House File 2788 - Reprinted HOUSE FILE 2788 BY COMMITTEE ON APPROPRIATIONS (SUCCESSOR TO HF 2563) (SUCCESSOR TO HSB 704) (As Amended and Passed by the House May 1, 2026 ) A BILL FOR An Act relating to abortions including definitions, informed 1 consent, dispensing of abortion-inducing drugs, and other 2 abortion-related provisions. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 HF 2788 (3) 91 ak/ko/md

H.F. 2788 DIVISION I 1 ABORTION —— DEFINED 2 Section 1. Section 146B.1, subsection 1, Code 2026, is 3 amended to read as follows: 4 1. “Abortion” means the termination of a human pregnancy 5 with the intent other than to produce a live birth or to remove 6 a dead fetus. “Abortion” does not include any of the following: 7 a. Treatment of a spontaneous termination of pregnancy, 8 commonly known as a miscarriage. 9 b. Removal of the products of conception after an incomplete 10 or inevitable loss of a pregnancy. 11 c. Treatment of an ectopic pregnancy. 12 Sec. 2. Section 146E.1, subsection 1, Code 2026, is amended 13 to read as follows: 14 1. “Abortion” means the termination of a human pregnancy 15 with the intent other than to produce a live birth or to remove 16 a dead fetus same as defined in section 146B.1 . 17 DIVISION II 18 INFORMED CONSENT 19 Sec. 3. Section 146A.1, Code 2026, is amended by adding the 20 following new subsection: 21 NEW SUBSECTION . 1A. Prior to performing an abortion, 22 a physician shall perform an in-person examination of the 23 pregnant woman including screening for indicia of coercion or 24 abuse. A physician shall, if necessary, refer the woman to an 25 appropriate health care provider for treatment consistent with 26 the examination results. 27 Sec. 4. Section 146A.1, subsection 6, Code 2026, is amended 28 by adding the following new paragraphs: 29 NEW PARAGRAPH . 0a. “Abortion” means the same as defined in 30 section 146B.1. 31 NEW PARAGRAPH . 00a. “Health care provider” means a 32 person who is licensed, certified, or otherwise authorized or 33 permitted by the laws of this state to administer health care 34 in the ordinary course of business or in the practice of a 35 -1- HF 2788 (3) 91 ak/ko/md 1/ 6

H.F. 2788 profession. 1 NEW PARAGRAPH . 0b. “Physician” means the same as defined 2 in section 146B.1. 3 Sec. 5. NEW SECTION . 146A.2 Prerequisites for dispensing 4 abortion-inducing drugs —— licensee discipline. 5 1. As used in this section, unless the context otherwise 6 requires: 7 a. “Abortion-inducing drug” means the same as defined in 8 section 146F.1. 9 b. “Chemical abortion” means the same as defined in section 10 146F.1. 11 c. “Dispense” means the same as defined in section 146F.1. 12 d. “Medical emergency” means the same as defined in section 13 146A.1. 14 e. “Pregnant” or “pregnancy” means the human female 15 reproductive condition of having a living unborn child within 16 the pregnant woman’s body throughout every stage of the unborn 17 child’s life and development, from fertilization to full 18 gestation and childbirth. 19 2. A physician who is performing or attempting to perform 20 a chemical abortion shall do all of the following prior to 21 prescribing or dispensing an abortion-inducing drug to a 22 pregnant woman: 23 a. Obtain the signature of the woman on the United States 24 food and drug administration patient agreement form required 25 for each abortion-inducing drug authorized to be manufactured 26 or sold in the United States. 27 b. Obtain written confirmation from the woman that the woman 28 has been informed of all of the following information: 29 (1) The gestational age-specific risks of abortion-inducing 30 drugs. 31 (2) The risks related to the specific abortion-inducing 32 drug or drugs to be used, including hemorrhage, failure to 33 remove all tissue of the unborn child, sepsis, sterility, and 34 possible continuation of the pregnancy. 35 -2- HF 2788 (3) 91 ak/ko/md 2/ 6

H.F. 2788 (3) That the United States federal food and drug 1 administration recommends that the pregnant woman follow up 2 with the woman’s health care provider approximately seven 3 to fourteen calendar days after the administration of an 4 abortion-inducing drug to confirm complete termination of 5 pregnancy has occurred and to evaluate the degree of bleeding. 6 (4) That women using abortion-inducing drugs have suffered 7 trauma from seeing the remains of the unborn child in the 8 process of a chemical abortion. 9 c. Advise the pregnant woman how to access emergency 10 surgical intervention in case of an incomplete abortion, severe 11 bleeding, or other medical complications. 12 3. Subsection 2 shall not apply to a chemical abortion 13 performed in response to a medical emergency. 14 4. This section shall not be construed to impose civil or 15 criminal liability on a woman upon whom a chemical abortion has 16 been performed. 17 5. A physician who fails to comply with this section is 18 subject to licensee discipline under chapter 148. 19 6. The board of medicine shall adopt rules pursuant to 20 chapter 17A to administer this section. 21 DIVISION III 22 DISPENSING ABORTION-INDUCING DRUGS 23 Sec. 6. NEW SECTION . 146F.1 Definitions. 24 As used in this chapter, unless the context otherwise 25 requires: 26 1. “Abortion-inducing drug” means any drug, chemical, or 27 other substance that is prescribed or administered with the 28 intent of performing an abortion. “Abortion-inducing drug” 29 does not include a drug, chemical, or other substance that 30 is prescribed or administered for a purpose other than to 31 perform an abortion, even if the drug may be known to cause an 32 abortion. 33 2. “Chemical abortion” means an abortion performed by the 34 administration or use of an abortion-inducing drug. 35 -3- HF 2788 (3) 91 ak/ko/md 3/ 6

H.F. 2788 3. “Dispense” means to distribute, administer, or send an 1 abortion-inducing drug to the ultimate user. 2 4. “Health care setting” means a pharmacy, clinic, medical 3 office, or hospital. 4 5. “Hospital” means the same as defined in section 135B.1. 5 6. “Interested party” means any of the following persons: 6 a. A woman upon whom a chemical abortion was performed or 7 attempted. 8 b. The personal representative of a woman upon whom a 9 chemical abortion was performed or attempted. 10 7. “Medical emergency” means the same as defined in section 11 146A.1. 12 8. “Personal representative” means an administrator or 13 an executor, or if there is no such personal representative 14 appointed, then a person legally authorized to perform 15 substantially the same functions. 16 Sec. 7. NEW SECTION . 146F.2 Dispensing of abortion-inducing 17 drugs —— restrictions. 18 1. A person shall not dispense an abortion-inducing drug in 19 this state unless all of the following criteria are met: 20 a. The drug is dispensed in a health care setting directly 21 to the woman prescribed the drug. 22 b. The person dispensing the drug is authorized to do so 23 pursuant to section 147.107. 24 2. Subsection 1 does not apply to the dispensing of an 25 abortion-inducing drug in response to a medical emergency. 26 Sec. 8. NEW SECTION . 146F.4 Private cause of action —— 27 civil liability. 28 1. A person who dispenses an abortion-inducing drug 29 in violation of section 146F.2 shall be civilly liable 30 to any interested party for all damages caused by the 31 abortion-inducing drug. A person who is subject to licensee 32 discipline under chapter 148 or 155A shall be immune from civil 33 liability under this section. 34 2. In addition to compensatory or punitive damages, a 35 -4- HF 2788 (3) 91 ak/ko/md 4/ 6

H.F. 2788 prevailing plaintiff who brings an action under this section is 1 entitled to court costs and reasonable attorney fees. 2 3. In an action brought under this section, the name and 3 other identifying characteristics of a woman who sought or 4 obtained an abortion-inducing drug shall be redacted without 5 a court order from all pleadings and documents filed in the 6 action. The court may make further orders as necessary to 7 protect the identity and privacy of the woman who sought or 8 obtained an abortion-inducing drug. 9 4. This section shall not be construed to impose civil or 10 criminal liability on a woman upon whom a chemical abortion is 11 performed. 12 Sec. 9. NEW SECTION . 146F.5 Licensee discipline. 13 A licensee who fails to comply with this chapter is subject 14 to licensee discipline under chapter 148 or 155A. 15 DIVISION IV 16 ABORTION-RELATED PROVISIONS 17 Sec. 10. Section 144.29A, subsection 1, paragraph k, Code 18 2026, is amended to read as follows: 19 k. The method used for an induced termination, including 20 whether mifepristone or misoprostol was used. 21 Sec. 11. Section 144.29A, subsection 1, Code 2026, is 22 amended by adding the following new paragraph: 23 NEW PARAGRAPH . l. If a spontaneous termination of 24 pregnancy, whether the patient ingested mifepristone or 25 misoprostol within fourteen calendar days prior to the date of 26 the spontaneous termination of pregnancy. 27 Sec. 12. Section 144.29A, subsection 7, paragraph c, Code 28 2026, is amended to read as follows: 29 c. “Spontaneous termination of pregnancy” , commonly known 30 as a miscarriage, means the occurrence of an unintended 31 termination of pregnancy at any time during the period from 32 conception to twenty weeks gestation and which is not a 33 spontaneous termination of pregnancy at any time during the 34 period from twenty weeks or greater which is reported to the 35 -5- HF 2788 (3) 91 ak/ko/md 5/ 6