EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb0108*
HOUSE BILL 108
J1 5lr0888
HB 1233/24 – HGO (PRE–FILED)
By: Delegate Metzgar
Requested: September 18, 2024
Introduced and read first time: January 8, 2025
Assigned to: Health and Government Operations
A BILL ENTITLED
AN ACT concerning 1
Public Health – Abortion 2
(Heartbeat Bill) 3
FOR the purpose of requiring that an abortion be performed by a physician, rather than a 4
qualified provider; repealing certain provisions of law related to State interference 5
with an abortion, regulations related to abortion, and liability or criminal 6
punishment for qualified providers who perform an abortion; prohibiting a physician 7
from knowingly performing, inducing, or attempting to perform or induce an abortion 8
under certain circumstances and subject to certain exceptions; establishing 9
requirements for performing or inducing an abortion on a pregnant woman; 10
requiring that certain requirements relating to the performance or inducement of 11
abortions be enforced exclusively through private civil actions; authorizing any 12
person, other than an officer or employee of the State or a local governmental entity 13
in the State, to bring certain civil actions; providing for sovereign, governmental, and 14
official immunity under certain circumstances; and generally relating to abortions. 15
BY repealing 16
Article – Health – General 17
The part designation “Part II. Abortion Procedures” immediately preceding Section 18
20–207; Section 20–209; the part designation “Part III. Information” 19
immediately preceding Section 20–211; and the part designation “Part IV. 20
Effect of Refusal to Participate or Refer” immediately preceding Section 21
20–214 22
Annotated Code of Maryland 23
(2023 Replacement Volume and 2024 Supplement) 24
BY adding to 25
Article – Health – General 26
Section 20–202 and 20–204 through 20–212 27
Annotated Code of Maryland 28 2 HOUSE BILL 108
(2023 Replacement Volume and 2024 Supplement) 1
BY repealing and reenacting, with amendments, 2
Article – Health – General 3
Section 20–207, 20–208, and 20–214 4
Annotated Code of Maryland 5
(2023 Replacement Volume and 2024 Supplement) 6
SECTION 1. BE IT ENACTED BY THE GENERAL ASSE MBLY OF MARYLAND, 7
That the part designation “Part II. Abortion Procedures” immediately preceding Section 8
20–207; the part designation “Part III. Information” immediately preceding Section 9
20–211; and the part designation “Part IV. Effect of Refusal to Participate or Refer” 10
immediately preceding Section 20–214 of Article – Health – General of the Annotated Code 11
of Maryland be repealed. 12
SECTION 2. AND BE IT FURTHER ENACTED, That the Laws of Maryland read 13
as follows: 14
Article – Health – General 15
[20–207.] 20–201. 16
(A) In [Part II of] this subtitle[, “qualified provider”] THE FOLLOWING WORDS 17
HAVE THE MEANINGS IN DICATED. 18
(B) “FETAL HEARTBEAT ” MEANS CARDIAC ACTIVI TY OR THE STEADY AND 19
REPETITIVE RHYTHMIC CONTRACTION OF THE F ETAL HEART WITHIN TH E 20
GESTATIONAL SAC. 21
(C) “GESTATIONAL AGE ” MEANS THE AMOUNT OF TIME THAT HAS ELAPSE D 22
FROM THE FIRST DAY O F THE PREGNANT WOMAN ’S LAST MENSTRUAL PER IOD. 23
(D) “GESTATIONAL SAC ” MEANS THE STRUCTURE THAT COMPRISES THE 24
EXTRAEMBRYONIC MEMBR ANES THAT ENVELOP A BABY AND THAT I S TYPICALLY 25
VISIBLE BY ULTRASOUN D AFTER THE 4TH WEEK OF PREGNANCY . 26
(E) “PHYSICIAN” means an individual[: 27
(1) Who] WHO is licensed[, certified, or otherwise authorized by law] to 28
practice MEDICINE in the State[; and 29
(2) For whom the performance of an abortion is within the scope of the 30
individual’s license or certification] UNDER TITLE 14 OF THE HEALTH OCCUPATIONS 31
ARTICLE. 32
HOUSE BILL 108 3
(F) “PREGNANCY” MEANS THE HUMAN FEMA LE REPRODUCTIVE COND ITION 1
THAT: 2
(1) BEGINS WITH FERTILIZA TION; 3
(2) OCCURS WHEN THE WO MAN IS CARRYING THE DEVELOPING BABY ; 4
AND 5
(3) IS CALCULATED FROM TH E FIRST DAY OF THE W OMAN’S LAST 6
MENSTRUAL PERIOD . 7
(G) “STANDARD MEDICAL PRAC TICE” MEANS THE DEGREE OF SKILL, CARE, 8
AND DILIGENCE THAT A N OBSTETRICIAN OF OR DINARY JUDGMENT , LEARNING, AND 9
SKILL WOULD EMPLOY I N SIMILAR CIRCUMSTAN CES. 10
20–202. 11
THE GENERAL ASSEMBLY FINDS , ACCORDING TO CONTEMP ORARY MEDICAL 12
RESEARCH, THAT: 13
(1) FETAL HEARTBEAT HAS B ECOME A KEY MEDICAL PREDICTOR 14
THAT A BABY WILL REA CH LIVE BIRTH; 15
(2) CARDIAC ACTIVITY BEGINS AT A BIOLOGIC ALLY IDENTIFIABLE 16
MOMENT IN TIME , NORMALLY WHEN THE FE TAL HEART IS FORMED IN THE 17
GESTATIONAL SAC ; 18
(3) THE STATE HAS A COMPELLIN G INTEREST FROM THE OUTSET OF 19
A WOMAN’S PREGNANCY IN PROTE CTING THE HEALTH OF THE WOMAN AND THE LI FE 20
OF THE BABY; AND 21
(4) TO MAKE AN INFORMED C HOICE ABOUT WHETHER TO CONTINUE 22
HER PREGNANCY , THE PREGNANT WOMAN H AS A COMPELLING INTE REST IN 23
KNOWING THE LIKELIHO OD OF HER BABY SURVI VING TO FULL–TERM BIRTH BASED 24
ON THE PRESENCE OF C ARDIAC ACTIVITY . 25
[20–208.] 20–203. 26
An abortion must be performed by a [qualified provider] PHYSICIAN. 27
20–204. 28
(A) FOR THE PURPOSES OF D ETERMINING THE PRESE NCE OF A FETAL 29
HEARTBEAT UNDER THIS SECTION, “STANDARD MEDICAL PRA CTICE” INCLUDES 30 4 HOUSE BILL 108
EMPLOYING THE APPROP RIATE MEANS OF DETEC TING A HEARTBEAT BASED ON THE 1
ESTIMATED GESTATIONA L AGE OF THE BABY AN D THE CONDITION OF T HE WOMAN 2
AND HER PREGNANCY . 3
(B) EXCEPT AS PROVIDED IN SUBSECTIONS (D) AND (E) OF THIS SECTION, A 4
PHYSICIAN MAY NOT KN OWINGLY PERFORM OR I NDUCE OR ATTEMPT TO PERFORM 5
OR INDUCE AN ABORTION O N A PREGNANT WOMAN : 6
(1) BEFORE A PHYSICIAN DE TERMINES IN ACCORDAN CE WITH 7
SUBSECTION (C) OF THIS SECTION WHET HER THE BABY HAS A D ETECTABLE 8
HEARTBEAT; AND 9
(2) IF THE PHYSICIAN DETE RMINES THAT THE BABY HAS A 10
DETECTABLE HEARTBEAT . 11
(C) (1) TO DETERMINE WHETHER A BABY HAS A DETECTA BLE 12
HEARTBEAT, A PHYSICIAN SHALL US E A TEST THAT IS: 13
(I) CONSISTENT WITH THE P HYSICIAN’S GOOD FAITH AND 14
REASONABLE UNDERSTAN DING OF STANDARD MED ICAL PRACTICE; AND 15
(II) APPROPRIATE FOR THE E STIMATED G ESTATIONAL AGE OF 16
THE BABY AND THE CON DITION OF THE PREGNA NT WOMAN AND HER PRE GNANCY. 17
(2) A PHYSICIAN MAKING A D ETERMINATION UNDER P ARAGRAPH (1) 18
OF THIS SUBSECTION S HALL RECORD IN THE P REGNANT WOMAN ’S MEDICAL 19
RECORD: 20
(I) THE ESTIMATED GESTATI ONAL AGE OF THE BABY; 21
(II) THE METHOD USED TO ES TIMATE THE GESTATION AL AGE; 22
AND 23
(III) THE TEST USED FOR DET ECTING A FETAL HEART BEAT, 24
INCLUDING THE DATE , TIME, AND RESULTS OF THE T EST. 25
(D) SUBSECTION (B) OF THIS SECTION DOES NOT APPLY TO A PHYSI CIAN 26
WHO PERFORMS OR INDUCES AN ABORTION IF THE P HYSICIAN: 27
(1) BELIEVES THAT A MEDIC AL EMERGENCY EXISTS THAT PREVENTS 28
COMPLIANCE WITH SUBS ECTION (B) OF THIS SECTION; AND 29
(2) COMPLIES WITH THE REQ UIREMENTS OF § 20–205 OF THIS 30 HOUSE BILL 108 5
SUBTITLE. 1
(E) A PHYSICIAN IS NOT IN VIOLATION OF SUBS ECTION (B) OF THIS SECTION 2
IF: 3
(1) THE PHYSICIAN COMPLIE S WITH SUBSECTION (C) OF THIS 4
SECTION; AND 5
(2) THE METHOD USED TO TE ST FOR THE PRESENCE OF A FETAL 6
HEARTBEAT DOES NOT D ETECT A HEARTBEAT . 7
(F) THIS SECTION MAY NOT BE CONSTRUED TO : 8
(1) CREATE OR RECOGNIZE A RIGHT TO ABORTION BE FORE A FETAL 9
HEARTBEAT IS DETECTE D; 10
(2) AUTHORIZE THE INITIAT ION OF A CAUSE OF AC TION AGAINST OR 11
THE PROSECUTION OF A WOMAN ON WHOM AN ABO RTION IS PERFORMED O R 12
INDUCED OR ATTEMPTED TO BE PERFORMED OR INDUCED IN VIOLATION OF THIS 13
SECTION; 14
(3) WHOLLY OR PARTLY REPE AL, EITHER EXPRESSLY OR BY 15
IMPLICATION, ANY OTHER STATUTE TH AT REGULATES OR PROH IBITS ABORTION; OR 16
(4) RESTRICT A POLITICAL SUBDIVISION FROM REG ULATING OR 17
PROHIBITING ABORTION IN A MANNER THAT IS A T LEAST AS STRINGENT AS THE 18
LAWS OF THE STATE. 19
20–205. 20
(A) IF AN ABORTION IS PER FORMED OR INDUCED ON A PREGNANT WOMAN 21
BECAUSE OF A MEDICAL EMERGENCY , THE PHYSICIAN WHO PE RFORMS OR INDUCES 22
THE ABORTION SHALL E XECUTE A WRITTEN DOC UMENT THAT: 23
(1) CERTIFIES THE ABORTIO N IS NECESSARY DUE T O A MEDICAL 24
EMERGENCY ; AND 25
(2) SPECIFIES THE WOMAN ’S MEDICAL CONDITION REQUIRING THE 26
ABORTION. 27
(B) A PHYSICIAN SHALL : 28
(1) INCLUDE THE DOCUMENT EXECUTED UNDER SUBSE CTION (A) OF 29 6 HOUSE BILL 108
THIS SECTION IN THE PREGNANT WOMAN ’S MEDICAL RECORD ; AND 1
(2) MAINTAIN A COPY OF TH E DOCUMENT IN THE PH YSICIAN’S 2
PRACTICE RECORDS . 3
(C) A PHYSICIAN WHO PERFOR MS OR INDUCES AN ABO RTION ON A 4
PREGNANT WOMAN SHALL : 5
(1) IF THE ABORTION IS PE RFORMED OR INDUCED T O PRESERVE THE 6
HEALTH OF THE PREGNA NT WOMAN, EXECUTE A WRITTEN DO CUMENT THAT : 7
(I) SPECIFIES THE MEDICAL CONDITION THE ABORTI ON IS 8
ASSERTED TO ADDRESS ; AND 9
(II) PROVIDES THE MEDICAL RATIONALE FOR THE PH YSICIAN’S 10
CONCLUSION THAT THE ABORTION IS NECESSAR Y TO ADDRESS THE MEDICAL 11
CONDITION; OR 12
(2) FOR AN ABORTION OTHER THAN AN ABORTION DES CRIBED IN 13
ITEM (1) OF THIS SUBSECTION , SPECIFY IN A WRITTEN DOCUMENT THAT MATERN AL 14
HEALTH IS NOT A PURP OSE OF THE ABORTION . 15
(D) THE PHYSICIAN SHALL M AINTAIN A COPY OF A DOCUMENT EXECUTED 16
UNDER SUBSECTION (C) OF THIS SECTION IN T HE PHYSICIAN’S PRACTICE RECORDS . 17
20–206. 18
(A) (1) NOTWITHSTANDING ANY O THER PROVISION OF LA W, THE 19
REQUIREMENTS OF §§ 20–204 AND 20–205 OF THIS SUBTITLE SHA LL BE ENFORCED 20
EXCLUSIVELY THROUGH THE PRIVATE CIVIL ACTIONS E STABLISHED IN § 20–207 OF 21
THIS SUBTITLE. 22
(2) ENFORCEMENT OF § 20–204 OR § 20–205 OF THIS SUBTITLE MAY 23
NOT BE TAKEN OR THRE ATENED BY THE STATE, A POLITICAL SUBDIVIS ION OF THE 24
STATE, A STATE’S ATTORNEY, OR AN EXECUTIVE OR A DMINISTRATIV E OFFICER OR 25
EMPLOYEE OF THE STATE OR A POLITICAL SUBDIVISION OF THE STATE AGAINST 26
ANY PERSON, EXCEPT AS PROVIDED I N § 20–207 OF THIS SUBTITLE. 27
(B) SUBSECTION (A) OF THIS SECTION MAY NOT BE CONSTRUED TO : 28
(1) LEGALIZE THE CONDUCT PROHIBITED BY THIS S UBTITLE; 29
(2) LIMIT IN ANY WAY OR A FFECT THE AVAILABILI TY OF A REMEDY 30 HOUSE BILL 108 7
ESTABLISHED BY § 20–207 OF THIS SUBTITLE; OR 1
(3) LIMIT THE ENFORCEABIL ITY OF ANY OTHER LAW S THAT 2
REGULATE OR PROHIBIT ABORTION. 3
20–207. 4
(A) ANY PERSON, OTHER THAN AN OFFICE R OR EMPLOYEE OF THE STATE 5
OR A LOCAL GOVERNMEN TAL ENTITY IN THE STATE, MAY BRING A CIVIL AC TION 6
AGAINST ANY PERSON W HO: 7
(1) PERFORMS OR INDUCES A N ABORTION IN VIOLAT ION OF § 20–204 8
OR § 20–205 OF THIS SUBTITLE; 9
(2) KNOWINGLY ENGAGES IN CONDUCT THAT AIDS OR ABETS THE 10
PERFORMANCE OR INDUC EMENT OF AN ABORTION , INCLUDING PAYING FOR OR 11
REIMBURSING THE COST S OF AN ABORTION THR OUGH INSURANCE OR OT HERWISE, 12
IF THE ABORTION IS P ERFORMED OR INDUCED IN VIOLATION OF § 20–204 OR § 13
20–205 OF THIS SUBTITLE , REGARDLESS OF WHETHE R THE PERSON KNEW OR 14
SHOULD HAVE KNOWN TH AT THE ABORTION WOUL D BE PERFORMED OR IN DUCED IN 15
VIOLATION OF § 20–204 OR § 20–205 OF THIS SUBTITLE; OR 16
(3) INTENDS TO ENGAGE IN THE CONDUCT DESCRIBE D IN ITEM (1) OR 17
(2) OF THIS SUBSECTION . 18
(B) EXCEPT AS PROVIDED IN SUBSECTION (C) OF THIS SECTION , IF A 19
CLAIMANT PREVAILS IN AN ACTION BROUGHT UN DER THIS SECTION , THE COURT 20
SHALL AWARD : 21
(1) INJUNCTIVE RELIEF SUF FICIENT TO PREVENT T HE DEFENDANT 22
FROM VIOLATING § 20–204 OR § 20–205 OF THIS SUBTITLE OR ENGAGING IN ACTS 23
THAT AID OR ABET VIO LATIONS OF § 20–204 OR § 20–205 OF THIS SUBTITLE; 24
(2) STATUTORY DAMAGES IN AN AMOUNT OF NOT LES S THAN $10,000 25
FOR EACH ABORTION TH AT THE DEFENDANT PER FORMED OR INDUCED IN 26
VIOLATION OF § 20–204 OR § 20–205 OF THIS SUBTITLE , AND FOR EACH ABORTIO N 27
PERFORMED OR INDUCED IN VIOLATION OF § 20–204 OR § 20–205 OF THIS SUBTITLE 28
THAT THE DEFENDANT A IDED OR ABETTED ; AND 29
(3) COSTS AND ATTORNEY ’S FEES. 30
(C) A COURT MAY NOT AWARD RELIEF UNDER THI S SECTION IN RESPONS E 31
TO A CIVIL ACTION BR OUGHT UNDER SUBSECTI ON (A)(1) OR (2) OF THIS SECTION IF 32 8 HOUSE BILL 108
THE DEFENDANT DEMONS TRATES THAT THE DEFE NDANT PREVIOUSLY PAI D THE 1
FULL AMOUNT OF STATU TORY DAMAGES UNDER S UBSECTION (B)(2) OF THIS 2
SECTION IN A PREVIOU S ACTION FOR: 3
(1) THE PARTICULAR ABORTI ON PERFORMED OR INDU CED IN 4
VIOLATION OF § 20–204 OR § 20–205 OF THIS SUBTITLE; OR 5
(2) THE PARTICULAR CONDUC T THAT AIDED OR ABET TED AN 6
ABORTION PERFORMED O R INDUCED IN VIOLATI ON OF § 20–204 OR § 20–205 OF 7
THIS SUBTITLE. 8
(D) NOTWITHSTANDING ANY O THER PROVISION OF LA W, A PERSON MAY 9
NOT BRING AN ACTION UNDER THIS SECTION A FTER 4 YEARS AFTER THE DATE THE 10
CAUSE OF ACTION AROS E. 11
(E) NOTWITHSTANDING ANY O THER PROVISION OF LA W, THE FOLLOWING 12
ARE NOT A DEFENSE TO AN ACTION BR OUGHT UNDER THIS SEC TION: 13
(1) IGNORANCE OR MISTAKE OF LAW; 14
(2) A DEFENDANT ’S BELIEF THAT THE RE QUIREMENTS OF THIS 15
SUBTITLE ARE UNCONST ITUTIONAL; 16
(3) A DEFENDANT ’S RELIANCE ON ANY CO URT DECISION THAT HA S 17
BEEN OVERRULED ON AP PEAL OR BY A SUBSEQU ENT COURT, EVEN IF THAT COURT 18
DECISION HAD NOT BEE N OVERRULED WHEN THE DEFENDANT ENGAGED IN 19
CONDUCT THAT VIOLATE S § 20–204 OR § 20–205 OF THIS SUBTITLE; 20
(4) A DEFENDANT ’S RELIANCE ON ANY FE DERAL OR STATE COURT 21
DECISION THAT IS NOT BINDING ON THE COURT IN WHICH THE ACTION HAS B EEN 22
BROUGHT; 23
(5) NONMUTUAL ISSUE PRECL USION OR NONMUTUAL C LAIM 24
PRECLUSION; 25
(6) THE CONSENT OF THE BA BY’S MOTHER TO THE ABOR TION; OR 26
(7) ANY CLAIM THAT THE EN FORCEMENT OF THIS SU BTITLE OR THE 27
IMPOSITION OF CIVIL LIABILITY AGAINS T THE DEFENDANT WILL VIOLATE THE 28
CONSTITUTIONAL RIGHT S OF THIRD PARTIES , EXCEPT AS PROVIDED B Y § 20–208 OF 29
THIS SUBTITLE. 30
(F) IT IS AN AFFIRMATIVE DEFENSE TO AN ACTION BROUGHT UNDER THIS 31 HOUSE BILL 108 9
SECTION IF: 1
(1) A PERSON SUED UNDER SU BSECTION (A)(2) OF THIS SECTION 2
REASONABLY BELIEVED , AFTER CONDUCTING A R EASONABLE INVESTIGAT ION, 3
THAT THE PHYSICIAN P ERFORMING OR INDUCIN G THE ABORTION HAD C OMPLIED 4
OR WOULD COMPLY WITH § 20–204 OR § 20–205 OF THIS SUBTITLE; OR 5
(2) A PERSON SUED UNDER SU BSECTION (A)(3) OF THIS SECTION 6
REASONABLY BELIEVED , AFTER CONDUCTING A R EASONABLE INVESTIGAT ION, 7
THAT THE PHYSICIAN P ERFORMING OR INDUCIN G THE ABORTION WOULD COMPLY 8
WITH § 20–204 OR § 20–205 OF THIS SUBTITLE . 9
(G) THE DEFENDANT HAS THE BURDEN OF PROVING AN AFFIRMATIVE 10
DEFENSE UNDER SUBSECTION (F) OF THIS SECTION BY A PREPONDERANCE OF THE 11
EVIDENCE. 12
(H) THIS SECTION MAY NOT BE CONSTRUED TO IMPO SE LIABILITY ON ANY 13
SPEECH OR CONDUCT PR OTECTED BY THE FIRST AMENDMENT OF THE U.S. 14
CONSTITUTION, AS MADE APPLICABLE T O THE STATES THROUGH THE U.S. 15
SUPREME COURT’S INTERPRETATION OF THE FOURTEENTH AMENDMENT OF THE 16
U.S. CONSTITUTION, OR BY ARTICLE 40 OF THE MARYLAND DECLARATION OF 17
RIGHTS. 18
(I) (1) NOTWITHSTANDING ANY O THER PROVISION OF LA W, THE STATE, 19
A STATE OFFICIAL, OR A STATE’S ATTORNEY MAY NOT INTERVENE IN AN ACTION 20
BROUGHT UNDER THIS S ECTION. 21
(2) THIS SUBSECTION MAY N OT BE CONSTRUED TO P ROHIBIT A 22
PERSON FROM FILING A N AMICUS CURIAE BRIE F IN AN ACTION. 23
(J) NOTWITHSTANDING ANY O THER PROVISION OF LA W, A COURT MAY NOT 24
AWARD COSTS OR ATTORNEY’S FEES UNDER THE MARYLAND RULES OF CIVIL 25
PROCEDURE OR ANY OTHE R RULE ADOPTED BY TH E SUPREME COURT OF 26
MARYLAND TO A DEFENDA NT IN AN ACTION BROU GHT UNDER THIS SECTI ON. 27
(K) NOTWITHSTANDING ANY O THER PROVISION OF LA W, A CIVIL ACTION 28
UNDER THIS SECTION M AY NOT BE BROUGHT BY AN INDIVIDUAL WHO IM PREGNATED 29
THE ABORTION PATIENT THROUGH AN ACT OF RA PE, SEXUAL ASSAULT , INCEST, OR 30
ANY OTHER ACT PROHIB ITED BY LAW. 31
(L) NOTWITHSTANDING ANY OTHER PROVISION OF LAW, A CIVIL ACTION 32
BROUGHT UNDER THIS S ECTION SHALL BE BROU GHT IN: 33
10 HOUSE BILL 108
(1) THE COUNTY IN WHICH A LL OR A SUBSTANTIAL PART OF THE 1
EVENTS OR OMISSIONS GIVING RISE TO THE C LAIM OCCURRED ; 2
(2) THE COUNTY OF RESIDEN CE FOR ANY ONE OF TH E INDIVIDUAL 3
DEFENDANTS AT THE TI ME THE CAUSE OF ACTI ON OCCURRED ; 4
(3) THE COUNTY OF THE PRI NCIPAL OFFICE IN THE STATE OF ANY 5
ONE OF THE DEFENDANT S THAT IS NOT AN IND IVIDUAL; OR 6
(4) THE COUNTY OF RESIDEN CE FOR THE CLAIMANT IF THE 7
CLAIMANT IS AN INDIV IDUAL RESIDING IN THE STATE. 8
(M) IF A CIVIL ACTION IS BROUGHT UNDER THIS S ECTION IN ANY ONE OF 9
THE VENUES DESCRIBED IN SUBSECTION (L) OF THIS SECTION , THE ACTION MAY 10
NOT BE TRANSFERRED T O A DIFFERENT VENUE WITHOUT THE WRITTEN CONSENT 11
OF ALL PARTIES. 12
20–208. 13
(A) A DEFENDANT AGAINST WH OM AN ACTION IS BROU GHT UNDER § 20–207 14
OF THIS SUBTITLE DOE S NOT HAVE STANDING TO ASSERT THE RIGHTS OF WOMEN 15
SEEKING AN ABORTION AS A DEFENSE TO LIAB ILITY UNDER THAT SEC TION UNLESS: 16
(1) THE U.S. SUPREME COURT HOLDS THAT TH E COURTS OF THE 17
STATE MUST CONFER STA NDING ON THAT DEFEND ANT TO ASSERT THE 18
THIRD–PARTY RIGHTS OF WOME N SEEKING AN ABORTIO N IN STATE COURT AS A 19
MATTER OF FEDERAL CO NSTITUTIONAL LAW ; OR 20
(2) THE DEFENDANT HAS STA NDING TO ASSERT THE RIGHTS OF 21
WOMEN SEEKING AN ABORTION UNDER TH E TESTS FOR THIRD –PARTY STANDING 22
ESTABLISHED BY THE U.S. SUPREME COURT. 23
(B) (1) THIS SECTION MAY NOT BE CONSTRUED TO LIMI T OR PRECLUDE 24
A DEFENDANT FROM ASS ERTING THE DEFENDANT ’S PERSONAL CONSTITUT IONAL 25
RIGHTS AS A DEFENSE TO LIABILITY UNDER § 20–207 OF THIS SUBTITLE. 26
(2) A COURT MAY NOT AWARD RELIEF UNDER § 20–207 OF THIS 27
SUBTITLE IF THE COND UCT FOR WHICH THE DE FENDANT HAS BEEN SUE D WAS AN 28
EXERCISE OF STATE OR FEDERAL CONS TITUTIONAL RIGHTS TH AT PERSONALLY 29
BELONG TO THE DEFEND ANT. 30
[20–209. 31
HOUSE BILL 108 11
(a) In this section, “viable” means that stage when, in the best clinical judgment 1
of the qualified provider based on the particular facts of the case before the qualified 2
provider, there is a reasonable likelihood of the fetus’s sustained survival outside the womb. 3
(b) Except as otherwise provided in this subtitle, the State may not interfere with 4
the decision of a woman to terminate a pregnancy: 5
(1) Before the fetus is viable; or 6
(2) At any time during the woman’s pregnancy, if: 7
(i) The termination procedure is necessary to protect the life or 8
health of the woman; or 9
(ii) The fetus is affected by genetic defect or serious deformity or 10
abnormality. 11
(c) The Department may adopt regulations that: 12
(1) Are both necessary and the least intrusive method to protect the life or 13
health of the woman; and 14
(2) Are not inconsistent with established clinical practice. 15
(d) The qualified provider is not liable for civil damages or subject to a criminal 16
penalty for a decision to perform an abortion under this section made in good faith and in 17
the qualified provider’s best clinical judgment in accordance with accepted standards of 18
clinical practice.] 19
20–209. 20
(A) A PERSON MAY NOT PERFO RM OR INDUCE AN ABOR TION ON A 21
PREGNANT WOMAN IN T HE STATE UNLESS THE ABOR TION IS VOLUNTARY AN D 22
INFORMED. 23
(B) CONSENT TO AN ABORTIO N IS VOLUNTARY AND I NFORMED ONLY IF : 24
(1) THE PHYSICIAN WHO IS TO PERFORM OR INDUCE THE ABORTION 25
INFORMS THE PREGNANT WOMAN ON WHOM THE AB ORTION IS TO BE PERF ORMED 26
OR INDUCED OF: 27
(I) THE PHYSICIAN’S NAME; 28
(II) THE PARTICULAR MEDICA L RISKS ASSOCIATED W ITH THE 29
PARTICULAR ABORTION PROCEDURE TO BE EMPL OYED, INCLUDING, WHEN 30 12 HOUSE BILL 108
MEDICALLY ACCURATE : 1
1. THE RISKS OF INFECTIO N AND HEMORRHAGE ; 2
2. THE POTENTIAL DANGE R TO A SUBSEQUENT 3
PREGNANCY AND OF INF ERTILITY; AND 4
3. THE POSSIBILITY OF IN CREASED RISK OF BREA ST 5
CANCER FOLLOWING AN INDUCED ABORTION AND THE NATURAL PROTECTI VE 6
EFFECT OF A COMPLETE D PREGNANCY IN AVOID ING BREAST CANCER ; 7
(III) THE PROBABLE GESTAT IONAL AGE OF THE BAB Y AT THE 8
TIME THE ABORTION IS TO BE PERFORMED OR I NDUCED; AND 9
(IV) THE MEDICAL RISKS ASS OCIATED WITH CARRYIN G THE 10
CHILD TO TERM ; 11
(2) THE PHYSICIAN WHO IS TO PERFORM OR INDUCE THE ABORTION 12
OR THE PHYSICIAN ’S AGENT INFORMS THE PREGNANT WOMAN THAT : 13
(I) MEDICAL ASSISTANCE BE NEFITS MAY BE AVAILA BLE FOR 14
PRENATAL CARE , CHILDBIRTH, AND NEONATAL CARE ; 15
(II) THE FATHER IS LIABLE FOR ASSISTANCE IN TH E SUPPORT 16
OF THE CHILD WITHOUT REGARD TO WHETHER TH E FATHER HAS OFFERED TO PAY 17
FOR THE ABORTION ; AND 18
(III) PUBLIC AND PRIVATE AG ENCIES PROVIDE PREGN ANCY 19
PREVENTION COUNSELIN G AND MEDICAL REFERR ALS FOR OBTAINING PR EGNANCY 20
PREVENTION MEDICATIO NS OR DEVICES, INCLUDING EMERGENCY CONTRACEPTION 21
FOR VICTIMS OF RAPE OR INCEST; 22
(3) THE PHYSICIAN WHO IS TO PE RFORM OR INDUCE THE ABORTION 23
OR THE PHYSICIAN ’S AGENT: 24
(I) PROVIDES THE PREGNANT WOMAN WITH PRINTED 25
MATERIALS THAT DESCR IBE THE BABY AND LIS T AGENCIES THAT OFFE R 26
ALTERNATIVES TO ABOR TION OR SONOGRAM SER VICES AT NO COST TO THE 27
PREGNANT WOMAN; AND 28
(II) INFORMS THE PREGNANT WOMAN THAT THOSE MAT ERIALS: 29
1. HAVE BEEN PROVIDED BY THE DEPARTMENT ; 30 HOUSE BILL 108 13
2. ARE ACCESSIBLE ON A W EBSITE SPONSORED BY THE 1
DEPARTMENT ; 2
3. DESCRIBE THE BABY AND LIST AGENCIES THAT 3
OFFER ALTERNATIVES T O ABORTION; AND 4
4. INCLUDE A LIST OF AGE NCIES THAT OFFER 5
SONOGRAM SERVICES AT NO COST TO THE PREGN ANT WOMAN ; 6
(4) BEFORE ANY SEDATIVE O R ANESTHESIA IS ADMI NISTERED TO THE 7
PREGNANT WOMAN AND A T LEAST 24 HOURS BEFORE THE ABO RTION OR AT LEAST 2 8
HOURS BEF ORE THE ABORTION IF THE PREGNANT WOMAN W AIVES THIS 9
REQUIREMENT BY CERTI FYING THAT SHE CURRE NTLY LIVES 100 MILES OR MORE 10
FROM THE NEAREST ABO RTION PROVIDER THAT IS A FACILITY THAT P ERFORMS 11
MORE THAN 50 ABORTIONS IN ANY 12–MONTH PERIOD : 12
(I) THE PHYSICIAN WHO IS TO PERFORM OR INDUCE THE 13
ABORTION OR AN AGENT OF THE PHYSICIAN WHO IS ALSO A SONOGRAPHE R 14
CERTIFIED BY A NATIO NAL REGISTRY OF MEDI CAL SONOGRAPHERS PER FORMS A 15
SONOGRAM ON THE PREG NANT WOMAN ON WHOM T HE ABORTION IS TO BE 16
PERFORMED OR INDUCED ; AND 17
(II) THE PHYSICIAN WHO IS TO PERFORM OR INDUCE THE 18
ABORTION DISPLAYS TH E SONOGRAM IMAGES IN A QUALITY CONSISTENT WITH 19
CURRENT MEDICAL PRAC TICE IN A MANNER THA T THE PREGNANT WOMAN MAY VIEW 20
THEM AND HEAR THE FE TAL HEARTBEAT IN A M ANNER CONSISTENT WIT H THE 21
STANDARD OF CARE ; 22
(5) THE PHYSICIAN WHO IS TO PERFORM OR INDUCE THE ABORTION 23
PROVIDES, IN A MANNER UNDERSTA NDABLE TO A LAYPERSO N, A VERBAL 24
EXPLANATION OF THE R ESULTS OF THE SONOGR AM IMAGES, INCLUDING A MEDICAL 25
DESCRIPTION OF THE D IMENSIONS OF THE EMB RYO OR BABY, THE PRESENCE OF 26
CARDIAC ACTIVITY , AND THE PRESENCE OF EXTERNAL MEMBERS AND INTERNAL 27
ORGANS; 28
(6) THE PHYSICIAN WHO IS TO PERFORM OR INDUCE THE ABORTION 29
OR AN AGENT OF THE P HYSICIAN WHO IS ALSO A SONOGRAPHER CERTIF IED BY A 30
NATIONAL REGISTRY OF MEDICAL SONOGRAPHERS M AKES AUDIBLE THE HEA RT 31
AUSCULTATION FOR THE PREGNANT WOMAN TO HE AR, IF PRESENT, IN A QUALITY 32
CONSISTENT WITH CURR ENT MEDICAL PRACTICE AND PROVIDES , IN A MANNER 33
UNDERSTANDABLE TO A LAYPERSON, A SIMULTANEOUS VERBA L EXPLANATION OF 34
THE HEART AUSCULTATION ; 35 14 HOUSE BILL 108
(7) BEFORE RECEIVING A SO NOGRAM UNDER ITEM (6) OF THIS 1
SUBSECTION AND BEFOR E THE ABORTION IS PE RFORMED OR INDUCED A ND BEFORE 2
ANY SEDATIVE OR ANES THESIA IS ADMINISTER ED, THE PREGNANT WOMAN 3
COMPLETES AND CERTIF IES WITH HER SIGNATU RE AN ELE CTION FORM THAT 4
STATES AS FOLLOWS : 5
“ABORTION AND SONOGRAM ELECTION 6
(1) THE INFORMATION AND P RINTED MATERIALS UND ER § 20–209(B)(3) OF 7
THE HEALTH – GENERAL ARTICLE HAVE BEEN PRO VIDED AND EXPLAINED TO ME. 8
(2) I UNDERSTAND THE NATUR E AND CONSEQUENCES O F AN ABORTION. 9
(3) MARYLAND LAW REQUIRES THAT I RECEIVE A SONOGRAM P RIOR TO 10
RECEIVING AN ABORTIO N. 11
(4) I UNDERSTAND THAT I HAVE THE OPTION TO V IEW THE SONOGRAM 12
IMAGES. 13
(5) I UNDERSTAND THAT I HAVE THE OPTION TO H EAR THE HEARTBEAT . 14
(6) I UNDERSTAND TH AT I AM REQUIRED BY LAW T O HEAR AN EXPLANATIO N 15
OF THE SONOGRAM IMAG ES UNLESS I CERTIFY IN WRITING O NE OF THE FOLLOWING : 16
___ I AM PREGNANT AS A RES ULT OF SEXUAL ASSAUL T, INCEST, OR 17
OTHER VIOLATIONS OF THE MARYLAND PENAL CODE T HAT HAVE BEEN REPORT ED 18
TO LAW ENFORCEMENT AUTHOR ITIES OR THAT HAVE N OT BEEN REPORTED 19
BECAUSE I REASONABLY BELIEVE T HAT DOING SO WOULD P UT ME AT RISK OF 20
RETALIATION RESULTIN G IN SERIOUS BODILY INJURY. 21
___ I AM A MINOR AND OBTAI NING AN ABORTION IN ACCORDANCE 22
WITH § 20–103 OF THE HEALTH – GENERAL ARTICLE. 23
___ MY BABY HAS AN IRREVE RSIBLE MEDICAL CONDI TION OR 24
ABNORMALITY , AS IDENTIFIED BY REL IABLE DIAGNOSTIC PRO CEDURES AND 25
DOCUMENTED IN MY MED ICAL FILE. 26
(7) I AM MAKING THIS ELECT ION OF MY OWN FREE W ILL AND WITHOUT 27
COERCION. 28
(8) FOR A WOMAN WHO LIVES 100 MILES OR MORE FROM T HE NEAREST 29
ABORTION PROVIDER TH AT IS A FACILITY THA T PERFORMS MORE THAN 50 30 HOUSE BILL 108 15
ABORTIONS IN ANY 12–MONTH PERIOD : 1
___ I CERTIFY THAT , BECAUSE I CURRENTLY LIVE 100 MILES OR 2
MORE FROM THE NEARES T ABORTION PROVIDER THAT IS A FACILITY T HAT 3
PERFORMS MORE THAN 50 ABORTIONS IN ANY 12–MONTH PERIOD , I WAIVE THE 4
REQUIREMENT TO WAIT 24 HOURS AFTER THE SONO GRAM IS PERFORMED BE FORE 5
RECEIVING THE ABORTI ON PROCEDURE . MY PLACE OF RESIDENCE IS ___________. 6
––––––––––––––––––––––––––––––––– –––––––––––––––––––––––– 7
(SIGNATURE) (DATE)”; 8
(8) BEFORE THE ABORTION I S PERFORMED OR INDUC ED, THE 9
PHYSICIAN WHO IS TO PERFORM OR INDUCE TH E ABORTION RECEIVES A COPY OF 10
THE SIGNED , WRITTEN CERTIFICATIO N REQUIRED UNDER ITE M (7) OF THIS 11
SUBSECTION; AND 12
(9) THE PREGNANT WOMAN IS PROVIDED THE NAME OF EACH 13
PERSON WHO PROVIDES OR EXPLAINS THE INFO RMATION REQUIRED UND ER THIS 14
SECTION. 15
20–210. 16
(A) NOTWITHSTANDING ANY O THER PROVISION OF LA W, THE STATE HAS 17
SOVEREIGN IMMUNITY , A POLITICAL SUBDIVISION HAS GOVE RNMENTAL IMMUNITY , 18
AND EACH OFFICER AND EMPLOYEE OF THE STATE OR A POLITICAL SUBDIVISION 19
HAS OFFICIAL IMMUNIT Y IN ANY ACTION, CLAIM, OR COUNTERCLAIM OR A NY TYPE 20
OF LEGAL OR EQUITABL E ACTION THAT CHALLE NGES THE VALIDITY OF ANY 21
PROVISION OR APPLICATION OF TH IS SUBTITLE, ON CONSTITUTIONAL GR OUNDS OR 22
OTHERWISE. 23
(B) NOTWITHSTANDING ANY O THER PROVISION OF LA W, A PROVISION OF 24
STATE LAW MAY NOT BE CONSTRUED TO WAIVE O R ABROGATE AN IMMUNI TY 25
DESCRIBED IN SUBSECT ION (A) OF THIS SECTION UNLE SS IT EXPRESSLY WAIVES 26
IMMUNITY UNDER THIS SECTION. 27
20–211. 28
(A) NOTWITHSTANDING ANY O THER PROVISION OF LA W, ANY PERSON WHO 29
SEEKS DECLARATORY OR INJUNCTIVE RELIEF TO PREVENT THE STATE, A POLITICAL 30
SUBDIVISION, ANY GOVERNMENTAL ENT ITY OR PUBLIC OFFICI AL IN THE STATE, OR 31
ANY PERSON IN THE STATE FROM ENFORCING ANY STATUTE, ORDINANCE, RULE, 32
REGULATION , OR ANY OTHER TYPE OF LAW THAT REGULATES O R RESTRICTS 33
ABORTION OR THAT LIM ITS TAXPAYER FUNDING FOR INDIVIDUALS OR E NTITIES 34 16 HOUSE BILL 108
THAT PERFORM OR PROM OTE ABORTIONS , IN ANY STATE OR FEDERAL COUR T, OR 1
THAT REPRESENTS ANY LITIGANT SEEKING SUC H RELIEF IN ANY STATE OR 2
FEDERAL COURT , IS JOINTLY AND SEVER ALLY LIABLE TO PAY T HE COSTS AND 3
ATTORNEY’S FEES OF THE PREVAI LING PARTY. 4
(B) FOR PURPOSES OF THIS SECTION, A PARTY IS CONSIDERE D A 5
PREVAILING PARTY IF A FEDERAL OR STATE COURT: 6
(1) DISMISSES ANY CLAIM O R CAUSE OF ACTION BR OUGHT AGAINST 7
THE PARTY THAT SEEKS THE DECLARATORY OR I NJUNCTIVE RELIEF UND ER 8
SUBSECTION (A) OF THIS SECTION , REGARDLESS OF THE RE ASON FOR THE 9
DISMISSAL; OR 10
(2) ENTERS JUDGMENT IN TH E PARTY’S FAVOR ON ANY SUCH CLAIM 11
OR CAUSE OF ACTION . 12
(C) REGARDLESS OF WHETHER A PREVAILING PARTY S OUGHT TO RECOVER 13
COSTS OR ATTORNEY ’S FEES IN THE UNDERL YING ACTION, A PREVAILING PARTY 14
UNDER THIS SECTION M AY BRING A CIVIL ACTION TO RECOVER CO STS AND 15
ATTORNEY’S FEES AGAINST A PER SON THAT SOUGHT DECL ARATORY OR INJUNCTIV E 16
RELIEF UNDER SUBSECT ION (A) OF THIS SECTION WITH IN 3 YEARS AFTER THE DATE 17
ON WHICH, AS APPLICABLE: 18
(1) THE DISMISSAL OR JUDG MENT UNDER SUBSECTIO N (B) OF THIS 19
SECTION BECOMES FINA L ON THE CONCLUSION OF APPELLATE REVIEW ; OR 20
(2) THE TIME FOR SEEKING APPELLATE REVIEW EXP IRES. 21
(D) IT IS NOT A DEFENSE T O AN ACTION BROUGHT UNDER SUBSECTION (C) 22
OF THIS SECTION THAT : 23
(1) A PREVAILING PARTY UND ER THIS SECTION FAILED TO SEEK 24
RECOVERY OF COSTS OR ATTORNEY’S FEES IN THE UNDERL YING ACTION; 25
(2) THE COURT IN THE UNDE RLYING ACTION DECLIN ED TO 26
RECOGNIZE OR ENFORCE THE REQUIREMENTS OF THIS SECTION; OR 27
(3) THE COURT IN THE UNDE RLYING ACTION HELD T HAT ANY 28
PROVISION OF THIS SECTION IS I NVALID, UNCONSTITUTIONAL , OR PREEMPTED BY 29
FEDERAL LAW , NOTWITHSTANDING THE DOCTRINES OF ISSUE O R CLAIM 30
PRECLUSION. 31
20–212. 32 HOUSE BILL 108 17
(A) A STATUTE THAT REGULAT ES OR PROHIBITS ABOR TION MAY NOT BE 1
CONSTRUED TO REPEAL ANY OTHER STATUTE TH AT REGULATES OR PROHIBITS 2
ABORTION, EITHER WHOLLY OR PAR TLY, UNLESS THE REPEALING STATUTE 3
EXPLICITLY STATES TH AT IT IS REPEALING T HE OTHER STATUTE . 4
(B) A STATUTE MAY NOT BE C ONSTRUED TO RESTRICT A POLITICAL 5
SUBDIVISION FROM REG ULATING OR PROHIBITI NG ABORTION IN A MANNER THAT IS 6
AT LEAST AS STRINGEN T AS THE LAWS OF THE STATE UNLESS THE STAT UTE 7
EXPLICITLY STATES TH AT POLITICAL SUBDIVI SIONS ARE PROHIBITED FROM 8
REGULATING OR PROHIB ITING ABORTION IN TH E MANNER DESCRIBED I N THE 9
STATUTE. 10
(C) (1) EVERY STATUTE THAT RE GULATES OR PROHIBITS ABORTION IS 11
SEVERABLE IN EACH OF ITS APPLICATIONS TO EVERY PERSON AND CIR CUMSTANCE . 12
(2) IF ANY STATUTE THAT R EGULATES OR PROHIBIT S ABORTION IS 13
FOUND BY ANY COURT T O BE UNCONSTITUTIONA L, EITHER ON ITS FACE O R AS 14
APPLIED, THEN ALL AP PLICATIONS OF THAT S TATUTE THAT DO NOT V IOLATE THE 15
U.S. CONSTITUTION AND THE MARYLAND CONSTITUTION SHALL : 16
(I) BE SEVERED FROM THE U NCONSTITUTIONAL 17
APPLICATIONS; 18
(II) REMAIN ENFORCEABLE , NOTWITHSTANDING ANY OTHER 19
LAW; AND 20
(III) BE INTERPRETED AS IF CONTAINING LAN GUAGE LIMITING 21
THE STATUTE ’S APPLICATION TO THE PERSONS, GROUP OF PERSONS , OR 22
CIRCUMSTANCES FOR WH ICH THE STATUTE ’S APPLICATION WILL N OT VIOLATE THE 23
U.S. CONSTITUTION AND THE MARYLAND CONSTITUTION. 24
[20–214.] 20–213. 25
(a) (1) A person may not be required to perform or participate in, or refer to 26
any source for, any medical procedure that results in artificial insemination, sterilization, 27
or termination of pregnancy. 28
(2) The refusal of a person to perform or participate in, or refer to a source 29
for, these medical procedures may not be a basis for: 30
(i) Civil liability to another person; or 31
(ii) Disciplinary or other recriminatory action against the person. 32 18 HOUSE BILL 108
(b) (1) A licensed hospital, hospital director, or hospital governing board may 1
not be required: 2
(i) To permit, within the hospital, the performance of any medical 3
procedure that results in artificial insemination, sterilization, or termination of pregnancy; 4
or 5
(ii) To refer to any source for these medical procedures. 6
(2) The refusal to permit or to refer to a source for these procedures may 7
not be grounds for: 8
(i) Civil liability to another person; or 9
(ii) Disciplinary or other recriminatory action against the person by 10
this State or any person. 11
(c) (1) The refusal of an individual to submit to or give consent for an abortion 12
or sterilization may not be grounds for loss of any privileges or immunities to which the 13
individual otherwise would be entitled. 14
(2) Submitting to or granting consent for an abortion or sterilization may 15
not be a condition precedent to the receipt of any public benefits. 16
(d) Notwithstanding any other provision of this section, a health care provider, a 17
licensed hospital, a hospital director, or a hospital governing board is not immune from civil 18
damages, if available at law, or from disciplinary or other recriminatory action, if the failure 19
to refer a patient to a source for any medical procedure that results in sterilization or 20
termination of pregnancy would reasonably be determined as: 21
(1) The cause of death or serious physical injury or serious long–lasting 22
injury to the patient; and 23
(2) Otherwise contrary to the standards of medical care. 24
SECTION 3. AND BE IT FURTHER ENACTED, That, if any provision of this Act or 25
the application thereof to any person or circumstance is held invalid for any reason in a 26
court of competent jurisdiction, the invalidity does not affect other provisions or any other 27
application of this Act that can be given effect without the invalid provision or application, 28
and for this purpose the provisions of this Act are declared severable. 29
SECTION 4. AND BE IT FURTHER ENACTED, That this Act shall take effect 30
October 1, 2025. 31