Planned Parenthood of Southeastern Pennsylvania v. Casey Joint Appendix Vol. 2

    Nos. 91-744 and 91-902

In the

B>upratte (Eourt of tt\z Mnitefc ^tateo
October Term, 1991

Planned Parenthood of Southeastern Pennsylvania,
Reproductive Health and Counseling Center, Women’s
Health Services, Inc., Women’s Suburban Clinic, Allentown
Women’s Center, and Thomas Allen, M.D., on behalf of himself
and all others similarly situated, _ _  , _Petitioners and Cross-Respondents,

—v.—
Robert P. Casey, Allan S. Noonan, and Ernest D. Preate, Jr., 

personally and in their official capacities,
Respondents and Cross-Petitioners.

ON w rits  of c ertio rari to  th e  united  states court  of a ppe a ls
FOR THE THIRD CIRCUIT

JOINT APPENDIX 
VOLUME II

Kathryn Kolbert
{Counsel o f Record)

Andrew Dwyer 
Ellen K. Goetz 
American Civil Liberties Union 

Foundation 
132 W. 43rd Street 
New York, New York 10036 
(212) 944-9800

Linda J. Wharton 
Women’s Law Project 
125 South Ninth Street 
Suite 401
Philadelphia, Pennsylvania 19107 
(215) 928-9801
Attorneys fo r Petitioners 

and Cross-Respondents

Ernest D. Preate, Jr.
John G. Knoor, III 

{Counsel o f Record)
Kate L. Mershimer 
Office of the Attorney General 
15th Floor, Strawberry Square 
Harrisburg, Pennsylvania 17120 
(717) 783-1471

Attorneys for Respondents 
and Cross-Petitioners

PETITION FOR CERTIORARI (NO. 91-744) FILED NOVEMBER 7, 1991 
PETITION FOR CERTIORARI (NO. 91-902) FILED DECEMBER 9, 1991 

CERTIORARI GRANTED JANUARY 21, 1992



1

TABLE OF CONTENTS

Page

Relevant Docket Entries .......................................... 1

Excerpts from Transcript of Hearing on Plaintiffs’
Motion for a Temporary Restraining Order,
April 21, 1988 ......................................................  23

Excerpts from Transcript of Hearing on Plaintiffs’
Motion for a Preliminary Injunction,
May 9, 1988 .......................................................... 27

Order Granting Plaintiffs’ Request for Class
Certification (Oct. 25, 1988)...............................  42

Plaintiffs’ Amended Complaint for Declaratory
and Injunction R elie f.............................................44

Order Clarifying May 23, 1988, Preliminary
Injunction (Jan. 11, 1990) .................................  72

Defendants’ Answer......................................................74

Stipulation of Uncontested Facts ............................... 86

Supplemental Stipulation of
Uncontested Facts ............................................. 102

Stipulation of Voluntary Dismissal ............................112

Excerpts from Trial Transcript,
July 30 through August 1, 1990 ..........................113



Non-Jury Trial - Day 1 ..................................... 113

Non-Jury Trial - Day 2 ..................................... 204

Non-Jury Trial - Day 3 ...................................... 315

Excerpts from Defendants’ Trial Exhibits................ 393

Defendants’ Exhibit 1: Excerpts from 
Magee-Womens Hospital Informed 
Consent for Termination of
Pregnancy Form ................................................. 393

Defendants’ Exhibit 2: Excerpts from 
Women’s Health Services (WHS)
Individual Counseling Guidelines/
Post Abortion Group Guidelines/
Personal Counseling Guideline........................... 396

Defendants’ Exhibit 3: WHS Consent
for Abortion Form ............................................. 410

Defendants’ Exhibit 4: WHS 
November 20, 1986
Memo Re Parental Notification .......................415

Defendants’ Exhibit 5: Excerpts from
WHS Patient Record Form ................................418

Defendants’ Exhibit 8:
WHS Advertisements .........................................441

Defendants’ Exhibit 9: Excerpts from 
Planned Parenthood of 
Southeastern Pennsylvania (PPSP)
Center Policy and Procedure Manual .............. 444

11



Ill

Defendants’ Exhibit 10: Excerpts from
PPSP Request for Abortion Form .....................451

Defendants’ Exhibit 11: Excerpts from
PPSP Fact Sheet ................................................. 453

Defendants’ Exhibit 13: Excerpts 
from Guidelines of
Women’s Suburban Clinic (WSC) .....................457

Defendants’ Exhibit 14: WSC 
Disclosure of Risk,
Benefits and Alternatives Form ......................... 461

Defendants’ Exhibit 17: WSC Information
Prior to Consent/Certification
by Patient Form ................................................. 464

Defendants’ Exhibit 18: WSC
Parental Involvement Form ................................465

Defendants’ Exhibit 19: WSC
Physician’s Certification Form ........................... 466

Defendants’ Exhibit 20: WSC
Protocol Regarding Minors ................................467

Defendants’ Exhibit 26: Excerpts from
Reproductive Health and Counseling
Center (RHCC) Consent Forms .......................469

Defendants’ Exhibit 30:
RHCC Advertisements ...................................... 473



IV

Defendants’ Exhibit 32: Allentown 
Women’s Center (AWC)
Counseling Checklist ...........................................474

Defendants’ Exhibit 33: Excerpts
from AWC Confidential Patient
Record Form ......................................................477

Defendants’ Exhibit 35:
AWC Advertisements .........................................484

Defendants’ Exhibit 36:
AWC Consent Form ...........................................486

Defendants’ Exhibit 37:
Northeast Women’s Center
Guidelines for Informed Consent .....................487

Defendants’ Exhibit 39:
Summary Compilation of
Quarterly Reports ............................................... 488

Defendants’ Exhibit 45: Commonwealth 
of Pennsylvania Department 
of Health (DOH) Abortion Facility 
Registration Form ............................................. 489

Defendants’ Exhibit 46: DOH 
Abortion Quarterly
Facilities Report Form .......................................491

Defendants’ Exhibit 47A: DOH 
Report of Induced Termination 
of Pregnancy Form
(version no. 1)  493



V

Defendants’ Exhibit 47B: DOH 
Report of Induced Termination 
of Pregnancy Form
(version no. 2) ...................................................497

Defendants’ Exhibit 47C: DOH 
Report of Induced Termination 
of Pregnancy Form
(version no. 3)  500

Defendants’ Exhibit 48: DOH 
Certification Regarding
Spousal Notice Form .........................................504

Defendants’ Exhibit 49: Excerpts 
from DOH Directory of 
Social Service Organizations 
for Referrals for
Pregnant Women ............................................... 506

Defendants’ Exhibit 50: Excerpts
from DOH Printed Information
on Medical Assistance Benefits ......................... 508

Defendants’ Exhibit 51: DOH Notices
Required by Abortion Control Act ...................518

Defendants’ Exhibit 54: Deposition
Excerpts of Thomas E. Allen, M .D .....................519

Defendants’ Exhibit 55: Deposition
Excerpts of Sue Roselle .................................... 522

Defendants’ Exhibit 56: Deposition
Excerpts of Carol C. Wall .................................. 527



VI

Defendants’ Exhibit 57: Deposition
Excerpts of Sherley Hollos ................................532

Defendants’ Exhibit 58: Deposition
Excerpts of Jane S. G re e n ..................................538

Defendants’ Exhibit 59: Deposition
Excerpts of Sylvia Stengle .................................. 541

Defendants’ Exhibit 60:
Discovery Excerpts ............................................. 552

Excerpts from Plaintiffs’ Trial Exhibits......................556

Plaintiffs’ Exhibit 49: DOH Instructions 
and Definitions for Report of 
Induced Termination of
Pregnancy Form (July 1988) ..............................556

Plaintiffs’ Exhibit 60: Veto Message
to the Pennsylvania Senate on
S.B. 742 of Governor Dick Thornburgh
(Dec. 23, 1981) ....................................................572

Plaintiffs’ Exhibit 61: Message
to Pennsylvania Senate on Signing
of 1982 Pennsylvania Abortion
Control Act of
Governor Dick Thornburgh
(June 11, 1982) ....................................................583

Plaintiffs’ Exhibit 62: Veto Message 
to Pennsylvania House of Representatives 
on H.B. 1130 of Governor
Robert Casey (Dec. 17, 1987) ...........................592



VI1

Plaintiffs’ Exhibit 67: Excerpts from 
The Federal Role in Determining the
Medical and Psychological 
Impact of Abortion on Women,
H.R. Rep. No. 392,
101st Cong., 1st Sess. (1989) .............................599

Plaintiffs’ Exhibit 89:
Diagnostic Criteria for
Post-Traumatic Stress Disorder ......................... 606

Excerpts from Verifications Filed 
in Support of Plaintiffs’
Preliminary Injunction Motion ......................... 608

Excerpts from Verification
of Sue Roselle (Apr. 19, 1988) ........................ 608

Excerpts from Verification
of Sylvia Stengle (Apr. 18, 1988) .......................615

The following opinions and orders have been omitted in 
printing this Joint Appendix because they appear on the 
following pages in the Appendix to the Petition for a Writ 
of Certiorari in No. 91-744.

Planned Parenthood v. Casey, 947 F.2d 682 
(3d Cir. 1991) .......................................................... la

Planned Parenthood v. Casey, 744 F. Supp. 1323 
(E.D. Pa. 1990) .....................................................  104a

Order of the United States District Court 
for the Eastern District of Pennsylvania, 
filed August 24, 1990 ............................................. 285a



393

EXCERPTS FROM DEFENDANTS’ TRIAL EXHIBITS

Defendants’ Exhibit 1:
Excerpts from Magee-Womens Hospital 

Informed Consent for 
Termination of Pregnancy Form

MAGEE-WOMENS HOSPITAL 
Pittsburgh, PA 15213
INFORMED CONSENT FOR TERMINATION OF 
PREGNANCY

I hereby authorize __________________________ ,
M.D., and/ or such associates and assistants as he/she 
may select and supervise to perform the following 
procedure(s):________________________ •

The doctor has explained to me the nature and 
purpose of the procedure(s), the risks associated with the 
treatment, the available alternatives and risks of these 
alternatives, as summarized below.

1. The medical procedure to be used i s ____________ ,
which has been explained to my full satisfaction.

2. The risks involved with the procedure(s) include 
severe blood loss, infection, perforation, 
incompleteness, possible need for further surgery 
(hysterectomy, removal of tubes and ovaries), 
possible sterility, danger to subsequent pregnancies,
fatality and ________________, which have been
explained to my full satisfaction.



394

3. I understand that possible alternatives to the 
abortion procedure include childbirth and possible 
placement for adoption which have been explained 
to my full satisfaction. I fully understand the risks of 
these alternatives, which have been explained to me.

4. I fully understand that there is no guarantee that this 
procedure will be successful or that it will terminate 
my pregnancy.

5. If any unforeseen condition arises in the course of 
the abortion which, in accordance with good medical 
practice calls for procedures in addition to or 
different from those contemplated, I further 
authorize the above-named physician or his designee 
to perform such procedures which in his professional 
judgment are necessary.

6. I understand that it is my responsibility to bring to 
the attention of the staff physician and Magee- 
Womens Hospital any unusual symptoms following 
the procedure and to report for check-ups or 
pregnancy tests as recommended.

7. I have had full opportunity to ask additional 
questions of the doctor(s) and staff about this 
procedure and the risks and alternatives involved 
and am satisfied with the answers. I have no further 
questions. I understand that I am free to withhold 
or withdraw my consent to perform this procedure at 
any time prior to the abortion without prejudicing 
my future care.

8. I understand that Pennsylvania law requires that 
fetal tissue removed during an abortion be submitted 
for pathological examination.



395

Magee-Womens Hospital will be responsible for fetal 
tissue:

_________ Yes _________No

I certify that I have read (or had read to me) and 
fully understand the above consent to abortion and 
the explanations referred therein were made to me.

PATIENT SIGNATURE DATE TIME

PATIENT IDENTIFIED PRE-OPERATIVELY BY:

* *



396

Defendants’ Exhibit 2:
Excerpts from Women’s Health Services (WHS) 

Individual Counseling Guidelines/
Post Abortion Group Guidelines/ 
Personal Counseling Guidelines

INDIVIDUAL COUNSELING GUIDELINES 
Abortion Clinic

The purpose of this interview is to establish that the 
woman understands her pregnancy options and desires 
an abortion, has a genuinely informed consent, and to 
obtain the necessary history for the medical record.

Before the interview the counselor should review the 
chart, looking for LMP, any pelvic exam, age, distance 
traveled, occupation, whether anyone is accompanying 
her, marital status, medical history, record of prior visits 
and lab work. This information is helpful to have in 
mind when greeting and getting to know the woman so 
that we can provide service in a manner that will meet 
her needs as well as those of the people accompanying 
her.

The usual interview covers steps 1 thru 14 of the 
outline below and takes from ten to thirty minutes. The 
average time is about twenty minutes but can vary due to 
specific circumstances. In this interview the counselor 
must assess the woman’s individual needs and determine 
the best way to organize the session. Women who are 
conflicted and unable to resolve those conflicts in a short 
period of time (15 minutes) should be referred 
immediately to the personal counselor or to a counseling 
administrator.

There are times when all information given to the 
patient including the post abortion follow up instructions



397

and the contraceptive instructions should be done in the 
individual session. Women who are deaf, have 
significant English language problems, adolescents under 
15, those who are slow to comprehend, or who have 
emotional disabilities should be given all information in 
this individual session. The latter paragraphs below 
describe the steps in covering this additional information.

Suggested interview outline:

1. Give an overview of what the woman will experience 
during her stay--where she will be, how long she will 
be in certain places.

2. Tell the woman what you will be talking about 
during the interview and that you will (1) discuss any 
questions or concerns the woman has about the 
abortion (2) discuss the procedure (3) take her 
medical history. In this way a contract is informally 
set. It is important that the woman knows what to 
expect from the counselor during the interview-that 
the goals are clearly defined. For those who are to 
have all information individually the counselor would 
also include (3) care afterwards and (4) birth control 
in her overview of the interview.

3. Encourage the woman to ask any questions she may 
have. She will be more ready to listen if this is done 
first. Find out what she knows about the abortion 
procedure. Her questions, level of information and 
concerns will help the counselor gauge where to 
start. It is up to the counselor to decide in what 
order to cover the necessary information with the 
woman so that it attends to those individual needs 
that are within the limits of the counselor’s goals and 
capabilities.



398

4. The counselor usually describes the procedure next, 
reviewing each step and what the patient will feel. 
The counselor starts by making certain that the 
woman understands basic reproductive anatomy and 
the menstrual cycle.

5. The complications should be listed and an 
explanation of how they might occur. These must be 
presented in a way that is both realistic and in 
perspective to the chance of occurrence. We believe 
a genuinely informed consent should be part of any 
medical procedure. All patients should have 
infection, hemorrhage, perforation and in­
completeness, the possibility of further medical 
treatment or surgery, i.e. hysterectomy, removal of 
tubes or ovaries resulting in sterility, as well as 
fatality explained to them. Emphasize that in an EA 
the most common complication is incompleteness.*

6. Assess the woman’s readiness for the abortion by 
asking her if it was an easy or difficult decision, and 
with whom she has been able to discuss this. If the 
woman is not ready for the abortion, the counselor 
should stop here, attempt to help resolve the issues 
and get help from the personal counselor or 
supervisor if needed. The counselor should make 
sure that the woman understands all the options 
available to her including abortion or a full term 
delivery where she could either keep the child or put 
it up for adoption.

7. Take the histories on pages 1, 2, 3, 4, 5 of the chart.

8. Take her vital signs and record them.

9. Have her read or read to her the consent. Have



399

patient sign the consent. Witness the consent.

10. All women should be given a copy of the WHS 
"Guide to Birth Control Options" and asked to look 
it over in preparation for the recovery group.

11. When the interview is finished, allow the patient to 
stay in the counseling room, and take the chart to 
the lab for the test results.

12. If the blood type is Rh Negative explain the meaning 
of this before you escort her from the counseling 
room.

13. Get and record her weight, instruct her to use the 
restroom if possible and then have a seat in the 
waiting area.

14. Counselor should take her completed chart to flow 
and get her next assignment.

If the patient is to receive all information on an
individual basis the counselor will:

A. Review all information on the post abortion 
instructions* after completing the histories in 
step 7. The attached envelopes should be 
reviewed also.

*The EA patient will be given additional 
instructions in the Recovery Room. Tell her in 
counseling that if the fetal tissue is less than 8 
weeks LMP, she will need a pregnancy test 
within 2 to 3 weeks after the abortion as well as 
a check-up by 8 weeks. She should make her 
check-up appointment after getting her



400

pregnancy test results. For a check-up made 
after 8 weeks the woman will be charged for an 
annual exam. Tell the patient that on the slight 
chance she is still pregnant at the time of the 
UCG, it is important that she have a repeat 
procedure to terminate the pregnancy. The fetus 
can be damaged by infection from the uterus 
having been entered.

B. The review of the birth control methods is done 
next. The goals are to give accurate birth 
control information, assess the woman’s needs 
for a method and usually urge the woman to 
choose a method to prevent further pregnancies. 
The counselor gives a brief introductory 
overview to all the methods, and then, 
depending on how the woman responds, 
discusses all, one, or several of the methods. 
Each woman is instructed in the use of foam and 
condoms since it is an easily available back-up 
method. If a woman states she does not plan to 
use any, this is explored-complete information 
on birth control is given so that she will know 
about the methods for the future. If she does 
not want a method, that decision is respected.

C. Complete steps 8 and 9.

*  *  *

Summary of Charting Inservice

5. Specific charting areas

a. Page One will no longer be reviewed in depth by 
the receptionist. This will now be the



401

counselor’s responsibility. Clerical will cover the 
"black dot" questions (allergies, heart, epilepsy, 
seizures, diabetes, hepititis, jaundice) and the 
"white dot" data needed for sizing in order to 
make the necessary referrals to the NP/PA’s.
The counselor covers items 1-36 recording for 
any circled items: date of occurrence and 
description (original onset, degree of problem, 
treatment if any). Counselor covers any 
medication taken today, medications taken 
previously, any allergies and allergic reactions to 
medicines. The allergies are circled in red on 
page one and the counselor writes the allergy in 
red on page 5 on allergy line. Remember to 
write N/A at any section where there is nothing 
to record to indicate you covered the data.

The counselor should review any 
questionable histories with NP/PA’s to 
determine if any special exam or care is 
necessary.

Counselor must be fully aware of the 
contraindications to abortion in Medical 
Standards.

b. Page 2 - It is important to record what isn’t as 
well as what is (birth control history — none used 
for example). The counselor checks the 
appropriate box in the laboratory section when 
VD culture is done in procedure.

c. Page 3 - The counseling paragraph should 
summarize Relationship issues (a stress situation, 
how partner, parents, friends, others of 
significance have responded to decision, degree 
of support wanted and available, how do parents 
and/or partner see their emotional and financial 
responsibility to patient; ability to communicate 
(any need for special explanations due to



402

language problems, slowness); the decision 
(difficulties, pros and cons, reason for 
termination, any issues concerning morality of 
abortion). If the woman is having the abortion 
for medical reasons this must be stated and that 
the option of a second opinion with genetic 
counseling was offered must be recorded.
Special Cases 1) Reasons for not telling parent 
if underage, 2) If patient is victim - raped or 
incest - and on MA it must be recorded in 
counseling paragraph as the reason for the 
abortion, 3) If full interview done and reason for 
doing this is to be recorded.

The counseling paragraphs should be written 
in complete sentences, no slang should be used, 
be descriptive, discreet and avoid the counselor’s 
personal judgments about the patient or her life 
style. The paragraph should only summarize 
information related to the abortion decision.

All pamphlets given to her, referrals to 
personal counselor, other referrals such as to 
PAAR, Neighborhhod Legal Services, etc. should 
be recorded under recommendations and 
referrals.

When a patient is voided, the administrator 
should record the related information in the box 
on the bottom of page 3 so we can use the same 
insert if the patient returns for termination of 
that pregnancy.



403

PERSONAL COUNSELING SESSION

Interviewer:_______________ Case#_______
(Initials) (If appropriate)

Nickname: DOB:

INTRODUCTORY COMMENT: I understand that
you’ve been having a difficult time with this decision. 
Perhaps by talking about your concerns and hearing the 
answers to your questions, you will be better able to 
decide what is best. Our discussion is intended to be of 
help to you. Any time you don’t understand why I’m 
asking a particular question, please feel free to ask me 
about my reasons for asking that particular question.

INTERVIEW QUESTIONS:

1. When you think of pregnancy, what kinds of things 
come to mind?

2. How long have you been pregnant?______________

3. Have you ever had an abortion? __ No __ Yes
(Number:__ )

4. Who have you chosen to tell about your pregnancy? 
People* told. Their reaction

This person accompanied patient.



404

Partner’s reaction to pregnancy - initially:
_Positive__ Negative__ Not Told

_________ ’s current reaction is :__ Positive__ Negative
(Name of Partner)

5. What were your beliefs about abortion before this 
happened?

_AB acceptable
_AB acceptable, difficult decision 
_AB unacceptable, unless under cases of rape, 

incest, MR, etc.
_AB unacceptable 

Comment:

6. Do you have other children? __ Yes ___No

7. How do you see a child fitting into your life right 
now?

8. What is your religious background?
_Christian __ Jewish __ Moslum___Catholic
_Protestant __ N/A



405

9. Have you ever been hospitalized for a nervous 
disorder? No Yes Where?

10. Have you ever seen a counselor, psychologist,
psychiatrist? __ No __ Yes

11. Do you have any questions of me?
No
Client asked about procedure.
Client asked about fees.
Client asked about feelings women have post 
AB.

__  Client asked if the procedure will affect
future pregnancies.
Other (specify)______________________

CLIENT ORIENTATION DURING INTERVIEW

Internal Control...........External Control

Little Denial Present...........Denial Evident

Self Esteem Present...........Poor Self Esteem

INTERVENTIONS

__  Support for assertive right to make personal
choice, whether AB, pregnancy to term, 
adoption.

__  Showed pictures of early fetal development.
__  Gave reading materials.
__  Gave list of phone numbers related to religious



406

groups/individuals (client may contact)
Cognitive restructuring to establish fact(s)/realty 
related to _____________

RECOMMENDA TIONS

__  None needed/none requested
Client is comfortable with her current personal 
choice.
Suggested she give AB more thought.
Client is to return to another session on (date)

Client is to return for another session "when 
needed"
Contact West Penn Hospital for genetic
counseling/information
Call for sizing appointment
Suggested she seek support from significant
other(s). Specify ________________________

Suggested she return for post AB session. 
Suggested that AB doesn’t appear to fit within 
her value system. We discussed other options 
for a second time.

OTHER RECOMMENDATIONS not aforementioned

CLIENT DECISION
Keep scheduled appointment for procedure 

_Very comfortable with decision 
Comfortable with decision



407

Schedule procedure 
_Very comfortable with decision 
_Comfortable with decision 

Schedule another personal counseling session 
Give procedure further thought 
Discuss potential decision with significant 
other(s)__________________________________

Keep Pregnancy
Adoption procedure (__ gave information on
local adoption agencies)

INTERVIEW QUESTIONS WITH PERSON (S) 
ACCOMPANYING CLIENT

Not applicable, no one accompanied her
Mother __  Relative

(Specify________ )
Father __  Friend
Partner Counselor

1. What are your thoughts regarding this pregnancy?

2. Flow long have you known about this pregnancy? _

3. Who else have you told?_______________________
Does the client know this? __ Yes __ No

4. What are some of your concerns?________________

5. In what areas are you willing to be helpful if she 
decides to carry her pregnancy to term?



408

Emotional support, no matter what she decides. 
None, she’s on her own.
Lodging, she can live with me/us
Child care (full time/part time/occasionally)
Financial
Just food for she’ll be on her own
Other (specify) ______________________ _ _

6. Have you told her how much support/help she can
expect from you? __ Yes __ No
(If "no", when do you plan to do so? __________ )

7. Do you have any questions of me?
About the procedure 
Fees
AB effect on future pregnancies
Other (specify) ___________________________

8. Interview’s impression of significant others. Check 
(7) all that apply.

Opinion seeker
Initator (person is appropriately assertive)
Information seeker
Opinion giver
Information giver
Elaborator
Organizer/coordinator
Evaluator/critic
Aggressor
Blocker (person avoids reality of situation)
Moralizer
Supporter
Passive
Observer
Follower
Compromises



409

Harmonizer 
Recognition seeker 
Self-confessor 
Dominator 
Help seeker

RECOMMENDATIONS TO SIGNIFICANT OTHER(S)

Not needed, 
already Dresent Needed

Offer emotional support, no 
matter what she decides. 
Make position clear to 
client
Seek counsel from other
sources,
e.g.,
Return with client for 
another session 
Stop enabling client’s 
excessive dependency 
Read the same material 
given to client so topics can 
be discussed.

Comments: (please use reverse side)



410

Defendants’ Exhibit 3:
WHS Consent for Abortion Form

CONSENT FOR ABORTION

I hereby authorize a Staff Physician to perform upon 
me a VACUUM ASPIRATION ABORTION, including 
all the mechanical aspects, which have been explained to 
me.

I consent to the administration of anesthesia to be 
applied by or under the direction of the staff physician, 
and the use of such anesthetics as s/he may deem 
advisable.

If any unforeseen condition arises in the course of 
the abortion which, in accord with good medical practice, 
calls for procedures in addition to or different from those 
contemplated, I further request and authorize the staff 
physician to perform such procedures, or administer any 
medication which s/he may deem advisable or to have 
me admitted to a hospital facility.

I understand that it is my responsibility to bring to 
the attention of Women’s Health Services, Inc. any 
unusual symptoms following the abortion and to report 
for check-ups or pregnancy tests as recommended.

The nature and purpose of an abortion by vacuum 
aspirations, other abortion techniques, and the 
alternatives to abortion, including childbirth and 
adoption, the risks involved, and the possibility of 
complications and detrimental physical and psychological 
effects which are not anticipated but may occur, 
including by way of illustration and not limitation, 
hemorrhage, infection, perforation, incompleteness as 
well as the possible need for further surgery (i.e. 
hysterectomy, removal of tubes and ovaries), possible 
sterility and fatality, all of which have been fully



411

explained to me.
I authorize Women’s Health Services to dispose of 

all fetal tissue as it sees fit.
I CERTIFY THAT I HAVE READ (OR HAD 

READ TO ME) AND FULLY UNDERSTAND THE 
ABOVE CONSENT OF ABORTION AND THAT THE 
EXPLANATIONS THEREIN REFERRED TO WERE 
MADE.

Date____  Time__
Signature of Patient

Signature of Person authorized to give consent, if not 
patient

Relationship to Patient

Signature of Physician

Signature of Witness

ECTOPIC PRECAUTIONS
I certify that I have received a copy of the sheet 

listing the precautions for possible ectopic pregnancy, 
have read it and understand the importance of the 
medical follow-up.

Date_____ Signature of
Patient



412

Alternate contact person in addition to myself:

Relationship Phone Number

Signature of Witness

EARLY ABORTION SPECIAL INSTRUCTIONS

I certify that I have received a copy of the sheet 
describing the special instructions for early abortion 
patients, have read it and understand the importance of 
the medical follow-up.
Date____  Signature of

Patient

Signature of person authorized to give consent, if not 
patient

Relationship to Patient

Signature of Witness

POST ABORTION INSTRUCTIONS

I certify that I have received a copy of the sheet 
describing instructions for after the abortion, have read it 
and understand the importance of the medical follow-up.

Date_____ Signature of
Patient



Signature of 
Witness

413

Signature of Person authorized to give consent, if not 
patient

Relationship to Patient

CONSENT FOR ORAL CONTRACEPTION

I hereby authorize a staff physician of Women’s 
Health Services, Inc. and/or whomever s/he may 
designate as a practitioner to perform:

Contraceptive Services and Supplies
I have received and agreed to read the patient 

information on oral contraceptions provided by the 
manufacturer.

I do hereby release Women’s Health Services, Inc. 
from any and all claims which I may have by reason of 
their providing me this service.

I understand that it is my responsibility to bring to 
the attention of Women’s Health Services, Inc., any 
unusual symptoms and to report for check-ups as 
recommended.

I CERTIFY THAT I HAVE READ (OR HAD 
READ TO ME) AND FULLY UNDERSTAND THE 
ABOVE CONSENT TO CONTRACEPTIVE 
SERVICES AND SUPPLIES, AND THAT THE 
EXPLANATIONS THEREIN REFERRED TO WERE 
MADE AND THAT ALL BLANKS OR STATEMENTS 
REQUIRING INSERTION OR COMPLETION WERE 
FILLED IN.



414

Date____  Signature of
Patient

Signature of person authorized to give consent, if not 
patient

Relationship to Patient

Signature of Witness

I do hereby release Women’s Health Services, Inc. 
from any and all claims which I may have by reason of 
their providing me this service I understand that it is my 
responsibility to bring to the attention of Women’s 
Health Services, Inc., any unusual symptoms and to 
report for check-ups as recommended.

Date____  Gynecological Exam

Signature of
Patient_________________________________________

Date____  Antibiotic Therapy

Signature of 
Patient



415

Defendants’ Exhibit 4: 
WHS November 20, 1986 

Memo Re Parental Notification

To: All Paraprofessional Counselors, Nurse
Counselors, Clerical Staff, Administrative Staff, 
Personal Counselors

From: Liz Lincoln

Date: November 20, 1986

RE: Addition to 11/23/86 memo regarding parental
notification

Please re-read the 11/23/86 memo. A copy is on 
the staff lounge bulletin board for convenience.

While we are not going to ask parents to come in 
when we make an appointment for an adolescent, if a 
parent or parents come in on the day of the abortion we 
will get their signature on the consent page of the chart 
using the following guidelines.

1. Front Reception - Ahead of time, identify which 
patients on the appointment list are less than 18 (up 
to day before 18th birthday). When the adolescent 
signs in, ask if anyone has accompanied her. If a 
parent or parents are there, instruct her to tell them 
not to leave the facility until they are notified the 
abortion is done.

2. Counselors - Nurse/Counselors - After greeting the 
patient who has parents here give her an overview of 
the counseling interview and ask if the parent can sit 
in on the description of the abortion and the



416

complications so the parent can sign the part of the 
consent for "others authorized to give consent". 
Most should agree if this is presented as described 
below.

Try to include just one parent - although if both 
want to come we should accommodate that. Use 
one of the four rooms with windows since those 
rooms are larger. Extra chairs will be put in scale 
room for you to use and return when needed.

Review the procedure, possible complications, and 
options to abortion with the parent and adolescent. 
Answer questions. Give reassurance if needed. Get 
parent’s consent on line titled "signature of person 
authorized to give consent, if not patient". Write 
parent on line titled "relationship to patient". Escort 
parent back to front waiting areas. The patient 
herself will sign on "Signature of patient" line after 
the interview is completed. Counselor witnesses at 
that point.

If the adolescent seems ambivalent, her decision 
making process and support system should be 
discussed before bringing the parents in, rather than 
after they are returned to the waiting area. Any 
conflicts about the decision should be resolved 
before including the parent.

If the patient does not want to include the parent, 
one of the counseling administrators or another 
counselor if available will cover the information with 
the parent and get the parent’s signature.

This instance should be rare. The discussion of the 
decision, and support system, the history taking, vital



417

signs, etc. will always occur without the parents. If 
this is made clear and if the adolescent wants to be 
here, it will be all right with most of them to include 
the parents for the description of the procedure and 
complications.

If a separate discussion is needed for parent consent 
use separate consent sheet to expedite time and 
staple to original consent. Review procedure, 
complications, and options with parent.

We are doing this to comply with our 
liability insurance requirements. This is not 
part of the abortion control act.

REMINDER: After the procedure is done, the
counselor accompanying the adolescent 
through procedure should see parents 
and tell them they can go out for an 
hour at that time if they wish. Give 
estimated discharge time.



418

Defendants’ Exibit 5:
Excerpts from WHS Patient Record Form

WOMEN’S HEALTH SERVICES, INC. 
PATIENT RECORD

Name _________________________________
Address________________________________
City______________________  County 
State_____________________  Zip Code
Home Phone (____ ) ____________________
Business Phone (____ ) __________________

Date of Birth__________________ Age __________
___ Single (Never Married) ___ Married
___ Widowed ___ Separated ___ Divorced
Name you wish to be called by __________________
Occupation____________________________________
Place of Employment___________________________
Referred to WHS by:___________________________
What is your doctor’s (clinic’s):
Name _______________________________________
Address _____________________________________
Telephone Number_____________________________

(Area Code)

First Day of last normal menstrual period:
1. 4.
2. 5.
3. 6.



419

Do you consider yourself to be in good health: Yes No 
Circle the number for each of the following you have or 
have ever had:

1. epilepsy or seizures
2. hepatitis or jaundice
3. heart disease
4. rheumatic fever
5. heart murmer
6. diabetes (suger)
7. sexually transmitted 

disease (gonorrhea, 
syphilis, herpes, 
chlamydia)

8. disease or surgery of 
uterus, ovaries or 
tubes

9. extopic (tubal) 
pregnancy

10. cesarean section
11. Pelvic Inflammatory 

Disease (PID)
12. cancer
13. vaginal infection
14. urinary tract/ 

bladder/kidney 
infection

15. asthma
16. fainting, dizzy spells
17. breast lump or 

tumor
18. high blood pressure
19. sickle cell disease
20. blood transfusion
21. anemia
22. bleeding tendency

23. chest pains
24. shortness of breath
25. nausea and/or 

vomiting
26. frequent headaches
27. migraines
28. double vision
29. varicose veins
30. blood clots 

(phlebitis)
31. swollen feet or 

ankles
32. leg cramps
33. smoking
34. ever been 

hospitalized 
overnight



420

Any Family history of cancer, diabetes, T.B., allergies, 
epilepsy, heart problems, high blood pressure?

WHO WHAT

Have you taken medication, today: 
No Yes, I took

Date Medication Time

Date Medication Time

Date Medication Time

OPTIONAL: For Research Purposes Only
Religion________  Ethnic Background_____
Education - Last Grade Completed_________

List any other Allergies such as bee stings, eggs, etc.



421

Place an (X) in the appropriate column for any 
medicines you have ever used or are allergic to:
USED ALLERGIC
_____________ Doxycycline _____________
_____________ Aspriin _____________
_____________ Penicillin _____________
_____________ Tetracycline _____________
_____________ Sulfa
_____________ Codeine
____________  Demerol
_____________ Antibiotics
_____________ Tranquilizers
_____________ Sedatives
_____ ______(Novocaine) local anesthetic
_____________ Rho gam
_____________ Dilantin _____________
_____________ Anticoagulant
_____________ Other
Description of Reaction

Patient Name______________ _ _  Patient Number

HISTORY AT INITIAL VISIT:

Date:_________________

MENSTRUAL HISTORY:

Age of onset__ length of cycle___ days of flow
Amount of flow: Scant Moderate Heavy 
Amount of Discomfort:
Relieved by:



422

INTERNAL EXAM:
Ever had one: Yes No Date_______

PAP SMEAR:
Ever had one: Yes No Date_______

Date_______
Date_______
Date_______
Date_______
Date_______

ANY ABNORMALITIES: Yes No Date
If Yes, explain_________________________

CONTRACEPTIVE

Dates
Used

Problem Dates
Used

Problem

Pill

IUD

Dia­
phragm

Foam

Con­
doms

Other

1



423

PREGNANCY: Give dates (month & year); sex, male or 
female. If Cesarean section, circle dates.

Live
births

Still
births

Now
living

Spon.
AB

Induced
AB

Where

Types

Total
Preg­
nancies

Complications: 
Birthweight over 10 lbs. 
Ectopic pregnancies 
Multiple pregnancies

RH infants (jaundiced) 
Molar Pregnancies 
Hemorrhage



424

Patient Name Patient Number

ABORTION COUNSELING

Date ______________________________
Return Date_________________________
Time In _________________ Time Out
Referred from ______________________
Counseling received there? Yes No

1. contraceptive
2. abortion & alternatives
3. personal

Was abortion an easy or difficult decision? 
(If difficult, explain below)

Able to discuss decision with concerned others:
Yes No
(If no, explain below)

With her today:
1) Name ______________________________

Relationship__________________________
2) Name ______________________________

Relationship__________________________
3) Name ______________________________

Relationship__________________________

Pregnancy Test
Date __________________________________
Place __________________________________

Positive Negative
Emergency Contact:______________________
Describe Woman’s Mood:



425

Have you ever had professional counseling? 
Yes No

If yes, explain _______________________

Contact between 9-4 Monday thru Friday at:
Number Place Letter /Other 
Nickname "Shelly" Yes No /Address

Check appropriate box(es):
__  Woman understands and desires termination,

appears to have no problems with this and should do 
well.

__ Abortion related problems
_ Other life problems



426

Consent form signed Yes No
Physicians Signature ____________________
Counselor’s signature ___________________
Interview Group Counselor’s signature _____
Recommendations/Referrals ______________

Counselor’s signature_______________

RESCHEDULE/VOID INFORMATION,

Date

Signed

[4]

Patient Name__________________Patient Number

PHYSICAL FINDINGS

Date_______ BP___ P___ Temp____Hgt.___ Wgt._
Return date if applicable___________

BP___ P___ Temp___ Hgt.___ Wgt.___
LMP:__________  Weeks since LMP___________
Sizing_______  LMP Sonar results__________
Name____________________ NP/PA
SBE Prophalaxis__ Yes___No

Comments:



427

Contraceptive Desired 280.C. F&C

PROCEDURE
Date:____________________________
Pelvic Exam: Describe Positive Findings

External Genitalia + - _________
Vaginitis + - _________________
Acute Cervicitis + - ____________
Adnexal Mass or Tenderness + - _
Uterus: Estimated Uterine Size

Weeks from LMP
Anterior Midposition Posterior

OPERATIVE REPORT: VACUUM ASPIRATION
Date__________________________
Sound_______ cm Dilation to:____
Cannula:_____ mm KARMAN
Nesacaine 2% 12cc Carbocaine 1%
Pitressin 2.5 units or 5 units
Other ________________________
Uterine exploration: curette forceps both 
I.U.D. + - Molar Degeneration + - 
Tissue Volume Small Mod. Large(for gest.)
Villi Seen + - Molar Degeneration + - ?
Fetal Age______ (Weeks from LMP by tissue exam)
Embryo/Fetus: + - Incomplete ?Complete 

Probably Complete
Blood Loss:______________cc. Perforation + -
Tissue to Pathology + - Rush + - 
Comment:



428

Complications + - (comment below)

Patient state during procedure: 
Notes and Comments:

ORDERS FOR RECOVERY AND DISCHARGE
Immune Globulin 

_Yes __ No
Valium________  I.M., P.O.____________
Pitocin_____________ cc.________________
Methergine 0.2mg. I.M.___________________
Methergine 0.2mg. P.O. 6 tablets/12 tablets
Doxycycline 200mg. P.O._______________
Other _______________________________
28 day O .C .__________________________
Acetominophen 1000 mg. ______________
Ibuprofen 400 mg._____________________
Other _______________________________
Return for pregnancy test 2 weeks

_Yes __ No
Early Abortion Instructions

__ Yes __ No
Extopic Precautions 

__ Yes __ No
The Standard Dilation and Vacuum 
Technique was performed as stated above
Signed_______________________________
Time in___________________ Time Out _
Procedure Counselor:

Aspiration

M.D.



429

RECOVERY ROOM
Time of Admission__________ AM/PM Date

Hour

Blood
Pressure

Pulse

Bleed­
ing

N Sm
Mod
Hvy

N Sm
Mod
Hvy

N Sm
Mod
Hvy

N Sm
Mod
Hvy

Pain/
Cramps

N M M 
S

N M M 
S

N M M 
S

N M M
S

Allergies: No Yes_______________
Previous Medication

Dosage Route & Site Time By
1.
2.
RH Negative: Yes No 

Immune Globulin Given: Yes No 

RH Inf. and Card: Yes No 

Lab Comments:



430

Medi­
cation
Admin­
istered

Doasage Route & 
Site

Time By

l.Doxy-
cycline

200 mg. P.O.

2.1bu-
profen

400 mg. P.O.

3.

4.

5.

Medication
Dispensed

Dosage Amount By

l.Mether-
gine

0.2 mg. P.O. 6 tablets/ 
12 tablets 
lq. 6 hours

2.Ampi-
cillin

250 mg. QID x 12 
doses

3.



431

Contraceptive: 28-day O.C. Type/Amount __________
Given By ________________________ _____
F&C Tubal Vasectomy Diaphragm Has Own/None 
Insurance Form Completed: Yes No 
MA Forms: Yes No 
Post Abortion Instructions:

Instruction Sheet: Yes No 
Contraceptive Instructions: Yes No 
Can read thermometer? Yes No 
Thermometer given Yes No

Check-up: WHS_________ Private M.D.__________
Excuse needed fo r______________________  Yes No

No. of days_______ Given: Yes No
Transportation:

Car Cab Bus Train Plane Walk 
Other___
By Self With Family/Friend 

Emotional Condition:
Interacts openly Composed Withdrawn Upset 
Referred for Personal Counseling 

Physical Condition:
No Problems Cramps: Mild Moderate Severe 
Other

M.D.
Time of Discharge AM/PM
Signed RN/LPN
Signed RN/LPN



432

Patient Name_________________ Patient Number_

REPEAT PROCEDURE/EMERGENCY CHECK
Date ________________________________________
Time of Admission

________ AM Repeat Procedure Recheck
________ PM Repeat Admission Pis. Circle

PREGNANCY TEST Positive Negative 
Pelvic Exam: Describe Positive Findings

Vaginitis + - ____________________
Acute Cervicitis + - _______________
Adnexal Mass or Tenderness + - _________
Uterus: Estimated Uterine Size 

(Wks from LMP)
Anterior Midposition Posterior

Carbocaine 1%____ cc Pitressin 2.5 units/5 units
Dilation: Yes to __ Fr. No
Cannula:__ mm BERKLEY KARMAN

Material Aspirated ___________________________

Blood Loss:_____________ cc Perforation + -
Tissue to Pathology + - Rush + - 
Comment:

Complications: + - (comment below)

Patient state during Procedure
Notes and Comments ______
Impression: ______________

Plan:___________________________________

ORDERS FOR RECOVERY AND DISCHARGE
Methergine 0.2 mg. I.M. ________________



433

Methergine 0.2 mg. P.O. ___________
Doxycycline 200 mg. P.O. __________
Acetominophen 1000 mg. P.O. _______
Ibuprofen 400 mg. _________________
Other
Return for Pregnancy test 2 weeks Yes No 
Ectopic Precautions Yes No

Signed __________________________________M.D.
Time In ________________ Time Out____________
Procedure Counselor:

RECOVERY ROOM

Hour

Blood Pressure

Pulse

Bleeding N Sm Mod Hvy N Sm Mod Hvy

Pain/Cramps N M M S N M M S

Allergies: No Yes _____________________
Previous Medication Dosage Route & Site Time By



434

1 .

Med­
ication
Admin­
istered

Dosage Route & 
Site

Time By

l.Doxy-
cycline

200mg. P.O.

2.1bu-
profen

400mg.

3.

4.

5.
Medication Dispensed Dosage Amount By
1.
2.

Excuse needed for___________ Yes No
No. of days__ Given Yes No

Transportation:
Car Cab Bus Train Plane Walk 
Other
By Self With Family/Friend 

Emotional Condition:
Interacts openly Composed Withdrawn Upset 
Referred for Personal Counseling 

Physical Condition:
No problems Cramps: Mild Moderate Severe 
Other

M.D.
Time of Discharge a m / pm
Signed RN/LPN
Signed RN/LPN



435

WOMEN’S HEALTH SERVICES, INC. 
CONTRACEPTIVE CLINIC

Patient Name_________________ _ Patient Number__

Put an (X) in the appropriate column for each of the 
following you have had only since your last visit to the 
Women’s Health Services, Inc.

*  *  *

Patient Name __________________ Patient Number

Visit # Date Visit #  Date

Chief Complaint: Chief Complaint:

History: History:

Temp. BP P Wt. LMP Temp. BP P Wt. LMP

Thyroid: Thyroid:

Breasts: Breasts

Heart: Heart:

Lungs Lungs

Abdomen: Abdomen:



436

Pelvic: Vulva Pelvic: Vulva

Vagina Vagina

Cervix Cervix

Corpus Corpus

Adnexa Adnexa

Rectal Rectal

Extremeties: Extremeties:

Tests: PAP GC Tests: PAP GC

Wet Prep Wet Prep

Other Other

Impression: Impression:

Plan: Plan:

Contraception: Contraception:

Next Appointment: 
Wks. Mos.

Next Appointment: 
Wks. Mos.

RN/PA M.D. RN/PA M.D.



437

* *

CONSENT FOR ABORTION
I hereby authorize a Staff Physician to perform upon 

me a VACUUM ASPIRATION ABORTION, including 
all the medical aspects, which have been explained to 
me.

I consent to the administration of anesthesia to be 
applied by or under the direction of the staff physician, 
and to the use of such anesthetics as s/he may deem 
advisable.

In the course of the abortion if any unforseen 
condition arises which, in accord with good medical 
practice, calls for procedures in addition to or different 
from those contemplated, I further request and authorize 
the staff physician to perform such procedures, and to 
administer any medication which s/he may deem 
advisable and to have me admitted to a hospital facility.

I understand it is my responsibility to bring to the 
attention of Women’s Health Services, Inc. any unusual 
symptoms following the abortion and to report for check­
ups and pregnancy tests as recommended.

I understand the nature and purpose of an abortion 
by vacuum aspiration. I understand that there are other 
abortion techniques. I understand the alternatives to 
abortion, including childbirth and adoption. I understand 
the risks involved with an abortion, and the possibility of 
complications and detrimental physical and psychological 
effects which may occur. These include, by way of 
illustration and not limitation, hemorrhage, infection, 
perforation, hem atom etra, cervical damage, 
incompleteness as well as the possible need for further 
surgery (e.g. laparoscopy, laparotomy, hysterectomy, 
removal of tubes and ovaries), possible sterility and 
fatality. All of these matters have been fully explained 
to me.



438

I authorize Women’s Health Services to dispose of 
all fetal tissue in accordance with state and federal laws.

I CERTIFY THAT THIS ENTIRE ABORTION 
CONSENT HAS BEEN READ TO ME AND THAT I 
HAVE READ OR HAD THE OPPORTUNITY TO 
READ THE ENTIRE CONSENT FORM AND THAT 
I UNDERSTAND THE ABOVE CONSENT FOR 
ABORTION AND THE THE EXPLANATIONS 
HEREIN REFERRED TO WERE MADE.
Date__________  Time__________
Signature of Patient______________________________
Signature of Person authorized to give consent, if not 
patient ________________________________________

Relationship to Patient________________________
Signature of Physician____________________________
Signature of Witness______________________________

ECTOPIC PRECAUTIONS
I certify that I have received a copy of the sheet 

listing the precautions for possible extopic pregnancy, 
have read it and understand the importance of the 
medical follow-up. Date
Signature of Patient _____________________________
Alternate contact person in addition to myself:

Relationship ______ _________________________
Phone Number ___________________________

Signature of Witness _____________________________

EARLY ABORTION SPECIAL INSTRUCTIONS
I certify that I ahve received a copy of the sheet 

describing the special instructions for early abortion 
patients, have read it and understnad the importance of
the medical follow-up. D ate______________
Signature of Patient
Alternate contact person in addition to myself:



439

Relationship_________________________________
Signature of Witness _____________________________

POST ABORTION INSTRUCTIONS
I certify that I have received a copy of the sheet 

describing instructions for after the abortion, have read it 
and understand the importance of the medical follow-up

Date___________
Signature of Patient _____________________________
Signature of Person authorized to give consent, if not 
patient:

Relationship ________________________________
Phone Number_______________________________

Signature of Witness _____________________________

CONSENT FOR ORAL CONTRACEPTION
I have received and agreed to read the patient 

information enclosure regarding oral contraceptives 
distributed by the manufacturer. I understand that it is 
my responsibility to bring to the attention of Women’s 
Health Services, Inc. any unusual symptoms and to report 
for check-ups as recommended. I CERTIFY THAT I 
HAVE READ (OR HAD READ TO ME) AND 
FULLY UNDERSTAND THE ABOVE CONSENT TO 
CONTRACEPTIVE SERVICES AND SUPPLIES, AND 
THAT THE EXPLANATIONS HEREIN REFERRED
TO WERE MADE. Date___________
Signature of Patient _____________________________
Signature of Person authorized to give consent, if not 
patient:

Relationship to patient
Phone Number______

Signature of Witness



440

I do hereby consent to have Women’s Health Services, 
Inc. provide to me the service noted below.

Date_______________ Gynecological Exam
Signature of Patient_______________________

Date_______________ Antibiotic Therapy
Signature of Patient_______________________

Date_______________ Lamicel Insertion
Signature of Patient_______________________

FINANCIAL PAGE

Insurance Company ______________
Insurance Address________________
Agreement #  ___________________
Group # ________________________
Subscriber_______________________
Sub. Employer___________________
HMO Center____________________
HMO M R #_____________________
HA Family I.D.# ________________
MA # __________________________
Line # _____________________ R.C.
State _________________
Exp. Date_____________  D.D.

D.D.
D.D.
D.D.
D.D.

M C/Visa#______________________
Sub. Name______________________
Exp. Date_______________________



441

Defendants’ Exhibit 8: 
WHS Advertisements

The Pittsburgh Press 

Ask a friend

"I was very pleased with the professionalism and 
personal treatment. I would refer any of mv 
friends to WHS."

About Women’s Health Services
"Counseling Services for Men & Women"

"PMS Program-Abortion Services-Gyn Care" 
Fulton Building ■ 107 6th St.

Downtown Pittsburgh
(412) 562-1900

WAMO 1500 Chamber of Commerce Bldg.
FM 106 Pittsburgh, Pennsylvania 15219-1905

(412) 471-2181

WOMENS HEALTH SERVICES.....

IF Y O U ’RE C O N C E R N E D  ABO U T  AN 
UNPLANNED PREGANCY...HELP IS JUST A 
PHONE CALL AWAY....562-1900. WOMENS
H E A L T H  S E R V I C E S ___ F U L T O N
BLDG...DOWNTOWN OFFERS YOU HELP IN 
MAKING DECISIONS ABOUT YOUR LIFE. 
WOMENS HEALTH SERVICES HAS A HIGHLY



442

SKILLED GYNECOLOGICAL STAFF AND A 
COUNSELING STAFF AND YOUR VISIT WILL BE 
KEPT COMPLETLY CONFIDENTIAL. IF THE 
PIECES OF THE PUZZLE DON’T QUITE FIT...LET 
WOMENS HEALTH SERVICES HELP....OUR 
PHYSICIANS PROVIDE SKILLED MEDICAL CARE 
AND YOU’LL BE TREATED IN A REASSURED 
AND COURTEOUS MANNOR. FOR A GYN 
APPOINTMENT..OR ANSWERS TO QUESTIONS 
ABOUT AN UNPLANNED PREGNANCY CALL THE 
PHONE STAFF AT 562-1900....BETWEEN 8 and 5PM 
...MONDAY THRU FRIDAY....SATURDAY 8 to
4PM.....WOMENS HEALTH SERVICES...IN THE
FULTON BUILDING ...DOWNTOWN.....FREE
PREGNANCY TESTING IS AVAILABLE DAILY. 
FOR MORE INFORMATION CALL WOMENS
HEALTH SERVICES AT 562-1900.....HELP IS JUST A
PHONE CALL AWAY.

THE CAMPUS
OF ALLEGHENY COLLEGE 

Ask a friend

"Everyone treated me nicely. I felt comfortable 
and relaxed, the procedure was explained step by 
step. I liked that."

About Women’s Health Services

Where Experience Makes A Difference 
Early & Later Abortions-Confidential Counseling 

Fulton Building ■ 107 6th St.
Downtown Pittsburgh



443

1-800-323-4636

Phone Listing:

ABORTION SERVICES DIVISION OF 
WOMEN’S HEALTH SERVICES INC

1st & 2nd Trimester Abortions in a 
comfortable setting. Highest medical 

standards.

107 6 St Pittsburgh PA 
Toll Free Dial "1” & Then--800 426-4636



444

Defendants’ Exhibit 9: 
Excerpts from Planned Parenthood 

of Southeastern Pennsylvania (PPSP) 
Center Policy and Procedure Manual

C. Counseling and education.

1. All pregnancy test clients will receive 
appropriate options counseling if desired by patient. 
Intensive counseling may be scheduled for a separate 
visit if deemed necessary by client and counselor.

2. The purpose of pregnancy counseling and 
referral is to support a woman in clarifying and 
achieving her immediate reproductive goal. All 
applicable alternatives (parenting, adoption, foster 
care, infertility testing, pregnancy termination, 
contraception) will be presented in an unbiased 
manner. As a result of the counseling session, the 
patient should understand:

a. Her alternatives, including description and 
approximate cost of services, and time 
constraints.
b. Advantages and disadvantages of her 
alternatives.
c. Specific resources for reaching her goal, 
including the support of her partner, friends 
and/or family, medical care, financial aid, 
transportation, bilingual services, counseling and 
education.
d. Methods of contraception available if found to 
be not pregnant.
e. What to do in an emergency.
f. Information about the accuracy of the test.



445

3. All counseling is confidential (within leqal 
limitations) and will be conducted in privacy.

a. Results should be given to the woman alone 
and the partner or significant other brought in if 
desired by her.

4. Every patient age 17 and younger who is making 
a decision concerning a positive pregnancy test shall 
be encouraged to talk to a parent or an alternative 
adult.

5. Every patient should be given the opportunity to 
consider:

a. Clinical information with reqard to her 
gestation of pregnancy.
b. Any aspect of her medical evaluation which 
pertains to the options available to her.
c. Review of contraceptive history and plans.
d. Options available for continuing or 
terminating a pregnancy, including appropriate 
referrals.
e. Potential effect each option suggests for the 
future.

6. A Consumer Feedback Form (#54) must be 
given to each patient referred for abortion services.

a. Request the patient return the Consumer 
Feedback Form within six weeks.

7. Document that pregnancy alternatives were 
discussed.

8. Pregnancy options counseling may be offered 
without testing if woman brings written results of a 
positive pregnancy test done elsewhere. Women 
who have used home pregnancy tests should have



446

another test done at the Center.

D. Referrals.

1. Prenatal care and delivery.
a. A minimum of two direct service referrals 
must be provided.
b. The CHOICE Hotline can be given as an 
additional resource.

2. Adoption and foster care.
a. Provide the patient with appropriate referrals.

3. Abortion.
a. A minimum of three referral sources is given 
from the approved Referral Lists (#55a and 
55b) as indicated and available.

4. Up to date information is maintained at each 
site regardinq social services, Medicaid, drug abuse 
programs, as well as all medical referrals.

5. Document all counseling, advice, and referrals 
on the medical record.

6. Consumer Feedback form (#54) is given to 
patient to be completed and mailed back to PPSP 
center.

E. Counseling personnel.

1. Personnel suitable for pregnancy options 
counseling
a. Physicians, clinicians, Center Managers, 
Center Assistants, social workers, and selected, 
trained and appropriately supervised volunteers.



447

2. Qualifications of counseling personnel.
a. The ability to respect, understand and 
empathize with the woman as an individual.
b. A sincere belief in the right of the woman to 
make her own decision after she has explored all 
the options.

3. Training of counseling personnel.
a. The counselor must have a complete 
knowledge of the facts regarding abortion. 
These include:

1) The facts about relative risks of early 
abortion as opposed to late abortion;
2) Availability of services;
3) Facility evaluation;
4) Cost of services.

b. Counselors must be thoroughly knowledgeable 
about all methods of contraception and 
community-wide contraceptive services.
c. Counselors must have knowledge regarding 
facilities for prenatal care.
d. Counselors must have knowledge regarding 
the necessary procedures for adoption and the 
location of adoption agencies.
e. Counselors must have knowledge regarding 
the availability of insurance coverage or other 
reimbursement for abortion, and prenatal care 
and delivery.
f. Counselors must have knowledge of the 
availability of psychiatric consultation which may 
be requested or which may be medically 
advisable.
g. Counselors must be familiar with all legal 
requirements for sterilization procedures which 
may be requested in conjunction with abortion.



448

* *

K. Procedure for Center Assistant/Counselor.

1. Each patient will be seen individually by a 
Center Assistant/Counselor. Counselors will pick up 
charts, so keep completed charts in order. Keep 
Center Manager informed of unusual situations that 
may need special attention or patients with potential 
problems.

2. Have on hand:
a. Pap slips.
b. GC slips.
c. Serology slips.
d. Medical and information forms.
e. Several pens.
f. Pencil.
g. China marker.

3. Greet patient and take her to counseling office. 
Explain your role as it relates to patient visit and 
Center procedure. The counselor performs role of 
advocate, assistant, and support to the patient.

4. Review patient’s medical history (#16) with her. 
Make special note of potential problems and consult 
with appropriate staff as needed. Be sure all forms 
are completed.

5. Discuss patient’s decision to have an abortion 
and provide opportunity for her to explore feelings. 
Let her know other options are available and you 
can provide her with referrals. Involve others 
accompanying client to facility, if appropriate. 
Support person can be included in procedure room



449

if, in staffs judgement, their involvement would be 
supportive to the client.

6. Explain, answer questions, discuss the abortion 
fact sheet (#21), including risks, and consent (#18). 
Have client sign and witness. Must be able to give 
informed consent.

7. Review birth control methods (#42) and discuss 
patient’s choice. Have patient sign contraceptive 
consent and witness.

8. Review "safer sex" practices.(#99)

9. Review possible medical concerns with Center 
Manager, medical support staff, and physician prior 
to the procedure.

10. Ascertain that slips for GC and Pap have been 
completed and are in the patient’s chart. Label Pap 
slides, GC plates with client name, date, and 
specimen number if appropriate. Be sure all 
specimen numbers have been recorded on lab sheet 
in chart.

11. Record results of pregnancy test, urine dipstick, 
hematocrit, and Rh factor on lab sheet in chart.

12. Record drug allergies and significant medical 
problems in red on outside of chart.

13. Provide a written social history in patient’s 
record reflecting the counseling session. The 
followinq questions can be used in evaluating the 
abortion counseling session:

a. Do I feel I have a clear picture of the



450

woman’s intellectual and emotional status in 
regard to her abortion decision?
b. Are there conflicts between her emotional and 
intellectual status on the abortion decision?
c. Who else is involved in decision-making and 
what are their reactions? Does this woman have 
support for her decision?
d. If the woman decided alone, how did she 
reach the decision to do so and what are her 
feelings about it?
e. What are her contraceptive plans for the 
future?
f. Were there other problems, i.e. relationship, 
sexuality that were dealt with?
g. How will she react post-abortion? Does she 
desire future counseling services?
h. Is she clear in regard to the abortion 
procedure?
i. For extended first trimester procedures, follow 
all of the above steps plus:

1) Explain laminaria insert procedure plus 
possible complications.
2) Have patient sign laminaria consent 
(#90) and witness.
3) Schedule abortion appointment for the 
following day and review pre-abortion 
instructions.

*  *  *



451

Defendants’ Exhibit 10: 
Excerpts from PPSP 

Request for Abortion Form

Planned Parenthood Southeastern Pennsylvania 

Request for Abortion

Name

Address_____________________  Birth Date_______

I have received from Planned Parenthood a fact 
sheet containing detailed information on the nature and 
purpose of an abortion, the risks involved, and the 
possibility of complications. I have read the fact sheet 
which has been explained to me, and which I understand. 
I have had all my questions answered. I also understand 
that a doctor is available to answer any additional 
questions I may have. No guarantee or assurance has 
been made to me as to the results which may be 
obtained and I am aware, on the basis of the fact sheet 
and the explanation I received, of the risks involved in 
an abortion and the possible complications.

I hereby request that a doctor authorized by Planned 
Parenthood perform an abortion upon me if s/he, in 
her/his medical judgment approves the performance of 
the abortion. If any unforeseen condition arises in the 
course of the abortion calling in her/his judgment for 
procedures in addition to or different from those 
contemplated, I further request and authorize her/him to 
do whatever s/he deems advisable to protect my health 
and welfare.



452

I consent to the administration of a local anesthetic. 
To my knowledge, I am not allergic to any anesthetics.

I hereby give my permission to the employees of 
Planned Parenthood Southeastern Pennsylvania and 
others authorized by them to use information contained 
in my medical record for statistical purposes, with the 
understanding that confidentiality will be maintained.

Signature________________________  Date_________

I witness the fact that the patient received, read, and 
said she understood the fact sheet.

Witness________________________________________

[ ] Physicians must sign only for minors under the age 
of 18 without parental consent:

I have discussed with the patient the abortion she 
has requested and I believe she is sufficiently mature and 
intelligent to understand the nature and consequences of 
her condition and of the procedure. I believe that the 
abortion she has requested is in her best interest.

Physician



453

Defendants’ Exhibit 11: 
Excerpts from PPSP Fact Sheet

Facts About Early Abortion

What It Is
A surgical procedure to end a pregnancy within 14 

weeks from the first day of the last menstrual period.

How It Is Done
The standard method is vacuum aspiration (suction 

curettage):

1. A local anesthetic is injected into or around 
the cervix (the lower part of the uterus). You 
may notice stinging or pressure, which goes away 
quickly. Some women don’t feel anything.

2. The opening of the cervix is stretched slowly 
by a series of narrow rods (dilators), each a little 
wider than the one before. The largest dialator 
may be about as thick as a fountain pen. You 
may feel strong cramping during this part of the 
procedure.

3. When the cervical opening is wide enough to 
admit it, a cannula (a hollow plastic tube) is 
inserted into the uterus. This tube is attached to 
a suction machine, which is then turned on. You 
may notice a pulling or tugging feeling at this 
time.

4. After the uterus has been emptied by gentle 
suction, an ordinary spoon-shaped curette may 
be used to make sure that the uterus has been



454

emptied.

Possible Problems
As with any kind of surgery, complications can occur 

with early abortion. Early abortion by vacuum aspiration 
is, however, very safe. Fewer than 1 woman in 100 will 
have a serious problem, including but not limited to:

Infection
Infection is caused by germs from the vagina and 

cervix getting into the uterus. The risk of infection 
related to early abortion is less than 1 in 100 cases. 
Such infections mostly respond to antibiotics, but, in 
some cases, a repeat vacuum aspiration or 
hospitalization is necessary. Surgery may also be 
required. You can decrease your chances of 
developing an infection by not having intercourse 
until after your post-abortion exam and not inserting 
ANYTHING into your vagina, including tampons.

Bleeding
Bleeding from the uterus heavy enough to 

require treatment occurs less than 1 in 1,000 cases. 
This bleeding problem may require medications to 
help the uterus contract, a repeat vacuum aspiration 
or dilation and curettage, or rarely, surgery.

Cervical Tear
The cervix sometimes is torn during the 

procedure. This happens in less than 1 in 100 cases. 
Stitches may be required to repair the injury.

Incomplete Abortion
Sometimes, the contents of the uterus may not 

be quite emptied. The frequency of this event is less 
than 1 in 100 cases. This problem can lead to



455

infection, hemorrhage, or both. To remove the 
tissue, it may be required to repeat the vacuum 
aspiration or perform a dilation and curettage at the 
clinic or in a hospital. In rare instances, surgery may 
be required.

Perforation
Rarely, an instrument may go through the wall 

of the uterus. This event happens in about 2 per 
1,000 cases. Should this happen, hospitalization is 
often required for observation and/or completion of 
the abortion. To inspect the condition of the uterus 
in this state, a small telescope (laparoscope) is 
inserted through the navel. Sometimes, an 
abdominal operation is required to repair the 
damage. This can include hysterectomy (removal of 
the uterus), which makes it impossible to have 
children. The frequency of hysterectomy in this 
setting is about 1 in 10,000 cases.

Failure to Tertninate the Pregnancy
Once in a while, the early abortion procedure 

will not end the pregnancy. The chance of this event 
is about 2 per 1,000 cases. This possibility is one 
reason that a post-abortion examination is essential. 
In such cases, another abortion procedure is 
suggested, since the first attempted abortion can 
harm normal development of the pregnancy. The 
other possibility is that a tubal (ectopic) pregnancy 
may exist, which requires an abdominal operation to 
remove.

Death
Early abortion is one of the safest operations in 

all of medicine. Information from the Centers for 
Disease Control (CDC) shows that the risk of death



456

from an early abortion is about 1 per 100,000 cases. 
In contrast, the risk of death related to tonsillectomy 
is about 3 deaths per 100,000 cases. The risk of a 
woman dying from full-term pregnancy and childbirth 
is at least 7 times greater than that from early 
abortion.

Anesthesia Reaction
Some women may be allergic to novocaine 

derivatives. If you know this, it is important to tell 
the doctor.

Effect of Abortion on Future Wanted Pregnancies
At this point there is no clear proof that one 

early abortion carries any risk to future pregnancies. 
Some studies have shown that women who have had 
two or more such abortions may have an increased 
risk of premature births or miscarriages in future 
pregnancies. Different studies have shown otherwise.

Emotional Reactions
Strong feelings after abortion are common, and 

when they happen they mostly go away quickly. 
Most women report a sense of relief, although some 
feel depression or guilt. Serious psychiatric 
disturbances (such as psychosis or serious 
depression) after abortion appear to be less frequent 
than after childbirth.

Deciding whether or not to have an abortion is a 
very private matter. You need to be sure and 
comfortable that having an abortion is what you want to 
do, even if it is a hard decision to make.



457

Defendants’ Exhibit 13:
Excerpts from Guidelines of 

Women’s Suburban Clinic (WSC)

Guidelines of Women’s Suburban Clinic (WSC) 
Protocol

OPTIONS COUNSELING/REFERRAL

I. ELIGIBILITY: Any woman who has

-- a positive pregnancy test 
-- requests options counseling at 

WSC
-- is eligible for options counseling.

II. INTAKE:

-  An appointment card is used for information 
on options counseling clients (see forms).

-- This card is completed as described in 
abortion intake procedures except that the 
medical history is not necessarily taken (if 
medical history is not taken this is noted in 
pencil on front of card).

-- Appointments are scheduled during the 
counselor’s assigned times, as designated in 
the appointment book.

-- Options counseling clients are NOT given a 
"Disclosure of Risks, Benefits, and 
Alternatives to Abortions" to read after they 
return their medical history to the front 
desk.



458

* *

V. DISPOSITION:

-  If a client chooses to have an abortion, she 
can be scheduled for an appointment at 
WSC or referred to another appropriate 
facility (see Referral Counseling). If a 
woman chooses to have an abortion at WSC, 
the appointment should not be made for the 
same day as the option counseling.

-- If a woman chooses to continue the 
pregnancy, the counselor may make a 
referral to appropriate community resourses 
(Examples: Pre-natal Care or Adoption 
Informatian).

-  Options Counseling Notes will be recorded 
by the counselor (see forms-Appendix B).

* * *

ABORTION AND SUPPORT SERVICES 

VII. COUNSELING

The individual counseling is provided to all women 
who come to WSC for abortion services (see 
Counseling Standards). This counseling, usually 
done on the same day as the abortion, is not offered 
for the purpose of exploring pregnancy (see Options 
Counseling), although alternatives may be discussed. 
Rather, this counseling session assumes that the 
decision to abort has been carefully thought out 
prior to the session. The objectives of this session



459

are clearly defined under "Objectives" in the 
Counseling Standards section of the WSC 
Guidelines.

If, in the process of the session, the counselor 
determines that the client has not clearly decided to 
abort, he/she will suggest that the client not proceed 
with the abortion that day. The counseling session 
then procedes under the protocol for "Options 
Counseling, with the abortion (if chosen) being 
rescheduled for another day.

c. The Counseling Session: The pre-abortion session 
flows according to the clients needs and questions. 
The client’s partner or other accompanying person is 
also encouraged to accept information, ask questions, 
and explore feelings at WSC. These "signifigant 
others" may be invited to joinq the counseling 
session, but only after the women has seen the 
counselor alone, thus giving her the opportunity to 
discuss any private concerns, (see also, Counseling 
Signifigant Others).

* *

E. Limitations and Referrals: The counselors role is to 
discuss the clients’ concerns primarily regarding the 
abortion decision. For those women who display a 
need for further counseling or assistance which is 
non-abortion related, the counselor may refer the 
client to an appropriate agency or individual. A 
resource book is maintained by WSC under the 
supervision of the head counselor. The Resource 
Book includes numerous community resources.



460

F. Counseling Signifigant Others: Any person who 
accompanies a client to WSC is offered the 
opportunity and is encouraged to see a counselor. 
This may include the client’s partner, her parents, 
and/or any "Signifigant Other". The counselor may 
see the Signifigant Other with the client, or after the 
clients’ counseling session. This is left up to the 
discretion of the client and the counselor.

* * *



461

D e f e n d a n t s ’ E x h ib it  14:
W S C  D is c lo s u r e  o f  R is k , B e n e f it s

a n d  A lte r n a t iv e s  F o rm

WOMEN’S SUBURBAN CLINIC

DISCLOSURE OF RISKS, BENEFITS AND 
ALTERNATIVES

Because abortion is a form of minor surgery, which, like 
all surgery, has certain statistical risks, it is the policy of 
Women’s Suburban Clinic to provide detailed 
information regarding the risks, benefits and alternatives 
to abortion so that you can make a clear and conscious 
choice.

Alternatives: The alternative to ending a pregnancy is to 
continue it to term and birth. This usually leads to 
parenthood or adoption. Pregnancy and childbirth have 
some medical and psychological risks. Both the benefits 
and risks of parenthood and adoption should be carefully 
considered before deciding upon an abortion.

Benefits: The benefits of early abortion depend upon the 
individual. Abortion permits the planning of parenthood. 
Abortion eliminates the decision between parenthood 
and adoption.

Risks: 96% of all early abortions take place without any 
complications at all. Complications associated with 
abortion are generally less frequent than with childbirth. 
In childbirth some 15 to 20 out of 100,000 women do not 
survive. Abortion is 5 to 10 times safer.



462

Below is a list of possible complications to abortion. 
You will be asked to sign a consent form indicating that 
you understand these risks before you have an abortion.

Please read this form carefully so that you understand 
that we cannot guarantee that the results obtained from 
an abortion will always be perfect. Complications may 
occur and require further treatment. A member of 
Women’s Suburban Clinic staff is on-call 24 hours a day 
for consultation; and we will assume financial 
responsibility for treatment of all medical (not 
psychological) complications to abortion if such 
treatment is given at or recommended by Women’s 
Suburban Clinic.

Medical Risks:
a) Risk of Infection: In approximately 1 in 100

cases, minor or possible major infections can occur after 
an abortion. Antibiotics are necessary to treat these 
infections and, very rarely, infections may lead to 
reduced fertility.

b) Incomplete Abortion: Sometimes all of the tissue 
may not be removed during the abortion. This happens 
in approximately 1 in 100 cases, and may lead to 
infection unless treatment is begun soon or the abortion 
is redone.

c) Continued Pregnancy: In as many as 1 in 100
cases, a woman may still be pregnant after an abortion. 
This may be due to multiple pregnancies (i.e. twins), a 
double uterus, or a pregnancy in the tubes (ectopic 
pregnancy). A failed abortion may be detected by 
follow-up exam and pregnancy test after which the 
abortion can be redone. A tubal or ectopic pregnancy is 
difficult to detect and will require a hospitalization and 
surgery.



463

d) Bleeding or Hemorrhage: Heavy bleeding
immediately or shortly after an abortion may happen in a 
very small number of cases. This requires evaluation and 
treatment, which depends upon the cause of the 
bleeding.

e) Perforation or Laceration: Very rarely an
instrument may tear the cervix or puncture the wall of 
the uterus. These cuts will generally heal themselves, 
with no treatment, but occasionally they may require 
hospitalization or surgery.

f) Anesthetic Reaction: Anesthetics do not always 
eliminate all pain. In very rare instances, local 
anesthetics cause extremely severe reactions, including 
convulsions or cardiac arrest.

Psychological Risks:
Sometimes women express negative feelings after 

having had an abortion. These feelings may include a 
sense of loss, guilt, regret or sadness.

The likelihood of your experiencing these feelings 
depends on many factors including your feelings about 
abortion, your religious convictions, your cultural and 
social norms, and the support you receive from your 
family and friends.

You will have the opportunity to discuss these 
factors with a counselor before the abortion to reduce 
the likelihood of their causing negative feelings later. If 
negative feelings do occur, you may return to Women’s 
Suburban Clinic for counseling and/or referral for more 
involved therapy.



464

INFORMATION PRIOR TO CONSENT

I,  , certify that on
___________________ , 1988, I orally informed
_________________________ prior to her consenting to
an abortion, of the nature of the proposed procedure and 
treatment of abortion and of the risks and alternatives to 
abortion or treatment that a reasonable patient would 
consider material to the decision whether or not to 
undergo the abortion.

D e f e n d a n t s ’ E x h ib it  17:
W S C  I n fo r m a t io n  P r io r  to  C o n s e n t /

C e r t if ic a t io n  by P a t ie n t  F o r m

physician qual i f i ed physician
assistant

health care practitioner technician delegated by
either physician

CERTIFICA TION BY PA TIENT

I, _____________________ , certify that prior to my
consenting to an abortion at the Women’s Suburban 
Clinic, the person who has signed the above statement 
called INFORMATION PRIOR TO CONSENT ’ told 
me about the nature of the proposed procedure and 
treatment of abortion and of the risks and alternatives to 
abortion and treatment.

Date:____________ , 1988

patient



465

D e f e n d a n t s ’ E x h ib it  18:
W S C  P a r e n ta l  In v o lv e m e n t  F o r m

Parental Involvement

I , _______________________ have carefully considered
with the counselor the possibility of involving my parents 
or guardians in my decision to terminate my pregnancy. 
However, I choose not to do so. I understand that if, 
during my abortion, I have any complications which 
hospitalization, the hospital may choose to call my 
parents. On the medical history form, I have given 
Women’s Suburban Clinic the number where my parent 
can be reached in case of emergency.

Client’s Signature

or
I am the parent/guardian o f_________
and I am aware of her decision to abort.

Signature

or
My parent/guardian is aware of my decision to abort, but 
could not be present today. I have given Women’s 
Suburban Clinic a number where my parent can be 
reached in case of emergency.

Client’s Signature



466

Defendants’ Exhibit 19:
WSC Physician’s Certification Form

PHYSICIAN’S CERTIFICATION

I certify that prior to the abortion I had a private 
medical consultation with the above client and 
determined that in my best clinical judgment the 
abortion was necessary.

Signature of Physician



467

Defendants’ Exhibit 20: 
WSC Protocol Regarding Minors

II. STANDARDS

D. Protocol Regarding Minors

1. It is one of the underlying philosophies of Women’s 
Suburban Clinic that all women capable of informed 
consent be provided the opportunity to "choose". 
These choices involve the decision regarding an 
unplanned pregnancy, the decision regarding whom 
they choose to inform about their pregnancy and 
what method of birth control they choose to use. As 
with any woman, this philosophy also pertains to 
minors. However, in the case of a minor (any 
woman under 18 years of age), the issue of whom 
she chooses to inform or not inform is carefully 
explored.

2. For any minor who at the time of scheduling her 
abortion has not informed one of her parents of her 
decision, the following will occur:
a. Anyone under 18 years of age whose parent(s) 

do not know about her decision to have an 
abortion is strongly encouraged to come to 
Women’s Suburban Clinic for precounseling. 
The reason for this is to allow the counselor on 
opportunity to explore more fully with the young 
woman her feelings regarding involving her 
parent(s). Further, a pre-counseling session 
would allow the teenager time to discuss her 
pregnancy with her parent(s) in the event that 
after counseling she chooses to do so. If the 
young woman chooses not to involve her 
parent(s) the counselor would then want to



468

explore other people (siblings, other relatives, or 
friends) who could provide a support system. It 
is ultimately the right of this teenager to decide 
whom, if anyone, she wants to involve. In all 
cases the minor will be asked on her Medical 
History form the name of her parent or 
guardian, and how to contact them in the event 
of an emergency.

3. For those minors who choose not to inform their 
parent(s) it is the role of the Women’s Suburban 
Clinic staff, as with all clients, to review and educate 
them regarding how to take a temperature and read 
a thermometer, what is considered a complication, 
and what to do in the event that a complication 
occurs.

4. All minors will be asked to complete a parental 
involvement form at the completion of counseling.



469

Defendants’ Exhibit 26: 
Excerpts from Reproductive Health and 

Counseling Center (RHCC) 
Consent Forms

INFORMATION PRIOR TO CONSENT

I, __________________________________, certify
that on _________________ , 19_, I orally informed
_________________prior to consenting to an abortion,
of the nature of the proposed procedure and treatment 
of abortion and of the risks and alternatives to abortion 
or treatment that a reasonable patient would consider 
material to the decision whether or not to undergo the 
abortion.

PHYSICIAN QUALIFIED
PHYSICIAN
ASSISTANT

HEALTH CARE TECHNICIAN
PRACTITIONER DELEGATED BY

EITHER PHYSICIAN 
(COUNSELOR)



470

CERTIFICATION BY PATIENT

I, _________________________ , certify that prior
to my consenting to an abortion at the Reproductive 
Health and Counseling Center, the person who has 
signed the above statement called "Information Prior To 
Consent" told me about the nature of the proposed 
procedure and treatment of abortion and of the risks and 
alternatives to abortion and treatment.

________ , 19_________________________________________________
DATE PATIENT

PHYSICIAN’S CERTIFICATION

I ,_________________________ , hereby
Patient’s Signature

acknowledge that I will have a private medical

consultation with D r.________________. I have just

cause to terminate this pregnancy because of the

following reason:



471

Physical 

Emotional 

Psychological 

Familial 

__  Age

l  ___________________________________________________ ,

M.D. through a private medical consultation, do hereby 

certify that to the best of my clinical judgment this 

abortion is necessary.

* * *

After careful consideration I have 
decided:

1) I will not inform my parents of my 
decision to terminate my pregnancy.

(2) Parent(s) are aware of my decision, 
but are unable to be here today.



472

I understand that while I am a patient of 
the Reproductive Health and Counseling 
Center that all reasonable measures will 
be taken to maintain my confidentiality. 
However, if it is necessary for me to be 
hospitalized at any time during or after 
my care here, the hospital may choose 
to notify my parents about any treatment 
they may give me.

Name

Date

Witness



473

Defendants’ Exhibit 30: 
RHCC Advertisements

REPRODUCTIVE HEALTH AND 
COUNSELING CENTER

■ first and second 
trimester abortion 
services

■ general & local 
anesthesia

■ Routine gynecology 
care

■ pregnancy testing

■ counseling services

■ vd screening

■ vasectomy service

Quality reproductive health care . . .

ALL SERVICES HELD 
IN STRICT 

CONFIDENCE!
Call 874-4361

(Crozer Chester Medical Center Annex) 
15th & Upland Av Chester, Pa.



474

Defendants’ Exhibit 32: 
Allentown Women’s Center (AWC) 

Counseling Checklist

COUNSELING CHECKLIST

1) Determine that patient has a clear decision to 
terminate pregnancy, knows options, and determine a log 
reasons for abortion (ie: financial, emotional, age, timing 
factor, life circumstances, medical, doesn’t want children 
or any more children).

2) If first pelvic exam, prepare patient.

3) Explain procedure, discuss pain management, assuage 
fear, empower patient.

4) Obtain informed consent, explain risks.

5) Review medical history and flag problems, discuss if 
abnormal menstrual period.

6) Explore birth control - pursue and explain only if 
patient desires the information

7) Have patient sign appropriate consents. Must sign 
abortion consent, dispensing of medication consent, and 
medical records release. Oral contraceptive consent 
must be signed only for those patients wanting to start 
the pill immediately.

ADDITIONAL INFORMATION REQUIRED FOR 
GENERAL ANESTHESIA



475

1) Provide complete aftercare instructions.
2) Explain how to take oral contraceptives for those 
patients taking then for the first time.
3) Have patient sign general aneathesia consent.
4) Obtain patient’s driver’s signature.

MINORS

1) Explain that if complications develop, their 
confidentiality may be broken.
2) Make certain minor knows all options.
3) Determine and record whether patient’s parent(s) are 
here or know she’s here. Record reason(s) why a patient 
chose not to tell her parents.
4) If a parent is here, the parent MUST co-sign for 
abortion.

IMPORTANT FACTORS TO CONSIDER WHEN
DOING PRE-ABORTION
COUNSELING

1) Make no promises that there will be no problems now 
or later.
2) It is better to see patient alone, at least briefly.
3) Counseling should be organic and cover concerns 
patient presents. Be empathetic, nonjudgemental, and 
caring.
4) Body language of counselor is just as important as 
what she says.
5) Observe patient to make sure she’s listening. Do not 
over inform. Her ability to process may be restricted.
6) Be nonjudgemental in recording counseling notes. 
(Do NOT record anything that you wouldn’t want patient 
to read, or anything that could be used against her later, 
ie: court).
7) Repeat patients who have had more than one



476

abortion. Review risks, and concentrate efforts on 
encouraging effective birth control use.
8) Prepare patient for being ineligible for procedure if 
you suspect she could be greater that 14 weeks LMP.
9) If patient is greater than 12 weeks LMP, advise her 
that she may need an ultrasound.
10) If you feel uncomfortable (for any reason) counseling 
a particular patient, give that patient to another 
counselor.
11) Ambivalent patient: When you have exhausted all 
possible information giving and patient is still ambivalent 
you can give patient these options.

a) Offer patient to leave the clinic and rethink 
decision. Give her time that she must be back if she still 
wants abortion that day.

b) Have patient and significant other sit together in 
counseling room to discuss decision. Counsel another 
patient and go back to her later.

c) If you feel patient needs more time to decide, you 
have the right to tell her that we can reschedule her 
appointment for another day, that she needs more time 
to make her decision.
12) Time management is important with short term 
counseling. If you are having a problem with a 
counseling session, notify clinic supervisor so that patient 
flow won’t be disturbed.
13) Take time to share, vent, and discuss counseling 
cases with other counselors here.
14) If you are having any problems with a client in 
counseling don’t hesitate to have another counselor or 
clinic supervisor assist you with that particular client.



477

Defendants’ Exhibit 33: 
Excerpts from AWC 

Confidential Patient Record Form

* *

For patients under 18:
Who of the following knows of and consents to your 
abortion?
Mother_______________ Father_______________
Guardian________________
If they are not aware you are here, why not?

PROCEDURE

Name_______________________  Date__________
Patient discussed need for aboriton with physician and
stated it is necessary __________________________

Physician’s Initials
BP_______  P_______  Temp.______
LMP Date_______ or_______ weeks LMP
Heart_______  Lungs_______  Abdomen_____
Comments ___________________________________
Pelvic Exam: Normal ________________________

Abnormal findings: ______________
Uterus: Anterverted__________________________

Retroverted_________________________
Midposition_________________________

Estimated duration of gestation based on uterine size:

Pap smear __________________________________
GC culture, cervix___  rectum___  urethra



478

pharynx___
Room_______________ Nurse:________________
Pre-op medication:_______________________________

OPERATIVE REPORT
Procedure Performed

Patient was placed in dorsal lithotomy position, 
prepped and draped in usual manner. A
paracervical block was administered using___ cc of
___ % ____ caine. The uterus was sounded to
___ cm. The cervix was dialated to a # ___
dialation using gradually increasong dialators. A
# ___ cannula was placed in the uterus and vacuum
aspiration was performed. Uterine exploration with 
a sharp curette followed. Estimated blood loss was
___ cc. Gross examination of POC Grams_______
Normal POC______ Other (describe)_______
Villi seen______ Consistent w ith____ weeks
gestation

Send specimen for microscopic pathology 
Instructions

Complications:



479

Post-Operative Medication

Immune Ergotrate Other
globulin, mini­
dose

Immune Birth
globulin, full- 
dose

Control Pills

Pitocin Tetracycline

Notes or comments_____
Procedure Not Performed

Physician’s Signature 
Referral: * *

Counselor Signature

* *

Do not sign unless you fully understand the following.

I, _______________________ being______years old,
request that my present pregnancy be terminated. I 
understand that the termination of this pregnancy (i.e. 
abortion) will be by vacuum aspiration and curettage as
explained to me. I understand that Dr.___________  or
a designated associated physician will be performing the 
termination procedure.

I further understand and give my consent to the taking of 
medical tests, cultures, and smears that are deemed 
necessary.



480

I have fully and completely disclosed my medical history, 
including allergies, blood conditions, prior and current 
use of or reactions to medications and drugs. I 
understand that a full and complete disclosure of my 
medical history is important to help minimize the risks of 
complications which may occur with termination of 
pregnancy. I understand that the physician of Allentown 
Women’s Center is relying on my disclosures as being 
truthful and complete.

The first day of my last normal menstrual period
was____ 19___. I understnad that this information
concerning my last period is important to the diagnosis 
and method of treatment, and that the physician’s 
decision to proceed with the termination is based on the 
above information as well as findings from examination.

I fully understand the purpose of the procedure is to 
terminate my pregnancy. I know that I can continue the 
pregnancy, but it is my choice to end it now. No one has 
forced me to do so.

I consent to the administration of such local anesthesia 
as may be deemed necessary or advisable by my 
physician. I understand that local anesthetics do not 
always eliminate all pain, that in a small number of 
cases, patients can have an allergic reaction which could 
result in shock or even death.

I fully understand that the practice of medicine and 
surgery is not an exact science and that qualified 
physicians cannot assure the results thereof. I realize 
there are inherent risks of minor and major 
complications which many occur in this and all surgical 
procedures, without the fault of the physician. No 
guarantee has been made to me. I understand that the



481

surgical procedure which I am about to undertake will in 
all probability involve a certain amount of pain and loss 
of blood. I also understand that the surgical procedure 
which I have requested is occasionally accompanied or 
followed by certain complications including, but not 
limited to, perforation of the uterus (putting a hole 
through the uterine muscle), hemorrage, retainded tissue 
and/or infection, all of which could be severe enough to 
require surgery resulting in hysterectomy (removal of the 
uterus), and/or sterility (never being able to become 
pregnant again). If any of the above reactions or 
complication do ocurr, I further realize that I may need 
to be hospitalized which would be at my own expense. I 
realize that such complications can be caused by other 
medical conditions and not related to the pregnancy 
termination procedure, by my own failure to follow post­
operative instructions, or by the treatment of the follow­
up physician. I know that every effort is made to protect 
my confidentiality, but that if I have a medical problem 
that needs treatment, my confidentiality may be 
jeopardized.

I understand that any questions I have will be answered 
by my physician, nurse and/or counselor, and I will ask 
any questions I have before leaving. If I have any 
questions or complications after leaving, I agree to call 
the Allentown Women’s Center at 215-264-5657. I 
realize that immediate treatment may be necessary to 
avoid more severe complications.

I understand the importance of post-operative follow-up 
care and I realize that I am responsible for scheduling a 
post-abortion check-up in 2-3 weeks to be certain that no 
medical problem has occured, that I may be unaware of, 
and to check that the procedure has been complete. I 
agree to report any and all post abortion problems to the



482

Allentown Women’s Center, particularly fever, heavy 
bleeding, severe cramping or pain, or the absense of a 
normal period within eight weeks of the procedure.

I certify that I have read (or had read to me) and fully 
understand the above consent form, regarding 
termination of pregnancy, that the explanations therein 
referred to were made, and that all blanks or statements 
requireing insertion or completion were filled in. I 
further certify that all information I have supplied, in this 
entire record, is true to the best of my knowledge and 
belief.

DO NOT SIGN UNTIL YOU HAVE COMPLETELY 
READ AND FULLY UNDERSTAND THE ABOVE

SIGNATURE___________________________________
WITNESS_______________________________________
D A T E _________________________________________
I certify that I have explained, translated, or otherwise 
informed the patient of the above.
SIGNATURE___________________________________
DATE_________________________________________
RELATIONSHIP TO THE PATIENT_______________

DRUGS DISPENSED
I request that drugs not be dispensed to me in safety 
closure containers.
SIGNATURE___________________________________
WITNESS_______________________________________
DATE

CONSENT TO ORAL CONTRACEPTIVES
I have chosen to use oral contraception as a birth 

control method and request the physician at Allentown 
Women’s Center prescribe this method for me. I



483

understand the possible side effects to the method 
include severe headaches, leg cramps, blurred vision, 
blood clots, chest pain and stroke. I agree to report any 
and all side effects to Allentown Women’s Center or to 
my own physician or clinic. I am aware that the most 
serious side effects of birth control pills can be fatal. I 
have read the information sheets and fully disclosed any 
risk factors in my medical history that might be 
contraindications to taking oral contraceptives. 
SIGNATURE 
WITNESS 
DATE

CONSENT FOR RELEASE OF MEDICAL RECORDS
I give permission for release of information from my 
medical records from the Allentown Women’s Center to 
my follow-up care provider and, if specified below, my 
referral source.

Referred by 
SIGNATURE
WITNESS DATE



484

Defendants’ Exhibit 35: 
AWC Advertisements

DONNELLY DIRECTORY

ALLENTOWN
WOMEN’S
CENTER

ABORTION SERVICES 
AWAKE OR ASLEEP 

EARLY PREGNANCY TESTS 
GYNECOLOGICAL CARE 

VD TESTING
ALL SERVICES CONFIDENTIAL 

264-5657

Rt 22 & Airport Rd. Allentown

ALLENTOWN WOMEN’S 
CENTER

ABORTION SERVICES 
AWAKE OR ASLEEP 
EARLY PREGNANCY 
TESTING 
CONFIDENTIAL 
COUNSELING

Rt 22 & Airport Rd Allentown 
Toll Free —- 800 372-8500



485

*  *  *

ALLENTOWN WOMEN’S CENTER--
■ ABORTION SERVICES
■ AWAKE OR ASLEEP
■ SATURDAY HOURS 

AVAILABLE

Rt 22 & Airport Rd
Allentown Toll Free — 800 372-8500



486

Defendants’ Exhibit 36:
AWC Consent Form

I,  , have requested an abortion at
the Allentown Women’s Center, although I have also 
stated I don’t think abortion should be legally available 
to women.

I have been offered waiting time to reconsider my 
decision to abort this pregnancy. I have been offered 
genetic counseling, psychological counseling, and an 
explanation of the resources for financial and emotional 
support available to me to continue this pregnancy. I 
have been asked to consider how I expect to feel after an 
abortion, and urged not to take the irreversible step of 
terminating my pregnancy until I have fully processed the 
options before me.

I take full responsibility for my decision to terminate this 
pregnancy. I acknowledge and understand that my 
doctor here and the support staff are caring, responsible 
people who are helping me implement my voluntary, 
uncoerced request to terminate this pregnancy.

If in the future I ever publicly state that the Allentown 
Women’s Center counseled me inadequately or that I 
was not fully aware of the gravity of what I was doing in 
terminating my pregnancy I understand that I will, by so 
doing, give up all rights to confidentiality and that the 
staff of the Allentown Women’s Center will defend their 
non-directive counseling protocols publicly.

Signature________________________________________
D ate__________________________
Witness



4 8 7

Defendants’ Exhibit 37: 
Northeast Women’s Center 

Guidelines for Informed Consent

GUIDLINES FOR INFORMED CONSENT

I. Individual Counseling Session
A. Exploration of all options
B. Determination of Reason for Abortion

1. to meet qualifications for abortion control act
2. to assure that patient is sure of abortion decision

C. Review of medical history to determine medical 
eligibility.

D. Distribution of follow-up & after care 
instructions

E. Distribution of birth control information
F. Opertunity to explore feelings about abortion
G. Completion of State Health Dept, form

1. report of induced termination of pregnancy.

II. Group Counseling
A. Explaination of abortion procedure
B. Explaination of possible risks, and complications
C. Explaination birth control methods.
D. Explaination of written consent
E. Signing of consent form
F. Question and Answer

III. Physician Consultation
A. Determination of reasons for abortion
B. Question and answer period.
C. Abortion procedure



488

Defendants’ Exhibit 39:
Summary Compilation of Quarterly Reports

CUMULATIVE/YEARLY TOTALS: 1985 & 1986

Facilities: WHS, PPSP, WSC, AWC, RHCC

Conditions/
Indications

1985* 1986

Cardiac 59 (0.31%) 63 (0.30%)

Diabetes 27 (0.14%) 17 (0.08%)
Genetic 5 (0.03%) 5 (0.02%)
Hydatid Mole 7 (0.04%) 6 (0.03%)
Hypertension 40 (0.21%) 19 (0.09%)
Malignancy 5 (0.3%) 1 (0.005%)
Psych. 42 (0.22%) 29 (0.14%)

Radiation 11 (0.06%) 15 (0.07%)
Renal — —

Rubella — —

Incest 3 (0.016%) 23 (0.11%)
Rape 176 (0.93%) 276 (1.31%)

All Abortions 18,999 21,029

♦Includes all date except 2nd Quarter of PPSP



489

Defendants’ Exhibit 45:
Commonwealth of Pennsylvania 
Department of Health (DOH)

Abortion Facility Registration Form

COMMONWEALTH OF PENNSYLVANIA 
DEPARTMENT OF HEALTH

ABORTION FACILITY REGISTRATION FORM

Effective April 24, 1988, every facility at which abortions 
are performed shall file this form within 30 days with the 
Bureau of Quality Assurance, Pennsylvania Department 
of Health, P.O. Box 90, Harrisburg, Pennsylvania 17108. 
Subsequent changes should be reported immediately, 
using this same form.

1. What is the name of your facility?

2. What is the mailing address of your facility
Street ________________________
Post Office ____________________
Zip Code______________________

3. In what county is your facility located?

4. Does your facility have any parent, subsidiary, or 
affiliated organizations, corporations, or associations?

No ___ Yes (If yes, list names and addresses
below)
a. Name____________ b.Name______________

Address Address

5. Does your facility have any parent, subsidiary or



490

affiliated organizations, corporations or associations 
which have contemporaneous commonality of 
ownership, beneficial interest, directorship or 
officership with any other facility? (If yes, list names
and addresses below) __ No __ Yes
a. Name________  b.Name_______

Address Address_____

6. Registration forms filed by facilities which have
received state appropriated funds during the 12 
month period preceding a request to inspect or copy 
such forms shall be deemed public information. Has 
your facility received such funds? __ No __ Yes

7. Is this form an update of a previously submitted 
Registration Form?

_No __ Yes (List items and check type of
update)
a .  __________  _____  ______  _____
b . __________ __________________________

Change Add Delete

8. Date Submitted:
MO DAY YR



491

Defendants’ Exhibit 46:
DOH Abortion Quarterly Facilities 

Report Form

COMMONWEALTH OF PENNSYLVANIA 
Department of Health

ABORTIONS: QUARTERLY FACILITIES REPORT

Effective April 24, 1988, every facility in which an 
abortion is performed within Pennsylvania during any 
quarter year shall file a report with the State Health 
Data Center, Pennsylvania Department of Health, P.O. 
Box 90, Harrisburg, Pennsylvania 17108. Reports are 
due within 30 days of the end of the quarter.

1. Reporting Period (check one):
_Jan. 1 -- Mar. 31 __ Apr. 1 -- Jun. 30

__ Jul. 1 -- Sep. 30 __ Oct. 1 -- Dec. 31

2. What is the name of your facility?

3. What is the mailing address of your facility?
Street_______________________________
Post Office__________________________
Zip Code____________________________

4. In what county is your facility located?

5. How many abortions were performed in your facility 
in each trimester of pregnancy during the reporting 
period?



492

First Trimester: 0-14 weeks completed from the first 
day of last menstrual period _______________

Second Trimester: 15-26 weeks completed from first 
day of last menstrual period _______________

Third Trimester: 27 weeks or more completed from 
first day of last menstrual period ________________

TOTAL ABORTIONS PERFORMED__________

6. Did your facility receive state appropriated funds 
within the 12 month period immediately preceding 
filing of the report?__ NO __ YES

Date Submitted __________________________
MO DAY YR



493

Defendants’ Exhibit 47A:
DOH Report of Induced 

Termination of Pregnancy Form 
(version no. 1)

FORMS MUST BE SUBMITTED TO THE 
PENNSYLVANIA DEPARTMENT OF HEALTH 
WITHIN 15 DAYS AFTER EACH REPORTING 
MONTH.

COMMONWEALTH OF PENNSYLVANIA 
DEPARTMENT OF HEALTH

REPORT OF INDUCED TERMINATION 
OF PREGNANCY

1. FACILITY NAME
2. COUNTY OF PREGNANCY TERMINATION

3. DATE OF PREGNANCY TERMINATION 
(Month, Day, Year)

4. PATIENTS IDENTIFICATION

5. AGE LAST BIRTHDAY
6. MARRIED? __ YES __ NO
7a. RESIDENCE-STATE
7b. COUNTY______________________________
8. Of Hispanic Origin? (Specify No or Yes -- If yes,

specify Cuban, Mexican, Puerto Rican, etc .)___ NO
YES Specify:

9. RACE
__ American Indian

_Black 
__ White

_Other (Specify) ____________________



494

10. EDUCATION (Specify only highest grade 
completed)
Elementary/Secondary (0-12) ___________________
College (1-4 or 5 + )___________________________

11. DATE LAST NORMAL MENSES BEGAN (Month,
Day, Year) __________________________________

12. CLINICAL ESTIMATE OF GESTATION (Weeks)

13. PREVIOUS PREGNANCIES (Complete each 
section)

OTHER
LIVE BIRTHS TERMINATIONS

13a Now 
Living

13b Now 
Dead

13c Spon­
taneous

13d
Induced 
Do not 
include 
this
termin­
ation

Number
None

Number
None

Number
None

Number
None

14. TERMINATION PROCEDURES
TYPE OF TERMINATION PROCEDURES 

14a. PROCEDURE THAT TERMINATED 
PREGNANCY 

(Check only one)
Suction Curettage
Sharp Curettage
Dilation and Evacuation (D&E)
Intra-Uterine Saline Instillation
Intra-Uterine Prostaglandin Instillation
Hysterotomy
Hysterectomy
Other (Specify)________



495

Other (Specify)________
14b. ADDITIONAL PROCEDURES USED FOR 

THIS TERMINATION, IF ANY 
(Check all that apply)

Suction Curettage
Sharp Curettage
Dilation and Evacuation (D&E)
Intra-Uterine Saline Instillation
Intra-Uterine Prostaglandin Instillation
Hysterotomy
Hysterectomy
Other (Specify)________

15. MEDICAL COMPLICATIONS OF PREGNANCY 
_ Rubella

Hydatid Mole 
Endocervical Polyp 
Malignancies
Complication resulting from termination (Specify)

16. LENGTH AND WEIGHT OF THE FETUS 
(Report only if termination subsequent to 19 weeks 
of gestation) Length cm Weight gm

17. DID A MEDICAL EMERGENCY EXIST? (Use 
back of form for explanations, if needed)
___ YES Explain basis for judgment:
___ NO Was the fetus viable prior to procedure?

(Respond only if termination subsequent 
to 19 weeks of gestation)

___ YES Explain basis for determination that
the abortion is necessary, and the 
reason for selected termination 
procedure:

___ NO Explain basis for determination of
non-viability:

18. REFERRING PHYSICIAN, AGENCY, OR 
SERVICE (If any)
NAME



496

19. ATTENDING PHYSICIAN
Name_____________________________________
Licence Number

SIGNATURE AND DATE SUBMITED 
_______________________________ Mo.__Day__ Yr.



497

Defendants’ Exhibit 47B:
DOH Report of Induced 

Termination of Pregnancy Form 
(version no. 2)

FORMS MUST BE SUBMITTED TO THE 
PENNSYLVANIA DEPARTMENT OF HEALTH 
WITHIN 15 DAYS AFTER EACH REPORTING 
MONTH

COMMONWEALTH OF PENNSYLVANIA 
DEPARTMENT OF HEATLH

REPORT OF INDUCED TERMINATION 
OF PREGNANCY

1. FACILITY NAME
2. COUNTY OF PREGNANCY TERMINATION
3. PATIENTS IDENTIFICATION (Do Not Use 

Patient’s Name)
4a. RESIDENCE-STATE 
4b. COUNTY
5. DATE OF PREGNANCY TERMINATION 

(Month, Day, Year)
6. AGE AT LAST BIRTHDAY
7. CLINICAL ESTIMATE OF GESTATION (Weeks)
8. PREVIOUS PREGNANCIES (Complete each 

section)

LIVE BIRTHS
OTHER
TERMINATIONS



498

8a Now 
Living

8b Now 
Dead

8c Spon­
taneous

8d Induced 
(Do not 
include 
this
termin­
ation)

Number
None

Number
None

Number
None

Number
None

9. TERMINATION PROCEDURES
TYPE OF TERMINATION PROCEDURES 

9a. P R O C E D U R E  T H A T  T E R M I N A T E D  
PREGNANCY 

(Check only one)
Suction Curettage
Sharp Curettage
Dilation and Evacuation (D&E)
Intra-Uterine Saline Instillation
Intra-Uterine Prostaglandin Instillation
Hysterotomy
Hysterectomy
Other (Specify)

9b. ADDITIONAL PROCEDURES USED FOR THIS 
TERMINATION, IF ANY 

(Check all that apply)
Suction Curettage
Sharp Curettage
Dilation and Evacuation (D&E)
Intra-Uterine Saline Instillation
Intra-Uterine Prostaglandin Instillation
Hysterotomy
Hysterectomy
Other (Specify)

10. MEDICAL COMPLICATIONS OF PREGNANCY 
Rubella



499

Hydatid Mole 
Endocervical Polyp 
Malignancies
Other Complications Resulting From Pregnancy 
(Specify)
Complication Resulting From Termination 
(Specify)

11. ATTENDING PHYSICIAN 
Licence Number

12. SIGNATURE AND DATE SUBMITTED
MO DAY YR



500

Defendants’ Exhibit 47C:
DOH Report of Induced 

Termination of Pregnancy Form 
(version no. 3)

FORMS MUST BE SUBMITTED TO THE 
PENNSYLVANIA DEPARTMENT OF HEALTH 
WITHIN 15 DAYS AFTER EACH REPORTING 
MONTH.

COMMONWEALTH OF PENNSYLVANIA 
DEPARTMENT OF HEATLH

REPORT OF INDUCED TERMINATION 
OF PREGNANCY

1. FACILITY NAME
2. DATE OF PREGNANCY TERMINATION

(Month, Day, Year)
3. PATIENTS IDENTIFICATION 

(Do Not Use Patient’s Name)
4. AGE LAST BIRTHDAY 
5a. RESIDENCE-STATE 
5b. COUNTY
6. DATE LAST NORMAL MENSES BEGAN

7.

8 .

(Month, Day, Year) 
Of Hispanic Origin? (Specify No or Yes -- if yes, 
specify Cuban, Mexican, Puerto Rican, etc.)

_NO YES Specify:
RACE

_American Indian 
_Black 

__ White
__ Other (Specify) ________________________



501

9. EDUCATION (Specify only highest grade 
completed)
Elementary/Secondary (0-12) __________________
College (1-4 or 5 + ) _________________________

10. MEDICAL COMPLICATIONS
Pre-existing medical conditions which would 
complicate pregnancy (Specify)

__  Complication resulting from termination
(Specify)

11. PREVIOUS PREGNANCIES (Complete each 
section)

OTHER
LIVE BIRTHS TERMINATIONS

11a Now 
Living

lib  Now 
Dead

11c Spon­
taneous

lid
Induced 
(Do not 
include 
this
termin­
ation)

Number
None

Number
None

Number
None

Number
None

12. TERMINATION PROCEDURES
TYPE OF TERMINATION PROCEDURES 

12a. PRO CED URE  THAT TERMINATED 
PREGNANCY 

(Check only one)
Suction Curettage
Sharp Curettage
Dilation and Evacuation (D&E)
Intra-Uterine Saline Instillation 
Intra-Uterine Prostaglandin Instillation 
Hysterotomy 
Hysterectomy



502

Other (Specify)________
12b. ADDITIONAL PROCEDURES USED FOR 

THIS TERMINATION, IF ANY 
(Check all that apply)

Suction Curettage
Sharp Curettage
Dilation and Evacuation (D&E)
Intra-Uterine Saline Instillation
Intra-Uterine Prostaglandin Instillation
Hysterotomy
Hysterectomy
Other (Specify)________

13. CLINICAL ESTIMATE OF GESTATION AT 
TIME OF THE ABORTION*
(Weeks)________
DETERMINATION OF GESTATIONAL AGE 
Types of inquiries/examinations/tests utilized:

Basis for diagnosis: _________________
14. DID A MEDICAL EMERGENCY EXIST?

__ NO __ YES
Explain basis for judgement below.

15. Was patient married? __ YES __ NO
IF YES, WAS NOTICE GIVEN TO THE
SPOUSE? __ YES __ NO
IF NO, CHECK REASONS FOR NO 
NOTIFICATION

_ Spouse is not father of child.
Spouse, after diligent effort, could not be 

located.
Pregnancy was result of a spousal sexual 

assault which was reported to a law enforcement 
agency.

_ Patient had reason to believe that furnishing 
of notice would likely result in the infliction of



503

bodily injury by her spouse or another individual. 
Medical Emergency.

16. REFERRING PHYSICIAN, AGENCY, OR 
SERVICE (If any)
NAME:_____________________________________

17. ATTENDING PHYSICIAN
Name_______________________________________
Licence Number____________________________

SIGNATURE AND DATE SUBMITTED
MO DAY YR

*IF GESTATIONAL AGE IS 24 WEEKS OR 
MORE, COMPLETE REVERSE OF FORM.

COMPLETE FOLLOWING ITEMS ONLY 
IF GESTATIONAL AGE IS 24 WEEKS 

OR MORE

18. BASIS FOR THE JU DGM ENT  THAT 
ABORTION WAS NECESSARY TO PREVENT 
THE PATIENTS DEATH OR SUBSTANTIAL 
AND IRREVERSIBLE IMPAIRMENT OF A 
MAJOR BODILY FUNCTION.

19. NAME OF CONCURRING PHYSICIAN

20. NAME OF SECOND PHYSICIAN IN
ATTENDANCE_____________________

21. WEIGHT OF ABORTED FETUS
_____________ gm



504

Defendants Exhibit 48: 
DOH Certification Regarding 

Spousal Notice Form

COMMONWEALTH OF PENNSYLVANIA 
DEPARTMENT OF HEALTH

ABORTIONS: SPOUSAL NOTICE

CERTIFICATION REGARDING SPOUSAL NOTICE

I understand that as a married woman, I am required 
to notify my spouse of the fact that I am about to 
undergo an abortion, prior to obtaining such abortion, 
unless I am exempt from the notification requirements 
due to one of the reasons set forth below. Pursuant to 
this requirement, I hereby certify that:

CHECK APPROPRIATE BLANK(S)

_____  I have notified my spouse that I am about to
undergo an abortion.

_____  I have not notified my spouse that I am about to
undergo an abortion for the following reasons(s):
_____  My spouse is not the father of the child.
_____  My spouse, after diligent effort, could

not be located.
_____  The pregnancy is a result of spousal

sexual assault which has been reported 
to a law enforcement agency having the 
requisite jurisdiction.



505

_____  I have reason to believe that the
furnishing of notice to my spouse is 
likely to result in the infliction of bodily 
injury upon me by my spouse or by 
another individual.

I understand that any false statement made herein is 
punishable by law.

Signature/Date

NOTICE: ANY FALSE STATEMENT MADE
HEREIN IS PUNISHABLE BY LAW.



506

Defendants’ Exhibit 49: 
Excerpts from DOH Directory of 
Social Service Organizations for 
Referrals for Pregnant Women

COMMONWEALTH OF PENNSYLVANIA

DEPARTMENT OF HEALTH

DIRECTORY OF SOCIAL SERVICES 
ORGANIZATIONS

JULY, 1990

The agencies listed provide a variety of services which 
may assist a woman through pregnancy, upon childbirth, 
and while the child is dependent. Private physicians, 
clinics, and hospitals may also offer these services.

Examples of services which may be provided directly, or 
by referral, include but are not limited to counseling, 
pregnancy testing, medical care, legal and financial 
assistance, transportation, childbirth instruction, housing, 
job placement, continuing education and adoption 
information. Where the agency offers primarily a 
specialized service, it has been noted. "Special Services" 
have been numerically coded according to the following 
index:



507

01- Abuse (Drugs, Domestic, Child)
02- Adoption
03- Book Resources on Childbirth (Childbirth 

Instruction)
04- Clothing
05- Counseling (Job, General, Psychological, Prenatal, 

Family)
06- Emergency Assistance
07- Food
08- Food Stamps
09- Fuel
10- Furniture
11- Hot Line Services
12- Interpreting Services
13- Job Training/Placement
14- Legal Referral
15- Nutrition
16- Information & Referral
17- Schooling/Education
18- Shelter/Housing
19- Short-term Crisis Intervention
20- Teens
21- Telephone Referral
22- Transportation
23- WIC (Women, Infants and Children)

Nutrition Program
24- Foster Care
25- Financial Assistance
26- Medical Care/Testing
27- Family Planning
28- Day Care

*  *  *



508

Defendants’ Exhibit 50:
Excerpts from DOH Printed Information 

on Medical Assistance Benefits

COMMONWEALTH OF PENNSYLVANIA 

DEPARTMENT OF HEALTH

MEDICAL ASSISTANCE BENEFITS FOR 
PRENATAL CARE, CHILDBIRTH 

AND NEONATAL CARE

JULY, 1990

You may or may not qualify for medical assistance 
benefits, depending on your income. For persons who 
qualify, the Medical Assistance Program will pay for 
doctor, clinic, hospital, and other related medical 
expenses so you can receive prenatal care, delivery 
services, and care for your newborn baby. You can apply 
for Medical Assistance benefits at your local County 
Assistance Office.

Under the Healthy Beginnings Program you may be 
eligible for Medical Assistance because you are pregnant. 
A pregnant woman is allowed to have more income to 
qualify for this benefit and may receive prenatal care 
from certain providers while the formal application for 
assistance is being processed.

Your County Assistance Office can tell you which 
providers participate in the Medical Assistance Program 
and can answer your questions about other available



509

benefits. County Assistance Offices are listed for your 
information. The attached pamphlets on Medical 
Assistance and Healthy Beginnings also may be of 
assistance to you.

If you are pregnant or have children three years old 
or younger, Healthy Beginnings could provide you free 
health care for yourself and your children.

In October 1989, this program will be expanded to 
include children up to four years old.

If you or your family’s income is less than or equal 
to the chart on the back of this card, you should call, 
toll-free 1-800-842-2020, or contact your local county 
assistance office.

*  *  *

FAMILY
SIZE

MONTHLY 
INCOME GUIDE

one person 
two persons

$ 498

(or a pregnant woman)
three persons 
four persons 
five persons 
six persons

$ 668 
$ 838 
$1,008 
$1,178 
$1,348



510

If your income is close to these figures, call 1-800- 
842-2020. We may still be able to help you.

Healthy Beginnings covers all your health care needs 
including prescriptions, dental care, physician, delivery 
and other necessary hospital costs.

If you think you quality for Healthy Beginnings, call 
1-800-842-2020, today!

*  *  *

FACTS

MEDICAL
ASSISTANCE

CAN
HELP

THIS BROCHURE CONTAINS SOME BASIC 
INFORMATIO N ABOUT MEDICAL 
ASSISTANCE. PLEASE READ IT 
CAREFULLY, IT WILL TELL YOU WHAT 
TO BRING WITH YOU WHEN YOU APPLY.



511

Commonwealth of Pennsylvania 
ROBERT P. CASEY 

GOVERNOR

Department of Public Welfare 
JOHN F. WHITE, JR. 

SECRETARY

OFFICE OF MEDICAL ASSISTANCE

REMEMBER -  
MEDICAL ASSISTANCE 

CAN HELP!

The Medical Assistance program is designed to help 
you pay doctor, hospital, and other medical-related 
expenses so you and your family can receive continuing 
medical and dental care when your medical and dental 
costs are higher than you can afford.

This brochure contains some basic information about 
Medical Assistance. Please read it carefully. It will tell 
you what to bring with you when you apply.

If you do have any questions, please call your local 
county assistance office. They want to help.

Note: Some counties may be using health
maintenance organizations (HMOs) or health insuring 
organizations (HIOs) in addition or in place of the 
regular Medical .Assistance Program. If you live in one 
of these counties, your local county assistance office will 
be able to explain these other programs to you.



512

Facts About Medical Assistance
■ You can apply for Medical Assistance in the county 

where you live in Pennsylvania.
■ You can work, and still may be able to get Medical 

Assistance.
■ You can own a house and have a car and still get 

Medical Assistance.
■ You don’t have to get a welfare check to get Medical 

Assistance.
■ You don’t have to live with children to get Medical 

Assistance.
■ You can be getting social security, unemployment or 

some other kind of income and still may be eligible 
for Medical Assistance.

Persons who are eligible for Medical may be eligible 
for some services under Medical Assistance which 
medicare does not cover. However, Medical Assistance 
does not automatically pay the difference between a 
medical provider’s charge and the Medicare payment.

How Does Medical Assistance Work?
If you are eligible for Medical Assistance, you may 

go to a doctor, hospital, or other health-care provider for 
medical services. If the health-care provider participates 
in the Medical Assistance Program, and if you have no 
other medical insurance which will cover the medical 
service, the State will pay for the medical service.

Some services require prior authorization by the 
state Office of Medical Assistance. A brochure entitled 
Prior Authorization of Medical/Dental Services explains 
this.

Please note that payments are made to the provider 
not to the patient.

You may be asked to pay a small amount to the 
provider for the service. This is called a co-pay. Ask



513

your county assistance officer for the brochure What is
Co-Pay?, which explains how co-pay works.

Out-of-State Services
The Department will pay for medical services

furnished to you while out of of state if:
■ You require emergency medical care while 

temporarily away from your home.
■ You would be risking your health if you wait for the 

service until you returned home
■ You live in a state border area and recipients in your 

area regularly use medical resources in a neighboring 
state.

■ The Department decides, based upon the medical 
provider’s advice, that you have better access to the 
type of medical service you need in another state.

Who Can Receive Medical Assistance?

There are three categories of Medical Assistance.
You may be eligible for one of them:

1) Categorically Needy: This is for persons who are 
eligible for cash assistance, or for people who receive 
Supplemental Security Income (SSI). These persons 
receive a blue Medical Assistance card.

2) Medically Needy Only: Ths is for persons who are 
not eligible for cash assistance or SSI but whose 
income is not enough to cover their medical 
expenses. These persons receive a green Medical 
Assistance care.

3) State Blind Pension: This is for persons who are 
eligible for and receive a check from the State Blind 
Pension Program. These persons receive a pink



514

Medical Assistance card.

Ask your county assistance office for Services 
Covered by the Medical Assistance Card. This shows the 
benefits covered by each of the three Medical Assistance 
categories.

How Do I Apply for Medical Assistance?
You must file an application with you local county 

assistance office. You may pick up your application at 
the local county assistance office or phone the office and 
have one mailed to you.

If you are unable to apply for yourself, a relative, 
friend, hospital representative or other person may apply 
in your behalf.

When you return the application to your county 
assistance office, a worker will look over your application 
with you to make sure you have completed all items. 
The worker will help you complete the application if you 
need help. If there is some information you are not able 
to get, your county assistance office can help you to get 
this information.

When you apply for Medical Assistance, you will 
need to provide information about yourself and your 
family to help the county assistance office decide what 
kind of help you can receive. It you don’t have it on 
hand, apply anyway.

You will need:
■ Birth certificates and other forms of identification 

for yourself and other family members in your home, 
such as a driver’s license or school or work 
identification.

■ Your social security card and social security cards for 
other persons in the home for whom you are 
applying (your worker can help you apply for these if



515

you do not have them).
■ Letters or forms that show how much money you and 

other family members living in the home get from 
social security, Supplemental Security Income (SSI), 
Veteran’s pensions, unemployment compensation, 
worker’s compensation, retirement or other kinds of 
income.

■ Wage stubs (if you are working) and wage stubs for 
other family members living in the home who are 
working.

■ Health and medical insurance policies and bank 
books, savings books and any other records to show 
how much money you and other family members 
living in the home have available.

■ Life insurance policies.

Your worker can tell you what additional 
information you will need to be eligible for Medical 
Assistance and help you to get this information.

After your worker determines that you are eligible 
for Medical Assistance, you will receive a Medical 
Assistance Card which is good through the date shown 
on the card. You will receive a new card before the old 
one expires. If you card is lost, stolen or destroyed, tell 
your county assistance office immediately. They will 
replace it so you don’t have to miss any medical 
appointments.

As a recipient, you have certain rights and 
responsibilities. A pamphlet titled Your Rights and 
Responsibilities in Public Assistance Programs describes 
them.

How Do I Find a Medical Provider Who Will Accept the 
Medical Assistance Card as Payment?

First, check with your present doctor, dentist or



516

other medical provider to see if the Medical Assistance 
card will be accepted. If not, you may want to ask 
someone you know who receives Medical Assistance for 
the name of a doctor or dentist.

If you cannot find a doctor or dentist who accepts 
the Medical Assistance card, contact your caseworker at 
the local county assistance office, who will help you 
locate a medical provider who accepts the card.

What If I Don’t Agree With the Decision of the County 
Assistance Office?

If the county assistance office determines that you 
are not eligible for the Medical Assistance Program, you 
will receive a notice from your county assistance office. 
You have the right to appeal the decision and request a 
fair hearing. If you are already receiving medical 
assistance and if you appeal within 10 days from the date 
of the notice, your Medical Assistance coverage will 
continue pending the outcome of the fair hearing.

Your county assistance office is there to help you. 
You should call them with questions you may have about 
Medical Assistance eligibility or coverage.

The Mission o f the Department o f Public Welfare 
is to:

Promote, improve and sustain the quality of family 
life,
Break the cycle of dependency,
Promote respect for employees
Protect and serve Pennsylvania’s most vulnerable
citizens, and



517

Manage our resources effectively.



518

Defendants’ Exhibit 51: 
DOH Notices Required by 

Abortion Control Act

COMMONWEALTH OF PENNSYLVANIA

DEPARTMENT OF HEALTH

NOTICES REQUIRED BY 
ABORTION CONTROL ACT

JULY, 1990

1. It is generally unlawful for any individual to coerce a 
woman to undergo abortion.

2. Any physician who performs an abortion upon a 
woman without according her a private medical 
consultation may be liable to her for damages in a 
civil action at law.

3. The father of a child is liable to assist in the support 
of that child, even in instances where the father has 
offered to pay for an abortion. The availability of 
support payments will depend, in part, on the 
father’s income. You may wish to consult with a 
lawyer regarding the availability of support payments.

4. The law permits adoptive parents to pay costs of 
prenatal care, childbirth and neonatal care.



519

Defendants’ Exhibit 54: 
Deposition Excerpts of 
Thomas E. Allen, M.D.

BY MS. MERSHIMER:

* * *

[9] Q. While you’ve been at Magee, have you 
performed any abortions because there was a medical 
emergency?

A. No.
Q. How about at WHS?
A. Not -- no.

* * *

[13] Q. All right. Now, Exhibit B attached to 
Defendants’ Exhibit 1 is Magee’s informed consent form?

A. Informed consent, correct.
Q. And this, you make sure every patient signs?
A. Reads this and signs it, or has it read to her if 

she can’t understand it.
Q. Now, in cases of a minor, do you have the 

parent sign it, also?
A. It’s required by Magee. There’s no question 

about it. You can’t do an abortion there without having 
the parent’s consent.

Q. Does Magee require a parent’s consent of a non 
abortion surgical procedure, also?

A. Yes. Everything except delivery of term -  or a 
delivery.

* * *

[28] Q. Now, Interrogatory 15, I had asked you



520

about the allegations in the Complaint that the Act 
unduly restricts a woman’s access to counseling, and you 
refer to various verifications in your Answer?

A. I think that was my attorney’s --
MR. ZEMAITIS: Yes. I don’t think there’s any

obligation under the Federal Rules of Civil Procedure or 
otherwise that every plaintiff be able to state from his or 
her own personal knowledge facts that support a 
particular allegation of the Complaint.

MS. MERSHIMER: I’m not saying that there is.
[29] A. Yes.

Q. My question to you is: Do you have any
knowledge upon that aspect of the Complaint, that 
allegation?

A. No, I do not.

*  *  *

[71] Q. Have you ever performed an abortion on 
anyone without having their informed consent?

A. No.
Q. So that would include both adults and minors?
A. Right.

* * *

[78] Q. Excluding abortion, would you ever perform 
a surgical procedure on somebody without their informed 
consent?

A. No.
Q. And, again excluding abortion, would you ever 

perform a surgical procedure on a minor without the 
consent of a parent?

A. No. Probably not. I can’t think of -- except an 
emancipated minor who is not considered to be a minor. 
A woman who -- a teenager who has a child is not



521

considered a minor for any operative procedure, except 
as defined by this Act.

Q. Okay. Let’s just clarify the question, then. 
Again excluding abortion, would you ever perform a 
surgical procedure on an unemancipated minor without 
the consent of the parent?

A. No. But by my definition, a person who is 
pregnant is emancipated to some degree.

Q. That’s your personal definition.
[79] A. That’s my personal definition, yes.

* * *



522

Defendants’ Exhibit 55: 
Deposition Excerpts of Sue Roselle

* * *

[7] Q. In Paragraph 2 of your verification, you [8] 
talked about the staff you’re responsible for, and you 
mentioned 13 physicians.

A. Yes.
Q. Is that still the same number of physicians 

currently being used by WHS?
A. I believe we have 12 physicians currently.
Q. And Dr. Allen this morning said that all the 

physicians are part-time.
A. That’s correct.
Q. Is there any approximate hours that they work?
A. There is one physician who works approximately 

20 hours a week, and then everyone else is what we call 
as-needed, which is when we schedule them.

Q. And you perform abortions at WHS three days a 
week?

A. That’s correct.
Q. For the most part, counseling occurs the same 

day as the abortion service --
A. That’s correct.
Q. -  is provided? It’s more difficult for her to take 

us down when I’m still asking a question [9] and you 
answer. I understand how it is. I have the same habit. 
Also, the record reads a little easier.

What, it’s like 95 percent of all the counseling occurs 
on the same day the abortion services are provided?

A. Approximately 95 percent.

* * *

Q. In Paragraph 6, which would be on Page 3, it



523

lists the prices of the abortion procedure costs depending 
upon how late the pregnancy we’re talking about?

A. That’s correct.
Q. Have those prices changed since you initially 

filled out this verification?
A. Yes, they have.

[10] Q. Could you tell me what the new prices are?
A. $295 if 12 weeks or less; $395 if 13 to 14 weeks; 

$600 if 15 to 16 weeks; and $625 if 17 weeks.
Q. And no abortions after 17 weeks gestation —
A. That’s correct.
Q. -- are performed at WHS; is that correct?
A. That’s correct.
Q. Is there any particular reason why the prices 

went up, anything you can attribute it to?
MR. ZEMATHS: You mean other than general

economic trends?
MS. MERSHIMER: Right.
Q. Other than like labor costs went up or -  
A. No.

[17] Q...........WHS still encourages minors to bring a
parent or another adult with them?

A. That is correct.
Q. Is your preference to have a parent?
A. That’s correct.
Q. Is there a reason why you like the parent to 

attend with a minor?
A. To encourage family communications.
Q. If a minor calls up, when she first telephones, is 

that when it’s encouraged, the minor is encouraged to 
bring her parent along?

A. Yes.



524

*  *  *

[20] Q. And the paraprofessional counselors, there’s 
no education requirement to be a paraprofessional 
counselor?

A. That’s correct.

* * *

Q. And what’s covered during this counseling 
interview is a discussion about her options, her decision 
to have an abortion, make sure she’s not unduly 
ambivalent about what she’s doing and make sure she’s 
not being coerced to have an abortion and [21] to talk 
about future contraceptive use. Is that pretty much it?

A. That’s it.
Q. This next line talks about if a patient appears 

ambivalent about her decision and the abortion is 
rescheduled to give her more time to consider her 
options.

A. That’s correct.

Q. And then the personal counselor is what? It’s a 
more intense discussion, or what?

A. The personal counselor is prepared to at least 
masters degree level and has five years post masters 
experience in therapy, and it focuses on the pregnancy as 
a problem in relationship to the rest of the factors in her 
life.

*  *  *

[22] Q. When a parent does attend, does both the 
minor and the parent sign the informed consent form?



525

A. That’s correct.

*  *  *

[43] Q. In Paragraph 35, you discuss your concern 
about putting the identity of the referring [44] 
performing physicians in a report to the Department of 
Health, and then you state, "I can state with complete 
certainty that because of the harassment and violence 
directed toward physicians who refer or perform abortion 
procedures, WHS will lose many of its referring 
physicians and possibly some of its performing physicians 
if this section goes into effect." Now, focusing on 
performing physicians, that information is being provided 
on the reports currently.

A. That’s correct.
Q. And have you lost any performing physicians for 

that reason?
A. We have lost a couple of physicians. They have 

not given that reason for them leaving. The rest of the 
physicians have continued to express a lot of concern 
about that information becoming available to the public.

[79] Q. I take it from your response to Interrogatory 
No. 24 on Page 18 that WHS advertises in some local 
newspapers in the Pittsburgh area, on radio stations, and 
some college newspapers and also in the phone book?

A. That’s correct.

*  *  *

[80] Q. I’m looking at Interrogatory No. 2 on Page 3 
focusing on WHS’ Answer. Remember you said you 
weren’t sure of the percentages of minors that are



526

accompanied by an adult? Does that refresh your 
recollection, 75 percent of the minors are accompanied 
by an adult?

A. Yes.
Q. And that on the next page, that 50 percent of 

the minors are accompanied by one or both of their 
parents?

A. That’s correct.
Q. Now, when a minor is accompanied by an adult, 

not necessarily their parent, does that adult participate or 
is involved at all in any part of the counseling or 
informed consent aspect?
[81] A. No.

Q. But if the minor is accompanied by one of the 
parents, then the parent is involved in part of that 
counseling session, and particularly as to informed 
consent?

A. That’s correct.

*  *  *

[84] Q. When I asked you if any of the physicians 
that had left WHS was because their identity, performing 
physician’s identity was listed on the reports to the 
Department of Health, you said that wasn’t the reason 
they gave you?

A. That is not the reason they gave me.
Q. Did any of the reasons they gave you have [85] 

to do with any of the requirements of Pennsylvania law?
A. No.

*  *  *



527

Defendants’ Exhibit 56: 
Deposition Excerpts of Carol C. Wall

BY MS. MERSHIMER:

*  *  *

[10] Q. And abortions at the Center City Clinic still 
occur on Wednesdays, Thursdays, Fridays, and [11] 
Saturdays?
A. Yes.
Q. And what are the general hours of the clinic then?
A. They are regular medical clinic hours. Abortions 
would be performed approximately four to five hours 
each of those days.

* *

[12] Q. Now, the cost that you stated in your 
Verification of an abortion in the first trimester if they 
were not on Medical Assistance was $225.

Does that still remain the price?
A. No.

The price now is $240.
Q. Is there any specific reason why the price has gone 
up?
A. Yes.

The costs have gone up.
Q. What?
A. The costs of salaries and non-salary costs have gone 
up.
Q. Supplies and things like that?
[13] A. Yes
Q. And I see here that the fees cover the direct cost of 
the procedure, including counseling, medical testing, and 
examination, and abortion procedure, medical



528

supervision during the post-surgical recovery, and 
post-abortion examination?
A. That’s correct.

* * *

[14] Q. When you said the direct cost, which is now 
$240, covers these various procedures, do you know how 
much of that charge covers the cost providing personal 
counseling?
A. No.

The salaried costs are broken down at some point 
when we are figuring what we have to [15] charge in 
order to cover our costs, but I don’t know exactly how 
much the counseling part of it would be.

* * *

[16] Q. At Planned Parenthood are any abortions [17] 
performed because there is a medical emergency?
A. I would say no.

Could you be more specific on what medical 
emergency means to you?
Q. Well, there are two definitions of medical emergency 
that have been used in this lawsuit. One is the medical 
emergency definition that is contained in the Act.
A. Yes.
Q. And then the other definition of medical emergency 
is that which was provided by the Plaintiffs in response 
to Interrogatories, which give me a second and I will find 
it here. It was in response to Interrogatory NO. 18 
where the Plaintiff said, "A medical emergency occurs 
whenever, in the judgement of the attending physician, a 
combination of circumstances presented requires 
immediate medical attention to protect the life or the 
health of the patient."



529

A. Yes; then my answer is definitly no as I said before. 
Q. No as to either definition?
A. Yes.

[18] Q. Now, Planned Parenthood encourages minors to 
involve their parents in the decision to have an abortion; 
correct?
A. Yes.
Q. Do you encourage a minor to bring the parent along 
to the procedure if the parent is agreeable?
A. Yes.
Q. Why does Planned Parenthood do that?
A. Our experience is that very young women need to 
have the help and support of their family members and 
want it.
Q. If a parent does attend with the minor, does the 
parent also sign the Informed Consent Form?
A. No.

*  *  *

[20] Q. So you contract with the physicians?
A. Yes.
Q. How many physicians do you contract with?
[21] A. At this time three to four different physicians.

*  *  *

[24] Q. The counselors for Planned Parenthood, is there 
any minimum education requirement?
A. No.
Q. Are there any sort of certificates or degrees that they 
have to have?
A. No.



530

Q. But they must attend the training program at 
Planned Parenthood?
A. Yes.
Q. Could you tell me about the training program?
A. The training program is mainly in-service at the 
beginning of the time that they start working with us, and 
it is carried out by the clinical staff, the management of 
the clinical [25] staff.
Q. Is there any length of time that this in-service 
training occurs?
A. I don’t know. It varies with the individuals and their 
backgrounds. I do know that.

We do have some people who have Master’s degrees 
in counseling and some have Bachelor’s degrees who 
have had a major in a field that’s related. And we have 
some people who have not had that kind of formal 
training.
Q. You had said that the number of counselors you 
have varies on how many procedures are being 
performed?
A. Yes.
Q. You mean how many counselors you have coming in 
on any given day?
A. That’s correct.
Q. How many counselors do you have as a pool to use? 
A. I don’t know.
Q. Is it more than ten?
A. No.

I would say fewer probably.
[26] Q. And they are all paid or are there any 
volunteers?
A. There are some volunteers, yes.
Q. The ones that are paid, what is their salary?
A. I don’t remember.
Q. Well, do you know the starting salary?
A. No.



531

It would be around $15,000, $16,000 a year 
annualized, but I’m not sure.

* * *

[66] Item NO. 3 that states "all counseling is confidential 
(within legal limitations) and will be conducted in 
privacy."

MR. CIPOLLA: Where is this?
BY MS. MERSHIMER:
Q. I’m sorry, the second page of Exhibit-A.
A. Okay, thank you. You want to know -  what is your 
question?
Q. I just wanted to see, first of all, if you found that 
statement.
A. Yes, I have it.
Q. What are the legal limitations? I just didn’t know 
that there were any ones that affect counseling. What is 
meant by that?
A. The one that I recall is that in the cases — in a case 
of, I believe, it’s rape or incest of a minor, our facility 
just, as any other helping facility, is required by law to 
report that to the municipality in which our facility is 
located. That is one.

* * *

[71] Q. There is a section on the bottom of this form 
requiring physicians to sign for minors under the age of 
18 without parental consent; is that correct?
A. Yes.

* * *



532

Defendants’ Exhibit 57: 
Deposition Excerpts of Sherley Hollos

BY KATE MERSHIMER:

* * *

[4] A. I’m the Executive Director of Women’s 
Suburban Clinic.
Q. Could you tell me what your job duties include as 
Executive Director?
A. Well, I am responsible to the Board of Directors. 
We are a 501C3, so all my department heads report to 
me and I’m responsible for the overall management of 
the clinic.

* * *

[7] Q. Now, abortions are performed at Women’s 
Suburban Clinic on Tuesdays, Wednesdays, Thursdays 
during afternoon and early evening hours?
A. That’s correct.
Q. And that is still the current situation?
A. Yes.
Q. Would you have any problem, as I ask you questions, 
if I refer to Women’s Suburban Clinic as WSC?
A. No problem.
Q. Is there any other sort of shorthand form you use?
A. That’s what we always call it, WSC.
Q. Now, how many physicians are there at WSC?
A. There are two physicians that practice at WSC.
[8] Q. And do they both work those Tuesday, 
Wednesday, and Thursday hours?
A. There is one physician present each day.

* * *



533

[11] Q. Now, the nurse practitioners, the RNs and the 
LPNs, do they do any counseling?
A. Not exactly, but a nurse by definition deals with the 
whole person. It’s a matter of definition of what you call 
counseling.
Q. Well, is it fair to say that what you are talking about 
with the nurses, if they are going through the procedure, 
whenever there are questions presented by the patients, 
they are going to take the time to answer those 
questions?
A. Certainly, but a nurse is not a counselor in that they 
do the formal counseling prior to the procedure.

* * *

[12] Q. And the fee was $225 at the time of the 
Verification.

Is that still the same?
A. It’s $245 now.
Q. Is there any particular reason why that fee rose?
A. Inflation.
Q. Basic cost of salary increase and supplies, thing like 
that?
A. Yes.

And extra papers that we have to deal with.
Q. The extra papers being the reporting forms of the 
State, the Department of Health?
[13] A. Yes.
Q. Do you know how much of that $20 increase is due 
to the extra reporting provisions versus just the standard 
cost of salaries going up?
A. No, I don’t.

* * *

[19] Q. Now, minors are all encouraged to come in for



534

precounseling; is that correct?
A. That’s correct; if they are not coming with their 
parent.
Q. And WSC encourages the parents to come; is that 
correct?
A. Yes.
Q. Why is that?
A. Because it’s important for any woman having an 
abortion to have a support system beyond the clinic. 
And for a minor the obvious support system is the 
parent.

* * *

[20] Q. Now, is that the form, the Certification by 
Patient, that any patient must sign prior to having an -- 
A. Every patient must sign.
Q. That is to have an abortion?
A. Yes.
Q. And this is the form where they acknowledge that 
they were told about the risks of [21] the abortion and 
alternatives to abortion?
A. Yes.
Q. Now, if a minor has an abortion, that minor has to 
sign that form?
A. I believe so. I am not a counselor. I know that you 
have to sign the next form, the Parental Involvement 
Form.
Q. If the parent comes with their minor to the clinic, do 
they have to sign any forms?
A. Yes; then they sign the Parental Involvement Form 
to the "or," "I am the parent and guardian and I am 
aware of her decision to abort."
Q. Is this the way it works with the minor; if the minor 
comes alone and doesn’t want to involve their parents, 
they sign this first paragraph of the Parental Involvement



535

Form?
A. Yes.
Q. And if the parent or guardian does come with the 
minor, then that parent or guardian must sign the second 
paragraph of the Parental Involvement Form?
A. That’s correct.
Q. And then if the parent or guardian does know about 
the abortion but was unable to attend, [22] then, again, 
the minor would sign the last paragraph?
A. Correct.
Q. And then there is a third form called Physician’s 
Certification?
A. Yes.
Q. All doctors have to sign that form?
A. Yes.
Q. Is that in the case of any patient or just minors?
A. Any patient.
Q. And are there any times where a physician refuses to 
sign this form?
A. Not to my knowledge.

* * *

[30] Q . . .  . When we initially got onto the exhibit, we 
were talking about minors coming in for precounseling 
prior to the abortion appointment?
A. Yes.
Q. Do most minors do that, come in for the 
precounseling session?
A. Most -  I don’t know statistically how many do, but 
that’s a question that is always asked.
Q. It says here that the minors are asked to come in for 
precounseling, but it is not a requirement; is that 
correct?
A. All minors who have not informed a parent come in 
for precounseling.



536

Q. So they must come in for precounseling?
A. Yes; unless there are very extenuating circumstances. 
[31] Q. Do such minors that come in for precounseling 
because they have not informed a parent, do they ever 
change their mind and then bring their parent to the 
abortion -- 
A. Yes.
Q. Do you know how much of a period of time there is 
between the precounseling session and the abortion 
appointment?
A. It depends. It could be anywhere from the night 
before to more time.
Q. A week or two weeks?
A. It would be dependent on their LMP date. How 
much, you know, how much time there is.
Q. So if they are in their thirteeth week of LMP, if they 
are going to have the abortion performed at WSC, there 
is not much time to wait?
A. That would be a good example.

* * *

[33] A............. The only thing that isn’t explicit -  is
explicitly discussed is the alternative to having an 
abortion, but you can see that that happens because in 
the Disclosure of Risk Benefits and Alternatives it is 
gone over orally. And they are given that piece of paper, 
the Consent Form, before they see the counselor and 
asked to read it but not to sign it so that they have time 
to read it before sitting down in the counseling session.

* * *

[40] Q. And is it still Women’s Suburban’s estimate that 
if the Parental Consent Provision goes into effect it 
would require at least additional three-quarter time



537

counseling positions at a cost of about $15,000 per year? 
A. I think that is accurate.

* * *

[44] Q. Now, that part of the law that requires the 
performing physician’s identity to be submitted to the 
Department of Health, since that has gone into effect 
have you known of any doctors who perform abortions 
that have stopped performing abortions because their 
identity is on that form?
A. I don’t know of any personally.



538

Defendants’ Exhibit 58: 
Deposition Excerpts of Jane S. Green

BY MS. MERSHIMER:

* * *

[8] Q. First trimester abortions, the price listed in, I 
think it is an April ’88 Verification, list the price as two 
hundred and ten dollars, is that still the price?
A. It remains the same.

* * *

Q. How about for early second trimester abortions; is it 
still three sixty-five?
A. That’s correct.

*  *  *

[12] Q. Are abortions still performed on Wednesday and 
Friday afternoons and Saturday mornings?
A. On Saturday mornings, not at this point; Wednesday 
and Friday and Tuesday.
Q. Tuesday, all day Tuesday?
A. Tuesday afternoon.
Q. Is Wednesday just Wednesday afternoon or all day 
Wednesday?
A. Wednesday evening. So that is wrong. That says 
Wednesday from ten to three, so it is Wednesday 
evening.

* *

[20] Q. Now, paragraph eleven of your Verification,



539

approximately in the middle, there is a discussion, "If the 
woman already has had a postive test when she calls 
RHCC and wants to terminate her pregnancy, an 
abortion appointment can be scheduled usually within 
one week’s time."

Is that still correct information?
A. That is correct information.
Q. Does it ever take more than a week to schedule the 
abortion appointment?
A. Sometimes. It depends upon her medical history. 
There are certain questions that telephone counselors 
ask, in terms of medical history. And if the woman 
needs to obtain a physician’s note, then it could take 
longer.

* * *

[23] Q. Now, RHCC encourages parental involvement in 
the abortion decision; is that correct?
A. What do you mean, in terms of that?
Q. I was just reading paragraph eighteen, it says, "In 
general, RHCC supports and encourages parental 
involvement in the abortion decision where possible."
A. That’s correct.
[24] Q. Why is that?
A. Well, we feel that it is important because when the 
minor goes back into her home, that the parent will have 
a better understanding perhaps of what the minor is 
going through. Unfortunately, that is not always the 
case. But that is primarily the reason why we would 
want that support from the parent. We only can give 
short term relationship counseling and we can’t go back 
with that person.
Q. Just to go back for a minute, you said that the 
parent, when he or she accompanies a minor does not 
attend the group session that goes over the risks and the



540

informed consent provision.
A. That’s correct.
Q. So is the parent ever advised?
A. That’s why we have the waiting room counselling, 
that’s then when the waiting room counselor would do 
that with the parents.
Q. The waiting room counselor would advise the 
parents of possible complications?
A. That’s correct.

* * *



541

Defendants’ Exhibit 59: 
Deposition Excerpts of Sylvia Stengle

BY MS. MERSHIMER:

*  *  *

[6] Q. You are the executive director of Allentown 
Women’s Center?
A. Yes.
Q. Do you have any problem if I refer to Allentown 
Women’s Center in this deposition as AWC?
A. That sounds fine.
Q. As director, you are responsible for the overall 
operation of the clinic?
A. That’s correct.

* *

[11] Q.............The items on this two page document
Counselling Checklist are the items covered during an 
abortion counselling session; is that correct? Please, 
review it.
Q. Yes, this is accurate.

* * *

[16] Q. -  you said that pregnancy testing and counselling 
was available at AWC Monday through Saturday,with 
abortions being performed three to five days a week, 
depending upon patient needs?
A. Uh-huh.
Q. Is that information still correct?
A. Yes.
Q. And then it says, "An appointment usually can be



542

scheduled in approximately one week’s time."
A. Yes.
Q. Is there any variation, does it ever take longer or 
shorter?
A. Yes.
Q. Do you ever know how long it takes?
A. Well, if we have more appointments than we have 
available slots, we attempt to add a day so we do not 
need to ask patients to wait.

Sometimes if we have more appointments than we 
have available slots, we get backed up and patients need 
to wait more than a week, depending upon physician 
availability, we either can or cannot solve that lag. If 
that is how it goes.

*  *  *

[46] Q. Exhibit "B" we discussed earlier and that is the 
counselling checklist, two page document.
[47] At the bottom of the page there is a section 
concerning minors and the first statement under that 
says, explain if complications develop their confidentiality 
may be broken. When or why would that occur?
A. If a patient requires a hospital transfer or a visit to a 
hospital, it might be that that care provider would not 
honor her confidentiality or it might be that the 
circumstances are such that her confidentiality is 
violated. For example, if a minor would have a gush of 
heavy bleeding, which sometimes happens even if there is 
no complication, and it were in the middle of the night, 
it might be very appropriate for her to involve her 
parents and the confidentiality might then be broken. 
We have no control over that.

We want our minors to understand as we provide the 
service to them, that their health and care is more 
important than their privacies around the abortion,



543

because that makes the overall experience safer for the 
minor if she has that frame of reference.

*  *  *

[49] Q. The fourth statement says, "If a parent is here, 
the parent must co-sign consent for abortion."
A. That’s correct.

* *

Q. Exhibit "C" is an eight page patient record; is that 
correct?
A. Yes.

[50] Q. And then in the middle of that are questions 
about pregnancy and history, live births, still births, 
miscarriages, abortions and complications of pregnancies; 
do you know why that information is gathered?
A. That information is gathered because it helps us both 
as we provide surgery to that patient and as we counsel 
that patient around her decision. The complications of 
pregnancy is largely important medically.

* * *

[51] Q. When I was reviewing the Interrogatories and I 
saw that a parent must sign the consent form;if a parent 
comes with a minor, is there a specific space on this on 
this paper where they sign or some separate form that 
they sign?
A. They sign where it says, "Witness." There is not a 
line that says,parent. There in not a provision in the 
form for a line that says parent at this time.



544

* * *

[58] Q. Is it correct, is the newspaper article correct in 
stating under the policy, if a woman -- I am sorry. The 
policy forces women who seek abortions, but say they 
think abortion should be illegal to delay the procedure? 
A. That’s correct.
Q. Could you explain this policy to me?
A. Yes. We do not have a set of questions that we ask 
patients about their views on whether or not abortion 
should be legel. There is no quiz or sequence of 
information seeking. However, some patients volunteer 
to us that they believe that abortion in wrong, is murder 
or should be illegal or [59] some combination of those 
attitude sets. Those patients who volunteer to us that 
abortion should be illegal and should not be available to 
women, we suggest to those patients that perhaps they 
should continue their pregnancy or consider that as a 
very serious option. And we consider that to be a red 
flag. That indicates that they might have difficulty with 
the decision later.

And that it is important that they process their 
decision making very carefully before they take the 
irreversible action of terminating their pregnancy, which 
sometimes women who are opposed to abortion want to 
quote "just get this over with." Those patients we suggest 
that they come back on another day and we explain to 
them all of their options.

And we further explain to them that they must take 
responsibility for their own decision making, that they 
cannot suggest that we as providers are responsible for 
the fact that they are having an abortion. And we ask 
them to sign a consent form that indicates that they have 
had full options counselling and that they take 
responsibility for their own decision making.
[60] And that it has a concluding paragraph that says



545

if they would ever allege that they had not been 
counselled properly when they had an abortion at the 
Allentown Women’s Center and their options had not 
been fully explained to them, that we would indeed 
defend what we had done and open our records so that 
could be shown.

MS. MERSHIMER: Could I got a copy of this
form?

MR. ZEMAITIS: We will take it under advisement. 
BY MS. MERSHIMER:
Q. The newspaper article implied that a woman that 
would reflect that abortion was wrong, murder, illegal, 
either had to say she had changed her abortion belief or 
that she had signed this consent form; is the newspaper 
article summarizing that accurately?
A. No.
Q. If a woman who initially says that she feels abortion 
is wrong or illegal, and you advise her to think it over 
some more, and if she does and she returns to AWC, 
must she sign this additional form that you just said no 
matter what?
A. There are several points here you are addressing, 
[61] so I cannot answer your question as phrased.
Q. Why don’t you explain the subtle points?
A. Approximately, fifteen per cent of our patients, we 
become aware that they think abortion is wrong. Those 
patients are not required to delay their procedure, except 
in certain instances. For instance, if they exhibit extreme 
ambivalence about the decision or if they are extremely 
distraught.

If in the best judgment of the counselor and the 
clinic supervisor, they had not adequately processed their 
decision making, we suggest to them that they take some 
time and come back another day.

Often they agree with us; infrequently, we turn them 
away.



546

Your question also included if a patient thinks 
abortion is illegal; if a patient thinks abortion is illegal, 
we share information with her about its legality, we give 
her accurate information. That slender number of 
patients who want to affirm the right to have an 
abortion, want to exercise the right to have an abortion 
without affirming it for other women who say, I believe 
abortion should not be legal. That patient, we say, [62] 
let’s talk this over. And that patient, as of our new 
policy, we suggest that she come back another day for 
her procedure and process her own decision making and 
the difficulty we have with that position.

Our concern as a clinic is largely that we want it to 
be very clear for the record and to her, that all of her 
options have been explored and that this is a decision 
that she must take responsibility for. And that she must 
process before she makes an irreversible act.
Q. You said that this consent form, that such a woman 
must sign at the end has a paragraph about how if she 
ever says that she was not counselled properly,, that you 
will release the information publicly to the extent to 
defend it or maybe not to the extent, but to defend that 
you indeed counselled her?
A. Yes. If she says one, she had an abortion and two, it 
was at the Allentown Women’s Center, and three, 
indicates in some way she did not have her options 
explained to her or was inadequately counselled or that 
in any way we were not non-directive or in some way 
coerced her into a rushed decision, we will then defend 
ourselves against those mistruths [63] by opening the 
record.
Q. The newspaper article, it said that two women were 
told to wait and they said that you had made that 
statement.
A. That’s correct.
Q. Is it true that you had said since the policy was



547

started in April, that indeed two women were told to 
wait?
A. The first woman was in April. We had a staff 
meeting following her visit to our clinic. She indeed was 
asked to wait, but at that time the form had not been 
developed. It was developed as the result of her visit to 
our clinic. But functionally, she was asked to wait and 
went through the clarification of her options having been 
explained and so forth and so on, as we discussed in the 
form.

The form was then developed and then was used 
with the second patient, who came in, who volunteered 
to us that she felt that abortion should be illegal, but 
indeed that she did want one.
Q. The newspaper article said that both women came 
back, one saying she had dropped her opposition to legal 
abortion and the other signed a consent [64] form. The 
woman they are saying, dropped her opposition of legal 
abortion, is that the first woman in April?
A. Yes, yes.
Q. Is that accurate what the newspaper stated that she 
dropped her opposition to legal abortion?
A. It’s accurate, she said that. I think it is also 
important that you have a complete picture, that had she 
not said that we still would have given her an abortion 
on the second visit, if it was clear to us that that is what 
she wanted.
Q. Do you know how long a period of time was 
between her first visit to AWC and her second visit when 
she had the abortion?
A. No, but it was short.
Q. Less than a week, more than a week, do you know? 
A. That is retrievable. I don’t even know if that is 
retrievable at this point. It was short. It was probably 
not more than a week, but I can’t guarantee it. I could 
say with pretty well absolute certainty that it was two



548

weeks.
Q. With the second woman who signed the consent 
form, do you know the period of time between when [65] 
she first came to AWC and when she returned and 
signed the consent form?
A. The same, it was short.
Q. With the same, probably under a week, but definitely 
under two weeks.

You had said early on, and correct me if I am wrong, 
that women who say they believe abortion is wrong or 
murder or illegal, that raises a red flag to AWC that they 
might have some trouble or some ambiguity or 
uncertainty with the abortion decision; is that fair?
A. It raises a red flag about more than that. It raises a 
red flag about that they might possibly have more guilt 
or more damaged self-worth or some kind of adverse 
psychological sequelae is more likely in those instances. 
So all of those things are taken, you know, addressed by 
the counselor in her thinking process.

* * *

[66] Q. Who has to sign the consent form?
A. Let’s take this very slow. If approximately fifteen 
per cent of our patients we become aware without asking 
that they believe in some way that abortion is wrong or 
murder or something to that effect, but still wish to have 
one. Less than one per cent of our patients volunteer to 
us that they believe that abortion should not be available 
to other women, it should be illegal, which is stronger 
and more extreme. But that they would like to exercise 
the option of having a legal abortion and they would also 
like to cutoff that option for other women.

Those women in the fifteen per cent category, 
sometimes we ask patients to wait, because they are so 
ambivalent or so distraught as they present themselves to



549

us that we want to give them or sometimes they are 
coerced. Those women we want to give the opportunity 
to further process their decision making before they take 
an irreversible act. That is for the best interest of the 
patient.

That slender number of patients [67] who say that 
abortion should be illegal, not only for their sake, but 
also because we want to share with them that we need to 
make it clear that they must take responsibility for their 
own decision making and not lay it at the feet of the 
provider, that we are going to ask them to delay their 
abortion and return on another day after they have fully 
processed that they have explored their options and that 
they understand that they must take responsibility for 
their decision making.

MR. ZEMAITIS: Let me just ask a question, which 
I think will help clear it up.

The fifteen per cent, the larger group of women,are 
all of those women required to sign this new form?

THE WITNESS: None of them. This form has only 
been used twice and we see over four thousand patients 
a year.

MR. ZEMAITIS: The only time the form is used is 
in that much smaller group of people, where the woman 
thinks that abortion should be illegal and she returns on 
a second visit; is that right?
[68] THE WITNESS: She then returns on a second visit 
and she then -- to date, all of these women have 
remained steadfast in their desire to terminate their 
pregnancy.

There may be many more women who come to our 
clinic who think that abortion should be illegal, but we 
do not ask questions about that.
BY MS. MERSHIMER:
Q. So it is this one per cent or even smaller group --

MR ZEMAITIS: Much smaller.



550

BY MS. MERSHIMER:
Q. -- that feel abortion should not be available for all 
women that are asked to sign a consent form?
A. Correct.
Q. Or what is this form called, because I do not want to 
call it a consent form?
A. It’s so new, it doesn’t have a name.

I would just like to say that there is an error in this 
article. We never say, you may return if you change your 
mind. We do not attempt [69] to change people’s minds.

* * *

[70] Q. For the record, we have had marked as 
Defendant’s Exhibit-21 the form that we have been 
discussing for the last few minutes; that has no caption to 
it, correct?
A. Yes.
Q. You had said that one woman had returned to the 
clinic;that second women, and she had signed this form? 
A. Yes.
Q. If she had not signed the form,had refused to sign 
the form, could she have received an abortion at AWC? 
A. I think not. But I think the form functions largely as 
an information sharing and educational device. So I 
think it’s extremely unlikely that such a situation would 
arise.
Q. In the last paragraph --

MR. ZEMAITIS: You have not had to face that
situation yet?

THE WITNESS: That’s correct.
BY MS. MERSHIMER:
In the last paragraph, one of the statements [71] is that, 
"If in the future I 
A. There should be an "If."
Q. "If in the future I ever publicly state that the



551

Allentown Women’s Center counselled me inadequately 
or that I was not fully aware of the gravity of what I was 
doing in terminating my pregnancy, I understand that I 
will by so doing, give up all right to confidentiality and 
that the staff of the Allentown Women’s Center will 
defend their non-directive counselling protocols publicly."

My question to you is: What is meant by "all right to 
confidentiality?"
A. We are affirming our right to confirm that this 
patient who has already said that she had an abortion at 
the Allentown Women’s Center, to give our version of 
that event and to represent it accurately, specifically the 
counselling component.
Q. So you would not release her entire patient record 
then?
A. No, we would not do that and that is not made clear 
or unclear by this statement. But we would not, in fact, 
consider that to be relevant. We would only correct any 
misinformation that she might be giving out about our 
facility.

* * *



552

Defendants’ Exhibit 60:
Discovery Excerpts

PLAINTIFF’S OBJECTIONS AND RESPONSES 
TO DEFENDANTS’ REQUESTS FOR ADMISSIONS

Plaintiffs respond to Defendants’ Requests for 
Admissions as follows:

*  *  *

Request for Admission No. 2:
While delay in the performance of an abortion may 

increase the risks to the patient from both a mortality 
and a morbidity standpoint, the increased risks may be 
negligible and are dependent upon the stage of gestation 
(first, second, or third trimester). A week delay in the 
first trimester will not likely result in a harm while there 
may be greater risks in the second trimester, with the 
risks more worthy of consideration in the latter part of 
the second trimester and throughout the third trimester.

Response to Request for Admission No. 2:
Request for Admission No. 2 is admitted.

*  *  *

Request for Admission No. 8:
Some early abortions may be more dangerous than 

later abortions due to the condition of the patient, the 
type of procedure used in performing the abortion, or 
the skill of the performing physicians.

Response to Request for Admission No. 8:
Request for Admission No. 8 is admitted.

*  *  *



553

DEFENDANTS’ RESPONSES TO PLAINTIFFS’ 
REQUESTS FOR

ADMISSION AND INTERROGATORIES 
ADDRESSED TO DEFENDANTS

* *

Request for Admission No. 10
Adolescents have one of the highest suicide rates of 

any segment of the population.

RESPONSE:
Defendants object to this interrogatory as being 

irrelevant to the constitutionality of the Act, particularly 
in that this admission does not distinguish between males 
and females and in that it does not relate to pregnant 
teens. Without waiving this objection, Admission No. 10 
is DENIED.

ANSWER TO INTERROGATORY NO. 10:
The attached two tables (Exhibits 2 and 3) 

demonstrate that in Pennsylvania and the United States, 
teenagers have the lowest rate of suicide among the age 
groups.

*  *  *



554

Commonwealth of Pennsylvania - Department of Health 
State Health Data Center

Resident Suicide Deaths by Age and Sex, 
Number and Rate, Pennsylvania, 1987 (Provisional)

BY NUMBER:

AGE
GROUP

TOTAL MALES FEMALES

All Ages 1,489 1,210 279

Under 10 0 0 0

10-14 14 12 2

15-19 89 72 17
20-24 145 127 18

25-34 319 269 50

35-44 219 173 46

45-54 180 129 51

55-64 178 131 47

65-74 194 165 29
75 + 151 132 19



555

BY RATE:*

AGE
GROUP

TOTAL MALES FEMALES

All Ages 12.5 21.3 4.5

Under 10 - - -

10-14 1.8 3.0 0.5

15-19 9.8 15.6 3.8

20-24 14.8 25.8 3.7

25-34 16.4 27.9 5.1

35-44 14.1 22.9 5.8

45-54 15.4 23.2 8.3

55-64 14.2 22.6 6.9

65-74 19.7 39.6 5.1

75 + 20.6 51.3 4.0

Rate per 100,000 estimated 1986 population for each 
specified age group.

*  *  *



556

EXCERPTS FROM PLAINTIFFS’ TRIAL EXHIBITS

Plaintiffs’ Exhibit 49:
DOH Instructions and Definitions 

for Report of Induced 
Termination of Pregnancy Form 

(July 1988)

INSTRUCTIONS AND DEFINITIONS 
REPORT OF INDUCED TERMINATION 
OF PREGNANCY

INTRODUCTION

Pennsylvania 
Department of Health 

State Health Data Center 
July, 1988

Purpose: These instructions and definitions are designed 
as an aid to acquaint hospital and clinic personnel, 
physicians, and others with responsibilities related to 
completing and filing reports of induced termination of 
pregnancy (induced abortion), The purpose is to achieve 
improved reporting by promoting better understanding of 
the forms and of the uses of information entered on 
them.

Generally the person in charge of the institution or 
facility where the induced abortion is performed has the 
overall responsibility for obtaining the required data, 
preparing the report, and filing the report with the 
Department of Health. For abortions performed outside 
a hospital, clinic, or other institution, the physician 
performing the abortion is responsible for preparing and 
filing the report.



557

State Reporting Requirements: The reports shall be
completed by the hospital or other licensed facility, 
signed by the physician who performed the abortion and 
transmitted to the Department of Health within 15 days 
after each reporting month. Mail to the

Department of Health 
State Health Data Center 

ISSR Unit 
P. 0. Box 90 

Harrisburg, PA 17108

Specific Responsibilities: The hospital, clinic or other
institution or facility where the induced abortion is 
performed is responsible for obtaining the necessary 
data, completing the form, and filing it with the State 
within the time period specified by law. To ensure the 
proper performance of these responsibilities, it is 
preferable that one staff member be given the overall 
responsibility and authority to see that the reports are 
completed and filed on time. Specifically, the hospital, 
clinic, or other institution should:

o Develop efficient procedures for prompt preparation 
and filing of reports.

o Collect and record the information required by the 
report.

o Prepare a correct and legible report, making certain 
that every item is completed.

o File the report within the time specified in the 
Abortion Control Act (15 days after each reporting 
month).



558

o Cooperate with State officials concerning queries on 
report entries.

o Call on the State Health Data Center at (717) 
783-2548 for advice and assistance when necessary.

Physician: For induced abortions performed in a
hospital, clinic, or other institution, the physician 
performing the abortion is responsible for providing the 
medical information required by the report. When an 
induced abortion is performed outside a hospital, clinic, 
or other institution, the physician performing the 
abortion is responsible for obtaining all of the necessary 
data, completing the form, and filing it with the State 
within the time period specified by law.

PART I - GENERAL INSTRUCTIONS FOR 
COMPLETING REPORTS

The data necessary for preparation of the induced 
termination of pregnancy report are obtained from the:

o Patient

o Attending physician 

o Hospital or clinic records

The data obtained from these reports are very important 
from both a demographic and a public health viewpoint. 
Therefore, it is essential that these reports be prepared 
accurately. These general rules should be followed:

o File the original report with the Department of 
Health. These reports have sequential file numbers. 
Do not reproduce or duplicate these forms.



559

o Avoid abbreviations except those recommended in 
the specific item instruction.

o Spell entries correctly.

o Refer problems not covered in these instructions to 
the State Health Data Center.

o Use the current form designated by the State.

o Type all entries whenever possible. Do not use worn 
typewriter ribbons.

o If a typewriter cannot be used, print legibly in black 
ink.

o Complete each item following the specific 
instructions for that item.

PART II -  COMBATING THE REPORT OF 
INDUCED TERMINATION OF PREGNANCY

These instructions pertain to the 1988 Report of Induced 
Termination of Pregnancy.

1-2 PLACE OF TERMINATION

1. FACILITY NAME

Enter the full name of the hospital or clinic where the 
induced termination of pregnancy occurred.

If the induced termination of pregnancy occurred in a 
hospital or a clinic that is physically situated within a 
hospital or is administratively a part of a hospital, enter 
the full name of the hospital.



560

If the induced termination of pregnancy occurred in a 
freestanding clinic, a clinic that is physically and 
administratively separate from a hospital, enter the full 
name of the clinic.

If the induced termination of pregnancy occurred in a 
physician’s office or some other place, enter the name of 
the office or place.

In the coding boxes, enter the five-digit number found on 
the first line of your mailing label, as shown below.

8-0228
WOMENS HEALTH SERVICES 
107 SIXTH STREET 
FULTON BUILDING 3RD FLOOR 
PITTSBURGH, PA 15222

ATTN: PATRICIA MADDEN

2. COUNTY OF PREGNANCY TERMINATION

Enter the name of the county where the pregnancy 
termination occurred. In the coding boxes, enter the 
correct county code. See Appendix A.

3. PATIENTS IDENTIFICATION

Enter the hospital, clinic, or other patient identification 
number. This number must be one that would enable 
the facility or physician to access the medical file of this 
patient. Do not use the patient’s name.



561

4 a-b. RESIDENCE OF PATIENT

The patient’s residence is the place where her household 
is located. This is not necessarily the same as her "home 
State." "voting residence," "mailing address," or "legal 
residence." The State and county should be that of the 
place where the patient actually lives. Never enter a 
temporary residence such an one used during a visit, 
business trip, or a vacation. Residence for a short time 
at the home of a relative or friend is considered to be 
temporary and should not be entered here. Place of 
residence during a tour Of military duty or during 
attendance at college is not considered temporary and 
should be entered an the place of residence of the 
patient on the report.

If the patient has been living in a facility where an 
individual usually resides for a long period of time, such 
as a group home, mental institution, nursing home, 
penitentiary, or hospital for the chronically ill, this facility 
should be entered as the place of residence.

4 a. RESIDENCE - STATE

Enter the name of the State where the patient lives. 
This may differ from the State in her mailing address. If 
the patient is not a resident of the United States, enter 
the name of the country and the name of the unit of 
government that is the nearest equivalent of a State.

4 b. RESIDENCE - COUNTY

Enter the name of the county where the patient lives.

In the coding boxes, enter the correct county code. See 
Appendix A. For counties outside Pennsylvania, leave



562

5. DATE OF PREGNANCY TERMINATION

Enter the exact month, day, and year of the pregnancy 
termination.

The date the pregnancy was actually terminated should 
be entered. This may not necessarily be the date the 
procedure was begun.

Enter the full name of the month - January, February, 
March, etc. Do not use a number or abbreviation to 
designate the month.

6. AGE LAST BIRTHDAY

Enter the age of the patient in years at her last birthday.

7. CLINICAL ESTIMATE OF GESTATION

Enter the length of gestation as estimated by the 
attending physician in completed menstrual weeks. Do 
not compute this information from the date last normal 
manses began and date of termination. If the attendant 
has not done a clinical estimate of gestation, enter 
"None."

8. PREVIOUS PREGNANCIES (complete each 
section)

8 a. Now Living

Enter the number of children born alive to this patient 
who are still living at the time of this termination. Do 
not include children by adoption. Check "None" if the

blank.



563

patient has had no previous pregnancies, or if all 
previous children are dead.

8 b. Now Dead

Enter the number of children born alive to this patient 
who are no longer living at the time of this termination. 
Do not include children by adoption. Check "None" if 
the patient has had no previous pregnancies or if all 
previous children are still living.

8 c. Spontaneous

Enter the number of previous pregnancies that ended 
spontaneously and did not result in a live born infant. 
This should not include induced terminations. Check 
"None" if the patient has had no previous pregnancies or 
if all previous pregnancies ended in live born infants.

8 d. Induced

Enter the number of previous induced terminations 
(induced abortions) that this patient has had. Do not 
include this termination. Check "None" if the patient has 
had no previous induced terminations.

9 a-b. TYPE OF TERMINATION PROCEDURES

(Definitions of certain abortion procedures can be found 
in Appendix B)

9 a. Check the box that describes the primary 
procedure that actually terminated this pregnancy. 
Check only one box. If more than one procedure was 
used, identify the additional procedure(s) in item 9b. If 
a procedure not listed was used, check "Other" and



564

specify on the line provided.

9 b. Check the box(es) that describe the additional 
procedure(s) used. If no additional procedures were 
used, leave all boxes blank. If a procedure not listed was 
used, check "Other" and specify on the line provided.

10. MEDICAL COMPLICATIONS OF PREGNANCY 

Check all that apply. If none apply, leave item blank.

11. NAME OF ATTENDING PHYSICIAN

Enter the full name of the attending physician. Be sure 
to spell it correctly and verify correct spelling. This item 
is used to query for missing or additional information.

Complete the license number of the physician, the 
signature, and the date submitted to the Department of 
Health.



565

APPENDIX A
PENNSYLVANIA COUNTY CODES

COUNTY COUNTY
CODE COUNTY CODE COUNTY

01 Adams 35 Lackawanna
02 Allegheny 36 Lancaster
03 Armstrong 37 Lawrence
04 Beaver 38 Lebanon
05 Bedford 39 Lehigh
06 Berks 40 Luzerne
07 Blair 41 Lycoming
08 Bradford 42 McKean
09 Bucks 43 Mercer
10 Butler 44 Mifflin
11 Cambria 45 Monroe
12 Cameron 46 Montgomery
13 Carbon 47 Montour
14 Centre 48 Northampton
15 Chester 49 Northumberland
16 Clarion 50 Perry
17 Clearfield 51 Philadelphia
18 Clinton 52 Pike
19 Columbia 53 Potter
20 Crawford 54 Schuylkill
21 Cumberland1 55 Snyder
22 Dauphin 56 Somerset
23 Delaware 57 Sullivan
24 Elk 58 Susquehanna
25 Erie 59 Tioga
26 Fayette 60 Union
27 Forest 61 Venango
28 Franklin 62 Warren



566

29 Fulton 63 Washington
30 Greene 64 Wayne
31 Huntingdon 65 Westmoreland
32 Indiana 66 Wyoming
33 Jefferson 67 York
34 Juniata



567

APPENDIX B
DEFINITIONS OF INDUCED ABORTION 

PROCEDURES

Suction curettage (Also known an vacuum aspiration). - 
In this procedure the cervical canal is dilated by the 
successive insertion of instruments of increasing diameter 
called dilators. When the opening is large enough, a 
flexible tube (cannula) is inserted into the uterine cavity, 
and the fetal and placental tissues are then suctioned out 
by an electric vacuum pump.

Sharp curettage (Also known as dilatation and curettage, 
D & C, or surgical curettage). - This procedure involves 
the dilation of the cervix an in suction, although usually 
to a larger diameter. The fetal and placental tissues are 
then scraped out with a curette, which resembles a small 
spoon.

Dilation and evacuation (D & E). - This procedure, used 
most frequently in the second trimester, involves opening 
the cervix (dilation) and using primarily sharp 
techniques, but also suction and other instrumentation 
such an forceps for evacuation.

Intrauterine saline instillation (Also known as saline 
abortion and saline amniotic fluid exchange). - This 
procedure entails withdrawing a portion of the amniotic 
fluid from the uterine cavity by a needle inserted through 
the abdominal wall and replacing this fluid with a 
concentrated malt solution. This process induces labor, 
which results in the expulsion of the usually dead fetus 
approximately 24 to 48 hours later.

Intrauterine prostaglandin instillation. - This procedure 
involves injecting a prostaglandin - a substance with



568

hormonelike activity - into the uterine cavity through a 
needle inserted through the abdominal wall. The 
interval between injection and expulsion tends to be 
shorter than in a saline abortion.

Hysterotomy. - This procedure involves surgical entry 
into the uterus, as in a cesarean section, that removes a 
fetus that is too small to survive even with extraordinary 
life support measures. It is usually performed only if 
other abortion procedures fail.

Hysterectomy. - In this procedure, the uterus is removed 
either with the fetus inside or after the fetus has been 
removed. It is usually performed only when a 
pathological condition of the uterus, such as fibroid 
tumors, warrants its removal or when a woman desires 
sterilization.

All definitions, except for D & E, are from Legalized 
Abortion and the Public Health (Institute of Medicine, 
1975). The definition of D & E is based on national 
Center for Health Statistics consultation with the Center 
for Health Promotion and Education, Centers for 
Disease Control.

Ail other procedures should be shown an "Other" and the 
specific procedure listed. This category includes 
procedures using a combination of agents, such as urea 
and prostaglandin, prostaglandin and oxytocin, or 
prostaglandin and saline.



569

APPENDIX C 
DEFINITIONS

The following definitions are included in the 1977 
revision of the Model State Vital Statistics Act and 
Regulations. The definitions of live birth and fetal death 
conform to the definitions adopted by the Assembly of 
the World Health Organization.

Live birth is the complete expulsion or extraction from its 
mother of a product of human conception, irrespective of 
the duration of pregnancy, which after such expulsion or 
extraction, breathes, or shows any other evidence of life 
such an beating of the heart, pulsation of the umbilical 
cord, or definite movement of voluntary muscles, 
whether or not the umbilical cord has been cut or the 
placenta is attached.

Note - If an infant breathes or shows any other evidence 
of life after complete delivery, even though it may be 
only momentary, the birth must be registered as a live 
birth and a death certificate must also be filed.

Fetal death is death prior to the complete expulsion or 
extraction from its mother of a product of human 
conception, irrespective of the duration of pregnancy; the 
death is indicated by the fact that after such expulsion or 
extraction, the fetus does not breathe or show any other 
evidence of life, such as beating of the heart, pulsation of 
the umbilical cord, or definite movement of voluntary 
muscles.

Induced termination of pregnancy is the purposeful 
interruption of pregnancy with the, intention other than 
to produce a live-born infant or to remove a dead fetus 
and which does not result in a live birth.



570

Note - If an induced termination is performed on a fetus 
of 16 weeks gestation or longer, a Certificate of Fetal 
Death as well as a Report of Induced Termination of 
Pregnancy must be filed.



571

REPORT OF INDUCED TERMINATION OF 
PREGNANCY MONTHLY TRANSMITTAL FORM

Please return this page with all of your completed 
Report of Induced Termination of Pregnancy forms for 
the reporting period of AUGUST 25-31 by September 
15, 1988. Also, complete the requested information 
below for your facility:

FACILITY I.D .__ -_____________

NAME OF FACILITY____________________________

CONTACT PERSON/TITLE_______________________

TELEPHONE NUMBER ( ) ____ - __________

DATE SUBMITTED______________________________

NUMBER OF COMPLETED FORMS ENCLOSED

Please complete and return this page even if you do not 
have any procedures to report.

MAIL TO: Pennsylvania Department of Health 
State Health Data Center 
ISSR Unit 
PO Box 90
Harrisburg, PA 17108



572

Plaintiffs’ Exhibit 60:
Veto Message to the Pennsylvania Senate 

on S.B. 742
of Governor Dick Thornburgh 

(Dec. 23, 1981)

December 23, 1981

To the Honorable, the Senate
of the Commonwealth of Pennsylvania

I have before me for action Senate Bill 742, Printer’s 
No. 1535, which would establish a number of detailed 
procedures and requirements with respect to the 
performance of medical abortions.

Perhaps no issue in recent times has generated more 
concern, conflict and passion than the issue of what, if 
any, restrictions should be imposed upon the ability to 
obtain an abortion. Perhaps, then, it should not be 
surprising that this bill has led to a considerable amount 
of public passion and controversy. Unfortunately, it also 
appears to have generated a considerable amount of 
misinformation and misunderstanding.

Many who favor stringent limitations on abortion 
appear to perceive this bill as a means of furthering that 
objective. Many who oppose most or all restrictions on 
abortion appear to perceive this bill as preventing 
virtually all abortions.

I have carefully studied this bill and those opinions 
of the United States Supreme Court and other federal 
courts which establish the legal and constitutional 
parameters for the performance of medical abortions. I 
also have reviewed similar laws in other states and a 
variety of relevant materials and opinions reflecting all



573

points of view on the cluster of issues related to the 
abortion question.

I have concluded that this bill does far less to restrict 
the ability of a woman to elect to have an abortion than 
its proponents perceive or its opponents fear.

I have stated a number of times in the past my 
personal opposition to abortion on demand, and my view 
that abortion should not be employed as an alternative 
to birth control techniques. I have also expressed my 
concern that too many abortions are too casually 
undertaken. This is a matter of particular concern with 
regard to teen-agers who are usually less equipped than 
adults to independently evaluate the decision to have an 
abortion or understand the consequences it may later 
entail.

On the other hand, I also have stated in the past my 
personal view that abortion should be a permissable 
medical option in certain narrowly restricted situations, 
including threat to the life of the mother, rape, incest or 
serious and irreparable harm to the health of the mother.

While this bill contains a number of proposed 
requirements with which I am in agreement, I have 
concluded that it really does little, if anything, to prohibit 
abortions which can now be performed in the 
Commonwealth.

What this bill would do is erect a series of hurdles 
which would have to be cleared by a pregnant woman 
interested in obtaining an abortion.

Any competent, pregnant, adult intent upon 
obtaining an abortion who could negotiate those hurdles, 
could obtain one, much as she now could in this state. It 
must be assumed that the same services now available to 
assist and counsel women considering abortion would be 
available to provide assistance to any such woman in 
negotiating the procedural hurdles contained in this bill.

On the other hand, for those women, often minors,



574

who face the dilemma of an unwanted pregnancy with 
fear or ignorance, some of these proposed procedures 
would provide certain valuable information and 
protection.

Specifically, the bill would permit a pregnant woman 
to elect an abortion before the fetus is viable -  that is, 
capable of surviving outside the body of the mother — if 
her physician made a medical determination that it was 
necessary in light of all factors relevant to the well-being 
of the woman, including physical, emotional, 
psychological, age and family circumstances.

The bill would, however, require women seeking 
such abortions to be counselled on the options with 
regard to an unwanted pregnancy and the consequences 
of each, including the medical risks involved in both 
proceeding with an abortion and with carrying the fetus 
to term. It would then require a waiting period of one 
day, which would provide the woman with an opportunity 
to assess and reflect upon this information. This waiting 
period would not apply where a medical emergency 
compelled the performance of an abortion.

The bill would require minors and adjudged 
incompetents to obtain the consent of a parent or 
guardian for an abortion if so desired. In the alternative, 
such a pregnant woman could obtain a court order 
authorizing the performance of an abortion upon a 
finding either that the woman is mature and capable of 
giving her informed consent, or that the performance of 
an abortion would be in the woman’s best interests. In 
such a proceeding, the pregnant woman would be 
entitled to court-appointed counsel, and all proceedings 
would be confidential. In assessing the best interests of a 
minor seeking an abortion, I must assume that any court 
would rely heavily on the best medical judgment of the 
petitioner’s physician.

The bill would require that any abortion after the



575

first trimester of pregnancy be performed in a hospital.
The bill would require certain precautions to help 

insure the survival of an aborted fetus which was viable. 
Where a physician has determined prior to an abortion 
that the fetus is, in fact, viable, an abortion could only be 
performed upon a determination by the woman’s 
physician that the abortion was necessary to preserve her 
life or health, and then, to the extent medically feasible, 
by the method most likely to preserve the viability of the 
fetus. I am advised that this is already the case pursuant 
to current normal medical practice.

The bill would require that physicians performing 
abortions file reports setting forth certain detailed 
information relating to the facts and circumstances 
involved in the abortion. Such records would not contain 
the identity of the pregnant woman, but would be 
available for public inspection.

The bill would place restrictions an abortion-related 
coverage that could be provided in health care and 
disability insurance policies.

The bill provides for an annual review by the state 
Health Advisory Board of the standards and criteria for 
assessing viability, While the specific question of viability 
in any particular case appears to be left to the medical 
determination of the attending physician, the regularly 
revised standards devised by this board would appear to 
constitute a presumption against which each physician’s 
determination could be judged. I have reservations 
about this provision. It has the potential to further 
politicize and complicate the whole issue of abortion. It 
will focus undue attention on a small board that may not 
reflect the consensus in the medical community at any 
given time on an issue that seems best left to the 
unfettered determination of individual treating physicians 
on a case-by-case basis. This is particularly troublesome 
since, by law, only half of that board’s members are



576

physicians. I do not object to a periodic review and 
revision of criteria of viability. I believe, however, that 
this should be the responsibility of the recognized 
organizations of the medical community -- not of 
government.

Finally, this bill defines human life as beginning at 
the moment of fertilization. Much of the intent and 
purpose of the bill appears to flow from that assertion.

I do not believe that I have the scientific or 
theological expertise to affirm or refute that premise, nor 
do I believe that the members of the General Assembly 
do. The U.S. Supreme Court has noted the consensus 
among medical practitioners and theologians over a long 
period of time that human life does not begin until the 
time of viability or even later. The court has noted that 
this has been the predominant view in the Jewish and 
Protestant communities, and was also "official Roman 
Catholic dogma" until the last century.

It has been argued by many that the extremely 
detailed nature of some of the counselling and reporting 
requirements, when combined with the stringent criminal 
penalties that are provided for virtually any violation, is 
intended to deter women from seeking abortions and 
physicians from performing them, even under
circumstances where the courts have made clear that 
abortions cannot be constitutionally restricted. I believe 
that these provisions, combined with the "human life" 
definition and power of a small state board to set 
standards of viability, have given rise to most of the 
concern and consternation expressed over this bill.

In performing my responsibility to properly evaluate 
this bill, I must carefully weigh not only the literal 
substance of the bill but what its effects could be. There 
is no bill to which I have given more careful 
consideration or undertaken more precise review and 
reflection. I have reached the following conclusions.



577

The medical necessity test for obtaining an abortion 
prior to the viability of a fetus, is consistent with U.S. 
Supreme Court holdings and is, in my view, reasonable.

The requirement for counselling and assessment are, 
in my view, reasonable for someone confronting a 
surgical procedure of this type and a personal decision of 
this magnitude -- one which studies show could have 
lasting emotional impact. Requiring a physician to 
provide such counselling or medical advice is, in my 
view, reasonable and comparable to the kinds of things 
physicians do in other similar situations. Indeed, I would 
think that any thoughtful and sensitive physician, under 
any circumstances, would agree that it is appropriate to 
apprise a patient of the various potential medical, 
psychological and other risks and effects associated with 
such a procedure. Further, I think it is right to explain 
to a pregnant woman that there are alternatives to 
abortion if her only objection is raising the child or her 
only fear is the inability to support the child. An 
abortion that would not be performed but for ignorance 
or fear is perhaps an abortion best not performed.

On the other hand, I doubt that requiring the 
preparation and availability of detailed color photographs 
of a fetus at various gestational increments is necessary 
to an informed abortion decision. Moreover, their 
presentation would likely cause many women 
considerable anguish and distress.

While I personally believe that a brief, so-called 
"waiting period" is reasonable, I must note that 
comparable provisions in other bills have been held 
unconstitutional by a number of federal appeals courts.

I feel that the provision for parental or guardian 
consent, or in the alternative, court review, is reasonable 
and consistent with traditional and legal parental 
responsibilities for the welfare of their minor children, 
and with the traditional role of the courts to determine,



5 7 8

when necessary, the best interests of minor children. At 
no time is a minor more likely to need or stand to 
benefit from the guidance and support of a responsible 
adult than when facing the emotional trauma and 
dilemma of an unwanted pregnancy. I believe, however, 
that if the alternative of a court determination is to meet 
constitutional standards of reasonableness, it should 
include a specific, limited time period within which the 
court must act rather than the more general and 
undefined term, "promptly", as the bill now provides.

I do not believe that the requirement that an 
abortion on a woman beyond the first trimester of 
pregnancy be performed in a hospital is unreasonable. 
In fact, the great majority of abortions are performed in 
the first trimester. Abortions performed beyond that 
period are more likely to entail greater risks, 
complications and care. However, I have serious 
reservations about the proposed requirement that all 
such abortions be performed on an in-patient basis. The 
necessity of proceeding on an in-patient basis, in my 
view, should be determined on a case-by-case basis by 
the attending physician. Clearly, proceeding on an 
in-patient basis would involve a greater burden and cost 
to the woman involved. Where the need to proceed on 
an in-patient basis is not reasonably related to maternal 
health or the protection of a potentially viable fetus, this 
requirement would appear to be unduly restrictive and 
thus unconstitutional.

The provisions which limit the aborting of a fetus 
medically determined to be viable and which require 
precautions to preserve the life of an aborted fetus which 
is in fact viable are, in my view, right and reasonable. In 
fact, the overwhelming majority of abortions are 
performed before any question of viability arises. I 
cannot disregard a recent Philadelphia Inquirer 
investigative feature which exposed the fact that in at



579

least some cases of more advanced pregnancy, viable 
fetuses were being aborted and permitted to die. If a 
fetus is capable of living and growing outside the womb, 
it is difficult for me to accept that it does not embody a 
human life. If we are to regard ourselves as a
humanitarian society, I believe that we must take every 
reasonable precaution in favor of the preservation of 
innocent life. This would include, in my view, 
requirements such as the ones in this bill for the 
presence of a second physician where an aborted fetus 
may be viable and utilization of the abortion technique, 
where consistent with maternal life and health, most 
likely to preserve a viable fetus.

I am troubled, however, by the provision in Section 
3212 (B) of the bill which, when read in conjunction with 
the definitions of "born alive" and "viability" in Section 
3208, would appear to require the use of every 
scientifically possible means, including artificial 
sustenance, to maintain in a technical state of life, 
presumably indefinitely, an aborted fetus or organism, 
however defective, deficient, or diseased, that does not 
embody any prospect of human life as we know it. 
While this may not have been the intent of the 
legislation, this provision could require a physician, under 
the risk of severe criminal penalties, to artificially 
maintain even an aborted anencephalic fetus, that is, one 
with no head or brain. Such cases have been 
documented.

The provision would establish a higher standard of 
care for a viable fetus or human organism than is 
required in the case of a diseased or failing adult. 
Whether and when artificial means of sustenance should 
be employed is a decision which, in my view, is best left 
to the affected family and their physician.

I believe that some general reporting requirements 
are reasonable and could provide the kind of data that



580

would be beneficial in enabling us to make more 
informed judgments about the continuing questions 
related to the matter of abortion. Indeed, 30 other states 
have enacted legislation with some type of reporting 
requirements. However, I have reservations about
several of the specific reporting requirements proposed 
in this bill, and a particular concern about the availability 
of such reports for general public inspection. I am 
concerned that this could lead to the compromising of 
the identities and privacy of women who have obtained 
abortions, and of the doctor-patient relationship.

I also have some reservations about the
constitutionality of some of the restrictions in the 
insurance provision and on the use of public health 
facilities in performing abortions. Where the latter are 
the only accessible facilities for women who are seeking 
abortions under circumstances where they would be 
permitted in private facilities, the application of this 
restriction seems unfair and has been held
unconstitutional.

I have reviewed the history and development of this 
bill, it appears to me that the various amendments and 
revisions to the bill as initially proposed reflect a genuine 
effort to adopt procedures to insure informed consent by 
adults and reasonable protection for the well-being of 
minors considering abortion, as well as standards and 
procedures for protecting and preserving, to the extent 
possible and consistent with the life and health of the 
mother, the potential for new human life, and to do so 
within the constitutional limitations prescribed by the 
U.S. Supreme Court.

The U.S. Supreme Court has recognized the interest 
of a state in reasonably regulating abortion in ways 
related to maternal health and well-being, and for the 
purpose of protecting the "potentiality of human life." I 
believe that many provisions of the bill, as I have



581

indicated, are consistent with those interests and are 
reasonable, particularly with regard to those women who, 
because of their circumstances, would benefit from the 
guidance and protection afforded by them.

On the other hand, I am concerned that other 
provisions, and to some extent, the overall tone and 
tenor of the bill, would have the effect of imposing an 
undue and, in some cases, unconstitutional burden upon 
even informed, mature adults intent upon obtaining an 
abortion under circumstances in which the U.S. Supreme 
Court has determined they are entitled to do so. For 
example, Section 3213 would preclude the victim of a 
rape who has made an informed and mature decision 
that she absolutely does not want to bear any child that 
might result from that rape from exercising the option of 
menstrual extraction, and would force her to wait the 
five weeks or more that is required for the fact of 
pregnancy to be determined. This requirement would 
appear to needlessly subject a woman in such a stressful 
situation to additional trauma.

Likewise, I am concerned that some of the detailed, 
complex, and burdensome requirements of the bill, 
accompanied as they are by severe criminal penalties, 
could well foster an atmosphere in which many 
physicians would be deterred from providing the kind of 
abortion-related medical services to which the U.S. 
Supreme Court has held their patients are 
constitutionally entitled. This could well disrupt the 
traditional doctor-patient relationship and impinge upon 
the right of physicians to practice. Of even greater 
concern is the potential for more experienced and 
conscientious physicians to refrain from involvement in 
even medically necessary abortions, and to abandon the 
field to marginal practitioners. It could even lead to a 
resurgence of "back alley" abortions, which no thoughtful 
person would wish to happen. I believe that this concern



582

could be alleviated by reduced criminal sanctions which 
would still be sufficient to deter physicians from willful 
violations.

I am also concerned that in its entirety the bill in its 
current form goes further than is necessary in protecting 
the state interests in this area to which I have referred. 
In so doing, it threatens to create additional regulation 
and bureaucracy and to unduly involve government in 
the private lives of its citizens.

Accordingly, and after extensive consideration and 
deliberation, I am returning this bill without my 
signature. In so doing, I wish to indicate the availability 
of my office to work with the General Assembly in 
developing revised legislation to effectuate the provisions 
with which I have indicated my agreement consistent 
with the objections I have expressed.

N .

Dick Thornburgh 
Governor



583

Plaintiffs’ Exhibit 61:
Message to Pennsylvania Senate on Signing of 

1982 Pennsylvania Abortion Control Act 
of Governor Dick Thornburgh 

(June 11, 1982)

June 11, 1982

To the Honorable, the Senate
of the Commonwealth of Pennsylvania

I have before me for consideration Senate Bill 439, 
Printer’s No. 2049, which would require the 
Commonwealth to provide to criminal justice agencies 
certain criminal record information, upon appropriate 
request, free of charge. This bill has been subject to a 
number of unrelated amendments, the most important, 
and only controversial, one of which has to do with the 
procedures related to the performance of abortions in 
the Commonwealth.

I was confronted with such a measure in the form of
S.B. 742 last December. That bill contained 11 
provisions to which I objected. In addition, the overall 
tone and tenor was such that I felt it could have a 
chilling effect in a constitutionally-protected area, and 
created an aura of undue government intrusion into 
private lives which conflicted with my convictions and 
philosophy. On Dec. 23, 1981, I vetoed that bill, setting 
forth in detail those concerns and objections.

My careful review of this revised measure reveals 
that the statement of the bill’s sponsor that the new 
measure was "tailored" to meet my objections appears to 
be accurate. My review reveals that virtually every item 
in the initial bill to which I objected has been removed 
or appropriately revised in the current measure.

Key among the 11 provisions to which I objected in



584

the original bill were:
*A definition of "human life" as commencing at 

the instant of fertilization. I objected to this, and it 
has been removed from the current bill.

*A requirement that the state Health Advisory 
Board set standards of fetus viability and, moreover, 
review and revise such standards on an annual basis. 
I objected to this and expressed the view that the 
question of viability was more properly determined 
on a case-by-case basis by an attending physician. 
This provision has been removed from the current 
bill.

*A provision requiring that detailed color 
photographs depicting the incremental development 
of the human fetus in the womb be made available 
for showing to women contemplating abortion. I 
objected to this and expressed the view that if 
imposed an unreasonable and potentially anguishing 
burden on women contemplating abortion. This 
provision has been removed from the current bill.

*A requirement that all abortions after the first 
trimester be performed on an in-patient basis. I felt 
that this was a matter better left to the judgment of 
the woman involved and her treating physician. I 
objected to this provision, and it has been removed 
from the current bill.

*A prohibition of menstrual extraction, even in 
cases of rape. I found this objectionable. This has 
now been eliminated in the bill currently before me.

*A provision prohibiting the inclusion of 
abortion coverage in standard medical insurance 
policies issued in the Commonwealth. I objected, 
and this provision has been removed from the 
current bill.

'Provisions which would have required the use 
of heroic efforts and artificial sustenance to maintain



585

in a technical state of survival any fetus once aborted 
which was capable of being so maintained, however 
deformed and regardless of its prospects for any 
meaningful life as we know it. This would even have 
included anancephalic fetuses (i.e., those literally 
born without a head or brain). I objected to this. It 
has been eliminated in the current bill before me. 
Under the current bill, physicians would only be 
required to provide the same types of treatment to 
an infant aborted alive that they would to a live 
adult under comparable circumstances. This is 
totally consistent with existing medical standards and 
legal obligations.

‘Certain reporting requirements relative to the 
performance of abortions which in my view did not 
adequately protect the confidentiality of the 
doctor-patient relationship and the right of personal 
privacy. I objected, and the relevant provisions have 
been eliminated in the current measure.

*A provision effectively preventing the 
performance of abortions in state-owned or operated 
hospitals. I objected to this, and expressed the view 
that it would discriminate against women seeking 
abortions who did not have access to private 
hospitals. This provision has been eliminated. The 
new bill would permit abortions to be performed in 
state-owned or operated hospitals unless there was 
another nearby hospital in which such an abortion 
could be performed.

Severe criminal penalties on doctors who 
violated even the ministerial provisions of the act. I 
objected to this. The penalty structure has been 
drastically altered in the current bill. In certain 
cases, criminal sanctions have been removed 
altogether. In the other instances, the criminal 
sanctions imposed are now consistent with penalties



586

that already exist for comparable conduct and in 
laws similar to this one as enacted in many other 
states.

*A provision for court review of requests by a 
juvenile for an abortion that failed to impose any 
time limit within which the court must act, and thus 
created the prospect of an indefinite and 
unappealable delay in the process. I objected to this 
omission, and the current bill would now impose a 
requirement for speedy action in such court 
proceedings.
This bill does contain eight provisions concerning 

abortion procedures which were contained in the original 
bill presented to me. At the time I vetoed that bill, I 
stated that I did not approve of abortion on demand, and 
had become convinced "too many abortions are too 
casually undertaken." I also stated that I had become 
convinced by reports, including an investigative account 
by the Philadelphia Inquirer, that a need existed to 
provide better protection for viable fetuses, particularly 
those aborted alive. Indeed, it is worth noting that even 
one of the most vocal legislative opponents of regulating 
abortion procedures acknowledged during recent floor 
debate on this bill that ". . . there is an abortion 
problem."

I believe that society has in obligation to provide 
certain basic protection for pregnant women 
contemplating or confronting the abortion process, 
particularly juveniles, and for a viable fetus which 
embodies human life. I believe that this interest of 
society in ensuring informed consent and protecting 
human health and life should be achieved with the 
minimum possible intrusion into the private lives of our 
citizens, and with the least possible interference in a 
decision-making process which should essentially be 
between a woman and her treating physician.



5 8 7

I recognize that both proponents and opponents of 
this bill have contended that it would limit or prohibit 
abortions. Even the original bill, with its excessive and 
objectionable provisions, would not in my view have 
prevented anyone intent upon obtaining an abortion 
from doing so. I believe that the provisions in the 
current bill address the legitimate interests of society in 
providing the basic protections I have referred to in a 
minimally intrusive -- and acceptable -  manner.

Under this bill, any abortion could be performed, 
prior to the viability of the fetus, if it is found to be 
medically or otherwise "necessary." The determination of 
necessity is left strictly to the judgment of a treating 
physician. The definition of "necessary" permits the 
physician to consider a wide array of criteria, including 
physical, emotional, psychological, and even familial 
factors and the age of the woman seeking the abortion. 
Under the necessity test as defined in this bill, it clearly 
appears that very few, if any, abortions which can now be 
performed under existing legal and medical standards 
would be prohibited. The necessity test as articulated in 
this bill is totally consistent with the express language of 
the United States Supreme Court on this subject in Doe 
vs. Bolton.

This bill would impose a requirement that a woman 
contemplating abortion be counselled on all available 
options and the medical consequences of each. I believe 
this requirement to be reasonable for someone 
confronting a surgical procedure of this type and a 
personal decision of this magnitude -- one which studies 
show could have a lasting emotional impact. Indeed, I 
would think that any thoughtful and sensitive physician, 
under any circumstances, would agree that it is 
appropriate to apprise a patient of the various potential 
medical psychological and other risks and effects asso­
ciated with such procedure. Further, I think it is right to



588

explain to a pregnant woman that there are alternatives 
to abortion if her only objection is raising the child or 
her only fear is the inability to support the child. An 
abortion that would not be performed but for ignorance 
or fear is perhaps an abortion best not performed.

It is important to note that, unlike the previous bill, 
this bill would not require physicians to personally 
provide all aspects of such counselling, but rather only 
those respecting medical matters. Other information and 
counselling may be provided, as is now practiced in 
responsible facilities, by knowledgeable counselors.

This bill would require a 24-hour "waiting period" 
between the counselling and the actual performance of 
an abortion. This period would provide a woman with 
an opportunity to assess and reflect upon this 
information. I believe this to be a reasonable 
requirement, particularly since this waiting period would 
not apply where a medical emergency compelled the 
performance of an abortion. Absent such medical need, 
I can foresee no harm arising from such a brief period of 
delay and reflection. Indeed, I would think that such a 
period of reflection is normal and reasonable whenever 
someone is evaluating and confronting surgical 
procedures that are even less imbued with stress and 
risk.

This bill would require minors and adjudged 
incompetents seeking an abortion to obtain the consent 
of a parent or guardian. In the alternative, such a 
pregnant woman could obtain a court order within a 
fixed brief time period, authorizing the performance of 
an abortion upon a finding either that the woman is 
mature and capable of giving her informed consent, or 
that the performance of an abortion would be in the 
woman’s best interests. In such a proceeding, the 
pregnant woman would be entitled to free, 
court-appointed counsel, and all proceedings would be



589

kept confidential. In assessing the best interests of a 
minor seeking an abortion, I must assume that any court 
would rely heavily on the best medical judgment of the 
petitioner’s physician. I continue to feel that this 
provision is reasonable and consistent with traditional 
and legal parental responsibilities for the welfare of their 
minor children, and with the traditional role the courts 
have played in determining the best interests of minor 
children. At no time is a minor more likely to need or 
stand to benefit from the guidance and support of a 
responsible adult than when facing the emotional trauma 
and dilemma of an unwanted pregnancy. Moreover, the 
justification for such guidance is certainly as compelling 
in the case of an abortion as that of current consent 
requirements for such comparatively routine surgical 
procedures as the removal of an appendix or tonsils.

This bill would require that any abortion after the 
first trimester of pregnancy be performed in a hospital, 
although not necessarily on an in-patient basis. Of all 
abortions performed last year in this state, 94.4 percent 
were performed during the first trimester. Abortions 
performed beyond that period are more likely to entail 
greater risks, complications and care. I believe this 
provision represents a reasonable and responsible 
precaution.

The bill would require certain precautions to help 
ensure the survival of an aborted fetus which was viable. 
Where a physician has determined prior to an abortion 
that the fetus is, in fact, viable, an abortion could only be 
performed upon a determination by the woman’s 
physician that the abortion was necessary to preserve her 
life or health, and then, to the extent medically feasible, 
by the method most likely to preserve the viability of the 
fetus. I am advised that this is already the case pursuant 
to current normal medical practice.

The bill would require the presence of a second



590

physician to attend to the fetus should it be aborted 
alive. If a fetus is capable of living and growing outside 
the womb, it is difficult for me to accept that it does not 
embody a human life. If we are to regard ourselves as a 
humanitarian society, I believe that we must take every 
reasonable precaution in favor of the preservation of 
innocent life. I do believe these precautionary provisions 
to be reasonable and responsible.

While protecting the identities of individuals seeking 
abortions, physicians performing abortions, and those 
associated with facilities providing abortion, this bill does 
require that reports be filed with the state Health 
Department regarding abortions.

I believe that these reporting requirements are 
reasonable and could provide the kind of data that would 
be beneficial in enabling us to make more informed 
judgments about the continuing questions related to the 
matter of abortion. Indeed, 30 other states have enacted 
legislation with these types of reporting requirements.

Twenty-two other states have enacted laws
comparable to Senate Bill 439, without evidence of the 
extreme effects predicted by both proponents and 
opponents of this measure.

I recognize that there is a legitimate difference of 
opinion, and, in some cases, a conflict among courts, 
over the constitutionality of some of these provisions -- 
most notably, the waiting period and parental consent 
requirements. While I believe firmly that issues such as 
this, which touch upon questions of life itself, must be 
resolved as a matter of conscience and conviction, I also 
recognize that, as Governor, I have an obligation to 
reject legislation which is patently unconstitutional. I do 
not, however, feel that I must undertake to resolve all 
possible Constitutional contentions in evaluating 
legislation. This is the province of the courts.

In this regard, I note that the U.S. Supreme Court



591

has agreed to review a number of lower court decisions 
on statutes related to abortion and thus to provide final 
and definitive judgments on the constitutionality of a 
number of state laws which encompass virtually all of the 
provisions in the measure now before me about which 
questions have been raised. The bill before me would 
not take effect for six months. Thus, it is highly likely 
that the Supreme Court will provide clear guidance for 
all the states in this area before this bill would take 
effect. Obviously, any provisions in this bill which are 
inconsistent with the determination about to be made by 
the Supreme Court could not and would not take effect.

With that understanding, and consistent with my 
convictions on this issue as explained in my message of 
December 23, 1981, I am herewith signing this bill.

N _________________________
Dick Thornburgh 

Governor



592

Plaintiffs’ Exhibit 62:
Veto Message to Pennsylvania House 

of Representatives on H.B. 1130 
of Governor Robert Casey 

(Dec. 17, 1987)

December 17, 1987

TO THE HONORABLE THE HOUSE OF 
REPRESENTATIVES OF THE COMMONWEALTH 
OF PENNSYLVANIA

I am returning without my approval House Bill 1130, 
Printer’s No. 2546, entitled "AN ACT amending Title 18 
(Crimes and Offenses) of the Pennsylvania Consolidated 
Statutes, limiting the defense of justification in certain 
cases; PROVIDING FOR DISTRICT ATTORNEYS’ 
STANDING AND INTEREST IN PRISONER 
LITIGATION; adding provisions relating to the 
establishment and operation of the Pennsylvania 
Commission on Sentencing; REGULATING MATTERS 
RELATING TO THE PERFORMANCE AND 
FUNDING OF ABORTIONS, THE PROTECTION OF 
WOMEN WHO UNDERGO ABORTION AND 
THEIR SPOUSES, AND THE PROTECTION OF 
CHILDREN SUBJECT TO ABORTION; increasing the 
penalties for false reports to law enforcement authorities; 
making an editorial change; and making repeals."

I was elected Governor of Pennsylvania to carry out 
the pledges I made to the people of this Commonwealth, 
and I will not break faith with those people, or break my 
promises to them. I have stated repeatedly that I am 
opposed to abortion on every moral ground. I believe 
that our society must not tolerate the destruction of



593

human life, and that we have a moral obligation to work 
to end this tragedy. This legislation, if corrected in the 
manner discussed below, will provide us with an 
opportunity to take a step forward in limiting this 
destruction.

In its present form, however, I have concluded that it 
is not constitutional and that I must veto it. But I 
strongly reaffirm today my commitment to joining with 
the clear majority of the Legislature who voted for this 
bill, and the majority of Pennsylvanians who voted for 
me on the basis of my clearly stated agenda for this 
state, to sign into law the strongest possible measure 
controlling abortion consistent with the Constitution and 
my oath to it.

There are two considerations that the gubernatorial 
role in the process compels me to interject into the 
legislation at this point. These two concerns intersect. 
The first is simply this: In order to ensure that the
measures we adopt actually take effect and contribute to 
the reduction and someday, I hope, the elimination of 
abortions in our state, they must be not only 
well-intentioned but well-drafted and able to withstand 
the constitutional challenges that will be mounted against 
them.

The second consideration may be just as simply 
stated: I promised the people of Pennsylvania, and I
took an oath, that I would uphold the Constitution. The 
legitimacy of our system of government, the finest on 
earth, depends not just upon our pursuit of the moral 
good, but also upon our adherence to the rule of law. 
Our law, and my oath as Governor, require that I 
execute those laws -- including the Constitution -- as 
interpreted by the courts, until such time as we are 
successful, through the democratic process, in changing 
the courts or the law they interpret.

These tasks are not ones that I take lightly. I would



594

do both the people, and the values I cherish and seek to 
promote, a grave disservice were I not to give them my 
fullest attention and care. Given the magnitude of the 
issue, and its importance to so many Pennsylvanians, I 
have taken it as a solemn duty to review this matter, and 
the state of the law, in considerable depth. The adoption 
of concrete, final language by the Legislature enabled 
me, beginning last week, to undertake a comprehensive 
study of that language and the United States Supreme 
Court’s rulings on the subject of abortion. I have 
wrestled continuously over the past few days with each of 
the questions potentially raised by the state of the law 
and its application to this bill. It is only after this 
searching analysis that I am ready to discuss this 
legislation fully with the Legislature and the people of 
this state.

A few sections of the bill call for our particular 
attention. The first of these is the informed consent 
provision that would be included in Section 3205 of the 
new law. The United States Supreme Court has ruled 
that a state cannot prohibit a physician from delegating 
to another qualified individual the counseling task in the 
informed consent context. The wording of the proposed 
Section 3205 is, however, potentially ambiguous on that 
point, and may possibly be read by some as requiring 
that counseling be carried out only by the performing or 
referring physician.

I do not believe that the legislation suffers from such 
a constitutional defect, however. When read in pari 
materia with the Medical Practice Act of 1985 governing 
all medical procedures in the Commonwealth, it is clear 
that, absent an express legislative declaration otherwise, 
physicians may delegate the functions in question to 
individuals qualified to perform such counseling. A 
statute is to be read so as to render it constitutional, and 
with such a reading Section 3205 is constitutional. I



595

therefore believe that this section of the bill must be so 
construed and thus passes constitutional muster.

Section 3209 requires that, except as provided in that 
section, before an abortion may be performed the 
woman must verify that she has notified the child’s father 
of her decision to seek an abortion. To the extent that 
our law continues to allow the termination of the 
procreative process once set in motion, a decent society 
ought to do everything possible to promote participation 
and prudence in that decision by both the mother and 
father.

The Supreme Court has consistently adhered to a 
legal framework established in Roe v. Wade, and which 
may be summarized as follows: The right to obtain an 
abortion is derived from the right of privacy. This right 
of privacy protects various facets of an individual’s life 
against government intervention and surveillance. While 
some of the concerns that give rise to this right of 
privacy grow out of such contexts as marriage, 
procreation, family relationships, and child-rearing -  all 
of which involve more than one individual -- the right of 
privacy is an individual right, accruing to each and every 
person individually and beyond the reach of the state. It 
was on this basis that the Court struck down a 
requirement that a woman obtain her spouse’s consent 
before she could undergo an abortion.

Other rulings by the Court have declared that a state 
may not compel disclosure of information protected by 
an individual’s right of privacy to any third-party; that a 
state lacks a legally justifiable interest in simply knowing 
the identity of a woman seeking an abortion; and that a 
state cannot intervene in the marital relationship to 
dictate the relations between husband and wife. In 
striking down spousal consent requirements, the Court 
held that a state cannot delegate to any third-party -  
even a husband -- a power that the state cannot exercise



596

itself.
Moreover, in the one context in which the Court has 

upheld the involvement of others in an individual 
abortion decision -  parental consent and notice laws 
regulating minors seeking abortions -- the Court has 
permitted states to require such involvement only as a 
mature substitute for an immature minor’s decision. The 
Court has mandated that a mature minor must be able 
to pursue an abortion without parental consent, or even 
notice. The case law makes plain that the Court treats 
consent and notice requirements equivalently in regard 
to their impingement upon the individual exercise of the 
abortion decision to which the Court has extended 
privacy protection.

I strongly disagree with this reasoning as a matter of 
morality, wisdom, and constitutional interpretation. My 
duty, however, requires me to pursue our objectives 
within the Constitution. The Supreme Court’s decisions 
make it clear that the paternal notice requirement will 
be struck down as unconstitutional if enacted. Moreover, 
every state statute requiring merely spousal notice that 
has been taken before a federal court has been struck 
down. I am forced to conclude that this provision poses 
the almost certain and unacceptable prospect of 
invalidation, and costly, unsuccessful, and avoidable 
litigation.

In addition, Section 3214, which requires the 
reporting of information to the Department of Health, 
remains substantially unchanged from the version 
summarily struck down by the Supreme Court less than 
two years ago. The Court has indicated that the 
government has a sustainable interest in the collection of 
health-related data in the abortion control context. 
However, where information concerning identifiable 
individuals is maintained by the government, sufficient 
safeguards against its release must exist under the law;



597

the government must, of course, have a legitimate 
health-related concern for knowing the specific identity 
of the individuals to whom that data pertains. In its 
Thornburgh decision striking down this Section, the Court 
explicitly found substantial portions of the data required 
under the Act not to be health-related and therefore to 
be constitutionally infirm.

While eliminating the public copying provision that 
the Court struck down, the bill as drafted neither 
provides the types of confidentiality safeguards required 
and which are utilized for other sensitive health data, nor 
excludes any of the data — such as method of payment, 
the woman’s personal history, and the bases for medical 
judgment -- that the Court specifically singled out as 
unwarranted. In that light, the provision unnecessarily 
invites invalidation and would not represent responsible 
legislation.

Finally, I must note that our concerns cannot end 
with protecting unborn children, but must extend to 
protecting, and promoting the health, of all our children, 
and their mothers. The right to life must mean the right 
to a decent life. Our concern for future mothers must 
include a concern for current mothers. Our respect for 
the wonders of pregnancy must be equaled by a 
sensitivity to the traumas of pregnancy. This 
Administration has called for significantly increased 
support for child and maternal health programs, for 
education, for rape counseling and support services. And 
we will continue to advance more programs born of the 
recognition that our moral responsibility to mothers and 
children does not end at birth. Those proposals deserve 
to receive the same overwhelming vote of approval in 
the Legislature that this bill received.

Let me restate in summary the distinction between 
personal belief and constitutional duty as it applies to 
this legislation. I believe abortion to be the ultimate



598

violence. I believe strongly that Roe v. Wade was 
incorrectly decided as a matter of law and represents a 
national public policy both divisive and destructive. It 
has unleashed a tidal wave that has swept away the lives 
of millions of defenseless, innocent unborn children. In 
according the woman’s right of privacy in the abortion 
decision both exclusivity and finality, the Supreme Court 
has not only disregarded the right of the unborn child to 
life itself, but has deprived parents, spouses, and the 
state of the right to participate in a decision in which 
they all have a vital interest. This interest ought to be 
protected, rather than denied, by the law. This policy 
has had, and will continue to have, a profoundly 
destructive effect upon the fabric of American life. But 
these personal beliefs must yield to the duty, imposed by 
my oath of office, to follow the Constitution as 
interpreted by the Supreme Court of the United States.

In light of these conclusions imposed upon me by my 
oath and obligation as Governor, I am returning this bill 
to the Legislature without my signature, for revision 
along the lines indicated. Most importantly, I emphasize 
again that we must — and we will -  enact a strong and 
sustainable Abortion Control Act that forms a humane 
and constitutional foundation for our efforts to ensure 
that no child is denied his or her chance to walk in the 
sun and make the most out of life. I will sign this bill 
when it reaches the end of the legislative process and 
attains those standards.

N
Robert Casey 

Governor



599

Plaintiffs’ Exhibit 67:
Excerpts from The Federal Role 
in Determining the Medical and 

Psychological Impact o f Abortion on Women,
H.R. Rep. No. 392, 101st Cong., 1st Sess. (1989)

THE FEDERAL ROLE IN DETERMINING THE 
MEDICAL AND PSYCHOLOGICAL IMPACT OF 
ABORTION ON WOMEN

[6] Although CDC researchers have concluded that 
abortion is generally safe, Dr. Willard Cates, Jr., and Dr. 
David Grimes, both former directors of the CDC 
Abortion Surveillance Branch, have re[7]ported that the 
earlier an abortion is performed, the safer it is for the 
woman.31 For example, Dr. Cates and Dr. Grimes 
reported that the risk of death to the pregnant woman 
obtaining an abortion doubles for every two weeks’ delay 
after eight weeks of gestation.32 However, they 
concluded that "once pregnant, a woman encounters an 
increased risk of death, no matter what her choice of 
outcomes," and that before 16 weeks gestation, legal 
abortion is safer than any other alternative outcomes.33

In concluding that abortion does not cause long-term

31 Cates, W., Jr. and Grimes, D A . (1981). Morbidity and Mortality 
of Abortion in the United States, in Hodgson, J.E. (Ed.) Abortion and 
Sterilization: Medical and Social Aspects. London: Academic Press 
Inc., p. 158; in subcommittee files.

32 Ibid., p. 171.

33 Ibid., p. 170.



600

health problems, the Surgeon General’s draft report 
apparently rejected the medical reports that linked 
abortion to later reproductive hazards. Similarly, CDC 
researchers have criticized some of the research 
presented as evidence of medical problems resulting 
from abortion as having obvious methodological flaws.34 
For example, the National Right-to-Life Committee 
presented the subcommittee with a chapter written by 
Matthew J. Bulfin from New Perspectives on Human 
Abortion as evidence of the dangers of abortion.35 In 
the chapter, Dr. Bulfin, a physician in private practice, 
documented the number of patients who came to him 
with infections, anxiety, and other problems resulting 
from a prior abortion. He concluded that 159 (20 
percent) of 802 abortion patients that he saw had suf­
fered from serious complications (including marital 
break-up).

CDC researchers have stated that it is not 
scientifically appropriate to assume that these kind of 
statistics are representative of abortion patients, since 
Dr. Bulfin’s patients apparently came to see him because 
they had medical problems.36 The weakness of these 
statistics is that they do not compare the number of 
abortion patients with problems to the total number of 
women who have had abortions. Therefore, when a

34 Cates, W., Jr. (1979). Late effects of induced abortion, Journal of 
Reproductive Medicine, Vol. 22, pp. 207-212.

Bulfin, M.J. (1981). Complications of Legal Abortion: A 
Perspective From Private Practice, in Hilgers, T.W., Horan, D.J., and 
Mall, D. Frederick, MD: Altheia Books, pp. 145-150; available in 
subcommittee files.

36 This kind of research was criticized in: Cates, W., Jr. (1979). Late 
effects of induced abortion: Hypothesis or knowledge? Journal of 
Reproductive Medicine, Vol. 22, pp. 207-212.



601

study is based on patients seeking treatment in one 
doctor’s office, it is considered anecdotal data, rather 
than scientific research. Dr. Koop rejected anecdotal 
evidence as unscientific in his review of the medical 
evidence.37 Moreover, studies reported in book 
chapters, such as Dr. Bulfin’s, are not peer reviewed by 
scientists, and are therefore not considered scientific 
evidence.38 * * * * * *

* * *

[10] In their review paper presented to the Surgeon 
General, the American Psychological Association 
concluded that, despite the flaws in the research, there is 
so little evidence of psychiatric problems following 
abortion, and so much evidence of relief, that therefore 
abortion does not cause more psychiatric problems than 
unwanted pregnancy.53 They also argued that given the 
large number of abortions, any significant psychiatric 
problems would have become very obvious to the mental 
health system in the last 15 years.54 Dr. Henry David, 
who represented the American Public Health Association 
in his meetings with Dr. Koop and in his Congressional 
testimony, acknowledged that some women have psychi­
atric problems following abortion. However, his research

37 Hearing, testimony of Dr. C. Everett Koop, p. 232.

38 Hearing, testimony of Dr. Jaroslav F. Hulka, pp. 3, p. 331.

Testimony on the Psychological Sequelae of abortion, on behalf of
the Public Interest Directorate of the American Psychological
Association, presented to the Office of the U.S. Surgeon General,
December 2, 1987, pp. 25, 29; document available in subcommittee
files.

54 Ibid. p. 3.



602

results indicate that the numbers are small, and there is 
no conclusive evidence that those psychiatric problems 
necessarily resulted from the abortion itself, rather than 
from the breakup of the relationship (which resulted in 
the unwanted pregnancy) or other factors.55 *

* *

[11] The National Right-to-Life Committee "white 
paper" also summarized the psychological research and 
concluded that the evidence was unclear but possibly 
showed more negative effects for abortion compared to 
maintaining the pregnancy.

One major study quoted by both the pro-choice 
advocates and the anti-abortion advocates helps illustrate 
the controversies. Dr. Henry David conducted a study of 
more than one million women in Denmark, to determine 
whether women who had obtained abortions 3 months 
earlier were more likely to be treated in psychiatric 
hospitals than were women who have given birth 3 
months earlier or women who had not been pregnant.

Dr. David’s research was cited as one of the best 
studies of the psychiatric impact of abortion by the 
Right-to-Life white paper and by pro-choice
advocates.62 Dr. David reported that approximately 12 
women per 10,000 abortions or deliveries were 
hospitalized, compared to 7 per 10,000 for all women of 
reproductive age. He also reported that separated, 
divorced, or widowed women who obtained abortions 
were much more likely to be hospitalized in a psychiatric 
facility than divorced, separated or widowed women who 
give birth, perhaps because it "may have been an

55 Hearing, testimony of Dr. Henry David, p. 144.

Hearing, testimony of Dr. Wanda Franz, p. 144.62



603

originally wanted pregnancy."63
In contrast, the Right-to-Life white paper 

misrepresented this study, quoting statistics for divorced, 
separated, and widowed women having abortions (63.8 
per 10,000) as if they applied to all women having 
abortions. When asked to explain this error or mis­
representation, Dr. Wanda Franz, vice president of the 
National Right-to-Life Committee, testified "The issue 
here is that the direction of the findings are that those 
women who had abortions had higher rates" and 
speculated that the abortion decision may have caused 
the breakup of the relationship.64 She did not answer 
the question of why the psychiatric rates that applied to 
the less than 10 percent of the women who were 
divorced, separated, or widowed were incorrectly cited as 
if they applied to all of the more than 27,000 women 
who had obtained abortions.65

The major focus of the "white paper" was a meta­
analysis, which is a statistical comparison that includes 
the data from several previously conducted research 
studies. The white paper was the one [12] new research 
paper for which Dr. Koop and his staff requested de­
tailed criticisms. The paper was vehemently criticized by 
CDC scientists and other researchers who were asked to 
review the quality of their scientific evidence. For 
example, scientists at the Center for Health Promotion 
and Disease Prevention at CDC reported the following

63 Hearing, testimony of Dr. Henry David, p. 97.

64 Hearing, testimony of Dr. Wanda Franz, pp. 144-145.

65 The statistics are clearly presented in the published article, which
was reviewed by the Surgeon General and his staff: David, H.P.,
Rasmussen, N.K., and Holst, E. (1981). Postpartum and postabortion 
psychotic reactions, Family Planning Perspectives, Vol. 13, pp. 88-93.



604

problems with the meta-analysis:
"1. The authors combine outcomes that are not 

well defined and are probably not comparable;
"2. The comparison groups used in the studies 

that were analyzed are inappropriate;
"3. The analysis was based on studies that, 

according to the authors of the report, are largely 
flawed as to design and methodology; and,

"4. The authors’ assumptions] . . . cannot be 
justified from the data."
The CDC scientists concluded that "Since the meta­

analysis used a combination of studies with disparate 
results, the conclusions based on such analysis have little 
value."66

Scientists from the National Center for Health 
Statistics who were asked to review the white paper for 
the Surgeon General concluded that "the meta-analysis 
has no value" and that "The conclusions drawn by the 
authors seem to be based on a priori beliefs rather than 
on objective review of the evidence."67

* * *

[14] For example, in his meeting with the American 
Council on Science and Health, Dr. Koop stated ". . . 
there is no doubt in my mind that there are physical 
effects of abortion and mental effects of abortion. They 
are, I think, a very tiny percentage of the number of 
people that are aborted. . . .  I don’t think there is any 
way that one could do an honest report and come up 
with such overwhelming statistics that you could use it as

66

67

This review document is in Hearing, pp. 151-155. 

Hearing, p. 156.



605

a weapon against abortion itself."83 Similarly, in his 
meeting with the National Organization of Episcopalians 
for Life, he stated "The problems that truly present 
health problems are someplace down here. They’re 
quite minuscule."84

* * *

83 Transcript of meeting of Dr. C. Everett Koop with the American 
Council on Science and Health, February 4, 1988, p. 7.

M Transcript of Dr. C. Everett Koop’s meeting with the National 
Organization of Episcopalians for Life, March 31, 1988, p. 8; available 
in subcommittee files.



606

Plaintiffs’ Exhibit 89: 
Diagnostic Criteria for 

Post-Traumatic Stress Disorder

A. The person has experienced an event that is outside 
the range of usual human experience and that would 
be markedly distressing to almost anyone, e.g., 
serious threat to one’s life or physical integrity; 
serious threat or harm to one’s children, spouse, or 
other close relatives and friends; sudden destruction 
of one’s home or community; or seeing another 
person who has recently been, or is being, seriously 
injured or killed as the result of an accident or 
physical violence.

B. The traumatic event is persistently reexperienced in 
at least one of the following ways:
(1) recurrent and intrusive distressing recollections 

of the event (in young children, repetitive play in 
which themes or aspects of the trauma are 
expressed)

(2) recurrent distressing dreams of the event
(3) sudden acting or feeling as if the traumatic event 

were recurring (includes a sense of reliving the 
experience, illusions, hallucinations, and 
dissociative [flashback] episodes, even those that 
occur upon awakening or when intoxicated)

(4) intense psychological distress at exposure to 
events that symbolize or resemble an aspect of 
the traumatic event, including anniversaries of 
the trauma

C. Persistent avoidance of stimuli associated with the 
trauma or numbing of general responsiveness (not 
present before the trauma), as indicated by at least 
three of the following:
(1) efforts to avoid thoughts or feelings associated



607

with the trauma
(2) efforts to avoid activities or situations that 

arouse recollections of the trauma
(3) inability to recall an important aspect of the 

trauma (psychogenic amnesia)
(4) markedly diminished interest in significant 

activities (in young children, loss of recently 
acquired developmental skills such as toilet 
training or language skills)

(5) feeling of detachment or estrangement from 
others

(6) restricted range of affect, e.g., unable to have 
loving feelings

(7) sense of a foreshortened future, e.g., does not 
expect to have a career, marriage, or children, or 
a long life

D. Persistent symptoms of increased arousal (not
present before the trauma), as indicated by at least
two of the following:
(1) difficulty falling or staying asleep
(2) irritability or outbursts of anger
(3) difficulty concentrating
(4) hypervigilance
(5) exaggerated startle response
(6) physiologic reactivity upon exposure to events 

that symbolize or resemble an aspect of the 
traumatic event (e.g., a woman who was raped in 
an elevator breaks out in a sweat when entering 
any elevator)

E. Duration of the disturbance (symptoms in B, C, and
D) of at least one month.

Specify delayed onset if the onset of symptoms was at
least sue months after the trauma.



608

EXCERPTS FROM VERIFICATIONS FILED IN 
SUPPORT OF PLAINTIFFS’ 

PRELIMINARY INJUNCTION MOTION

Excerpts from Verification of Sue Roselle 
(Apr. 18, 1988)

VERIFICATION OF SUE ROSELLE 

* * *
6. WHS provides approximately 11,800 free 

pregnancy tests and 7,600 first and early second trimester 
abortions each year. The abortion procedure costs as 
follows: $275 if twelve weeks or less from the last 
menstrual period; $375 if thirteen to fourteen weeks 
from the last menstrual period; and $500 if fifteen to 
sixteen weeks from the last menstrual period. The fee 
includes the abortion procedure, laboratory testing, 
personal counseling including contraceptive care, 
pathological examination and medical supervision during 
the post-surgical recovery period.

7. If our clients are eligible for medical assistance, 
WHS takes the necessary information and seeks 
reimbursement from the Commonwealth. Medical 
assistance is available only where the abortion is 
necessary because of a life-threatening condition, or 
because the patient was a victim of rape or incest. In 
1987, WHS was reimbursed for 249 such abortions. 
Where a client receives medical assistance from the 
state, but is not eligible for medical assistance for an 
abortion, WHS nevertheless will discount the cost of the 
abortion. Last year WHS accomodated 1,470 clients who 
were unable to pay the full amount. WHS has never 
turned away any client seeking an abortion merely 
because of inability to pay.



609

*  *  *

9. Our patients come primarily from Allegheny 
County. In 1987, however, 761 of our abortion patients 
came from areas in excess of two hours traveling time 
(100 miles) from the clinic.

*  *  *

11. When they present themselves at the clinic, if 
indicated, women are examined by a nurse practitioner 
or physician’s assistant and everyone receives a 
pregnancy test and blood tests. In addition, all women 
are required to have an individual interview with a 
counselor on the day their abortion is to be performed. 
These interviews routinely last twenty minutes to an 
hour. During this interview, a woman is counseled with 
respect to her options and her decision to have an 
abortion. In that connection, the counselor seeks to 
ensure that the woman is not unduly ambivalent about 
her decision and that she is not being coerced. In 
addition, the counselor discusses future contraceptive use 
with the patient. If the patient appears ambivalent about 
her decision, the counselor will refer her to one of our 
staff therapists and the abortion will be rescheduled to 
give the patient more time to consider her options. On 
occasion, the clinic will refuse to perform the abortion if 
convinced of a patient’s continued ambivalence. This is 
rare, however, because the great majority of our patients 
have absolutely decided to have an abortion before 
seeking medical care.

* *

20. In general, WHS supports and encourages 
parental involvment in the abortion decision where



610

possible.
21. Under Section 3206, WHS will require the 

presence of a parent in order to give counseling to that 
parent sufficient to assure the parent is able to give his 
or her informed consent. We foresee no circumstances 
in which we would secure parental informed consent 
over the telephone, by mail, or means other than by an 
in-person visit to our clinic. This, in turn, may cause 
serious delays in the abortion even in cases where the 
parent is prepared to consent. Many parents will find it 
difficult to come to the clinic for the necessary 
counseling because of their work schedules, illness or 
other commitments.

22. The implementation of the parental consent 
requirement will cause administrative and scheduling 
nightmares inasmuch as at present, we normally do 
parental counseling on the day of the abortion 
procedure, which are performed only three days a week.

*  *  *

24. Some parents may not be able to come to the 
clinic for many days, or possibily even weeks, after their 
minor daughter has decided to seek an abortion. This 
would be true even in cases where the parent fully 
consents to the minor’s having an abortion. The 
resulting delay caused by this could be both dangerous 
and prohibitive since most minors decide to have an 
abortion much later in their pregnancies than adults.

25. The additional costs incurred for minors and 
their parents who must come long distances -- whether 
together or separately -- could also be extremely 
burdensome and may result in the minor’s effectively 
being deprived of her right to have an abortion.

26. Another problem with Section 3206 is that it 
does not state what procedures and documentation are



611

necessary for obtaining legally valid parental consent. 
Thus, because this section is so vague and uncertain, 
WHS will have to be extremely conservative in deciding 
on the kind of identification that will be required from 
the parent, resulting in further delay of the abortion 
procedure. If the parent does not have the proper 
documentation of parentage, the abortion would have to 
be rescheduled.

27. WHS also is greatly concerned about the effect 
the parental consent and judicial bypass provisions will 
have on minors themselves. Adolescents as a group are 
reluctant to establish contact with unfamiliar 
organizations. It is a difficult enough chore to call the 
clinic. The additional burden of being forced to go to a 
parent when reluctant to face a court may have one of 
several disastrous results for the adolescent: (a) the teen 
will come in later for her abortion because of the greater 
time it will take her to resolve the higher level of fear 
and confusion created by the legal requirements. The 
later she has an abortion, the more likely she is to have 
complications; (b) the teen will tell no one until the 
pregnancy is so advanced that someone else finally 
confronts her. The parents and teen may then have no 
options because the advanced stage of the pregnancy at 
this time precludes an abortion; (c) the teen will attempt 
a self-induced or illegal abortion with resulting 
permanent damage to her reproductive system or death; 
(d) the teen will run away from home; or (e) the 
situation will be deemed unresolvable by the teen and 
suicide will be viewed as the only escape. (Adolescents 
have been documented to have one of the highest suicide 
rates of any segment of the population).

28. Sections 3207(b) and 3214(f) will require WHS, 
respectively, to file annual reports identifying our facility 
and quarterly reports showing the total number of 
abortions performed per trimester of pregnancy. Under



612

the Act, these reports, if filed by facilities receiving any 
state-appropriated funds, will be open to public 
inspection.

29. WHS does receive state-appropriated funds in 
the form of state medical assistance funding for the 
victims of rape and incest and for patients whose 
pregnancy must be terminated because of physical 
conditions that are life-threatening. Additionally, WHS 
receives federal funds that are appropriated by the state 
for the purpose of counseling and testing clients who are 
in high risk groups for exposure to the Human 
Immunodeficiency Virus (HIV), the precursor of AIDS.

30. Inasmuch as WHS does receive state- 
appropriated funds, we are extremely troubled that our 
reports will be open for public inspection and copying. 
Over the years, WHS has been the target of continued 
harassment and violence by anti-abortion groups. On 
many occasions we have discovered anti-abortion 
advocates going through our trash to find any scraps of 
information they might put to use. Public disclosure of 
the information filed in the reports required by the Act 
is certain to enhance the frequency and intensity of the 
harassment and violence. In turn, women will be further 
intimidated from using our clinic for fear of being 
subjected to verbal and physical abuse. The intimidation 
deters all of our clients, and not just those pursuing their 
legal right to have an abortion. Many women intending 
to have an abortion in our clinic have also told me of 
their fear that the procedure itself will be interrupted by 
demonstrations, bomb scares and similar activities. 
Finally, such anti-abortion activities adversely effect the 
ability of WHS to operate its business and offer its 
services to the public.

31. In addition, Sections 3207(b) and 3214(f) provide 
that confidentiality of the required reports is conditioned 
upon whether a facility has received state-appropriated



613

funds within the 12-month period preceding the filing of 
the report. The retroactivity of this provision is 
disturbing to WHS because, at least with respect to 
reports we must file during the coming year, we have 
been deprived of a choice of whether to protect the 
confidentiality of our records no longer accepting state- 
appropriated funds. In 1987, WHS received medical 
assistance reimbursement for the treatment of only 249 
patients. Had we known that receipt of such a relatively 
small amount of money would threaten the 
confidentiality of WHS records, we may well have 
decided to discontinue accepting medical assistance. 
Similarly, it was only in March of 1988 that WHS 
contracted for state-appropriated federal funding of HIV 
testing and counseling. Before that time WHS had been 
offering HIV testing and counseling for a small fee. Had 
we known of the confidentiality implications of our 
accepting the federal funds, we may have decided not to 
enter into the contract.

* *

34. The identification of facilities in Department 
reports is certain to open the door to increasing 
anti-abortion harassment and violence. In addition, 
some of the information that is required to be reported, 
coupled with the Department’s right to identify facilities, 
exacerbates the risk. For example, under 3214(h), all 
physicians are required to report complications that they 
judge to have resulted from an abortion or attempted 
abortion. The definition of "complication" is vague; and 
the reporting requirment could permit physicians to 
exploit, abuse, or even inadvertently misconstrue the 
complications reporting procedure to the derogation of 
facilities such as WHS.

35. The second grave risk of section 3214 is the risk



614

posed by the requirement that the names of all referring 
and performing physicians must be reported to the 
Department. I can state with complete certainty that 
because of the harassment and violence directed toward 
physicians who refer or perform abortions procedures, 
WHS will lose many of its referring physicians and 
possibly some of its performing physicians if this section 
goes into effect.

36. Many of our referring physicians in particular, 
are extremely protective of their anonymity because of 
legitimate fears (often based on past experience) that any 
kind of documentation or record-keeping connecting 
them with any phase of the abortion decision could cause 
them to lose their medical practice, hospital and other 
professional privileges, as well as the ability to reside in 
their communities peacefully and without harassment.

37. For example, I personally know two medical 
doctors who, although they do not perform abortions, do 
refer clients to WHS for abortions on the strict condition 
that we not use their names in any WHS reports. They 
insist upon this because in the past, each has been 
subjected to public abuse, picketing and pamphleteering 
based on their having performed or referred abortions 
during their medical residencies. Each of these doctors 
has told me emphatically that under no circumstances 
would he refer any abortions to WHS or any other clinic 
under the new Act — even if there were no risk of public 
disclosure at all. The mere requirement that their names 
appear on reports filed with a Commonwealth agency is 
sufficient, based on their past experience, to deter them 
from making any future referrals.

38. The net effect of this will be that women will be
unable to find physicians willing to refer or to perform
abortions for them, which in turn, operates to deny them
their right to choose to have an abortion.

* * *



615

Excerpts from Verification of 
Sylvia Stengle (Apr. 18, 1988)

VERIFICATION OF SYLVIA STENGLE

* *

7. For patients who receive medical assistance from 
the Commonwealth, AWC’s fee for an abortion is $195. 
In the case of those medical assistance patients who 
require an abortion because of a life-threatening disease 
or because they were victims of rape or incest, AWC -- 
in the past -- has received reimbursement from the state, 
so that no fee was charged directly to the patient. The 
amount involved is relatively small. In 1987, AWC 
received less than $4,000 in medical assistance funds.

8. With the passage of this Act, AWC has decided 
to stop taking medical assistance funds from the state 
immediately.

* *

10. Our patients come primarily-from an 18-county 
area in northeastern Pennsylvania encompassing the 
counties of Lehigh, Northampton, Carbon, Schuylkill, 
Luzerne, Lackawanna, Lebanon, Berks, Bucks, Pike, 
Chester, Lancaster, Susquehanna, Wayne, Monroe, 
Montgomery, Columbia and Wyoming. Many of these 
counties have no local services available to women 
seeking abortions, AWC being the closest facility to 
which the women can turn. In 1987, 138 (3.26%) of our 
abortion patients came from areas in excess of two hours 
traveling time (100 miles) from the clinic; 1,220 or 29% 
came from areas in excess of lh hours traveling time (75 
miles); and 2,276 or 54% came from areas in excess of 1



616

hour traveling time (50 miles).

* * *

17. If the patient appears ambivalent about her 
decision to have an abortion, the counselor will review 
options and suggest that the patient take more time to 
consider her decision before terminating the pregnancy. 
On occasion, the clinic has refused to permit an abortion 
if, after consultation, the counselor and the clinic 
supervisor are convinced of the woman’s extreme 
ambivalence, coercion, or that she is otherwise overly 
distraught. Sometimes, we will refer these women to 
outside counselors. Such instances are infrequent, 
however, because the great majority of our patients have 
absolutely decided to have an abortion before making an 
appointment here.

*  *  *

24. Section 3206 requires that in order for a minor 
who is less than 18 years old and not emancipated to 
obtain an abortion, either one parent must give his or 
her informed consent to the abortion, or the minor must 
go through a judicial bypass procedure. This is certain to 
cause dangerous delays which could effectively deprive 
many minors of their right to have an abortion. Often, 
minors are overwhelmed by the prospect of involving 
parents because of fears of retaliation or rejection by the 
parents. Even where parents are involved and willing to 
consent, they may have scheduling problems making it 
difficult for them to come to the clinic.

25. Under the parental consent provision of the Act, 
AWC will have to insist upon a personal visit to the 
clinic by a parent so that we can give the counseling 
necessary to assure that the parent’s (and minor’s)



617

consent is informed. Normally, we will want the parent 
and daughter to come together for counseling, although 
this will not always be possible.

26. Requiring a consenting parent to come to the 
clinic for counseling and consent will most certainly 
cause serious delays -- even in cases where a parent is 
willing to consent. Many parents will find it difficult to 
visit the clinic because of work schedules, illness, 
burdensome travel distances and costs, or other 
commitments.

* * *

28. Some parents may not be able to get to the 
clinic for days, even weeks, after the daughter has 
decided to seek an abortion. Ensuing delays could be 
both dangerous and prohibitive since it is 
well-documented that minors as a group decide to have 
abortions much later in their pregnancies than do adults.

29. The likelihood of dangerous delay is particularly 
great in our part of the state because AWC services such 
a large (18-county) area. Furthermore, travel time and 
costs for minors and their parents will surely increase in 
cases where the parent and minor will not be able to 
come for joint counseling on the day of the procedure, 
the delay and costs will be even greater.

30. An antecedent, and perhaps more serious delay 
arises from the minor’s fear and hesitation in divulging to 
her parents that: first, she has been sexually active; 
second, that she is pregant; and third; that she wishes to 
have an abortion. The prospect of the disruption and 
trauma erupting from such disclosure may cause the 
minor to delay telling her parents for days and even 
weeks. It is well-known that the risk of complications 
from an abortion increase dramatically with each day’s 
delay, particularly after the 10 to 12 weeks gestation 
period.



618

31. Another disturbing aspect of 3206 is that it does 
not state what procedures and documentation are 
necessary for obtaining legally valid parental consent. 
This vagueness leaves AWC uncertain as to what we 
must require. We are concerned that no matter what 
identification procedures we adopt, we may be subject to 
civil liability. We are even more concerned about the 
penalties to our physicians who may be subject to 
suspension or revocation of their medical licenses. In 
any event, because the Act fails to provide guidance, we 
will be forced to implement stringent documentation 
requirements which, in turn, will cause further delays in 
the abortion procedure.

*  *  *

34. Second trimester abortions involve far more risks 
of complications than earlier abortions, and each passing 
day enhances these risks. At some point, the minor will 
suddenly find herself with no options and be forced to 
continue the pregnancy. Some will respond by trying to 
obtain illegal abortions or by attempting to self-induce an 
abortion. Others may resort to suicide. Problem 
pregnancy is a leading cause of suicide among adolescent 
women. In the past, AWC has had to do suicide 
counseling with pregnant minors. The new Act will only 
exacerbate the trauma and risks for these young women.

35. AWC is also troubled by sections 3207(b) and 
3214(f) of the Act. Under these sections, AWC’s annual 
reports (identifying our facility and its affiliates) and 
quarterly reports (stating the total number of abortions 
performed per trimester of pregnancy) to the 
Department of Health will be open for public inspection 
and copying as long as AWC receives state-appropriated 
funds.

* * *



619

37. During the past 12 months, AWC has received 
stateappropriated funds in the form of reimbursements 
for services to patients who are under state medical 
assistance. We are therefore extremely concerned about 
the prospect of our reports having no confidentiality. 
Over the years, AWC has been the target of continued 
harassment and threats of violence by anti-abortion 
groups. These groups are eager to obtain as much 
information as possible to fuel their activities. Public 
disclosure of the information filed in the reports is 
certain to intensify their activities. Women, in turn, will 
be even more intimidated from using our clinic for fear 
of being subject to verbal or even physical abuse. Too, 
anti-abortion harassment severely cripples AWC’s ability 
to operate the clinic and offer its services to the public. 
Had we known that receipt of a relatively small amount 
of state funds would compromise the confidentiality of 
AWC’s records, we could have decided to discontinue 
accepting state medical assistance as a means of 
containing the level of harassment we now endure.

38. As to the future, AWC has decided that with the 
enactment of the Act, it will terminate immediately all 
receipt of state-appropriated funding so that in 12 
months time, the confidentiality of our records can be 
protected. This will mean that AWC will have to insist 
that patients who are on medical assistance must pay for 
our services or else be turned away. Thus, in the final 
analysis, it will be poverty-level women who will be the 
real victims of the Act.

39. AWC also finds it sadly ironic that while on the 
one hand, the Commonwealth reimburses the cost of 
abortions for medical assistance patients who were 
victims of rape, incest or have life-threatening conditions, 
and on the other, it penalizes providers of those 
abortions by depriving them of the right of confidentiality 
over their records.



620

40. Section 3214(a) sets out additional reporting 
requirements including, among other things, 
identification of all physicians who refer for, or perform 
abortions, and the reporting of complications that may 
have resulted from an abortion or attempted abortion. 
In addition, Section 3214(e) permits the Department of 
Health to issue an annual report based upon this 
information, and provides only that the report shall not 
lead to the disclosure of the identity of any person filing 
a report or about whom the report is filed.

41. These two provisions seriously threaten the 
availability of referring and performing physicians to 
AWC, and therefore affect its ability to continue 
providing services to our patients. Many of our 
physicians are highly protective of their anonymity 
because of legitimate fears of anti-abortion activities. 
Many physicians who would otherwise work for AWC, 
will not because of legitimate fears of anti-abortion 
harassment, picketing and violence. Likewise, referring 
physicians have told me that any kind of documentation - 
- even if only state-filed reports not open to the public -  
connecting them with any aspect of the abortion decision 
could cause them to be subject to harassment in the 
communities in which they reside.

42. For example, several of AWC’s present referring 
physicians will not permit us to send correspondence to 
their offices for fear that members of their own staffs 
will divulge to anti-abortion groups that they refer 
patients for abortions. One has told me that the new 
record-keeping provisions of 3214 would mean that many 
doctors will stop referring for abortions altogether. 
Thus, patients coming to these doctors for help would 
have to go elsewhere for information about AWC or 
similar facilities, even though the information is at the 
doctors’ fingertips.

43. Another doctor who has performed abortions for



621

AWC in the past has told me that in light of the new 
Act, he would not consider working for the clinic any 
longer for fear of public exposure and harrassment. At 
one time, this doctor had performed abortions in his 
private practice but stopped doing so after receiving 
threats that anti-abortionists would begin picketing his 
home.

44. A third doctor with whom I have spoken, and 
who also stopped performing abortions because of 
threats from anti-abortionists, has told me that he too 
would be unwilling to refer patients to AWC for fear of 
reprisal and harassment. He also told me that he 
believes the hospitals, in order to preserve the 
confidentiality of their records, will stop performing 
abortions, and that private doctors who perform 
abortions will stop accepting patients on state medical 
assistance. This will have serious repercussions for many 
women on medical assistance.

45. For example, women with serious health 
problems cannot normally go to a clinic to have an 
abortion. Rather, they would have to go to a hospital for 
the procedure. If the woman is on public assistance, 
however, and the doctor and/or hospital refuse to 
perform her abortion, the woman will have no options 
whatsoever -- other than to lie about her physical 
condition so as to secure an abortion at a clinic (and 
thereby take the risk of serious medical complications). 
These women will be effectively and wholly deprived of 
their right to choose to have an abortion.

46. In my opinion, the sole purpose of the Act’s 
various reporting requirements, along with the attendant 
risks of public disclosure of certain information in these 
reports, is to harass and deter physicians and clinics.

* * *



RECORD PRESS, INC., 157 Chambers Street, N.Y. 10007 (212) 619-4949
83365 • 58