podaa aommuJo3 REGULAR CALENDAR

February 28, 2018

HOUSE OF REPRESENTATIVES

REPORT OF COMMITTEE

The Majority of the Committee on Judiciary to which was referred HB 1721-FN,

AN ACT relative to coercive . Having considered the same, report the same with the following resolution: RESOLVED, that it is INEXPEDIENT TO

LEGISLATE.

Joseph Hagan

FOR THE MAJORITY OF THE COMMITTEE

Original: House Clerk Cc: Committee Bill File MAJORITY COMMITTEE REPORT

Committee: Judiciary Bill Number: HB 1721-FN Title: relative to coercive abortions. Date: February 28, 2018 Consent Calendar: REGULAR Recommendation: INEXPEDIENT TO LEGISLATE

STATEMENT OF INTENT

This law is purportedly intended to protect women from so-called coercive abortions, but it does so by targeting medical providers rather than individuals doing the "coercing." Moreover, nowhere in the bill's five pages does it define "coercion." HB 1721 claims to protect women from coercive by dictating a specific screening process, ignoring the fact that health care providers are already legally and ethically required to obtain a patient's independent informed consent. It is standard medical practice to provide patient education and informed consent for any medical procedure, yet this bill singles out abortion providers. In practice, this bill would impose an undue burden on a woman's constitutional right by making it all but impossible for abortion providers to treat her. For instance, under the law, a woman who generally has a "negative view toward abortion" but nevertheless seeks to terminate her pregnancy is branded a "vulnerable person" for whom informed consent is inherently suspect. In such circumstances, this law compels state mandated speech in violation of the First Amendment by forcing health care providers to deliver the state's message that a woman is a "vulnerable person" even if the provider does not agree with the statement. Due to these serious flaws in this bill, a bi-partisan majority of this committee rejected this bill.

Vote 15-3.

Rep. Joseph Hagan FOR THE MAJORITY

Original: House Clerk Cc: Committee Bill File REGULAR CALENDAR

Judiciary HB 1721-FN, relative to coercive abortions. MAJORITY: INEXPEDIENT TO LEGISLATE. MINORITY: OUGHT TO PASS. Rep. Joseph Hagan for the Majority of Judiciary. This law is purportedly intended to protect women from so-called coercive abortions, but it does so by targeting medical providers rather than individuals doing the "coercing." Moreover, nowhere in the bill's five pages does it define "coercion." HB 1721 claims to protect women from coercive abortion by dictating a specific screening process, ignoring the fact that health care providers are already legally and ethically required to obtain a patient's independent informed consent. It is standard medical practice to provide patient education and informed consent for any medical procedure, yet this bill singles out abortion providers. In practice, this bill would impose an undue burden on a woman's constitutional right by making it all but impossible for abortion providers to treat her. For instance, under the law, a woman who generally has a "negative view toward abortion" but nevertheless seeks to terminate her pregnancy is branded a "vulnerable person" for whom informed consent is inherently suspect. In such circumstances, this law compels state mandated speech in violation of the First Amendment by forcing health care providers to deliver the state's message that a woman is a "vulnerable person" even if the provider does not agree with the statement. Due to these serious flaws in this bill, a bi-partisan majority of this committee rejected this bill. Vote 15-3.

Original: House Clerk Cc: Committee Bill File HB 1721 relative to coercive abortions

This law is purportedly intended to protect women from so-called coercive abortions, but it does so by targeting medical providers rather than individuals doing the "coercing." Moreover, nowhere in the bill's five pages does it define "coercion." HB 1721 claims to protect women from coercive abortion by dictating a specific screening process, ignoring the fact that health care providers are already legally and ethically required to obtain a patient's independent informed consent. It is standard medical practice to provide patient education and informed consent for any medical procedure, yet this bill singles out abortion providers. In practice, this bill would impose an undue burden on a woman's constitutional right by making it all but impossible for abortion providers to treat her. For instance, under the law, a woman who generally has a "negative view toward abortion" but nevertheless seeks to terminate her pregnancy is branded a "vulnerable person" for whom informed consent is inherently suspect. In such circumstances, this law compels state mandated speech in violation of the First Amendment by forcing health care providers to deliver the state's message that a woman is a "vulnerable person" even if the provider does not agree with the statement. Due to these serious flaws in this bill, a bi-partisan majority of this committee rejected this bill.

12007 REGULAR CALENDAR

February 27, 2018

HOUSE OF REPRESENTATIVES

REPORT COMMITTEE

The Minority of the Committee on Judiciary to which was referred HB 1721-FN,

AN ACT relative to coercive abortions. Having considered the same, and being unable to agree with the

Majority, report with the recommendation that the bill be REFERRED FOR INTERIM STUDY.

Rep. Kurt Wuelper

FOR THE MINORITY OF THE COMMITTEE

Original: House Clerk Cc: Committee Bill File MINORITY COMMITTEE REPORT

Committee: Judiciary Bill Number: HB 1721-FN Title: relative to coercive abortions. Date: February 27,2018 Consent Calendar: REGULAR Recommendation: OUGHT TO PASS

STATEMENT OF INTENT

The minority believes that far too many women are forced to "choose abortion against their own desire or will. the extent of forced abortion has been well documented as part of the sex trafficking business. Testimony in writing and in person supported the need for this legislation. While opponents decry the bill's focus on the abortion provider, the minority see that provider as the final point at which the coercion can be stopped. We see this bill as an important protection for vulnerable women from those who exploit legal abortion to enslave them.

Rep. Kurt Wuelper FOR THE MINORITY

Original: House Clerk Cc: Committee Bill File REGULAR CALENDAR

Judiciary HB 1721-FN, relative to coercive abortions. OUGHT TO PASS. Rep. Kurt Wuelper for the Minority of Judiciary. The minority believes that far too many women are forced to "choose" abortion against their own desire or will. the extent of forced abortion has been well documented as part of the sex trafficking business. Testimony in writing and in person supported the need for this legislation. While opponents decry the bill's focus on the abortion provider, the minority see that provider as the final point at which the coercion can be stopped. We see this bill as an important protection for vulnerable women from those who exploit legal abortion to enslave them.

Original: House Clerk Cc: Committee Bill File

MINORITY REPORT 00 COMMITTEE: -TL-L cti fi-n-t7

BILL NUMBER:

TITLE:

DATE: CONSENT CALENDAR: YE

OUGHT TO PASS Amendment No. OUGHT TO PASS W/ AMENDMENT

pi INEXPEDIENT-TO LEGISLATE n INTERIM STUDY (Available only 2nd year of biennium)

REGULAR CALENDAR

Judiciary HB 1721-FN, relative to coercive abortions. OUGHT TO PASS. Rep. Kurt Wuelper for the Minority of Judiciary. The minority b lieves that far too many women are forced to "choose" abortion against their own desire or will e extent of forced abortion has been well documented as part of the sex trafficking business ony in writing and in person supported the need for this legislation. While opponents the bill's focus on the abortion provider, the minority see that provider as the final point a the coercion can be stopped. We see this bill as an important protection for vulnerable women those who exploit legal abortion to enelene them.

Y Ir -,-- Ire — et, t-fAr, 79 It4.1..a. ILICI)V1/1 • ---• ,, /VV - , , re- r" 4 t ii1 - a-T td4L" jVii 6O4A7d-Lonit 6,6244,11f, il)..e1.4y)tki; ia.-;. a..1 dA/L12±(Z•vt-Tp,frt.tici-vt, .2itJ A4,0 ieA: o4e,,74-4,;A. ,to ca,vv ,LI.A-171 COMMITTEE VOTE:

RESPECTFULLY SUBMITTED,

• Copy to Committee Bill File Rep. For the Minority Rev. 02/01/07 - Blue Voting Sheets HOUSE COMMITTEE ON JUDICIARY

EXECUTIVE SESSION on HB 1721-FN

BILL TITLE: relative to coercive abortions.

DATE: February 27, 2018

LOB ROOM: 208

MOTIONS: INEXPEDIENT TO LEGISLATE Moved by Rep. DiLorenzo Seconded by Rep. Hagan Vote: 15-3

CONSENT CALENDAR: NO

Statement of Intent: Refer to Committee Report

Respectfully submitted, Cry S CM Rep Sandra Keans, Clerk HOUSE COMMITTEE ON JUDICIARY

EXECUTIVE SESSION on HB 1721-FN

BILL TITLE: relative to coercive abortions.

DATE: ")---7 /79 LOB ROOM: 208

MOTION: (131e ase heck one box)

❑ OTP WITL 0 Retain (1st year) 0 Adoption of Amendment # O Interim Study (2nd year) (if offered)

Moved by Rep. Seconded by Rep. Vote: /5'3

MOTION: (Please check one box)

❑ OTP ❑ OTP/A ❑ ITL 0 Retain (Pt year) 0 Adoption of Amendment # O Interim Study (2nd year) (if offered)

Moved by Rep. Seconded by Rep. Vote:

MOTION: (Please check one box)

O OTP 0 OTP/A ❑ ITL 0 Retain (1st year) 0 Adoption of Amendment # O Interim Study (2nd year) (if offered)

Moved by Rep. Seconded by Rep. Vote:

MOTION: (Please check one box)

O OTP 0 OTP/A 0 ITL 0 Retain (1st year) 0 Adoption of Amendment # O Interim Study (2nd year) (if offered)

Moved by Rep. Seconded by Rep. Vote:

CONSENT CALENDAR: YES NO / /) Minority Report? X Yes No If yes, author, Rep: a)C/e(--1- Motion

Respectfully submitted: Rep Sandra Keans, Clerk

STATE OF NEW HAMPSHIRE 1/29/2018 1:55:35 PM OFFICE OF THE HOUSE CLERK Roll Call Committee Registers Report 2018 SESSION

JUDICIARY

Bill #: Title: 0 l 3( aol g ict t121,Ak PH Date: 0 / I t( insO Exec Session Date: 2t_

Motion: Amendment #:

MEMBER YEAS NAYS

Hagan, Joseph M. Chariman t/ Rouillard, Claire A. Vice Chairman V Hopper, Gary S. V

Sylvia, Michael J. li Hull, Robert-- - hi-ePeZ6L—, 1/ Wuelper, Kurt F. V Graham, Robert V. V Hynes, Dan k/ Janvrin, Jason A. A/ Leavitt, John A. ,/ Wall, Janet G. V Horrigan, Timothy 0. Berch, Paul S. V Smith, Suzanne J. i Kenison, Linda B. / Keans, Sandra B. Clerk \/ DiLorenzo, Charlotte I. A/ Altschiller, Debra A/ TOTAL VOTE:

1

Page: 1 of 1 Hearing Minutes HOUSE COMMITTEE ON JUDICIARY

CONTINUED PUBLIC HEARING ON HB 1721-FN

(reconvened from January 31, 2018)

BILL TITLE: relative to coercive abortions.

DATE: February 14, 2018

LOB ROOM: 208 Time Public Hearing Reconvened: 10:05 a. m.

Time Adjourned: 11:25 a. in.

Committee Members: Reps. Hagan, Rouillard, Keans, Hopper, Sylvia, Wuelper, R. Graham, Hynes, Leavitt, Suzanne Smith, Wall, Horrigan, Berch, Kenison, DiLorenzo and Altschiller and Webb

Bill Sponsors: Rep. Wuelper Rep. M. Pearson Rep. Nelson Rep. Itse Rep. Notter Rep. Baldasaro Rep. Brown Rep. Seidel

TESTIMONY Use asterisk if written testimony and/or amendments are submitted.

Kayla Montgomery, Planned Parenthood - oppose This bill interferes with patient/doctor relationship. Findings in bill are not accurate.

Q. Rep. Kenison: Page 4, Line 23 - four (4) year period to bring action? Ans. Could have later regrets nothing to do with actual

Q. Rep Berch: 4-year date is an awareness date not time limit for action. Is there a definition for emotional complication? Ans. (Page 4, Line 24)

Q. Rep. Rouillard: Concern w/constitutionality.

Q. Rep. Kenison: Does this bill cover others besides doctor? Ans. Yes.

Q. Rep. Berch: Page 1, Line 6 - Had heartache, is it ture for all medical conditions: Ans. Yes.

Q: Rep. Webb: What is the harm? Ans. Single out abortion procedures. *Read letter from provider, Jennifer Castle, NP

Q. Rep. Rouillard: How often do parents meet with provider? Ans. Parents do talk with them but at different meeting. Each provider re-asks questions of patient. Q. If patient is under 18? Ans. If not appearance of coercion? - Ans. Schedule. Q. Page 3 - Screening Requirements - What happens if not all the questions are answered? Ans. Reschedule.

Q, Rep. Hagan: Coercion - by criminal activity and ? Ans. Often are the escape for trafficking.

Rep. Kenison: Believe intent is all people, not just providers.

Q. Rep. Hopper: Has there been any assistance to authorities for criminal activity? Ans. Yes, have taken action. Page 2 (HB 1721 continued)

*Darlene Pawlik, Raymond, NH, representing self- support Was a victim of prostitution, at 17 had four different pimps. Called Planned Parenthood, Haverhill, MA; but did go to appointment. - Now married for 28 years.

Jeanne Hruska, New Hampshire American Civil Liberties Union - oppose This bill is unworkable and unconstitutional. Definition of "vulnerable" would prevent going forward. Term of "coercion" not defined. Reasonable patient. "Emotional attachment" Interferes with the first amendment speech. If you have no compunctions, you may be easier to get that a woman who dislikes the idea.

Q. Rep. Rouillard: Page 2, Line 29, a "medical emergency" -- This does not comply with constitutional rulings. Ans. Yes Q. Page 2, Line 31 - "create grave peril of immediate and irreversible loss of major bodily function." Ans. No aware of any other state. Q. Page 5, Line 12 - " abortion is necessary to avert her death " Ans. Agree will make it too risky for providers.

Rep. Kathleen Souza, Hills. 43, Manchester - support Language may be wrong but concerns is very important. Sees women going/exiting Manchester clinic in tears, as a sidewalk observer. Concerned about quality of counseling. Q. Rep. Horrigan: Sidewalk counselors offering services but obviously are not licensed? Ans. True.

Respectfully submitted, Zo_ax.es Rep. Sandra Keans, Clerk HOUSE COMMITTEE ON JUDICIARY

CONTINUED PUBLIC HEARING ON HB 1721-FN

BILL TITLE: relative to coercive abortions.

DATE: / /

ROOM: 208 Time Public Hearing Called to Order: /0 ,0

Time Adjourned: /(/;

(please circle if present)

Committee Members: Reps a a Kean ,'Hopper, lvia,41u11, uel Gral anvrin, ercE," ,A1LC;renzo Ue/e/3

Bill Sponsors: Rep. Wuelper Rep. M. Pearson Rep. Nelson Rep. Itse Rep. Notter Rep. Baldasaro Rep. Brown Rep. Seidel

TESTIMONY

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1 SIGN UP SHEET

To Register Opinion If Not Speaking

Bill # l /7.2--/ Date toi ,U/S7 Committee

** Please Print All Information **

(check one) Name Address Phone Representing Pro Con ge1.15 s a 1k ric-'W- of (11,., (A),-A Lva Sre-4- .>< ‘, X\ / L T (pavtuAr-rAL- 2.„- a., GCe,- X a, ;-31Se(71 n' o et-patN(00k- (9.1,}1P- -- O vi __--( -- Er-Q-et-tgrii- ><-. (1C-c[A ctJ (r6.---(b i_J-} /71/1_ ,Lat-e_sti 14-) tAii.D-- ste_4-(- solnugAl uuraH HOUSE COMMITTEE ON JUDICIARY

PUBLIC HEARING ON HB 1721-FN

BILL TITLE: relative to coercive abortions.

DATE: January 31, 2018

LOB ROOM: 208 Time Public Hearing Called to Order: 11:58 a.m.

Time Recessed: 12:48 p.m.

Public Hearing to reconvene February 14th

Committee Members: Reps. Hagan, Rouillard, Keans, Hopper, Sylvia, Hull, Wuelper, R. Graham, Hynes, Janvrin, Leavitt, Suzanne Smith, Wall, Horrigan, Berch, Kenison, DiLorenzo and Altschiller

Bill Sponsors: Rep. Wuelper Rep. M. Pearson Rep. Nelson Rep. Itse Rep. Notter Rep. Baldasaro Rep. Brown Rep. Seidel

TESTIMONY

* Use asterisk if written testimony and/or amendments are submitted.

Rep. Kurt Wuelper, prime sponsor Introduced the bill to the committee. Criminalizing forced abortion; civil and criminal penalties.

Q, Rep. Rouillard: Currently physicians must have consent form? Ans. Yes, but in clinics no relationships exist. Q. Has only momentary meeting with anesthesiologist, but still considered to be informed with a relationship. Q. All over the United States Attorney Generals refuse to follow the law. Page 5, Line - any person, not necessarily an attorney can intervene.

Q. Rep. DiLorenzo: Should there be a definition of coercion? Ans. Bill creates system to interview woman and make a judgment.

Q. Rep. Kenison: Page 4, Line 23-26 Four (4) years is a long time to change opinion of whether actually coerced? Ans. May not realize. Q. To bring action preponderance/beyond?

Q. Rep. Altschiller: Aware that a system already exists to inform patients? Ans. Yes. Q. So how does this add to the statutes? Ans. Specifically, do not know they refer to coercion.

Q. Rep. Rouillard: Changing statute from two to four for bringing action?

*Dr. Oge Young, ALOG, NAMI, patient, - oppose Everyone is pro-life/anti-abortion in a perfect world. Abortion rate is dropping precipitously, still believe a woman make the best decision for herself. Not true that abortion providers encourage procedure. 20-30% of woman suffer postpartum depression; 5% abortions. Thirty-five years (35) seeing more pressure to keep - parents, minister, risk of losing life in child birth 30x greater than of abortion. Candid opinion: This legislation is not about what is best for a woman. Submmited written testimony.

Q. Rep. Hopper: Do you know doctor that flies into Manchester Clinic? Page 2 (HB 1721 continued)

*Kristen Smith, CMA, CPT - Nottingham, NH, representing self - support 11 week abortion at Feminist Health Center, Stratham; 5 years later when she married and was more mature; a new pregnancy occurred; She had an anxiety disorder after learning about abortion - thinks there was not enough counseling before procedure and would like to see more support for women. Submitted written testimony.

Rachel Allen, MSN, WHNP,BC and Dalia Vidunas, Executive Director, Equality Health Center - oppose *Rachel Allen: Medical licensure adherence to standards; adhere rigorously to providing information so that person makes own decision. Strict systems, no appointment made by others. Rash procedure - often provide services that all OBGYNs do not have time for. Submitted written testimony.

*Dalia Vidunas: At any time when a woman feels pressure and there is a hint of coercion, we stop the movement immediately --- including not allowing a person to go home, if they have a fear of violence. Referrals put licenses in jeopardy according to this bill constant assessment form. Submitted written testimony.

Public hearing was recessed at 12:48 p. m. To be reconvened February 14, 2018

Respectfully submitted,

Rep. Sandra B. Keans, Clerk

Pink Cards: Rep. Al Baldasaro - support Margaret Drye, Plainfield, NH - declined to speak

HOUSE COMMITTEE ON JUDICIARY

PUBLIC HEARING ON HB 1721-FN

BILL TITLE: relative to coercive abortions.

DATE: / 1 2

ROOM: 208 Time Public Hearing Called to Order: I/ '62)

Time Adjourned: /X-: ,dzceerS.0

(please circle if present)

Committee Members: Reps. Hagan, Rouillard, Hopper, Sylvia, Hull, Wuelper, R. Graham, Hynes, Janvrin, Leavitt, Wall, Horrigan, Berch, Kenison, DiLorenzo, Mulligan, Altschiller and Keans

~.PD Wuelper ) Rep. M. Pearson Rep. Nelson ep. se Rep. Notter Rep. Baldasaro Rep. Brown Rep. Seidel

TESTIMONY

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Good morning. My name is Dr. Oge Young. I have practiced Ob/Gyn in Concord for 35 years. I am a past president of the NH Medical Society and continue to serve on their council representing the obstetricians in our state. Also, I am a Clinical Professor of Ob/Gyn at Dartmouth's Geisel School of Medicine having taught students and residents for years. I am speaking in opposition to HB1721.

The bill states that women seek abortions in great haste. That has never been my experience. It is a difficult decision that requires very thoughtful consideration. It is not made easily. The bill states abortion providers encourage women to make a decision quickly without adequate counseling. That is far from the truth. We encourage women to take their time, carefully weighing the consequences of their decisions, making sure that it is the right decision for them.

The bill states numerous researchers have found that women who choose abortion in violation of their conscience are prone to suffer severe psychologic distress following the abortion. I agree with that statement, but that is why we are careful in our counseling to make sure that her decision is not in violation of her conscience. You should know that severe depression in new moms- so called PP depression follows the birth of a baby 20-30% of the time. Severe depression follows an abortion in less than 5% of women.

The bill states there are many cases in which women who would prefer to keep their pregnancies are forced by others to undergo unwanted abortions. This is just not true. Those of us who see these women make certain that they choose clearly on their own volition to have pregnancy terminations.

In fact, I have seen far more women pressured or coerced into keeping their pregnancies and not having an abortion. Many women have shared with me that they have to keep their pregnancies because they have told their parents that they are pregnant. And, if they were to have an abortion they would have no place to live. Several women shared with me that they confided in their ministers when trying to make this difficult decision, and were told that they would be disinvited from their congregations if they had pregnancy terminations. Maybe we need a bill prohibiting pressure or coercion to not having an abortion?

This bill states that the "medical, emotional and psychologic consequences of an abortion are serious and can be lasting." Very true, but the medical, emotional and psychologic consequences of having a baby are very serious and those of us who have kids know they are everlasting. Do any of you know that the risk of dying in childbirth is 30 times the risk of dying with a safe abortion?

This bill distrusts women and their care providers.This law shows disregard for the years physicians have devoted to learning clinical judgement, medical/surgical skills and the time we spend developing honest relationships with our patients. Will we start to see laws setting forth what cardiologists or surgeons or oncologists must say to patients before treating them? I hope not. Kristen Smith CMA, CPT 179 Stage Road Nottingham, NH 03290 [email protected] 603-231-1933 Re: HB1721-FN

In my 20s I had an unwanted pregnancy. 1 had zero emotional support. I still lived at home. I had an anxiety disorder that made me immobilized with fear. My convinced me that abortion was my only choice. If I did not have the abortion I would be homeless. I had nowhere to go if I had a baby. My conscience said no, but I was not supported in any other options. I was trapped.

I was taken to the Feminist Health Center in Stratham. I just needed these people to take care of me and make me feel better. They were kind and made me feel justified about my choice. I was given no information on fetal development or other choices. My unborn baby was estimated to be 11 weeks old. I was so terrified that the only thing I could feel was fear. I thought nothing of post psychological distress.

Five years later my husband and I conceived our first son. I learned all I could about fetal development. I saw photos of 11 week old humans. I saw beating hearts and fingernails and hands and feet. When the realization hit that I had paid someone to pry open my cervix, pulverize the life in my uterus and vacuum it out I had complete nervous breakdown. My anxiety disorder exploded and depression crushed me. I had taken the life of my first born. I couldn't get over it. I wouldn't get over it. I stopped functioning. My guilt was crushing. If I hadn't been pregnant with my son I wouldn't be here.

I am a Certified Medical Assistant and Phlebotomist for a family practice. I see women of all ages that felt abortion was their only option. Husbands, boyfriends, schools, councilors, abusers and family often push abortion for their own interests. The dialogue I have with them reveals they are anxious, depressed, sad and full of shame and self hatred. They were scared, vulnerable, abused, and overwhelmed and now they are still suffering. Mental illness in the post abortive population is rampant. Many self medicate. These women, like myself, didn't want an abortion, but were forced by the lack of support in any other "choice".

What women NEED are facts; pragmatic objective information and a comprehensive screening interview to see who is vulnerable and at risk for coercion and mental illness. Women deserve the right to make fully autonomous, informed, educated decisions. Abortion providers, who claim to care about women, need to disclose and offer this information. Women have the right to know EXACTLY what abortion entails. Abortion is not the removal of a cancer, or a parasite or a mass of tissue. They need to understand the stage of development their baby is in. They need to be told they may suffer with Post Abortion Stress Syndrome and have information on mental health services. This is NOT coercion and manipulation.

Coercion and manipulation is the omission of this information.

The irony here, is that, in a bid to liberate women, abortion has taken this newfound liberation and uses it not to protect the weak and vulnerable, but instead to perpetuate the very violence women were once oppressed by. That is why legislators who want to stand up for the most marginalized and vulnerable should absolutely be fighting against any form of aggression that treats another human being's body as property. It's just that simple. It's the same reason we are against , murder, human trafficking and . Abortion does not equate empowerment. It continues to adhere to patriarchal constructs. We have a moral responsibility to give women ALL the facts and ALL the resources to make a more educated and informed choice. That includes a decision free from fear and coercion. BCC Equality Health Center Quality . Compassion • Respect

Testimony of Rachel Allen, NISN, WHNP-BC House Judiciary Committee House Bill 1721 January 31, 2018 Position: OPPOSE

I submit this testimony on behalf of myself, the Equality Health Center, and the communities we proudly serve. As a health care provider specializing in sexual and reproductive health, I urge the committee to vote inexpedient to legislate on HB 1721. The mandates contained in this bill would not contribute to the health and safety of people seeking abortion care and it is inappropriate for the legislature to interfere with provider patient relationships.

I am honored and proud to be an abortion provider. I know people are capable of making healthcare decisions for themselves. I have seen this decision making process in action every single day of my career. Bills like HB 1721 that are based on shame and stigma rather than science and reality ignore the complicated and unique life situations faced by those seeking abortion services and do a major disservice to the autonomy and intelligence of people navigating their own lives.

Informed consent and abortion counseling represent two different areas of abortion decision making and education. At Equality Health Center this process starts at the first point of contact, either when a client comes to the health center for free pregnancy testing and options counseling or when contact is made over the phone. In order for a person to make an informed choice they must be able to make healthcare decisions for themselves, that decision must be voluntary, and they must have relevant information about their options in making their decision. We provide this information because we are guided by the principles of medical ethics and believe in empowering clients with information so they can make the best decision for themselves.

As abortion providers we already set an incredibly rigorous standard for informed consent. At Equality Health Center we screen in multiple ways for evidence or coercion or outside pressure, including in our written intake forms and in our face to face counseling. We see every person alone without a third party present for intake and counseling. We do not allow anyone but the client to schedule or get information about appointments or access medical information without express permission of the client. If there is evidence of coercion, abuse, or a safety risk to a client we mobilize rapidly and effectively to ensure that client's safety, including referrals to domestic abuse support, legal aid, and networking with family and friends.

The counseling we provide addresses feelings and emotions associated with pregnancy decision making, as well as contraceptive choices and reproductive life planning. This is a critical opportunity to link people to preventative healthcare and social services available at our health center or closer to their home. We excel in this care because we create an environment of trust and safety for our patients without shame. Our counselors have a collective 85 years of experience in helping people making pregnancy and decisions and are incredibly skilled at building trusting relationships with clients because of their compassion and intelligence.

The language of this bill is offensive and shaming. It discredits people making pregnancy decisions in assuming vulnerability, and it misrepresents health care providers and facilities who provide abortion care. Healthcare providers have a rightful degree of autonomy in how they deliver care, but we are united in adhering to medical ethics and the principles of informed consent.

38 South Main St, Concord, EN // 03301 " tetcw.equalitvhc.org • 603-225-2739 13-IC Equality Health Center Quality • Compassion • Respect

This bill attempts to paint the fact that most abortions take place in facilities devoted to abortion and family planning services as problematic. The fact that we are specialists is a strength, not a weakness. Our commitment to providing this care means that we work every day to ensure that each person who walks through our door is empowered, informed, and safe. I provide this care proudly alongside an incredible team that surrounds our patients with compassion and respect.

Lastly, there are already consequences to providing inappropriate or harmful medical care. We are licensed providers, nationally board certified, subject to malpractice claims, and most importantly we are people who have committed our careers to helping clients in complex and challenging situations. We do not need the threat of felony charges to treat our clients with respect or to ensure their safety, that is truly at the core of our practice and we already do that every single day.

People are unique and pregnancy decision making can be incredibly complex. Abortion is a necessary medical procedure and that necessity will never be legislated away. This bill would do nothing to protect patients and would make an already difficult situation worse. I affirm the rights of those I serve to make healthcare decisions for themselves, and I stand firmly in opposition to undue political interference in those decisions and urge the committee to deem this bill inexpedient to legislate.

38 South %lain St, Concord, MI 03301 • ictetc.equalitvhc.org • 603- 225- 2739 Equality Health Center Quality • Compassion • Respect

January 31, 2018 House Judiciary Committee Testimony on HB1721

Thank you for reading the following testimony. My name is Dalia Vidunas. I am the Executive Director of Equality Health Center. I am here to let you know that I do not support HB1721, relative to coercive abortions.

HB1707 makes several erroneous assumptions including that woman are not given complete and accurate information to all options prior to an abortion procedure, that women are "rushed" into a decision, and that providers are willing to risk their licenses by not ensuring that women are giving informed consent for a procedure.

On the day of the procedure, a woman meets with an intake worker, medical assistant for lab work, healthcare worker for an ultrasound. She then meets with one of our health care workers for counseling and education for approximately 45 or more minutes. Initially, she is always seen alone at this time. Only if the woman asks to have someone join her, like her partner, does that occur. If at any point in time a woman indicates that she is feeling pressured to have an abortion (including during intake, lab work, ultrasound, counseling, and with the practitioner) she is told immediately that Equality Health Center will not be able to perform the abortion procedure that day. Our trained health workers will then explore with her what her options are. This includes working with the local domestic violence shelters if appropriate. Our health workers are trained in working with a woman to develop a safety plan if needed. At Equality Health Center, our counselors have over 85 years of combined experience working with patients.

This bill severely limits who is qualified to meet with a woman to discuss her options. No other medical procedure has this type of restriction regarding the qualification on who can meet with a client. Again, at Equality Health Center, we have over 85 years of combined experience counseling and educating women about their options.

HB1721 also opens up providers to liability for actions of unrelated third parties. Practitioners and medical offices provide referrals to patients for a variety of different reasons. There is not a single issue/procedure/etc in which the referring practitioner is held responsible for the practitioner referred to. If that were the case, why would any practitioner make any referrals to anyone? Their medical license would potentially be in jeopardy with every referral. This bill is an attempt to single out providers who perform abortions.

H81721 will compromise Equality Health Center's ability to provide high quality, affordable health care. I urge you to vote Inexpedient to Legislate on HB1721.

I thank you all for your time and your consideration.

Dalia Vidunas, MSW Executive Director Equality Health Center

38 South Main Street Concord, NH 03301 603.225,2739 www.equalityhc.org N HC Equality Health Center i Quality • Compassion • Respect Counseling Assessment All Information you provide is confidential

Name: Date of Birth:

During your visit today, you will meet with a healthworker who will check-in with you about your abortion decision, review your medical history, the procedure and aftercare. So that we may be of help to you, we encourage you to tell us about any of the questions, concerns, fears, or feelings you may have about the abortion. We want you to feel that all of your questions have been addressed and your concerns have been voiced.

Please check any of the following that concern you today: ❑ I feel unsure about my decision to have an abortion. ❑ I wonder if the procedure, counseling, and financial arrangements are confidential. ❑ I am not sure how I will feel after the abortion. ❑ I worry that the abortion will hurt. ❑ I worry about the embryo or fetus. ❑ Will this affect future pregnancy? ❑ What will be the effects of this decision on my relationship with my partner? ❑ Someone is pressuring me to have this abortion.

Please circle all of the words that describe how you feel about your decision to have an abortion:

Comfortable Sad Resolved Nervous Irresponsible Relieved Confident Angry Numb Responsible Grieving Guilty Confused Resigned Trapped Ashamed Alone Worried Selfish Peaceful Supported Calm Empowered Strong Anxious

Please let us know if there are other issues concerning you today or other questions or feelings you may be having.

Healthworker Notes: The following information has been discussed with the patient The patient has considered all her options: abortion, adoption, and parenting The patient has made her own decision to have an abortion and expresses confidence in that decision We reviewed any questions about the procedure, medications and aftercare. Notes:

Healthworker Signature: Date:

Name• DOB: Date:

Contraception Counseling (EHC staff to fill out this section)

Risks and proper use of the following contraceptives were reviewed with client: (Check off all methods that apply, the date reviewed and your initials.)

Method Date ITW initials

Miscellaneous Birth Control Counseling Notes:

Consent for Contraception

I have received written information on the birth control method I've chosen: how it works, how to use it, side effects, risks, benefits and effectiveness. I have had the opportunity to ask questions and discuss the method.

Signature: Date:

Staff Witness: Date:

Revised June 2017 Forced Abortion in America Coercion can escalate to violence, even murder I

The UnChoice 64% felt pressured by others to abort.' Her "choice" can include loss of home, income and family, or violence and even murder.' Homicide is the leading killer of pregnant women."' Her "choice" can be based on disinformation from credentialed experts, negligent counselors or even trusted pastors.3

Intense pressure to abort can come from husbands, parents, doctors, partners, counselors, or close friends and family. They may threaten or blackmail a woman into abortion. These are not idle threats. Coercion can escalate to violence. Women who resist abortion have been beaten, tortured and killed. One husband jumped on his wife's stomach to force an abortion. A mother forced her daughter at gunpoint to go to the abortion clinic. A woman was forcibly injected by the baby's father with an drug.' (Download the 22-page "Forced Abortion in America" Report at www.unchoice.info/resources.htm.)

Unwanted Non-Choice ... Their Choice, Not Hers. Reasons women give for having abortions:4 Forced by mother • Father opposed Husband or boyfriend persuaded me • No other option given Would have been kicked out • Loss of family's support Lack of support from society • Clinic persuaded me In 95% of all cases, the male partner played a central role in the decision.5 45% of men interviewed at abortion clinics recalled urging abortion, including 37% of married men.6 In the above study, men justified being the primary decision maker, regarding the abortion.6 64% of women who aborted felt pressured by others.'

Coerced Choice ... Taken to the Clinic to Make Sure She Keeps the Appointment A former abortion clinic security guard testified before the Massachusetts legislature that the greatest threat to women at abortion clinics were the men who accompanied them.' Many women are also pressured by clinic staff financially rewarded for selling abortions.'

Forced Choice ... Threats Can Escalate to Violence or Murder — the Leading Killer of Pregnant Women The pressure can escalate. Many pregnant women have been killed by partners trying to prevent the birth, and being pregnant places women at higher risk of being attacked? Murder is the leading cause of death among pregnant women!' 92% of women surveyed list domestic violence and assault as the women's issue that is of highest concern to them."

Uninformed Non-Choice ... "When I learned the truth, I can't tell you how betrayed I felt." • 54% were unsure of their decision, yet 67% received no counseling beforehand.' • 84% received inadequate counseling beforehand) 79% were not told about alternatives.' • Many were misinformed by experts about fetal development, abortion alternatives or risks." • Many were denied essential personal, family, societal or economic support!'

Unsafe Choice ... American Voters Concerned About Coercion and Risks; Support Research and Screening. Nearly half of voters believe coerced abortion is common. They'll support candidates who advocate legislation holding abortionists liable for failing to screen for evidence of coercion.'3Nearly 80% of abortions take place in non-hospital facilities, ill-equipped for emergency care!' Americans are kept in the dark about unwanted abortions, risks and risk factors.

The Aftermath. Women Pay a High Price. Trauma.' Injury.' Grief. Death from All Causes)? 6 Times Higher Suicide., • 31% had health complications afterwards.' • 65% suffer multiple symptoms of post-traumatic stress disorder? • 65% higher risk of clinical depression)5 • 10% have immediate complications, some are life-threatening.'6 • 3.5x higher risk of death from all causes!' • Suicide rates 6 times higher if women abort vs. giving birth'

Elliot Institute E AfterAbortion.org M Fact Sheets & Healing, www.UnChoice.info Citations

1.VM Rue et. al., "Induced abortion and traumatic stress: A preliminary comparison of American and Russian women," Medical Science Monitor .10(10): SR5-16 (2004).

2.See the special report, "Forced Abortion in America" atwwwunchoice.info/resources.htm.

3.M Gissler et. at, "Pregnancy Associated Deaths in Finland 1987-1994 -- definition problems and benefits of record linkage,"Acta Obsetricia et Gynecologica Scandinavica 76:651-657 (1997); and M. Gissler, "Injury deaths, suicides and homicides associated with pregnancy, Finland 1987-2000,"Europeanf Public Health 15(5):459-63 (2005).

4. Frederica Mathewes-Green, Real Choices (Ben Lomond, CA: Conciliar Press, 1997).

5.Mary K. Zimmerman, Passage Through Abortion (New York, Prager Publishers, 1977).

6.Arthur Shostak and Gary McLouth,Men and Abortion: Lessons, Losses, and Love (New York: Preager Publishers, 1984).

7.Brian McQuarrie, "Guard, clinic at odds at abortion hearing,"Boston Globe, April 16,1999.

8. Carol Everett with Jack Shaw, NoodMoney (Sisters, OR: Multnomah Books, 1992). See also Pamela Zelunan and Pamela Warwick, "The Abortion Profiteers," Chicago Sun Times special reprint, Dec. 3,1978 (originally published Nov. 12, 1978), p. 2-3, 33.

9. Julie A. Gazmararian et al., "The Relationship Between Pregnancy Intendedness and Physical Violence in Mothers of Newborns, " Obstetrics & Gynecology, 85 :1031(1995); Hortensia Amaro et al., "Violence During Pregnancy and Substance Use," American Journal of Public Health, 80: 575 (1990); and J. McFarlane et al., "Abuse During Pregnancy and : Urgent Implications for Women's Health, " Obstetrics & Gynecology, 100:27, 27-36 (2002).

10.I.L. Horton and D. Cheng, "Enhanced Surveillance for Pregnancy-Associated Mortality-Maryland, 1993-1998,"JAMA 285(11): 1455-1459 (2001); see also J. Mcfarlane et. al., "Abuse During Pregnancy and Femicide: Urgent Implications for Women's Health," Obstetrics & Gynecology 100: 27-36 (2002).

11."Is Your Mother's Feminism Dead? New Agenda for Women Revealed in Landmark 'Rya-Year Study," press release from the Center for the Advancement of Women (www.advancewomen.org), June 24, 2003; and Steve Ertelt, "Pro-Abortion Poll Shows Majority of Women Are Pro- Life," LifeNews.com (www.lifenews.com/nat13.html), June 25, 2003.

12.See Theresa Burke,Forbidden Grief The Unspoken Pain ofAbortion (Springfield, IL: Acorn Books, 2000) andwww.unchoiceinfo.

13."National Opinion Survey of Goo Adults Regarding Attitudes Toward a Pro-Woman/Pro-Life Agenda, " proprietarypoll conimissioned by the Elliot Institute, conducted in Dec. 2002.

14.D. Reardon,Abortion Malpractice (Denton, TX: Life Dynamics, 1993)

15.JR Cougle, DC Reardon & PK Coleman, "Depression Associated With Abortion and Childbirth: A Long-Term Analysis of the NLSY Cohort," Medical Science Monitor 9(4):CR105-112, 2003.

16.Frank, et.al., "Induced Abortion Operations and Their Early Sequelae,"Journa/ of the Royal College of General Practitioners 35(73):175-180, April 1985; Grimes and Cates, "Abortion: Methods and Complications", in Human Reproduction, 2nd ed., 796-813; M.A. Freedman, "Comparison of complication rates in first trimester abortions performed by physician assistants and physicians," Am J. Public Health 76(5):550-554, 1986).

17.DC Reardon et. al., "Deaths Associated With Pregnancy Outcome: A Record Linkage Study of Low Income Women," Southern Medical Journal95 (8).234-41, (2002).

1/07 Shock Study: 55% of Sex-Trafficking Victims Become Pregnant, Forc... https://www.printfriendly.com/print?url_s=uGGQ—_PdN_—_PcSn...

Shock Study: 55% of Sex-Trafficking Victims Become Pregnant, Forced Into Abortions

www.lifenews.com/2014/09/24/shock-study-55-of-sex-trafficking-victims-become-pregnant-forced-into-abortions/

September 24, 2014

By its very nature the crime of human trafficking strips each victim of his or her humanity. Sex trafficking in particular, which is categorized by law as a "severe form" of human trafficking, rebrands the person as a product to be bought and sold for pleasure. In the United States alone, the Central Intelligence Agency estimates that around 50 000 women and children are trafficked into the United States and as many as 400.000 domestic minors are also involved in the trade each year. These alarming figures testify to the firm foothold that this hidden criminal activity has in the United States.

On September 11, the House Energy and Commerce. Health Subcommittee held a hearing on a bill highlighting the importance of healthcare professionals in their role on the front lines of identifying victims of trafficking and responding appropriately. The Trafficking Awareness Training for Health Care Act of 2014 introduced by North Carolina Rep. Renee Ellmers (R), seeks to provide proper training for these professionals tallow them to recognize indicators of trafficking and offer help.

Former Senior Advisor on Trafficking in Persons for the U.S. Department of State and founder of the non-profit Global Centurion, Laura Lederer was one of five witnesses who testified. According to Dr. Lederer's recent study entitled, "The Health_ Consequences of Sex Trafficking and Their Implications for Identifying Victims in Healthcare Facilities " out of the 107 sex trafficking survivors surveyed, 87.7% reported seeking care from a healthcare professional during the time of trafficking. More specifically, the most common point of contact occurred in the emergency room with 63% of victims seeking care there. These new findings — in contrast with the much lower overall 28% figure found in a 2005 study cited in the Hearing — emphasize the significant role that a healthcare provider can play in preventing further abuse.

Definitions of Modern Day Slavery

Human trafficking, or trafficking in persons (TIP), refers to the activity of holding a person in a compelled service, and is a crime under U.S. and international law. The Trafficking Victims Protection Act of 2000 (TVPA) defines sex trafficking in particular as "the recruitment, harboring, Shock Study: 55% of Sex-Trafficking Victims Become Pregnant, Forc... https://www.printfriendly.com/print?url_s=uGGC_—_PdNflptSn..

transportation, provision or obtaining of a person for the purpose of a commercial sex act." As one of the fastest-growing criminal industries, TIP generates about $32 billion per year, and it has accurately been referred to as "modern- day slavery."

"Throwaway Kids": Early Abuse in the Home as a Precipitator

Twelve to 74 years old is the average age of entry into sex trafficking in the United States. Vednita Carter, a survivor of sexual exploitation and founder of a Minneapolis shelter called Breaking Free, shared this troubling reality with the subcommittee while explaining that pimps actively seek out minors who have run away from home. Lederer emphasized the problem of an abusive family life as it increases the risk of running away and, with it, one's vulnerability to being trafficked. "In all of the survivors that I've interviewed [at least 150 in just this past year], there was something that happened in the home early on — some abuse, either physical, sexual — that drove these children out onto the streets," she said. She also recalled the heartbreaking name attributed to this homeless population of minors: "throwaway kids," those who "don't really have places — homes — where they have a loving environment." Estimates of this population in America: 1 to 1.5 million.

Carter expounded on the general recruitment process for minors, as a "brainwashing," composed of two steps: the pimp offers security — a place to stay, food to eat, protection, even affection — then emotionally and psychologically manipulates the minors to feel indebted as well as threatened that the "security" will be taken away.

Abortion Forced on Trafficking Victims

Lederer testified that forced abortion is an "especially disturbing trend in sex trafficking." Her study shows that 55% of the women surveyed had at least one abortion, and 30% had multiple abortions during the time of trafficking. Of these, more than half responded that the abortion was not their choice, and many responded by saying that the pressure from pimps to continue the trade did not allow for the time to carry a baby. "Notably, the phenomenon of forced abortion in sex trafficking transcends the political boundaries of the , violating both the pro-life belief that abortion takes innocent life, and the pro-choice ideal of women's freedom to make their own reproductive choices," she continued.

Carter likewise shared a personal account of another survivor: "I got pregnant six times and had six abortions during this time. 1 had severe scar tissue from these abortions, because there was no follow up care. In a couple of cases I had bad infections—so bad that I eventually had to have a hysterectomy." These instances of forced abortion cover the crimes, allow for ongoing abuse, and further rob the victim of any sense of humanity as that humanity in her womb is also snuffed out.

Role of Healthcare Professionals

The bill has a practical focus that would direct the Department of Health and Human Services (HHS) to award a grant to an eligible school for the development of evidence-based best Shock Study: 55% of Sex-Trafficking Victims Become Pregnant, Fore... https://www.printfriendly.cons/print?url_s=uGGC_—_PdN_--,

practices for healthcare professionals responding to TIP. The school would then develop curricula to train professionals on these best practices, and afterwards design, carry out, and analyze the results of a pilot training program.

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Another witness, Dr. Hanni stoklosa, an emergency physician at Brigham and Women's Hospital in Boston, emphasized the need for evidence-based and trauma-informed training for all healthcare professionals including dentists and dermatologists to pediatricians and emergency physicians such as herself. Because victims may suffer beatings that include damage to the teeth, and oftentimes are branded on the skin to reflect the sex trafficker's ownership, these professionals who will be treating victims must be trained properly to identify signs of trafficking, to avoid re-traumatizing or shaming victims, and to provide supportive resources.

The Trafficking Awareness Training for Health Care Act of 2014 recognizes the significant impact that the health care provider can potentially have in rescuing and helping untold victims of human trafficking. The breakdown of the family and the devaluing of human life, including the child in the womb, also continue to merit their own research and action for a more humane culture.

LifeNews Note: Genevieve Plaster is a research assistant at Charlotte Lozier Institute. Joan 6 Lovering Health Center Dedicated to choice & sexual health

Testimony on HB 1721-FN January 31, 2018 Linda Griebsch Greenland NH 03840

Good morning. My name is Linda Griebsch and I was the Executive Director of the Joan G. Lovering Health Center. This organization was founded by local New Hampshire women in response to a gap in New Hampshire for women's health care services. The health center provides these valuable services: 1. Gynecology for all ages, including family planning, cancer detection and menopause care. We also have provided first trimester abortions for the last 37 years without major incidence or complication. We refer our patients to make sure that they receive other care they may need. We have patients who have depended on us for nearly 40 years for their health maintenance and care. 2. STD clinics where we provide testing and treatment, as well as testing, risk assessment counseling and referral for HIV and HCV. This clinic is for men and women, (61% are men). I am here before you today in my capacity as an expert in the provision of women's health care and also as a person who has been a NH state legislator and a policy analyst for domestic violence and .

I am submitting written testimony on HB 1721-FN. I oppose the passage of this bill for the following reasons:

• Many of the listed purposes of the bill have no scientific basis or have questionable evidence of truth and some are clearly offensive and should not be recorded into law. • The underlying assumption that women are incapable of making decisions on their own behalf without the intervention of a "qualified "person is demeaning, not based in fact and should not be codified into law. This bill ignores 95%+ of women who make decisions about pregnancy every day and live comfortably with those decisions whether to continue a pregnancy or not. There will always be people who choose to blame others for decisions they make. At our health center, we do not do procedures on women who do not take responsibility for the decision or imply in any way that they are not making their own decision. • The consequences of a woman continuing a pregnancy that she is not equipped to handle mentally, emotionally, physically or financially effects not only the woman but the resultant child as well and often society in general. • This bill is unnecessary and creates a major obstacle for women accessing abortion without benefit to the woman. Requiring every women to see a therapist or psychologist before their appointment adds cost and time for people who often have jobs where they can't afford to miss work time. If the woman has insurance, it is unlikely that this extra visit will be covered. • Internet information is abundantly available to everyone. Access to the internet, even in lower income is often available at home and certainly at the local library or through friends and relatives. Even before we see them, most patients are well informed about the procedure and also the services which might help them, if they want to continue a pregnancy. Regardless of the availability of information, we still go through all the information with every patient.

559 Portsmouth Avenue — POB 456 — Greenland NH 03840 — (603) 436-7588 www.joangloveringhealthcenter.org • This bill is covering something that is already mandated, namely informed consent, and it does it in a way that is disrespectful of women and their ability to make decisions for themselves. All health facilities are required to get informed consent. Even if the patient wishes to waive this requirement, informed consent is gone over in detail at all clinics, because it is the standard for medical care. • When people undergo any kind of surgery, they often spend more time with agents of the clinician than with the person actually performing the surgery. These agents are often trained by the practice. It is accepted and common medical procedure and has been working quite well for some time. In our facility it takes many months of training before we allow someone to work one on one with clients. • Peer counseling is a common approach and a basis for much of women's health care. • This procedure is not the same as seeing a primary care physician. Almost all insurances now require that a patient have a primary care physician. Women are often referred to us by the physician with whom they have a relationship. In addition, contrary to what is stated in the bill, we see many of our patients on a regular basis for follow up and routine care.

For these reasons and because this is the kind of policy that is a medical cost driver, something that we all want to avoid, with no appreciable benefits to patient or practitioner, I ask that you vote this bill out of committee with a recommendation of Inexpedient To Legislate.

Thank you for you• consideration.

559 Portsmouth Avenue — POB 456 — Greenland NH 03840 — (603) 436-7588 www.joangloveringhealthcenter.org TO: Members of the House Judiciary Committee

I am writing to oppose HB 1721, An Act to Protect Women from Coercive Abortions

My name is Jane Fairchild, a Concord resident.

As you know, the landmark case of Roe V Wade clearly states that a woman has a right to privacy regarding her choice to have or not have an abortion. According to Roe, that decision lies squarely with her and her health care provider, who are the sole decision makers as to whether she wants or needs an abortion. The fundamental right to abortion has been the law of the land for over 50 years, yet a minority of extremists continue to attempt to chip away at this right. Such efforts by anti-abortion vigilantes determined to impose their own beliefs without regard for the rights of others should not be allowed to undermine common sense decisions and constitutional rights of others.

HB 1721 is one of those bills designed to create more obstacles to a woman choosing to have an abortion.

The State cannot protect its' citizens from every small chance of harm or personal problem. The state cannot and should not attempt to intervene in a woman's or a families' business about private situations in which the state cannot determine the factual truth. There is no evidence that "coercion" to have an abortion is widespread or even exists. Abortion is a woman or a families' decision, and she is free to seek input and advice from a physician or health care provider if she so chooses. To attempt to intervene in this decision is overreach by the State.

This bill is designed to create an excessive burden on a pregnant woman by requiring a doctors' visit for "evaluation" of her motives before going to the clinic or provider for the abortion, thus creating unnecessary time delays in having the procedure. It also places a burden on healthcare providers to have to discuss the procedure with a patient whom he/she may never have met before, and requires the provider to then go through a certification procedure to the abortion provider. Does a private physician really want or accept this additional procedure and want to be placed in the middle of every woman's choice to assert her right to have an abortion? To set up yet another system of regulation and enforcement on already overworked physicians and providers for a completely unwarranted procedure is a waste of time and money.

This legislature and others across the country have repeatedly tried to undermine a woman's right to have a legal and safe abortion. This is one of those attempts. There is absolutely no reason to enact this piece of legislation and no evidence to indicate that coercion is a widespread practice that needs to be regulated by the state.

HB 1721 should be determined to be Inexpedient to Legislate. DIOCESE OF MANCHESTER

January 31, 2018

The Honorable Joseph Hagan, MD, Chair House Judiciary Committee Legislative Office Building, Room 208 Concord, New Hampshire 03301

Re: HB 1721 (Relative to Coercive Abortions)

Dear Representative Hagan and Members of the Judiciary Committee:

As the Director of the Office of Public Policy of the Roman Catholic Diocese of Manchester, and on behalf of Bishop Peter Libasci, I write to express our support for HB 1721. This bill that is a reasonable step to help address a serious matter that persons on all sides of the abortion debate should want to prevent — the problem of coerced abortions.

It is fundamental to Catholic teaching that every human being is to be respected from conception to natural death. This bill advances the dignity of women by taking steps to ensure that a woman is not being forced to consent to a procedure she does not actually desire. Coercion may come from boyfriends who use psychological pressure or physical threats, husbands who threaten divorce, parents who threaten to withdraw financial support, or employers who imply termination or other penalties.

Women who are experiencing an unplanned pregnancy deserve better. They deserve to know that choosing life for their baby does not mean abandoning all hope for an education, for meaningful employment, and for a better life. They deserve to know that others will not only care enough to ask if abortion is what they really want but also will help them find the proper resources to carry their baby to term.

We urge you to recommend this bill as ought to pass. Thank you for your consideration of our position and for your service to the people of the State of New Hampshire.

Sincerely,

Meredith P. Cook, Esq. Director, Office of Public Policy

153 ASH STREET, MANCHESTER, NH 03104 (603) 669-3100 FAX (603) 669-0377 WWW.CATHOLICNH.ORG poonpanui su ilig littp://www.gencourt.state.nh.us/bill_status/billText.aspasy=2018&...

HB 1721-FN - AS INTRODUCED

2018 SESSION 18-2515 01/04

HOUSE BILL 172 1-FN

AN ACT relative to coercive abortions.

SPONSORS: Rep. Wuelper, Straf. 3; Rep. M. Pearson, Rock. 34; Rep. Nelson, Carr. 5; Rep. Itse, Rock. 10; Rep, Notter, Hills. 21; Rep. Baldasaro, Rock. 5; Rep. Brown, Graf. 16; Rep. Seidel, Hills. 28

COMMITTEE: Judiciary

ANALYSIS

This bill establishes the protection from coercive abortion act to protect women from coercive abortions.

Explanation: Matter added to current law appears in bold italics. Matter removed from current law appears [in brackets and otruckthrough.] Matter which is either (a) all new or (b) repealed and reenacted appears in regular type. 18-2515 01/04

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Eighteen

AN ACT relative to coercive abortions.

Be it Enacted by the Senate and House of Representatives in General Court convened:

1 Statement of Findings. The general court finds that: I. Abortion is one of many options used by physicians to treat a crisis pregnancy. Other tools, such as a referral for financial aid, legal counseling, or marital counseling, may sometimes better serve a woman's needs by helping to alleviate a crisis situation and allow her to carry a wanted pregnancy to term. II. Some women seek abortions in great haste and under emotional stress. Many state that they made poor decisions because they did not adequately think through alternative ways of coping with their crisis situations. III. Some abortion providers encourage clients to make a decision quickly and without adequate counseling to alleviate stress which may result in an ill-considered decision which will later be regretted. IV. Numerous researchers have found that women who choose abortion in violation of their consciences are significantly more prone to suffer severe psychological distress following an abortion. V. There are many cases in which women who would prefer to keep their pregnancies feel forced by

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others to undergo unwanted abortions which they subsequently regret. When a woman is being pressured",, into an unwanted abortion, the physician is her last hope for an ally against her oppressors. VI. Over 80 percent of all abortions are performed in clinics devoted solely to providing abortions and family planning services. Most women who seek abortions at these facilities do not have any relationship with the physician who performs the abortion before or after the procedure. Women do not return to the facility for post-surgical care. In most instances, the woman's only actual contact with the physician occurs simultaneously with the abortion procedure with little opportunity to receive counseling concerning her decision. WI. There are well established predisposing risk factors in the medical and psychiatric literature which are predictive of a greater likelihood of regrets or other adverse emotional reactions to abortion. These risk factors include feelings of being pressured to have the abortion. VIII. It is essential that women who are at a higher risk of suffering severe psychological distress following an abortion shall be screened and counseled appropriately if any pre-identifying risk factors are present. IX. "The medical, emotional, and psychological consequences of abortion are serious and can be lasting, and this is particularly so when the patient is immature. An adequate medical and psychological case history is important to the physician." H.L. v Matheson, 450 U.S. 398, 411 (1980). X. Some complications reportedly associated with abortion may become clearly evident only several years, or even decades, after the abortion. 2 New Chapter; Protection From Coercive Abortion Act. Amend RSA by inserting after chapter 132-A the following new chapter: CHAPTER 132-B PROTECTION FROM COERCIVE ABORTION ACT 132-B:1 Purpose. The purpose of this chapter is to: I. Ensure that no woman's consent to a recommendation to abort is the result of coercion or s in conflict with her own personal beliefs or desires to give birth to her unborn child. II. Protect women from feeling pressured into unwanted abortions. III. Protect women from individuals or circumstances that would pressure them nto a violation of their conscience. 132-B:2 Short Title. This chapter may be cited as the protection from coercive abortion act. 132-B:3 Definitions. In this chapter: I. "Abortion" means the use or prescription of any instrument, medicine, drug or any 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 or to remove a dead fetus. II. "Abortion practitioner" means the licensed physician who induces an abortion. III. "Abortion providers" means and includes the physician performing the abortion, and any individuals or corporations acting as agents of the physician who have contact with the patient and provide counseling, screening, referrals, or directly assist with the abortion procedure itself, and any corporation or owner or partner of a business or corporation that employs or contracts with the physician to perform abortions, and any physician, referral service, business, agency, or corporation that makes referrals to abortion providers. IV. "Medical emergency" means that condition which, on the basis of the physician's best clinical judgment, so complicates a pregnancy as to necessitate an immediate abortion to avert the death of the mother or for which a 24-hour delay will create grave peril of immediate and irreversible loss of major bodily function.

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V. "Qualified person" means a licensed physician or an agent of the abortion practitioner who is a licensed psychologist, licensed social worker, licensed professional counselor, licensed APRN, licensed physician assistant, or licensed registered nurse. VI. "Reasonable patient" means a patient who is capable of thoughtfully considering and weighing both technical and summary information to determine its relevancy to that patient's choices in order to arrive at a free and informed choice either to follow or reject a medical recommendation. VII. "Vulnerable person" means any person who is submitting to an unwanted abortion due to pressure from others. 132-B:4 Screening Requirements. I. Except in the case of a medical emergency, no abortion shall be performed or induced without prior screening of the patient for evidence of coercion of a vulnerable person. Except in the case of a medical emergency, consent to abortion is free from unnecessary exposure to risks and coercion only if the following are true: (a) Prior to the abortion practitioner's recommendation for an abortion, a qualified person has privately evaluated the woman to determine if she is a vulnerable person, and in particular if she is seeking an abortion under pressure to do so from other persons. (b) Evaluation of the woman to identify if she may be a vulnerable person shall include investigation of her views about abortion and any possible emotional attachment which she may have developed with her unborn child. If she describes a negative view toward abortion, or an emotional attachment to her unborn child, or otherwise indicates that the abortion is unwanted, is her "only choice," or is being sought to satisfy some other person's desires which are contrary to her own, the presumption shall exist that she is a vulnerable person. IL(a) The evaluation of the woman shall be done individually, in a private room in the absence of third parties, such as parents, spouse, or others, to protect her privacy and increase her opportunity to express herself freely. (b) If a woman is identified as a vulnerable person, she must be informed of this evaluation and continue to receive non-directive counseling by a qualified person, or be referred to other sources of assistance or counseling that may be deemed appropriate by the qualified person, until she is able to make a fully free decision, either to have an abortion or to carry the pregnancy to term with respect to her own views, needs, and desires. (c) If upon evaluation the qualified person concludes that the woman seeking an abortion may be a vulnerable person seeking abortion against her own self interests because of pressure or coercion from a third party, the qualified person shall assist her in finding resources to mitigate the pressure or protect her from the coercion. This assistance may include with the consent of the woman, and shall include at the request of the woman, disclosure of information to the pressuring parties as to the negative impact a coerced abortion may have on a vulnerable person and referrals for interventive aid in the form of family counseling, marital counseling, legal aid, or other appropriate measures. (d) If, after having received additional counseling and interventive assistance on her behalf, the patient identified as a vulnerable person persists in her request for an induced abortion, and if the qualified person has made the reasonable judgment that the patient has freely and voluntarily decided to continue her request for an abortion in accordance with her own autonomous views, needs, and desires, the qualified person shall provide a written statement to the abortion practitioner certifying, to the best of that qualified person's knowledge, that the patient's request for an abortion is freely and voluntarily made and is consistent with the patient's own autonomous views, needs, and desires. No abortion shall be performed upon a person previously identified as a vulnerable person in the absence of this certification by a qualified person that the patient's request for an abortion is freely made and is consistent with the

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patient's own autonomous views, needs, and desires. III. Whenever the patient seeking abortion is under 18 years of age, a qualified person shall interview the woman to determine if her pregnancy is the result of a criminal act, including acts of incest, rape, or . If the qualified person determines that a criminal act was or is likely to have occurred, written notice will be given to the abortion practitioner, the proper law enforcement officials, and the child protection authorities. 132-B:5 Criminal Penalties. Except in the case of a medical emergency, no physician shall knowingly perform an abortion on a woman who has not consented to the abortion, who has revoked her consent, or who has consented under the coercion or duress of another person. Such person shall be guilty of a class B felony. 132-B:6 Civil Remedies. I. In addition to whatever remedies are available under the common or statutory law of this state, the failure to comply with the requirements of this chapter shall provide a basis for a civil action for malpractice, negligence, fraud, extortion, battery, and a violation of the individual's civil rights. Any intentional violation of this chapter shall be admissible in a civil suit as prima facie evidence of a failure to obtain a voluntary consent. II. Any action for civil remedies based on a failure to comply with the requirements of this chapter shall be brought within 4 years after the date at which the woman becomes, or should have been, aware that the abortion was the probable or contributory cause of a physical or emotional complication and has recovered from any psychological complication, including shame, which may impede the patient's ability adequately to pursue a civil remedy. III. Notwithstanding the provisions of paragraph II, in the case of a woman who has died, any action under this chapter shall be brought within 4 years of her death. IV. No abortion provider shall be held liable for any claim of injury based on the premise that too much information was provided to the patient, provided such information was accurate or reasonably assumed to be accurate. V. In a civil action under this chapter: (a) The jury may request a copy of this chapter, or shall be presented with a copy of this chapter upon the demand of counsel for either party. (b) In determining liability, the absence of voluntary and fully informed consent shall create the presumption that the plaintiff would not have undertaken the recommended abortion. This burden can be overcome by a preponderance of evidence showing that the woman would have acceded to the recommendation even if the information had been disclosed. (c) In allowing the testimony of expert witnesses, the technical-medical aspect of induced abortion shall be a separate issue from the screening, counseling, disclosure, and recommendation process. With regard to proper procedures for screening, counseling, and the recommendation of alternative forms of crisis resolution, the testimony of physicians or persons who care for women in crisis pregnancies shall be allowed as expert testimony. (d) Any abortion provider that makes referrals to an abortion practitioner whose practice is inside or outside this state shall be fully responsible for ensuring that all provisions of this chapter are satisfied. In the absence of adequate screening and voluntary consent, the referring abortion provider shall be liable for all injuries sustained. 132-B:7 Medical Emergency. If a medical emergency compels the performance of an abortion, the abortion practitioner shall inform the woman, before the abortion if possible, of the medical indications supporting his or her judgment that an abortion is necessary to avert her death or to avert substantial and irreversible impairment of a major bodily function. In such an event, the requirements of this

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chapter shall not apply. 132-B:8 Severability. If any provision of this chapter or the application thereof to any person or circumstance is held invalid, the invalidity does not affect other provisions or applications of the chapter which can be given effect without the invalid provisions or application, and to this end the provisions of this chapter are severable. 132-B:9 Applicability. Nothing in this chapter shall be construed as creating or recognizing a right to abortion. It is not the intent of this chapter to make lawful an abortion that is currently unlawful. 132-B:10 Right of Intervention. The general court, by joint resolution, may appoint one of its members who sponsored the legislation which enacted this chapter in his or her official capacity to intervene as a matter of right in any case in which the constitutionality of this law is challenged. 3 Effective Date. This act shall take effect January 1, 2019.

LBAO 18-2515 11/15/17

HB 1721-FN- FISCAL NOTE AS INTRODUCED

AN ACT relative to coercive abortions.

FISCAL IMPACT: [ X 1 State [ ] County [ ] Local [ ] None

Estimated Increase / (Decrease) STATE: FY 2019 FY 2020 FY 2021 FY 2022 Appropriation $0 $0 $0 $0 Revenue $0 $0 $0 $0 Indeterminable Expenditures Indeterminable Indeterminable Indeterminable Increase Increase Increase Increase Funding Source: [X] General [ ] Education [ ] Highway [ ] Other

METHODOLOGY: This bill contains a penalty that may have an impact on the New Hampshire judicial and correctional systems. There is no method to determine how many charges would be brought as a result of the changes contained in this bill to determine the fiscal impact on expenditures. However, the entities impacted have provided the potential costs associated with these penalties below. Judicial Branch FY 2019 FY 2020 Routine Criminal Felony Case $457 $462 Complex Civil Case $737 $745 Appeals Varies Varies It should be noted that average case cost estimates for FY 2019 and FY 2020 are based on data that is more than ten years old and does not reflect changes to the courts over that same period of time or the impact these changes may have on processing the various case types.

Department of Corrections

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FY 2017 Average Cost of $36,960 $36,960 Incarcerating an Individual FY 2017 Annual Marginal Cost $4,555 $4,555 of a General Population Inmate FY 2017 Average Cost of Supervising an Individual on $557 $557 Parole/Probation

Many offenses are prosecuted by local and county prosecutors. When the Department of Justice has investigative and prosecutorial responsibility or is involved in an appeal, the Department would likely absorb the cost within its existing budget. If the Department needs to prosecute significantly more cases or handle more appeals, then costs may increase by an indeterminable amount.

The Department of Health and Human Services indicates this bill would have no fiscal impact on the Department.

The Judicial Council does not anticipate this bill will have a fiscal impact on its costs.

The New Hampshire Association of Counties determined this bill would have no impact on county revenues or expenditures.

AGENCIES CONTACTED: Judicial Branch, Departments of Corrections, Justice, and Health and Human Services, Judicial Council and New Hampshire Association of Counties

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