the colorado senate recently passed a bill, 32 to 1, requiring pregnant women to submit to HIV testing. the lone dissenting vote came from a republican who believes that the measure would “remove the negative consequences that take place from poor behavior and unacceptable behavior.”
apparently the senator believes that living with the consequences of untreated HIV appropriately punishes poor behavior. on the other hand, the rest of the state’s senators apparently believe that a fetus’ medical needs outweigh a woman’s right to privacy. according to one of the bill’s sponsors, “What this bill will do and why itâ€™s so important to test the woman when she is pregnant â€” if she is HIV-positive, treatment is started immediately to protect the baby, the unborn baby.â€
now, don’t get me wrong – i think HIV testing is a good idea. it’s a good idea if you’re sexually active and if there’s a possibility you could be exposed to HIV. it’s a good idea if you’re a pregnant woman who wants to make the most informed choices about health care for yourself and your fetus. so it’s a good idea to require doctors to offer
the test, and to either require health insurance to cover it, or to pay for it out of government coffers. but requiring women to get tested – which is the likely outcome of an opt-out system – bothers me. interjecting the government anywhere in a woman’s reproductive health care bothers me, because in this country, it’s a quick jump to measures that limit reproductive choice, and that impinge on a woman’s right to conduct her life as she sees fit.
i believe the wording of the bill is highly problematic, even though it’s basically the existing syphilis law with HIV tacked on:
25-4-201. Pregnant woman to take blood test. (1) Every licensed health care provider authorized to provide care to a pregnant woman in this state for conditions relating to her pregnancy during the period of gestation or at delivery shall take or cause to be taken a sample of blood of the woman at the time of the first professional visit during the first trimester for testing pursuant to this section. The blood specimen obtained shall be submitted to an approved laboratory for standard serological test for syphilis and HIV. Every other person permitted by law to attend pregnant women in this state but not permitted by law to take blood samples shall cause a sample of blood of each pregnant woman to be taken by a licensed health care provider authorized to take blood samples and shall have the sample submitted to an approved laboratory for a standard serological test for syphilis and HIV. A pregnant woman may decline to be tested as specified in this subsection (1), in which case the licensed health care provider shall document that fact in her medical record.
(2) If a pregnant woman entering a hospital for delivery has not been tested for HIV during her pregnancy, the hospital shall notify the woman that she will be tested for HIV unless she objects and declines the test. If the woman declines to be tested, the hospital shall document that fact in the pregnant woman’s medical record.
25-4-203. Birth certificate – blood test.
In reporting every birth and stillbirth, physicians and others required to make such reports shall state on the certificate whether a blood test for syphilis and HIV has been made upon a specimen of blood taken from the woman who bore the child for which a birth or stillbirth certificate is filed and the approximate date when the specimen was taken. In no event shall the birth certificate state the result of the test.
first, they’re requiring a sample of blood to be taken for the purposes of the HIV test, whether a woman agrees to be tested or not. then, the bill allows women to opt out, rather than requiring affirmative assent to the procedure, which would provide more protection for the woman. nothing will prevent a provider from taking the blood and “oops!” either “forgetting” to give the woman the option to decline the test, or “losing” any documentation of her refusal. finally, if they do offer her the option to decline, and she does, the fact of her refusal must be documented. why? and how will that information be used down the line? will providers be allowed to refuse to treat women who decline the test? will health insurers refuse coverage to women – or their infants – who have not tested negative? and what is the purpose of recording the fact or absence of the test on the child’s birth certificate?
the legislation is broadly written to cover all providers treating women for “conditions relating to … pregnancy.” this would require that a woman seeking an abortion must go through the HIV rigamarole. and to what end?
while this legislation might have evolved from good intentions, the potential for abuse seems very high, and the rationale behind requiring the testing, flimsy at best. i can only hope the house shows better sense than the senate and defeats it.