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A00318 Summary:

BILL NOA00318A
 
SAME ASSAME AS S02888-A
 
SPONSORPaulin (MS)
 
COSPNSRGottfried, Galef, Arroyo, Barron, Blake, Dickens, D'Urso, Colton, Cook, Epstein, Seawright, Taylor, Woerner, McDonough, Jean-Pierre, Fernandez, Walker, Hyndman, Wright, Buttenschon, Simotas, Jacobson, Griffin, Ashby, Simon
 
MLTSPNSRThiele
 
Add 2500-l, Pub Health L
 
Relates to informing maternity patients about the risks associated with cesarean section.
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A00318 Actions:

BILL NOA00318A
 
01/09/2019referred to health
01/15/2019reported
01/17/2019advanced to third reading cal.5
01/23/2019passed assembly
01/23/2019delivered to senate
01/23/2019REFERRED TO HEALTH
05/07/2019recalled from senate
05/07/2019RETURNED TO ASSEMBLY
05/07/2019vote reconsidered - restored to third reading
05/07/2019amended on third reading 318a
06/04/2019repassed assembly
06/04/2019returned to senate
06/04/2019COMMITTED TO RULES
06/20/2019SUBSTITUTED FOR S2888A
06/20/20193RD READING CAL.137
06/20/2019SUBSTITUTION RECONSIDERED
06/20/2019RECOMMITTED TO RULES
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A00318 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A318A
 
SPONSOR: Paulin (MS)
  TITLE OF BILL: An act to amend the public health law, in relation to informing maternity patients about the risks associated with cesarean section   PURPOSE OR GENERAL IDEA OF BILL: To amend the public health law, in relation to informing maternity patients about the risks associated with Cesarean section.   SUMMARY OF SPECIFIC PROVISIONS: Section one amends the public health law is amended by adding a new section § 2500-1. Subdivision one provides definitions and establishes a procedure for a maternal health provider to provide a written communication to each pregnant woman for whom a Cesarean section delivery is planned and to each patient following an unplanned Cesarean delivery. Subdivision two provides that the Commissioner of Health shall consult with the American College of Obstetricians and Gynecologists and the New York State Association of Licensed Midwives to develop a written commu- nication or communications for maternal health care providers to distribute to patients as required under this section. Section two provides the effective date.   JUSTIFICATION: In New York State, nearly 20% of babies are delivered via Cesarean section, with the rate of use of Cesarean section delivery ranging from 8% to 32%, depending on facility. According to the American College of Obstetricians and Gynecologists (ACOG), Cesarean delivery is recommended for certain medical conditions to prevent maternal and infant morbidity and mortality. However, for low-risk pregnancies, Cesarean delivery increases the risk of maternal mortality and morbidity and infant morbidity. Potential maternal injuries associated with Cesarean delivery include but are not limited to: heavy blood loss that results in hysterectomy or a blood transfusion, ruptured uterus, injury to other organs including the bladder, and other complications from a major surgery. Cesarean delivery also carries higher risk of infant injury and can result in situations requiring the neonatal intensive care unit (NICU). Additionally, after a Cesarean delivery, future vaginal deliv- eries may be risky. Because of this, Cesarean delivery may be recom- mended in the future. However, vaginal birth after Cesarean (VBAC) may be possible, depending upon your health characteristics. In future pregnancies, there is risk of the Cesarean section scar breaking during pregnancy or labor (uterine rupture). Additionally, women's risk of developing placenta previa or accrete in future pregnancies is higher after Cesarean deliveries than vaginal births. Because of these risks, it is important that all women who plan to have a Cesarean delivery be informed about the risks, both immediate and in the future. It is also important that women who experience unplanned Cesarean sections be informed about how having a Cesarean section may impact their maternal health in the future. While it is customary for informed consent to be given before a Cesarean section, informed consent documents are not standardized and may contain medical jargon. Addi- tionally, in emergency situations, lengthy discussions about the impact of the Cesarean delivery on future pregnancies cannot be guaranteed to occur at the time of informed consent and informed consent may focus solely on the Cesarean surgery. This written communication will provide standardized information in plain English about risks associated with Cesarean section delivery and about the potential impact of the Cesarean on future pregnancies, based on ACOG guidance. This act directs the Commissioner of Health to establish a formal writ- ten communication or communications for a maternal health care provid- er, defined as any physician, midwife, nurse practitioner, or physician assistant, or other maternal health care practitioner acting within his or her lawful scope of practice attending a pregnant woman, to provide to each maternal patient who plans to deliver via Cesarean section or delivered via Cesarean section to inform them about risks associated with Cesarean section delivery, as well as how having a Cesarean section may impact future pregnancies. The Commissioner has the option to develop more than one version of the communication, tailored to specific situations such as pregnant women who have a primary Cesarean section planned or women who have already undergone a prior Cesarean section. For example, a version of the commu- nication geared towards women who have already had a prior Cesarean section may include information about vaginal birth after Cesarean (VBAC) and the specific risks associated with having multiple Cesarean sections.   PRIOR LEGISLATIVE HISTORY: A.10809B of 2018, amended on third reading   FISCAL IMPLICATION: None to the state.   EFFECTIVE DATE: This act shall take effect 180 days after it shall become a law. Effec- tive immediately, the department of health may make regulations and take other actions reasonably necessary for the timely implementation of this act on that date.
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A00318 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         318--A
                                                                  Cal. No. 5
 
                               2019-2020 Regular Sessions
 
                   IN ASSEMBLY
 
                                       (Prefiled)
 
                                     January 9, 2019
                                       ___________
 
        Introduced  by M. of A. PAULIN, GOTTFRIED, GALEF, ARROYO, BARRON, BLAKE,
          DICKENS, D'URSO, COLTON, COOK, EPSTEIN,  SEAWRIGHT,  TAYLOR,  WOERNER,
          McDONOUGH,  JEAN-PIERRE,  FERNANDEZ, WALKER, HYNDMAN, WRIGHT, BUTTENS-
          CHON, SIMOTAS, JACOBSON, GRIFFIN -- Multi-Sponsored by  --  M.  of  A.
          THIELE  --  read  once  and  referred  to  the  Committee on Health --
          advanced to a third reading, passed by Assembly and delivered  to  the
          Senate,  recalled  from  the  Senate, vote reconsidered, bill amended,
          ordered reprinted, retaining its place on the order of third reading
 
        AN ACT to amend the public health law, in relation to informing materni-
          ty patients about the risks associated with cesarean section
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1.  The  public health law is amended by adding a new section
     2  2500-l to read as follows:
     3    § 2500-l. Duty of providers  of  primary  cesarean  section  maternity
     4  services  to  inform.  1.  (a) Every maternal health care provider shall
     5  provide the written communication established in subdivision two of this
     6  section prior to delivery to each pregnant woman  for  whom  a  cesarean
     7  section delivery is planned.
     8    (b)  Every  maternal  health  care  provider  who  performs a cesarean
     9  section which was not  planned  prenatally  shall  provide  the  written
    10  communication  established  in  subdivision  two  of this section to the
    11  patient following delivery.
    12    (c) As used in this section:    "maternal  health  care  provider"  or
    13  "provider"  shall  mean  a  physician,  midwife,  nurse practitioner, or
    14  physician assistant, acting within his or her scope of practice,  manag-
    15  ing the pregnancy of a pregnant woman.
    16    2.  (a)  The  commissioner  shall  develop  a written communication or
    17  communications for maternal  health  care  providers  to  distribute  to
    18  maternity patients as required in subdivision one of this section, which
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD01662-04-9

        A. 318--A                           2
 
     1  contains  information  about cesarean section delivery. The commissioner
     2  shall consult with appropriate  health  care  professionals,  providers,
     3  consumers,  educators  and  patients or organizations representing them,
     4  including  but  not limited to the American College of Obstetricians and
     5  Gynecologists and the New York State Association of Licensed Midwives to
     6  develop such written communication or communications.
     7    (b) Such written communication or communications  shall  include,  but
     8  not be limited to information on:
     9    i. potential maternal injuries associated with cesarean delivery; and
    10    ii. potential risks to the fetus; and
    11    iii. the impact a cesarean delivery may have on future pregnancies and
    12  deliveries; and
    13    iv.  circumstances in which cesarean delivery may be necessary to save
    14  the life of the mother or fetus.
    15    (c) The commissioner shall ensure that all information included in the
    16  written communication or communications are maintained  and  updated  to
    17  reflect current clinical guidelines.
    18    § 2. This act shall take effect on the one hundred eightieth day after
    19  it  shall  have  become a law.  Effective immediately, the department of
    20  health may make regulations and take other  actions  necessary  for  the
    21  timely implementation of this act on its effective date.
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