19 CSR 10-15.010
Abortion Report
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.
AUTHORITY: sections 188.055 and 192.006, RSMo 2016, and
section 188.052, RSMo Supp. 2022*. This rule was previously filed
as 13 CSR 50-151.010 and 19 CSR 30-15.010. Original rule filed Sept.
30, 1980, effective Jan. 12. 1981. Changed to 19 CSR 10-15.010, July
30, 1998. Amended: Filed Oct. 24, 2017, effective April 30, 2018.
Amended: Filed Sept. 27, 2022, effective April 30, 2023.
*Original authority: 188.052, RSMo 1979, amended 2019; 188.055, RSMo 1974,
amended 1979; and 192.006, RSMo 1993, amended 1995.