```

[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5551 Introduced in House (IH)]

113th CONGRESS
  2d Session
                                H. R. 5551

 To ensure that women seeking an abortion receive an ultrasound and an 
opportunity to review the ultrasound before giving informed consent to 
                          receive an abortion.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                           September 18, 2014

Mrs. Bachmann (for herself, Mr. Huelskamp, Mr. Harris, Mr. Pearce, Mr. 
    Brady of Texas, Mr. Pitts, Mr. Long, Mr. Gibbs, Mr. Huizenga of 
Michigan, Mr. Latta, and Mr. Johnson of Ohio) introduced the following 
    bill; which was referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL

 
 To ensure that women seeking an abortion receive an ultrasound and an 
opportunity to review the ultrasound before giving informed consent to 
                          receive an abortion.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Heartbeat Informed Consent Act''.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) The presence of a heartbeat in a woman's unborn child 
        will be a material consideration to many women contemplating 
        abortion.
            (2) The presence of a heartbeat in a woman's unborn child 
        is a developmental fact that illustrates to the woman that her 
        baby is already alive.
            (3) On about the 21st or 22nd day after fertilization 
        (which is about 5 weeks from the first day of the last 
        menstrual period) the heart of an unborn child begins to beat.
            (4) The heartbeat of an unborn child can be visually 
        detected at an early stage of pregnancy using an ultrasound 
        machine, typically, at 4 to 4.5 weeks after fertilization (6 to 
        6.5 weeks from the first day of the last menstrual period) on 
        transvaginal ultrasound, and at 5.5 to 6 weeks after 
        fertilization (7.5 to 8 weeks from the first day of the last 
        menstrual period) on transabdominal ultrasound.
            (5) The heartbeat of an unborn child can be made audible at 
        later stages, including by using a handheld Doppler fetal 
        monitor.
            (6) Less than five percent of all natural pregnancies end 
        in spontaneous miscarriage after detection of cardiac activity. 
        A fetal heartbeat is therefore a key medical indicator that an 
        unborn child is likely to achieve the capacity for live birth.
            (7) The observation of a heartbeat in a woman's unborn 
        child, when a heartbeat has been detected, is an important 
        component of full informed consent.
            (8) Ensuring full informed consent for an abortion is 
        imperative, because of the profound physical and psychological 
        risks of an abortion. As the Supreme Court has observed, 
        ``[t]he medical, emotional, and psychological consequences of 
        an abortion are serious and can be lasting.'' H.L. v. Matheson, 
        450 U.S. 398, 411 (1981). The woman's decision whether to abort 
        ``is an important, and often a stressful one, and it is 
        desirable and imperative that it be made with full knowledge of 
        its nature and consequences.'' Planned Parenthood v. Danforth, 
        428 U.S. 52, 67 (1976). ``Whether to have an abortion requires 
        a difficult and painful moral decision,'' in which ``some women 
        come to regret their choice to abort the infant life they once 
        created and sustained,'' and ``[s]evere depression and loss of 
        esteem can follow . . . The State has an interest in ensuring 
        so grave a choice is well informed. It is self-evident that a 
        mother who comes to regret her choice to abort must struggle 
        with grief more anguished and sorrow more profound when she 
        learns, only after the event, what she once did not know . . 
        .'' Gonzales v. Carhart, 550 U.S. 124, 159-160 (2007).
            (9) Requiring providers to give a woman an opportunity to 
        observe her unborn child's heartbeat is constitutionally 
        permissible, and the ultrasound image of an unborn child is 
        truthful, nonmisleading information. ``In attempting to ensure 
        that a woman apprehend the full consequences of her decision, 
        the State furthers the legitimate purpose of reducing the risk 
        that a woman may elect an abortion, only to discover later, 
        with devastating psychological consequences, that her decision 
        was not fully informed. If the information the State requires 
        to be made available to the woman is truthful and not 
        misleading, the requirement may be permissible.'' (Opinion of 
        O'Connor, Kennedy, and Souter, Planned Parenthood v. Casey, 505 
        U.S. 833, 882 (1992)).
            (10) Further, recent research, taking into account 22 
        studies with control groups and more than 877,000 women over a 
        14-year period, finds that women who have had an abortion have 
        an 81 percent increased risk for mental health problems and 10 
        percent of the mental health problems of women who have had an 
        abortion are directly attributed to abortion.

SEC. 3. AMENDMENT TO THE PUBLIC HEALTH SERVICE ACT.

    The Public Health Service Act (42 U.S.C. 201 et seq.) is amended by 
adding at the end the following:

                    ``TITLE XXXIV--INFORMED CONSENT

``SEC. 3401. DEFINITIONS.

    ``In this title:
            ``(1) Abortion.--The term `abortion' means the intentional 
        use or prescription of any instrument, medicine, drug, or any 
        other substance, device, or method to terminate the life of an 
        unborn child, or to terminate the pregnancy of a woman known to 
        be pregnant, with an intention other than--
                    ``(A) to produce a live birth and preserve the life 
                and health of the child after live birth; or
                    ``(B) to remove an ectopic pregnancy, or to remove 
                a dead unborn child who died as the result of a 
                spontaneous abortion, accidental trauma, or a criminal 
                assault on the pregnant female or her unborn child.
            ``(2) Abortion provider.--The term `abortion provider' 
        means any person legally qualified to perform an abortion under 
        applicable Federal and State laws.
            ``(3) Embryonic or fetal heartbeat.--The term `embryonic or 
        fetal heartbeat' means embryonic or fetal cardiac activity or 
        the steady and repetitive rhythmic contraction of the embryonic 
        or fetal heart.
            ``(4) Qualified agent.--The term `qualified agent' means--
                    ``(A) a registered diagnostic medical sonographer 
                who is certified in obstetrics and gynecology by the 
                American Registry for Diagnostic Medical Sonography 
                (ARDMS);
                    ``(B) a nurse midwife, or an advanced practice 
                nurse practitioner in obstetrics, with certification in 
                obstetrical ultrasonography; or
                    ``(C) any other agent of an abortion provider who 
                has received training in obstetrical ultrasonography.
            ``(5) Unborn child.--The term `unborn child' means a member 
        of the species homo sapiens, at any stage of development prior 
        to birth.
            ``(6) Unemancipated minor.--The term `unemancipated minor' 
        means a minor who is subject to the control, authority, and 
        supervision of his or her parents or guardians, as determined 
        under the law of the State in which the minor resides.
            ``(7) Woman.--The term `woman' means a female human being 
        whether or not she has reached the age of majority.

``SEC. 3402. REQUIREMENT OF INFORMED CONSENT.

    ``(a) Requirement of Compliance by Providers.--Any abortion 
provider in or affecting interstate or foreign commerce, who knowingly 
performs any abortion, shall comply with the requirements of this 
title.
    ``(b) Performance and Review of Ultrasound.--
            ``(1) Requirement.--If an ultrasound is performed on a 
        woman by an abortion provider (or the provider's agent) prior 
        to having any part of an abortion performed, the abortion 
        provider (acting directly or through the provider's agent) 
        shall--
                    ``(A) ensure that any agent of the provider 
                performing the ultrasound is a qualified agent;
                    ``(B) during the performance of the ultrasound, 
                display the ultrasound images (as described in 
                paragraph (2)) so that the pregnant woman may view the 
                images; and
                    ``(C) provide a medical description of the 
                ultrasound images of the unborn child's cardiac 
                activity, if present and viewable.
            ``(2) Quality of ultrasound images.--To be displayed in 
        accordance with paragraph (1)(B), ultrasound images shall--
                    ``(A) be of a quality consistent with standard 
                medical practice;
                    ``(B) contain the dimensions of the unborn child; 
                and
                    ``(C) accurately portray the presence of external 
                members and internal organs, if present.
            ``(3) Viewing images and listening to description.--This 
        section may not be construed to be a requirement that the 
        pregnant woman view the ultrasound images required to be 
        displayed, or listen to the description of the images required 
        to be given, by the provider or the provider's agent pursuant 
        to paragraph (1).
    ``(c) Audible Embryonic or Fetal Heartbeat.--
            ``(1) Requirement.--Prior to a woman giving informed 
        consent to having any part of an abortion performed, if the 
        pregnancy is at least 8 weeks after fertilization (10 weeks 
        from the first day of the last menstrual period), the abortion 
        provider (acting directly or through the provider's employee) 
        shall, using a hand-held Doppler fetal monitor, make the 
        embryonic or fetal heartbeat of the unborn child audible for 
        the pregnant woman to hear.
            ``(2) Unsuccessful attempts at detecting heartbeat.--An 
        abortion provider (or the provider's employee) shall not be in 
        violation of paragraph (1) if--
                    ``(A) the provider (acting directly or through the 
                provider's employee) has attempted, consistent with 
                standard medical practice, to make the embryonic or 
                fetal heartbeat of the unborn child audible for the 
                pregnant woman to hear using a hand-held Doppler fetal 
                monitor;
                    ``(B) that attempt does not result in the heartbeat 
                being made audible; and
                    ``(C) the provider has offered to attempt to make 
                the heartbeat audible at a subsequent date.
            ``(3) Ability to not listen.--Nothing in this section shall 
        be construed to prevent the pregnant woman from not listening 
        to the sounds detected by the hand-held Doppler fetal monitor, 
        pursuant to paragraph (1).

``SEC. 3403. EXCEPTION FOR MEDICAL EMERGENCIES.

    ``(a) Exception.--The provisions of section 3402 shall not apply to 
an abortion provider in the case that the abortion is necessary to save 
the life of a mother whose life is endangered by a physical disorder, 
physical illness, or physical injury, including a life-endangering 
physical condition caused by or arising from the pregnancy itself.
    ``(b) Certification.--
            ``(1) In general.--Upon a determination by an abortion 
        provider under subsection (a) that an abortion is necessary to 
        save the life of a mother, such provider shall certify the 
        specific medical conditions that support such determination and 
        include such certification in the medical file of the pregnant 
        woman. The certification shall be kept by the abortion provider 
        for a period of not less than 5 years. If the female is a 
        minor, then the certification shall be placed in the medical 
        file of the minor and kept for at least 5 years after the minor 
        reaches the age of majority.
            ``(2) False statements.--An abortion provider who knowingly 
        or recklessly falsifies a certification under paragraph (1) is 
        deemed to have knowingly or recklessly failed to comply with 
        this title for purposes of section 3404.

``SEC. 3404. PENALTIES.

    ``(a) In General.--An abortion provider who knowingly or recklessly 
fails to comply with any provision of this title shall be subject to 
civil penalties in accordance with this section in an appropriate 
Federal court.
    ``(b) Commencement of Action.--The Attorney General may commence a 
civil action under this section.
    ``(c) First Offense.--Upon a finding by a court that a respondent 
in an action commenced under this section has knowingly or recklessly 
violated a provision of this title, the court shall notify the 
appropriate State medical licensing authority and shall assess a civil 
penalty against the respondent in an amount not to exceed $100,000 for 
each such violation.
    ``(d) Second and Subsequent Offenses.--Upon a finding by a court 
that the respondent in an action commenced under this section has 
knowingly or recklessly violated a provision of this title, the court 
shall notify the appropriate State medical licensing authority and 
shall assess a civil penalty against the respondent in an amount not to 
exceed $250,000 for each such violation if the respondent has been 
found in a prior civil action to have knowingly or recklessly committed 
another violation of a provision of this title.
    ``(e) Private Right of Action.--A woman upon whom an abortion has 
been performed in violation of this title, or the parent or legal 
guardian of such a woman if she is an unemancipated minor, may commence 
a civil action against the abortion provider for any knowing or 
reckless violation of this title for actual and punitive damages.''.

SEC. 4. PREEMPTION.

    Nothing in this Act or the amendments made by this Act shall be 
construed to preempt any provision of State law to the extent that such 
State law establishes, implements, or continues in effect greater 
disclosure requirements regarding abortion than those provided under 
this Act and the amendments made by this Act.

SEC. 5. SEVERABILITY.

    If any provision of this Act, an amendment by this Act, or the 
application of such provision or amendment to any person or 
circumstance is held to be unconstitutional, the remainder of this Act 
and the amendments made by this Act, and the application of the 
provisions of such remainder to any person or circumstance, shall not 
be affected thereby.
                                 <all>
```