Planned Parenthood is calling on Kentucky Gov. Andy Beshear to veto last week’s legislative changes to Kentucky’s abortion ban.

Contrary to Republican backers’ claims, the amendment would do “nothing to improve patient safety,” says a release from Planned Parenthood Alliance Advocates, “and instead puts pregnant Kentuckians’ lives at even greater risk.”?

The organization on Monday sent the Democratic governor a letter outlining its objections to House Bill 90, which was hastily amended last week to spell out when medical providers in Kentucky are permitted to end a pregnancy under the abortion ban’s exemption for preventing serious physical harm or death.

Sen. Julie Raque Adams, R-Louisville, who presented the bill to the state Senate, cited a “desperate need for clarity” as the reason for the amendment.

Republican lawmakers attached the abortion amendment to a bill that was originally meant to clear the way for freestanding birth centers in Kentucky. The surprise action came in the final three days before the General Assembly recessed for the 10-day veto-period.

Tamarra Wieder, Kentucky state director for Planned Parenthood Alliance Advocates, said the measure “will put Kentuckians’ lives in danger by forcing pregnant patients to suffer through medical crises before they can receive care.”?

Planned Parenthood also complains that the Republican-controlled legislature passed the measure with “virtually no input from the public.”

The bill specifies that medical providers can intervene to provide “lifesaving miscarriage management,” remove molar and ectopic pregnancies, treat sepsis and hemorrhage and more.

It also leaves the determination of an emergency to “the physician’s reasonable medical judgment.”

Defining abortion

Anti-abortion activist Addia Wuchner, executive director of Kentucky Right to Life, told a House committee that the measure clarifies “what is not an abortion.”?

Opponents say the bill’s language is misleading.?

Sen. Karen Berg, a physician, cited “misspeak” when voting against the measure in committee last week.?

“When you say that ‘we’re talking about abortions that aren’t abortions’ — they are abortions,” said Berg, D-Louisville.? “The definition of an abortion is the termination of a pregnancy prior to viability. You can talk about spontaneous abortions, you can talk about elective abortions, you can talk about emergent abortions. They’re still all abortions.”?

Planned Parenthood’s statement says: “By codifying anti-abortion rhetoric such as so-called ‘maternal-fetal separation’ and redefining critical, lifesaving procedures as something other than abortion, HB 90 ignores evidence-based medical standards and forces doctors to ignore their years of training.”

Pointing to the bill’s redefinition of abortion, Planned Parenthood cites the American? College of Obstetrics and Gynecology Guide to Language and Abortion. ?The guide says the term “maternal-fetal separation” is used by abortion opponents “to justify or to mandate performing medical procedures that carry more risk for the patient, such as cesarean deliveries or inductions of labor, rather than abortion.”

Dr. Virginia Stokes, an OB-GYN who has protested the state’s abortion laws with Kentucky Physicians for Reproductive Freedom, said in a statement after HB 90 passed that the clarification “creates more restrictions now, and could still result in delayed care for patients.”

“In addition to being callous, this bill is not in line with appropriate standards of care for miscarriage management,” Stokes said. “It does not allow for treatment decisions until the woman’s life is already in danger.”?

Providers have long criticized the ban on those grounds. Dr. Jeffrey M. Goldberg, the legislative advocacy chair for the Kentucky chapter of the American College of Obstetricians and Gynecologists, who worked on the new language, called it “an acceptable short term solution for dealing with a really serious problem that’s in front of us.”?

“We already work within statutory restrictions that are, from a medical perspective, very ambiguous,” Goldberg previously said. “There’s a great deal of work to be done. This is not perfect. I don’t want to give anybody the illusion that we all think this is great.”?

The Republican amendment comes as reports have surfaced across the country, including in Kentucky, of women who say they were denied? access to medication and other care to treat miscarriages and pregnancy complications because of state abortion bans, leading in some cases to preventable deaths. Kentucky OB-GYNs have said the state’s abortion ban is forcing them to violate their oath as physicians and causing “devastating consequences” for patients.?

On Kentucky’s political right the amendment is being applauded. Richard Nelson, the executive director of the conservative Commonwealth Policy Center, said the final version of HB 90, calling it? “clearly pro-woman and pro-child as it acknowledges the unborn as a ‘child’ and asserts that ‘the right to life is the most fundamental human right, forming the basis for all other rights.'”

Kentucky legislature approves late-breaking ‘clarification’ of state abortion law

“The bill legalizes free-standing birthing centers and brings much-needed clarity to health professionals who were previously uncertain about what constitutes an abortion under Kentucky law,” he said.?

Beshear’s office did not respond to a Tuesday inquiry about his plans for the bill.?

Speaking last week about the abortion portion of HB 90, Beshear said: “One question I’m going to have is: Is it more or less restrictive than the current understanding in the medical community that we have right now?”

If he vetoes it, the Republican supermajority can easily override him when lawmakers return to Frankfort on March 27-28 to wrap up the session.

Birth center advocates not involved in crafting amendment

Mary Kathryn DeLodder, the director of the Kentucky Birth Coalition, said the abortion additions were not something her organization worked on. The Kentucky Birth Coalition worked for years to make freestanding birth centers a reality in the state.?

“We are very happy that the bill is passed,” DeLodder said. “It’s interesting to see the discussion not be about birth centers anymore. The conversation has changed, because the bill has changed, and in one way, it’s nice that nobody’s arguing about birth centers anymore.”?

HB 90 still would lift the certificate of need requirement for freestanding birth centers, thus removing a process some have criticized as a “competitor’s veto.”?

Freestanding birth centers are health care facilities that are meant to feel like a home. They do not offer c-sections or anesthesia. They are for low-risk pregnancies, and not every pregnancy will qualify for such a birth.??

CON attempts to certify that there is a need for a service, be that extra beds in a hospital, an extra MRI machine or a new facility altogether, like a freestanding birthing center.?

CON laws are meant to control health care costs by limiting duplicate services, according to the National Conference of State Legislatures (NCSL). Without CON, hypothetically, a community could have many duplicates of the same service. That could force a facility — such as a hospital — to raise prices to compensate for underutilized services brought on by that competition.

Anticipating the end of the certificate of need requirement, several people have already expressed interest in opening a birth center, DeLodder said. She still has concerns about the portion of the bill that requires a medical doctor to oversee the centers.?

“There are some physicians who we know are supportive of birth centers, but how many of them are there out there, and how many of them will be willing to become a medical director is yet to be seen,” she said. “And as people work to develop those relationships in different areas of the state where they wish to open birth centers … I think time will be the only thing that will tell whether that’s going to end up being a challenge or not.”