Legislature(2017 - 2018)BELTZ 105 (TSBldg)
03/07/2018 01:30 PM JUDICIARY
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SB 124-ABORTION PROCEDURES; CHILD SURRENDER 1:34:21 PM CHAIR COGHILL announced the consideration of SB 124. 1:36:04 PM SENATOR CATHY GIESSEL, Alaska State Legislature, Juneau, Alaska, sponsor of SB 124, said the purpose of this legislation is to give babies the opportunity to be born alive. The bill lays out the following guidelines: When performing or inducing an abortion the physician shall use the method that provides the best opportunity for the unborn child to survive. A child born alive as a result of an abortion shall receive the same degree of professional skill, care and diligence to preserve the life and health of the child as a child born in the course of natural birth at the same fetal age. A child born alive as a result of an abortion may be surrendered to a physician or an employee of the hospital or facility where the abortion is performed. A child born alive as a result of an abortion is considered to be a child in need of aid if the parent is unwilling or unable to care for the child. This bill applies to all abortions performed or induced after the effective date. u This bill take effect immediately. This bill take effect immediately. SENATOR GIESSEL said in Roe v. Wade, 410 U.S. 113 (1973) the Supreme Court maintained that the state has an interest in protecting the life of a fetus after viability. That is the point at which the fetus is capable of living outside the womb. She said the protection of fetal life after viability has biological justifications and may proscribe abortion during the period of viability, except when necessary to preserve the life and health of the mother. SENATOR GIESSEL referenced Planned Parenthood of Central Missouri v. Danforth, 428 U.S. 52, 63(1976), 410 U. S., at 160, 163. That court upheld the definition of viability in Roe. It signifies the point at which the fetus is "potentially able to live outside the mother's womb, albeit with artificial aid," and presumably capable of "meaningful life outside the mother's womb,". She also referenced Whitner v. State of South Carolina, 328 S.C. 1, 7-8 (S.C.1997) that addressed the issue of when a fetus is entitled to protection. That court held that a viable fetus was a "person" for the purposes of the Children's Code in South Carolina. 1:39:38 PM SENATOR GIESSEL summarized some of the sentinel events in the development of a fetus. Week 5: vital organs form; week 8: eyelids form; week 6: brain waves detected; week 9; sucking thumb and yawning. She continued to describe fetal development: Fetal development 14 weeks after conception. Finger Pads -2nd and 3rd months of pregnancy. 3rd and 4th months - the buckling and folding of this skin layer is partially responsible for the unique stresses in fingertip pads. Ridges, the faint lines on fingertips that are the foundation of finger prints start developing around this time. SENATOR GIESSEL advised that at this stage of development, removing the fetus from the uterus requires dilation and evacuation. She said the new term for this procedure is dismemberment. Fetal development 23 weeks after conception. By six months of age fingerprints and footprints are fully developed. Three main patterns have developed from the ridges (arches, loops, whorls). These patterns on the fingertips, palms and soles are used to grasp things. SENATOR GIESSEL said it's been documented that by 20 weeks a fetus feels pain. At 24 weeks there is response to sound. She noted that in Alaska abortion is allowed at this stage. Fetal development 27 weeks after conception: Baby's eyelids can partially open and eyelashes have formed. The central nervous system can direct rhythmic breathing movements and control body temperature. Fetal development 31 weeks after conception: Baby's eyes can open wide. Red blood cells are forming in your baby's bone marrow. Baby's toenails are visible. SENATOR GIESSEL said a baby would be considered term approaching 37 weeks. She noted that in Alaska an abortion could be performed at this stage. SENATOR GIESSEL said the concept of SB 124 is that babies would have the best opportunity to survive at the age of viability. She made the following points: · In the second trimester, 96 percent of abortion procedures are dilatation and evacuation. This is also called dismemberment. · The Centers for Disease Control reports, in 2014 that 9 percent of all abortions are performed on these very developed babies. · In the U.S. about 100,000 babies each year are aborted using the D&E procedure. SENATOR GIESSEL discussed the following points regarding the dismemberment procedure. · It is never medically necessary to preserve the life of the mother in acute medical emergencies. · Dilation of the cervix takes at least 36 hours · It is often guided by ultrasound, forceps grip each extremity and tears it off. · The head must be crushed to remove it. 1:45:45 PM SENATOR GIESSEL discussed survival rate estimates at different gestational ages. At 23 weeks or less, the potential survival rate is about 35 percent. The estimates rise as gestational age increases. She displayed data to show that other states and countries limit the age after which an abortion may be performed. Multiple states identify 20 weeks as the limit and 20 states ban an abortion once there is viability. She said the bill takes that into account and requires the doctor to deliver a viable baby with the best chance of survival. SENATOR GIESSEL said some people oppose the bill because they don't believe it would make a meaningful difference. She's heard the argument that it would only save 2-3 lives in Alaska. She maintained that vastly underestimates the impact and pointed out that every life matters. She displayed pictures of Alaskan children who have Downs Syndrome and noted that in Iceland pregnant women are tested for this genetic disorder. Parents of children with this genetic disorder are told they will be responsible for the medical and special education costs for their child. She said the test is only 85 percent accurate and she suspects many children without Downs Syndrome are aborted. 1:50:01 PM SENATOR GIESSEL noted that Oskar Schindler received a ring at a reunion with Jewish people whose lives he saved. It was inscribed with a quote from the Talmud that said, "…whoever saves a life, it is considered as if he saved an entire world." She said that's what this bill is about. She cited a recent poll in which 76 percent said that abortion should be limited after the end of the first trimester. To the question of whether abortion should be prohibited for genetic issues, 64 percent agreed. She maintained that the bill is in keeping with the sentiments of Americans. Eight states have identified 20 weeks as the cutoff for abortion and challenges have been raised in six of those states. She said SB 124 is modeled after the federal bill that failed to pass the Senate last month. The only difference is that this bill does not identify the age of viability and it does not provide a penalty. She advised that she would not oppose adding those things to the bill. 1:52:32 PM SENATOR KELLY asked her to clarify that nothing in the bill encourages abortions for genetic disorders such as Downs Syndrome. SENATOR GIESSEL said she called out Iceland to demonstrate how far an abortion mandate can go. She added, "These are productive individuals and absolutely should be given the opportunity to be born alive." 1:53:42 PM SENATOR WIELECHOWSKI said his research shows that the earliest a premature baby can survive is 21 weeks and 4 or 5 days. He asked if she agrees. SENATOR GIESSEL replied that is approximately correct at present but technology is always improving, which is why the bill doesn't identify an age of viability. SENATOR WIELECHOWSKI directed attention to the DHSS 2016 Induced Termination of Pregnancy Statistics publication that her office provided. On page 6 it says that 99.5 percent of induced terminations in Alaska were performed at 13 weeks or less gestational age. He asked if she had any reason to dispute that. SENATOR GIESSEL said no. CHAIR COGHILL said this is an issue that is near and dear to his heart and he appreciates the sponsor bringing it forward. Abortion is a question that is discussed as a moral issue, a legal issue, and a political issue but it's really a child issue. Roe v. Wade made it a legal issue and people like himself are trying to value a life under the rule of law in the best way possible. People who are very, very prolife don't believe this bill goes far enough. It preserves the woman's right and still gives the child a chance to be treated well. He asked Ms. Nore to go through the sectional analysis. 1:57:25 PM KARI NORE, Staff, Senator Cathy Giessel, Alaska State Legislature Juneau, Alaska provided the following sectional analysis for SB 124, version U: Section 1: Amends AS 18.16.010 by adding new subsections to provide for a physician to use the method of terminating the pregnancy that best provides for the unborn child to survive outside the mother's womb. It requires health practitioners present at the procedure to exercise the same degree of professional practice and diligence to preserve the life of the viable child born as would be provided to a child born through the course of natural birth. Provides definitions for "alive," "clinical judgment," "fertilization," and "fetal age." Section 2: Amends AS 18.16 by adding a new section that would allow a parent of a child born alive during the process of an abortion to surrender the child to a physician or employee of the hospital. The person to whom the child had been surrendered will notify the Department of Health and Social Services as required under AS 47.10.013(d). Section 3: Amends AS 47.10.011 and adds a provision in the Child in Need of Aid (CINA) statue to include a child born alive during the termination of a pregnancy whose parent is unwilling or unable to care for the infant. Section 4: Adds an applicability provision that states that AS 18.16.010(k)-(m), added by Sec. 1, AS 18.16.012, added by Sec. 2, and AS 47.10.011, as amended by Sec. 3 apply to abortions performed or induced on or after the effective dates of those sections. Section 5: Provides for an immediate effective date for this Act 1:59:25 PM SENATOR WIELECHOWSKI referenced the language in Section 1 and asked which methods of abortion allow for a child to survive. SENATOR GIESSEL said that would be an induced delivery. SENATOR WIELECHOWSKI asked if a hysterotomy (c section) is a safer method of abortion. SENATOR GIESSEL said yes, and if it's a question of saving the mother's life, a c section would be done. SENATOR WIELECHOWSKI asked if a c section is major surgery. SENATOR GIESSEL replied some regard it as that but it's become rather minimal surgery. SENATOR WIELECHOWSKI said the information he's seen indicates a woman who has had a c section stays in the hospital 2-3 days and is recommended to stay off work for six weeks. He asked if she agreed. SENATOR GIESSEL said it depends on the woman and her fundamental health. CHAIR COGHILL said his daughter had twins with a c section and she had two days of rest with the twins and then she went back to work. SENATOR WIELECHOWSKI referenced a document from the Mayo Clinic that said, "After a c section you face a higher risk of potentially serious complications in a subsequent pregnancy, including problems with the placenta." He asked if she would agree with that statement. SENATOR GIESSEL replied a phenomenal number of c sections are done in this country. It's become a very common way to deliver babies and it's an overstatement to say it jeopardizes future pregnancies or the life of the mother. SENATOR WIELECHOWSKI responded that it's a direct quote from the Mayo Clinic. Noting that 21 weeks and 4 days was the earliest a premature baby has survived, he asked how many abortions in Alaska in the last five years were done after 21 weeks. SENATOR GIESSEL replied those numbers are on page 11 of the DHSS 2016 Induced Termination of Pregnancy Statistics publication. She directed attention to the category of "Not Stated" which could mean those not wanting to admit the age of the child at the time of the abortion. SENATOR WIELECHOWSKI asked if she agrees that in 2016 there were zero abortions at 21-24 weeks. SENATOR GIESSEL agreed and pointed out that four were in the "Not Stated" category and two are in the 17 to 20-week bracket. She said technology is always improving and she believes that every life is worth saving. SENATOR WIELECHOWSKI noted that the lowest recorded age for a surviving fetus in the world is 21 weeks. He asked if a physician would be required to perform a different type of abortion procedure on fetuses under 21 weeks. CHAIR COGHILL requested he share the document with world statistics with the committee. He asked him to restate the question. SENATOR WIELECHOWSKI said a baby born May 20, 1987 at 21 weeks and five days was the earliest premature baby in the world. A more recent document said a baby was born at 21 weeks and four days. If the bill passes, he asked if physicians would have to perform induced labor or a hysterotomy if the gestational age is younger than 21 weeks and four days. SENATOR GIESSEL replied it is left to the professional judgement of the physician. She added that because gestational age is often incorrect, it's not advisable to set a specific date in these situations. CHAIR COGHILL asked if ultrasound or other technology helps to determine gestational age. SENATOR GIESSEL confirmed that ultrasounds are very helpful in determining gestational age and viability. SENATOR WIELECHOWSKI noted that since 1999, 0.5 percent of abortions are done at 13 weeks or earlier. He asked if it's possible to induce labor or perform a hysterotomy that would save the life of a child at 13 weeks gestational age. SENATOR GIESSEL said the bill doesn't limit the age because technology advances may make that possible at some point. SENATOR COGHILL commented on technologic advances in other areas and said, "We're continually trying to figure out ways how we guard that life." SENATOR WIELECHOWSKI asked if it's accurate that if the technology were to improve, any woman who wanted an abortion would need to have a c section. SENATOR GIESSEL replied the bill doesn't make that dramatic statement. SENATOR WIELECHOWSKI asked if she would agree that's the effect of the bill. SENATOR GIESSEL clarified that the bill says, "In the professional judgment of the physician, if viability is likely then the best opportunity for survival must be given to the baby." SENATOR WIELECHOWSKI asked if there are criminal penalties if a physician violates the provision. SENATOR GIESSEL said she purposely did not include that but would welcome an amendment. The physician is required to use their ethical and professional judgment. 2:11:42 PM SENATOR WIELECHOWSKI directed attention to page 2 lines 5-7, that defines "alive." He asked if "spontaneous respiratory or cardiac function or pulsation of the umbilical cord means after removal from the womb. SENATOR GIESSEL said yes. SENATOR WIELECHOWSKI said he assumes pulsation of the umbilical cord happens very early on. SENATOR GIESSEL said pulsation of the umbilical cord indicates the circulatory system is functioning. CHAIR COGHILL said if he were to look at accountability he'd start with the reporting. He opined that based on the 2016 report, the DHSS fiscal note will be easy to challenge. SENATOR WIELECHOWSKI directed attention to the definitions of induced termination procedures in Appendix A on page 18 and 19 of the DHSS 2016 report. Noting that she said that induced labor and a hysterotomy provided the best opportunity for the unborn child to survive, he asked which of the procedures would be induced labor. SENATOR GIESSEL said none of the listed procedures would result in a live birth. "There's no way that induced delivery, induced labor would be listed here. It's not a way to kill the baby." 2:16:58 PM SENATOR WIELECHOWSKI read the language on page 1, lines 7-9. He said if induced labor isn't a method of terminating the pregnancy, that leaves a hysterotomy or c section. Should the bill pass, every woman in Alaska who wants an abortion would be required to get a c section if the physician determines that is the best way to save the child. He asked if she agreed with his reading. SENATOR GIESSEL said she was somewhat tempted to suggest he was practicing medicine without a license. She said the normal way a pregnancy is terminated is with the delivery of the baby. The methods listed on page 18 of the report are induced termination procedures that do not result in a live birth. SENATOR WIELECHOWSKI said he didn't have any medical expertise but the language in Section 1 seems to leave a woman who wants to terminate a pregnancy with the only option of having a c section. SENATOR KELLY read the definition of "Induced Termination of Pregnancy" on page 18 of the report and said he didn't think it followed that the woman would have to have a c section. CHAIR COGHILL added that termination of pregnancy that results in a live birth would be added to the statutes if the bill were to pass. 2:20:03 PM SENATOR GIESSEL said the subject of c section came up because it is a method of terminating a pregnancy that would be employed if it were an emergency procedure to save the mother's life. A D&E is not an emergency procedure because it takes at least 36 hours to dilate the cervix. SENATOR WIELECHOWSKI asked for confirmation that the bill doesn't seek to ban D&Es. SENATOR GIESSEL replied it is a procedure called dismemberment. SENATOR WIELECHOWSKI asked if she was seeking to ban the procedure. SENATOR GIESSEL responded that the procedure involves dilating the cervix and entering it with a tool that grasps and dismembers pieces of babies. CHAIR COGHILL said that for some people, the controversy is there should never be any dismemberment. Not at at any stage. He agrees with that viewpoint. The bill maintains the mother's right to terminate the pregnancy and directs the physician to use their clinical judgment and use the procedure that provides the best opportunity for the unborn child to survive. The question of viability rests with the physician. SENATOR GIESSEL confirmed that viability is the basis of the bill. CHAIR COGHILL thanked the sponsor for the introduction. His intention is to take public testimony Monday, consider amendments on Wednesday, and move the bill either Wednesday or Friday. 2:23:10 PM CHAIR COGHILL held SB 124 in committee.