Testimony Opposing Anti-Reproductive Health Care Legislation

Patient Testimony

Kelly, Concord, NH (read by Kayla Montgomery):

Today I want to share Kelly’s story. She lives in Concord, and a few years ago she was pregnant with her second child. She found out later in pregnancy that her son had a fetal diagnosis and would likely not survive birth. She couldn’t be here today so I wanted to deliver for you some of her story. These are her words:

"We had to make the most difficult choice a parent can make. We thought about what would be the best, kindest thing to do for our child. We decided to terminate because it would be the kindest decision to do for our son, our daughter, us. 

Terminating for medical reasons was the most difficult, heart-wrenching decision I’ve ever had to make in my life. I knew in that moment how lucky I was to have safe, local, medical care and the ability to choose what would be done to me. I didn’t have to go out of state to get the care I needed. When it was over, I hurt like any other parent would after losing a child. Each person is different, each pregnancy is different, and there is no one size fits all solution. It is critically important for women to focus on the decision that is right for her life, her baby’s life, her family’s life, and not have to worry about state laws that don’t take into account complex medical situations."
 

Dana Peirce, Yarmouth, ME:

Hello, my name is Dana Peirce, and I live in Yarmouth, Maine. Yes, my story is that of a Mainer, but if these bans passed in New Hampshire, my story could easily be of any Granite State woman. Complications in pregnancies don’t stop at borders. I am a wife, a mother of 2 living children, and a veterinarian. I am a Morehead-Cain scholar, and a world champion rower. I am also someone who has had an abortion later in pregnancy. 

On January 25th, 2019, I was 32 weeks pregnant with my son Cameron. That morning, my husband and I, along with our 3 year old daughter, went to what we expected to be a routine ultrasound in a normal pregnancy. But that’s when we found out that Cameron had lethal skeletal dysplasia, the result of a random, rare genetic mutation that occurs during sperm development. It is lethal because babies with this condition cannot breathe outside the womb—their rib cages are too small. Cameron’s femur was also broken, and there was evidence of multiple other healed fractures. 

In short, Cameron was actively suffering, and faced death by suffocation if he managed to make it to term and survive delivery. I cannot really put into words the intensity of anguish and grief that my husband and I felt in those moments, and in the days and weeks that followed. But I must emphasize that my strongest thoughts were that I would not let my son suffer any longer than he already had. 

Unfortunately, our grief was then compounded by the limits on abortion rights in our country. Those restrictions meant that we had to fly across the country and pay $25,000 cash in order to end our son’s suffering. I was incredibly fortunate to be able to afford the cost of travel, missed work, lodging, and the fee for the abortion itself, but the majority of women in my situation in this country would not have been so lucky.

Bans and limits on abortion later in pregnancy add exponentially to mothers’ grief and suffering. We should instead be making laws to ensure that women facing situations like mine are guaranteed safe, compassionate care and support. Abortion for any reason is a deeply personal decision and should not have anyone involved other than the pregnant woman, her medical team, and any others that she chooses to advise her.

Please join me in trusting and empowering women to make ethical, loving decisions for their own bodies. Please oppose HB 622 and HB 625. Thank you. 

Elected Official Testimony

Testimony from Manchester Mayor Joyce Craig, opposing HB 430

RE: HB 430

CITY OF MANCHESTER

Joyce Craig Mayor

Dear Chairman Gordon and Members of the Committee,

Coming before your committee today is HB430, repealing the prohibition on entering or remaining on a public way or sidewalk adjacent to a reproductive health care facility. I urge the House Finance Committee recommend this bill as “Inexpedient to Legislate” to the full House.

Manchester is home to one of New Hampshire’s five Planned Parenthood Health Centers. Planned Parenthood provides high quality, affordable health care to the residents of Manchester and the surrounding communities. The Health Center has a great relationship with the City and with our Police Department’s community policing division.

New Hampshire’s buffer zone law, which passed with bipartisan support in 2014, protects the patients at health centers while also protecting First Amendment rights. The Planned Parenthood here in Manchester underwent recent renovations, and while they are not currently utilizing this buffer zone law, it is a necessary tool moving forward to ensure that patient, providers, and volunteers have a small area of separation for their privacy and safety.

New Hampshire’s current bi-partisan buffer zone law protects the privacy and safety of those utilizing services provided by Planned Parenthood, while also protecting resident’s First Amendment Rights, and I urge you to vote against repeal.

Sincerely,

Joyce Craig Mayor

Provider Testimony

Courtney Jones, Section Chair, New Hampshire ACOG:

Dear Chairman Gordon:

I am writing on behalf of the American College of Obstetricians and Gynecologists (ACOG) with deep concern regarding abortion related legislation: HB 622, HB 625, HB 430, HB 434, HB 596, and HB 233. These upcoming bills collectively threaten physicians’ ability to provide the most appropriate reproductive medical care to women in New Hampshire.

ACOG opposes any legislation that limits women’s access to reproductive health services, including pregnancy termination. Pregnancy termination has been shown time and again to be safe and is a widely accepted medical practice. Decisions regarding pregnancy termination are deeply personal and should be made by a patient in consultation with her physician free of interference from the New Hampshire State Legislature.

The bills currently under consideration threaten to deny patients’ access to pregnancy termination and further seek to criminalize patients and physicians faced with difficult and private choices. We implore you and the members of your committee to reject these bills which we view as harmful to patients, physicians, and their ability to make safe, appropriate medical decisions.

Sincerely,
Courtney B. Jones, MD
Section Chair, New Hampshire ACOG
 

Christine Arsnow, MD, FAAP, Vice President of the NH Chapter of the American Academy of Pediatrics:

Dear Members of the House Judiciary Committee,

My name is Dr. Christine Arsnow. I am a pediatrician and Vice President of the New Hampshire Pediatric Society, the state chapter of the American Academy of Pediatrics, which represents 242 pediatricians in New Hampshire. My testimony is on behalf of that organization.

I am testifying in opposition to House Bills 434 and 596 because I believe that affordable access to emergency contraception and abortion is a crucial aspect of women’s healthcare.

In addition, I would like to state the NH American Academy of Pediatrics opposition to HB622, HB625, HB430, and HB233.

A national report conducted by the CDC National Center for Health Statistics showed that 55% of male and female teens have had sexual intercourse by age 18.1: As a mother of two young daughters, I understand the temptation to hide from these statistics. While we educate and foster a culture of responsible sexual behavior, we must offer options for women. These bills seek to severely restrict access to abortion and emergency contraception, which would have a negative impact on teenagers.

Teen pregnancy and childbearing bring substantial social and economic costs on teen parents and their children. Pregnancy and birth are significant contributors to high school dropout rates among girls. Only about 50% of teen mothers are able to earn a high school diploma compared to approximately 90% of women who do not give birth during adolescence. 2: Children born to teenage mothers are more likely to have lower school achievement and to drop out of high school, have more health problems, be incarcerated at some time during adolescence, give birth as a teenager, and face unemployment as young adults.

3: Teenage pregnancy disproportionately impacts Black, Hispanic and Native people, and women from low-income backgrounds. 4: Teens in child welfare systems are at higher risk of teen pregnancy and birth than other groups. Young women living in foster care are more than twice as likely to become pregnant than those not in foster care. 5: Because women from low-income backgrounds are at higher risk for teen pregnancy, it is crucial to provide affordable emergency contraception and abortion services.

Studies suggest that almost 1 in 4 of women will have had an abortion by the age of 45.6 The Hyde Amendment currently bans the use of federal funds for abortion coverage for individuals enrolled in Medicaid,7 which means that these procedures must be paid for out of pocket or via state funds for those without private insurance. Taking away state support as this bill suggests would mean that women with low income, including teenagers, would need to pay out of pocket for abortions. At an average cost of over $500,8 this is out of reach for many women.

Emergency contraception is a medication that can prevent pregnancy when used in the days immediately following unprotected intercourse. According to the 2006–2010 National Survey of Family Growth (NSFG) 11% of all sexually active women and nearly 1 in 4 sexually active women ages 20-24 reported ever using emergency contraception.9 About half of these women reported using emergency contraception because of fear of method failure (45%), and half because they had unprotected sex (49%). It is appalling to imagine any young woman would be in a position where she could not access emergency contraception.

Abortion and emergency contraception are two necessary aspects of women’s reproductive health that must be available and affordable to all women. The decision to proceed with one of these therapies should be between a woman and her doctor and should not be limited by the government. I strongly oppose this bill.

Thank you for taking the time to read my testimony. 
 

James Madara, President and CEO of the American Medical Association:

Dear Chairman Gordon:

On behalf of the American Medical Association (AMA) and our physician and medical student members, I am writing to express our concern about abortion-related legislation that would interfere with physicians’ ability to provide timely reproductive medical care to women in New Hampshire. We believe such legislation represents a troubling legislative intrusion into the practice of medicine.

The AMA believes that all women should have access to reproductive health services, including abortion. The early termination of pregnancy is a safe, established, and accepted medical practice, and the decision whether, when, and how to perform an abortion is a medical matter that should be made between a physician and his or her patient, free of external interference and subject to the physician's clinical judgment, the patient's informed consent, and the standards of good medical practice.

Protecting the sanctity of the patient-physician relationship, including defending the freedom of communication and medical decision-making between patients and their physicians, is a core priority for the AMA and a fundamental tenet of high-quality medical care. We view efforts to deny patients access to established and accepted medical services as unacceptable governmental interference into the practice of medicine. We strongly urge you and the members of your committee to reject legislation that would limit timely access to abortion and other reproductive health services.

We thank you for the opportunity to express our views on this important matter. If the AMA can be of assistance, please contact Annalia Michelman, JD, AMA Advocacy Resource Center, at [email protected].

Sincerely,

James L. Madara, MD
 

William Palmer, Governor of the American College of Physicians:

Thank you for reaching out to the NH ACP chapter and its executive council in regards of the proposed house bills that will ban abortion, curtail insurance coverage and repeal buffer zones.

ACP believes that a woman has the right to make health care decisions about matters that affect her personal, individual health and in the past joined with other physician organizations to oppose bills that interfere with physician-patient relationship and restrict a woman’s right to make autonomous decisions in respect of her reproductive health.

In a position paper on “Women’s Health Policy in the United States” published in the Annals of Internal Medicine in June of 2018 ACP states that it “believes in respect for the principle of patient autonomy on matters affecting patients' individual health and reproductive decision-making rights, including about types of contraceptive methods they use and whether or not to continue a pregnancy as defined by existing constitutional law. Accordingly, ACP opposes government restrictions that would erode or abrogate a woman's right to continue or discontinue a pregnancy. Women should have sufficient access to evidence-based family planning and sexual health information and the full range of medically accepted forms of contraception.”

We are in favor of joining other medical and health care organizations in a concerted opposition to the aforementioned bills and we will identify members and direct them to you about testifying against the bills.

Best,
ACP NH Council
 

Joann Buonomano MD, CPE, FAAFP, president of the NH Academy of Family Physicians:

Dear Chairman Gordon:

On behalf of the NH Academy of Family Physicians 25 member board, our primary care physicians and the state’s two Family practice residency programs we are writing in strong opposition to the upcoming reproductive rights hearings on HB622, HB625, HB430, HB434, HB596, and HB233.

We endorse the AMA letter sent on January 29 on this issue.

Our group is composed of a diverse group of family doctors ranging in age from 27 - 75 years old. We care for our patients throughout their lifespan. We stand by our patient’s side during birth, childhood crisis, tragic accidents, chronic disease, joyful ceremonies and death. We carry out our ethical duty to protect our patient’s right to self-determination. We uphold our duty to ensure we are helping our patients remain safe from domestic violence, human trafficking and yes, a forced pregnancy. The decision to carry a pregnancy can be a complex private journey for many of us. Our patients and their families have the right to explore safe, non-stigmatized alternative options based on their individual medical, emotional and other personal circumstances.

We strongly urge the members of this committee to honor the training of family physicians, AMA and our surgical OBGYN colleagues on the private sanctity of this matter by standing up in complete opposition to the legislation HB622, HB625, HB430, HB434, HB596, and HB233.

Sincerely,
Joann Buonomano
 

Patrick Ho, President, New Hampshire Psychiatric Society

To: The Honorable Edward Gordon

From: Patrick Ho, MD, MPH, President, New Hampshire Psychiatric Society

Date: February 8, 2021

On behalf of the New Hampshire Psychiatric Society and our members, I am writing to express our concern about and strong opposition to abortion-related legislation that would interfere with physicians’ ability to provide timely reproductive medical care to women in New Hampshire. We stand firmly with our colleagues from the New Hampshire Medical Society and our state’s other medical societies and believe that such legislation would be detrimental to the practice of medicine in our state.

The New Hampshire Psychiatric Society agrees with the stance of the American Medical Association that all women should have access to reproductive health services, and that this ought to include abortion. The early termination of pregnancy is a safe, established, and accepted medical practice. Physicians should play a key role in helping their patients choose whether, when, and how to perform an abortion without stigma. Furthermore, inability to access adequate reproductive medical care can be extremely detrimental to a woman’s physical and mental health. As physicians who care deeply for the patients that we serve, we believe that efforts to deny access to established and accepted medical services as unacceptable. We strongly urge you and the members of your committee to protect the rights and health of our citizens and reject legislation that would limit timely access to abortion and other reproductive health services.

Thank you for your consideration. Please do not hesitate to reach out to me at [email protected] with further questions.

Sincerely,

Patrick Ho, MD, MPH
President, New Hampshire Psychiatric Society

Ashley Lamb,  MD, MPH, opposing HB 434

To the Members of the House Judiciary Committee,

My name is Ashley Lamb. I am an internal medicine and pediatrics physician. I currently work at the University of New Hampshire Health & Wellness. With this testimony, I represent my views, not the views of UNH.

I am writing to oppose HB 434. Specifically, I am concerned about section 132:44:

“Use of School Tuition and Fees for Abortion Prohibited.  No part of any tuition or fees paid to a public institution of higher education shall be used in any way to pay for an abortion, provide or perform an abortion, make a referral for abortion, or provide facilities for an abortion or for training to provide or perform abortion.”

I am very concerned about how this bill would impact my role as a physician and my relationship with my patients. Students turn to me as a provider to help them when they have questions or concerns about their health. I feel very lucky to be able to help them myself the vast majority of the time by diagnosing and treating conditions such as UTIs, pneumonias and strep throat or by suturing closed a large cut. We cannot, however, provide every service for our patients. We do not, for instance, have dentists or optometrists at UNH Health & Wellness. Therefore, it is also my job to help students get to services that they need that we are unable to provide ourselves. For example, last week when a student came to me with tooth pain, I helped them find a local dentist. Two days ago, a student presented with eye strain from virtual learning and I help them find an optometrist.

Similarly, we do not provide fertility services or abortion care at UNH Health & Wellness. When a PhD student came to me last semester having a difficult time conceiving, I was able to refer her to a fertility specialist. If HB 434 passes, I would be able to refer the next student who comes to me when they are pregnant to an obstetrician for prenatal care but not to an obstetrician for abortion care, no matter the student’s clinical situation. Both prenatal care and abortion care are medically safe and legal. It is not my role as a physician to make decisions for my patients. I provide options and advice and help patients make decisions for themselves. It is also not the role of the legislature to make decisions for physicians or patients. Please do not let HB 434 interfere with the provider/patient relationship.

In conclusion, please oppose HB 434, which would restrict my ability as a physician to speak freely with pregnant student patients about all of the medically appropriate and legally allowed options.

Thank you very much for reading my written testimony. I would love to have delivered it live, but I was unable to take time away from my clinical responsibilities during the pandemic to do so.

Respectfully,
Ashley Lamb MD MPH

Anonymous provider, opposing HB 233:

TESTIMONY: Oppose HB 233

Dear members of the house judiciary committee,

I could not attend today’s hearing, but wanted to submit my opposition to HB233 in written form. Please include it in the permanent record.

As an Obstetrician-Gynecologist, born, raised, and practicing in New Hampshire, I understand that women should be trusted to make decisions regarding their own health, and that these decisions should be guided by medically accurate information.

The public and political discourse regarding abortion can often be inaccurate – and not based on medical science. HB 233, the so-called “born alive” bill, creates an inflammatory and misleading dialogue under the guise of abortion restriction, but would actually dictate how doctors proceed after an early labor with respect to neonatal resuscitation and neonatal hospice.  These situations are complex and devastating; doctors must be able to provide each patient with individualized and compassionate care. 

For example, I met “Leah” under very difficult circumstances.  I was working in the labor triage unit when she presented at 18 weeks of pregnancy, in unstoppable preterm labor.  This was a twin pregnancy conceived using IVF; she had persevered through infertility and multiple medical procedures to try to realize her dream of starting a family.  Unfortunately, her examination showed a fully dilated cervix with regular, painful uterine contractions. Babies born at 18 weeks of gestation have no hope of survival; the lungs and organs are simply not formed enough to sustain life.  When her babies came, one of them passed quickly, and the other made gasping attempts to breathe for just over an hour, during which time she held him on her chest, keeping him warm, singing gently to him, until he passed away as well.  The compassionate care she and her babies received allowed a woman in a terrible circumstance the opportunity to be a mother in her child’s last moments. 

The so-called “born alive” bill ignores medical realities and belittles the real life experiences of families who have faced difficult circumstances like Leah’s.  This bill would force medical intervention even when doing so would be futile, and would strip families from the dignity of compassionate end of life care.  In doing so, this bill would negatively impact families who are grieving a significant loss. Health care decisions should be made by women, in consultation with their loved ones and doctors, not by politicians or legislatures.   New Hampshire has traditionally upheld the values of privacy regarding personal medical decisions. Please oppose HB 233.

NH Provider