MEAD, J.
[¶ 1] After Kayla Doherty gave birth to a healthy son in June 2014, she filed a complaint against Merck & Co., Inc., and the United States in the United States District Court for the District of Maine, alleging that in February 2012, at a community health center for which the United States was responsible, a physician negligently failed, as a result of Merck's defective applicator, to insert into her arm an implant manufactured by Merck that was designed to prevent pregnancy for at least three years. Pursuant to 4 M.R.S. § 57 (2016) and M.R. App. P. 25, the federal court (Hornby, J.) has certified three questions of state law to us:
[¶ 2] We answer the first question in the affirmative. Accordingly, we decline to answer the second question. In answer to the third question, pursuant to 24 M.R.S. § 2931 (2016) Doherty may not recover any damages on her claims against either defendant.
[¶ 3] The United States District Court denied without prejudice the defendants' motion to dismiss Doherty's complaint. The court stated in its certification to us that "the following factual allegations are properly pleaded. The plaintiff's factual allegations are therefore taken as true for the purpose of testing the defendants' argument that Maine law allows no recovery to the plaintiff even if her allegations are proven." See Miller v. Town of Wenham, 833 F.3d 46, 51 (1st Cir. 2016) (stating that in reviewing the dismissal of a claim pursuant to Fed. R. Civ. P. 12(b)(6), the federal courts "accept as true all well-pled facts alleged in the complaint and draw all reasonable inferences in the plaintiff's favor" (alteration and quotation marks omitted)).
[¶ 4] Doherty's complaint alleges that on January 26, 2012, she visited a federally-supported health care center in Albion to inquire about birth control options. She saw a physician, who recommended the use of an implantable drug manufactured by Merck consisting of a single, four-centimeter-long rod inserted under the skin of the inner side of the patient's upper arm with a syringe-like applicator. The drug, which is designed to be effective for at least three years unless the rod is removed sooner by a physician, works by inhibiting ovulation. Merck knew, or should have known, that the applicator had a history of failed insertion attempts occurring when, unbeknownst to the treating physician, the rod would remain stuck in the applicator following the procedure.
[¶ 5] On February 28, 2012, the physician who recommended the drug to Doherty carried out the implantation procedure, but failed to check her arm to see if it was successful. A pregnancy test at the health care center on October 16, 2013, confirmed that Doherty was pregnant. An examination and subsequent ultrasound examination failed to locate the rod in either of Doherty's arms. A nurse later told Doherty that the physician "believes it was never inserted."
[¶ 6] On June 9, 2014, Doherty gave birth to a healthy boy following a long and painful delivery. In connection with her pregnancy, Doherty suffered nausea, mental and physical pain and suffering, insomnia, swelling, and weight gain. She also incurred expenses, and she lost wages as a result of missing work for medical appointments. Following the birth of her son, Doherty received mental health counseling and suffered emotional distress as a result of being unprepared to raise a child as a single mother.
[¶ 7] Doherty filed suit against Merck on theories of strict product liability, breach of warranty, negligence, and negligent misrepresentation; and against the United States for the negligence of the physician, and for the physician's failure to obtain her informed consent. The complaint also asked the federal court to declare that 24 M.R.S. § 2931 is unconstitutional, both facially and as applied. Merck and the United States moved to dismiss the complaint on the grounds that (1) pursuant to 24 M.R.S. § 2931(1), the birth of a healthy child is not a "legally recognizable injury" for which Doherty may recover damages; and (2) pursuant to 24 M.R.S. § 2931(2), Doherty did not undergo a "failed sterilization procedure" that would invoke the statute's exception and allow her to recover
[¶ 8] A threshold issue is whether we will agree to consider the certified questions. See Bankr. Estate of Everest v. Bank of Am., N.A., 2015 ME 19, ¶ 13, 111 A.3d 655 ("Title 4 M.R.S. § 57 authorizes, but does not require, us to consider a certified question of state law posed by a federal court in certain circumstances." (quotation marks omitted)). In resolving that issue,
Id. ¶¶ 13-14, 111 A.3d 655 (alterations, citation, and quotation marks omitted).
[¶ 9] Here there is no dispute as to the facts to be accepted as true at this stage of the case; no clear controlling precedent that would answer the questions; and one alternative that would be determinative of the case, in that the federal court stated in its certification that "a decision by the Law Court that no recovery is available to the plaintiff under Maine law even if all her factual allegations are true ... would be determinative of the cause and would end the lawsuit now." Therefore, we agree to consider the certified questions.
[¶ 10] Maine's "wrongful birth" statute provides, in part:
24 M.R.S. § 2931(1)-(2).
[¶ 11] The first certified question asks whether section 2931 applies to Merck. We have often said that "[i]n interpreting a statute, we seek to effectuate the intent of the Legislature, which is ordinarily gleaned from the plain language of the statute. We will not look beyond the plain language
[¶ 12] Section 2931 is not at all ambiguous in that it bars a specific legal claim regardless of the party that the claim is brought against: "No person may maintain a claim for relief or receive an award for damages based on the claim that the birth and rearing of a healthy child resulted in damages to him." 24 M.R.S. § 2931(2). Consistent with the Legislature's stated public policy — "the birth of a normal, healthy child does not constitute a legally recognizable injury," 24 M.R.S. § 2931(1) — the statute addresses only the basis for the claim, not the identity of the defendant. In the case of a legislative public policy decision,
Waddell v. Briggs, 381 A.2d 1132, 1135 (Me. 1978).
[¶ 13] Here, Doherty claims that she is entitled to damages resulting from injuries that she suffered when the failure of Merck's product resulted in a non-remarkable pregnancy leading to the birth of her healthy child. That is precisely the claim barred by the very clear language of the statute. Doherty's argument that the statute applies to the physician who treated her but not to Merck disregards the statute's declaration that the birth of a healthy child is not a legally recognizable injury ab initio; therefore, it is not actionable against any defendant. As a result, unless the "failed sterilization procedure" exception contained in section 2931(2) and discussed infra applies, Doherty may not recover damages against either Merck or the United States for the birth and expense of raising her healthy child.
[¶ 14] For these reasons, we answer the first certified question in the affirmative.
[¶ 15] The second certified question asks whether our holding in Macomber v. Dillman, 505 A.2d 810 (Me. 1986), a case involving a failed tubal ligation procedure
[¶ 16] The third certified question asks if the single exception to the statute's blanket prohibition against claims based on the birth of a healthy child is applicable on these facts. The relevant section provides:
24 M.R.S. § 2931(2).
[¶ 17] The term "sterilization procedure" is not defined in the Maine Health Security Act, 24 M.R.S. §§ 2501-2988 (2016), where section 2931 is located. Doherty argues that the exception should apply here because Merck's implantable, long-term drug is "synonymous with sterilization," and therefore "the only reasonable interpretation of [section 2931] is that the term `sterilization procedure' ... applies to any long-lasting effort to render a woman infertile." We disagree, and conclude that the Legislature intended "sterilization procedure" to include medical or surgical procedures that alter the body's anatomy for the purpose of permanently ending the possibility of procreation. The term does not include temporary pharmaceutical intervention in the reproductive process, such as the implant Doherty sought, nor does it include physical intervention, such as an intrauterine device, that is designed to be reversible without permanently altering the body's reproductive organs. These are methods of contraception, and in section 2931 the Legislature explicitly made an exception to its prohibition against recovering damages for the birth of a healthy child only for "sterilization." 24 M.R.S. § 2931(2).
[¶ 18] Our construction is supported by the Legislature's near-contemporaneous definition of the term "sterilization procedure[ ]" in title 34-B. In the Due Process in Sterilization Act of 1982, 34-B M.R.S. §§ 7001-7017 (2016), the effective date of which predated the enactment of section 2931 by two years, the Legislature stated that it "finds and declares that sterilization procedures are generally irreversible and represent potentially permanent and highly significant consequences for the patient involved." 34-B M.R.S. § 7002 (emphases added) (enacted by P.L. 1983, ch. 459, § 7 (effective Jan. 15, 1984)). The Act goes on to define "[s]terilization" as "a medical or surgical procedure, the purpose of which is to render an individual permanently incapable of procreation." 34-B M.R.S. § 7003(9) (emphases added).
[¶ 19] This definition was known to the Legislature when it enacted section 2931 just two years later. See Musk v. Nelson, 647 A.2d 1198, 1202 (Me. 1994) ("The Legislature is presumed to be aware of the state of the law and decisions of this Court when it passes an act."). During that short time interval, the Legislature was aware
[¶ 20] Other courts and authorities are in accord with our conclusion that sterilization is commonly understood to mean a procedure that is intended to be permanent. See Semian v. Ledgemere Transp., Inc., 2014 ME 141, ¶¶ 8-9, 106 A.3d 405 (stating that when a statute is "reasonably susceptible to different interpretations" the Law Court may "look to extrinsic information to determine the Legislature's intent" (quotation marks omitted)).
[¶ 21] In a 1942 case where the United States Supreme Court reviewed an Oklahoma compulsory sterilization statute, Justice Douglas emphasized the gravity of sterilization as a permanent procedure, writing, "We are dealing here with legislation which involves one of the basic civil rights of man.... There is no redemption for the individual whom the law touches. Any experiment which the State conducts is to his irreparable injury. He is forever deprived of a basic liberty." Skinner v. Oklahoma, 316 U.S. 535, 541, 62 S.Ct. 1110, 86 L.Ed. 1655 (1942).
[¶ 22] Courts to the present day have continued to recognize the distinction between permanent sterilization and reversible contraception.
Cheng v. Att'y Gen., 623 F.3d 175, 182-83, 187 & n.6 (3d Cir. 2010) (alterations, ellipsis and quotation marks omitted).
[¶ 23] Beyond the widely-held view of numerous courts, Black's Law Dictionary defines "sterilization" as "[t]he act of making (a person or other living thing) permanently unable to reproduce." Black's Law Dictionary 1640 (10th ed. 2014) (emphasis added); see also Stedman's Medical Dictionary 1475 (25th ed. 1990) (defining "sterilization" as "[t]he act or process by which an individual is rendered incapable of ... reproduction, as by vasectomy, salpingectomy, or castration"); Richard Sloane, The Sloane-Dorland Annotated Medical-Legal Dictionary 670 (1987) (defining "sterilize" as "to render incapable of reproduction"); Webster's Third New International Dictionary Unabridged 2238 (1986) (defining "sterilization" as "a procedure by which a human ... is made incapable of reproduction"). Contrary to Doherty's assertion that the Black's definition is unreliable because it dates to 1905, that the definition is of such long standing suggests that the Legislature would have been clear had it intended to expand the commonly-understood meaning — the same meaning that it used in 34-B M.R.S. § 7003(9) in 1984 — to encompass Doherty's situation.
[¶ 24] For these reasons, we conclude that the "failed sterilization procedure" exception is not applicable on the facts presented to us. Accordingly, our answer to the third certified question is that pursuant to section 2931, Doherty may not recover any damages on her claims against Merck or the United States.
The entry is:
SAUFLEY, C.J., with whom ALEXANDER and GORMAN, JJ., join, concurring.
[¶ 25] Although we concur with the Court's answers, we write separately to make clear the very limited scope of the questions presented and our responses to those questions.
[¶ 26] The federal court has not asked us to determine whether the wrongful life statute goes beyond declaring that the birth and the life of a healthy child do not constitute damages, that is, legally recognizable injury. 24 M.R.S. § 2931(1) (2016). Nor has it asked us to determine whether, if the statute does go beyond the gender-neutral declaration that a child is not an "injury," doing so constitutes an unconstitutional violation of a woman's right to equal protection under the law. Id.
[¶ 27] Moreover, in light of the questions presented, we are not required to consider whether a person may bring claims of ordinary medical malpractice for any negligent medical care provided to a person who sought medical care to avoid pregnancy as a result of a medical condition. For example, a person who suffers from certain illnesses may be seriously or fatally harmed by a pregnancy. In answering the questions presented, we are not required to consider whether a claim of medical malpractice for contraception failure may proceed in those circumstances. Put another way, those injuries would be factually distinct from the nature of the claim before the federal court related to the birth of an unanticipated but healthy child. In the end, we are not asked to determine whether that type of harm to a person, unrelated to the child, falls outside of the statute's limitation on negligence actions.
[¶ 28] Finally, although we cannot disagree with the Court's careful parsing of the concepts of "sterilization," particularly as used in other statutory contexts, it is clear from the lengths the Court goes to in attempting to distinguish various methods of permanent or semi-permanent contraception that medicine has outstripped the statutory definitions and that further attention to the language of 24 M.R.S. § 2931 (2016) is needed.
[¶ 29] In sum, we write to clarify that we do not opine on the constitutionality of the statute, and we do not opine on whether a person may maintain a claim for other types of injuries — unrelated to the existence of a healthy child — arising from allegations of medical malpractice in the context of a pregnancy.