H.F. 2389 Section 1. NEW SECTION . 146E.1 Definitions. 1 As used in this section, unless the context otherwise 2 requires: 3 1. “Abortion” means the termination of a human pregnancy 4 with the intent other than to produce a live birth or to remove 5 a dead fetus. 6 2. “Abortion-inducing drug” means a drug, medicine, mixture, 7 or preparation, when prescribed or administered with the intent 8 to terminate the pregnancy of a woman known to be pregnant. 9 “Abortion-inducing drug” includes mifepristone and misoprostol. 10 3. “Department” means the department of public health. 11 4. “Dispense” means relative to an abortion-inducing drug, 12 to deliver the abortion-inducing drug to the ultimate user. 13 5. “Health care setting” means a clinic, medical office, or 14 hospital. 15 6. “Medical emergency” means the same as defined in section 16 146B.1. 17 7. “Medication abortion” means an abortion performed by the 18 administration or use of an abortion-inducing drug. 19 8. “Outpatient surgical facility” means the same as defined 20 in section 135.61. 21 Sec. 2. NEW SECTION . 146E.2 Facility where medication 22 abortions performed —— posting of signs. 23 1. A private office, freestanding outpatient surgical 24 facility, hospital, or other facility in which medication 25 abortions are performed shall conspicuously post a sign in 26 a location specified in this section, clearly visible to 27 patients, which reads as follows: 28 Recent developing research has indicated that a medication 29 abortion utilizing an abortion-inducing drug is not always 30 effective in ending a pregnancy. It may be possible to avoid, 31 cease, or even to reverse the intended effects of a medication 32 abortion that utilizes an abortion-inducing drug. Please 33 consult with a health care professional immediately. 34 2. The sign required pursuant to subsection 1 shall be 35 -1- LSB 5515HV (3) 89 pf/rh 1/ 5

H.F. 2389 printed with lettering that is legible and shall be at least 1 three-quarters of an inch in boldface type. 2 3. A facility in which medication abortions are performed 3 that is a private office or a freestanding outpatient surgical 4 facility shall post the required sign in each patient waiting 5 room and patient consultation room used by patients on whom 6 medication abortions are performed. A hospital or any other 7 facility in which medication abortions are performed that 8 is not a private office or freestanding outpatient surgical 9 facility shall post the required sign in each patient admission 10 area used by patients on whom medication abortions are 11 performed. 12 Sec. 3. NEW SECTION . 146E.3 Medication abortion —— informed 13 consent. 14 1. Except in the case of a medical emergency, in addition to 15 compliance with the prerequisites of chapter 146A, a physician 16 shall not perform or attempt to perform a medication abortion 17 unless the physician who will perform the medication abortion, 18 the referring physician, or an agent of either physician 19 obtains written certification from the pregnant woman that the 20 woman has been informed, by telephone or in person, prior to 21 the medication abortion of all of the following: 22 a. All of the risks commonly associated with a medication 23 abortion. 24 b. That it may be possible to reverse the intended effects 25 of a medication abortion if the woman changes her mind but that 26 time is of the essence. 27 c. That information on and assistance with reversing 28 the effects of a medication abortion is available on the 29 department’s internet site. 30 2. Following the dispensing of an abortion-inducing drug, 31 the attending physician or an agent of the attending physician 32 shall provide written medical discharge instructions to the 33 woman which must include the following statement: 34 Recent developing research has indicated that a medication 35 -2- LSB 5515HV (3) 89 pf/rh 2/ 5

H.F. 2389 abortion utilizing an abortion-inducing drug is not always 1 effective in ending a pregnancy. It may be possible to avoid, 2 cease, or even to reverse the intended effects of a medication 3 abortion that utilizes an abortion-inducing drug. Please 4 consult with a health care professional immediately. 5 3. The attending physician or an agent of the attending 6 physician shall maintain documentation verifying compliance 7 with this section in the woman’s medical record. 8 Sec. 4. NEW SECTION . 146E.4 Informational materials. 9 The department shall publish and shall make available 10 on the department’s internet site, materials designed to 11 inform a woman of the possibility of reversing the effects 12 of a medication abortion if the woman changes her mind, and 13 information on and assistance with resources that may be 14 available to help reverse the effects of a medication abortion. 15 Sec. 5. NEW SECTION . 146E.5 Dispensing of mifepristone. 16 A person shall not dispense mifepristone to a patient in this 17 state for use by such patient in inducing a medication abortion 18 unless the mifepristone is dispensed directly to such patient 19 in a health care setting. 20 Sec. 6. NEW SECTION . 146E.6 Licensee discipline —— penalty. 21 1. Failure of a physician to comply with this chapter is 22 grounds for licensee discipline under chapter 148. 23 2. A person who intentionally, knowingly, or recklessly 24 violates section 146E.5 is guilty of a serious misdemeanor. 25 Sec. 7. NEW SECTION . 146E.7 Construction. 26 This chapter shall not be construed to create or recognize a 27 right to an abortion or to impose civil or criminal liability 28 on a woman upon whom an abortion is performed. 29 EXPLANATION 30 The inclusion of this explanation does not constitute agreement with 31 the explanation’s substance by the members of the general assembly. 32 This bill relates to medication abortions. 33 The bill requires a private office, freestanding outpatient 34 surgical facility, hospital, or other facility in which 35 -3- LSB 5515HV (3) 89 pf/rh 3/ 5

H.F. 2389 medication abortions are performed to conspicuously post a 1 sign in a location as described in the bill relating to the 2 effectiveness and possibility of avoiding, ceasing, or even 3 reversing the effects of a medication abortion. 4 The bill requires that, except in the case of a medical 5 emergency, in addition to compliance with the abortion 6 prerequisites of Code chapter 146A, a physician shall not 7 perform or attempt to perform a medication abortion unless 8 the physician who will perform the medication abortion, 9 the referring physician, or an agent of either physician 10 obtains written certification from the pregnant woman. The 11 written certification shall provide that the woman has been 12 informed, by telephone or in person, prior to the medication 13 abortion, of all of the risks commonly associated with a 14 medication abortion, that it may be possible to reverse 15 the intended effects of a medication abortion if the woman 16 changes her mind but that time is of the essence, and that 17 information on and assistance with reversing the effects of a 18 medication abortion is available on the department of public 19 health’s (DPH) internet site. Following the dispensing of an 20 abortion-inducing drug, the attending physician or an agent of 21 the attending physician shall provide written medical discharge 22 instructions to the woman which must include the statement 23 specified in the bill. 24 The bill requires DPH to publish and to make available 25 on DPH’s internet site, materials designed to inform a woman 26 of the possibility of reversing the effects of a medication 27 abortion if the woman changes her mind, and information on and 28 assistance with the resources that may be available to help 29 reverse the effects of a medication abortion. 30 The bill also prohibits a person from dispensing 31 mifepristone to a patient in this state for use by such patient 32 in inducing a medication abortion unless the mifepristone is 33 dispensed directly to such patient in a health care setting. 34 Failure of a physician to comply with the bill is grounds for 35 -4- LSB 5515HV (3) 89 pf/rh 4/ 5

H.F. 2389 licensee discipline. 1 A person who intentionally, knowingly, or recklessly 2 violates the provisions of the bill relating to dispensing of 3 mifepristone is guilty of a serious misdemeanor. A serious 4 misdemeanor is punishable by confinement for no more than one 5 year and a fine of at least $430 but not more than $2,560. 6 The bill also provides that the bill shall not be construed 7 to create or recognize a right to an abortion or to impose 8 civil or criminal liability on a woman upon whom an abortion 9 is performed. 10 -5- LSB 5515HV (3) 89 pf/rh 5/ 5