Illinois could be the

SAFEST PLACE IN THE NATION 

for reproductive
healthcare

How is Illinois' reproductive health system performing right now?

Not Well

In Cook County mothers are primarily dying of pregnancy-related medical conditions due to ineffective (gaps in) healthcare during pregnancy and the postpartum year.

Outside of Cook County deaths due to mental health conditions are the biggest drivers; especially related to opioid overdose.

Furthermore:

Research predicts the capacity strain of 2023 on Illinois' reproductive health care delivery system will exacerbate our maternal mortality crisis.

Copyright 2022 Holistic Birth Collective NFP

In Cook County mothers are primarily dying of pregnancy-related medical conditions due to ineffective (gaps in) healthcare during pregnancy and the postpartum year.

Outside of Cook County deaths due to mental health conditions are the biggest drivers; especially related to opioid overdose.

In Cook County mothers are primarily dying of pregnancy-related medical conditions due to ineffective (gaps in) healthcare during pregnancy and the postpartum year.

Outside of Cook County deaths due to mental health conditions are the biggest drivers; especially related to opioid overdose.

ENTER:

RLJA

The Reproductive Liberty and Justice Act

View the bill on the Illinois General Assembly website here:

The RLJA amends existing statutes to 1) remove from Illinois law punitive action by the state in response to Substance Use Disorder among pregnant and birthing people, 2) provides equitable treatment for parents of stillborn babies in receiving vital records of their babies’ births, and 3) clearly establishes violations of people’s rights in childbirth as human rights violations under the Illinois Human Rights Act, expanding the avenues for justice and accountability for such violations.

View the bill on the Illinois General Assembly website here:

RLJA Updates

RLJA is currently filed as HB 003

HB 003 is alive until denied, passed, or the end of 2024.

HB 003 is currently stalled at the capital.

We'll let you know when it progresses!

Human Rights are Unconditional

The Reproductive Liberty & Justice Act promotes just treatment under the Illinois law for pregnant, birthing and parenting people in Illinois in three distinct ways..

1. abolish punitive policies

Sections 5, 15, 20, 30, 40, & 45

Sections 5, 15, 20, 30, 40, & 45

2. Enact Liam's Law Notice

Sections 10 & 35

3. Defend the Human rights of patients receiving maternity care

Sections 25 & 50

Human Rights are Unconditional

The Reproductive Liberty & Justice Act promotes just treatment under the Illinois law for pregnant, birthing and parenting people in Illinois in three distinct ways..

1. abolish punitive policies

Sections 5, 15, 20, 30, 40, & 45

2. Enact Liam's Law Notice

Sections 10 & 35

3. Defend the Human rights of patients receiving maternity care

Sections 25 & 50

let's break it down...

The bill contains ten sections which amend a law already in place. See an explanation of each proposed amendment below:

Plans of Safe Care. The Division of Substance Use Prevention and Recovery, in consultation with the Illinois Perinatal Quality Collaborative or its successor organization, shall develop a standardized Plan of Safe Care form to support discharge planning for mothers and infants affected by prenatal substance exposure. Plans of Safe Care shall not be recorded in the State Central Registry described in Section 7 of the Abused and Neglected Child Reporting Act and shall not be discoverable or admissible as evidence in any proceeding pursuant to the Juvenile Court Act of 1987 or the Adoption Act unless the named party waives his or her right to confidentiality in writing.

As used in this Section, “Plan of Safe Care” means a written or electronic document designed to ensure the safety and well-being of a newborn who has been identified by his or her health care provider as being affected by prenatal substance exposure or withdrawal symptoms, or a fetal alcohol spectrum disorder (FASD), and his or her gestational parent.

______________________

For more info: https://health.ny.gov/prevention/captacara/

Requires hospitals to notify bereaved parents of their right to request and receive a certificate of birth resulting in stillbirth via a written form to be known as a “Liam’s Law notice”

  • Removes from the definition of a “neglected child” a newborn with a positive toxicology result at birth
  • Specifies that a CAPTA notification cannot be used against a parent in DCFS court proceedings
    • Sec. 3.5. CAPTA notification. The Department shall develop a standardized CAPTA notification form that is separate and distinct from the form for written confirmation reports of child abuse or neglect as described in Section 7 of this Act. A CAPTA notification shall not be treated as a report of suspected child abuse or neglect under this Act. CAPTA notifications shall not be recorded in the State Central Registry and shall not be discoverable or admissible as evidence in any proceeding pursuant to the Juvenile Court Act of 1987 or the Adoption Act.
  •  Narrows scope of physician’s authority to take custody of a child without consent of parent, without a court order, and with full immunity from civil and criminal liability
    • Currently: a physician can take “temporary protective custody” of a child, without a court order and with full legal immunity if he has reason to believe the child cannot remain in the parent’s custody “without endangering the child’s health or safety.”
    • This statutory language is so broad that it appears to have engendered confusion among health care professionals about the circumstances under which it is appropriate for them to exercise this coercive authority. This misunderstanding has contributed to many physicians and hospital administrators believing that they have state sanctioned authority to seize custody of a child whenever that child’s parent makes a decision that does not match the sensibilities of hospital staff members.
    • Speaker unidentified: “You can take… Protective custody is just the right to do what you think is right for the baby. And, DCFS, if they say, ‘yes, that we agree with you, cause this is our rule’. You give the vitamin K and then do any of us really care what happens next?” [April 12, 2018 meeting of the Perinatal Advisory Committee of IDPH, emphasis added]
    • “Preventing detrimental outcomes and protecting babies from a poor choice is achieved through education but also through the impact of child welfare interventions,” Glick wrote in a September 2017 letter to fellow pediatricians as DCFS was considering changes [to its policy that parental refusal of Vitamin K injections at birth be reported as “medical neglect”]. “This can be a very powerful incentive for parents to not put their child a risk.” Notably, Dr. Jill Glick works at the University of Chicago Medical Center where the primary care patient population generally resides on the Southside of Chicago.
    • RLJA amends Section 5 of ANCRA to be more specific and consistent with Section 300.120 of the Illinois Administrative Code (link here) which specifies that taking temporary protective custody is only appropriate when “leaving the child in the home or in the care and custody of the child’s caregiver presents an imminent danger to the child’s life or health” (Ill. Administrative Code, Title 89, Sec. 300.120(a)(1), emphasis added).
      • Sec. 5. An officer of a local law enforcement agency, designated employee of the Department, or a physician treating a child may take or retain temporary protective custody of the child without the consent of the person responsible for the child’s welfare, if (1) he has reason to believe that there exists a substantial and imminent risk of death, serious illness, or severe personal injury to the child if he or she is not immediately removed from his or her home or from the custody of the person responsible for the child’s welfare; and (2) there is not time to apply for a court order under the Juvenile Court Act of 1987 for temporary custody of the child
    •  Example of physicians taking temporary protective custody inappropriately:

      https://www.chicagotribune.com/news/breaking/ct-vitamin-k-shot-lawsuit-illinois-dcfs-20190924-4qxfsnq4yva5hni36b545yp3bi-story.html

  • Creates privacy shield making it unlawful for mandated reporters to disclose information regarding a pregnant or postpartum patient’s substance use
    • (b-1) It is unlawful for any person described in paragraphs (1), (2), (3), and (10) of subsection (a) of Section 4 to disclose to the Department or to any law enforcement agency the results of:
      • (1) any verbal screening questions concerning drug or alcohol use of a pregnant or postpartum person;
      • (2) any toxicology test administered to a person who is pregnant or has given birth within the 12 weeks prior to the administration of the toxicology test; or
      • (3) any toxicology test administered to a newborn.
    • A mandated reporter described in this subsection shall not disclose a patient or client’s confidential information described under paragraphs (1), (2), or (3) to a law enforcement agency or to the Department unless a law enforcement agency has successfully obtained and furnished a search warrant issued under Section 108-3 of the Code of Criminal Procedure of 1963.
    • Indiana’s SB 186 was the inspiration for the privacy shield law (see link below).
      https://iga.in.gov/legislative/2016/bills/senate/186#document-9e4e1dbb

(325 ILCS 5/4.4)

Sec. 4.4. DCFS duty to report to State’s Attorney. Whenever the Department receives, by means of its statewide toll-free telephone number established under Section 7.6 for the purpose of reporting suspected child abuse or neglect or by any other means or from any mandated reporter under Section 4, a report of a newborn infant whose blood, urine, or meconium contains any amount of a controlled substance as defined in subsection (f) of Section 102 of the Illinois Controlled Substances Act or a metabolite thereof, with the exception of a controlled substance or metabolite thereof whose presence in the newborn infant is the result of medical treatment administered to the mother or the newborn infant, the Department must immediately report that information to the State’s Attorney of the county in which the infant was born.

(Source: P.A. 95-361, eff. 8-23-07.)

Repeals Section 3.4 of the Medical Patient Rights Act to replace with new Article 5B of the Illinois Human Rights Act (See Rights of Patients Receiving Maternity Care)

Amends the Illinois Health & Hazardous Substances Registry Act to codify current Adverse Pregnancy Outcomes Reporting System (APORS) reporting protocol to reflect inclusion of Substance Affected Infants.

Moves the threshold for a fetal death to be considered a stillbirth from 26 weeks gestation to 20 weeks gestation.

Changes nomenclature from “certificate of stillbirth” to “certificate of birth resulting in stillbirth” to prevent the potential to confuse certificate of stillbirth with fetal death certificate

Positive toxicology result cannot be used as evidence of child neglect nor as grounds to establish parent unfitness

Sec. 5B-101. Rights of patients; maternity care; disclosure of medical information.

  • (a) As used in this Section:
    • “Maternity care” means the health care provided in relation to pregnancy, labor, and childbirth, and the postpartum period, and includes prenatal care, care during labor and birthing, and postpartum care extending through one-year postpartum. Maternity care shall seek to optimize positive outcomes for the patient, and be provided on the basis of the physical and psychosocial needs of the patient. Notwithstanding any of the above, all care shall be subject to the informed and voluntary consent of the patient, or the patient’s legal proxy, when the patient is unable to give consent.
  • (b) In addition to any other right provided under this Act, every patient has the following rights whenever receiving maternity care:
    • (1) The right to choose a maternity care provider from the full range of providers available in the patient’s community.
    • (2) The right to choose the patient’s birth setting from the full range of birthing options available in the patient’s community.
    • (3) The right to leave the patient’s maternity care professional to select another if the patient becomes dissatisfied with the quality of the care provided.
    • (4) The right to receive information about the names of those health care professionals involved in the patient’s care and in the care of the patient’s newborn.
    • (5) The right to privacy and confidentiality of records, except as provided by law.
    • (6) The right to receive information concerning the patient’s condition and proposed treatment, including methods of relieving pain.
    • (7) The right to refuse any treatment offered to the patient or the patient’s infant.
    • (8) The right to be informed if the patient’s caregivers wish to enroll the patient or the patient’s infant in a research study.
    • (9) The right to access the patient’s own medical records under Section 8-2001 of the Code of Civil Procedure.
    • (10) The right to receive information in a language in which the patient can communicate in accordance with federal law.
    • (11) The right to receive emotional and physical support during labor and birth.
    • (12) The right to freedom of movement during labor and to give birth in the position of the patient’s choice, to the extent medically possible.
    • (13) The right to contact with the patient’s newborn, except where necessary care must be provided to the patient or the patient’s infant.
    • (14) The right to decide, in consultation with their caregivers, when the patient or the patient’s newborn will leave the birth site for home, based on their conditions and circumstances.
  • (c) The Department of Public Health, the Department of Healthcare and Family Services, the Department of Children and Family Services, and the Department of Human Services shall post, either by physical or electronic means, information about these rights on their publicly available websites. Every health care provider, day care center licensed under the Child Care Act of 1969, Head Start, and community center shall post information about these rights in a prominent place and on their websites, if applicable.
  • (d) The Department of Human Rights shall adopt rules to implement this Section.
  • (e) Nothing in this Section or any rules adopted under subsection (d) shall be construed to require a physician, health care professional, hospital, hospital affiliate, or health care provider to provide care inconsistent with generally accepted medical standards or available capabilities or resources.
  • (f) Notwithstanding any other provision of law, and except as otherwise provided in this Section, a patient has the right for a physician, health care provider, health services corporation, or insurance company to administer any of the following medical tests without disclosing the results of the tests to a State or local law enforcement agency or the Department of Children and Family Services:
    • (1) Any verbal screening or questioning concerning the drug or alcohol use of a pregnant or postpartum person.
    • (2) Any toxicology test administered to a person who is pregnant or has given birth within the previous 12 weeks.
    • (3) Any toxicology test administered to a newborn.
  • (g)A physician, health care provider, health services corporation, or insurance company who administers a medical test described under paragraph (1), (2), or (3), may disclose the results of the test if a law enforcement agency has successfully obtained and furnished a search warrant issued under Section 108-3 of the Code of Criminal Procedure of 1963.

___________________________________

For an extra resource on Birth Rights check out this PDF by Birth Rights Bar Association. 

Does this all really matter?

Let's lay some groundwork!

ALL Pregnant people

have the right to

reproductive health care in Illinois

How many pregnant people?

1 out of every 5 people in Illinois is presumably capable of pregnancy. Of that population, about 8% experiences a pregnancy each year.

In 2020 nearly 200,000 Illinois residents were pregnant and nearly 10,000 people from out of state received pregnancy care in Illinois.

What are the rights of pregnant people in illinois?

The following are

in Illinois under the Reproductive Health Act of 2019:

(775 ILCS 55/1-15)
Sec. 1-15. Fundamental Reproductive Health Rights

Every individual has a fundamental right to make autonomous decisions about the individual’s own reproductive health, including the fundamental right to use or refuse reproductive health care.

  • “Reproductive health care includes, but is not limited to: contraception; sterilization; preconception care; maternity care; abortion care; and counseling regarding reproductive health care”

Every individual who becomes pregnant has a fundamental right to continue the pregnancy and give birth or to have an abortion, and to make autonomous decisions about how to exercise that right.

In practice do all people benefit from equal access to these rights?

NO!

Do YOU know the universal human rights for maternity care patients?

If we want to defend them, we’ve got to know them!

Key TERMS:

1. abolish punitive policies

RLJA amends existing statutes to remove from the Illinois law punitive action by the state in response to Substance Use Disorder among pregnant and birthing people.

Punitive policies harm babies AND their mothers.

HBC proudly partners with Pregnancy Justice in demanding that NO PERSON should fear arrest or be subjected to government control or retribution as a result of pregnancy or any outcome of pregnancy.

RLJA is how we actively seek to remove systems of harm that wrap families in fear to replace them with systems of care that wrap families in support and dignity. 

Wraparound Services

CONTEXT MATTERS

[1] Punitive substance use policies are one of the major ways Illinois enacts pregnancy criminalization. In states with punitive PSUPs, prenatal substance use is either:

  • a criminal offense
  • defined as child abuse or neglect
  • grounds for termination of parental rights
  • used as evidence to substantiate reports of child abuse or neglect
  • may result in being placed in a CPS registry

Yet public health research consistently finds punitive state policies are associated with:

  • Decreased rates of adequate prenatal care
  • Decreased rates of psychosocial service use
  • Decreased utilization of opioid agonist therapy
  • Decreased engagement in substance use disorder treatment
  • Increased rates of neonatal abstinence syndrome (NAS)
  • Increased rates of opioid overdose

[i] Angélica Meinhofer, Allison Witman, Johanna Catherine Maclean, and Yuhua Bao. “Prenatal substance use policies and newborn health.” Health Economics 31 (2022): 1452-1467.

*, *** Virginia A. Reising, Ashley Horne, and Amanda C. Bennett. “The interaction of neonatal abstinence syndrome and opioid use disorder treatment availability for women insured by Medicaid.” Public Health Nursing 38 (2021): 98-105

** March of Dimes. Nowhere to Go: Maternity Care Deserts Across the U.S. (2022 Report). Arlington, VA: March of Dimes, 2022.

March of Dimes research link HERE.

States with Punitive Prenatal
Substance Use Policies

Across the entire state, there is only one resource that offers comprehensive integrated prenatal care and substance use treatment, which is considered the gold standard of care.”

[i] Angélica Meinhofer, Allison Witman, Johanna Catherine Maclean, and Yuhua Bao. “Prenatal substance use policies and newborn health.” Health Economics 31 (2022): 1452-1467.

*, *** Virginia A. Reising, Ashley Horne, and Amanda C. Bennett. “The interaction of neonatal abstinence syndrome and opioid use disorder treatment availability for women insured by Medicaid.” Public Health Nursing 38 (2021): 98-105

** March of Dimes. Nowhere to Go: Maternity Care Deserts Across the U.S. (2022 Report). Arlington, VA: March of Dimes, 2022.

March of Dimes research link HERE.

Families Belong Together

Download the One-Pager to share and learn more!

2. Enact Liam's law Notice

RLJA amends existing statutes to provide equitable treatment for parents of stillborn babies in receiving vital records of their babies’ births.

Families who experience stillbirth deserve recognition

HBC proudly partners with Gifts from Liam to increase awareness and share education to prevent pregnancy and infant loss and support families who have experienced the death of a baby.

The Liam’s Law Notice “Corrects deficiencies in the implementation of Public Act 93-578, such that all families affected by stillbirth are treated with dignity and respect by this State.”

As of January 2023, 45 states, including Illinois, have enacted laws that grant bereaved parents of a stillborn child the option to request and receive a certificate recognizing the stillbirth that is separate from a fetal death certificate.

Illinois was among the earliest states to enact legislation creating an optional certificate of stillbirth after the General Assembly passed Public Act 93-578 in 2003.

Unfortunately, implementation of Public Act 93-578 was unsuccessful and most bereaved parents were not informed that this option was available to them. In fact, only 71 certificates were issued in the first 10 years. Liam was stillborn in Cook County at 40 weeks gestation. Liam’s birth was in 2016, 13 years after P.A. 93-578 became law [410 ILCS 535/20.5]. His mother was only given a fetal death certificate and not informed that she could also receive a certificate of stillbirth. 

Liam’s Law Notice adds clarifying language to Sections 20 and 20.5 of the Vital Records Act [410 ILCS 535/20.5] so that Illinois statute is more consistent with the recommendations of the National Center for Health Statistics. Furthermore, Liam’s Law Notice adds a new section to the Hospital Licensing Act [210 ILCS 85] requiring hospitals to provide written notification to patients who have suffered a stillbirth of their right to request and receive a certificate of birth resulting in stillbirth. The form for this written notice shall be developed by the Department of Public Health, in consultation with each Community Action Team for the two Illinois-based Fetal Infant and Mortality Review projects.

All Pregnant People who experience stillbirth should have the right to a Liam's law notice.

Download the one-pager to share and learn more!

3. Defend the Human rights of patients receiving maternity care

RLJA amends existing statutes to clearly establish violations of people’s rights in childbirth as human rights violations under the Illinois Human Rights Act, expanding the avenues for justice and accountability for such violations.

Violated rights cause physical, mental and emotional harm to birthing people and their families.

Though it can happen to anyone, these situations result in higher likelihood to have rights violated when receiving maternity care:

Source: Birth Rights Bar Association

Pregnant and birthing people retain the rights to:

Yet these rights (and more) are routinely violated, causing physical, mental and emotional harms to birthing people and their families.

RLJA offers additional remedies for those harmed by violations including proceedings before the Illinois Human Rights Commission and potential enforcement by the Attorney General.

Do YOU know the universal human rights for maternity care patients?

If we want to defend them, we’ve got to know them!
Download the one-pager to share and learn more.

How You can help:

R
E
A
D

Read/Share The RLJA

Please encourage others to read about RLJA on our website or via the “One-Pager,” which you can download here:

R
E
A
C
H

Reach Out

Reach out to us at HBC or the RLJA’s Chief sponsor in the House, Rep. Mary Flowers if you have questions, concerns or suggestions about the contents of the bill.

J
O
I
N

Join the List

Join the list of supporters to add your logo to the materials distributed to the public and to legislators!

READ

Read & Share

Please encourage others to read about HB003 on our website or via the “One-Pager,” which you can download here:

REACH

Reach Out

Reach out to us at HBC or the RLJA’s Chief sponsor in the House, Rep. Mary Flowers if you have questions, concerns or suggestions about the contents of the bill.

JOIN

Join the list

Join the list of supporters to add your logo to the materials distributed to the public and to legislators!

And don't miss a beat!

Subscribe to our HBC newsletter to get the latest updates on RLJA!

Thank you to our RLJA supporters!

Let’s make Illinois the

SAFEST PLACE IN
THE NATION

for reproductive
healthcare

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