Republican lawmakers in the Iowa House and Senate advanced several bills targeting abortion procedures and providers this week, as a legislative deadline approached.

Several political factors make this year a perfect time for the GOP to curtail Iowa women’s reproductive rights. First, it’s an election year, and no issue motivates social conservative voters more than abortion. Second, 2020 may be the last year of a Republican trifecta. Democrats have a realistic chance to win control of the Iowa House (now split 53-47) in November, which would take any anti-abortion legislation off the table. Finally,  Governor Kim Reynolds will soon have appointed four of the seven Iowa Supreme Court justices, ensuring that the high court will uphold almost any abortion restriction passed this year.

Where things stand on the anti-abortion bills introduced this year:

CONSTITUTIONAL AMENDMENT TO PERMIT FUTURE ABORTION BANS

Senate Joint Resolution 2001 (renamed since last month) would amend the Iowa Constitution to state,

To defend the dignity of all human life, and to protect mothers and unborn children from efforts to expand abortion even to the day of birth, we the people of the State of Iowa declare that this Constitution shall not be construed to recognize, grant, or secure a right to abortion or to require the public funding of abortion.

Although the amendment would not directly ban any procedure, it would make any future abortion ban, no matter how extreme, immune to challenge under the Iowa Constitution.

The Iowa Senate approved the amendment along party lines (32 votes to 18) on February 13. A bill with identical language cleared the House Judiciary Committee on February 12 and is eligible for floor debate. The House is scheduled to hold a public hearing for comments on the proposal at 6:00 pm on February 25.

Democrats don’t have the votes to stop the amendment in the Iowa House this year. But before this provision could be added to the state constitution, both legislative chambers would have to approve it again in 2021 or 2022. If Democrats win control of the Iowa House this November, that will not happen.

If the GOP trifecta holds, the amendment will probably get through the House and Senate again. In that case, the proposal will come before Iowa voters in 2022. Republicans will surely portray the amendment as “neutral” on abortion, even though their real agenda is to ban the procedure under any circumstances, at any stage of pregnancy.

NEW BURDENS FOR ABORTION PROVIDERS

Republicans across the country have long targeted abortion clinics with burdensome fees and regulations. They propose these measures in the name of patient safety, even though the same laws and rules don’t apply to clinics performing far more risky procedures. A case in point was the Iowa Board of Medicine’s effort to ban the use of telemedicine only for abortions. (The Iowa Supreme Court unanimously struck down that administrative rule in 2015.)

House Study Bill 678 would require “abortion facilities” to be licensed and pay an annual licensing fee of $2,000. The bill exempts hospitals where some abortions are performed, making clear that the goal is to place extra financial burdens on clinics operated by other providers (such as the Planned Parenthood facilities around the state or the Emma Goldman Clinic in Iowa City). The Iowa Department of Inspections and Appeals would be required to write rules on granting or revoking licenses for abortion facilities.

The bill’s sponsor is Human Resources Committee chair Shannon Lundgren, who has no medical background. The lobbyist declarations reveal that these regulations would serve no legitimate medical purpose. No patient advocacy or health care groups are registered in favor–only organizations ideologically opposed to all abortions (the Iowa Catholic Conference, FAMiLY Leader, the Iowa Right to Life Committee). The Department of Inspections and Appeals didn’t ask for this bill and is registered “undecided.”

The Human Resources Committee approved the bill along party lines on February 18.

REQUIRING DOCTORS AND FACILITIES TO MISINFORM WOMEN ABOUT ABORTIONS

Many women seeking abortions in the first trimester do not require any surgical procedure. They can take medication to induce an abortion.

House Study Bill 672 would require all facilities where medical abortions are administered to post a sign in all waiting rooms and consultation rooms that reads:

Recent developing research has indicated that a medication abortion utilizing an abortion-inducing drug is not always effective in ending a pregnancy. It may be possible to avoid, cease, or even to reverse the intended effects of a medication abortion that utilizes an abortion-inducing drug. Please consult with a health care professional immediately.

The bill would also require physicians or their representatives to convey to women, before administering a medication abortion:

a.All of the risks commonly associated with a medication abortion.
b. That it may be possible to reverse the intended effects of a medication abortion if the woman changes her mind but that time is of the essence.
c. That information on and assistance with reversing the effects of a medication abortion is available on the department’s internet site.

After giving a patient an abortifacient, the physician or agent would be required to tell the patient,

Recent developing research has indicated that a medication abortion utilizing an abortion-inducing drug is not always effective in ending a pregnancy. It may be possible to avoid, cease, or even to reverse the intended effects of a medication abortion that utilizes an abortion-inducing drug. Please consult with a health care professional immediately.

When the House Human Resources Committee considered the bill on February 18, Lundgren admitted under questioning by Democratic State Representative Karin Derry that she was not aware of any clinical trials supporting the proposed mandatory statements about the potential to reverse the intended effects of a medication abortion. Lundgren cited one study of twelve people in California, the results of which were inconclusive.

Derry pointed out that the American College of Obstetricians and Gynecologists “does not support the use of progesterone to stop a medication abortion, because the treatment does not meet clinical standards and it’s not based on scientific evidence.” Furthermore, the Food and Drug Administration has not evaluated the claim that medications can be reversed. She urged colleagues to reject the bill, which she said was grounded in “junk science.”

Democratic State Representative Heather Matson read from a letter the American College of Obstetricians and Gynecologists wrote in opposition to the bill, saying it “fundamentally undermines the informed consent process,” adding that “scripting physicians and compelling them to provide medically inaccurate information, and steer patients toward untested procedures, HSB 672 is in direct violation of a physician’s oath to care.”

Nevertheless, committee Republicans approved the proposal along party lines.

REQUIRING DEATH CERTIFICATES AND BURIAL OR CREMATION AFTER ABORTIONS

House Study Bill 660 would require the remains of fetuses to be buried or cremated following an abortion, miscarriage, or stillbirth that occurred in a medical facility. The bill would not apply to miscarriages or stillbirths that happened at home.

Health providers would have to ask a woman who has had a miscarriage, abortion or stillbirth to choose either burial or cremation of fetal remains; parental consent would be required for minors who had an abortion (but not those who had a miscarriage or stillbirth). Death certificates would be issued in all cases where a pregnancy ended after twelve weeks gestation. The bill would forbid abortion clinics from selling fetal tissue (which does not happen in Iowa).

When this bill came up in the House Human Resources Committee, Republican State Representative Anne Osmundson, the floor manager, said the concept was to treat all fetal remains “with dignity,” because “it’s a baby.” State Representative Beth Wessel-Kroeschell, the committee’s ranking Democrat, remarked that the bill would be “particularly difficult” for women “suffering a loss.” She questioned why the death certificate and disposal requirements would not apply to anyone who lost a baby during an attempted home birth.

Wessel-Kroeschell pointed out that many women struggle to carry a baby to term, and the bill would burden infertile couples every time they have a miscarriage. She said she’d received many letters about the proposal and read one of them. The writer, a self-described “pro-life” and “practicing Catholic” in Ankeny, said she was devastated physically and emotionally after her first pregnancy ended in a miscarriage. Requiring a burial or cremation after a miscarriage would be “like salt in the wound.”

Republicans on the Human Resources Committee approved the bill along party lines anyway.

TRANSVAGINAL ULTRASOUNDS AND 72-HOUR WAITING PERIOD STALLED–FOR NOW

Senate File 2215 would require a 72-hour waiting period for abortions at all stages of pregnancy. The Iowa Supreme Court struck down a waiting period in 2018, but two of the justices who concurred in the 5-2 majority opinion have since died, and two have retired. The bill’s sponsor, State Senator Brad Zaun, commented, “we’ve got a new court and I believe in this bill and I can file any bill that I want.”

The bill would mandate medically unnecessary and invasive transvaginal ultrasounds for patients seeking to terminate a pregnancy, and would dictate what physicians or ultrasound technicians must do and say to women while performing that procedure.

During the subcommittee meeting on February 18, Iowa Senate Minority Leader Janet Petersen demonstrated that Republicans hadn’t thought through several of this bill’s provisions. For instance, would women seeking medical assistance to complete a miscarriage be required to wait for 72 hours before receiving a “D&C” to clear the uterine lining? Those procedures are medically classified as abortions, whether or not the woman intended to terminate the pregnancy.

Petersen also found it strange that “Senator Zaun, Mr. ‘I don’t believe in traffic cameras,’ is now going to dictate that the government require transvaginal ultrasounds.”

Republicans moved the bill out of subcommittee anyway. It was on the Senate Judiciary Committee’s agenda for February 20, the last day before the legislature’s “funnel” deadline for non-appropriations bills. But committee leaders did not bring it up for a vote.

I would be wary about pronouncing this effort dead for the session. I expect Republicans will attach language on a waiting period and trans-vaginal ultrasounds to some other bill in March or April.

Erin Davison-Rippey, Iowa Executive Director of Planned Parenthood North Central States, commented in a news release this week, “The reproductive health and freedom of Iowans are under attack like never before as anti-abortion politicians in Des Moines with no medical expertise try to dictate what should be private health care decisions.” Unfortunately, I expect Republicans to see these bills through, as it may be years before they have a better opportunity to curtail reproductive rights.

Top image: Screen shot from the Iowa House Democrats video of the House Human Resources Committee’s February 18 meeting. Republican Representative Anne Osmundson is on the far left.