New Hampshire Ultrasound Mandate for Abortion Care Repealed

CONCORD - On Friday, HB 1673 was signed into law, which repeals New Hampshire’s ultrasound mandate requirement for all abortion care, effective immediately. 

Previously, state law - as passed in last year’s state budget package - required every person seeking abortion care to first undergo an ultrasound, at every stage of pregnancy, regardless of medical necessity. HB 1673 addresses only the ultrasound mandate provision of New Hampshire’s abortion ban; additional legislation, HB 1609, is still waiting to go to the governor’s desk that would add an exception for fatal fetal diagnoses to the 24-week ban.

Statement from Kayla Montgomery, VP of Public Affairs for Planned Parenthood of Northern New England and Planned Parenthood New Hampshire Action Fund:

“For nearly six months, Granite Staters seeking abortion care have been needlessly forced to first undergo an ultrasound because extreme lawmakers slipped this government mandate into the state budget last year. To be clear, these procedures can be invasive and are not always medically necessary. 

We are grateful bipartisan lawmakers came together this year to listen to patients and providers and repeal this barrier to care that served only to shame women and put up roadblocks to accessing abortion. 

While the signing of HB 1673 is an important step forward to address the harm caused by New Hampshire’s first abortion ban in modern history, we urge the Legislature to quickly send its companion bill, HB 1609, to the governor’s desk to ensure Granite Staters in complex circumstances later in pregnancy have access to the care they need without being forced to travel out-of-state.”

BACKGROUND:

24-Week Abortion Ban:

• This ban is extreme for many reasons. It has no exceptions for fatal fetal diagnoses, rape, or incest; and it has a very narrow exception for maternal physical health.
• The abortion ban, which was passed as part of HB 2 in 2021, also requires all people seeking abortion care eto first undergo an ultrasound, at every stage of pregnancy, regardless of medical necessity.
• Additionally, this abortion ban criminalizes health care providers with a class B felony which could come with up to seven years in prison and a fine up to $100,000, allows husbands to file civil actions, and allows the patient’s parents to file civil actions.
• There are no other medical procedures in New Hampshire law subject to felony charges and imprisonment for health care professionals.

Ultrasound Mandate Provision:

• Section 39 of HB 2 states: “Except in the case of medical emergency as specifically defined in paragraph III, no abortion shall be performed, induced, or attempted by any health care provider unless a health care provider has first made a determination of the probable gestational age of the fetus…the health care provider shall conduct an obstetric ultrasound examination of the patient for the purpose of making the determination.”
• While ultrasounds are performed in some circumstances, they may be unnecessary for some patients accessing abortion. This is especially true for medication abortion, which is a safe and effective way to terminate a pregnancy at early gestations and accounts for about 39 percent of all abortion care nationally. Requiring an ultrasound to obtain a medication abortion creates unnecessary barriers to abortion access, including transportation and cost.
• According to the American College of Obstetricians and Gynecology, “For patients with regular menstrual cycles, a certain last menstrual period within the prior 56 days, and no signs, symptoms, or risk factors for ectopic pregnancy, a clinical examination or ultrasound examination is not necessary before medication abortion.” With this provision, however, an ultrasound will be required to access abortion care. 
• The new law requires an ultrasound before all abortion care to determine gestational age. In the earliest stages of pregnancy, at PPNNE a transvaginal ultrasound is necessary to meet that requirement. At PPNNE, for abortion care after 11 weeks, an abdominal (or pelvic) ultrasound is generally used. 
• Requiring ultrasounds prior to all abortion care is intended to shame patients. During the Committee of Conference, a state representative advocating for this provision explained that “ultrasound images can be useful to that mother to connect to the baby that’s inside of her so that she’s better able to make a decision as is whether she wants to go forward with the procedure.” This type of statement makes clear that some New Hampshire lawmakers do not trust patients to make their own health care decisions.

Abortion Ban Public Comment:

• When New Hampshire’s abortion ban and ultrasound requirement was being considered in 2021, nearly 200 New Hampshire health care providers expressed their opposition to this law.
• On February 2, 2022, a contingent of medical providers from The Elliot Hospital cosigned a letter to senators and Governor Sununu asking them to repeal this law because “it will lead to cruel and unnecessary physical and emotional harm to the women of New Hampshire.”
• In March, 2022, a coalition of statewide medical providers urged the New Hampshire House and Senate to mitigate the harm caused by New Hampshire’s abortion ban and ultrasound mandate.

Additional Legislation:

• HB 1609 was filed by six Republicans, led by Representative Dan Wolf, to mitigate the harm caused by New Hampshire’s abortion ban and ultrasound mandate. As amended by the House and Senate, it repeals the ultrasound mandate provision and adds a critical exception for fatal fetal diagnoses to the 24-week abortion ban. HB 1609 has been passed by the House and Senate and is currently waiting to go to the governor’s desk.
• The Senate adopted SB 399 as amended, which preserves the abortion ban but mitigates the harm caused by the ultrasound mandate. SB 399 had a public hearing in the House Judiciary Committee on Wednesday, April 13 and the committee voted to pass the bill unanimously the next day. On May 5, the House laid SB 399 on the table, 177-156.

Polling:

• Recent UNH Survey Center polling released in February, 2022, shows that New Hampshire overwhelmingly supports Roe v. Wade. Across the state, 65% of Granite Staters want the new Supreme Court Justice to be someone who would vote to uphold Roe v. Wade - including a majority of registered Democrats, registered undeclared, and registered Republican voters. Just 20% of Granite Staters want the next Supreme Court Justice to vote to overturn Roe.
• Polling released in July, 2021 from the UNH Survey Center shows that New Hampshire’s abortion ban is deeply unpopular, with only one-third of Granite Staters in support of it. Nearly half of independent Granite Staters oppose this ban, as do 27 percent of Republicans.
• The UNH Survey Center polling also shows that only 31 percent of Granite Staters support the provision signed by Governor Sununu that mandates medically unnecessary, often invasive ultrasounds before abortion care at all stages of pregnancy.
• The truth is, most Granite Staters and most Americans support access to safe, legal abortion. If someone has decided to have an abortion, more than 8 in 10 respondents want the experience to be supportive and nonjudgmental, without added burdens or protesters, affordable and safe. 

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Planned Parenthood of Northern New England (PPNNE) is the largest provider of reproductive and sexual health care across the State of New Hampshire. We serve New Hampshire residents through 5 health centers in Derry, Exeter, Keene, Manchester and White River Junction, VT. Last year we saw more than 10,000 patients at these sites. PPNNE was named a 2021 Guardian of Excellence Award^® winner by Press Ganey, the national leader in health care consumer and workforce engagement. Press Ganey recognizes PPNNE as a top-performing health care organization, achieving the 95^th percentile or above for performance in patient experience, out of more than 20,000 medical practices.

Planned Parenthood New Hampshire Action Fund (PPNHAF) is an independent, nonpartisan, not-for-profit organization formed as the advocacy and political arm of Planned Parenthood of Northern New England in New Hampshire. The Action Fund engages in educational and electoral activity, including voter education, grassroots organizing, and legislative advocacy.