Full opinion text
OPINION ANNE E. THOMPSON, Chief Judge. I. Introduction Plaintiffs, Planned Parenthood of Central New Jersey and several physicians, bring this action against defendants, the Attorney General of the State of New Jersey, the New Jersey Board of Medical Examiners and the Commissioner of the Department of Health and Senior Services, pursuant to- 42 U.S.C. §§ 1983 and 1988 and pursuant to 28 U.S.C. §§ 2201 and 2202. Plaintiffs seek declaratory and in-junctive relief from this Court to prevent the New Jersey Partial-Birth Abortion Ban Act of 1997, ch. 262, 1997 N.J. Sess. Law Serv. 871-72 (West), codified at N.J. Stat. Ann. §§ 2A:65A-5 to -7 (the “Act”), from taking effect. This Act exposes those who perform “partial-birth abortions” to professional license revocation and fines. Plaintiffs challenge the constitutionality of the Act on the grounds that it is vague and that it imposes an undue burden on a woman’s right to choose to have an abortion. The matter is before the Court on plaintiffs’ request for a declaration that the Act is unconstitutional and for a preliminary and permanent injunction. Plaintiffs contend that an injunction is necessary to prevent irreparable harm to themselves and their patients from the statute’s chilling effect on their ability to provide abortion services. The Court has reviewed the parties’ briefs, proposed findings of fact and conclusions of law, affidavits of the experts, testimony of the witnesses, and relevant caselaw. For the reasons set forth below, the Court grants to plaintiffs the relief they seek. II. Findings of Fact A. The Challenged Statute The Act prohibits the performance of a “partial-birth abortion.” See N.J. Stat. Ann § 2A:65A-6(a). The Act defines the banned conduct as “an abortion in which the person performing the abortion partially vaginally delivers a living human fetus before killing the fetus and completing the delivery,” N.J. Stat. Ann. § 2A:65A-6(e), and further defines the phrase “vaginally delivers a living human fetus before killing the fetus” to mean “deliberately and intentionally delivering into the vagina a living fetus, or a substantial portion thereof, for the purpose of performing a procedure the physician or other health care professional knows will kill the fetus, and the subsequent killing of the human fetus,” N.J. Stat. Ann. § 2A:65A-6(f). The ban applies throughout pregnancy. The Act does not define “partially” as it modifies “vaginally delivers,” “deliver,” “substantial,” “substantial portion,” or “procedure.” The Act does not require that the fetus be intact or viable at the time the “partial-birth abortion” is performed. The Act allows an otherwise banned procedure only when such a procedure “is necessary to save the life of the mother whose life is endangered by a physical disorder, illness or injury.” N.J. Stat. Ann. § 2A:65A-6(b). The Act contains no exception for procedures necessary to preserve the woman’s health. Under the Act, “knowing” performance of a “partial-birth abortion” subjects a physician to immediate license revocation and a $25,000 fine for each incident. See N.J. Stat. Ann. § 2A:65A-6(c). An ambulatory health care facility in which a “partial-birth abortion” occurs is also subject to immediate revocation of its license under the Act. See N.J. Stat. Ann. § 2A:65A-6(d); see also Senate Women’s Issues, CHILDREN AND FAMILY SERVICES COMMITTEE, Statement to the Gen. Assembly, No. 2409-L.1997, c. 262 (“[T]he bill provides that a woman upon whom a partial-birth abortion is performed shall be immune from civil or criminal liability for a violation of the provisions of the bill.”). B. Parties 1. Plaintiffs Plaintiff Gerson Weiss, M.D., is licensed to practice medicine in the State of New Jersey. He is a professor in and Chairman and Chief of Service of the Department of Obstetrics and Gynecology at the University of Medicine and Dentistry of New Jersey-New Jersey Medical School (“UMDNJ”), located in Newark, New Jersey. He is also Director of the Center for Reproductive Medicine, which is affiliated with Hackensack Hospital. Dr. Weiss is board-certified in obstetrics and gynecology, and has a subspecialty board-certification in reproductive endocrinology. In his position as Chairman and Chief of Service at UMDNJ, Dr. Weiss oversees the provision of all obstetrical and gynecological care at the hospital, including abortions up through eighteen weeks measured from the first day of the woman’s last menstrual period (“Imp”). He established the training program and teaches residents to provide the full range of obstetric and gynecological care, including abortions. Dr. Weiss has performed abortions since 1968, and has personally performed between 500 and 1000 abortions. He has used the suction curettage, or vacuum aspiration, dilation and evacuation, or D & E, and installation methods. He has also performed hysterotomy abortions. Dr. Weiss was qualified to testify as an expert in obstetrics and gynecology, including abortion methods. He sues on his own behalf and on behalf of his patients. Plaintiff David Wallace, M.D., is licensed to practice medicine in the State of New Jersey. He is President of the Medical Staff at Monmouth Medical Center, which is affiliated with the St. Barnabas Health Care System in Long Branch, New Jersey. He is Chairman of the Department of Obstetrics and Gynecology and ■ Director of the Residency Program. Dr. Wallace is board-certified in obstetrics and gynecology, and is eligible for certification in maternal-fetal medicine. Since 1980, Dr. Wallace has performed between 1500 and 2000 abortions. He currently performs about fifty abortions annually. Dr. Wallace provides, supervises, and teaches abortions through twenty-three weeks Imp. For procedures in the first trimester, he uses the vacuum aspiration method. For early second trimester procedures, through sixteen weeks Imp, he uses the D & E method. In his supervisory capacity, he teaches and supervises the perfonnance of these abortion techniques. Dr. Wallace was qualified to testify as an expert in obstetrics and gynecology, including abortion methods. He sues on his own behalf and on behalf of his patients. Plaintiff Herbert Holmes, M.D., is licensed to practice medicine in the State of New Jersey. He is a clinical associate professor of obstetrics and gynecology at UMDNJ, where he is the primary physician who performs abortions. He is also an attending surgeon at Newark Beth Israel Hospital with primary responsibility for abortions. Annually, Dr. Holmes performs four to five hundred first trimester suction curettage abortions and two to three hundred second trimester D & E abortions up through eighteen weeks Imp. He performs D & E abortions after eighteen weeks Imp where there is a demonstrable fetal abnormality. Until recently, while he was affiliated with United Hospitals in Newark, New Jersey, Dr. Holmes performed induction and installation abortions through twenty weeks Imp generally, and through twenty-four weeks Imp in the case of fetal abnormality or risk to the mother s health. Dr. Holmes was qualified to testify as an expert in obstetrics and gynecology, including abortion practice. He sues on his own behalf and on behalf of his patients. Plaintiff Planned Parenthood of Central New Jersey (“Planned Parenthood”) is an ambulatory health care facility licensed pursuant to N.J.A.C. § 8:43A-1.3, which provides vacuum aspiration abortions up to fourteen weeks Imp. It sues on its own behalf and on behalf of its patients. Among plaintiffs’ patients are women seeking abortions for a wide range of reasons, including the protection of health and life. They include women who develop serious health problems because of their pregnancies, and women for whom pregnancy presents particularly significant risks because of preexisting health conditions such as neurological disease, kidney disease, severe high blood pressure, cardiac conditions, cancer, diabetes, and other physical and mental health disorders. Among plaintiffs’ patients seeking abortions are women for whom a pregnancy endangers health, but not necessarily life. One such example is the risk of blindness that pregnancy poses for certain diabetic women. 2. Defendants Defendant Peter G. Verniero is Attorney General of the State of New Jersey and is responsible for enforcement of the Act. See N.J. Stat. Ann. § 2A:65A-6(c), (d). He is sued in his official capacity. The Office of the Attorney General declined to defend the Act. Defendant New Jersey Board of Medical Examiners is responsible under the Act for license revocation in cases where physicians are found to have violated the Act. See N.J. Stat. Ann. § 2A:65A-6(c). The Office of the Attorney General, charged with representing all state entities including the Board of Medical Examiners, declined to defend the Act. Defendant Len Fishman is Commissioner of the Department of Health and Senior Services (“HSS”) of New Jersey and is responsible under the Act for license revocation in cases where ambulatory health care facilities are found to have violated the Act. See N.J. Stat. Ann. § 2A:65A-6(d). He is sued in his official capacity. As stated above, the Office of the Attorney General, charged with representing HHS, declined to defend the Act. The New Jersey State Legislature was granted permission by this Court to intervene to defend the Act. See Planned Parenthood of Central N.J. v. Verniero, No. 97-6170, slip op. at 1 (D.N.J. Dec. 24, 1997) (Order). C. Witnesses 1. Plaintiffs’ Witnesses In addition to testimony by Drs. Weiss, Wallace and Holmes, plaintiff also offered into evidence the curriculum vitae and declaration of Carolyn Westhoff, M.D. Dr. Westhoff is an Associate Professor of Clinical Obstetrics and Gynecology and of Public Health at the College of Physicians and Surgeons of Columbia University in New York City, New York. She is also Medical Director of Family Planning and an associate attending physician at Columbia Presbyterian Medical Center in New York City. She is board-certified in obstetrics and gynecology. Dr. Westhoff presently performs only first trimester abortions, but has in her career performed more than five hundred second trimester abortions, including D & E, induction, saline installation and hysterotomy abortions. She teaches courses dealing with epidemiology, sexuality and reproduction, and reproductive health, including abortion techniques. 2. Defendants’ Witnesses Frank Henry Boehm, M.D., is Professor of Obstetrics and Gynecology at Vanderbilt University and Director of Obstetrics at Vanderbilt Medical Center. He is board-certified in obstetrics and gynecology and as a maternal fetal medicine specialist. Dr. Boehm has in his career performed first trimester D & C abortions and second trimester D & E, induction and hysteroto-my abortions, and he teaches these abortion methods. In the past ten years, he has performed only two D & E abortions on live fetuses. Dr. Boehm was qualified to testify as an expert in obstetrics and gynecology, including abortion methods. Watson A. Bowes, Jr., M.D., is Clinical ‘ Professor of Obstetrics and Gynecology at the University of North Carolina. He is board-certified in obstetrics and gynecology and as a maternal fetal medicine specialist. Between 1965 and 1967, while a resident at the University of Colorado, Dr. Bowes performed less than one hundred induction abortions. Since 1967, he has performed four or five abortions on live fetuses in cases where the life of the mother was at risk, including two D & E and one or two induction abortions, all before eighteen weeks Imp. With this above exception, Dr. Bowes has observed no abortions on live fetuses since 1967. He does perform between twenty and forty dilation and curettage, or D & C, procedures, a variation of the D & E method, annually where there has been an incomplete spontaneous abortion. He has also performed D & E and induction abortions in cases of fetal death. He teaches D & C, D & E, and induction abortion procedures. Dr. Bowes was qualified to testify as an expert in obstetrics and gynecology, including abortions. D. Abortion Practice An understanding of abortion in general and the various abortion methods in particular is necessary to any evaluation of the Act’s constitutionality. The Court’s understanding of these issues was derived from expert witness testimony, exhibits and affidavits. See Fed.R.Evid. 702 (“If scientific, technical, or other specialized knowledge will assist the trier of fact to understand the evidence or to determine a fact in issue, a witness qualified as an expert by knowledge, skill, experience, training, or education, may testify thereto in the form of an opinion or otherwise.”); Virgin Islands v. Sanes, 57 F.3d 338, 341 (3d Cir.1995) (noting the district court’s broad discretion to admit or rely on expert testimony). 1. Abortion Practice Generally The abortion procedure is considered to be generally safe. The risk of death from abortion does, however, increase as the pregnancy progresses. The following five conventional methods of abortion have been described to the Court: (1) suction curettage; (2) dilation and evacuation, or D & E; (3) induction, including installation; (4) hysterotomy; and (5) hysterectomy. In choosing which abortion procedure is most appropriate and in performing such procedure, the physician takes into account a number of factors, including the health and medical history of the patient, the gestational age, condition and position of the fetus, the skill of the physician, and the facilities available. Performance of a particular procedure will vary from physician to physician and, in procedures performed by one physician, from patient to patient. During each procedure, however, the intent of the physician is to terminate the pregnancy as efficiently as possible and in the way that is safest for the woman. 2. Specific Abortion Procedures a. Suction Curettage Approximately ninety percent (90%) of all abortions are performed prior to twelve weeks Imp. Suction curettage, also known as vacuum aspiration, is considered the standard of care during the first trimester, takes less than five minutes to complete, and is performed in an out-patient setting. During the procedure, the physician first cleanses the vagina and then grasps the cervix with a clamp. She then inserts into the cervix mechanical dilators-smooth metal or plastic dowels-of increasing diameter to gradually dilate the cervix. Once the cervix is sufficiently dilated, the physician inserts a cannula-a hollow tube with a blunt tip and openings on its side-into the uterus. The cannula is attached to a suction or vacuuming device. Suction is used to remove the uterine contents, including the amniotic fluid, the fetus and the placenta. Once this is done, the physician may scrape the uterine walls with a cu-rette-a loop of metal with a sharp to dull edge-to insure that the uterus is empty. During the suction curettage procedure, the cannula runs through the vagina and cervix into the uterus. The fetus may come through the cannula either intact or disarticulated. At times, part of the intact fetus may be in the vagina and part in the uterus, or a disarticulated part of the fetus may be in the vagina while the remainder of the fetus is in the uterus. In either of these situations, that part of the fetus which remains in the uterus may still have a heartbeat. b. Dilation and Evacuation (D & E) Dilation and evacuation, or D & E, procedures make up eighty to ninety percent (80-90%) of abortions performed after the first trimester and are performed from thirteen to twenty weeks Imp. During this procedure, the physician dilates the cervix in one of two ways. The physician may use mechanical dilators, as described above, or osmotic dilators. Osmotic dilators-thin straws containing laminaria or some other substance which swells when it comes in contact with water-are inserted into the cervical canal twelve to thirty hours prior to the procedure. The dilators swell and either partially or completely dilate the cervix. When the cervix is sufficiently dilated, the physician removes the dilators, grasps the cervix, and cleans the vagina. After using light suction to rupture the amniotic sac, the physician begins a largely blind procedure, inserting forceps into the uterus, grasping a conception product and pulling it out. This action is repeated until the fetus has been removed. Lastly, the physician uses suction to remove the placenta. During the D & E procedure, the fetus may be removed from the uterus and brought through the cervix and vagina either intact or disarticulated. Whether disarticulation occurs will depend largely on the amount of dilation, ie., whether the cervix is sufficiently dilated to permit the fetus to pass through the internal os, and the gestation of the fetus, ie., the fetus is more frail and prone to disarticulation during earlier stages of pregnancy. With this in mind, it may happen that part of the intact fetus will be in the vagina and part in the uterus or a disarticulated part of the fetus will be in the vagina while the remainder of the fetus is in the uterus. In either of these situations, that part of the fetus which remains in the uterus may still have a heartbeat. From approximately fourteen weeks Imp until term, the physician may grasp the fetus by the feet or legs and draw the fetus intact through the cervix into the vagina where the fetal head may get stuck in the internal cervical os. At this point, the fetus may still have a heartbeat. The physician will apply suction to dislodge the head. However, if this does not work, the physician must either disarticulate the fetal head and deliver it apart from the body or collapse the fetal head in order that the fetus may be delivered intact. This latter option resembles a procedure the American College of Obstetricians and Gynecologists (“ACOG”) calls an “intact dilatation and extraction.” See ACOG Exeoutive BoaRD, Statement on Intact Dilatation and Extraction 1 (January 12, 1997) (“ACOG Statement”). The intact dilatation and extraction, or intact D & X, has not been the subject of clinical trials or peer-reviewed studies and, as a result, there are no valid statistics on its relative safety. As its “elements are part of established obstetric techniques,” id., the procedure may be presumed to pose similar risks of cervical laceration and uterine perforation. However, because the procedure requires less instrumentation, it may pose a lesser risk. Moreover, the intact D & X may be particularly helpful where an intact fetus is desirable for diagnostic purposes. c. Induction and Installation During the second trimester, but generally not before sixteen weeks Imp, the majority of abortions performed that are not D & E abortions are induction abortions. During this procedure, the physician places osmotic dilators in the cervix twelve to twenty-four hours before administering medications intravenously, intra-muscularly or by suppository to induce labor. Substances used to induce labor include prostaglandin E2 and F2 alpha. Installation abortions, a subset of inductions, involve injecting a substance into the uterus through the abdomen using a needle or into the cervix using a needle or a cannula to cause uterine contractions. Substances used during installation abortions include concentrated urea or sodium chloride solutions. Labor lasts anywhere from ten to thirty hours, generally resulting in the delivery of an intact fetus. In twenty-five percent (25%) of cases, a cu-rette is then needed to remove the placenta. During an induction abortion, fetal demise may occur prior to delivery. Sodium chloride, when injected into the uterus or through the cervix, will immediately kill the fetus. Urea solutions, prostaglandins or uterine contractions may cause fetal death before delivery. If the fetus becomes entangled in the umbilical cord, the physician may need to cut the cord in order to effect the delivery. As in the D & E, the fetal head may become lodged in the internal cervical os, requiring the physician to disarticulate the fetal head and deliver it separate from the fetal body or deflate the fetal head in order to effect delivery of the fetus intact. Some complication, such as maternal hemorrhaging, may also necessitate an expeditious delivery, possibly resulting in disarticulation. In any of these situations, fetal death may occur while the fetus is partially in the uterus and partially in the vagina. Induction abortions are considered to be generally safe, entail a low risk of uterine perforation and, as they normally result in delivery of an intact fetus, are beneficial for fetal anomaly diagnosis. However, the induction procedure is medically inappropriate in those situations where labor would be contraindicated, such as where the woman has a severe cardiac condition, suffers from hypertension or asthma, or has had a previous cesarian section. Moreover, induction abortions require the woman to experience the same physiological and emotional stress as labor and delivery at term, must be performed in a hospital setting, and are less available and more expensive than other out-patient abortion procedures. d. Hysterotomy and Hysterectomy Hysterotomy and hysterectomy are used rarely to terminate pregnancies. A hys-terotomy is a pre-term cesarean section, where the abdomen is incised, the uterus is incised and the fetus is delivered out of the uterus through the abdomen. The risk of maternal death attending hysterotomies is three to four times that involved in vaginal delivery and any future deliveries must be performed by cesarian section due to the abdominal scar. A hysterectomy is the removal of the uterus. Hysterectomies also carry an enhanced risk of morbidity and mortality to the woman due to the incidence of hemorrhage. Furthermore, they eliminate the possibility of future childbirth. For these reasons, hysterectomies are generally not performed unless an independent reason requires removal of the uterus before term, e.g., cervical cancer. III. Conclusions of Law A. Legal Standard for Injunctive Relief Plaintiffs challenge the constitutionality of the Act on the grounds that it is vague and that it imposes an undue burden on a woman’s right to choose to have an abortion. Plaintiffs seek an Order from this Court granting plaintiffs’ request for declaratory relief and for a preliminary and permanent injunction. In deciding whether to issue a preliminary injunction, a district court weighs four factors: “(1) whether the movant has shown a reasonable probability of success on the merits; (2) whether the movant will be irreparably injured by denial of the relief; (3) whether granting preliminary relief will result in even greater harm to the nonmoving party; and (4) whether granting the preliminary relief will be in the public interest.” Gerardi v. Pelullo, 16 F.3d 1363, 1373 (3d Cir.1994) (quoting SI Handling Systems, Inc. v. Heisley, 753 F.2d 1244, 1254 (3d Cir.1985)). In deciding whether to issue a permanent injunction, “ ‘the court must determine if the plaintiff has actually succeeded on the merits (i.e., met its burden of proof).’ ” ACLU of N.J. v. Black Horse Pike Reg. Bd. of Educ., 84 F.3d 1471, 1477 n. 3 (3d Cir.1996) (quoting CIBA-GEIGY Corp. v. Bolar Pharmaceutical Co., Inc., 747 F.2d 844, 850 (3d Cir.1984), cert. denied, 471 U.S. 1137, 105 S.Ct. 2678, 86 L.Ed.2d 696 (1985)). B. Preliminary Issues Before reaching constitutional analysis of the Act, certain preliminary issues raised by the Legislature must be addressed. The Legislature contends that this Court lacks subject matter jurisdiction because plaintiffs lack standing. Alternatively, the Legislature contends that the cause of action is not ripe for adjudication and that abstention is mandated pursuant to Railroad Comm’n of Tex. v. Pullman Co., 312 U.S. 496, 61 S.Ct. 643, 85 L.Ed. 971 (1941). Each issue is addressed in turn. 1. Standing The Legislature argues that this Court is bound by New Jersey law to read the Act in such a way as to preserve its constitutionality. The Legislature contends that the Court must narrowly construe the Act to limit its scope, ie., to limit the Act’s proscription to the intact D & X abortion procedure described in the ACOG Statement. If this is done, the Legislature contends, plaintiffs do not have standing because they do not, by their own admission, perform that procedure. For the following reasons, this argument is rejected. See Planned Parenthood of Wise. v. Doyle, 162 F.3d 463, 465 (7th Cir.1998) (“The standing of the physician plaintiffs, and of Planned Parenthood as the owner of abortion clinics in Wisconsin, to maintain this suit is not open to question.” (citing Planned Parenthood of Central Mo. v. Danforth, 428 U.S. 52, 62, 96 S.Ct. 2831, 49 L.Ed.2d 788 (1976); Doe v. Bolton, 410 U.S. 179, 188-89, 93 S.Ct. 739, 35 L.Ed.2d 201 (1973))). State statutes must be construed to avoid constitutional difficulty whenever possible. See Communications Workers of Am. v. Beck, 487 U.S. 735, 762, 108 S.Ct. 2641, 101 L.Ed.2d 634 (1988); United States v. Navarro, 145 F.3d 580, 589 (3d Cir.1998); Hamilton Amusement Ctr. v. Verniero, 156 N.J. 254, 280, 716 A.2d 1137, 1149 (1998). While this “canon of construction that a court should strive to interpret a statute in a way that will avoid an unconstitutional construction is useful in close cases, ... it is not a license for the judiciary to rewrite language enacted by the legislature.” Chapman v. United States, 500 U.S. 453, 464, 111 S.Ct. 1919, 114 L.Ed.2d 524 (1991) (citation and quotation marks omitted); see also Reno v. ACLU, 521 U.S. 844, 884, 117 S.Ct. 2329, 138 L.Ed.2d 874 (1997) (noting that a court “may impose a limiting construction on a statute only if it is ‘readily susceptible’ to such a construction” (quoting Virginia v. American Booksellers Ass’n, Inc., 484 U.S. 383, 397, 108 S.Ct. 636, 98 L.Ed.2d 782 (1988))). This limitation on the Court’s ability to narrowly construe an ambiguous statute is informed by separation of powers and federalism concerns. See Salinas v. United States, 522 U.S. 52, 118 S.Ct. 469, 475, 189 L.Ed.2d 352 (1997). This Court is not in a position to rewrite the Act to cure its constitutional infirmities. To do so would involve the federal court in legislating state law, an activity clearly beyond its judicial role and specifically reserved to the state. See Little Rock Family Planning Servs., P.A. v. Jegley, No. 97-581, slip op. at 28 (E.D.Ark. Nov. 13, 1998) (“[R]ewriting a statute to cure its constitutional infirmities would impermissi-bly involve a federal court in ‘positive legislative enactment clearly beyond its judicial role.’ ’’(citation omitted)). Thus, contrary to the Legislature’s contentions, these principles of statutory construction support plaintiffs’ standing to raise a vagueness challenge to the Act. As physicians who provide abortions, plaintiff doctors are subject to license revocation and civil liability under the Act. See N.J. Stat. Ann. § 2A:65A-6(c). Likewise, as an ambulatory health care facility which provides abortions, plaintiff Planned Parenthood is subject to license revocation under the Act. See N.J. Stat. Ann. § 2A-.65A-6(d). Thus, there is no question that plaintiffs are the “one[s] against whom these ... statutes directly operate.” Doe v. Bolton, 410 U.S. 179, 188, 93 S.Ct. 739, 35 L.Ed.2d 201 (1973). Plaintiffs allege that the Act’s definition of “partial-birth abortion” is so vague that it could be reasonably interpreted to encompass all conventional abortion methods except hysterectomies and hysterotomies. Plaintiffs further allege that they have performed and wish to continue performing these conventional abortions, but that, if the Act goes into effect, they will be forced to stop. Plaintiffs allege facts sufficient to establish their vulnerability under the Act and, thus, to support their standing on the vagueness issue. See Summit Med. Assoc., P.C. v. James, 984 F.Supp. 1404, 1429 (M.D.Ala.1998) (finding standing where court is unable to determine conclusively that abortions performed by plaintiffs “fall outside of the range of abortions proscribed by the act”). Plaintiffs also have standing to challenge the Act on the basis that it imposes an undue burden on a woman’s right to choose to have an abortion. It is well-established “that doctors have standing ‘to assert the rights of women patients as against governmental interference with the abortion decision.’ ” Evans v. Kelley, 977 F.Supp. 1283, 1302 (E.D.Mich.1997) (quoting Singleton v. Wulff, 428 U.S. 106, 115-16, 96 S.Ct. 2868, 49 L.Ed.2d 826 (1976)). Third-party standing in this context is justified by the close fiduciary relationship between doctor and patient and by the patient’s right to privacy and mootness concerns. See Carhart v. Stenberg, 972 F.Supp. 507, 520-21 (D.Neb.1997); Women’s Med. Prof. Corp. v. Voinovich, 911 F.Supp. 1051, 1058 (S.D.Ohio 1995), aff'd, 130 F.3d 187 (6th Cir.1997), cert. denied, — U.S. -, 118 S.Ct. 1347, 140 L.Ed.2d 496 (1998). Under the Act, plaintiff doctors face license revocation and civil liability and plaintiff Planned Parenthood faces license revocation. Plaintiffs allege that, if the Act goes into effect, it will have the effect of prohibiting physicians from performing and thus effectively preclude women from obtaining most conventional abortions. Such “governmental interference with the abortion decision” supports plaintiffs’ standing on the undue burden issue. 2. Ripeness The Legislature contends that, even if plaintiffs have standing, the cause of action is not ripe for adjudication. “Ripeness concerns whether the legal issue at the time presented in a court is sufficiently concrete for decision.” United States ex rel. Ricketts v. Lightcap, 567 F.2d 1226, 1232 (3d Cir.1977). The ripeness doctrine is intended “to prevent the courts, through avoidance of premature adjudication, from entangling themselves in abstract disagreements.” Abbott Labs. v. Gardner, 387 U.S. 136, 148, 87 S.Ct. 1507, 18 L.Ed.2d 681 (1967), overruled on other grounds, Califano v. Sanders, 430 U.S. 99, 97 S.Ct. 980, 51 L.Ed.2d 192 (1977). In determining whether a particular case is ripe for adjudication, a district court must consider “the ’ fitness of the issues for judicial decision and the hardship to the parties of withholding court consideration.” Id. at 149; see also Blanchette v. Connecticut Gen. Ins. Corp., 419 U.S. 102, 143 n. 29, 95 S.Ct. 335, 42 L.Ed.2d 320 (1974) (listing as factors for case-by-case ripeness determination, inter alia, likelihood that plaintiff will disobey the law, present injury due to threat of prosecution, and likelihood of prosecution). Plaintiffs’ case is ripe for adjudication. As this Court has taken time to develop a comprehensive record and resolution of the case depends almost exclusively on matters of law, the case is fit for judicial determination. See Abbott Labs., 387 U.S. at 149; Artway v. Attorney General of N.J., 81 F.3d 1235, 1249 (3d Cir.1996). The facts also support a finding of significant hardship to plaintiffs if the Act goes into effect. When a plaintiff alleges the intention to engage in conduct which is “arguably affected with a constitutional interest” and legislatively-proscribed and a credible threat of prosecution exists, there is no requirement that the plaintiff first expose herself to liability in order to challenge the statute’s constitutionality. See Babbitt v. United Farm Workers Nat’l Union, 442 U.S. 289, 298, 99 S.Ct. 2301, 60 L.Ed.2d 895 (1979). Plaintiffs are subject to the Act’s proscriptions and perform constitutionally-permissible abortions which potentially come within the Act’s definition of “partial-birth abortion.” Thus, the threat of liability under the Act is more than “imaginary or speculative.” Younger v. Harris, 401 U.S. 37, 42, 91 S.Ct. 746, 27 L.Ed.2d 669 (1971); see also Women’s Med. Prof. Corp. v. Voinovich, 911 F.Supp. 1051, 1058 (S.D.Ohio 1995) (finding plaintiff doctors’ challenge to state ban of D & X abortions “ripe for decision because a doctor facing criminal penalties for performing abortions may sue for pre-enforcement review of the relevant statute” (citing Doe v. Bolton, 410 U.S. 179, 188, 93 S.Ct. 739, 35 L.Ed.2d 201 (1973))), aff'd, 130 F.3d 187 (6th Cir.1997), cert. denied, — U.S. -, 118 S.Ct. 1347, 140 L.Ed.2d 496 (1998). 3. Pullman Abstention Finally, the Legislature submits that this Court must refrain from adjudicating plaintiffs’ claim pursuant to Railroad Commission of Texas v. Pullman, 312 U.S. 496, 61 S.Ct. 643, 85 L.Ed. 971 (1941). “Pullman abstention allows federal courts, in rare cases, to abstain from deciding a case if a state court’s resolution of a state law issue would obviate the need for the federal court to reach a federal constitutional issue.” Artway v. Attorney General of N.J., 81 F.3d 1235, 1270 (3d Cir.1996). The doctrine is intended to serve three purposes: (1) to avoid needless “friction” between federal and state judiciaries; (2) to reduce the likelihood of erroneous interpretations of state law; and (3) to avoid unnecessary constitutional rulings. Pullman, 312 U.S. at 499-501; see also United States v. City of Pittsburgh, 757 F.2d 43, 45 (3d Cir.1985) (offering as the two basic purposes for Pullman abstention “the avoidance of unnecessary constitutional pronouncements, and the avoidance of undue interference with sensitive state programs”). “Pullman abstention ‘is an extraordinary and narrow exception to the duty of a District Court to adjudicate a controversy properly before it ... [and is] justified ... only ... in exceptional circumstances.’ ” Artway, 81 F.3d at 1270 (quoting Colorado River Water Conser v. Dist. v. United States, 424 U.S. 800, 813, 96 S.Ct. 1236, 47 L.Ed.2d 483 (1976)). In the Third Circuit, three such “exceptional circumstances” must exist before a. court may abstain pursuant to Pullman: First, there must be uncertain issues of state law underlying the federal constitutional claims brought in the federal court. Second, these state law issues must be amenable to an interpretation by the state courts that would obviate the need for or substantially narrow the scope of the adjudication of the constitutional claims. And third, it must appear that an erroneous decision of state law by the federal court would be disruptive of important state policies. D'Iorio v. County of Delaware, 592 F.2d 681, 686 (3d Cir.1978), overruled in part on other grounds, Kershner v. Mazurkiewicz, 670 F.2d 440, 448 (3d Cir.1982). If all three circumstances are present, the district court must determine whether abstention is consistent with equity “by weighing such factors as the availability of an adequate state remedy, the length of time the litigation has been pending, and the impact of delay on the litigants.” Artway, 81 F.3d at 1270; see also Coast Cities Truck Sales, Inc. v. Navistar Internat'l Transp. Co., 912 F.Supp. 747, 780 (D.N.J.1995). Uncertainty of state law underlies plaintiffs’ challenge to the Act on vagueness grounds. Although this uncertainty would ordinarily militate in favor of abstention, the Supreme Court has made dear that “not every vagueness challenge to an uninterpreted state statute or regulation constitutes a proper case for abstention.” Procunier v. Martinez, 416 U.S. 396, 401, 94 S.Ct. 1800, 40 L.Ed.2d 224 (1974), overruled in part on other grounds, Thornburgh v. Abbott, 490 U.S. 401, 109 S.Ct. 1874, 104 L.Ed.2d 459 (1989). The Procunier Court went on to explain: Where the case turns on the applicability of a state statute or regulation to a particular person or a defined course of conduct, resolution of the unsettled question of state law may eliminate any need for constitutional adjudication. Abstention is therefore appropriate. Where, however, as in this case, the statute or regulation is challenged as vague because individuals to whom it plainly applies simply cannot understand what is required of them and do not wish to forswear all activity arguably within the scope of the vague terms, abstention is not required. In such a case no single adjudication by a state court could eliminate the constitutional difficulty. Rather it would require “extensive adjudications, under the impact of a variety of factual situations,” to bring the challenged statute or regulation “within the bounds of permissible constitutional certainty.” Id. at 401 n. 5 (citations omitted). Plaintiffs’ challenge falls into the latter category, making abstention inappropriate in this case. The Act is challenged as vague because plaintiffs, individuals and entities to whom the Act clearly applies, allege that they cannot understand what is proscribed. As a result, plaintiffs contend they will be required to stop performing constitutionally-permissible abortion procedures, arguably within the scope of the Act’s vague terms, in order to avoid license revocation and fines. Given the array of possible factual situations in which vagueness of the Act may be an issue, no single adjudication by a New Jersey state court could eliminate the constitutional question. See id.; see also United States v. City of Pittsburgh, 757 F.2d 43, 45 (3d Cir.1985) (“[T]he mere possibility that a constitutional adjudication may be avoided by a state court interpretation of state law, by itself, is insufficient reason to require abstention.”); Erwin Chemerinsky, Federal Jurisdiction § 12.2, at 693 (1994) (noting that abstention is appropriate in vagueness cases “only if there is a substantial possibility that the state court could provide a narrowing construction that would save the statute from being invalidated”). Because the Act is not susceptible to a state court interpretation which would render unnecessary or substantially limit the federal constitutional question, it is this Court’s duty to exercise its jurisdiction. See Marks v. Stinson, 19 F.3d 873, 882-83 n. 6 (3d Cir.1994), cert. denied, 513 U.S. 1111, 115 S.Ct. 901, 130 L.Ed.2d 785 (1995). Abstention is especially inappropriate here because plaintiffs do not challenge the Act solely on vagueness grounds. See Procunier, 416 U.S. at 401-02. C. Vagueness Plaintiffs argue that the Act is unconstitutionally vague because key terms of the Act’s definition of “partial-birth abortion” are susceptible to multiple interpretations. Plaintiffs suggest that, by failing to adequately define “substantial portion,” “partially vaginally deliver,” and “living,” the Legislature has left those individuals and entities subject to the Act’s penalties without fair warning of the proscribed conduct and the Act open to arbitrary and discriminatory enforcement. The Legislature counters that the Act utilizes commonly-understood words and states plainly what conduct is prohibited. To comport with due process, a statute must give fair warning as to what conduct is forbidden. See Village of Hoffman Estates v. Flipside, Hoffman Estates, 455 U.S. 489, 498, 102 S.Ct. 1186, 71 L.Ed.2d 362 (1982); Colautti v. Franklin, 439 U.S. 379, 390, 99 S.Ct. 675, 58 L.Ed.2d 596 (1979), overruled in part on other grounds, Webster v. Reproductive Health Servs., 492 U.S. 490, 109 S.Ct. 3040, 106 L.Ed.2d 410 (1989); Grayned v. City of Rockford, 408 U.S. 104, 108, 92 S.Ct. 2294, 33 L.Ed.2d 222 (1972). Without such a warning, people “steer far wider of the unlawful zone ... than if the boundaries of the forbidden areas were clearly marked.” Grayned, 408 U.S. at 109 (quoting Baggett v. Bullitt, 377 U.S. 360, 372, 84 S.Ct. 1316, 12 L.Ed.2d 377 (1964)). For this reason, a “statute which either forbids or requires the doing of an act in terms so vague that men of common intelligence must necessarily guess at its meaning and differ as to its application, violates the first essential of due process of law.” Smith v. Goguen, 415 U.S. 566, 572 n. 8, 94 S.Ct. 1242, 39 L.Ed.2d 605 (1974) (quoting Connolly v. General Constr. Co., 269 U.S. 385, 391, 46 S.Ct. 126, 70 L.Ed. 322 (1926)). A statute is also void for vagueness if it lacks sufficient standards of application such that it is open to arbitrary and discriminatory enforcement. See Grayned, 408 U.S. at 108. Such a law “impermissibly delegates basic policy matters to policemen, judges, and juries for resolution on an ad hoc and subjective basis, with the attendant dangers of arbitrary and discriminatory application.” Id. A higher degree of clarity is required when “uncertainty induced by the statute threatens to inhibit the exercise of constitutionally protected rights.” Colautti, 439 U.S. at 391; see also Hoffman Estates, 455 U.S. at 499 (“[Pjerhaps the most important factor affecting the clarity that the Constitution demands of a law is whether it threatens to inhibit the exercise of constitutionally protected rights.”). A statute will be struck as unconstitutionally vague for failure to satisfy this heightened standard, even if it “could conceivably have had some valid application.” Kolender v. Lawson, 461 U.S. 352, 358-59 n. 8, 103 S.Ct. 1855, 75 L.Ed.2d 903 (1983); see also Hoffman Estates, 455 U.S. at 494-95; Colautti, 439 U.S. at 390-91; Planned Parenthood of Wis. v. Doyle, 162 F.3d 463, 469 (7th Cir.1998) (“[A] statute that punishes a class of constitutionally punishable abortions so vaguely that it makes doctors afraid to perform constitutionally permissible abortions is quite likely to infringe constitutional rights.”). The Act bans “partial-birth abortions.” As defined in the Act, a “partial-birth abortion” is “an abortion in which the person performing the abortion partially vaginally delivers a living human fetus before killing the fetus and completing the delivery.” N.J. Stat. Ann. § 2A:65A6(e). The Act further defines “vaginally delivers a living human fetus before killing the fetus” as “deliberately and intentionally delivering into the vagina a living fetus, or a substantial portion thereof, for the purpose of performing a procedure the physician or other health care professional knows will kill the fetus, and the subsequent killing of the human fetus.” N.J. Stat. Ann. § 2A65A-6(f). Any vagueness analysis must focus on these definitions. The Court finds that, because persons of ordinary intelligence must guess at the meaning of phrases such as “partially vaginally delivers,” “living,” and “substantial portion,” the Act is void for vagueness. The phrase “partially vaginally delivers,” as it is used in the Act, is subject to more than one reasonable interpretation. In common usage, the term “deliver” means simply “to give birth to.” Web-steR’s ThiRD New International Dictionary 597 (1976). However, in obstetrics, “deliver” has a broader meaning and is used to refer “to bringing] out through the cervix, out of the uterus, out of the woman.” Modifying “deliver” with “vaginally” merely stresses that the physician must bring out through the vagina. Two interpretations of the phrase “partially vaginally delivers” emerge. “Partially vaginally delivers” may describe, as the Legislature contends, the situation where an intact fetus is delivered in part through the vagina. The phrase may also encompass the situation where a fetal part is delivered through the vagina. In so finding, the Court rejects the Legislature’s suggestion that the use of the term “birth,” in “partial-birth abortion,” renders the latter interpretation unreasonable. “Birth” is defined as “the emergence of a new individual from the body of its parent.” Id. at 221. The Legislature contends that this definition is not consistent with the extraction of fetal parts. While this may be true, the extraction of fetal parts is consistent with the definition provided by the Legislature in the Act. As used in the Act, the term “birth” is only part of the term “partial-birth abortion,” which is defined as “an abortion in which a person performing the abortion partially vaginally delivers a living human fetus before killing the fetus and completing the delivery.” It is this definition which permits at least two reasonable interpretations: the delivery of an intact fetus in part through the vagina or the delivery of a fetal part through the vagina. See Hope Clinic v. Ryan, 995 F.Supp. 847, 855 n. 1 (N.D.Ill.1998) (“We refuse to read another definition into the statute when the term at issue is already defined within the statute. It is from the definitions within the statute that we draw the statute’s meaning.”). The Act’s use of the phrase “living human fetus” is consistent with both of these interpretations. The term “living” means “having life.” Webster’s ThiRD New InterNATIONAL DICTIONARY 1324 (1976). “Life” is defined as “the quality that distinguishes a vital and functional being from a dead body ... characterized by the capacity to perform certain functional activities including metabolism, growth, reproduction, and some form of responsiveness or adaptability.” Id. at 1306. Each expert who testified at the hearing agreed that “living,” as it is used in the medical profession, means having a heartbeat, a vital sign that is detectable as early as the seventh week Imp. A “fetus,” as defined by one dictionary, is “a developing human from ... three months after conception to birth.” Id. at 842. Furthermore, as Drs. Weiss and Holmes testified, physicians refer to a pregnancy as a “fetus,” rather than as an embryo, from the seventh to ninth week Imp until birth. That the Act bans procedures performed as early as seven weeks Imp is consonant with the lack of a viability requirement. There is also no requirement that the fetus be intact at the time of the prohibited conduct. The Court does not find persuasive the Legislature’s argument that use of the phrase “living human fetus” necessarily implies an intact fetus. A fetus may be “living,” ie., have a heartbeat, despite disarticulation. Thus, in the absence of further definition in the Act, “living human fetus” may be reasonably interpreted as a human fetus, from as early as seven weeks Imp until birth, either intact or disarticulated, which retains a heartbeat. The “substantial portion” language only compounds the vagueness problem. Use of “substantial portion thereof’ feeds confusion about whether the fetus must be intact. That is, the phrase may be read to require whole or partial delivery into the vagina of an intact living fetus. Conversely, the language may be read to provide for the situation where a “substantial portion” of the fetus is delivered into the vagina, disarticulated from the remainder of the fetus which remains in the uterus with a heartbeat. The phrase also creates new confusion over what constitutes a “substantial portion.” The breadth of what men of ordinary intelligence might consider a “substantial portion” to be is indicated by the expert testimony received in this case. Definitions ranged from “any part of the fetus” to “any part of my body that was removed that I would miss .... certainly a limb” to “a breech delivery, up to the thorax.” During almost every conventional abortion procedure, an intact fetus with a heartbeat may be delivered in part into the vagina or a substantial fetal part may be delivered into the vagina while the remainder of the fetus is in the uterus with a heartbeat. In a suction curettage abortion, the cannula is placed through the vagina and cervix and into the uterus. The fetus may come through the cannula either intact or disarticulated. Part of the intact fetus may be in the vagina and part in the uterus, or a disarticulated part of the fetus may be in the vagina while the remainder of the fetus is in the uterus. In either of these situations, the fetus may still have a heartbeat. Whatever step the physician takes next, before completing the delivery, may kill the fetus. Suction curettage would thus come within the Act’s definition of a “partial-birth abortion.” In a D & E abortion, the physician uses suction and forceps to remove the fetus, either intact or disarticulated. During evacuation of the uterus, part of the intact fetus may be in the vagina and part in the uterus or a disarticulated part of the fetus may be in the vagina while the remainder of the fetus is in the uterus. The fetus may still have a heartbeat. Alternatively, it may happen that the physician grasps the fetus by the feet or legs and draws the fetus intact through the cervix and into the vagina until the fetal head lodges in the internal cervical os. At this point, the fetus may still have a heartbeat. In any of these situations, the next step taken by the physician, before completing the delivery, may kill the fetus. This would bring the D & E within the Act’s definition of a “partial-birth abortion.” Finally, during any induction or installation abortion, it is possible that the fetus will become entangled in the umbilical cord, that the fetal head will become lodged in the internal cervical os, or that some other complication, such as maternal hemorrhaging, will occur. In any of these situations, the fetus may still have a heartbeat and may be positioned partially in the uterus and partially in the vagina. Any subsequent step taken by the physician before completing the delivery, e.g., cutting the umbilical cord, disarticulating or deflating the fetal head, could kill the fetus. An induction might then qualify as a “partial-birth abortion” under the Act. Because the phrases “partially vaginally delivers,” “living human fetus,” and “substantial portion” have more than one interpretation, those subject to the penalties of the Act cannot, with any certainty, determine what conduct is prohibited. As a result, they may steer far wider of the unlawful zone, see Grayned v. City of Rockford, 408 U.S. 104, 109, 92 S.Ct. 2294, 33 L.Ed.2d 222 (1972), and refuse to perform many conventional abortion procedures, e.g., suction curettage, D & E and induction abortions, even if the Legislature did not intend to proscribe those procedures. This lack of precision also leaves the Act open to arbitrary and discriminatory enforcement. Id. at 108-09. Given that the Act “threatens to inhibit the exercise of constitutionally protected rights,” Colautti v. Franklin, 439 U.S. 379, 391, 99 S.Ct. 675, 58 L.Ed.2d 596 (1978), overruled in part on other grounds, Webster v. Reproductive Health Servs., 492 U.S. 490, 109 S.Ct. 3040, 106 L.Ed.2d 410 (1989), such vagueness cannot be tolerated. Because this Court finds the Act to be constitutionally infirm due to its use of “partially vaginally delivers,” “living human fetus,” and “substantial portion,” there is no need to address at length the Legislature’s reliance on the Act’s use of “procedure” and “subsequent killing.” Suffice it to say, it is the Court’s understanding that performance of an abortion is unique. Names are given to certain types of abortion methods, but each time those methods are performed, their progression depends on the particulars of the physician and the patient. The physician cannot know, before the abortion begins, what steps 'will be necessary and she cannot know, during or after the abortion, where and when fetal demise occurs, unless the fetus is still living upon delivery. All that is certain is that the physician intends to terminate the pregnancy in the safest way possible for the mother. In this context, it becomes clear that the Legislature’s reliance on “procedure” and “subsequent killing” to inject clarity into the Act is misplaced. These terms merely require that, during an abortion procedure, while the fetus or a “substantial portion” of the fetus is partly in the uterus and partly in the vagina, the physician does something which she knows may cause fetal death, if the fetus has not already died. This situation may occur during any conventional abortion procedure, except a hysterectomy or hysterotomy. The Court also finds unconvincing the Legislature’s suggestion that the Act’s scienter requirement cures its vagueness problems. A scienter requirement may, in some cases, alleviate a vagueness problem. In Colautti, the Supreme Court found an abortion statute’s vagueness compounded by its lack of a scienter requirement and noted that such a requirement “ ‘may avoid those consequences to the accused which may otherwise render a vague or indefinite statute invalid.’ ” Colautti, 439 U.S. at 395 n. 13 (quoting Screws v. United States, 325 U.S. 91, 101, 65 S.Ct. 1031, 89 L.Ed. 1495 (1945)). The Court went on to explain: “The requirement that the act must be willful or purposeful may not render certain, for all purposes, a statutory definition of the crime which is in some respects uncertain. But it does relieve the statute of the objection that it punishes without warning an offense of which the accused was unaware.” Id. (quoting Screws, 325 U.S. at 102). This qualification is significant. Certainly, “[a] scienter requirement cannot eliminate vagueness ... if it is satisfied by an ‘intent’ to do something that is in itself ambiguous.” Nova Records, Inc. v. Sendak, 706 F.2d 782, 789 (7th Cir.1983); see also Sewell v. Georgia, 435 U.S. 982, 987, 98 S.Ct. 1635, 56 L.Ed.2d 76 (1978) (Brennan, J., dissenting) (remarking that scienter requirement should not save an otherwise unconstitutionally vague statute where requirement “provides no reasonable assurance that persons will know or ought to know when they are likely to violate” the statute); United States v. Corrow, 119 F.3d 796, 804 n. 11 (10th Cir.1997) (“We do not say that a scienter requirement alone will rescue an otherwise vague statute, recognizing ‘it is possible willfully to bring about certain results and yet be without fair warning that such conduct is proscribed.’ ” (quoting 1 W. LaFave & A. Scott, Jr., Substantive Criminal Law § 2.3, at 131 (1986))), cert. denied, — U.S. -, 118 S.Ct. 1089, 140 L.Ed.2d 146 (1998); Record Head Corp. v. Sachen, 682 F.2d 672, 677-78 (7th Cir.1982) (finding ordinance unconstitutionally vague on the basis that its scienter requirement was circular and nonclarifying); Note, The Void-for-Vagueness Doctrine in the Supreme Court, 109 U. Pa. L.Rev. 67, 87 n. 98 (1960) (noting that the scienter requirement “must envisage not only a knowing what is done but a knowing that what is done is unlawful or, at least, so ‘wrong’ that it is probably unlawful”). To hold otherwise would be to suggest that a legislature may avoid vagueness challenges altogether by simply including a scienter requirement in every enactment. Inclusion of a scienter requirement does not alleviate the Act’s vagueness problems. The Act requires that the person performing the abortion deliberately and intentionally deliver[] into the vagina a living fetus, or a substantial portion thereof, for the purpose of performing a procedure the physician or other health care professional knows will kill the fetus, and the subsequent lolling of the fetus. N.J. Stat. Ann. § 2A:65A-6(f) (emphasis added). This scienter requirement does not render more certain that language which renders the statute vague. As a result, the requirement fails to alleviate the Act’s vagueness because “it is satisfied by an ‘intent’ to do something that is in itself ambiguous.” Nova Records, Inc. v. Sendak, 706 F.2d 782, 789 (7th Cir.1983); see also Little Rock Family Planning Servs., P.A. v. Jegley, No. 97-581, slip op. at 41-42 (E.D.Ark. Nov. 13, 1998) (rejecting defendant’s argument that intent requirement cures partial-birth abortion ban’s vagueness); Planned Parenthood of Greater Iowa, Inc. v. Miller, 1 F.Supp.2d 958, 962 (S.D.Iowa 1998) (same). That the Act should be struck as unconstitutionally vague finds support in the caselaw from the vast majority of federal district and circuit courts which have considered vagueness challenges in the partial-birth abortion context. See Planned Parenthood of Wis. v. Doyle, 162 F.3d 463, 469-70 (7th Cir.1998) (directing district court to enter preliminary injunction); A Choice for Women v. Butterworth, No. 98-774, slip op. at 20-25 (S.D.Fla. Nov. 23, 1998) (permanent injunction); Intermountain Planned Parenthood v. Montana, No. 97-477, slip op. at 7-11 (D. Mont. June 29, 1998) (same); Miller, 1 F.Supp.2d at 961—62 (preliminary injunction); Brancazio v. Underwood, No. 98-495, slip op. at 3 (S.D.W. Va. June 11, 1998) (temporary restraining order); Hope Clinic v. Ryan, 995 F.Supp. 847, 853-56 (N.D.Ill.1998) (preliminary and permanent injunction); Planned Parenthood of So. Ariz., Inc. v. Woods, 982 F.Supp. 1369, 1378-79 (D.Ariz.1997) (same); Carhart v. Stenberg, 11 F.Supp.2d 1099, 1131-32 (D.Neb.1998) (permanent injunction); Evans v. Kelley, 977 F.Supp. 1283, 1304-11 (E.D.Mich.1997) (same); Causeway Med. Suite v. Foster, No. 97-2211, slip op. at 1 (E.D.La. July 21, 1997) (temporary injunction); Rhode Island Med. Soc. v. Pine, No. 97-416, slip op. at 1 (D.R.I. July 11, 1997) (temporary restraining order); see also Women’s Med. Prof. Corp. v. Voinovich, 911 F.Supp. 1051, 1063-67 (S.D.Ohio 1995) (finding ban on “Dilation and Extraction” unconstitutionally vague because its definition includes the D & E abortion procedure), aff'd, 130 F.3d 187, 198-200 (6th Cir.1997), cert. denied, — U.S. -, 118 S.Ct. 1347, 140 L.Ed.2d 496 (1998); cf. Summit Med. Assoc., P.C. v. James, 984 F.Supp. 1404, 1437-38 (M.D.Ala.1998) (certifying questions to the state supreme court regarding what abortion procedures the partial-birth abortion ban reaches); Planned Parenthood of Alaska, Inc. v. Alaska, No. 97-6019, slip op. at 6-12 (Alaska Super.Ct. Mar. 13, 1998) (permanently enjoining partial-birth abortion ban as void-for-vagueness under provisions of Alaska State Constitution). The Act fails to define with any certainty the conduct that is proscribed and, as a result, leaves the Act open to “arbitrary and discriminatory enforcement.” Papachristou v. City of Jacksonville, 405 U.S. 156, 170, 92 S.Ct. 839, 31 L.Ed.2d 110 (1972). The Court acknowledges the difficulty faced by the Legislature in defining conduct which had earned no recognized medical name at the time of enactment. However, the Court cannot accept the Legislature’s argument that, had it wished to prohibit conventional abortion procedures, e.g., suction curettage, D & E and induction abortions, it would have expressly done so. As the Legislature readily admits, it was “quite capable of employing such terminology” and, as such, was quite capable of expressly excluding such procedures from the Act’s proscription. See, e.g., Ohio Rev.Code Ann. § 2919.15(A) (excluding suction curettage and suction aspiration abortion procedures specifically from definition of prohibited conduct). This it did not do. Lack of a recognized medical term for an objectionable procedure is no fault of the Legislature, but failure to give fair warning is the flaw of draftsmanship. The Act will be struck as unconstitutionally vague. D. Undue Burden Plaintiffs also contend that the Act unduly burdens the woman’s constitutional right to obtain an abortion because its language covers many conventional abortion methods and because it contains no health exception and an inadequate life exception. In response, the Legislature argues that Roe v. Wade, 410 U.S. 113, 93 S.Ct. 705, 35 L.Ed.2d 147 (1973), and Planned Parenthood of Southeastern Pennsylvania v. Casey, 505 U.S. 833, 112 S.Ct. 2791, 120 L.Ed.2d 674 (1992), do not control because a “partial-birth abortion” is a form of infanticide rather than an “abortion” within the meaning of those cases. Alternatively, the Legislature argues that, even if Casey and Roe control, the Act does not place an undue burden on plaintiffs because conventional abortions are not banned and because the dilatation and extraction abortion procedure, the only procedure banned under the Act, is never necessary to preserve the life or health of the woman, obviating the need for such exceptions. In Casey, the Supreme Court reaffirmed the essential holding of Roe that women have a constitutional right “to choose to hav