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State Laws

Tennessee


Political Information

Executive (Governor)

Anti-choice

Senate

Anti-choice

House

Anti-choice

Abortion-Care Policies

Abortion Providers

Abortion Providers: Restrictions

Tennessee 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

Every abortion provider must have admitting privileges at a hospital in the same or an adjacent county.  Nothing requires a hospital to grant such privileges, and no exception is made for rural areas. § 39-15-202 (h) (Enacted 2012).

Tennessee has an unconstitutional and unenforceable regulatory scheme that is uniquely imposed on abortion providers and needlessly requires them to convert their practices to mini-hospitals. These requirements included:

Any facility used to terminate a pregnancy at any stage is deemed an ambulatory surgical treatment center, and therefore, must comply with all requirements of ambulatory surgical treatment centers despite lack of medical necessity. The statute exempts only those physicians’ offices that do not provide a "substantial number" of procedures. Tenn. Code Ann. § 68-11-201(3) (Enacted 1998).

Under this scheme, abortion facilities-including private physicians’ offices-must comply with dozens of administrative, professional qualification, and physical-plant requirements. Tenn. Comp. R. & Regs. 1200-8-10-.01 to .14. For example, each facility must provide a mattress and pillow as well as a "at least one chair, a bedside table, [and] an over bed tray" despite the fact that there are no overnight patients. Tenn. Comp. R. & Regs. 1200-8-10-.04(20)(b)(3). Each facility must also have one or more surgical suites and the suites are required to meet the same standards as hospital operating rooms, including those using general anesthesia. Tenn. Comp. R. & Regs. 1200-8-10-.06(1)(t) – (v).

A federal court permanently enjoined enforcement of the statute against certain providers due to the vagueness of the phrase "a substantial number of abortions." Bristol Reg’l Women’s Ctr., P.C. v. Tenn. Dep’t of Health, No. 3:99-0465 (M.D. Tenn. Oct. 23, 2001) (order granting judgment in favor of providers in relation to vagueness of statute).  Subsequently, a state court declared the statute to be unconstitutional and unenforceable in all circumstances. Tenn. Dep’t of Health, v. Boyle, No. M2001-01738-COA-R3-CV, 2002 WL 31840685 (Tenn. Ct. App. Dec. 19, 2002).

Tennessee requires any facility that provides surgical abortion care to be classified as an ambulatory surgical center. Tenn. Code Ann. § 68-11-201(3) (Enacted 1998; Last Amended 2015). Two clinics were unable to meet the new requirements by the deadline, so a federal judge issued a preliminary injunction blocking Tennessee officials from enforcing the statute in those two counties. In 2017, the court issued a partial judgment to permanently enjoin the ambulatory surgical center and admitting privileges requirements. Adams & Boyle, P.C. et al v. Slatery et al, No. 3:15-cv-00705 (M.D. Tenn, Aug. 14, 2015).

Another statute imposed additional administrative requirements solely on ambulatory surgical treatment centers providing abortion care. Tenn. Code Ann. §68-11-223 (Enacted 1989). The Tennessee attorney general has concluded that certain administrative requirements imposed solely on abortion facilities were unconstitutional and unenforceable. Tenn. Op. Att’y Gen. No. 89-123 (Sept. 26, 1989).

Tennessee has an unconstitutional requirement that all second-trimester abortion services be provided in a hospital. Tenn. Code Ann. § 39-15-201(c)(2) (Enacted 1989).

The Tennessee Supreme Court struck down the second-trimester hospitalization requirement as unconstitutional under the Tennessee Constitution. Planned Parenthood of Middle Tenn. v. Sundquist, 38 S.W.3d 1 (Tenn. 2000). See also Akron v. Akron Ctr. for Reprod. Health, 462 U.S. 416 (1983) (holding second-trimester hospitalization requirement unconstitutionally burdens a woman’s constitutional right to choose).

Restrictions on Who May Provide Abortion Services

Tennessee prohibits certain qualified health-care professionals from providing abortion services.

Only a physician licensed or certified by the state may provide abortion care. Tenn. Code Ann. § 39-15-201(c) (Enacted 1989).

An additional law states that no nurse practitioner or physician’s assistant may write or sign a prescription for or dispense any medication or provide any procedure involving a medication whose sole purpose is to cause an abortion. Tenn. Code Ann. § 53-10-104(c) (Enacted 1994).


Abortion Rights

Post-Viability Ban

Tennessee’s post-viability abortion restriction states that no abortion may be provided after viability unless necessary to preserve the woman’s life or health.  A copy of the physician’s certificate of necessity must be filed with the district attorney general before the abortion is provided.  Tenn. Code Ann. § 39-15-201(c)(3) (Enacted 1989).

NARAL Pro-Choice America supports the legal framework established in Roe v. Wade. Regarding the right to abortion in the third trimester, Roe allows for restrictions on post-viability abortion so long as they contain adequate exceptions to protect the woman’s life and health. However, many states have bans with inadequate exceptions, no exceptions at all, or define viability as occurring at a particular point in pregnancy. A state may not prohibit abortion prior to viability, which is that point at which a fetus is capable of "meaningful life" outside a woman’s body. Roe v. Wade, 410 U.S. 113, 163 (1973). Because viability is a point that varies with each pregnancy, states may not declare that it occurs at a particular gestational age NARAL Pro-Choice America does not oppose restrictions on post-viability abortion, such as Tennessee’s, that contain adequate exceptions to protect the woman’s life and health.


Abortion Bans Throughout Pregnancy: Procedure Ban

Tennessee has an unconstitutional and unenforceable ban that outlaws abortion procedures as early as 12 weeks.  Tenn. Code Ann. § 39-15-209 (Enacted 1997).

Tennessee’s ban is unconstitutional according to the U.S. Supreme Court’s decision in Stenberg v. Carhart.  530 U.S. 914 (2000).  In Stenberg, the court held that a similar ban, which had no exception to protect a woman’s health and was written so broadly as to ban more than one procedure, placed an undue burden on a woman’s right to choose.

Tennessee’s unconstitutional law makes the knowing or reckless provision of any abortion procedure that falls within a broad definition a felony, unless necessary to preserve the life of a woman endangered by a physical disorder, illness, or injury.  Tenn. Code Ann. § 39-15-209 (Enacted 1997).

There is also a Federal Abortion Ban, which applies nationwide regardless of state law.  The federal ban prohibits certain second-trimester abortion procedures and has no exception for a woman’s health.  In April 2007, the U.S. Supreme Court upheld the ban, making it the first time since Roe v. Wade that the court has upheld a ban on a previability abortion procedure.


Abortion Bans Throughout Pregnancy: Ban by Week

Tennessee outlaws abortion after 20 weeks without an adequate exception to protect women’s health or for cases in which the pregnancy is the result of rape or incest. If a woman qualifies for such an exception, the physician must certify it in writing and a second physician—who cannot be in the same practice as the first—must agree with the assessment. The abortion must be provided in a hospital with "appropriate" neonatal services for premature infants and the physician must have admitting privileges at that hospital. The only exception is if no such hospital exists within 30 miles.

This law specifies that fetal viability must be presumed at 24 weeks. Tenn. Code Ann. § 39-15-211 to -212 (Enacted 2017), S. 1180, 110th Leg, Reg. Sess. (Tenn. 2017).


Near-Total Abortion Ban

In 2019, Tennessee enacted a near-total ban on abortion, to become effective if the Supreme Court overturns Roe v. Wade.  The ban prohibits any person from using or prescribing any instrument, medicine, drug, substance, or device with intent other than to increase the probability of a live birth unless necessary to prevent the death of the pregnant person.  A person who provides a prohibited abortion is guilty of a Class C Felony, punishable by three (3) to fifteen (15) years in prison and a fine up to $10,000. TN ST § 39-15-213 (Enacted 2019), TN ST § 40-35-111.


Biased Counseling

Biased Counseling

The informed written consent of a woman must be obtained prior to an abortion. Tenn. Code Ann. § 39-15- 202 (Enacted 1989; Last Amended 2015).  

A court held that additional provisions of this law, providing biased counseling, physician-only counseling, and mandatory-delay requirements, are unconstitutional.  Planned Parenthood of Middle Tenn. v. Sundquist, 38 S.W.3d 1 (Tenn. 2000). However, in 2014, voters approved a ballot measure that amends the state constitution and allows elected officials to impose new restrictions on abortion rights. In 2015, the legislature passed and the governor signed this biased-counseling restriction into law. Tenn. Code Ann. § 39-15-202 (Enacted 1989; Last Amended 2015).   

These provisions provide that a woman may not obtain an abortion until the third day following the day the attending physician recites a state-mandated lecture that must include:  (1) the number of weeks elapsed from the probable time of conception and, if more than 24 weeks have elapsed, that the "child" may be viable and the physician has "a legal obligation to take steps to preserve the life" of a viable "child"; (2) that "abortion in a considerable number of cases constitutes a major surgical procedure"; (3) that "numerous" public and private agencies and services are available to assist her during her pregnancy and after the birth of the child and that her physician will provide her with a list of such agencies and services upon request; and (4) the risks and benefits associated with abortion and with childbirth.  Tenn. Code Ann. § 39-15-202 (Enacted 1989; Last Amended 2015).

In addition, the Tennessee attorney general has issued an opinion stating that this informed-consent law — (minus the provisions previously ruled unconstitutional) applies to the use of mifepristone because Tennessee law defines abortion as including the use of a medication. Tenn. Op. Att’y Gen. No. 01-030 (Mar. 7, 2001).


Mandatory Delays

Mandatory Delay

Tennessee requires that a woman wait 48 hours between the time she receives biased-counseling materials and when she can get the abortion – creating a two-trip requirement. Tenn. Code Ann. § 39-15- 202 (Enacted 1989; Last Amended 2015).

A court held that additional provisions of this law, providing biased counseling, physician-only counseling, and mandatory-delay requirements, are unconstitutional.  Planned Parenthood of Middle Tenn. v. Sundquist, 38 S.W.3d 1 (Tenn. 2000). However, in 2014, voters approved a ballot measure that amends the state constitution and allows elected officials to impose new restrictions on abortion rights. In 2015, the legislature passed and the governor signed this mandatory-delay restriction into law.


Insurance Coverage for Abortion

Prohibits Abortion Coverage in the Insurance Exchange

Does Tennessee expressly prohibit plans in its state exchange from covering abortion services?

Yes.  Health-insurance policies offered in the state health-insurance exchange may not include abortion coverage, with no exception.  Nothing in the law prohibits the purchase of abortion coverage outside the exchange through an optional rider for which an additional premium is paid.  However, insurers are not required to offer such riders and there is no evidence that such separate policies exist. (Even if they did exist, offering women the "option" to pay for separate abortion coverage is a false promise because no one plans for an unplanned pregnancy.)  Tenn. Code. Ann. § 56-26-134 (Enacted 2010).


Abortion Coverage for Low-Income People

Restricts Low-Income Women’s Access to Abortion

Tennessee prohibits public funding for abortion for women eligible for state medical assistance for general health care unless the procedure is necessary to preserve the life of a woman endangered by a physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy itself, or the pregnancy is the result of rape or incest.  Tenn. Managed Care Contractor Risk Agreement, §2.7.8.4 (Rev. May 19, 2008) at http://www.tn.gov/tenncare/forms/eastwestmcocontract.pdf.


Young People & Abortion

Parental Consent

Tennessee law restricts young women’s access to abortion.

Is the law enforceable?  Yes.  A federal court reversed a lower court’s grant of a preliminary injunction. Memphis Planned Parenthood, Inc. v. Sundquist, 175 F.3d 456 (6th Cir. 1999).

Who is considered a minor?  A young woman under the age of 18 who has never been married or freed by court order or otherwise from the care, custody, and control of her parents.

What is required – parental consent or parental notice?  Consent

Who must provide consent?  One parent.

Are there other trusted adults who may provide consent instead?  No.

What is the process for obtaining consent?  A young woman may not obtain an abortion unless the physician secures the signed written consent of one parent.

May the parental mandate be waived if a young woman is a victim of rape or incest?  Yes, but only if a criminal charge of incest is pending against a parent; then the signed written consent of that parent is not required.

May the parental mandate be waived if a young woman is a victim of child abuse?  No.

May the parental mandate be waived if a young woman’s health is threatened?  Yes, but only if the physician determines that "a medical emergency exists that so complicates the pregnancy as to require an immediate abortion."

May the parental mandate be waived under any other circumstances?  Yes, the young woman may try to obtain permission from a judge.

If a young woman must obtain permission from a judge, what is the process?  She must secure a court order stating either that she is mature and well informed enough to make her own decision or that an abortion is in her best interests.

Are there other significant requirements under the law?  No.

Has a court considered the constitutionality of this law?  Yes.  An appellate court held that it was unlikely that the plaintiff would prevail on its claim that provisions of the law were unconstitutional, thus reversing a lower court’s grant of a preliminary injunction.  Memphis Planned Parenthood, Inc. v. Sundquist, 175 F.3d 456 (6th Cir. 1999).

Other information about the law:  The Tennessee attorney general has issued an opinion stating that this minors’ access law applies to the use of mifepristone because Tennessee law defines abortion as including the use of a drug to terminate a pregnancy.  Tenn. Op. Att’y Gen. No. 01-030 (Mar. 7, 2001).

Tenn. Code Ann. §§ 37-10-301, -302, -305, -307 (Enacted 1988), -303 (Enacted 1988; Last Amended 2006), -304 (Enacted 1988; Last Amended 1989), -306 (Enacted 1988; Last Amended 1989).


Family-Planning Policies

Insurance Coverage & Contraception

No state measure.

Contraception Coverage for Low-Income People

No state measure.

Emergency Contraception

No state measure.

Other Important Issues

Clinic Protections

No state measure.

Refusals & Guarantees

Refusals of Medical Care

ABORTION REFUSAL CLAUSE

Tennessee allows certain individuals or entities to refuse to provide abortion services.

To whom does the refusal clause apply? Physicians and hospitals.

What does the refusal clause allow? Allows physicians to refuse to provide abortion care and other individuals to refuse to participate in abortion services. Allows hospitals to refuse to permit abortion care or accept a patient for abortion services.

Does the law require the refusing entity to notify the persons affected? No.

Are there circumstances under which a refusal clause may not be exercised? No.

Does the law require the refusing individual or entity to provide medically and factually accurate information or provide a referral for abortion services? No.

Does the law provide a mechanism for women to otherwise obtain specific reproductive-health services, information, or referrals if an individual and/or entity exercises a refusal clause? No.

Tenn. Code Ann. §§ 39-15-204, -205 (Enacted 1989).

CONTRACEPTION REFUSAL CLAUSE

Tennessee allows certain individuals or entities to refuse to provide contraceptive procedures, supplies, or information.

To whom does the refusal clause apply? Private institutions, physicians, and agents or employees of private institutions or physicians.

What does the refusal clause allow? No private institution or physician, nor any agent or employee of a private institution or physician that objects on the basis of religion or conscience may be required to provide contraceptive procedures, supplies, or information. The refusal to provide contraceptive procedures, supplies, or information shall not be the basis for liability.

Does the law require the refusing entity to notify the persons affected? No.

Are there circumstances under which a refusal clause may not be exercised? No.

Does the law require the refusing individual or entity to provide medically and factually accurate information or provide a referral for contraceptive procedures, supplies, or information? No.

Does the law provide a mechanism for women to otherwise obtain specific reproductive-health services, information, or referrals if an individual and/or entity exercises a refusal clause? No.

Tenn. Code Ann. § 68-34-104(5) (Enacted 1971).


Counseling & Referral Bans

No state measure.

Everyone should be able to decide if, when, how, and with whom they start or grow a family.

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