The ACLU of Georgia works to ensure that every person can make the best decision for themselves and their family about whether and when to have a child without undue political interference.

SISTERSONG V. GEORGIA

Georgia physicians, reproductive health care providers, and advocates filed a lawsuit in the Superior Court of Fulton County on June 26, bringing a state constitutional challenge against H.B. 481, a law banning abortion at approximately six weeks of pregnancy — just two weeks after a person’s first missed period and before many people even know they are pregnant. This lawsuit comes one week after a federal appeals court allowed Georgia’s six-week ban to take effect for the first time since it was passed in 2019, causing an immediate, devastating crisis as clinics were forced to turn away patients in waiting rooms across the state and to cancel many upcoming appointments.

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THE PAST

Roe v. Wade is the landmark U.S. Supreme Court decision that famously invalidated the Texas law in 1973 on the ground that the constitutional right to privacy encompasses a woman’s decision whether or not to continue her pregnancy.

The Court found that the state could not “override the rights of the pregnant woman” by “adopting one theory of life.” Characterizing this right as ‘fundamental’ to a woman’s ‘life and future,’ the Court held that the state could not interfere with the abortion decision unless it had a compelling reason.

In a companion case to Roe, Doe v. Bolton, which the ACLU argued before the Justices, the U.S. Supreme Court overturned a Georgia law prohibiting abortions except when necessary to preserve a woman's life or health or in cases of fetal abnormality or rape. The Court held the Georgia law unconstitutional, because it imposed too many restrictions and interfered with a woman's right to decide, in consultation with her physician, to terminate her pregnancy.

Georgia's Maternal Mortality Crisis

Georgia is one of the most dangerous states in America for a pregnant woman — even more so if that woman is black. In 2016, The Yale School of Public Health found that the pregnancy-related maternal mortality ratio in Georgia was 40.8 per 100,000 live births.

The maternal death rate for white women in Georgia is more than twice that for white women nationally. The maternal death rate for black women in Georgia is twice that for white women in Georgia and 6 times the rate for white women, nationally. Half of Georgia’s 159 counties have no OB-GYNs. Rather than second guessing women's healthcare decisions, politicians should address Georgia's maternal health crisis.

Did you know?

  • 50th out of 50Georgia's ranking in maternal mortality rates compared to the rest of the U.S.
  • 48thGeorgia's ranking in U.S. healthcare coverage for women
  • 2xMaternal mortality rate for white women in Georgia compared to the national average
  • 6xMaternal mortality rate for black women in Georgia compared to the national average
  • 40%of all labor and delivery facilities in Georgia have closed over the last 20 years
  • 70%of Georgians support Roe v. Wade

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Stop. The. Bans.

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Andrea Young Remarks on Sistersong v. Georgia

Executive Director Andrea Young delivers remarks on the Sistersong v. Georgia lawsuit that was filed on July 26, 2022, challenging H.B. 481, a law banning abortion at approximately six weeks of pregnancy.

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HB 481 & REPRODUCTIVE RIGHTS IN GEORGIA

Facts on Maternal/Fetal Health

  • Georgia has the 5th lowest number of policies supportive of the health of women and children (ex: Georgia does not require reasonable accommodations for pregnant employees).
  • The CDC lists Georgia’s rate of pregnancy-related deaths as 28.8 maternal deaths per 100,000 live births in 2018-2020, among the ten highest in the country.
  • Between 2015 and 2017, the Georgia Department of Public Health recognized 87% of pregnancy-related deaths over the time period were preventable.
  • Black women are 2.3 times as likely to die from pregnancy as white women in the state of Georgia.

Facts on Abortion in Georgia Before Dobbs and Sistersong v. Kemp

  • Abortions were allowed until 22.0 weeks last menstrual period (LMP), with narrow exceptions for after that week.
  • In 2019, the abortion rate in Georgia was 16.9 abortions per 1,000 women of reproductive age. 65% of patients were Black, 21% white, 9% Hispanic, 5% “other race”.
  • 87% of Georgia abortion patients are unmarried and more than 60% already have at least one child.
  • Abortion is safer than pregnancy, with complications occurring in fewer than 1% of abortions.

Restrictions

  • 24 hour waiting period (O.C.G.A. § 31-9A-3(2))

  • Young people have to notify a parent or get a court order (§ 15-11-682)

  • Nurse practitioners et al are prohibited from providing abortion services despite there being no medically necessary reason for this limitation (§ 16-12-141(B), 43-34-110, 43-34-25(L),

  • Medicaid, with very narrow exceptions, will not cover abortion.

  • Health plans offered on the state insurance exchange (§ 33-24-59.17) or employee state health plans (§ 45-18-4) cannot cover abortion.

HB 481 (Six Week Ban)

  • Section 10 of H.B. 481 requires that, before performing an abortion, a physician first make “a determination of the presence of a detectable human heartbeat.
  • As amended by H.B. 481 § 3, “[d]etectable human heartbeat” is defined as “embryonic or fetal cardiac activity or the steady and repetitive rhythmic contraction of the heart within the gestational sac.” 
  • Section 4 then provides that “[n]o abortion is authorized or shall be performed if an” embryo/fetus “has been determined . . . to have a detectable human heartbeat,” and “[n]o abortion is authorized or shall be performed in violation of” the code section requiring such a determination. H.B. 481.

  • Section 4 also contains exceptions to the Six Week Ban:

    • Medical emergency exception: allows for an abortion in the case of a patient’s medical emergency, but expressly prohibits a physician from considering “a diagnosis or claim of a mental or emotional condition. . .or that the pregnant woman will purposefully engage in” suicide, self-harm, or dangerous behaviors likely to result in death or self-harm. (codified in O.C.G.A. §16-12-141(b)(1), (a)(3)).

    • Rape/Incest resulting in pregnancy that is at or below 22 weeks LMP but only when “an official police report has been filed alleging the offense of rape or incest.” (codified at O.C.G.A. §16-12-141(b)(2)).

    • When the “physician determines, in reasonable medical judgment, that the pregnancy is medically futile,” defined as when the embryo/fetus has anomaly that is incompatible with sustaining life after birth. (codified at O.C.G.A. §16-12-141(a)(4), (b)(3)).

 

 

 

 

Physician Consequences for Violating HB 481

  • Potential imprisonment of 1 to 10 years. 
  • Potential licensing penalties up to and including revocation, because it could constitute both “unprofessional conduct” under and independent grounds for such discipline.
  • A patient may also bring a civil action against the physician for violating Section 4. H.B. 481.

HB 481 and Fetal Personhood

  • Section 2 of H.B. 481 declares that it is the policy of the State of Georgia to recognize embryos/fetuses “as natural persons,” H.B. 481 § 2(6); purporting to promote a “more expansive state recognition of embryos/fetuses “as persons”.
  • Section 3 of H.B. 481 amends O.C.G.A. § 1-2-1 – which contains definitions of “Persons and their Rights” that apply throughout the Georgia Code - to define “natural person” as including “any human being including an unborn child,” and defines “unborn child” as an embryo/fetus “at any stage of development” in utero. 
  • Mandates the inclusion in “population based determinations” of all “natural persons,” including embryos/fetuses in utero with “a detectable human heartbeat.” 

HB 481 and Records Access Provision

  • H.B. 481 gives GA prosecutors in both the judicial circuit where the abortion provider is located and the judicial circuit where the patient resides with seemingly unrestricted access to personal health and medical records, without giving the patient due process rights.

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