Packages of Mifepristone tablets are displayed in a family planning clinic. (Photo: Anna Moneymaker/Getty Images)
New legislation in Ohio that would require doctors to read a legal declaration before medication abortions informing patients they can sue them could create a recent barrier to constitutionally protected abortion care, experts say.
Led by Republicans Ohio Senate Bill 309 would require health care providers who prescribe abortion-inducing drugs to provide patients with a declaration and written information about their ability to sue their health care providers before the drugs could be prescribed.
A statement included in the bill’s language read: “The State of Ohio wants you to be aware that you and your family can hold the manufacturer, distributor, healthcare provider, and health care facility financially liable” if a patient dies, is injured, or experiences complications.
Providers, facilities and manufacturers will also be liable for “debilitating side effects,” such as rupture of an unknown ectopic pregnancy or infection, “if the provider fails to address the side effect” or “if the drug fails to terminate the pregnancy, resulting in a failed abortion or requiring surgical intervention.”
Doctors, researchers and supporters say the bill could have a chilling effect on relationships between doctors and patients.
“I think it can be really detrimental to the doctor-patient relationship,” said Dr. Tracy Griffith, an OB/GYN at University Hospitals and fellow of the American College of Obstetrics and Gynecology. “It appears to have been designed to create distrust.”
Griffith said she and other doctors have already been trained to consider the risks of the medications they prescribe and to have conversations about what is best for the particular patient they are working with.
According to Griffith, training includes treating any complications that may arise, and always has.
The recent measure passed by the Ohio Legislature would not address any of the alleged problems with the drug itself raised by anti-abortion groups and anti-abortion lawmakers.
“This bill will not improve the safety of this drug or the medical advice I give them,” Griffith said.
“This will deter providers from providing the drug or deter patients from this option.”
According to the bill, performing a medical abortion before submitting a declaration of legal responsibility may result in a lawsuit from patients, maternal grandparents if the patient was a minor or died during the procedure, and also “the father of the unborn child if the father is married to her” at the time of the medical abortion.
A pregnant woman’s next of kin can also sue providers, facilities and drug manufacturers if the person dies “as a result of an abortion or abortion-related complications.”
People suing over a drug abortion can seek three times the cost of the drug plus “compensation for injuries and losses.”
The fact that the legal liability only applies to medication abortions is a huge red flag for Griffith in a state that has constitutional protections for abortion care but also has a Republican-majority Legislature that has crafted several bills to further regulate reproductive health care.
“There is no other area of medicine where we are talking about the potential criminalization of health care,” Griffith said.
The anti-abortion lobbying group Ohio Right to Life issued a statement expressing its consent to the bill.
“Women facing difficult choices should be given all the information they need to make such a critical decision,” Ohio Right to Life Executive Director Carrie Snyder said in a statement.
“We hope that more women will recognize the dangers of abortion pills and make the decision to choose life for themselves and their baby.”
Medical abortion has been proven to be a protected method, and studies have shown very infrequent cases of solemn health problems, even if provided via telehealth.
Rates are comparable to or safer than over-the-counter pain relievers.
A 2024 study published in the journal Nature Medicine found that of more than 6,000 medical abortions obtained via telehealth, 97.7% “occurred without any subsequent known intervention or ongoing pregnancy after initial treatment.”
The study also found that 99.8% of medication abortions were not associated with “serious adverse events.”
A 2015 study published in the journal Obstetrics and Gynecology studied women participating in the California Medicaid program who had abortions and found that less than 1% of patients sought care in the emergency department for abortion-related complications after the procedure.
For medication abortion specifically, the study found a “serious complication rate” of 0.16%.
By comparison, data shows that about 1-2% of people taking painkillers like Advil and Aleve “experienced serious gastrointestinal complications during treatment.” 2013 study.
Epidemiology professor Alison Norris has already spent time at the Statehouse providing lawmakers with data on the disease draft bills that could directly and indirectly affect reproductive health care and abortion drugs.
She’s willing to do it again for the latest measure.
“It is illogical to hold health care providers who offer abortion care to a different standard,” Norris told the Capital Journal.
The professor is also a principal investigator for the Ohio Policy Evaluation Network (OPEN), a group of professors and academic researchers from throughout Ohio and other states focused specifically on examining the impact of abortion and contraception policies.
“We know that the abundance of regulations creates an environment in which it is difficult, and sometimes impossible, to provide the standard of care that we want,” Norris said.
Norris said that with standards of care already including assuring patients about the risks and benefits of treatment and the likelihood of complications, “creating a complex legal environment makes it more difficult for providers to deliver care in the best way.”
Norris stated that because the safety of medication abortion has been scientifically proven, it would be better if more and more providers could offer such care, rather than regulating the treatment in a way that discourages exploit.
“The evidence shows that it is common, safe and very acceptable to people,” Norris said. “There are different people for whom this is the best care, and we should reduce the barriers to excellent care.”
Clinics like Planned Parenthood in Ohio are currently used to legislation which is trying to regulate issues around a constitutional amendment approved by 57% of Ohioans in 2023 and they see it as another “political attack.”
“This is another example of lawmakers not listening to the will of voters,” said Lauren Blauvelt, executive director of Planned Parenthood Advocates of Ohio.
“It shows that it is not legislators who are invested in serving their communities… but in their own interests.”
The recent regulations have been referred to the Ohio Senate Health Committee, but no hearing has been scheduled yet.
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