116 3rd St SE
Cedar Rapids, Iowa 52401
Bill advanced by Iowa lawmakers would require in-person doctor visits for medication abortion
Another bill, introduced last week, would make getting an abortion a crime
The Gazette offers audio versions of articles using Instaread. Some words may be mispronounced.
DES MOINES — Iowans seeking to access abortion pills in the state would be required to have an in-person visit with a health care provider under a bill advancing in the Iowa Senate, as other Republican-led states also attempt to place restrictions on medication abortions.
State Senate lawmakers considered the bill, Senate Study Bill 3115, on the same day that anti-abortion advocates flooded the Iowa Capitol to push lawmakers to abolish abortion in the state after Republican Rep. Zach Dieken, of Granville, introduced a bill that would make abortion illegal.
The advocates could be heard cheering and singing in the rotunda during the subcommittee meeting on Monday.
The bill placing restrictions on medication abortion advanced 2-1, with Republican Sens. Jason Schultz, of Schleswig, and Cherielynn Westrich, of Ottumwa, signing on to move it forward and Democratic Sen. Janice Weiner, of Iowa City, declining to do so.
Schultz, who chaired the subcommittee and chairs the Iowa Senate Judiciary Committee, said the increase in abortion pills coming to Iowa from out of state motivated him to take up the legislation, which he argues will protect women and prevent Iowans from receiving “black market, unprescribed pharmaceuticals.”
“A licensed facility handling (abortion pill prescriptions) bothers me less than somebody — an activist in another state — who is just trying to pump out as many of these drugs for political reasons as they can,” Shultz told reporters after the subcommittee. “I want a real health care provider who is available for after care, who's reachable.”
Since a law restricting most abortions in Iowa — once a fetus’ heartbeat can be detected, generally around six weeks — went into effect in 2024, the number of Iowans accessing medication pills by mail has increased. This includes mifepristone, a medication used within the first 10 weeks of pregnancy that blocks the progesterone hormone, which is needed for a pregnancy to continue.
This matches the national uptick in medication abortions following the Supreme Court's Dobbs decision in 2022, overturning Roe v. Wade. Medication abortions made up 63 percent of all abortions in the country in 2023, compared to 53 percent in 2020, according to the Guttmacher Institute, a nonprofit that supports abortion rights.
Along with requiring in-person visits with health care providers to receive the abortion pill, the bill would also:
- Require the person being prescribed the drug to sign a form confirming that they have been informed of specific health and safety information about the pill, including the gestational age-specific risks of abortion-inducing drugs, the risks related to the specific abortion-inducing drugs; and that women using abortion-inducing drugs have “suffered trauma from seeing the remains of the unborn child in the process of a chemical abortion and that it may be possible to reverse the intended effects of a chemical abortion.”
- Require a screening of the patient to determine signs of coercion or abuse.
- Create a civil liability for physicians who don’t inform patients how to access emergency surgical intervention in cases of an incomplete abortion, severe bleeding or other medical complications and provide information on certain health and safety risks caused by taking the medication.
- Require the Iowa Department of Health and Human Services to publish a notice on its website stating that it may be possible to reverse the effects of a chemical abortion.
- Require hospitals and health care providers to file reports with HHS in cases where patients are treated for abortion-drug-related complications, including their state and county, age, when they took the pill, and “probable post-fertilization age of the unborn child” at the time of the complication. The report must also identify the physician who performed the chemical abortion.
- Require HHS to produce an annual statistical report on complications resulting from chemical abortions using the anonymized data collected from the required reports.
- Create a private cause of action against anyone who violates the bill’s dispensing requirements for the person who received the chemical abortion, the biological father of the unborn child, or the grandparent, parent, sibling, child, legal guardian or conservator of the person who received the chemical abortion. The person who brings the private cause of action is entitled to $50,000 in statutory damages alongside punitive and compensatory damages.
Weiner said access to medication abortion via telehealth is a “lifeline” for women at high risk of domestic violence. When knocking on doors last year, she said she learned Iowans are most concerned about affordability and access to health care, not restricting the abortion pill.
“This isn't about safety. It's about making it even harder for women in Iowa to get health care,” Weiner said. ”We are not Texas. We are Iowa, and in Iowa, we believe in science, we believe in helping our neighbors, and we believe in staying out of their business.”
Health care providers concerned about ‘inaccurate’ bill language
Representatives for health care provider organizations and physicians argued the Senate bill would further restrict access to abortions and reproductive health care in rural Iowa, take away agency from patients, and force physicians to act against medical standards.
Teresa Fuller, who practices family medicine in rural Iowa, said removing the option for prescribing abortion pills via telehealth would exacerbate the health care access gap in rural Iowa and ruin trust between physicians and patients by reporting adverse effects and disclosing inaccurate medical information to them.
“I took an oath to first do no harm, and I think lying to my patients does immense harm,” Fuller said.
Francesca Turner, legislative chair for the American College of Obstetricians and Gynecologists, said the bill’s “vague and medically inaccurate” language would confuse both patients and providers. She added that promoting medication abortion reversal, which she said is not supported by medical evidence, conflicts with accepted medical standards.
The FDA has found that performing abortions using mifepristone followed by misoprostol is safe and effective.
During the subcommittee, multiple supporters of the bill cited a recently published study from the right-leaning think tank Ethics and Public Policy Center stating 1 in 10 women experience adverse effects after taking the abortion pill. The study, released in 2025, has not been peer-reviewed nor was it published in a medical journal. Reproductive rights advocates have criticized it, arguing it's not supported by science.
Westrich and Shultz said they would like to examine the accuracy of the adverse effects and health implications of the abortion pill that the bill requires health care providers to disclose to patients.
"I don't think this is going to change availability. I think it will regulate it in a way where we're not going to have those bad actors …,” Westrich said. “Informed consent is very important. And we don't want any unintended consequences so I do look forward to hearing from those folks that are going to be dealing with this hands-on.”
Shultz told reporters he was not aware of the source of information about the adverse effects or potential risks of medication abortion stated in the bill.
Anti-abortion activists say guardrails needed for 'dangerous' medication
Briana Neuvirth said she regrets the chemical abortion she got 16 years ago after not being accurately advised on the side effects and potential impacts. She said the Senate bill’s requirements around obtaining it in the state would stop this from happening to other Iowans.
“I honestly thought that I was dying that night. It was a terrifying experience, and I was all alone throughout the whole process,” Neuvirth said. “The physical recovery was long. It took two months for the bleeding to stop.”
Other anti-abortion advocates have been rallying around restricting the abortion pill, including during the Iowa March for Life last June. During the event, the leader of the anti-abortion advocacy group Pulse Life Advocates, Maggie DeWitte, said the group was teeing up legislation to place “guardrails” on medication abortion in the state.
The Senate bill shared similarities with the group’s proposed legislation.
During the subcommittee, DeWitte said multiple in-person visits were required when the medication was first introduced over two decades ago and said the legislation would restore prior “safeguards.”
“Now, this drug has virtually no restrictions, can be shipped through the mail directly to the woman's home with no oversight or physical examination from a doctor,” DeWitte said.
Due to shield laws in other states, which allow health care providers to prescribe mifepristone to patients in other states, any law passed in Iowa would have a limited impact unless the federal government takes action on the issue.
Last year, anti-abortion groups denounced the U.S. Food and Drug Administration’s approval of a generic abortion pill ahead of the government shutdown in October. Now, they are calling on the Trump administration to establish “reasonable rules” around the distribution of the abortion pill, similar to its actions during President Donald Trump’s first term in office.
In the meantime, attorneys general in six Republican-led states are attempting to curb the flow of mifepristone into their states by bringing lawsuits against doctors in other states prescribing the drug, according to Reuters.
Shultz told reporters that the bill would be most effective if the U.S. Supreme Court were to strike down these shield laws.
House bill would make getting an abortion a crime
Last week, Dieken introduced a bill, House File 2316 that would consider abortions to be homicide under Iowa law.
The legislation would amend Iowa code to include the death of an “unborn child” to be eligible for damages for the wrongful death of a child. The bill includes exceptions for miscarriages or lifesaving procedures conducted to save the life of the mother or the child.
“Abortion is child sacrifice. We must not be comfortable with it. We are a pro-life state. I believe that many of us are pro-life in this room and love children,” Dieken said during remarks on the Iowa House floor Monday afternoon. “Don't doubt that at all, but we have the majority. We have a pro-life Republican governor, and yet it's still legal to kill children in our state.”
Dieken told the Gazette-Lee Des Moines Bureau that he ran for office four years ago with the goal of abolishing abortion.
Republican Rep. Steve Holt, who chairs the House Judiciary Committee and assigns bills to subcommittees, told the Gazette-Lee Des Moines Bureau he still is considering whether to advance Dieken’s proposal, adding that his caucus is looking at other pro-life bills to put forward this session.
Holt said he has concerns about punishing women who get abortions under Dieken’s bill.
Daily Newsletters