The Women's Reproductive Health Information Act

of 2012. CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES

(a)Definitions. For the purposes of this § 3218.1, the following words and phrases are defined to mean:

(1)Abortion means the use or prescription of any instrument, medicine, drug, or other substance or device to terminate the pregnancy of a woman known to be pregnant with an intention other than to increase the probability of a live birth, to preserve the life or health of the child after live birth, to act upon an ectopic pregnancy, or to remove a dead unborn child who died as the result of natural causes in utero, accidental trauma, or a criminal assault on a pregnant woman or her unborn child, and which causes the premature termination of the pregnancy;

(2)Act means the Women's Reproductive Health Information Act of 2012 codified at Title 10 GCA § 3218.1;

(3)Complication means that condition which includes but is not limited to hemorrhage, infection, uterine perforation, cervical laceration, pelvic inflammatory disease, endometriosis, and retained products. The Department may further define the term “complication” as necessary and in a manner not inconsistent with this § 3218.1;

(4)Conception means the fusion of a human spermatozoon with a human ovum;

(5)Department means the Department of Public Health and Social Services;

(6)Facility or medical facility means any public or private hospital, clinic, center, medical school, medical training institution, health care facility, physician's office, infirmary, dispensary, ambulatory surgical treatment center, or other institution or location wherein medical care is provided to any person;

(7)First trimester means the first twelve

(12)weeks of gestation;

(8)Gestational age means the time that has elapsed since the first day of the woman's last occurring menstruation; CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES

(9)Hospital means any building, structure, institution or place, public or private, whether organized for profit or not, devoted primarily to the maintenance and operation of facilities for the diagnosis, treatment and provision of medical or surgical care for three

(3)or more non-related individuals, admitted for overnight stay or longer in order to obtain medical, including obstetric, psychiatric and nursing care of illness, disease, injury or deformity, whether physical or mental and regularly making available at least clinical laboratory services and diagnostic x-ray services and treatment facilities for surgery or obstetrical care or other definitive medical treatment;

(10)Medical emergency means a condition which, in reasonable medical judgment, so complicates the medical condition of the pregnant woman as to necessitate the immediate termination of her pregnancy to avert her death or for which a delay will create a serious risk of substantial and irreversible physical impairment of a major bodily function. No condition shall be deemed a medical emergency if based on a claim or diagnosis that the woman will engage in conduct which would result in her death or in substantial and irreversible physical impairment of a major bodily function;

(11)Physician means any person licensed to practice medicine or surgery or osteopathic medicine under the Physicians Practice Act (Title 10 GCA § 12201, et seq.) or in another jurisdiction of the United States;

(12)Pregnant or pregnancy means that female reproductive condition of having an unborn child in the mother's uterus;

(13)Qualified person means an agent of a physician who is a psychologist, licensed social worker, licensed professional counselor, registered nurse, or physician;

(14)Records Section means the Guam Memorial Hospital Medical Records Section;

(15)Unborn child or fetus each means an individual organism of the species homo sapiens from conception until live birth; CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES

(16)Viability means the state of fetal development when, in the reasonable judgment of a physician based on the particular facts of the case before him or her and in light of the most advanced medical technology and information available to him or her, there is a reasonable likelihood of sustained survival of the unborn child outside the body of his or her mother, with or without artificial support; and

(17)Woman means a female human being whether or not she has reached the age of majority.

(b)Informed Consent Requirement. No abortion shall be performed or induced without the voluntary and informed consent of the woman upon whom the abortion is to be performed or induced. Except in the case of a medical emergency, consent to an abortion is voluntary and informed if and only if:

(1)at least twenty-four

(24)hours before the abortion, the physician who is to perform the abortion or a qualified person has informed the woman in person of the following:

(A)the name of the physician who will perform the abortion;

(B)the following medically accurate information that a reasonable person would consider material to the decision of whether or not to undergo the abortion:

(i)a description of the proposed abortion method and

(ii)the immediate and long-term medical risks associated with the proposed abortion method, including but not limited to any risks of infection, hemorrhage, cervical or uterine perforation, and any potential effect upon future capability to conceive as well as to sustain a pregnancy to full term;

(C)the probable gestational age of the unborn child at the time the abortion is to be performed;

(D)the probable anatomical and physiological characteristics of the unborn child at the time the CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES abortion is to be performed;

(E)the medical risks associated with carrying the child to term;

(F)any need for anti-Rh immune globulin therapy if she is Rh negative, the likely consequences of refusing such therapy, and the cost of the therapy;

(2)at least twenty-four

(24)hours before the abortion, the physician who is to perform the abortion or a qualified person has informed the woman in person, that:

(A)medical assistance benefits may be available for prenatal care, childbirth, and neonatal care and that more detailed information on the availability of such assistance is contained in the printed materials given to her and described in Subsection

(c)of this § 3218.1;

(B)public assistance may be available to provide medical insurance and other support for her child while he or she is a dependent and that more detailed information on the availability of such assistance is contained in the printed materials given to her and described in Subsection

(c)of this § 3218.1;

(C)public services exist which will help to facilitate the adoption of her child and that more detailed information on the availability of such services is contained in the printed materials given to her and described in Subsection

(c)of this § 3218.1;

(D)the printed materials in Subsection

(c)of this Section 3218.1 describe the unborn child;

(E)the father of the unborn child is liable to assist in the support of this child, even in instances where he has offered to pay for the abortion. In the case of rape or incest, this information may be omitted; and

(F)she is free to withhold or withdraw her consent to the abortion at any time without affecting her right to future care or treatment and without the loss of any locally or federally funded benefits to which she might CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES otherwise be entitled.

(3)At least twenty-four

(24)hours before the abortion, the physician who is to perform the abortion or a qualified person has given the woman a copy of the printed materials described in Subsection

(c)of this § 3218.1. If the woman is unable to read the materials, they shall be read to her. If the woman asks questions concerning any of the information or materials, answers shall be provided to her in a language she can understand.

(4)The information in Subsections (b)(l), (b)(2) and (b)(3) of this § 3218.1 is provided to the woman individually and in a private room to protect her privacy and maintain the confidentiality of her decision and to ensure that the information focuses on her individual circumstances and that she has an adequate opportunity to ask questions.

(5)Prior to the abortion, the woman certifies in writing on a checklist certification provided by the Department that the information required to be provided under Subsections (b)(l), (b)(2) and (b)(3) of this § 3218.1 has been provided. All physicians who perform abortions shall report the total number of certifications received monthly to the Records Section. The Records Section shall make the number of certifications received available to the public on an annual basis.

(6)Except in the case of a medical emergency, the physician who is to perform the abortion shall receive and sign a copy of the written checklist certification prescribed in Subsection (b)(5) of this § 3218.1 prior to performing the abortion. The physician shall retain a copy of the checklist certification in the woman's medical record.

(7)In the event of a medical emergency requiring an immediate termination of the pregnancy, the physician who performed the abortion shall clearly certify in writing the nature of the medical emergency and the circumstances which necessitated the waiving of the informed consent requirements of this § 3218.1. This certification shall be signed by the physician who performed the emergency CH. 3. PUBLIC HEALTH AND SOCIAL SERVICES termination of pregnancy, and shall be permanently filed in both the patient records maintained by the physician performing the emergency procedure and the records maintained by the facility where the emergency procedure occurred.

(8)A physician shall not require or obtain payment from anyone for providing the information and certification required by this § 3218.1 until the expiration of the twentyfour

(24)hour reflection period required by this § 3218.1.

(c)Publication of Materials. The Department shall cause to be published printed materials in English and any other culturally sensitive languages which the Department deems appropriate within one hundred eighty

(180)days after this Act becomes law. The printed materials shall be printed in a typeface large enough to be clearly legible and shall be presented in an objective, unbiased manner designed to convey only accurate scientific information. On an annual basis, the Department shall review and update, if necessary, the following easily comprehensible printed materials:

(1)Printed materials that inform the woman of any entities available to assist a woman through pregnancy, upon childbirth and while her child is dependent, including but not limited to adoption services. The printed materials shall include a list of the entities, a description of the services they offer, and the telephone numbers of the entities, and shall inform the woman about available medical assistance benefits for prenatal care, childbirth, and neonatal care. The Department shall ensure that the materials described in this § 3218.1 are comprehensive and do not directly or indirectly promote, exclude, or discourage the use of any entity described in this