H.F. 383 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. “Medical emergency” means the same as defined in section 12 146B.1. 13 5. “Medication abortion” means an abortion induced by an 14 abortion-inducing drug. 15 6. “Outpatient surgical facility” means the same as defined 16 in section 135.61. 17 Sec. 2. NEW SECTION . 146E.2 Facility where medication 18 abortions performed —— posting of signs. 19 1. A private office, freestanding outpatient surgical 20 facility, hospital, or other facility in which medication 21 abortions are performed shall conspicuously post a sign in 22 a location specified in this section, clearly visible to 23 patients, which reads as follows: 24 Recent developing research has indicated that a medication 25 abortion utilizing an abortion-inducing drug is not always 26 effective in ending a pregnancy. It may be possible to avoid, 27 cease, or even to reverse the intended effects of a medication 28 abortion that utilizes an abortion-inducing drug. Please 29 consult with a health care professional immediately. 30 2. The sign required pursuant to subsection 1 shall be 31 printed with lettering that is legible and shall be at least 32 three-quarters of an inch in boldface type. 33 3. A facility in which medication abortions are performed 34 that is a private office or a freestanding outpatient surgical 35 -1- LSB 1118HV (1) 89 pf/rh 1/ 4

H.F. 383 facility shall post the required sign in each patient waiting 1 room and patient consultation room used by patients on whom 2 medication abortions are performed. A hospital or any other 3 facility in which medication abortions are performed that 4 is not a private office or freestanding outpatient surgical 5 facility shall post the required sign in each patient admission 6 area used by patients on whom medication abortions are 7 performed. 8 Sec. 3. NEW SECTION . 146E.3 Medication abortion —— informed 9 consent. 10 1. Except in the case of a medical emergency, in addition to 11 compliance with the prerequisites of chapter 146A, a physician 12 shall not perform or attempt to perform a medication abortion 13 unless the physician who will perform the medication abortion, 14 the referring physician, or an agent of either physician 15 obtains written certification from the pregnant woman that the 16 woman has been informed, by telephone or in person, prior to 17 the medication abortion of all of the following: 18 a. All of the risks commonly associated with a medication 19 abortion. 20 b. That it may be possible to reverse the intended effects 21 of a medication abortion if the woman changes her mind but that 22 time is of the essence. 23 c. That information on and assistance with reversing 24 the effects of a medication abortion is available on the 25 department’s internet site. 26 2. Following the dispensing of an abortion-inducing drug, 27 the attending physician or an agent of the attending physician 28 shall provide written medical discharge instructions to the 29 woman which must include the following statement: 30 Recent developing research has indicated that a medication 31 abortion utilizing an abortion-inducing drug is not always 32 effective in ending a pregnancy. It may be possible to avoid, 33 cease, or even to reverse the intended effects of a medication 34 abortion that utilizes an abortion-inducing drug. Please 35 -2- LSB 1118HV (1) 89 pf/rh 2/ 4

H.F. 383 consult with a health care professional immediately. 1 3. The attending physician or an agent of the attending 2 physician shall maintain documentation verifying compliance 3 with this section in the woman’s medical record. 4 Sec. 4. NEW SECTION . 146E.4 Informational materials. 5 The department shall publish and shall make available 6 on the department’s internet site, materials designed to 7 inform a woman of the possibility of reversing the effects 8 of a medication abortion if the woman changes her mind, and 9 information on and assistance with resources that may be 10 available to help reverse the effects of a medication abortion. 11 Sec. 5. NEW SECTION . 146E.5 Licensee discipline. 12 Failure of a physician to comply with this chapter is grounds 13 for licensee discipline under chapter 148. 14 EXPLANATION 15 The inclusion of this explanation does not constitute agreement with 16 the explanation’s substance by the members of the general assembly. 17 This bill relates to informed consent for medication 18 abortions. 19 A medication abortion is defined in the bill as an abortion 20 induced by an abortion-inducing drug, defined as a drug, 21 medicine, mixture, or preparation, when it is prescribed or 22 administered with the intent to terminate the pregnancy of a 23 woman known to be pregnant. An abortion-inducing drug includes 24 mifepristone and misoprostol. 25 The bill requires a private office, freestanding outpatient 26 surgical facility, hospital, or other facility in which 27 medication abortions are performed to conspicuously post a 28 sign in a location as described in the bill relating to the 29 effectiveness and possibility of avoiding, ceasing, or even 30 reversing the effects of a medication abortion. 31 The bill requires that, except in the case of a medical 32 emergency, in addition to compliance with the abortion 33 prerequisites of Code chapter 146A, a physician shall not 34 perform or attempt to perform a medication abortion unless 35 -3- LSB 1118HV (1) 89 pf/rh 3/ 4

H.F. 383 the physician who will perform the medication abortion, 1 the referring physician, or an agent of either physician 2 obtains written certification from the pregnant woman. The 3 written certification shall provide that the woman has been 4 informed, by telephone or in person, prior to the medication 5 abortion, of all of the risks commonly associated with a 6 medication abortion, that it may be possible to reverse 7 the intended effects of a medication abortion if the woman 8 changes her mind but that time is of the essence, and that 9 information on and assistance with reversing the effects of a 10 medication abortion is available on the department of public 11 health’s (DPH) internet site. Following the dispensing of an 12 abortion-inducing drug, the attending physician or an agent of 13 the attending physician shall provide written medical discharge 14 instructions to the woman which must include the statement 15 specified in the bill. 16 The bill requires DPH to publish and to make available 17 on DPH’s internet site, materials designed to inform a woman 18 of the possibility of reversing the effects of a medication 19 abortion if the woman changes her mind, and information on and 20 assistance with the resources that may be available to help 21 reverse the effects of a medication abortion. 22 Failure of a physician to comply with the bill is grounds for 23 licensee discipline under Code chapter 148. 24 -4- LSB 1118HV (1) 89 pf/rh 4/ 4