Bill
HSB 704
The bill tightens informed consent and dispensing rules for abortion-inducing drugs, adds stricter reporting, and creates private enforcement and licensing consequences.
Purpose and scope
- This bill proposes comprehensive changes related to abortions in Iowa, focusing on informed consent, dispensing abortion-inducing drugs, and reporting complications from chemical abortions. It redefines abortion for certain reporting and penalties purposes and adds new requirements for health care providers, pharmacies, and institutions.
Key provisions
1) Abortion defined (Division I)
- Defines abortion as the termination of a human pregnancy with the intent not to produce a live birth or to remove a dead fetus.
- Excludes spontaneous termination of pregnancy (miscarriage) where all products of conception are not expelled, from the abortion definition for relevant reporting and penalties.
2) Informed consent requirements (Division II)
- New in-person examination requirement: Before performing an abortion, a physician must conduct an in-person exam of the pregnant woman, including screening for coercion or abuse; referrals to appropriate providers if indicated.
- For chemical abortions (drug-induced abortions), prior to prescribing or dispensing abortion-inducing drugs:
- The woman must sign an FDA patient agreement form for each abortion-inducing drug.
- The woman must provide written confirmation that she was informed about:
- Gestational-age–specific risks and risks of the specific drug,
- Potential failure, hemorrhage, infection, sepsis, sterility, or continuation of pregnancy,
- FDA-recommended follow-up (about 7–14 days) to confirm termination and assess bleeding,
- Psychological/traumatic aspects of seeing fetal remains,
- Possible reversal of the intended effects and information about reversal resources on the department’s site.
- The physician must advise on how to access emergency surgical intervention if needed.
- These informed-consent requirements do not apply in a medical emergency.
- Violations can trigger licensee discipline; the Board of Medicine will issue rules to administer these provisions.
3) Information and resources (Division II)
- The Department of Health and Human Services (DHS) must publish on its site:
- Notice that reversal of chemical abortion effects may be possible,
- Information and resources about reversing chemical abortions.
4) Dispensing of abortion-inducing drugs (Division III)
- Definitions: clarifies terms such as abortion-inducing drug, chemical abortion, dispense, health care setting, etc.
- Dispensing restrictions: A drug can be dispensed only in a health care setting directly to the woman and by an individual authorized to dispense under current law, with exceptions for medical emergencies.
- Establishes a process for reporting abortion-inducing drug complications and for annual aggregated statistical reporting:
- Hospitals or attending physicians must file a report within 30 days of discharge/death, using a department form, detailing patient age, residence, date of drug use, postfertilization age, practitioners involved, specific complications, and ICD codes.
- Reports are confidential and not subject to open records.
- The department must publish anonymized annual statistical reports on its site.
5) Private cause of action and licensee discipline (Division III)
- Creates a private civil right of action against individuals who dispense abortion-inducing drugs in violation of the division.
- Eligible damages include statutory damages of $50,000, plus actual damages, costs, and attorney fees; punitive damages possible.
- Privacy protections for the woman; redaction of identifying information in pleadings.
- Prohibits imposing liability on the woman herself.
- Violations trigger licensee discipline.
6) Abortion-related provisions (Division IV)
- Amends reporting requirements to include whether mifepristone or misoprostol was used to induce a spontaneous termination and whether either drug was ingested within 14 days prior to the termination.
Impact and stakeholders
Timeline and implementation notes
- The bill outlines ongoing annual reporting obligations, with December 31 deadlines for the comprehensive annual statistical report.
- Board of Medicine rules and department regulations would be required to implement the new informed consent and dispensing provisions.
- Some provisions exclude medical emergencies from certain requirements.
Overall, HSB 704 tightens informed-consent and drug-dispensing controls for abortion-inducing drugs and establishes new reporting and private enforcement mechanisms.
Compiled from official sources — confirm details with the bill’s official record.
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