Senate File 359 H-8313 Amend Senate File 359, as passed by the Senate, as follows: 1 1. By striking everything after the enacting clause and 2 inserting: 3 < Section 1. NEW SECTION . 146C.1 Legislative findings and 4 intent. 5 1. The general assembly finds all of the following: 6 a. Abortion carries significant physical and psychological 7 risks to the pregnant woman, and these physical and 8 psychological risks increase exponentially with the 9 postfertilization age of the unborn child. 10 b. As the second trimester of a pregnancy progresses, in the 11 vast majority of uncomplicated pregnancies, the health risks to 12 the pregnant woman of undergoing an abortion are greater than 13 the risks of carrying a pregnancy to term. 14 c. Medical complications from dilation and evacuation 15 abortions include but are not limited to pelvic infection; 16 incomplete abortions and retained tissue; blood clots; heavy 17 bleeding or hemorrhage; laceration, tear, or other injury to 18 the cervix; puncture, laceration, tear, or other injury to the 19 uterus; injury to the bowel or bladder; depression; anxiety; 20 substance abuse; and other emotional or psychological problems. 21 Further, in abortions performed in the second trimester, there 22 is a higher risk of requiring a hysterectomy, other reparative 23 surgery, or blood transfusion. 24 d. The state of Iowa has legitimate interests from the 25 outset of pregnancy in protecting the health of women, as the 26 medical, emotional, and psychological consequences of abortion 27 are serious and can be lasting. 28 2. Based upon the findings specified in subsection 1, it is 29 the intent of the general assembly through application of this 30 chapter to restrict the practice of nontherapeutic or elective 31 abortion to the period prior to the unborn child achieving the 32 postfertilization age of fifteen weeks. 33 Sec. 2. NEW SECTION . 146C.2 Definitions. 34 As used in this chapter, unless the context otherwise 35 -1- SF359.4881 (4) 87 pf/rh 1/ 8 #1.

requires: 1 1. “Abortion” means the termination of a human pregnancy 2 with the intent other than to produce a live birth or to remove 3 a dead fetus. 4 2. “Attempt to perform an abortion” means an act, or 5 an omission of a statutorily required act, that, under the 6 circumstances as the actor believes them to be, constitutes a 7 substantial step in a course of conduct planned to culminate in 8 the performing of an abortion. 9 3. “Department” means the department of public health. 10 4. “Fertilization” means the fusion of a human spermatozoon 11 with a human ovum. 12 5. “Major bodily function” includes but is not limited 13 to functions of the immune system, normal cell growth, and 14 digestive, bowel, bladder, neurological, brain, respiratory, 15 circulatory, endocrine, and reproductive functions. 16 6. “Medical emergency” means a situation in which an 17 abortion is performed to preserve the life of the pregnant 18 woman whose life is endangered by a physical disorder, physical 19 illness, or physical injury, including a life-endangering 20 physical condition caused by or arising from the pregnancy, or 21 when continuation of the pregnancy will create a serious risk 22 of substantial and irreversible impairment of a major bodily 23 function of the pregnant woman. 24 7. “Medical facility” means any public or private hospital, 25 clinic, center, medical school, medical training institution, 26 health care facility, physician’s office, infirmary, 27 dispensary, ambulatory surgical center, or other institution or 28 location where medical care is provided to any person. 29 8. “Perform” , “performed” , or “performing” , relative to an 30 abortion, means the use of any means, including medical or 31 surgical, to terminate the pregnancy of a woman known to be 32 pregnant with the intent other than to produce a live birth or 33 to remove a dead fetus. 34 9. “Physician” means a person licensed under chapter 148. 35 -2- SF359.4881 (4) 87 pf/rh 2/ 8

10. “Postfertilization age” means the age of the unborn 1 child as calculated from fertilization. 2 11. “Probable postfertilization age” means what, in 3 reasonable medical judgment, will with reasonable probability 4 be the postfertilization age of the unborn child at the time 5 the abortion is to be performed. 6 12. “Reasonable medical judgment” means a medical judgment 7 made by a reasonably prudent physician who is knowledgeable 8 about the case and the treatment possibilities with respect to 9 the medical conditions involved. 10 13. “Severe fetal abnormality" means a life-threatening 11 physical condition that, in the physician’s reasonable medical 12 judgment, regardless of the provision of life-saving medical 13 treatment, is incompatible with life outside the womb. 14 14. “Unborn child” means an individual organism of the 15 species homo sapiens from fertilization to live birth. 16 Sec. 3. NEW SECTION . 146C.3 Determination of 17 postfertilization age —— certain abortions prohibited —— 18 exceptions —— reporting requirements —— penalties. 19 1. Except in the case of a medical emergency or a 20 severe fetal abnormality, in addition to compliance with 21 the prerequisites of chapter 146A, an abortion shall not be 22 performed or be attempted to be performed unless the physician 23 performing the abortion has first made a determination of the 24 probable postfertilization age of the unborn child or relied 25 upon such a determination made by another physician. In making 26 such a determination, a physician shall make such inquiries 27 of the pregnant woman and perform or cause to be performed 28 such medical examinations and tests the physician considers 29 necessary in making a reasonable medical judgment to accurately 30 determine the postfertilization age of the unborn child. 31 2. a. A physician shall not perform or attempt to perform 32 an abortion upon a pregnant woman when it has been determined, 33 by the physician performing the abortion or by another 34 physician upon whose determination that physician relies, that 35 -3- SF359.4881 (4) 87 pf/rh 3/ 8

the probable postfertilization age of the unborn child is 1 fifteen or more weeks unless, in the physician’s reasonable 2 medical judgment, any of the following applies: 3 (1) The pregnant woman has a condition which the physician 4 deems a medical emergency. 5 (2) The abortion is necessary to preserve the life of an 6 unborn child. 7 (3) The unborn child is afflicted with a severe fetal 8 abnormality. 9 b. If an abortion is performed under this subsection, the 10 physician shall terminate the pregnancy in the manner which, 11 in the physician’s reasonable medical judgment, provides the 12 best opportunity for an unborn child to survive, unless, in the 13 physician’s reasonable medical judgment, termination of the 14 pregnancy in that manner would pose a greater risk than any 15 other available method of the death of the pregnant woman or 16 of the substantial and irreversible physical impairment of a 17 major bodily function. A greater risk shall not be deemed to 18 exist if it is based on a claim or diagnosis that the pregnant 19 woman will engage in conduct which would result in the pregnant 20 woman’s death or in substantial and irreversible physical 21 impairment of a major bodily function. 22 3. A physician who performs or attempts to perform an 23 abortion shall report to the department, on a schedule and in 24 accordance with forms and rules adopted by the department, all 25 of the following: 26 a. If a determination of probable postfertilization age of 27 the unborn child was made, the probable postfertilization age 28 determined and the method and basis of the determination. 29 b. If a determination of probable postfertilization age of 30 the unborn child was not made, the basis of the determination 31 that a medical emergency existed or that the unborn child was 32 afflicted with a severe fetal abnormality. 33 c. If the probable postfertilization age of the unborn 34 child was determined to be fifteen or more weeks, the basis 35 -4- SF359.4881 (4) 87 pf/rh 4/ 8

of the determination of a medical emergency, the basis of the 1 determination that the unborn child was afflicted with a severe 2 fetal abnormality, or the basis of the determination that the 3 abortion was necessary to preserve the life of an unborn child. 4 d. The method used for the abortion and, in the case of 5 an abortion performed when the probable postfertilization age 6 was determined to be fifteen or more weeks, whether the method 7 of abortion used was one that, in the physician’s reasonable 8 medical judgment, provided the best opportunity for an unborn 9 child to survive or, if such a method was not used, the basis 10 of the determination that termination of the pregnancy in 11 that manner would pose a greater risk than would any other 12 available method of the death of the pregnant woman or of the 13 substantial and irreversible physical impairment of a major 14 bodily function. 15 4. a. By June 30, annually, the department shall issue a 16 public report providing statistics for the previous calendar 17 year, compiled from the reports for that year submitted in 18 accordance with subsection 3. The department shall ensure that 19 none of the information included in the public reports could 20 reasonably lead to the identification of any woman upon whom an 21 abortion was performed. 22 b. (1) A physician who fails to submit a report by the end 23 of thirty days following the due date shall be subject to a 24 late fee of one hundred dollars for each additional thirty-day 25 period or portion of a thirty-day period the report is overdue. 26 (2) A physician required to report in accordance with 27 subsection 3 who has not submitted a report or who has 28 submitted only an incomplete report more than one year 29 following the due date, may, in an action brought in the 30 manner in which actions are brought to enforce chapter 148, 31 be directed by a court of competent jurisdiction to submit a 32 complete report within a time period stated by court order or 33 be subject to contempt of court. 34 (3) A physician who intentionally or recklessly falsifies 35 -5- SF359.4881 (4) 87 pf/rh 5/ 8

a report required under this section is subject to a civil 1 penalty of five hundred dollars. 2 5. Any medical facility in which a physician is authorized 3 to perform an abortion shall implement written medical 4 policies and procedures consistent with the requirements and 5 prohibitions of this chapter. 6 6. The department shall adopt rules to implement this 7 section. 8 Sec. 4. NEW SECTION . 146C.4 Civil actions and penalties. 9 1. Failure of a physician to comply with any provision of 10 section 146C.3, with the exception of the late filing of a 11 report or failure to submit a complete report in compliance 12 with a court order, is grounds for licensee discipline under 13 chapter 148. 14 2. A woman upon whom an abortion has been performed in 15 violation of this chapter may maintain an action against the 16 physician who performed the abortion in intentional or reckless 17 violation of this chapter for actual damages. 18 3. A woman upon whom an abortion has been attempted in 19 violation of this chapter may maintain an action against the 20 physician who attempted the abortion in intentional or reckless 21 violation of this chapter for actual damages. 22 4. A cause of action for injunctive relief to prevent a 23 physician from performing abortions may be maintained against a 24 physician who has intentionally violated this chapter by the 25 woman upon whom the abortion was performed or attempted, by 26 a parent or guardian of the woman if the woman is less than 27 eighteen years of age at the time the abortion was performed 28 or attempted, by a current or former licensed health care 29 provider of the woman, by a county attorney with appropriate 30 jurisdiction, or by the attorney general. 31 5. If the plaintiff prevails in an action brought under 32 this section, the plaintiff shall be entitled to an award for 33 reasonable attorney fees. 34 6. If the defendant prevails in an action brought under 35 -6- SF359.4881 (4) 87 pf/rh 6/ 8

this section and the court finds that the plaintiff’s suit was 1 frivolous and brought in bad faith, the defendant shall be 2 entitled to an award for reasonable attorney fees. 3 7. Damages and attorney fees shall not be assessed against 4 the woman upon whom an abortion was performed or attempted 5 except as provided in subsection 6. 6 8. In a civil proceeding or action brought under this 7 chapter, the court shall rule whether the anonymity of any 8 woman upon whom an abortion has been performed or attempted 9 shall be preserved from public disclosure if the woman does not 10 provide consent to such disclosure. The court, upon motion 11 or on its own motion, shall make such a ruling and, upon 12 determining that the woman’s anonymity should be preserved, 13 shall issue orders to the parties, witnesses, and counsel 14 and shall direct the sealing of the record and exclusion of 15 individuals from courtrooms or hearing rooms to the extent 16 necessary to safeguard the woman’s identity from public 17 disclosure. Each such order shall be accompanied by specific 18 written findings explaining why the anonymity of the woman 19 should be preserved from public disclosure, why the order is 20 essential to that end, how the order is narrowly tailored to 21 serve that interest, and why no reasonable less restrictive 22 alternative exists. In the absence of written consent of the 23 woman upon whom an abortion has been performed or attempted, 24 anyone, other than a public official, who brings an action 25 under this section shall do so under a pseudonym. This 26 subsection shall not be construed to conceal the identity 27 of the plaintiff or of witnesses from the defendant or from 28 attorneys for the defendant. 29 9. This chapter shall not be construed to impose civil 30 or criminal liability on a woman upon whom an abortion is 31 performed or attempted. 32 Sec. 5. EFFECTIVE DATE. This Act, being deemed of immediate 33 importance, takes effect upon enactment. > 34 2. Title page, lines 1 and 2, by striking < fetal body parts 35 -7- SF359.4881 (4) 87 pf/rh 7/ 8