S. HRG. 113–844 

S. 1696, THE WOMEN’S HEALTH PROTECTION ACT: 

REMOVING BARRIERS TO CONSTITUTIONALLY 

PROTECTED REPRODUCTIVE RIGHTS 

HEARING 

BEFORE THE

COMMITTEE ON THE JUDICIARY 

UNITED STATES SENATE 

ONE HUNDRED THIRTEENTH CONGRESS 

SECOND SESSION 

JULY 15, 2014 

Serial No. J–113–69 

Printed for the use of the Committee on the Judiciary 

( 
S. 1696, THE WOMEN’S HEALTH PROTECTION ACT: REMOVING BARRIERS 

TO CONSTITUTIONALLY PROTECTED REPRODUCTIVE RIGHTS 
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99–962 PDF 2017

S. HRG. 113–844 

S. 1696, THE WOMEN’S HEALTH PROTECTION ACT: 

REMOVING BARRIERS TO CONSTITUTIONALLY 

PROTECTED REPRODUCTIVE RIGHTS 

HEARING 

BEFORE THE

COMMITTEE ON THE JUDICIARY 

UNITED STATES SENATE 

ONE HUNDRED THIRTEENTH CONGRESS 

SECOND SESSION 

JULY 15, 2014 

Serial No. J–113–69 

Printed for the use of the Committee on the Judiciary 

( 
(II) 

COMMITTEE ON THE JUDICIARY 

PATRICK J. LEAHY, Vermont, Chairman 

DIANNE FEINSTEIN, California 

CHUCK SCHUMER, New York 

DICK DURBIN, Illinois 

SHELDON WHITEHOUSE, Rhode Island 

AMY KLOBUCHAR, Minnesota 

AL FRANKEN, Minnesota 

CHRISTOPHER A. COONS, Delaware 

RICHARD BLUMENTHAL, Connecticut 

MAZIE HIRONO, Hawaii 

CHUCK GRASSLEY, Iowa, Ranking Member 

ORRIN G. HATCH, Utah 

JEFF SESSIONS, Alabama 

LINDSEY GRAHAM, South Carolina 

JOHN CORNYN, Texas 

MICHAEL S. LEE, Utah 

TED CRUZ, Texas 

JEFF FLAKE, Arizona 

KRISTINE LUCIUS, Chief Counsel and Staff Director 

KOLAN DAVIS, Republican Chief Counsel and Staff Director 
(III) 

C O N T E N T S 

JULY 15, 2014, 10:03 A.M. 

STATEMENTS OF COMMITTEE MEMBERS 

Page 

Blumenthal, Hon. Richard, a U.S. Senator from the State of Connecticut ........ 1 

Feinstein, Hon. Dianne, a U.S. Senator from the State of California, 

prepared statement .......................................................................................... 103 

Grassley, Hon. Chuck, a U.S. Senator from the State of Iowa ............................ 2 

WITNESSES 

Witness List ............................................................................................................. 39 

Baldwin, Hon. Tammy, a U.S. Senator from the State of Wisconsin .................. 4 

prepared statement .......................................................................................... 40 

Black, Hon. Diane, a Representative in Congress from the State of Tennessee 6 

prepared statement .......................................................................................... 42 

Blackburn, Hon. Marsha, a Representative in Congress from the State of 

Tennessee .............................................................................................................. 9 

prepared statement .......................................................................................... 47 

Chireau, Monique V., M.D., M.P.H., F.A.C.O.G., Durham, North Carolina ....... 14 

prepared statement .......................................................................................... 60 

Chu, Hon. Judy, a Representative in Congress from the State of California ..... 8 

prepared statement .......................................................................................... 45 

Northup, Nancy, President and Chief Executive Officer, Center for Reproductive Rights, New York, New York ....................................................................... 12 

prepared statement .......................................................................................... 49 

Parker, Willie, M.D., Birmingham, Alabama ........................................................ 16 

prepared statement .......................................................................................... 71 

Taylor, Hon. Chris, State Representative, Wisconsin State Legislature, 76th 

District, Madison, Wisconsin ............................................................................... 19 

prepared statement .......................................................................................... 98 

Tobias, Carol, President, National Right to Life Committee, Washington, DC . 18 

prepared statement .......................................................................................... 75 

QUESTIONS 

Questions submitted to Dr. Monique V. Chireau by Senator Grassley ............... 116 

Questions submitted to Nancy Northup by Senator Blumenthal ........................ 109 

Questions submitted to Nancy Northup by Senator Coons .................................. 106 

Questions submitted to Dr. Willie Parker by Senator Blumenthal ..................... 111 

Questions submitted to Dr. Willie Parker by Senator Coons .............................. 107 

Questions submitted to Hon. Chris Taylor by Senator Blumenthal ................... 113 

Questions submitted to Hon. Chris Taylor by Senator Coons ............................. 108 

Questions Submitted to Carol Tobias by Senator Graham .................................. 117 

Questions submitted to Carol Tobias by Senator Grassley .................................. 114 

ANSWERS 

Responses of Dr. Monique V. Chireau to questions submitted by Senator 

Grassley ................................................................................................................ 167 

Attachment to responses of Dr. Monique V. Chireau to questions submitted 

by Senator Grassley ............................................................................................. 174 

Responses of Nancy Northup to questions submitted by Senators Coons and 

Blumenthal ........................................................................................................... 118 
Page

IV 

Responses of Dr. Willie Parker to questions submitted by Senators Coons 

and Blumenthal .................................................................................................... 133 

Responses of Hon. Chris Taylor to questions submitted by Senators Coons 

and Blumenthal .................................................................................................... 139 

Responses of Carol Tobias to questions submitted by Senators Graham and 

Grassley ................................................................................................................ 144 

MISCELLANEOUS SUBMISSIONS FOR THE RECORD 

A Critical Mass: Women Celebrating Eucharist et al., July 15, 2014, letter ..... 339 

Abortion Care Network, Dallas Schubert, Chair, and Charlotte Taft, Executive Director, statement ....................................................................................... 209 

Abortion Care Network et al., July 14, 2014, letter ............................................. 322 

Abortion Rights Fund of Western Mass et al., July 22, 2014, letter ................... 325 

Advocates for Youth, Washington, DC, statement ................................................ 350 

American Congress of Obstetricians and Gynecologists (ACOG) et al., July 

11, 2014, letter ..................................................................................................... 239 

American Congress of Obstetricians and Gynecologists (ACOG), Hal C. Lawrence III, M.D., F.A.C.O.G., Executive Vice President and Chief Executive 

Officer, statement ................................................................................................. 217 

American Congress of Obstetricians and Gynecologists (ACOG), Hal C. Lawrence III, M.D., F.A.C.O.G., Executive Vice President and Chief Executive 

Officer, attachment to statement ........................................................................ 227 

American Journal of Obstetrics & Gynecology, September 2013, article ............ 202 

Americans United for Life (AUL), Washington, DC, statement .......................... 358 

Association of American Physicians & Surgeons, The, et al., July 15, 2014, 

letter ...................................................................................................................... 376 

Branstad, Hon. Terry E., Governor of Iowa, and Hon. Kim Reynolds, Lieutenant Governor of Iowa, July 15, 2014, joint letter .............................................. 367 

Calhoun, Byron C., M.D., F.A.C.O.G., F.A.C.S., F.A.S.A.M., M.B.A., Professor 

and Vice Chair, Department of Obstetrics and Gynecology, West Virginia 

University-Charleston, July 11, 2014, letter ..................................................... 374 

California–District IX of ACOG et al., July 15, 2014, letter ................................ 341 

Center for Reproductive Rights, Nancy Northup, President and Chief Executive Officer, July 15, 2014, letter ........................................................................ 238 

Concerned Women for America Legislative Action Committee (CWALAC), 

Penny Young Nance, President and Chief Executive Officer, July 14, 2014, 

letter ...................................................................................................................... 410 

Daugherty, Hon. Duffy, New Hampshire House of Representatives, July 15, 

2014, letter ............................................................................................................ 405 

Grau, Hon. Randon J., Oklahoma House of Representatives, July 15, 2014, 

letter ...................................................................................................................... 409 

Guttmacher Institute, Susan A. Cohen, Acting Vice President for Public Policy, statement ....................................................................................................... 241 

Henneberqer, Melinda, Politics Daily, ‘‘Kermit Gosnell’s Pro-Ghoice Enablers 

(Is This What an lndustry That Self-Regulates Looks Like?),’’ January 

23, 2011, article .................................................................................................... 369 

Ibis Reproductive Health, Kelly Blanchard, President; Amanda Dennis, Associate; Kate Grindlay, Senior Project Manager; Daniel Grossman, Vice President for Research; Britt Wahlin, Director of Development and Communications; joint statement ........................................................................................... 245 

Nanney, Hon. Wendy, South Carolina House of Representatives, et al., July 

15, 2014, letter ..................................................................................................... 379 

NARAL Pro-Choice America, Washington, DC, statement .................................. 256 

National Abortion Federation (NAF), Washington, DC, and Abortion Providers in Ohio, Pennsylvania, and Tennessee, statement ................................ 307 

National Asian Pacific American Women’s Forum (NAPAWF), Washington, 

DC, statement ...................................................................................................... 355 

National Council of Jewish Women (NCJW), Nancy K. Kaufman, Chief Executive Officer, statement ......................................................................................... 264 

National Family Planning & Reproductive Health Association (NFPRHA), 

Clare Coleman, President and Chief Executive Officer, statement ................. 352 

National Latina Institute for Reproductive Health (NLIRH), Jessica Gonza ́lezRojas, Executive Director, July 21, 2014, letter ................................................ 318 

National Latina Institute for Reproductive Health (NLIRH), Jessica Gonza ́lezRojas, statement ................................................................................................... 332 
Page

V 

National Network of Abortion Funds (NNAF), Stephanie Poggi, Executive 

Director, statement .............................................................................................. 269 

National Partnership for Women & Families, Debra Ness, President; Sarah 

Lipton-Lubet, Director of Reproductive Health Programs; Melissa Safford, 

Policy Advocate; statement ................................................................................. 271 

National Women’s Health Network, Cynthia A. Pearson, Executive Director, 

July 13, 2014, letter ............................................................................................. 346 

National Women’s Health Network, Cynthia A. Pearson, Executive Director, 

statement .............................................................................................................. 347 

National Women’s Law Center, Judy Waxman, Vice President for Health 

and Reproductive Rights, statement .................................................................. 276 

New York Abortion Access Fund (NYAAF), New York Abortion Access Fund 

Board of Directors, statement ............................................................................. 280 

Pence, Hon. Michael R., Governor of Indiana, July 21, 2014, letter ................... 368 

Perkins, Tony, President, Family Research Council, et al., July 14, 2014, 

letter ...................................................................................................................... 365 

Physicians for Reproductive Health, Nancy Stanwood, M.D., M.P.H., Board 

Chair, statement .................................................................................................. 343 

Physicians for Reproductive Health, Nancy Stanwood, M.D., M.P.H., Board 

Chair and Associate Professor of Obstetrics, Gynecology & Reproductive 

Sciences, Yale University School of Medicine, statement ................................. 289 

Planned Parenthood Federation of America and Planned Parenthood Action 

Fund, Dana Singiser, Vice President of Public Policy and Government Relations, statement .................................................................................................... 286 

Planned Parenthood Federation of America and Planned Parenthood Action 

Fund, Washington, DC, attachment to statement ............................................ 320 

Planned Parenthood of Southern New England, New Haven, Connecticut, 

statement .............................................................................................................. 236 

Preterm Birth Paper Publication List (Exhibit 2), July 11, 2014, list ................ 391 

Psychological Effects Publication List (Exhibit 1), Bibliography of Peer-Reviewed Studies on Abortion and Psychological Health, July 11, 2014, list ..... 381 

Red River Women’s Clinic, Tammi Kromenaker, Clinic Director, statement ..... 295 

Reproductive Health Technologies Project (RHTP), Jessica Arons, President 

and Chief Executive Officer, statement ............................................................. 300 

Torres, Leah, M.D., M.S., Salt Lake City, Utah, statement ................................ 251 

Treat, Hon. Greg, Oklahoma State Senate, July 15, 2014, letter ........................ 407 

University of California, San Francisco, School of Medicine, Advancing New 

Standards in Reproductive Health Program (ANSIRH), Diana Greene Foster, Ph.D., Acting Director and Director of Research, statement ..................... 232 

Weinstein, Dana, Rockville, Maryland, July 14, 2014, letter .............................. 304 

ADDITIONAL SUBMISSIONS FOR THE RECORD 

Submissions for the record not printed due to voluminous nature, previously 

printed by an agency of the Federal Government, or other criteria 

determined by the Committee, list: .................................................................... 411 

Case files documented August 19, 2011: 

http://www.cruz.senate.gov/files/documents/20141218lStories.pdf ........ 411 

(1) 

S. 1696, THE WOMEN’S HEALTH 

PROTECTION ACT: REMOVING 

BARRIERS TO CONSTITUTIONALLY 

PROTECTED REPRODUCTIVE RIGHTS 

TUESDAY, JULY 15, 2014 

UNITED STATES SENATE, 

COMMITTEE ON THE JUDICIARY, 

Washington, DC. 

The Committee met, pursuant to notice, at 10:03 a.m., in 

Room SD–226, Dirksen Senate Office Building, Hon. Richard 

Blumenthal, presiding. 

Present: Senators Blumenthal, Klobuchar, Franken, Coons, 

Hirono, Grassley, Hatch, Graham, Lee, and Cruz. 

OPENING STATEMENT OF HON. RICHARD BLUMENTHAL, 

A U.S. SENATOR FROM THE STATE OF CONNECTICUT 

Senator BLUMENTHAL. Welcome to everyone. Thank you for joining us today. Thank you to our witnesses. Thanks to our Ranking 

Member, Senator Grassley, and most especially to Senator Leahy, 

the Chairman of the Judiciary Committee, for giving me this privilege of chairing this hearing. 

We are convened today to hear testimony regarding the Women’s 

Health Protection Act: Removing Barriers to Constitutionally Protected Reproductive Rights, and our first panel consists of a number of our colleagues who have positions and views on this issue. 

We welcome you this morning from the House, as well as my colleague Senator Baldwin of the Senate, who is my cosponsor in the 

measure that is now pending before the Senate and who has been 

a leader for a long time in this area. 

We have support from more than 30 of our Senate colleagues, 

and my understanding is that the companion measure introduced 

by Representative Chu has 125 cosponsors in the House, or thereabouts. 

The reason for this bill is essentially the cascading avalanche of 

restrictions on reproductive health care around the country. What 

we see increasingly is, in effect, an avalanche of measures that purportedly protect women’s health care, but in reality restrict reproductive rights. This bill is about stopping laws that purport to be 

about health when really they interfere with the doctor-patient relationship and have the effect, the very practical impact of harming 

women and limiting constitutionally protected rights. Our goal, 

speaking for myself, our goal is to stop politicians from playing doctor and stop public officials from interfering in significant medical 
2 

decisions that should be made by medical experts and patients together. 

This legislation would eliminate limitations on access to abortion 

services and eliminate the targeting and unwarranted restrictions 

against abortion providers and clinics, no matter where a woman 

may live. In fact, more than half the States now have these very 

unwarranted and unconstitutional restrictions, and the majority of 

women in our country live in those States. They have passed 92 restrictions on a woman’s right to choose in those States, since 2011 

more than 100, and in 2014 at least another dozen of these harmful 

laws have been enacted. So we are talking about serious harassment of reproductive health care providers, singling them out for 

regulations that apply to no other medical services, regulations 

that do nothing to improve a woman’s health or safety, and, in fact, 

are more likely to harm them. These regulations are designed to 

shut doors of vital health care providers forever, and that purpose 

has been fulfilled across the country as the availability of these 

services has been restricted. 

These regulations are in effect a pernicious charade, and one of 

the purposes that I see in this hearing is to remove the patina of 

respectability and show that they are, many of them, irresponsible 

and even reprehensible. Under the guise of protecting women’s 

health care, they actually endanger it. 

I want to thank again our witnesses and my fellow members for 

making this hearing happen. We may disagree on these issues, but 

I know that we are going to have a very enlightening and engaging 

hearing. And I want to turn now to the Ranking Member, Senator 

Grassley, for his remarks. 

OPENING STATEMENT OF HON. CHUCK GRASSLEY, 

A U.S. SENATOR FROM THE STATE OF IOWA 

Senator GRASSLEY. Thank you to our colleagues in the other body 

that are here, as well as the Senator from Wisconsin, and thank 

you for the succeeding panel that will be here. 

Four and a half years ago, a woman walked into an abortion clinic with the expectations that she would have her pregnancy terminated and that she would walk out of that clinic without major side 

effects. She was 41 years old and 19 weeks pregnant. She had 

three children, and she was also a grandmother. She and her 

daughter entered the clinic, but she never left alive. Her name was 

Karnamaya Mongar. She was one of the many victims of Kermit 

Gosnell. 

Kermit Gosnell operated a clinic in West Philadelphia for four 

decades. He made a living by performing abortions that no other 

doctor should ever do. The grand jury report charging Kermit 

Gosnell stated, ‘‘Gosnell’s approach was simple: keep volume high, 

expenses low, break the law. That was his competitive advantage.’’ 

Also according to the grand jury report: ‘‘Gosnell ran a baby charnel house. It smelled of cat urine. Furniture and blankets were 

stained with blood. Instruments were not sterilized, and medical 

equipment was broken. He provided same-day service. Required 

counseling was ignored. The bigger the baby, the bigger the charge. 

Ultrasounds were forged so that the government would never know 

how old aborted babies truly were. Babies were born alive, killed 
3 

after breathing on their own, by sticking scissors into the back of 

the baby’s neck and cutting the spinal cord. These were live, 

breathing, squirming babies.’’ 

He did not care about the well-being of these aborted babies. He 

did not care about the health of the women. Women were put 

under because he disliked the moaning and groaning and screaming. 

This practice and his disregard for the law led to the death of 

two women, including the one that I have already mentioned. 

Now, Pennsylvania has a law against abortions after 24 weeks. 

It also has a very commonsense law that says women should receive counseling about abortion procedures and they must wait 24 

hours after the first visit to the provider in order to fully consider 

the decisions that they are about to make. 

While it is true that Kermit Gosnell ignored the law, these laws 

have saved lives. They have saved women from horrible, life-threatening procedures. They have saved babies. 

If the bill we are discussing today, the Women’s Health Promotion Act, were to become law, Pennsylvania’s laws would be invalidated. Abortion providers would not be required to counsel 

their patients or give them 24 hours to consider what they were 

about to do. And, more importantly, it would lead to inhumane, unsanitary, heinous, dangerous, shocking, and unsafe abortions. The 

law that helped convict Kermit Gosnell would be wiped away. 

This proposed legislation is an attempt to override U.S. Supreme 

Court precedent by severely restricting the ability of States to regulate abortion. It would invalidate hundreds of abortion-related 

laws, such as clinic regulations, admitting privileges requirements, 

regulations on abortion-inducing drugs, reflection periods, 

ultrasound requirements, conscience protections, sex-selection bans, 

and limitations on the use of State funds and facilities for abortion 

training. 

Now, my home State of Iowa has laws on the books to protect 

the unborn and the health of the women. For example, an Iowa law 

stipulates that when inducing an abortion by providing an abortion-inducing drug, a physician must be physically present with the 

woman at the time the abortion-inducing drug is provided. That 

was enacted to ensure that women were not taking abortion-inducing drugs via webcam and then far from a medical provider who 

may save the life if a problem came about. 

We also have a law on the books to protect the rights of medical 

professionals. Specifically, the law says: ‘‘An individual who may 

lawfully perform, assist, or participate in medical procedures which 

will result in an abortion shall not be required against that individual’s religious beliefs or moral convictions to perform, assist, or 

participate in such procedures. A person shall not discriminate 

against any individual in any way, including but not limited to employment, promotion, advancement, transfer, licensing, education, 

training, or granting of hospital privileges or staff appointments, 

because of the individual’s participation in or refusal to participate 

in recommending, performing, or assisting in an abortion procedure.’’ 

Iowa and many other States have taken action on their own to 

make sure that abortions are done safely. They have protected indi-
4 

viduals from having to kill babies against their own religious beliefs. 

Yet the bill before us would invalidate these laws and would 

allow abortion providers to set standards of care for their patients 

with no oversight from the States. It would allow health care workers to determine when a life is viable, ensuring that there are several and various standards across the country. The bill would invalidate laws enacted by 10 States since 2010, which declare that 

unborn children are capable of experiencing pain at least by 20 

weeks of fetal age, and that generally prohibit abortion after that 

point. 

If the bill before us were to be signed into law, the Federal Government would send a message to States that enacting laws to protect patients and regulate the health and welfare of their citizens 

is not one of their Tenth Amendment rights. It would allow Congress to intrude on States’ rights and nullify such laws. 

This bill is a weak political opportunity before the midterm elections. It is unfortunate that the majority is using this issue to appear compassionate and concerned about women’s rights when, in 

reality, the bill disregards popular and commonsense laws enacted 

in various states aimed at protecting women and children across 

this country and stopping murders like Kermit Gosnell. Large majorities of Americans support strong abortion restrictions that this 

bill would overturn. 

This bill will not become law because the American people will 

not support it. I thank the witnesses once again. 

Thank you. 

Senator BLUMENTHAL. Thank you, Senator Grassley. 

We will now hear from our colleagues, and, again, my thanks to 

the Congresswomen who have come to join us. Let us begin with 

Senator Baldwin, if we may. 

STATEMENT OF HON. TAMMY BALDWIN, 

A U.S. SENATOR FROM THE STATE OF WISCONSIN 

Senator BALDWIN. Thank you, Chairman Blumenthal and Ranking Member Grassley and members of the Committee, for this opportunity. I am encouraged that the Committee is pursuing a constructive conversation on this issue, and I am grateful for the opportunity to share my work on the Women’s Health Protection Act. 

I would also like to recognize the tireless advocacy of my Wisconsin State Representative Chris Taylor, who is here today and 

will be on the second panel to share her experience working to defend women’s access to health care in Wisconsin. I thank her for 

her testimony today. 

Americans across the country expect to have access to high-quality, dependable health care when they and their families need it. 

Indeed, my colleagues and I have worked to reform and improve 

health care, the entire health care system, to expand access to 

quality, affordable health care options so that all patients have 

health care that meets their needs. 

Unfortunately, for women in this country, this access has come 

under attack. Over the last 40 years, politicians across the country 

have been increasingly chipping away at the constitutional rights 

guaranteed under Roe v. Wade, which affirmed that women have 
5 

the right to make their own personal health care decisions and 

have access to safe and legal reproductive care. 

Since that landmark decision by our Nation’s highest Court, too 

many States have been trying to turn back the clock on women’s 

access to quality care. 

In just the past 3 years, States across the country have enacted 

a total of 205 provisions that restrict women’s access to safe abortion services. This year, 13 States have been busy working to erode 

women’s freedoms and have already adopted 21 new restrictions 

designed to limit access to abortion. 

In my home State of Wisconsin, we are now ranked as one of the 

worst States when it comes to women’s reproductive rights thanks 

to the restrictive measures enacted by our Governor and our legislature. 

To name just one, last year our Governor signed a measure forcing women—who are already required by law to make two separate 

trips to the clinic—to also undergo an invasive ultrasound 24 hours 

before receiving abortion care. 

This same law also forces health care professionals to have unnecessary admitting privileges at a local hospital. If it were not for 

a Federal judge temporarily blocking this provision, two of Wisconsin’s four abortion clinics would have been forced to shut their 

doors, and others would have been forced to reduce services, leaving many Wisconsin women out in the cold. 

But women and their families should not have to rely on lastminute court decisions to be able to make the best decisions for 

themselves and their families. 

I recently heard from a mother in Middleton, Wisconsin, who was 

not so lucky. When she found out her baby had a severe fetal 

anomaly and would not survive delivery, she had to endure the 

consequences of the Governor’s new law before the Federal court 

judge blocked the provision. 

She had to undergo an emergency termination, and a clinic in 

Milwaukee was the only place that would do the procedure. But because the Governor was set to sign the law imposing these unreasonable requirements on providers, the clinic was preparing to 

close its doors and would not schedule her procedure. She and her 

husband were forced to find child care for their two sons and travel 

out of State so she could receive the medical care that she needed. 

The threat in Wisconsin and in States across the country is clear. 

Some politicians are doing this because they think they know better than women and their doctors. And the fact is that they do not. 

Women are more than capable of making their own personal, 

medical decisions without consulting their legislator. 

It is not the job of politicians to play doctor and to dictate how 

professionals practice medicine. Nor is it our job to intrude in the 

private lives and important health decisions of American families. 

This is why I was proud to be a cosponsor of the Women’s Health 

Protection Act with my colleagues Senator Blumenthal and Congresswoman Chu to put a stop to these relentless attacks on women’s freedom. 

Let me conclude by briefly describing the bill. 

The Women’s Health Protection Act would prohibit these laws 

that undermine and infringe on a woman’s constitutional rights 
6 

guaranteed under Roe v. Wade. Specifically, our bill would outlaw 

any mandate or regulation that does not significantly advance 

women’s health or safety. Our legislation also protects women by 

invalidating measures that make abortion services more difficult to 

access and restrictions on the provision of abortion services that 

are not imposed on any other medical procedures. 

Congress is responsible for enforcing every American’s fundamental rights guaranteed by our Constitution. Throughout history, 

when States have passed laws that make it harder—or even impossible—to exercise those rights, we have necessarily stepped in with 

Federal protections. The Women’s Health Protection Act would ensure that every woman--no matter where she lives—has access to 

safe, quality reproductive health care without interference from 

politicians. 

I thank you for your time. 

[The prepared statement of Senator Tammy Baldwin appears as 

a submission for the record.] 

Senator BLUMENTHAL. Thank you, Senator. 

Representative Black. 

STATEMENT OF HON. DIANE BLACK, A REPRESENTATIVE 

IN CONGRESS FROM THE STATE OF TENNESSEE 

Representative BLACK. Chairman Blumenthal, Ranking Member 

Grassley, and Members of the Committee, thank you for the opportunity to testify before you today. As has been said, my name is 

Diane Black, and I am privileged to have the honor of serving in 

the House of Representatives on behalf of Tennessee’s 6th Congressional District. 

Prior to entering public service, I built my career around the 

health care sector as a registered nurse. My career began as an 

emergency room nurse, where I spent the majority of my career, 

but I have also worked as a long-term care nurse and as part of 

an outpatient surgery team. I decided to run for office after I witnessed firsthand how poor public policy was directly impacting my 

ability to deliver health care and, more importantly, the unfortunate outcomes on the lives of my patients. 

Today I am here to share with you, as a colleague in the House, 

and also as a mother, a grandmother, and a nurse, my grave concerns with the Chairman’s legislation. Although called ‘‘The Women’s Health Protection Act,’’ this bill would nullify and declare unlawful any law at any level of the Government—whether Federal, 

State, or local—that presents what the bill deems to be an undue 

burden on women seeking an abortion. This legislation would effectively overturn the majority of State laws regulating abortions. 

As a nurse, I can tell you that abortion is unlike any other medical procedure. This is an act that does not just involve the mother, 

but the child. It takes the life of an unborn child and in the process 

imposes many serious medical risks to the mother. 

To be clear and transparent, I am unapologetically pro-life. And 

while I believe that the life of an unborn must be protected, I also 

believe that we must do everything in our power to protect any 

woman who decides to have an abortion, even though I may disagree with their choice. 
7 

During my time in the ER, a young woman came in after having 

complications with her abortion, which had been done at a clinic 

that was not regulated properly. When the complications occurred, 

there was no answer at the after-hours number that she called. 

And by the time she reached the hospital, she was dying and there 

was nothing that I or the doctors could do to save her life. 

As a result of an abortion, the young woman lost her precious 

life. Her life could have been saved if proper regulations had been 

in place that protected her health and well-being and that held the 

abortionist accountable. 

Now, infections occur in 1 to 5 percent of the abortions. Cervical 

lacerations, incompetent cervix, and other injuries can occur to the 

cervix and other organs during abortion procedures. Worse, minors 

are up to twice as likely to experience cervical lacerations during 

an abortion and overall are even more susceptible to short-term 

risks than are older women. 

Women who have had abortions are at a 37 percent increased 

risk of pre-term birth in subsequent pregnancies, a 30 to 50 percent increased risk of placenta previa in subsequent pregnancies, 

and 18 percent more likely to develop breast cancer as opposed to 

the average of just 12 percent. In the case of women with a family 

history of breast cancer, this jumps up to 80 percent. 

Abortions not only pose serious physical risks but endanger a 

woman’s mental health as well. Studies show that after having an 

abortion, a woman is 81 percent more likely to develop a mental 

health issue, is at a 37 percent increased risk of depression, a 110 

percent increased risk of alcohol abuse, and sadly, a 155 percent 

increased risk of suicide. 

After the horrific case of abortionist Kermit Gosnell, Americans 

know that even though abortions are legal, these procedures that 

are risky and must be regulated. Perhaps this is why 39 States require that abortions be performed by a licensed physician and why 

26 States require abortion clinics to meet the same clinic standards 

as ambulatory surgical care clinics. And just as important, 42 

States prohibit abortion after a certain point in the pregnancy, and 

about 9 States prohibit abortions at 20 weeks, or at the start of the 

sixth month of pregnancy, when medical research affirms that unborn children can feel pain during an abortion. We are, after all, 

discussing a medical procedure that ends a human life. 

Let us also not forget that the Supreme Court indicated in 

Planned Parenthood v. Casey that the Government has an interest 

in preserving fetal life. Senate bill 1696 represents a sweeping attempt to undermine dozens of measures enacted by States to protect women, all under the false pretense that abortions are safe 

and rare. 

My hope today is that we can reach across party lines, realize 

our preconceived notions on this topic, and see abortion for what 

they really are. Abortion is brutal—to both the mother and the unborn child. It is not health care. To reference the Supreme Court, 

a dilatation and extraction abortion, which represents the majority 

of abortion procedures in America, is as generally gruesome as partial birth abortion. These abortion procedures are the most common 

for abortions performed in the second trimester of pregnancy, 

where the unborn child is literally torn apart limb by limb. 
8 

In considering this and the many health care risks that can occur 

as a result of abortions, I strongly urge you to reconsider advancing 

Senate bill 1696 and any other effort that would undermine current laws that exist to protect the health and well-being of women 

and unborn children at the Federal level, State, and local government level. 

Thank you again for the opportunity to be here today, and I yield 

back. 

[The prepared statement of Representative Diane Black appears 

as a submission for the record.] 

Senator BLUMENTHAL. Thank you, Representative Black. 

Representative Chu. 

STATEMENT OF HON. JUDY CHU, A REPRESENTATIVE 

IN CONGRESS FROM THE STATE OF CALIFORNIA 

Representative CHU. Thank you, Chairman Blumenthal, Ranking 

Member Grassley, and Committee members for the opportunity to 

testify today. Every woman should have access to affordable and 

comprehensive health care coverage that protects her right to 

choose. This should be the case regardless of her income, the type 

of insurance she has, or the State she resides in so that she can 

make personal health decisions based on what is best for her and 

her family. 

But we are witnessing an alarming moment in time. Attacks on 

reproductive rights are intensifying. Having lost in our court system with Roe v. Wade, opponents of reproductive freedom are trying to undercut our constitutional right and make it increasingly 

difficult to access a legal abortion. They are trying to take us back 

to a time before Roe, when 1.2 million women resorted to illegal 

abortions each year. Their goal is to take us back to a time when 

unlicensed doctors, in unsanitary conditions, performed abortions 

that led to infections, hemorrhages, and at times, death. They are 

taking us back to a time when many women knew the hazards, but 

risked all of this because they were desperate—and this was their 

only option. 

The new trend is to shut down abortion services, but this time 

State by State. 

This is happening all across the country. Individual States have 

signed into law restrictive regulations that single out abortion services. Between 2011 and 2013, more than two dozen States passed 

over 200 restrictions that block access to abortion services. This 

translates to more restrictions placed on women’s health care in 3 

years than in the entire preceding decade. 

The effect of these laws is that a woman’s constitutional right 

now depends on her address. The rights of women residing in my 

home State of California now vastly differ from the rights of 

women living in Texas or Mississippi. According to the Guttmacher 

Institute, 56 percent of women—over half of women in our country—now live in a State that is hostile to abortion. 

These laws range from mandatory waiting periods to biased 

counseling requirements to the exact size requirements and corridor width for the offices in which the procedure is to take place. 

They are laws like the recent one in Texas, which make no sense 

medically. They require doctors performing abortion procedures to 
9 

have formal admitting privileges at a hospital within 30 miles of 

their clinic, among other senseless requirements. We already see 

the effects. After the law passed, clinics began closing their doors. 

For women in Texas, this means longer waits, higher costs, and 

canceled appointments. Some have to travel over 150 miles to get 

to the nearest clinic. These obstacles have put many women in desperate circumstances, some of which may very well endanger their 

lives. 

We need laws that put women’s health and safety first—not politics. And that is why we introduced the Women’s Health Protection 

Act this Congress. We recognized that without the ability to access 

it, the right to abortion is meaningless. This bill would outlaw the 

restrictive State laws that target abortion services and shut down 

clinics across the country. The bill would outlaw State-mandated 

medical procedures such as forced ultrasounds, restrictions on 

medication abortions, and other onerous TRAP laws. Simply put, 

this bill would end discrimination against abortion access for 

women based on their zip code. 

I am so proud to be the lead sponsor of this bill in the House 

and to partner with Senators Blumenthal, Baldwin, and Congress 

Members Fudge and Frankel to push as hard as we can on this 

bill. We already have 124 cosponsors in the House. 

Constitutional rights should never be subject to the personal 

whims or beliefs of political leaders. Nor should the safety of mothers, daughters, sisters, or wives be jeopardized in the process. 

Thank you for the opportunity to testify, and thank you for holding this important hearing to discuss how we can protect the 

health, safety, and rights of all women. 

[The prepared statement of Representative Judy Chu appears as 

a submission for the record.] 

Senator BLUMENTHAL. Thank you, Representative Chu. 

Representative Blackburn. 

STATEMENT OF HON. MARSHA BLACKBURN, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF TENNESSEE 

Representative BLACKBURN. Thank you, Mr. Chairman. I appreciate the opportunity to join you all. Senator Grassley, thank you 

for the invitation. 

I think that it is fair to say that every one of us at this table, 

and certainly each of you, we all want what is best for women. We 

differ on what that is, and we differ on how to get there. And I am 

very appreciative of the opportunity to be here and to talk with you 

about this legislation, the Women’s Health Protection Act. 

In my opinion, it is something that is extraordinarily broad, it is 

loosely written, and through its wide-ranging words would, in my 

opinion, substitute the special interests of the abortion industry for 

both the well-being of women and the value of human life. 

The legislation would jeopardize and nullify hundreds of laws, as 

has previously been mentioned at this table, laws that protect both 

mothers and their unborn children. Among my concerns with the 

bill—and Senator Grassley mentioned several of these—it would 

render impossible efforts by the States to limit abortions based on 

the sex of the child; it would put a double pressure on women, who 
10 

are often forced by familial or cultural pressures, to exercise male 

bias in pregnancy and eliminate a female child. 

Furthermore, this legislation sets a dangerous precedent because 

it would place unconstitutional limits on a State’s ability to assure 

the safety of medical facilities. Abortions are indeed invasive medical procedures and should be regulated by the States as such. 

In addition, by considering this legislation, many of your constituents perceive that this body is out of touch with the consensus 

opinion in this country. Public opinion polls show time and again 

that the American people support limits on abortion. They support 

this. Sixty percent of Americans believe abortion should not be permitted in the second trimester, and an overwhelming 80 percent 

believe it should never happen in the third. Women hold these convictions at a higher percentage than men, and it is no wonder. We 

bear life—and we bear the burden when public policies fail to support women at a critical hour. 

The Committee would be well advised to consider how far this 

bill goes in reversing and uprooting both a long-existing and rising 

consensus. S. 1696 would attack conscience exemptions that have 

existed since the 1973 abortion decision. It would bar laws that 

provide for periods of reflection and consideration before an abortion is chosen. It would even prevent a State from assuring that 

a physician is physically present when abortion drugs are given or 

even that only a physician may perform a surgical abortion. It 

would make the abortion process less safe. 

What the Senate should be considering today is the Pain-Capable 

Unborn Child Protection Act which passed the House of Representatives on June 17, 2014, on a bipartisan vote, 228–196. The PainCapable Act is a piece of legislation that is supported by the American people. It is based in science and filled with compassion. The 

Pain-Capable Unborn Child Protection Act limits abortions after 

the 20th week of pregnancy except in the instances of rape, incest, 

or to protect the life of the mother. Our Nation is one of only about 

seven countries in the world to allow elective abortion to term, and 

this legislation would take one small but vital step to move us closer to the international norms. 

Polls by Quinnipiac University, the Washington Post, and the 

Huffington Post have all shown that a strong majority of people 

support limiting abortion after the 20th week of pregnancy. 

Quinnipiac University’s poll shows that women support a 20-week 

limit in even greater numbers than men—60 percent of women 

versus 20 percent in opposition—a 35-point margin. 

Let me give you an example of why these have changed. You all 

have an exhibit from me, and I want to show you this. This is a 

3-D ultrasound of my grandson. It was made on March 11, 2009, 

before his birth June 12, 2009. This is the wonder of science. And 

I have to tell you how exciting it was for me to see this ultrasound. 

I was thrilled. I could tell—I could tell—before he was born, 3 

months before he was born, he had my eyes and nose. Now, for a 

grandmother, that is a really big deal. I could see his hands. I 

could see his arms. And I could see him peacefully resting in his 

mother’s womb. 

That is the wonder of science. That is life. Our Constitution does 

not put a qualifier on life. The pursuit of life, liberty, pursuit of 
11 

happiness, those protections, the right to life, liberty, pursuit of 

happiness, even in the mother’s womb. 

I urge this Committee to reconsider this legislation. We have 

mentioned today the horrors of the Kermit Gosnell trial, the Philadelphia-based abortionist who ran a dangerous, illegal, and ghastly 

so-called clinic. He was tried, rightfully convicted for the crimes he 

committed and the deaths that he caused in that terrible place. Yet 

the legislation that you are considering, the Women’s Health Protection Act, could be used to validate the acts that placed him behind bars and to invalidate the bipartisan legislation put in place. 

I find it so curious that your legislation is termed ‘‘The Women’s 

Health Protection Act.’’ In my opinion, it would be more accurately 

titled ‘‘The Removal of Existing Protections and Safety Measures 

for Women Undergoing Abortion Act.’’ 

I encourage you to reconsider your legislation, to take up the 

Pain-Capable Unborn Child Protection Act, and to be more in line 

with the consensus of Americans and the States who are making 

certain that abortion is indeed safe, legal, and rare. 

I yield the balance of my time. 

[The prepared statement of Representative Marsha Blackburn 

appears as a submission for the record.] 

Senator BLUMENTHAL. Thanks to each of you, and we are going 

to move to our next panel. We really appreciate your being here 

this morning. Thanks for your excellent testimony. 

Before you get too comfortable, I am going to ask you to stand 

because the custom of our Committee is to swear in our witnesses. 

If you would please rise? Do you affirm that the testimony you are 

about to give is the truth, the whole truth, and nothing but the 

truth, so help you God? 

Ms. NORTHUP. I do. 

Dr. CHIREAU. I do. 

Dr. PARKER. I do. 

Ms. TOBIAS. I do. 

Ms. TAYLOR. I do. 

Senator BLUMENTHAL. Thank you. Let me introduce our witnesses before they give their testimony. 

We are going to begin with Nancy Northup, who is the president 

and CEO of the Center for Reproductive Rights. She has worked 

as a constitutional litigator and Federal prosecutor before her appointment at the Center for Reproductive Rights, which is a global 

human rights organization that has documented rights abuses, 

brought ground-breaking cases before Federal and State courts, 

U.N. committees, regional human rights bodies, and has built the 

legal capacity of women’s right advocates in more than 55 countries. 

Dr. Monique Chireau is an obstetrician/gynecologist in Durham, 

North Carolina, and affiliated with multiple hospitals in the area, 

including Duke University Hospital and Durham Veterans Affairs 

Medical Center. She is one of 250 doctors at Duke University Hospital and one of 5 at Durham Veterans Affairs Medical Center who 

specialize in obstetrics and gynecology. 

Dr. Willie Parker, our third witness, has over 20 years of experience providing comprehensive women’s medical care. He is board 

certified and trained in preventive medicine and epidemiology 
12 

through the Centers for Disease Control. Dr. Parker currently provides abortion care for women in Alabama and Mississippi. 

Carol Tobias is president of the National Right to Life Committee. She has held various positions at the National Right to Life 

Committee since 1991. 

Representative Chris Taylor represents Assembly District 76 in 

the Wisconsin Assembly. Representative Taylor has a long history 

of working with the State legislature even prior to her election in 

2011, and she has led numerous State and local coalitions in various settings around the State of Wisconsin. 

We welcome you all and thank you very, very much for being 

here this morning. Nancy Northup. 

STATEMENT OF NANCY NORTHUP, PRESIDENT, CENTER 

FOR REPRODUCTIVE RIGHTS, NEW YORK, NEW YORK 

Ms. NORTHUP. Thank you, Senator Blumenthal, and thank you, 

Ranking Member Grassley, for having us here today for this important hearing. I am Nancy Northup, and I am president and CEO 

of the Center for Reproductive Rights. 

Today, one of our most basic protections of our Constitution—the 

right to make for ourselves the important decisions of our lives— 

is under assault for women throughout vast swaths of the Nation. 

There have been over 200 State laws passed in the last 3 years designed to make it harder or impossible for women to access abortion services in their communities. And we are not blocked by 

courts. This new wave of restrictions is shutting down clinics, closing off essential services, and harming women. 

This is the newest tactic in a four-decade campaign to deprive 

women of the promise of Roe v. Wade. There have been during 

those four decades terrorizing physical attacks; clinics bombed, 

vandalized, and torched; doctors and clinic workers murdered; and 

clinics blockaded. Twenty-five years ago, I locked arms with members of my church and concerned citizens in Baton Rouge to form 

a human chain of protection around a reproductive health care clinic as hundreds of Operation Rescue protesters descended, intent on 

obstructing patients from entering. This scene was played out over 

and over again across the Nation. Federal action was needed and 

taken in 1994, with Congress’ passage of the Freedom of Access to 

Clinic Entrances Act. 

Today, women’s access to abortion services is being blocked 

through an avalanche of pretextual laws that are designed to accomplish by the pen what could not be accomplished through brute 

force—the closure of facilities providing essential reproductive 

health care to the women of this country. 

At an alarming rate, States are passing laws that single out reproductive health care providers for excessively burdensome regulations designed to regulate them out of practice under the false 

pretense of health and safety. 

When Mississippi enacted such a law in 2012, a State Senator 

put it quite plainly: ‘‘There is only one abortion clinic in Mississippi,’’ he said. ‘‘I hope this measure shuts that down.’’ Right 

now, Mississippi’s sole clinic is holding on by virtue of a temporary 

court order. 
13 

Even when not flatly stated, the true purpose of these laws is 

evident. Abortion is one of the safest medical procedures, yet it is 

being singled out for burdensome restrictions not placed on comparable medical procedures. For example, obstetricians who perform miscarriage completions in their office practices are not subject to these onerous requirements, despite the fact that they are 

performing virtually the same medical procedure as abortion providers, who are subject to these requirements. 

The American Medical Association and the American College of 

Obstetricians and Gynecologists have gone on record against many 

of these laws. And, indeed, you have their testimony before you 

today for the ACOG. Courts have found some so at odds with medical standards that they can serve no purpose but to prevent 

women from ending a pregnancy. 

But the road blocks keep coming. A year ago, Texas passed a 

sweeping set of restrictions to devastating effect. At least one-third 

of that State’s clinics have been forced to stop providing abortion 

care. There is no clinic left in the Rio Grande Valley, an impoverished area with over 1.3 million residents. If the final requirement 

of Texas’ restrictions is allowed to go into effect in September, the 

number of clinics will plummet to less than ten to serve a sprawling State of over 260,000 square miles and 13 million women. 

Even before this new law, a 2012 study in Texas found that 7 

percent of women reported attempts to self-abort before seeking 

medical care. Now women are crossing the border into Mexico to 

buy miscarriage-inducing drugs at flea markets or off the shelves 

at pharmacies—and then seeking needed emergency care back in 

Texas. 

Like all of us here, I come to the issue of abortion rights with 

my own set of life experiences, personal commitments, and religious beliefs. As the Supreme Court wisely noted over 20 years ago 

in Planned Parenthood v. Casey, men and women of good conscience can disagree, and probably always will, about the moral 

and spiritual implications of ending a pregnancy. In reaffirming the 

basic tents of Roe v. Wade, the Court reminded us that ‘‘it is a 

promise of the Constitution that there is a realm of personal liberty 

which the government may not enter.’’ The most fundamental decisions about our reproductive health and lives are for each of us to 

make, and not for the government. 

One in three women in the United States makes the decision at 

some point in her life that ending a pregnancy is the right choice 

for her. That decision is based on her individual circumstances, her 

health, and her life. None of us walk in her shoes. None of us know 

the factors that lead to her decision. 

And when a woman makes that decision, she needs good, safe, 

reliable care from a health care provider she trusts, in or near the 

community that she calls home. 

But today a woman’s ability to do so increasingly depends on the 

State in which she happens to live. Like 20 years ago, Congress 

needs to take action to ensure that women’s constitutional rights 

and their ability to make the most personal of decisions is not 

taken from them. 

Thank you. 
14 

[The prepared statement of Nancy Northup appears as a submission for the record.] 

Senator BLUMENTHAL. Thank you, Ms. Northup. 

Dr. Monique Chireau. 

STATEMENT OF MONIQUE V. CHIREAU, M.D., 

DURHAM, NORTH CAROLINA 

Dr. CHIREAU. Yes, thank you. It is an honor to be here today, 

Senator Blumenthal, Senator Grassley. My name is Dr. Monique 

Chireau. I am on the faculty of the Duke University Medical 

School. I am also a practicing obstetrician/gynecologist and a clinical researcher. 

S. 1696 could reasonably be interpreted to invalidate virtually 

any type of current State laws which place restrictions or regulations on abortion. It would also endanger health care providers’ 

freedom of conscience and would prohibit the future enactment of 

such protective laws. 

The stated purpose of the bill, as we have understood it, is to 

protect women’s health by ensuring that abortion services will continue to be available. Implicit in this stated purpose of the bill are 

the four following assumptions: number one is that abortion is good 

and safe for women; number two, that State abortion restrictions 

and regulations are medically unwarranted; number three, that access to abortion is important to women’s health; and, number four, 

that the State has no interest in protecting unborn children. I will 

address each of these in turn. 

The Centers for Disease Control define an induced abortion as 

‘‘an intervention performed by a licensed clinician that is intended 

to terminate a suspected or known intrauterine pregnancy and 

produce a nonviable fetus at any gestational age.’’ The U.S. Supreme Court has repeatedly acknowledged that abortion is inherently different from other medical procedures, because no other 

procedure involves the purposeful termination of a potential life, 

and that the abortion decision has implications far broader than 

those associated with other medical treatment. 

Assumption number one is that abortion is good for women. 

However, a substantial body of literature indicates that induced 

abortion is associated with significant risks and potential harms to 

women. It is stated to be very safe at early gestational ages; however, in a very large study from Finland of 42,619 women, the maternal mortality rate from abortion was 14.1 per 100,000. Approximately 20 percent of the women in this study experienced severe 

adverse events, such as hemorrhage and infection. 

This study included both surgical and medical abortions. These 

statistics represent a significant burden of disease, and if they were 

extrapolated to the United States, that would translate into 

260,000 adverse events per year. 

Further research has also demonstrated that the risk for abortion performed at greater than 21 weeks is greater—is greater 

when performed at 21 weeks than at lower gestational ages. The 

risks for death ranged from about 0.1 to 0.4 per 100,000 to 8.9 per 

100,000. However, because of problems with the denominator of 

this study, the results cannot easily be extrapolated. The point is 

that late abortion carries a 77 times increased risk for mortality 
15 

compared with early abortion, and that is a significant issue. This 

is mortality. This is not morbidity. This is death. 

Other complications can occur following abortion. Induced abortion of a first pregnancy, as we have heard earlier, increases the 

risk of subsequent preterm birth. There is also a robust literature 

on mental health problems following abortion. These mental health 

problems include anxiety, depression, and so on. 

Assumption number two is that State abortion restriction regulations are medically unwarranted. States have a compelling interest 

in protecting the health of their citizens, and they have the authority to do so within regulatory frameworks, including State medical 

boards and departments of health. Historically, States have regulated medical procedures and clinics by establishing standards for 

training and credentialing. These standards protect patients from 

injury and death. 

This is important because the fact of the matter is that patientphysician interactions do not occur within a vacuum. The issue of 

whether patients have access is a two-sided issue, a two-edged 

issue. This is because access can be—you can have access to care 

which is inadequate, being performed by incompetent practitioners, 

or you can have access to good care. 

And zip codes do matter. In many zip codes in the United States, 

patients have access to care which is inadequate, which endangers 

their health. This bill would not protect the rights of patients because it would remove the ability of States to regulate the practice 

of medicine. 

In addition, the scope of practice for different types of clinicians 

is carefully defined. Recently, there have been attempts by midlevel practitioners in several States to assume the role of providing 

abortions. Again, this particular bill would remove the ability of 

States to monitor and supervise the practice of medicine through 

abortion. 

One of the questions that comes up in any of these discussions 

regarding the need for improved regulation, including monitoring of 

the access to clinics, widths of hallways so that emergency personnel can enter buildings, is, what is there to fear from complying 

with the law? If laws are enacted in order to protect the health of 

patients and—the health of patients and to protect really practitioners as well by providing them with the appropriate conditions 

to practice in, what is there to fear in this circumstance? 

The question really is, To what extent are we willing to surrender States’ ability to regulate laws regarding the provision of 

medical care? 

Finally, the fact that the State does have an interest in protecting unborn life is not acknowledged in this particular bill. 

There is no mention of unborn children at all, in spite of the fact 

that the purpose of the bill is to eliminate most regulations or restrictions on abortion. The Supreme Court has recognized since Roe 

v. Wade that States have a compelling interest in the potentiality 

of unborn life throughout the pregnancy. This is because unborn 

children and their mothers are vulnerable to injury, exploitation, 

and social disadvantage. We care about whether a nurse who is 

mixing chemotherapy is exposing her fetus to potentially carcinogenic or teratogenic drugs, and this relates to the interest around 
16 

when pregnancy begins. If we do believe that pregnancy begins at 

conception rather than at implantation, which is our standard medical definition, we need to begin to consider how to best protect the 

fetus at early gestational ages. Similarly, neonatologists are pushing back the boundaries of neonatal viability. This bill does not 

take into account these scientific advances because it removes restrictions on abortions at various gestational ages. 

So in conclusion, I would like to say that S. 1696 is a measure 

that seeks to overturn longstanding State restrictions on abortion 

that have been supported in the courts. It ignores not only widely 

supported policies and scientific evidence, but also prior Supreme 

Court rulings, and clearly targets State regulations which protect 

the health of our most vulnerable citizens—pregnant women and 

their unborn children. All access is not equal. Zip codes do matter, 

because we want patients’ zip codes to provide—practitioners within zip codes to provide care that is sensitive, affordable, comprehensive, and competent. 

Thank you. 

[The prepared statement of Dr. Monique Chireau appears as a 

submission for the record.] 

Senator BLUMENTHAL. Thank you, Dr. Chireau. 

Dr. Parker. 

STATEMENT OF WILLIE PARKER, M.D., 

BIRMINGHAM, ALABAMA 

Dr. PARKER. Good morning, Senators. I consider it a real privilege to speak before this body this morning. My name is Dr. Willie 

Parker, and I am here to today to offer testimony in support of the 

Women’s Health Protection Act. 

I have devoted my whole career to helping women have the families that they want by providing them with prenatal care and delivering their babies, as well as providing them with medically accurate sex education, contraception, and, when they need it, safe 

abortion care. 

If there is a war to defend the right to safe and legal abortion, 

then Mississippi, where I practice, is on the front line. The State 

recently passed laws restricting the provision of abortion to obstetrician/gynecologists and those with hospital admitting privileges. 

Now, this law, which is completely medically unnecessary, would 

shut down the one remaining clinic in that State, and thereby 

would effectively deny women in that State access to abortion. On 

top of this, the State also has mandated delays that are both costly 

and burdensome to the women seeking this care. A woman’s access 

should not be denied to her simply because she lives in the State 

of Mississippi, or anywhere else, for that matter. The thing that 

should determine the care that a woman receives, it should be determined by medical evidence and not by her zip code. 

Now, the proponents of these laws would say that they are protecting the health of women, and they are within their right to believe that, but the truth would suggest otherwise. Here are the 

facts in Mississippi: there are far too many teen and unintended 

pregnancies; the infant mortality and maternal mortality rates are 

extremely high; and there are far, far too many Mississippians living in abject poverty. These realities confront every woman wheth-
17 

er she has an undesired pregnancy or a wanted but fatally flawed 

one. What women in Mississippi need is safe, compassionate medical care, and that need is urgent, and that care should include 

abortion. Because of these facts, I made what I consider to be the 

moral decision to provide abortion care in this State. 

Now, invariably, given the climate around abortion in this country, I field questions from people regarding that decision, and the 

most frequently asked question is: Why? Why do you do this? Well, 

the short answer is because if I do not, who is going to do it? 

If women in Mississippi and States surrounding can find a way 

to travel from rural areas under hostile circumstances to access the 

abortion care that they are entitled to, then I made a personal decision that I wanted there to be someone at that clinic to meet them 

when they came. 

One patient that I often think of as I think about the work that 

I do is one of the first patients I took care of in Mississippi, who 

was a 35-year-old pregnant woman with five children, the youngest 

of whom had recently died the year before from cancer. This 

woman found herself with an unplanned pregnancy, and she confided in me that at this particular point in her life she could not 

care for another child, either economically or emotionally. 

Now, she had already traveled an extensive distance to come to 

the mandated counseling that she was required to receive. And 

while she was completely resolute when she walked in the door and 

knew what was best for her and her family, she was still required 

to be delayed in her decision for political reasons that had nothing 

to do with her or her medical care. 

Other women that I saw on that same day were returning for 

their procedure after having made the mandated wait, and they 

had recently completed a second trip from hours away to receive 

their care. These women made it to the clinic despite distance, 

work considerations, child care obligations, and travel costs. These 

women typify the hardships that Mississippi women and many 

other women around this country face as they endure the barriers 

created by the present laws. 

In the 24 years that I have practiced medicine, I have learned 

a few things, and this is what I can tell you. Every patient is 

unique. Every woman is different. And when it comes to abortion, 

every one of them is grappling with a dilemma. I define a dilemma 

as a situation in which one has to make a decision between two undesirable outcomes, and yet one does not have the luxury of not 

making that decision. 

While the stories of the women that I see might differ, what they 

all have in common is that for them it is increasingly difficult for 

them to access abortion. So as I said earlier, people ask me, ‘‘Why 

do you do it?’’ Well, I think the answer is very simple. I want for 

women what I want for myself. I want a life of dignity, good health, 

self-determination, and I want the opportunity to excel and to contribute in the manner that I best can. 

We know that when women have access to abortion, contraception, and medically accurate sex education, they thrive in just the 

matters that I mentioned. It should be the same for all women, no 

matter where they live, because the ability to live the life that you 

imagine should not be limited by your zip code. 
18 

Thank you. 

[The prepared statement of Dr. Willie Parker appears as a submission for the record.] 

Senator BLUMENTHAL. Thank you, Dr. Parker. 

Ms. Tobias. 

STATEMENT OF CAROL TOBIAS, PRESIDENT, NATIONAL 

RIGHT TO LIFE COMMITTEE, WASHINGTON, DC 

Ms. TOBIAS. Mr. Chairman, Senator Grassley, and members of 

the Committee, thank you for giving me this opportunity to testify. 

I am Carol Tobias, president of the National Right to Life Committee. NRLC is a nationwide federation of 50 State-affiliated 

right-to-life organizations. We are the Nation’s oldest and largest 

pro-life organization. 

We find the formal title or marketing label, ‘‘Women’s Health 

Protection Act,’’ to be highly misleading. The bill is really about 

just one thing: stripping away from elected lawmakers the ability 

to provide even the most minimal protections for unborn children, 

at any stage of their development. The proposal is so sweeping and 

extreme that it would be difficult to capture its full scope in any 

short title. Calling it the ‘‘Abortion Without Limits Until Birth Act’’ 

would be more in line with truth-in-advertising standards. 

In its 1980 ruling in Harris v. McRae, upholding the Hyde 

amendment, the U.S. Supreme Court said: ‘‘Abortion is inherently 

different from other medical procedures, because no other procedure involves the purposeful termination of a potential life.’’ 

Even many Americans who identify as ‘‘pro-choice’’ struggle with 

the abortion issue because they see it as a conflict involving life 

itself. Many, while not fully sharing our view that the unborn child 

should be directly protected in law, nevertheless support the kinds 

of laws this bill would strike down, laws that take into account 

what most Americans recognize as a life-or-death decision. 

In contrast, the drafters of S. 1696 apparently believe that any 

woman considering abortion must be shielded from any information 

that may cause her to change her mind. 

Under S. 1696, elective abortion would become the procedure 

that must always be facilitated, never delayed, never impeded to 

the slightest degree. 

What types of laws would the bill invalidate? The list includes 

limits on abortions after 20 weeks, past the point at which unborn 

children can experience pain, which are supported by sizable majorities nationwide; laws limiting abortion after viability; laws protecting individuals or private medical institutions from being forced 

to participate in abortion, which about three-fourths of the people 

support, and which the great majority of States have enacted; laws 

requiring that information be provided regarding alternatives to 

abortion, which 88 percent of the public supported in a Gallup poll; 

laws providing periods for reflection; laws prohibiting abortion because of the child’s sex, which over 85 percent support. All these 

would be invalid. 

Having failed in many cases to persuade the Federal courts to 

strike down the laws they dislike, the extreme abortion advocates 

now come to Congress and demand that this Federal pro-abortion 

statutory bulldozer be unleashed to scrape everything flat. 
19 

The bill would subject any law or Government policy that affects 

the practice of abortion, even indirectly, to an array of sweeping 

legal tests, designed to guarantee that almost none will survive. 

The general rule would be that any law that specifically regulates 

abortion would be presumptively invalid. The same would be true 

of any law that is not abortion-specific but has the effect or claimed 

effect of reducing access to abortion. 

It is apparent that those who crafted this bill believe that where 

abortion is involved, immediate access to abortion at any stage of 

pregnancy is the only thing that matters. 

Mr. Chairman, in a November interview with the newspaper Roll 

Call, you said, ‘‘As the election approaches, I think the voters are 

going to want to know where legislators stand on these issues.’’ But 

to know where every Senator stands on S. 1696 would require a 

vote by the full Senate. By all means, let us see where they stand. 

But in the spirit of ‘‘pro-choice,’’ how about giving the Senate a 

choice as well? On May 13, Senator Graham proposed an agreement under which S. 1695, which has 35 cosponsors, would receive 

a vote of the full Senate, along with a separate vote on his PainCapable Unborn Child Protection Act, S. 1670, which has 41 cosponsors. The Pain-Capable Unborn Child Protection Act would 

protect unborn children in the sixth month and later, with narrow 

exceptions. By this stage in their development, if not sooner, there 

is abundant evidence that unborn babies will experience great pain 

as their arms and legs are wrenched off by brute force in the common second-trimester dismemberment procedure known as D&E. 

Mr. Chairman, in your response to Senator Graham’s proposal, 

you made clear your opposition to his bill. But you went on to say, 

and I quote, ‘‘I am more than happy to cast a vote on it along with 

the Women’s Health Protection Act, and I hope they will be considered. This issue deserves to be before this body.’’ 

We agree. We challenge you and the leadership of the majority 

party to allow the American people to see where every Senator 

stands on both of these major abortion-related bills. Let the American people see which bill reflects the values of each member of the 

U.S. Senate: life or death for unborn children. Thank you. 

[The prepared statement of Carol Tobias appears as a submission 

for the record.] 

Senator BLUMENTHAL. Thank you, Ms. Tobias. 

Ms. Taylor. 

STATEMENT OF HON. CHRIS TAYLOR, STATE REPRESENTATIVE, WISCONSIN STATE LEGISLATURE, 76TH DISTRICT, 

MADISON, WISCONSIN 

Ms. TAYLOR. Thank you so much. Good morning. My name is 

Chris Taylor, and I am a State representative from the great State 

of Wisconsin, representing the 76th Assembly District. I so appreciate the opportunity, Chairman Blumenthal, to testify in strong 

support of the Women’s Health Protection Act, and I thank Ranking Member Grassley and Committee members for this opportunity 

today. 

I also want to thank my Senator, Tammy Baldwim, whom we are 

very proud of in Wisconsin, for leading the way in cosponsoring 

this important bill. 
20 

I am also the former public policy director for Planned Parenthood of Wisconsin. I have been for over a decade monitoring, advocating for, and attempting to get passed good public policy on reproductive health care. 

There is a consensus in Wisconsin about what Wisconsinites 

want the State legislature to focus on, and it is not abortion restrictions. It is on the critical economic issues that face our State. We 

have a stagnant economy in Wisconsin. We have stagnant wages. 

Working families are struggling. Those are the issues that Wisconsinites want the State legislature to focus on. But, unfortunately, 

that has not been the focus over the last 3 years, and Wisconsin 

has become one of the many battleground States where fights over 

a woman’s ability to access abortion care are being waged. 

We have only a few health centers in Wisconsin that provide 

abortions, and we have over a dozen abortion restrictions which 

have nothing to do with the health and safety of women and everything to do with politics. 

Wisconsin is on the verge of becoming a State like Mississippi 

where abortion is simply not accessible. A woman’s ability to access 

safe, legal abortion should not be dependent on where she lives or 

subject to the political whims of her State legislature, and that is 

why I am urging you to pass the Women’s Health Protection Act. 

Since 2011, we have seen a proliferation of abortion restrictions 

in Wisconsin, including restrictions on medication abortion, banning telemedicine, and requiring physicians who perform abortions 

to have hospital admitting privileges within 30 miles of their practices. We also have a forced ultrasound law. The hospital admitting 

privileges mandate is only imposed on physicians who provide 

abortions. 

I am very fortunate to serve on the Health Committee in the 

State Assembly. There was no medical evidence or testimony presented that the admitting privileges status of a woman’s abortion 

provider in any way enhances the health and safety of women who 

have abortions. In fact, there was no health care provider or health 

care organization who advocated for this law at all. 

In contrast, the medical community vocally opposed this mandate, including the Wisconsin Academy of Family Physicians, the 

Wisconsin Hospital Association, the Wisconsin Public Health Association, and the Wisconsin Medical Society that stated, ‘‘This requirement interferes with the patient-physician relationship and 

places an unneeded and unprecedented burden on Wisconsin physicians and women.’’ 

The effect of the hospital admitting privileges law is going to be 

to shut down one of four health centers that provides abortions because the two physicians at this center are ineligible for these admitting privilege requirements. That means that over one-third of 

the women who seek abortions in Wisconsin are going to have to 

go elsewhere. The effect of that is to increase waiting times at the 

three remaining health centers. Currently, there are delays of 3 to 

4 weeks to obtain an abortion in Wisconsin. With the closure of this 

clinic, those delays would be extended to 8 to 10 weeks. 

Finally, we would have no health care provider providing abortions post 18 weeks, and so women who have complications or tragedies in pregnancy past 18 weeks are going to have to go else-
21 

where. A delay of this magnitude clearly impacts all Wisconsin 

women seeking abortion care, but it has particular devastating effects on low-income women who rely on public transportation and 

cannot afford uncompensated work time and travel costs. So for 

poor women, these additional barriers may be insurmountable. 

The same law that requires admitting privileges also forces a 

woman seeking abortion to undergo an ultrasound 24 hours before 

the procedure. The provider must also describe and display the 

image to the woman. This is the most humiliating and degrading 

law that I have seen in Wisconsin. It is certainly the Government 

at its biggest and most intrusive. Women are not able to refuse in 

most cases what is an invasive vaginal ultrasound. Physicians have 

no ability to tailor their medical care to the unique situation of 

each individual woman or adopt the best standard of care. 

The medical community in Wisconsin also vocally opposed this 

restriction. They said that the mandatory performance of an 

ultrasound before an abortion is not an accepted medical practice 

or standard of care. This practice does not add to the quality or 

safety of the medical care being provided. Simply put, ultrasounds 

are being used in Wisconsin as political bludgeons. 

Unfortunately, my Republican colleagues did not listen to the 

Wisconsin medical community. They did not listen to their own 

Democratic colleagues. We have 18 women in my caucus, in my 

Democratic caucus. As we talked about these issues prior to the debate, we realized we all had our own experiences that caused us 

to make very personal decisions about reproductive health care. We 

had members who had experienced pregnancy loss, miscarriage, 

stillbirths, high-risk pregnancies, and sexual assault. And we are 

just a microcosm of all the women in Wisconsin who we represent. 

We decided that though we might be ignored by our colleagues 

on the other side of the aisle, that we would never be silent, and 

we decided to tell our own personal stories about why these laws 

are so harmful to women and have nothing to do with the reality 

of women’s lives and experiences. 

It is not my role as a legislator to dictate the most personal private decisions of my constituents. I have no business as a legislator 

dictating insupportable medical practices to a physician who is 

ethically obligated to provide the best care for women, and patients. But I am in the business of ensuring that the people in my 

district, the people I represent, are able to exercise their most fundamental, personal decisions about their lives. As it stands, with 

States legislating away those rights, we need the Women’s Health 

Protection Act more than ever. Wisconsin women and women 

throughout this country simply cannot wait. 

Thank you. 

[The prepared statement of Hon. Chris Taylor appears as a submission for the record.] 

Senator BLUMENTHAL. Thank you very much to all of our witnesses. I am going to ask, without objection, that all of your full 

statements be entered in the record, along with a statement from 

our colleague, Senator Feinstein. 

[The prepared statement of Senator Dianne Feinstein appears as 

a submission for the record.] 
22 

Senator BLUMENTHAL. And to begin the questions. A number of 

our colleagues have votes at noon, so we will try to move along as 

quickly as we can. 

Ms. Northup, there have been some very dismaying and sweeping claims about the breadth of this proposed legislation. Ms. 

Tobias referred to it as the ‘‘Abortion Without Limits Act.’’ In fact, 

it is narrowly targeted to certain kinds of, in effect, bogus legislation, legislation that masquerades as health protection but really 

is designed to prevent access to abortion services that are constitutionally protected. 

So I wonder if you could speak a little bit to the limited nature 

of this legislation, the fact, for example, that it specifically prohibits restrictions—and I am quoting from the Act—that ‘‘are more 

burdensome than those restrictions imposed on medically comparable procedures.’’ In other words, it sets medically comparable 

procedures as the criteria for preventing certain kinds of bars to access to abortion services. Could you speak to that issue? 

Ms. NORTHUP. Yes, Senator Blumenthal. Thank you for that 

question, because I think we did hear a lot this morning about the 

alleged sweep of this law. But, in fact, it is very targeted to what 

is happening right now in the country. It is very targeted to this 

new tactic of the last several years in which State legislatures have 

been passing laws that purport to be about health and safety but 

are not. And that has been shown to be defied in many ways. 

I would definitely recommend everyone read the testimony submitted for the record for today’s hearing from the executive vice 

president and CEO of the American College of Obstetricians and 

Gynecologists, and that, of course, is the well-respected organization to which the vast majority of OB/GYNs belong in this country. 

And in that testimony, they make quite clear—and I am quoting— 

‘‘The American College of Obstetricians and Gynecologists strongly 

support S. 1696, the Women’s Health Protection Act.’’ And they do 

so because from a scientific and medical perspective, these laws are 

not warranted. 

And I think what is really critical about the bill, which you 

pointed out, Senator, is right from the start, if this is something 

that is treating medically similar practices and procedures and 

services the same, there is no objection. Nothing is going to be 

struck. So that is the starting point. 

Second, if there is a substantial safety basis for the regulations, 

well, then, it is not a law that is unwarranted. That law will stand. 

So if it is treating similar medical procedures similarly, if it actually advances a safety basis, then that law is going to stand. And 

I think that is important, and there are factors that courts would 

look at in that. But that is what is really critical. If it is a true 

safety law, if it is not about singling out abortion provision for the 

motive of shutting down clinics, then that law stands. 

Senator BLUMENTHAL. In fact, a number of the regulations that 

have been claimed to be struck down by this legislation the Act 

specifically says would not be affected, for example, funding or insurance or parental consent, other kinds of regulations that are 

now on the books. 

Let me ask you, in terms of these regulations, many have been 

struck down by the courts. Many have been found to be unconstitu-
23 

tional. Why a Federal Act that prevents these laws from being 

passed as a matter of statute as opposed to simply having the jurisprudential route work its way? 

Ms. NORTHUP. Well, we are here today because we have just said 

200 of these underhanded laws have been passed, and it is not 

right that women should have to go to court year after year after 

year to get the medical services that the Constitution guarantees 

them. So I think it is important that it be made clear what kind 

of these are already on record. As I said, the American Medical Association is on record against many of these laws, ACOG is on 

record against many of these laws, and courts are finding many of 

these laws unconstitutional. It should not be a charade every year 

where women are under threat of losing access to services. And we 

need to make sure that we have strong protections because what 

is happening right now, we talked about Texas, which will go down 

to ten clinics in September if that law goes into effect. We have 

talked about Mississippi. We talked of Dr. Parker’s practices hanging on by a court order. And the unfairness of these laws—in Mississippi, the hospitals would not consider giving admitting privileges, not based on medical competency but based on their opposition or other reasons that have nothing to do with the competency 

of the doctors. 

So we need to make sure that there are strong protections, that 

we do not have this happen every year, and that women can be assured that, wherever they live, their personal, private decision is 

going to be respected. 

Senator BLUMENTHAL. While they are on the books, they have a 

very practical impact on women’s lives and a very severely restrictive impact on their legal rights and a very invasive and intrusive 

consequence for their exercise of personal choice. Is that correct? 

Ms. NORTHUP. That is absolutely correct. 

Senator BLUMENTHAL. Let me ask you finally on this round of 

questioning, the issue of admitting privileges, why are admitting 

privileges unnecessary, irrelevant, and in many instances found to 

be unconstitutional? 

Ms. NORTHUP. Well, thank you. That is a very important question because that is one of the underhanded tactics that has been 

sweeping the Nation. And, again, I would commend the testimony 

that has been filed by the American College of Obstetricians and 

Gynecologists where they oppose those. It is also the case that the 

American Medical Association and ACOG, in a brief in the Fifth 

Circuit as one example, went on record to talk about how there is 

no medically sound basis for that requirement. 

And what is really, I think, important for us to keep in mind is— 

and the AMA and ACOG talk about this in their briefs—abortion 

is safe, one of the safest procedures. And an example of how this 

underhanded tactic has closed a clinic in El Paso, Texas—it is not 

open now because of it—17,000 patients were seen in that clinic in 

10 years, and not one of those had to be taken to a hospital or 

transferred by the clinic. 

So these laws are unwarranted, and they are unfair. And I know 

that many of us here disagree about the constitutional issues 

around abortion, about the moral issues around it. But I would 

hope that we could agree that State legislatures should be trans-
24 

parent in their laws; they should not pretend to be about one thing 

when they are actually about another, because to do so undermines 

our faith in the rule of law. It is unfair, it is undemocratic, and it 

is unconstitutional. 

Senator BLUMENTHAL. Thank you very much. My time has expired. 

All of the documents that you referenced will be made a part of 

our record, without objection. 

[The information referred to appears as a submission for the 

record.] 

Senator BLUMENTHAL. Senator Grassley. 

Senator GRASSLEY. Yes, Ms. Tobias, you heard me mention 

Kermit Gosnell in my opening statement. We have the grand jury 

report reconstructing how he had been engaged in an enterprise to 

kill babies, even violate the law, and I think obviously violating the 

trust of his patients. 

State laws were in place in that State, but as the grand jury report says, authorities did not do inspections for fear it would be 

seen as ‘‘putting barriers up to women seeking abortions.’’ 

So my question: Wouldn’t this particular piece of legislation 

make it easier for these types of individuals to continue to operate 

with impunity? 

Ms. TOBIAS. This legislation would make it easier for them to operate. The law actually says—this legislation actually says that if 

a provision would single out abortion, it would be invalid, or if it 

would impede access to abortion. And one of the factors to help determine whether or not it impedes access to abortion is allowing 

the abortion provider to determine whether or not the new law, any 

law, would impede his ability to render services. 

So, yes, abortionists like Kermit Gosnell would be able to continue to practice, to set up shops. Actually we did see that many 

of the State health departments decided, after hearing about 

Gosnell and realizing that they as well as Pennsylvania had not 

done any kind of inspection of the clinics, went in and started 

doing them, and they were finding some horrible situations, and 

some clinics have been shut down because of that. 

But this law would say that if a law is specific to abortion, it is 

invalid, or if it would impede access to abortion. And then even 

then, from there it has to go on to whether or not the State can 

prove that it is going to improve access for women, health benefits 

for women, and even then, if it would be yes, then is it the narrow 

means possible? There are so many layers set up in this legislation 

that practically any law dealing with abortion or impeding access 

in any way to abortion would be considered invalid. 

Senator GRASSLEY. Dr. Chireau, some States have laws on the 

books that would require providers of abortion to be located near 

a health facility in the event that medical care is needed, and that 

would probably involve the life of a woman. Some States also require abortion providers to have admitting privileges to hospitals. 

First of all, do you agree with the laws? And then, second, could 

you elaborate on why they make sense in your expert medical opinion and tradition? 

Dr. CHIREAU. Yes, thank you for the question. So all too often— 

and this has been my experience as a practitioner—when abortion 
25 

complications occur, patients are told to present to the emergency 

room. They are not given any documentation. No one is told what 

was done and what the complications were. This has happened to 

me in practice. A patient experienced perforation of her uterus during a late abortion, had a very complicated hospital course, and I 

called the abortionist and asked, ‘‘Why did you do this? You knew 

that you perforated her at the time.’’ And essentially what he told 

me was that he knew that he did it, but that he did not want to 

send her to the emergency room. And I said, ‘‘That is really malpractice. It is not appropriate.’’ And, again, his response was, ‘‘Well, 

she started moving.’’ I said, ‘‘That is your issue. If a patient is moving during a procedure, that is your issue. You should be performing the procedure in such a way that it is comfortable.’’ 

But to get to—more directly to respond to your question, I do believe that physicians should have admitting privileges because that 

is part of the standard of care. If you perform a procedure on a patient, if you are caring for a patient, you need to be able to followup 

on the complications of that procedure. That is a surgical maxim. 

As an OB/GYN or a general surgeon or whatever surgical specialty 

you happen to be in, you need to take responsibility for that patient, if they have a complication, to either admit them to the hospital and care for them yourselves or arrange for transfer to the 

hospital so that that patient can be taken care of. Transfer agreements are very important because they provide for continuity of 

care, and this is why I believe that physicians (a) need to have admitting privileges and (b) need to be located within a hospital so 

that patients can be managed. So there are a couple of issues here. 

Number one, admitting privileges imply a level of competence in 

clinical practice on the part of physicians. If physicians cannot obtain admitting privileges, there are reasons why, and that is why 

peer review is generally the rule when patients are applying for 

privileges. When physicians cannot get privileges, it is most often 

because there are issues of competence; they have a trail in their 

background of malpractice events that causes their peers at the 

hospital to say this person is not someone that we want to be on 

the medical staff. 

Hospital credentialing protects patients. Hospital credentialing 

requires that a physician has demonstrated competence in doing 

specific procedures and that they are not running from medical 

boards or running from adverse actions on behalf of their licenses. 

Physician-to-physician communications improve the process of 

care. One of the major problems with morbidity and mortality in 

any surgical specialty, medical specialty, is the hand-off. It is like 

a baton hand-off in a race. If you fumble the hand-off, you lose the 

race. If you fumble the hand-off in medicine, patients are injured. 

Admitting privileges allow for discipline. If physicians are practicing outside the scope of practice, if their skills begin to deteriorate after time, admitting privileges provide for a regulatory framework where physicians who are in trouble or causing problems with 

patients can be disciplined. And this is one of the reasons why I 

think many people in the abortion industry oppose credentialing, 

because it exposes the fact if they are not competent, if they have 

had excessive numbers of complications, if they have a trail of injured patients and lawsuits, this is going to be exposed. And then, 
26 

finally, I think that it establishes the fact that if you cannot get 

privileges, you cannot meet the standards for medical practice. 

Finally, an important issue is that being on a hospital staff or 

being on a medical—part of a medical society implies that you are 

part of the medical community. If you are outside of that medical 

community, then clearly something is wrong; there is some issue 

going on. 

I hope I have answered your question. 

Ms. TOBIAS. Senator Grassley, excuse me. I have an article by 

Melinda Henneberger that talks about what happens when the 

abortion industry is allowed to regulate itself. I would like to request that this be added into the permanent record. 

Senator BLUMENTHAL. Without objection. 

[The article referred to appears as a submission for the record.] 

Senator BLUMENTHAL. And Senator Grassley has some documents he would like to enter. 

Senator GRASSLEY. Yes, I have 15 different—but I would just like 

to mention five: Concerned Women of America, Legislative Action 

Committee, a group of 30 female State legislators across the country, the Association of American Physician Surgeons, the American 

Association of Pro-Life Obstetricians and Gynecologists, and, last, 

several OB/GYN physicians, including John Thorpe, North Carolina; Steven Calvin, Minnesota; and Byron Calhoun of West Virginia. 

Thank you. 

Senator BLUMENTHAL. Thank you. All those documents will be 

made a part of the record, without objection. 

[The information referred to appears as a submission for the 

record.] 

Senator BLUMENTHAL. Senator Hirono. 

Senator HIRONO. Thank you, Mr. Chairman. 

I represent a State, Hawaii, that has been a leader in protecting 

women’s health and safety. And, in fact, in 1970, we were, I believe, the first in the country to decriminalize abortion, a woman’s 

right to choose, and, therefore, protecting a woman’s right to 

choose. 

And I also want to mention by background that the State senator 

who led the charge to provide women in Hawaii the right to choose 

was a practicing Catholic, and the Governor of the State of Hawaii, 

who allowed this bill, this very important bill, to become law to 

protect a woman’s right to make that choice, was a practicing 

Catholic who went to Mass every single day. We in Hawaii understand the separation of church versus state. 

Now, I do agree that abortion is a different procedure from other 

medical procedures because its foundation is a constitutional right. 

So in my view, there should be a high burden on laws that limit 

or abridge such a constitutional right. 

We have heard a lot of testimony from our panel members, so I 

wanted to ask Ms. Northup: Because the right to make this kind 

of a choice is based on a constitutional right, do you think that 

anti-choice laws should be based on medical necessity? 

Ms. NORTHUP. Absolutely, and I want to just say again all that 

this bill is about is being sure that women’s critical access to reproductive health care, including abortion services—and as I said in 
27 

my testimony, that is an issue for one in three women in the 

United States. That is women in every State, every congressional 

district, every city, and every town, and her health care is important to her. 

But this bill is about making sure that because State legislatures 

cannot just blatantly ban abortion, which is the desire of some people who sit in them, and some States have certainly been pushing 

that envelope. North Dakota has banned abortion at essentially 6 

weeks, and that is now in the courts. Of course, it has been enjoined because it is blatantly unconstitutional. The State in its responsive briefs in the case said they basically thought Roe v. Wade 

should be overturned. So you have that battle going on. 

But you also have this, you know, underhanded attempt to do 

what they cannot do by the front door by the back door. And so it 

is important that you make sure that regulation of abortion is not 

just about singling out abortion providers, but is actually based on 

good medical practice and scientific evidence. 

So the response to even Dr. Chireau’s statement is, look, if outpatient doctors who are doing, you know, outpatient surgeries need 

to have admitting privileges, that is fine. You know, let that be the 

medical standard that is applied across the board. No objection to 

that. This bill has nothing to say to that—— 

Senator HIRONO. I do not mean to cut you off, Ms. Northup, but 

I do have a question for Dr. Parker—my time is limited. 

Dr. Parker, you provide abortion services in Mississippi even if 

you do not even live there. I understand that you were denied hospital privileges in Mississippi. Is that correct? 

Dr. PARKER. Great to see you again, Senator. 

Senator HIRONO. Aloha. 

Dr. PARKER. As you know, I used to live in Hawaii and enjoyed 

serving under your leadership. 

With regard to my decision to travel to Mississippi to provide 

abortion care, it is in part in response to the fact that well over 

85 percent live in a county where there is no abortion provider, and 

so as I said earlier, my decision to go there was based on the fact 

that if nobody else will go, who is going to go? 

Senator HIRONO. Yes, I understand. 

Dr. PARKER. When I made that decision, the regulations changed 

in the State of Mississippi to require hospital privileges. I made an 

effort to apply to all of the hospitals in the given area, and many 

of the hospitals declined to evaluate my application. So why they 

chose to do that I am not sure, but in order to meet the law, I was 

about to—I was unable to do so because there were hospitals who 

simply declined to evaluate my credentials. I am not sure why they 

did that. 

Senator HIRONO. I think your experience just points out how difficult these laws make it for women in certain States to have access to certain kinds of health care services. 

Ms. Northup, I would imagine that these kinds of restrictions 

would disproportionately impact certain populations such as low-income women, women of color, and immigrant women. Would that 

be the case? 

Ms. NORTHUP. That is absolutely the case, and I gave the example in my testimony that in the Rio Grande Valley, which is one 
28 

of the poorest areas in the Nation, the clinic in McAllen, Texas, 

that had been providing good care for a long time to those residents 

had to close. And, again, it was under those circumstances where 

the doctors were not allowed to get their privileges. 

Senator HIRONO. Thank you. I just have one question for Ms. 

Tobias. Do you believe that Roe v. Wade should be overturned? 

Ms. TOBIAS. Yes, I believe—— 

Senator HIRONO. Thank you. 

Thank you, Mr. Chairman. 

Ms. TOBIAS. The answer is yes. I believe unborn children should 

be protected. 

Senator BLUMENTHAL. Thank you. 

Senator Graham. 

Senator GRAHAM. Thank you very much, Mr. Chairman. I want 

to thank you for having the hearing because I think it is an important topic, and I would like to join with Ms. Tobias’ recommendation that we have a hearing on my bill, which is the Pain-Capable 

Unborn Child Protection Act, S. 1670, and have a joint vote on the 

Senate floor and see where everybody falls out on it, because it is 

a subject worthy of debate. 

Let us see if we can find some common ground here about how 

these laws work. Ms. Tobias, is it your understanding that S. 1670 

would prevent a ban on third trimester abortions that protect— 

with exceptions for the life of the mother and rape and incest? 

Ms. TOBIAS. S. 1670? 

Senator GRAHAM. Excuse me. The other one, S. 1696. 

Ms. TOBIAS. The one today? 

Senator GRAHAM. Yes, ma’am. I am sorry. 

Ms. TOBIAS. Yes, this bill would limit—would prevent a ban on 

abortion in the last trimester. It would prevent—— 

Senator GRAHAM. Could you—Ms. Northup, do you agree with 

that? 

Ms. NORTHUP. The bill has provisions that track the constitutional standard that do say that post-viability there needs to be an 

exception for a woman’s life and health, as the Supreme Court has 

said. 

Senator GRAHAM. So could a State pass a law that banned abortion in the last trimester except for life of the mother and rape and 

incest? Your answer would be no? 

Ms. NORTHUP. The standard would have to be the one the Supreme Court has recognized. 

Senator GRAHAM. What do you say, Ms. Tobias? 

Ms. TOBIAS. Well, I think probably one of the best examples 

would be when the sponsor of the bill, Chairman Blumenthal, was 

asked if this bill would ban abortions. It talks about life or health, 

and he said that the health exception makes no distinction between 

physical or psychological health. So it would be very difficult—it 

would be impossible under this bill to ban abortions for health if 

psychology and psychological health is going to be comparable. 

Senator GRAHAM. Thank you. There are 13 States that ban elective abortions after 20 weeks except in the case of rape, incest, and 

the life of the mother. Would this bill strike those laws down? 

Ms. TOBIAS. Yes, it would. 

Senator GRAHAM. Do you agree with that, Ms. Northup? 
29 

Ms. NORTHUP. Like the Ninth Circuit did with Arizona’s 20-week 

ban, yes, it would be unconstitutional, and this bill tracks the U.S. 

Constitution standards. 

Senator GRAHAM. Thank you. States that have waiting periods, 

requiring a waiting period before the abortion is performed, would 

this bill strike that down? 

Ms. TOBIAS. Yes, this bill would say that if you impede access to 

abortion in any way, it would be struck down. 

Senator GRASSLEY. Do you agree with that? 

Ms. NORTHUP. I do not. It depends on what the court would look 

at. So, again, as we were talking about before—— 

Senator GRAHAM. So you do not know how the bill works? 

Ms. NORTHUP. Oh, yes, I do. It is that the first question would 

be, is this type of waiting period something that is also imposed on 

similar—— 

Senator GRAHAM. Well, the ones that are on the books, the ones 

that you are familiar with, can you name one State law with a 

waiting period that you think would survive? 

Ms. NORTHUP. Well, I would say that I think it is important that 

we look at the factors in the bill. Does it apply to similar services? 

Senator GRAHAM. Can you name one State with a waiting period 

requirement that you think would survive scrutiny under this bill? 

Ms. NORTHUP. Well, if it were able to say that it did not significantly impede access to services, if it was a waiting period that is 

not a particularly long one—— 

Senator GRAHAM. So you cannot give an example. 

Ms. Tobias, does this bill ban States’ requirements that a person 

can exercise their conscience about not performing an abortion? 

There are laws on the books that say that, right? 

Ms. TOBIAS. Yes. If someone says that, according to their conscience, they cannot take the life of an unborn child, that would be 

impeding or reducing access to abortion, which would be invalid—— 

Senator GRAHAM. Would this legislation invalidate those laws? 

Ms. TOBIAS. Yes, it would. 

Senator GRAHAM. Do you agree with that, Ms. Northup? 

Ms. NORTHUP. I do not agree. This legislation does not address 

the issue of conscience objection. 

Senator GRAHAM. Should it? Would you accept an amendment offered by me to make sure people of conscience do not have to do 

something like this? 

Ms. NORTHUP. Well, I think we have important laws that are on 

the books that respect people’s rights of conscience, and so—— 

Senator GRAHAM. Well, do you—as to this issue, would you accept an amendment by me to this bill to exempt conscience? 

Ms. NORTHUP. Well, I am not elected to make those decisions. 

Senator GRAHAM. I got you. Fair enough. 

Ms. NORTHUP. I think this bill clearly does not cover that. 

Senator GRAHAM. Fair enough. I think the answer would be no. 

So, Dr. Parker, is it standard medical practice for physicians operating on a child at 20 weeks to provide anesthesia to that child? 

Dr. PARKER. Well, Senator, I am not well versed in fetal surgery 

because most surgeries at 20 weeks would have to occur in utero. 
30 

Senator GRAHAM. Right, it would. Ms. Chireau, are you familiar 

with what would be the standard of care there? 

Dr. CHIREAU. Yes, it is, and that is because when fetal surgery 

is done—and I am very well aware of the fetal surgery landscape. 

Initially, when fetal surgery was being done, fetuses reacted very 

strongly to incisions, to placement of catheters, so—— 

Senator GRAHAM. Is it standard medical practice to provide anesthesia when you operate—— 

Dr. CHIREAU. Yes. 

Senator GRAHAM [continuing]. On a baby at 20 weeks? 

Dr. CHIREAU. Yes. 

Senator GRAHAM. Medical encyclopedias—and I am sorry I am 

running over; I will wrap it up here—encourage parents to talk to 

the baby at 20 weeks. They can hear sounds. They react to your 

voice. They can hear your heartbeat as a mother. They can hear 

your stomach growling, and they can react to loud noises. Does 

that make sense to you, Ms. Chireau? 

Dr. CHIREAU. Yes, it does. 

Senator GRAHAM. Okay. Has anyone ever been born at 20 weeks 

that survived? 

Dr. CHIREAU. As far as I am aware, no. 

Dr. PARKER. Not to my knowledge. 

Senator GRAHAM. I can show you twins. Thanks. 

Senator BLUMENTHAL. Senator Hatch. 

Senator HATCH. Well, thank you, Mr. Chairman. 

You know, Congress has a few times told the States that they 

had to pass certain legislation, but only as a condition of receiving 

Federal funds of some kind. Now, I am in my 38th year here in 

the U.S. Senate, and on this Committee, and I do not recall Congress ever passing a law that prohibited States from enacting entire categories of laws simply because Congress says so. I do not 

recall that. 

Can anyone on this panel give me an example of that? And if not, 

why is abortion so unique that Congress has this authority in this 

area but not in any other? Anybody care to take a crack at that? 

I do not see it, personally. 

Well, let me ask a question to you, Ms. Tobias. States have been 

passing laws regarding abortion for almost 200 years. The Supreme 

Court took over in its Roe v. Wade decision, and since 1973 the 

United States has had the most permissive abortion laws in the 

world today. But most Americans have always opposed most abortions, and the vast majority of Americans support reasonable and 

commonsense abortion regulations. At least that has been my experience, and I do not think it is a false experience. 

This bill attempts to wipe it all out to eliminate even minimal 

regulations that most Americans support and that the Supreme 

Court has already said are constitutional. 

Now, I opposed this kind of legislation more than 20 years ago 

when I was Ranking Member of what is considered today the 

HELP Committee. This bill would not regulate abortions. It would 

regulate the States telling them what laws they may or may not 

pass. 

How does Congress have the authority to do that? 
31 

Ms. TOBIAS. Currently the law—other than what the Supreme 

Court will or will not allow—has the State legislatures elected by 

the people setting the laws for their States. I think that is actually 

a very good way to handle this. The States have been dealing with 

the conscience clauses, setting up the waiting periods, informed 

consent provisions, and the courts have been allowing these to 

stand. So it is difficult to say that a law that the Court has upheld 

is unconstitutional. So we certainly think that Congress would be 

overstepping in passing a law that would completely override a procedure that the Supreme Court has said is different. 

Senator HATCH. This bill would prohibit restricting abortions 

based on the reasons for the abortion. The way I read the bill, neither States nor the Federal Government could prohibit abortions 

performed because, for example, a child is a girl or because the 

child has a disability. Is that the way you understand it? 

Ms. TOBIAS. Yes. 

Senator HATCH. Dr. Chireau, this bill sounds like it is very deferential to medical judgment and that abortion should be treated 

like any other medical procedure. But under this bill, politicians, 

lawyers, and judges would make final decisions on such things 

such as which medical procedures are ‘‘comparable,’’ which tasks 

doctors may delegate to other personnel, which drugs may be dispensed, which medical services may be provided through telemedicine, how many visits to a medical facility are necessary, the relative safety of abortion services, which methods advance the safety 

of abortion or the health of women more or less than others. 

Now, from your perspective as a doctor, doesn’t this bill actually 

compromise the practice of medicine? 

Dr. CHIREAU. I think it does compromise the practice of medicine, 

and I believe that is on two levels: number one, for the reasons 

that you have enumerated; number two, because I do believe that 

current legislation in the States to set clinic—specify access to clinics and so on and so forth is protective to patients. So I think that 

it is doubly a problem, number one, for those reasons that you have 

listed and also because the regulations that have been enacted 

were enacted in an attempt to prevent abortion providers from 

being exempted from the same sorts of regulatory frameworks that 

other medical practitioners have to operate within. 

Senator HATCH. This bill would prohibit restrictions on abortions 

that are not also imposed on what it calls ‘‘medically comparable 

procedures.’’ Now, that is just one of the key terms in this bill that 

are brand new and completely undefined. But this bill makes a 

pretty clear statement that there is nothing unique about abortion, 

nothing that makes it different from any other medical procedure. 

And that, of course, is not true. 

Dr. CHIREAU. That is correct. 

Senator HATCH. Whether you are pro-abortion or anti-abortion. 

Even in Roe v. Wade, the Supreme Court said that the State has 

unique reasons for restricting abortion because it involves what the 

Court called ‘‘potential human life.’’ And in Harris v. McRae, the 

Supreme Court in 1980 held that the abortion ‘‘is inherently different from other medical procedures because no other procedure 

involves the purposeful termination of a potential life.’’ 
32 

I do not think that we need the Supreme Court to tell us that, 

but there it is. Doesn’t that settle this question and completely undercut the entire theory behind this bill? 

Dr. CHIREAU. Yes, I believe that it does, and I think that the 

issue of comparable procedures is really false. I believe that abortion is a unique procedure. As you have said, it is the only procedure that terminates a human life. 

In addition, from the technical perspective, an abortion is a very 

different procedure from, say, completing a miscarriage or doing a 

dilation and curettage on an non-pregnant woman. 

Senator HATCH. Mr. Chairman, could I ask just a couple more 

questions? 

Senator BLUMENTHAL. Sure. 

Senator HATCH. I know that there are just two of us here. 

Senator BLUMENTHAL. We are approaching a vote, and Senator 

Cruz is here, so—— 

Senator HATCH. Oh, I did not see Senator—— 

Senator CRUZ. Take all the time you—— 

Senator HATCH. Well, let me just ask one more. 

The Supreme Court created one set of rules in 1973 for evaluating the constitutionality of abortion regulations. Then the Court 

changed the rules in 1992. Now, this bill creates yet another standard: prohibiting regulations that a State cannot show by clear and 

convincing evidence significantly advanced the safety of abortions. 

Now, it is bad enough that the Supreme Court sometimes does 

Congress’ job, but here is Congress attempting to turn around and 

do the Court’s job. 

But it gets worse. This bill applies its rules and regulations to 

all State and Federal statutes, to all State and Federal regulations 

in the past, in the present, and in the future. Does this mean, for 

example, that States would be required to repeal any laws or regulations already on the books that do meet these new rules? 

Dr. CHIREAU. Yes, sir, I think that that is a very important point. 

I think that essentially this law guts States’ rights with respect to 

abortion. It creates abortion as a special protected class of procedure and abortion providers as a special protected class of providers. 

Senator HATCH. Well, I cannot imagine why any State legislature 

would support this, no matter their position on abortion. Now, I am 

having real trouble here with this approach, but at least I wanted 

to raise these issues because I think they are important issues. 

Thank you, Mr. Chairman. 

Senator BLUMENTHAL. Thank you. 

Senator HATCH. Sorry to impose on Senator Lee and Senator 

Cruz. 

Senator BLUMENTHAL. Senator Cruz, Senator Lee was here earlier, so I am going to call on him at this point. Thank you. Thanks, 

Senator Hatch. 

Senator LEE. Thank you, Mr. Chairman. Thanks to all of you for 

joining us today. 

There was a time when the humanity of an unborn child could 

plausibly be dismissed as philosophical conjecture. Today we know 

it is a biologic fact. For every excited announcement, every baby 

shower, every ultrasound image posted on Facebook, all of this at-
33 

tests to this scientifically confirmed, very deep human truth. The 

only difference is that unborn boys and girls are small and they are 

helpless and they are mute. They cannot speak for themselves. 

They rely on strangers. They rely on us to speak for them. 

I believe in the innate dignity of every human life, and I believe 

every human society is rightly judged by how it treats its most vulnerable members—the aged, the poor, the sick, the disabled, the 

abused, the homeless, the widowed, and the orphaned, the pregnant mother in crisis, and, of course, the unborn child in the womb. 

Neither our society at large nor our laws have to pit the vulnerable one against another. We can choose instead, we have the 

power to choose instead to welcome and to love and to protect all, 

even and especially the weakest among us. Making that choice presents an enormous challenge to all of us as policymakers, as citizens, as neighbors and friends, as parents and children ourselves. 

But the challenge of life is, after all, why we are here: to use our 

strength in defense of the weak. We should choose to embrace that 

challenge and to do so with love and with open arms. We can 

choose life, and when this debate finally 1 day ends, I think we 

will. I think we will choose life. 

So let me start with a couple of questions for Ms. Tobias, if I 

might. At a rudimentary level, does S. 1696 even consider the possibility that there might be more than one life involved and at 

stake when a woman seeks an abortion? 

Ms. TOBIAS. No, it does not. 

Senator LEE. And yet this proposed legislation would have farreaching effects, potentially not just for one life but for two, in any 

given instance. Isn’t that right? 

Ms. TOBIAS. For every abortion that is performed, there is a 

human life that is destroyed. This bill does not mention it, treating 

the child as a tumor instead. 

Senator LEE. So in that respect, it is very different than other 

legislation that might just affect one person, might just affect the 

health of one person. This one involves the potential in each instance for the destruction of one person’s life, its complete termination. 

Ms. TOBIAS. Yes. 

Senator LEE. Many medical experts and health providers have 

strong moral and ethical concerns, as they have every right to 

have, with providing abortions. And yet this bill, as I understand 

it, would have the Federal Government telling the States that they, 

the States, may not protect the rights of conscience for medical providers. My own State, for example, guarantees the right of a medical provider to refuse to participate, admit, or treat for an abortion 

based on moral or based on religious grounds. These laws matter. 

I can point to several instances in which, absent such laws, university or hospital policies would have forced medical personnel to perform abortions, notwithstanding and against serious moral or religious objections. 

So, Ms. Tobias, let me just ask, what role do freedom-of-conscience laws currently play? And what effect would this bill have 

on those laws? And what concerns should we have and would you 

have with such an outcome? 
34 

Ms. TOBIAS. A lot of people go into the medical field because they 

want to take care of people. They go into obstetrics and gynecology, 

they become delivery room nurses because they want to take care 

of pregnant women and babies, and they do not want to kill unborn 

children. If they are told that they have no choice, that they will 

have to perform or participate in the performance of an abortion 

procedure, they will either be doing something that is very strongly, deeply offensive to them, or they will leave the field, which 

means we would have a lot of wonderful doctors and nurses who 

could be helping pregnant women and their children, finding something else completely to do. I think that would actually be a huge 

detriment to the medical community. This bill would strike down 

conscience laws because those laws would impede or reduce access 

to abortion. 

Senator LEE. Thank you. Thank you for your answers. 

I see my time has expired. Thank you, Mr. Chairman. 

Senator BLUMENTHAL. Thank you. 

Senator Cruz. 

Senator CRUZ. Thank you, Mr. Chairman. I want to thank each 

of the witnesses for coming and joining us today. 

The legislation this Committee is considering is extreme legislation. It is legislation designed to eliminate reasonable restrictions 

on abortion that States across this country have put in place. It is 

legislation designed to force a radical view from Democrats in the 

Senate that abortion should be universally available, common, 

without limit, and paid for by the taxpayer. 

That is an extreme and radical view. It is a view shared by a 

tiny percentage of Americans, although a very high percentage of 

activists in the Democratic Party, who fund and provide manpower 

politically. And it is also a very real manifestation of a war on 

women given the enormous health consequences that unlimited 

abortion has had, damaging the health and sometimes even the 

lives of women. 

I have with me 317 statements from Texas women who have 

been hurt by abortion, along with letters from Texans opposing this 

bill, along with letters from pro-life doctors, nurses, lawmakers 

across the United States that, with the Chairman’s permission, I 

would like to have entered into the record. 

Senator BLUMENTHAL. Without objection. 

[The information referred to appears as a submission for the 

record.] 

Senator CRUZ. A number of the restrictions that this legislation 

would invalidate are restrictions, commonsense restrictions, that 

the vast majority of Americans support, for example, restrictions on 

late-term abortions. The overwhelming majority of Texans do not 

want to see late-term abortions performed except in circumstances 

when necessary to save the life of the mother. And yet the United 

States’ laws and the law that would be reflected in this bill is extreme by any measure. 

Today the United States is one of seven countries in the world 

that permits abortion after 20 weeks. We are in such distinguished 

company as China, North Korea, and Vietnam—those known paragons of human rights. 
35 

If you look at some other countries across the world, in France 

abortion is prohibited after 12 weeks. In Italy abortion is prohibited after 121⁄2 weeks. In Spain abortion is prohibited after the first 

trimester. In Portugal abortion is prohibited after 10 weeks. This 

is the norm across the world, and yet this legislation would say 

that the 23 States who have enacted limits on late-term abortion, 

their laws would be set aside. 

A question I would ask Dr. Parker: Is it your view that these nations—France, Italy, Spain, Portugal—that they are somehow extreme or manifest a hostility to the rights of women? 

Dr. PARKER. Senator Cruz, thank you for your question. I am not 

an international human relations expert. I can tell you that when 

abortion is legal and safe that the known mortality related to 

women taking desperate measures when abortion is illegal is greatly minimized, as demonstrated by what happened in this country 

after 1973. 

I do know that internationally in a country like Ghana, where I 

have traveled, whereas they have made great strides toward reducing their maternal death rate by having better access to maternal 

care, despite the fact that abortion is legal, because it is so heavily 

stigmatized when women do not access that care, that—the major 

cause of maternal mortality in Ghana is related to unsafe abortion. 

So if access to legal and safe service being a reality for women 

with an unplanned or wanted pregnancy or a lethally flawed pregnancy reflects human rights values, then countries that restrict 

that, we would have to question their commitment to the humanity 

and safety of the women in their populations. 

Senator CRUZ. Well, thank you for your views, Dr. Parker. I 

would note that the suggestion that somehow France or Italy or 

Spain or Portugal or much of the civilized world is somehow insensitive to the rights of women is rather extraordinary. And the idea 

that America would rush out to embrace China and North Korea 

for the standard on human rights is chilling. 

I would note that this law would also set aside State laws prohibiting taxpayer-funded abortion. Thirty-two States have laws to do 

that. This law would also imperil State laws providing for parental 

notification if your child needs an abortion that at a minimum before that serious medical treatment that a parent has a right to be 

notified. Thirty-eight States have that law, and yet this extreme 

bill in Congress would imperil every one of those laws. 

And, finally, if I may have another 30 seconds to just share some 

of the stories from women in Texas: 

Nona submitted this story. She said, ‘‘I was told I just had a blob 

of tissue by Planned Parenthood after they did my pregnancy test 

and then referred me to a nearby abortion clinic. I was not given 

the option of having a sonogram. I was not given the option of 

hearing my baby’s heartbeat. Had I been given the opportunity of 

seeing my baby and hearing the heartbeat, I can assure you that 

I would not have chosen abortion. I would have chosen life instead 

of death. How can anyone believe that abortion should be legal 

after seeing a baby living in the womb of its mother on a sonogram 

and hearing the heartbeat of that baby? I felt I was pressured by 

Planned Parenthood because they told me that the best thing I 

could do was have an abortion since I was so young. I was 15 years 
36 

old and still in high school. That abortion ruined any chance of me 

giving birth. As a result, I have had five miscarriages, three of 

them have been tubal pregnancies requiring emergency surgery 

and were very near death experiences. I have suffered from bouts 

of depression and attempted suicide, self-mutilation. My experience 

of emotional trauma after abortion is the same as millions of other 

women and their families.’’ 

I have 317 statements, each as powerful as that in terms of the 

human consequences of what this legislation would produce. 

Thank you, Mr. Chairman. 

Senator BLUMENTHAL. Thank you. 

Ms. Northup, would this legislation prohibit the use of 

ultrasounds when a patient requests them? 

Ms. NORTHUP. Oh, no, not at all. This law again is just very focused on those underhanded type of restrictions that are treating 

abortion not like similarly situated medical practices that do not 

advance health and safety and are harming access to services. 

Senator BLUMENTHAL. In essence, it would be irrelevant to the 

instance that Senator Cruz has just described. 

Ms. NORTHUP. Yes, absolutely. It also very explicitly does not 

cover the question of insurance funding. It is not addressing that. 

It would not invalidate those laws. It has nothing to do with minors. It specifically says it does not address issues about parental 

consent and notification laws. 

Senator BLUMENTHAL. Dr. Chireau, have you ever performed an 

abortion? 

Dr. CHIREAU. No, I have not. 

Senator BLUMENTHAL. Dr. Parker, how many abortions have you 

performed? 

Dr. PARKER. I do not have the numbers right off, but I can tell 

you that over 20 years of patient care, I have seen thousands of 

women, and some of those women have needed abortion care. 

Senator BLUMENTHAL. And in your experience—over how many 

years? 

Dr. PARKER. Twenty. 

Senator BLUMENTHAL. Twenty years—has the width of a hallway 

in those clinics where you have performed your medical services affected the quality or expertness of those medical services? 

Dr. PARKER. No, Senator. 

Senator BLUMENTHAL. Has the admitting privileges within that 

State affected the quality or effectiveness of your medical services? 

Dr. PARKER. Only to the extent that they prevented me from providing care to women. 

Senator BLUMENTHAL. They have barred you entirely, but admitting privileges are irrelevant to the quality and excellence of your 

medical services because anyone in need of a hospital will be admitted to that hospital. 

Dr. PARKER. Correct, Senator. 

Senator BLUMENTHAL. And the waiting period, is that relevant to 

the quality or effectiveness of your medical services? 

Dr. PARKER. The reality, Senator, is that women are extremely 

thoughtful, and most women that I meet, when they present to me 

to be counseled about their options, they have been thinking about 

what they are going to do about their pregnancy from the minute 
37 

that they found they were pregnant. So I know women to be extremely thoughtful, and I have not seen any woman’s ability to 

make this complex decision enhanced by being forced to wait longer 

than she has already thought about it. 

Senator BLUMENTHAL. Thank you. 

Ms. Northup, in response to a number of Senator Graham’s questions, you essentially said that the limits embodied and incorporated in this bill were the constitutional standards. Is that correct? 

Ms. NORTHUP. That is correct. For example, most States under 

the Supreme Court’s constitutional rulings can ban abortion later 

in pregnancy, and do. And as long as they have an exception for 

women’s health and life, those laws are on the books now, and they 

would still be on the books. 

Senator BLUMENTHAL. In effect, this law basically enforces the 

Constitution. 

Ms. NORTHUP. Absolutely enforces every woman’s constitutional 

right to make the important decisions for herself. 

Senator BLUMENTHAL. And, finally, in those countries—and a reference was made to a number of them—where abortion is made illegal, is it made safer? 

Ms. NORTHUP. No. Around the world many of the places where 

abortions happen, women are terminating pregnancies where it is 

illegal and it is unsafe. And whether you see this country before 

Roe v. Wade or you look at places in Latin America and Sub-Saharan Africa today, when women do not have access to safe and legal 

abortion, they are harmed. 

Senator BLUMENTHAL. You made reference, speaking about the 

State of Texas, to women in Texas going across the border to Mexico so that they could buy at a flea market drugs necessary, they 

thought, for abortions because they could not get that service in the 

United States? 

Ms. NORTHUP. Yes. As the clinics have been shrinking in Texas 

because of laws that—again, I commend the American Medical Association’s brief in the Fifth Circuit talking about the medically unnecessary laws that have been passed in Texas. That is the AMA, 

a very mainstream medical opinion. Because it is taking clinics 

from three dozen, cut by a third, and it will be down to less than 

ten if it is allowed to go into effect, women have been going over 

the border in Mexico. They have been buying medication on the 

black market. They have been trying to self-abort. And the situation is going to be worse. Women are hurt when they cannot get 

the medical care that they need. 

Senator BLUMENTHAL. Ms. Taylor, in your experience in Wisconsin, have the restrictions on women’s access to reproductive 

rights made abortions safer? 

Ms. TAYLOR. No, Mr. Chairman, they have not. 

Senator BLUMENTHAL. Have they created confusion, in fact, discouraged women from seeking to exercise their right? 

Ms. TAYLOR. Absolutely, and they have sent women out of State. 

Senator BLUMENTHAL. Thank you. 

We are voting, so I apologize. I am going to have to close the 

hearing. My colleagues are on their way there. I want to enter into 

the record, without objection, various statements, including 
38 

Planned Parenthood in Southern New England, a statement that 

has been submitted for the record. 

As is our custom, our record will remain open for 1 week in case 

my colleagues have additional questions, and I again really want 

to thank every one of our witnesses for participating in this very, 

very important hearing. Thank you all for attending. 

[Whereupon, at 12:08 p.m., the Committee was adjourned.] 

[Additional material submitted for the record follows.] 
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A P P E N D I X 

ADDITIONAL MATERIAL SUBMITTED FOR THE RECORD
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PREPARED STATEMENT OF SENATOR TAMMY BALDWIN
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PREPARED STATEMENT OF REPRESENTATIVE JUDY CHU
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QUESTIONS SUBMITTED TO NANCY NORTHUP BY SENATOR COONS
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QUESTIONS SUBMITTED TO DR. WILLIE PARKER BY SENATOR COONS
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QUESTIONS SUBMITTED TO NANCY NORTHUP BY SENATOR BLUMENTHAL
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QUESTIONS SUBMITTED TO DR. WILLIE PARKER BY SENATOR BLUMENTHAL
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409 
410 
411 

ADDITIONAL SUBMISSIONS FOR THE RECORD

A list of material and links can be found below for Submissions for the Record not 

printed due to voluminous nature, previously printed by an agency of the Federal 

Government, or other criteria determined by the Committee: 

Case files documented August 19, 2011: 

http://www.cruz.senate.gov/files/documents/20141218lStories.pdf 

Æ