House File 2788 H-8433 Amend the amendment, H-8432, to House File 2788, as follows: 1 1. By striking page 1, line 1, through page 6, line 10, and 2 inserting: 3 < Amend House File 2788 as follows: 4 1. By striking everything after the enacting clause and 5 inserting: 6 < DIVISION I 7 ABORTION —— DEFINED 8 Section 1. Section 146B.1, subsection 1, Code 2026, is 9 amended to read as follows: 10 1. “Abortion” means the termination of a human pregnancy 11 with the intent other than to produce a live birth or to remove 12 a dead fetus. “Abortion” does not include any of the following: 13 a. Treatment of a spontaneous termination of pregnancy, 14 commonly known as a miscarriage. 15 b. Removal of the products of conception after an incomplete 16 or inevitable loss of a pregnancy. 17 c. Treatment of an ectopic pregnancy. 18 Sec. 2. Section 146E.1, subsection 1, Code 2026, is amended 19 to read as follows: 20 1. “Abortion” means the termination of a human pregnancy 21 with the intent other than to produce a live birth or to remove 22 a dead fetus same as defined in section 146B.1 . 23 DIVISION II 24 INFORMED CONSENT 25 Sec. 3. Section 146A.1, Code 2026, is amended by adding the 26 following new subsection: 27 NEW SUBSECTION . 1A. Prior to performing an abortion, 28 a physician shall perform an in-person examination of the 29 pregnant woman including screening for indicia of coercion or 30 abuse. A physician shall, if necessary, refer the woman to an 31 appropriate health care provider for treatment consistent with 32 the examination results. 33 Sec. 4. Section 146A.1, subsection 6, Code 2026, is amended 34 by adding the following new paragraphs: 35 -1- HF 2788.4337.4358 (4) 91 ak/ko 1/ 6 #1.

NEW PARAGRAPH . 0a. “Abortion” means the same as defined in 1 section 146B.1. 2 NEW PARAGRAPH . 00a. “Health care provider” means a 3 person who is licensed, certified, or otherwise authorized or 4 permitted by the laws of this state to administer health care 5 in the ordinary course of business or in the practice of a 6 profession. 7 NEW PARAGRAPH . 0b. “Physician” means the same as defined 8 in section 146B.1. 9 Sec. 5. NEW SECTION . 146A.2 Prerequisites for dispensing 10 abortion-inducing drugs —— licensee discipline. 11 1. As used in this section, unless the context otherwise 12 requires: 13 a. “Abortion-inducing drug” means the same as defined in 14 section 146F.1. 15 b. “Chemical abortion” means the same as defined in section 16 146F.1. 17 c. “Dispense” means the same as defined in section 146F.1. 18 d. “Medical emergency” means the same as defined in section 19 146A.1. 20 e. “Pregnant” or “pregnancy” means the human female 21 reproductive condition of having a living unborn child within 22 the pregnant woman’s body throughout every stage of the unborn 23 child’s life and development, from fertilization to full 24 gestation and childbirth. 25 2. A physician who is performing or attempting to perform 26 a chemical abortion shall do all of the following prior to 27 prescribing or dispensing an abortion-inducing drug to a 28 pregnant woman: 29 a. Obtain the signature of the woman on the United States 30 food and drug administration patient agreement form required 31 for each abortion-inducing drug authorized to be manufactured 32 or sold in the United States. 33 b. Obtain written confirmation from the woman that the woman 34 has been informed of all of the following information: 35 -2- HF 2788.4337.4358 (4) 91 ak/ko 2/ 6

(1) The gestational age-specific risks of abortion-inducing 1 drugs. 2 (2) The risks related to the specific abortion-inducing 3 drug or drugs to be used, including hemorrhage, failure to 4 remove all tissue of the unborn child, sepsis, sterility, and 5 possible continuation of the pregnancy. 6 (3) That the United States federal food and drug 7 administration recommends that the pregnant woman follow up 8 with the woman’s health care provider approximately seven 9 to fourteen calendar days after the administration of an 10 abortion-inducing drug to confirm complete termination of 11 pregnancy has occurred and to evaluate the degree of bleeding. 12 (4) That women using abortion-inducing drugs have suffered 13 trauma from seeing the remains of the unborn child in the 14 process of a chemical abortion. 15 c. Advise the pregnant woman how to access emergency 16 surgical intervention in case of an incomplete abortion, severe 17 bleeding, or other medical complications. 18 3. Subsection 2 shall not apply to a chemical abortion 19 performed in response to a medical emergency. 20 4. This section shall not be construed to impose civil or 21 criminal liability on a woman upon whom a chemical abortion has 22 been performed. 23 5. A physician who fails to comply with this section is 24 subject to licensee discipline under chapter 148. 25 6. The board of medicine shall adopt rules pursuant to 26 chapter 17A to administer this section. 27 DIVISION III 28 DISPENSING ABORTION-INDUCING DRUGS 29 Sec. 6. NEW SECTION . 146F.1 Definitions. 30 As used in this chapter, unless the context otherwise 31 requires: 32 1. “Abortion-inducing drug” means any drug, chemical, or 33 other substance that is prescribed or administered with the 34 intent of performing an abortion. “Abortion-inducing drug” 35 -3- HF 2788.4337.4358 (4) 91 ak/ko 3/ 6

does not include a drug, chemical, or other substance that 1 is prescribed or administered for a purpose other than to 2 perform an abortion, even if the drug may be known to cause an 3 abortion. 4 2. “Chemical abortion” means an abortion performed by the 5 administration or use of an abortion-inducing drug. 6 3. “Dispense” means to distribute, administer, or send an 7 abortion-inducing drug to the ultimate user. 8 4. “Health care setting” means a pharmacy, clinic, medical 9 office, or hospital. 10 5. “Hospital” means the same as defined in section 135B.1. 11 6. “Interested party” means any of the following persons: 12 a. A woman upon whom a chemical abortion was performed or 13 attempted. 14 b. The personal representative of a woman upon whom a 15 chemical abortion was performed or attempted. 16 7. “Medical emergency” means the same as defined in section 17 146A.1. 18 8. “Personal representative” means an administrator or 19 an executor, or if there is no such personal representative 20 appointed, then a person legally authorized to perform 21 substantially the same functions. 22 Sec. 7. NEW SECTION . 146F.2 Dispensing of abortion-inducing 23 drugs —— restrictions. 24 1. A person shall not dispense an abortion-inducing drug in 25 this state unless all of the following criteria are met: 26 a. The drug is dispensed in a health care setting directly 27 to the woman prescribed the drug. 28 b. The person dispensing the drug is authorized to do so 29 pursuant to section 147.107. 30 2. Subsection 1 does not apply to the dispensing of an 31 abortion-inducing drug in response to a medical emergency. 32 Sec. 8. NEW SECTION . 146F.4 Private cause of action —— 33 civil liability. 34 1. A person who dispenses an abortion-inducing drug 35 -4- HF 2788.4337.4358 (4) 91 ak/ko 4/ 6

in violation of section 146F.2 shall be civilly liable 1 to any interested party for all damages caused by the 2 abortion-inducing drug. A person who is subject to licensee 3 discipline under chapter 148 or 155A shall be immune from civil 4 liability under this section. 5 2. In addition to compensatory or punitive damages, a 6 prevailing plaintiff who brings an action under this section is 7 entitled to court costs and reasonable attorney fees. 8 3. In an action brought under this section, the name and 9 other identifying characteristics of a woman who sought or 10 obtained an abortion-inducing drug shall be redacted without 11 a court order from all pleadings and documents filed in the 12 action. The court may make further orders as necessary to 13 protect the identity and privacy of the woman who sought or 14 obtained an abortion-inducing drug. 15 4. This section shall not be construed to impose civil or 16 criminal liability on a woman upon whom a chemical abortion is 17 performed. 18 Sec. 9. NEW SECTION . 146F.5 Licensee discipline. 19 A licensee who fails to comply with this chapter is subject 20 to licensee discipline under chapter 148 or 155A. 21 DIVISION IV 22 ABORTION-RELATED PROVISIONS 23 Sec. 10. Section 144.29A, subsection 1, paragraph k, Code 24 2026, is amended to read as follows: 25 k. The method used for an induced termination, including 26 whether mifepristone or misoprostol was used. 27 Sec. 11. Section 144.29A, subsection 1, Code 2026, is 28 amended by adding the following new paragraph: 29 NEW PARAGRAPH . l. If a spontaneous termination of 30 pregnancy, whether the patient ingested mifepristone or 31 misoprostol within fourteen calendar days prior to the date of 32 the spontaneous termination of pregnancy. 33 Sec. 12. Section 144.29A, subsection 7, paragraph c, Code 34 2026, is amended to read as follows: 35 -5- HF 2788.4337.4358 (4) 91 ak/ko 5/ 6

c. “Spontaneous termination of pregnancy” , commonly known 1 as a miscarriage, means the occurrence of an unintended 2 termination of pregnancy at any time during the period from 3 conception to twenty weeks gestation and which is not a 4 spontaneous termination of pregnancy at any time during the 5 period from twenty weeks or greater which is reported to the 6 department as a fetal death under this chapter . 7 Sec. 13. REPEAL. Chapter 146C, Code 2026, is repealed. > 8 2. Title page, by striking lines 1 through 3 and inserting 9 < An Act relating to abortions including definitions, informed 10 consent, dispensing of abortion-inducing drugs, and other 11 abortion-related provisions. >> 12 ______________________________ WOOD of Taylor -6- HF 2788.4337.4358 (4) 91 ak/ko 6/ 6 #2.