Missouri Revised Statutes













Chapter 188

Regulation of Abortions

←188.037

Section 188.039.1

188.043→

August 28, 2015

Seventy-two hour waiting period for abortions required--medical emergency exception, definition--informed consent requirements--department to provide model consent forms--waiting period restrained or enjoined, effect of.

188.039. 1. For purposes of this section, "medical emergency" means

a condition which, on the basis of the physician's good faith clinical

judgment, so complicates the medical condition of a pregnant woman as to

necessitate the immediate abortion of her pregnancy to avert her death or

for which a delay will create a serious risk of substantial and

irreversible impairment of a major bodily function.



2. Except in the case of medical emergency, no person shall perform

or induce an abortion unless at least seventy-two hours prior thereto the

physician who is to perform or induce the abortion or a qualified

professional has conferred with the patient and discussed with her the

indicators and contraindicators, and risk factors including any physical,

psychological, or situational factors for the proposed procedure and the

use of medications, including but not limited to mifepristone, in light of

her medical history and medical condition. For an abortion performed or an

abortion induced by a drug or drugs, such conference shall take place at

least seventy-two hours prior to the writing or communication of the first

prescription for such drug or drugs in connection with inducing an

abortion. Only one such conference shall be required for each abortion.



3. The patient shall be evaluated by the physician who is to perform

or induce the abortion or a qualified professional during the conference

for indicators and contraindicators, risk factors including any physical,

psychological, or situational factors which would predispose the patient to

or increase the risk of experiencing one or more adverse physical,

emotional, or other health reactions to the proposed procedure or drug or

drugs in either the short or long term as compared with women who do not

possess such risk factors.



4. At the end of the conference, and if the woman chooses to proceed

with the abortion, the physician who is to perform or induce the abortion

or a qualified professional shall sign and shall cause the patient to sign

a written statement that the woman gave her informed consent freely and

without coercion after the physician or qualified professional had

discussed with her the indicators and contraindicators, and risk factors,

including any physical, psychological, or situational factors. All such

executed statements shall be maintained as part of the patient's medical

file, subject to the confidentiality laws and rules of this state.



5. The director of the department of health and senior services shall

disseminate a model form that physicians or qualified professionals may use

as the written statement required by this section, but any lack or

unavailability of such a model form shall not affect the duties of the

physician or qualified professional set forth in subsections 2 to 4 of this

section.



6. As used in this section, the term "qualified professional" shall

refer to a physician, physician assistant, registered nurse, licensed

practical nurse, psychologist, licensed professional counselor, or licensed

social worker, licensed or registered under chapter 334, 335, or 337,

acting under the supervision of the physician performing or inducing the

abortion, and acting within the course and scope of his or her authority

provided by law. The provisions of this section shall not be construed to

in any way expand the authority otherwise provided by law relating to the

licensure, registration, or scope of practice of any such qualified

professional.



7. If the provisions in subsection 2 of this section requiring a

seventy-two-hour waiting period for an abortion are ever temporarily or

permanently restrained or enjoined by judicial order, then the waiting

period for an abortion shall be twenty-four hours; provided, however, that

if such temporary or permanent restraining order or injunction is stayed or

dissolved, or otherwise ceases to have effect, the waiting period for an

abortion shall be seventy-two hours.



(L. 1979 H.B. 523, et al., A.L. 1986 H.B. 1596, A.L. 2003 H.B. 156,

A.L. 2010 S.B. 793, A.L. 2014 H.B. 1307 & 1313)



*Effective 10-10-14, see § 21.250. H.B. 1307 & 1313 was vetoed July

2, 2014. The veto was overridden on September 10, 2014.



(2006) Informed consent requirement is not unconstitutionally vague,

and twenty-four-hour waiting period does not violate due process

clause of state constitution or state constitutional rights to

liberty and privacy. Reproductive Health Services of Planned

Parenthood v. Nixon, 185 S.W.3d 685 (Mo.banc).





2010

2003

1991



2010



188.039. 1. For purposes of this section, "medical emergency" means

a condition which, on the basis of the physician's good faith clinical

judgment, so complicates the medical condition of a pregnant woman as to

necessitate the immediate abortion of her pregnancy to avert her death or

for which a delay will create a serious risk of substantial and

irreversible impairment of a major bodily function.



2. Except in the case of medical emergency, no person shall perform

or induce an abortion unless at least twenty-four hours prior thereto the

physician who is to perform or induce the abortion or a qualified

professional has conferred with the patient and discussed with her the

indicators and contraindicators, and risk factors including any physical,

psychological, or situational factors for the proposed procedure and the

use of medications, including but not limited to mifepristone, in light of

her medical history and medical condition. For an abortion performed or an

abortion induced by a drug or drugs, such conference shall take place at

least twenty-four hours prior to the writing or communication of the first

prescription for such drug or drugs in connection with inducing an

abortion. Only one such conference shall be required for each abortion.



3. The patient shall be evaluated by the physician who is to perform

or induce the abortion or a qualified professional during the conference

for indicators and contraindicators, risk factors including any physical,

psychological, or situational factors which would predispose the patient to

or increase the risk of experiencing one or more adverse physical,

emotional, or other health reactions to the proposed procedure or drug or

drugs in either the short or long term as compared with women who do not

possess such risk factors.



4. At the end of the conference, and if the woman chooses to proceed

with the abortion, the physician who is to perform or induce the abortion

or a qualified professional shall sign and shall cause the patient to sign

a written statement that the woman gave her informed consent freely and

without coercion after the physician or qualified professional had

discussed with her the indicators and contraindicators, and risk factors,

including any physical, psychological, or situational factors. All such

executed statements shall be maintained as part of the patient's medical

file, subject to the confidentiality laws and rules of this state.



5. The director of the department of health and senior services shall

disseminate a model form that physicians or qualified professionals may use

as the written statement required by this section, but any lack or

unavailability of such a model form shall not affect the duties of the

physician or qualified professional set forth in subsections 2 to 4 of this

section.



6. As used in this section, the term "qualified professional" shall

refer to a physician, physician assistant, registered nurse, licensed

practical nurse, psychologist, licensed professional counselor, or licensed

social worker, licensed or registered under chapter 334, 335, or 337,

acting under the supervision of the physician performing or inducing the

abortion, and acting within the course and scope of his or her authority

provided by law. The provisions of this section shall not be construed to

in any way expand the authority otherwise provided by law relating to the

licensure, registration, or scope of practice of any such qualified

professional.



2003



188.039. 1. For purposes of this section, "medical emergency" means

a condition which, on the basis of the physician's good faith clinical

judgment, so complicates the medical condition of a pregnant woman as to

necessitate the immediate abortion of her pregnancy to avert her death or

for which a delay will create a serious risk of substantial and

irreversible impairment of a major bodily function.



2. Except in the case of medical emergency, no person shall perform

or induce an abortion unless at least twenty-four hours prior thereto a

treating physician has conferred with the patient and discussed with her

the indicators and contraindicators, and risk factors including any

physical, psychological, or situational factors for the proposed procedure

and the use of medications, including but not limited to mifepristone, in

light of her medical history and medical condition. For an abortion

performed or an abortion induced by a drug or drugs, such conference shall

take place at least twenty-four hours prior to the writing or communication

of the first prescription for such drug or drugs in connection with

inducing an abortion. Only one such conference shall be required for each

abortion.



3. The patient shall be evaluated by a treating physician during the

conference for indicators and contraindicators, risk factors including any

physical, psychological, or situational factors which would predispose the

patient to or increase the risk of experiencing one or more adverse

physical, emotional, or other health reactions to the proposed procedure or

drug or drugs in either the short or long term as compared with women who

do not possess such risk factors.



4. At the end of the conference, and if the woman chooses to proceed

with the abortion, a treating physician shall sign and shall cause the

patient to sign a written statement that the woman gave her informed

consent freely and without coercion after the physician had discussed with

her the indicators and contraindicators, and risk factors, including any

physical, psychological, or situational factors. All such executed

statements shall be maintained as part of the patient's medical file,

subject to the confidentiality laws and rules of this state.



5. The director of the department of health and senior services shall

disseminate a model form that physicians may use as the written statement

required by this section, but any lack or unavailability of such a model

form shall not affect the duties of the physician set forth in subsections

2 to 4 of this section.



1991



188.039. 1. No physician shall perform an abortion unless, prior to

such abortion, the physician certifies in writing that the woman gave her

informed consent, freely and without coercion, after the attending physician

had informed her of the information contained in subsection 2 of this section

and shall further certify in writing the pregnant woman's age, based upon

proof of age offered by her.



2. In order to insure that the consent for an abortion is truly informed

consent, no abortion shall be performed or induced upon a pregnant woman

unless she has signed a consent form that shall be supplied by the state

department of health and senior services, acknowledging that she has been

informed by the attending physician of the following facts:



(1) That according to the best medical judgment of her attending

physician whether she is or is not pregnant;



(2) The particular risks associated with the abortion technique to be

used;



(3) Alternatives to abortion shall be given by the attending physician.



3. The physician may inform the woman of any other material facts or

opinions, or provide any explanation of the above information which, in the

exercise of his best medical judgment, is reasonably necessary to allow the

woman to give her informed consent to the proposed abortion, with full

knowledge of its nature and consequences.



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