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Freedom of Choice Act

Maryland has created additional protections for reproductive rights by adding an affirmative right to choose into its state law. This law ensures women’s access to pre-viability abortions and would remain in effect even if Roe v. Wade were overturned.

“[T]he state may not interfere with the decision of a woman to terminate a pregnancy: (1) Before the fetus is viable; or (2) At any time during the woman’s pregnancy, if [t]he termination procedure is necessary to preserve the life or health of the woman; or . . . [t]he fetus is affected by a genetic defect or serious deformity or abnormality.” Md. Code Ann., Health-Gen. § 20-209 (Enacted 1991).


Low-Income Women’s Access to Abortion

Maryland prohibits public funding for abortion for women eligible for state medical assistance for general health care unless: (1) continuation of the pregnancy is likely to result in the woman’s death; (2) the woman is a victim of rape, incest, or a sexual offense reported to a law enforcement, public health, or social agency; (3) the fetus is affected by a genetic defect or serious deformity or abnormality; (4) abortion is medically necessary because there is substantial risk that continuation of the pregnancy could have a serious and adverse effect on the woman’s present or future physical health; or (5) continuation of the pregnancy is creating a serious effect on the woman’s mental health and if carried to term there is substantial risk of serious or long lasting effect on the woman’s future mental health. S.B. 125, 2004 Reg. Sess., 418th Gen. Assem. (Md. 2004); Md. Regs. Code tit. 10, §§ 09.02.04(G), 09.34.04(A)(5), 09.34.04(B)(2).

Protection Against Clinic Violence

A person who physically detains an individual or obstructs, impedes, or hinders an individual’s passage, with the intent to prevent the individual from entering or exiting a medical facility, is guilty of a misdemeanor and may be fined up to $1000, imprisoned for up to 90 days, or both. Md. Code Ann., Crim. § 10-204 (Enacted 2002).

Question 6

Many Marylanders will remember Question 6, when 62% of voters in a statewide referendum affirmed a woman’s legal right to choice. The language of Question 6 read:

Revises Maryland’s abortion law to prohibit state interference with woman’s abortion decision before fetus is viable, or, under certain conditions, at any time and to provide certain exceptions to the requirement that a physician notify an unmarried minor’s parent or guardian prior to minor’s abortion; repeals pre-abortion information requirements about abortion alternatives; repeals some, and clarifies other, provisions related to abortion referral; requires that abortions be performed by licensed physicians; provides good-faith immunity under certain conditions to physicians performing abortions; authorizes State to adopt abortion regulations; repeals certain penalty and disciplinary provisions related to the performance of abortions.

The passage of Question 6 codified Roe v. Wade in Maryland, making abortion legal even if the U.S. Supreme Court were to reverse Roe v. Wade. Maryland is one of seven states that explicitly protects reproductive choice in state law.

The battle began in the General Assembly, where pro-choice legislators introduced a bill that would codify the protections of Roe v. Wade into state law and overturn the state’s restrictive 1968 abortion law. This would have protected Maryland women if Roe were ever overturned at the federal level. Unfortunately, the bill suffered a nine day filibuster in the 1990 Maryland Senate. In the following election, NARAL Pro-Choice MD worked exceptionally hard to ensure more pro-choice legislators were elected. In the 1991 session of the General Assembly, SB 162 passed the Senate (29-18) and the House of Delegates (84-52). Governor Schaefer signed the bill into law on February 18th.

Anti-choice activists gathered enough petition signatures to force the measure onto the ballot, and in 1992, it appeared on the ballot as Question 6. A vote for Question 6 upheld the law, and NPCM was part of broad coalition of pro-choice and other groups called Maryland For Choice (MFC) that fought to pass Question 6.

On November 3rd, 1992, Maryland voters went to the ballot box and voted for Questions 6 by a wide margin, with more than 60% of voters in favor of enacting the pro-choice law. On it’s 20th anniversary, we celebrated the achievement of the Maryland for Choice campaign, and all the coalition partners, staff, volunteers, donors, and voters who worked to keep Maryland a pro-choice state. Were you a part of the Question 6 campaign? We’d love to hear your story! Email us at

Insurance Coverage for Contraception

Maryland law requires health insurance plans that cover prescription drugs to provide equitable coverage for contraception.

What is required?
If a health insurance plan provides coverage for prescription drugs, it must provide coverage for any Food and Drug-Administration-approved prescription contraceptive drug or device, insertion or removal of such drug or device, and any medically necessary exam associated with the use of such drug or device.

To which insurance plans does the law apply?
Insurance plans, nonprofit health service plans, and health maintenance organization (HMO) contracts that provide coverage for prescription drugs.

Does the law provide additional protections for women?
Yes. Insurers may not impose a different co-payment or coinsurance for contraceptives than that imposed on any other prescription drug.

Does the law contain a refusal clause, allowing certain employers and/or insurers to refuse to provide or pay for contraceptive coverage?

To whom does the refusal clause apply?
Religious employers for whom contraceptive coverage conflicts with their bona fide religious beliefs and practices.

What does the refusal clause allow?
A religious employer may require issuers of its health insurance plans exclude coverage for contraception.

Is this refusal clause overbroad, jeopardizing insurance coverage for contraception for women?
Yes. By failing to define the term “religious employer,” the law’s refusal clause inappropriately includes a wide range of entities that perform non-religious functions in the public sphere.

Does the law require the refusing entity to notify the persons affected?
Yes. An employer exercising a refusal clause must provide employees reasonable and timely notice of the exclusion.

Are there circumstances under which a refusal clause may not be exercised?

Does the law provide a mechanism for women to obtain contraceptive coverage if their employer exercises a refusal clause?

MD. Code Ann., Ins. § 15-826 (Enacted 1998).

Protection Against Clinic Violence

A person who physically detains an individual or obstructs, impedes, or hinders an individual’s passage, with the intent to prevent the individual from entering or exiting a medical facility, is guilty of a misdemeanor and may be fined up to $1000, imprisoned for up to 90 days, or both. Md. Code Ann., Crim. § 10-204 (Enacted 2002).

SB232/HB616: Education – Pregnant and Parenting Students – Attendance Policy


NARAL Pro-Choice Maryland works to ensure that every child-bearing individual has the freedom to decide if, when, and how many children to have. We honor pregnancy in all its complexity and in doing so we support pregnant and parenting students as they navigate the challenges of building their families and completing their education. SB232/HB616 focuses on creating and clarifying excused absences for pregnant and parenting students in Maryland public schools for both medical and legal appointments, pertaining to both the parent who gave birth and the co-parent.  


Title IX’s promise of equal opportunity for women in Maryland has been for too long unrealized regarding pregnant and parenting students. Students are frequently pushed out of school or encouraged to attend separate educational facilities or GED programs where access to a rigorous education, such as advanced placement and honors courses, are limited.  

Currently, lawful absences under COMAR include “illness” of the student and “court summons”  Many school districts simply cut and paste straight from this list of lawful excuses to develop their official attendance policies. As currently written, these policies do not reflect information these youth are seeking as both students and parents. Where students stand in their relationship with their school and available support to finish high school figure into pregnancy decision-making. Unfortunately, some students will face unsupportive families and will need to change school districts while establishing new homes.Transparency, uniformity, and predictability are needed across school districts to help youth make the best decisions to achieve their educational and parenting goals.   


  • Defines excused absences for pregnancy or parenting-related health conditions (current COMAR attendance policy language only lists “illness” – pregnancy is not an illness).
  • Provides at a minimum 10 days of excused absences for a parenting student after the birth of the student’s child, for both mother and co-parent (not limited to ten days, but will prohibit schools forcing youth to return to school too soon that would interfere with recovery or infant bonding).
  • Allows excused absences for a parenting student to care for one’s own child who has a medical appointment or has taken ill.
  • Authorizes policies that a pregnant and parenting student be allowed time to make up missed school equal to at least as many days as the student was absent.
  • Creates excused absences for a pregnant and parenting student to participate in legal appointments to pursue particular family law actions, such as adoption, custody, and visitation.
  • Requires that these policies be published on school district websites.
  • Allows school faculty, staff, or administrators to have a better understanding of the rights of these youth and discourage violations under Title IX.

SB232/HB616 is not alone in its advocacy for pregnant and parenting youth. This bill was modeled from a New Mexico law passed in 2013. There are also other states, like Nebraska, which are introducing similar bills this year which serve to protect the rights of pregnant and parenting students by allowing them to form families without severe educational ramifications. Maryland school districts fail to protect their students’ Title IX rights when teen parents are forced to drop out due to unwarranted truancy investigations or an inability to make up work missed. By passing SB232/HB 616, Maryland legislators displayed their support of young parents and their academic endeavors, no longer forcing pregnant and parenting students to choose between their children and school.  


NARAL Pro-Choice Maryland served as the lead advocates of SB232/HB616.  We are joined by the following groups: 

o Maryland Conference of NAACP 

o CASA de Maryland 

o Women’s Law Center of Maryland 

o ACLU of Maryland 

o NARAL Pro-Choice Maryland 

o National Women’s Law Center 

o Maryland Catholic Conference 


o Homeless Persons’ Representation Project 

o MD Chapter of American College of Obstetricians/Gynecologists 


o Coalition to Protect Maryland’s Children (members b 

  • Adoptions Together
  • Advocates for Children & Youth
  • Associated Catholic Charities
  • Baltimore Child Abuse Center
  • Citizens Review Board for Children
  • Court Appointed Special Advocates
  • Family Tree
  • MD Chapter. National Association of Social Workers
  • MD Chapter of American Academy of Pediatrics
  • State Council on Child Abuse & Neglect

Talking Points – Pregnant and Parenting Students Attendance Policy 

  • Attendance and Teen Pregnancy

o Higher rates of absences are correlated with educational decline, increased high school dropout rates, weakened socio-emotional development, increased health risk behaviors, and greater risk of future unemployment.[1] 

o As a result from their status as a pregnant student or mother, young women are hindered in their potential to learn as many schools do not provide proper resources or support. These students may miss more than the allotted excused absences provided by the school, forcing them to drop out or trigger a truancy investigation. Pregnant and parenting students have the right to pursue a rigorous education equal to non-pregnant and non-parenting students. 

o When excused absences pertaining to pregnant and parenting students are not meaningfully established and their rights to a full high school education not clearly communicated, students may perceive being unwelcomed and/or an experience school push-out by faculty and staff. 

  • Teen Pregnancy and High School Dropout Rates

o Only 40% of teen mothers finish high school, with less than 2% of young mothers completing college by age 30.[2]Approximately 1,000 13 to 17 year-olds gave birth in Maryland in 2015. 

o Close to half of female dropouts and one-third of male dropouts say that becoming a parent was a factor in their decision to leave school.[3] 

o Economic instability can continue to the next generation as two-thirds of families formed by teen mothers are poor, with nearly one in four enrolling in welfare benefits after the birth of the first child. It has been found that two-thirds of children born to minor parents earn high school diplomas as compared to 81% of their peers.[4] 

o Lower graduation rates affect not only the individual well-being of teenage parents, but also negatively affect our economy as opportunities for meaningful participation in the workforce is diminished. 

  • Protection for Pregnant and Parenting Students under Title IX

o Title IX of the Education Amendments of 1972 prohibits schools that receive federal funds from discriminating against students on the basis of sex, which includes a student’s “actual or potential” parental, family or marital status and a student’s “pregnancy, childbirth, false pregnancy, termination of pregnancy or recovery there from.”[5] 

o Title IX prohibits schools from assuming that pregnant students cannot attend school or participate in school-sponsored activities.[6] 

o A school cannot require pregnant students to produce a doctor’s note in order to continue in school or school-sponsored activities.[7] However, if a doctor’s note is required for all students to participate in a certain activity, a pregnant student may be required to produce such.[8] 

o The school should provide excused absences and reasonable adjustments to the number of excused absences provided to students. [9] 

o Both the parent who gave birth and the co-parent should be protected under Title IX and given the same protection 

o The school must provide the same special services it provides to students with temporary medical conditions including, home instruction/at-home tutoring/independent study.[10] 



[1] Michael A. Gottfried. Retained Students and Classmates’ Absences in Urban Schools. (American Education Research Association, 2013) 1392-1423 

[2] Shuger, L. (2012). Teen Pregnancy and High School Dropout: What Communities are Doing to Address These Issues. 

[3] National Coalition for Women and Girls in Education (NCWGE). Title IX at 40: Working to Ensure Gender Equity in Education. Washington, DC: NCWGE, 2012. 

[4] National Conference of State Legislatures, Postcard: Teen Pregnancy Affects Graduation Rates, 2013 

[5] National Women’s Law Center. Title IX Protections for Pregnant and Parenting Students: A Guide for Schools. (National Women’s Center, 2009) 1-4 

[6] National Women’s Law Center. Title IX Protections 

[7] National Women’s Law Center. Title IX Protections 

[8] National Women’s Law Center. Title IX Protections 

[9] National Women’s Law Center. Title IX Protections 

[10]U.S. Department of Education Know Your Rights: Pregnant or Parenting? Title IX Protects You from Discrimination at School 

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We fight for a future that includes access to all reproductive health care no matter your zip code or employer. Maryland must lead the charge. Are you with us?