Opinion ID: 391414
Heading Depth: 1
Heading Rank: 3

Heading: Provisions Affecting All Abortions

Text: 30 We look first at those provisions of the ordinance which apply to all abortions, which necessarily include those performed during the first trimester. Our initial inquiry is to determine if any of them directly interfere with the right of a pregnant woman and her physician to decide whether she should obtain an abortion. As the Supreme Court recently reemphasized in Colautti v. Franklin, 439 U.S. 379, 387, 99 S.Ct. 675, 681, 58 L.Ed.2d 596 (1979), this is in all respects a medical decision up to the point where important state interests provide compelling justifications for intervention ....A. Parental Notice and Consent 4 31 The district court held sections 1870.05(A) (parental notice) and 1870.05(B) (parental consent) invalid. Though the original defendants did not appeal these holdings, the intervenors have done so. The intervenors argue that the fundamental right of parents to control, educate, nurture and guide the actions of their minor children is one which the state is constitutionally empowered to protect. This right has been recognized recently by the Supreme Court in connection with abortion regulations in Danforth, supra, 428 U.S. at 73, 96 S.Ct. at 2843; Bellotti v. Baird, 443 U.S. 622, 637-39, 99 S.Ct. 3035, 3045-46, 61 L.Ed.2d 797 (1979); and H. L. v. Matheson, --- U.S. ----, ----, 101 S.Ct. 1164, 1171, 67 L.Ed.2d 388 (1981). While parental rights were recognized, the Court held that a blanket provision requiring consent of a parent or person standing in loco parentis may not be imposed as a condition for abortion of an unmarried minor during her first twelve weeks of pregnancy. Danforth, 428 U.S. at 74, 96 S.Ct. at 2843. In Bellotti, 443 U.S. at 643, 99 S.Ct. at 3048, the Court noted the unique nature and consequences of the abortion decision which make it inappropriate, on the basis of deference to parental rights, to provide a possible third-party veto over the decision of the pregnant woman and her doctor to terminate the patient's pregnancy. We believe the district court correctly applied these principles in finding section 1870.05(B) unconstitutional. See Wynn v. Carey, 582 F.2d 1375, 1390 (7th Cir. 1978); Margaret S. v. Edwards, 488 F.Supp. 181, 202-03 (E.D.La.1980); Planned Parenthood Association of Kansas City v. Ashcroft, 483 F.Supp. 679, 687 (W.D.Mo.1980). 32 The decision in H. L. v. Matheson, supra, requires a different treatment of section 1870.05(A). The Utah statute there involved required a physician to (n)otify, if possible, the parents or guardians of the woman upon whom the abortion is to be performed, if she is a minor or the husband of the woman, if she is married. --- U.S. at ----, 101 S.Ct. at 1166-67. Because the plaintiff in H. L. was an unmarried fifteen-year old who resided at home and was dependent on her parents the only decision of the Court was that the Utah statute was not facially unconstitutional when questioned by one in her circumstances. Justices Stewart and Powell were two of the six Court members who made up the majority. In a separate concurrence these Justices emphasized that the opinion of the Court did not decide whether (the Utah statute) unconstitutionally burdens the right of a mature minor or a minor whose best interests would not be served by parental notification. --- U.S. at ----, 101 S.Ct. at 1173-74 (Powell, J., concurring). 33 The plaintiffs in the present case are abortion clinics and a physician. No minor female is questioning the validity of the Akron ordinance. The intervenors who appealed the portion of the district court judgment finding section 1870.05(A) invalid are parents of unmarried minor daughters. Neither the maturity nor condition with respect to emancipation of these minors is shown. The decision of the Supreme Court leads to the conclusion that section 1870.05(A) is a constitutionally permissible regulation insofar as it applies to immature minors who live with their parents, are dependent upon them and are not emancipated by marriage or otherwise. Until the requirements of section 1870.05(A) are questioned by a minor who claims to be mature or emancipated or claims that notice would not be in her best interest, we cannot hold the section facially invalid. The finding that section 1870.05(A) is unconstitutional is reversed. B. Informed Consent 5 34 The plaintiffs have not appealed from the district court's ruling that the general informed consent requirement of section 1870.06(A) is valid. However, the defendants contend on appeal that the district court erred in holding section 1870.06(B) unconstitutional in its entirety. They argue that the subsections within 1870.06(B) should be considered separately and that only those requirements which fail to pass constitutional scrutiny, when considered individually, should be voided. We believe the district court properly considered section 1870.06(B) as a unit and correctly concluded that the provision setting forth detailed and specific information which must be given to each abortion patient by the attending physician is impermissible. The requirements of section 1870.06(B) impose restrictions or regulations governing the medical judgment of the pregnant woman's attending physician with respect to the termination of her pregnancy. Danforth, 428 U.S. at 80, 96 S.Ct. at 2846. Such restrictions or regulations are not permitted during the first trimester of pregnancy. The district court correctly held section 1870.06(B) invalid, not because it would burden the physician, but because its effect would be to encumber the exercise of the patient's constitutionally protected right by placing obstacles in the path of the doctor upon whom she was entitled to rely for advice in connection with her decision. Whalen v. Roe, 429 U.S. 589, 604 n. 33, 97 S.Ct. 869, 879 n. 33, 51 L.Ed.2d 64 (1977). 35 The district court concluded that section 1870.06(C) serves a valid state interest in the health of its female citizens. This section requires counseling by the attending physician and specifies that the physician must advise the patient of the particular risks associated with her own pregnancy and with the abortion technique to be employed. The district court determined that the state could rationally conclude that this counseling should be done by the attending physician rather than another individual. 36 Section 1870.06(C) impinges on the medical judgment of the attending physician in exactly the same way as section 1870.06(B). It requires the doctor to make certain disclosures in all cases, regardless of his own professional judgment as to the desirability of doing so. Such a requirement is clearly invalid for first trimester abortions. The district court appears not to have considered the nature of the restriction imposed by the section, but only the degree. This was error. Further, the district court required only that the state demonstrate a valid interest in maternal health as justification for section 1870.06(C). A compelling state interest must exist to support a legally significant intrusion into the abortion decision. Finally, even assuming the existence of a compelling state interest, the district court failed to require the defendants to demonstrate that the requirements of section 1870.06(C) are narrowly drawn to serve that interest. As has been stated, the practice of all three plaintiff clinics has been for the counseling to be conducted by persons other than the doctor who performs the abortion. In the absence of a showing that the state's compelling interest in maternal health would be served by a requirement that such counseling be done by the attending physician, this section is invalid. 37 Rather than attempting to show the existence of a compelling state interest in the regulation, the defendants argue that the requirements of section 1870.06(C) are reasonable and do not unduly burden the abortion decision. We believe section 1870.06(C) suffers from the same infirmities as section 1870.06(B). It seeks to impose a requirement which is unsupported by a compelling state interest but has the effect of encumbering the exercise of the pregnant woman's constitutional right. 38 It is possible that some of the individual requirements of sections 1870.06(B) and (C) could be successfully defended. See, e. g., Charles v. Carey, supra; Margaret S. v. Edwards, supra; Planned Parenthood Association of Kansas City v. Ashcroft, supra. As written, however, they have the effect of going far beyond the valid requirement of section 1870.06(A) and extending the permissible reach of the informed consent provision. We affirm the holding of the district court that 1870.06(B) is invalid and reverse the holding that 1870.06(C) is constitutional.C. Waiting Period 39 Section 1870.07 requires a 24-hour waiting period between the time a pregnant woman signs the consent required in section 1870.06(A) and the time an abortion may be performed. In upholding the validity of this provision, the district court relied primarily upon this court's decision in Wolfe v. Schroering, 541 F.2d 523 (6th Cir. 1976). The district court acknowledged that there was no claim in Wolfe v. Schroering that this particular regulation significantly burdened the abortion process. Id. at 526. In the present case the plaintiffs argue that the waiting period requires an additional trip to the clinic, making the process more expensive, imposes impermissible physical and psychological burdens on a woman seeking a first trimester abortion, and is not narrowly drawn to achieve a lawful objective. 40 Since section 1870.07 causes a legally significant impact or consequence on the abortion decision, it cannot be applied to first trimester abortions. Assuming some state interest in postponing abortion decisions, the evidence falls far short of establishing a compelling interest which is served by the requirement. The obvious effect of the requirement is to impose upon the process of obtaining an abortion a delay which has no medical basis. Though there was evidence that a period of delay before surgery is often beneficial, there was none that an inflexible requirement of a 24-hour waiting period for an abortion serves any interest of the state, much less a compelling interest which is required under strict scrutiny analysis. Medical witnesses for the defendants testified that a reasonable work-up time is customary and often necessary prior to surgery. However, none related this in-hospital practice to the very brief procedures involved in early stage abortions. 41 The unstated purpose of section 1870.07 is to require a cooling off period during which second thoughts might come into play. The district court appears to have recognized this effect: 42 The state interest furthered by the waiting period requirement is the insurance that a woman's abortion decision is made after careful consideration of all the facts applicable to her particular situation. This is an important state interest considering the irreversible nature and possible lasting consequences of the abortion decision. 43 479 F.Supp. at 1204. 44 Desirable as such careful consideration may be, it is beyond the state's power to require. Charles v. Carey, supra, 627 F.2d at 785-86; Margaret S. v. Edwards, supra, 488 F.Supp. at 212-13. We reverse the holding that section 1870.07 is constitutional. 45