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CHILD INTERSTATE ABORTION NOTIFICATION ACT 

HEARING 

BEFORE THE

SUBCOMMITTEE ON THE CONSTITUTION 

OF THE

COMMITTEE ON THE JUDICIARY 

HOUSE OF REPRESENTATIVES 

ONE HUNDRED TWELFTH CONGRESS 

SECOND SESSION 

ON

H.R. 2299 

MARCH 8, 2012 

Serial No. 112–87 

Printed for the use of the Committee on the Judiciary 

( 

Available via the World Wide Web: http://judiciary.house.gov 

(II) 

COMMITTEE ON THE JUDICIARY 

LAMAR SMITH, Texas, Chairman 

F. JAMES SENSENBRENNER, JR., 

Wisconsin 

HOWARD COBLE, North Carolina 

ELTON GALLEGLY, California 

BOB GOODLATTE, Virginia 

DANIEL E. LUNGREN, California 

STEVE CHABOT, Ohio 

DARRELL E. ISSA, California 

MIKE PENCE, Indiana 

J. RANDY FORBES, Virginia 

STEVE KING, Iowa 

TRENT FRANKS, Arizona 

LOUIE GOHMERT, Texas 

JIM JORDAN, Ohio 

TED POE, Texas 

JASON CHAFFETZ, Utah 

TIM GRIFFIN, Arkansas 

TOM MARINO, Pennsylvania 

TREY GOWDY, South Carolina 

DENNIS ROSS, Florida 

SANDY ADAMS, Florida 

BEN QUAYLE, Arizona 

MARK AMODEI, Nevada 

JOHN CONYERS, JR., Michigan 

HOWARD L. BERMAN, California 

JERROLD NADLER, New York 

ROBERT C. ‘‘BOBBY’’ SCOTT, Virginia 

MELVIN L. WATT, North Carolina 

ZOE LOFGREN, California 

SHEILA JACKSON LEE, Texas 

MAXINE WATERS, California 

STEVE COHEN, Tennessee 

HENRY C. ‘‘HANK’’ JOHNSON, JR., 

Georgia 

PEDRO R. PIERLUISI, Puerto Rico 

MIKE QUIGLEY, Illinois 

JUDY CHU, California 

TED DEUTCH, Florida 

LINDA T. SA ́ NCHEZ, California 

JARED POLIS, Colorado 

RICHARD HERTLING, Staff Director and Chief Counsel 

PERRY APELBAUM, Minority Staff Director and Chief Counsel 

SUBCOMMITTEE ON THE CONSTITUTION

TRENT FRANKS, Arizona, Chairman 

MIKE PENCE, Indiana, Vice-Chairman 

STEVE CHABOT, Ohio 

J. RANDY FORBES, Virginia 

STEVE KING, Iowa 

JIM JORDAN, Ohio 

JERROLD NADLER, New York 

MIKE QUIGLEY, Illinois 

JOHN CONYERS, JR., Michigan 

ROBERT C. ‘‘BOBBY’’ SCOTT, Virginia 

PAUL B. TAYLOR, Chief Counsel 

DAVID LACHMANN, Minority Staff Director 

(III) 

C O N T E N T S 

MARCH 8, 2012 

Page 

THE BILL 

H.R. 2299, the ‘‘Child Interstate Abortion Notification Act’’ ................................ 3 

OPENING STATEMENTS 

The Honorable Trent Franks, a Representative in Congress from the State 

of Arizona, and Chairman, Subcommittee on the Constitution ....................... 1 

The Honorable Jerrold Nadler, a Representative in Congress from the State 

of New York, and Ranking Member, Subcommittee on the Constitution ....... 15 

WITNESSES 

Teresa Stanton Collett, Professor of Law, University of St. Thomas School 

of Law 

Oral Testimony ..................................................................................................... 18 

Prepared Statement ............................................................................................. 21 

The Very Rev’d. Katherine Hancock Ragsdale, President and Dean, Episcopal 

Divinity School 

Oral Testimony ..................................................................................................... 41 

Prepared Statement ............................................................................................. 43 

Michael J. New, Ph.D., Department of Social Sciences, University of Michigan—Dearborn 

Oral Testimony ..................................................................................................... 49 

Prepared Statement ............................................................................................. 51 

LETTERS, STATEMENTS, ETC., SUBMITTED FOR THE HEARING 

Prepared Statement of the Honorable Lamar Smith, a Representative in 

Congress from the State of Texas, and Chairman, Committee on the Judiciary ......................................................................................................................... 16

APPENDIX 

MATERIAL SUBMITTED FOR THE HEARING RECORD

Prepared Statement of the Honorable Trent Franks, a Representative in 

Congress from the State of Arizona, and Chairman, Subcommittee on the 

Constitution .......................................................................................................... 69 

Prepared Statement of the Honorable Ileana Ros-Lehtinen, a Representative 

in Congress from the State of Florida ................................................................ 71 

Response to Post-Hearing Questions from Teresa Stanton Collett, Professor 

of Law, University of St. Thomas School of Law ............................................... 72 

Response to Post-Hearing Questions from the Very Rev’d. Katherine Hancock 

Ragsdale, President and Dean, Episcopal Divinity School ............................... 76 

Prepared Statement of Americans United for Life, submitted by the Honorable Trent Franks, a Representative in Congress from the State of Arizona, 

and Chairman, Subcommittee on the Constitution ........................................... 83 

Page

IV 

Material submitted by the Honorable Jerrold Nadler, a Representative in 

Congress from the State of New York, and Ranking Member, Subcommittee 

on the Constitution 

Prepared Statement of the National Latina Institute for Reproductive 

Health ............................................................................................................ 104 

Prepared Statement of the American Civil Liberties Union (ACLU) ........... 109 

Letter in opposition to H.R. 2299, the ‘‘Child Interstate Abortion Notification Act’’ ......................................................................................................... 115 

Prepared Statement of the Center for Reproductive Rights ......................... 117 

Letter in opposition to H.R. 2299, the ‘‘Child Interstate Abortion Notification Act’’ ......................................................................................................... 134 

Prepared Statement of the National Abortion Federation ............................ 137 

Prepared Statement of the National Partnership for Women & Families 

(PRCH) ........................................................................................................... 140 

Prepared Statement of the Physicians for Reproductive Choice and 

Health ............................................................................................................ 145 

Prepared Statement of the Reproductive Health Technologies Project ....... 149 

(1) 

CHILD INTERSTATE ABORTION 

NOTIFICATION ACT 

THURSDAY, MARCH 8, 2012 

HOUSE OF REPRESENTATIVES, SUBCOMMITTEE ON THE CONSTITUTION, COMMITTEE ON THE JUDICIARY, Washington, DC. 

The Subcommittee met, pursuant to call, at 9:41 a.m., in room 

2141, Rayburn Office Building, the Honorable Trent Franks (Chairman of the Subcommittee) presiding. 

Present: Representatives Franks, King, Jordan, Nadler, Scott, 

and Quigley. 

Staff present: (Majority) Paul Taylor, Subcommittee Chief Counsel; Jacki Pick, Counsel; Sarah Vance, Clerk; (Minority) David 

Lachmann, Subcommittee Staff Director; and Veronica Eligan, Professional Staff Member. 

Mr. FRANKS. Good morning, and welcome to this Constitution 

Subcommittee hearing on H.R. 2299, the ‘‘Child Interstate Abortion 

Notification Act.’’ 

Without objection, the Chair is authorized to declare the recess 

of the Committee at any time. 

The Child Interstate Abortion Notification Act, more commonly 

known as CIANA, is a very reasonable measure that would prevent 

the transportation of a minor across State lines in circumvention 

of a parental consent law that applies to a minor’s abortion procedure. This law is consistently supported by 70 percent of the American people in national opinion polls. 

More than 30 States have made it clear through legislation that 

parents have the right to know whether their minor daughters are 

trying to undergo an abortion. Parents play a critical role in the 

well-being of their daughters, particularly in such a context. And 

I would quote the bill sponsor, Ms. Ros-Lehtinen, ‘‘As a mother and 

a grandmother, I understand the importance of the unconditional 

love and support that parents can give to their children. This responsibility is nonnegotiable and nontransferable. This bill assures 

young women that they are not alone, if ever they find themselves 

contemplating undergoing an abortion.’’ 

Parental notification laws have proven to be effective at lowering 

the abortion rate among minors, and, therefore, they are effective 

at lowering the attending risks that accompany abortion. 

Abortion is a serious surgical procedure with serious physical 

and psychological risks, some of which can be especially detrimental when experienced at a young age. These include increased 

2 

risks of breast cancer, extremely premature birth in subsequent 

pregnancy—that is, delivering at 28 weeks of gestation or less— 

and suicide. 

When a woman experiences an abortion early in life, she can lose 

the protective effect against breast cancer that full-term pregnancy 

provides through inherent changes in breast tissue. Many developed countries legalized abortion in the early 1970’s, and breast 

cancer rates have increased as much as 80 percent since then in 

these same countries. 

Likewise, when a woman has one induced abortion, she is 50 to 

70 percent more likely to experience an extremely premature birth, 

again, defined as a delivery at 28 weeks or earlier, when she later 

attempts to carry a wanted child to term. This could be due to 

damage to the cervix during the abortion, rendering it less competent. 

When a woman has two abortions, she becomes 160 percent more 

likely to have an extremely premature birth. An extremely premature birth carries greatly increased risks for many serious 

health issues. For example, babies who are extremely premature 

have 38 times the risk of cerebral palsy than babies born full-term. 

And there are increased risks for autism and mental retardation. 

Abortions performed on African-American women are approximately five times the rate of Caucasian women. And, consequently, 

African-American women have four times the risk of extremely premature birth. 

It is also true that the danger of subsequent premature birth is 

significantly greater when an abortion is performed on a girl under 

17 years of age. 

Premature birth rates are now up more than 43 percent since 

Roe v. Wade became law. Forty-nine studies worldwide have confirmed this causal link between abortion and premature birth. 

Abortion and suicide are also correlated. 

A study by two economists appearing in the January 18th, 2012, 

online version of the Journal of Economic Inquiry shows that parental involvement laws correlate with a decrease in the incidence 

of teen suicide. Quote, ‘‘The adoption of a law requiring a parent’s 

notification or consent before a minor can obtain an abortion is associated with an 11 to 21 percent reduction in the number of 15- 

through 17-year-old females who commit suicide,’’ unquote. 

Ladies and gentlemen, we have a responsibility to ensure that 

parents are able to protect their minor daughters from an invasive 

surgical procedure that takes the life of their grandchild and sometimes brings with it additional, significant, and deadly hidden 

costs. This bill is a step in that direction. 

And I would now recognize the Ranking Member for 5 minutes 

for an opening statement. 

[The bill, H.R. 2299, follows:] 

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Mr. NADLER. Thank you, Mr. Chairman. 

Today we consider legislation that is at once another flagrant 

violation of the Constitution and an assault on the health and wellbeing of young women and the health care providers. 

Before we start discussing this bill, versions of which we have 

considered in the 105th, 106th, 107th, 108th, and 109th Congresses, and I presume will have no more success in this Congress, 

I think it is important to note that this is the ninth time this Committee has met in this Congress to assault the reproductive rights 

of women. 

The 112th Congress has had just over 200 legislative days so far. 

If the Republican leadership had put as much effort into helping 

distressed homeowners or creating jobs or reforming our immigration laws as they have into the war on women, most of our problems might have been solved by now. 

Instead, we get this warmed over and facially unconstitutional 

legislation yet again. Some States have chosen to enact parental 

notification or consent laws. Some, like mine, have considered this 

issue and decided it is not good for the welfare of young women 

and have declined to do so. 

This bill would substitute the judgment of Congress for the judgment of people who live in States like mine. In fact, even where 

the young women’s State of residence and the State in which the 

doctor is located have both decided not to enact such laws, this bill 

would impose a new Federal parental notification law that is more 

draconian and more unconstitutional than the laws of most States. 

Perhaps we should just disband our State legislatures and let 

Washington decide these important family issues for us. If it would 

spare the rest of us endless speeches about federalism and State’s 

rights, I might be tempted to go along with it. 

I would just note, in this regard, that many Members of this 

Committee recently voted to allow the laws of some States to preempt the concealed carry firearm laws in other States, including 

mine. Congress would, in effect, allow any State to nullify our laws 

and require us to allow anyone lunatic to walk our streets with a 

concealed weapon if so much as one other State says they can. 

As a matter of policy, this bill would place many young women 

in an impossible situation. In some cases, the young woman may 

not be able to go to her parents and can turn only to a grandparent, a sibling, or a member of the clergy. Indeed, sometimes the 

parents may pose a threat to the life and health of the young 

woman, if they learn that she is pregnant. 

That is what happened to Spring Adams, a 13-year-old from 

Idaho. She was shot to death by her father after he found out that 

she planned to terminate her pregnancy, one he caused by his act 

of incest. 

I would commend the authors of the bill for not allowing him to 

sue in this new version of the bill. It is a step in the right direction 

from the prior versions of the bill, albeit a small step. 

This bill also uses a narrow definition of medical emergencies 

that applies only where, ‘‘abortion was necessary to save the life of 

the minor because her life was endangered by a physical disorder, 

physical injury, or physical illness, including a life-endangering 

physical condition caused by or arising from the pregnancy itself.’’ 

16 

That clearly falls far short of the Supreme Court’s requirement 

that any restriction on the right to choose must have an explicit 

exception to protect the life or health of the woman. 

There are many things far short of death that threaten a young 

woman. She deserves prompt and professional medical care, and 

the Constitution still protects her right to receive that care. Requiring that young women have their health destroyed is beyond cruel. 

It is anything but pro-life. 

I know that I have rankled some of my colleagues in the past by 

comparing this bill to the fugitive slave law. I would never suggest 

that this bill turns young women into slaves, so don’t say that I 

did. I won’t even presume to know what Frederick Douglass might 

think of this bill. 

But by requiring a young woman or any American to carry the 

law of their States on their backs as they travel around the country 

to other States is inimical to our Federal system. We have a few 

laws in New York that I think might benefit the people of other 

States, but I am not sure the proponents of this legislation would 

particularly like it. 

I know of no laws since the Fugitive Slave Act that literally says 

that you take the law of the State from which you leave when you 

go to some other State, and use the power of the Federal Government to enforce the law of the first State in the jurisdiction of the 

second State. 

So when she goes from State A to State B, and State B allows 

abortions, let’s say without parental notification, this bill says that 

that is illegal and that the doctor who performs the abortion in the 

State where it is perfectly legal to do so without parental notification commits a crime because of the law in the other State. 

So this bill uses the power of the Federal Government to export 

the law of one State, to enforce it another against the public policy 

of the State. And as I said, I know of no law since the Fugitive 

Slave Act that attempted to use the power of the Federal Government in exporting the law of one State to another State. 

Congress, in any event, should not be tempted to play doctor. It 

is always bad medicine for women. This unconstitutional and illconsidered legislation will harm young women. 

But perhaps the intention is to punish young women who desire 

to have abortions. In fact, that seems to be the intention of a lot 

of legislation, so maybe it is not ill-considered. Maybe it is simply 

ill-motivated. 

I look forward to the testimony of our witnesses, and yield back 

the balance of my time. 

Mr. FRANKS. Without objection, other Members’ opening statements will be made a part of the record. 

[The prepared statement of Mr. Smith follows:] 

Prepared Statement of the Honorable Lamar Smith, a Representative in 

Congress from the State of Texas, and Chairman, Committee on the Judiciary 

Across the country, officials must obtain parental consent before children can engage in certain school activities such as field trips and contact sports. 

In nearby Maryland, school systems even require a parent’s note before sunscreen 

can be applied to a student. 

And my home state of Texas, along with the large majority of states, requires parental consent before anyone can tattoo a minor. 

17 

Abortion is a serious medical procedure. And most states—my home state of 

Texas included—have some form of parental involvement law that requires that at 

least one parent be given notice, or give their consent, before their minor daughter 

receives an abortion. 

Yet today, it remains legal for complete strangers to evade those state parental 

involvement laws and transport minors across state lines to obtain secret abortions 

without the minor’s parents ever knowing about it. 

Because this tragic gap in the law involves interstate commerce, under the Constitution, only Congress can address it. The Child Interstate Abortion Notification 

Act ensures state parental involvement laws are not evaded through interstate activity. 

Parental involvement in the abortion decisions of minor girls leads to improved 

medical care for minors who seek abortions, and provides increased protection for 

young girls against sexual exploitation by adult men. 

Parental involvement ensures that parents have the opportunity to provide medical history and other information to abortion providers prior to the performance of 

an abortion. 

The medical, emotional and psychological consequences of an abortion are serious 

and lasting. An adequate medical and psychological case history is critically important to any physician, and often only parents can provide such information for their 

daughters as well as any suitable family medical history. 

Parental involvement also improves medical treatment of pregnant minors. It ensures that parents have adequate knowledge to recognize and respond to any postabortion complications that may develop. 

Without the knowledge that their daughters have had abortions, parents are unable to ensure that their children obtain routine postoperative care. 

Finally, teenage pregnancies often occur as a result of predatory practices of men 

who are usually much older than their minor victim. This results in the transportation of victims across state lines by an individual who has a great incentive to 

avoid criminal liability for his conduct. 

Parental involvement laws ensure that parents have the opportunity to protect 

their daughters from those who would victimize them further, and the bill under 

discussion today does just that. 

The House passed this legislation with large bipartisan support when it was last 

brought up for a vote. I hope and expect it will enjoy the same broad support this 

year. 

Mr. FRANKS. And I certainly hope people listen very carefully to 

statements like this and think through it. 

Witnesses, thank you for being here this morning. We welcome 

you. 

Dr. Teresa Collett is a professor of bioethics and professional responsibility at the University of St. Thomas School of Law. Professor Collett is an elected member of the American Law Institute, 

and she has testified before committees of the United States Senate 

and House of Representatives, as well as before State legislative 

committees. 

Most recently, she represented various medical groups in the defense of the Federal ban of partial-birth abortion and the Governors of Minnesota and North Dakota in a parental consent case 

before the United States Supreme Court. She has served as a special attorney general for the States of Oklahoma and Kansas, and 

has assisted other States attorneys general in defending laws protecting human life and marriage. 

And, welcome, Professor Collett. 

The Very Rev. Dr. Katherine Hancock Ragsdale was appointed 

president and dean of Episcopal Divinity School in Cambridge, 

Massachusetts, in March of 2009. Dean Ragsdale has appeared on 

William F. Buckley’s Firing Line, Faith Under Fire, Religion and 

Ethics, and many other broadcasts. 

18 

Dean Ragsdale served on the national boards of NARAL, Prochoice America. She is the editor of ‘‘Boundary Wars: Intimacy and 

Distance in Healing Relationships,’’ and the author of ‘‘The Role of 

Religious Institutions in Responding to the Domestic Violence Crisis.’’ 

Welcome, Dean Ragsdale. 

Dr. Michael New is an assistant professor of political science at 

the University of Michigan-Dearborn, a Phi Beta Kappa graduate 

of Dartmouth College. He holds a master’s degree in statistics and 

a Ph.D. in political science from Stanford University. He completed 

his postdoctoral research at the MIT Harvard Data Center. 

Dr. New’s research interests span from campaign finance reform 

to the positive impact of pro-life legislation and States’ informed 

consent laws, Medicaid funding rules and parental notification laws 

for minors. 

His work has been featured in peer-reviewed scholarly journals, 

such as the State Politics & Quarterly Policy and in major media 

outlets such as National Review Online, the Weekly Standard, and 

the New York Post. 

I want to thank all witnesses, again, for appearing before us 

today. Each of the witness’s written statements will be entered into 

the record in its entirety, and I would ask that each witness summarize his or her testimony in 5 minutes or less. And to help you 

stay within that time, there is a timing light on your table. When 

the light switches from green to yellow, you will have 1 minute to 

conclude your testimony. When the light turns red, it signals that 

witness’s 5 minutes have expired. 

Before I recognize the witnesses, it is the tradition of this Committee that they be sworn, so if you will please stand to be sworn. 

[Witnesses sworn.] 

Mr. FRANKS. Thank you, and please be seated. 

I will recognize our first witness, Professor Collett, for 5 minutes. 

Pull your microphone closer to you maybe. Is that on? 

TESTIMONY OF TERESA STANTON COLLETT, PROFESSOR OF 

LAW, UNIVERSITY OF ST. THOMAS SCHOOL OF LAW 

Ms. COLLETT. Mr. Chairman, other Members of the Committee 

and distinguished guests, I am delighted to appear to testify in 

favor of this important piece of legislation related to the health 

care of minors. 

I am a professor of law at the University of St. Thomas in Minnesota. My opinions I express here today do not represent the university or any other organization or person. They are opinions, 

however, that I have derived by virtue of my scholarly studies of 

the operation of parental involvement laws, as well as my practice 

in litigation in representing States defending their parental involvement laws. 

This particular piece of legislation has appeared before this Committee numerous times, as Congressman Nadler mentioned. In fact, 

it is a common-sense piece of legislation that represents the consensus across the country. Thirty-seven States currently have parental involvement laws in effect, and another six States have 

passed them but had them enjoined by judicial action or by an 

opinion of their State attorney general. 

19 

These laws are based on common-sense protection of girls in recognition of the particular health benefits that derive from them. 

First and foremost, as the United States Supreme Court itself 

has observed, parental involvement allows the parent to provide 

needed medical history and details to a physician who is about to 

undertake treatment of their minor daughter. It also allows the 

parent to guide that minor in the selection of an abortion provider, 

knowing the difference between a competent doctor as opposed to 

someone who is simply practices in this area to generate money 

and engages in unsanitary conduct. 

Second, they allow the opportunity of those parents to ensure 

that the girl’s well-being is properly considered by that abortion 

provider. 

And finally, and I believe most importantly, as the Supreme 

Court has observed, it ensures that the parents have the ability to 

monitor for post-abortion complications. 

The Chairman mentioned particularly surgical abortions, but 

surgical abortions are not the only form of abortion being engaged 

in by abortion clinics today. There are also abortions using RU-486, 

which was approved for use by the FDA but had not been tested 

on the use of minors. There has been no follow-up study, notwithstanding the FDA’s requirement that such studies be submitted to 

the FDA on the use of RU-486 for minors. 

Therefore, it is of critical importance that parents know about 

the medical condition of their minor, as well as about the medical 

treatment that has been undertaken, so that they can monitor for 

adverse effects, such as hemorrhaging or infection, the primary adverse side effect from abortion. 

The Ranking Member mentioned the need on occasion for an 

emergency abortion. In a study that I did in preparation for my 

testimony as an expert witness in Alaska, I actually looked for 

State records regarding the number of emergency bypasses done related to abortion of any kind, and there are few States that actually report that to the departments of health. Among them are Alabama, Nebraska, and Wisconsin. 

What those States reported in the period from 2005 to 2010 is 

that were over a total of four—four—emergency abortions. In Alabama, the number of abortions ranged from 781 to 654 during that 

time period. In 2005, there was exactly one emergency bypass. In 

2006, there was exactly one emergency bypass. And from 2007 to 

2010, none. 

In Wisconsin, the number was zero for a 5-year period. And in 

Nebraska, the number was one in a 5-year period. 

This legislation is obviously constitutional and relies on the longstanding Supreme Court precedent that allows Congress to correct 

the problems that can be created in federalism. 

The State of Missouri, for example, attempted to create a statute 

that precluded intentionally taking a minor out of State in order 

to obtain abortion and avoid that State’s parental consent law. In 

reviewing the law, the Missouri Supreme Court upheld it only in 

so far as it applied in State, but it could not reach the conduct of 

abortion providers in Illinois who were actively advertising for girls 

to cross State lines to avoid parental consent. 

20 

This law is no different than the law upheld by the Supreme 

Court in Caminetti, which forbids the transport of women across 

State lines for immoral purposes, or any other numerous laws. 

If FACE is constitutional, a favorite of abortion activists, then 

certainly this law is constitutional. 

Thank you, Mr. Chairman. 

[The prepared statement of Ms. Collett follows:] 

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Mr. FRANKS. Thank you, Professor Collett. 

And Rev. Ragsdale, please, for 5 minutes. 

TESTIMONY OF THE VERY REV’D. KATHERINE HANCOCK 

RAGSDALE, PRESIDENT AND DEAN, EPISCOPAL DIVINITY 

SCHOOL 

Rev. RAGSDALE. Chairman Franks, Ranking Member—— 

Mr. FRANKS. Rev. Ragsdale, would you pull that in and push the 

button? That will work. 

Rev. RAGSDALE. Thank you very much. 

Mr. FRANKS. Yes, ma’am. 

Rev. RAGSDALE. And thank you for the opportunity to testify once 

again on this bill. 

I come before you as an Episcopal priest with over 15 years in 

parish ministry, now serving as president of one of the Episcopal 

Church’s 10 seminaries. My interest in and perspective on this 

issue are shaped by my life as a parish priest, by my current work 

educating future priests, and by my responsibilities as an Episcopalian, because this bill flies in the face of, is completely contrary to, 

the official position of the Episcopal Church. 

I recall vividly one day when I left my home to pick up a 15-yearold girl and drive her to Boston for an 8 a.m. appointment for an 

abortion. I didn’t know the girl. I knew her school nurse. The nurse 

had called me a few days earlier to see if I knew where she might 

find money to give the girl for bus fare to and cab fare home from 

the hospital. I was stunned. 

A 15-year-old was going to have to get up at dawn and take multiple buses to the hospital alone. The nurse shared my concern but 

explained that the girl had no one to turn to. She feared for her 

safety if her father found out, and there were no other relatives 

close enough to help. 

There was no one to be with her, so I went, and during our hourlong drive, we talked. She told me about her dreams for the future, 

all the things she thought she might like to do and be. I talked to 

her about the kind of hard work and personal responsibility it 

would take to get there. She talked to me about her guilt at being 

pregnant. I talked to her about God. 

Later, I drove her back to her school and walked her to the 

nurse’s office and turned her over to someone who would look out 

for her for the rest of the day, and I drove home wondering how 

many bright, funny, thoughtful, girls, girls brimming with promise, 

had no one to help them. 

I did not take her across State lines, nor did I, to my knowledge, 

break any laws. But if either of those things had been necessary 

to help that girl, I would have done them. 

And if helping young women like her should be made illegal, I 

will nonetheless continue to do it. I have no choice. 

Some years ago, I stood before an altar and a bishop of the people of God, and vowed to love and serve the people among whom 

I work. Even if you tell me that it is a crime to exercise my ministry, I will have no choice. And I assure you, I am not alone. 

I would like to acknowledge that we probably all have much in 

common here: although we may differ as to when, if ever, abortion 

is a morally appropriate choice, I wish we could all acknowledge 

42 

the fact that it is a legally protected choice. And, certainly, we can 

all agree that we would like for all women to have fewer reasons 

to consider abortion, and we all deeply desire that every teen facing 

any significant decision be able to turn to her parents for guidance 

and support. 

That is the world we wish for. The Episcopal Church, certainly, 

hopes and works for such a world even as we passed a resolution 

opposing parental notification laws, because we know that, unfortunately, for far too many young women, this is not the world they 

actually live in and must find a way to navigate. 

We know that young women do get pregnant, sometimes due to 

poor choices or carelessness, too often due to violence or coercion. 

And while you surely know the statistics that an overwhelming 

majority of minor women considering an abortion do, indeed, talk 

to their parents, some won’t and others can’t. 

That is why many years ago now the Episcopal Church passed 

a resolution opposing any parental consent or notification mandates that did not include provision for nonjudicial bypass. We 

thought it was far too onerous to require a teenager already undergoing the trauma of an unintended pregnancy to also have to face 

and navigate an intimidating judicial system. 

It was our view that any morally responsible notification or consent requirement had to allow young women to turn for help to a 

responsible adult other than a parent or a judge, to go instead to 

a grandparent or an aunt, a teacher, a neighbor, a counselor, minister, rabbi, a doctor. 

Our position encourages the very thing this bill would outlaw. 

Certainly, we want young people to be able to talk to their parents, 

but when they can’t or won’t, we want to make it easier not harder 

for them to turn to other responsible adults. 

And most certainly, we don’t want to make it harder for their 

doctors to be their allies and advocates. We adopted this resolution 

by a large majority not because we don’t care about parental notification and involvement, but because we know that no one can simply legislate healthy communication with families, and we know 

that of those girls who do not involve their parents, many feared 

violence or being thrown out of their home. 

There is no excuse good enough to justify legislation that further 

imperils young people who are already living in danger in their 

own homes. Teens deserve to be able to talk, to turn to their parents for love and support and guidance. But when they can’t, we 

want them to turn to some responsible adult. 

Please don’t outlaw the very help we want our children to have. 

Oppose this bill. Oppose it out of compassion for those young people who cannot for reasons of safety comply with its provisions. 

I am sure that each of your families is a loving and supportive 

one, and your daughter knows she can always turn to you for anything. But what about her best friend? What about your neighbor’s 

daughter? 

Please don’t leave any scared teenager alone and without help. 

Thank you for the opportunity to provide this testimony. 

[The prepared statement of Rev. Ragsdale follows:] 

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Mr. FRANKS. Dr. New, I will recognize you now 5 minutes, sir. 

Just pull that microphone close. We are going to have to just 

start turning those on at the beginning of the hearing, I think, because they fool everybody always. 

Is it on now? 

TESTIMONY OF MICHAEL J. NEW, Ph.D., DEPARTMENT OF 

SOCIAL SCIENCES, UNIVERSITY OF MICHIGAN—DEARBORN 

Mr. NEW. Chairman Franks, distinguished guests, thank you. I 

appreciate this opportunity to offer testimony on behalf of the 

Child Interstate Abortion Notification Act. I am currently assistant 

professor of political science at the University of Michigan-Dearborn. I am also an adjunct scholar at the Charlotte Lozier Institute, the research and education arm of the Susan B. Anthony List 

here in Washington, D.C. I have a Ph.D. in political science and a 

master’s degree in statistics, both from Stanford University. 

I have authored nine articles which have appeared in various 

peer-reviewed journals, three of which have been on the topic of 

State-level pro-life legislation. In March 2011, an article of mine on 

this topic was published in State Politics & Policy Quarterly, which 

is the top State politics journal in the country. 

I have evaluated the research on parental involvement laws that 

has appeared in peer-reviewed journals in public health, economics, 

and political science. I have come across 18 peer-reviewed studies 

in total. 

The peer-reviewed research on the impact of State-level parental 

involvement laws arrives at a great deal consensus about their effects. 

In my testimony this morning, I want to highlight the four most 

important findings. 

First, every peer-reviewed study I have seen, 16 in total, finds 

that State parental involvement laws reduce the in-State abortion 

rate for minors. This is true of studies that analyze time series 

cross-sectional data, allow for simultaneous analysis of multiple 

laws. It is also true of States that focus on the individual—on the 

impact of an individual State-level law. 

There have been separate studies analyzing the laws of six 

States, including Indiana, Massachusetts, Minnesota, Mississippi, 

Missouri, and Texas. The findings are all very similar. After the 

passage of a parental involvement law, the research shows a statistically significant reduction in the in-State minor abortion rate 

from anywhere from 13 percent to 42 percent. Most of these find 

the decline somewhere between 15 and 20 percent in the in-State 

minor abortion rate. 

My own research shows that those States which require both 

parents be involved, Minnesota, Mississippi, have seen even larger 

declines. 

Secondly, parental involvement laws are always worth enacting 

because the in-State decline in the abortion rate consistently exceeds any out-of-State increase. The two best studies in State-level 

parental involvement laws both show this. 

The first study looked at the Massachusetts law that took effect 

in 1981. That study appeared in the American Journal of Public 

Health. 

50 

The second study analyzed the Texas law, which took effect in 

2000. That study appeared in the New England Journal of Medicine in 2006. 

Both studies are unique because they analyze monthly data on 

in-State minor abortions, out-of-State minor abortions, and births 

to minors. Both studies found that after the enactment of both the 

Massachusetts law and the Texas law, the in-State minor abortion 

decline clearly exceeded the out-of-State increase. 

Furthermore, both studies did find evidence of short-term increases in the minor birthrate. The Texas study found that girls 

who are over 17-and-a-half-years-old are more likely to give birth. 

Another Texas study analyzing similar data showed the birthrate 

for 17-year-olds increased by 2 percent after the parental involvement law took place. 

The Massachusetts study suggested that in the year after the parental law took effect, 100 minors gave birth instead of having 

abortions as a result of law. 

Third, every State that tracks out-of-State abortions after a parental involvement law takes effect finds an increase in the number 

of girls who obtain abortions in adjacent States without parental 

involvement laws. Now, the number depends on the State. In large 

States like Texas, relatively few minor girls cross the State line to 

have an abortion. But in smaller States, like Massachusetts and 

Missouri, a much larger percent do. In fact, a fairly substantial decline—or, a fairly substantial percentage of the minor abortion rate 

decline in States like Massachusetts and Missouri is due to minor 

girls crossing State lines and having abortions in States where the 

laws are more permissive. 

The fourth and final point I would like to make is that the 

knowledge that parents will be involved with an abortion decision 

provides teen girls with a strong disincentive to engage in unprotected sexual activity. There is a very broad research, very body of 

research, I should say, on the positive public health of parental involvement laws. 

A 2003 study in the Journal of Health Economics found that parental involvement laws are reducing teen pregnancy rate anywhere from 4 to 9 percent. A 2008 study in the Journal of Law, 

Economics and Organization, found that parental involvement laws 

reduced the gonorrhea rate for minors from anywhere from 12 to 

20 percent. 

Finally, this past February, the Journal of Economic Inquiry 

published a study which shows that the enactment of parental involvement law lowers the teen suicide rate for minor girls. 

As such, I would encourage Members of the Committee to support the Child Interstate Abortion Notification Act. It will give parents more involvement over how their minor daughters resolve 

pregnancies. 

I think it is safe to say that parents are more invested in the 

well-being of their minor daughter than a boyfriend, a friend, or a 

relative. They also have better knowledge of their daughter’s medical history. There is evidence where minor girls obtained abortions 

without their parent’s knowledge and died because they did not realize they were allergic to the anesthesia. 

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Based on the testimony I have given, I am confident that the 

Child Interstate Abortion Notification Act will lead to fewer abortions and better public health outcomes for teen girls. Thank you. 

[The prepared statement of Mr. New follows:] 


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Mr. FRANKS. Thank you, Dr. New. 

And thank all of you. 

Professor Collett, you know you heard some of the previous comments related to the constitutionality of the law. And I guess it is 

always a good thing to sometimes restate the obvious. Essentially, 

this bill says that one cannot circumvent parental consent laws in 


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a State by, without the parent’s knowledge, taking a minor girl 

across State lines for an abortion. 

Obviously, I have a little girl. She is only 3. But I hope that she 

doesn’t run into somebody who would have the philosophy of Rev. 

Ragsdale. 

With that said, can you tell me—if you could kind of expand on 

your reasoning for why this is a constitutional law? 

Ms. COLLETT. Certainly. In fact, this bill is far narrower than the 

Free Access to Clinic Entrance Act, because it operates only on 

residents of the State when they leave their State. It applies the 

home State law, and simply facilitates the State’s ability to protect 

minors consistent with that. 

There are numerous Supreme Court decisions that allow when 

there is interstate movement of persons related to commercial activity, that that interstate movement of persons can be constitutionally regulated by this Congress. For example, in the Caminetti 

case, the taking of women across State lines for immoral purposes, 

was upheld. Certainly the Raich case dealing with medical marijuana, the court upheld the congressional authority to involve itself 

in medical determinations. 

It is very clearly constitutional. This Congress has on numerous 

occasions relied upon the interstate commerce clause for its power. 

That is the enumerated power that, under this instance, it would 

be appropriate to uphold the statute under. 

Mr. FRANKS. Well, I always find it a little unnerving when people 

tell me that to say, you know, that someone taking a minor child 

of someone else’s across the State lines to perform or have a surgery performed upon them, that somehow that it is unconstitutional to recognize parent’s rights in that regard, it just astonishes 

me beyond comprehension. 

Dr. New, you testified that the academic research on parental involvement laws say that it has an impact on their in-State minor 

abortion rates, and I would like for you to expand on that. 

But you also say that there is a frequent crossing of State lines 

among minor girls where there is a proximity of a State that does 

not have these laws and where there are people that will actually 

take someone else’s child across State lines to have a surgery performed on them that will take another child’s life and endanger the 

first child’s life. 

So would you say that your study in this area points to the conclusion that parental involvement laws are successful in reducing 

abortions but that there would be an even greater success in reducing abortions if Congress enacted a law prohibiting the transportation of minors across State lines to have abortion laws without 

the parent’s knowledge or involvement? 

Mr. NEW. Yes. I think those are both fair statements. I mean, literally, every peer-reviewed study on this topic shows that when a 

State passes a parental involvement law, the in-State minor abortion rate goes down. There is a very broad consensus about that. 

Sixteen peer-reviewed studies in total that I have looked at, and 

they all arrive at the same conclusion. 

They also found, the studies can really track accurately both the 

in-State decline and compare it to the out-of-State increase. There 

are some States that have reciprocal reporting arrangements, 

57 

where they know kind of what is happening to these minor girls, 

pretty much every study also finds—both studies that look at that 

do find the in-State decline exceeds the out-of-State decrease. 

So I think it is fair to say that these laws are effective. We also, 

again, do see a short-term increase in minor birthrates, meaning 

that once these laws are passed, some minors who otherwise had 

abortions decided to give birth. 

But I do think these laws would be made more effective if the 

Child Interstate Abortion Notification Act did take effect, because 

in many States, especially States with close proximity to other 

States with more permissive laws, you do see a substantial part of 

the in-State minor abortion decline due to the fact that minors 

cross State lines. 

That was certainly true in Massachusetts. When Massachusetts 

passed their law in 1981, it was surrounded by—basically every 

other State did not have a parental involvement law, including 

New York, including New Hampshire, including Rhode Island up 

until 1982, including Connecticut. 

And, again, a number of Massachusetts minors circumvented 

that law by getting abortions in other States. 

There was a study of the Missouri law that was enacted in 1985, 

and it was again similar. Illinois does not have a parental involvement law, and there was evidence that many minors did go across 

the border and obtain abortions in Illinois. 

So I really do think that the Child Interstate Abortion Notification Act would really strengthen these parental involvement laws 

that are already doing a lot of good in the respective States. 

Mr. FRANKS. You know, I can’t help but wonder how parents feel 

when they find that some stranger has taken their minor daughter 

across State lines for an abortion, so that they can keep it from 

their parents. I know how I would react. But I am wondering why 

that isn’t something that is more obvious to everyone here. 

So I will now recognize Mr. Nadler for 5 minutes for questions. 

Mr. NADLER. Thank you, Mr. Chairman. 

Rev. Ragsdale, a moment ago the Chairman said he hoped his 

daughter never ran into someone like you or with your philosophy. 

Could you describe the kind of situations where another adult, either relative or perhaps a clergy person, might need to assist a 

young woman who is pregnant, where it would be in her welfare 

for that person to do so? And is a parent always the best person 

to have involvement in a situation, or is it even possible? 

Rev. RAGSDALE. Well, Mr. Nadler, you actually referenced just 

such a situation in your opening remarks, where the father shot 

the daughter, who had hoped to get an abortion. 

A lot of young women seeking abortions were impregnated by 

their fathers, or they are in homes where the parents are sufficiently emotionally unstable that they may disrupt the entire family. Children are thrown out of their homes. They are beaten. 

One of the past times that I testified on this, I was still a parish 

priest. And a man in my parish with a teenage daughter said to 

me, ‘‘I would be furious if you did that with my daughter.’’ I said, 

‘‘Well, I wouldn’t have to do that with your daughter. If she came 

to me because she was afraid to talk to you, I know that you are 

58 

safe. I would take her, go with you her to talk to you and deal with 

this.’’ 

But there are young women who are in danger. They are in danger of being beaten. They are in danger of being killed. They are 

in danger of being thrown out of their homes. 

They have to find another way to get these procedures. And I 

don’t want them doing it without any adult support, nor does the 

Episcopal Church. 

So that is why we support nonjudicial bypass provisions that 

would allow a grandparent, a teacher, a clergy person to accompany these young women and to keep them safe. 

Mr. NADLER. There has been a lot of talk recently that a requirement in law that insurance policies cover contraceptives is an assault on the religious liberty of those employers who don’t want to 

pay insurance even if they don’t have to pay extra, because it is 

against their religion to have people use contraceptives. 

Would this bill be an assault on your religious liberty or the religious liberty of the Episcopal Church in saying that what your 

ministry compels you to do would become a criminal act? 

Rev. RAGSDALE. Yes. 

Mr. NADLER. In exactly the same way as it is alleged that the 

contraceptive requirement is an assault on the religious liberty of 

some other church? 

Rev. RAGSDALE. Well, I am not sure in exactly the same way, because I don’t concur that the contraceptive coverage is an assault 

on the religious liberty—— 

Mr. NADLER. Well, I don’t agree on that either, and I don’t think 

this is an assault on religious liberty, but if that is, this is. 

Rev. RAGSDALE. But I am not taking Federal money, and, therefore, to interfere with my ability to do my ministry is an assault. 

Mr. NADLER. Would be even worse. 

Rev. RAGSDALE. And to fulfill the provisions that the Episcopal 

Church has passed in general convention many years ago. 

Mr. NADLER. Thank you. 

Let me ask you this. We heard, from 2005 through 2010, 559 judicial bypasses were sought in the State of Idaho. During that 

time, a total of 24 were granted. In three of those years, none were 

granted at all. 

That is half a percent of young women who managed to find their 

way through the court system, who tried to do so. The records for 

the other States are no better. Many judges simply refuse to grant 

the bypass ever. 

Would you say the judicial bypass system is a sham in practice? 

Rev. RAGSDALE. I would like to believe that there are some responsible, ethical judges who behave appropriately, and it is sort 

of in my business to believe things in contradiction to the evidence 

from time to time, but it certainly seems the evidence suggests 

that, yes, it is a sham. 

When the Episcopal Church suggested—insisted on nonjudicial 

bypass provisions, this was before we had this experience. We simply wanted it because we thought navigating the court system was 

just too much to ask, too intimidating to ask of a young woman already in a tricky situation. 

59 

Having seen since the evidence of what actually happens in these 

judicial bypass procedures, it seems clear that they are ineffective 

at best and often abusive. And we really would not want to subject 

any person to those procedures as they are exercised in most 

States. 

Mr. NADLER. Thank you. 

Professor Collett, this bill only has an exception if an abortion is, 

‘‘necessary to save the life of the minor because her life was endangered by a physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising 

from the pregnancy itself.’’ 

Does is exception comply with the constitutional mandate that 

you have to permit an abortion when necessary for the life or 

health of the mother? And to the extent that a woman might need 

a medical treatment that is inconsistent with pregnancy, she needs 

medical treatment that is inconsistent with pregnancy, but is not 

caused or arising from the pregnancy itself, wouldn’t the Constitution require that an abortion be permitted in that case as well, contrary to this law, to this bill, rather? 

Ms. COLLETT. Congressman Nadler, in fact, I believe the constitutional case that you are relying on is Doe v. Bolton, which was 

a statutory construction case. It was not an interpretation of the 

Constitution. It was an interpretation of the—— 

Mr. NADLER. Excuse me, there is not a constitutional requirement under applicable Supreme Court law that abortions be allowed for the life or health of the mother? 

Ms. COLLETT. I am sorry, Congressman Nadler. If I could complete my answer. 

In Doe v. Bolton, where they gave the life or health of the mother 

language, it was statutory construction. In Planned Parenthood v. 

Casey, which was an opinion that occurred 20 years later, in fact, 

they upheld an emergency exception remarkably similar to this on 

a constitutional basis where the language did not have the health 

of the mother. 

In Ayotte v. Planned Parenthood of Northern New England, the 

most recent United States Supreme Court case dealing with parental involvement laws, the Court, in fact, even upheld the statute at 

issue in that case without an emergency exception. 

I believe this is completely constitutionally consistent with 

Planned Parenthood v. Casey and Ayotte. 

Mr. NADLER. So it is your belief that an abortion can be refused 

even if, constitutionally, even if refusing that abortion would wreck 

the health of the mother but wouldn’t kill her? 

Ms. COLLETT. I believe the Court has upheld similar exceptions. 

Mr. NADLER. The answer is yes, you believe that that is the state 

of the law. 

Ms. COLLETT. I believe that is the state of the law. 

Mr. NADLER. Thank you. You are in a very small minority, I 

must tell you. 

Thank you. I yield back. 

Mr. FRANKS. All right, I would now yield to Mr. Jordan for 5 

minutes. 

Mr. JORDAN. I thank the Chairman for the time and for this legislation, this hearing. 

60 

Dr. New, the premise from Ms. Ragsdale is that if we have this 

law or, frankly, any parental notification, parental consent law, 

that there is the potential that minors can be harmed if they have 

to communicate with their parents. 

You cited a number of studies. 

Mr. NEW. Yes. 

Mr. JORDAN. Do any of the studies show that that actually—you 

see an increase in harm to minors where you have States with parental notification, parental consent laws? 

Mr. NEW. I am not aware of any body of peer-reviewed research 

which shows an increase in child abuse rates that follow from the 

enactment of State-level parental involvement laws, so, no, I have 

yet to see a study that would show that. 

Mr. JORDAN. So your answer is that not one single study shows 

that involving the people who care most about children, their parents, not one single study shows that there is an increase in child 

abuse? Is that accurate? 

Mr. NEW. I have researched the academic literature, and I think 

I have been fairly thorough. There may something out there I 

haven’t seen, but I have been very thorough in my reading, and I 

have yet to come across one peer-reviewed study that—— 

Mr. JORDAN. Not one single study? 

Mr. NEW. No. 

Mr. JORDAN. Okay. 

And, Professor Collett, do you know of any studies that show 

what the reverend asserts? 

Ms. COLLETT. In fact, there is a study to the contrary by 

Henshaw and Kost. Of course, Stanley Henshaw is a demographer 

of the Guttmacher Institute, a research affiliate of Planned Parenthood. The study is ‘‘Parental Involvement in Minors’ Abortion Decisions.’’ It was published in 1992. Table 5 of that particular study, 

Congressman, in fact, indicates that although minors had initially, 

a small minority of minors, had expressed concerns that there 

would be violence or be thrown out of their home, and that is why 

they were reluctant to inform the parents, when researchers inquired after the fact, there was not a single study in which violence 

had occurred. 

Mr. JORDAN. So, in fact, we don’t have one study that shows that 

there is an increase in harm to young people, but we have research 

that shows it actually could be positive. 

Ms. COLLETT. There is no research that shows harm. 

Mr. JORDAN. Okay. 

Reverend, let me ask you a slightly different question. There was 

an article recently published in the Journal of Medical Ethics, two 

bioethicists/philosophers argued for what they term after-birth 

abortion. And they assert, and I quote, ‘‘We claim that killing a 

newborn could be ethically permissible in all circumstances where 

abortion would be.’’ 

And I want to know, first, if you are familiar with the article; 

and, second, if you agree with the assertion of these two 

bioethicists/philosophers. 

Rev. RAGSDALE. I am not familiar with that particular article. I 

am certainly familiar with philosophers who have made similar arVerDate Aug 31 2005 15:25 Apr 18, 2012 Jkt 000000 PO 00000 Frm 00064 Fmt 6633 Sfmt 6601 H:\WORK\CONST\030812\73214.000 HJUD1 PsN: DOUGA
61 

guments. It is sort of the job of academic philosophers to think way 

outside the box. 

We, obviously, utterly disagree and don’t consider it a responsible 

position. 

Mr. JORDAN. Okay. And what would you call the term after-birth 

abortion? Is there a better definition, better language for that? 

Rev. RAGSDALE. I am sorry, I don’t think there is any such thing 

as after-birth abortion. Abortion is the termination of—— 

Mr. JORDAN. Yes, it seems to me this is infanticide. It is murder. 

It is the taking of innocent human life. 

Mr. NADLER. Would the gentleman yield for a moment? 

Mr. JORDAN. These ethicists seem to—— 

Mr. NADLER. I think I can help clear this up. Will the gentleman 

yield for a moment? 

Mr. JORDAN. I would be happy to yield. 

Mr. NADLER. I think just about everyone on this side of the aisle 

and on that side of the aisle voted for the—what was that called?— 

the Born Alive Infants Protection Act, which was on this issue. I 

stated at the time that this was absurd, that this was infanticide 

and murder, and we all voted for it, and stated at the time that 

it was unnecessary because it was already the law in every State 

that it was murder. 

Mr. JORDAN. And I appreciate that, but we have a journal printing this kind of ridiculous—— 

Mr. NADLER. There is always some nut out there. 

Mr. JORDAN. Yeah. My question was to the reverend, and she answered the question. 

Rev. RAGSDALE. One of the repercussions of the tenure system. 

You are encouraged and entitled to think any bizarre thing you 

want and to publish it, and it pushes the envelope. 

Mr. JORDAN. Well, that is good to hear. 

Mr. Chairman, with that, I would yield back. 

Mr. FRANKS. Well, thank you, Mr. Jordan. 

It is kind of ironic that, you know, that we have talked about— 

at least we have some agreement here that after-birth abortion is 

murder, and yet somehow there is some argument that 10 minutes 

earlier before you travel 5 inches down a birth canal, that all of a 

sudden everything is changed. 

And it is also interesting that our President voted twice against 

the legislation that would have protected children born alive in his 

legislative career. 

With that, I would yield to Mr. Quigley for 5 minutes for questions. 

Mr. QUIGLEY. Thank you, Mr. Chairman. 

Mr. Chairman, I think anyone watching these hearings or the 

hearing, since I have been here for 3 years now, understands how 

just extraordinarily emotional and how powerful they are, how 

strong people’s feelings are, how difficult the decisions that have to 

be made are. 

And for me, what that seems to bring out is the fact that, sitting 

here in Washington, I have absolutely no right to tell people how 

they handle that decision. It is impossible for us to know all of the 

scenarios that exist under those circumstances, all of the risk, all 

of the dangers, all of the emotional turmoil that takes place. And 

62 

for us to put ourselves in that place is inappropriate, especially for 

those who claim that government’s role is least, that government 

shouldn’t intrude on people’s lives. 

So I appreciate that nothing we say here ever, if I am here 3 

years more or 30 years more, will ever change anyone else’s mind. 

But I will say this, however any of us feel, it is worse and it is 

wrong for us to place ourselves above anybody’s decision-making 

process, especially when it comes to something as serious as this. 

But I will ask the reverend one question. 

Are you aware what major medical groups have said or talked 

about in terms of confidentiality in medical care for minors? 

Rev. RAGSDALE. I believe virtually every medical group that one 

can name is on the record as opposing this sort of regulation, because of their interest in protecting the doctor-patient relationship 

and not wanting to pit doctors against the young women who come 

to them for help. 

Mr. QUIGLEY. And, well, the scenarios that you have seen, and 

for what you know, how would you imagine that this measure 

would actually, in reality, be enforced? Border patrols or questions 

or putting doctors in a very unique position? 

Rev. RAGSDALE. I think the goal is to have a chilling effect on 

doctors and make them unwilling to perform abortions. 

It is interesting that the success of these parental notification requirements is being measured by Dr. New as reducing abortions, 

which suggests to me that their point here is not actually protecting young women’s health but reducing abortions, which is a 

constitutionally protected right. 

So I think the goal is to have a chilling effect on doctors, to deny 

young women the adult support that they might need to move forward safely with this procedure. And I think the result will be, and 

I think the result has been, and perhaps the reason that the statistics don’t show abuse is that the young women are not foregoing 

abortions, the ones who are in danger, so much so they are getting 

them illegally or without any adult support. 

Mr. QUIGLEY. Right, and I think it teaches us that there is a difference between correlation and causation. 

Rev. RAGSDALE. Well, exactly. 

Mr. QUIGLEY. And there is also a difference that wasn’t taken 

into consideration of where the abortions are actually taking place. 

It is not taking place in the same State for the reasons we were 

talking about before. 

Thank you, and I yield back, Mr. Chairman. 

Mr. FRANKS. I thank the gentleman. I have to thank him for his 

tone, but placing himself above someone else’s decision, he mentioned that, and that is one of the challenges with this legislation, 

we are trying to make sure that perfect strangers don’t place themselves above a parent’s right to decide things over their own children. The judges, obviously, you testified that they have some reticence to do so, but a perfect stranger who finds the arrogance to 

do that is just astonishing to me. 

And you are right, too, Mr. Quigley. There are intense feelings 

about this. There were intense feelings when we were debating the 

issue of slavery, when the Supreme Court said slaves weren’t persons. But people’s minds did change, finally. They did change. 

63 

Mr. King, I would recognize you for 5 minutes, sir. 

Mr. KING. Thank you, Mr. Chairman. 

And again, I thank the witnesses for your testimony, and this 

raises a number of questions in my mind as I listened to their response. 

I would turn first Professor Collett. 

Would you assert that there existed a conscience protection for 

medical practitioners prior to the passage of Obama care? 

Ms. COLLETT. Well, certainly, there is the Weldon act and the 

Hill-Burton Act that protected both medical institutions as well as 

individual practitioners in certain instances. 

Mr. KING. And is it also your understanding that the passage of 

the Patient Protection and Affordable Health Care Act has struck 

that language of conscience protection and allowed for an executive 

branch to, essentially, impose obligations on health care practitioners that go beyond that conscience protection that you cited? 

Ms. COLLETT. Actually, Congressman, I believe that is an issue 

that is being litigated as we speak on behalf of a number of both 

individuals and religiously affiliated institutions. I do believe that 

they will be successful in their litigation, because I do not believe 

that the Secretary of Health’s regulation will withstand constitutional scrutiny. 

Mr. KING. Thank you. 

And I turn to Rev. Katherine Hancock Ragsdale and ask if you 

agree with, at least philosophically, with conscience protection for 

medical practitioners? 

Rev. RAGSDALE. No. 

Mr. KING. You think they should be compelled, then, to provide 

sterilization, abortifacients, and contraceptives even if they object 

to it on religious terms? 

Rev. RAGSDALE. You know, I am a church person. I believe in 

conscience. We are big supporters of conscience. We believe that everyone’s conscience should be respected as long as they pay the 

price for it. 

Civil disobedience, if you are willing to pay the price for it. Conscientious objection, if you are willing to pay the price for it. 

But if you are not willing to shoot people, don’t join the Army. 

If you are not willing to carry a gun at all, don’t become a police 

officer. If you are not willing to experiment on animals, medical research probably is not the place for you. If you are not willing to 

provide full medical care, don’t go into—— 

Mr. KING. I am sorry, the clock is ticking, so I do get your point. 

And let me then ask the question, if this conscience protection 

then apparently, if you are willing to pay the price, so in your testimony you talk about assisting a young lady and you state that you 

don’t believe that you violated any laws. But you also assert, if I 

note this testimony, that you have you have no choice because of 

your oath and your commitment. You say, I have no choice even 

if you tell me it is a crime to exercise my ministry, I will have no 

choice. And I assure you I am not alone. 

So are you saying to this Congress, then, that if this legislation 

passes and you are met with the same or a similar question for an 

individual that you described in this testimony, that you would 

cross the State line, you would violate Federal law, you would be 

64 

willing to go to jail for a year or pay a $100,000 fine, if you believe 

it violated your conscience to fail to serve? 

Rev. RAGSDALE. I hope to God that I would have the courage of 

my convictions and my faith to do that. 

Mr. KING. Do you believe that a judge should have a conscience 

protection? 

Rev. RAGSDALE. I beg your pardon? 

Mr. KING. Do you believe that a judge should have—— 

Rev. RAGSDALE. That a judge should not have to uphold the law 

if he disagrees with it? 

Mr. KING. I mean, just to suspend this for a second, I would like 

to turn to Professor Collett, and then I will come back to you on 

this. 

Professor Collett, I will tell the narrative here, and that is that 

the parental notification law that was passed in Iowa, I was part 

of, that the gentleman, Mr. Nadler, discussed. And I met with 

judges around the State, and I can think one in particular who expressed to me how troubled he was that the law required him to 

provide for the judicial waiver, the judicial bypass, I think as it 

was referred to. And he was greatly troubled because of his faith, 

because of his convictions. 

But he found himself, a sworn judge, required to carry out the 

law. And now, because of the language in the law, he was required 

to provide that judicial bypass even though it violated his most profound moral and religious convictions. 

Do you believe judges should have conscience protection? 

Ms. COLLETT. Congressman, this actually came up on the Texas 

subadvisory committee on drafting court rules for parental notification and parental consent in that State. At that time, we determined it was appropriate for a judge to recuse, as they can on any 

matter where they believe their personal values will not allow 

them to render a judgment under law. 

Mr. KING. And, Reverend, is it your position that not to recuse 

or to apply the same philosophy to the judges as you would the 

medical practitioners, either pay the price or leave the profession 

and find something else to do? 

Rev. RAGSDALE. Well, you understand I am not a legal expert. 

Recusal sounds like a reasonable alternative to me, but I haven’t 

given this a lot of thought. 

Mr. KING. But if you would allow a judge to recuse himself, 

wouldn’t you allow a medical practitioner to recuse himself as well? 

Rev. RAGSDALE. Medical practitioners have a responsibility to respond to the emergencies in front of them. If there is another doctor handy that you can hand off to, that is fine. If not, it is your 

job to provide medical care. 

Mr. KING. Thank you. There are very few pregnancies that are 

emergencies. 

I yield back. 

Mr. FRANKS. Thank you, Mr. King. 

I now recognize Mr. Scott for 5 minutes. 

Mr. SCOTT. Thank you, Mr. Chairman. I think a lot of the questions I have have been answered. I just have a couple of technical 

questions. 

65 

Professor Collett, in the phrase ‘‘knowingly transports,’’ would 

that include a taxicab driver who, a young lady hops in the cab and 

says take me to the abortion clinic; I need an abortion. 

Would they be guilty of violating this code section? 

Ms. COLLETT. Congressman, I don’t believe so, because it also requires with the intention to assist her in obtaining the abortion. 

Mr. SCOTT. Taking them to the abortion clinic is not assisting? 

Ms. COLLETT. It is not with the intention of assisting her in 

doing that. 

Mr. SCOTT. Okay, knowingly transport, does that include someone who hops in the taxicab with the pregnant teenager? 

Ms. COLLETT. Have they hopped in the taxicab with the intention 

of helping her evade the State’s parental involvement law? 

Mr. SCOTT. The question is transports. 

Ms. COLLETT. I understand, Congressman. Because this has 

criminal sanctions, it will be strictly construed under constitutional 

standards, and, therefore, you have to meet all elements. 

Mr. SCOTT. So if it is strictly—you are not transporting; you are 

just accompanying. Is that the same thing? 

Ms. COLLETT. Again, it depends on the intention. 

Mr. SCOTT. The mens rea is just on the intent to get an abortion, 

not the mens rea to evade the parental consent; is that right? 

Ms. COLLETT. Crossing State lines, that is correct. 

Mr. SCOTT. The law exempts parents from the application. Does 

it exempt a sister? 

Ms. COLLETT. No, not on the face of the statute. 

Mr. SCOTT. So the sister accompanying a pregnant sister would 

violate criminal law by accompanying her sister to the abortion 

clinic? 

Ms. COLLETT. Unless the law that is to be applied, the law of the 

minor’s residence, includes siblings. There are a couple States that 

do. 

Mr. SCOTT. I am sorry. Where is it exempt from this law? 

Ms. COLLETT. The requirement is that they apply the law of the 

minor’s residence. And, therefore, if the law of the minor’s residence allows another adult relative to accompany the minor, they 

would not be a violation of the law—— 

Mr. SCOTT. But in absence of that, the sister would be violating 

Federal law. 

Ms. COLLETT. That would be correct. 

Mr. SCOTT. Okay, if a college student who lived in a State, was 

a resident of a State, without parental consent law, went to college 

in a State without a parental consent law, and sought an abortion, 

why does this law require a 24-hour parental consent? 

Ms. COLLETT. The law does not use college attendance as a 

standard. Under that standard, there would be numerous adults 

that would be subject to the involvement of someone else. This law 

deals with adults only. 

Mr. SCOTT. The college wasn’t—if you are in another State without a parental consent law for any reason, say college, your home 

State does not have a parental consent law, you are performing the 

abortion in a State that is not the residence of the teenager. This 

law requires a 24-hour notice, notwithstanding the fact that neither State has a parental consent law; is that right? 

66 

Ms. COLLETT. I am sorry, Congressman. Could you direct me to 

the provision. I am confused by your—— 

Mr. SCOTT. Page 7, line 15. 

Ms. COLLETT. I am sorry, I will need the section, because I don’t 

have your printing. 

Mr. SCOTT. Section 3, Child Interstate Abortion Notification, and 

it says offense generally, number two, parental notification, if a 

physician who performs or endorses an abortion on a minor who is 

a resident of a State other than the State in which the abortion is 

performed must provide or cause to provide 24-hour actual notice 

to parents. 

Ms. COLLETT. The numbering is different that I printed off of 

Thomas, but I see where you are now. I am sorry. 

Yes, it does. 

Mr. SCOTT. So there is no parental consent law in the State in 

which abortion is being performed, no parental consent law in the 

teenager’s home residence, and yet Federal law is requiring a parental notice. 

Ms. COLLETT. On a minor who is a resident of a State other than 

State in which the abortion is being performed, yes. 

Mr. SCOTT. Okay. And is there any judicial bypass in that? 

There can’t be any judicial bypass, because you don’t have a system in either State; is that right? 

Ms. COLLETT. It does not appear to be the case, although most 

States have emancipation laws, so you can get an order of partial 

emancipation. That is done in numerous States. 

There are at least two States that have parental involvement 

laws that have no judicial bypass in them. 

Mr. SCOTT. Rev. Ragsdale, can you explain whether it is better 

or worse for a teenager to be accompanied when they go to get an 

abortion? 

Rev. RAGSDALE. Accompanied by an adult? Yes, we want teenagers to have support, adult support, preferably from their parents. 

When that is not safe or not possible, we would like them to have 

other adult support. To ask a teenager to undergo any significant 

decision, and any medical procedure without adult support, seems 

to us uncharitable and unwise. 

Mr. FRANKS. We appreciate the witnesses here. We appreciate 

your time today. 

I always think it is important sometimes just to restate. This bill 

essentially says that someone cannot arrogate unto themselves the 

parent’s role of taking a minor girl across State lines for an abortion without the parent’s knowledge. I am not even sure why we 

debate that sometimes. It doesn’t seem like we have come very far 

at times. 

But in any case, I thank the witnesses. 

And without objection, all Members will have 5 legislative days 

to submit to the Chair additional written questions for the witnesses, which we will forward and ask the witnesses to respond as 

promptly as they can so that the answers may be made part of the 

record. 

Without objection, all Members will have 5 legislative days with 

which to submit any additional materials for inclusion in the 

record. 

67 

And with that, again, I thank the witnesses. I thank the Members and observers. 

And this hearing is now adjourned. 

[Whereupon, at 10:43 a.m., the Subcommittee was adjourned.] 

(69) 

A P P E N D I X 

MATERIAL SUBMITTED FOR THE HEARING RECORD

Prepared Statement of the Honorable Trent Franks, a Representative in 

Congress from the State of Arizona, and Chairman, Subcommittee on the 

Constitution 

The Child Interstate Abortion Notification Act, more commonly known as 

‘‘CIANA,’’ is a modest measure to prevent the transportation of a minor across state 

lines to avoid parental consent laws that apply to abortion procedures. This law is 

consistently supported by approximately 70% of the American people in national 

opinion polls. 

More than 30 states have made it clear through legislation that parents have the 

right to know whether their daughters are trying to undergo abortions. Parents play 

a critical role in the well-being of their daughters, particularly in the abortion context. I quote the bill’s sponsor, Ms. Ros-Lehtinen: ‘‘As mother and a grandmother, 

I understand the importance of the unconditional love and support that parents can 

give to their children. This responsibility is non-negotiable and non-transferable. 

This bill assures young women that they are not alone if they ever find themselves 

contemplating undergoing an abortion.’’ (unquote) 

Parental notification laws have proven to be effective at lowering the abortion rate 

among minors, and therefore they are effective at lowering the attendant risks that 

accompany abortion. Abortion is a serious surgical procedure, with physical and psychological risks, some of which can be especially detrimental when experienced at 

a young age. These include increased risk of breast cancer, extremely pre-term birth 

in subsequent pregnancy (that is, delivering at 28 weeks gestation or less), and suicide. 

Where a woman experiences an abortion early in life, she can lose the protective 

effect against breast cancer that a full term pregnancy provides with the inherent 

changes in breast tissue. Many developed countries legalized abortion in the early 

1970s, and breast cancer rates have increased as much as 80% since the 1970s in 

these same countries. 

Likewise, where a woman has one induced abortion, she is 50% -70% more likely 

to experience an ‘‘extremely pre-term birth’’ (delivery at 28 weeks or earlier) when 

she later attempts to carry a wanted child to term. This could be due to damage 

to the cervix during abortion, rendering it less competent. Where a woman has two 

abortions, she is 160% more likely to have an extremely pre-term birth. 

An extremely pre-term birth carries greatly increased risks for many serious 

health issues. For example, babies who are extremely pre-term have 38 times the 

risk of cerebral palsy than babies born full-term, in addition to increased risk for 

autism and mental retardation. Note that abortionists perform abortions on black 

women at approximately five times the rate of white women, and black babies therefore have four times the risk of extremely pre-term birth. Also note that the danger 

of subsequent premature birth is greater where the abortive woman is a girl under 

seventeen years of age. Premature birth rates are up greater than 43% since Roe 

70 

v. Wade became law. Forty-nine studies worldwide confirm the abortion/premature 

birth causal link. 

Next, abortion and youth suicide are correlated. A study by two economists appearing in the January 18, 2012 online version of the Journal of Economic Inquiry 

shows that parental involvement laws are correlated with a decrease the incidence 

of teen suicide. ‘‘The adoption of a law requiring a parent’s notification or consent 

before a minor can obtain an abortion is associated with an 11%-21% reduction in 

the number of 15- through 17-year-old females who commit suicide.’’ 

We must enable parents to protect their daughters from an invasive surgical procedure that has significant, and sometimes deadly hidden costs. 

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71 

Prepared Statement of the Honorable Ileana Ros-Lehtinen, a 

Representative in Congress from the State of Florida 

I would like to thank the House Constitution Subcommittee for holding this hearing. The Child Interstate Abortion Notification Act (CIANA) is an important bill and 

I am pleased it is receiving the serious consideration it deserves. CIANA deals not 

only with abortion, but also with parental rights. This bill would make it a federal 

offense to knowingly transport a minor across state lines with the purpose of obtaining an abortion and circumventing the parental consent and/or notification laws of 

the minor’s home state. It would prohibit doctors from performing abortions on out 

of state minors without obtaining parental consent for the procedure. This requirement would apply to all out of state abortions. Physicians would be exempted from 

these requirements if the minor has a judicial bypass from their home state, the 

minor claims to have been abused by a parent and the doctor informs state authorities or if the minor’s life is immediately endangered by the continuation of the pregnancy. 

Parents are entitled to the right of being involved in their child’s life. Responsibility to guide and direct their children’s development belongs to the parents. This 

responsibility is non-negotiable and non-transferable. Currently, minors cannot get 

a tattoo without parental consent. Children cannot even take aspirins for headaches 

at their school without prior authorization from parents. However, that same minor 

can be taken across state lines to obtain an abortion without so much as a phone 

call to her mother or father. This is unacceptable and fundamentally corrosive to 

the institution of the family. More than 30 states have passed laws that require either parental notification and/or consent before a minor can undergo an abortion 

procedure. Moreover, in poll after poll a majority of the American people have made 

it clear that parents should be involved if their minor daughter is considering terminating her pregnancy. As mother and a grandmother, I understand the importance 

of the unconditional love and support that parents can give to their children. This 

bill assures young women that they are not alone if they ever find themselves contemplating undergoing an abortion. Having this right ripped away by individuals 

seeking to confuse, and at times even coerce, minors is criminal and the federal government must recognize it as such. Predatory and bullying tactics by a former boyfriend, or his parents, have led to young women being rushed into a decision they 

ultimately would not have chosen if allowed the chance to reflect and consult with 

their families. 

As a pro-life advocate, I believe that innocent life is sacred and unique. The precious gift of life is something that the unborn are entitled to through their inherent 

dignity as human beings. Congress has had the courage and wisdom to ensure this 

basic precept. Through legislation prohibiting the use of federal funds for abortions 

this body has unequivocally stood by the rights of the unborn. CIANA aims to resolve a gaping hole in Congress’ long tradition of supporting pro-life issues. 

This legislation is neither radical nor draconian. On the contrary, this legislation 

is borne out of common sense and affirming our commitment to the unborn and to 

the rights of parents everywhere. Once again, I thank the House Constitution Subcommittee for convening this hearing and I look forward to working with my congressional colleagues as we move forward on consideration of this important legislation. 

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