Senate File 359 H-8362 Amend the amendment, H-8313, to Senate File 359, as passed by 1 the Senate, as follows: 2 1. By striking page 1, line 1, through page 8, line 3, and 3 inserting: 4 < Amend Senate File 359, as passed by the Senate, as follows: 5 1. By striking everything after the enacting clause and 6 inserting: 7 < Section 1. NEW SECTION . 146C.1 Legislative findings and 8 intent. 9 1. The general assembly finds all of the following: 10 a. Abortion carries significant physical and psychological 11 risks to the pregnant woman, and these physical and 12 psychological risks increase exponentially with the 13 postfertilization age of the unborn child. 14 b. As the second trimester of a pregnancy progresses, in the 15 vast majority of uncomplicated pregnancies, the health risks to 16 the pregnant woman of undergoing an abortion are greater than 17 the risks of carrying a pregnancy to term. 18 c. Medical complications from dilation and evacuation 19 abortions include but are not limited to pelvic infection; 20 incomplete abortions and retained tissue; blood clots; heavy 21 bleeding or hemorrhage; laceration, tear, or other injury to 22 the cervix; puncture, laceration, tear, or other injury to the 23 uterus; injury to the bowel or bladder; depression; anxiety; 24 substance abuse; and other emotional or psychological problems. 25 Further, in abortions performed in the second trimester, there 26 is a higher risk of requiring a hysterectomy, other reparative 27 surgery, or blood transfusion. 28 d. The state of Iowa has legitimate interests from the 29 outset of pregnancy in protecting the health of women, as the 30 medical, emotional, and psychological consequences of abortion 31 are serious and can be lasting. 32 2. Based upon the findings specified in subsection 1, it is 33 the intent of the general assembly through application of this 34 chapter to restrict the practice of nontherapeutic or elective 35 -1- H8313.5147 (2) 87 pf/rh 1/ 8 #1.

abortion to the period prior to the unborn child achieving the 1 postfertilization age of fifteen weeks. 2 Sec. 2. NEW SECTION . 146C.2 Definitions. 3 As used in this chapter, unless the context otherwise 4 requires: 5 1. “Abortion” means the termination of a human pregnancy 6 with the intent other than to produce a live birth or to remove 7 a dead fetus. 8 2. “Attempt to perform an abortion” means an act, or 9 an omission of a statutorily required act, that, under the 10 circumstances as the actor believes them to be, constitutes a 11 substantial step in a course of conduct planned to culminate in 12 the performing of an abortion. 13 3. “Department” means the department of public health. 14 4. “Fertilization” means the fusion of a human spermatozoon 15 with a human ovum. 16 5. “Major bodily function” includes but is not limited 17 to functions of the immune system, normal cell growth, and 18 digestive, bowel, bladder, neurological, brain, respiratory, 19 circulatory, endocrine, and reproductive functions. 20 6. “Medical emergency” means a situation in which an 21 abortion is performed to preserve the life of the pregnant 22 woman whose life is endangered by a physical disorder, physical 23 illness, or physical injury, including a life-endangering 24 physical condition caused by or arising from the pregnancy, or 25 when continuation of the pregnancy will create a serious risk 26 of substantial and irreversible impairment of a major bodily 27 function of the pregnant woman. 28 7. “Medical facility” means any public or private hospital, 29 clinic, center, medical school, medical training institution, 30 health care facility, physician’s office, infirmary, 31 dispensary, ambulatory surgical center, or other institution or 32 location where medical care is provided to any person. 33 8. “Perform” , “performed” , or “performing” , relative to an 34 abortion, means the use of any means, including medical or 35 -2- H8313.5147 (2) 87 pf/rh 2/ 8

surgical, to terminate the pregnancy of a woman known to be 1 pregnant with the intent other than to produce a live birth or 2 to remove a dead fetus. 3 9. “Physician” means a person licensed under chapter 148. 4 10. “Postfertilization age” means the age of the unborn 5 child as calculated from fertilization. 6 11. “Probable postfertilization age” means what, in 7 reasonable medical judgment, will with reasonable probability 8 be the postfertilization age of the unborn child at the time 9 the abortion is to be performed. 10 12. “Reasonable medical judgment” means a medical judgment 11 made by a reasonably prudent physician who is knowledgeable 12 about the case and the treatment possibilities with respect to 13 the medical conditions involved. 14 13. “Severe fetal abnormality" means a life-threatening 15 physical condition that, in the physician’s reasonable medical 16 judgment, regardless of the provision of life-saving medical 17 treatment, is incompatible with life outside the womb. 18 14. “Unborn child” means an individual organism of the 19 species homo sapiens from fertilization to live birth. 20 Sec. 3. NEW SECTION . 146C.3 Determination of 21 postfertilization age —— certain abortions prohibited —— 22 exceptions —— reporting requirements —— penalties. 23 1. Except in the case of a medical emergency or a 24 severe fetal abnormality, in addition to compliance with 25 the prerequisites of chapter 146A, an abortion shall not be 26 performed or be attempted to be performed unless the physician 27 performing the abortion has first made a determination of the 28 probable postfertilization age of the unborn child or relied 29 upon such a determination made by another physician. In making 30 such a determination, a physician shall make such inquiries 31 of the pregnant woman and perform or cause to be performed 32 such medical examinations and tests the physician considers 33 necessary in making a reasonable medical judgment to accurately 34 determine the postfertilization age of the unborn child. 35 -3- H8313.5147 (2) 87 pf/rh 3/ 8

2. a. A physician shall not perform or attempt to perform 1 an abortion upon a pregnant woman when it has been determined, 2 by the physician performing the abortion or by another 3 physician upon whose determination that physician relies, that 4 the probable postfertilization age of the unborn child is 5 fifteen or more weeks unless, in the physician’s reasonable 6 medical judgment, any of the following applies: 7 (1) The pregnant woman has a condition which the physician 8 deems a medical emergency. 9 (2) The abortion is necessary to preserve the life of an 10 unborn child. 11 (3) The unborn child is afflicted with a severe fetal 12 abnormality. 13 b. If an abortion is performed under this subsection, the 14 physician shall terminate the pregnancy in the manner which, 15 in the physician’s reasonable medical judgment, provides the 16 best opportunity for an unborn child to survive, unless, in the 17 physician’s reasonable medical judgment, termination of the 18 pregnancy in that manner would pose a greater risk than any 19 other available method of the death of the pregnant woman or 20 of the substantial and irreversible physical impairment of a 21 major bodily function. A greater risk shall not be deemed to 22 exist if it is based on a claim or diagnosis that the pregnant 23 woman will engage in conduct which would result in the pregnant 24 woman’s death or in substantial and irreversible physical 25 impairment of a major bodily function. 26 3. A physician who performs or attempts to perform an 27 abortion shall report to the department, on a schedule and in 28 accordance with forms and rules adopted by the department, all 29 of the following: 30 a. If a determination of probable postfertilization age of 31 the unborn child was made, the probable postfertilization age 32 determined and the method and basis of the determination. 33 b. If a determination of probable postfertilization age of 34 the unborn child was not made, the basis of the determination 35 -4- H8313.5147 (2) 87 pf/rh 4/ 8

that a medical emergency existed or that the unborn child was 1 afflicted with a severe fetal abnormality. 2 c. If the probable postfertilization age of the unborn 3 child was determined to be fifteen or more weeks, the basis 4 of the determination of a medical emergency, the basis of the 5 determination that the unborn child was afflicted with a severe 6 fetal abnormality, or the basis of the determination that the 7 abortion was necessary to preserve the life of an unborn child. 8 d. The method used for the abortion and, in the case of 9 an abortion performed when the probable postfertilization age 10 was determined to be fifteen or more weeks, whether the method 11 of abortion used was one that, in the physician’s reasonable 12 medical judgment, provided the best opportunity for an unborn 13 child to survive or, if such a method was not used, the basis 14 of the determination that termination of the pregnancy in 15 that manner would pose a greater risk than would any other 16 available method of the death of the pregnant woman or of the 17 substantial and irreversible physical impairment of a major 18 bodily function. 19 4. a. By April 1, annually, the department shall issue a 20 public report providing statistics for the previous calendar 21 year, compiled from the reports for that year submitted in 22 accordance with subsection 3. The department shall ensure that 23 none of the information included in the public reports could 24 reasonably lead to the identification of any woman upon whom an 25 abortion was performed. 26 b. (1) A physician who fails to submit a report by the end 27 of thirty days following the due date shall be subject to a 28 late fee of one hundred dollars for each additional thirty-day 29 period or portion of a thirty-day period the report is overdue. 30 (2) A physician required to report in accordance with 31 subsection 3 who has not submitted a report or who has 32 submitted only an incomplete report more than one year 33 following the due date, may, in an action brought in the 34 manner in which actions are brought to enforce chapter 148, 35 -5- H8313.5147 (2) 87 pf/rh 5/ 8

be directed by a court of competent jurisdiction to submit a 1 complete report within a time period stated by court order or 2 be subject to contempt of court. 3 (3) A physician who intentionally or recklessly falsifies 4 a report required under this section is subject to a civil 5 penalty of five hundred dollars. 6 5. Any medical facility in which a physician is authorized 7 to perform an abortion shall implement written medical 8 policies and procedures consistent with the requirements and 9 prohibitions of this chapter. 10 6. The department shall adopt rules to implement this 11 section. 12 Sec. 4. NEW SECTION . 146C.4 Civil actions and penalties. 13 1. Failure of a physician to comply with any provision of 14 section 146C.3, with the exception of the late filing of a 15 report or failure to submit a complete report in compliance 16 with a court order, is grounds for licensee discipline under 17 chapter 148. 18 2. A woman upon whom an abortion has been performed in 19 violation of this chapter may maintain an action against the 20 physician who performed the abortion in intentional or reckless 21 violation of this chapter for actual damages. 22 3. A woman upon whom an abortion has been attempted in 23 violation of this chapter may maintain an action against the 24 physician who attempted the abortion in intentional or reckless 25 violation of this chapter for actual damages. 26 4. A cause of action for injunctive relief to prevent a 27 physician from performing abortions may be maintained against a 28 physician who has intentionally violated this chapter by the 29 woman upon whom the abortion was performed or attempted, by 30 a parent or guardian of the woman if the woman is less than 31 eighteen years of age at the time the abortion was performed 32 or attempted, by a current or former licensed health care 33 provider of the woman, by a county attorney with appropriate 34 jurisdiction, or by the attorney general. 35 -6- H8313.5147 (2) 87 pf/rh 6/ 8

5. If the plaintiff prevails in an action brought under 1 this section, the plaintiff shall be entitled to an award for 2 reasonable attorney fees. 3 6. If the defendant prevails in an action brought under 4 this section and the court finds that the plaintiff’s suit was 5 frivolous and brought in bad faith, the defendant shall be 6 entitled to an award for reasonable attorney fees. 7 7. Damages and attorney fees shall not be assessed against 8 the woman upon whom an abortion was performed or attempted 9 except as provided in subsection 6. 10 8. In a civil proceeding or action brought under this 11 chapter, the court shall rule whether the anonymity of any 12 woman upon whom an abortion has been performed or attempted 13 shall be preserved from public disclosure if the woman does not 14 provide consent to such disclosure. The court, upon motion 15 or on its own motion, shall make such a ruling and, upon 16 determining that the woman’s anonymity should be preserved, 17 shall issue orders to the parties, witnesses, and counsel 18 and shall direct the sealing of the record and exclusion of 19 individuals from courtrooms or hearing rooms to the extent 20 necessary to safeguard the woman’s identity from public 21 disclosure. Each such order shall be accompanied by specific 22 written findings explaining why the anonymity of the woman 23 should be preserved from public disclosure, why the order is 24 essential to that end, how the order is narrowly tailored to 25 serve that interest, and why no reasonable less restrictive 26 alternative exists. In the absence of written consent of the 27 woman upon whom an abortion has been performed or attempted, 28 anyone, other than a public official, who brings an action 29 under this section shall do so under a pseudonym. This 30 subsection shall not be construed to conceal the identity 31 of the plaintiff or of witnesses from the defendant or from 32 attorneys for the defendant. 33 9. This chapter shall not be construed to impose civil 34 or criminal liability on a woman upon whom an abortion is 35 -7- H8313.5147 (2) 87 pf/rh 7/ 8

performed or attempted. 1 Sec. 5. EFFECTIVE DATE. This Act, being deemed of immediate 2 importance, takes effect upon enactment. >> 3 2. Title page, lines 1 and 2, by striking < fetal body parts 4 and providing penalties. > and inserting < an unborn child, 5 providing penalties, and including effective date provisions.> 6 3. By renumbering as necessary. > 7 ______________________________ RIZER of Linn -8- H8313.5147 (2) 87 pf/rh 8/ 8 #2. #3.