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House Study Bill 660 - IntroducedA Bill ForAn Act 1relating to fetal deaths including the disposition of
2bodily remains, and the filing of a fetal death certificate,
3and providing penalties.
4BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. Section 144.1, Code 2020, is amended by adding
2the following new subsections:
3 NEW SUBSECTION. 1A. “Bodily remains” means the physical
4remains, corpse, or body parts of a dead fetus, which remains
5were expelled or extracted following a fetal death. “Bodily
6remains” does not include medical waste.
7 NEW SUBSECTION. 9A. “Induced termination of pregnancy”
8means a termination of pregnancy by any means of a woman known
9to be pregnant with the intent other than to produce a live
10birth or to remove a dead fetus.
11 NEW SUBSECTION. 9B. “Induces a termination of pregnancy”
12means the use of any means to terminate the pregnancy of a
13woman known to be pregnant with the intent other than to
14produce a live birth or to remove a dead fetus.
15 NEW SUBSECTION. 11A. “Medical facility” means the same as
16defined in section 146B.1.
17 NEW SUBSECTION. 11B. “Medical waste” means discarded
18biologic product such as blood, tissue, or body parts removed
19from medical facilities as well as bedding, bandages, syringes,
20and similar materials that have been used in treating patients,
21but does not include bodily remains.
22 NEW SUBSECTION. 12A. “Spontaneous termination of pregnancy”
23means an unintended termination of pregnancy at any time during
24the period from conception to twenty weeks gestation.
25 NEW SUBSECTION. 13A. “Stillbirth” means an unintended fetal
26death occurring after a gestation period of twenty completed
27weeks, or an unintended fetal death of a fetus with a weight of
28three hundred fifty or more grams.
29 Sec. 2. Section 144.29, subsection 1, Code 2020, is amended
30to read as follows:
311. A fetal death certificate for each fetal death which
32occurs in this state after a gestation period of twenty twelve
33 completed weeks or greater, or for a fetus with a weight of
34three hundred fifty grams or more shall be filed as directed
35by the state registrar within three days after delivery and
-1-1prior to final disposition of the fetus bodily remains. The
2certificate shall be registered if it has been completed and
3filed in accordance with this chapter.
4 Sec. 3. Section 144.29A, subsection 7, Code 2020, is amended
5to read as follows:
67. For the purposes of this section:
7a. “Health care provider”, “health care provider” means an
8individual licensed under chapter 148, 148C, 148D, or 152,
9or any individual who provides medical services under the
10authorization of the licensee.
11b. “Inducing a termination of pregnancy” means the use of
12any means to terminate the pregnancy of a woman known to be
13pregnant with the intent other than to produce a live birth or
14to remove a dead fetus.
15c. “Spontaneous termination of pregnancy” means the
16occurrence of an unintended termination of pregnancy at
17any time during the period from conception to twenty weeks
18gestation and which is not a spontaneous termination of
19pregnancy at any time during the period from twenty weeks or
20greater which is reported to the department as a fetal death
21under this chapter.
22 Sec. 4. NEW SECTION. 144.29B Final disposition of bodily
23remains after fetal death.
241. When a fetal death occurs in an institution or medical
25facility, the individual in charge of the institution or
26medical facility shall inform the woman that the woman may
27determine the final disposition of the bodily remains. A
28determination request by the woman under this subsection may
29be made within the time frame established by rule of the
30department.
312. a. The individual in charge of the institution or
32medical facility where the bodily remains were expelled or
33extracted shall obtain from the woman a written authorization
34for final disposition on a form prescribed and furnished or
35approved by the department.
-2- 1b. The authorization may allow final disposition to be by
2the individual in charge of the institution or medical facility
3where the bodily remains were expelled or extracted or another
4person assuming responsibility for the final disposition of the
5bodily remains.
6c. The woman may direct, in the written authorization, that
7the final disposition of the bodily remains be completed as
8follows:
9(1) Only by burial, interment, or cremation when the bodily
10remains are the result of an induced termination of pregnancy,
11a spontaneous termination of pregnancy, or a stillbirth.
12(2) In addition to the means specified in subparagraph
13(1), when the bodily remains are the result of a spontaneous
14termination of pregnancy or a stillbirth, by means in
15compliance with chapter 142C.
16d. When the bodily remains are the result of an induced
17termination of pregnancy and the pregnant woman is a minor, the
18institution or medical facility shall obtain parental consent
19for the authorization of final disposition of the bodily
20remains, unless the minor has received a waiver of notification
21pursuant to chapter 135L.
22e. The written authorization provided under paragraph
23“c” shall allow the woman to waive direction of the final
24disposition of the bodily remains and instead authorize the
25institution or medical facility to select the manner of final
26disposition by burial, interment, or cremation.
27f. The individual in charge of the institution or medical
28facility where the bodily remains were expelled or extracted or
29the person assuming responsibility for the final disposition
30of the bodily remains shall ensure that the final disposition
31of the bodily remains is performed in compliance with the
32authorization for final disposition and shall retain the
33authorization as specified by rule of the department.
343. If the woman chooses a location of final disposition
35other than the location of final disposition that is usual and
-3-1customary for the institution or medical facility, the woman is
2responsible for the costs related to the final disposition of
3the bodily remains at the chosen location.
44. The final disposition of the bodily remains shall not be
5by simultaneous cremation.
65. The bodily remains shall not be treated as medical waste.
76. The bodily remains may be moved from the place where the
8bodily remains were expelled or extracted to be prepared for
9final disposition with the consent of the person who certified
10the death.
117. The final disposition of the bodily remains under
12this section shall comply with all other requirements for
13disposition of bodily remains under this chapter and other
14applicable law.
158. The department shall adopt rules pursuant to chapter 17A
16to administer this section.
17 Sec. 5. Section 144.31A, subsection 1, Code 2020, is amended
18to read as follows:
191. As used in this section:
20a. “Certificate of birth resulting in stillbirth”,
21“certificate of birth resulting in stillbirth” means a document
22issued based upon a properly filed fetal death certificate to
23record the birth of a stillborn fetus.
24b. “Stillbirth” means stillbirth as defined in section
25136A.2.
26 Sec. 6. Section 144.52, subsection 7, Code 2020, is amended
27to read as follows:
287. Knowingly violates a provision of section 144.29A or
29144.29B.
30EXPLANATION
31The inclusion of this explanation does not constitute agreement with
32the explanation’s substance by the members of the general assembly.
33This bill relates to fetal deaths, fetal death certificates,
34and disposition of bodily remains.
35FETAL DEATHS AND DISPOSITION OF BODILY REMAINS. The bill
-4-1amends provisions in Code chapter 144 (vital statistics) to
2establish a process for a woman to direct the final disposition
3of bodily remains following a fetal death. The bill provides
4definitions for the purposes of the bill. The bill provides
5that when a fetal death occurs in an institution or medical
6facility, the individual in charge of the institution or
7medical facility shall inform the woman that the woman may
8determine the final disposition of the bodily remains. A
9determination request by the woman may be made within the time
10frame established by rule of the department of public health
11(DPH). The individual in charge of the institution or medical
12facility where the bodily remains were expelled or extracted
13shall obtain from the woman a written authorization for final
14disposition on a form prescribed and furnished or approved by
15DPH.
16The authorization may allow final disposition to be
17by the individual in charge of the institution or medical
18facility or another person assuming responsibility for the
19final disposition of the bodily remains. In the written
20authorization, the woman may provide for disposition of the
21bodily remains as specified in the bill. When the bodily
22remains are the result of an induced termination of pregnancy,
23a spontaneous termination of pregnancy, or a stillbirth,
24disposition may be only by burial, interment, or cremation.
25When the bodily remains are the result of a spontaneous
26termination of pregnancy or a stillbirth, disposition may also
27be made in compliance with Code chapter 142C (the revised
28uniform anatomical gift Act). When the bodily remains are
29the result of an induced termination of pregnancy and the
30pregnant woman is a minor, the institution or medical facility
31shall obtain parental consent for the authorization of final
32disposition of the bodily remains, unless the minor has
33received a waiver of notification pursuant to Code chapter 135L
34(notification requirements regarding pregnant minors).
35The individual in charge of the institution or medical
-5-1facility where the bodily remains were expelled or extracted or
2the person assuming responsibility for the final disposition
3of the bodily remains shall ensure that the final disposition
4of the bodily remains is performed in compliance with the
5authorization for final disposition, and such person shall
6retain the authorization as specified by rule of DPH.
7If the woman chooses a location of final disposition other
8than the location of final disposition that is usual and
9customary for the institution or medical facility, the woman is
10responsible for the costs related to the final disposition of
11the bodily remains at the chosen location.
12The final disposition of the bodily remains shall not be
13by simultaneous cremation. The bodily remains shall not be
14treated as medical waste.
15The bodily remains may be moved from the place where the
16bodily remains were expelled or extracted to be prepared for
17final disposition with the consent of the person who certified
18the death. The final disposition of the bodily remains
19under the bill shall comply with all other requirements for
20disposition of bodily remains under Code chapter 144 and other
21applicable laws.
22A person who knowingly violates a provision of the bill
23relating to the final disposition of bodily remains after a
24fetal death is guilty of a serious misdemeanor. A serious
25misdemeanor is punishable by confinement for no more than one
26year and a fine of at least $315 but not more than $1,875.
27FILING OF FETAL DEATH CERTIFICATE. The bill requires a fetal
28death certificate to be filed for each fetal death which occurs
29in the state after a gestation period of 12 completed weeks or
30greater. Current law requires a fetal death certificate to
31be filed for each fetal death which occurs in the state after
32a gestation period of 20 completed weeks or greater or for a
33fetus with a weight of 350 grams or more.
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2bodily remains, and the filing of a fetal death certificate,
3and providing penalties.
4BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. Section 144.1, Code 2020, is amended by adding
2the following new subsections:
3 NEW SUBSECTION. 1A. “Bodily remains” means the physical
4remains, corpse, or body parts of a dead fetus, which remains
5were expelled or extracted following a fetal death. “Bodily
6remains” does not include medical waste.
7 NEW SUBSECTION. 9A. “Induced termination of pregnancy”
8means a termination of pregnancy by any means of a woman known
9to be pregnant with the intent other than to produce a live
10birth or to remove a dead fetus.
11 NEW SUBSECTION. 9B. “Induces a termination of pregnancy”
12means the use of any means to terminate the pregnancy of a
13woman known to be pregnant with the intent other than to
14produce a live birth or to remove a dead fetus.
15 NEW SUBSECTION. 11A. “Medical facility” means the same as
16defined in section 146B.1.
17 NEW SUBSECTION. 11B. “Medical waste” means discarded
18biologic product such as blood, tissue, or body parts removed
19from medical facilities as well as bedding, bandages, syringes,
20and similar materials that have been used in treating patients,
21but does not include bodily remains.
22 NEW SUBSECTION. 12A. “Spontaneous termination of pregnancy”
23means an unintended termination of pregnancy at any time during
24the period from conception to twenty weeks gestation.
25 NEW SUBSECTION. 13A. “Stillbirth” means an unintended fetal
26death occurring after a gestation period of twenty completed
27weeks, or an unintended fetal death of a fetus with a weight of
28three hundred fifty or more grams.
29 Sec. 2. Section 144.29, subsection 1, Code 2020, is amended
30to read as follows:
311. A fetal death certificate for each fetal death which
32occurs in this state after a gestation period of twenty twelve
33 completed weeks or greater, or for a fetus with a weight of
34three hundred fifty grams or more shall be filed as directed
35by the state registrar within three days after delivery and
-1-1prior to final disposition of the fetus bodily remains. The
2certificate shall be registered if it has been completed and
3filed in accordance with this chapter.
4 Sec. 3. Section 144.29A, subsection 7, Code 2020, is amended
5to read as follows:
67. For the purposes of this section:
7a. “Health care provider”, “health care provider” means an
8individual licensed under chapter 148, 148C, 148D, or 152,
9or any individual who provides medical services under the
10authorization of the licensee.
11b. “Inducing a termination of pregnancy” means the use of
12any means to terminate the pregnancy of a woman known to be
13pregnant with the intent other than to produce a live birth or
14to remove a dead fetus.
15c. “Spontaneous termination of pregnancy” means the
16occurrence of an unintended termination of pregnancy at
17any time during the period from conception to twenty weeks
18gestation and which is not a spontaneous termination of
19pregnancy at any time during the period from twenty weeks or
20greater which is reported to the department as a fetal death
21under this chapter.
22 Sec. 4. NEW SECTION. 144.29B Final disposition of bodily
23remains after fetal death.
241. When a fetal death occurs in an institution or medical
25facility, the individual in charge of the institution or
26medical facility shall inform the woman that the woman may
27determine the final disposition of the bodily remains. A
28determination request by the woman under this subsection may
29be made within the time frame established by rule of the
30department.
312. a. The individual in charge of the institution or
32medical facility where the bodily remains were expelled or
33extracted shall obtain from the woman a written authorization
34for final disposition on a form prescribed and furnished or
35approved by the department.
-2- 1b. The authorization may allow final disposition to be by
2the individual in charge of the institution or medical facility
3where the bodily remains were expelled or extracted or another
4person assuming responsibility for the final disposition of the
5bodily remains.
6c. The woman may direct, in the written authorization, that
7the final disposition of the bodily remains be completed as
8follows:
9(1) Only by burial, interment, or cremation when the bodily
10remains are the result of an induced termination of pregnancy,
11a spontaneous termination of pregnancy, or a stillbirth.
12(2) In addition to the means specified in subparagraph
13(1), when the bodily remains are the result of a spontaneous
14termination of pregnancy or a stillbirth, by means in
15compliance with chapter 142C.
16d. When the bodily remains are the result of an induced
17termination of pregnancy and the pregnant woman is a minor, the
18institution or medical facility shall obtain parental consent
19for the authorization of final disposition of the bodily
20remains, unless the minor has received a waiver of notification
21pursuant to chapter 135L.
22e. The written authorization provided under paragraph
23“c” shall allow the woman to waive direction of the final
24disposition of the bodily remains and instead authorize the
25institution or medical facility to select the manner of final
26disposition by burial, interment, or cremation.
27f. The individual in charge of the institution or medical
28facility where the bodily remains were expelled or extracted or
29the person assuming responsibility for the final disposition
30of the bodily remains shall ensure that the final disposition
31of the bodily remains is performed in compliance with the
32authorization for final disposition and shall retain the
33authorization as specified by rule of the department.
343. If the woman chooses a location of final disposition
35other than the location of final disposition that is usual and
-3-1customary for the institution or medical facility, the woman is
2responsible for the costs related to the final disposition of
3the bodily remains at the chosen location.
44. The final disposition of the bodily remains shall not be
5by simultaneous cremation.
65. The bodily remains shall not be treated as medical waste.
76. The bodily remains may be moved from the place where the
8bodily remains were expelled or extracted to be prepared for
9final disposition with the consent of the person who certified
10the death.
117. The final disposition of the bodily remains under
12this section shall comply with all other requirements for
13disposition of bodily remains under this chapter and other
14applicable law.
158. The department shall adopt rules pursuant to chapter 17A
16to administer this section.
17 Sec. 5. Section 144.31A, subsection 1, Code 2020, is amended
18to read as follows:
191. As used in this section:
20a. “Certificate of birth resulting in stillbirth”,
21“certificate of birth resulting in stillbirth” means a document
22issued based upon a properly filed fetal death certificate to
23record the birth of a stillborn fetus.
24b. “Stillbirth” means stillbirth as defined in section
25136A.2.
26 Sec. 6. Section 144.52, subsection 7, Code 2020, is amended
27to read as follows:
287. Knowingly violates a provision of section 144.29A or
29144.29B.
30EXPLANATION
31The inclusion of this explanation does not constitute agreement with
32the explanation’s substance by the members of the general assembly.
33This bill relates to fetal deaths, fetal death certificates,
34and disposition of bodily remains.
35FETAL DEATHS AND DISPOSITION OF BODILY REMAINS. The bill
-4-1amends provisions in Code chapter 144 (vital statistics) to
2establish a process for a woman to direct the final disposition
3of bodily remains following a fetal death. The bill provides
4definitions for the purposes of the bill. The bill provides
5that when a fetal death occurs in an institution or medical
6facility, the individual in charge of the institution or
7medical facility shall inform the woman that the woman may
8determine the final disposition of the bodily remains. A
9determination request by the woman may be made within the time
10frame established by rule of the department of public health
11(DPH). The individual in charge of the institution or medical
12facility where the bodily remains were expelled or extracted
13shall obtain from the woman a written authorization for final
14disposition on a form prescribed and furnished or approved by
15DPH.
16The authorization may allow final disposition to be
17by the individual in charge of the institution or medical
18facility or another person assuming responsibility for the
19final disposition of the bodily remains. In the written
20authorization, the woman may provide for disposition of the
21bodily remains as specified in the bill. When the bodily
22remains are the result of an induced termination of pregnancy,
23a spontaneous termination of pregnancy, or a stillbirth,
24disposition may be only by burial, interment, or cremation.
25When the bodily remains are the result of a spontaneous
26termination of pregnancy or a stillbirth, disposition may also
27be made in compliance with Code chapter 142C (the revised
28uniform anatomical gift Act). When the bodily remains are
29the result of an induced termination of pregnancy and the
30pregnant woman is a minor, the institution or medical facility
31shall obtain parental consent for the authorization of final
32disposition of the bodily remains, unless the minor has
33received a waiver of notification pursuant to Code chapter 135L
34(notification requirements regarding pregnant minors).
35The individual in charge of the institution or medical
-5-1facility where the bodily remains were expelled or extracted or
2the person assuming responsibility for the final disposition
3of the bodily remains shall ensure that the final disposition
4of the bodily remains is performed in compliance with the
5authorization for final disposition, and such person shall
6retain the authorization as specified by rule of DPH.
7If the woman chooses a location of final disposition other
8than the location of final disposition that is usual and
9customary for the institution or medical facility, the woman is
10responsible for the costs related to the final disposition of
11the bodily remains at the chosen location.
12The final disposition of the bodily remains shall not be
13by simultaneous cremation. The bodily remains shall not be
14treated as medical waste.
15The bodily remains may be moved from the place where the
16bodily remains were expelled or extracted to be prepared for
17final disposition with the consent of the person who certified
18the death. The final disposition of the bodily remains
19under the bill shall comply with all other requirements for
20disposition of bodily remains under Code chapter 144 and other
21applicable laws.
22A person who knowingly violates a provision of the bill
23relating to the final disposition of bodily remains after a
24fetal death is guilty of a serious misdemeanor. A serious
25misdemeanor is punishable by confinement for no more than one
26year and a fine of at least $315 but not more than $1,875.
27FILING OF FETAL DEATH CERTIFICATE. The bill requires a fetal
28death certificate to be filed for each fetal death which occurs
29in the state after a gestation period of 12 completed weeks or
30greater. Current law requires a fetal death certificate to
31be filed for each fetal death which occurs in the state after
32a gestation period of 20 completed weeks or greater or for a
33fetus with a weight of 350 grams or more.
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