Maria Braley

Dear Honorable Chair and Members of the House Judiciary Committee, My name is Dr. Maria Braley, and I am a board-certified family physician practicing in New Hampshire. I care for patients across the lifespan, including pregnant patients, and I am writing to respectfully oppose HB1590 because of the serious and unintended harm it would cause to patients and to the physicians who care for them. While HB1590 is framed as a technical effort to “harmonize” legal definitions, in practice it expands the concept of legal personhood to include a fetus more broadly within the criminal code. This change would insert criminal law into routine medical care and create legal ambiguity around the treatment of pregnancy complications. Pregnancy is medically complex, and complications such as miscarriage, ectopic pregnancy, premature rupture of membranes, and severe maternal illness require timely, evidence-based medical intervention. Delays in treatment, even just a few hours, can result in hemorrhage, infection, permanent infertility, or death. Laws that expand criminal liability related to fetal outcomes create hesitation and fear among clinicians, increasing the risk that medically necessary care will be delayed while providers seek legal clarification rather than act immediately in the best interest of their patient. Miscarriage occurs in approximately 10–20% of recognized pregnancies, and management often involves the same medications and procedures used in abortion care. HB1590 risks creating confusion and legal exposure for physicians providing standard miscarriage treatment. Patients experiencing pregnancy loss are already facing emotional and physical trauma; they should not also face barriers to care or fear that their physicians may be constrained from treating them promptly and appropriately. This bill also threatens access to reproductive and fertility care, including IVF and other assisted reproductive technologies, which depend on clear legal distinctions between embryos, fetuses, and legal persons. Expanding personhood definitions can expose physicians and fertility specialists to legal risk and may result in reduced availability of these services in New Hampshire. Patients who are trying to build families could lose access to care in their own state. From a workforce perspective, laws that increase criminal liability for providing standard medical care make it more difficult to recruit and retain physicians. New Hampshire already faces shortages in primary care and obstetrics. Policies that create legal uncertainty and personal risk for clinicians will discourage physicians from practicing here and may lead hospitals to reduce or eliminate maternity services, particularly in rural communities. This ultimately harms patients by reducing access to prenatal care, delivery services, and emergency obstetric care. As physicians, our ethical and professional obligation is to provide timely, evidence-based care to protect the health and life of our patients. HB1590 would interfere with that obligation by introducing legal ambiguity and fear into critical medical decision-making. Medical care should be guided by clinical evidence and the physician-patient relationship, not by the threat of criminal interpretation. For these reasons, I respectfully urge the Committee to vote Inexpedient to Legislate (ITL) on HB1590 to protect the health, safety, and access to care of patients in New Hampshire. Thank you for your time and consideration. Sincerely, Maria Boylan, DO Board Certified Family Physician Penultimate Past President, NH Medical Society Board member, NH Academy of Family Physicians