House approved a fetal heartbeat abortion ban after adding some exceptions for rape, incest

The Iowa House of Representatives approved a measure approved a measure Tuesday banning nearly all abortions in the state after brokering a deal designed to unite Republicans and clear the 51-vote majority needed to pass the bill.

Legislators approved Senate File 359 — which bans most abortions after a fetal heartbeat is detected — on a 51-46 vote late Tuesday night. The Senate approved the measure early Wednesday morning.

The legislation advanced out of the House Human Resources Committee in March, but for weeks it was unclear whether Republicans would muster enough votes to advance it off the floor.

To win approval, the House's most ardent anti-abortion members made concessions, including allowing exceptions to the ban for some victims of rape or incest.

The changes brought some members on board.

Rep. Dave Heaton, R-Mount Pleasant, was among those Republicans who initially said he could not vote for the bill but was persuaded to vote for it by changes unveiled publicly Tuesday morning.

"There were (originally) so many restrictions on the mother’s decision. It troubled me because it was just too restrictive," he said. "And now we’ve loosened it up (creating exceptions for) incest, rape, the life of the mother, fetal anomaly. It’s enough for me to get on board."

Democrats, who argued against the bill for about nine hours, said the new exemptions do little to moderate the measure they called "frightening," "unconstitutional" and "extreme."

"All women, regardless of age, income or race, should be able to obtain reproductive health services including abortion free from political and economic barriers," said Rep. Beth Wessel-Kroeschell, D-Ames. "Placing restrictions on abortion only forces desperate women to find a way around those restrictions."

More: Republicans hope a challenge to Iowa's fetal heartbeat bill will overturn Roe v. Wade. How would that work?

Six Republicans voted against the bill: Chip Baltimore of Boone; Jane Bloomingdale of Northwood; Lee Hein of Monticello; David Maxwell of Gibson; Andy McKean of Anamosa; and Louis Zumbach of Coggon.

What the law would do

The measure would require physicians to conduct abdominal ultrasounds to test for a fetal heartbeat on women seeking abortions. If that heartbeat is detected, a physician cannot perform an abortion.

Previously, the legislation only allowed exceptions to that ban in cases of "medical emergency," which was defined as a situation in which the life of the mother was in danger.

Republicans on Tuesday amended the bill to also allow exceptions if:

the mother was raped and reports the rape to a law enforcement agency, a public or private health agency or a family physician within 45 days

the mother was the victim of incest and reports the issue to a law enforcement agency, a public or private health agency or a family physician within 140 days

"not all the products of conception are expelled" following a spontaneous miscarriage

a physician certifies that the fetus has an abnormality that, in the physician’s "reasonable medical judgment," is incompatible with life

Rep. Mary Wolfe, D-Clinton, noted that physicians would not be tasked with confirming reports of incest or rape that are made by women seeking abortions. She also questioned whether the state should be requiring victims of violence to report crimes within a certain time frame.

“That is a good message to be sending to the children of Iowa that, you know what, if you’re scared and you don’t know what to do and you finally get the guts to go to your mom or your dad and tell them what happened but it’s 50 days after you were raped instead of 45, you’re stuck with that baby because the Iowa Legislature decided you needed to accept responsibility for coming forward," she said.

The bill's floor manager, Rep. Shannon Lundgren, R-Dubuque, said those requirements would allow justice to be served.

“I believe this legislation is important because we need to do everything in our power to encourage young women ... to come forward and tell people that they’ve been raped so that we can bring that perpetrator to justice," she said.

Rep. Steven Holt, R-Denison, said he disagreed with the exemptions because they water down the intent of the legislation.

"I do not agree with the exceptions in the amendment, for I believe that all unborn lives matter and that all unborn lives should be protected," he said. "However I will vote to protect most of the unborn and we will continue to work to protect all unborn children."

Criminal penalties for doctors?

The bill no longer includes civil or criminal penalties for physicians, as some previous versions did.

And although it includes language granting women legal immunity, it does not do so for physicians.

That led some Democrats to question whether a physician could be charged with murder if somebody later questioned whether the abortion he or she performed met the requirements of the law.

"The courts, I can tell you, will likely interpret this as an intentional omission," said Rep. Todd Prichard, D-Charles City. "They will review that and say that the Legislature had a choice, and they chose not to provide immunity for doctors. This is extremely dangerous."

He called it a "glaring and perhaps purposeful" omission from the bill that could frighten doctors who want to provide legal abortions.

Rep. Chip Baltimore, R-Boone, disagreed, saying the bill does not make an unborn child a "person" and an abortion would not meet the statutory definition of murder.

Training could be threatened at OB-GYN residency program

Democrats said the legislation could negatively affect the University of Iowa Carver College of Medicine and Iowa Obstetrics and Gynecology Department.

Josh Lehman, senior communications director for the Iowa Board of Regents said in a statement the program is required to provide family planning training "including all forms of contraception and training in the provision of abortion, if the student so chooses."

"If this law was passed, limitations on abortions in Iowa would eliminate the ability to meet training requirements," he said.

School leaders have said they would likely have to arrange out-of-state training options for students if it could no longer do so on its own.

Rep. Mary Mascher, D-Iowa City, warned the changes would reduce the numbers of qualified OB-GYNs across the state.

"This change would result in a weakened program affecting all Iowans who seek all types of obstetric and gynecological care, not just those seeking to end a pregnancy," she said. "Fewer well-qualified obstetricians and gynecologists as well as physicians from other specialties will choose to train and live in a state that appears to devalue the practice of medicine. Patients will lose access to critical life-sustaining services."

Rep. Jon Jacobsen, R-Treynor, said the implication the program would lose its accreditation amounts to "scare tactics," arguing there are other ways for the school to meet its accreditation standards.

Correction: An earlier version of this story incorrectly described the length of time victims of rape had to report, under the bill.