More in NC abortion bill than just a 12-week ban
A new North Carolina proposal to ban, with some exceptions, abortion after 12 weeks pregnancy is much more complicated than a simple 12-week ban.
The bill contains new hoops that women seeking an abortion, and their doctors, would need to jump through, leaving questions about how the bill would actually impact abortion care in the state.
That includes potential new licensing requirements that Planned Parenthood’s lobbyist at the North Carolina General Assembly said none of the group's existing abortion clinics in the state meet. The bill also mandates at least one extra doctor's visit to get an abortion, requiring that an in-person conversation occur at least 72 hours before an abortion is performed.
Complete analysis is difficult because the 46-page bill was released to the public late Tuesday night, then given an abbreviated schedule for committee discussion. The state legislature’s Republican majority plans to pass the bill by Thursday, an extraordinarily quick timetable for complex legislation.
Even the N.C. Department of Health and Humans Services, which regulates abortion and would be tasked with enforcing multiple aspects of the bill, said it couldn’t give a chapter-and-verse description Wednesday, with a spokesperson saying the department was working “to understand all of the impacts of the legislation.”
But here, based on a reading of Senate Bill 20, information from bill sponsors and Wednesday morning’s limited committee discussion, is what the bill does.
Current law
North Carolina law now bans abortion after 20 weeks pregnancy, with exceptions after that in the case of medical emergencies. The law requires a conversation with a doctor at least 72 hours before the abortion is performed about the potential risks and other information, including state aid available if the child is born, but that conversation can happen by phone.
72 hours
This bill requires the 72-hour conversation to be in person, which bill critics said will make it more difficult to get an abortion, particularly for women who have trouble getting off work, have other children to care for, live far from a clinic or wish to travel from out of state for an abortion. The bill also adds multiple new attestations a woman must sign before the abortion, including in the case of a drug-induced abortion, acknowledgment that she has the right to see the remains of her unborn child.
Three visits
A drug-induced abortion requires at least two visits under this bill. The first comes at least 72 hours before the abortion is scheduled, for the doctor to go over various informed consent requirements. A second is for the doctor to administer the first dose of the drug, which must be done in person. A second dose would not require a doctor’s presence, bill sponsors said. However, the doctor’s office is required to to schedule a follow up visit seven to 14 days after a drug is administered to confirm that the pregnancy is terminated and to assess bleeding. The bill says the doctor “shall make all reasonable efforts to ensure that the woman returns” for that appointment. The multiple visits will make abortions more difficult for women who can’t easily take time off work, or women traveling from a state with more restrictive abortion laws, to get an abortion in North Carolina, bill opponents said.
New clinic rules
The bill calls for new standards and licensing requirements for abortion clinics and indicates those requirements would be written in the future by the N.C. Medical Care Commission, which is appointed by the governor. The bill says those rules couldn't be more stringent than the ones set for ambulatory surgery centers. Riley, Planned Parenthood’s lobbyist, told lawmakers Wednesday that none of her group's facilities in the state meet those requirements now and that the bill aims “to shut down abortion clinics.”
Exceptions
Current law allows abortions after 20 weeks in the case of medical emergencies. This bill builds on that, allowing some abortions after the new 12-week cutoff, but the rules are tiered. In cases of rape or incest abortion would be allowed through 20 weeks of pregnancy. If the fetus has a “life-limiting anomaly” abortion would be legal through 24 weeks. Abortion would stay legal at any time if a doctor declares a medical emergency.
Hospitals only after 12 weeks
The bill also says any abortions performed after the first trimester of a pregnancy must be performed in a hospital. Planned Parenthood noted that hospital visits mean extra costs, which anyone who gets an abortion after 12 weeks would incur, a potential roadblock for low-income patients.
10 week ban?
The bill distinguishes between surgical abortions and drug-induced abortions, which are more common. Surgical abortions generally would be legal for the first 12 weeks of pregnancy. But drug-induced abortions, defined in the bill as a “medical abortion,” would be subject to a number of new rules. Among them: Before physicians can sign off on a medical abortion, they must verify that the “probable gestational age” of the unborn child is no more than 70 days, or 10 weeks. Senate Republicans said that's because Mifepristone, part of the most common abortion regimen in the United States, has only been approved by the Food and Drug Administration for use in first 70 days after a woman's last menstrual period. In practice, Planned Parenthood lobbyist Jillian Riley said, the bill “will ban abortion after 10 weeks.”
Penalties
The bill doesn’t include criminal penalties for women who get an abortion outside the allowed time frames, but doctors who provide one could face a $5,000 fine and the possibility of losing their license. The bill also creates a new class D felony and $250,000 fine for any physician who doesn’t provide care for babies who survive a botched abortion.
Penalties for mailing drugs
Any person or organization caught sending abortion-inducing drugs directly to a woman could face a $5,000 fine per violation. Illegally advertising these drugs would also bring a $5,000 fine.
Down syndrome
The bill has anti-eugenics language, saying it’s illegal to perform an abortion at any point in the pregnancy if a doctor knows the woman seeking the abortion wants it “in whole or in part” because of the unborn child’s race, sex or the “presumed presence of Down syndrome.” This adds to an existing ban on abortions based on the unborn child’s sex.
Parental leave
The bill promises state employees up to eight weeks of paid leave after giving birth and up to four weeks after becoming a parent, including by adoption. Gov. Roy Cooper already provided, via a 2019 executive order, for paid leave for many state employees. This would expand the benefit to more employees and write it into state law. The bill has $20 million in it to cover leave costs.
Money
Including the paid leave funding, Republican lawmakers said they put $180 million in pro-family funding into the bill. That includes $75 million to expand access to child care, more than $16 million to reduce infant and maternal mortality, close to $59 million for foster care, kinship care and children’s homes, $7 million to help people without insurance pay for birth control and $3 million over the next two years for community college tuition grants.
Domestic violence and guns
The bill creates a new misdemeanor crime of domestic violence, which is meant to close a loophole in existing law that allows people convicted of various domestic violence crimes to still pass a background check when they buy a gun. The federal background check system doesn’t flag these crimes because of the way North Carolina’s current law reads and a federal court ruling from several years ago.
Other penalties
The bill also increases the criminal punishment for assault on a pregnant woman. And the current 10-year GPS monitoring requirement for many repeat and violent sex offenders would increase to lifetime monitoring.
Correction: This article has been updated to indicate the bill was released late Tuesday night, not Monday night.
