House Study Bill 186 - Introduced HOUSE FILE _____ BY (PROPOSED COMMITTEE ON HEALTH AND HUMAN SERVICES BILL BY CHAIRPERSON NORDMAN) A BILL FOR An Act relating to medication abortions including required 1 informed consent and the dispensing of abortion-inducing 2 drugs to patients within the state. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 2662YC (2) 91 lh/ko

H.F. _____ Section 1. NEW SECTION . 146F.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 health and human 11 services. 12 4. “Dispense” means relative to an abortion-inducing drug, 13 to deliver the abortion-inducing drug to the ultimate user. 14 5. “Health care setting” means a clinic, medical office, or 15 hospital. 16 6. “Medical emergency” means the same as defined in section 17 146B.1. 18 7. “Medication abortion” means an abortion performed by the 19 administration or use of an abortion-inducing drug. 20 8. “Organized outpatient health facility” means the same as 21 defined in section 10A.711. 22 Sec. 2. NEW SECTION . 146F.2 Facility where medication 23 abortions performed —— posting of signs. 24 1. A private office, freestanding organized outpatient 25 health facility, hospital, or other facility in which 26 medication abortions are performed shall conspicuously post a 27 sign in a location specified in this section, clearly visible 28 to patients, which reads as follows: 29 Recent developing research has indicated that a medication 30 abortion utilizing an abortion-inducing drug is not always 31 effective in ending a pregnancy. It may be possible to avoid, 32 cease, or even to reverse the intended effects of a medication 33 abortion that utilizes an abortion-inducing drug. Please 34 consult with a health care professional immediately. 35 -1- LSB 2662YC (2) 91 lh/ko 1/ 5

H.F. _____ 2. The sign required pursuant to subsection 1 shall be 1 printed with lettering that is legible and shall be at least 2 three-quarters of an inch in boldface type. 3 3. A facility in which medication abortions are performed 4 that is a private office or a freestanding organized outpatient 5 health facility shall post the required sign in each patient 6 waiting room and patient consultation room used by patients on 7 whom medication abortions are performed. A hospital or any 8 other facility in which medication abortions are performed that 9 is not a private office or freestanding organized outpatient 10 health facility shall post the required sign in each patient 11 admission area used by patients on whom medication abortions 12 are performed. 13 Sec. 3. NEW SECTION . 146F.3 Medication abortion —— informed 14 consent. 15 1. Except in the case of a medical emergency, in addition to 16 compliance with the prerequisites of chapter 146A, a physician 17 shall not perform or attempt to perform a medication abortion 18 unless the physician who will perform the medication abortion, 19 the referring physician, or an agent of either physician 20 obtains written certification from the pregnant woman that the 21 woman has been informed, by telephone or in person, prior to 22 the medication abortion of all of the following: 23 a. All of the risks commonly associated with a medication 24 abortion. 25 b. That it may be possible to reverse the intended effects 26 of a medication abortion if the woman changes her mind but that 27 time is of the essence. 28 c. That information on and assistance with reversing 29 the effects of a medication abortion is available on the 30 department’s internet site. 31 2. Following the dispensing of an abortion-inducing drug, 32 the attending physician or an agent of the attending physician 33 shall provide written medical discharge instructions to the 34 woman which must include the following statement: 35 -2- LSB 2662YC (2) 91 lh/ko 2/ 5

H.F. _____ Recent developing research has indicated that a medication 1 abortion utilizing an abortion-inducing drug is not always 2 effective in ending a pregnancy. It may be possible to avoid, 3 cease, or even to reverse the intended effects of a medication 4 abortion that utilizes an abortion-inducing drug. Please 5 consult with a health care professional immediately. 6 3. The attending physician or an agent of the attending 7 physician shall maintain documentation verifying compliance 8 with this section in the woman’s medical record. 9 Sec. 4. NEW SECTION . 146F.4 Informational materials. 10 The department shall publish and shall make available 11 on the department’s internet site, materials designed to 12 inform a woman of the possibility of reversing the effects 13 of a medication abortion if the woman changes her mind, and 14 information on and assistance with resources that may be 15 available to help reverse the effects of a medication abortion. 16 Sec. 5. NEW SECTION . 146F.5 Dispensing of mifepristone. 17 A person shall not dispense mifepristone to a patient in this 18 state for use by such patient in inducing a medication abortion 19 unless the mifepristone is dispensed directly to such patient 20 in a health care setting. 21 Sec. 6. NEW SECTION . 146F.6 Licensee discipline —— penalty. 22 Failure of a physician to comply with this chapter is grounds 23 for licensee discipline under chapter 148. 24 Sec. 7. NEW SECTION . 146F.7 Construction. 25 This chapter shall not be construed to create or recognize a 26 right to an abortion or to impose civil or criminal liability 27 on a woman upon whom an abortion is performed. 28 EXPLANATION 29 The inclusion of this explanation does not constitute agreement with 30 the explanation’s substance by the members of the general assembly. 31 This bill relates to medication abortions. 32 The bill requires a private office, freestanding organized 33 outpatient health facility, hospital, or other facility in 34 which medication abortions are performed to conspicuously post 35 -3- LSB 2662YC (2) 91 lh/ko 3/ 5

H.F. _____ a sign in a location as described in the bill relating to the 1 effectiveness and possibility of avoiding, ceasing, or even 2 reversing the effects of a medication abortion. 3 The bill requires that, except in the case of a medical 4 emergency, in addition to compliance with the abortion 5 prerequisites of Code chapter 146A, a physician shall not 6 perform or attempt to perform a medication abortion unless 7 the physician who will perform the medication abortion, the 8 referring physician, or an agent of either physician obtains 9 written certification from the pregnant woman. The written 10 certification shall provide that the woman has been informed, 11 by telephone or in person, prior to the medication abortion, 12 of all of the risks commonly associated with a medication 13 abortion, that it may be possible to reverse the intended 14 effects of a medication abortion if the woman changes her 15 mind but that time is of the essence, and that information 16 on and assistance with reversing the effects of a medication 17 abortion is available on the department of health and human 18 services (HHS) internet site. Following the dispensing of an 19 abortion-inducing drug, the attending physician or an agent of 20 the attending physician shall provide written medical discharge 21 instructions to the woman which must include the statement 22 specified in the bill. 23 The bill requires HHS to publish and to make available 24 on HHS’s internet site, materials designed to inform a woman 25 of the possibility of reversing the effects of a medication 26 abortion if the woman changes her mind, and information on and 27 assistance with the resources that may be available to help 28 reverse the effects of a medication abortion. 29 The bill also prohibits a person from dispensing 30 mifepristone to a patient in this state for use by such patient 31 in inducing a medication abortion unless the mifepristone is 32 dispensed directly to such patient in a health care setting. 33 Failure of a physician to comply with the bill is grounds for 34 licensee discipline. 35 -4- LSB 2662YC (2) 91 lh/ko 4/ 5

H.F. _____ The bill also provides that the bill shall not be construed 1 to create or recognize a right to an abortion or to impose 2 civil or criminal liability on a woman upon whom an abortion 3 is performed. 4 -5- LSB 2662YC (2) 91 lh/ko 5/ 5