HB 1109
Department of Legislative Services
Maryland General Assembly
2021 Session
FISCAL AND POLICY NOTE
First Reader
House Bill 1109 (Delegate Ciliberti)
Health and Government Operations
Health - Abortion - Ultrasound and Waiting Period
This bill generally prohibits a physician from performing or inducing an abortion on a
pregnant woman (1) within 24 hours after the woman receives specified transabdominal
ultrasound imaging or (2), if the woman resides at least 100 miles from the facility, within
two hours after the woman receives specified transabdominal ultrasound imaging.
Violators are subject to a penalty of up to $2,500.
Fiscal Summary
State Effect: General fund revenues may increase to the extent fines are imposed in the
District Court due to the bill’s penalty provision. Expenditures are not materially affected.
Local Effect: The bill is not anticipated to materially affect local government finances or
operations.
Small Business Effect: Meaningful.
Analysis
Bill Summary: The medical professional performing the transabdominal ultrasound
imaging must (1) be trained in sonography and working under the supervision of a licensed
physician; (2) if possible, determine the gestational age of the fetus; (3) if gestational age
cannot be determined, verbally offer to the woman other ultrasound imaging to determine
the gestational age of the fetus; (4) if present and viewable, include in the ultrasound image
the dimensions of the fetus and an accurate portrayal of the presence of external members
and internal organs of the fetus; (5) make a print of the ultrasound image to document any
measurements taken to determine the gestational age of the fetus; (6) verbally offer to the
woman during the transabdominal ultrasound imaging the option to view the ultrasound
image, receive a printed copy of the ultrasound image, and hear the fetal heartbeat; and
(7) obtain from the woman specified written certification.
A woman is not required to accept anything offered during the transabdominal ultrasound
imaging performed.
The facility in which an abortion is performed must maintain a printed copy of the
ultrasound image for the greater of seven years or an amount of time as required by federal
or State law.
These requirements do not apply to a woman seeking an abortion if (1) the woman is the
victim of an alleged rape or of incest and (2) the incident of rape or incest is reported to
law enforcement.
Current Law: The State may not interfere with a woman’s decision to end a pregnancy
before the fetus is viable, or at any time during a woman’s pregnancy, if the procedure is
necessary to protect the life or health of the woman, or if the fetus is affected by a genetic
defect or serious deformity or abnormality. This is consistent with the U.S. Supreme Court’s
holding in Roe v. Wade, 410 U.S. 113 (1973). A viable fetus is one that has a reasonable
likelihood of surviving outside of the womb. The Maryland Department of Health may adopt
regulations consistent with established medical practice if they are necessary and the least
intrusive method to protect the life and health of the woman.
If an abortion is provided, it must be performed by a licensed physician. A physician is not
liable for civil damages or subject to a criminal penalty for a decision to perform an
abortion made in good faith and in the physician’s best medical judgment using accepted
standards of medical practice.
Small Business Effect: Meaningful for physicians whose practices currently encompass
performing abortions to comply with the bill.
Additional Information
Prior Introductions: HB 1321 of 2020 received a hearing in the Health and Government
Operations Committee, but no further action was taken. HB 1075 of 2019, a similar bill,
received a hearing in the House Health and Government Operations Committee, but no
further action was taken.
Designated Cross File: None.
HB 1109/ Page 2
Information Source(s): Maryland Department of Health; Department of Legislative
Services
Fiscal Note History: First Reader - March 5, 2021
rh/jc
Analysis by: Amber R. Gundlach Direct Inquiries to:
(410) 946-5510
(301) 970-5510
HB 1109/ Page 3


Statutes affected:
Text - First - Health - Abortion - Ultrasound and Waiting Period: 20-209 Health General, 20-210 Health General