Iowa lawmakers advanced legislation Monday that would require abortion drugs to be dispensed in person, direct hospitals to report medication abortion complications to the state, and expand potential civil liability for providers, as Iowa enforces a fetal heartbeat abortion ban.
The proposal, Senate Study Bill 3115, cleared a Senate subcommittee after testimony from abortion opponents and medical groups.
Under the measure, providers would be required to dispense mifepristone and misoprostol directly to patients in a healthcare setting, rather than via telehealth or mail.
The bill would also allow certain relatives and the father of the pregnancy to sue providers who violate the in-person dispensing requirement.
Supporters argued that the change is needed to ensure an in-person exam before the drugs are provided.
"This drug has virtually no restrictions and can be shipped through the mail directly to the woman's home with no oversight or physical examination from a doctor," said Maggie DeWitte, executive director of Pulse Life Advocates.
"This bill would restore some of the initial safeguards, such as an in-person, physical examination by a physician."
Opponents said the bill would add new limits for doctors practicing in Iowa and would not eliminate access to abortion pills obtained outside the formal healthcare system.
The bill would also require doctors to tell patients, "It may be possible to reverse the intended effects of a chemical abortion, but time is of the essence," and it would require hospitals to report medication abortion complications to the state.
An American College of Obstetricians and Gynecologists (ACOG) physician quoted by Iowa Public Radio said the only randomized controlled trial studying abortion "reversal" was stopped early because of patient harm.
The published trial reported that it stopped enrolling new participants after severe bleeding events, and the researchers could not calculate the intervention's effectiveness, so the study did not yield a reliable success rate.
At the federal level, the Food and Drug Administration said it determined in December 2021 that the mifepristone Risk Evaluation and Mitigation Strategy should be modified to remove the in-person dispensing requirement and add pharmacy certification.
Medication abortions have grown as a share of abortions in the formal U.S. healthcare system.
During a medication abortion, mifepristone blocks progesterone, causing the uterine lining to break down and cutting off support to the embryo. Misoprostol then induces contractions and bleeding to expel the embryo from the uterus.
The Guttmacher Institute reported that there were about 642,700 medication abortions in 2023, accounting for 63% of abortions in the formal healthcare system.
In Iowa, state guidance says physicians must comply with informed-consent requirements, including ultrasound-related provisions, and the fetal heartbeat law signed in 2023 prohibits certain abortions once a fetal heartbeat is detected, with exceptions described in the guidance.
Jim Thomas ✉
Jim Thomas is a writer based in Indiana. He holds a bachelor's degree in Political Science, a law degree from U.I.C. Law School, and has practiced law for more than 20 years.
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