The abortion issue magically transforms conservatives from people who want to keep bureaucrats from getting between you and your doctor into people eager to let the government limit pregnant women’s medical care. The Iowa House demonstrated that contradiction again yesterday, as representatives approved a ban on most abortions after 20 weeks gestation.

House File 657 is modeled on a Nebraska statute with the intent of stopping Omaha physician Leroy Carhart from opening an abortion clinic in Iowa. State representatives voted 60 to 39 to send the bill to the Senate. The yes votes included 56 Republicans and four Democrats: Dan Muhlbauer (district 51), Brian Quirk (district 15), Kurt Swaim (district 94) and Roger Thomas (district 24). Three first-term Republicans–Kim Pearson (district 42), Glen Massie (district 74) and Tom Shaw (district 8)–voted no, along with the rest of the House Democratic caucus. Those Republicans have argued against the bill because it would ban less than 1 percent of abortions in Iowa; their opposition forced House Republican leaders to pull the bill out of the House Human Resources Committee and send it to Government Oversight instead.

Excerpts from yesterday’s arguments for and against House File 657 are after the jump, along with thoughts about the bill’s prospects in the Iowa Senate.

Various news accounts described the “emotional” floor debate over House File 657. Reading the comments from many Republicans, I’m struck by how they refused to acknowledge the kind of circumstances that lead women to seek an abortion after 20 weeks. Representative Walt Rogers, a supporter of the bill, described how he turned against legal abortion after feeling baby kicks: “It was the coolest moment in my life to feel my child inside my wife’s stomach.” Good for you, Mr. Rogers, but why should your “cool moment” give you power to make life and death choices for other adults?

First-term Republican Representative Mary Ann Hanusa floor-managed House File 657. She is from Council Bluffs, where Carhart’s clinic would be located. Speaking on the House floor yesterday, she argued that “protecting the well being of a 20-week-old unborn child and shielding it from the agony and painful death of an abortion” should be as important a topic as other bills the House as debated, related to the care of animals. Hanusa also told her colleages,

“There is a substantial and growing body of medical and scientific evidence that unborn babies at 20 weeks can feel intense pain when they are aborted. …Medical studies show that these unborn children recoil from painful stimulation as you and I might and that this dramatically increases their release of stress hormones.”

Hanusa said Iowans’ sense of decency and compassion and our common humanity dictate that we as a state protect these vulnerable individuals. She said the bill does have an exception for the life of the mother.

“This is a bill about saving babies,” said Rep. Dawn Pettengill, R-Mount Auburn. “When you have a 20-week-old baby, it is able to live and it should not be taken in the way it has to be taken when you do an abortion at that age.”

Pettengill later broke down in tears as she graphically described the different procedures used for late-term abortions. “These are living people,” she said.

I am not aware of any fetuses surviving at 20 weeks gestation. It is rare for fetuses to survive even at 22 or 23 weeks. But more to the point, Pettengill does not recognize that women do not seek abortions that late in pregnancy without compelling reasons related to the health of the mother or baby.

In her opening remarks, Democratic State Representative Beth Wessel-Kroeschell described what the Nebraska law put one pregnant woman through:

Make no doubt about it, HF 657 puts our daughter’s lives and health at risk. This bill is an extreme measure which is being sold to us as a way to keep a Nebraska physician out of Iowa. If keeping this dr. out of Iowa is necessary, there are ways to do that without risking the lives of our daughters. Using this bill for that means is equivalent to using a sledgehammer to kill a fly.

Women terminate pregnancies for many reasons. Although we may disagree with them on why, most Iowans agree that those decisions should be left up to a woman, her family, doctor, and faith advisors.

It puts our daughters at risk when a much wanted pregnancy goes wrong. We will illustrate this for Iowan’s during today’s debate.

A Nebraska woman, Danielle Deaver was excited about her pregnancy and planning for her second child. She had experienced numerous miscarriages but felt confident about her current pregnancy because she is the mother of a healthy 2 year old.  Through no fault of her own, tragedy happened: her water broke at 22 weeks. Desperate to continue the pregnancy her dr. put her on 24 hour bedrest hoping her body would replenish the amniotic fluid that protects babies and allows them to thrive in their mother’s uterus. Common practice in obstetrics has been that once a pregnant woman’s water breaks, she will deliver the baby within 24 hours to avoid life threatening infections.

Prayers, medicine and her sheer will did not replace Danielle’s amniotic fluid. As a mother, I can’t imagine how awful it must feel to realize that you can no longer protect your much anticipated pregnancy. Danielle had lost the ability to protect her unborn child and her uterus was instead crushing and suffocating the baby. Now her fetus is in distress.

Knowing that there was no hope that her pregnancy could continue to viability and knowing the baby would not survive, Danielle and her husband Robb asked to have labor induced to prevent infection and preserve their fertility. As the happy parents of a 2 year old, they wanted another chance; they knew that Danielle was at risk of infection which could not only risk her ability to have another pregnancy but could also kill her.

Based on the Nebraska 20 week ban (a bill that is very similar to HF 657) which went into effect one month earlier, three attorneys advised the Deaver medical team that they would risk losing their license, going to prison and various lawsuits if they induced Danielle’s labor. Their hands were tied and they could not use best medical practices.

Dannielle Deaver went home and waited for a life threatening infection in either her or her baby. Her life was in danger. She went home and waited for her life to be put at “immediate danger.” Finally, 8 days later, she went into labor and watched her baby die.

I feel strongly, that a family who is in this situation should not have their decisions made by politicians. It should be the family’s decision.

I may not always agree with all the decisions that Iowans make for their family, but I respect that they have the right to make them. I respect that every family is different. I respect that every pregnancy is unique. I oppose this bill not only because it does not allow for an exception for rape and incest, or real exception for the health and life of a woman, but I oppose this bill because it is extreme.

HF 657 takes away a couple’s decision making powers regarding the first days and months of parenting and put it in the hands of the government. We can all feel for this couple, struggling to make the decision that is best for their circumstances. And because each situation is different, we must protect a family’s ability to make decisions in consultation with those they trust.

Families are allowed to make many health care and life and death decisions for children. Does this bill indicate that government will move toward making these decisions for parents?  

Danielle and Robb Deaver deserved to make the decision for the child they had hoped for and loved even if it were not the decision you or I may have made.

A friend of mine once faced a choice similar to Danielle Deaver’s. At a routine 20-week ultrasound, she learned that the baby she was carrying had no chance of life outside the womb because of major anomalies, including missing vital organs. Because of her religious beliefs, she decided to continue the pregnancy for as long as possible. During the subsequent month before the fetus died, my friend developed health problems related to excessive amniotic fluid. Her blood pressure skyrocketed, and her doctor warned she was at risk for a stroke. She eventually delivered a stillborn baby, after which her health issues subsided. She told me after the experience that she didn’t regret her choice, but she would never want the government to make that choice for others.

Under House File 657, it would probably take a stroke before a woman in my friend’s condition would be deemed to have a “medical emergency” justifying an abortion. Representative Mary Mascher was among the House Democrats who pointed out that the bill would endanger women with health complications that did not immediately threaten their lives. Representative Sharon Steckman developed this argument well in her speech yesterday, which is worth reading in full:

Mr. Speaker,  ladies and gentlemen of the House

After reading this bill I have some major concerns about the health and safety of a woman who might be affected by this law.  In fact, I  think it’s clear that this bill will actually put our sisters and daughters at very grave risk.

A woman facing the decision to terminate a pregnancy after 20 weeks is most likely to also be facing a serious health complication………this legislation only causes more concerns for her health and safety.

The bill states that it will be illegal to terminate a pregnancy unless, in the physician’s medical judgment, the pregnant woman has a condition which is deemed a medical emergency.  That sounds good – until we look closer.

My first concern is on page 4, lines 23-26 we find the definition of “medical emergency”,  I quote, “a condition which, in reasonable medical judgment, so complicates the medical condition of a pregnant woman as to necessitate the immediate abortion of the human pregnancy to avert the woman’s death”………further down, lines 27 and 28 it states, “a serious risk of substantial and irreversible physical impairment of a major  bodily function.”

In other words, a woman could have a condition which will ultimately kill her, but if it isn’t killing her RIGHT NOW, she has to wait until she’s on death’s door.

How does that protect the health and safety of a woman?  It doesn’t.

The definition of medical emergency talks about   termination only being allowed if it is “immediately necessary.”  How would we measure this immediate danger of death……. Days, months, hours?

For example, if a woman is diagnosed with breast cancer,  and needs chemotherapy or radiation treatment to begin as soon as possible…would she be able to terminate that pregnancy in order to start treatment immediately under this bill?

Or would she have to be in Hospice before it would be considered “immediate danger”?   I can’t imagine a woman having to make a heart breaking decision such as this…..and also have to sort out what this bill means.

Let’s assume that we know a woman who for sure would fit under the exception in this bill – say that she has some other “immediate danger”, and is much closer to death.  This woman is losing blood from a uterine rupture  and will die soon if she does not get help.

Here is my second concern….

I know  Rep. Hagenow is from the Des Moines area….

His constituents in immediate danger  would have a short trip to Iowa Methodist Medical Center, right in DesMoines.

How fortunate, your constituents health and safety could be immediately taken care of ……..mine would not be so lucky….I represent Mason City….Des Moines is the closest hospital in this situation…..2 hours……………..yet the distance is not the only problem…..

And here is another problem I have with this bill. The other problem is called EMTALA…a federal law that says you cannot transport anyone in an emergency unless they have first been stabilized.

So first in Mason City we must stabilize the patient, but to do that we must terminate the pregnancy, but we can’t do that unless we have the poor woman at a certain hospital which is two hours away, but we can’t get her to the hospital unless she is stabilized………This is a major problem with this bill.

A federal law requires stabilization, while a state law prohibits taking action to stabilize her.  How will this turn out?  Probably fatally for some woman in an emergency situation.

On page 1 , lines 24 and 25 it states, “The state has a legitimate interest from the outset of pregnancy in protecting the health of the woman.”

How are we accomplishing that goal in this bill?

While we may disagree, Rep. Hagenow,  about the reasons a woman may choose to end a pregnancy, I would hope we could agree that protecting a woman’s health and safety at all times is paramount.  This bill hopelessly fails to meet that standard.

On a day when we are so focused on maps, this bill is creating a death map for women across Iowa.

I strongly encourage my colleagues to vote no.  This is not about politics anymore – this is about the health and safety of our sisters and daughters.  Thank you.

A family I know faced a choice like what Steckman describes. The mother received a cancer diagnosis after the 20-week mark in her second pregnancy. She rejected medical advice to have an abortion, opting to wait a couple of months until labor could be safely induced before starting cancer treatment. The baby was born at seven months gestation and thrived. A few years down the road, his father was a widower raising two young children. There’s no guarantee the mother would have survived if she had begun cancer treatment sooner, of course. But the Iowa House majority would force every woman to take that risk.

Many Democrats mentioned losses in their own family as they argued against House File 657:

Rep. Janet Petersen, D-Des Moines, a mother of three who once had a stillborn child, choked up in tears as she spoke on the House floor about her personal experience of a pregnancy that did not go as planned.

“This bill forces a mom to carry a baby to term even when the baby will not survive,” Petersen said. “Moms who have to say goodbye to a baby know the heartache of phantom kicking, dealing with their milk coming in and enduring a painful labor without a live baby to hold when it’s over. Supporting this bill adds another cruel punishment to what is already an overwhelming and ongoing experience of heartache.”

Representative Ruth Ann Gaines urged legislators to vote no even though she adopted a child with developmental disabilities, whose birth mother considered abortion. She too saw House File 657 as threatening women’s lives. Sharing her own family’s perspective, Representative Helen Miller

told of how one of her daughters who was pregnant with triplets was advised by doctors to abort one of the children because of a medical situation. She didn’t and all three children died.

“Here’s what my daughter lives with everyday,” Miller said.  “She wonders if she had done something and followed her doctor’s advice and reduced pregnancy to two, could she have saved two of those children.”

Later in the debate, Wessel-Kroeschell warned that the bill would deter obstetricians from wanting to practice in Iowa, because as Representative Mary Wolfe noted, an obstetrician could be charged with a class C felony for inducing an abortion with the intent of saving a woman’s life.

Meanwhile, Representative Kirsten Running-Marquardt noted that it’s ironic Republicans want to reduce sex education funding if their goal is to have fewer abortions induced. State Representative Anesa Kajtazovic

questioned why the body is debating an issue that has affected so few families compared to other maternity issues. Kajtazovic said just six abortions were performed in the state last year after 20 weeks of pregnancy, compared 700 Iowa families that have experienced a miscarriage or stillbirth in the past year.

“What’s sad is that we have members in this body politicizing what is such a personal and difficult decision that a woman is faced with sometimes in her pregnancy,” Kajtazovic said.

Several men in the House Democratic caucus spoke against House File 657, including Representative Tyler Olson and Representative Chris Hall. Mark Smith, who has extensive experience as a social worker, expressed concern that suicide is not considered a medical emergency under the bill. He added,

“The key here is who makes the decision. Is it the woman who faces threats to her life or severe fetal anomalies or is it those in the room today who may be guessing at the unique circumstances that Iowa women face?” Smith asked. “As I reviewed my faith and my belief system, the decision on who should make this difficult and painful decision should be the woman. … I don’t believe that these are decisions that should be made by gray-haired legislators like myself.”

None of those arguments changed a single vote yesterday, and House File 657 now goes to the Senate. Bills coming out of the Government Oversight Committee are not subject to today’s second “funnel” deadline, so it will be considered at some point.

If House File 657 comes to a floor vote in the Senate, it will pass. None of the 24 Senate Republicans are pro-choice, while several of the 26 Democrats are anti-choice. Senate Majority Leader Mike Gronstal is probably not going to keep it off the floor if it clears a Senate committee. He’s in an awkward position, because although he is pro-choice, Carhart’s abortion clinic would be located in his district, where many residents do not support legal abortion at any stage of pregnancy. Gronstal is already the Republicans’ top target in the 2012 Iowa Senate elections.

The best chance for keeping this bill off Governor Terry Branstad’s desk is to stop it from coming out of the Senate Human Resources Committee, where it will probably be referred. Eight Democrats and five Republicans serve on that committee, meaning that two Democrats would have to vote for the bill to send it out. Senate Human Resources Committee Chair Amanda Ragan is strongly pro-choice.

Share any relevant thoughts in this thread.

UPDATE: Craig Robinson goes after the GOP dissenters at The Iowa Republican blog:

For months, Pearson, Massie, and Shaw have taken every opportunity to speak out about their opposition to the late term abortion ban.  They have sent numerous press releases, repeatedly defended their position on the radio, and done interviews with reporters, yet when it came time to debate the bill, the three didn’t utter a word on the floor of the House.

Some pro-life advocates hold these three freshmen legislators in high regard for their principled stand.  While I have been a vocal critic of their opposition to the bill, I do find it admirable that they want to outlaw all abortions in the state.  That is why I think it is unacceptable and disappointing that the three of them sat in the House Chamber like bumps on a log while ever liberal woman in the chamber took to the microphone to speak out against the bill.

I understand that the three were not going to support the bill, but that doesn’t mean that they couldn’t advocate for their position or speak on behalf of life in general.  Frankly, I find it cowardly that Rep. Pearson felt the need to confront me at a coffee shop about my position on the bill, but can’t say a single word when its debated in the house.  Meanwhile, Rep. Walt Rodgers and Rep. Dawn Pettengill were the only two Republicans besides Rep. Mary Ann Hanusa, who managed the bill, to provide a pro-life viewpoint.

There are a number of people who think that Pearson, Massie, and Shaw have shown leadership for holding firm on their position. A real leader would have engaged in last night’s debate.  While it is true that that the debate was about a late term abortion ban, the debate, which the media watched and reported on extensively, was all about the abortion in general.  Had they weighed in a productive and respectful way, not only would they have gained the respect of their Republican colleagues, they also would have helped their cause of passing a personhood bill.

Robinson also criticized the socially conservative group The FAMiLY Leader, which didn’t cheer passage of House File 657:

In an email entitled “Disappointment at the Capitol,” Chuck Hurley and Danny Carroll of The Family Leader revealed that the House had planned to debate an amendment to House File 656, a bill dealing with waivers from abortion notification requirements for pregnant minors, saying that the life of each human begins at conception. But House Republican leaders determined that the amendment would not be germane.

“So after two attempts, the House Republicans have failed to advance a bill to protect life at conception,” Hurley and Carroll asked. “Is it not reasonable to ask why? How can such a large majority of Republicans – 60 out of 100 – fail to advance a policy that most, if not all, say they support?”

LATE UPDATE: The bill was not referred to the Senate Human Resources Committee. It went to the Senate Government Oversight Committee and stalled there. Committee Chairman Tom Courtney said in April that it was too late in the legislative session to adequately review the bill this year, and he would prefer to take it up in 2012. Council Bluffs Mayor Tom Hanafan, a Democrat, urged the Senate to act on the bill before adjourning to prevent his city from becoming “home to a clinic that specializes in later term abortions.” Senate Majority Leader Gronstal said he would not block the bill from coming to a vote and would let the normal committee process work.