2009 North Dakota Code
14 Domestic Relations and Persons
14-02.1 Abortion Control Act

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CHAPTER 14-02.1 ABORTION CONTROL ACT 14-02.1-01. Purpose. The purpose of this chapter is to protect unborn human life and maternal health within present constitutional limits. It reaffirms the tradition of the state of North<br>Dakota to protect every human life whether unborn or aged, healthy or sick. 14-02.1-02. Definitions. As used in this chapter: 1. &quot;Abortion&quot; means the termination of human pregnancy with an intention other than to<br>produce a live birth or to remove a dead embryo or fetus. 2. &quot;Abortion facility&quot; means a clinic, ambulatory surgical center, physician's office, or<br>any other place or facility in which abortions are performed, other than a hospital. 3. &quot;Hospital&quot; means an institution licensed by the state department of health under<br>chapter 23-16 and any hospital operated by the United States or this state. 4. &quot;Human being&quot; means an individual living member of the species of homo sapiens,<br>including the unborn human being during the entire embryonic and fetal ages from<br>fertilization to full gestation. 5. &quot;Infant born alive&quot; or &quot;live born child&quot; means a born child which exhibits either<br>heartbeat, spontaneous respiratory activity, spontaneous movement of voluntary<br>muscles or pulsation of the umbilical cord if still attached to the child. 6. &quot;Informed consent&quot; means voluntary consent to abortion by the woman upon whom<br>the abortion is to be performed provided that: a. The woman is told the following by the physician who is to perform the abortion,<br>by the referring physician, or by the physician's agent, at least twenty-four<br>hours before the abortion: (1) The name of the physician who will perform the abortion; (2) The abortion will terminate the life of a whole, separate, unique, living<br>human being; (3) The particular medical risks associated with the particular abortion<br>procedure to be employed including, when medically accurate, the risks<br>of infection, hemorrhage, danger to subsequent pregnancies, and<br>infertility; (4) The probable gestational age of the unborn child at the time the abortion<br>is to be performed; and (5) The medical risks associated with carrying her child to term. b. The woman is informed, by the physician or the physician's agent, at least<br>twenty-four hours before the abortion: (1) That medical assistance benefits may be available for prenatal care,<br>childbirth, and neonatal care; (2) That the father is liable to assist in the support of her child, even in<br>instances in which the father has offered to pay for the abortion; and Page No. 1 (3) That she has the right to review the printed materials described in section<br>14-02.1-02.1. The physician or the physician's agent shall orally inform<br>the woman the materials have been provided by the state of North<br>Dakota and that they describe the unborn child and list agencies that<br>offer alternatives to abortion. If the woman chooses to view the materials, copies of them must be furnished to her. The physician and<br>the physician's agent may disassociate themselves from the materials<br>and may comment or refrain from comment on them, as they choose. c. The woman certifies in writing, prior to the abortion, that the information<br>described in subdivisions a and b has been furnished to her and that she has<br>been informed of her opportunity to review the information referred to in<br>paragraph 3 of subdivision b. d. Prior to the performance of the abortion, the physician who is to perform or<br>induce the abortion or the physician's agent receives a copy of the written<br>certification prescribed by subdivision c. 7. &quot;Licensed physician&quot; means a person who is licensed to practice medicine or<br>osteopathy under chapter 43-17 or a physician practicing in the armed services of<br>the United States or in the employ of the United States. 8. &quot;Medical emergency&quot; means that condition which, on the basis of the physician's<br>best clinical judgment, so complicates a pregnancy as to necessitate an immediate<br>abortion to avert the death of the mother or for which a twenty-four-hour delay will<br>create grave peril of immediate and irreversible loss of major bodily function. 9. &quot;Probable gestational age of the unborn child&quot; means what, in the judgment of the<br>attending physician, will with reasonable probability be the gestational age of the<br>unborn child at the time the abortion is planned to be performed. 10. &quot;Viable&quot; means the ability of a fetus to live outside the mother's womb, albeit with<br>artificial aid. 14-02.1-02.1. Printed information - Referral service. 1. The state department of health shall publish in English, and in every other language<br>that the department determines is the primary language of a significant number of<br>state residents, the following easily comprehensible printed materials: a. Geographically indexed materials designed to inform the woman of public and<br>private agencies and services available to assist a woman through pregnancy,<br>upon childbirth, and while the child is dependent, including adoption agencies.<br>The materials must include a comprehensive list of the agencies available, a<br>description of the services they offer and a description of the manner, including<br>telephone numbers, in which they might be contacted, or, at the option of the<br>department, printed materials, including a toll-free, twenty-four-hour-a-day<br>telephone number that may be called to obtain, orally, such a list and<br>description of agencies in the locality of the caller and of the services they offer. b. Materials, published in a booklet format, designed to inform the woman of the<br>probable anatomical and physiological characteristics of the fetus at two-week<br>gestational increments from the time when a woman can be known to be<br>pregnant to full term, including any relevant information on the possibility of the<br>survival of the fetus and pictures representing the development of a fetus at<br>two-week gestational increments. The majority of the pictures included in the<br>booklet must be full color photograph-style images and the pictures must<br>contain the dimensions of the fetus and must be realistic and appropriate for<br>the stage of pregnancy depicted. The materials must be objective, Page No. 2 nonjudgmental, and designed to convey only accurate scientific information<br>about the fetus at the various gestational ages. The materials required under<br>this subsection must be reviewed, updated, and reprinted as needed. 2. The materials required under subsection 1 must be available at no cost from the<br>state department of health upon request and in appropriate number to any person,<br>facility, or hospital, and, except for copyrighted material, must be available on the<br>department's internet website. The department may make the copyrighted material<br>available on its internet website if the department pays the copyright royalties. 14-02.1-03. Consent to abortion - Notification requirements. 1. No physician shall perform an abortion unless prior to such performance the<br>physician certified in writing that the woman gave her informed consent as defined<br>and provided in section 14-02.1-02 and shall certify in writing the pregnant woman's<br>marital status and age based upon proof of age offered by her. Prior to the period of<br>pregnancy when the fetus may reasonably be expected to have reached viability, no<br>abortion shall be performed upon an unemancipated minor unless the attending<br>physician certifies in writing that each of the parents of the minor requesting the<br>abortion has been provided by the physician in person with the information provided<br>for in section 14-02.1-02 at least twenty-four hours prior to the minor's consent to the<br>performance of abortion or unless the attending physician certifies in writing that the<br>physician has caused materials of section 14-02.1-02 to be posted by certified mail<br>to each of the parents of the minor separately to the last-known addresses at least<br>forty-eight hours prior to the minor's consent to the performance of abortion. When<br>a parent of the minor has died or rights and interests of such parent have been<br>legally terminated, this subsection shall apply to the sole remaining parent. When<br>both parents have died or the rights and interests of both parents have been legally<br>terminated, this subsection shall apply to the guardian or other person standing<br>in loco parentis. Notification by the attending physician is not required if the minor<br>elects not to allow the notification of one or both parents or her guardian and the<br>abortion is authorized by the juvenile court in accordance with section 14-02.1-03.1.<br>None of the requirements of this subsection apply in the case of a medical<br>emergency, except that when a medical emergency compels the performance of an<br>abortion, the physician shall inform the woman, prior to the abortion if possible, of<br>the medical indications supporting the physician's judgment that an abortion is<br>necessary to avert her death or for which a twenty-four-hour delay will create grave<br>peril of immediate and irreversible loss of major bodily function, and shall certify<br>those indications in writing. 2. Subsequent to the period of pregnancy when the fetus may reasonably be expected<br>to have reached viability, no abortion, other than an abortion necessary to preserve<br>her life, or because the continuation of her pregnancy will impose on her a<br>substantial risk of grave impairment of her physical or mental health, may be<br>performed upon any woman in the absence of: a. The written consent of her husband unless her husband is voluntarily separated<br>from her; or b. The written consent of a parent, if living, or the custodian or legal guardian of<br>the woman, if the woman is unmarried and under eighteen years of age. 3. No executive officer, administrative agency, or public employee of the state of North<br>Dakota or any local governmental body has power to issue any order requiring an<br>abortion, nor shall any such officer or entity coerce any woman to have an abortion,<br>nor shall any other person coerce any woman to have an abortion. 14-02.1-03.1. Parental consent or judicial authorization for abortion of unmarried minor - Statement of intent. The legislative assembly intends to encourage unmarried Page No. 3 pregnant minors to seek the advice and counsel of their parents when faced with the difficult<br>decision of whether or not to bear a child, to foster parental involvement in the making of that<br>decision when parental involvement is in the best interests of the minor and to do so in a manner<br>that does not unduly burden the right to seek an abortion. 1. No person may knowingly perform an abortion upon a pregnant woman under the<br>age of eighteen years unless: a. The attending physician has secured the written consent of the minor woman<br>and both parents, if living, or the surviving parent if one parent is deceased, or<br>the custodial parent if the parents are separated or divorced, or the legal<br>guardian or guardians if the minor is subject to guardianship; b. The minor woman is married and the attending physician has secured her<br>informed written consent; or c. The abortion has been authorized by the juvenile court in accordance with the<br>provisions of this section. 2. Any pregnant woman under the age of eighteen or next friend is entitled to apply to<br>the juvenile court for authorization to obtain an abortion without parental consent.<br>Proceedings on such application must be conducted in the juvenile court of the<br>county of the minor's residence before a juvenile judge or referee, if authorized by<br>the juvenile court judge in accordance with the provisions of chapter 27-05, except<br>that the parental notification requirements of chapter 27-20 are not applicable to<br>proceedings under this section. All applications in accordance with this section must<br>be heard by a juvenile judge or referee within forty-eight hours, excluding Saturdays<br>and Sundays, of receipt of the application. The purpose of the hearing before the<br>juvenile judge or referee must be to determine: a. Whether or not the minor is sufficiently mature and well informed with regard to<br>the nature, effects, and possible consequences of both having an abortion and<br>bearing her child to be able to choose intelligently among the alternatives. b. If the minor is not sufficiently mature and well informed to choose intelligently<br>among the alternatives without the advice and counsel of her parents or<br>guardian, whether or not it would be in the best interests of the minor to notify<br>her parents or guardian of the proceedings and call in the parents or guardian<br>to advise and counsel the minor and aid the court in making its determination<br>and to assist the minor in making her decision. c. If the minor is not sufficiently mature and well informed to choose intelligently<br>among the alternatives and it is found not to be in the best interests of the<br>minor to notify and call in her parents or guardian for advice and counsel,<br>whether an abortion or some other alternative would be in the best interests of<br>the minor. 3. All proceedings in connection with this section must be kept confidential and the<br>identity of the minor must be protected in accordance with provisions relating to all<br>juvenile court proceedings. 4. The court shall keep a stenographic or mechanically recorded record of the<br>proceedings which must be maintained on record for forty-eight hours following the<br>proceedings. If no appeal is taken from an order of the court pursuant to the proceedings, the record of the proceedings must be sealed as soon as practicable<br>following such forty-eight-hour period. 5. Following the hearing and the court's inquiry of the minor, the court shall issue one<br>of the following orders: Page No. 4 a. If the minor is sufficiently mature and well informed concerning the alternatives<br>and without the need for further information, advice, or counseling, the court<br>shall issue an order authorizing a competent physician to perform the abortion<br>procedure on the minor. b. If the minor is not sufficiently mature and well informed, the court may: (1) Issue an order to provide the minor with any necessary information to<br>assist her in her decision if the minor is mature enough to make the<br>decision but not well informed enough to do so. (2) Issue an order to notify the minor's parents or guardian of the pendency<br>of the proceedings and calling for their attendance at a reconvening of<br>the hearing in order to advise and counsel the minor and assist the court<br>in making its determination if the court finds that to do so would be in the<br>best interests of the minor. (3) Issue an order authorizing an abortion by a competent physician if the<br>court has determined that it would not be in the best interests of the<br>minor to call in her parents or guardian but has found that it would be in<br>the minor's best interests to authorize the abortion. 6. The minor or next friend may appeal the determination of the juvenile court directly<br>to the state supreme court. In the event of such an appeal, any and all orders of the<br>juvenile court must be automatically stayed pending determination of the issues on<br>appeal. Any appeal taken pursuant to this section by anyone other than the minor or<br>next friend must be taken within forty-eight hours of the determination of the juvenile<br>court by the filing of written notice with the juvenile court and a written application in<br>the supreme court. Failure to file notice and application within the prescribed time<br>results in a forfeiture of the right to appeal and render the juvenile court order or<br>orders effective for all intents and purposes. 7. Upon receipt of written notice of appeal, the juvenile court shall immediately cause to<br>be transmitted to the supreme court the record of proceedings had in the juvenile<br>court. 8. An application for appeal pursuant to this section must be treated as an expedited<br>appeal by the supreme court and must be set down for hearing within four days of<br>receipt of the application, excluding Saturdays and Sundays. 9. The hearing, inquiry, and determination of the supreme court must be limited to a<br>determination of the sufficiency of the inquiry and information considered by the<br>juvenile court and whether or not the order or orders of the juvenile court accord with<br>the information considered with respect to the maturity and information available to<br>the minor and the best interests of the minor as determined by the juvenile court.<br>The determination of the juvenile court may not be overturned unless found to be<br>clearly erroneous. 10. After hearing the matter the supreme court shall issue its decision within twenty-four<br>hours. 11. Within forty-eight hours of the hearing by the supreme court, the record of the<br>juvenile court must be returned to the juvenile court and the juvenile court shall seal<br>it at the earliest practicable time. 12. Nothing in this section may be construed to prevent the immediate performance of<br>an abortion on an unmarried minor woman in an emergency where such action is<br>necessary to preserve her life and no physician may be prevented from acting in<br>good faith in such circumstances or made to suffer any sanction thereby other than Page No. 5 those applicable in the normal course of events to the general review of emergency<br>and nonemergency medical procedures. 13. Nothing in this section may be construed to alter the effects of any other section of<br>this chapter or to expand the rights of any minor to obtain an abortion beyond the<br>limits to such rights recognized under the Constitution of the United States or under<br>other provisions of this code. 14-02.1-03.2. Civil damages for performance of abortions without informed consent. Any person upon whom an abortion has been performed without informed consent as<br>required by sections 14-02.1-02, 14-02.1-02.1, subsection 1 of section 14-02.1-03, 14-02.1-03.2,<br>and 14-02.1-03.3 may maintain an action against the person who performed the abortion for ten<br>thousand dollars in punitive damages and treble whatever actual damages the plaintiff may have<br>sustained. Any person upon whom an abortion has been attempted without complying with sections 14-02.1-02, 14-02.1-02.1, subsection 1 of section 14-02.1-03, 14-02.1-03.2, and<br>14-02.1-03.3 may maintain an action against the person who attempted to perform the abortion<br>for five thousand dollars in punitive damages and treble whatever actual damages the plaintiff<br>may have sustained. 14-02.1-03.3. Privacy of woman upon whom an abortion is performed or attempted. In every proceeding or action brought under section 14-02.1-03.2, the court shall rule whether the<br>anonymity of any woman upon whom an abortion is performed or attempted should be preserved<br>from public disclosure if she does not give her consent to such disclosure. The court, upon<br>motion or sua sponte, shall make such a ruling and, upon determining that her anonymity should<br>be preserved, shall issue orders to the parties, witnesses, and counsel, and shall direct the<br>sealing of the record and exclusion of individuals from courtrooms or hearing rooms, to the extent<br>necessary to safeguard her identity from public disclosure. Each such order must be accompanied by specific written findings explaining why the anonymity of the woman should be<br>preserved from public disclosure, why the order is essential to that end, how the order is narrowly<br>tailored to serve that interest, and why no reasonable less restrictive alternative exists. This<br>section may not be construed to conceal the identity of the plaintiff or of witnesses from the<br>defendant. 14-02.1-03.4. Required notice at abortion facility. 1. Any abortion facility that performs abortions shall display signs that contain<br>exclusively the following words: &quot;NOTICE: No one can force you to have an abortion. It is against the law for a spouse, a boyfriend, a parent, a friend, a medical<br>care provider, or any other person to in any way force you to have an abortion.&quot; 2. The signs must be located so that the signs can be read easily and in areas that<br>ensure maximum visibility to women at the time a woman gives consent to an<br>abortion. 3. The display of signs pursuant to this section does not discharge any other legal duty<br>of an abortion facility or physician. 4. The state department of health shall make the signs required by this section<br>available for download in a printable format on its internet website. 14-02.1-04. Limitations on the performance of abortions - Penalty. 1. No abortion may be done by any person other than a licensed physician using<br>medical standards applicable to all other surgical procedures. 2. After the first twelve weeks of pregnancy but prior to the time at which the fetus may<br>reasonably be expected to have reached viability, no abortion may be performed in<br>any facility other than a licensed hospital. Page No. 6 3. After the point in pregnancy when the fetus may reasonably be expected to have<br>reached viability, no abortion may be performed except in a hospital, and then only if<br>in the medical judgment of the physician the abortion is necessary to preserve the<br>life of the woman or if in the physician's medical judgment the continuation of her<br>pregnancy will impose on her a substantial risk of grave impairment of her physical<br>or mental health. An abortion under this subsection may only be performed if the above-mentioned medical judgment of the physician who is to perform the abortion<br>is first certified by the physician in writing, setting forth in detail the facts upon which<br>the physician relies in making this judgment and if this judgment has been concurred<br>in by two other licensed physicians who have examined the patient. The foregoing<br>certification and concurrence is not required in the case of an emergency when the<br>abortion is necessary to preserve the life of the patient. 4. An abortion facility may not perform an abortion on a woman without first offering the<br>woman an opportunity to receive and view at the abortion facility or another facility<br>an active ultrasound of her fetus. The offer and opportunity to receive and view an<br>ultrasound must occur at least twenty-four hours before the abortion is scheduled to<br>be performed. The active ultrasound image must be of a quality consistent with<br>standard medical practice in the community, contain the dimensions of the fetus,<br>and accurately portray the presence of external members and internal organs,<br>including the heartbeat, if present or viewable, of the fetus. The auscultation of the<br>fetal heart tone must be of a quality consistent with standard medical practice in the<br>community. The abortion facility shall document the woman's response to the offer,<br>including the date and time of the offer and the woman's signature attesting to her<br>informed decision. 5. Any licensed physician who performs an abortion without complying with the<br>provisions of this section is guilty of a class A misdemeanor. 6. It is a class B felony for any person, other than a physician licensed under chapter<br>43-17, to perform an abortion in this state. 14-02.1-05. Preserving life of a viable child - Penalty. An abortion of a viable child may be performed only when there is in attendance a physician other than the physician<br>performing the abortion who shall take control and provide immediate medical care for the viable<br>child born as a result of the abortion. The physician performing it, and subsequent to the abortion, the physician required by this section to be in attendance, shall take all reasonable<br>steps in keeping with good medical practice, consistent with the procedure used, to preserve the<br>life and health of the unborn child. Failure to do so is a class C felony. 14-02.1-06. Soliciting abortions. Repealed by S.L. 1999, ch. 50, § 79. 14-02.1-07. Records required - Reporting of practice of abortion. 1. Records: a. All abortion facilities and hospitals in which abortions are performed shall keep<br>records, including admission and discharge notes, histories, results of tests and<br>examinations, nurses' worksheets, social service records, and progress notes,<br>and shall further keep a copy of all written certifications provided for in this<br>chapter as well as a copy of the constructive notice forms, consent forms, court<br>orders, abortion reports, and complication reports. All abortion facilities shall<br>keep records of the number of women who availed themselves of the<br>opportunity to receive and view an ultrasound image of their fetuses pursuant to<br>section 14-02.1-04, and the number who did not; and of each of those<br>numbers, the number who, to the best of the reporting abortion facility's<br>information and belief, went on to obtain the abortion. Records must be Page No. 7 maintained in the permanent files of the hospital or abortion facility for a period<br>of not less than seven years. b. The medical records of abortion facilities and hospitals in which abortions are<br>performed and all information contained therein must remain confidential and<br>may be used by the state department of health only for gathering statistical data<br>and ensuring compliance with the provisions of this chapter. 2. Reporting: a. An individual abortion report for each abortion performed upon a woman must<br>be completed by her attending physician. The report must be confidential and<br>may not contain the name of the woman. This reporting must include the data<br>called for in the United States standard report of induced termination of<br>pregnancy as recommended by the national center for health statistics. b. All abortion reports must be signed by the attending physician and submitted to<br>the state department of health within thirty days from the date of the abortion.<br>All complication reports must be signed by the physician providing the<br>post-abortion care and submitted to the state department of health within thirty<br>days from the date of the post-abortion care. c. A copy of the abortion report must be made a part of the medical record of the<br>patient at the facility or hospital in which the abortion was performed. In cases<br>when post-abortion complications are discovered, diagnosed, or treated by<br>physicians not associated with the facility or hospital where the abortion was<br>performed, the state department of health shall forward a copy of the report to<br>that facility or hospital to be made a part of the patient's permanent record. d. The state department of health is responsible for collecting all abortion reports<br>and complication reports and collating and evaluating all data gathered<br>therefrom and shall annually publish a statistical report based on data from<br>abortions performed in the previous calendar year. e. The state department of health shall report to the attorney general any apparent<br>violation of this chapter. 14-02.1-07.1. Forms. The state department of health shall make available to physicians, hospitals, and all abortion facilities the forms required by this chapter. 14-02.1-08. Protection of viable fetus born alive - Penalty. 1. A person is guilty of a class C felony if the person knowingly, or negligently, causes<br>the death of a viable fetus born alive. 2. Whenever a fetus which is the subject of abortion is born alive and is viable, it<br>becomes an abandoned and deprived child, unless: a. The termination of the pregnancy is necessary to preserve the life of the<br>mother; or b. The mother and her spouse, or either of them, have agreed in writing in<br>advance of the abortion, or within seventy-two hours thereafter, to accept the<br>parental rights and responsibilities for the fetus if it survives the abortion<br>procedure. 14-02.1-09. Humane disposal of nonviable fetus. The licensed physician performing the abortion, if performed outside of a hospital, must see to it that the fetus is disposed of in a<br>humane fashion under regulations established by the state department of health. A licensed Page No. 8 hospital in which an abortion is performed must dispose of a dead fetus in a humane fashion in<br>compliance with regulations promulgated by the state department of health. 14-02.1-10. Concealing stillbirth or death of infant - Penalty. It is a class A misdemeanor for a person to conceal the stillbirth of a fetus or to fail to report to a physician or to<br>the county coroner the death of an infant under two years of age. 14-02.1-11. General penalty. A person violating any provision of this chapter for which another penalty is not specifically prescribed is guilty of a class A misdemeanor. Any person<br>willfully violating a rule or regulation promulgated under this chapter is guilty of an infraction. 14-02.1-12. Short title. This chapter may be cited as the North Dakota Abortion Control Act. Page No. 9 Document Outline chapter 14-02.1 abortion control act

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