The Utah lawmaker who is mostly frequently tied to abortion restrictions since the overturn of Roe v. Wade in 2022 now wants to require doctors to differentiate some abortions in medical records upon patients’ request — a move opposed by the country’s largest OB-GYN group.
Under HB480 from Rep. Karianne Lisonbee, R-Clearfield, Utah health care providers must, upon request, note in a patient’s medical record that an abortion was “not an elective” one if it was provided for reasons listed in the legislation. The House Judiciary Committee voted along party lines Tuesday to advance the bill.
Among the patients who would be able to ask for changes to their medical records in a yet-to-be-adopted substitute Lisonbee unveiled Friday are those who have experienced a miscarriage, those whose pregnancy was the result of rape or incest, those whose fetus “had a defect that is uniformly diagnosable and uniformly lethal,” and those whose abortion was otherwise “medically indicated.”
That final category includes any abortion “to remove a deceased fetus; to remove an ectopic pregnancy; that is necessary to avert the death of the woman; or that is necessary to avert a serious physical risk of substantial impairment of a major bodily function of a woman,” the substitute bill says.
Abortion is currently legal up to 18 weeks in Utah, with limited exceptions. Lisonbee was the House sponsor for a near-total trigger ban lawmakers passed in 2020, which is blocked as it makes its way through state courts.
Lisonbee’s new version of HB480 defines which fetal abnormalities qualify an abortion as elective or necessary more narrowly than Utah’s current abortion restrictions, which makes exceptions when two doctors agree “the fetus has a fetal abnormality that in the physicians’ reasonable medical judgment is incompatible with life.”
And the substitute contradicts itself on what is considered an elective abortion.
Elective abortions are defined in the current version of the bill as any abortion “that is not a medically indicated abortion” — meaning abortions after rape, incest or identification of a fatal fetal abnormality would be legally classified as elective, despite being labeled “not an elective abortion” in the medical records section of the bill.
“Because medical terminology is really centered around technical terms, doctors don’t mean to say to women, ‘Look, you had an abortion,’” Lisonbee told the House committee Tuesday. “But it happens to many women who have miscarriages, and they take that to heart.”
Medical providers often use the word “abortion” to describe the termination of any pregnancy, whether it was induced or not
That terminology appears in one of the world’s most widely used medical textbooks, the Merck Manual. And pregnancy loss is identified in International Classification of Diseases, 10th Revision — more commonly known as ICD-10 — codes used to uniformly identify medical diagnoses as an “abortive outcome,” with the word “abortion” appearing throughout the codes.
The procedures and medications for abortions, no matter the reason, are the same.
In a statement to The Salt Lake Tribune, the American College of Obstetricians and Gynecologists, the nation’s largest group of providers in that medical field, said, “Precise and accurate documentation is critical for appropriate care. In general, we oppose legislative interference with the medical record.”
(Leah Hogsten | The Salt Lake Tribune) Hundreds of anti-abortion activists rally at Pro-Life Utah's March for Life at the Utah Capitol on Saturday, in conjunction with the national March for Life in D.C., Jan. 22, 2022.
During a public comment period Tuesday, two people spoke in support of the bill. Both represented anti-abortion nonprofit Pro-Life Utah, which helped draft Utah’s trigger law and, in recent years, has received a significant proportion of its funding from the Legislature.
“Some women carry unnecessary shame and guilt quietly over this, and I’ve talked with these kinds of women,” said Danielle Cypers, a registered lobbyist for the group. “Others I’ve spoken with now believe they have no option but to vote against any pro-life legislation, because without their abortion, they would have died. We cannot blur this line for these women anymore.”
In states where abortion has been banned, however, there have been numerous documented instances of women experiencing pregnancy complications losing their lives as doctors and hospitals grapple with the language legislators used in the laws.
People with life-threatening pregnancies in Louisiana have reportedly been forced to undergo a risky cesarean section rather than a less invasive abortion procedure by physicians trying to avoid the appearance of violating the state’s abortion ban.
Abortion rights advocates argue changing medical terminology around abortion is a tactic to further restrict abortion access.
Republican lawmakers in South Carolina unsuccessfully attempted to bar medical professionals from coding a miscarriage as an abortion last year, and the American Association of Pro-Life Obstetricians and Gynecologists has compiled its own glossary of medical terminology.
When a 10-year-old girl who became pregnant as a result of rape was forced to travel from Ohio to Indiana for an abortion in 2022, the head of anti-abortion group Americans United for Life said in congressional testimony that because of the girl’s circumstances, the procedure was “not an abortion.”
Utah’s Planned Parenthood affiliate is leading the lawsuit challenging a near-total ban in the Beehive State. Its president, Shireen Ghorbani, has openly talked about her own experience with miscarriage.
“I deeply empathize with the heartbreak of losing a wanted pregnancy, which is compounded by the stigma that is a direct result of the ways abortion care has been weaponized for political purposes,” Ghorbani said in a statement. “The fact remains that each pregnancy is unique, and every person’s circumstance deserves compassion and understanding, not further governmental interference into essential health care.”
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