Senate File 534 S-3345 Amend Senate File 534 as follows: 1 1. By striking everything after the enacting clause 2 and inserting: 3 < Section 1. FINDINGS. The general assembly finds 4 all of the following: 5 1. Abortion can cause serious short-term and 6 long-term physical and psychological complications for 7 women including but not limited to uterine perforation, 8 uterine scarring, cervical perforation or other 9 injury, infection, bleeding, hemorrhage, blood clots, 10 failure to actually terminate the pregnancy, incomplete 11 abortion or retained tissue, pelvic inflammatory 12 disease, endometritis, missed ectopic pregnancy, 13 cardiac arrest, respiratory arrest, renal failure, 14 metabolic disorder, shock, embolism, coma, placenta 15 previa in subsequent pregnancies, preterm delivery in 16 subsequent pregnancies, free fluid in the abdomen, 17 organ damage, adverse reactions to anesthesia and other 18 drugs, and psychological or emotional complications 19 such as depression, anxiety, sleeping disorders, and 20 death. 21 2. Abortion has a higher medical risk when the 22 procedure is performed later in the pregnancy. 23 Compared to an abortion at eight weeks’ gestation or 24 earlier, the relative risk increases exponentially 25 at higher gestations. The incidence of major 26 complications is highest after twenty weeks of 27 gestation. 28 3. The state has a legitimate concern for the 29 public’s health and safety. 30 4. The state has a legitimate interest from the 31 outset of pregnancy in protecting the health of the 32 woman. More specifically, the state has a legitimate 33 concern with the health of women who undergo abortions. 34 5. There is substantial evidence that by at least 35 twenty weeks after fertilization, an unborn child has 36 the physical structures necessary to experience pain. 37 6. There is substantial evidence that by twenty 38 weeks after fertilization, an unborn child seeks to 39 evade certain stimuli in a manner which, in an infant 40 or an adult, would be interpreted as a response to 41 pain. 42 7. Anesthesia is routinely administered to an 43 unborn child twenty weeks or more after fertilization 44 when the unborn child undergoes prenatal surgery. 45 8. Even before twenty weeks after fertilization, 46 the unborn child has been observed to exhibit hormonal 47 stress responses to painful stimuli, and a reduction 48 in such response results when pain medication is 49 administered directly to the unborn child. 50 -1- SF534.3246 (2) 84 pf/nh 1/ 6 #1.

9. It is the purpose of the state of Iowa to assert 1 a compelling state interest in protecting the unborn 2 child from the stage at which substantial medical 3 evidence indicates the unborn child is capable of 4 feeling pain. 5 Sec. 2. NEW SECTION . 146A.1 Definitions. 6 As used in this chapter, unless the context 7 otherwise requires: 8 1. “Abortion” means abortion as defined in section 9 146.1. 10 2. “Attempt to perform or induce an abortion” means 11 an act, or an omission of a statutorily required act, 12 that, under the circumstances as the actor believes 13 them to be, constitutes a substantial step in a course 14 of conduct planned to culminate in the performance or 15 inducing of an abortion. 16 3. “Department” means the department of public 17 health. 18 4. “Fertilization” means the fusion of a human 19 spermatozoon with a human ovum. 20 5. “Medical emergency” means a condition which, in 21 reasonable medical judgment, so complicates the medical 22 condition of a pregnant woman as to necessitate the 23 termination of the human pregnancy to avert the woman’s 24 death or to avoid a serious risk of substantial and 25 irreversible physical impairment of a major bodily 26 function. “Medical emergency” does not include a 27 condition which is based on a claim or diagnosis that 28 the pregnant woman will engage in conduct which would 29 result in the pregnant woman’s death or in substantial 30 and irreversible physical impairment of a major bodily 31 function. 32 6. “Medical facility” means any public or private 33 hospital, clinic, center, medical school, medical 34 training institution, health care facility, physician’s 35 office, infirmary, dispensary, ambulatory surgical 36 center, or other institution or location where medical 37 care is provided to any person. 38 7. “Physician” means a person licensed under 39 chapter 148. 40 8. “Postfertilization age” means the age of the 41 unborn child as calculated from the fertilization of 42 the human ovum. 43 9. “Probable postfertilization age” means what, 44 in reasonable medical judgment, will with reasonable 45 probability be the postfertilization age of the unborn 46 child at the time an abortion is to be performed. 47 10. “Reasonable medical judgment” means a medical 48 judgment made by a reasonably prudent physician who 49 is knowledgeable about the case and the treatment 50 -2- SF534.3246 (2) 84 pf/nh 2/ 6

possibilities with respect to the medical conditions 1 involved. 2 11. “Unborn child” means an individual organism of 3 the species homo sapiens from fertilization until live 4 birth. 5 Sec. 3. NEW SECTION . 146A.2 Determination of 6 postfertilization age prior to abortion —— abortion 7 prohibited at twenty or more weeks postfertilization age 8 —— exceptions —— reporting requirements —— penalties. 9 1. Except in the case of a medical emergency, 10 an abortion shall not be performed or induced or 11 be attempted to be performed or induced unless 12 the physician performing or inducing the abortion 13 has first made a determination of the probable 14 postfertilization age of the unborn child or relied 15 upon such a determination made by another physician. 16 In making such a determination, a physician shall make 17 such inquiries of the pregnant woman and perform or 18 cause to be performed such medical examinations and 19 tests the physician considers necessary in making a 20 reasonable medical judgment to accurately determine the 21 postfertilization age of the unborn child. 22 2. a. A physician shall not perform or induce 23 or attempt to perform or induce an abortion upon a 24 pregnant woman when it has been determined, by the 25 physician performing or inducing the abortion or 26 by another physician upon whose determination that 27 physician relies, that the probable postfertilization 28 age of the unborn child is twenty or more weeks unless, 29 in the physician’s reasonable medical judgment, any of 30 the following applies: 31 (1) The pregnant woman has a condition which the 32 physician deems a medical emergency. 33 (2) It is necessary to preserve the life of an 34 unborn child. 35 b. An abortion performed or induced under this 36 subsection shall be performed or induced in a medical 37 facility that provides the appropriate level of 38 perinatal care as specified in 641 IAC 150. 39 3. A physician who performs or induces or attempts 40 to perform or induce an abortion shall report to 41 the department, on a schedule and in accordance with 42 forms and rules adopted by the department, all of the 43 following: 44 a. If a determination of probable postfertilization 45 age of the unborn child was made, the probable 46 postfertilization age determined and the method and 47 basis of the determination. 48 b. If a determination of probable postfertilization 49 age of the unborn child was not made, the basis of the 50 -3- SF534.3246 (2) 84 pf/nh 3/ 6

determination that a medical emergency existed. 1 c. If the probable postfertilization age of the 2 unborn child was determined to be twenty or more weeks, 3 the basis of the determination of a medical emergency, 4 or the basis of the determination that the abortion was 5 necessary to preserve the life of an unborn child. 6 d. The method used for the abortion and, in the 7 case of an abortion performed when the probable 8 postfertilization age was determined to be twenty or 9 more weeks, whether the method of abortion used was one 10 that, in the physician’s reasonable medical judgment, 11 provided the best opportunity for the unborn child to 12 survive or, if such a method was not used, the basis 13 of the determination that termination of the human 14 pregnancy in that manner would pose a greater risk than 15 would any other available method of the death of the 16 pregnant woman or of the substantial and irreversible 17 physical impairment of a major bodily function. 18 4. a. By June 30, annually, the department shall 19 issue a public report providing statistics for the 20 previous calendar year, compiled from the reports for 21 that year submitted in accordance with subsection 22 3. The department shall ensure that none of the 23 information included in the public reports could 24 reasonably lead to the identification of any woman upon 25 whom an abortion was performed. 26 b. (1) A physician who fails to submit a report by 27 the end of thirty days following the due date shall be 28 subject to a late fee of five hundred dollars for each 29 additional thirty-day period or portion of a thirty-day 30 period the report is overdue. 31 (2) A physician required to report in accordance 32 with subsection 3 who has not submitted a report or who 33 has submitted only an incomplete report more than one 34 year following the due date, may, in an action brought 35 in the manner in which actions are brought to enforce 36 chapter 148, be directed by a court of competent 37 jurisdiction to submit a complete report within a time 38 period stated by court order or be subject to contempt 39 of court. 40 (3) A physician who intentionally or recklessly 41 falsifies a report required under this section is 42 subject to a civil penalty of one hundred dollars. 43 5. Any medical facility in which a physician is 44 authorized to perform an abortion shall implement 45 written medical policies and procedures consistent with 46 the requirements and prohibitions of this chapter. 47 6. The department shall adopt rules to administer 48 this section. 49 Sec. 4. NEW SECTION . 146A.3 Civil and criminal 50 -4- SF534.3246 (2) 84 pf/nh 4/ 6

actions —— penalties. 1 1. Failure of a physician to comply with any 2 provision of section 146A.2, with the exception of the 3 late filing of a report or failure to submit a complete 4 report in compliance with a court order, is grounds for 5 license discipline under chapter 148. 6 2. A physician who intentionally or recklessly 7 performs or attempts to perform an abortion in 8 violation of this chapter is guilty of a class “C” 9 felony. 10 3. A woman upon whom an abortion has been performed 11 in violation of this chapter or the biological father 12 may maintain an action against the physician who 13 performed the abortion in intentional or reckless 14 violation of this chapter for actual damages. This 15 subsection shall not be interpreted to apply to a 16 biological father when the pregnancy is the result of 17 rape or incest. 18 4. A woman upon whom an abortion has been attempted 19 in violation of this chapter may maintain an action 20 against the physician who attempted to perform the 21 abortion in intentional or reckless violation of this 22 chapter for actual damages. 23 5. A cause of action for injunctive relief to 24 prevent a physician from performing abortions may be 25 maintained against a physician who has intentionally 26 violated this chapter by the woman upon whom the 27 abortion was performed or attempted to be performed, 28 by the spouse of the woman, by a parent or guardian of 29 the woman if the woman is less than eighteen years of 30 age or unmarried at the time the abortion was performed 31 or attempted to be performed, by a current or former 32 licensed health care provider of the woman, by a county 33 attorney with appropriate jurisdiction, or by the 34 attorney general. 35 6. A woman upon whom an abortion was performed or 36 was attempted to be performed shall not be subject to 37 prosecution for a violation of this chapter. 38 7. If the plaintiff prevails in an action brought 39 under this section, the plaintiff shall be entitled to 40 an award for reasonable attorney fees. 41 8. If the defendant prevails in an action brought 42 under this section and the court finds that the 43 plaintiff’s suit was frivolous and brought in bad 44 faith, the defendant shall be entitled to an award for 45 reasonable attorney fees. 46 9. Damages and attorney fees shall not be assessed 47 against the woman upon whom an abortion was performed 48 or attempted to be performed except as provided in 49 subsection 8. 50 -5- SF534.3246 (2) 84 pf/nh 5/ 6

10. In a civil or criminal proceeding or action 1 brought under this chapter, the court shall rule 2 whether the anonymity of any woman upon whom an 3 abortion has been performed or attempted shall be 4 preserved from public disclosure if the woman does 5 not provide consent to such disclosure. The court, 6 upon motion or on its own motion, shall make such a 7 ruling and, upon determining that the woman’s anonymity 8 should be preserved, shall issue orders to the parties, 9 witnesses, and counsel and shall direct the sealing of 10 the record and exclusion of individuals from courtrooms 11 or hearing rooms to the extent necessary to safeguard 12 the woman’s identity from public disclosure. Each such 13 order shall be accompanied by specific written findings 14 explaining why the anonymity of the woman should 15 be preserved from public disclosure, why the order 16 is essential to that end, how the order is narrowly 17 tailored to serve that interest, and why no reasonable 18 less restrictive alternative exists. In the absence 19 of written consent of the woman upon whom an abortion 20 has been performed or attempted, anyone, other than 21 a public official, who brings an action under this 22 section shall do so under a pseudonym. This subsection 23 shall not be construed to conceal the identity of the 24 plaintiff or of witnesses from the defendant or from 25 attorneys for the defendant. 26 Sec. 5. NEW SECTION . 146A.4 Construction. 27 Nothing in this chapter shall be construed as 28 creating or recognizing a right to an abortion. 29 Sec. 6. NEW SECTION . 146A.5 Severability clause. 30 If any provision of this chapter or its application 31 to any person or circumstance is held invalid, 32 the invalidity does not affect other provisions or 33 application of this chapter which can be given effect 34 without the invalid provision or application, and to 35 this end the provisions of this chapter are severable. 36 Sec. 7. EFFECTIVE UPON ENACTMENT. This Act, being 37 deemed of immediate importance, takes effect upon 38 enactment. > 39 2. Title page, by striking lines 1 through 4, and 40 inserting < An Act relating to abortions, including 41 late term abortions with certain exceptions, providing 42 penalties, and including effective date provisions. > 43 ______________________________ MARK CHELGREN -6- SF534.3246 (2) 84 pf/nh 6/ 6 #2.