An Act To Authorize Certain Health Care Professionals Who Are Not Physicians To Perform Abortions
Maine Legislature, Session 128, LD 1763
Committee: Judiciary
Sponsors: McCREIGHT, KATZ, HYMANSON, LONGSTAFF, MOONEN, PERRY, BREEN, CARSON, GRATWICK, MIRAMANT
Amends: 22 MRSA §1596, 22 MRSA §1597-A, 22 MRSA §1598, 22 MRSA §1599-A

Legislative Document
No. 1763
H.P. 1217
House of Representatives, January 3, 2018
An Act To Authorize Certain Health Care Professionals Who Are 
Not Physicians To Perform Abortions
Submitted by the Department of the Attorney General pursuant to Joint Rule 203.
Reference to the Committee on Judiciary suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative McCREIGHT of Harpswell.
Cosponsored by Senator KATZ of Kennebec and
Representatives: HYMANSON of York, LONGSTAFF of Waterville, MOONEN of Portland, 
PERRY of Calais, Senators: BREEN of Cumberland, CARSON of Cumberland, GRATWICK 
of Penobscot, MIRAMANT of Knox.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA §1596, as repealed and replaced by PL 1989, c. 274, §1 and 
amended by PL 2003, c. 689, Pt. B, §6, is further amended to read:
§1596.  Abortion and miscarriage data
1.  Definitions.  As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings.
A.  "Abortion" means the intentional interruption of a pregnancy by the application of 
external agents, whether chemical or physical, or the ingestion of chemical agents 
with an intention other than to produce a live birth or to remove a dead fetus, 
regardless of the length of gestation.
B.  "Miscarriage" means an interruption of a pregnancy other than as provided in 
paragraph A of a fetus of less than 20 weeks gestation.
C.  "Health care professional" means a physician or physician assistant licensed under 
Title 32, chapter 36 or 48 or an advanced practice registered nurse licensed under 
Title 32, chapter 31 to practice as an advanced practice registered nurse.
2.  Abortion reports.  A report of each abortion performed shall must be made to the 
Department of Health and Human Services on forms prescribed by the department. These 
report forms shall may not identify the patient by name or otherwise and shall must 
contain only the information requested on the United States Standard Report of Induced 
Termination of Pregnancy, published by the National Center for Health Statistics, dated 
January 1978, or any more recent revision of a standard report form.
The form containing that information and data shall must be prepared and signed by the 
attending physician health care professional who performed the abortion and transmitted 
to the department not later than 10 days following the end of the month in which the 
abortion is performed.
A physician health care professional who reports data on an abortion pursuant to this 
section shall be is immune from any criminal liability for that abortion under section 
1598.
3.  Miscarriage reports.  A report of each miscarriage shall must be made by the 
physician health care professional in attendance at or after the occurrence of the 
miscarriage to the Department of Health and Human Services on forms prescribed by the 
department.  These report forms shall must contain all of the applicable information 
required on the certificate of fetal death in current use.
The report form shall must be prepared and signed by the attending physician health care 
professional in attendance at or after the occurrence of the miscarriage and transmitted to 
the department not later than 10 days following the end of the month in which the 
miscarriage occurs.
The identity of any patient or physician health care professional reporting pursuant to 
this section is confidential and the department shall take the steps which are necessary to 
insure ensure the confidentiality of the identity of patients or physicians health care 
professionals reporting pursuant to this section.
Sec. 2.  22 MRSA §1597-A, sub-§§2 to 4, as enacted by PL 1989, c. 573, §2, are 
amended to read:
2.  Prohibitions; exceptions.  Except as otherwise provided by law, no person a 
health care professional, as defined in section 1596, subsection 1, paragraph C, may not 
knowingly perform an abortion upon a pregnant minor unless:
A.  The attending physician health care professional has received and will make part 
of the medical record the informed written consent of the minor and one parent, 
guardian or adult family member;
B.  The attending physician health care professional has secured the informed written 
consent of the minor as prescribed in subsection 3 and the minor, under all the 
surrounding circumstances, is mentally and physically competent to give consent;
C.  The minor has received the information and counseling required under subsection 
4, the minor has secured written verification of receiving the information and 
counseling and the attending physician health care professional has received and will 
make part of the medical record the informed written consent of the minor and the 
written verification of receiving information and counseling required under 
subsection 4; or
D.  The Probate Court or District Court issues an order under subsection 6 on petition 
of the minor or the next friend of the minor for purposes of filing a petition for the 
minor, granting:
(1)  To the minor majority rights for the sole purpose of consenting to the 
abortion and the attending physician health care professional has received the 
informed written consent of the minor; or
(2)  To the minor consent to the abortion, when the court has given its informed 
written consent and the minor is having the abortion willingly, in compliance 
with subsection 7.
3.  Informed consent; disallowance of recovery.  No physician A health care 
professional, as defined in section 1596, subsection 1, paragraph C, may not perform an 
abortion upon a minor unless, prior to performing the abortion, the attending physician 
that health care professional has received the informed written consent of the minor.
A.  To ensure that the consent for an abortion is informed consent, the attending 
physician health care professional who will perform the abortion shall:
(1)  Inform the minor in a manner which that, in the physician's health care 
professional's professional judgment, is not misleading and which that will be 
understood by the patient, of at least the following:
(a)  According to the physician's health care professional's best judgment the 
minor is pregnant;
(b)  The number of weeks of duration of the pregnancy; and
(c)  The particular risks associated with the minor's pregnancy, the abortion 
technique that may be performed and the risks involved for both;
(2)  Provide the information and counseling described in subsection 4 or refer the 
minor to a counselor who will provide the information and counseling described 
in subsection 4; and
(3)  Determines whether the minor is, under all the surrounding circumstances, 
mentally and physically competent to give consent.
B.  No recovery may be Recovery is not allowed against any physician health care 
professional upon the grounds that the abortion was rendered without the informed 
consent of the minor when:
(1) The physician health care professional, in obtaining the minor's consent, acted 
in accordance with the standards of practice among members of the same health 
care profession with similar training and experience situated in the same or 
similar communities; or
(2)  The physician health care professional has received and acted in good faith 
on the informed written consent to the abortion given by the minor to a 
counselor.
4.  Information and counseling for minors.  The provision of information and 
counseling by any physician health care professional, as defined in section 1596, 
subsection 1, paragraph C, or counselor for any pregnant minor for decision making 
regarding pregnancy shall must be in accordance with this subsection.
A.  Any physician health care professional or counselor providing pregnancy 
information and counseling under this subsection shall, in a manner that will be 
understood by the minor:
(1)  Explain that the information being given to the minor is being given 
objectively and is not intended to coerce, persuade or induce the minor to choose 
either to have an abortion or to carry the pregnancy to term;
(2)  Explain that the minor may withdraw a decision to have an abortion at any 
time before the abortion is performed or may reconsider a decision not to have an 
abortion at any time within the time period during which an abortion may legally 
be performed;
(3)  Clearly and fully explore with the minor the alternative choices available for 
managing the pregnancy, including:
(a)  Carrying the pregnancy to term and keeping the child;
(b)  Carrying the pregnancy to term and placing the child with a relative or 
with another family through foster care or adoption;
(c)  The elements of prenatal and postnatal care; and
(d)  Having an abortion;
(4)  Explain that public and private agencies are available to provide birth control 
information and that a list of these agencies and the services available from each 
will be provided if the minor requests;
(5)  Discuss the possibility of involving the minor's parents, guardian or other 
adult family members in the minor's decision making concerning the pregnancy 
and explore whether the minor believes that involvement would be in the minor's 
best interests; and
(6)  Provide adequate opportunity for the minor to ask any questions concerning 
the pregnancy, abortion, child care and adoption, and provide the information the 
minor seeks or, if the person cannot provide the information, indicate where the 
minor can receive the information.
B.  After the person provides the information and counseling to a minor as required 
by this subsection, that person shall have the minor sign and date a form stating that:
(1)  The minor has received information on prenatal care and alternatives to 
abortion and that there are agencies that will provide assistance;
(2)  The minor has received an explanation that the minor may withdraw an 
abortion decision or reconsider a decision to carry a pregnancy to term;
(3)  The alternatives available for managing the pregnancy have been clearly and 
fully explored with the minor;
(4)  The minor has received an explanation about agencies available to provide 
birth control information;
(5)  The minor has discussed with the person providing the information and 
counseling the possibility of involving the minor's parents, guardian or other 
adult family members in the minor's decision making about the pregnancy;
(6)  The reasons for not involving the minor's parents, guardian or other adult 
family members are put in writing on the form by the minor or the person 
providing the information and counseling; and
(7)  The minor has been given an adequate opportunity to ask questions.
The person providing the information and counseling shall also sign and date the 
form, and include that person's address and telephone number.  The person shall keep 
a copy for that person's files and shall give the form to the minor or, if the minor 
requests and if the person providing the information is not the attending physician 
health care professional performing the abortion, transmit the form to the minor's 
attending physician health care professional performing the abortion.
Sec. 3.  22 MRSA §1597-A, sub-§8, ¶B, as enacted by PL 2003, c. 452, Pt. K, 
§11 and affected by Pt. X, §2, is amended to read:
B.  An attending physician A health care professional, as defined in section 1596, 
subsection 1, paragraph C, or counselor may not knowingly fail to perform any action 
required by this section.  A person who violates this paragraph commits a civil 
violation for which a fine of not more than $1,000 may be adjudged for each 
violation.
Sec. 4.  22 MRSA §1598, sub-§1, as amended by PL 1993, c. 61, §2, is further 
amended to read:
1.  Policy.  It is the public policy of the State that the State not restrict a woman's 
exercise of her private decision to terminate a pregnancy before viability except as 
provided in section 1597-A.  After viability an abortion may be performed only when it is 
necessary to preserve the life or health of the mother. It is also the public policy of the 
State that all abortions may be performed only by a physician, a physician assistant or an 
advanced practice registered nurse.
Sec. 5.  22 MRSA §1598, sub-§3, ¶A, as enacted by PL 1979, c. 405, §2, is 
amended to read:
A.  Only a person licensed under Title 32, chapter 36 or chapter 48, to practice 
medicine in Maine the State as a medical or an osteopathic or medical physician, or 
physician assistant or a person licensed under Title 32, chapter 31 to practice in the 
State as an advanced practice registered nurse may perform an abortion on another 
person.
Sec. 6.  22 MRSA §1599-A, as enacted by PL 1993, c. 61, §4, is amended to read:
§1599-A.  Informed consent to abortion
1.  Consent by the woman.  A physician health care professional, as defined in 
section 1596, subsection 1, paragraph C, may not perform an abortion unless, prior to the 
performance, the attending physician health care professional certifies in writing that the 
woman gave her informed written consent, freely and without coercion.
2.  Informed consent.  To ensure that the consent for an abortion is truly informed 
consent, the attending physician health care professional, as defined in section 1596, 
subsection 1, paragraph C, shall inform the woman, in a manner that in the physician's 
health care professional's professional judgment is not misleading and that will be 
understood by the patient, of at least the following:
A.  According to the physician's health care professional's best judgment she is 
pregnant;
B.  The number of weeks elapsed from the probable time of the conception;
C.  The particular risks associated with her own pregnancy and the abortion technique 
to be performed; and
D.  At the woman's request, alternatives to abortion such as childbirth and adoption 
and information concerning public and private agencies that will provide the woman 
with economic and other assistance to carry the fetus to term, including, if the woman 
so requests, a list of these agencies and the services available from each.
SUMMARY
This bill allows a physician assistant or an advanced practice registered nurse 
licensed as such in this State to perform abortions, in addition to a licensed allopathic or 
osteopathic physician.