3701-47-03 Reporting forms.
(A) "Abortion report" in this rule means a form completed in
compliance with division (C) of this rule.
(B) The department shall be responsible for collecting and collating abortion
data reported to the department as required by this rule.
(C) An individual abortion report for each abortion performed upon a woman shall
be completed by her attending physician. The report shall be confidential and
shall not contain the name of the woman. This report shall include, but not be
limited to the following, in so far as the patient makes the data available
which is not within the physician's knowledge:
(1) Patient number;
(2) Facility name and address;
(3) Date of abortion;
(4) Zip code of residence of pregnant woman;
(5) Age of pregnant woman;
(6) Race;
(7) Marital status;
(8) Number of previous pregnancies;
(9) Years of education;
(10) Number of living children;
(11) Number of previously induced abortions;
(12) Date of last induced abortion;
(13) Date of last live birth;
(14) Method of contraception at time of conception;
(15) Date of last menstrual period;
(16) Medical condition of the woman at the time of the abortion;
(17) Rh type of pregnant woman;
(18) Type of abortion procedure;
(19) Complications by type;
(20) Type of procedure done after the abortion;
(21) Type of family planning recommended;
(22) Type of additional counseling given;
(23) Signature of attending physician.
(D) Abortion reports shall by submitted by the hospital to the department within
fifteen (15) days after the discharge of the woman.
(E) Appropriate certificate of birth shall be made out after the twentieth (20
th
) week of gestation.
(F) A copy of the abortion report shall be made a part of the medical record of
the patient of the facility in which the abortion was performed.
(G) Each hospital shall file monthly and yearly (Fiscal year: July-June) reports
listing the total number of women who had undergone a post twelve week gestation
abortion and received post abortion care. These reports shall be filed within
thirty (30) days following the end of the reporting period.
(H) Every case in which a physician treats a post abortion complication shall be
reported on a post abortion complication form. The report shall be made upon a
form prescribed by the department and shall be signed by the attending
physician.
HISTORY: Eff 9-1-75; 12-2-76;
2-13-99
Rule promulgated under: RC Chapter
119
.
Rule authorized by: RC
3701.341
Rule amplifies: RC
3701.341
R.C.
119.032
Review Date: February 1, 2004