Massachusetts Medical Society: Testimony in Support of An Act Removing Obstacles And Expanding Access to Women’s Reproductive Health

Testimony in Support of An Act Removing Obstacles And Expanding Access to Women’s Reproductive Health

The Massachusetts Medical Society wishes to be recorded in strong support of key elements of House bill 3320 and Senate Bill 1209, collectively referred to hereinafter as the ROE Act.  This includes support for provisions in the ROE Act relative to eliminating the requirement of parental consent, updating terminology in the Massachusetts legal code to be rooted in medicine and science, and ensuring safety net coverage for abortion.  As a professional association of physicians and medical students advocating to improve patient care, the Medical Society supports policies that enhance and protect the physician-patient relationship and preserve physicians’ ability to make clinical decisions for the benefit of patients.  We believe these provisions in the ROE Act effectuate those goals.

The Massachusetts Medical Society has long supported legislative approaches to health care issues that provide due deference to medical judgment and due respect to the physician-patient relationship, both within the context of abortion, and relative to clinical care more broadly.  Current Massachusetts law contains antiquated, medically unnecessary provisions that tie the hands of doctors and interfere with the physician-patient relationship, including a statute that unduly regulates physicians’ ability to exercise medical judgment to choose the most appropriate abortion procedure for a given patient.  Our laws politicize the provision of a basic component of healthcare, fundamentally stigmatizing abortion – and both the people who seek it and those who provide it – and causing undue barriers and delays to access care.  The Medical Society supports provisions of the ROE Act that will align laws governing abortion, a valid medical procedure in the continuum of reproductive health care, with those related to all other pregnancy-related care, and modernize state law to conform with current medical standards.  

The Medical Society believes that the only criteria needed to consent to abortion should be pregnancy and medical decision-making capacity.  As such, we support eliminating mandatory parental consent and the judicial bypass process teenagers must navigate to access safe, legal abortion.  Under the ROE Act, the process for minors accessing abortion would be aligned with the process for minors accessing all other pregnancy-related care.  By eliminating parental consent requirements, the ROE Act ensures the small percentage of young people who cannot turn to their parents when they experience an unintended pregnancy will still be protected—without delaying their care or causing them to leave the state to receive it.  Timely access to medical care is especially important for pregnant teenagers because of the significant medical, personal, and social consequences of adolescent childbearing.  Moreover, putting medically unnecessary barriers in the way to care for young people often leads them to seek care out of state, which could jeopardize their health and safety if they are unable to obtain appropriate follow up care as medically indicated.[1]  

The current process requiring a young person to navigate the court system to obtain judicial authorization offers no support or protection for young people, while often causing undue stress, anxiety, and fear.  Under the ROE Act, a young person in need of care would be supported by qualified medical professionals in the Commonwealth who offer non-directive, comprehensive options counseling to all pregnant patients.  Medical providers are most apt to gauge young people’s medical decision-making capacity and necessarily make that assessment in the process of obtaining informed consent from patients.  Where judges lack specialized training in handling these sensitive matters, medical providers are proficient and adept in recognizing abuse and coercion and can connect young people to a network of support.  Moreover, medical providers are mandated reporters under state law and are obligated to report abuse or suspected abuse, including sexual abuse, to the appropriate authorities. 

Not only does the judicial bypass system not support young people, it has harmful impacts.  A recent study of Massachusetts’ judicial bypass system published in the Journal of Obstetrics & Gynecology showed that the judicial bypass process disproportionately affects young people of color and young people of low socioeconomic status, reflective of existing, pervasive inequities in access to health care.  Requiring parental or judicial consent is associated with delays in access for minors seeking abortion.  The aforementioned study found that minors who obtained parental consent experienced an average delay in access to care of 9 days, whereas those who obtained judicial consent experienced an average delay of 15 days.[2]  These unnecessary delays can have a detrimental clinical impact, limiting patients’ care options by rendering them ineligible for medication abortion, a nonsurgical option only available to patients in the first 10 weeks of pregnancy.  In fact, one-in-three minors from the study who accessed abortion through the judicial bypass system lost access to medication abortion.  Delays in access to reproductive health care make care more expensive and increase associated risks of the procedure, ultimately failing to protect the best interests of the patient.  

The ROE Act also removes medically unnecessary statutory provisions and inflammatory language that were written to restrict abortion access and that do not reflect current medical standards. The Medical Society supports provisions of the ROE Act that will update pregnancy and abortion-related medical terminology used in our legal codes to reflect the most recent scientific evidence and knowledge, ensuring Massachusetts laws are rooted in medicine and science. 

Lastly, the Medical Society supports codifying the state safety net program’s coverage of abortion care. The current safety net program helps people with low incomes who are ineligible for MassHealth coverage access pregnancy-related care.  Access to health care is not equitable when it is limited only to those who can afford it.  Enshrining this coverage into law will ensure that when it comes to decisions about whether or not to end a pregnancy, a person has the health coverage they need so they can genuinely access their full range of options and make the medical decision that is right for them.  

The Commonwealth should pass legislation that will respect the rights of pregnant people and recognize abortion as health care.  For these reasons, the Massachusetts Medical Society supports these critical elements of the ROE Act.     

[1] New York and Vermont do not have a minimum age of consent required to access abortion.  In Connecticut, people under the age of 16 are able to access abortion without parental consent

[2] Janiak E, Fulcher IR, Cottrill AA, et al. Massachusettsʼ Parental Consent Law and Procedural Timing Among Adolescents Undergoing Abortion. Obstetrics & Gynecology. 2019;133(5):978-986. doi:10.1097/aog.0000000000003190.

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