1 STATE OF OKLAHOMA
1
2 1st Session of the 58th Legislature (2021)
2
3 SENATE BILL 778 By: Daniels
3
4
4
5
5
6 AS INTRODUCED
6
7 An Act relating to abortion; creating the Oklahoma
7 Abortion-Inducing Drug Risk Protocol Act; defining
8 terms; limiting provision of abortion-inducing drugs
8 to certain practitioners and procedures; prohibiting
9 provision through certain methods; requiring certain
9 examination; stating criteria of examination;
10 providing for complication management; requiring
10 scheduling and certain efforts of follow-up visit;
11 prohibiting provision of abortion-inducing drugs in
11 certain locations; requiring informed consent within
12 certain time period except under specified
12 conditions; directing use of certain form; stating
13 criteria of valid form; stating additional criteria;
13 requiring State Department of Health to publish and
14 update certain materials; requiring qualified
14 physician to provide certain information; requiring
15 completion and submission of certain report; stating
15 required inclusions and exclusions of report;
16 requiring certain reporting of adverse event; stating
16 criteria of report; requiring Department to prepare
17 and submit certain report; deeming reports public
17 records; prohibiting certain actions relating to
18 identity of woman; directing reports to be made
18 available to certain entities; requiring Department
19 to communicate reporting requirements; specifying
19 additional reporting requirements; requiring
20 Department to create and distribute certain forms;
20 providing criminal penalties; providing for certain
21 civil remedies, disciplinary sanctions and injunctive
21 relief; specifying certain judicial procedures;
22 providing certain construction and intent;
22 authorizing certain intervention; providing
23 severability; providing for codification; and
23 providing an effective date.
24
24
Req. No. 1362 Page 1
 1 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
1
2 SECTION 1. NEW LAW A new section of law to be codified
2
3 in the Oklahoma Statutes as Section 1-756.1 of Title 63, unless
3
4 there is created a duplication in numbering, reads as follows:
4
5 This act shall be known and may be cited as the “Oklahoma
5
6 Abortion-Inducing Drug Risk Protocol Act”.
6
7 SECTION 2. NEW LAW A new section of law to be codified
7
8 in the Oklahoma Statutes as Section 1-756.2 of Title 63, unless
8
9 there is created a duplication in numbering, reads as follows:
9
10 As used in this act:
10
11 1. “Abortion” means the act of using or prescribing any
11
12 instrument, medicine, drug or any other substance, device or means
12
13 with the intent to terminate the pregnancy of a woman known to be
13
14 pregnant, with knowledge that the termination by those means will
14
15 with reasonable likelihood cause the death of the unborn child.
15
16 Such use, prescription or means is not an abortion if done with the
16
17 intent to:
17
18 a. save the life or preserve the health of the unborn
18
19 child,
19
20 b. remove a dead unborn child caused by spontaneous
20
21 abortion, accidental trauma or a criminal assault on
21
22 the pregnant woman or her unborn child,
22
23 c. remove an ectopic pregnancy, or
23
24
24
Req. No. 1362 Page 2
 1 d. treat a maternal disease or illness for which the
1
2 prescribed drug is indicated;
2
3 2. “Abortion-inducing drug” means a medicine, drug or any other
3
4 substance prescribed or dispensed with the intent of terminating the
4
5 pregnancy of a woman known to be pregnant, with knowledge that the
5
6 termination will with reasonable likelihood cause the death of the
6
7 unborn child. This includes the off-label use of drugs known to
7
8 have abortion-inducing properties, which are prescribed specifically
8
9 with the intent of causing an abortion, such as mifepristone
9
10 (Mifeprex), misoprostol (Cytotec) and methotrexate. This definition
10
11 does not apply to drugs that may be known to cause an abortion, but
11
12 which are prescribed for other medical indications, such as
12
13 chemotherapeutic agents and diagnostic drugs. The use of such drugs
13
14 to induce abortion is also known as “medical”, “medication”, “RU–
14
15 486”, “chemical”, “Mifeprex regimen” or “drug-induced” abortion;
15
16 3. “Adverse Event”, according to the Food and Drug
16
17 Administration, means any untoward medical occurrence associated
17
18 with the use of a drug in humans, whether or not considered drug-
18
19 related. It does not include an adverse event or suspected adverse
19
20 reaction that, had it occurred in a more severe form, might have
20
21 caused death;
21
22 4. “Associated physician” means a person licensed to practice
22
23 medicine in the state including medical doctors and doctors of
23
24 osteopathy, that has entered into an associated physician agreement;
24
Req. No. 1362 Page 3
 1 5. “Complication” means any adverse physical or psychological
1
2 condition arising from the performance of an abortion which
2
3 includes, but is not limited to, uterine perforation, cervical
3
4 perforation, infection, heavy or uncontrolled bleeding, hemorrhage,
4
5 blood clots resulting in pulmonary embolism or deep vein thrombosis,
5
6 failure to actually terminate the pregnancy, incomplete abortion
6
7 (retained tissue), pelvic inflammatory disease, endometritis, missed
7
8 ectopic pregnancy, cardiac arrest, respiratory arrest, renal
8
9 failure, metabolic disorder, shock, embolism, coma, placenta previa
9
10 in subsequent pregnancies, preterm delivery in subsequent
10
11 pregnancies, free fluid in the abdomen, hemolytic reaction due to
11
12 the administration of ABO-incompatible blood or blood products,
12
13 adverse reactions to anesthesia and other drugs, subsequent
13
14 development of breast cancer, psychological complications such as
14
15 depression, suicidal ideation, anxiety, sleeping disorders, death
15
16 and any other adverse event as defined by the Food and Drug
16
17 Administration criteria provided in the Medwatch Reporting System;
17
18 6. “Gestational age” means the time that has elapsed since the
18
19 first day of the woman’s last menstrual period, also known as “last
19
20 menstrual period” or “LMP”;
20
21 7. “Hospital” means an institution providing medical and
21
22 surgical treatment and nursing care for sick or injured people, or
22
23 institutions defined under Section 1-701 of Title 63 of the Oklahoma
23
24 Statutes;
24
Req. No. 1362 Page 4
 1 8. “Physician” means any person licensed to practice medicine
1
2 in this state. The term includes medical doctors and doctors of
2
3 osteopathy;
3
4 9. “Pregnant” or “pregnancy” means that female reproductive
4
5 condition of having an unborn child in the mother’s uterus;
5
6 10. “Provide” or “provision” means, when used regarding
6
7 abortion-inducing drugs, any act of giving, selling, dispensing,
7
8 administering, transferring possession to or otherwise providing or
8
9 prescribing an abortion-inducing drug;
9
10 11. “Qualified physician” means a physician licensed in this
10
11 state who has the ability to:
11
12 a. identify and document a viable intrauterine pregnancy,
12
13 b. assess the gestational age of pregnancy and to inform
13
14 the patient of gestational age-specific risks,
14
15 c. diagnose ectopic pregnancy,
15
16 d. determine blood type and administer RhoGAM if a woman
16
17 is Rh negative,
17
18 e. assess for signs of domestic abuse, reproductive
18
19 control, human trafficking and other signals of
19
20 coerced abortion,
20
21 f. provide surgical intervention or has entered into a
21
22 contract with another qualified physician to provide
22
23 surgical intervention, and
23
24
24
Req. No. 1362 Page 5
 1 g. supervise and bear legal responsibility for any agent,
1
2 employee or contractor who is participating in any
2
3 part of procedure including, but not limited to, pre-
3
4 procedure evaluation and care;
4
5 12. “Reasonable medical judgement” means a medical judgment
5
6 that would be made by a reasonably prudent physician knowledgeable
6
7 about the case and the treatment possibilities with respect to the
7
8 medical conditions involved; and
8
9 13. “Unborn child” means an individual organism of the species
9
10 homo sapiens, beginning at fertilization, until the point of being
10
11 born-alive as defined in Title 1 U.S.C., Section 8(b).
11
12 SECTION 3. NEW LAW A new section of law to be codified
12
13 in the Oklahoma Statutes as Section 1-756.3 of Title 63, unless
13
14 there is created a duplication in numbering, reads as follows:
14
15 Abortion-inducing drugs shall only be provided by a qualified
15
16 physician following procedures laid out in this act. It shall be
16
17 unlawful for any manufacturer, supplier, physician, qualified
17
18 physician or any other person to provide any abortion-inducing drug
18
19 via courier, delivery or mail service.
19
20 SECTION 4. NEW LAW A new section of law to be codified
20
21 in the Oklahoma Statutes as Section 1-756.4 of Title 63, unless
21
22 there is created a duplication in numbering, reads as follows:
22
23
23
24
24
Req. No. 1362 Page 6
 1 A. The qualified physician providing an abortion-inducing drug
1
2 shall examine the woman in person, and prior to providing an
2
3 abortion-inducing drug, shall:
3
4 1. Independently verify that a pregnancy exists;
4
5 2. Determine the woman’s blood type, and if she is Rh negative,
5
6 be able to and offer to administer RhoGAM at the time of the
6
7 abortion;
7
8 3. Inform the patient that she may see the remains or her
8
9 unborn child in the process of completing the abortion; and
9
10 4. Document, in the woman’s medical chart, the gestational age
10
11 and intrauterine location of the pregnancy, and whether she received
11
12 treatment for Rh negativity, as diagnosed by the most accurate
12
13 standard of medical care.
13
14 B. A qualified physician providing an abortion-inducing drug
14
15 shall be credentialed and competent to handle complication
15
16 management including emergency transfer, or shall have a signed
16
17 contract with an associated physician who is credentialed to handle
17
18 complications and be able to produce that signed contract on demand
18
19 by the pregnant woman or by the State Department of Health. Every
19
20 pregnant woman to whom a qualified physician provides any abortion-
20
21 inducing drug shall be given the name and phone number of the
21
22 associated physician.
22
23 C. The qualified physician providing any abortion-inducing drug
23
24 or an agent of the qualified physician shall schedule a follow-up
24
Req. No. 1362 Page 7
 1 visit for the woman at approximately seven (7) to fourteen (14) days
1
2 after administration of the abortion-inducing drug to confirm that
2
3 the pregnancy is completely terminated and to assess the degree of
3
4 bleeding. The qualified physician shall make all reasonable efforts
4
5 to ensure that the woman returns for the scheduled appointment. A
5
6 brief description of the efforts made to comply with this subsection
6
7 including the date, time and identification by name of the person
7
8 making such efforts, shall be included in the woman’s medical
8
9 record.
9
10 SECTION 5. NEW LAW A new section of law to be codified
10
11 in the Oklahoma Statutes as Section 1-756.5 of Title 63, unless
11
12 there is created a duplication in numbering, reads as follows:
12
13 Notwithstanding any other provision of this act or the laws of
13
14 this state, abortion-inducing drugs shall not be provided in any
14
15 school facility or on state grounds including, but not limited to,
15
16 elementary, secondary and institutions of higher education in this
16
17 state.
17
18 SECTION 6. NEW LAW A new section of law to be codified
18
19 in the Oklahoma Statutes as Section 1-756.6 of Title 63, unless
19
20 there is created a duplication in numbering, reads as follows:
20
21 A. No abortion-inducing drug shall be provided without the
21
22 informed consent of the pregnant woman as described in this section
22
23 to whom the abortion-inducing drug is provided.
23
24
24
Req. No. 1362 Page 8
 1 B. Informed consent to a chemical abortion shall be obtained at
1
2 least seventy-two (72) hours before the abortion-inducing drug is
2
3 provided to the pregnant woman, except if in reasonable medical
3
4 judgment, compliance with this subsection would pose a greater risk
4
5 of:
5
6 1. The death of the pregnant woman; or
6
7 2. The substantial and irreversible physical impairment of a
7
8 major bodily function not including psychological or emotional
8
9 conditions, of the pregnant woman.
9
10 C. A form created by the State Department of Health shall be
10
11 used by a qualified physician to obtain the consent required prior
11
12 to providing an abortion-inducing drug.
12
13 D. A consent form is not valid and consent is not sufficient,
13
14 unless:
14
15 1. The patient initials each entry, list, description or
15
16 declaration required to be on the consent form as detailed in
16
17 paragraphs 1 through 6 of subsection E of this section;
17
18 2. The patient signs the “consent statement” described in
18
19 paragraph 11 of subsection E of this section; and
19
20 3. The qualified physician signs the “qualified physician
20
21 declaration” described in paragraph 12 of subsection E of this
21
22 section.
22
23 E. The consent form shall include, but is not limited to, the
23
24 following:
24
Req. No. 1362 Page 9
 1 1. The probable gestational age of the unborn child as
1
2 determined by both patient history and by ultrasound results used to
2
3 confirm gestational age;
3
4 2. A detailed description of the steps to complete the chemical
4
5 abortion;
5
6 3. A detailed list of the risks related to the specific
6
7 abortion-inducing drug or drugs to be used including, but not
7
8 limited to, hemorrhaging, failure to remove all tissue of the unborn
8
9 child which may require an additional procedure, sepsis, sterility
9
10 and possible continuation of pregnancy;
10
11 4. Information about Rh incompatibility including that if she
11
12 has an Rh-negative blood type, she should receive an injection of Rh
12
13 immunoglobulin at the time of the abortion to prevent Rh
13
14 incompatibility in future pregnancies;
14
15 5. That the risks of complications from a chemical abortion
15
16 including incomplete abortion, increase with advancing gestational
16
17 age;
17
18 6. That it may be possible to reverse the effects of the
18
19 chemical abortion should she change her mind, but that time is of
19
20 the essence;
20
21 7. That she may see the remains of her unborn child in the
21
22 process of completing the abortion;
22
23
23
24
24
Req. No. 1362