Texas House of Representatives

Committee on State Affairs

July 2, 2013

3:30 p.m. – 12:12 a.m.



Link to video of proceedings on Texas House of Representatives website (requires RealPlayer software): http://www.house.state.tx.us/video-audio/committee-broadcasts/committee-archives/player/?session=83&committee=450&ram=13070215450

Link to Witness List: http://www.legis.state.tx.us/tlodocs/83R/witlistmtg/html/C4502013070215301.htm

Committee Members:

Clerk: Toni Barcellona

Rep. Cook, Call to Order and Introductory Remarks


Starts at 0:00:11. Transcribed by David Walton


REP. COOK: The Committee on State Affairs will come to order, and the clerk will call the roll.


CLERK: Cook?


REP. COOK: Here.


CLERK: Giddings?




CLERK: Craddick?


CLERK: Farrar?




CLERK: Frullo?




CLERK: Geren?




CLERK: Harless?


CLERK: Hilderbran?




CLERK: Huberty?




CLERK: Menéndez?




CLERK: Oliveira?


CLERK: Smithee?




CLERK: Turner?




REP. COOK: [Mumbling] A quorum is present. [Unintelligible] I want to welcome everyone and thank you for being here and for your participation.  If I may have everyone’s attention, to please listen closely. I want to remind everyone that this committee has held public hearings to receive testament on this sensitive matter during the first regular session, during the regular session, the first call special session, and then again today.  So that we may hear as many people as possible, each person will be given three, uh, minutes to present their testimony. At two and a half minutes, you will hear a beep, which is an indication that you have thirty seconds to conclude.  It’s important that your, um, remarks, uh, focus exclusively on House Bill 2.   Once again, your remarks must focus exclusively on House Bill 2.  And remember, if you plan to testify, you’ll be required to register under the Electronic Witness Affirmation System prior to giving testimony. If you have not registered through this system, you will not be called up. There are signs posted at this hearing that indicate only those with Capitol media credentials may film or record this committee proceeding. The hearing is broadcast live over the Internet, and is archived for later viewing. Those who do not adhere to these guidelines will be asked to leave. The Department of Public Safety officials are here and available to ensure everyone’s safety and to assist you as needed. Additionally, the two clerks out front are available if you have questions, or if you need additional assistance in registering or in testifying. We have made available nine overflow rooms on this, uh, nine  overflow rooms. Show Representative Craddick here.  On E2, it’s uh, E2, 10, 12, 14, 16, 26, and 28; on E1, 12, 16, and 26.  If you are in an overflow room and we call your name to testify, we may move on to the next witness, but let the clerks know up front that you are here and we will call you up next. I plan to call several people up at a time, so if you hear your name called, please be ready to come. So that witnesses may be swift, uh, may make it swiftly to the front when called to testify, I’ve asked DPS to keep the back of the room and the aisles clear, with the exception of electronic media access.  There are seats reserved on the back row for the media, seats reserved for upcoming witnesses, uh, in the front to the left of the dais, and seats in the middle reserved for House members. We recognize that this issue evokes a lot of emotion and passion responses. However, in order to conduct this public hearing, we, hearing, we must maintain order. I am respectfully giving notice that outbursts and disorderly conduct cannot be tolerated. Such behavior may leave us with no choice but to stand at ease, restore order, or cease taking testimony altogether. Therefore, please show each other mutual respect to everyone trying to participate in this public hearing. I want to remind everyone that as noted in our committee postings, we will take testimony until 12:01 AM on July 3rd, 2013. For those of you who do not get an opportunity to testify before we adjourn, I want to remind you that if you’ve registered through the Electronic Witness Affirmation System, your position on the bill will be indicated in the official record. Uh, before we uh, start, um, um, before we get started, I want to recognize Vice Chairman Giddings to make a statement.




Rep. Giddings, Introductory Statement


Transcribed by David Walton


REP. GIDDINGS: Uh, thank you very much, Mr. Chairman, uh members, uh, much of what I was going to say, Mr. Chairman, you’ve already said, and so I might be a bit repetitive, but that’s okay. Certainly I want to, uh, thank all of those persons who have come here to testify and express their positions on what is obviously a very critical, and very hotly-debated issue. Both sides are very, very passionate, and, as the Chairman has said, this comittee has heard testimony on this issue in the regular session and the first call session. You may think that, that some members may have made up their minds, and that would be understandable. But regardless of what side of the issue we are on, everybody here is committed to have a hearing that is fair, and where every witness is treated with respect. Witnesses, this is your opportunity to bring new information, and to get your comments on the record. You may see some of the members coming, and going, and if that is the case, we want you to know that this is on the Internet, we have it up in our offices, we have it on our iPad, and so we likely will not miss anything that you have to say, even if we do leave for a few minutes. Finally, as the Chairman has said, this committee is asking everyone to refrain from any outbursts, to respect the committee process, to respect one another, and to adhere to the procedures that have been outlined for the hearing. We are aware, and we do apologize, for the technical glitch that we experienced at the last State Affairs hearing, where those who signed up first were called last. We believe that problem has been corrected, but the Chairman just said to me that there are 1,600 people and counting in terms of the witnesses, and probably our system has never seen an overload like this, so if it appears to you that somehow that’s going that way again, there are clerks that will certainly talk to you about that. It’s difficult for us to control the time, and uh, because, uh, likely at some time this evening I will be chairing, I think it was important for the Chairman and I both to say that, uh, you know, we know that witnesses may get emotional, uh, and please understand, uh, we are compassionate, but we are going to try to keep the hearing moving. Um, and again, we thank you for coming, and uh, we are prepared to, uh, hear, uh, your, uh,  testimony.


REP. TURNER: Mr. Chairman, just a couple of process questions.


REP. COOK: Uh, go ahead.


REP. TURNER: OK. Uh, in terms of the order, uh, I know that there are several witnesses who are characterized as experts; are they on your list to come up first?


REP. COOK: We are, uh, Chairman Turner, uh, we’re gonna attempt to work them in as early as we can.  Once again, uh, Chair Giddings, uh, alluded to the fact that the system is being taxed in ways it’s never been taxed before, so, uh, with respect to the number, and it continues to grow, so we’re gonna try to make sure that we get, uh, uh, this new, uh, relevant testimony in.


REP. TURNER: Right, uh, that’s ‘cause, I just wanted to make sure, since, the, the nature of the testimony that’s set for the bill, I know that there are several who’ve indicated at least to me that they’re experts and would like to testify, so that was one. Secondly, um, because of  the nature of this hearing and, um, everything surrounding it, I know that there are, there’s an interest from a couple of people to have, like, court reporters here to, to take down what is being said today. What, what’s your view on that?


REP. COOK: Uh, I, I don’t know that that’s appropriate. Once again, this has been recorded live, we have the media here, uh, um, so I think, uh, I think we need to uh, uh, continue to operate, uh, as we normally do in this and each, each committee. And what I’d like to do is, uh, it is now, uh, uh, uh, a little before 4:00, so the sooner we can get started taking–


REP. TURNER: Right, but–


REP. COOK: –testimony, the better off we’re gonna be.


REP. TURNER: Right, but the, the court reporters are already here, um–


REP. COOK: Well, once again, I don’t think that’s appropriate. Uh, um, so at this time–


REP. TURNER: –Okay, one last, well, I know, I’m sorry, Mr. Chairman, one last question, and because of the, of the number of people that are here, is there a particular reason why we're not using the auditorium today?


REP. COOK: Uh, Representative Turner, once again, uh, one of the things we wanted to ensure was uh, uh, the, uh, maximum security for each person that's here. And, uh, and as a result, this was the recommendation of where we should hold this hearing.


REP. FARRAR: Mr. Chairman, this room is smaller than the, than our typical room, and I understand the, the issues with the Reagan building and why we had to move, but is it, I mean, is the auditorium available right now, because this is a pretty constricted space, and, um the redistricting committee met in there, and I believe, I don't know, this is maybe a hundred people, and maybe the auditorium holds three times that many.


REP. COOK: Once again, Representative Farrar, this room has been recommended, uh, I'm gonna follow the recommendation of the folks that are tasked with making sure that we have security, and, uh, so we're going to be meeting here.  Uh, uh, I would suggest that we get started taking testimony, because we've got a lot of folks who would like, who would like to get started.  I think it will work, if we can get started.  Is there any other question?


REP. TURNER: Are we, are we gonna vote today, Mr. Chairman, or are we gonna vote tomorrow?


REP. COOK: What we're gonna do right now is get through the testimony.


REP. TURNER: But in terms of, when do you anticipate us voting?


REP. COOK: You know, I can't anticipate that until the appropriate time.  So, um, uh, with this, at this time, the Chair is gonna lay out House Bill 2, and call on Representative Laubenberg to explain the bill.




Rep. Laubenberg, Opening Remarks on House Bill 2


Transcribed by David Walton


REP. LAUBENBERG: Mr. Chairman, committee members, it is my desire to allow the most time for all the witnesses who have come, uh, forward today to testify. So, with your permission, I will keep my opening remarks to a minimum.  House Bill 2 addresses abortion law and regulations in our state. House Bill 2 also addresses the health and safety for a woman who undergoes an abortion procedure. There are four main parts to this bill. The thirty-mile rule, uh, where an abortion clinic must be within thirty miles of a local, of a hospital, and the physician must also have admitting privileges. The pre-born pain act, which would limit abortion at five months, with the exception of life to the mother and severe fetal abnormality. The regulation of the RU-486 regimen, um, that must be administered by the FDA guidelines, and must be administered by a physician, and it does allow for the physician to follow the dosage amounts, as defined by the American College of Obstetricians and Gynecologists. The last part deals with the Ambulatory Surgical Centers that abortion clinics beginning in September, uh, 1st, of 2014, would be required to have the equivalent minimum standards of, of, Ambulatory Surgical Centers. With this, Mr. Chairman, I conclude my opening remarks for the bill.


REP. COOK: Members, do we have questions?  Uh, Representative Farrar?  Representative Hilderbran, Hilderbran?




Questions for Rep. Laubenberg from Rep. Hilderbran


Transcribed by David Walton


REP. HILDERBRAN: Thank you, Mr. Chairman. So, on the um, on raising the standards, uh, for the clinics to perform these services, under your bill, they have uh, when does the bill become effective?  Uh, September 1st?


REP. LAUBENBERG: The bill is com–becomes effective, the entire bill will become effective ninety-one days after the end of the session–




REP. LAUBENBERG: –and then the ambulatory–




REP. HILDERBRAN: –have a year in which to comply.




REP. HILDERBRAN: So, we've heard about this bill in committee, and seen reports in the media, and had discussions on the floor.  It's misleading to say that access for early-term abortions would be denied because there wouldn't be access to those services, because they have a year to comply, and there's nothing in the law, uh, to stop them–


REP LAUBENBERG: That's right.


REP. HILDERBRAN: –from elevating their standards so they could comply with the law, and protect the health and safety of the clients.


REP. LAUBENBERG: Absolutely.


REP. HILDERBRAN: The other thing is I, uh, appreciate you raising, is uh, it seems like too much in the media, we see reports of twenty weeks, when we’ve been talking about five months, and so I'm glad you, uh, said that, I know you have before, but, uh–


REP. LAUBENBERG: Thank you, Chairman.


REP. HILDERBRAN: –the, um, what it reminds me of is, we have in current law, which is disturbing, and that is, in current law, we're having abortions at six months.




REP. HILDERBRAN: And all we're talking about, in that provision, is make, uh, restricting them with a four-week difference, so they would not have abortions after five months.  Is that correct?


REP. LAUBENBERG: That is correct.  And now, I'm basing it on the science and technology that we have today, that we did not have forty years ago, that shows that at five months, that baby does feel the pain of an abortion.


REP. HILDERBRAN: Not only that, they can live without the womb, we've had a very recent report on the news of, about a pre-born, uh, a–


REP. LAUBENBERG: That’s right.


REP. HILDERBRAN: –a premature baby, and I know there's been others that've been miraculous and have survived.


REP. LAUBENBERG: That's correct, because, uh, um, this bill bases the age of the baby on what's called the post-fertilization age, which is actually two weeks farther than the um, uh, menstrual age, the gestational age, and so you could be looking at about a twenty-two-week, um, baby.


REP. HILDERBRAN: The objective of this bill, all parts included, but the holistic objective of this bill, is to save lives, to save lives of mothers, of women who are, uh, having these services performed on them, and to protect the unborn.


REP. LAUBENBERG: Abso- Four main points. Women should have a standard of practice and care that is common throughout medicine.  It is for the health and safety of a woman who does, ultimately, choose to have an abortion. Secondly, that babies can feel the pain of abortion at five months. And, last but not least, because it's, it, it focuses on the value of life.








Questions for Rep. Laubenberg from Rep. Turner


Transcribed by David Walton


REP. TURNER: Mr. Chairman?


REP COOK: Rep- uh, Representative Farrar, did you have one first?




REP. COOK: Chairman Turner?


REP. TURNER: Thank you, Chairman Cook.


REP. TURNER: Thank you, thank you, Chairman Cook.  Uh, Representative Laubenberg, just a few questions with respect to, uh, the ambulatory surgical centers and the, uh, and the hospital procedures. What, um, privileges. What happens, and bear in mind, the emphasis has been on the standard of care, standard of the practice, and the health and safety of women, what happens if, um, by imposing the same requirements for the ambulatory surgical centers is the same for the clinics, and then having doctors have hospital privileges, what happens if the effect of that is to reduce the number of clinics from forty-two to five or six?




REP. TURNER: What happens then?


REP. LAUBENBERG: Chairman Turner, my whole focus is on the health and safety of the woman, and you hear lots of things that I do not believe that will happen. I think it's important to make sure that at any stage up to the five months, that a woman has an abortion, that she should have the same level of care as anyone going in for any other kind of procedure.


REP. TURNER: And I, I understand that, and I respect you for that–




REP. TURNER: –but what would take place, though, if the net effect of the bill is to reduce the number of clinics from forty-two to, to, to, let's say to five, that's the number I'm hearing. Would that not have the opposite intent of what, of what you're intending, opposite effect of what you're intending?


REP. LAUBENBERG: Chairman Turner, I, I appreciate your question, it's a very hypothetical question, and my intent of this bill is for the health and safety of the woman.


REP. TURNER: No, let me–




REP. TURNER: I got you, and let me ask it this way, Representative Laubenberg, if, if the clinics were to go out of business, let's say if thirty-seven of the clinics were to go out of business, would that create in, in your, would it be your belief that the woman's safety would be enhanced rather than, uh, negatively affected?  I'm t–




REP. TURNER: What happens if, if, if, thirty-seven clinics go away?


REP. LAUBENBERG: Again, Chairman Turner, very respectfully–


REP. TURNER: Right. I–


REP. LAUBENBERG: –we're talking hypotheticals. The focus is on the health and safety for the woman.


REP. TURNER: OK. What, what would it take, do you know what the cost would be for these clinics to comply with the standards for ambulatory surgical centers?


REP. LAUBENBERG: It would probably vary from clinic to clinic, depending on their location and their construction costs in that area.


REP. TURNER: Okay. And, and many of these clinics, with the exception of, of let's say like Houston, Dallas, San Antonio, many of these other clinics are in, are in, like, the rural settings, okay? Is it your belief that they can, that they have the resources, the financial resources, to comply with the bill as it currently stands?


REP. LAUBENBERG: Yes, Chairman Turner.


REP. TURNER: Okay. Is there anything which, is there anything that, that, you would be willing to include in the bill, that would say that the state would have to, uh, provide the necessary financial resources for these clinics to be able to comply? And the reason why I'm saying–




REP. TURNER: –that is, let's assume everything in your bill is correct. OK? Let's assume that by going to clinics from, from the clinics to the ambulatory surgical centers, that that would enhance the safety of women. Let's just assume that'd be the case. Would it also then be important for the state of Texas, by imposing this bill, putting, enacting this bill, for the state of Texas to provide the necessary funding for these clinics to be able to meet these standards? Would that be acceptable to you?


REP. LAUBENBERG: Chairman Turner, I said this when we had the floor debate, and I'm going to say, uh, uh, stay with the same position that the way the bill is written today is the way that I would like to keep it.


REP. TURNER: No, and I'm s–and I understand that–




REP. TURNER: –I mean–


REP. LAUBENBERG: –are you asking about an amendment?


REP. TURNER: –for example, I'm Vice Chair of Appropriations, and what I'm asking is, would it be acceptable with you, um, and I know if, like yourself and others, would join with me, would it be acceptable say within this bill, the passage of this bill, that the state will have a corresponding responsibility to provide the funding in order to ensure that the clinics, uh, meet the ambulatory surgical center requirements? And I will tell you, to the extent that we can go that far, I am open and receptive, more receptive to your bill.   So I'm, I mean, I'm not–


REP. LAUBENBERG: I appr–I appreciate that very much.


REP. TURNER: –so what I'm saying is that, is there, are you willing to accept, a, a, a revision, an amendment to the bill that says that the funding must cor–must be provided so that the clinics can meet the financial requirements needed to meet the ambulatory surgical center standards.


REP. LAUBENBERG: Um, again, Chairman Turner, you know, I've said that I would like to keep the bill as it is, with no changes. And I can't speak for Appropriations, you probably know that better than I have–or I do, um, but I do believe the focus of this, and this is what I'd like to stay with, if you don't mind, um, is the health and safety aspect of this provision in the bill.


REP. TURNER: Right. But will you, would you join with me in an amendment to this bill that says that for those clinics that are in rural Texas, for example, that might, that may not have the necessary funding to, uh, meet the requirements of the ambulatory surgical centers, that the state will have, that the state must be responsible to providing the necessary funding for these clinics to, to, to meet the requirements in this bill.


REP. LAUBENBERG: Again, very respectfully, Chairman, um, I don't want to take any amendments on this bill at this time, thank you.


REP. TURNER: Okay. Let me ask, then, on another, on another issue then, um, right now, many of the clinics that we're talking about have to be inspected anyway, right now, in, according to state law.




REP. TURNER: Okay. Would you be amenable to, in order to enhance the standard of practice, and for health and safety purposes, would you be amenable, then, simply saying that the state would have to increase the number of inspections of these abortion clinics, without necessarily having to have them meet the ambulatory surgical centers?  For example, I'm saying that instead of, instead of running the risk of clinics being shut down–




REP. TURNER: –that it - that the state would have to inspect these clinics more.  And I would join with you in supporting that mechanism of calling for more inspections of these clinics to make sure that they meet certain health care standards. Would that - would you be amenable to that?


REP. LAUBENBERG: I really appreciate every offer that you've made. Again, I just want to keep the bill in, in the same, um, way that it is, that it's, that I'm presenting it today.


REP. TURNER: But do you think my idea is a good one? My amendment? I mean, do you, do you think it would - it would enhance the safety of clinics for there to be more inspections?


REP. LAUBENBERG: I think raising them to the standards of the ambulatory surgical centers will provide the best, um, level of, um, medical, um,  care for that woman.


REP. TURNER: Then help me to, help me to understand how the - how the women's health care is enhanced if the clinic goes out of business.


REP. LAUBENBERG: Again, that's the hypothetical that, you know, I don't believe, and you may believe, but I, uh, don't believe the clinics will go out of business. And I do think having a higher standard of care, that is common throughout medicine, does, does provide better health care for the, for a woman.


REP. TURNER: Okay. You don't want them to go out of business under your bill. Would that be fair?


REP. LAUBENBERG: I–no. They can be in business.




REP. LAUBENBERG: I just want them to make sure, I just want to make sure that they have–


REP. TURNER: Right, and that's what I'm saying. It's not your goal for them to go out of business.


REP. LAUBENBERG: No, that is not my intent–




REP. LAUBENBERG: –in this bill.  That’s correct.


REP. TURNER: You want them, you want them to stay around, you simply want the standard to, to be raised to the level of the ambulatory surgical centers.




REP. TURNER: Okay. Then will, will you agree with me that if they were to go out of business, if they were to go out of business, that that would be adverse to the health and safety of women.


REP. LAUBENBERG: Again, we're talking hypothetical.


REP. TURNER: I know, Representative, but if they go out of business, what happens if they–


REP. LAUBENBERG: I don't believe they will go out of business.


REP. TURNER: But if they were to go out of business, what would happen–


REP. LAUBENBERG: That's a hypothetical.


REP. TURNER: Will you agree that it would not be in a woman's best health and safety interest if they were to go? I'm, I'm–


REP. LAUBENBERG: I agree that raising 'em to the standard of an ambulatory surgical center will be the best way to help, uh, to have, to provide the health and safety for a woman.


REP. TURNER: Okay. And then on the, on the issue the, the doctor having privileges, it's my understanding that it's not, it's, it's pretty much up to the hospitals to decide what those requirements are.


REP. LAUBENBERG: Yes, it is.


REP. TURNER: A hospital doesn't have to grant you privileges to be–


REP. LAUBENBERG: That is correct.


REP. TURNER: –to be a doctor. What happens then, if, if a hospital says no to, to, to these doctors?


REP. LAUBENBERG: Then it, the hospital and the doctor would, could find out why and raise his standards. Two-thirds of the, uh, uh, abortion physicians have hospital privileges now. And I think, y'know, it's a local community issue, and usually if a doctor is there part of a community, I think he and the hospital can work that out.


REP. TURNER: Right, but the, but the hospitals, I mean you, you recognize, the hospitals are not obligated to–


REP. LAUBENBERG: That is correct.


REP. TURNER: –grant the privileges. Would you be acceptable to an amendment that says that if this bill passes, if this bill passes, that, that the hospitals cannot then refuse these doctors permission.


REP. LAUBENBERG: No, Rep–Chairman Turner.


REP. TURNER: Okay. And then lastly, uh, with respect, uh, there are no exceptions to this bill at all.


REP. LAUBENBERG: There are exceptions. I, I said earlier, and I laid it out, to the physical life of the mother, and the fetal, uh, severe fetal abnormality.


REP. TURNER: Okay. But the exception regarding rape, you're not, you're not open to that amendment.


REP. LAUBENBERG: You, there is rape and incest now. And my bill would take it through five months.


REP. TURNER: But after twenty weeks, is there an exception for rape and incest? There's not.


REP. LAUBENBERG: At twenty weeks, it's five months, is over half the pregnancy.


REP. TURNER: Okay. Let me, let me pause right now–


REP. LAUBENBERG: Respectfully, yes.


REP. TURNER: Okay, I understand. I would like to work with you about amendments to, to, uh, that I believe would be of benefit for the health and safety of women, um, as it relates to this bill.  I think, I think more inspections, I think would be one, I think it's important, if we're going to impose these mandates, and I know there are many people in this room who have consistently been opposed of, uh, to mandates being imposed on local communities. And I would simply say, if we're going to impose these - the mandates in this bill, then the state should be responsible for providing the necessary funding to the local communities. Because, um, based on my read, and correct me if I'm wrong, that to the ex- that the only areas, that may still be able to satisfy the conditions of the bill would be Houston, Dallas, and probably San Antonio. If, I mean, correct me if I'm wrong. And so, I would, I would like to think that if raising the standards is in the best safety and health interest of women, and I'm not gonna argue with anybody on that, let's assume that that is the case, that it's, it creates, um, enhanced safety, um, for women, then the state should also be willing to ante up the necessary funding to ensure that we don't lose the clinics as we raise the standards. Now, I'm prepared to join with you on that.  If, if that is the goal, if that is the intent, and if we are, to support the bill, I'm prepared to join with you on that. But I do think that, uh, we should not be imposing mandates of any kind on local communities, if the state is not also willing to provide the necessary funding to ensure that they meet state mandates. And I don't think, that's not a new position, that is a philosophy that I've learned from many people, uh, in this room, sitting next to a few. I would hope that we would be willing to carry it forward in this particular bill. And that is the amendment that I intend to carry forward, uh, in this committee, Mr. Chairman, if not here, later on the floor. That if we want to do this, then I think the co–the dollars for this bill, so that we do not lose the clinics, should be provided by the state. Otherwise, do not impose unfunded mandates on local communities.


REP. SMITHEE: Mr. Chairman?


REP. COOK: Uh, yeah, uh, I'm gonna go ahead and recognize, uh, Chairman Smithee, and I know–




REP. COOK: –I know you all have–if you'll go ahead and do that, and then what I'd like to do is go ahead and notice my first state witnesses where they can go ahead and come over and sit in the witness area, and then Representative Farrar and Menéndez can ask questions, but at least we'll have our witnesses teed up, 'cause we can talk a long time, but we do have a lot of witnesses, we'd like to get to 'em. So–




REP. SMITHEE: Well, and that's what I was going to say, um Mr. Chairman, you know, we can have these member-on-member discussions on the House floor, we've got unlimited time, but we've got, the list has grown three hundred since, uh, Ms. Laubenberg stood up, and these people have come a long way to be here–


REP. COOK: Well, we're, we're closing in on nineteen hundred–


REP. SMITHEE: –we really–


REP. COOK: –right now, and, um,


REP. SMITHEE: –it's just not fair to take away their time so that we can talk, and I wanna hear what they have to say–


REP. TURNER: But, but this, Representative Smithee, this is at the beginning of a special session. We have, we have over twenty days left. I mean, I could understand if, if that position was being taken in the last [unintelligible] session. But we are imposing these rules. This session is, this special session is thirty full days.


REP. [UNIDENTIFIED]: Today's day two.


REP. TURNER: So don't, uh, don't, the only point that I'm making, the point that I'm making, is that I think we have every right to ask whatever questions we have, as we have done in the regular session. I think we have every right. I am, I, I drove in just like everybody else, some flew. I know that there are some who are interested in, in pushing this thing right on through. But I didn't, I didn't set the limits here. I didn't say cut off at midnight.




REP. TURNER: I understand, but the point that I'm making is, I think, you know, we have every right to ask legitimate questions in good faith. Especially when this is at the beginning of another special session. Now I could understand if we were at the end. I could understand that. But we're not.


REP. COOK: Once again, the, uh, the testimony is gonna be, uh, it's gonna end at 12:01. You know, it's up to the committee, but I would suggest that we prepare ourselves to hear public testimony, uh–


REP. FARRAR: Mr. Chairman, I have to say that, that, midnight deadline is an artificial one. There's no, there's no impetus, and I, I've asked, and I think there's interest, and I think the attendance has shown interest, in the subsequent meeting–


REP. COOK: Once again–


REP. FARRAR: –and the subsequent hearing–


REP. COOK: –we [unintelligible] at 12:01, we're going to end the testimony then. I'd like to get started, but if we want to keep talking, it still, it's, it's, it's–I don't think, uh, I think it'd be more appropriate to, to, to get to the witnesses, which is what I'd like to attempt to do. Matter of fact, uh, I'm, I'm gonna go ahead and call the first state once again–


REP. FARRAR: Sure. I have–


REP. COOK: –we have seating right over here–


REP. FARRAR: Mr. Chairman, I have a question.


REP. COOK: –if you would please let me call the first state, then I'm glad to answer your question. If Ellen Cooper, uh, Dianne Costa, uh, Collette Mazlack, Charles, uh, Lingerfelt, Sarah, is this Splites, Splittes, Carter Snead, Marijane Smitherman, and Karon Stewart, if those witnesses would please make their way into the room, uh where we can be prepared to, to uh, start the testimony, and once again we will be starting with, uh, uh, Ellen Cooper, so, if, so wa–make her way up to, uh, uh, uh, make her way up to the front, once again. Now then, Representative Farrar, uh, go ahead, and I think, uh, Chair Giddings has a, also has a question.




Questions for Rep. Laubenberg from Rep. Farrar


Transcribed by David Walton


REP. FARRAR: Representative Laubenberg, when you filed this legislation, I think you and Chairman Turner spoke about some of the issues.  Did you look at the effects of, of the legislation in terms of closing clinics–was that a concern of yours when you contemplated the legislation?


REP. LAUBENBERG: Representative Farrar, my concern, my interest, is the health and safety of women.




REP. FARRAR: That wasn't my question. My question was, did you look at capacity. Did you look at the potential for, for, for clinic closings?


REP. LAUBENBERG: You asked what my intention was in filing this bill. It is for the health and safety–


REP. FARRAR: I didn't–


REP. LAUBENBERG: –of women


REP. FARRAR: –that wasn't my actual, that wasn't my question. My question was, did you look at the potential effects of your bill and the capacity issue. Did you look at that when you looked at, when you filed this bill.


REP. LAUBENBERG: Representative Farrar, respectfully, my intent for this bill is for the health and safety of women.


REP. FARRAR: Did you look at capacity? Can you answer that? It's a quick, it's just a yes or no.


REP. LAUBENBERG: It's for the health and safety of women.


REP. FARRAR: Okay. You're not gonna answer. Um, did, were you aware at the time it's, it's, that South of I-10, so McAllen, Corpus Christi and West of 35, Lubbock, El Paso, and, and East Texas, Tyler, would not have, were you aware that under the provisions of your bill, would, would potentially not have a facility? Did you look at that?


REP. LAUBENBERG: Again, respectfully, Representative Farrar, it's for the health and safety of every woman who would undergo an abortion.


REP. FARRAR: Is it fair to say you didn't look at that, at the capacity issue?


REP. LAUBENBERG: I am looking at the health and safety of the woman.


REP. FARRAR: All right. Um, did you file your bill in response to any sort of state data that - that talks about how we, how there was an emergency where there were a number of complications or deaths, or–do you have any state data that supports the - the need, to, to go to the ambulatory surgical center standard?


REP. LAUBENBERG: Again, Representative Farrar, women should have a standard of practice that is common throughout medicine. It is for the health and safety, regardless of whatever stage they are in, having an abortion–


REP. FARRAR: Is it, is it fair to say then that, um, you did not, because I assume if you had that evidence, I would use it to prove it up, to prove up my legislation.


REP. LAUBENBERG: I think you will hear a lot of witnesses testifying today that will have a lot of information.


REP. FARRAR: State–from the state, that actually catalogs this as required by law, to, to, that, that is the regulatory body? Did it come from that source?


REP. LAUBENBERG: I can't speak for every witness.


REP. FARRAR: It's just a quick–


REP. LAUBENBERG: –that will be here today.


REP. FARRAR: –question. Is the state coming to speak about evidence?


REP. LAUBENBERG: I think you can have the state as a resource, as a resource witness.


REP. FARRAR: Did you - did you look to the state for this information?


REP. LAUBENBERG: And they may be here today, I'm not sure.


REP. FARRAR: Did you look to the state for this information?


REP. LAUBENBERG: And again, Representative Farrar, I am focusing on the health and safety for women undergoing an abortion.


REP. FARRAR: Um, in your, Okay, I guess you're not gonna answer. Um, in the legislation, the exceptions are very narrow. Um, you don't, the, you, you provide for the life, life-threatening situations and, I, and others about the functionality of, of–


REP. LAUBENBERG: And severe fetal abnormality.


REP. FARRAR: I'm talking about the women right now. I’m talking about the exception on the woman. So, because the constitutional standard talks about the life of the woman–life and health of the woman, and it seems like you've, the, this legislation only talks about the life, but it doesn't talk about the "and health" part. Correct? 'Cause, it wouldn't, for instance, if a woman is undergoing chemotherapy, and um, has to think about, and finds herself pregnant and has to think about, does she, does she continue her - her pregnancy, or does she save her own life–would that woman be protected under - under your legislation, under that exception?


REP. LAUBENBERG: The constitution allows the, Roe v. Wade allows the states to regulate how we want to, uh, determine what's allowed under you know, under abortion–


REP. FARRAR: Under certain parameters–


REP. LAUBENBERG: –certain parameters–


REP. FARRAR: –right, but it also includes, it, it's wide enough to include the health of the woman. And so, your–the language in your bill is pretty narrow and talks about only her, whether she's going to live or die, and–I'll pull it up–necessary to avert the death, or substantial and irreversible physical impairment of a major bodily function, and that's on page two at the top. So your legislation doesn't provide for other exceptions, for her "and health"– it’s pretty narrow.


REP. LAUBENBERG: It provides for the physical health, and the mental health, mental illness is a very–


REP. FARRAR: Okay, I'll get to that point.




REP. FARRAR: Let's talk about the physical health. So this is only physical impairment of a ma- major bodily - major bodily function, or her death, is basically the narrowness of your bill. So if she is, if she finds, if she is going through a pregnancy, and she finds she has cancer, and so, or she's undergoing other kinds of medication that's incompatible with her, with her pregnancy, would she be able to terminate her pregnancy after the twenty-week ban?


REP. LAUBENBERG: If it's affecting the physical life of that woman, and it, it would be allowed.


REP. FARRAR: But it's not necessarily, but it's not necessarily a, a death situation, and it's not necessarily a physical impairment of a major bodily function. So that's...


REP. LAUBENBERG: It, it does say that. Uh–




REP. LAUBENBERG: [Unintelligible] that are necessary to avert the death, or substantial and irreversible physical impairment of a major bodily function, of the pregnant woman.


REP. FARRAR: Does chemotherapy fall under that?


REP. LAUBENBERG: Representative Farrar, I believe that the physical life to the mother, as determined by her doctor, is covered in this bill.


REP. FARRAR: So you're saying that chemother- chemotherapy would fall under one of these two. But what it's not, what if it's not, um, a cancer that's terminal? What if it's, uh, early stages of something else? What if it - what if that's the situation, so you’re not facing death -




REP. LAUBENBERG: If it's going to affect her physical health– if the exception -


REP. FARRAR: But your language doesn't say physical health. Your language says physical impairment of a major bodily function.


REP. LAUBENBERG: Well that is the, that is the intent. This is what Lege counsel gave a broad enough cover cover–language–that it would cover.


REP. FARRAR: I'm sorry, but, just, I don't see that. That's a major–


REP. LAUBENBERG: I’m reading it out of the bill.


REP. FARRAR: –major bodily function is not the same thing. Um, and you were talking about, um, you were talking as well about the psychological, uh,  issues. You don't make an exception for psychological conditions.


REP. LAUBENBERG: That is correct.


REP. FARRAR: So if a woman is, say, on suicide watch, um, she would, and she's beyond the ban, you would–she would be, she would have to continue with her pregnancy?


REP. LAUBENBERG: Again, Representative Farrar, for five months, the woman can have an abortion, for any reason. At five months, that is over halfway through the pregnancy–


REP. FARRAR: I understand that, I know the law. But I'm talking about after the five months.


REP. LAUBENBERG: This bill is dealing with the physical life exception for the mother -


REP. FARRAR: I know that, but - I’m sorry -


REP. LAUBENBERG: - at five months -


REP. FARRAR: I'm talking about a woman on suicide watch. She would have to carry the pregnancy to term, then.


REP. LAUBENBERG: She could have the abortion up to five months.


REP. FARRAR: But not after five months, correct?


REP. LAUBENBERG: That is correct.


REP. FARRAR: All right. Thank you for answering that. Um, also, there is–my final question is in, it, for forty years of, of these cases being litigated, the language on viability doesn't draw it at twenty weeks. In fact, I will read to you, um, that uh, viability is necessarily a flexible term, and that states cannot place viability, which essentially is a medical concept, at a specific point in the gestation period, because when viability is achieved may vary with each pregnancy. Uh, the determination of viability must be left to the physician's judgement. Why do you feel that you need to jump over a physician's judgement?


REP. LAUBENBERG: Okay. This legislation is actually not focusing on the viability, it is focusing on the pain, that there is substantial medical evidence that recognizes that an unborn child is capable of experiencing pain, by not later than twenty weeks. And that -


REP. FARRAR: And viability is a floor, though. And you're, and you're trying to lower the floor. So if we know the Constitutional standard exists, and you're trying to bring it down to this–




REP. FARRAR: –why do you, why are you usurping that–why are you jumping ahead of, of, of the medical profession, basically? Medical opinion?


REP. LAUBENBERG: Again, evidence that we have today, that we did not have forty years ago–we didn't have the technology forty years ago that show the various stages of development of the unborn child. We didn't have the technology forty years ago that show what the unborn child is feeling at various stages. Pain is one of these developments that we have now learned, and that's why I'm focusing on that aspect.


REP. FARRAR: But you, I mean, you recognize this is forty years' worth of litigation. We're not going back in time to forty years. Right?


REP. LAUBENBERG: We always move forward, and this is new evidence, this is new evidence–




REP. FARRAR: These cases have been litigated up to this point, so I'm asking you why, why you are–or, I guess, just straight out, are you trying to redefine viability by, by, by this new standard?


REP. LAUBENBERG: I'm defining what is taking place inside the womb at five months–that a pre-born baby is capable of feeling the pain of an abortion.


REP. FARRAR: And in your mind is that, is that–for you, that's a a viability standard?


REP. LAUBENBERG: That–that gives the state a compelling state interest. I am focusing on the pain.


REP. FARRAR: So you're trying to define–you're trying to, to define viability, then, at the twenty-week timeframe?


REP. LAUBENBERG: I'm not–no, you're talking about viability. I'm talking about pain.


REP. FARRAR: Okay, what, what does pain mean to you? So, if we have a Constitutional standard of viability, what, what–is that where–I mean, are you trying to, to redefine viability at twenty weeks?


REP. LAUBENBERG: I'm defining pain. You're talking about viability. I'm talking about pain.


REP. FARRAR: But we know that if this case is litigated–like all the other, all the other cases, have come back to the same thing, forty years of litigation, have come back to this point of viability. And so, if you know that the floor is this, and you're trying to lower the floor, you know it's not Constitutional. Are you trying–are you trying to prove that it is? Are you trying to prove a new Constitutional standard, is my question.


REP. LAUBENBERG: Actually, I am raising the standard, because with the technology that we have today, pain is a compelling interest for the state to take part in, to protect that baby from that abortion at five months, based on the pain that substantial medical evidence shows us.


REP. FARRAR: Is that–do you believe that's a Constitutional standard?


REP. LAUBENBERG: Yes I do. I do believe that, you know, this will be litigated, and it will probably go up to the Supreme Court, and they will probably take a look at the findings–


REP. FARRAR: Is that your purpose?


REP. LAUBENBERG: My purpose is to stop the pain–stop the baby from having the pain of an abortion. You’re the one talking about -




REP. FARRAR: All right. So if this case is thrown out, as it has been in other case–in other states, or there is an injunction placed against it, as it has been in other states, um, you will pursue litigation? Or, the, the, the supporters of this will pursue litigation? Is that what you anticipate?


REP. LAUBENBERG: I anticipate that people who oppose this bill will probably litigate. Folks that support this, if this passes, would not want to litigate, because we would like to have this in law now to protect that baby.


REP. FARRAR: But if it's thrown out, or an injunction is issued against it?


REP. LAUBENBERG: Again, Representative Farrar, you're talking things. I am here to focus on this piece of legislation, and what is in this legislation, and what my intent for this legislation, and my intent is for the pain -




REP. FARRAR: Okay, I've heard the same answers for everything, so I'll save you and I'll save me the time.






Questions for Rep. Laubenberg from Rep. Menéndez


Transcribed by David Walton


REP. MENÉNDEZ: Mr. Chairman?


REP. COOK: Yes, uh, and then we have Chair Giddings, and I remind you that as, as we're sitting here, we're now approaching 2,000, so it would be nice if sooner than later we could get to witnesses. But go on.


REP. MENÉNDEZ: And, Mr. Chairman, while I respect and appreciate, uh, the, the great efforts that all of these witnesses and people who've come on both sides of this issue–many of our constituents, the hundred and seventy and some odd thousand that each of us represents can not be here, and maybe they have questions that we have to ask for on their behalf. Thank you, Mr. Chairman. Um, Representative Laubenberg, you–and you know, I agree that increasing the health of all Texans should be our overriding, overarching goal. The question that I have is that in your bill, you're making the abortion facilities meet the new ambulatory surgical standards. And the question I have is, do you know if today, at existing ASCs, do you know if physicians are required to have privileges at hospitals? Because your bill requires them. Is that not not correct for an abortion facility?


REP. LAUBENBERG: That is another part of the bill, yes.


REP. MENÉNDEZ: Yes. But it does–your bill requires that an abortion–that a doctor performing an abortion have privileges, correct?


REP. LAUBENBERG: That is correct.


REP. MENÉNDEZ: But currently, state regulations don't require that a doctor at every ambulatory surgical center have admitting privileges at a hospital. I'm not sure if you were aware of that.


REP. LAUBENBERG: What we're talking about is abortion. This is a–




REP. LAUBENBERG: –unique procedure all to its own.


REP. MENÉNDEZ: I see. So–but you do understand, then, that in your bill, though, then you're actually setting a standard more stringent for some ambulatory surgical centers than others. You're saying that it's okay to have a higher standard than–for one set of ASCs than others. Is that correct?


REP. LAUBENBERG: I'm setting the standard for the abortion provider.


REP. MENÉNDEZ: No, I understand, but in, in some times when I hear your, your arguments, I hear you saying we need to raise the standards of an abortion to the same standards as an - as an ambulatory surgical center–they must have these high standards, but then, current ASCs don't have the requirement for doctors to be, to have admitting privileges, so in a sense, you're actually raising them past the ambulatory surgical centers. Shouldn't we just require all ambulatory surgical centers have–because if your logic has been that the abortions should be as safe as other, uh, processes, or other things that are conducted at these, shouldn't they all have the same requirements?


REP. LAUBENBERG: Um, Representative Menéndez, what I'm trying to focus on in this bill, is a very specific procedure that is taking place. It involves women, and I want the best care for women.


REP. MENÉNDEZ: Okay. All right. So, the next question would be: if–don't you agree, that - that hospitals want to ensure safe patient care for all their patients, including abortion patients? Wouldn't you agree with me on that?




REP. MENÉNDEZ: So, the question is, if they're responsible for that care delivered in the hospital, but they, they're not responsible for the doctors performing the–whatever procedure at an ASC, they can't–the hospital's not going to be responsible for those actions, one way or another, so in a sense, regardless of whether or not the physician provides care for that person, it would create a role for the hospital to ensure care for something that happened outside of the hospital, by requiring them to have admitting privileges.  Do you understand the dilemma that you're putting hospitals in?


REP. LAUBENBERG: By having the admitting privileges, then, the doctor already has a relationship with the hospital.


REP. MENÉNDEZ: Correct. But we established early on that the hospitals can't be forced to give them admitting privileges. So isn't this almost an artificial way to, to create a limitation to access?


REP. LAUBENBERG: Actually, it helps the abortion–the abortionist to be more accountable to the medical community in which they provide the, uh, abortions. And I think it would encourage um, you know, a higher standard for the abortion doctors.


REP. MENÉNDEZ: I'm just not sure if there are any hospitals in Texas that currently perform abortions, and so I'm not sure if by requiring the hospitals to give the admitting privileges to the hospital, if you're putting the position–you're creating an, a standard that won't be able to be met. That's all. And, and so, while I probably believe that everyone here agrees with you in wanting to have - have a safer environment for all patients, including women of Texas, I don't want us to use certain artificial barriers to entry that will create a system where no-one would have access to what they're trying to achieve. And that's what the question, the reason I'm asking, because I'm concerned that we're, we're mandating something that hospitals would just refuse to do.


REP. LAUBENBERG: Well, like I said earlier, um, already, you know, two-thirds of them do have admitting privileges, and I think this is going to make sure that those who, uh, are performing abortions have a better relationship in their communities, that they're part of the community. We encourage them to meet the standards of their local hospitals.


REP. MENÉNDEZ: Thank you. I have two amendments that we didn't have a chance to on the floor, to - and one of them has to do–you know, you and I have had long conversations, and you know of my interest in the issues of mental health. I've filed, for years, many many bills on mental health, and I think that you and I agree. And so the question is, do you believe that, um, mental health is any less important than a woman's, uh, physical health?


REP. LAUBENBERG: I think any part of a woman's health is important. But again, in my legislation, you know, my exception is for the physical health.


REP. MENÉNDEZ: And - and the reason I ask, is because we had a lady testify, the last time we had the bill before us, that was on medication that is known to cause birth defects. And her mental well-being requires her to maintain that. So if she were to become pregnant, then she'd have to make a decision: do I maintain–and, and not to try to make any light of it, but my sanity–do I maintain my mental health, for the well-being of the baby, or do I choose–and that - that choice is a box that I would never want anybody to be in, and I'm sure you wouldn't either. It's, it's a difficult–don't you agree it's a difficult?


REP. LAUBENBERG: Again, Representative Menéndez, she would have five months to make that decision.


REP. MENÉNDEZ: I - I understand that, and here's something that has to do with the five-month criteria: going to the case of - of a diagnosis of breast cancer. You don't know when you might be diagnosed with cancer of any kind. What if you get diagnosed with cancer at the nineteenth week, or, or the twentieth week, and then you have two or three children? And so the question is, do you have to make a choice between caring for the children you have, or caring for the child–you're, you're having to choose between not having the chemotherapy, or, or taking care of the baby you're carrying. So that's the reason why I think government putting this artificial twentieth week uh, line, is, is not always a black-and-white decision, because of the fact that there's that case–and how do you feel about that? Where there's a woman who finds out about something that's very serious in the nineteenth or twentieth week, and - and what is she to do?


REP. LAUBENBERG: And again, Representative Menéndez, we are talking about over half the pregnancy, a five-month old baby feeling the pain of an abortion.


REP. MENÉNDEZ: And I, I understand what you're saying, and, and I, but I think the pain of the three, or the two, or the one other child that she may have–and that the–losing his mother, or her mother–


REP. LAUBENBERG: And that would fall under the physical life of the mother.


REP. MENÉNDEZ: So, you're saying–well, I mean, yeah, we don't–I mean, I–so you're saying the doctor would get to determine whether or not the cancer was terminal or not. Is that what you're saying?


REP. LAUBENBERG: [Inaudible]


REP. MENÉNDEZ: Well, I don't know–I don't know if the terminal cancer or not; I'm not a doctor. And I don't think you–


REP. LAUBENBERG: Well, I understand -


REP. MENÉNDEZ: Yeah. So the question–that's, that's the reason why I think these are such difficult issues to put in black and white terms on a piece of legal document–that, that, we're not going to be there to make those decisions. Um, in 2011, do you know how many of these abortions were performed past the twentieth week? Do you know? I, I have it in front of me if you want it.


REP. LAUBENBERG: Yeah, I've got it in a notebook [unintelligible]–




REP. MENÉNDEZ: Yeah, you know it's four hundred and forty-two, or 0.5%, half of one percent were at twenty-one weeks or later, and so obviously this is - is not a large number. And I, I can–I agree with you that–look, if it were up to me, nobody would ever need or want to have an abortion, but it, it's not my decision. I'm never gonna be in that position. So let me ask you about the fetal abnormalities, or anomalies, where you - you have the exceptions. The question that I have is, is there a list of the fetal anomalies?


REP. LAUBENBERG: I’m - I'm following the language that is already in the statute now, in the health and safety codes. Would you like me to read that to you?


REP. MENÉNDEZ: No, no; I’m just - I'm just curious–you don't have to read it to me; I'm just curious because there was a lady, um, who wrote a letter, and um, they had an anomaly that the fetus was going to– uh, there was nothing they could do. The fetus was gonna die, and I'm not sure if it would fall under–this lady was told that the baby would pass at some point, and um, she just couldn't go on, and so–I'll tell you what it is, so that we could see and cross-reference with the situation that you have with your, with your bill, to make sure, because I would not want to have anybody in the position where this lady was forced to carry: hydrops fetalis, in which abnormal amounts of fluid build up in the body. The condition was very grave, and the baby would pass at some point, but they couldn't control or tell the lady when, and where, and she, she ends her letter with saying if the twenty-week ban had been in place four years ago, then I would not have been able to make the choice. Waiting for your child to pass is certainly a viable option for many who have been in my position, but this is–so the path that I chose, or would choose again, physically I face a small chance of developing complications from continuing to carry it while she was sick. Mentally and emotionally, however, I would have deteriorated, and mental illness can be just as debilitating as physical illness. I hate for other families denied the right to choose what's best for them. And she said these decisions, finally, are hard enough without placing extra limits. And so, Representative Laubenberg, while I do not have the capacity to judge you or anybody in this room–I know that, that your, your intentions are good ones–I just think that it's a dangerous place where we start going into, um, making, trying to pass judgement, and I'm fearful that this bill will actually do more harm than good in the long run, because it'll force young women who are ten hours away from a clinic–if, if El Paso loses the clinic, they're gonna–they're–and they feel like they cannot have the baby, and maybe they were a victim of rape or incest, and they've gone twenty weeks because they didn't know, because they might be thirteen or fourteen, and not be aware. We put them in a position where they might have to put their life in danger, and so that's why I am opposed to your bill, and I, I do appreciate and respect you as a person, and your motives, but I just can't support this legislation. Thank you, Mr. Chairman.




Questions for Rep. Laubenberg from Rep. Giddings


Transcribed by David Walton


REP. COOK: Chair Giddings.


REP. GIDDINGS: All right. Thank you, Mr. Chairman; I'll be Uh, very, very, uh, brief. Uh, Representative Laubenberg, on, on, five, six or more occasions, you've indicated that your primary concern and focus is on the health and safety of, of women, and I think all of us want quality health care for women and everybody else, as far as that goes. And I really don't want to have it appear that some of us don't care about the health and safety of women–I, I just think, almost universally, uh, throughout this hundred and fifty members, that all of us care about the health and safety of women. Would you agree with that?


REP. LAUBENBERG: Absolutely.


REP. GIDDINGS: Okay. And, having said that, Representative Laubenberg, a story that I won't repeat today, in the interest of time. You heard me talk about what happened to my assistant's granddaughter, who had liposuction. And so I just happened to be looking through, just while you were talking, and, uh, I want to point this out. Uh, the University of Cincinnati College of Medicine did a study, and its background, they say this. Many state medical boards and legislatures are in the process of developing regulations that restrict procedures in the office setting with the intention of enhancing patient safety. The highest quality data in existence on office procedure adverse incidents have been collected by the state of Florida. And they go on to say that an incident study with prospective data collection was performed. Individual reports that resulted in death or a hospital transfer were further investigated, by determining the reporting physician's board certification status, hospital privilege status, and office accreditation status. In–


REP. COOK: Show Representative Harless here. Excuse me.


REP. GIDDINGS: –Okay. And in three years, uh, they zeroed in on plastic surgery and facelifts, which seem to be the highest of the lot. In three years there were thirteen procedure-related deaths, and forty-three procedure-related complications that resulted in a hospital transfer. At the end of the day, they said that 96% of the physicians reporting these surgical incidents were board-certified, and all had hospital privileges. The conclusion was this: restrictions on office procedures for medically necessary procedures, such as requiring office accreditation, board certification, and hospital privileges, would have little effect on overall safety of surgical procedures in a physician's office. So I guess my premise to you, and my recommendation to you, and my suggestion to you, is that all of us are universally concerned about the health and safety of women as they are involved in whatever medical, surgical procedures that they have–that we could have passed a bill in an instant, I think, if we had a bill that was a bill that dealt with the health and safety of women–whether it was facelifts, liposuctions, or whatever. And so, I, I have some difficulty, just zeroing in on this one thing when we know how much danger there is out there as it res–as it relates to liposuction, and as it relates to facelifts and plastic surgery.


REP. LAUBENBERG: Are you asking–are you just making a statement?


REP. GIDDINGS: I made a statement–




REP. GIDDINGS: –and if you want to respond, that's fine–okay–but I do want–I did want to say that all of us are concerned about the health and safety of women. Thank you.


REP. LAUBENBERG: I do not challenge anyone's intentions, absolutely.




Questions for Rep. Laubenberg from Rep. Huberty


Transcribed by David Walton


REP. COOK: Members, are there any other questions for Representative Laubenberg?


REP. HUBERTY: Just one comment, Mr. Chairman. Uh, Representative Laubenberg, thanks for being here. This seems like deja vu, right? You know, we've been through this three times. Um, you know, and I listened to all of my colleagues on this dais for tens and tens of hours of tes–you know, hours and hours of testimony on this issue, and, and, and I've read the bill. Um, intent of the bill is, is–what you're trying to get after is–and I understand what Chairman Turner was asking you, but it's about, it's about–part of it's safety, right? Second part's fetal pain; there's a drug piece of the bill, right?




REP. HUBERTY: And then the admitting privileges. So I just have one question. Is there anything in your bill that would prevent these clinics–at all–from complying with what you're asking them to do?


REP. LAUBENBERG: Absolutely not.


REP. HUBERTY: So, is it misleading to suggest that everybody's saying that the - the clinics would then close? They have the right to be able to meet the guidelines, right? Just like we -


REP. LAUBENBERG: That's correct, and they have well over a year to do it.


REP. HUBERTY: And, and, we, we come up here every year–every other year, and, and pass legislation, and ask people to comply with a new regulation, whether it's–you know, whatever it may be. Right?


REP. LAUBENBERG: [Unintelligible]


REP. HUBERTY: And so it's up to these clinics to be able to make sure they comply. Is that right?


REP. LAUBENBERG: That is true. That's correct.


REP. HUBERTY: Thank you for bringing this forward. Thank you.






Questions for Rep. Laubenberg from Rep. Turner


Transcribed by David Walton


REP. TURNER: I, I–Mr. Chairman?


REP COOK: Hold on [unintelligible]


REP. TURNER: Thank you, I can't–I can't resist. I can’t resist. And where do they get the money from?


REP. LAUBENBERG: You want to ask me–I think we had that discussion earlier–


REP. TURNER: I know. But I'm saying that there is one fundamental element that would keep clinics from raising their standards–


REP. LAUBENBERG: It's where any of this [unintelligible]–


REP. TURNER: I know. But we are, but we are mandating the standard. I'm not–look–the only point that I'm saying–if you all are would join with me in making sure that the money is provided, on a state mandate, then, then, that's not an issue. But, we–you can't mandate something from the state without also having a responsibility to fund it. I–I think that you're, you're–we cannot ignore that factor. But we are, but we are propose–what's being proposed in HB2 will cost money. And I think it's important to identify how much money it will cost to raise these clinics to that standard. And I - I've yet to hear a figure. I mean, have you seen any?




REP. LAUBENBERG: It will depend on the location and the local construction costs, so–and you're basically talking about, you know, adding a generator, um, filtering system, you know, the hygenical part of it.


REP. TURNER: Well, there's some additional requirements, in terms of spacing–


REP. LAUBENBERG: Right, well–


REP. TURNER: –I mean, that–that–there are several more, there are several more elements–


REP. LAUBENBERG: –well, I'm not disagreeing with that, that cost will vary, depending on where the clinic’s–


REP. TURNER: –I just think at some point, maybe there's an expert who can identify at least what the costs are, so everyone would have a better understanding of what we're proposing. Thank you, Mr. Chairman.




Questions for Rep. Laubenberg from Rep. Farrar


Transcribed by David Walton


REP. FARRAR: And also, Mr. Chairman, the cost of the abortion itself.  I think that needs to be recognized when we're dealing with the issue of access–an undue burden -


REP. COOK: We've got some witnesses that maybe can help with that–


REP. FARRAR: Right, and I'll just tell you, we–do you know what the costs will be–what the cost is at an abortion facility versus at an ASC?


REP. LAUBENBERG: Well, that is determined by the, uh, term of the pregnancy.


REP. FARRAR: I just–I'm talking about, um, I mean throw a figure out there, what have you looked at?


REP. LAUBENBERG: Jessica, I don't have those costs. Um -


REP. FARRAR: I think you should. I, I–I'll say it again to you, $450 at an abortion facility versus over $1200 at an ASC, and I think that's a significant burden on women; I think that's something that we have to, we have to look at. Thank you.


REP. COOK: Uh, Chairman Smithee, did you have any–




REP. COOK: Okay. Okay, members, we're going to–you gonna reserve the right to close?


REP. LAUBENBERG: And, Mr. Chairman I reserve the right to close. Thank you.


REP. COOK: Okay. And, and before we bring up the first witness, uh just to let folks know, if you have written testimony, you uh, uh–DPS has a box out, outside the door, and you can submit it to them, and then your written testimony will be part of the record, so once again: written testimony, please give to DPS outside, and they will make sure that it’s got.




Ellen Cooper, Department of State Health Services, NEUTRAL


Transcribed by Catherine Cook


REP. COOK: With that, I want to call our first witness. Remember when you come up, please state your name, and who you represent, and uh, uh, your position on the bill, for, against, or neutral.  The first witness is, uh, Ellen Cooper, Department State Health Service, here as a resource witness, neutral on the bill. And - and before you start, I wanna make sure, I wanna call up Carl Lindemann, Jane Norwood, James Stewart, and Stacy Wilson, if they would, if they’re not in here, if they’ll come in. Okay, go ahead, Ms. Cooper.


MS. COOPER: I’m Ellen Cooper with the Department of State Health Services.


REP. COOK: And, members, she is here as a resource witness, so, uh, to the extent you have questions, Representative Farrar,  I’ll recognize you for your first question.


REP. FARRAR: Um, Ms. Cooper, or Dr. Cooper, I –


MS. COOPER: Cooper. Ms.


REP. FARRAR: Ms., okay, got it, I’m sorry.  Um, what, uh, thank you for coming, and tell me, what sort of facilities do you regulate?


MS. COOPER: Uh, we regulate all the, uh, non long term care facilities, such as hospitals, ambulatory surgical centers, birthing centers, substance abuse treatment facilities, um, we also do, um, I’m trying to think of what I left out, uh, narcotic treatment programs, um, end stage renal disease facilities, dialysis facilities –




MS. COOPER: I think that’s all of them.


REP. FARRAR: Um, so you regulate doctors’ and dentists’ - dentists’ office where outpatient-


MS. COOPER: We do not regulate any sort of physicians’ offices or clinics-


REP. FARRAR: Even though outpatient surgery is performed there?


MS. COOPER: Well, we, we do if it’s an ambulatory surgical center, but if it’s just a doctor’s office -


REP. FARRAR: Mm-hmm.


MS. COOPER: - or clinic, then no, that regulatory authority would fall under the licensure – the professional licensure of the, uh, medical professionals, uh, such as the um, for physicians, their medical license, medical board-


REP. FARRAR: So it falls under the license but you don’t – you don’t inspect doctors’ and dentists’ offices where outpatient surgery is being performed right now?


MS. COOPER: Correct, we don’t regulate those.


REP. FARRAR: So, um, would you say that abortion clinics have a higher amount of regulations than – and scrutiny than these places where doctors are performing vasectomies, LASIK surgeries, colonoscopies? For instance?


MS. COOPER: Well, I think a key difference is that it’s regulated as a facility versus individual licensed professionals. In the facilities, they are, obviously, the, the physicians and nurses and other professionals are also operating under their own professional licensure, but this is an additional licensure for the facility.


REP. FARRAR: Okay. And can you describe this current regulation that, that abortion facilities are under, and also the auditing and inspection of these- of licensed abortion facilities?


MS. COOPER: Um, uh, these facilities are, uh, regulated under, it’s uh, the Texas Administrative Code and, uh, Chapter 135, and, um, as far as requirements for inspections, uh, that our compliance staff do, they are, um, surveyed every year at the abortion facilities.


REP. FARRAR: And what about –


REP. [UNIDENTIFIED]: Excuse me, can I make one thing clear, I was just gonna ask, you said Chapter 135, that’s the ambulatory surgical center regulation-


MS. COOPER: I’m sorry, uh, 139 is abortion.


REP. [UNIDENTIFIED]: Okay. And 135 are the surgical centers?


MS. COOPER: Correct.


REP. [UNIDENTIFIED]: Okay, that’s good, thanks.


REP. COOK: Go ahead, Representative Farrar, do you have any other questions?


REP. FARRAR: I’m sorry, I – uh – where were we?


MS. COOPER: Just, uh, that every year, every licensed abortion facility -


REP. FARRAR: Oh, yeah, the -


MS. COOPER:  has to be surveyed, um, in addition to any sort of –


REP. FARRAR: As opposed to the other facilities that you – the hospitals, the other facilities that you – that you inspect, what is - what is, what’s the inspection rate on those other facilities?


MS. COOPER: It varies somewhat, um –


REP. FARRAR: Examples?


MS. COOPER: They try, for example, at ASCs to, um, do surveys – they try every three years but it can be up to six years.


REP. FARRAR: Three years? ASCs are checked every three years but licensed abortion facilities are checked every year?  That seems a bit –


MS. COOPER: That’s right.


REP. FARRAR: - that the regulations are stricter, then, for, for abortion facilities. I understand, too, that the inspections are surprise inspections, correct?


MS. COOPER: That’s right, they’re unannounced.


REP. FARRAR: All right. Um, and uh, so we have a three-year inspection  on the ASCs, can you explain the difference between an ASC and an abortion facility? And what, uh, and what’s the purpose of an ASC?


MS. COOPER: Okay. Well, um, ambulatory surgical centers , um, they perform a wide array of surgical procedures comparable to that in an operating room in a hospital. Um, they have a lot of, um, yeah I can’t specify all the procedures that they do because they’re fairly extensive, but they’re based on, uh, being outpatient, um, the people are not admitted as inpatients. That’s the key difference, I think, between those and hospitals.


REP. FARRAR: Okay. Um, and under this legislation, medical abortions are gonna be required to be done now at an ASC, so could you explain what the medical benefit of early abortion care would be to have it done at an ASC?


MS. COOPER: I wouldn’t be able to answer that, um, it’s medication administration?


REP. FARRAR: But there are no incisions, no general anesthesia, no –


MS. COOPER: Correct.


REP. FARRAR: None of that, so I guess I’ll ask a med- a medical expert on that one. Um, would you say that, um, licensed abortion facilities are as well if not more regulated than the ASCs?


MS. COOPER: They’re, they’re so different in certain respects, um, you can’t really compare those, it’s – each of the health facilities has their own regulatory requirements and, and vary a great deal, so it’s, it’s just not really possible to answer.

REP. FARRAR: Would - would you say that your team that does these audits, ‘cause I understand they’re all – they fan out all over the state – would you say that your team does a good job at auditing these facilities?


MS. COOPER:  Well (laughs), I’d like to say they do, I, that’s so subjective, I just, I –


REP. FARRAR: But they meet – I mean, are they – are you getting reports back that these are, uh, these facilities have high rates of infections, that they, um, are unsanitary, things that have been alleged?


MS. COOPER: Um, it may be helpful, I do have, um information in terms of, um abortion facilities and some complaint data, but I don’t have, um, can’t really answer that.


REP. FARRAR: Do you have a high rate, um, well, let me back up a little bit. Um, are abortion facilities required by law to report complications?


MS. COOPER: Yes. They are.


REP. FARRAR: Okay. And, um, can you tell me about some of that, uh, how, um, what about if there’s a death at a clinic?


MS. COOPER: Um, if there’s ever any, uh, maternal death related to, uh, an abortion, it has to be reported to the department immediately.


REP. FARRAR: Okay.  Um, and, would you s– what is the rate of – how many deaths have there been, I mean, I’m just wondering why – why we’re trying to increase – to overregulate to a level where, um, we, I mean, is there – I’m trying to determine the need. Have you had, uh, what is – I mean, how many deaths have occurred in, say, the last, um, since 2000?


MS. COOPER: Um, I, I have, um, the data that’s, um, available on our website, uh, from our Center for Health Statistics, which, uh, indicates that there have been five deaths from 2000 through 2011, um, and we’ve had no additional deaths reported.


REP. FARRAR: Okay, um, and would you say, um, you say that, um – I’m looking at something also, as well – that you have one complaint from an abortion facility currently on file? Is that correct?


MS. COOPER: Um, I can’t really answer, I know we –


REP. FARRAR: This is - this is for the last year.


MS. COOPER: Um, I can’t answer how many complaints –


REP. FARRAR: I’m sorry, not a complaint, it’s an enforcement action, forgive me. So this has actually been investigated and you’re up to point.  You’ve had one?


MS. COOPER:  Right, we’ve had–


REP. FARRAR: Is that correct?


MS. COOPER: We have an elevated enforcement process so that, um, if there are any particularly egregious, um, situations, or anything that is considered serious enough that it rises to our Enforcement Review Committee, um, and then, um, as far as, um, I believe I have May 2012 through May 2013 and there was one facility that had an elevated enforcement action.


REP. FARRAR: And can you talk about what that – what the issue was in that – in that enforcement action?


MS. COOPER: I don’t, I don’t know. Um –


REP. FARRAR: If I told you it was a failure to turn in a report, would that be –


MS. COOPER: Oh, it is, actually –


REP. FARRAR: - correct?


MS. COOPER: - I think, um, it had to do with reporting data.


REP. FARRAR: All right.


MS. COOPER: That’s on our website.


REP. FARRAR: And how many ASCs do you have – do you inspect?


MS. COOPER: There are 421 ASCs.


REP. FARRAR: Okay. And you have 37 abortion facilities, correct?


MS. COOPER: As of today there are 36.


REP. FARRAR: Okay. Thank you. And so, all right. And how many enforcement actions do you have currently on file with ASCs?


MS. COOPER: I believe in that same time period there were six?


REP. FARRAR: All right. Thank you. Um, on abortion facilities, are they required to have a quality assurance program?


MS. COOPER: Yes, they are.


REP. FARRAR: Are they required to have infection control?




REP. FARRAR: Are they required to have emergency drills and protocols for emergencies?


MS. COOPER: Correct.


REP. FARRAR: When a complication occurs in an abortion facility, what is the medical protocol?


MS. COOPER: Um, in an abortion facility, the, uh, as far as our regulations, the physicians are required to either have, um, admitting privileges, or they have, um, an agreement or set-up process in place with a physician who - who does have admitting privileges –


REP. FARRAR: And this is for an abortion facility or an ASC?


MS. COOPER: That’s an abortion facility.


REP. FARRAR: Okay. And the transfer – the agreement transfer – I understand has also to do with the medical records, so –




REP. FARRAR: -  it goes with them, is that correct?


MS. COOPER: That is for ASCs.




MS. COOPER: Uh, ASCs require either, uh, physician privileges or that a written transfer agreement is in place.


REP. FARRAR: Okay, but if something goes wrong, I mean, what, what – what’s gonna happen?


MS. COOPER: Generally, uh, either facility is gonna call 911 and, um, that person will be taken to an emergency department at the closest hospital.


REP. FARRAR: Okay. So it’s the same. Um, so, abortion - abortion procedures right now are required after 16 weeks to be done at ASCs, correct?


MS. COOPER: Correct.


REP. FARRAR: Um, is there a difference in the rates of complication in those performed now at ASCs versus abortion, uh, facilities?


MS. COOPER: I, I really don’t know. Um, I can say there are several ways that complications of all abortions at any location are, um, they all have the same requirements in terms of reporting, so, um, I can’t distinguish –


REP. FARRAR: Do you have data that would cause us concern, I mean, is there s– I’m trying to determine the reason for having this. Has there been a spike in incidents? Has it been a growing trend? I mean, do you have any sort of data that would cause alarm for yourself and the inspectors to require a change to a higher standard?


MS. COOPER: I’m not aware of anything, um, but you know, I can’t say one or - one way or the other, really.


REP. FARRAR: Okay. So, if, um, can you explain specifically why requiring abortions to be done in an ASC would reduce complications, and which complications those – do you believe would be addressed?


MS. COOPER: I can’t answer that –


REP. FARRAR: Okay. I’ll ask the medical person, thank you. Um, do you know what the rate of complication is in Texas?


MS. COOPER: I don’t.


REP. FARRAR: Okay. So, is it safe to say that it hasn’t caused alarm?


MS. COOPER:  Not that I’m aware of.


REP. FARRAR: You don’t – you’re not receiving information back from your inspectors that would cause alarm, then?


MS. COOPER: Correct.


REP. FARRAR:  Okay. Uh, let’s see. I may have other questions, Mr. Chairman, but I’ll yield for the moment.


REP. COOK: Uh, uh, Chair Harless has a question.


REP. HARLESS: Hi. Um, it’s my understanding from the testimony that we’ve heard, either today or past testimony on this, that there are 400 such ambulatory sur- surgical centers across Texas. Is there any reason why a abortion provider could not contract with one of those ambulatory service centers? Surgical?


MS. COOPER: I, I, there would be no reason that I would know of in terms of our regulatory function.


REP. HARLESS: Okay. So, in essence, they could contract with one of these centers and still provide their abortion services.


MS. COOPER: Correct.


REP. HARLESS: Thank you.


REP. COOK: Members, any other questions before we go to the next witness? Uh, Chairman Turner?


REP. TURNER: You know, Ms. Cooper, that’s an interesting question. Have you looked at the bill? Do you know whether or not the bill will allow that to occur?


MS. COOPER: As far as –


REP. TURNER: Whether or not allow a clinic to contract with an ambulatory surgical, uh,  center. The way I’m reading it, I don’t, I don’t see that, but that would be an interesting concept.  Do you know how much it would cost for a clinic to go from being a clinic to an ambulatory surgical center? Any idea?


MS. COOPER: I really don’t have – you know – a way to give an official number. It, it varies, um, in terms of whether, uh, someone were to purchase a new facility, build a new facility, do construction –


REP. TURNER: Your job is primarily to look at whether or not they are complying.


MS. COOPER: Right. We do, um, the original licensure, which, uh, I manage licensing for health facilities, and then we do the compliance as well as the enforcement piece.


REP. TURNER: And, and – and I – I just – I wanna be clear. What is – are you seeing a problem out there with the clinics now as relates to the health and safety of women in these, in these abortion clinics, the 36 that exist in the state of Texas?


MS. COOPER: Not to my knowledge.


REP. TURNER: Would it be helpful to have more insp—right now they’re being inspected once on an annual basis.  Would it be helpful to have more inspections?


MS. COOPER: I can’t answer that.


REP. TURNER: Okay. Do you think it would make any difference at all in – well, you’re on the compliance –


MS. COOPER: That’s an opinion –


REP. TURNER: Yeah, you’re on - well, you’re on the compliance portion. But I think it’s important to note what the problem is that we’re trying to fix. That’s what I’m trying to get an understanding of. So, is – from your vantage point, from what you’re seeing, talking to your staff, to the people out there in the field, is there – is there a problem out there that you all have identified from a compliance point of view that needs to be addressed by those of us in the legislature?


MS. COOPER: Not that I’m aware of.


REP. TURNER: Fair enough. Thank you. Thank you very much.


REP. COOK: Chair Menéndez.


REP. MENÉNDEZ: Thank you, Mr. Chairman. I – earlier in your testimony I believe you, um, also mentioned that you regulate the, uh, birthing centers, is that correct?


MS. COOPER: That’s correct.


REP. MENÉNDEZ: Um, at the last time we heard this bill, we had some – we had an OB/GYN stand at the podium and testify that, um, the birthing process was more, uh, dangerous than, an actual, uh, abortion. The question that I have is, do the birthing centers have the same level of regulatory compliance that the ASCs have? Are they as high or are they as low – do they –


MS. COOPER: Again, it’s really difficult to compare facility types –


REP. MENÉNDEZ: No, no, I know, but –


MS. COOPER: I can say they, they –


REP MENÉNDEZ: Do you inspect them once a year?


MS. COOPER: No. And –


REP. MENÉNDEZ: How often do you inspect the birthing centers?


MS. COOPER: I can find out. I’m not sure. I, I think abortion facilities are the only ones done annually.


REP. MENÉNDEZ: Annually. And, in that report, or the evidence that was presented earlier, the one enforcement action came about because of some paperwork, is that correct?


MS. COOPER: My – as I recall, it is - it was related to required reporting that the facility hadn’t, uh, reported in a timely manner. But I – again, I’m not certain. That’s my memory, so –


REP. MENÉNDEZ: I’m trying to have some research done on the, uh, mortality – mortality rates between the – the procedure of abortion and – and birth rates, and I’m sure you don’t have that, uh, but I’m gonna get something to that effect. Thank you. Thank you, Mr. Chairman.


REP. COOK: Yes, Chair Giddings.


REP. GIDDINGS: Yes, just one quick question. I, I think I understood you to say that you don’t regulate or have oversight – uh, oversight over the office, for instance, of a plastic surgeon.


MS. COOPER: That’s correct.


REP. GIDDINGS: You do not. Thank you.


REP. COOK: Representative Farrar.


REP. FARRAR: Clarifying question on the – on the, uh, if an ASC – you have all these ASCs and five are - provide abortion services – would – if anyone – if a -  if a facility, an abortion facility, contracted with an ASC, would that ASC have to become – meet some other kind of regulation standard, or would it – would it change their - their regulatory, uh, conditions?


MS. COOPER: Not to my knowledge. Um, they are – abortion facilities and ambulatory surgical centers are two distinctly different facility types –


REP. FARRAR: Mm-hmm.


MS. COOPER: And, um, the ambulatory surgical centers, uh, it’s within their scope of practice to perform abortions, but the majority of those facilities do not. So –


REP. FARRAR: So – okay. But under the legislation, you would – I don’t see it either, providing a provision for a contracting –


MS. COOPER: To my knowledge, there’s –


REP. FARRAR: - situation.


MS. COOPER: No – there would be – there’s certainly nothing in our regulatory licensing rules that would prohibit that, and nothing I’m aware of in the legislation.


REP. FARRAR: Thank you.


REP. COOK: So in conclusion, uh, an abortion doctor could contract with an ASC, uh, service. Correct?


MS. COOPER: That would be my understanding, yes.




Dianne Costa, FOR


Transcribed by Catherine Cook


REP. COOK: Okay. Members, any other questions? If not, we’re gonna go ahead and call our next witness. Uh, Dianne Costa, here representing herself, uh, to speak for the bill. Dianne Costa? And Dianne, now, we’re - I’m gonna put you on a – you’re officially the first one on a timer, okay?


MS. COSTA: Put it on!


REP. COOK: Three minutes. All right, let’s roll. Thank you.


MS. COSTA: Thank you. My name is Dianne Costa. My address is 3119 Misty Oak Drive, Highland Village, Texas, in Denton County. I am owner of Coun- CEMA – Counseling, Education and Mediation Associates of North Texas. I was born and raised in San Antonio, Texas, went to Baptist Memorial Hospital School of Radiology, where I worked in the areas of nuclear medicine, radiation therapy, and ultrasound. As a 20-year-old, I was part – part of my job –


REP. COOK: And just to make sure, you are testifying for the bill.


MS. COSTA: I’m for the bill.


REP. COOK: Okay. Go ahead, then.


MS. COSTA: - of my requirements was to perform ultrasound on women seeking abortion and giving their clinic results as to the age of the child. Um, I later was employed at Wilford Hall, Lackland Air Force Base, where I was employed for approximately ten years. I met my husband, Dr. Dennis Costa, there. He’s a hematologist and oncologist. We’re blessed to, uh, have nine children. Seven boys, two girls. Sixteen grandchildren with two more on the way. We believe that we were to populate the earth, (laughs), we took it literally. Um, but, um, I’m also the former mayor of the city of Highland Village, Texas. I was there, uh, for eight years on the council, four years, uh, councilmember, four years as mayor, til my term limit in 2010. I currently serve on the governing board of the Texas Health Presby Hospital in Flower Mound, Texas. So, kind of with that backdrop, I want to address, uh, the issue before us here today. Uh, while people are passionate about this, I really don’t see this as a pro-choice/pro-life issue. Um, abortion is legal in Texas. This is about raising, in my opinion, the health standards of the facilities. It’s a medical issue and safety for women. As a former elected official, it is our responsibility to educate those we represent to the defined meaning of each piece of legislation. I have been on the other side of this podium, so I want to say thank you so much for your service because, um, you don’t get paid the big bucks, right, to do this? Um, but you have, we all have a profound burden to educate our constituents. So let’s not, um, get distracted through the emotions and fear tactics. Um, we all know that many of the facilities that we’re talking about do have financial resources, um, they do receive, many of them, state funds, federal funds –


REP. COOK: Thirty seconds.


MS. COSTA: Okay. So, um, so it’s their – it’s their job to educate their constituents. So, um, we know that physicians serve in this area – in that – many in these outlying areas – and they wouldn’t be able to serve if they didn’t accept Medicaid, Medicare, so there are, um, availability for these people to get – the women to get the resources that they need. It can’t be distracted from what the real issue of this is, so I want us to stay focused on what this is. Um, I have a report here from Stanford University that basically says, um, that abortions performed 21 weeks or later, there was more of a 75 times higher –


REP. COOK: Time’s up.


MS. COSTA:  And thank you so much –


REP. COOK: And just a reminder, once you provide your testimony, you’re gonna need to give up your seat because we have more people coming in, and so, um –


MS. COSTA: Happy to do so.


REP. COOK: We thank you, and, uh, so I’m gonna call up Collette Mazlack -


MS. COSTA: Thank you.


REP. COOK: Thank you, uh, here representing herself to speak against the bill.




Colette Mazlack, AGAINST


Transcribed by Catherine Cook


MS. MAZLACK: Good afternoon, ladies and gentlemen. Thank you for allowing me to speak today. I’d rather not have the microphone, I think I can speak fairly loudly. My name is Colette –


REP. [UNIDENTIFIED]: Mr. Chairman, Mr. Chairman. It’s important for the recording and for the people that are listening to you outside of this –


MS. MAZLACK: Oh, okay. It’s hard for me to regulate the sound.


REP. [UNIDENTIFIED]: That’s okay.


MS. MAZLACK: Does that sound okay?




MS. MAZLACK: Thank you.


REP. COOK: You’re fine. Once again, your name and who you’re representing.


MS. MAZLACK: Okay, my name is Colette Mazlack. I just recently moved to Williamson County. I am speaking against the bill, and I wanted to let you know that as a Texas woman, this bill does not speak for me nor anyone else that I know. As a Republican – Republican thinker, I strongly believe in less government in our lives. This includes government intention – intention? – intervention in our lives - in a woman’s pregnancy. The obvious intent of this bill is to effectively greatly reduce access to abortions in Texas, and any other stated reason is just a story. There is nothing wrong with the clinics as they are now. I will not attempt to justify my position on abortion, nor will I attempt to change your position on abortion. I support you and I would not intrude on something so personal as the choices regarding a pregnancy and the choice to become a parent. I was raised with the security of knowing that I would be able to choose when and how to have a baby, and now that security is being effectively taken away with this bill, by a helpful government. Um, the ground I stand on, I feel, is rather unstable. I have personally known the poverty and desperation that comes with being very poor, and the panic involved when your good car won’t even take you on Highway 35, much less out of town for an abortion. Restricting abortions, which likely will happen will happen with this bill because of clinics getting shut down, um, would likely reduce the number of abortions, that’s true, but at what cost? There will be more women in desperate poverty situations with not enough money for childcare, staying in abusive relationships when they can’t afford to get out, and the cycle of poverty and welfare will continue. And I’m sorry, I’m quite nervous, so I’m - hopefully you can understand me –


REP. COOK: You’re doing fine.


MS. MAZLACK: Years ago, my family lived in El Paso, and my mother was married to a compulsive gambler and an alcoholic and a cheat. And abusive. We were too poor for food. My brother would stand in front of the refrigerator and cry. My mother lost so much weight she became anorexic and lost her breast milk for my, uh, baby brother. There wasn’t enough money for even formula. Social Services would not help us, as her combined income, being married, was too high. It didn’t matter where the money was going. And with us being all pre-school and infants, we were not able – is that the thirty second –


REP. COOK: Yes, ma’am.


MS. MAZLACK: Oh, goodness.  And, um, anyway, she wasn’t able to afford – luckily she was able to scrounge up enough money for an abortion. If she had had to – if the law goes through now, she would have had to drive all the way into Dallas or San Antonio. We would never have been able to do it. I can only imagine how bad her health would have been if we had had to continue with that pregnancy. She probably would have lost her teeth. Her health. It would have been absolutely devastating. I believe, uh, women should continue to choose if they want to go with a pregnancy and have less government in our lives.


REP. COOK: Thank you very much for being here and thank you for your testimony.


MS. MAZLACK: Thank you.



Charles Lingerfelt, FOR


Transcribed by Jennifer McNichols


REP. COOK: Charles Lingerfelt here to test- uh, representing himself to speak for the bill.


MR. LINGERFELT: Good Afternoon Ladies & Gentleman, I don’t think you’ll have a problem hearing me. I’m from Dallas, Texas, I’m a semi-retired educator, coach and principal. I’m here to speak for the bill today.


REP. COOK: Make sure we have your name.


MR. LINGERFELT: Charles Lingerfelt.


REP. COOK: Okay. Very good, thank you.


MR. LINGERFELT: I did say that, I believe. I’m here today to speak for the bill and I am wanting to stand for women and the babies of Texas. I believe the abortion process is already intrusive and wretched as it is and so it being an invasion of privacy and to me an invasion of the first home of the baby who lives in the womb of the mother. Um. because of that, I believe I can support this bill. Um, I think we have too many already, abortions. There are people around the state who would gladly take in the babies, uh,  for adoption process rather than this obtrusive (sic) process. I think that if you’re going to have the clinics, they should have a certain high standard and the higher you raise the standard, uh, the better off it is for the mother as well as the baby - all those involved. I am a father. I want you to know that I wasn’t born here in Texas, I’m a Tennessean by birth, but I’m a Texan by choice. I moved here to Texas in 1969 with my three small children and we’ve been happy with Texas ever since. Three of my children were born here in Texas, the last three. I’m a grandfather of 14 grandchildren and all 14 of them were born here in Texas and the youngest is three years old. I would ask you today, would you idly stand by and allow someone to break into your home, invasively and obtrusively and do nothing about it? And yet, that is what hap- happens to the home, the first home, of a child, of a baby, an unborn baby. And so I will always stand with the unborn, I will always stand with the rights of the mother and when the mother chooses, based upon the Constitution of Texas, uh, given that right to make her choice to have this child and give life to this baby, I think it ought to be honored and, and not ridiculed and criticized. If a woman chooses to give life, she is to be honored and revered. And today, that’s why I’m here, to honor and revere her choice.


REP. COOK: Thank you.




Sarah Speights, AGAINST


Transcribed by Jennifer McNichols


REP. COOK: Uh, Sarah Speights here representing herself to speak against the bill.


MS. SPEIGHTS: Good Evening. My name is Sarah Speights, I’m here representing myself and I’m a mother, um, and I am opposed to - to this bill. First of all, this bill isn’t about women’s health, if it were, we wouldn’t have all of these doctors, and the obstetricians, and the gynecologists saying this is unnecessary. And secondly, and Representative Farrar just did very well in trying to find out - we don’t have a problem! If the clinic doesn’t - I mean there is no problem with the clinics and abortions being done now. I’ve been listening to this debate since the regular session and nobody has told me what’s wrong with the abortion clinics that necessitates this tripling of the price to get an abortion at a much higher cost facility. As Lieutenant Governor Hobby used to say, “If it ain’t broke, don’t fix it.” And I think that’s our situation here. In addition, I don’t think this is about the sanctity of life because if it were, this bill would also be outlawing the death penalty. But it doesn’t. We’re only talking about abortions in this bill. I think this bill is about controlling girls and women. I’d like to draw your attention to a book out there, it’s called The Battle for God, written by Karen Armstrong who is a former nun and a historian of religion and she follows modern religions. And The Battle for God looks at 3 extremist groups, the extremist Christians in the United States, extremist Jews in Israel, and extremist Muslims in the Middle East. And a continual theme in all of those, is the control of women and girls. We have had legalized abortion in this state for quite a long time now and I think it has worked well. Once again, I don’t know what we’re fixing because it’s not broken. Um, I support these people’s right to their beliefs and their practices but they don’t have the right to force me and girls and young women to live by their beliefs. And I hope that you will not make government, intrude government into these personal decisions. And in closing, I’d just like to say, abortion is a very sad event. I don’t know any woman or any girl who has ever found it otherwise and it lives with them for all of their lives. No one does it as birth control. Please vote against this bill.


REP. COOK: Thank you Ms. Speights.


REP. COOK: Uh, Carter Snead? Here, uh,  representing himself for the bill.




Carter Snead, FOR


Transcribed by Catherine Cook


MR. SNEAD: Thank you very much. Uh, thank you all. I’m Professor Carter Snead from the University of Notre Dame’s School of Law, where I am also the Director for the Notre Dame Center for Ethics and Culture, and I’m here today to provide testimony on a very narrow question, namely whether HB2’s prohibition on abortion at or after 20 weeks post-fertilization is lawful under the United States Constitution.  The most important and decisive point that I’d like to emphasize to the committee members is that there is absolutely nothing in the text, history, or tradition of the US Constitution that precludes the State of Texas from extending the most basic protections of the law, uh, to 20-week-old or older unborn children who are capable of experiencing pain. For your purposes as legislators, this is sufficient Constitutional warrant to enact the modest restriction on abortion and its practice that you are considering during this session.  Moreover, there are no precedents of the US Supreme Court that speak precisely to the very unique features of the proposed 20-week abortion ban. This fact likewise provides additional Constitutional justification for legislators to enact the bill under consideration.  And for those legislators who might find it useful, I will reflect briefly on how the ban might be received by the Court in light of relevant precedents. The arc of abortion jurisprudence in America has, for better or worse, been an exercise on the part of justices in the majority, usually in a sharply divided five to four decision to find, by their rights, an appropriate balance between the State interest in the lives of unborn children at all stages of pregnancy and a woman’s liberty interest in seeking an abortion. Justice Kennedy, whose vote is decisive at the moment for evaluating any limit on abortion, has written that at the heart of the precedent is this notion of balance among these interests. And Justice Kennedy has also noted that the Court has not yet enumerated, quote, an exhaustive list of State interests that are implicated by abortion. Texas, along with several other states and the US House of Representatives, has - have recently identified a State interest in unborn - in the unborn child that has never before been considered, namely its obligation in justice to protect unborn children capable of experiencing the excruciating pain involved in an abortion. The fact of fetal pain confirmed by leading experts on all sides of the abortion dispute is a decidedly new and deeply salient moral fact that weighs heavily in favor of the unborn child in the balance at the heart of the Court’s jurisprudence. It provides a novel, Constitutionally significant interest that the State may, and I would argue must, invoke to justify its efforts to regulate the practice of abortion. This new information about the nature of the unborn child forces us to confront the fact that she is one of us, not merely insofar as she is a living, albeit immature, member of the human species, but also in that she experiences pain much as we do, and this insight about who the unborn child -


REP. COOK: (unintelligible)


MR. SNEAD: Yeah, 30 seconds, I got it. The insight about who the unborn child is, never before considered by the Court, offers a new and overwhelming justification to limit abortion. Now, in my prepared remarks I have reflected extensively on how the Court’s jurisprudence with respect to the significance of viability factors into this, and the short answer is, that serves as a proxy for the State’s interest. Fetal pain is a new proxy that justifies regulations on abortion in precisely the same way. Thank you.


REP. COOK: Thank you very much for your testimony. Now I’m gonna remind the crowd, uh, please, uh, please hold any applause or any, uh, display, okay? Thank you very much in advance for working with us on that. Okay, uh, Marijane Smitherman? Here representing herself to speak for the bill.




Marijane Smitherman, FOR


Transcribed by Catherine Cook


MS. SMITHERMAN: Hi. My name’s Marijane Smitherman. I represent myself, I, uh, I’m in favor of House Bill 2. I’m here actually to talk about one part of House Bill, and that is the drug RU486. After hearing you all talk, I also decided that I would be here to speak for the women that live in the rural areas that you, Representative Turner, talked about, and also to talk about the constituents maybe in your area and, um, speak for all those women that can’t be here that rely on you as legislatures (sic), that, um, trust the clinic that they’re going to for the abortion, and that maybe don’t have access to an internet where they can actually look up what the drug RU486 is about. Right now if you go on the FDA website, they list the category of a person who is not a good, um, client to take RU486, and it specifically states that if you’re not able to go back into the clinic to receive the second dose within two days, that this is not a good drug for you. It also says that if you can’t come back in ten days to have your uterus checked to see that the baby has been expelled, that you should not be given RU486. Current practice right now in our abortion clinics is to give the, the mom, give the woman the first dose in the clinic and then to send her home with the second dose in a paper bag for her to take the second dose at home and by herself. And as we stated, a lot of these women are in rural areas. What will happen if they take that second dose at home and they begin to hemorrhage? How will they get someplace that can help them? So I just - I’m here to speak on their behalf. I would like for you to vote in favor of House Bill 2 because it does ask that the standards, the FDA standards are followed when issuing RU486. Now these right here are two prescriptions that I brought. This is for my son and this is for my dog. And, as we know, every time we get a prescription, it has FDA requirements on here. You know, take with food, do not operate heavy machinery, um, make sure you take all the prescription, take four times a day, etc., etc. So, are we willing to forego that and not protect women? Even my dog, okay? If I did not follow this for my dog over and over, I would, you know, dog endangerment. So I urge you to please vote for House Bill 2. To vote against House Bill 2 is really a war on women.


REP. TURNER: Mr. Chairman -


REP. COOK. Pardon me? Did you want to ask a question?


REP. TURNER: Yes, please.


MS. SMITHERMAN: Oh, you want to ask me a question? Go ahead, please.


REP. TURNER: Yes, please. Did you listen to the testimony of Ms. Cooper who’s over compliance with the Texas Department of Health Services? Did you listen to -


MS. SMITHERMAN: The first woman that spoke?


REP. TURNER: Ms. Cooper, the resource witness from the Department of Health Services.


MS. SMITHERMAN: Again, was that the first woman that spoke?


REP. TURNER: I don’t know if it was first -


REP. COOK: Yes, the first witness.


REP. TURNER: It could have been, yes.


MS. SMITHERMAN: Well, actually, after the three minutes, which is what I thought we were all allowed to speak, I kind of zoned out. I’m sorry.


REP. TURNER: Well, that’s fine. She was -


REP. COOK: She was a resource -


MS. SMITHERMAN: Why don’t, why don’t you ask me the question and I’ll see if I can answer it.


REP. TURNER: Well, she said she’s over compliance. She noted that there was not a noticeable problem out there that she could testify to. And she’s over compliance for the clinics.


MS. SMITHERMAN: For compliance with RU486?


REP. TURNER: Over the clinics. Over the clinics.


MS. SMITHERMAN: Over the clinics.


REP. TURNER: Right. I’m just wondering, but - but since you -


MS. SMITHERMAN: I did not hear her speak specifically about RU486. I heard her talk about cleanliness, um, standards to the ambulory- ambulatory facilities, I heard that, but I can guarantee you that if she would have mentioned RU486, I definitely would have been paying attention. I actually had an opportunity to speak to Representative Howard about this, and also my own State Senator, I think it was in March or April, I think I was in there, and to tell you the truth, I was unaware of what the FDA standards were until I myself went to the FDA website and was very - it’s very disturbing to find out that people that you would trust to take care of women, that is, women at these abortion provider clinics, would - would engender the trust of these women but yet not follow out federally set guidelines for protection.


REP. TURNER: Thank you.


MS. SMITHERMAN: You’re welcome.


REP. COOK: Okay, um, and after this, we’re about to finish up this first set, so if, um, we’ll start with Bradley - Brad - Bradley - the next on deck, Bradley Price, Sarah Watkins, David Welch, Laura Gallagher, Thomas Valentine, Kristin Morgan, Amy Cornwell, and Mary Catharine Maxian. If, uh, if they would start making their way in here, um, and our next witness is - who are we up to - Karon Stewart, here representing herself to speak for the bill.




Karon Stewart, FOR


Transcribed by Catherine Cook


MS. STEWART: Chairman, I am Karen Michelle Stewart, I am from College Station, Texas, and I just want to address each one of you individually. I am a registered nurse who practices, um, her trade in labor and delivery. I have been working in labor and delivery in a rural community since 2009. I would ask that -


REP. COOK: Would you state for the record your position on the bill?


MS. STEWART: I am for the bill.


REP. COOK: Okay. Thank you.


MS. STEWART: Okay. I would ask that you hold these abortion providers and their staff accountable, just like you hold me accountable. Because I am a registered nurse who practices my trade, again, in labor and delivery. It is my contention that all pregnancies have to go through some process of labor and delivery and they need to be assisted in that process with someone who is familiar with labor and delivery. Um, no matter what gestation a baby, or, as some of you may call it, a fetus, no matter what gestation that child or that life is ended or delivered and is alive, the mother has to go through the process of delivering that life. I would ask that you guys really consider holding the staff accountable. Not just the abortion provider, um, but the staff. And this bill will help to, uh, to hold those staff accountable. I know that you hold me accountable and I appreciate your accountability. Your accountability is causing the labor and delivery services in Texas to, um, be sought after not just by Texans, but also Mexican women who are coming here, and so I would encourage you to make our abortion clinics that desirable as well, by holding us all accountable.


REP. COOK: Thank you very much for your testimony.


MS. STEWART: Thank you.


REP. COOK: Okay, who to call, okay. Okay, uh, the Chair calls Carl, uh, Lindemann, here representing himself to speak against the bill.




Carl Lindemann, AGAINST


Transcribed by Catherine Cook


MR. LINDEMANN: Chairman Cook, Vice-Chair Giddings, and the other members of the State Affairs Committee, my name is Carl Lindemann and I live here in Austin. Thank you for the opportunity to offer testimony against the bill. I have two brief points to make. Uh, one regards process; the other, who is affected by this bill if enacted. First, uh, Representative - Representative Laubenberg has stated time and again that this is a health bill. It’s a health bill. Time and again. I heard it at least five, six, seven times, maybe. There are substantive concerns with this bill that have been also raised time and time again, uh, as to whether legislators and not medical professionals should make medical decisions. Who should be in charge of best practice? And with no disrespect to this committee, that appears to be in the purview of the Public Health Committee. That committee has jurisdiction over all matters pertaining to the protection of public health, including supervision and control of the practice of medicine and dentistry and other allied health services. So as a matter of process - now, again, Representative Laubenberg says time and again this is a health bill. Well, if health issues are to be decided by legislators, it would seem best to me that those on the health committee, they should be hearing a health bill. Now second, as to who this bill affects, who will have to deal with it directly if it is enacted? These are your constituents under 40. They are consistently underrepresented in the legislature. Representative Eric Johnson and Representative Lance Goodman have been very good about this. They are to be commended for working to change that with the creation of the Young Texans Legislative Caucus. That just went to be in the last year. According to Representative Johnson, and I paraphrase, about 58 percent of Texans are under the age of 40. So the policy reflects more the interest - the policy reflects more of the interest of older citizens. So, the problem here is - or the question I have for you is will you vote on this bill on behalf of the aging members of your district who are not directly affected by it or the younger ones who will have to live with it? Now, again, that’s 58 percent of Texans are under 40. So are we talking about the younger ones who will have to live with it, and the larger question: Will you represent the future of Texas or the past? So -


REP. COOK: Thirty seconds.


MR. LINDEMANN: Um, lastly there’s just a wealth of information about the millennial generation, the under 40. So, again, those details about who these people are - actually, knowing the time restraint, I have an, uh, uh, opinion piece in the Austin American Statesman detailing the demographics. Are there any que - again, thank you for the opportunity. Are there any questions?


REP. COOK: Thank you very much for - Ms. Thompson, what we’re doing is, um, because some of the other members are sitting in we’re not taking questions from anybody, but members now if you want to have one of the other members ask. Thank you very much for being here and thank you for your testimony. At this time the, uh, Chair’s gonna call, uh, Jane Norwood, here represent- uh, representing herself, uh, against the bill.




Jane Norwood, Ph.D., AGAINST


Transcribed by Catherine Cook


DR. NORWOOD: Thank you. My name is Dr. Jane Norwood. I am a resident of Austin, Texas, Travis County, and I’m here to speak against the bill. I’m a licensed master social worker and I hold a Ph.D. in social work research from the University of Texas. I am proud to say I am your former employee. I retired as the Director of Professional Development from the Texas Department of Family and Protective Services. I am currently a consultant on child welfare services with an agency in California. I have spent a 45 career, uh, year career in social work working with the poor, the abused, the neglected, the disenfranchised, and the marginal in our society. But I’m not really here as a - on a professional basis. I’m here for personal reasons. At birth, I was the child of two frightened, terrified 17-year-olds. Given their age, their ethnic and cultural milieu, the prevailing norms of their society, I doubt they even knew what causes pregnancy. But once pregnancy occurred, they were bullied into a teenage marriage, bullied into putting the baby - that would be me - out for adoption, and it was only after I had children of my own that I realized how heart-wrenching it must have been to them to hand over a child, made worse by no choice in the matter. So in honor of those two teenagers who had no choices, I am here today to testify in favor of personal choice in private matters. I think it is clear that the effect of this bill will be to reduce the number of abortion clinics in Texas. I think it is clear that the intent of this bill is to reduce the options and the choices. But this bill, even those - for those who support it, should recognize it will not reduce the number of abortions. Abortion has, and will always continue to be, available to those who choose it.  This bill will reduce the number of legal, safe, medically supervised abortions and open wide the door to illegal, unsafe, exploitive providers. This bill will have no impact on those who can afford to travel to a safe and legal clinic, even if it’s outside the state. This bill clearly targets the poor, the unaware, the young, and the naive. However, what concerns me most about this legislation is the government overreach and intrusion into our personal lives. The government that can ban abortion today can mandate it tomorrow. What control of decisions about reproduction will interest the next group to achieve political power? I respect you. You have power. But what about the people that come after you? A ban on sterilization? Mandatory sterilization? No vasectomies west of I-35? What you are voting on this bill is not about abortion. It’s about the right of the people to exercise choice over personal decisions. Freedom requires constant vigilance. I urge you to stand on the side of freedom, liberty, and choice, and vote against this governmental intrusion into private lives. Thank you.


REP. COOK. Thank you very much for your testimony. James Stewart? Here representing himself to testify for the bill.




James Stewart, FOR


Transcribed by Catherine Cook


MR. STEWART: Hello, fellow Texans. My name is James Stewart and I’m here in favor of the bill. Before I begin, I would like to begin in prayer. Thank you. Father, I ask that you give me the words to speak. Father, I ask that you would bless the ears that hear. In your name I pray. Amen. I am here to represent the side that most people don’t get to hear. I’m here to represent the fathers that don’t get to be fathers. The brothers who don’t get to be brothers. And the uncles who don’t get to be uncles. I speak this firsthand because my sister had an abortion. I don’t get to be the uncle to that child. That innocent little life that got taken. I will never get to know him. I’m here on behalf of some of my friends - close friends and family.  There are others they chose have sex with and get pregnant, chose to end the life of that baby that was rightfully theirs as well. They never got to meet him. They never got to know him. They never got to share a single moment with him, not even one. They had no say so. At least with this bill - let me first say that I, I am absolutely against abortion, but at least with this bill, it would assure the fathers, the uncles, and so on that the baby that gets taken away from them would at least feel no pain while it’s being dismembered and murdered within the womb of a woman. A woman who took that right away from the other half that made it. That’s all I have to say. Thank you very much.


REP. COOK: Thank you for your testimony. Uh, Stacy Wilson, here, Tex- uh,  representing Texas Hospital Association here, uh, to testify against the bill.




Stacy Wilson, Texas Hospital Association, AGAINST


Transcribed by Catherine Cook


MS. WILSON: Good afternoon, Chairman Cook, members of the committee, my name is Stacy Wilson and I am here on behalf of the Texas Hospital Association, testifying against Section 2 of, of House Bill 2. Um, I’ve submitted written testimony and we have testified about this issue before, so I am not gonna belabor this knowing that there are many, many others who wish to testify. I’d like to briefly make four points about Section 2, and just to refresh your recollection, Section 2 is the portion of the bill that requires physicians who perform abortions to have active admitting privileges at hospitals. Um, that - and the hospitals are specified by geographic area. Um, the purpose of privileging, and there’s some background information in what I’ve provided to you in written testimony, is for the hospital to talk about and regulate what happens inside the hospital. So if a neurosurgeon, for example, comes up and wants to do neurosurgery, applies for those privileges at a hospital that doesn’t perform neurosurgery, the hospital is not gonna grant those privileges because neurosurgery is not performed in the hospital. Similarly, if there are procedures that are performed outside the hospital, the hospital doesn’t have an interest in regulating what happens outside those hospital walls. Um, so if you have, I think Vice-Chair Giddings, um, you talked about liposuction. If you have a plastic surgeon who is performing liposuction in an outpatient clinic, but has surgery privileges at a hospital to do hand reconstruction, for example, the hospital is gonna look at what that person is doing inside the hospital. So what are they doing in terms of reconstruction? What kinds of - how safe is that conduct inside the hospital? They will never look at what happened with regard to the liposuction unless it’s reported to the national practitioner data bank or there’s some kind of complaint that is taken to the Texas Medical Board. Um, the third point I’d like to make is, hospitals are very committed to ensuring that the patients they treat receive the highest quality care always. Um, that is of paramount importance to us. Um, and we think that requiring hospitals to grant privileges to physicians who do not practice in the hospital doesn’t further that goal. We think the more appropriate way to do that is to have the Texas Medical Board, who regulates all physicians, and sets the standard of care, handles physi- handles complaints against physicians, to handle this particular piece. And finally, clearly, we don’t want any patient to have complications from any kind of outpatient procedure. If they do develop emergency medical conditions, then the appropriate thing, and this is addressed in the bill, is for them to be able to contact the physician that performed the procedure or for them to go to their nearest emergency department where they will receive high quality care from the emergency physician who is either at the facility or, in some rural communities, is on call and can be at the facility or at least report in within 30 minutes. Um, we think that that’s the appropriate way for that to be handled for women who have complications. And, with that, I’ll -


REP. MENÉNDEZ: Mr. Chairman -


REP. COOK: Thank you for your testimony.


REP. MENÉNDEZ: I have a couple questions. These are questions that I posed to the author of the bill and I want to know if, uh, I’m sorry - you’re the general counsel for the -


MS. WILSON: Associate general counsel.


REP. MENÉNDEZ: Associate general counsel for the Texas Hospital Association, correct?


MS. WILSON: That’s correct.


REP. MENÉNDEZ: So the question that I posed to Representative Laubenberg earlier is that her bill requires abortion facilities to meet ambulatory surgical center standards. And I wanna ask you, do, currently do ASCs - are their physicians required to have privileges at hospitals?


MS. WILSON: Um, under current regulation they have an option.  They can either have current admitting privileges at hospitals or they have to have a transfer agreement with the hospital.


REP. MENÉNDEZ: But there are no state regulations that require that exact - the privileges -


MS. WILSON: They require either one.


REP. MENÉNDEZ: One or the other.


MS. WILSON: Correct.


REP. MENÉNDEZ: So then, uh, does - it seems to me - and seeing as you’re a lawyer, I’m not - that this bill actually sets a higher standard for these new abortion surgical centers versus what we have in existing law, is that correct?


MS. WILSON: It takes away one of the options that a facility would have or a physician would have to be able to meet the obligation, yes.


REP. MENÉNDEZ: But that is a new, higher standard, is that -


MS. WILSON: It is a more limited standard, yes.


REP. MENÉNDEZ: A more limited standard. Okay.


MS. WILSON: Correct.


REP. MENÉNDEZ: In your opinion, uh, will hospitals in Texas be willing to grant privileges under the requirements of this bill?


MS. WILSON: No. I don’t - in my opinion, no, and the reason is hospitals in Texas don’t perform elective abortions. Hospitals in Texas perform less than 0.1 percent of abortions in Texas, and those are for health of the mother, fetal - severe fetal abnormality, ectopic pregnancy, it’s those kinds of procedures that are done at hospitals. So, frankly, it doesn’t seem to me, because the hospital, like in my neurosurgery example, because the hospital isn’t performing those kinds of functions inside its walls, they’re not going to be willing to grant privileges to those physicians.


REP. MENÉNDEZ: So if your hospitals aren’t granting the privileges, then if the doctor can’t meet the requirements of the law, then possibly we’ve set an artificial standard, don’t you agree?


MS. WILSON: It could be that they wouldn’t have - if they don’t have the privileges and they can’t meet the requirements in the bill -




MS. WILSON: - then they may not be able to perform the procedure.


REP. MENÉNDEZ: Right. If they can’t perform the procedure, then in essence we’ve created a legal barrier for the abortions to happen at all.


MS. WILSON: That’s a possibility, yes, sir.


REP. MENÉNDEZ: Don’t hospitals want to ensure that their patients have, uh, safe care for abortion patients, don’t you want that?


MS. WILSON: Absolutely.


REP. MENÉNDEZ: Okay. So - I mean, are you aware of any other procedures that require the physicians to have hospital privileges?


MS. WILSON: Not that are not conducted inside the hospital. No, sir.


REP. MENÉNDEZ: So there’s no other requirement in any other procedure currently that you have to have a privilege unless you do it in the hospital, is that correct?


MS. WILSON: That’s correct.


REP. MENÉNDEZ: So this is a brand new, new ground.


MS. WILSON: Yes, sir.


REP. MENÉNDEZ: Are there any doctors - currently, does every hospital have a doctor in an emergency room?


MS. WILSON: Um, the hospital - either most hospitals have a physician inside the emergency department. For certain hospitals in certain rural communities and critical access hospitals, they have to have a physician who is - can be available within 30 minutes.


REP. MENÉNDEZ: Okay. My final question, Mr. Chairman. Uh, if a hospital did grant privileges to a doctor performing abortions, which they don’t do today, correct?


MS. WILSON: That’s correct.


REP. MENÉNDEZ: But if they did, in an outpatient clinic and who also performs some services in the hospital, like a hysterectomy or labor and delivery, would the hospital review the procedures performed outside of the hospital?


MS. WILSON: No. Not as part of their credentialing, unless, again, it resulted in some kind of sanction or complaint with the Texas Medical Board or with the national practitioner data bank, no. Because it’s not what the hospital is gonna be granting permission for that physician to do inside the hospital.


REP. MENÉNDEZ: Okay. So, this is - these - this and other reasons are why the Texas Hospital Association is testifying against this bill.


MS. WILSON: Yes, sir.


REP. MENÉNDEZ: Thank you, Mr. Chairman.


REP. COOK: Chairman Turner has a question.


REP. TURNER: Thank you. Ms. Wilson, is that correct? Are you reading this as I am reading - Section - Section 2 is a - is a - well, it’s the crux of this - of HB2, and the way I’m reading Section 2, I mean, in order for these, um, clinics to be elevated to the ambulatory surgical centers, they must have privileges at the hospital.


MS. WILSON: The physicians who are performing the abortions must have the privileges - active admitting privileges at a hospital.


REP. TURNER. Right. And - and you’re speaking for the Texas Hospital Association and representing our hospitals across the state of Texas, correct?


MS. WILSON: That is correct.


REP. TURNER: Urban as well as rural?


MS. WILSON: Yes, sir.


REP. TURNER: Okay. And if right - if under the status quo, you all are not granting permission to, to these physicians that are not practicing at your hospitals, and you all don’t intend to do it even after this bill - let’s say this bill is enacted - then Section 2 is a provision that can - that can - that cannot be complied with.


MS. WILSON: Yes, sir.


REP. TURNER: And if Section 2 cannot be complied with, then the bill, in essence, is outlawing abortion in the state of Texas. I mean, that is - that is - that is the effect of this bill.


MS. WILSON: If the doctor can’t comply with the requirements - if no doctors in Texas can comply with these requirements to have admitting privileges, then the answer would be yes. In effect, no - no doctor would be able to perform the procedure.


REP. TURNER: Give me your response to, uh, if the legislature were to mandate hospitals to grant, uh, admitting privileges. How would the hospitals respond to, to, to that - because the way I am reading it, the only way that clinics that elevate themselves to ambulatory surgical centers can provide abortions is that the hospitals must grant admitting, uh, privileges for the doctors, and the only way for that to happen is for the legislature to amend the bill to mandate that to occur. How - what would be the response to, to the hospitals - by the hospitals if we were to mandate it?


MS. WILSON: I think it sets a really dangerous precedent for anyone to tell the hospital who they can and can’t grant privileges to, because the hospital is responsible - their license is on the line. So in order to ensure that good quality of care is performed inside the hospital, the hospital credentials physicians and then they grant them privileges through a pretty rigorous process to ensure that the care - those services - they’re qualified to provide the services in the hospital and that those services are provided at a high quality of care. If, basically, the discretion is taken away from the medical staff, um, that could open them up to liability for somebody that they are required, then, to accept, that could cause a lot of problems for many hospitals.


REP. TURNER: All right. And I - ane I would agree. Um, if the - if the clinics were able to build themselves out to become ambulatory surgical centers, okay, but if - and if the hospitals still are not willing to grant, um, admitting privileges, then in essence, the 36 clinics that exist today - in essence, I mean, they still go out of business.


MS. WILSON: They would not be able to perform the procedure.


REP. TURNER:: 37. The 37 would go out of business. Um, now, as, as I read - as I read the - I know we had a lawyer here from out of the state of Texas - uh, but as I read the law, you cannot impose undue restrictions on, on abortions to the effect that you nullify them altogether. Now - and I know the emphasis by the author is for the health and safety -




REP. TURNER: And I respect that.


REP. LAUBENBERG: Absolutely.


REP. TURNER: Okay. But the question is whether or not under the bill - if the bill was enacted in its present form, whether or not you could achieve that goal of health and safety as identified by the author if the hospitals are saying to these people who are practicing outside of the hospital environment, “We are not going to grant admitting privileges.” I - Mr. Chairman, at some point in time I think - I think we -  the author or somebody has to address how we get over this hurdle. Because, to me, I see it as - it is a - um, it’s not a possibility. The hospitals in both rural and urban Texas are not going to grant the admitting privileges, and you are - and the effect of the bill is to outlaw abortions across the board. I mean, you can’t get past this. And I think it would be unwise for us to pass something that we know is, um, is unconstitutional. And I think that’s why this witness testimony is very critical. It’s very important. I don’t think as policymakers we can ignore what we are hearing today, and, and I don’t think we need to proceed until somebody can tell us how we get past it.


REP. COOK: I think we a couple of other, uh, uh, members that want to, uh, weigh in on this, uh, Chair Harless, I think you first and then Chair Smithee.


REP. HARLESS: Hi, thank you for being here today. So, um, so are you saying that there are no doctors that perform abortions that have admitting privileges at hospitals in Texas?


MS. WILSON: That I do not know.


REP. HARLESS: Okay. Do you think that there are some doctors that perform abortions that have admitting privileges at hospitals?


MS. WILSON: It is possible. I would say it’s unlikely, but it is possible.


REP. HARLESS: Okay, um, how many doctors at an average hospital have admitting privileges, because I know at Houston Northwest, the hospital in my district, there are a number of doctors. I have four doctors that I go to for different things, and all four of those have admitting privileges, and I know one is a gynecologist/obs- obstetrician and he does have admitting -




REP. HARLESS: - privileges at the hospital. So to say that there are no doctors that will qualify, I think, is way overstatement, don’t you think?


MS. WILSON: My testimony is that if you - that requiring a hospital to grant privileges for procedures that are being performed outside the hospital is an inappropriate way to - to guarantee the health and safety of a woman. And it’s - it opens the hospital up to liability, it’s expensive, all kinds of other things. Um, there could be - in the unlikely event there could be a physician who is an OB/GYN that also does abortions in clinics. I don’t - elective abortions in clinics. That is a possibility. I don’t know of any -


REP. HARLESS: I can name a few.


MS. WILSON: Okay. I don’t know of any, but - but if you have a physician who is coming in and they only practice in a clinic, and they only perform abortions and other kinds of outpatient procedures that are not performed in the hospital, the hospital is not gonna grant that particular physician privileges because they don’t practice inside the hospital.


REP. HARLESS: But a lot of these doctors practice in clinics and hospitals. Um, another thing I wanted to clarify -


REP. MENÉNDEZ: Hold on, hold on - is that a question, because I didn’t hear an answer to that. Do you agree with that?


MS. WILSON: It’s a possibility.




REP. HARLESS: Uh, another question I had - when you, uh, started you said you were testifying against Section 2 of the bill.


MS. WILSON: That is correct.


REP. HARLESS: Are you testifying just against that section or -


MS. WILSON: Yes, I am.


REP. HARLESS: - the entire bill, because it would -


MS. WILSON: Section 2.


REP. HARLESS: Okay. Thank you.


REP. COOK: Uh, Chairman Smithee.


REP. SMITHEE: Well, you’ve got me a little confused here -




REP. SMITHEE: - because, uh, you said - your basic testimony is that a physician - that a hospital will not, uh, credential a physician to perform services outside the hospital, correct?


MS. WILSON: Correct.


REP. SMITHEE: Is it your construction of the bill that it requires that to be done, that the bill requires that? Uh, I mean, every doctor - almost every doctor I know who is admitted to privileges in a hospital also practices outside the hospital in his or her own office. Correct?


MS. WILSON: That is correct, but -


REP. SMITHEE: And you’re not - you’re not - I didn’t mean to interrupt -


MS. WILSON: No, no, no. I’m sorry. I interrupted you.


REP. SMITHEE: Well, and so the doctor, despite the fact that he or she is privileged, uh, the hospital is not required, uh,  to, uh, be responsible for what they do outside the hospital setting, is it?


MS. WILSON: Uh, no.


REP. SMITHEE: So why would that be any different with what the physician did at the, uh, the abortion clinic, uh, as opposed to doing in the hospital?


MS. WILSON: So, when a physician applies for privileges, they apply for privileges to a particular department. So, for example, if you’re a gynecologist you would apply to the gynecology department. And so that department chair would look and grant you privileges, whether it’s to admit to the hospital and to perform certain procedures in alignment with that particular area of practice. So if somebody was trying to get admitting privileges - people aren’t getting - given admitting privileges just generally. They’re getting - given admitting privileges for a particular type of procedure or practice. So if somebody was seeking abortion procedures or abortion privileges, we would not give - hospitals in Texas are not gonna provide that.


REP. SMITHEE: I understand that, but you understand that there are some OB/GYNs - based on my knowledge - that do live - that do - that do births. Deliveries. And also may do abortions. Do you - is that your understanding?


MS. WILSON: I don’t know that. I would assume that to be true but I don’t know -


REP. SMITHEE: Okay. So you would have to speculate on that.


MS. WILSON: Yes, sir.


REP. SMITHEE: Now, all right. Now, um, you understand, don’t you, the need for this - uh, why it would be desirable for a physician who is performing particularly a 16 or 20-week abortion to have admitting privileges at a hospital, I mean, you understand the rationale for that, don’t you?


MS. WILSON: Well, it seems to me that if the - if the woman is having complications or having other emergency conditions that arise from an abortion procedure that’s performed outside the hospital, she is gonna come to the emergency department, and she - whether or not her physician is present or has admitting privileges is, frankly, kind of irrelevant to the care that she receives in that emergency department.


REP. SMITHEE: Let me give you an example.




REP. SMITHEE: You’re familiar with the Kermit Gosnell case in Philadelphia, aren’t you?


MS. WILSON: Yes, sir.


REP. SMITHEE: Okay, uh, one of the patients in the Gosnell case, uh, it was, it was a procedure gone wrong and, uh, there was a, uh, a problem in connection with the administration of the anesthesia to the patient. Uh, when the emergency medical services were called at the clinic, uh, the woman still had a heartbeat at that point. Uh, it took 20 minutes to get the woman out of the clinic because the hallways were cluttered, they couldn’t get the stretcher in, things like that. Um, but assuming the hallways had been open and a stretcher could have gone in, the woman lived at least 20 more minutes. She could have been put on the stretcher, taken to the - to the emergency facility - wouldn’t it be helpful if that physician who had been, uh, dealing with this woman could ad- go ahead and admit her immediately into the hospital so that she could get the appropriate medical care?


MS. WILSON: Well, she would have been treated in the emergency department by the emergency physicians who were on call there, so whether or not her doctor had admitting privileges -


REP. SMITHEE: I understand -


MS. WILSON: - wouldn’t have - wouldn’t have presumably affected whether her life was saved or not; that would have been up to the emergency physicians who were in the emergency department rendering the services.


REP. SMITHEE: Okay, well let me get back one more time to your general test - the general testimony that you gave, and - and you - I think you told Ms. Harless that you were not - that there may be physicians in the state of Texas who have admitting privileges at hospitals and who also do abortions, correct?


MS. WILSON: There may be.


REP. SMITHEE: Okay. And for you to either know or know how many would require you to speculate here today, correct?


MS. WILSON: Correct.


REP. SMITHEE: And so you really can’t testify under oath today about that talk, correct?


MS. WILSON: I can’t testify whether or not there are currently physicians who have admitting privileges, who are also performing elective abortions in outpatient clinics.


REP. SMITHEE: Thank you very much.


REP. COOK: Members, any other questions?




REP. COOK: Uh, Chair Giddings and then I think Representative Farrar has a question.


REP. GIDDINGS: I, I - uh, thank you, Mr. Chairman. I know that your example on, uh, physicians being admitted, they might have a specialty, according to your written testimony, such as cardiology.


MS. WILSON: Yes, ma’am.


REP. GIDDINGS: And that physician, uh, may not be, um, have - have training in cardiac catheterization.


MS. WILSON: Yes, ma’am.


REP. GIDDINGS: And so you’re saying in your written testimony that in many cases, the department head - or in all cases, from what I see here - the department head for cardiology might say yes, you can come in and practice cardiology, but not cardiac catheterization. So you’re saying, from what I understood you to say, the person must be practicing whatever area of their practice is within the hospital. Is that correct?


MS. WILSON: Correct.


REP. GIDDINGS: So if you’re not performing abortions in the hospital, then you’re not gonna be admitted, uh, as, as it relates to your abortion practice.


MS. WILSON: You would - that’s correct - you would be admitted - you might have admitting privileges to perform surgery or -


REP. GIDDINGS: Some other OB/GYN thing.


MS. WILSON: Correct.


REP. GIDDINGS: But not - you could be admitted to deliver babies.


MS. WILSON: Correct.


REP. GIDDINGS: But since you don’t practice abortions in the hospital, you would not, then, have admitting privileges as it relates to abortions.


MS. WILSON: That is - that’s correct.


REP. GIDDINGS: Okay. So it’s - it’s not your entire field, and it’s not that you are privileged - you must be practicing in your area of privilege within the hospital, not outside of the hospital.


MS. WILSON: For what you’ve been granted at the hospital, correct.




REP. COOK: Representative Farrar.


REP. FARRAR: The bill - speaking on that, the bill requires that, um, you - that it be a hospital that, uh, that has an OB/GYN area, and so can you speak to - are there hospitals outside of the major cities, uh, in Texas, along the triangle, so, are there hospitals in - or how many hospitals are there in South Texas, West Texas, East Texas, the Panhandle, that have OB/GYN areas or departments?


MS. WILSON: And, Representative Farrar, I do not have that data. I’d be happy to get that for you but I do not know that off the top of my head.


REP. FARRAR: All right. A concern of mine also is that religious hospitals - um, if the only hospital in the area, and religious hospitals don’t even provide - won’t even do a tubal ligation, much less - my concern is, would they offer - uh, provide hospital admitting privileges to a doctor who provides abortion care? Um, do you - do you - is that a conceivable scenario for you?


MS. WILSON: Um, more than likely, a faith-based hospital would probably, again, not grant privileges to somebody, again, for the more general purpose of providing abortions because they’re not doing that in the hospital. But of course, you know,. somebody like Christus, or even Seton here wouldn’t - wouldn’t do that, because again, they don’t - that’s not part of their religion.


REP. FARRAR: It’s against their religion. Right. Okay. Right. So that’s been a concern of mine, further constricting - I mean if you live in the, in the big cities in Texas -




REP. FARRAR: - you’ll be okay, but it’s a long distance from San Antonio to El Paso, from San Antonio to the Valley, and all points beyond that, and so that - that’s my concern. Thank you.


REP. TURNER: Mr. Chairman, two questions.  Is it possible that - that, um, Ms. Wilson’s testimony can be, um, reduced to writing and provided to us? Because I think - I think it’s critically important that we have it, and - and in view of the time sequence that we’re working on, and by virtue of the testimony that she has rendered today, I think it’s very important that her testimony be reduced to writing so that we can all, uh, review it.


REP. COOK: And I think Ms. Wilson can provide that to the - for us.


REP. TURNER: I’m talking about testimony -


REP. COOK: And that’s what I’m talking about. She can provide that for us.


MS. WILSON: I did submit written testimony -


REP. TURNER: No, but I’m talking about the exchange between Ms. Wilson and the committee. I’m talking about the exchange.


REP. COOK: I understand what you’re talking about. You know, I’m not sure we have - that’s not how we normally, um, annal committee work, and I’m not - I’m not certain we have the resources to do that, so I hope she maybe can provide you to the extent she can -


REP. TURNER: But that’s not what I’m - that’s not what I’m asking, Mr. Chairman. And I know -


REP. COOK: I answered the question -


REP. TURNER: I know, but we’re not operating under normal circumstances here.


REP. COOK: We sure aren’t. I’m gonna agree with you there.


REP. TURNER: No, we’re not operating under normal circumstances, Mr. Chairman.


REP. COOK: We’ve got 300 and counting -


REP. TURNER: I understand that, but what I’m asking is can her -


REP. COOK: And, and Ms. Wilson, I think you provided the same testimony at another session, I think you provided this testimony, uh, uh, in the first called special, so we just -


REP. TURNER: I’m asking -


REP. COOK: This is not - this is not new testimony to this committee.


REP. TURNER: I’m simply asking that her testimony, Mr. Chairman, be reduced to writing, the exchange between the committee and herself -


REP. COOK: And I’m telling you I don’t know if we have the, uh, if we’re able to do that, so I’m not gonna commit to something we may not be able to do. I understand your point and I know that Ms. Wilson has committed, uh, to giving you what she has, but I -


REP. TURNER: Well, let me just tell you what - let me tell you what my intent is, Mr. Chairman, ‘cause I like to put all my, my cards on the table and I think process is very important. And I think it’s very important that we not pass anything that we know will be unconstitutional.  I think that’s bad policy. And I take issue with that very strongly.  I would like to have her testimony reduced to writing so that I can submit it, or someone can submit it, to the Attorney General to give us an opinion as to whether or not, in view of her testimony - in view of her testimony, whether HB2 is Constitutional or not. I don’t think it’s - I don’t think it makes any sense to move forward on any bill that we know will not pass Constitutional muster.


REP. SMITHEE: Mr. Chairman, what -


REP. COOK: Uh, I’m gonna, I wanna keep this moving the right way, so if you have questions, direct them to me and I’ll recognize you, so I’m gonna recognize Chairman Smithee to, uh, uh -


REP. SMITHEE: What would a good solution be? You’re gonna have a tape; it’ll be available on the internet immediately. You could make a written transcription and provide it to the Attorney General, Mr. Turner.


REP. COOK: Yeah, uh, I was just - and that’s what I was just fixing to suggest is to have your staff take the tape -


REP. TURNER: And who’s gonna pay for that, Mr. Chairman? Who’s gonna pay for that?


REP. COOK: Well, you know, I wish I had a good answer for you. I know there’s been other members that have done exactly that.


REP. TURNER: But I asked for the court reporter at the very beginning and you denied that, Mr. Chairman. I asked for the court reporter. You denied that. Now, if you’re telling me - if you’re telling me that as a member of the legislature, and on a matter that is - that is before us at the Capitol, on a witness that’s testified at a duly called meeting, that the legislature - if you’re directing me to take my own personal resources to place her testimony in writing, and that’s the only way that I’m gonna get it, then fine. I will tell you, I am grateful that I work. And if the state is not going to do it, and if the committee is not going to do it, I will do it, and I will pay for it, because it’s just that important to me. It’s just that important. But I think as an elected official and as a member of this committee, that I believe I have the right to ask for her testimony to be reduced to writing for all of us to review it. I think I have that right, but I’m not gonna belabor it. I’m not - I will pay for it. Thank you very much. Thank you, Ms. Wilson. I will pay for it myself.


REP. COOK: Your point’s well taken. And, and just as a reminder, ‘cause you indicated that your opposition was only to part of the bill as it relates to admitting practice, but for the record we have to have you opposed to the bill.


MS. WILSON: Yes, sir.


REP. COOK: Thank you very much for being here. Thank you for your testimony.


REP. HUBERTY: Mr. Chairman?


REP. COOK: Uh, wait a second, Representative Huberty, and by the way, if you’re sitting on the wings over here I can’t see your light, so I don’t know that you have -


REP. HUBERTY: No - no problem, Mr. Chairman. Um, you know, I just want to follow back up on something. You talked about the faith-based hospitals.


MS. WILSON: Mm-hmm.


REP. HUBERTY: And have you talked to them? I mean, you testified - I mean, I listened to your testimony and you said, you said “I don’t know, I’m not sure,” your, your, you - is your testimony on the faith-based hospitals, that was your opinion. That was not a fact that you stated.


MS. WILSON: I have not polled the faith-based hospitals to ask them that question.


REP. HUBERTY: Okay. But you testified that - something completely different.




REP. HUBERTY: Uh, that’s what I heard - I’m a little bit confused.


MS. WILSON: Okay, well then let me clarify, ‘cause I don’t want there to be any misunderstanding.




MS. WILSON: It is my opinion that, based on their tenets of their faith, they would be unwilling and would not grant privileges to physicians that performed abortions, because that violates the basic tenets of their faith.


REP. HUBERTY: Okay, And, and the, the point of the admitting privileges as I understand it in the bill is to make sure if something goes wrong, that if the woman’s life is in jeopardy, that the, the, uh, the woman’s life could be saved, or if there was an injury or something that happened. That’s the intent of - of what Representative Laubenberg testified to. Is that correct?


REP. FARRAR: One more question -


MS. WILSON: And I think I said, I think what the woman should do is to come to the - their nearest emergency department where the emergency services personnel will render the appropriate aid to ensure that the patient is - try to save their life.


REP. HUBERTY: Okay. I just wanted to make sure I was clear on that. Thank you.


MS. WILSON: I’m sorry for misunderstanding -


REP. COOK: Representative Farrar has a question.


REP. FARRAR: And today, uh, doctors at ASCs don’t all have hospital privileges, correct?


MS. WILSON: That is correct, because they can have that or they can have a transfer agreement, yes -


REP. FARRAR: Or the transfer agreement, and so the transfer agreement, correct me if I’m wrong, but there’s a sharing of some parts of the medical record -


MS. WILSON: Correct.


REP. FARRAR: And so, actually, by - in my opinion - and this is just my mere, non-medically trained opinion, um, it seems to me that - that that would be - the sharing of that information, even basic information, would be, uh, be more desirable even than hospital visitation privileges, perhaps.


MS. WILSON: It could be, I mean, there’s a - since we’re moving to electronic health records -


REP. FARRAR: Right. It could go with that.


MS. WILSON: - I mean, a lot of this could be exchanged without actually having to put a chart on somebody’s, you know, stretcher, so -


REP. FARRAR: Right. Exactly. So, yeah. Thank you.


REP. COOK: Okay. Thank you very much for being here and thank you for your testimony. And just to let everybody know, we’ve opened up, uh, two more, uh, overflow rooms, which is E.110 and E.114. At this time the Chair is gonna call Bradley Price, Texas District of American Congress of Obstetricians and Gynecolog- Gynecologists, here, representing, uh, also representing himself, to speak against the bill.




Bradley Price, M.D., AGAINST


Transcribed by Catherine Cook


DR. PRICE: Yes, Mr. Chairman and members. Thank you. There’s been a lot of talk about OB/GYNs and I am one.


REP. COOK: Could we go ahead - we gotta start with your name, though -


DR. PRICE: Bradley Price. I am, uh - practice OB/GYN in Austin, right up the street at St. David’s Medical Center. Good karma today; I - I delivered three babies already today and I’m still able to be here. Got them at 5 a.m., 8 a.m., and 12 noon. And so, um, I am, uh - been in practice for 36 years. Also, and counting residency I’ve been in practice 40 years, which is right - right after Roe v. Wade. Um, and my, um, my point of view is that this - this bill is extremely intrusive into the practice of medicine. The legislature has no business practicing medicine. The House Bill 2 is not based on sound science, despite the efforts of the - of my colleagues to educate, uh, the legislature as much as possible with the best available medical knowledge. Uh, this bill would erode women’s health by denying Texas women the benefits of well-researched, safe, and proven protocols. House Bill 2 jeopardizes women’s health care and interferes with medical practice and the patient-physician relationship. House Bill 2 would have serious impact on a woman’s ability to access quality care. By requiring all abortion facilities to meet ASC standards, House Bill 2 would close many - or most of the state’s abortion clinics. By requiring doctors to have active hospital admitting privileges at a hospital within 30 miles, House Bill 2 would decrease the number of doctors that can provide care. By requiring women to come to an ambulatory surgical clinic on two separate occasions just to take a pill for a medical abortion would increase the likelihood they will not come back or not come back at all because of the cost, and by relying on unsubstantiated studies to ban terminations at or after 20 weeks, ideology is really being used in place of science. Um, the um, the interesting, uh, point of view that I have - I do not want to see the bad old days come back, when, uh, in 1973 I was an OB/GYN resident at Parkland Hospital. Roe v. Wade had just happened but there were no abortion clinics in Texas. Women were getting instrumented - coat hanger, if you will - coming in septic, sick, into the hospital, sometimes in septic shock, to be cared for, um, as they were having their miscarriages following this. I do not want to see us revert; there’s no reason to go back to the bad old days. The other thing is that this is very extremely intrusive into the practice of medicine. I’ll be happy to answer questions about OB -


REP. COOK: I think we have a question, uh, Chair Giddings?


REP. GIDDINGS: Just a quick question: as a physician practicing OB/GYN, uh, do you see this, uh, increasing health and safety for women -


DR. PRICE: Absolutely not.


REP. GIDDINGS: - or do you see it as the other way around?


DR. PRICE: Absolutely not. This did not come from the organization - our professional organization of OB/GYN. This - this is coming from politicians.


REP. GIDDINGS: Thank you.


REP. COOK: Representative - ‘cause I can’t see your lights, uh, Representative Farrar.


REP. FARRAR: Dr. Price, is it?




REP. FARRAR: So you sort of answered my question, which is I wanted to know if you felt that abortion was safer now, in the abortion facilities, um, under current regulations than it was - than prior to Roe v. Wade.


DR. PRICE: Extremely safe compared - compared particularly to the days when I first started as a resident in OB/GYN, and the other thing to realize is that pregnancy termination, first trimester, is way safer than taking a, a pregnancy to term.


REP. FARRAR: Yeah, I thought - I’ve understood that - something like seven times safer.


DR. PRICE: It’s huge.


REP. FARRAR: Yeah. So, let me ask you - you brought up a point - because I’m not sure people understand that - that this would require medical abortions to be performed at an ASC, which we-  we’ve concluded they’re - they’re down to five or six, perhaps, around the state, that would be left and, um, and so can you describe when we - when they have to come back for repeat visits and so, what I was explaining to someone about this was women that have to travel, and because we require - we have so many, um, so many parts to a woman - to go have an abortion. We have the sonogram, we have the 24-hour wait, and so it complicates the travel schedule for a woman. Um, and then now you’re talking about, um, could you describe the - the phases for the medical abortion and what that takes when a woman presents for that?


DR. PRICE: I don’t actually perform those, but as I understand it, there are two doses of uh, I should say RU486 is now called mifepristone, and those are, uh, taken at two separate doses. The current bill would require, uh, currently it’s - the first dose is at the clinic, second dose is given to the patient to take at the appropriate time, later. Uh, the current bill would - would, uh, require that women be with a doc to observe her taking these pills on two different occasions, what, 48 hours apart?


REP. FARRAR: And what are the medical benefits - I - I see obstacles, but what would be the medical -


DR. PRICE: There is zero medical benefit to that.


REP. FARRAR: - of doing that.


DR. PRICE: Absolutely zero.


REP. FARRAR: All right, thank you.


REP. SMITHEE: Mr. Chairman, can I ask a question -


REP. COOK: Any other questions? Oh, yes, Chairman Smithee.


REP. SMITHEE: Doctor, thank you for being here. I just have a couple of questions, and you testified you’d already performed several births today -


DR. PRICE: That’s correct.


REP. SMITHEE: Have you ever performed abortions at all?


DR. PRICE: Yes, I have, early in my practice. Um -


REP. SMITHEE: Okay. Now, tell me a little bit about - I understand that with a 20-week requirement, we’re talking primarily - we’re dealing primarily with unborn babies somewhere in the 20 to 27-week range that that’s going to impact. Is that - would you agree with - am I right on that one?

DR. PRICE: No, I’m thinking 24 weeks is probably the limit to viability, and that seems to be where the Supreme Court has come down.


REP. SMITHEE: So 20 to 24 in there is it - that’s kind of what I understood. Now, let me ask you about that little baby at that age - at that gestational age of 20 to 24 months, now does the baby -


DR. PRICE: Weeks.


REP. SMITHEE: - weeks, I’m sorry. Does the baby have a heartbeat at that point?


DR. PRICE: Sure. Uh, let - let me put this in context. Basically the only abortions that would be occurring at that late date would be, uh, for lesions that are incompatible with life. Or, um, so by and large. So something that - so something huge impactful on that baby. It’s not the, uh, the average baby.


REP. SMITHEE: Well, the question was does the baby have a heartbeat at that point?


DR. PRICE: Of course.


REP. SMITHEE: Has there been a - uh, normally could you detect a brain wave at that point?


DR. PRICE: Yes, probably.


REP. SMITHEE: And, uh, is the baby generally already developed, like, most of the glandular structure, like thyroid, adrenal glands?




REP. SMITHEE: And has the baby probably began (sic) developing fingernails and hair and things like that?




REP. SMITHEE: And, uh - so - and has the baby already started developing pain receptors, uh, a neural system that would be able to, to feel and to show signs of recoiling from pain?


DR. PRICE: The neural system - the neural system is intact. Here’s the problem with that whole pain argument, is that if you’re worried about pain at 20 weeks, what about fetal pain at 40 weeks? Are we gonna ask babies to go through the birth canal still? Is vaginal delivery out of the question? So, I mean, that - if you take it to its illogical conclusion, that’s where you go.


REP. SMITHEE: I mean, I’m just asking about - can the baby logically have a neural system that could feel and sense pain at that - at 20 weeks?


DR. PRICE: I think you can - you can probably say that’s true. The other problem with the old pain issue is that what goes into the memory bank. So I came through my mom’s birth canal, I have - and it’s probably painful but I don’t remember any of it.


REP. SMITHEE: Well, so sometimes at 20 to 24 weeks the mother will actually have felt the baby kick at that point.


DR. PRICE: 20 weeks is about right, yes.


REP. SMITHEE: And, uh, also there - have you ever not- have you ever seen or observed where a baby at that age can even show signs of detecting his or her own mother’s voice?


DR. PRICE: Eh - maybe.


REP. SMITHEE: Okay. Now, let me ask you just a little bit about the abortion procedure. At 20 weeks, what kind of procedure is generally used? It’s a little past the, the vacuum or the suction stage, isn’t it?


DR. PRICE: Yeah, I personally don’t do them, but I understand it’s called a D&E - dilatation and extraction.


REP. SMITHEE: Okay, so it’s a dilatation and extraction. And the dilatation refers to dilating the cervix, correct?


DR. PRICE: Cervix, that’s correct.


REP. SMITHEE: And, uh, and that’ll take several day- uh, hours, maybe a day, is that right?


DR. PRICE: Dilation can be done mechanically in a matter of minutes.


REP. SMITHEE: Oh. And then the, uh, the other - is it the extraction or evacuation - what does the E stand for generally?


DR. PRICE: Extraction.


REP. SMITHEE: And so how - so you’ve got this baby inside the womb that’s, uh, maybe eight to ten inches long, right?


DR. PRICE: Uh, I’d say more like five.


REP. SMITHEE: Okay. Well, uh, the literature I saw said about eight is the average. Would you dis - would you think more like five inches long?


DR. PRICE: I think in centimeters.


REP. SMITHEE: And it’s a - it’s a living, breathing bab- I mean, it’s a living baby with a heartbeat in there, so you gotta do something to get the baby out. How do you get the baby out of the womb?


DR. PRICE: Uh, like I said, I don’t do that procedure, but it’s, um, it’s with - oh, basically it’s instruments, like a ring forceps - something that you can grasp with but would not be - would not injure the uterus. You’ve gotta worry about - you don’t wanna go through all the way through the uterine wall.


REP. SMITHEE: So you don’t injure the uterus but you’re gonna grab the baby with the forceps, is that right?


DR. PRICE: Well, I’m not - you can’t say “you,” ‘cause I don’t  -


REP. SMITHEE: Okay, but I’m - but the - the physician that’s doing this procedure is gonna grab the baby with the forceps, is that right?


DR. PRICE: Um, that - that’s gotta be some way to get baby out, yes.


REP. SMITHEE: But that’s how it’s normally done? You just reach in through the dilated cervix and grab the baby out?


DR. PRICE: Uh, I think there’s suction involved also, there’s a big - there’s a big suction vacu rap, as well. And so that helps with, uh, that’s part of it.


REP. SMITHEE: Is the baby still alive at that point?


DR. PRICE: Um, I’m not, uh - like I say, a lot of these are done for - for lesions that are incompatible with life, so in some cases - in some cases it’s a baby that’s, um - it’s not - actually, for - for, uh, stillborn babies, we can use medical treatment to, uh, deliver a baby. So, and, um - so with, um, prostaglandin.


REP. SMITHEE: Prostaglandin is the Upjohn product that basically induces a fairly violent labor, right?


DR. PRICE: Well, the - of course, this - we’re talking about a stillbirth where the baby’s already dead. Um -


REP. SMITHEE: Okay. But let’s get back to the D&E. I’m just talking how you get the baby out, and what I’m wondering is, do you - do you terminate the baby while the baby’s still inside the womb, or do you terminate the baby while you’re removing the baby, or do you terminate the baby - and by terminate I mean terminate their life - after you bring them out of the womb?


DR. PRICE: I’m not privy to those gruesome details.


REP. SMITHEE: Well that is something I think we need to know, ‘cause I mean, that’s the heart of what we’re talking about here, is - is what we’re doing to these babies, and I think if we’re gonna talk about what’s gonna be legal and not legal, we at least oughta know what we’re talking about, and the procedure that goes into this. Now - now what happens to the - the remains of the child after that?


DR. PRICE: Well, I think if, uh, if it’s suspected that there is an abnormality, say abnormal chromosome, then, uh, some of the - at least part of the tissue and placenta would go to the pathologist.


REP. SMITHEE: What about the other remains, uh - are they just disposed of, or?


DR. PRICE: If it’s - I think there are different rules that have to do with 20 weeks and beyond, so beyond 20 weeks, uh, usually there’s a funeral and under 20 weeks there’s not.


REP. SMITHEE: And so are the remains given to the - to the mother, or how does that work?


DR. PRICE: Oh, uh, I’d have to  - you’d have to ask somebody that does this procedure.


REP. SMITHEE: And, uh, are there any health risks to the mother, uh, when she’s having this 20 to 24-week D&E abortion?


DR. PRICE: Uh, potentially, yes. That the, uh, the uterus could be injured. That’s why they’re using fairly large instruments so that they’re less likely to perforate the uterus.


REP. SMITHEE: Well, um, in fact the risk of death to the mother goes up substantially at, at even 16 weeks, doesn’t it?


DR. PRICE: It’s pretty much proportional to the gestational age.


REP. SMITHEE: Well the figures I saw were one in 530,000 up to eight weeks and then from 16 to 20 weeks it goes to one in 17,000, and then after 21 weeks they’re showing one in 6,000. I mean, does that - does that - those are the numbers that I got through some literature. Does that seem to be about right, or -


DR. PRICE: The whole line of questioning distorts the issue since the majority of pregnancy terminations take place very early in pregnancy, and so - so this is the one in a thousand kind of thing you’re talking about.


REP. SMITHEE: Thank you, Mr. Chairman.


REP. MENÉNDEZ: Mr. Chairman, just a quick -




REP. MENÉNDEZ: Just a quick - just to follow up on that, if I heard you correctly, Chairman Smithee, were you talking about the danger to the mother in the abortion procedure, is that what you were -


REP. SMITHEE: That’s right.


REP. MENÉNDEZ: Okay. I have an analysis study here - a research study that was done by a few doctors, and they did, I wanted to ask the doctor if this sounds about right. In this study, and they - they studied, uh, live births and legally induced abortions in the United States between 1998 and 2005. And they used data from the Centers for Disease Control and Prevention - a pregnancies mortality survey, and the results were this - and see if the doctor thinks this was more in line. Pregnancy associated mortality rate among women who delivered a baby was 8.8 deaths per 100,000 live births. The mortality rate related to induced abortion was point - was 0.6 deaths per 100,000. So, uh, it seems that if you do the math, it’s - legally induced abortion is about 14 times safer than - than birth. Is that accurate?


DR. PRICE: You’re right. That sounds right.


REP. MENÉNDEZ: And you’re a doctor, correct?


DR. PRICE. 0.6 compared to 8.8 -


REP. MENÉNDEZ: 0.6 compared to 8.8, deaths, right?


DR. PRICE: That’s right.


REP. MENÉNDEZ: Okay. I just was checking, because I think since the bill has to - we’ve been told that the bill is about increasing the health of a woman. Right?


REP. SMITHEE: I think you’re using a wrong assumption, Jose, and that is that, uh, your figures relate to abortion all through the pregnancy, and the 20-week provision doesn’t deal with those.




REP. SMITHEE: The risk goes up substantially after 16 weeks.




REP. SMITHEE: And so I think you’re comparing the wrong thing to the wrong thing. I think what would be interesting is to compare the 20 to 24-week risk -




REP. SMITHEE: - with the full-term -


REP. MENÉNDEZ: Which is fine. I think we should get that information, because I think - what I - I heard you earlier, and I was admiring your trial lawyer skills as you were leading him down the path, I was thinking to myself, this - this bill is, I’ve been told all along, is about a woman’s health, not necessarily the actual procedure of the abortion. You know, I was thinking, and I noticed - so I was wondering when - where we were going - and now I will - I’ll be happy to share with you whenever I get the information on what the rates are - the differences, because I think it’s important that we do deal with the facts.


REP. SMITHEE: And I would agree. I would like to see that - I don’t know the numbers -


REP. MENÉNDEZ: I don’t, either.


REP. SMITHEE: - and I’d like to see those compared.


REP. MENÉNDEZ: Thank you, Mr. Chairman. Thank you, doctor.


REP. FARRAR: Follow-up question: how - uh, what is the frequency - what is the rate of abortions after 20 weeks?


DR. PRICE: Very, very low. I can’t even think - I’ve been in practice 36 years and I can’t think - I can’t think of a single one.


REP. FARRAR: Okay. Well, I - would it surprise you that it was - I was looking through my notes. I remember a number of 400, um, and I don’t remember the time period but it was - it was ver- a pretty low number, and we could recall the DSHS person because I think that’s where I got the number from. Um, and also the procedure that, uh, Chairman Smithee was talking about before - that is a prescribed medical procedure -


DR. PRICE: That is correct.


REP. FARRAR: - in these situations, right?


DR. PRICE: That’s true.


REP. FARRAR: It is sanctified by the - no one’s gonna lose their medical license -




REP. FARRAR: It’s sanctified by the board of - whoever - medical examiners, or -


DR. PRICE: Uh, it used to be - uh, Texas Medical Board.


REP. FARRAR: There you go. All right. Thank you very much.


REP. COOK: Okay, once again, I can’t see the end - uh, Representative Huberty.


REP. HUBERTY: I just wanna clarify something on the - on the drug, the R486 (sic) drug or whatever it’s called - I think you said that there isn’t a requirement for follow-up back at the - are you familiar with it enough to, to, to talk about it? Because I think that’s what you said. I just wanna make sure I’m clear on that.


DR. PRICE: It’s two doses that are 48 hours apart, um, and so, um -so the first dose is given in the clinic and then the second dose is given as a take-home to take -


REP. HUBERTY: ‘Cause I’m reading the requirements and it’s called -


DR. PRICE: Mifepristone.


REP. HUBERTY: Mi- Mifeprex, I think is what it is, but it says day one, provider’s office, day three at the provider’s office, and day four - day 14 at the provider’s office, so that’s the FDA recommended requirement, and I think that’s what the bill is talking about, is the FDA requirement. So we’re meeting the guidelines of the FDA.


DR. PRICE: The - the problem with the FDA guidelines is that data has come out since the FDA approved that particular drug. There - that data is based - is the data that got that drug approved -




DR. PRICE: - but that - the research continues to go on and procedures get refined.


REP. SMITHEE: Do you - you don’t -


DR. PRICE: So the data that I’m talking about that’s tested has been - has come out since the FDA approved that. That’s why that. That’s why it’s different than exactly -


REP. HUBERTY: You don’t issue drugs the FDA doesn’t approve, but you issue drugs to your patients based on the guidelines -


DR. PRICE: As a matter of fact, I used a drug last night, um, that, um, for - to help induce labor that originally came out to protect the GI tract from ibuprofen-induced ulcers. Uh, it turns out to be a prostaglandin, given in very tiny doses. We have a very good protocol, it’s been tested, and I gave her three doses of that overnight, her water was broken, she’s at term, cervix not very ripe so I didn’t want to start oxytocin, gave the citatec and, uh, misoprostol and, um, that’s not on the FDA, uh, approved. But that’s something that we use day in and day out. And so the same thing with the protocol - that’s what these tested protocols, um, have come out since the FDA approved that particular drug. So research - knowledge doesn’t stop with FDA approval.


REP. HUBERTY: No, right. But the guidelines that - the guidelines - again, we’re making sure we understand this but the bill’s talking about making sure we’re meeting FDA guidelines on this, or - the new - the new protocol, right? And so the new protocol says this, and this is what we’re ask - this is what the bill has -


DR. PRICE: That’s why the legislature shouldn’t get into the practice of medicine.


REP. HUBERTY: I understand, but what I’m saying is, is that the bill is saying that we’re requiring it to - the FDA guideline or the protocol is suggesting this and that’s what we’re asking the doctors to follow.


DR. PRICE: I - and I’m saying that knowledge has come out since the FDA approved that drug that improves the way it can be used.


REP. HUBERTY: Gotcha. Thank you.


REP. COOK: Uh, Dr. Price, thank you for - oh, we have one more question? Chair Giddings.


REP. GIDDINGS: Yes, very quickly sir. Um, Doctor, um, have - have you ever been on one of these credentialing committees for privileges, and if you haven’t been on one, do you - are you aware of how this - how they operate?


DR. PRICE: Oh, yeah, uh - interesting - I was thinking about that as you were talking, and so first, as you were talking about faith-based and whether they would, um - so I just, uh, reapplied at Seton, and there was not a single mention in a ten-page document about whether I do abortions or not.


REP. GIDDINGS: Uh-huh. Okay. Is - is our understanding basically correct on that, in that, uh, while you have this general title of OB/GYN, that the credentialing committee is generally looking at the procedures or - or the practices that you have within the hospital?


DR. PRICE: That is true.


REP. GIDDINGS: And so, you know, you might be doing somebody’s hand on the outside, because you are an M.D., and in an emergency I guess you could, but you would never be approved to do that, uh, within the hospital if that’s not what you practice within the hospital.


DR. PRICE: That’s true. There’s an oversight committee within - within the hospital that watches to make sure that certain doctors don’t have multiple bad outcomes. And that's part of the credentialing process when that person comes up for credentialing.


REP. GIDDINGS: Thank you.


DR. PRICE: Sure.


REP. GIDDINGS: Thank you, Mr. Chairman.


REP. COOK: Thank you, Dr. Price -


REP. MENÉNDEZ: Mr. Chairman, one last thing, because I’m reading some stuff - I just wanna make sure for the record, Doctor, you don’t perform abortions?




REP. MENÉNDEZ: You deliver babies?


DR. PRICE: That’s right.


REP. MENÉNDEZ: You take care of women.


DR. PRICE: That’s true.


REP. MENÉNDEZ: You’ve been doing it for 40 years?


DR. PRICE: 40 years counting residency.


REP. MENÉNDEZ: You were in residency when Roe v. Wade had just started, and -


DR. PRICE: Right - a few months after.


REP. MENÉNDEZ: A few months, and you saw women coming in who had tried to perform self-induced abortions.


DR. PRICE: That’s right, or gone to shady providers to get instrumented -


REP. MENÉNDEZ: So you’re here today because you care about women’s health.


DR. PRICE: That is exactly right. Couldn’t have said it better myself.


REP. MENÉNDEZ: Okay. Thank you, Doctor. Thank you, Mr. Chairman.


REP. COOK: Okay, and while we get ready for the next witness I’m gonna go ahead and call another series of witnesses to come in the room and be ready. Uh, Mikeal Love, Vivian Bal -

Bal- Ballard, Carolyn Connor, Natalie Goodnow, Dina Mullins, Deanne Mullens, Deborah McGregor, Carolyn Connor, Natalie, uh, Goodnow, uh, Toni, uh, McKinley, Sylvia Guzman, and Bill Kelly, if they will make their way to the room, and at this time the Chair is gonna call David Welch, Texas Pastor Council, here to testify for the bill.



David Welch, Texas Pastor Council, FOR


Transcribed by Jennifer McNichols


REP. COOK: Go ahead.


MR. WELCH: Mr. Chair, Honorable Committee. My name is Dave Welch, I’m the Executive Director of the Texas Pastor Council, we’re a multi-racial, inter-denominational coalition representing over 1,000 churches around the state of Texas. And I am here to testify in favor of HB2. First of all, this bill starts at the beginning, where we should always start, with the first order of government and that is to protect the life of its citizens. Any government that fails to do that is an illegitimate government. So the first principle of this is essentially looking at an industry whose sole purpose is to take human life. That’s what they do. So any, uh, I guess I would call it, unplaced anxiety over the profits and the conveniences of an industry that exists solely to take human life, I think are indeed misplaced. Why is it that we should be questioned that, first of all, they should be first of all held to the same medical standards of any other surgical procedure, uh, in, being performed on women in any other facility? I - I just find that, uh, amazing that we’re even asking this question, okay? But, but start at the beginning to issue the, uh, in addressing the question of the 20 weeks, 22 weeks, the five months time period. I held in my arms 20 years ago a little baby girl - her name was Jennifer Michelle, who was born at 21 weeks. 11” long, 15 ounces. Fingers, toes, eyes, hair, beautiful little baby girl. She was mine. Mine and my wife’s. Born at 21 weeks. And she only lived eight hours but God gave us those eight hours a special gift to our life. And I find it frankly, just flat inhumane, that any - any society would not protect the life of such innocent children who have nobody else to watch over them. Whose existence depends on a mother, and if the mother fails to act as the first line of defense, on a society that says we will value that life. And so therefore we have a situation now where we have restrictions on simply 22 weeks acting like anything less than 22 weeks isn’t a human being. First of all, I reject that notion. So 22 weeks is a very limited, very reasonable standard of dismembering and taking apart a human being. In regards to the facilities themselves, of requiring that the facility doing surgery that is risky, on women, that takes the life every time of an unborn child essentially, except for those fortunate to survive the abortion. It’s again, just simple common sense, it’s human decency. These other factors of requiring the use of RU486 to abide by the standards given by the FDA. Again, common sense and reasonable. Thank you to this committee. I would like to express our appreciation for those of you who have stood for life and voted for it and we hope you will continue to do so. Thank you.


REP. COOK: Thank you. Uh, Lori -  Lori Gallagher here to testify, representing herself, here to testify for the bill.




Lori Gallagher, FOR


Transcribed by Jennifer McNichols


MS. GALLAGHER: Uh, first these - this is a uh, ultrasound of my babies at 13 weeks right here and Dr. Christopher Seeker, one of the best doctors in Austin [unintelligible]. Legs crossed on this picture 13 weeks, 17 weeks. We’re talking about human beings. My name is Lori Gallagher and I’m a fulltime wife and mother of two beautiful girls ages three and two. I’m here to support HB2 because I murdered my babies through abortion and the resulting miscarriages in my adult life. I accepted a lie that there would be no support and help for me and my baby even though I’ve never seen a human turn away from a mother with child in need. For the first five years of our marriage, we attempted to carry a child and had three miscarriages. After my doctor examined me, I had to undergo two laparoscopies for scar tissue damage on my uterine lining, adhesions and a blocked fallopian tube. I attribute this directly to abortion the procedures. My husband and I were told we would not be able to have children but by the grace of God we conceived. However they were considered high-risk pregnancies. Throughout my pregnancies with my two daughters, not one time did the best doctors in Austin call them a fetus or a clump of cells. Not one time. The only time my baby was called those names was by a doctor I paid to murder it. I watched our two girls develop on an ultrasound screen. My two beautiful blond-haired, blue-eyed girls develop from four weeks because I was at a high risk pregnancy so I got to see it from the very beginning all the way through. Four weeks to birth and my doctor always said, “Here’s your baby’s tiny feet. Here’s your baby’s tiny hand. Here’s your baby’s tiny heart.” Even after 15 years, I continue to suffer through my eternal choice to murder my babies through abortion. The great state of Texas has a right to regulate birth abortion after the first trimester. Is three months not enough time? I am here to beg you to exercise that right. More than 75,000 women a year in Texas are murdering babies they would have loved more than anything in this world had they given them their right to live. My choice came when I opened my womb to life. I had no right to end it. I am a lesser woman for not taking responsibility for my choices and for attempting to hide my shame by murdering a tiny human being. Almost every woman that seeks an abortion had the choice of opening up their womb to life. And every woman that does open her womb to life should not have the right to so carelessly end the life that results from that choice. I would have loved my baby had I allowed it to be born. As a fifth generation Texan I beg you to pass this bill.


REP. COOK: Thank you.


MS. GALLAGHER: Thank you for your time and consideration.


REP. COOK: Thank you for being here and for your testimony. Who’s next? Uh, at this time, Chair calls Thomas Valentine. Thomas if you can tell us, please state your name, who you represent and your position on the bill.




Thomas Valentine, AGAINST


Transcribed by Jennifer McNichols


MR. VALENTINE: Yes, sir, uh, my name is Thomas Valentine, I’m here in opposition to the - to the bill. I am here reluctantly in opposition to the bill and you’ll see why. Uh, Mr. Chairman, I’m also a 57-year rape survivor and I want to make it clear that no rape kit could have fixed what has happened to me. I only say this because you all are our leaders-- when you get your facts and information incorrect it matters and it matters on this issue very much. But more on topic, I’ve been in public service in the area of health policy for decades. Uh, longer than, uh, many of you all. I’ve served this body as the senior analyst and team lead for Health and Human Services at the Legislative Budget Board for 13 years, as deputy director of the Department of Protective and Regulatory Services for four years, lead audit manager for Health and Human Services at the State Auditor’s office for four years, chief of staff for the Congressman of the 10th Congressional District here in Texas for two years and before my retirement, uh, I was, uh, eight years the senior policy advisor for Health and Behavioral Health for the Health and Human Services Commission -- these issues are not foreign to me. I was blissfully nonpartisan -- not bi-partisan but nonpartisan. I’ve always held this body with the highest respect and served it with nothing but humility. I was joyful in my service to this body and now I’m here feeling like you have let, not only me, down but my entire family. You have used partisan politics in an effort to split this state apart and cast it in the deceptive cloak of women’s health and safety. I am the pro-life father of a daughter, daughter-in-law and granddaughter, so these issues are very difficult for me. But for me, pro-life includes these women that are already on this earth. Your political effort to mobilize your base at the expense of the women I love to me is reprehensible and if news can be trusted, may not be working well. This special session has nothing to do with womens’ health. You have taken the proud effort on behalf of women enacted by the 83rd regular session, uh, which provided significant funding for improving the health care of women across the board and made it unmemorable by your actions here at this special session to restrict women’s rights. I was not born yesterday, I understand that politicians work their will, even at the expense of the governed but understand this...


REP. COOK: Mr. Valentine, 30 seconds.


MR. VALENTINE: If harm comes to any women I love I will hold this body responsible if it is the result of this legislation. You’re spending tax dollars in order to tear this state apart after decades of respecting this body, you have created in me nothing but despair. Uh, I hope you all will do the right thing and end this expensive and dangerous fiasco.


REP. COOK: Thank you. Thank you for your testimony Mr. Valentine. Kristin Morgan. Excuse me, we can have, I’m showing Kristin Morgan so uh-




Kristin Morgan, FOR


Transcribed by Jennifer McNichols


MS. MORGAN: They told me she could be part of my testimony.


REP. COOK: No. I’ve got one person here.


MS. MORGAN: Okay. Can I give this to the clerk to pass around?


REP. COOK: That’s fine, you can give it to the clerk there.


MS. MORGAN: My name is Kristin Morgan and I’m for the bill to pass.


REP. COOK: And you’re here representing yourself?




REP. COOK: Thank you.


MS. MORGAN: And it’s kind of hard coming after the gynecologist, because that’s a viable 22 week baby. She was born at 22 weeks. They told me that she couldn’t live but she was born and they say that she didn’t feel pain. When my daughter come out, she was kicking and when they drew blood from her she screamed. They said that she would cry, she would kick her little feet together. And the pain they, it was anything when she would get upset we could put our hand on her and it would soothe her. They would play lullaby music in her little bassinet, their cradle thing, that she was in and it would calm her down so all of her senses were intact by 22 weeks. And then they say about the mental. You have, you got people were talking about the mental part of it. I’ve been on, I do have a mental disorder and I do take mental medication - it’s a class D - it’s Depakote and I take it as a Class D and it has caused - known for-  Spina Bifida. I was on that medicine and they risked, they looked to see of the risk of what it was more important and since I’d already had it in my system when I conceived her, that me being on her, it was more dangerous to take me off it than it was to my baby. And with further monitoring, they checked her for Spina Bifida, they checked her for all the stuff and she was born fine with that. And so when it comes to the mental part I was on a Class D medication which they would, usually they don’t want you to breastfeed or anything to that point but they still had me do that, and they still had me breastfeed. And so they told me that she’d have Down’s Syndrome, they told me she’d have Cerebral Palsy, they told me that she’d be a vegetable. She’s 21, she just graduated college, she’s living on her own, she’s fixin’ to get married. You know, the doctors told me, having, I had a doctor and the neonatologist they said that a 22 week baby wasn’t viable. And what part of her isn’t viable? She’s a walking testimony. You know? So how can anybody say, these are doctors, and these are neonatologists, they’re practicing medicine. They had looked at me and told me my daughter’s odds in living was like winning the lottery. But my daughter lived. So who? They can tell us everything but they don’t know. God let my daughter live. She lived and had no- they said she would have everything, she was never even sick. She has no medical problems. And - everything. She has fingernails, eyelashes, she had everything when she was born. And she stayed in the NICU for six months and that was only to gain weight because she was 1 pound 6 ounces and she was 10 inches long. And she had to stay til her due date. And then she came home on her due date.


REP. COOK: Chairman Hilderbran? Did you finish your comment?


MS. MORGAN: Absolutely.

REP. COOK: You did great. Uh, go ahead and -


MS. MORGAN: Thank you.


REP. HILDERBRAN: So is this your daughter here behind you?




REP. HILDERBRAN: That - do you wanna - okay. We didn’t know if you were have her speak too and all that stuff wanted to and all that.


MS. MORGAN: No, no...


REP. HILDERBRAN: So there’s the 22 week old that’s now 22 years old.




MS. MORGAN: That’s her. And another thing, I’m sorry, they said about memory, one of you guys were asking about memory. It’s Smittee (sic), Mr. Smittee was asking about memory, if the babies can remember. She was born at 22 weeks. She still to this day is petrified and I have been asked by her doctors and her pediatricians through her life, that she has rebound memories too because they had to stick her She only had two ounces of blood in her entire body so anytime they did any tests on her, they had to do a blood transfusion. And so she now, anytime she goes to a needle, it’s like post-traumatic almost, because she memorized, because she remembers having to have the feeding tubes and the central lines and having to have the [unintelligible] so she does remember the pain that was inflicted on her. So that’s why for the abortion bill, there is pain in these babies. I’m not a doctor but I was a mother sitting in that NICU for six months watching my baby suffer. You know.


REP. COOK: Ms. Morgan, thank you very much for that very compelling testimony.


MS. MORGAN: You’re welcome.


REP. COOK: At this time, the chair is going to call Amy Cornwell here representing herself to testify for the bill.




Amy Cornwell, FOR


Transcribed by Jennifer McNichols


MS. CORNWELL: Hi, my name is Amy Cornwell, and I’m from San Antonio, Texas. Abortion to me is not just a religious choice in the sense of right or wrong. To me, it’s really about life. That being said, um, I’m for the bill. I have three kids, a, um, almost seven year old, a four year old, and a two year old. Some of you, I’m sure, are trying to calculate my age. Um, I’m a young mom. When I was 19, I found out I was pregnant. Once I found out I was pregnant, I felt all my hopes and dreams that I had for myself were gone. I was going to have my baby. And because of all that, all the young stereotypes of mom and not to help the TV shows that are out, I felt that this was a death sentence for myself. But that’s what I wanted. Five days after finding out I was pregnant I went to a med clinic to be treated for a UTI. One of the questions among many were, “Are you pregnant?” I think the doctor heard the hesitation in my nerves and in my voice when I answered that I was. She gave me a lot of advice that I wasn’t looking for. She told me that I would most likely drop out of college and that I wouldn’t be able to care for my baby, that I wouldn’t be able to handle the responsibility of a child. Before I knew it I was going in the direction to Parent- Planned Parenthood to have an abortion. I wasn’t given abortion as my - I wasn’t given abortion as my only option, I was given it as my option. But because of my moral conviction, I chose to have my son, Colten David Cornwell. He is the most amazing little guy in my life. I wake up daily and I can’t believe that he’s mine. I’ve had some really hard times and there have definitely been some times when funds have been short but I’ve never woken up and wished that didn’t have him. Now, because I had Colten, I also had the desire to be a stay at home mom which gave me the opportunity to launch my own career. I now have been successfully self-employed for six years. If you’re a mom, a dad, an uncle, a brother, or a sister, if you’ve had an opportunity to experience the process of pregnancy, you know that most likely a sonogram is done around 20 weeks to find out the sex of your child, which is also when they’re wanting to give - give it the last option to have an abortion. The state makes the, the state’s job is to make sure medical - medical procedures are safe for babies and moms. Does it make sense that abortion clinics do not have to follow these guidelines? I feel fortunate to live in a state that stands for life. I feel fortunate that I chose life. Again, it’s not just a religious issue but it’s a life issue. Thank you.


REP. COOK: Thank you very much for being here. Thank you for your testimony. Uh, Mary Catharine Mackim...here, uh, Texas Right to Life and self, uh, here testifying for the bill.




Mary Catharine Maxian, M.D., Texas Right to Life, FOR


Transcribed by Catherine Cook


DR. MAXIAN: Thank you. I’m Dr. Mary Catharine Maxian. I’m an anesthesiologist in Houston, Texas and I am testifying in support of HB2. I have a lot of things I wanted to say based on what the other people have said, but, um, a lot of people have given testimony that there’s nothing wrong with the clinics, and why would we need to have a bill if there’s nothing broken that we need to fix? But there’s obviously something broken when you have clinics like Douglas Karpen in Houston and there’s testimony - there’s an investigation going on right now where he has had babies born alive very frequently and he twists their heads off and if we’re regulating the clinics like we’re supposed to be then why is that happening? And if we did raise the standards of our clinics to the ambulatory surgical care centers standards then we can avoid problems like what happened in Gosnell’s clinic where a patient died, as you heard testimony, because the - the hallways did not meet the guidelines that would have been, um, required under the ambulatory surgical care centers. Also, um, we don’t know what the complication risk - uh, rate - is for abortions because when there’s complications from abortion, a lot of times you can, um, diagnose it as something like sepsis or hemorrhage or something like that, and that’s often what the death certificate is gonna say. It’s not gonna say that the patient died from abortion and so it’s not even gonna be reported to the state that it was a complication of abortion. In the case of, um, Ms. Morbelli, who was a kindergarten teacher and, um, had a late term abortion by Dr. Carhart, the death certificate did not say abortion but that is exactly what caused her death, was a late term abor- abortion that she had. Um, I did my training, um, in medical school at Baylor College of Medicine and the OB/GYNs, um, on staff at Baylor College of Medicine often did abortions, um, on the side. They had hospital privileges at, um, the hospitals where I worked and they also did abortions on the side, so it’s totally a non-issue that they would not be able to get abortion, um, admitting privileges at a hospital because there are, and I have - I know them, um, and Abby Johnson can also give you their names if you really do want their names of, um, abortionists that do abortions outside of hospitals and also simultaneously have privileges at hospitals. So I don’t see why that would be an issue at all. Um, it also is totally relevant who your admitting physician is and in the case of a per- a person who’s going to, um, to an ER because of an abortion related complication I can explain, although I don’t have the time, exactly why it’s very important that the person doing the abortion has the admitting privileges at the hospital. Why the OB/GYN said that, um, it’s painful to be delivered naturally and how you can compare that to a D&E, I just can’t even imagine. The government does have an interest in practice of medicine and protecting human life, that’s the whole purpose and we’re very highly regulated.


REP. COOK: Thank you very much for your testimony, Doctor. Uh, Mikeal Love, here representing himself, speaking for the bill. Michael.


REP. GIDDINGS: Mike? I called him Mikael -


[Crosstalk, laughter]




Mikeal Love, M.D., FOR


Transcribed by Catherine Cook


DR. LOVE: Yeah, it’s Texan, not Greek. My name is Mikeal Love. I’m an M.D. OB/GYN who practices here in Austin. Been here since ‘92,. practice with Brad Price. Love the guy, bike with him, but disagree with him completely. As an OB/GYN I’m Chairman of the CME committee which oversees education for physicians in seven hospitals here in Central Texas. I’m a member of the American College of Medical Quality. I’ve been the Chairman of the OB/GYN section at my hospital and I have signed off on privileges for physicians who perform abortions. They apply - they apply for general gynecologic privileges and I sign off on those. There’s not a problem for that to happen in a hospital. To say otherwise is just smoke and mirrors. Requiring privileges for the physicians who perform abortions is standard of care. To say otherwise, again, is smoke and mirrors. If you read the agreement on mifeprex, it says the ability to provide surgical intervention or make plans to provide such care through others. If you read ACOG practice bulletin number 67 on medical abortions it says you have to be available on a 24-hour basis in case of hemorrhage to provide a D&C. Physicians who wish to provide medical abortion services either should be trained in surgical abortion or should work in conjunction with a clinician who is trained in surgical abortion. This is the standard of care. No two ways about it. Now, second point, FDA regulations. You know, the FDA tries to regulate medicines for our safety, not just to make us jump through hoops. Medicine can be used off-label. It happens all the time. We use methotrexate off-label to treat ectopic pregnancies. But we do it in such a fashion that is responsible. If we’re not doing it in a hospital we make sure the patient is competent enough to make follow-up. And that’s the whole reason behind the FDA regulations is to make sure patients don’t get into trouble. There was a great article published in OB/GYN Magazine, which is considered the gold standard of this, um, thing, and it talks about medical versus surgical abortion and the complication rate, and I can provide that for you if you’re interested. Last, I’d like to say is practicing medicine that is safe and within the standard of care does not restrict care. Care is restricted when physicians or clinics refuse to comply with the standard of care and choose to close their doors. That’s their choice. That’s not the state closing ‘em as has been said.


REP. COOK: Dr. Love, thank you for your testimony.


REP. HARLESS: I have a question.


REP. COOK: Go ahead, Representative Harless.


REP. HARLESS: Have you ever treated a patient after complications from a medical abortion because, uh, the doctor that performed the abortion wasn’t available or didn’t have the credentials?


DR. LOVE: Yes, as an OB/GYN we take emergency room call and I’ve been called to the emergency room to take care of these patients ‘cause their doctors just basically say “go to the nearest hospital” and they don’t have privileges, so it gets dumped on me. And that’s cons- what we consider in medical terminology a dump. Um, I’ve taken care of a septic abortion before, um, I’ve ta- uh, the last case was a lady who did come in New Year’s Eve, who was six weeks post RU486, bleeding, and still had her, um, fetal tissue inside. Now, she elected to not stay. She elected to leave and go home and follow up with the clinic if she could get ahold of him. That was New Year’s Eve. But yeah, this happens, and that’s the reason these physicians need to have privileges. Two thirds of the physicians who perform abortions in Texas have hospital privileges. And again, I signed off on these privileges. There’s no problem with them getting privileges, contrary to what the representative of Texas Hospital Association said, they can get privileges for gy- for general gynecologic procedures. In fact, um, one of the abortion providers here in town who I’ve signed off on his privileges before and he works at St. David’s with us, I asked him about this and he said for a physician who performs abortions not to have privileges is akin to patient abandonment.


REP. HARLESS: So, um, do you do a D&C in your office?


DR. LOVE: No. I would not. It’s a blind procedure. Blind meaning you’re shoving an instrument up inside the uterus and trying to scrape tissue out. Personally, when I do a D&C, I use an ultrasound because I wanna make sure I don’t perforate the uterus. As a resident I worked in one of the largest abortion facilities in Louisville, Kentucky and we also took care of the complications from that facility at the hospital where we worked. Um, and so we saw that periodically where a uterus had been perforated or a hemorrhage would occur. I mean, hemorrhage is actually common - in that study in the OB/GYN Journal talked about hemorrhage. Um, it occurs eight times more frequently in medical abortions than surgical abortions. When you look at complications overall, they are fourfold higher in medical abortions than surgical abortions.


REP. HARLESS: Now, do you think it would be possible for a doctor that performs abortions to get, uh, privileges at an ASC center like we were talking about earlier?


DR. LOVE: Sure, he would need to apply for general gynecologic privileges like he would at the hospital. Just like - I mean, I’ve worked with several doctors who have had privileges and have privileges at St. David’s whose primary job outside the hospital is to perform abortions. And they have privileges. And they come and assist for special cases.


REP. HARLESS: Thank you.


REP. COOK: Chair, I think Chairman Turner has a question first.


REP. TURNER: Yes, Doctor, you practice in, in, in the Austin area?


DR. LOVE: Yes, I do, at St. David’s Hospital.


REP. TURNER: And you were here for the testimony of Ms. Wilson who testified on behalf of the Texas Hospital Association?


DR. LOVE: Yes.


REP. TURNER: You take - you take issue with that?


DR. LOVE: I take issue with the fact that these doctors can’t get privileges, ‘cause I’ve signed off on these privileges before. For general gynecologic privileges, and as I was saying, one of the doctors here in town whose primary job, or his primary focus is on abortions has privileges at St. David’s. He comes and performs those at St. David’s for medical indications like when, you know the issue of medical incompatib - or life is incompatible - and, um -


REP. TURNER: But is he doing other things at St. David’s?


DR. LOVE: You know, I signed off on general gynecologic privileges. I don’t keep track of what else he does.


REP. TURNER: But - but that’s important. Because if he’s doing other things than just abortions, that is important. Because what Ms. Wilson indicated is that when they are doing other things in addition to just abortions and it fits within the discipline within that hospital, then privileges are granted. But when they are only doing abortions outside of the hospital - ‘cause I think it’s very important that the testimony be correct. Okay?


DR. LOVE: I understand where you’re coming from - I’m just telling you as the chairman of the committee -


REP. TURNER: I understand, but let me ask - let me ask the question now.


DR. LOVE: Okay.


REP. TURNER: Um, so is it your testimony that for those physicians who are only doing abortions outside of the hospital, and that’s all they’re doing, that there is no problem with the hospital granting physician privileges for that hospital?


DR. LOVE: I don’t see a problem. As I’ve stated, I have signed off on these privileges on one such physician. I know two other physicians who only perform abortions -




DR. LOVE: And they have had privileges at the hospitals where I’ve worked.


REP. TURNER: But were they doing other things at that hospital in addition?


DR. LOVE: I - I never saw their name on the surgical board doing other things -


REP. TURNER: But I think it’s important to give testimony based on one or two examples versus giving testimony with regards to the practice in the state of Texas. Now there may be situations, and Ms. Wilson wasn’t saying that there might not be a situation where a physician may be performing abortions outside -


DR. LOVE: Mm-hmm.


REP. TURNER: - and were not granted. But as a general rule that’s not the case. And I would suspect, if - and you tell me if I’m right or wrong, that in places like Houston and Dallas and San Antonio that there may be cases where physicians are performing abortions and they may be able to get hospital privileges. But outside of those major areas - outside of those major areas, then there is a significant, uh, uh,  hurdle when you’re talking about physicians performing abortions getting hospital privileges.


DR. LOVE: You have proof of this?


REP. TURNER: Well, I’m - the proof was the testimony of Ms. Wilson, who was representing the Texas Hospital Association.


DR. LOVE: And she didn’t have all the answers, and I’m just telling you as a section, or ch- chairman, I’ve signed off on those privileges.


REP. TURNER: You signed off the privileges as it relates to this particular area. Are you- can you- is it your testimony that outside of this area for whi-  in which you practice that there is not a problem? Is that your testimony?


DR. LOVE: I don’t see a problem with it, yeah.


REP. TURNER: Is it -


DR. LOVE: As the chairman - as the past chairman of the OB/GYN section - let me repeat this - I signed off on the general gynecologic privileges for these - for this physician. He now has privileges at St. David’s Hospital and he comes there and helps with terminations of pregnancies, okay?


REP. TURNER: And I appreciate your testimony, Doctor, but it’s one thing to - to talk about a particular case - it’s one thing to render testimony with regards to a particular case versus what is the general practice in the state of Texas. Those are two different things. And you cannot - you cannot impose a bill that has a statewide implication that has the potential of closing 36 clinics based on what is done with one doctor that came into - um, um, that you had a dealings with - and then make a - then implement a bill with statewide implications. Wouldn’t you think that’s -


DR. LOVE: Well, first of all, I don’t know what - you’re theorizing this closure of 36 clinics - I mean, that’s something that I haven’t seen any proof of whatsoever. I haven’t seen financials on it. If you show me the financials, and if you want to show me how much it’s gonna cost -


REP. TURNER: Can you tell me how much it will cost for a clinic -


DR. LOVE: Well, you’re the one who brought it up. I’m open to what you say.


REP. TURNER: But you’re the doctor. You’re rendering the testimony.


DR. LOVE: I’m not a financial planner. I’m talking about from a medical standpoint about standard of care medicine, that doesn’t restrict care. That’s based upon the individual who owns that clinic and chooses to close it. That’s their choice.


REP. TURNER: And I’m asking you, Doctor, how much do you think it would cost for a clinic to meet the standards defined in HB2?


DR. LOVE: Okay, let me rephrase that. I’m not a financial planner and I don’t sit down and study that, so what I’m talking about is standard of care, and when you look at using RU486, having privileges, when you look at ACOG, which helps define the standard of care, saying you need to be able to perform a D&C on an emergency basis, when two-thirds of the abortion providers in this state have hospital privileges -


REP. TURNER: And it’s my understanding that ACOG - it’s my understanding that ACOG and certainly the Texas Hospital Association are not in support of this bill.


DR. LOVE: Well, that’s very interesting. And I’m not - I haven’t talked to the spokesperson for ACOG. I’m just telling you what their medical practice bulletin says -


REP. TURNER: Well, would it - would -


DR. LOVE: And that’s what we use for standard of care.


REP. TURNER: I accept that, but would it be important to you if they were opposed to the bill?


DR. LOVE: Not necessarily, because I don’t know -


REP. TURNER: But you’re fighting -


DR. LOVE: I don’t know who the state - who the spokesperson was and how they came up with that decision to say they’re not in favor of it, because they make statements periodically that they come back and retract. I don’t even know if they’ve read the bill. I haven’t discussed it with them.


REP. TURNER: Well, I think - but it’s - but you can’t cite the standards from ACOG, and then if they are against it, and then you just - you decide it’s not important, it’s not relevant any more. You - you can’t take the good and then not take what you don’t agree with to slam it. So - but let me -


DR. LOVE: Okay, well I don’t know who made the statement, I don’t know what he was using, I don’t know if he was just jumping on the - you know, the media rhetoric bandwagon. I’m telling you what they have in print. What they have in print in their practice bulletin number 67 -


REP. TURNER: I am with you.


DR. LOVE: - is about hospital privileges, and that’s the issue here. It’s not what some spokesperson said who got put in print, ‘cause I don’t even know who it was. I don’t know if he really was even speaking for ACOG. Just because he said he was, I mean, people say that all the time. That doesn’t mean it’s necessarily so.


REP. TURNER: Well, all I can indicate to you is that the representative from the Texas Hospital Association came here today and testified against HB2 -


DR. LOVE: I saw that.


REP. TURNER: Section 2 -


DR. LOVE: I saw that.


REP. TURNER: Which is the guts of HB2. And if we’re talking about women’s safety, and their health, if Section 2 cannot be implemented, then you cannot have HB2 without Section 2.


DR. LOVE: Well, there’s no reason why it can’t be impl- be implemented.


REP. TURNER: And I am all for safety. And I’m all for women’s safety. And I’m all for children. And since, you know, just on, on a quick aside, since I have - well, I’ll save that for another time. But I appreciate your testimony. I appreciate you being here today.


REP. COOK: Chair Giddings?


REP. GIDDINGS: Uh, thank you, um, Mr. Chairman. Um, Doctor, are you a member of - I guess all physicians are members of the American Congress of - you are a member?


DR. LOVE: Yes, I am.


REP. GIDDINGS: Okay, uh, and is, uh, is your hospital St. David’s?


DR. LOVE: St. David’s Hospital.


REP. GIDDINGS: Yeah, and -


DR. LOVE: Known as the safest hospital in the United States.


REP. GIDDINGS: Wonderful. Uh, thank you for that. Are you guys members of the Texas Hospital Association?


DR. LOVE: I’m sure they are.


REP. GIDDINGS: Okay. And, uh, you are the person for OB/GYN that approves, um, credentialing. So are you the department chair?


DR. LOVE: I was in the past.


REP. GIDDINGS: Okay. So, uh, you approved this sometime in the past.


DR. LOVE: Mm-hmm.


REP. GIDDINGS: And - and how long ago was that?


DR. LOVE: It was about four years ago.


REP. GIDDINGS: It was about four years ago.


DR. LOVE: Mm-hmm.


REP. GIDDINGS: And so then, what is the practice at St. David’s? Is it that, uh, the department chair approves the privileges and then, uh, that approval is then reviewed?


DR. LOVE: Yes, it is.


REP. GIDDINGS: Okay. So you approve -


DR. PRICE: And then we have a general medical staff that approves it, so -


REP. GIDDINGS: Okay. And then they do that. Okay. Uh, do you agree or do you not agree with - with this - it’s about two sentences from the Texas Hospital Association - “If a physician does not perform any procedures in the hospital or performs a procedure that the hospital does not perform, there is no process for the hospital to grant privileges to that physician. Thus, if the hospital does not perform elective abortions, a physician seeking privileges to perform abortions would not be granted those privileges.”


DR. LOVE: Well, first of all, an abortion in the first trimester is a D&C. D&C is like the most commonly performed surgery in America. And when you apply for general gynecologic privileges, that is part of the general gynecologic privileges, a D&C. You don’t necessarily call - you don’t necessarily call it an abortion, it’s a D&C. And the point of having privileges is so that when you have a complication such as hemorrhage, retained tissue, septic abortion, you can come in and manage that since that’s your patient. That’s the way it’s set up. When I - when I have a patient who has a complication from a delivery, I manage that. Or my call partner does. I mean, that’s the way it’s set up in the practice of medicine. You don’t just tell them to go somewhere. If somebody does neurosurgery, they don’t tell their patients just to go to any hospital they choose to - to take care of the complications. They go to where that physician has privileges so that physician can take care of those complications. He knows the patient and it’s part of the patient-physician relationship.


REP. GIDDINGS: Okay, I do want to go back to that question.


DR. LOVE: Okay.


REP. GIDDINGS: Did you agree with that statement or did you not?


DR. LOVE: No, I don’t agree with it, because you’re applying for general privileges - general gynecologic privileges, which includes a D&C, and an abortion is a D&C.


REP. GIDDINGS: Yeah. Well, in that case, every, uh, OB/GYN is also an abortion doctor. If they do D&C, and everybody does it.


DR. LOVE: Well, that’s - that’s an erroneous statement.


REP. GIDDINGS: Okay, well, tell me what you were saying, then.


DR. LOVE: No, what I’m saying is, is that the physician who performs an abortion is performing a D&C. That’s the procedure. You can call it an abortion. You can call it an elective termination of pregnancy, therapeutic abortion, whatever you wanna call it, it’s a D&C. That’s the surgery that the physician is performing upon that person. Okay? So when they apply for privileges at the hospital, they apply for general gynecologic privileges, which include a D&C. That way they can manage their complications just like it talks about in the RU486 or in the, um, ACOG bulletin. That’s the whole point, is that the physician is there to manage their complications. There will be complications. The paper from Penland showed that there will be. I mean, a very well done study that’s done in such a way it’s the gold standard when you want to look at complications associated with either surgical or medical abortions. But there will be complications and that physician needs to be able to handle that. We take that for granted in every other surgical field. We would not tolerate surgeons just dumping their patients off and letting somebody else pick up the complications.


REP. GIDDINGS: So general OB/GYN privileges always include D&C.


DR. LOVE: Yes, that’s basic privileges for general gynecologic care.


REP. GIDDINGS: Okay. And a D&C is a what?


DR. LOVE: Dilatation and curettage.


REP. GIDDINGS: Yeah, but is it - is it the abortion or an aftermath of an abortion - what is it?


DR. LOVE: Well, it is a particular surgery where you dilate the cervix and evacuate the contents of the uterus. You can do it for an elective abortion, you can do it for people who had incomplete abortions, you can do it if you’re sampling the uterus, such as you’re, um, staging a woman for endometrial cancer. You can do it if you’re also, uh, removing polyps that you’ve noticed on one of your prior studies.


REP. GIDDINGS: Mm-hmm. So it’s not always an abortion.


DR. LOVE: That’s correct.


REP. GIDDINGS: Okay. That’s - that’s what I thought. It could be for some of these other, uh, procedures. Okay. So the D&C is not always an elective abortion? It’s not always removing tissue from an abortion. It can be to sample and stage for - uh -


DR. LOVE: Yes, ma’am. So that you can stage a person to know what type of endometrial cancer they have, to know which type of therapies you need to proceed with.


REP. GIDDINGS: Or to remove polyps.


DR. LOVE: Yes, ma’am.


REP. GIDDINGS: Okay. So, uh, the physician could be performing D&Cs based on these two things and - and which one of those is more likely to happen? You know, when people who have these privileges are performing D&Cs is it because of the polyps and the staging and some other kind of - of matters, uh -


DR. LOVE: Well, it would depend on the physician. If you’re talking about a gynecologic oncologist, he’s gonna be staging for endometrial cancer. If you’re talking about a general, um, gynecologist, they’re gonna be doing more things related to irregular bleeding, looking for polyps, for me it’s gonna be more like missed abortions, where a patient comes in bleeding and has remaining tissue inside the uterus.


REP. GIDDINGS: Thank you, Doctor. I think my last question is this one. Uh, if - if we pose the question to - we just talked about the credentialing you did. If we po- if we, um, pose the question to St. David’s in terms of whether or not the hospital, um, allows the performing of abortions, what would that - uh, uh, just general - we’re not talking about saving somebody’s life or whatever - what would the answer to that question be?


DR. LOVE: Under certain circumstances, yes. I mean, I’ve done it.


REP. GIDDINGS: Under certain circumstances such as -


DR. LOVE: Yes. Not just - not just for elective because they no longer wish to be pregnant. No, I don’t think they do that. But under certain circumstances, um, they can be done.


REP. GIDDINGS: So - so the answer from St. David’s would be that in terms of elective - elective abortions, and for that reason only, they don’t do that. That’s not -


DR. LOVE: To my knowledge, but it would be better to ask the, um, credentialing committee who sets that.


REP. GIDDINGS: You were - you were the chair of that four years ago?


DR. LOVE: I was chairman of my section of OB/GYN.




DR. LOVE: I signed off on the privileges after I reviewed them for doctors. I - I don’t set all the credentials. That’s the credentialing committee who sets the credentials. I was not part of that committee.


REP. GIDDINGS: You were the department head who made the recommendations?


DR. LOVE. Department chairman, yes, ma’am.


REP. GIDDINGS: Okay. Thank you.


REP. HUBERTY: Mr. Chairman?


REP. COOK: Yes, Representative Huberty?


REP. HUBERTY: I want to circle back, um - your colleague - we had a little exchange on Section 171063 of the bill, distribution of the anti-abortion drug. I think you heard - if you were here, maybe you heard my exchange with him.


DR. LOVE: Maybe.


REP. HUBERTY: Perhaps not, but - but the point is, is that - I’m assuming you agree with all portions of the bill, meaning that we’re asking - we’re asking the physician to follow the protocol. Right?


DR. LOVE: Mm-hmm.


REP. HUBERTY: Which is just not give the drug and - and, you know, then assume they’re gonna take it at home but make sure that there’s, uh,  physician’s information on there, we’re giving them all the information that goes with that. Would you agree that the protocol that’s provided by the FDA is - is probably the current protocol, what they’re talking about, and that’s what should be followed as we go forward, I mean, just in your expert opinion.


DR. LOVE: That’s what I feel should be followed. I mean, there are people who practice off-label choices.




DR. LOVE: Um, my feeling is, is that, you know, you can use drugs off-label if you have a solid enough database, then submit it to the FDA and have things changed.




DR. LOVE: I mean, that’s not a problem. I mean, it’s happened with other drugs. Um, if you’re gonna practice off-label I think a patient needs to know that and needs to know the risk -


REP. HUBERTY: And that’s - and that’s what’s in the bill. It says that we have to provide that, so we’re making sure we’re providing all that factual information.


DR. LOVE: Yeah.


REP. HUBERTY: That’s what the bill’s asking to be done. Um, and then follow-up, just in your opinion on the - on the ambulatory centers, um, you know obviously we’ve heard, you know Chairman Turner and I have had some discussion about the costs associated with that, but - but the one question would be, looking at it from a medical emergency, the impact of not having an ambulance accessible to a clinic, as an example, could be a life-threatening situation, would you agree with that?


DR. LOVE: Yes.


REP. HUBERTY: Okay. And so all we’re asking is, is that we’re providing that standard of care from the ambulatory center, so. Thank you for being here.


DR. LOVE: Mm-hmm.


REP. COOK: Any other questions?  Uh, Representative Frullo?


REP. FRULLO: Doctor, and I appreciate your testimony, could you give me a - you’ve mentioned one item, a D&C as a general gynelogical (sic) privilege. What are some of those other items that would fall under that category?


DR. LOVE: Well, you could do I&D of abscesses, uh, placement of, you know, IUDs, um, you know, small surgical procedures, if you need to remove skin - skin lesions, I mean it - you have to - when you apply - currently when I apply for privileges it includes anything up to a hysterectomy. I don’t do radical hysterectomies, I let the oncologist so that, um, but you could do laparoscopic surgery such as removal of cysts, um, diagnostic laparoscopies, laser, so -


REP. FRULLO: Quite a few procedures.


DR. LOVE: Well, actually laser has its own set of privileges, so. So. There’s a lot of privileges that are associated with it.


REP. FRULLO: Okay. Thank you.


REP: TURNER: Mr. Chairman.


REP. COOK: Uh, yes.


REP. TURNER: Just very quickly. Doctor, are you testifying here in your - as a volun- in a voluntary capacity or are you testifying on behalf of someone?


DR. LOVE: No. On behalf of myself.


REP. TURNER: Okay. So you’re not here representing any organization or where you’ve been paid by any organization to be here?


DR. LOVE: No, absolutely not.


REP. TURNER: Have you ever been - have you testified for us before in a paid capacity?


DR. LOVE: No, I have not.


REP. TURNER: Okay. So, no organization has - has paid you for -




REP. TURNER: And asked you to come in and speak here.




REP. TURNER: Okay. Thank you.


REP. COOK: Okay. At this time the Chair is gonna call, uh, Vivian Ballard, here representing herself to testify against the bill.




Vivian Ballard, AGAINST


Transcribed by Catherine Cook


MS. BALLARD: Good evening. My name is Vivian Ballard and I’m here opposing this bill. I have seen some of you before and told you that I am the wife of 33 years of a sixth generation Texan whose great-great-great grandfather signed the Texas Declaration of Independence. I am really disappointed with this proposed legislation because I believe that it is an unwarranted intrusion into the lives of the citizens of this state. Since this bill has been in the news so much, I have heard so many stories from Texans of a certain age who were teenagers or young adults when Roe v. Wade was not in effect, and they have talked to me about their experiences with getting pregnant and going to doctors who were not equipped to handle any medical procedure that they wanted to terminate a pregnancy. They have told me that they were unable to bear children again because of those back alley procedures. They have talked to me at great length and with great passion and they, the Texans that I have talked to, would urge you to reconsider your support of this legislation if you are supportive of it, because they don’t want their grandchildren to go back to those days. Because they know women have always had abortions and they know that women will suffer greatly if we go back in time to those times where people couldn’t get safe medical care. I personally support my doctor’s ability to advise me and my family and, frankly, unless you have a medical degree, I really don’t want to take medical advice from you. I trust my doctor. I trust my doctor to advise me about what I do with my body. I myself had a high-risk pregnancy, and I myself needed my doctor’s care and advice, and I believe that we need to stand with our doctors and let them be the professionals who take care of patients. I thank you for your consideration and I do appreciate your time.


REP. COOK: Thank you for your testimony. Uh, Dean Mullins? Deanne Mullens, excuse me. Here representing herself, for the bill.




Deanne Mullens, FOR


Transcribed by Catherine Cook


MS. MULLENS: Hi, I’m Deanne Mullens and I’m representing myself, and I live in Leander. Um, I am for any and all restrictions on abortions. When I was 15 I became pregnant while in an abusive relationship. When I told my parents they immediately scheduled an appointment with Planned Parenthood. While there, we were informed of our options, which were, essentially, have an abortion. They handed my parents a paper with all of the abortion clinics around them. I wanted to keep my child but my parents did not want that, feeling I was not equipped to handle it, and they were probably right. I am still against abortions. Um, I was against adoption at that time, um, fearing what my child would be going into. Knowing what I know now about adoption, I would have chosen that. My parents have decided, or my parents did decide that abortion was the only option and made the appointment for me. While I was on the table I begged and cried for my child’s life, asking the doctor to please stop. He told me that I would thank him later. Being 20 years ago, I have still not thanked that man. I will never thank him. I was rid- riddled with guilt and loss. I grieved for years and desperately tried to fill that hole by attempting to get pregnant again. Thankfully, I did not until many years later, married. I now have four children but I still ache for that one. As a family, we have fostered. We also are working on an adoption. I teach at a middle school, partly to make amends for my previous choice and to help those who are currently hurting. I have never been able to speak freely about my abortion. I have only confided to a handful of people, namely my husband, partly for fear and shame. I did not want to shame my family or cause people to look at me differently and now I am here telling my darkest secret in front of a room full of strangers. I share this in hopes of sparing other young women from the same thing. I speak on behalf of the children who will be missed because they were murdered prior to being born. I speak on behalf of families who want those children desperately to complete their family units but cannot have their own. I speak on behalf of the misled women; the ones who don’t know that they will be - the ones who are misled, saying that the abortion will be over in ten minutes but never thought of again and how untrue that is. I struggled with my abortion for ten years. For ten years I cried and begged for forgiveness. I hid that secret from even my very closest friends and for the last ten years they have been easier, but I do not feel completely redeemed. I would not wish that anguish on anyone and I believe the essence of pro-life is to, um, want the children to survive while simultaneously I want the women to remain whole and prevent the suffering that comes with a decision. I wasn’t - mental health is part of women’s health and that needs to be considered. Thank you.


REP. COOK: And thank you for your testimony. Uh, Carolyn Connor, here representing hers- herself to testify against the bill.




Carolyn Connor, AGAINST


Transcribed by Catherine Cook


MS. CONNOR: Thank you. My name is Carolyn Connor. I reside in Austin, Texas, Travis County. I’m against this bill. I’m a native Texas woman, a grandmother with two grown grandchildren. I’m here on behalf of all the poor young girls and women that this bill will affect. I thank God we were not the silent majority back in the day when I needed abortion 30 years ago. The women that came before me paved that road. I was young and stupid as most are at that age. The father was a lazy, no good, borderline sociopath that mooched off me and I already had one child. No way would he have ever supported a child. He couldn’t even support himself. This bill would have me tethered to that man forever. I already had one child by another husb- uh, husband and certainly couldn’t afford another. I made the right decision for me and my situation. My religion does not prohibit such procedures. My conscience is clear and I’ve never once looked back with regret. If your religion prevents it, then by all means, you should not have one, but that was the right decision for me. If I were ever faced with that choice again in a state that banned it, I would simply hop a plane to a civilized state and have the procedure there. And this is - and that’s what every woman with any cash or credit will do once this bill effectively closes most clinics engaging in such practices. It will only cause suffering and hardship for the poor women who will be driven into back alleys of the past. In many cases, they will die. This is unconscionable. I have a young granddaughter. They’re trying to break the cycle of teen pregnancy that has run in our family for generations. So far, she has made it to almost 24 without getting pregnant. She has such a good heart. I don’t think she would have an abortion even if she were raped.


REP. COOK: [Unintelligible]


MS. CONNOR: But that’s her choice and Constitutional right. For me personally, this not an abortion issue. Texas is not a theocrac- a theocracy, and I’m sick and tired of the values - my values - and rights being trampled on because they’re different from yours. And my religion is just as valid as yours.


REP. COOK: Thank you very much. Thank you. Thank you. Natalie Goodnow, here representing herself, testifying, uh, against the bill.




Natalie Goodnow, AGAINST


Transcribed by Catherine Cook


MS. GOODNOW: Hello. Good evening. Um, my name is Natalie Goodnow and I am a native Texan. Uh, thank you for this opportunity to speak against, um, HB2. Um, my father was born in San Antonio. He was a military family - part of a military family, so they moved a lot, but when they chose where to live, they chose Texas. My mother’s family chose to come to Texas 100 years ago from Mexico, um, and the other side of my mom’s family has been here since before this was Texas, so (laughs) I guess you could say I’m Texan all over. Um, but to the matter at hand, um, I want to reiterate that just because I’m pro-choice does not mean I am pro-abortion. I want desperately for abortions to be rare, safe, and legal. I believe that keeping abortions accessible and legal will help to keep women safe. Um, I believe very strongly that the bill as written will not keep women safe. Because this bill and the current policy in our state does not provide or promote comprehensive sexual and reproductive health education, because, um, this bill and the current policy in our state don’t help us get access to contraceptives for all who choose to use them, um, because we don’t have family-friendly school or workplace policies for women or men of all ages, any circumstance in life, so that they feel supported in making the beautiful decision to raise a family, because we don’t have fair pay, um, for all people so that all of us can earn a living wage, because we don’t have in this bill or in our state, um, comprehensive sexual violence prevention education for all so that we can put a stop to the abuse and rape of women in our state, because of all of these reasons, this bill will not keep women safe. It is powerless to keep women safe. In the face of all - and I’m sorry, I feel very strongly about this - in the face of all this structural, economic, sexual, and spiritual violence, it is inevitable that some women in our state - many women in our state - will turn this violence upon themselves, upon their own bodies, upon the seed that could some day become a child if that woman chooses to make that - that choice. As a community we know this is true because we remember the history before Roe v. Wade. The effect of this bill will be that the most vulnerable among us - poor women, women of color, women who live in rural areas - will have no place to go. Our prominent elected officials have been very clear and very public that the stated intention of this legislation is to shut down women’s health centers that provide abortions, and that will deprive the most vulnerable among us, not only of safe abortions but also of routine, regular women’s health care services like pap smears and mammograms. Um, the - and I’ve learned, I’m not an expert, but I know we have a history in this country of poor women and women of color even being forcibly sterilized or at the very least discouraged from having kids. I -  I view this proposed legislation as part of an ongoing pattern in our country of denying health, wellness, power, a voice, and a choice to the most vulnerable and the most powerless among us, and now it’s in the most difficult and private moment of their lives. Um, if we can’t trust a woman with a choice how could we trust her with a child? Please, give us our choice and our power.


REP. COOK: Thank you. Thank you very much for being here and thank you for your testimony.


MS. GOODNOW: Thank you.


REP. COOK: Uh, Deborah McGregor, uh, Care Net Pregnancy Center of Central Texas and self, uh, uh, uh, here in, in favor of the bill. For the bill.




Deborah McGregor, Care Net Pregnancy Center of Central Texas, FOR


Transcribed by Catherine Cook


MS. McGREGOR: Good afternoon. Uh, my name is Deborah McGregor and I am an attorney in good standing in the state of Texas and the Chief Executive Officer of Care Net Pregnancy Center of Central Texas in Waco, Texas, and I am testifying in support of HB2. I have been in this position as Chief Executive Officer of Care Net Pregnancy Center for eight years and have been in leadership as we have served at least 20,000 women during my time there who were facing crisis pregnancies or considering abortion, and at least 12,000 babies. In our pregnancy medical clinic, we, um, perform, uh, pre-pregnancy tests, 3D, 4D ultrasounds, we also - also offer services to women, uh, new and expectant mothers with children, um, under one, and we also, um, provide housing to women who have been kicked out of their homes to - because of continuing their pregnancy. I cannot know many of the women we see because of my leadership role and serving so many women, but there are occasions when some especially touch my heart and I follow up on them to make sure that we offer them excellent services as my job as a CEO, I always want to make sure that we offer excellent services, and regardless of their decision to continue or terminate a pregnancy. There are occasions when I hear horrendous stories through tears and wails and have helped women, uh, complete complaints to the Texas Medical Board and to HHSC for the care they received or not in an abortion clinic. I want to share the most recent one, uh, such story, which was recounted to me over the phone, uh, while one of our clients was lying in a hospital bed in Dallas, Texas on April the fifth of this year, 2013.  This young lady had been, uh, had done a medical rotation at our clinic and was very familiar with all that we do, very familiar with the risk and procedures, uh, surrounding an abortion and the sanctity of life for which we stood. But as an organization who does not pressure women, uh, into continuing their pregnancy, but equips them with the truth about the abortion risks and procedures, we did everything that we could to equip her to choose life, but she did choose to abort. She also gave us permission to follow up with her because we knew that she would be making this decision in - in private and in silent -


REP. COOK: Excuse me, uh, remember no cameras, okay? Thank you. Go ahead.


MS. McGREGOR: - as we knew, uh, and as we knew that abor- abortion physicians typically do not follow up with their patients, at least in our area, and it’s always been the case of our clients in Waco, Texas. Here’s what she told me when I called her to check on her the next day following, um, her procedure. Yesterday morning, and I told her that I would offer this testimony to you because it is still very fresh, uh, she does want to, uh, tell you her story, uh, but she’s not capable of recounting it herself.


REP. COOK: You’re gonna have to wrap up here.


MS. McGREGOR: Okay. Yesterday, uh, the morning of April fourth, I drove to the Dallas Planned Parenthood mega clinic for what was supposed to be a standard, uh, D&E. As a nurse, I knew what the procedure consisted of -


REP. COOK: Ms. McGregor, your time is up. Thank you very much. We can ask questions. Go ahead, Representative Farrar.


REP. HUBERTY: Go ahead. Go ahead, Jessica.


REP. FARRAR: You operate a crisis pregnancy center, is that what I understand?


MS. McGREGOR: Yes, ma’am.


REP. FARRAR: All right. Um, do - so when women present to you and they, uh, want to exercise their Constitutional right, do you refer them to a place where they can have a safe and legal abortion?


MS. McGREGOR: They don’t come to us for abortion.


REP. FARRAR: If they did? Would you? Is it your pol- is it against your policy to refer them?


MS. McGREGOR: It’s not who we are. We’re a Christian agency that offers alternatives to abortion.


REP. FARRAR: So your answer is no?


MS. McGREGOR: What was your question?


REP. FARRAR: Do you refer a woman, if a woman presented to you and said “I want an abortion,” would you refer her to a safe and legal, uh, place where she could have that done?


MS. McGREGOR: What we would tell her is we offer alternatives to abortion.


REP. FARRAR: Would you give her a referral?


MS. McGREGOR: We don’t make referrals to abortion clinics.


REP. FARRAR: Okay. All right. That was my question. Uh, what about contraception? If she’s - is that part of your counseling? [Unintelligible due to crosstalk] contraception?


MS. McGREGOR: When they come to us they come here pregnant.


REP. FARRAR: Right, but a lot of times these are people that don’t have information about contraception.


MS. McGREGOR: If they have a n-


REP. FARRAR: Do you steer them in that direction?


MS. McGREGOR: If they have a negative pregnancy test then what we tell them is the way - the best way that we know for them to not be back in our clinic, uh, especially if they’re single, is to not have sex outside of marriage. If they are married, then we refer them to their physician or their spiritual advisor to have that discussion with their husband.


REP. FARRAR: Do you - do you discuss contraception with the woman?


MS. McGREGOR: We don’t discuss contraception. We don’t - I mean, if they wanna see a physician, then they can see a physician about that and we will refer them to a physician to have that discussion, but we don’t discuss it -


REP. FARRAR: But that’s not part of your discussion. Thank you.


MS. McGREGOR: That’s not part of our services, no.


REP. FARRAR: I appreciate your answer.


MS. McGREGOR: Mm-hmm.


REP. HUBERTY:: Mr. Chairman?


REP. COOK: Uh, yes, uh, Representative Huberty.


REP. HUBERTY: So, I know with everybody we don’t have a lot of time, but I read the story -


MS. McGREGOR: Thank you.


REP. HUBERTY: - that - that you gave here, and I guess the synopsis of it was that she - this young lady went in and had an abortion done, and her, um, her - it- it’s, I guess, a Planned Parenthood clinic - and had a medical complication and went back up to the clinic and asked - said something’s not right, and she happened to be a nurse - said something’s not right, and they said, well, basically, you know, we can’t help you. You need to go to, to, to the clinic. And it turns out that she had a pretty major medical problem, is that -


MS. McGREGOR: Yes. She, uh, knew, by the way that she was feeling when she was leaving that something wasn’t right, um, and so she went back in and said “I think my blood pressure’s dropping, I’m having pressure in my uterus, in my rectum, I’m thinking that I’m losing blood,” and they said, well, um, basically, go to the emergency room. And they had her drive herself to the emergency room.


REP. HUBERTY: And so then she ended up with surgery and - and the doctor basically said they pierced her uterus and started -


MS. McGREGOR: They tore -


REP. HUBERTY: Tore it.


MS. McGREGOR: Ripped her uterus.


REP. HUBERTY: And at the end of the story, it was, a similar case occurred only three days before hers and what - what was the end result of that?