A new anti-abortion lawsuit attempts to obtain individual terminated pregnancy reports from the Indiana Department of Health. When we look closely at this problem, it appears to be about punishing patients and doctors rather than being open about abortion in Indiana.
For decades, states have gathered abortion-related statistics to monitor public health and inform policy decisions. Currently, 46 states require abortion reporting, but the types and amounts of data gathered vary. In Indiana, this information is gathered by TPRs, which must be given to the state health department within 30 days of an abortion (or three days if the individual is under the age of 16).
For years, anti-abortion groups have frequently requested these reports under the Indiana Access to Public Records Act, with some patient information blacked out. However, with the Indiana abortion prohibition, demands for individual TPR reports got more difficult. Given the low number of abortions following the restriction, the health department, after consulting with the Indiana public access counselor, stopped disclosing individual statistics.
A TPR is a medical record that should not be disclosed without the patient’s informed consent. Medical records document events and transactions between patients and healthcare providers, including diagnoses, treatments, lab tests, and other services. They provide the most intimate information about a person’s medical history.
The Indiana Department of Health wishes to dismiss this action, arguing that these reports are medical records and should not be shared. We agree. Consider how a group could seek your vasectomy report, bloodwork, or mammography results.
No organization needs these individual reports because the state already provides thorough quarterly reports. These reports contain demographic information (age, race, education, marital status) as well as abortion details (type, gestational age, county and facility, reason for abortion) to assist public health authorities and policymakers in making decisions.
The quarterly report contains sufficient information for these purposes, and individual reports provide no more important public health data. We advise anyone who believes individual reports should be shared to see the state’s quarterly report; it is difficult to argue for the necessity for individual data after reading it.
In the first three months of 2024, Indiana had 45 abortions, accounting for only 2% of the amount in the first quarter of 2023. If individual TPRs were revealed, the tiny number of cases would make it simple to identify people. Even with personal information removed, there is a significant risk of breaking confidentiality.
The 2024 first-quarter report also outlines why abortions were performed. During that time, 62% were for fatal fetal anomalies, 36% for major threats to the pregnant woman’s health or life, and 2% for rape or incest.
These people have already been through horrific and painful circumstances. They don’t deserve to have their medical records disclosed.
We cannot overlook the terror that this would cause for anyone seeking an abortion under our restricted exclusions. Knowing that their medical information could be revealed to an anti-abortion group may discourage people from obtaining necessary care following rape, incest, or a non-viable pregnancy. It appears that one of the goals of this campaign is to discourage Indiana residents and doctors from obtaining or giving this service.
Finally, the campaign for individual TPRs targets and threatens medical practitioners. This will undermine Indiana’s capacity to retain and attract medical providers. According to a survey from the Association of American Medical Colleges, 9.1% fewer medical students applied to residency programs in Indiana during 2023-2024, compared to a 0.4% reduction nationally.
This will have a significant influence on access to all healthcare in Indiana, not just obstetrics.
The litigation to force the release of individual TPRs is both destructive and wrong. It promotes intimidation over accountability and public health. We must preserve patients’ privacy and dignity, and guarantee that Indiana remains a place where Hoosiers can access healthcare and professionals may work without fear of unjustified persecution.