Senate File 12 - Introduced
SENATE FILE
BY JOHNSON
A BILL FOR
1 An Act establishing requirements for voluntary and informed
2 consent to an abortion, and including effective date
3 provisions.
4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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PAG LIN
1 1 Section 1. NEW SECTION. 146A.1 Definitions.
1 2 As used in this chapter unless the context otherwise
1 3 requires:
1 4 1. "Abortion" means abortion as defined in section 146.1.
1 5 2. "Department" means the department of public health.
1 6 3. "Medical emergency" means a condition which, on the basis
1 7 of a physician's good=faith clinical judgment, so complicates
1 8 the medical condition of a pregnant woman as to necessitate
1 9 the immediate abortion of the woman's pregnancy to avert the
1 10 woman's death or for which a delay will create a serious risk
1 11 of substantial and irreversible impairment of a major bodily
1 12 function of the pregnant woman.
1 13 4. "Qualified professional" means a physician licensed
1 14 pursuant to chapter 148, a physician assistant licensed
1 15 pursuant to chapter 148C, a registered nurse or licensed
1 16 practical nurse licensed pursuant to chapter 152, a
1 17 psychologist licensed pursuant to chapter 154B, a social
1 18 worker licensed pursuant to chapter 154C, or a mental health
1 19 counselor licensed pursuant to chapter 154D, acting under
1 20 the supervision of the physician performing or inducing
1 21 the abortion, and acting within the course and scope of the
1 22 qualified professional's authority as provided by law.
1 23 Sec. 2. NEW SECTION. 146A.2 Abortion == voluntary and
1 24 informed consent == waiting period.
1 25 1. Except in the case of a medical emergency, an abortion
1 26 shall not be performed or induced on a woman without the
1 27 woman's voluntary and informed consent, given freely and
1 28 without coercion. Consent to an abortion is voluntary and
1 29 informed and given freely and without coercion if, at least
1 30 seventy=two hours prior to the abortion, all of the following
1 31 conditions are met:
1 32 a. The physician who is to perform or induce the abortion
1 33 or a qualified professional has informed the woman orally,
1 34 in person, which shall be reduced to writing, of all of the
1 35 following:
2 1 (1) The name of the physician who will perform or induce
2 2 the abortion.
2 3 (2) Medically accurate information that a reasonable
2 4 patient would consider material to the decision of whether or
2 5 not to undergo the abortion, including all of the following:
2 6 (a) A description of the proposed abortion method.
2 7 (b) The immediate and long=term medical risks to the woman
2 8 associated with the proposed abortion method including but not
2 9 limited to infection, hemorrhage, cervical tear or uterine
2 10 perforation, harm to subsequent pregnancies or the ability
2 11 to carry a subsequent child to term, and possible adverse
2 12 psychological effects associated with the abortion.
2 13 (c) The immediate and long=term medical risks to the
2 14 woman, in light of the anesthesia and medication that is to be
2 15 administered, the gestational age of the fetus, and the woman's
2 16 medical history and medical condition.
2 17 (3) Alternatives to the abortion including making the woman
2 18 aware that information and materials shall be provided to the
2 19 woman detailing such alternatives to the abortion.
2 20 (4) A statement that the physician performing or inducing
2 21 the abortion is available for any questions concerning the
2 22 abortion and the telephone number at which the physician may be
2 23 later reached to answer any questions that the woman may have.
2 24 (5) The location of the hospital that offers obstetrical or
2 25 gynecological care located within thirty miles of the location
2 26 where the abortion is performed or induced and at which the
2 27 physician performing or inducing the abortion has clinical
2 28 privileges and where the woman may receive follow=up care by
2 29 the physician if complications arise.
2 30 (6) The gestational age of the fetus at the time the
2 31 abortion is to be performed or induced.
2 32 (7) The anatomical and physiological characteristics of the
2 33 fetus at the time the abortion is to be performed or induced.
2 34 b. The physician who is to perform or induce the abortion
2 35 or a qualified professional has provided the woman, in
3 1 person, with printed materials provided by the department
3 2 which describe the probable anatomical and physiological
3 3 characteristics of the fetus at two=week gestational increments
3 4 from conception to full term, including color photographs
3 5 or images of the developing fetus at two=week gestational
3 6 increments. Such descriptions shall include information about
3 7 brain and heart functions, the presence of external members and
3 8 internal organs during the applicable stages of development and
3 9 information on when the fetus is viable. The printed materials
3 10 shall prominently display the following statement: "The life
3 11 of each human being begins at conception. Abortion will
3 12 terminate the life of a separate, unique, living human being."
3 13 c. The physician who is to perform or induce the abortion
3 14 or a qualified professional has provided the woman, in person,
3 15 with printed materials provided by the department which
3 16 describe the various surgical and drug=induced methods of
3 17 abortion relevant to the stage of pregnancy, as well as the
3 18 immediate and long=term medical risks commonly associated with
3 19 each abortion method including but not limited to infection,
3 20 hemorrhage, cervical tear or uterine perforation, harm to
3 21 subsequent pregnancies or the ability to carry a subsequent
3 22 child to term, and the possible adverse psychological effects
3 23 associated with an abortion.
3 24 d. The physician who is to perform or induce the abortion
3 25 or a qualified professional has provided the woman with the
3 26 opportunity to view an active ultrasound of the fetus and
3 27 hear the heartbeat of the fetus if the heartbeat is audible.
3 28 The woman shall be provided with a geographically indexed
3 29 list maintained by the department of health care providers,
3 30 facilities, and clinics that perform ultrasounds, including
3 31 those that offer ultrasound services free of charge. Such
3 32 materials shall provide contact information for each provider,
3 33 facility, or clinic including telephone numbers and, if
3 34 available, internet site addresses. If the woman decides to
3 35 obtain an ultrasound from a provider, facility, or clinic other
4 1 than the facility at which the abortion will be performed or
4 2 induced, the woman shall be offered a reasonable time to obtain
4 3 the ultrasound examination before the date and time set for
4 4 performing or inducing an abortion. The person conducting the
4 5 ultrasound shall ensure that the active ultrasound image is
4 6 of a quality consistent with standard medical practice in the
4 7 community, contains the dimensions of the fetus, and accurately
4 8 portrays the presence of external members and internal organs,
4 9 if present or viewable, of the fetus. The auscultation of
4 10 fetal heart tone must also be of a quality consistent with
4 11 standard medical practice in the community. If the woman
4 12 chooses to view the ultrasound or hear the heartbeat or both
4 13 at the facility at which the abortion will be performed or
4 14 induced, such services shall be provided to the woman at the
4 15 facility at which the abortion is to be performed or induced at
4 16 least seventy=two hours prior to the abortion being performed
4 17 or induced.
4 18 e. Prior to an abortion being performed or induced on
4 19 a fetus of twenty=two weeks gestational age or older, the
4 20 physician who is to perform or induce the abortion or a
4 21 qualified professional has provided the woman, in person,
4 22 with printed materials provided by the department that offer
4 23 information on the possibility of the abortion causing pain to
4 24 the fetus. This information shall include but is not limited
4 25 to all of the following:
4 26 (1) That at least by twenty=two weeks of gestational age,
4 27 the fetus possesses all the anatomical structures, including
4 28 pain receptors, spinal cord, nerve tracts, thalamus, and
4 29 cortex, that are necessary in order to feel pain.
4 30 (2) A description of the actual steps in the abortion
4 31 procedure to be performed or induced, and at which steps the
4 32 abortion procedure could be painful to the fetus.
4 33 (3) That there is evidence that by twenty=two weeks of
4 34 gestational age, a fetus seeks to evade certain stimuli in a
4 35 manner that in an infant or an adult would be interpreted as a
5 1 response to pain.
5 2 (4) Anesthesia is given to a fetus that is twenty=two weeks
5 3 or more gestational age who undergoes prenatal surgery.
5 4 (5) Anesthesia is given to premature children who are
5 5 twenty=two weeks or more gestational age who undergo surgery.
5 6 (6) Anesthesia or an analgesic is available in order to
5 7 minimize or alleviate the pain to the fetus.
5 8 f. The physician who is to perform or induce the abortion
5 9 or a qualified professional has provided the woman, in person,
5 10 with printed materials provided by the department explaining
5 11 to the woman alternatives to abortion the woman may wish to
5 12 consider. The materials shall provide all of the following:
5 13 (1) Identification on a geographical basis of public
5 14 and private agencies available to assist a woman in carrying
5 15 a fetus to term, and to assist the woman in caring for
5 16 her dependent child or placing her child for adoption,
5 17 including agencies commonly known and generally referred to
5 18 as pregnancy resource centers, crisis pregnancy centers,
5 19 maternity homes, and adoption agencies. Such materials
5 20 shall provide a comprehensive list by geographical area of
5 21 the agencies, a description of the services they offer, and
5 22 the telephone numbers and addresses of the agencies provided
5 23 that such materials shall not include any programs, services,
5 24 organizations, or affiliates of organizations that perform or
5 25 induce, or assist in the performing or inducing of, abortions,
5 26 or that refer for abortions.
5 27 (2) An explanation of any programs and services available
5 28 to pregnant women and mothers of newborn children offered by
5 29 public or private agencies which assist a woman in carrying
5 30 a fetus to term and to assist the woman in caring for her
5 31 dependent child or placing her child for adoption, including
5 32 but not limited to prenatal care; maternal health care; newborn
5 33 or infant care; mental health services; professional counseling
5 34 services; housing programs; utility assistance; transportation
5 35 services; food, clothing, and supplies related to pregnancy;
6 1 parenting skills; educational programs; job training and
6 2 placement services; drug and alcohol testing and treatment; and
6 3 adoption assistance.
6 4 (3) The prominently displayed statement: "There are
6 5 public and private agencies willing and able to help you carry
6 6 your fetus to term, and to assist you and your child after
6 7 your child is born, whether you choose to keep your child or
6 8 place your child for adoption. The state of Iowa encourages
6 9 you to contact those agencies before making a final decision
6 10 about abortion. State law requires that your physician or a
6 11 qualified professional give you the opportunity to contact
6 12 agencies like these before you undergo an abortion."
6 13 g. The physician who is to perform or induce the abortion
6 14 or a qualified professional has provided the woman, in person,
6 15 with printed materials provided by the department explaining
6 16 that the father of the unborn child is liable to assist in the
6 17 support of the child, even in instances where the father has
6 18 offered to pay for the abortion. Such materials shall include
6 19 information on the legal duties and support obligations of the
6 20 father of a child, including but not limited to child support
6 21 payments, and the fact that paternity may be established by the
6 22 father's name on a birth certificate or statement of paternity,
6 23 or by court action. Such printed materials shall also state
6 24 that more information concerning paternity establishment and
6 25 child support services and enforcement may be obtained by
6 26 contacting the department of human services.
6 27 h. The physician who is to perform or induce the abortion or
6 28 a qualified professional has informed the woman that the woman
6 29 is free to withhold or withdraw the woman's consent to the
6 30 abortion at any time without affecting her right to future care
6 31 or treatment and without the loss of any state or federally
6 32 funded benefits to which the woman might otherwise be entitled.
6 33 2. All information required to be provided to a woman
6 34 considering abortion pursuant to subsection 1 shall be
6 35 presented to the woman individually, in the physical presence
7 1 of the woman and in a private room, to protect the woman's
7 2 privacy, to maintain the confidentiality of her decision, to
7 3 ensure that the information focuses on the woman's individual
7 4 circumstances, to ensure she has an adequate opportunity to
7 5 ask questions, and to ensure that she is not a victim of
7 6 coerced abortion. If a woman is unable to read the materials
7 7 provided to her, they shall be read to her. If a woman needs
7 8 an interpreter to understand the information presented in
7 9 the written materials, an interpreter shall be provided to
7 10 the woman. If a woman asks questions concerning any of the
7 11 information or materials, answers shall be provided in a
7 12 language the woman is able to understand.
7 13 3. An abortion shall not be performed or induced unless and
7 14 until the woman upon whom the abortion is to be performed or
7 15 induced certifies in writing on a checklist form provided by
7 16 the department that she has been presented all the information
7 17 required in subsection 1, that she has been provided the
7 18 opportunity to view an active ultrasound image of the fetus
7 19 and hear the heartbeat of the fetus if it is audible, and
7 20 that she further certifies that she gives her voluntary and
7 21 informed consent, freely and without coercion, to the abortion
7 22 procedure.
7 23 4. An abortion shall not be performed or induced on a
7 24 fetus of twenty=two weeks gestational age or older unless and
7 25 until the woman upon whom the abortion is to be performed or
7 26 induced has been provided the opportunity to choose to have an
7 27 anesthetic or analgesic administered to eliminate or alleviate
7 28 pain to the fetus caused by the particular method of abortion
7 29 to be performed or induced. The administration of anesthesia
7 30 or analgesics shall be performed in a manner consistent with
7 31 standard medical practice in the community.
7 32 5. A physician shall not perform or induce an abortion
7 33 unless and until the physician has obtained from the woman
7 34 her voluntary and informed consent given freely and without
7 35 coercion as provided in this section. If the physician has
8 1 reason to believe that the woman is being coerced into having
8 2 an abortion, the physician or qualified professional shall
8 3 inform the woman that services are available to her and shall
8 4 provide her with private access to a telephone and information
8 5 about such services, including domestic abuse or sexual assault
8 6 centers and orders of protection.
8 7 6. A physician shall not perform or induce an abortion
8 8 unless and until the physician has received and signed a copy
8 9 of the form prescribed in subsection 3. The physician shall
8 10 retain a copy of the form in the woman's medical record.
8 11 7. If a medical emergency exists, the physician who
8 12 performed or induced the abortion shall clearly certify in
8 13 writing the nature and circumstances of the medical emergency.
8 14 This certification shall be signed by the physician who
8 15 performed or induced the abortion, and shall be maintained in
8 16 the woman's medical record.
8 17 8. A person shall not require, obtain, or accept payment
8 18 for an abortion from or on behalf of a patient until at least
8 19 seventy=two hours have passed since the time the information
8 20 required by subsection 1 has been provided to the patient.
8 21 Nothing in this subsection shall prohibit a person or entity
8 22 from notifying the patient that payment for the abortion will
8 23 be required after the seventy=two=hour period has expired if
8 24 the patient voluntarily chooses to have the abortion.
8 25 9. By November 1, 2015, the department shall produce the
8 26 written materials and forms described in this section. Any
8 27 written materials produced shall be printed in a typeface
8 28 large enough to be clearly legible. All information shall
8 29 be presented in an objective, unbiased manner designed to
8 30 convey only accurate scientific and medical information. The
8 31 department shall furnish the written materials and forms at
8 32 no cost and in sufficient quantity to any person who performs
8 33 or induces abortions, or to any hospital or facility that
8 34 provides abortions. The department shall make all information
8 35 required by subsection 1 available to the public through its
9 1 department internet site. The department shall maintain a
9 2 toll=free, twenty=four=hour hotline telephone number thorough
9 3 which a caller may obtain information on a regional basis
9 4 concerning the agencies and services described in subsection 1.
9 5 Identifying information regarding persons who use the internet
9 6 site shall not be collected or maintained. The department
9 7 shall monitor the internet site on a regular basis to prevent
9 8 tampering and correct any operational deficiencies.
9 9 Sec. 3. EFFECTIVE DATES.
9 10 1. The provisions of this Act requiring the department of
9 11 public health to produce certain written materials and forms as
9 12 described in section 146A.2, subsection 9, as enacted in this
9 13 Act, by November 1, 2015, being deemed of immediate importance,
9 14 take effect upon enactment.
9 15 2. The remainder of this Act takes effect November 1, 2015.
9 16 EXPLANATION
9 17 The inclusion of this explanation does not constitute agreement with
9 18 the explanation's substance by the members of the general assembly.
9 19 This bill establishes new Code chapter 146A, requiring
9 20 voluntary and informed consent to an abortion.
9 21 The bill specifies the conditions of voluntary and informed
9 22 consent that must be completed at least 72 hours prior to an
9 23 abortion including:
9 24 1. The physician who is to perform or induce the abortion
9 25 or a qualified professional shall inform the woman orally, in
9 26 person, which shall be reduced to writing, of the name of the
9 27 physician who will perform or induce the abortion, medically
9 28 accurate information relating to the decision of whether or
9 29 not to undergo the abortion, the medical risks to the woman
9 30 associated with the abortion, alternatives to the abortion, how
9 31 the physician may be reached, the location of the hospital, the
9 32 gestational age of the fetus at the time the abortion is to
9 33 be performed or induced, and the anatomical and physiological
9 34 characteristics of the fetus at the time of the abortion.
9 35 2. The physician who is to perform or induce the abortion
10 1 or a qualified professional shall provide the woman, in
10 2 person, with printed materials provided by the department of
10 3 public health (DPH) which describe the probable anatomical
10 4 and physiological characteristics of the fetus at two=week
10 5 gestational increments and includes the prominently displayed
10 6 statement: "The life of each human being begins at conception.
10 7 Abortion will terminate the life of a separate, unique, living
10 8 human being."
10 9 3. The physician who is to perform or induce the abortion or
10 10 a qualified professional shall provide the woman, in person,
10 11 with printed materials provided by DPH which describe the
10 12 various methods of abortion relevant to the stage of pregnancy,
10 13 as well as the medical risks commonly associated with each
10 14 abortion method.
10 15 4. The physician who is to perform or induce the abortion
10 16 or a qualified professional shall provide the woman with the
10 17 opportunity to view an active ultrasound of the fetus and hear
10 18 the heartbeat of the fetus if the heartbeat is audible.
10 19 5. Prior to an abortion being performed or induced on a
10 20 fetus of at least 22 weeks gestational age, the physician
10 21 who is to perform or induce the abortion or a qualified
10 22 professional shall provide the woman, in person, with printed
10 23 materials provided by DPH that offer information on the
10 24 possibility of the abortion causing pain to the fetus.
10 25 6. The physician who is to perform or induce the abortion or
10 26 a qualified professional shall provide the woman, in person,
10 27 with printed materials provided by DPH explaining to the woman
10 28 alternatives to abortion she may wish to consider, including
10 29 the agencies, programs, and services available to assist her.
10 30 7. The physician who is to perform or induce the abortion or
10 31 a qualified professional shall provide the woman, in person,
10 32 with printed materials provided by DPH explaining that the
10 33 father of the unborn child is liable to assist in the support
10 34 of the child, even in instances where the father has offered
10 35 to pay for the abortion.
11 1 8. The physician who is to perform or induce the abortion
11 2 or a qualified professional shall inform the woman that she is
11 3 free to withhold or withdraw her consent to the abortion at any
11 4 time without affecting her right to future care or treatment
11 5 and without the loss of any state or federally funded benefits
11 6 to which she might otherwise be entitled.
11 7 The bill requires that all information required to be
11 8 provided to a woman considering abortion be presented to the
11 9 woman individually, in the physical presence of the woman and
11 10 in a private room, to protect her privacy, to maintain the
11 11 confidentiality of her decision, to ensure that the information
11 12 focuses on her individual circumstances, to ensure she has an
11 13 adequate opportunity to ask questions, and to ensure that she
11 14 is not a victim of coerced abortion.
11 15 Under the bill, an abortion is prohibited from being
11 16 performed or induced unless and until the woman upon whom the
11 17 abortion is to be performed or induced certifies in writing on
11 18 a checklist form provided by DPH that she has been presented
11 19 all the information required, that she has been provided the
11 20 opportunity to view an active ultrasound image of the fetus
11 21 and hear the heartbeat of the fetus if it is audible, and
11 22 that she further certifies that she gives her voluntary and
11 23 informed consent, freely and without coercion, to the abortion
11 24 procedure.
11 25 Under the bill, an abortion shall not be performed or induced
11 26 on a fetus of 22 weeks gestational age or older unless and
11 27 until the woman upon whom the abortion is to be performed or
11 28 induced has been provided the opportunity to choose to have an
11 29 anesthetic or analgesic administered to eliminate or alleviate
11 30 pain to the fetus caused by the particular method of abortion
11 31 to be performed or induced. The administration of anesthesia
11 32 or analgesics shall be performed in a manner consistent with
11 33 standard medical practice in the community.
11 34 Under the bill, a physician is prohibited from performing
11 35 or inducing an abortion unless and until the physician has
12 1 obtained from the woman her voluntary and informed consent
12 2 given freely and without coercion. If the physician has
12 3 reason to believe that the woman is being coerced into having
12 4 an abortion, the physician or a qualified professional shall
12 5 inform the woman that services are available for her and shall
12 6 provide her with private access to a telephone and information
12 7 about such services, including domestic abuse or sexual assault
12 8 centers and orders of protection. Additionally, a physician is
12 9 prohibited from performing or inducing an abortion unless and
12 10 until the physician has received and signed a copy of the form
12 11 specified under the bill. The physician is required to retain
12 12 a copy of the form in the woman's medical record.
12 13 If a medical emergency exists, the physician who performed
12 14 or induced the abortion is required to clearly certify in
12 15 writing the nature and circumstances of the medical emergency.
12 16 The certification must be signed by the physician who performed
12 17 or induced the abortion, and is required to be maintained in
12 18 the woman's medical record.
12 19 The bill prohibits a person from requiring, obtaining,
12 20 or accepting payment for an abortion from or on behalf of
12 21 a patient until at least 72 hours have passed since the
12 22 time that the information required has been provided to the
12 23 patient. However, this does not prohibit a person or entity
12 24 from notifying the patient that payment for the abortion
12 25 will be required after the 72=hour period has expired if she
12 26 voluntarily chooses to have the abortion.
12 27 The bill requires that by November 1, 2015, DPH shall produce
12 28 the written materials and forms described in the bill, and
12 29 any written materials produced shall be printed in a typeface
12 30 large enough to be clearly legible. All information is to
12 31 be presented in an objective, unbiased manner designed to
12 32 convey only accurate scientific and medical information. DPH
12 33 is required to furnish the written materials and forms at no
12 34 cost and in sufficient quantity to any person who performs or
12 35 induces abortions, or to any hospital or facility that provides
13 1 abortions. DPH is required to make all information required
13 2 available to the public through its department internet site.
13 3 DPH is also required to maintain a toll=free, 24=hour hotline
13 4 telephone number through which a caller may obtain information
13 5 on a regional basis concerning the agencies and services
13 6 offering alternatives to abortion.
13 7 The provisions requiring DPH to produce certain written
13 8 materials and forms by November 1, 2015, take effect upon
13 9 enactment. The remainder of the bill takes effect November 1,
13 10 2015.
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