standards set forth below and shall comply with the requirements.

1. The physician is certified or eligible for certification by the American Board of Obstetrics-Gynecology or the American Osteopathic Board of Obstetrics-Gynecology, and the physician satisfactorily completes at least 15 hours of Continuing Medical Education each year in obstetrics-gynecology.

2. The physician has admitting and surgical privileges at a nearby licensed hospital which has an operating room, blood bank, and intensive care unit. The hospital shall be accessible within 20 minutes driving time during the usual hours of operation of the clinic.

3. The procedure must be done in a location which is designated by the DOH as a LACF authorized to perform surgical procedures as described above. The facility must be in current and good standing at all times when surgical procedures are performed there. The LACF must have a written agreement with an ambulance service assuring immediate transportation of a patient at all times when a patient has been admitted for surgery and until the patient has been discharged from the recovery room.

4. The procedure must be done in an LACF which must have a Medical Director and a Credentials Committee which have duly evaluated the training, experience and skill of the physician at continuous and successive levels of complexity of the D & E procedure in pregnancies advancing in stages from 18 weeks LMP through 19 weeks LMP through 20 weeks LMP, and the physician has been granted successive practice privileges consistent with management of the increased risk to the health and safety of the patient at that stage documented in the personnel files maintained for the physician.

The Medical Director must agree to review the charts of all patients who suffer complications and in addition must review charts at random, and must calculate the complication rate of each physician.

5. The physician must perform the procedure only on a patient who has been examined and found to be within the eligibility criteria established for advanced D & E procedures in the LACF setting.

6. The procedure must be performed in an LACF providing adequate staff support and resources for the operative procedure as well as interim follow-up and post-operative care, and where a physician is available and readily accessible 24 hours/day to respond to any postoperative problem.

7. The physician must cooperate with the Medical Director to maintain contemporaneous and cumulative statistical records demonstrating the utilization and safety record of each stage of the procedure and of each surgeon. These records must be available for inspection by the Board and copies must be submitted to the Board semi-annually. These records must include the following information and the data must be maintained in monthly records. However, individual patients comprising the lists must be identified only by date and by initials and/or case number:

i. Number of patients who received termination procedures;

ii. Number of patients who received laminaria or osmotic cervical dilators who failed to return for completion of the procedure;

iii. Number of patients who reported for postoperative visits;

iv. Number of patients who needed repeat procedures;

v. Number of patients who received transfusions;

vi. Number of patients suspected of perforation;

vii. Number of patients who developed pelvic inflammatory disease within two weeks;

viii. Number of patients who were admitted to a hospital within two weeks of the procedure;

ix. Number of patients who died within 30 days.

Subparagraphs ii. through ix. above must be summarized by number and percentage of monthly total for post-18 week procedures. The Board must inspect such reports monthly for the first five months and at such further monthly intervals as it deems necessary.

After 20 weeks LMP
A physician may request from the Board permission to perform D & E procedures in an LACF after 20 weeks LMP. The request must be accompanied by proof, to the satisfaction of the Board, of superior training and experience as well as proof of support staff and facilities adequate to accommodate the increased risk to the patient of such procedure.

2. What are the procedures for disposal of tissues?

The physician must make suitable arrangements to insure that all tissues removed be properly disposed of by submitting to a qualified physician for pathologic analysis or by incineration or by delivery to a person/entity licensed to make biologic and/or tissue disposals in accordance with the rules of the Department of Health and Human Services applicable to an LACF.

(N.J.A.C. 13:35-4.2)

3. May a physician refuse to perform an abortion?

Physicians are not under any legal obligation to perform abortions. No one, including physicians, can be required to perform or assist in an abortion. Refusal to perform these services cannot subject a physician to liability (civil or criminal) disciplinary action or discriminatory treatment.

(N.J.S.A. 2A:65A-1.3)

4. May a hospital or other health care facility refuse to perform an abortion?

No hospital or other health care facility is required to perform an abortion or other sterilization service or procedure.

(N.J.S.A. 2A:65A-2)

5. Does a physician need parental consent for a minor seeking an abortion?

No. The consent to the performance of medical or surgical care and procedure by a hospital or by a physician licensed to practice medicine and surgery executed by a married person who is a minor, or by a pregnant woman who is a minor, on his or her behalf or on behalf of any of his or her children, shall be valid and binding, and, for such purposes, a married person who is a minor or a pregnant woman who is a minor shall be deemed to have the same legal capacity to act and shall have the same powers and obligations as has a person of legal age. Notwithstanding any other provision of the law, an unmarried, pregnant minor may give consent to the furnishing of hospital, medical and surgical care related to her pregnancy or her child, and such consent shall not be subject to disaffirmance because of minority. The consent of the parent or parents of an unmarried, pregnant minor shall not be necessary in order to authorize hospital, medical and surgical care related to her pregnancy or her child.

(N.J.S.A. 9:17A-1)

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