(2)
Definitions. As used
in this
rule or in Iowa Code chapter 146E:
"Private health agency" means any establishment, facility,
organization, or other entity that is not owned by a federal, state, or local government that either is a
health care provider or employs or provides the services of a health care provider. Establishments,
facilities, organizations, or other entities that are health care providers include the following:
1. A hospital as defined in Iowa Code section 135B.1;
2. A health care facility as defined in Iowa Code section 135C.1;
3. A health facility as defined in Iowa Code section 135P.1; or
4. A similar entity that either is a health care provider or employs or
provides the services of a health care provider.
"Public health agency" means any establishment; facility;
organization; administrative division; or entity that is owned by a federal, state, or local government that
either is a health care provider or employs or provides the services of a health care provider.
Establishments, facilities, organizations, administrative divisions, or other entities that are health care
providers include the following:
1. A hospital as defined in Iowa
Code section 135B.1;
2. A health care facility as defined in Iowa
Code section 135C.1;
3. A health facility as defined in Iowa Code
section 135P.1; or
4. A similar entity that either is a health
care provider or employs or provides the services of a health care provider.
"Standard medical practice" means the degree of skill, care,
and diligence that a physician of the same medical specialty would employ in like circumstances. As applied
to the method used to determine the presence of a fetal heartbeat for purposes of Iowa Code chapter 146E and
this rule, "standard medical practice" includes employing the appropriate means of detection depending on the
estimated gestational age of the unborn child and the condition of the woman and her pregnancy.
"The pregnancy is the result of a rape" means a circumstance
in which the pregnancy is the result of conduct that would constitute an offense under Iowa Code section
709.2, 709.3, 709.4, or 709.4A when perpetrated against a female, regardless of where the conduct
occurred.
"The pregnancy is the result of incest" means a circumstance
in which a sex act occurs between closely related persons that involves a vaginal penetration that causes a
pregnancy. The closely related persons must be related, either legitimately or illegitimately, as an
ancestor, descendant, brother or sister of the whole or half blood, aunt, uncle, niece, or nephew. For
purposes of this rule, a closely related person includes a stepparent, stepchild, or stepsibling, including
siblings through adoption.
"Unborn child" means an individual organism of the species
Homo sapiens from fertilization to live birth-that is, at all stages of development,
including embryo and fetus.
"Woman" means a female individual regardless of her
age.
(3)
Detection of fetal heartbeat. A
physician who intends to perform or induce an abortion must determine via ultrasound whether the
woman is
carrying an
unborn child with a detectable fetal heartbeat.
a.
Obligation. The obligation under this rule requires a bona fide effort to detect a fetal
heartbeat in the unborn child. This effort must be made in good faith and according to standard medical
practice and reasonable medical judgment.
b.
Method. The physician shall perform a transabdominal pelvic ultrasound on the woman to
determine whether the unborn child has a detectable fetal heartbeat. This shall be performed in a manner
consistent with standard medical practice, with real-time ultrasound equipment with a transducer of
appropriate frequency. The equipment must be properly maintained and in proper functioning order.
(4)
Fetal heartbeat exceptions. The following
applies to a
physician who intends to perform or induce an abortion under a fetal heartbeat exception as
defined in Iowa Code chapter 146E and this
rule:
a.
Incest or
rape. For purposes of this
rule, a pregnancy resulting from
incest or
rape may be reported within
the appropriate time frame to a licensed
physician whose services are retained for an abortion procedure.
(1) To determine whether the pregnancy is the result of
incest, a
physician
who intends to perform or induce an abortion must use the following information:
1. Whether the sex act occurred between the woman and a closely related
person, meaning, either legitimately or illegitimately, an ancestor, descendant, brother or sister of the
whole or half blood, aunt, uncle, niece, or nephew, including a stepparent, stepchild, or stepsibling to
include an adopted sibling.
2. The date the act
occurred.
3. If initial reporting was to someone other than the
physician who intends to perform or induce an abortion, the date the act was reported to a law enforcement
agency,
public health agency,
private health agency, or family
physician.
The physician who intends to perform or induce an abortion shall use this
information to determine whether the fetal heartbeat exception for incest applies. This information does not
prescribe the manner in which the physician is to obtain this information. This information and its source
shall be documented in the woman's medical records.
The physician who intends to perform or induce an abortion may rely on the
information received upon a good-faith assessment that the information is true. The physician who intends to
perform or induce an abortion may require the person providing the information to sign a certification form
attesting that the information is true.
(2) To
determine whether the pregnancy is the result of a
rape, a
physician who intends to perform or induce an
abortion must use the following information:
1. The date the sex act that
caused the pregnancy occurred.
2. The age of the woman seeking an
abortion at the time of that sex act.
3. Whether the sex act
constituted a rape.
4. Whether the rape was perpetrated against
the woman seeking an abortion.
5. If initial reporting was to
someone other than the
physician who intends to perform or induce an abortion, the date the
rape was reported
to a law enforcement agency,
public health agency,
private health agency, or family
physician.
The physician who intends to perform or induce an abortion shall use this
information to determine whether the fetal heartbeat exception for rape applies. This rule does not prescribe
the manner in which the physician is to obtain this information. This information and its source shall be
documented in the woman's medical records.
The physician who intends to perform or induce an abortion may rely on the
information received upon a good-faith assessment that the information is true. The physician who intends to
perform or induce an abortion may require the person providing the information to sign a certification form
attesting that the information is true.
b.
Fetal abnormality. A certification from an attending
physician that a fetus has a
fetal abnormality that in the attending
physician's reasonable medical judgment
is incompatible with life must contain the following information:
(1) The
diagnosis of the abnormality;
(2) The basis for the diagnosis,
including the tests and procedures performed, the results of those tests and procedures, and why those
results support the diagnosis; and
(3) A
description of why the
abnormality is incompatible with life.
The diagnosis and the attending physician's conclusion must be reached in good
faith following a bona fide effort, consistent with standard medical practice and reasonable medical
judgment, to determine the health of the fetus. The certification must be signed by the attending physician.
A physician who intends to perform or induce an abortion may rely in good faith on a certification from an
attending physician if the physician who intends to perform or induce an abortion has a copy of the
certification.
The certification must be included in the woman's medical records by the
physician who intends to perform or induce an abortion.
