New Iowa bill places extreme restrictions on abortion pill access, adds scare tactics and felony convictions

New Iowa bill places extreme restrictions on abortion pill access, adds scare tactics and felony convictions

Reps. Tom Determann, Luanna Stoltenberg, Brad Sherman, Helena Hayes, Bob Hederson, and Ann Osmundson.

By Ty Rushing

January 24, 2024

A new bill introduced by Iowa House Republicans would severely limit access to abortion medications through a 19-step process—including making them illegal to receive in the mail—and create an electronic record of who received the pill and the medical personnel involved in the process.

HF 2122 was introduced by Republican representatives Tom Determann of Clinton, Helena Hayes of New Sharon, Bob Henderson of Sioux City, Anne Osmundson of Volga, and Brad Sherman of Williamsburg.

Under the legislation, the Iowa Board of Pharmacy would create a new certification program devoted only to abortion medications. The pharmacy board would be in charge of acquiring the medications, regulating them, and distributing them, and this would be the only way to access the medication in Iowa.

Patients would not be allowed to order abortion medication through the mail from out of state, which is currently legal, or receive a prescription through a telemedicine appointment. 

The only way for a pharmacy, medical facility, or medical practitioner to access the pills for a patient is by being enrolled in the state’s certification program, which would include an extensive regulation process and criminal prosecution for missteps.

A little more than half of abortions in the United States are medication abortions. This method is typically used in the first 10-11 weeks of pregnancy when it’s most effective. Patients take one pill, and then, 24 hours later, take a second one. Failure rate is documented in only 1.1% of patients and the pill carries less risk than Tylenol or penicillin. 

Planned Parenthood also notes that people choose medical abortions because they are private and can be done in the comfortable place of the person’s choosing.

The new legislation in Iowa would make the process of acquiring a prescription for a medical abortion unnecessarily complicated for patients and providers at the behest of anti-abortion lawmakers, including one who had three abortions herself

For a physician to prescribe abortion medications to a patient, there is a 19-step process—letters A-S in Section 6 of the bill—that includes substeps within those steps. 

Besides making it astronomically harder for a person to receive abortion medication, some steps are simply scare tactics filled with false or disputed claims about reversing the process or playing up the risks of taking the medication to dissuade patients from seeking access.

A prime example of this comes in Section 6 “I” of the bill, which says that doctors would have to “inform the pregnant woman to whom an abortion-inducing medication is to be dispensed that the pregnant woman may see the remains of the unborn child in the process of completing the abortion, that it may be possible to reverse the effects of the medication-induced abortion if the pregnant woman changes her mind but that time is of the essence, that studies show that babies born following the abortion reversal process do not have a higher rate of birth defects than the general population, and that studies show that following the reversal process or otherwise treating a pregnant woman with progesterone during pregnancy does not lead to increased mortality rates.”

On its website, Planned Parenthood directly addresses claims about reversing medical abortion after taking the first pill: “These claims haven’t been proven in reliable medical studies—and they haven’t been tested for safety, effectiveness, or the likelihood of side effects—so experts like the American College of Obstetricians and Gynecologists reject these untested treatment ideas.”

Planned Parenthood also notes that taking both pills and then changing your mind about pregnancy can lead to birth defects and a person should immediately consult a medical professional in this instance.

An additional step not listed with the other 19 requires doctors to have hospital admitting privileges in the county or a contiguous county where the medication is provided. 

If a doctor does not have those privileges, they have to reach a written agreement with a doctor in that county that has to be submitted to the Iowa Department of Inspections, Appeals, and Licensing and validated through the board of pharmacy on an annual basis. That agreement would be available to members of the public upon request and the department would also have to provide copies to every hospital in a county or contiguous county where it was signed.

If a doctor completes every required step to be certified to prescribe abortion pills in Iowa, they would then have to write an annual report to the pharmacy board and the US Food and Drug Administration about any abortion complications or “adverse events” that include:

  • The number of patients they helped receive a medical abortion.
  • The age and race of the patient.
  • The county and state where the patient lives, or city and country if they are not a US resident.
  •  A list of staff involved in the process including their licensing numbers and “evidence of other qualifications.”
  • The exact medications prescribed and the date they were prescribed.
  • And details on any complications after the medical abortion and how they were addressed.

While this report is only supposed to be for “complications,” it includes blood loss as a complication which means that every single medical abortion would count since cramping and bleeding are part of the process. Again, complications are very rare, and having a medical abortion is akin to a heavy-flow period.

A manufacturer, distributor, physician, or pharmacist who violates any of the provisions in the code is found guilty of a class “D” felony (note, the bill does not say they would be charged with a felony but that they would automatically be deemed guilty.)

There is also a separate aggravated misdemeanor penalty for a manufacturer, distributor, physician, or pharmacist for “fraudulent use” of medical abortion. Those parties would also automatically be considered guilty, and fraudulent use is not defined in the bill.

Failure to comply would also open up providers to a medical malpractice lawsuit and punitive damages; discipline from the appropriate licensing board; and should a pregnant person die, their survivors can file a wrongful death suit.

The bill also grants the Iowa Attorney General’s Office authority to enforce the bill and defend its legality in court. 

In a statement after the legislation was introduced, Ruth Richardson, president and CEO of Planned Parenthood North Central States, said this was another act by politicians trying to strip patients of control over their bodies and a further attempt to “take away Iowans’ reproductive freedom” by going after medication abortion.

“These attacks are dangerous, irresponsible, and conflict with established scientific evidence,” she said. “Medication abortion has been proven to be safe and effective since being approved by the FDA more than 20 years ago. This is nothing more than a calculated attack on abortion access that will deny people the freedom to make their own health care decisions, further destabilize the health care workforce, and deepen disparities.”

UPDATE: Comments from Planned Parenthood added to the story.

  • Ty Rushing

    Ty Rushing is the Chief Political Correspondent for Iowa Starting Line. He is a trail-blazing veteran Iowa journalist, an Emmy-nominated filmmaker, and co-founder and president of the Iowa Association of Black Journalists. Send tips or story ideas to [email protected] and find him on social media @Rushthewriter.

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