A bill that aims to crack down on out-of-state providers who mail abortion pills to Iowans was advanced Monday by Republicans on a Senate panel.
The bill (SSB 3115) would require providers to only dispense abortion-inducing drugs directly to the patient in a health care setting. Providers who violate that could be sued by a person who took abortion pills, the father of their child or the pregnant person’s immediate family members.
Maggie DeWitte, executive director of Pulse Life Advocates, supports the bill.
“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,” she said. “This bill would restore some of the initial safeguards, such as an in-person, physical examination by a physician.”
Dane Schumann, a lobbyist for the American College of Obstetricians and Gynecologists (ACOG), said the bill would put new restrictions on Iowa doctors who follow the law, and “black market” medication abortions would continue.
“The irony of that is that, I think if this bill were to pass, that would be the only source for people to obtain these drugs, rather than through the legitimate physicians that are practicing in the state,” he said.
Sen. Jason Schultz, R-Schleswig, chaired the subcommittee and said he is working on an amendment to the bill. He said he does not want the bill to affect licensed Iowa doctors. Rather, he wants to target “black market” abortion pills.
“These drugs are dangerous and need to be handled in person by medical professionals,” Schultz said.
The U.S. Food and Drug Administration has approved a two-drug regimen of mifepristone and misoprostol for medication abortions in early pregnancy.
In Iowa, most abortions of any kind are banned after cardiac activity is detected, which can be as early as six weeks into a pregnancy. In-state dispensing of abortion pills is highly regulated, with patients required to have an ultrasound at least 24 hours before receiving abortion-inducing drugs.
Out-of-state providers can circumvent Iowa’s abortion restrictions and send pills to pregnant Iowans after cardiac activity is detectable. Six U.S.-based online clinics with providers licensed in other states mail abortion pills to Iowans, according to Plan C. There are also other organizations that sell abortion pills to Iowans without any medical support.
Abortion pills are typically mailed from states that have “shield laws,” which protect abortion providers from being sued by people in other states. Schultz said medical providers in those states likely couldn’t be sued under the proposal advancing in the Senate unless abortion shield laws are eventually overturned.
Schultz did not directly say if he wanted the bill to also apply to in-state telehealth providers.
Bill would require information about medication abortion “reversal”
Under the bill, doctors would have a new list of additional information they would have to provide to patients seeking to terminate their pregnancy with abortion pills. They would have to tell patients, "It may be possible to reverse the intended effects of a chemical abortion, but time is of the essence.” Hospitals would also have to report medication abortion complications to the state.
Dr. Francesca Turner, legislative chair of ACOG’s Iowa section, said the only randomized controlled trial studying abortion “reversal” was stopped early because of patient harm.
“Medication abortion reversal is not supported by medical evidence and raises significant safety concerns,” she said. “This bill would force physicians to offer information that is not evidence-based and conflicts with accepted medical standards.”
Seth Brown, a lobbyist for the Iowa Medical Society, echoed those concerns. He said doctors could either face legal consequences for not making required statements about abortion reversal or be sued for medical malpractice if they give medically unproven advice.
“So it’s a bit of a lose-lose from the physician standpoint,” Brown said.
Representatives of anti-abortion groups said some medication abortions have been reversed, and patients should be informed of all their options and all the risks associated with abortion pills.
“They should know that an incomplete abortion is a very real possibility,” said Josiah Oleson, lobbyist for The Family Leader. “They should know, in case they change their mind, that hundreds of women have their babies today because a doctor helped them reverse the effects of abortion drugs.”
Schultz said the Senate Judiciary Committee would likely consider the bill next week with an amendment.
