Iowa doctors criticize proposed rules for abortion restrictions

DES MOINES — It’s being proposed that doctors in Iowa would be required to ask multiple questions of rape and incest victims and document their answers before performing an abortion if a woman is more than six weeks pregnant.

That requirement is among the rules being proposed for implementing Iowa’s new abortion law, which would make abortion illegal once a fetus’ heartbeat can be detected, generally around six weeks. The new law includes an exception under which a woman can have an abortion beyond that six-week mark if her pregnancy is the result of rape or incest.

The “fetal heartbeat” law approved by statehouse Republicans is being challenged before the Iowa Supreme Court. For now, abortion in Iowa remains legal through 20 weeks of pregnancy.

If the new law survives that legal challenge, the Iowa Board of Medicine is required by law to adopt rules to govern implementation of the law. The state medicine board rules would go into effect at the same time as the law.

Under the proposed rules, when a patient claims to be the victim of rape and asks a physician for an abortion, the physician must ask on what date the rape occurred, how old the patient was at the time of the alleged rape, and when the patient reported the alleged rape to law enforcement or another health agency — if it was reported.

The physician is to record that information in the patient’s medical files and determine “whether the fetal heartbeat exception for rape applies.”

The law and proposed rules require similar fact-finding efforts by physicians in cases of incest.

‘Trust the doctors’

On Friday, a state medicine board member asked how a physician determines whether a patient has been raped.

An attorney for the Iowa Attorney General’s Office said that under the proposed rules, the physician is required to make that decision.

The new law “does require the doctor to make that determination, and it does so by setting forth the information that the doctor must gather,” Deputy Attorney General Leif Olson told the board.

“It doesn’t specify precisely the questions that have to be asked,” Olson said. “… It’s up to the doctor to determine which questions to ask to get to the right answer. And we trust the doctors using their professional judgment to know … how to elicit information from a patient to get to the root of a problem.”

Olson previously worked in the Texas Attorney General’s Office and former President Donald Trump’s labor department.

Doctors as investigators

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During the public comment period, Dr. Francesca Turner, an obstetrician/gynecologist in Des Moines, said the proposed rule “states that physicians must not only interpret the legal statutes regarding rape and incest, but also ask for facts surrounding the timing of events, such as the occurrence, the reporting, the individuals responsible and their familial relationship to the patient.”

“None of this information is necessary to provide medical care and abortion.”

Turner’s statement was signed by 100 Iowa physicians.

Dr. Deborah Ann Turner, an obstetrician/gynecologist in Des Moines and recent president of the League of Women Voters of the United States, said, “It is clear that these rules are written to assure that most women, and those who can become pregnant, and certainly girls who are a victim of incest or rape, are prevented from access to abortion and choice.”

Doctors also note it can be difficult for victims to recount the circumstances of traumatic events.

Medical experts, including the American College of Obstetricians and Gynecologists, say what’s detected at six weeks of pregnancy is not a heartbeat. Heartbeats, they says, cannot be detected until around 15 to 20 weeks of pregnancy.

Making the rules

The Iowa Board of Medicine on Friday voted to publish the proposed rules for public comment and will consider any feedback and discuss them at the board’s next meeting in December.

Per the normal process, the board has 180 days from when the law was signed to approve rules. That means the board has until Jan. 10 to approve new rules.

Iowa’s rule-making process provides standards and guidelines to assist with the implementation of new state laws. While legislators and the governor pass laws, state boards populated by governor appointees approve the rules that say how the law will be implemented.

Olson said the proposed rules for new abortion restrictions in Iowa were drafted by staffers from the state medicine board, the attorney general’s office, Health and Human Services Department and the Department of Inspections and Appeals.

Comments: (515) 355-1300, erin.murphy@thegazette.com