PURPOSE: Under section 188.055, RSMo, the Department of Health and Senior Services is responsible for providing abortion forms to abortion facilities, hospitals, and physicians. This rule establishes the content of the report of induced termination of pregnancy to be filed with the department for statistical purposes for each abortion performed or induced as required by section 188.052, RSMo.
PUBLISHER'S NOTE: The secretary of state has determined that the publication of the entire text of the material which is incorporated by reference as a portion of this rule would be unduly cumbersome or expensive. This material as incorporated by reference in this rule shall be maintained by the agency at its headquarters and shall be made available to the public for inspection and copying at no more than the actual cost of reproduction. This note applies only to the reference material. The entire text of the rule is printed here.
(1) The abortion report will include the following items: name of abortion facility or hospital; the city, town, or location of the abortion facility or hospital; county where the abortion facility or hospital is located; patient identification number; age of patient; marital status of patient; date of abortion; residence of patient (state, county, city or town, inside city limits (yes or no), and zip code); patient's race; patient's ethnicity; patient's education; previous pregnancy history; number of live births now living; number of live births now dead; number of spontaneous terminations and number of induced terminations; procedure used to complete abortion; type of termination procedure used (
check only one (1)); date last normal menses began; clinical estimate of gestation; method of estimating gestational age; biparietal diameter measurement (if gestation age greater than or equal to eighteen (18) weeks by date of last normal menses or clinical estimate); name and signature of attending physician; physician's Missouri license number; name of person completing report; fetus viable (yes or no); certifications of the physician who performed or induced the abortion; physician certification they have no knowledge that the woman sought the abortion solely because of a prenatal diagnosis, test, or screening indicating Down Syndrome or of the potential of Down Syndrome in the unborn child (yes or no); physician certification they have no knowledge that the woman sought the abortion solely because of the sex or race of the unborn child (yes or no); physician certification that the abortion was due to a "medical emergency," a condition which, based on reasonable medical judgment, so complicates the medical condition of the pregnant woman as to necessitate the immediate abortion of her pregnancy to avert the death of the pregnant woman or for which a delay will create serious risk of substantial and irreversible physical impairment of a major bodily function of the pregnant woman (yes or no);
1) Has the patient ever served on active duty in the Armed Forces of the United States and separated from such service under conditions other than dishonorable (yes or no); and
2) If the patient has answered question (1) in the affirmative, would the patient like to receive information and assistance regarding the agency's veteran services (yes or no). The information shall be reported on the Abortion Report, which is incorporated by reference in this rule as published October 2022 and may be obtained at
www.health.mo.gov or by calling (573) 751-6387. Within forty-five (45) days from the date of abortion, submit this form to: Department of Health and Senior Services, Attention: Bureau of Vital Records, PO Box 570, Jefferson City, MO 65102. This rule does not incorporate any subsequent amendments or additions.
(2) The abortion report shall be signed by the attending physician and submitted to the Department of Health and Senior Services, Bureau of Vital Records, PO Box 570, Jefferson City, MO 65102-0570, within forty-five (45) days of the abortion.
