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TCC Letter: Abortion Complication Reporting Procedures

Health and Human Services Commission- Brown Heatley Building

Rules Coordination Office (Attn: Karen Ray, Chief Counsel)

4900 North Lamar Boulevard

Austin, Texas 78751

Re: Comments on Proposed Rule 19R015

August 18, 2019

Dear Mrs. Ray:

As members of the Texas Conservative Coalition (TCC) we write to provide comments in support of the administrative rule changes proposed under project # 19RO15, related to abortion complication reporting procedures. 

Texas has historically required abortion providers to report certain complications arising from an abortion procedure to state health officials. While this reporting is important, it does not accurately capture additional problems or complications that arise after a woman leaves an abortion facility and seeks medical care elsewhere. This issue was addressed in 2017 by the Texas Legislature when reporting requirements were expanded to include certain defined complications and extended to other healthcare providers, such as emergency departments, with the goal of providing state leaders and, most importantly, the women of Texas, with a more comprehensive understanding of the potential dangers that can result from what is often described by abortion advocates as a routine and safe medical procedure. Although abortions have, unfortunately, come to be thought of as routine by some, their safety is not as well- established as advocates would like to claim. 

While nausea, vomiting, abdominal pain, and cramping are considered minor side effects that can occur up to two to four weeks after of an abortion,i a 2018 study explains that major abortion complications can include “uterine atony and subsequent hemorrhage, uterine perforation, injuries to adjacent organs (bladder or bowels), cervical lacerations, failed abortion, [and] septic abortion,” with some of these conditions resulting in death.ii Not surprisingly, the chances and likely severity of risks increases with the gestational age of the pregnancy, with this particular study finding that up to 50 percent of second trimester abortions result in some form of complication.iii It is critical to note that, due to the varying nature of abortion complication reporting laws by state, these figures, and other reported incidents of  abortion complications, may be grossly underestimated.

House Bill 13 (851, Capriglione/ Campbell) was adopted with the specific purpose of ensuring that data on serious abortion complications is made known and includes treatment at the health care facilities (i.e. emergency departments) in which women would mostly likely seek medical care for abortion complications. Although most of the rulemaking needed to implement HB 13 has already been enacted, adoption of these proposed rules, particularly the new Texas Administrative Code §131.61(e), requiring freestanding emergency rooms to follow the same specified reporting requirements as abortion facilities, will help to reduce confusion around HB 13’s requirements and ensure a better understanding of potentially life-threatening abortion complications. We urge you to finalize and adopt these proposed changes as soon as practicable. 

Thank you for your consideration of these comments and the critical work you do on behalf of the people of Texas. Please do not hesitate to contact Tom Aldred, Executive Director of the Texas Conservative Coalition, if you have any questions or would like any additional information concerning TCC’s position on these proposed rules. 



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