Highlights from the American College of Obstetricians and Gynecologists, et al.'s Friend-of-the-Court Brief in <i>Ayotte v. Planned Parenthood of Northern New England, et al.</i>

The American College of Obstetricians and Gynecologists, in conjunction with the American Medical Association, the New Hampshire Medical Society, the American Academy of Pediatrics, the New Hampshire Pediatric Society, the Society for Adolescent Medicine, the American Psychiatric Association, the North American Society of Adolescent and Pediatric Gynecology, the National Medical Association, and the American Public Health Association, submitted a friend-of-the-court brief to the U.S. Supreme Court in support of respondents in Ayotte v. Planned Parent of Northern New England, et al.

NEW HAMPSHIRE'S FAILURE TO INCLUDE A MEDICAL-EMERGENCY EXCEPTION JEOPARDIZES TEENAGERS' HEALTH

"The failure to include a medical-emergency exception in the [New Hampshire Parental Notification Prior to Abortion Act (hereafter the Act)] jeopardizes the health of New Hampshire minors, some of whom will have conditions that will require immediate abortions to protect their health…the Act would force physicians to violate ethical and professional obligations by requiring them to delay critical treatment in a medical emergency."

"The medically indicated treatment for some serious medical conditions that arise during pregnancy — including certain hypertensive disorders, infections, and placental anomalies — may be the prompt termination of the pregnancy. But the Act prohibits New Hampshire physicians from providing that medically indicated treatment."

"…even a short delay in diagnosis and effective treatment in certain circumstances can lead to increased rates of maternal morbidity. For example, delay in the treatment of chorioamnionitis can lead to widespread infection, including septic shock, and an increased risk of placental abruption. Likewise, even apparently mild preeclampsia can rapidly progress to the most severe forms of pregnancy-induced hypertension. When preeclampsia is severe, delaying termination of the pregnancy — even for the time necessary to obtain a court order — can be calamitous, causing placental abruption, eclampsia, renal failure, hemorrhage, and stroke."

"[P]regnant minors face an increased risk of some specific conditions when compared with adult women. This is due, in part, to the fact that these conditions more often affect women with poor or non-existent prenatal care. Minors, and especially the youngest minors, are the least likely group of women to receive timely, if any, prenatal care. Delayed prenatal care can lead to delayed diagnosis and treatment of conditions complicating pregnancy, and thus higher risks of complications and more advanced disease progression. For example, rates of eclampsia, the most severe form of hypertension in pregnancy, are higher in women who have not received appropriate prenatal treatment."

"[T]he relative rarity of these health conditions does not obviate the need for a medical-emergency exception in the Act. This Court has repeatedly noted that a medical condition's infrequency is irrelevant to whether a health exception is necessary in a law regulating abortion — and for good reason. It is of no comfort to the pregnant minor facing a medical emergency, or to the physician treating her, that most women have uncomplicated pregnancies and thus would never have to avail themselves of a medical-emergency exception."

MEDICAL-EMERGENCY EXCEPTIONS PROTECT TEENAGERS' HEALTH

"The existence of a medical-emergency exception in a law mandating parental involvement does not prevent a physician from contacting a parent in a health emergency if the circumstances permit. Rather, a medical-emergency exception merely provides physicians with a mechanism to treat critically ill patients with necessary speed where the delay in notifying a parent, or obtaining a court order, will itself endanger the patient's health."

"The State's argument that parental involvement is necessary in a medical emergency in the abortion context is inconsistent with the fact that doctors routinely treat minors without parental involvement in other emergency contexts. Thus, in New Hampshire, and throughout the country, doctors routinely provide a wide range of medical services, including surgery and other medical procedures with similar or greater risks than abortion, to minors without prior parental involvement in emergency situations."


MEDICAL-EMERGENCY EXCEPTIONS ARE NOT LOOPHOLES

"By definition, medical-emergency exceptions are intended to address the atypical scenario. This Court has nevertheless regularly required them in statutes that regulate abortion because it has insisted that women's health remain paramount when the state enacts such statutes."

"There is simply no evidence that physicians would [use a medical emergency exception as a loophole]…"


DOCTORS, NOT JUDGES, SHOULD DECIDE WHEN TO TREAT THEIR PATIENTS

"Contrary to New Hampshire's assertions, the Act's judicial bypass option does not negate the need for a health exception, as it does not address situations in which a minor needs emergency medical care before a bypass can be granted. Even very short delays can be catastrophic in a medical emergency."

"[B]ecause medical conditions are inherently unpredictable and change frequently, it is impossible to forecast with certainty when a serious health condition will rise to the level of a catastrophic condition. . . . [P]hysicians must have the ability to act quickly to protect their patient's health. The judicial bypass process, even if operated with dispatch, simply will not be fast enough in some cases."

"New Hampshire is simply wrong when it suggests that courts are the routine forum for determining treatment options in a medical emergency. Courts rarely become involved in medical decision-making. . . . Successful outcomes depend in many cases on physicians' ability to act immediately in a medical emergency."

To read the entire brief, go to: www.ayottevplannedparenthood.org.