In response to what one Republican called “a desperate need for clarity” in Kentucky abortion law, the General Assembly has approved language detailing the ban’s “life of the mother” exception and specifying some situations when doctors may end complex pregnancies.

Once a bill only to pave the way for freestanding birth centers in Kentucky, House Bill 90 now carries the abortion clarification language.

The legislation can now go to Democratic Gov. Andy Beshear for a signature or veto. He said he couldn’t say what he’ll do when asked about it during a weekly news conference Thursday, but he does have questions.

He pointed out that Kentucky’s abortion ban still would have no exceptions for victims of rape or incest, exceptions he has openly supported.

“Even with this bill, it would be significantly less access than virtually every other state in the United States,” Beshear said.

He also said he has questions about whether the new language would clarify or confuse the legal picture for health care providers.

“We were told by those that passed the trigger law originally that it provided an exception for the life of the mother, and now this bill is saying that it needs to be passed through law,” Beshear said. “So one question I’m going to have is: Is it more or less restrictive than the current understanding in the medical community that we have right now?”

‘Doctors just need to be doctors’?

All Democrats in the Republican-controlled Senate passed on the vote Thursday morning, saying they hadn’t had time to review the changes, which were first made public Wednesday, or to understand if the amendment would help or hurt pregnant women and medical providers.

“There is a desperate need for clarity on a lot of … medical issues that come up during the course of a pregnancy,” said Sen. Julie Raque Adams, R-Louisville,who carried HB 90 in the Senate. “There is a lot of misinformation out there in the medical community, and doctors just need to be doctors. And so this language that’s before us today adds some much needed clarity for the medical community.”

The House, which voted to concur with the Senate a few hours later, was less united with two Republicans opposing the changes and one Democrat supporting it.

Rep. Rachel Roarx, D-Louisville, said it’s currently “terrifying to be someone who can become pregnant in the state” and voted in favor of the bill “because if it does grant a pregnant individual the opportunity to have lifeaving care, then we need to do that.”

Rep. Kim King, R-Harrodsburg, meanwhile, voted against the bill, saying the “changes don’t really expand or protect pro-life measures here in Kentucky.”

Health care professionals in Kentucky and beyond have long said the state’s abortion laws are too medically vague and inhibit their ability to properly treat miscarriages, hemorrhages and other emergencies.

The clarification language was first added to a different bill Wednesday, but that bill – House Bill 414 — has yet to clear a chamber.

The clarification still instructs health care providers to “make reasonable medical efforts under the circumstances to preserve both the life of the mother and the life of the unborn child.”

But it specifies that doctors can intervene to remove molar and ectopic pregnancies, manage miscarriages, treat sepsis and hemorrhage and more.

It also leaves the determination of an emergency to “the physician’s reasonable medical judgment.”

In a statement after passage of HB 90, Amber Duke, executive director of the American Civil Liberties Union of Kentucky, said the changes demonstrate “the Kentucky General Assembly recognizes that when people experience pregnancy complications that put their lives at risk, they should receive appropriate medical care.”

“However, this bill does nothing to restore the right to abortion in the Commonwealth,” Duke said. “We will continue to fight to ensure that all Kentuckians, regardless of their circumstances, will be able to receive the abortion care that they need.”

‘It can’t be rushed’?

Since the U.S. Supreme Court ushered in Kentucky’s near-total abortion ban in 2022 by overturning the federal right to abortion, Republican legislative leaders have kept bills proposing exceptions to the ban bottled up — until Wednesday when two committees approved what Republicans say is clarifying language.

During the House debate, Rep. Matthew Lehman, D-Newport, said the proposed change was “shoved in our face.”

“This body is the reason these women are in danger,” he said. “We don’t give credit to firemen when they put out a fire that they started. The terrible part of this bill is we’re expecting women to get sick or be on the brink of death before they are allowed to make choices on their body.”

Rep. Nancy Tate, R-Brandenburg, who sponsored HB 414, said that “under no circumstances is this language expected or intended to be prescriptive.”

“Within this language, it says that ‘reasonable medical judgment’ means the range of conclusions or recommendations that licensed medical practitioners with similar sufficient training and experience may communicate to a patient based upon current and available medical evidence,” Tate said. “There’s also a clause within this language that says that in cases of emergencies, that the reasonable medical judgment can be used.”

That change, Tate said, will “save lives.”

Rep. Sarah Stalker, D-Louisville, said she would have supported HB 90 if it was still just a freestanding birth center bill, but voted against it with the abortion edits, calling the changes “false hope.”

“We are seeing this happening at a national level, and it’s terrifying. You have to pay attention to the language and the words that are being used very intentionally in this legislation to avoid medically accurate terminology, to make it appear as if women still have protections, as if people still have choices in certain circumstances when they do not,” she said.

In the Senate, Sen. Cassie Chambers Armstrong, D-Louisville, said she would support anything that “will save the lives of pregnant women in this state” but she felt the language was rushed through the process.

Chambers Armstrong said she hadn’t received the bill substitute in time to understand it and consult with experts, slamming “an intentional choice by the majority party in the way this legislation was moved to disenfranchise me and the people I represent on this very important issue.”

“I really hope that this bill does take a step forward in terms of allowing doctors to provide lifesaving care. I truly hope that that is what this legislation does. However, I don’t know that,” she said.

In committees Wednesday, Dr. Jeffrey M. Goldberg, the legislative advocacy chair for the Kentucky chapter of the American College of Obstetricians and Gynecologists (ACOG), said the language isn’t perfect and will need more work. But, he said, physicians already work under such ambiguity that something has to be done.

Sen. Karen Berg, D-Louisville, said the effort at clarity is still “full of words that have no meaning to a physician.”

“It’s an excellent effort to fix a huge — huge — problem of our own making,” said Berg, who is also a doctor. “But it can’t be rushed. It needs to be right.”

McKenna Horsley contributed to this story.?