Utah’s pre-abortion course would feature heartbeat audio, procedure images under new state bill

A bill now before the state Legislature would compel Utah women seeking an abortion to watch an online course displaying “medically-accurate” images of the procedure and then attest under penalty of perjury that they’ve viewed the presentation from start to finish.

Completing this online module is already a mandatory step before an abortion in Utah — although right-wing advocates argue the current informed process is too porous and believe women might be skimming over or skipping the course. But abortion rights groups see these new proposed restrictions as yet another episode in a long campaign to block access to pregnancy-ending procedures in Utah.

This bill’s tactic, says Karrie Galloway of Planned Parenthood Association of Utah, seems to be “a shaming of women: ’You don’t know what you’re doing, let me educate you. Let me educate you again and again and try it a different way so that you will change your mind.’”

Informed consent

Rep. Steve Christiansen, the sponsor of HB253, said his only goal is to make sure women are fully informed before terminating a pregnancy.

“For some reason, when it comes to abortion, there are some who want to push back when we try to ensure the woman receives relevant and complete information about what is about to happen,” he said in a Wednesday interview. “We would never push back regarding other medical procedures that could have the same or similar types of consequences on a person’s life and health.”

However, Rep. Rosemary Lesser, a freshman legislator who recently retired after decades practicing as an OB-GYN, said she’s never seen an informed consent form that warns patients against committing perjury.

“I have counseled thousands of women through the years, and I never recall that verbiage on an operative consent form,” said the Ogden Democrat, who said she’s concerned the bill is essentially “deciding that there needs to be a third party in the doctor-patient relationship, an uninvited third party.”

Utah lawmakers have enacted a slew of abortion restrictions over the years, establishing a mandatory 72-hour waiting period and requiring women to watch the health department informational module before the procedure. The current online module states that “Utah prefers childbirth over abortion” and walks through the phases of fetal development and different methods for ending a pregnancy.

However, Christiansen’s bill would also instruct the health department to make sure the program could only be viewed from beginning to end, with no skipping or fast-forwarding allowed. The module would have to feature audio of a fetal heartbeat, ultrasound video from six different points in a pregnancy and “medically-accurate visual images of what is happening to the unborn child at each step of each type of abortion procedure.”

After finishing the program, a woman would get a certificate with a unique code that state health officials could use to verify that she completed it.

The lawmaker said he’s proposing these steps after hearing that people can currently type in a web address that calls up the health department’s certificate of completion for the information module — a loophole that enables them to print off the required form without taking the course.

While Christiansen suggested that clinic staff are sometimes complicit in these workarounds, Galloway, CEO and president of Utah’s Planned Parenthood, said her organization “follows the letter and spirit of all laws.” And she expressed sympathy for state health officials who have to deal with ever-shifting mandates from Utah lawmakers, who she says keep grasping for new ways to discourage abortions.

In addition, the bill’s requirement that an informed consent visit must take place in person is particularly ill-timed during the pandemic, she said, when many of these mandated patient-provider conversations have been happening through telehealth.

“I am trying to keep our doors open for people who need reproductive health care,” she said. “And instead of working on a pandemic, [Christiansen] wants to intrude into the health care system to make it more problematic for my staff and problematic for women.”

While current law contains penalties for providers who violate the informed consent process, Christiansen’s legislation would expose patients to criminal liability by requiring women to affirm under penalty of perjury that they watched the entire health department module. And Christiansen’s bill would add a fine of $50,000 per violation for physicians who break informed consent laws, on top of the criminal charges they would already face.

Christiansen says there’s a simple way to avoid these stiff penalties.

“The doctor doesn’t need to pay a penny,” he said. “All he or she needs to do is simply comply.”

The West Jordan Republican also wants the health department to collect data on abortion complications, broken down by complication type and procedure type and showing whether these patients are being treated at abortion or medical clinics, doctor’s offices or hospitals. This additional data on abortion outcomes, he said, could help guide future policymaking efforts.

Gayle Ruzicka, president of the Utah Eagle Forum, praised Christiansen’s proposal as a way to make sure women are fully aware of what a pregnancy termination entails.

“Anybody should always be able to say that they had all the information before they make such a critical decision,” she said. “We want to make sure that they have the opportunity to know all there is to know and that there was nothing that they felt was later withheld from them.”

Abortion legislation sponsored last year by Christiansen would’ve forced women to undergo an ultrasound before the procedure and stirred up such a furor that all six female state senators — Republican and Democrat — walked out of the chamber in protest to the bill. The measure died in the final hours of the legislative session.

However, the Legislature in recent years has adopted several other abortion restrictions, even passing a bill that called for an outright ban on elective procedures as soon as the Supreme Court clears the way. Under that scenario, abortions would be permitted in Utah only in cases of rape or incest, if the woman’s life were at stake or for a severe fetal abnormality.

The Legislature in 2020 also approved legislation requiring health care facilities to dispose of fetal remains by burial or cremation after an abortion or miscarriage. A follow-up to the measure has surfaced this session, as Rep. Cheryl Acton has proposed criminalizing the out-of-state transport of fetal remains except for the purpose of burying them.

Acton wrote that she does not consider HB231 to be an abortion bill, because it doesn’t impose new limitations for terminating a pregnancy. The measure seeks to ensure that the aborted or miscarried fetal remains are “handled with dignity and not treated as medical waste” even if taken out of the state, she added.

Targeting abortion

Planned Parenthood believes that the bill takes aim at them, since they send fetal tissue across Utah borders to a lab for state-mandated pathology tests following an abortion; in response, Acton, R-West Jordan, said the organization could simply switch to an in-state lab, which “would probably save them effort and money.”

In the years since the landmark Roe v. Wade decision, the Utah Legislature has considered 95 abortion bills and passed nearly half of them, according to a review recently undertaken by the League of Women Voters of Utah. In the last five years alone, the state has passed more than a dozen new abortion laws, the League found.

And abortion rights advocates say lawmakers and state residents of all political stripes are increasingly wearied by these efforts to chip away at access.

“Utahns are overwhelmingly united in that they do not want more punitive abortion restrictions,” Lauren Simpson, policy director for Alliance for a Better Utah, said in a statement.

Responding to Christiansen’s proposal, Simpson said this session started as Utahns are dealing with a pandemic, financial insecurities and political extremism that has fueled a loss of trust in government.

“Now is not the time to be bringing forward another culture war bill,” she said. “Lawmakers would do well to address the issues facing Utahns on a day-to-day basis, instead of running legislation meant to divide us.”

Christiansen disagreed that the bill’s timing is wrong.

“I think that anytime, frankly, is a good time to make sure that we are protecting women and protecting the unborn,” he said. “I don’t think there is a bad time.”