Senate File 359 H-8436 Amend the amendment, H-8269, to Senate File 359, as passed by 1 the Senate, as follows: 2 1. By striking page 1, line 3, through page 3, line 23, and 3 inserting: 4 < DIVISION I 5 FETAL BODY PARTS 6 Section 1. NEW SECTION . 146D.1 Fetal body parts —— actions 7 prohibited —— penalties. 8 1. A person shall not knowingly acquire, provide, receive, 9 otherwise transfer, or use a fetal body part in this state, 10 regardless of whether the acquisition, provision, receipt, 11 transfer, or use is for valuable consideration. 12 2. Subsection 1 shall not apply to any of the following: 13 a. Diagnostic or remedial tests, procedures, or observations 14 which have the sole purpose of determining the life or health 15 of the fetus in order to provide that information to the 16 pregnant woman or to preserve the life or health of the fetus 17 or pregnant woman. 18 b. The actions of a person taken in furtherance of the final 19 disposition of a fetal body part. 20 c. The pathological study of body tissue, including genetic 21 testing, for diagnostic or forensic purposes. 22 d. A fetal body part if the fetal body part results from 23 a spontaneous termination of pregnancy or stillbirth and is 24 willingly donated for the purpose of medical research. 25 3. A person who violates this section is guilty of a class 26 “C” felony. 27 4. For the purposes of this section: 28 a. “Abortion” means as defined in section 146.1. 29 b. “Fetal body part” means a cell, tissue, organ, or other 30 part of a fetus that is terminated by an abortion. “Fetal body 31 part” does not include any of the following: 32 (1) Cultured cells or cell lines derived from a spontaneous 33 termination of pregnancy or stillbirth and willingly donated 34 for the purposes of medical research. 35 -1- H8269.5498 (5) 87 pf/rh 1/ 5 #1.

(2) A cell, tissue, organ, or other part of a fetus that is 1 terminated by an abortion that occurred prior to July 1, 2018. 2 (3) All cells and tissues external to the fetal body proper. 3 c. “Final disposition” means the disposition of fetal 4 body parts by burial, interment, entombment, cremation, or 5 incineration. 6 d. “Valuable consideration” means any payment including but 7 not limited to payment associated with the transportation, 8 processing, preservation, quality control, or storage of fetal 9 body parts. 10 DIVISION ___ 11 ABORTION PREREQUISITES AND PROHIBITIONS —— FETAL HEARTBEAT 12 Sec. ___. Section 146A.1, subsections 2 and 6, Code 2018, 13 are amended to read as follows: 14 2. Compliance with the prerequisites of this section shall 15 not apply to any of the following: 16 a. An abortion performed to save the life of a pregnant 17 woman. 18 b. An an abortion performed in a medical emergency. 19 c. The performance of a medical procedure by a physician 20 that in the physician’s reasonable medical judgment is designed 21 to or intended to prevent the death or to preserve the life of 22 the pregnant woman. 23 6. As used in this section , “unborn child” : 24 a. “Medical emergency” means a situation in which an 25 abortion is performed to preserve the life of the pregnant 26 woman whose life is endangered by a physical disorder, physical 27 illness, or physical injury, including a life-endangering 28 physical condition caused by or arising from the pregnancy, but 29 not including psychological conditions, emotional conditions, 30 familial conditions, or the woman’s age; or when continuation 31 of the pregnancy will create a serious risk of substantial 32 and irreversible impairment of a major bodily function of the 33 pregnant woman. 34 b. “Unborn child” means an individual organism of the 35 -2- H8269.5498 (5) 87 pf/rh 2/ 5

species homo sapiens from fertilization to live birth. 1 Sec. ___. NEW SECTION . 146C.1 Definitions. 2 As used in this chapter, unless the context otherwise 3 requires: 4 1. “Abortion” means the termination of a human pregnancy 5 with the intent other than to produce a live birth or to remove 6 a dead fetus. 7 2. “Fetal heartbeat” means cardiac activity, the steady and 8 repetitive rhythmic contraction of the fetal heart within the 9 gestational sac. 10 3. “Medical emergency” means the same as defined in section 11 146A.1. 12 4. “Medically necessary” means any of the following: 13 a. The pregnancy is the result of a rape which is reported 14 within forty-five days of the incident to a law enforcement 15 agency or to a public or private health agency which may 16 include a family physician. 17 b. The pregnancy is the result of incest which is reported 18 within one hundred forty days of the incident to a law 19 enforcement agency or to a public or private health agency 20 which may include a family physician. 21 c. Any spontaneous abortion, commonly known as a 22 miscarriage, if not all of the products of conception are 23 expelled. 24 d. The attending physician certifies that the fetus has a 25 fetal abnormality that in the physician’s reasonable medical 26 judgment is incompatible with life. 27 5. “Physician” means a person licensed under chapter 148. 28 6. “Reasonable medical judgment” means a medical judgment 29 made by a reasonably prudent physician who is knowledgeable 30 about the case and the treatment possibilities with respect to 31 the medical conditions involved. 32 7. “Unborn child” means the same as defined in section 33 146A.1. 34 Sec. ___. NEW SECTION . 146C.2 Abortion prohibited —— 35 -3- H8269.5498 (5) 87 pf/rh 3/ 5

detectable fetal heartbeat. 1 1. Except in the case of a medical emergency or when the 2 abortion is medically necessary, a physician shall not perform 3 an abortion unless the physician has first complied with the 4 prerequisites of chapter 146A and has tested the pregnant 5 woman as specified in this subsection, to determine if a fetal 6 heartbeat is detectable. 7 a. In testing for a detectable fetal heartbeat, the 8 physician shall perform an abdominal ultrasound, necessary to 9 detect a fetal heartbeat according to standard medical practice 10 and including the use of medical devices, as determined by 11 standard medical practice and specified by rule of the board 12 of medicine. 13 b. Following the testing of the pregnant woman for a 14 detectable fetal heartbeat, the physician shall inform the 15 pregnant woman, in writing, of all of the following: 16 (1) Whether a fetal heartbeat was detected. 17 (2) That if a fetal heartbeat was detected, an abortion is 18 prohibited. 19 c. Upon receipt of the written information, the pregnant 20 woman shall sign a form acknowledging that the pregnant woman 21 has received the information as required under this subsection. 22 2. a. A physician shall not perform an abortion upon a 23 pregnant woman when it has been determined that the unborn 24 child has a detectable fetal heartbeat, unless, in the 25 physician’s reasonable medical judgment, a medical emergency 26 exists, or when the abortion is medically necessary. 27 b. Notwithstanding paragraph “a” , if a physician determines 28 that the probable postfertilization age, as defined in 29 section 146B.1, of the unborn child is twenty or more weeks, 30 the physician shall not perform an abortion upon a pregnant 31 woman when it has been determined that the unborn child 32 has a detectable fetal heartbeat, unless in the physician’s 33 reasonable medical judgment the pregnant woman has a condition 34 which the physician deems a medical emergency, as defined in 35 -4- H8269.5498 (5) 87 pf/rh 4/ 5

section 146B.1, or the abortion is necessary to preserve the 1 life of an unborn child. 2 3. A physician shall retain in the woman’s medical record 3 all of the following: 4 a. Documentation of the testing for a fetal heartbeat 5 as specified in subsection 1 and the results of the fetal 6 heartbeat test. 7 b. The pregnant woman’s signed form acknowledging that 8 the pregnant woman received the information as required under 9 subsection 1. 10 4. This section shall not be construed to impose civil 11 or criminal liability on a woman upon whom an abortion is 12 performed in violation of this section. 13 5. The board of medicine shall adopt rules pursuant to 14 chapter 17A to administer this section. > 15 2. Title page, line 1, by striking < certain actions 16 regarding fetal body parts > and inserting < and requiring 17 certain actions relating to a fetus > 18 ______________________________ LUNDGREN of Dubuque -5- H8269.5498 (5) 87 pf/rh 5/ 5 #2.