Senate File 53 - Introduced
SENATE FILE
BY ZAUN
A BILL FOR
1 An Act relating to abortions including prohibiting abortions
2 after a certain postfertilization age with certain
3 exceptions, providing penalties, and including effective
4 date provisions.
5 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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PAG LIN
1 1 Section 1. FINDINGS. The general assembly finds all of the
1 2 following:
1 3 1. Abortion can cause serious short=term and long=term
1 4 physical and psychological complications for women including
1 5 but not limited to uterine perforation, uterine scarring,
1 6 cervical perforation or other injury, infection, bleeding,
1 7 hemorrhage, blood clots, failure to actually terminate the
1 8 pregnancy, incomplete abortion or retained tissue, pelvic
1 9 inflammatory disease, endometritis, missed ectopic pregnancy,
1 10 cardiac arrest, respiratory arrest, renal failure, metabolic
1 11 disorder, shock, embolism, coma, placenta previa in subsequent
1 12 pregnancies, preterm delivery in subsequent pregnancies,
1 13 free fluid in the abdomen, organ damage, adverse reactions
1 14 to anesthesia and other drugs, psychological or emotional
1 15 complications such as depression, anxiety, sleeping disorders,
1 16 and death.
1 17 2. Abortion has a higher medical risk when the procedure is
1 18 performed later in the pregnancy. Compared to an abortion at
1 19 eight weeks' gestation or earlier, the relative risk increases
1 20 exponentially at higher gestations. The incidence of major
1 21 complications is highest after twenty weeks of gestation.
1 22 3. The state has a legitimate concern for the public's
1 23 health and safety.
1 24 4. The state has a legitimate interest from the outset
1 25 of pregnancy in protecting the health of the woman. More
1 26 specifically, the state has a legitimate concern with the
1 27 health of women who undergo abortions.
1 28 5. There is substantial evidence that by at least twenty
1 29 weeks after fertilization, an unborn child has the physical
1 30 structures necessary to experience pain.
1 31 6. There is substantial evidence that by twenty weeks
1 32 after fertilization, an unborn child seeks to evade certain
1 33 stimuli in a manner which, in an infant or an adult, would be
1 34 interpreted as a response to pain.
1 35 7. Anesthesia is routinely administered to an unborn child
2 1 twenty weeks or more after fertilization when the unborn child
2 2 undergoes prenatal surgery.
2 3 8. Even before twenty weeks after fertilization, the unborn
2 4 child has been observed to exhibit hormonal stress responses to
2 5 painful stimuli, and a reduction in such response results when
2 6 pain medication is administered directly to the unborn child.
2 7 9. It is the purpose of the state of Iowa to assert a
2 8 compelling state interest in protecting the unborn child from
2 9 the stage at which substantial medical evidence indicates the
2 10 unborn child is capable of feeling pain.
2 11 Sec. 2. NEW SECTION. 146B.1 Definitions.
2 12 As used in this chapter, unless the context otherwise
2 13 requires:
2 14 1. "Abortion" means abortion as defined in section 146.1.
2 15 2. "Attempt to perform or induce an abortion" means an act,
2 16 or an omission of a statutorily required act, that, under the
2 17 circumstances as the actor believes them to be, constitutes a
2 18 substantial step in a course of conduct planned to culminate in
2 19 the performance or inducing of an abortion.
2 20 3. "Department" means the department of public health.
2 21 4. "Fertilization" means the fusion of a human spermatozoon
2 22 with a human ovum.
2 23 5. "Human pregnancy" means an individual organism of the
2 24 species homo sapiens from fertilization until live birth.
2 25 6. "Medical emergency" means a condition which, in
2 26 reasonable medical judgment, so complicates the medical
2 27 condition of a pregnant woman as to necessitate the immediate
2 28 abortion of the human pregnancy to avert the woman's death or
2 29 for which a delay will create a serious risk of substantial and
2 30 irreversible physical impairment of a major bodily function.
2 31 "Medical emergency" does not include a condition which is based
2 32 on a claim or diagnosis that the pregnant woman will engage in
2 33 conduct which would result in the pregnant woman's death or in
2 34 substantial and irreversible physical impairment of a major
2 35 bodily function.
3 1 7. "Medical facility" means any public or private hospital,
3 2 clinic, center, medical school, medical training institution,
3 3 health care facility, physician's office, infirmary,
3 4 dispensary, ambulatory surgical center, or other institution or
3 5 location where medical care is provided to any person.
3 6 8. "Physician" means a person licensed under chapter 148.
3 7 9. "Postfertilization age" means the age of the human
3 8 pregnancy as calculated from the fertilization of the human
3 9 ovum.
3 10 10. "Probable postfertilization age" means what, in
3 11 reasonable medical judgment, will with reasonable probability
3 12 be the postfertilization age of the human pregnancy at the time
3 13 the abortion is to be performed.
3 14 11. "Reasonable medical judgment" means a medical judgment
3 15 made by a reasonably prudent physician who is knowledgeable
3 16 about the case and the treatment possibilities with respect to
3 17 the medical conditions involved.
3 18 12. "Unborn child" means a human pregnancy in the
3 19 postembryonic stage.
3 20 Sec. 3. NEW SECTION. 146B.2 Determination of
3 21 postfertilization age ==== abortion prohibited twenty or more weeks
3 22 postfertilization ==== exceptions ==== reporting requirements ====
3 23 penalties.
3 24 1. Except in the case of a medical emergency, an abortion
3 25 shall not be performed or induced or be attempted to be
3 26 performed or induced unless the physician performing or
3 27 inducing the abortion has first made a determination of the
3 28 probable postfertilization age of the human pregnancy or relied
3 29 upon such a determination made by another physician. In making
3 30 such a determination, a physician shall make such inquiries
3 31 of the pregnant woman and perform or cause to be performed
3 32 such medical examinations and tests the physician considers
3 33 necessary in making a reasonable medical judgment to accurately
3 34 determine the postfertilization age of the human pregnancy.
3 35 2. a. A physician shall not perform or induce or attempt
4 1 to perform or induce an abortion upon a pregnant woman when it
4 2 has been determined, by the physician performing or inducing
4 3 the abortion or by another physician upon whose determination
4 4 that physician relies, that the probable postfertilization age
4 5 of the human pregnancy is twenty or more weeks unless, in the
4 6 physician's reasonable medical judgment, any of the following
4 7 applies:
4 8 (1) The pregnant woman has a condition which the physician
4 9 deems a medical emergency.
4 10 (2) It is necessary to preserve the life of the unborn
4 11 child.
4 12 b. If an abortion is performed or induced under this
4 13 subsection, the physician shall terminate the human pregnancy
4 14 in the manner which, in the physician's reasonable medical
4 15 judgment, provides the best opportunity for the unborn child
4 16 to survive, unless, in the physician's reasonable medical
4 17 judgment, termination of the human pregnancy in that manner
4 18 would pose a greater risk than any other available method of
4 19 the death of the pregnant woman or of the substantial and
4 20 irreversible physical impairment of a major bodily function.
4 21 A greater risk shall not be deemed to exist if it is based on
4 22 a claim or diagnosis that the pregnant woman will engage in
4 23 conduct which would result in the pregnant woman's death or in
4 24 substantial and irreversible physical impairment of a major
4 25 bodily function.
4 26 3. A physician who performs or induces or attempts to
4 27 perform or induce an abortion shall report to the department,
4 28 on a schedule and in accordance with forms and rules adopted by
4 29 the department, all of the following:
4 30 a. If a determination of probable postfertilization age of
4 31 the human pregnancy was made, the probable postfertilization
4 32 age determined and the method and basis of the determination.
4 33 b. If a determination of probable postfertilization
4 34 age of the human pregnancy was not made, the basis of the
4 35 determination that a medical emergency existed.
5 1 c. If the probable postfertilization age of the human
5 2 pregnancy was determined to be twenty or more weeks, the basis
5 3 of the determination of a medical emergency.
5 4 d. The method used for the abortion and, in the case of
5 5 an abortion performed when the probable postfertilization age
5 6 was determined to be twenty or more weeks, whether the method
5 7 of abortion used was one that, in the physician's reasonable
5 8 medical judgment, provided the best opportunity for the unborn
5 9 child to survive or, if such a method was not used, the basis
5 10 of the determination that termination of the human pregnancy
5 11 in that manner would pose a greater risk than would any other
5 12 available method of the death of the pregnant woman or of the
5 13 substantial and irreversible physical impairment of a major
5 14 bodily function.
5 15 4. a. By June 30, annually, the department shall issue a
5 16 public report providing statistics for the previous calendar
5 17 year, compiled from the reports for that year submitted in
5 18 accordance with subsection 3. Each report shall also provide
5 19 the statistics for all previous calendar years, adjusted to
5 20 reflect any additional information from late or corrected
5 21 reports. The department shall ensure that none of the
5 22 information included in the public reports could reasonably
5 23 lead to the identification of any woman upon whom an abortion
5 24 was performed.
5 25 b. (1) A physician who fails to submit a report by the end
5 26 of thirty days following the due date shall be subject to a
5 27 late fee of five hundred dollars for each additional thirty=day
5 28 period or portion of a thirty=day period the report is overdue.
5 29 (2) A physician required to report in accordance with
5 30 subsection 3 who has not submitted a report or who has
5 31 submitted only an incomplete report more than one year
5 32 following the due date, may, in an action brought in the
5 33 manner in which actions are brought to enforce chapter 148,
5 34 be directed by a court of competent jurisdiction to submit a
5 35 complete report within a time period stated by court order or
6 1 be subject to contempt of court.
6 2 (3) A physician who intentionally or recklessly falsifies
6 3 a report required under this section is subject to a civil
6 4 penalty of one hundred dollars.
6 5 5. The department shall adopt rules to implement this
6 6 section.
6 7 Sec. 4. NEW SECTION. 146B.3 Civil and criminal actions
6 8 ==== penalties.
6 9 1. Failure of a physician to comply with any provision of
6 10 section 146B.2, with the exception of the late filing of a
6 11 report or failure to submit a complete report in compliance
6 12 with a court order, is grounds for license discipline under
6 13 chapter 148.
6 14 2. A physician who intentionally or recklessly performs or
6 15 attempts to perform an abortion in violation of this chapter is
6 16 guilty of a class "C" felony.
6 17 3. A medical facility licensed in this state in which
6 18 abortions are performed or induced in violation of this chapter
6 19 is subject to immediate revocation of licensure.
6 20 4. A medical facility licensed in this state in which
6 21 abortions are performed or induced in violation of this chapter
6 22 is ineligible to receive state funding and is subject to
6 23 repayment of any state funds received from the state during the
6 24 time after which an abortion in violation of this chapter was
6 25 performed or induced.
6 26 5. A woman upon whom an abortion has been performed in
6 27 violation of this chapter or the biological father may maintain
6 28 an action against the physician who performed the abortion in
6 29 intentional or reckless violation of this chapter for actual
6 30 damages.
6 31 6. A woman upon whom an abortion has been attempted in
6 32 violation of this chapter may maintain an action against the
6 33 physician who attempted to perform the abortion in intentional
6 34 or reckless violation of this chapter for actual damages.
6 35 7. A cause of action for injunctive relief to prevent a
7 1 physician from performing abortions may be maintained against a
7 2 physician who has intentionally violated this chapter by the
7 3 woman upon whom the abortion was performed or attempted to be
7 4 performed, by the spouse of the woman, by a parent or guardian
7 5 of the woman if the woman is less than eighteen years of age or
7 6 unmarried at the time the abortion was performed or attempted
7 7 to be performed, by a current or former licensed health care
7 8 provider of the woman, by a county attorney with appropriate
7 9 jurisdiction, or by the attorney general.
7 10 8. A woman upon whom an abortion was performed or was
7 11 attempted to be performed shall not be subject to prosecution
7 12 for a violation of this chapter.
7 13 9. If the plaintiff prevails in an action brought under
7 14 this section, the plaintiff shall be entitled to an award for
7 15 reasonable attorney fees.
7 16 10. If the defendant prevails in an action brought under
7 17 this section and the court finds that the plaintiff's suit was
7 18 frivolous and brought in bad faith, the defendant shall be
7 19 entitled to an award for reasonable attorney fees.
7 20 11. Damages and attorney fees shall not be assessed against
7 21 the woman upon whom an abortion was performed or attempted to
7 22 be performed except as provided in subsection 10.
7 23 12. In a civil or criminal proceeding or action brought
7 24 under this chapter, the court shall rule whether the anonymity
7 25 of any woman upon whom an abortion has been performed or
7 26 attempted shall be preserved from public disclosure if the
7 27 woman does not provide consent to such disclosure. The court,
7 28 upon motion or on its own motion, shall make such a ruling
7 29 and, upon determining that the woman's anonymity should be
7 30 preserved, shall issue orders to the parties, witnesses,
7 31 and counsel and shall direct the sealing of the record and
7 32 exclusion of individuals from courtrooms or hearing rooms to
7 33 the extent necessary to safeguard the woman's identity from
7 34 public disclosure. Each such order shall be accompanied by
7 35 specific written findings explaining why the anonymity of the
8 1 woman should be preserved from public disclosure, why the
8 2 order is essential to that end, how the order is narrowly
8 3 tailored to serve that interest, and why no reasonable less
8 4 restrictive alternative exists. In the absence of written
8 5 consent of the woman upon whom an abortion has been performed
8 6 or attempted, anyone, other than a public official, who brings
8 7 an action under this section shall do so under a pseudonym.
8 8 This subsection shall not be construed to conceal the identity
8 9 of the plaintiff or of witnesses from the defendant or from
8 10 attorneys for the defendant.
8 11 Sec. 5. NEW SECTION. 146B.4 Construction.
8 12 1. Nothing in this chapter shall be construed as creating or
8 13 recognizing a right to an abortion.
8 14 2. Nothing in this chapter shall be construed as determining
8 15 life to begin at twenty weeks' gestation. Instead, it is
8 16 recognized that life begins at conception.
8 17 Sec. 6. NEW SECTION. 146B.5 Severability clause.
8 18 If any provision of this chapter or its application to any
8 19 person or circumstance is held invalid, the invalidity does
8 20 not affect other provisions or application of this chapter
8 21 which can be given effect without the invalid provision or
8 22 application, and to this end the provisions of this chapter are
8 23 severable.
8 24 Sec. 7. EFFECTIVE UPON ENACTMENT. This Act, being deemed of
8 25 immediate importance, takes effect upon enactment.
8 26 EXPLANATION
8 27 The inclusion of this explanation does not constitute agreement with
8 28 the explanation's substance by the members of the general assembly.
8 29 This bill relates to abortions. The bill provides findings
8 30 of the general assembly and definitions.
8 31 The bill provides that, except in the case of a medical
8 32 emergency, an abortion shall not be performed or induced
8 33 or be attempted to be performed or induced unless the
8 34 physician performing or inducing the abortion has first made
8 35 a determination of the probable postfertilization age of the
9 1 human pregnancy. Additionally, the bill prohibits a physician
9 2 from performing or inducing or attempting to perform or induce
9 3 an abortion upon a pregnant woman when it has been determined,
9 4 that the probable postfertilization age is 20 or more weeks
9 5 unless, in the physician's reasonable medical judgment, either
9 6 the pregnant woman has a condition which the physician deems a
9 7 medical emergency or it is necessary to preserve the life of
9 8 the unborn child. If an abortion is performed or induced when
9 9 the probable postfertilization age is 20 or more weeks, the
9 10 physician is required to terminate the pregnancy in a manner
9 11 which, in the physician's reasonable medical judgment, provides
9 12 the best opportunity for the unborn child to survive unless
9 13 such termination would pose a greater risk either of the death
9 14 of the pregnant woman or of the substantial and irreversible
9 15 physical impairment of a major bodily function of the woman
9 16 than would another available method.
9 17 The bill also requires certain reports to be filed by a
9 18 physician who performs or induces or attempts to perform or
9 19 induce an abortion with the department of public health, on
9 20 a schedule and in accordance with forms and rules adopted by
9 21 the department. The department is required to compile the
9 22 information collected annually and issue a public report,
9 23 ensuring that none of the information included in the public
9 24 reports could reasonably lead to the identification of any
9 25 pregnant woman upon whom an abortion was performed. The bill
9 26 provides monetary penalties for a physician who fails to submit
9 27 a report in a timely manner, submits an incomplete report, or
9 28 intentionally or recklessly falsifies a required report.
9 29 The bill provides for civil and criminal actions and
9 30 penalties relating to violations of the bill. Failure of a
9 31 physician to comply with any provision, with the exception of
9 32 the late filing of a report or failure to submit a complete
9 33 report in compliance with a court order, is grounds for license
9 34 discipline. A physician who intentionally or recklessly
9 35 performs or attempts to perform an abortion in violation of the
10 1 bill is guilty of a class "C" felony, which is punishable by
10 2 confinement for no more than 10 years and a fine of at least
10 3 $1,000 but not more than $10,000. The bill also provides that
10 4 a medical facility licensed in the state in which abortions
10 5 are performed or induced in violation of the bill is subject
10 6 to immediate revocation of licensure. Additionally, a
10 7 medical facility licensed in this state in which abortions are
10 8 performed or induced in violation of the bill is ineligible to
10 9 receive state funding and is subject to repayment of any state
10 10 funds received from the state during the time after which an
10 11 abortion in violation of the bill was performed or induced.
10 12 However, the woman upon whom the abortion was performed or was
10 13 attempted to be performed is not subject to prosecution for a
10 14 violation of the bill. The bill provides for the maintaining
10 15 of actions by certain people based on alleged violations of
10 16 the bill. A woman upon whom an abortion has been performed in
10 17 violation of the bill or the biological father may maintain
10 18 an action against the physician who performed the abortion
10 19 in intentional or reckless violation of the bill for actual
10 20 damages. A woman upon whom an abortion has been attempted
10 21 in violation of the bill may maintain an action against the
10 22 physician who attempted to perform the abortion in intentional
10 23 or reckless violation of the bill for actual damages.
10 24 Additionally, a cause of action for injunctive relief to
10 25 prevent a physician from performing abortions may be maintained
10 26 against a physician who has intentionally violated the bill by
10 27 the woman upon whom the abortion was performed or attempted
10 28 to be performed, by the spouse of the woman, by a parent or
10 29 guardian of the woman if the woman is less than 18 years of
10 30 age or unmarried at the time the abortion was performed or
10 31 attempted to be performed, by a current or former licensed
10 32 health care provider of the woman, by a county attorney with
10 33 appropriate jurisdiction, or by the attorney general.
10 34 The bill provides a process for preserving the anonymity of
10 35 the woman upon whom an abortion has been performed or attempted
11 1 from public disclosure if the woman does not provide consent to
11 2 such disclosure during any proceeding or action under the bill.
11 3 The bill also provides that the bill is not to be construed
11 4 as creating or recognizing a right to an abortion, and the
11 5 bill is not to be construed as determining life to begin at 20
11 6 weeks' gestation; instead, it is recognized that life begins
11 7 at conception.
11 8 The bill includes a severability clause as is applicable to
11 9 every Act or statute pursuant to Code section 4.12.
11 10 The bill takes effect upon enactment.
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