S.F. _____ Section 1. Section 146A.1, subsections 2 and 6, Code 2018, 1 are amended to read as follows: 2 2. Compliance with the prerequisites of this section shall 3 not apply to any of the following: 4 a. An abortion performed to save the life of a pregnant 5 woman. 6 b. An an abortion performed in a medical emergency. 7 c. The performance of a medical procedure by a physician 8 that in the physician’s reasonable medical judgment is designed 9 to or intended to prevent the death or to preserve the life of 10 the pregnant woman. 11 6. As used in this section , “unborn child” 12 a. “Medical emergency” means a situation in which an 13 abortion is performed to preserve the life of the pregnant 14 woman whose life is endangered by a physical disorder, physical 15 illness, or physical injury, including a life-endangering 16 physical condition caused by or arising from the pregnancy, but 17 not including psychological conditions, emotional conditions, 18 familial conditions, or the woman’s age. 19 b. “Unborn child” means an individual organism of the 20 species homo sapiens from fertilization to live birth. 21 Sec. 2. NEW SECTION . 146C.1 Definitions. 22 As used in this chapter, unless the context otherwise 23 requires: 24 1. “Abortion” means the termination of a human pregnancy 25 with the intent other than to produce a live birth or to remove 26 a dead fetus. 27 2. “Fetal heartbeat” means cardiac activity, the steady and 28 repetitive rhythmic contraction of the fetal heart within the 29 gestational sac. 30 3. “Medical emergency” means the same as defined in section 31 146A.1. 32 4. “Physician” means a person licensed under chapter 148. 33 5. “Reasonable medical judgment” means a medical judgment 34 made by a reasonably prudent physician who is knowledgeable 35 -1- LSB 5754XC (6) 87 pf/rh 1/ 5

S.F. _____ about the case and the treatment possibilities with respect to 1 the medical conditions involved. 2 6. “Unborn child” means the same as defined in section 3 146A.1. 4 Sec. 3. NEW SECTION . 146C.2 Abortion prohibited —— 5 detectable fetal heartbeat —— penalty. 6 1. Except in the case of a medical emergency, a physician 7 shall not perform an abortion unless the physician has first 8 complied with the prerequisites of chapter 146A and has 9 tested the pregnant woman as specified in this subsection, to 10 determine if a fetal heartbeat is detectable. 11 a. In testing for a detectable fetal heartbeat, the 12 physician shall perform an abdominal ultrasound, necessary to 13 detect a fetal heartbeat according to standard medical practice 14 and including the use of medical devices, as determined by 15 standard medical practice and specified by rule of the board 16 of medicine. 17 b. Following the testing of the pregnant woman for a 18 detectable fetal heartbeat, the physician shall inform the 19 pregnant woman, in writing, of all of the following: 20 (1) Whether a fetal heartbeat was detected. 21 (2) That if a fetal heartbeat was detected, an abortion is 22 prohibited. 23 c. Upon receipt of the written information, the pregnant 24 woman shall sign a form acknowledging that the pregnant woman 25 has received the information as required under this subsection. 26 2. A physician shall not perform an abortion upon a pregnant 27 woman when it has been determined that the unborn child has 28 a detectable fetal heartbeat, unless, in the physician’s 29 reasonable medical judgment, a medical emergency exists. 30 3. a. A physician who knowingly and intentionally performs 31 an abortion on a pregnant woman, when it has been determined 32 pursuant to subsection 2 that the unborn child has a detectable 33 fetal heartbeat and a medical emergency does not exist, is 34 guilty of a class “D” felony. 35 -2- LSB 5754XC (6) 87 pf/rh 2/ 5

S.F. _____ b. A physician charged or indicted for violation under this 1 subsection may request a hearing before the board of medicine 2 to determine if a medical emergency existed that necessitated 3 the performance of the abortion. The findings of the board of 4 medicine are admissible on the issue of medical emergency in 5 any criminal proceedings. Upon motion of the physician, the 6 court shall delay any criminal proceedings for not more than 7 thirty days to permit such a hearing to be held. 8 4. A physician shall retain in the woman’s medical record 9 all of the following: 10 a. Documentation of the testing for a fetal heartbeat 11 as specified in subsection 1 and the results of the fetal 12 heartbeat test. 13 b. The pregnant woman’s signed form acknowledging that 14 the pregnant woman received the information as required under 15 subsection 1. 16 c. Any information entered into evidence by the physician in 17 any hearing before the board of medicine pursuant to subsection 18 3. 19 5. This section shall not be construed to impose civil 20 or criminal liability on a woman upon whom an abortion is 21 performed in violation of this section. 22 6. The board of medicine shall adopt rules pursuant to 23 chapter 17A to administer this section. 24 Sec. 4. REPEAL. Chapter 146B, Code 2018, is repealed. 25 Sec. 5. SEVERABILITY CLAUSE. If any provision of this Act 26 or its application to a person or circumstance is held invalid, 27 the invalidity does not affect other provisions of applications 28 of this Act which can be given effect without the invalid 29 provision or application, and to this end the provisions of 30 this Act are severable. 31 EXPLANATION 32 The inclusion of this explanation does not constitute agreement with 33 the explanation’s substance by the members of the general assembly. 34 This bill relates to prerequisites for and prohibitions 35 -3- LSB 5754XC (6) 87 pf/rh 3/ 5

S.F. _____ against abortions relative to the testing for, and following 1 the detection of, a fetal heartbeat. 2 The bill provides that, except in the case of a medical 3 emergency, a physician shall not perform an abortion unless the 4 physician has first complied with the prerequisites of Code 5 chapter 146A and has tested the pregnant woman to determine if 6 a fetal heartbeat is detectable. The bill prescribes that in 7 testing for a detectable fetal heartbeat, the physician shall 8 perform an abdominal ultrasound, necessary to detect a fetal 9 heartbeat according to standard medical practice and including 10 the use of medical devices, as determined by standard medical 11 practice and specified by rule of the board of medicine. 12 Following the testing of the pregnant woman for a detectable 13 fetal heartbeat, the physician shall inform the pregnant woman, 14 in writing, whether a fetal heartbeat was detected and that 15 if a fetal heartbeat was detected, an abortion is prohibited. 16 Upon receipt of the written information, the pregnant woman 17 shall sign a form acknowledging that the pregnant woman has 18 received the information. 19 The bill prohibits a physician from performing an abortion 20 upon a pregnant woman when it has been determined that the 21 unborn child has a detectable fetal heartbeat, unless, in the 22 physician’s reasonable medical judgment, a medical emergency 23 exists. A physician who knowingly and intentionally performs 24 an abortion on a pregnant woman, when it has been determined 25 that the unborn child has a detectable fetal heartbeat and a 26 medical emergency does not exist, is guilty of a class “D” 27 felony. A class “D” felony is punishable by confinement for no 28 more than five years and a fine of at least $750 but not more 29 than $7,500. 30 A physician charged or indicted for a violation under the 31 bill may request a hearing before the board of medicine to 32 determine if a medical emergency existed that necessitated the 33 performance of the abortion. The findings of the board of 34 medicine are admissible on the issue of medical emergency in 35 -4- LSB 5754XC (6) 87 pf/rh 4/ 5

S.F. _____ any criminal proceedings. Upon motion of the physician, the 1 court shall delay any criminal proceedings for not more than 30 2 days to permit such a hearing to be held. 3 The bill requires the physician to retain in the woman’s 4 medical record documentation of the testing for a fetal 5 heartbeat and the results of the fetal heartbeat test; the 6 pregnant woman’s signed form acknowledging that the pregnant 7 woman received the required information prescribed under 8 the bill; and any information entered into by the physician 9 evidence in any hearing before the board of medicine. 10 The bill is not to be construed to impose civil or criminal 11 liability on a woman upon whom an abortion is performed in 12 violation of the bill. 13 The bill requires the board of medicine to adopt rules 14 pursuant to Code chapter 17A to administer the bill. 15 The bill amends Code section 146A.1 to provide that the 16 prerequisites of that Code section do not apply to an abortion 17 performed in a medical emergency, and eliminates the exception 18 for an abortion performed to save the life of a pregnant woman. 19 The bill also amends the definition of “medical emergency” used 20 under Code chapter 146A to be consistent with the definition of 21 “medical emergency” used in the bill. 22 The bill repeals Code chapter 146B which provides 23 limitations on and prerequisites for an abortion including 24 determination of the postfertilization age of a fetus and the 25 prohibition against performing or attempting to perform an 26 abortion after a pregnancy reaches a postfertilization age of 27 20 or more weeks that conflict with the bill. 28 The bill includes a severability clause that if any 29 provision of this bill or its application to a person or 30 circumstance is held invalid, the invalidity does not affect 31 other provisions of applications of this bill which can be 32 given effect without the invalid provision or application, and 33 to this end the provisions of this bill are severable. 34 -5- LSB 5754XC (6) 87 pf/rh 5/ 5