Add 2500-l, amd 2500 & 2803-n, Pub Health L; add 6524-a, Ed L
Requires a healthcare provider to inform a patient of the options for treatment following confirmation of the death of a fetus or embryo in utero, including surgical evacuation, the induction of labor and allowing the patient to spontaneously miscarriage; requires the healthcare provider to arrange for the removal of the fetus or embryo and the associated products of conception through surgical evacuation or the induction of labor within forty-eight hours of the confirmation of fetal or embryo death if requested to do so by the patient and if medically advisable, or to refer the patient to another healthcare provider capable of providing such services and to advise the patient of the facility registry; requires a healthcare provider to notify the patient of fetal or embryo death within twenty-four hours of confirmation of the death; requires the commissioner of health to establish a registry of facilities that provide certain services; requires hospitals to have healthcare personnel on call to perform certain procedures following the death of a fetus or embryo in utero; and requires certain healthcare providers who apply for a license to practice certain specialties to have training in performing certain procedures.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A10659
SPONSOR: Rules (Bichotte Herm TITLE OF BILL:
An act to amend the public health law, in relation to treatment follow-
ing the confirmation of fetal or embryo death in utero; to amend the
public health law, in relation to requiring the commissioner of health
to establish a registry of facilities providing certain services and to
requiring hospitals to have healthcare providers on call to perform
certain procedures; and to amend the education law, in relation to
requiring training in certain procedures
PURPOSE OR GENERAL IDEA OF BILL:
The purpose of this bill is to ensure expected mothers who encounter
fetal deaths get the treatment they need, especially in the event of an
emergency.
SUMMARY OF SPECIFIC PROVISIONS:
Section 1. This act shall be known and may be cited as "Mickie's law".
Section 2. Amended to require healthcare providers to arrange for the
removal of dead fetus or embryo at the request of patient and is
medically approved.
Subdivision 1. Provider should remove dead fetus at the request of the
patient within 48 hours provided that it is medically advisable
Subdivision 2. Provider must notify patient within 24hr after identify-
ing the results of fetus or embryo death and referring them to another
healthcare provider if not available to perform services.
Subdivision 3. Defines the term of healthcare provider for purposed of
this section.
Section 3. Section 2500 of the public health law is amended by adding a
new subdivision 5 that requires a registry of facilities that preform
surgical intervention procedure to remove the dead fetus or embryo.
Section 4. Section 2803-n of the public health law is amended by adding
a new subdivision 5 requiring obstetric care to have at least one
healthcare provider either present in the hospital or on call to remove
the dead fetus cr embryo upon the expectant mother's request.
Section 5. The education law is amended by adding a new section 6524-a
that requires applicants obtaining a license to practice obstetrics,
gynecology or general surgery to receive training to preform dilation
and curettage and dilation and evacuation procedures.
Section 6. Sets forth the effective date.
JUSTIFICATION:
This bill has been named Mickie's Law in honor of the fetus loss of
parents who experienced challenges with medical support while visiting a
private out-of-state hospital for their routine check-up and were
informed of their fetus passing. The parents were told that a D&E proce-
dure was needed to remove the dead fetus. Due to religious beliefs of
the private hospital, the healthcare provider informed them that they
needed to visit a public hospital to have the procedure done. While
carrying the dead fetus, the parents searched for a hospital in New York
to quickly remove the fetus before approaching a window of time where
the decomposing fetus would create toxic medical condition for the
expecting mother. Many of the public hospitals they spoke with indicated
that they had a scheduling conflict and were unable to perform the
procedure until the next 2 - 3 weeks. Although 2 weeks is within the
time frame a mother can carry a dead fetus before it begins to decom-
pose, it can be traumatic for the parents to know that their baby has
died and is decaying in the womb. This type of mental destress can
become debilitating to the expecting mother which can cause additional
health challenges. Fortunately, the parents were able to find a hospi-
tal that preformed the D&E procedure within 3 days after learning of his
passing. Many parents are not as fortunate in finding a facility or
provider to perform such procedure in a timely manner.
Challenges such as this have been known to be a contributing factor to
maternal mortality. In the United States, the alarming rate of maternal
mortality continues to increase; in 2020 23.8 deaths per 100,000 accord-
ing to the National Vital Statistics System. Even more alarming is the
rate of maternal mortality for Black women, who are three times more
likely than White women to die from a pregnancy-related cause. According
to the CDC, each year in the United States, about 700 expectant mothers
die during pregnancy or in the year after. Fetal mortality has slowly
decreased since 2019; however, according to a CDC study, Black women are
still the highest group to experience fetal death at 10.41 per 1,000
live births and fetal deaths.' Though the rate of Black women encounter-
ing these experiences have decreased from 2018 to 2019, rates are still
higher among mother 40 to 44 years of age (9.06) and 45 years of age and
older (9.79), and lowest among mothers 30 to 34 years old (5.09)which
was reported by U.S News in 2021.
According to the American Medical Association Patient Rights Code of
Medical Ethics Opinion 1.1.3, patients have the right to make decisions
about the care the physician recommends and to have those decisions
respected. Patients also have the right to receive information from
their physicians and to have opportunity to discuss the benefits, risks,
and costs of appropriate treatment alternatives, including the risks,
benefits and costs of forgoing treatment. It also states that patients
should be able to expect that their physicians will provide guidance
about what they consider the optimal course of action for the patient
based on the physician's objective professional judgment.
There are procedures that can remove a dead fetus. The first is a Dila-
tion and evacuation (D&E) which dilates the cervix and then evacuates
the fetus and the placenta from the uterus. The second is a Dilation and
curettage (D&C) which removes the tissue from inside of the uterus to
diagnose and treat certain uterine conditions - such as heavy bleeding -
or to clear the uterine lining after a miscarriage or abortion. Both
procedures are similar to that of an elective abortion. However, the
purpose is critically different. In 1973, the U.S. Supreme Court ruled
that the Constitution of the United States granted the right to have an
abortion. In 1992, the Supreme Court of the United States upheld the
right to have an abortion as established by the Roe v. Wade case in 1973
during the landmark case Planned Parenthood v. Casey, 505 U.S. 833.
After the Supreme Court's decision to overturn Roe v. Wade in 2022, it
has left many providers with questions. This is because any remains of a
fetus dead or viable is considered an abortion; however, woman should
have the right to get the fetus removed. In the situation with a Texas
woman, she experienced a miscarriage and was denied medical intervention
due to a Texas anti-abortion law. In this case, the fetus already died
in the womb thus, the procedure would not take a life away, instead
prevent possible health risks to the expectant mother. Although we talk
about abortions, we don't address dead fetus needing to be aborted.
PRIOR LEGISLATIVE HISTORY:
New bill
FISCAL IMPLICATIONS:
To be determined
EFFECTIVE DATE:
This act shall take effect on the thirtieth day after it shall have
become a law.
STATE OF NEW YORK
________________________________________________________________________
10659
IN ASSEMBLY
August 12, 2022
___________
Introduced by COMMITTEE ON RULES -- (at request of M. of A.
Bichotte Hermelyn) -- read once and referred to the Committee on
Health
AN ACT to amend the public health law, in relation to treatment follow-
ing the confirmation of fetal or embryo death in utero; to amend the
public health law, in relation to requiring the commissioner of health
to establish a registry of facilities providing certain services and
to requiring hospitals to have healthcare providers on call to perform
certain procedures; and to amend the education law, in relation to
requiring training in certain procedures
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. This act shall be known and may be cited as "Mickie's law".
2 § 2. The public health law is amended by adding a new section 2500-l
3 to read as follows:
4 § 2500-l. Treatment following fetal or embryo death in utero. 1.
5 Notwithstanding any provision to the contrary, in the event that a fetus
6 or embryo dies while in utero, and such death is confirmed by a health-
7 care provider, the healthcare provider shall inform the patient of the
8 options for treatment, including surgical evacuation, the induction of
9 labor and allowing the patient to spontaneously miscarry. At the
10 request of the patient, and if medically advisable, the healthcare
11 provider shall arrange for the removal of the fetus or embryo and the
12 associated products of conception through surgical evacuation or the
13 commencement of the induction of labor within forty-eight hours of the
14 confirmation of fetal or embryo death. If the healthcare provider is
15 unable to provide such services within forty-eight hours of the confir-
16 mation of fetal or embryo death, the healthcare provider shall refer the
17 patient to another healthcare provider or facility able to provide the
18 services within the forty-eight hour time frame and shall advise the
19 patient of the provider registry established pursuant to subdivision
20 five of section twenty-five hundred of this article.
21 2. If a patient has left the office or facility of the healthcare
22 provider who confirmed the fetal or embryo death prior to being advised
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD16132-06-2
A. 10659 2
1 of the death, the healthcare provider shall contact the patient within
2 twenty-four hours of confirmation of the fetal or embryo death and noti-
3 fy the patient of the death.
4 3. As used in this section, "healthcare provider" means a practitioner
5 in an individual practice, group practice, partnership, professional
6 corporation or other authorized form of association, a hospital, or a
7 clinic providing reproductive healthcare services.
8 § 3. Section 2500 of the public health law is amended by adding a new
9 subdivision 5 to read as follows:
10 5. The commissioner, in conjunction with the department of education,
11 shall establish a registry of facilities that perform surgical inter-
12 vention procedures following the death of a fetus or embryo in utero and
13 shall make such registry available to the public on the department's
14 website. The registry shall display the name, address and telephone
15 number of each such facility and shall contain a link to the facility's
16 website, if available.
17 § 4. Section 2803-n of the public health law is amended by adding a
18 new subdivision 5 to read as follows:
19 5. The hospital shall have at least one healthcare provider either
20 present in the hospital or on call to provide care to an expectant moth-
21 er who requests surgical evacuation or the induction of labor after her
22 fetus or embryo dies in utero.
23 § 5. The education law is amended by adding a new section 6524-a to
24 read as follows:
25 § 6524-a. Specialist training. Any applicant for a license under this
26 article to practice in the areas of obstetrics, gynecology or general
27 surgery is required to receive or have received training in performing
28 dilation and curettage and dilation and evacuation procedures prior to
29 application for such license.
30 § 6. This act shall take effect on the thirtieth day after it shall
31 have become a law.
