House File 2788 H-8432 Amend House File 2788 as follows: 1 1. By striking everything after the enacting clause and 2 inserting: 3 < DIVISION I 4 ABORTION —— DEFINED 5 Section 1. Section 146B.1, subsection 1, Code 2026, is 6 amended to read as follows: 7 1. “Abortion” means the termination of a human pregnancy 8 with the intent other than to produce a live birth or to remove 9 a dead fetus. “Abortion” does not include any of the following: 10 a. Treatment of a spontaneous termination of pregnancy, 11 commonly known as a miscarriage. 12 b. Removal of the products of conception after an incomplete 13 or inevitable loss of a pregnancy. 14 c. Treatment of an ectopic pregnancy. 15 Sec. 2. Section 146E.1, subsection 1, Code 2026, is amended 16 to read as follows: 17 1. “Abortion” means the termination of a human pregnancy 18 with the intent other than to produce a live birth or to remove 19 a dead fetus same as defined in section 146B.1 . 20 DIVISION II 21 INFORMED CONSENT 22 Sec. 3. Section 146A.1, Code 2026, is amended by adding the 23 following new subsection: 24 NEW SUBSECTION . 1A. Prior to performing an abortion, 25 a physician shall perform an in-person examination of the 26 pregnant woman including screening for indicia of coercion or 27 abuse. A physician shall, if necessary, refer the woman to an 28 appropriate health care provider for treatment consistent with 29 the examination results. 30 Sec. 4. Section 146A.1, subsection 6, Code 2026, is amended 31 by adding the following new paragraphs: 32 NEW PARAGRAPH . 0a. “Abortion” means the same as defined in 33 section 146B.1. 34 NEW PARAGRAPH . 00a. “Health care provider” means a 35 -1- HF 2788.4337 (1) 91 ak/ko 1/ 6 #1.

person who is licensed, certified, or otherwise authorized or 1 permitted by the laws of this state to administer health care 2 in the ordinary course of business or in the practice of a 3 profession. 4 NEW PARAGRAPH . 0b. “Physician” means the same as defined 5 in section 146B.1. 6 Sec. 5. NEW SECTION . 146A.2 Prerequisites for dispensing 7 abortion-inducing drugs —— licensee discipline. 8 1. As used in this section, unless the context otherwise 9 requires: 10 a. “Abortion-inducing drug” means the same as defined in 11 section 146F.1. 12 b. “Chemical abortion” means the same as defined in section 13 146F.1. 14 c. “Dispense” means the same as defined in section 146F.1. 15 d. “Medical emergency” means the same as defined in section 16 146A.1. 17 e. “Pregnant” or “pregnancy” means the human female 18 reproductive condition of having a living unborn child within 19 the pregnant woman’s body throughout every stage of the unborn 20 child’s life and development, from fertilization to full 21 gestation and childbirth. 22 2. A physician who is performing or attempting to perform 23 a chemical abortion shall do all of the following prior to 24 prescribing or dispensing an abortion-inducing drug to a 25 pregnant woman: 26 a. Obtain the signature of the woman on the United States 27 food and drug administration patient agreement form required 28 for each abortion-inducing drug authorized to be manufactured 29 or sold in the United States. 30 b. Obtain written confirmation from the woman that the woman 31 has been informed of all of the following information: 32 (1) The gestational age-specific risks of abortion-inducing 33 drugs. 34 (2) The risks related to the specific abortion-inducing 35 -2- HF 2788.4337 (1) 91 ak/ko 2/ 6

drug or drugs to be used, including hemorrhage, failure to 1 remove all tissue of the unborn child, sepsis, sterility, and 2 possible continuation of the pregnancy. 3 (3) That the United States federal food and drug 4 administration recommends that the pregnant woman follow up 5 with the woman’s health care provider approximately seven 6 to fourteen calendar days after the administration of an 7 abortion-inducing drug to confirm complete termination of 8 pregnancy has occurred and to evaluate the degree of bleeding. 9 (4) That women using abortion-inducing drugs have suffered 10 trauma from seeing the remains of the unborn child in the 11 process of a chemical abortion. 12 c. Advise the pregnant woman how to access emergency 13 surgical intervention in case of an incomplete abortion, severe 14 bleeding, or other medical complications. 15 3. Subsection 2 shall not apply to a chemical abortion 16 performed in response to a medical emergency. 17 4. This section shall not be construed to impose civil or 18 criminal liability on a woman upon whom a chemical abortion has 19 been performed. 20 5. A physician who fails to comply with this section is 21 subject to licensee discipline under chapter 148. 22 6. The board of medicine shall adopt rules pursuant to 23 chapter 17A to administer this section. 24 DIVISION III 25 DISPENSING ABORTION-INDUCING DRUGS 26 Sec. 6. NEW SECTION . 146F.1 Definitions. 27 As used in this chapter, unless the context otherwise 28 requires: 29 1. “Abortion-inducing drug” means any drug, chemical, 30 or other substance that is prescribed or administered with 31 the intent of performing an abortion. “Abortion-inducing 32 drug” includes the off-label use of drugs that are prescribed 33 or administered with the intent of performing an abortion. 34 “Abortion-inducing drug” does not include a drug, chemical, 35 -3- HF 2788.4337 (1) 91 ak/ko 3/ 6

or other substance that is prescribed or administered for a 1 purpose other than to perform an abortion, even if the drug may 2 be known to cause an abortion. 3 2. “Chemical abortion” means an abortion performed by the 4 administration or use of an abortion-inducing drug. 5 3. “Dispense” means to distribute, administer, or send an 6 abortion-inducing drug to the ultimate user. 7 4. “Health care setting” means a pharmacy, clinic, medical 8 office, or hospital. 9 5. “Hospital” means the same as defined in section 135B.1. 10 6. “Interested party” means any of the following persons: 11 a. A woman upon whom a chemical abortion was performed or 12 attempted. 13 b. The personal representative of a woman upon whom a 14 chemical abortion was performed or attempted. 15 7. “Medical emergency” means the same as defined in section 16 146A.1. 17 8. “Personal representative” means an administrator or 18 an executor, or if there is no such personal representative 19 appointed, then a person legally authorized to perform 20 substantially the same functions. 21 Sec. 7. NEW SECTION . 146F.2 Dispensing of abortion-inducing 22 drugs —— restrictions. 23 1. A person shall not dispense an abortion-inducing drug in 24 this state unless all of the following criteria are met: 25 a. The drug is dispensed in a health care setting directly 26 to the woman prescribed the drug. 27 b. The person dispensing the drug is authorized to do so 28 pursuant to section 147.107. 29 2. Subsection 1 does not apply to the dispensing of an 30 abortion-inducing drug in response to a medical emergency. 31 Sec. 8. NEW SECTION . 146F.4 Private cause of action —— 32 civil liability. 33 1. A person who dispenses an abortion-inducing drug 34 in violation of section 146F.2 shall be civilly liable 35 -4- HF 2788.4337 (1) 91 ak/ko 4/ 6

to any interested party for all damages caused by the 1 abortion-inducing drug. A person who is subject to licensee 2 discipline under chapter 148 or 155A shall be immune from civil 3 liability under this section. 4 2. In addition to compensatory or punitive damages, a 5 prevailing plaintiff who brings an action under this section is 6 entitled to court costs and reasonable attorney fees. 7 3. In an action brought under this section, the name and 8 other identifying characteristics of a woman who sought or 9 obtained an abortion-inducing drug shall be redacted without 10 a court order from all pleadings and documents filed in the 11 action. The court may make further orders as necessary to 12 protect the identity and privacy of the woman who sought or 13 obtained an abortion-inducing drug. 14 4. This section shall not be construed to impose civil or 15 criminal liability on a woman upon whom a chemical abortion is 16 performed. 17 Sec. 9. NEW SECTION . 146F.5 Licensee discipline. 18 A licensee who fails to comply with this chapter is subject 19 to licensee discipline under chapter 148 or 155A. 20 DIVISION IV 21 ABORTION-RELATED PROVISIONS 22 Sec. 10. Section 144.29A, subsection 1, paragraph k, Code 23 2026, is amended to read as follows: 24 k. The method used for an induced termination, including 25 whether mifepristone or misoprostol was used. 26 Sec. 11. Section 144.29A, subsection 1, Code 2026, is 27 amended by adding the following new paragraph: 28 NEW PARAGRAPH . l. If a spontaneous termination of 29 pregnancy, whether the patient ingested mifepristone or 30 misoprostol within fourteen calendar days prior to the date of 31 the spontaneous termination of pregnancy. 32 Sec. 12. Section 144.29A, subsection 7, paragraph c, Code 33 2026, is amended to read as follows: 34 c. “Spontaneous termination of pregnancy” , commonly known 35 -5- HF 2788.4337 (1) 91 ak/ko 5/ 6

as a miscarriage, means the occurrence of an unintended 1 termination of pregnancy at any time during the period from 2 conception to twenty weeks gestation and which is not a 3 spontaneous termination of pregnancy at any time during the 4 period from twenty weeks or greater which is reported to the 5 department as a fetal death under this chapter . > 6 2. Title page, by striking lines 1 through 3 and inserting 7 < An Act relating to abortions including definitions, informed 8 consent, dispensing of abortion-inducing drugs, and other 9 abortion-related provisions. > 10 ______________________________ WOOD of Taylor -6- HF 2788.4337 (1) 91 ak/ko 6/ 6 #2.