S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    318
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                (PREFILED)
 
                              January 9, 2019
                                ___________
 
 Introduced  by M. of A. PAULIN, GOTTFRIED, GALEF, ARROYO, BARRON, BLAKE,
   DICKENS, D'URSO, COLTON, COOK, EPSTEIN,  SEAWRIGHT,  TAYLOR,  WOERNER,
   McDONOUGH,  JEAN-PIERRE  --  Multi-Sponsored  by -- M. of A. THIELE --
   read once and referred to the Committee on Health

 AN ACT to amend the public health law, in relation to informing materni-
   ty patients about the risks associated with cesarean section
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  The  public health law is amended by adding a new section
 2500-l to read as follows:
   § 2500-L. DUTY OF PROVIDERS  OF  PRIMARY  CESAREAN  SECTION  MATERNITY
 SERVICES  TO  INFORM.  1.  (A) EVERY MATERNAL HEALTH CARE PROVIDER SHALL
 PROVIDE WRITTEN COMMUNICATION TO EACH PREGNANT WOMAN FOR WHOM THE MATER-
 NAL HEALTH CARE PROVIDER RECOMMENDS A PRIMARY CESAREAN SECTION DELIVERY,
 STATING THAT THE PRIMARY CESAREAN SECTION IS RECOMMENDED AND TO  PROVIDE
 THE JUSTIFICATION INCLUDING POTENTIAL RISKS AND BENEFITS FOR THE PRIMARY
 CESAREAN  SECTION  PRIOR  TO  THE  DELIVERY,  AS  PART OF THE PROCESS OF
 OBTAINING INFORMED CONSENT TO THE PRIMARY CESAREAN SECTION.
   (B) AS USED IN THIS SECTION:
   I. "MATERNAL HEALTH CARE PROVIDER" OR "PROVIDER" SHALL MEAN  A  PHYSI-
 CIAN, MIDWIFE, NURSE PRACTITIONER, OR PHYSICIAN ASSISTANT, ACTING WITHIN
 HIS  OR  HER  SCOPE  OF  PRACTICE,  MANAGING THE PREGNANCY OF A PREGNANT
 WOMAN.
   II. "PRIMARY CESAREAN SECTION DELIVERY" MEANS A FIRST LIFETIME  DELIV-
 ERY BY CESAREAN SECTION FOR A WOMAN.
   2.  IN  THE  EVENT  THAT  A  PRIMARY  CESAREAN  SECTION  IS NOT DEEMED
 MEDICALLY NECESSARY BY THE PROVIDER BUT THE PATIENT REQUESTS  A  PLANNED
 CESAREAN  SECTION  DELIVERY,  THE  MATERNAL  HEALTH  CARE PROVIDER SHALL
 PROVIDE WRITTEN COMMUNICATION TO THE PREGNANT WOMAN INDICATING THAT  THE
 PRIMARY  CESAREAN  SECTION  IS NOT MEDICALLY NECESSARY AND INCLUDING THE
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                       [ ] is old law to be omitted.
                                                            LBD01662-01-9

 A. 318                              2
 
 EXPLANATIONS REQUIRED UNDER SUBDIVISION FOUR OF THIS SECTION,  PRIOR  TO
 THE DELIVERY.
   3. IN THE EVENT THAT THE PRIMARY CESAREAN SECTION IS PERFORMED BUT NOT
 PLANNED PRENATALLY, THE MATERNAL HEALTH PROVIDER WHO PERFORMED THE CESA-
 REAN  SECTION  SHALL  PROVIDE  COMMUNICATION  IN  WRITING TO THE PATIENT
 EXPLAINING THE REASON FOR THE UNPLANNED CESAREAN SECTION  AND  INCLUDING
 THE  EXPLANATIONS REQUIRED UNDER SUBDIVISION FOUR OF THIS SECTION, AFTER
 THE DELIVERY.
   4. THE WRITTEN COMMUNICATION ABOUT A PRIMARY  CESAREAN  SECTION  UNDER
 SUBDIVISION ONE OF THIS SECTION SHALL EXPLAIN AT LEAST THE FOLLOWING:
   (A)  CESAREAN  BIRTH  CAN BE LIFE-SAVING FOR THE FETUS, THE MOTHER, OR
 BOTH IN SOME CASES.
   (B) POTENTIAL MATERNAL  INJURIES  ASSOCIATED  WITH  CESAREAN  DELIVERY
 INCLUDE  BUT  ARE  NOT  LIMITED  TO:    HEAVY BLOOD LOSS THAT RESULTS IN
 HYSTERECTOMY OR A BLOOD TRANSFUSION; RUPTURED UTERUS;  INJURY  TO  OTHER
 ORGANS  INCLUDING  THE  BLADDER;  AND  OTHER  COMPLICATIONS FROM A MAJOR
 SURGERY.
   (C) CESAREAN DELIVERY ALSO CARRIES HIGHER RISK OF  INFANT  INJURY  AND
 CAN  RESULT  IN SITUATIONS REQUIRING CARE IN THE NEONATAL INTENSIVE CARE
 UNIT (NICU).
   (D) AFTER A CESAREAN DELIVERY, FUTURE VAGINAL DELIVERIES MAY BE RISKY.
 BECAUSE OF THIS, CESAREAN DELIVERY MAY BE  RECOMMENDED  IN  THE  FUTURE.
 HOWEVER,  VAGINAL BIRTH AFTER CESAREAN (VBAC) MAY BE POSSIBLE, DEPENDING
 UPON THE PATIENT'S HEALTH CHARACTERISTICS.
   (E) IN FUTURE PREGNANCIES, THERE IS RISK OF THE CESAREAN SECTION  SCAR
 BREAKING DURING PREGNANCY OR LABOR (UTERINE RUPTURE).
   (F)  WOMEN'S  RISK  OF DEVELOPING PLACENTA PREVIA OR ACCRETE IN FUTURE
 PREGNANCIES IS HIGHER AFTER CESAREAN DELIVERIES THAN VAGINAL BIRTHS.
   (G) THE PATIENT SHOULD SPEAK TO HER HEALTH  CARE  PROVIDER  ABOUT  HER
 OPTIONS AND ANY QUESTIONS SHE MAY HAVE.
   § 2. This act shall take effect on the one hundred eightieth day after
 it  shall  have  become a law.  Effective immediately, the department of
 health may make regulations and take other  actions  necessary  for  the
 timely implementation of this act on its effective date.