SB 30-ABORTION: INFORMED CONSENT; INFORMATION    CHAIR FRED DYSON announced SB 30 to be up for consideration and called an at-ease from 1:36 to 1:38 p.m. He said the Department of Health and Social Services (DHSS) and the Department of Law (DOL) provided conceptual notes about the amendments to SB 30. The first two notes concern typos. DHSS suggested that it create a website to keep the pamphlet information updated with access by agencies to update their particular information as it became available. That approach decreases the fiscal note from $120,000 to $10,000 and he had not heard a good argument against it. The DOL suggested offering immunity from prosecution to providers who distribute the pamphlet or a printout as incentive for fulfilling the requirements for getting information to the patient/client. MS. JANICE DELAND supported SB 30. She related her experience 27 years ago when a doctor told her she had to have an abortion because she was miscarrying. MR. SID HEIDERSDORF, Juneau resident, said, "This is much needed legislation to protect women from unscrupulous abortion practices." He thought that abortion counseling was a sham and that most women are not adequately informed. Many states already require informed consent of this type. He also added that the 24-hour waiting period is important because a woman needs some breathing room from the intimidating atmosphere of a clinic after getting their information. MS. KARLEEN JACKSON, Deputy Commissioner, Department of Health and Social Services, supported SB 30. DHSS is particularly excited about making the information available on its website. That would not only allow physicians to download and print out the information, but it would allow women who have access to an Internet connection to get the information as they try to figure out what to do regarding a pregnancy. The fiscal note would be much lower if the information was on a website. MS. LINDA BOWDRE, Delta Junction resident, supported SB 30 and commented that she can't understand why the state has to have a bill to require doctors to explain a very serious medical procedure to their patients. MS. KARI THOMAS, Delta Junction resident, supported SB 30 and thought the website was a great idea, except that providers need to be held accountable to make sure they give the information to the patient. MS. ROSEANNE CURRAN, Cordova resident, supported SB 30. She noted, "It just makes sense to have as many facts as possible before any type of surgery or medical procedure, especially one as life changing as an abortion." MS. KAREN VOSBURGH, Mat-Su resident, supported SB 30 saying, "It's always a good idea to have more information rather than none or less." DR. COLEEN MURPHY, OB-GYN, said she has been practicing in Alaska since 1987 and is an active abortion provider. She has undergone credentialing and review by the National Abortion Federation to provide such services. She is currently undergoing her annual board certification for the American College of OB- GYN to provide many high quality services, including menopausal care, gynecologic services, contraceptive services, abortion and others. She noted that she just paid $10,000 on a premium for malpractice coverage to practice here. She is accountable to the American Medical Association's code of ethics for providing appropriate informed consent and she is held to a preexisting statute, AS 05.09.555, which discusses informed consent for all surgical and invasive medical procedures. She concluded by saying this bill is unnecessary and meddles with private discussions between a patient and a doctor. She said this would place obstructions to health care, as many women in Alaska have to travel from remote places to get abortion services; requiring a 24-hour wait only raises the cost of the care. CHAIR DYSON appreciated her mentioning that the Legislature is putting the language now in the Alaska Administrative Code about informed consent into statute. DR. MURPHY interrupted to say that she had just done a vaginal hysterectomy on a Jehovah's Witness who didn't want blood products. She suggested if the Legislature is going to specifically include abortion in statute, it should put all procedures, like that one, in as well. CHAIR DYSON replied the difference is that the human rights issue makes abortion different from other surgical procedures. He said he might agree that the 24-hour waiting period is an unfortunate choice and asked whether doctors still inject laminaria and then wait for a couple of hours as a procedure. DR. MURPHY replied that the National Abortion Federation does not recommend the use of cervical dilatation. She explained that the moment a foreign body is put in the cervix, basically, the abortion starts. The informed consent for people who use laminaria actually states that the minute laminaria is used, the abortion starts. CHAIR DYSON asked the standard length of time a patient stays for observation after the procedure. DR. MURPHY replied that the majority of patients are immediately observed for excessive blood loss. She explained that there are two different types of abortions now available - medical and surgical. The medical procedure involves giving a patient medicine. The patient can then safely deliver at home as an abortion. That procedure is growing in usage. The surgical procedure is done in the office and the patient is observed for signs of blood loss for approximately a half to one hour afterwards. She also said that more and more non-obstetrician gynecologists are getting trained in the use of medical abortion so they can offer it, if they haven't been surgically trained. She pointed out, "So, more and more women are actually doing this at home and it's going to be really hard for you to regulate that." CHAIR DYSON said he appreciated her information. He asked if a patient who flies in from rural Alaska would be able to fly home on the same day. DR. MURPHY replied if it's a surgical procedure, patients can generally fly home the same day. If they have to wait 24-hours and are using a laminaria procedure, they can return home 48 hours later. She noted that Medicaid pays for a minority of the abortions done in her office because most women pay for them out of pocket to avoid creating a paper trail. MS. THEA PITMANN, Anchorage resident, opposed SB 30, but was not opposed to trying to reduce the number of abortions that take place. She said the bad thing about this bill is that it addresses the issue after a woman is pregnant, instead of providing opportunities to prevent unwanted pregnancies in the first place. She urged the committee to do more research on this issue. MS. DIETRICH STITLER, Anchorage resident, opposed SB 30. She related how she was diagnosed with hemophilia at the age of 14 and it is medically dangerous for her to carry a pregnancy to term because a loss of blood during delivery could potentially be fatal. She didn't think the government should have a place in any pregnancy decision she might have to make. Her biggest concern is with their definition of medical necessity. She might not fall under that section, because having an abortion at the very moment would probably not be a life saving measure or an emergency situation. Her doctor would probably say that a delay in abortion could create a serious risk or that there is a significant chance that a delay may create a serious risk. She said this bill would add costs for additional office visits and create a waiting period that could increase the risk of complication. MS. ROBIN SMITH opposed SB 30. She said it is far more than an informed consent bill. The 24-hour waiting period makes it totally biased against rural women by increasing the cost of whatever stay they have to make in the city. Abortions cost more than $500 and one of the main reasons second trimester abortions occur is that women are trying to get funds together to pay for them. She pointed out the parental consent requirement has already been struck down by Alaska courts (although it is now in the Supreme Court, but she thought it would be struck down again). MS. SMITH also pointed out that this bill requires the facility to be state and federally approved and at this point the only facility that fits that description is Valley hospital. Most abortions are now conducted in a doctor's office. MS. PAULINE UDDER opposed SB 30 saying they should not place any more impediments in front of women who, according to our Supreme Court, still have the right to choose. She related how her 43- year old friend will have to fly to Seattle to get an abortion if it turns out that she is carrying a Downs-syndrome fetus. TAPE 03-18, SIDE B    CHAIR DYSON thanked all participants for their testimony and set SB 30 aside.