Florida issues abortion rules after six-week ban becomes law

By Jim Saunders ©2024 The News Service of Florida

TALLAHASSEE — With a law now in effect preventing abortions after six weeks of pregnancy, Florida healthcare regulators Thursday released emergency rules related to treating medical conditions that pose dangers to the lives of pregnant people or fetuses.

The state Agency for Health Care Administration published two rules that apply to hospitals and abortion clinics. The rules came a day after the six-week law took effect, significantly restricting abortion access in the state.

Regulators focused on certain medical conditions that might occur after six weeks of pregnancy and “can present an immediate danger to the health, safety and welfare of women and unborn children in hospitals and abortion clinics,” according to the rules.

Those conditions are “premature rupture of membranes,” commonly known as a pregnant person’s water breaking prematurely; situations when prematurely ruptured membranes cause doctors to induce births and babies die; ectopic pregnancies; and treatment of what are known as trophoblastic tumors.

The rules involve record-keeping and reporting about the treatments. One of the rules requires hospitals to have written policies and procedures about maintaining records related to treating the conditions. It also includes directives about what must be included in policies.

As an example, the rule said that, under the hospital policies, when a woman is diagnosed with premature rupture of membranes, “the patient shall be admitted for observation unless the treating physician determines that another course of action is more medically appropriate under the circumstances to ensure the health of the mother and the unborn baby.” If doctors choose another course of action, they would have to document the reasons.

Also, both rules say that it “does not constitute an abortion” if doctors try to induce live births and babies die because of prematurely ruptured membranes. Similarly, treatment of ectopic pregnancies and trophoblastic tumors will not be considered abortions. The hospital rule would require doctors to document such treatments in patients’ medical records.

An ectopic pregnancy occurs when a fertilized egg grows outside the main cavity of a woman’s uterus. “The fertilized egg can’t survive, and the growing tissue may cause life-threatening bleeding, if left untreated,” information on the Mayo Clinic’s website said.

Trophoblastic tumors “form during abnormal pregnancies,” with some tumors malignant but the majority benign, according to information on the Cleveland Clinic website. What is known as gestational trophoblastic disease is rare, the website said.

Florida lawmakers and Gov. Ron DeSantis in 2023 approved the six-week abortion limit. But it did not take effect until Wednesday, a month after the Florida Supreme Court upheld the constitutionality of a 15-week limit passed in 2022. The Supreme Court ruling also allowed the six-week law to move forward.

The law includes limited exceptions for when abortions can be performed after six weeks. For instance, it would allow abortions if two physicians “certify in writing that, in reasonable medical judgment, the termination of the pregnancy is necessary to save the pregnant woman’s life or avert a serious risk of substantial and irreversible physical impairment of a major bodily function of the pregnant woman other than a psychological condition.”

But the law’s opponents have contended that the exceptions are impractical and that the six-week limit will threaten the health of women who might have a variety of medical conditions but are unable to obtain abortions.

The rules published Thursday in the Florida Administrative Register pushed back against opponents, citing “disinformation.”

“The Agency (for Health Care Administration) finds there is an immediate danger to the health, safety, and welfare of pregnant women and babies due to a deeply dishonest scare campaign and disinformation being perpetuated by the media, the Biden Administration, and advocacy groups to misrepresent the Heartbeat Protection Act (the six-week law) and the state’s efforts to protect life, moms, and families,” the rules said.