Targeted Regulation of Abortion Providers (TRAP)
North Dakota imposes extra restrictions on abortion providers, despite the fact that all health-care providers already must comply with a variety of federal and state regulations governing health, safety, building and fire codes, and zoning requirements.
Restrictions on Where Abortion Services May Be Provided
North Dakota places medically unnecessary restrictions on where abortion services may be provided. Among the most common TRAP regulations are those restricting the provision of abortion services to hospitals or other specialized facilities, which require doctors to obtain medically unnecessary additional licenses, needlessly convert their practices to mini-hospitals at great expense, or provide abortion care only in hospitals, an impossibility in many parts of the country.
Every provider of medication abortion must enter into a written agreement in which a hospital and a separate doctor who has active admitting privileges and gynecological and surgical privileges at that hospital agree to accept and treat patients if complications arise. Nothing in the statute requires hospitals or doctors to agree to enter into such an arrangement. These requirements on medication abortion are in addition to an extensive list of conditions to which the medication's distributor requires each prescribing doctor to agree. N.D. Cent. Code § 14-02.1-03.5 (Enacted 2011). A court issued a permanent injunction against the law in 2013. MKB Management Corp. v. Burdick, No. 09-2011-CV-02205, (N.D. East Central Dist. July 15, 2013). However, the North Dakota Supreme Court reversed this decision, meaning these restrictions on medication abortion are currently in effect without restriction. MKB Management Corp. v. Burdick, (2014 N.D. 197).
Every physician providing abortion services must have admitting and staff privileges at a hospital within 30 miles of the abortion facility. This law was temporarily enjoined. MKB Management Corp. v. Burdick, No. 09-2011-CV-02205, (N.D. East Central Dist. July 31, 2013). The case settled when the physicians obtained admitting privileges at a nearby hospital. An abortion facility also must have a staff member trained in CPR present at all times when abortion care is scheduled to occur. S.2305, 63rd Gen. Assem., 1st Reg. Sess. (N.D. 2013) (Enacted 2013). North Dakota has an unconstitutional and unenforceable requirement that all abortion services after 12 weeks of pregnancy be provided in a licensed hospital. N.D. Cent. Code § 14-02.1-04(2) (Enacted 1975; Last Amended 1979).
A federal court permanently enjoined the statute based on a stipulation that the law was unconstitutional under Akron v. Akron Ctr. for Reprod. Health, 462 U.S. 416 (1983), and other U.S. Supreme Court precedent. Miks v. Olson, No. A3-82-78 (D.N.D. Aug. 25, 1983) (stipulation for judgment).
Restrictions on Who May Provide Abortion Services
North Dakota prohibits certain qualified health-care professionals from providing abortion services.
Only a physician licensed by the state to practice medicine or osteopathy or employed by the United States using applicable medical standards may provide surgical- or medication-abortion care. N.D. Cent. Code §§ 14-02.1-02(6), -04(1) (Enacted 1975; Last Amended 2011).