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Senate Study Bill 3115 - IntroducedA Bill ForAn Act 1relating to abortions including informed consent,
2dispensing abortion-inducing drugs, and reporting
3abortion-inducing drug complications.
4BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2INFORMED CONSENT
3 Section 1. Section 146A.1, Code 2026, is amended by adding
4the following new subsection:
5 NEW SUBSECTION. 1A. Prior to performing an abortion,
6a physician shall perform an in-person examination of the
7pregnant woman including screening for indicia of coercion or
8abuse. A physician shall, if necessary, refer the woman to an
9appropriate health care provider for treatment consistent with
10the examination results.
11 Sec. 2. Section 146A.1, subsection 6, Code 2026, is amended
12by adding the following new paragraphs:
13 NEW PARAGRAPH. 0a. “Abortion” means the same as defined in
14section 146B.1.
15 NEW PARAGRAPH. 00a. “Health care provider” means a
16person who is licensed, certified, or otherwise authorized or
17permitted by the laws of this state to administer health care
18in the ordinary course of business or in the practice of a
19profession.
20 NEW PARAGRAPH. 0b. “Physician” means the same as defined
21in section 146B.1.
22 Sec. 3. NEW SECTION. 146A.2 Dispensing abortion-inducing
23drugs — licensee discipline.
241. As used in this section, unless the context otherwise
25requires:
26a. “Abortion-inducing drug” means the same as defined in
27section 146F.1.
28b. “Chemical abortion” means the same as defined in section
29146F.1.
30c. “Dispense” means the same as defined in section 146F.1.
31d. “Medical emergency” means the same as defined in section
32146A.1.
33e. “Pregnant” or “pregnancy” means the human female
34reproductive condition of having a living unborn child within
35the pregnant woman’s body throughout every stage of the unborn
-1-1child’s life and development, from fertilization to full
2gestation and childbirth.
32. A physician shall do all of the following prior to
4prescribing or dispensing an abortion-inducing drug to a
5pregnant woman:
6a. Obtain the signature of the woman on the United States
7food and drug administration patient agreement form required
8for each abortion-inducing drug authorized to be manufactured
9or sold in the United States.
10b. Obtain written confirmation from the woman that the woman
11has been informed of all of the following information:
12(1) The gestational age-specific risks of abortion-inducing
13drugs.
14(2) The risks related to the specific abortion-inducing
15drug or drugs to be used, including hemorrhage, failure to
16remove all tissue of the unborn child, sepsis, sterility, and
17possible continuation of the pregnancy.
18(3) That the United States federal food and drug
19administration recommends that the pregnant woman follow up
20with the woman’s health care provider approximately seven
21to fourteen calendar days after the administration of an
22abortion-inducing drug to confirm complete termination of
23pregnancy has occurred and to evaluate the degree of bleeding.
24(4) That women using abortion-inducing drugs have suffered
25trauma from seeing the remains of the unborn child in the
26process of a chemical abortion.
27(5) That it may be possible to reverse the intended effects
28of a chemical abortion, but time is of the essence.
29(6) That information on reversing the effects of a chemical
30abortion is available on the department’s internet site.
31c. Advise the pregnant woman how to access emergency
32surgical intervention in case of an incomplete abortion, severe
33bleeding, or other medical complications.
343. Subsection 2 shall not apply to a chemical abortion
35performed in a medical emergency.
-2- 14. This section shall not be construed to impose civil or
2criminal liability on a woman upon whom a chemical abortion has
3been performed.
45. A physician who fails to comply with this section is
5subject to licensee discipline under chapter 148.
66. The board of medicine shall adopt rules pursuant to
7chapter 17A to administer this section.
8 Sec. 4. NEW SECTION. 146A.3 Informational materials.
91. As used in this section, “chemical abortion” means the
10same as defined in section 146F.1.
112. The department shall publish on the department’s
12internet site, in an easily accessible location and format, all
13of the following:
14a. Notice that it may be possible to reverse the effects of
15a chemical abortion.
16b. Information and resources on reversing the effects of a
17chemical abortion.
18DIVISION II
19DISPENSING AND REPORTING — ABORTION-INDUCING DRUGS
20 Sec. 5. NEW SECTION. 146F.1 Definitions.
21As used in this chapter, unless the context otherwise
22requires:
231. “Abortion-inducing drug” means any of the following:
24a. Mifepristone.
25b. Misoprostol.
26c. Any other drug, measure, or chemical approved by the
27United States food and drug administration when prescribed or
28administered with the intent to terminate the pregnancy of a
29woman known to be pregnant. “Abortion-inducing drug” includes
30off-label use of a drug known to have abortion-inducing
31properties, which is prescribed with the intent of causing an
32abortion. “Abortion-inducing drug” does not include drugs that
33may be known to cause an abortion but that are prescribed for
34other medical conditions.
352. “Abortion-inducing drug complication” means any physical
-3-1or psychological condition which, in the reasonable medical
2judgment of a health care provider, may occur as a primary or
3secondary result of the patient’s use of abortion-inducing
4drugs including but not limited to:
5a. Uterine perforation.
6b. Cervical laceration.
7c. Infection.
8d. Bleeding.
9e. Vaginal bleeding that qualifies under the common toxicity
10criteria established by the national cancer institute as a
11grade 2 or higher.
12f. Pulmonary embolism.
13g. Deep vein thrombosis.
14h. Failure to actually terminate the pregnancy.
15i. Incomplete abortion or retained tissue.
16j. Pelvic inflammatory disease.
17k. Endometritis.
18l. Missed ectopic pregnancy.
19m. Cardiac arrest.
20n. Respiratory arrest.
21o. Renal failure.
22p. Shock.
23q. Amniotic fluid embolism.
24r. Coma.
25s. Free fluid in the abdomen.
26t. Allergic reactions to anesthesia and abortion-inducing
27drugs.
28u. Mood, anxiety, or trauma-related disorder symptoms as
29described in the most recent diagnostic and statistical manual
30of mental disorders published by the American psychiatric
31association.
323. “Chemical abortion” means an abortion performed by the
33administration or use of an abortion-inducing drug.
344. “Department” means the department of health and human
35services.
-4- 15. “Dispense” means to distribute, administer, or send an
2abortion-inducing drug to the ultimate user.
36. “Health care provider” means the same as defined in
4section 146A.1.
57. “Health care setting” means a clinic, medical office, or
6hospital.
78. “Hospital” means the same as defined in section 135B.1.
89. “Interested party” means any of the following persons:
9a. A woman upon whom a chemical abortion was performed or
10attempted.
11b. The biological father of the unborn child who was aborted
12or was attempted to be aborted through a chemical abortion.
13c. A grandparent, parent, sibling, child, legal guardian,
14or conservator of the woman upon whom a chemical abortion was
15performed or was attempted.
1610. “Medical emergency” means the same as defined in section
17146A.1.
1811. “Physician” means the same as defined in section 146B.1.
1912. “Postfertilization age” means the same as defined in
20section 146B.1.
2113. “Pregnancy” or “pregnant” means the same as defined in
22section 146A.2.
2314. “Rural emergency hospital” means the same as defined in
24section 135B.1.
25 Sec. 6. NEW SECTION. 146F.2 Dispensing of abortion-inducing
26drugs — restrictions.
271. A person shall not dispense an abortion-inducing drug in
28this state unless all of the following criteria are met:
29a. The drug is dispensed in a health care setting directly
30to the woman prescribed the drug.
31b. The person dispensing the drug is authorized to do so
32pursuant to section 147.107.
332. Subsection 1 does not apply to the dispensing of an
34abortion-inducing drug in response to a medical emergency.
35 Sec. 7. NEW SECTION. 146F.3 Abortion-inducing drug
-5-1complication — reporting.
21. a. Within thirty calendar days of the date of discharge
3or death of a woman who presented with or was treated for
4an abortion-inducing drug complication, a hospital, rural
5emergency hospital, or an attending physician shall file a
6report with the department. The report shall be in a form
7prescribed by the department and include a list of the most
8common abortion complications and the most recent international
9classification of diseases code as maintained by the world
10health organization for each. The report must be completed and
11signed by the woman’s attending physician and contain all of
12the following information:
13(1) The age of the woman who presented with or was treated
14for an abortion-inducing drug complication.
15(2) The state and county of residence of the woman who
16presented with or was treated for an abortion-inducing drug
17complication.
18(3) The date the abortion-inducing drug was used by the
19woman.
20(4) The probable postfertilization age of the unborn child
21on the date of the abortion-inducing drug complication.
22(5) The identity of the physician who performed the
23chemical abortion, the facility where the chemical abortion was
24performed, and the referring physician, agency, or service, if
25any.
26(6) The specific complication or complications that led to
27the treatment and the most recent international classification
28of diseases code for each complication as maintained by the
29world health organization, if applicable.
30b. A report shall not contain the name of the woman or
31other information or identifiers that would make it possible to
32identify the woman who suffered the reported abortion-inducing
33drug complication.
342. A report filed pursuant to subsection 1 shall be
35confidential and not subject to disclosure under chapter 22.
-6- 13. a. On or before December 31, 2026, and every calendar
2year thereafter, the department shall prepare a comprehensive
3statistical report based upon the aggregated data gathered from
4reports filed pursuant to subsection 1 for the immediately
5preceding calendar year. The aggregated data shall be
6anonymized to prevent public disclosure of either of the
7following:
8(1) The hospital, rural emergency hospital, or attending
9physician that filed a report.
10(2) The woman about whom a report was filed.
11b. The anonymized aggregated data shall be made available to
12the public by the department in a downloadable format on the
13department’s internet site.
14 Sec. 8. NEW SECTION. 146F.4 Private cause of action —
15strict liability.
161. A person who dispenses an abortion-inducing drug
17in violation of this chapter shall be strictly liable
18to any interested party for all damages caused by the
19abortion-inducing drug.
202. In addition to compensatory or punitive damages, a
21prevailing plaintiff who brings an action under this section is
22entitled to all of the following:
23a. Statutory damages in the amount of fifty thousand
24dollars.
25b. Court costs.
26c. Reasonable attorney fees.
273. In an action brought under this section, the name and
28other identifying characteristics of a woman who sought or
29obtained an abortion-inducing drug shall be redacted without
30a court order from all pleadings and documents filed in the
31action. The court may make further orders as necessary to
32protect the identity and privacy of the woman who sought or
33obtained an abortion-inducing drug.
344. This section shall not be construed to impose civil or
35criminal liability on a woman upon whom a chemical abortion is
-7-1performed.
2 Sec. 9. NEW SECTION. 146F.5 Licensee discipline.
3A licensee who fails to comply with this chapter is subject
4to licensee discipline under chapter 148.
5DIVISION III
6ABORTION-RELATED PROVISIONS
7 Sec. 10. Section 144.29A, subsection 1, paragraph k, Code
82026, is amended to read as follows:
9k. The method used for an induced termination, including
10whether mifepristone or misoprostol was used.
11 Sec. 11. Section 144.29A, subsection 1, Code 2026, is
12amended by adding the following new paragraph:
13 NEW PARAGRAPH. l. If a spontaneous termination of
14pregnancy, whether the patient ingested mifepristone or
15misoprostol within fourteen calendar days prior to the date of
16the spontaneous termination of pregnancy.
17 Sec. 12. Section 144.29A, subsection 7, paragraph c, Code
182026, is amended to read as follows:
19c. “Spontaneous termination of pregnancy”, commonly known
20as a miscarriage, means the occurrence of an unintended
21termination of pregnancy at any time during the period from
22conception to twenty weeks gestation and which is not a
23spontaneous termination of pregnancy at any time during the
24period from twenty weeks or greater which is reported to the
25department as a fetal death under this chapter.
26 Sec. 13. Section 146B.1, subsection 1, Code 2026, is amended
27to read as follows:
281. “Abortion” means the termination of a human pregnancy
29with the intent other than to produce a live birth or to
30remove a dead fetus. “Abortion” does not include a spontaneous
31termination of pregnancy, commonly known as a miscarriage, if
32not all the products of conception are expelled.
33EXPLANATION
34The inclusion of this explanation does not constitute agreement with
35the explanation’s substance by the members of the general assembly.
-8- 1This bill relates to abortions, including informed
2consent, dispensing of abortion-inducing drugs, and reporting
3abortion-inducing drug complications.
4DIVISION I — INFORMED CONSENT. Under the bill, a physician,
5prior to performing or attempting to perform an abortion, is
6required to perform an in-person examination of the woman
7seeking an abortion, including screening for indicia of
8coercion or abuse; if necessary, the physician shall make a
9referral to an appropriate health care provider consistent with
10the examination results.
11The bill requires a physician, prior to prescribing
12or dispensing an abortion-inducing drug, to do all of the
13following: have the woman being prescribed or dispensed the
14drug sign a patient agreement form, obtain written confirmation
15that the physician has informed the woman of specific health
16and safety information related to abortion-inducing drugs
17as detailed in the bill, and advise the pregnant woman how
18to access emergency surgical intervention in cases of an
19incomplete abortion, severe bleeding, or other medical
20complications. The bill specifies that these requirements
21shall not apply to a chemical abortion performed in response to
22a medical emergency. The bill provides that the prohibition on
23dispensing of abortion-inducing drugs shall not be construed
24to impose civil or criminal liability on a woman upon whom
25a chemical abortion has been performed. Under the bill,
26a physician who fails to comply with the informed consent
27requirements is subject to licensee discipline. The bill
28requires the board of medicine to adopt rules to administer
29this division of the bill. The bill defines “abortion-inducing
30drug”, “chemical abortion”, “dispense”, “medical emergency”,
31and “pregnant” or “pregnancy”.
32The bill requires the department of health and human
33services (HHS) to publish on HHS’s internet site notice that it
34may be possible to reverse the effects of a chemical abortion,
35and information and resources on reversing the effects of a
-9-1chemical abortion.
2DIVISION II — DISPENSING AND REPORTING — ABORTION-INDUCING
3DRUGS. The bill defines “abortion-inducing drug”,
4“abortion-inducing drug complication”, “chemical abortion”,
5“dispense”, “interested party”, “medical emergency”,
6“physician”, “postfertilization age”, and “rural emergency
7hospital”.
8The bill prohibits a person from dispensing an
9abortion-inducing drug in this state unless the drug is
10dispensed in a health care setting directly to the woman
11prescribed the drug, and the person dispensing the drug is
12authorized to do so pursuant to Code section 147.107 (drug
13dispensing, supplying, and prescribing — limitations). These
14requirements do not apply to a medical emergency.
15The bill requires a hospital, rural emergency hospital,
16or the attending physician to file a report with HHS using a
17prescribed form within 30 days of discharge or death of a woman
18who presented with or was treated for an abortion-inducing
19drug complication. The form must be signed and completed
20by the attending physician and contain the age of the woman
21experiencing the abortion-inducing drug complication,
22the woman’s state and county of residence, the date the
23abortion-inducing drug was used by the woman, and the probable
24postfertilization age of the unborn child at the time of
25the abortion-inducing drug complication. The report must
26identify the physician who performed the chemical abortion,
27the facility where the chemical abortion was performed,
28the referring physician, agency, or service, if any, and
29the specific complication or complications that led to the
30treatment performed along with the most recent international
31classification of diseases code for each, if applicable. The
32report shall be confidential and not subject to disclosure
33under Code chapter 22 (open records).
34The bill also requires HHS to prepare annually on or
35before December 31 a comprehensive statistical report based
-10-1upon the aggregated data gathered from the reports filed on
2abortion-inducing drug complications. Under the bill, the data
3gathered by HHS must be anonymized to prevent public disclosure
4of either the physician or hospital that filed a report, or the
5woman about whom a report is filed. HHS is required to make the
6anonymized data publicly available in a downloadable format on
7its internet site.
8This division of the bill creates a private cause of action
9against any person who dispenses an abortion-inducing drug
10in violation of this division of the bill for all damages
11caused by the abortion-inducing drug suffered by a woman upon
12whom a chemical abortion was performed or was attempted; the
13biological father of the unborn child who was or was attempted
14to be aborted through a chemical abortion; or the grandparent,
15parent, sibling, child, legal guardian, or conservator of
16the woman upon whom a chemical abortion was performed or was
17attempted. A prevailing plaintiff in an action brought under
18this division of the bill, in addition to compensatory and
19punitive damages, is entitled to statutory damages in the
20amount of $50,000, court costs, and reasonable attorney fees.
21In an action brought under this division of the bill, the name
22and other identifying characteristics of a woman who sought or
23obtained an abortion-inducing drug shall be redacted from all
24pleadings and documents filed in the action without a court
25order, and the court may make further orders as necessary to
26protect the identity and privacy of the woman who sought or
27obtained an abortion-inducing drug. This division of the bill
28is not to be construed to impose civil or criminal liability
29upon a woman upon whom a chemical abortion is performed.
30Under the bill, a licensee that fails to comply with this
31division of the bill is subject to licensee discipline.
32DIVISION III — ABORTION-RELATED PROVISIONS. The bill
33amends Code section 144.29A (termination of pregnancy reporting
34— legislative intent) to require a health care provider that
35diagnoses or induces a spontaneous termination of pregnancy
-11-1to include in the required report to HHS if mifepristone or
2misoprostol was used to induce a spontaneous termination of
3pregnancy. Current law requires the health care provider
4to only disclose if mifepristone was used to induce a
5spontaneous termination of pregnancy. The bill also requires
6the health care provider to disclose whether mifepristone
7or misoprostol were ingested by the patient within 14 days
8prior to the spontaneous termination of pregnancy. The bill
9excludes a spontaneous termination from the definition of
10abortion for the purpose of the reporting requirements and
11penalties on abortions under Code chapter 146B (abortion —
12postfertilization age).
-12-ak/ko
2dispensing abortion-inducing drugs, and reporting
3abortion-inducing drug complications.
4BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2INFORMED CONSENT
3 Section 1. Section 146A.1, Code 2026, is amended by adding
4the following new subsection:
5 NEW SUBSECTION. 1A. Prior to performing an abortion,
6a physician shall perform an in-person examination of the
7pregnant woman including screening for indicia of coercion or
8abuse. A physician shall, if necessary, refer the woman to an
9appropriate health care provider for treatment consistent with
10the examination results.
11 Sec. 2. Section 146A.1, subsection 6, Code 2026, is amended
12by adding the following new paragraphs:
13 NEW PARAGRAPH. 0a. “Abortion” means the same as defined in
14section 146B.1.
15 NEW PARAGRAPH. 00a. “Health care provider” means a
16person who is licensed, certified, or otherwise authorized or
17permitted by the laws of this state to administer health care
18in the ordinary course of business or in the practice of a
19profession.
20 NEW PARAGRAPH. 0b. “Physician” means the same as defined
21in section 146B.1.
22 Sec. 3. NEW SECTION. 146A.2 Dispensing abortion-inducing
23drugs — licensee discipline.
241. As used in this section, unless the context otherwise
25requires:
26a. “Abortion-inducing drug” means the same as defined in
27section 146F.1.
28b. “Chemical abortion” means the same as defined in section
29146F.1.
30c. “Dispense” means the same as defined in section 146F.1.
31d. “Medical emergency” means the same as defined in section
32146A.1.
33e. “Pregnant” or “pregnancy” means the human female
34reproductive condition of having a living unborn child within
35the pregnant woman’s body throughout every stage of the unborn
-1-1child’s life and development, from fertilization to full
2gestation and childbirth.
32. A physician shall do all of the following prior to
4prescribing or dispensing an abortion-inducing drug to a
5pregnant woman:
6a. Obtain the signature of the woman on the United States
7food and drug administration patient agreement form required
8for each abortion-inducing drug authorized to be manufactured
9or sold in the United States.
10b. Obtain written confirmation from the woman that the woman
11has been informed of all of the following information:
12(1) The gestational age-specific risks of abortion-inducing
13drugs.
14(2) The risks related to the specific abortion-inducing
15drug or drugs to be used, including hemorrhage, failure to
16remove all tissue of the unborn child, sepsis, sterility, and
17possible continuation of the pregnancy.
18(3) That the United States federal food and drug
19administration recommends that the pregnant woman follow up
20with the woman’s health care provider approximately seven
21to fourteen calendar days after the administration of an
22abortion-inducing drug to confirm complete termination of
23pregnancy has occurred and to evaluate the degree of bleeding.
24(4) That women using abortion-inducing drugs have suffered
25trauma from seeing the remains of the unborn child in the
26process of a chemical abortion.
27(5) That it may be possible to reverse the intended effects
28of a chemical abortion, but time is of the essence.
29(6) That information on reversing the effects of a chemical
30abortion is available on the department’s internet site.
31c. Advise the pregnant woman how to access emergency
32surgical intervention in case of an incomplete abortion, severe
33bleeding, or other medical complications.
343. Subsection 2 shall not apply to a chemical abortion
35performed in a medical emergency.
-2- 14. This section shall not be construed to impose civil or
2criminal liability on a woman upon whom a chemical abortion has
3been performed.
45. A physician who fails to comply with this section is
5subject to licensee discipline under chapter 148.
66. The board of medicine shall adopt rules pursuant to
7chapter 17A to administer this section.
8 Sec. 4. NEW SECTION. 146A.3 Informational materials.
91. As used in this section, “chemical abortion” means the
10same as defined in section 146F.1.
112. The department shall publish on the department’s
12internet site, in an easily accessible location and format, all
13of the following:
14a. Notice that it may be possible to reverse the effects of
15a chemical abortion.
16b. Information and resources on reversing the effects of a
17chemical abortion.
18DIVISION II
19DISPENSING AND REPORTING — ABORTION-INDUCING DRUGS
20 Sec. 5. NEW SECTION. 146F.1 Definitions.
21As used in this chapter, unless the context otherwise
22requires:
231. “Abortion-inducing drug” means any of the following:
24a. Mifepristone.
25b. Misoprostol.
26c. Any other drug, measure, or chemical approved by the
27United States food and drug administration when prescribed or
28administered with the intent to terminate the pregnancy of a
29woman known to be pregnant. “Abortion-inducing drug” includes
30off-label use of a drug known to have abortion-inducing
31properties, which is prescribed with the intent of causing an
32abortion. “Abortion-inducing drug” does not include drugs that
33may be known to cause an abortion but that are prescribed for
34other medical conditions.
352. “Abortion-inducing drug complication” means any physical
-3-1or psychological condition which, in the reasonable medical
2judgment of a health care provider, may occur as a primary or
3secondary result of the patient’s use of abortion-inducing
4drugs including but not limited to:
5a. Uterine perforation.
6b. Cervical laceration.
7c. Infection.
8d. Bleeding.
9e. Vaginal bleeding that qualifies under the common toxicity
10criteria established by the national cancer institute as a
11grade 2 or higher.
12f. Pulmonary embolism.
13g. Deep vein thrombosis.
14h. Failure to actually terminate the pregnancy.
15i. Incomplete abortion or retained tissue.
16j. Pelvic inflammatory disease.
17k. Endometritis.
18l. Missed ectopic pregnancy.
19m. Cardiac arrest.
20n. Respiratory arrest.
21o. Renal failure.
22p. Shock.
23q. Amniotic fluid embolism.
24r. Coma.
25s. Free fluid in the abdomen.
26t. Allergic reactions to anesthesia and abortion-inducing
27drugs.
28u. Mood, anxiety, or trauma-related disorder symptoms as
29described in the most recent diagnostic and statistical manual
30of mental disorders published by the American psychiatric
31association.
323. “Chemical abortion” means an abortion performed by the
33administration or use of an abortion-inducing drug.
344. “Department” means the department of health and human
35services.
-4- 15. “Dispense” means to distribute, administer, or send an
2abortion-inducing drug to the ultimate user.
36. “Health care provider” means the same as defined in
4section 146A.1.
57. “Health care setting” means a clinic, medical office, or
6hospital.
78. “Hospital” means the same as defined in section 135B.1.
89. “Interested party” means any of the following persons:
9a. A woman upon whom a chemical abortion was performed or
10attempted.
11b. The biological father of the unborn child who was aborted
12or was attempted to be aborted through a chemical abortion.
13c. A grandparent, parent, sibling, child, legal guardian,
14or conservator of the woman upon whom a chemical abortion was
15performed or was attempted.
1610. “Medical emergency” means the same as defined in section
17146A.1.
1811. “Physician” means the same as defined in section 146B.1.
1912. “Postfertilization age” means the same as defined in
20section 146B.1.
2113. “Pregnancy” or “pregnant” means the same as defined in
22section 146A.2.
2314. “Rural emergency hospital” means the same as defined in
24section 135B.1.
25 Sec. 6. NEW SECTION. 146F.2 Dispensing of abortion-inducing
26drugs — restrictions.
271. A person shall not dispense an abortion-inducing drug in
28this state unless all of the following criteria are met:
29a. The drug is dispensed in a health care setting directly
30to the woman prescribed the drug.
31b. The person dispensing the drug is authorized to do so
32pursuant to section 147.107.
332. Subsection 1 does not apply to the dispensing of an
34abortion-inducing drug in response to a medical emergency.
35 Sec. 7. NEW SECTION. 146F.3 Abortion-inducing drug
-5-1complication — reporting.
21. a. Within thirty calendar days of the date of discharge
3or death of a woman who presented with or was treated for
4an abortion-inducing drug complication, a hospital, rural
5emergency hospital, or an attending physician shall file a
6report with the department. The report shall be in a form
7prescribed by the department and include a list of the most
8common abortion complications and the most recent international
9classification of diseases code as maintained by the world
10health organization for each. The report must be completed and
11signed by the woman’s attending physician and contain all of
12the following information:
13(1) The age of the woman who presented with or was treated
14for an abortion-inducing drug complication.
15(2) The state and county of residence of the woman who
16presented with or was treated for an abortion-inducing drug
17complication.
18(3) The date the abortion-inducing drug was used by the
19woman.
20(4) The probable postfertilization age of the unborn child
21on the date of the abortion-inducing drug complication.
22(5) The identity of the physician who performed the
23chemical abortion, the facility where the chemical abortion was
24performed, and the referring physician, agency, or service, if
25any.
26(6) The specific complication or complications that led to
27the treatment and the most recent international classification
28of diseases code for each complication as maintained by the
29world health organization, if applicable.
30b. A report shall not contain the name of the woman or
31other information or identifiers that would make it possible to
32identify the woman who suffered the reported abortion-inducing
33drug complication.
342. A report filed pursuant to subsection 1 shall be
35confidential and not subject to disclosure under chapter 22.
-6- 13. a. On or before December 31, 2026, and every calendar
2year thereafter, the department shall prepare a comprehensive
3statistical report based upon the aggregated data gathered from
4reports filed pursuant to subsection 1 for the immediately
5preceding calendar year. The aggregated data shall be
6anonymized to prevent public disclosure of either of the
7following:
8(1) The hospital, rural emergency hospital, or attending
9physician that filed a report.
10(2) The woman about whom a report was filed.
11b. The anonymized aggregated data shall be made available to
12the public by the department in a downloadable format on the
13department’s internet site.
14 Sec. 8. NEW SECTION. 146F.4 Private cause of action —
15strict liability.
161. A person who dispenses an abortion-inducing drug
17in violation of this chapter shall be strictly liable
18to any interested party for all damages caused by the
19abortion-inducing drug.
202. In addition to compensatory or punitive damages, a
21prevailing plaintiff who brings an action under this section is
22entitled to all of the following:
23a. Statutory damages in the amount of fifty thousand
24dollars.
25b. Court costs.
26c. Reasonable attorney fees.
273. In an action brought under this section, the name and
28other identifying characteristics of a woman who sought or
29obtained an abortion-inducing drug shall be redacted without
30a court order from all pleadings and documents filed in the
31action. The court may make further orders as necessary to
32protect the identity and privacy of the woman who sought or
33obtained an abortion-inducing drug.
344. This section shall not be construed to impose civil or
35criminal liability on a woman upon whom a chemical abortion is
-7-1performed.
2 Sec. 9. NEW SECTION. 146F.5 Licensee discipline.
3A licensee who fails to comply with this chapter is subject
4to licensee discipline under chapter 148.
5DIVISION III
6ABORTION-RELATED PROVISIONS
7 Sec. 10. Section 144.29A, subsection 1, paragraph k, Code
82026, is amended to read as follows:
9k. The method used for an induced termination, including
10whether mifepristone or misoprostol was used.
11 Sec. 11. Section 144.29A, subsection 1, Code 2026, is
12amended by adding the following new paragraph:
13 NEW PARAGRAPH. l. If a spontaneous termination of
14pregnancy, whether the patient ingested mifepristone or
15misoprostol within fourteen calendar days prior to the date of
16the spontaneous termination of pregnancy.
17 Sec. 12. Section 144.29A, subsection 7, paragraph c, Code
182026, is amended to read as follows:
19c. “Spontaneous termination of pregnancy”, commonly known
20as a miscarriage, means the occurrence of an unintended
21termination of pregnancy at any time during the period from
22conception to twenty weeks gestation and which is not a
23spontaneous termination of pregnancy at any time during the
24period from twenty weeks or greater which is reported to the
25department as a fetal death under this chapter.
26 Sec. 13. Section 146B.1, subsection 1, Code 2026, is amended
27to read as follows:
281. “Abortion” means the termination of a human pregnancy
29with the intent other than to produce a live birth or to
30remove a dead fetus. “Abortion” does not include a spontaneous
31termination of pregnancy, commonly known as a miscarriage, if
32not all the products of conception are expelled.
33EXPLANATION
34The inclusion of this explanation does not constitute agreement with
35the explanation’s substance by the members of the general assembly.
-8- 1This bill relates to abortions, including informed
2consent, dispensing of abortion-inducing drugs, and reporting
3abortion-inducing drug complications.
4DIVISION I — INFORMED CONSENT. Under the bill, a physician,
5prior to performing or attempting to perform an abortion, is
6required to perform an in-person examination of the woman
7seeking an abortion, including screening for indicia of
8coercion or abuse; if necessary, the physician shall make a
9referral to an appropriate health care provider consistent with
10the examination results.
11The bill requires a physician, prior to prescribing
12or dispensing an abortion-inducing drug, to do all of the
13following: have the woman being prescribed or dispensed the
14drug sign a patient agreement form, obtain written confirmation
15that the physician has informed the woman of specific health
16and safety information related to abortion-inducing drugs
17as detailed in the bill, and advise the pregnant woman how
18to access emergency surgical intervention in cases of an
19incomplete abortion, severe bleeding, or other medical
20complications. The bill specifies that these requirements
21shall not apply to a chemical abortion performed in response to
22a medical emergency. The bill provides that the prohibition on
23dispensing of abortion-inducing drugs shall not be construed
24to impose civil or criminal liability on a woman upon whom
25a chemical abortion has been performed. Under the bill,
26a physician who fails to comply with the informed consent
27requirements is subject to licensee discipline. The bill
28requires the board of medicine to adopt rules to administer
29this division of the bill. The bill defines “abortion-inducing
30drug”, “chemical abortion”, “dispense”, “medical emergency”,
31and “pregnant” or “pregnancy”.
32The bill requires the department of health and human
33services (HHS) to publish on HHS’s internet site notice that it
34may be possible to reverse the effects of a chemical abortion,
35and information and resources on reversing the effects of a
-9-1chemical abortion.
2DIVISION II — DISPENSING AND REPORTING — ABORTION-INDUCING
3DRUGS. The bill defines “abortion-inducing drug”,
4“abortion-inducing drug complication”, “chemical abortion”,
5“dispense”, “interested party”, “medical emergency”,
6“physician”, “postfertilization age”, and “rural emergency
7hospital”.
8The bill prohibits a person from dispensing an
9abortion-inducing drug in this state unless the drug is
10dispensed in a health care setting directly to the woman
11prescribed the drug, and the person dispensing the drug is
12authorized to do so pursuant to Code section 147.107 (drug
13dispensing, supplying, and prescribing — limitations). These
14requirements do not apply to a medical emergency.
15The bill requires a hospital, rural emergency hospital,
16or the attending physician to file a report with HHS using a
17prescribed form within 30 days of discharge or death of a woman
18who presented with or was treated for an abortion-inducing
19drug complication. The form must be signed and completed
20by the attending physician and contain the age of the woman
21experiencing the abortion-inducing drug complication,
22the woman’s state and county of residence, the date the
23abortion-inducing drug was used by the woman, and the probable
24postfertilization age of the unborn child at the time of
25the abortion-inducing drug complication. The report must
26identify the physician who performed the chemical abortion,
27the facility where the chemical abortion was performed,
28the referring physician, agency, or service, if any, and
29the specific complication or complications that led to the
30treatment performed along with the most recent international
31classification of diseases code for each, if applicable. The
32report shall be confidential and not subject to disclosure
33under Code chapter 22 (open records).
34The bill also requires HHS to prepare annually on or
35before December 31 a comprehensive statistical report based
-10-1upon the aggregated data gathered from the reports filed on
2abortion-inducing drug complications. Under the bill, the data
3gathered by HHS must be anonymized to prevent public disclosure
4of either the physician or hospital that filed a report, or the
5woman about whom a report is filed. HHS is required to make the
6anonymized data publicly available in a downloadable format on
7its internet site.
8This division of the bill creates a private cause of action
9against any person who dispenses an abortion-inducing drug
10in violation of this division of the bill for all damages
11caused by the abortion-inducing drug suffered by a woman upon
12whom a chemical abortion was performed or was attempted; the
13biological father of the unborn child who was or was attempted
14to be aborted through a chemical abortion; or the grandparent,
15parent, sibling, child, legal guardian, or conservator of
16the woman upon whom a chemical abortion was performed or was
17attempted. A prevailing plaintiff in an action brought under
18this division of the bill, in addition to compensatory and
19punitive damages, is entitled to statutory damages in the
20amount of $50,000, court costs, and reasonable attorney fees.
21In an action brought under this division of the bill, the name
22and other identifying characteristics of a woman who sought or
23obtained an abortion-inducing drug shall be redacted from all
24pleadings and documents filed in the action without a court
25order, and the court may make further orders as necessary to
26protect the identity and privacy of the woman who sought or
27obtained an abortion-inducing drug. This division of the bill
28is not to be construed to impose civil or criminal liability
29upon a woman upon whom a chemical abortion is performed.
30Under the bill, a licensee that fails to comply with this
31division of the bill is subject to licensee discipline.
32DIVISION III — ABORTION-RELATED PROVISIONS. The bill
33amends Code section 144.29A (termination of pregnancy reporting
34— legislative intent) to require a health care provider that
35diagnoses or induces a spontaneous termination of pregnancy
-11-1to include in the required report to HHS if mifepristone or
2misoprostol was used to induce a spontaneous termination of
3pregnancy. Current law requires the health care provider
4to only disclose if mifepristone was used to induce a
5spontaneous termination of pregnancy. The bill also requires
6the health care provider to disclose whether mifepristone
7or misoprostol were ingested by the patient within 14 days
8prior to the spontaneous termination of pregnancy. The bill
9excludes a spontaneous termination from the definition of
10abortion for the purpose of the reporting requirements and
11penalties on abortions under Code chapter 146B (abortion —
12postfertilization age).
-12-ak/ko