Health - Abortion - Ultrasound and Wait Time

EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
[Brackets] indicate matter deleted from existing law.
*hb1281*

HOUSE BILL 1281
J1 6lr2847
HB 1271/25 – HGO
By: Delegates Ciliberti, McComas, and Tomlinson
Introduced and read first time: February 12, 2026
Assigned to: Health

A BILL ENTITLED

AN ACT concerning 1

Health – Abortion – Ultrasound and Wait Time 2

FOR the purpose of prohibiting a qualified provider from performing or inducing an 3
abortion on a pregnant woman within a certain period of time after the woman 4
receives certain ultrasound imaging; establishing certain requirements related to 5
the performance of a certain transabdominal ultrasound; providing that a woman is 6
not required to accept anything offered during certain transabdominal ultrasound 7
imaging; an d generally relating to an ultrasound and waiting period before the 8
performance of an abortion. 9

BY repealing and reenacting, with amendments, 10
Article – Health – General 11
Section 20–209 12
Annotated Code of Maryland 13
(2023 Replacement Volume and 2025 Supplement) 14

BY adding to 15
Article – Health – General 16
Section 20–210 17
Annotated Code of Maryland 18
(2023 Replacement Volume and 2025 Supplement) 19

SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 20
That the Laws of Maryland read as follows: 21

Article – Health – General 22

20–209. 23

(a) In this section, “viable” means that stage when, in the best clinical judgment 24
of the qualified provider based on the particular facts of the case before the qualified 25
2 HOUSE BILL 1281

provider, there is a reasonable likelihood of the fetus’s sustained survival outside the womb. 1

(b) Except as PROVIDED IN § 20–210 OF THIS SUBTITLE OR AS otherwise 2
provided in this subtitle, the State may not interfere with the decision of a woman to 3
terminate a pregnancy: 4

(1) Before the fetus is viable; or 5

(2) At any time during the woman’s pregnancy, if: 6

(i) The termination procedure is necessary to protect the life or 7
health of the woman; or 8

(ii) The fetus is affected by genetic defect or serious deformity or 9
abnormality. 10

(c) The Department may adopt regulations that: 11

(1) Are both necessary and the least intrusive method to protect the life or 12
health of the woman; and 13

(2) Are not inconsistent with established clinical practice. 14

(d) The qualified provider is not liable for c ivil damages or subject to a criminal 15
penalty for a decision to perform an abortion under this section made in good faith and in 16
the qualified provider’s best clinical judgment in accordance with accepted standards of 17
clinical practice AND § 20–210 OF THIS SUBTITLE. 18

20–210. 19

(A) THIS SECTION DOES NOT APPLY TO A WOMAN SEEKING AN ABORTION IF: 20

(1) THE WOMAN IS THE VICTIM OF AN ALLEGED RAPE OR OF INCEST, 21
AS PROHIBITED UNDER § 3–323 OF THE CRIMINAL LAW ARTICLE; AND 22

(2) THE INCIDENT OF RAPE OR INCEST IS REPORTED TO LAW 23
ENFORCEMENT. 24

(B) A QUALIFIED PROVIDER MAY NOT PERFORM OR INDUCE AN ABORTION 25
ON A PREGNANT WOMAN: 26

(1) WITHIN 24 HOURS AFTER THE WOMA N RECEIVES 27
TRANSABDOMINAL ULTRASOUND IMAGING IN ACC ORDANCE WITH SUBSECTION (C) 28
OF THIS SECTION; OR 29

HOUSE BILL 1281 3

(2) IF THE WOMAN RESIDES AT LEAST 100 MILES FROM THE FACILITY 1
IN WHICH THE ABORTIO N WILL BE PERFORMED , WITHIN 2 HOURS AFTER THE 2
WOMAN RECEIVES TRANSABDOMINAL ULTRASOUND IMAGING IN ACCORDANCE WITH 3
SUBSECTION (C) OF THIS SECTION. 4

(C) THE MEDICAL PROFESSIO NAL PERFORMING THE TRANS ABDOMINAL 5
ULTRASOUND IMAGING REQUIRED UNDER SUBSECTION (B) OF THIS SECTION MUST: 6

(1) BE TRAINED IN SONOGRA PHY AND WORKING UNDE R THE 7
SUPERVISION OF A QUALIFIED PROVIDER; 8

(2) IF POSSIBLE, DETERMINE THE GESTATIONAL AGE OF THE FET US 9
BASED ON: 10

(I) MEASUREMENT OF THE FE TUS IN A MANNER CONS ISTENT 11
WITH THE STANDARD OF CARE; OR 12

(II) IF ONLY THE GESTATION AL SAC IS VISIBLE DU RING THE 13
TRANSABDOMINAL ULTRASOUND IMAGING, MEASUREMENT OF THE G ESTATIONAL 14
SAC; 15

(3) IF GESTATIONAL AGE CA NNOT BE DETERMINED UND ER ITEM (2) 16
OF THIS SUBSECTION , VERBALLY OFFER TO TH E WOMAN OTHER ULTRAS OUND 17
IMAGING TO DETERMINE GESTATIONAL AGE OF THE FETUS; 18

(4) IF PRESENT AND VIEWAB LE, INCLUDE IN THE ULTRA SOUND 19
IMAGE: 20

(I) THE DIMENSIONS OF THE FETUS; AND 21

(II) AN ACCURATE PORTRAYAL OF THE PRESENCE OF 22
EXTERNAL MEMBERS AND INTERNAL ORGANS OF THE FETUS; 23

(5) MAKE A PRINT OF THE U LTRASOUND IMAGE TO D OCUMENT ANY 24
MEASUREMENTS TAKEN TO DETERMINE THE GESTATIONAL AGE OF THE FETUS; 25

(6) VERBALLY OFFER TO THE WOMAN DURING THE 26
TRANSABDOMINAL ULTRASOUND IMAGING THE OPTION TO: 27

(I) VIEW THE ULTRASOUND IMAGE; 28

(II) RECEIVE A PRINTED COP Y OF THE ULTRASOUND IMAGE; 29
AND 30
4 HOUSE BILL 1281

(III) HEAR THE FETAL HEARTB EAT IN A MANNER CONS ISTENT 1
WITH THE STANDARD OF CARE; AND 2

(7) OBTAIN FROM THE WOMAN WRITTEN CERTIFICATION THAT: 3

(I) THE MEDICAL PROFESSIO NAL PERFORMING THE 4
TRANSABDOMINAL ULTRASOUND IMAGING OFFERED OPTIONS AS REQUIRED UNDER 5
ITEM (6) OF THIS SUBSECTION; AND 6

(II) IF APPLICABLE, THE WOMAN RESIDES AT LEAST 100 MILES 7
FROM THE FACILITY IN WHICH THE ABORTION WILL BE PERFORMED. 8

(D) A WOMAN IS NOT REQUIRE D TO ACCEPT ANYTHING OFFERED DURING 9
TRANSABDOMINAL ULTRA SOUND IMAGING PERFOR MED IN ACCORDANCE WI TH 10
SUBSECTION (C) OF THIS SECTION, INCLUDING OFFERS MADE UNDER SUBSECTION 11
(C)(3) AND (6) OF THIS SECTION. 12

(E) THE FACILITY IN WHICH AN ABORTION IS PERFORMED SHALL MAINTAIN 13
A PRINTED COPY OF THE ULTRASOUND IMAGE MADE UNDER SUBSECTION (C)(5) OF 14
THIS SECTION FOR THE GREATER OF: 15

(1) 7 YEARS; OR 16

(2) AN AMOUNT OF TIME AS REQUIRED BY FEDERAL OR STATE LAW. 17

(F) A QUALIFIED PROVIDER WHO VIOLATES THIS SECTION IS SUBJECT TO A 18
PENALTY OF UP TO $2,500. 19

(G) THIS SECTION MAY NOT BE CONSTRUED TO PROH IBIT A QUALIFIED 20
PROVIDER FROM USING ULTRASOUND IMAGING T HAT THE QUALIFIED PR OVIDER 21
CONSIDERS MEDICALLY APPROPRIATE, CONSISTENT WITH THE STANDARD OF CARE. 22

SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 23
October 1, 2026. 24