KentuckyHB 902025 Regular SessionHouseWALLET

AN ACT relating to maternal health and declaring an emergency.

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Bill Overview

Analyzed Economic Effects

13 provisions identified: 10 benefits, 2 costs, 1 mixed.

Abortion restrictions and felony penalties

The law ties its statewide abortion prohibition to a Supreme Court reversal of Roe restoring state authority, or a constitutional amendment. Once triggered, it applies immediately to the extent permitted and makes knowing conduct specifically intended to end unborn life a Class D felony. The pregnant woman cannot be criminally convicted under this provision. Exceptions cover physician treatment to prevent death or serious permanent damage to a life-sustaining organ, with reasonable efforts to preserve both lives. Accidental harm during physician treatment and contraception used before pregnancy can be detected, following manufacturer instructions, are not prohibited. Abortions are also prohibited at freestanding birthing centers in accordance with this provision; federal funding requirements limit enforcement and Medicaid application.

Restraint protections for pregnant inmates

Pregnant inmates generally must be handcuffed in front unless greater restraint is needed. People known to be pregnant generally cannot be restrained during labor, transport for delivery, or postpartum recovery. This includes travel to a freestanding birthing center. Exceptions require reasonable grounds for an immediate, credible serious threat or an escape risk that cannot reasonably be reduced another way.

Birth center consent and transfer protections

Birth centers must get each client's written informed consent explaining care risks, benefits, eligibility, and staff credentials. It must also explain complaint rights, access to regulations, liability insurance, emergency transfers, and how providers work together. Centers must have written transfer agreements with an obstetric hospital and a licensed emergency transport service. Hospital agreements must cover transfer duties, prompt notice, and safe transportation. The Cabinet must offer waiver processes when a center documents that a hospital or transport service failed to agree.

New safety standards for birth centers

Kentucky includes freestanding birthing centers in its health facility rules, including centers owned or run by hospitals. The Cabinet for Health and Family Services must adopt licensing rules by December 1, 2025. Rules must require birth center accreditation, address malpractice insurance, and generally require a hospital within 30 miles. The distance rule no longer applies if the nearby hospital closes after the center opens. Each center must have a licensed physician medical director who helps set care limits and review transfers and serious events.

Limits on liability after birth transfers

After a birth center transfer, a receiving provider or facility is generally liable only for its own negligent care. This rule applies to injury or death claims arising from care at the transferring center. A receiving provider that owns, runs, or provides care at that center can also be liable for care there. That liability covers acts or failures that violate its standard of care.

Pregnancy treatment exceptions and consent duties

Physicians using reasonable medical judgment may treat listed miscarriages, ectopic or abnormally implanted pregnancies, molar pregnancies, and remove a dead child. Other permitted care covers fetal life or health, life-threatening infection or bleeding, and protection against maternal death or permanent life-sustaining organ damage. Life- or organ-protecting procedures require reasonable medical efforts to preserve both lives; removing a dead child requires medical records and ultrasound results. Before covered care, physicians generally must hold a private consultation, discuss risks, benefits, and alternatives, and document written acknowledgment and informed consent. Emergencies waive the consultation requirement; remaining consent and record duties apply only without undue risk, with records completed promptly afterward.

Birth records and paternity help expand

Birth certificates must be filed within five working days; facility leaders or their representatives handle births in health facilities. Midwives are expressly included among those supplying medical information and certifying births. Outside facilities, the health care provider attending at or immediately after birth has first priority to file. Facilities must give unmarried mothers paternity information and forms, and help complete and send an affidavit when both parents request it. These paternity-service duties do not apply when the mother or alleged father is a minor; separate legal procedures govern those cases.

Comfort-focused care referrals for grieving families

Covered hospitals, birth centers, and attending doctors or midwives must offer or refer families for perinatal palliative care. This applies when prenatal diagnoses suggest possible death or uncertain or minimal long-term survival, or newborns have potentially life-limiting illnesses. Support covers the pregnant woman, birth father, and family, including counseling, grief support, keepsakes, and help with decisions. A coordinated care plan extends through pregnancy, delivery, newborn care, and death. The Cabinet must maintain an online provider list; these duties do not override the law's abortion provisions.

Newborn hearing checks and faster follow-up

Facilities offering obstetric or midwifery services must screen every infant's hearing using a state-approved method to keep their licenses. Possible hearing loss must be reported within 24 hours to parents, providers, the state office, and any scheduled audiology center. Reports showing no possible hearing loss go to the state office within one week, without identifying details. After receiving a concerning hospital or birth center report, the office must contact parents within three business days and arrange or refer follow-up. For births outside health facilities, the Cabinet must send screening information and provider options when the birth certificate is filed.

Online mental health information for families

The Cabinet must post its written information about mental health disorders during pregnancy and after birth on its website. Families, birth centers, and hospitals offering labor and delivery services can access it.

Required newborn tests and parent notices

Health facilities caring for infants 28 days old or younger must arrange required inherited-disorder tests and critical heart defect screening. Facilities or newborn-care providers must explain required screening to parents or guardians and arrange appropriate follow-up. Heart screening is required before discharge unless a prior echocardiogram or prenatal diagnosis already ruled out or diagnosed the condition. Testing is not required when parents meet the law's religious-objection requirements and object in writing.

Virus education and testing for newborns

Providers offering obstetric or prenatal care must give pregnant women and women who may become pregnant information about congenital cytomegalovirus. They can provide the information directly or link to the state's educational website. Providers must test infants by 21 days after birth if they fail their first two hearing screenings or have associated risk factors. Parents or guardians may opt out of this virus testing.

Fewer approval barriers for birth centers

The law lists freestanding birthing centers as exempt from certificate-of-need approval, a state review required for some health services. It also expressly exempts establishing and licensing centers with four beds or fewer. These exemptions do not remove birth center licensing duties. Birthing services can also use exemptions under two existing state provisions when they otherwise qualify.

Sponsors & Cosponsors

Sponsor

Jason Nemes
Republican • House

Cosponsors

Beverly Chester-Burton
Democrat • House
Candy Massaroni
Republican • House
Kim Banta
Republican • House
Ken Fleming
Republican • House
Kim Holloway
Republican • House
Mark Hart
Republican • House
Matt Lockett
Republican • House
Marianne Proctor
Republican • House
Nancy Tate
Republican • House

Roll Call Votes

All Roll Calls

Yes: 219 • No: 36

House vote • 3/27/2025

passed

Yes: 77 • No: 20

Senate vote • 3/27/2025

passed

Yes: 31 • No: 7

Senate vote • 3/13/2025

3rd reading, passed

Yes: 29 • No: 0 • Other: 5

House vote • 3/6/2025