House Amendment 784
S 474 - Session 125 (2023-2024)
Abortion - Fetal Heartbeat

Reps. King and Bamberg propose the following amendment (LC-474.HDB0188H):

Amend the bill, as and if amended, SECTION 1, by striking Section 44-41-610(9) and inserting:

(9) " PhysicianTrained healthcare provider" means any a person licensed to practice medicine and surgery, or osteopathic medicine and surgery, in this State.

Amend the bill further, SECTION 1, by striking Section 44-41-610(10)(12) and inserting:

 (10)(12) "Reasonable medical judgment" means a medical judgment that would be made by a reasonably prudent physician trained healthcare provider who is knowledgeable about the case and the treatment possibilities with respect to the medical conditions involved.

Amend the bill further, SECTION 1, by striking Section 44-41-625(A) and inserting:

(A) A  trained healthcare provider may perform, induce, or attempt to perform or induce an abortion on a minor who successfully petitions the court for an order granting her the right to obtain an abortion without the consent required in Section 44-41-31(1), and the probable gestational age of the unborn child is not more than twelve weeks, or upon the final disposition of the petition, whichever occurs later.

(B) A  trained healthcare provider may perform, induce, or attempt to perform or induce an abortion on a minor upon receiving consent that is obtained in accordance with Section 44-41-31(1), and the probable gestational age of the unborn child is not more than twelve weeks.

Amend the bill further, SECTION 1, by striking Section 44-41-630(A)(1) and inserting:

 (1) perform an obstetric ultrasound on the pregnant woman, using whichever method the  trained healthcare providerphysician or person and pregnant woman agree is best under the circumstances;

Amend the bill further, SECTION 1, by striking Section 44-41-640(B) and (C) and inserting:

(B) A trained healthcare provider may perform, induce, or attempt to perform or induce an abortion on a pregnant woman after the fetal heartbeat has been detected in accordance with Section 44-41-630 if: 

  (1) the pregnancy is the result of rape, and the probable gestational age of the unborn child is not more than twelve weeks; or

  (2) the pregnancy is the result of incest, and the probable gestational age of the unborn child is not more than twelve weeks.

(C) A trained healthcare provider who performs or induces an abortion on a pregnant woman based on an exception contained in subsection (B) must report the allegation of rape or incest to  the sheriff in the county in which the abortion was performed. The report must be made no later than twenty-four hours after performing or inducing the abortion, may be made orally or otherwise, and shall include the name and contact information of the pregnant woman making the allegation. Prior to performing or inducing an abortion, the trained healthcare provider who performs or induces an abortion based on an allegation of rape or incest must notify the pregnant woman that the trained healthcare provider will report the allegation of rape or incest to the sheriff. The trained healthcare provider shall make written notations in the pregnant woman's medical records that the abortion was performed pursuant to the applicable exception, that the doctor notified the sheriff of the allegation of rape or incest in a timely manner, and that the woman was notified prior to the abortion that the trained healthcare provider would notify the sheriff of the allegation of rape or incest.

Amend the bill further, SECTION 1, by striking Section 44-41-650(A) and (B) and inserting:

(A)  Except as provided in Section 44-41-660, no person shall perform, induce, or attempt to perform or induce an abortion on a pregnant woman before a physician determines in accordance with Section 44-41-630 whether the human fetus the pregnant woman is carrying has a detectable fetal heartbeat.It is not a violation of Section 44-41-640 if an abortion is performed or induced on a pregnant woman due to the existence of a fatal fetal anomaly. Section 44-41-630(B) does not apply to a trained healthcare provider or person who performs or induces an abortion if the trained healthcare provider or person determines according to standard medical practice that there exists a fatal fetal anomaly.

(B)  A person who violates subsection (A) is guilty of a felony and, upon conviction, must be fined ten thousand dollars, imprisoned not more than two years, or both.A trained healthcare provider or person who performs or induces an abortion based upon the existence of a fatal fetal anomaly shall make written notations in the pregnant woman's medical records of:

  (1) the presence of a fatal fetal anomaly;

  (2) the nature of the fatal fetal anomaly;

  (3) the medical rationale for making the determination that with or without the provision of life-preserving treatment life after birth would be unsustainable.

Amend the bill further, SECTION 1, by striking Section 44-41-660(A) and (B) and inserting:

(A)  It is not a violation of Section 44-41-640 if an abortion is performed or induced on a pregnant woman due to a medical emergency. Section 44-41-65044-41-630(B) does not apply to a physiciantrained healthcare provider or person who performs or induces an abortion if the physiciantrained healthcare provider or person determines according to standard medical practice that a medical emergency exists that prevents compliance with the section.

(B) A  physiciantrained healthcare provider or person who performs or induces an abortion on a pregnant woman based on the exception in subsection (A) shall make written notations in the pregnant woman's medical records of the following:

  (1) the physician'strained healthcare provider's or person's belief that a medical emergency necessitating the abortion existed;

  (2) the medical condition of the pregnant woman that assertedly prevented compliance with Section 44-41-65044-41-630(B); and

  (3) the medical rationale to support the physician'strained healthcare provider's or person's conclusion that the pregnant woman's medical condition necessitated the immediate abortion of her pregnancy to avert her deatha medical emergency necessitating the abortion existed.

Amend the bill further, SECTION 1, by striking Section 44-41-670(A), (B), and (C) and inserting:

(A) Section  44-41-68044-41-640 does not apply to a physiciantrained healthcare provider who performs a medical procedure that, by any in reasonable medical judgment, is designed or intended to prevent the death of the pregnant woman or to prevent the serious risk of a substantial and irreversible impairment of a major bodily function of the pregnant woman.

(B) A  physiciantrained healthcare provider who performs a medical procedure as described in subsection (A) shall declare, in a written document, that the medical procedure was necessary, by reasonable medical judgment, to prevent the death of the pregnant woman or to prevent the serious risk of a substantial and irreversible physical impairment of a major bodily function of the pregnant woman. In the document, the physiciantrained healthcare provider shall specify the pregnant woman's medical condition that the medical procedure was asserted to address and the medical rationale for the physician'strained healthcare provider's conclusion that the medical procedure was necessary to prevent the death of the pregnant woman or to prevent the serious risk of a substantial and irreversible impairment of a major bodily function of the pregnant woman.

(C) A  physiciantrained healthcare provider who performs a medical procedure as described in subsection (A) shall place the written document required by subsection (B) in the pregnant woman's medical records. For at least seven years from the date the document is created, the physicianowner of the pregnant woman's medical records shall maintain a copy record of the document in his own records.

Amend the bill further, SECTION 2.A., by striking Section 44-41-695(A) and inserting:

(A) Any abortion performed in this State must be reported by the licensed facility on the standard form for reporting abortions to the state registrar, Department of Health and Environmental Control, within seven days after the abortion is performed. The names of the patient and trained healthcare provider may not be reported on the form or otherwise disclosed to the state registrar. The form must indicate from whom consent was obtained, or circumstances waiving consent, and must include: 

  (1) Gestational age;

  (2) Method of abortion, of which the following was employed:

   (a) medication abortion such as, but not limited to, mifepristone/misoprostol or methotrexate/misoprostol;

   (b) manual vacuum aspiration;

   (c) electrical vacuum aspiration;

   (d) dilation and evacuation;

   (e) combined induction abortion and dilation and evacuation;

   (f) induction abortion with prostaglandins;

   (g) induction abortion with intra-amniotic instillation such as, but not limited to, saline or urea;

   (h) induction abortion; and

   (i) intact dilation and extraction (partial-birth);

  (3) Whether an intrafetal injection was used in an attempt to induce fetal demise such as, but not limited to, intrafetal potassium chloride or digoxin;

  (4) Age of the patient; and

  (5) If an exception under this article applies, the applicable exception.

Amend the bill further, SECTION 3, by striking Section 44-41-10(b) and inserting:

(b) " PhysicianTrained healthcare provider" means a person licensed to practice medicine in this State.