(Updated to include comments from opponents and supporters of the bill with edits throughout)
For the second time in four years, Gov. Laura Kelly has vetoed a bill requiring physicians to notify women that their drug-induced abortion can be reversed.
The bill, which was approved 26-11 in the Senate and 80-38 in the House, is based on the controversial idea that a medical abortion can be stopped halfway through a two-drug regimen. The House passed the bill one time with 85 votes.
The Legislature passed a similar bill in 2019 but couldn’t override the governor’s veto. The bill needs one more vote in the Senate to override the governor’s veto this year. The House had enough votes for an override on its first pass of the bill on March 29.
It was the second major piece of abortion legislation that the governor has vetoed since voters last summer rejected a constitutional amendment that would have removed the right to an abortion from the state constitution.
“In August, Kansans made clear that they believe personal health care decisions should be made between a woman and her doctor, not politicians in Topeka,” Kelly said.
“This bill would interfere with that relationship and, given the uncertain science behind it, could be harmful to Kansans’ health,” she said.
There are now two states that require similar notifications for a medical abortion, and similar laws in two other states are being litigated.
The legislation comes amid a legal battle over whether the Food and Drug Administration was authorized to approve the abortion-inducing drug mifepristone 23 years ago.
A federal district judge recently issued an order suspending the use of mifepristone nationwide and halting FDA efforts to expand access the drug since 2016.
The U.S. Fifth Circuit Court of Appeals put part of the ruling on hold, and the fast-moving case is now on appeal to the U.S. Supreme Court.
The court on Wednesday agreed to further delay a decision on whether to halt the lower-court rulings until Friday.
Supporters of the bill said the legislation was intended to give more information to women who might have second thoughts about having an abortion when they’re vulnerable.
They immediately urged the Legislature to override the veto.
“Once again, Gov, Kelly has sided with the extremist abortion industry over empowering women with facts about their true options concerning medication abortions and the potential to reverse the process once it has begun,” said Danielle Underwood, spokesperson for Kansans for Life.
“Why is Gov. Kelly so afraid of trusting women with this information?” she asked.
“We call upon legislators to truly reflect Kansas values and override this ideologically driven veto.”
Opponents said there’s no credible evidence that a medical abortion can be reversed and that it’s based on studies that are questionable and the mandated information is misleading and medically “suspect.”
They called it “state-mandated deception.”
“It’s one thing for politicians to mislead Kansans about abortion – we saw plenty of that last year, but Kansans saw through the lies and rejected giving politicians power over their personal, private decisions,” said the Senate’s top Democrat, Dinah Sykes.
“It’s another, however, to force physicians to lie to Kansans about abortion, and that’s exactly what HB 2264 would do,” Sykes said in a statement.
“This bill attempts to undermine Kansans’ right to bodily autonomy by willfully forcing blatant misinformation into a healthcare environment,” she said.
“This is an attempt to sway a woman away from making the decision that the people of Kansas resoundingly said she has a right to make on her own.
“We all want women to be empowered to make the best decision for herself and her family. Lying to women does not empower them; it endangers them.”
Republican state Rep. Susan Humphries of Wichita said the bill is about giving women information so they can make informed decisions about getting an abortion.
“Women have a right to know this information and it is being kept from them,” Humphries said during floor debate on the amendment.
“Women are in a hard place if they are going to get a chemical abortion,” she said.
“They may have a regret and when they call they have been told, ‘No, there’s nothing you can do,’” Humphries said.
“This bill can give hope and it is factual,” she said. “Thousands of pregnancies have been because of the abortion pill reversal protocol.”
Testifying before the House health committee, Kansans for Life lobbyist Jeanne Gawdun cited an article from Pregnancy Help News that reported that 4,000 babies had been saved from the reversal protocol.
The bill comes at a time when medical abortions are on the rise nationally and in Kansas. Supporters of the bill say it’s needed as abortion procedures evolve.
“Over two-thirds of abortions in Kansas are performed using the abortion pill. It is past time that our informed consent laws are updated to ensure that women have access to information about that method of abortion,” said Brittany Jones, policy and engagement director of Kansas Family Voice.
The bill would require any clinic providing medical abortions to post a sign — in at least three-quarter inch boldface type — telling women it’s possible to reverse the process once it has begun.
The sign would read as follows:
“NOTICE TO PATIENTS HAVING MEDICATION ABORTIONS THAT USE MIFEPRISTONE: Mifepristone, also known as RU-486 or mifeprex, alone is not always effective in ending a pregnancy. It may be possible to reverse its intended effect if the second pill or tablet has not been taken or administered.
“If you change your mind and wish to try to continue the pregnancy, you can get immediate help by accessing available resources,” the notice would read.
The bill also would require physicians to inform women that a medical abortion could be reversed within 24 hours of administering the first drug. Women would have to be notified in writing and by telephone or in person.
The bill also would apply to pharmacies that prescribe the drug mifepristone, which is used for inducing an abortion.
A violation on first offense would be a misdemeanor. A second or subsequent conviction would be a felony.
A $10,000 fine could be assessed against any medical facility that fails to post the signage, with each day considered a separate violation.
Kansas and other states have responded to research by California physician George Delgado, who published a 2012 article in the Annals of Pharmacotherapy explaining how the effects of the first abortion pill could be reversed.
The protocol employs two steps: first with the drug mifepristone and a second with the drug misoprostol.
The first drug blocks a hormone critical for starting the pregnancy. The second drug, administered to 24 to 48 hours later, flushes the uterus by causing cramping and bleeding similar to a miscarriage.
Delgado’s initial research said that when the hormone progesterone was introduced between the first and second pill, four of six women studied brought their pregnancy to term.
He published an article more recently in Issues in Law and Medicine that examined a larger group of women.
The later study examined 547 patients who took progesterone within 72 hours of taking the first abortion pill. The study found there were 257 live births.
Opponents of the bill have questioned Delgado’s research.
The American College of Obstetricians of Gynecologist has said bills similar to the one in Kansas represent “dangerous political interference and compromise patient care and safety.” It said the reversal procedure is not based on science.
The American Civil Liberties Union said Delgado’s first study in 2012 was not supervised by an institutional review board nor an ethical review committee to protect human research subjects.
The ACLU said Delgado didn’t examine long-term effects of the drug protocol including the woman’s health, pregnancy complications or the chances for birth defects.
Democratic state Rep. Kirk Haskins referred to the American College of Obstetricians and Gynecologists in making his case against studies that supported the bill.
“I have noticed a tendency that if we see a fact in the air, we’re just going to grab it and throw it,” Haskins said during the debate in the House. “We need to do better than that.”
Haskins said that a law simply requiring signage wouldn’t be sufficient.
“Just because we point at a sign on the wall does not mean individuals are going to read it or be informed about that,” he said.
“They are only going to read it and be informed if we provide appropriate data and research and support and make decisions that are valid and not biased.”
Jonathan Scrafford, a Wichita obstetrician, testified on behalf of the bill before the House health committee.
Scrafford said he personally delivered babies whose lives were saved by the abortion pill reversal protocol.
“I can personally and professionally attest to the tangible outcomes made possible only by thorough and accurate information about the process,” Scrafford said in written testimony.
“As a born-and-raised Kansan, I would want every woman in the midst of such a struggle to be guaranteed the information she would need to facilitate that reversal should she so desire,” he said in his testimony.
There are now two states – Nebraska and Utah – that require similar notifications for a medical abortion, according to the Guttmacher Institute, a research think tank that supports abortion rights.
Two other states – Indiana and North Dakota – have similar laws on the books that are not in effect as they are litigated in court.
And there are eight states – Arkansas, Idaho, Kentucky, Louisiana, Oklahoma, South Dakota, Tennessee and West Virginia – that would have notification requirements but are moot because they already ban almost all abortions.
If those bans were not in effect, then abortion reversal counseling requirements would be in effect in all but Oklahoma and Tennessee, where there are court cases, according to Guttmacher.
The American Medical Association joined a lawsuit in 2019 seeking to stop North Dakota’s law.
The lawsuit said physicians were being forced to provide information that was not supported by science. The law was temporarily blocked in 2019 but is still pending.
The AMA president said the North Dakota law required physicians “to mislead and misinform their patients with messages that contradict reality and science.”
