Several doctors and a Planned Parenthood chapter filed a lawsuit in federal court on Wednesday challenging North Carolina’s law banning abortions after the 20th week of pregnancy.
The health care providers contend the restriction, which offers exceptions only in cases of narrowly defined emergencies, violates the U.S. Constitution and poses a risk to women’s health.
“The 20-week ban presents physicians with an untenable choice: face criminal prosecution for providing medical care in accordance with their best medical judgment, or refuse to provide the critical care their patients seek,” states the lawsuit filed by Dr. Amy Bryant, a Chapel Hill-based obstetrician and gynecologist; Dr. Beverly Gray, a Durham-based OB-GYN; Dr. Elizabeth Deans, an OB-GYN also based in Durham, and the Raleigh-based Planned Parenthood South Atlantic.
The case was filed the same day that Planned Parenthood groups across the nation filed lawsuits in Alaska and Missouri, making similar challenges against laws they contend are designed to restrict a woman’s right to an abortion.
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The longstanding North Carolina law was amended in 2015 to apply a more narrow definition of what is an emergency.
In Roe v. Wade and related decisions, the U.S. Supreme Court has ruled that women have a right to abortion until the fetus is viable outside the womb — which often is considered to be about 24 weeks. Any ban on earlier abortions must allow exceptions to protect the life and health of the mother, according to the court rulings.
The amendment, which went into effect in January of this year, allows for abortions 20 weeks after the woman’s last menstrual period to “avert her death” or “for which a delay will create serious risk of substantial and irreversible physical impairment of a major bodily function.”
Rep. Paul “Skip” Stam, a Republican from Apex who has been a main sponsor of many state proposals to add abortion restrictions, said the change was made to “close holes” in a 20-week ban that has been in place since the early 1970s, shortly after the Roe v. Wade decision.
“It was full of holes,” Stam said. “This was just using a definition for ‘health’ that the courts have used.”
Stam declined to comment on the lawsuit without studying it first.
The 2015 amendment further specifies that doctors may not consider “psychological or emotional conditions” that might lead to her death or result in bodily harm.
Deans, one of the plaintiffs, grew up in North Carolina and moved back to the state in August 2015. The restriction, she said, has hampered her ability to provide her best care to her patients.
“The providers I know, we all are just trying to do the best we can to help our patients,” Deans said.
The ban, as it’s structured, could force some women to carry pregnancies to term, often at substantial health risks, even when it is clear the newborn will die quickly, according to the lawsuit.
Physicians caring for pregnant women typically do anatomy scans 18 to 20 weeks into a pregnancy, and it is then that diagnoses of severe fetal anomalies can come to light during the course of a wanted pregnancy.
In such circumstances, physicians in North Carolina find themselves in situations where a clock is ticking on options available in this state for the women under their care.
Dr. Matthew Zerden, an OB-GYN who has provided care for Planned Parenthood South Atlantic since 2011, said he has been troubled by an increase in regulations on women’s health care in recent years. Since 2013, legislators have adopted laws that require a 72-hour waiting period before an abortion can be performed, require doctors to submit an “ultrasound image of the unborn child” to the state’s Department of Health and Human Services whenever an abortion is performed after 16 weeks and redefines what a medical emergency is for women seeking an abortion after the 20-week limit.
“This strikes me as one of several laws in our state that are not based on science or medicine,” Zerden said. “They’re based in politics.”
Since the amended 20-week ban went into effect at the start of the year, Zerden said he knows of several dozen patients who have found themselves in situations where they are forced to consider whether to travel out of North Carolina to get abortions.
Most of the patients in those situations have received troubling news from the 18-week anatomy scans. Zerden said the women and their families are thrust into a whirlwind situation — in emotional turmoil over the news about problems with their pregnancy but also facing the 20-week barrier that limits their options in North Carolina.
Physicians who ignore the ban can face criminal prosecution.
Named as defendants in the lawsuit are Jim Woodall, the district attorney of Orange and Chatham counties; Roger Echols, the Durham County district attorney; Eleanor E. Greene, president of the North Carolina Medical Board; Rick Brajer, secretary of the North Carolina Department of Health and Human Services, and people who work for the officials.
Tami Fitzgerald, head of the N.C. Values Coalition and an abortion opponent, echoed a theme that other pro-life organizations have used in pushing for restrictions on exceptions to the 20-week ban.
“When North Carolina legalized abortion over 40 years ago, it did so with a ban on abortions after 20 weeks of pregnancy,” Fitzgerald said. “Based on new scientific discoveries showing that unborn babies feel excruciating pain at approximately 20 weeks of pregnancy, the state adopted a U.S. Supreme Court-sanctioned exception that would allow these late-term abortions only for ‘medical emergencies.’”
Many physicians dispute such claims. They often point to a 2005 study published in the Journal of the American Medical Association and a follow-up in 2013 by the American Congress of Obstetricians and Gynecologists that found no studies contradicting the research to say a fetus’s brain and nervous system are not developed at 20 weeks to feel pain.