S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  4927--A
                                                         Cal. No. 138
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 27, 2023
                                ___________
 
 Introduced by M. of A. PAULIN, GONZALEZ-ROJAS, JACOBSON, SIMON, EPSTEIN,
   LEVENBERG,  CLARK -- read once and referred to the Committee on Health
   -- ordered to a third reading, amended and ordered reprinted,  retain-
   ing its place on the order of third reading

 AN ACT to amend the public health law, in relation to the duty to inform
   maternity  patients  about  the risks associated with cesarean section
   for patients undergoing a  primary  cesarean  section  and  to  inform
   maternity  patients  about  the reason for performing primary cesarean
   section delivery
 
   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-m to read as follows:
   § 2500-M. DUTY OF PROVIDERS  OF  PRIMARY  CESAREAN  SECTION  MATERNITY
 SERVICES  TO INFORM. 1. THE COMMISSIONER SHALL REQUIRE THAT EVERY MATER-
 NAL HEALTH CARE PROVIDER, DEFINED AS ANY PHYSICIAN, MIDWIFE, NURSE PRAC-
 TITIONER, OR PHYSICIAN ASSISTANT, OR OTHER MATERNAL HEALTH CARE  PRACTI-
 TIONER  ACTING  WITHIN  HIS  OR HER LAWFUL SCOPE OF PRACTICE ATTENDING A
 PREGNANT WOMAN, TO PROVIDE WRITTEN COMMUNICATION TO EACH PREGNANT  WOMAN
 FOR  WHOM A PRIMARY CESAREAN SECTION DELIVERY, DEFINED AS FIRST LIFETIME
 DELIVERY VIA CESAREAN SECTION, IS  RECOMMENDED  AS  A  PLANNED  CESAREAN
 SECTION  DELIVERY  BASED ON MEDICAL NECESSITY, THAT THE PRIMARY CESAREAN
 SECTION IS RECOMMENDED AND TO PROVIDE THE JUSTIFICATION FOR THE  PRIMARY
 CESAREAN SECTION PRIOR TO THE DELIVERY.
   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  COMMISSIONER  SHALL  REQUIRE THAT THE
 MATERNAL HEALTH CARE PROVIDER PROVIDE WRITTEN COMMUNICATION TO THE PREG-
 NANT WOMAN REQUESTING THE PRIMARY CESAREAN SECTION INDICATING  THAT  THE
 PRIMARY  CESAREAN  SECTION IS NOT MEDICALLY NECESSARY AND TO EXPLAIN THE
 RISKS ASSOCIATED WITH THE CESAREAN SECTION PRIOR TO THE DELIVERY.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD08633-02-4
 A. 4927--A                          2
 
   3. IN THE EVENT THAT THE  PRIMARY  CESAREAN  SECTION  IS  NOT  PLANNED
 PRENATALLY, THE COMMISSIONER SHALL REQUIRE THAT THE MATERNAL HEALTH CARE
 PROVIDER  WHO  PERFORMED  THE  CESAREAN SECTION PROVIDE COMMUNICATION IN
 WRITING TO EACH WOMAN WHO DELIVERED VIA  PRIMARY  CESAREAN  SECTION  THE
 REASON FOR THE UNPLANNED CESAREAN SECTION AFTER THE DELIVERY.
   4.  THE  PROVIDER  SHALL  PROVIDE  COMMUNICATION TO THE PATIENT WITH A
 PLANNED CESAREAN SECTION THAT SHALL INCLUDE, BUT NOT BE LIMITED TO,  THE
 FOLLOWING INFORMATION, IN THE SUMMARY OF THE REPORT SENT TO THE PATIENT:
   "CESAREAN  BIRTH CAN BE LIFE-SAVING FOR THE FETUS, THE MOTHER, OR BOTH
 IN SOME CASES. HOWEVER,  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. CESAREAN DELIVERY ALSO  CARRIES  HIGHER  RISK  OF  INFANT
 INJURY  AND  CAN  RESULT  IN SITUATIONS REQUIRING THE NEONATAL INTENSIVE
 CARE UNIT (NICU). 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  POSSI-
 BLE,  DEPENDING UPON YOUR HEALTH CHARACTERISTICS. IN FUTURE PREGNANCIES,
 THERE IS RISK OF THE CESAREAN SECTION SCAR BREAKING DURING PREGNANCY  OR
 LABOR  (UTERINE  RUPTURE).  ADDITIONALLY,  WOMEN'S  RISK  OF  DEVELOPING
 PLACENTA PREVIA OR ACCRETE IN FUTURE PREGNANCIES IS HIGHER AFTER CESARE-
 AN DELIVERIES THAN VAGINAL BIRTHS. SPEAK TO YOUR  HEALTH  CARE  PROVIDER
 ABOUT YOUR OPTIONS AND ANY QUESTIONS YOU MAY HAVE."
   5.  THE  PROVIDER  SHALL  PROVIDE COMMUNICATION TO THE PATIENT WITH AN
 UNPLANNED CESAREAN SECTION THAT SHALL INCLUDE, BUT NOT  BE  LIMITED  TO,
 THE  FOLLOWING  INFORMATION,  IN  THE  SUMMARY OF THE REPORT SENT TO THE
 PATIENT:
   "YOUR MOST RECENT DELIVERY WAS VIA CESAREAN SECTION. CESAREAN DELIVERY
 CAN BE LIFE-SAVING FOR THE FETUS, THE MOTHER, OR  BOTH  IN  SOME  CASES.
 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 YOUR HEALTH CHARACTERISTICS. IN FUTURE PREGNANCIES, THERE  IS  RISK
 OF THE CESAREAN SECTION SCAR BREAKING DURING PREGNANCY OR LABOR (UTERINE
 RUPTURE).  ADDITIONALLY,  WOMEN'S  RISK OF DEVELOPING PLACENTA PREVIA OR
 ACCRETE IN FUTURE PREGNANCIES IS HIGHER AFTER CESAREAN  DELIVERIES  THAN
 VAGINAL  BIRTHS.  SPEAK  TO YOUR HEALTH CARE PROVIDER ABOUT YOUR OPTIONS
 AND ANY QUESTIONS YOU 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  promulgate  any rule or regulation necessary for the timely
 implementation of this act on its effective date.