A Bill for an Act
Page 1, Line 101Concerning the regulation of medical facilities that
Page 1, Line 102perform induced abortions after the first trimester of
Page 1, Line 103pregnancy.
Bill Summary
(Note: This summary applies to this bill as introduced and does not reflect any amendments that may be subsequently adopted. If this bill passes third reading in the house of introduction, a bill summary that applies to the reengrossed version of this bill will be available at http://leg.colorado.gov.)
The bill requires the department of public health and environment to annually license and to establish and enforce standards for the operation of medical facilities that perform medical or surgical induced abortions during the second or third trimester of pregnancy.
Page 2, Line 1Be it enacted by the General Assembly of the State of Colorado:
Page 2, Line 2SECTION 1. Legislative declaration. (1) The general assembly finds that:
Page 2, Line 3(a) Second- and third-trimester abortion clinics are not currently
Page 2, Line 4regulated by the Colorado department of public health and environment (CDPHE);
Page 2, Line 5(b) CDPHE is authorized to license, regulate, and inspect a wide
Page 2, Line 6spectrum of health-care facilities to ensure public health and safety,
Page 2, Line 7including freestanding emergency departments, critical access hospitals,
Page 2, Line 8psychiatric hospitals, community clinics, rehabilitation hospitals,
Page 2, Line 9convalescent centers, facilities for persons with intellectual and
Page 2, Line 10developmental disabilities, nursing care facilities, hospice care, assisted
Page 2, Line 11living residences, dialysis treatment clinics, ambulatory surgical centers, birthing centers, and home care agencies;
Page 2, Line 12(c) Gynecologic dilation and curettage (D&C) and second- and
Page 2, Line 13third-trimester obstetric D&C, dilation and evacuation, dilation and
Page 2, Line 14extraction, and inductions of labor are all normally performed in facilities
Page 2, Line 15regulated by CDPHE. The exception to this protocol is when these same
Page 2, Line 16procedures are used during an elective induced abortion at abortion clinics in the second and third trimester.
Page 2, Line 17(d) Birthing centers, which are licensed, regulated, and inspected
Page 2, Line 18by CDPHE are prohibited from inducing labor because of the associated
Page 2, Line 19risks, but second- and third-trimester abortion clinics routinely use labor-inducing drugs without any CDPHE oversight;
Page 2, Line 20(e) Second- and third-trimester abortion procedures are associated
Page 2, Line 21with significant risk. There is a 10% risk that a complication will arise
Page 3, Line 1during a second-trimester abortion, including cervical laceration,
Page 3, Line 2hemorrhage, uterine atony, anesthesia complications, uterine perforation,
Page 3, Line 3disseminated intravascular coagulation, and retained products of
Page 3, Line 4conception, and more than a 1.5% risk that a severe complication will
Page 3, Line 5arise, including hospitalization, transfusion, or further surgical
Page 3, Line 6intervention. The risk from instrument-assisted third-trimester dilation
Page 3, Line 7and extraction abortions is substantial. Blood loss increases by 7% for each additional week increase in gestational age.
Page 3, Line 8(f) The risk of dying from an abortion increases 38% for each
Page 3, Line 9week of gestation after 8 weeks. The risk of dying from a complication
Page 3, Line 10of an induced surgical abortion in the second and third trimester is greater
Page 3, Line 11than the risk of dying from procedures performed at ambulatory surgery
Page 3, Line 12centers in the United States and Canada, which centers in our state are regulated by CDPHE.
Page 3, Line 13(g) The Colorado Maternal Mortality Review Committee
Page 3, Line 14(MMRC) recommends strategies to achieve equity in maternal health
Page 3, Line 15outcomes and ways to reduce the incidence of preventable maternal
Page 3, Line 16mortality and morbidity. Pregnancy-associated mortality and
Page 3, Line 17pregnancy-related maternal mortality includes abortion-associated
Page 3, Line 18mortality and abortion-related maternal mortality. The MMRC
Page 3, Line 19recommends the use of evidence-based patient safety bundles,
Page 3, Line 20evidence-based screening tools, and improved coordination of care as key
Page 3, Line 21elements to reduce maternal mortality. It is difficult to ensure
Page 3, Line 22implementation of the MMRC recommendations without a licensing,
Page 3, Line 23regulating, and inspection process for second- and third-trimester abortion clinics.
Page 3, Line 24(2) Therefore, the general assembly declares that unregulated
Page 4, Line 1second- and third-trimester abortion clinics place Colorado women's lives in jeopardy and should be regulated by CDPHE.
Page 4, Line 2SECTION 2. In Colorado Revised Statutes, 25-1.5-103, amend (1)(a)(I)(A); and add (2)(e) as follows:
Page 4, Line 325-1.5-103. Health facilities - powers and duties of department
Page 4, Line 4- rules - limitations on rules - definitions. (1) The department has, in
Page 4, Line 5addition to all other powers and duties imposed upon it by law, the powers and duties provided in this section as follows:
Page 4, Line 6(a) (I) (A) To annually license and to establish and enforce
Page 4, Line 7standards for the operation of general hospitals, hospital units as defined
Page 4, Line 8in section 25-3-101 (2), freestanding emergency departments as defined
Page 4, Line 9in section 25-1.5-114, critical access hospitals as defined in section
Page 4, Line 1025-1.5-114.5, psychiatric hospitals, community clinics, rehabilitation
Page 4, Line 11hospitals, convalescent centers, facilities for persons with intellectual and
Page 4, Line 12developmental disabilities, nursing care facilities, hospice care, assisted
Page 4, Line 13living residences, dialysis treatment clinics, ambulatory surgical centers,
Page 4, Line 14birthing centers, second- and third-trimester abortion clinics,
Page 4, Line 15home care agencies, and other facilities of a like nature, except those wholly owned and operated by a governmental unit or agency.
Page 4, Line 16(2) As used in this section, unless the context otherwise requires:
Page 4, Line 17(e) "Second- and third-trimester abortion clinic" means a
Page 4, Line 18medical facility that performs either medical or surgical
Page 4, Line 19induced abortions after the first trimester of pregnancy but
Page 4, Line 20does not include a hospital or hospital unit that performs these procedures but is regulated separately.
Page 4, Line 21SECTION 3. Act subject to petition - effective date. This act
Page 4, Line 22takes effect at 12:01 a.m. on the day following the expiration of the
Page 5, Line 1ninety-day period after final adjournment of the general assembly; except
Page 5, Line 2that, if a referendum petition is filed pursuant to section 1 (3) of article V
Page 5, Line 3of the state constitution against this act or an item, section, or part of this
Page 5, Line 4act within such period, then the act, item, section, or part will not take
Page 5, Line 5effect unless approved by the people at the general election to be held in
Page 5, Line 6November 2026 and, in such case, will take effect on the date of the official declaration of the vote thereon by the governor.