I 

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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Heartbeat Informed 

5 Consent Act’’. 

6 SEC. 2. FINDINGS. 

7 The Congress finds as follows: 


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1 (1) The presence of a heartbeat in a woman’s 

2 unborn child will be a material consideration to 

3 many women contemplating abortion. 

4 (2) The presence of a heartbeat in a woman’s 

5 unborn child is a developmental fact that illustrates 

6 to the woman that her baby is already alive. 

7 (3) On about the 21st or 22nd day after fer8 tilization (which is about 5 weeks from the first day 

9 of the last menstrual period) the heart of an unborn 

10 child begins to beat. 

11 (4) The heartbeat of an unborn child can be 

12 visually detected at an early stage of pregnancy 

13 using an ultrasound machine, typically, at 4 to 4.5 

14 weeks after fertilization (6 to 6.5 weeks from the 

15 first day of the last menstrual period) on 

16 transvaginal ultrasound, and at 5.5 to 6 weeks after 

17 fertilization (7.5 to 8 weeks from the first day of the 

18 last menstrual period) on transabdominal 

19 ultrasound. 

20 (5) The heartbeat of an unborn child can be 

21 made audible at later stages, including by using a 

22 handheld Doppler fetal monitor. 

23 (6) Less than five percent of all natural preg24 nancies end in spontaneous miscarriage after detec25 tion of cardiac activity. A fetal heartbeat is therefore 


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1 a key medical indicator that an unborn child is likely 

2 to achieve the capacity for live birth. 

3 (7) The observation of a heartbeat in a wom4 an’s unborn child, when a heartbeat has been de5 tected, is an important component of full informed 

6 consent. 

7 (8) Ensuring full informed consent for an abor8 tion is imperative, because of the profound physical 

9 and psychological risks of an abortion. As the Su10 preme Court has observed, ‘‘[t]he medical, emo11 tional, and psychological consequences of an abortion 

12 are serious and can be lasting.’’ H.L. v. Matheson, 

13 450 U.S. 398, 411 (1981). The woman’s decision 

14 whether to abort ‘‘is an important, and often a 

15 stressful one, and it is desirable and imperative that 

16 it be made with full knowledge of its nature and 

17 consequences.’’ Planned Parenthood v. Danforth, 

18 428 U.S. 52, 67 (1976). ‘‘Whether to have an abor19 tion requires a difficult and painful moral decision,’’ 

20 in which ‘‘some women come to regret their choice 

21 to abort the infant life they once created and sus22 tained,’’ and ‘‘[s]evere depression and loss of esteem 

23 can follow . . . The State has an interest in ensur24 ing so grave a choice is well informed. It is self-evi25 dent that a mother who comes to regret her choice 


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1 to abort must struggle with grief more anguished 

2 and sorrow more profound when she learns, only 

3 after the event, what she once did not know . . .’’ 

4 Gonzales v. Carhart, 550 U.S. 124, 159–160 

5 (2007). 

6 (9) Requiring providers to give a woman an op7 portunity to observe her unborn child’s heartbeat is 

8 constitutionally permissible, and the ultrasound 

9 image of an unborn child is truthful, nonmisleading 

10 information. ‘‘In attempting to ensure that a woman 

11 apprehend the full consequences of her decision, the 

12 State furthers the legitimate purpose of reducing the 

13 risk that a woman may elect an abortion, only to 

14 discover later, with devastating psychological con15 sequences, that her decision was not fully informed. 

16 If the information the State requires to be made 

17 available to the woman is truthful and not mis18 leading, the requirement may be permissible.’’ 

19 (Opinion of O’Connor, Kennedy, and Souter, 

20 Planned Parenthood v. Casey, 505 U.S. 833, 882 

21 (1992)). 

22 (10) Further, recent research, taking into ac23 count 22 studies with control groups and more than 

24 877,000 women over a 14-year period, finds that 

25 women who have had an abortion have an 81 perVerDate Sep 11 2014 02:23 Sep 26, 2014 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H5551.IH H5551

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1 cent increased risk for mental health problems and 

2 10 percent of the mental health problems of women 

3 who have had an abortion are directly attributed to 

4 abortion. 

5 SEC. 3. AMENDMENT TO THE PUBLIC HEALTH SERVICE 

6 ACT. 

7 The Public Health Service Act (42 U.S.C. 201 et 

8 seq.) is amended by adding at the end the following: 

9 ‘‘TITLE XXXIV—INFORMED 

10 CONSENT 

11 ‘‘SEC. 3401. DEFINITIONS. 

12 ‘‘In this title: 

13 ‘‘(1) ABORTION.—The term ‘abortion’ means 

14 the intentional use or prescription of any instru15 ment, medicine, drug, or any other substance, de16 vice, or method to terminate the life of an unborn 

17 child, or to terminate the pregnancy of a woman 

18 known to be pregnant, with an intention other 

19 than— 

20 ‘‘(A) to produce a live birth and preserve 

21 the life and health of the child after live birth; 

22 or 

23 ‘‘(B) to remove an ectopic pregnancy, or to 

24 remove a dead unborn child who died as the re25 sult of a spontaneous abortion, accidental trauVerDate Sep 11 2014 02:23 Sep 26, 2014 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H5551.IH H5551

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1 ma, or a criminal assault on the pregnant fe2 male or her unborn child. 

3 ‘‘(2) ABORTION PROVIDER.—The term ‘abortion 

4 provider’ means any person legally qualified to per5 form an abortion under applicable Federal and State 

6 laws. 

7 ‘‘(3) EMBRYONIC OR FETAL HEARTBEAT.—The 

8 term ‘embryonic or fetal heartbeat’ means embryonic 

9 or fetal cardiac activity or the steady and repetitive 

10 rhythmic contraction of the embryonic or fetal heart. 

11 ‘‘(4) QUALIFIED AGENT.—The term ‘qualified 

12 agent’ means— 

13 ‘‘(A) a registered diagnostic medical 

14 sonographer who is certified in obstetrics and 

15 gynecology by the American Registry for Diag16 nostic Medical Sonography (ARDMS); 

17 ‘‘(B) a nurse midwife, or an advanced 

18 practice nurse practitioner in obstetrics, with 

19 certification in obstetrical ultrasonography; or 

20 ‘‘(C) any other agent of an abortion pro21 vider who has received training in obstetrical 

22 ultrasonography. 

23 ‘‘(5) UNBORN CHILD.—The term ‘unborn child’ 

24 means a member of the species homo sapiens, at any 

25 stage of development prior to birth. 


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1 ‘‘(6) UNEMANCIPATED MINOR.—The term 

2 ‘unemancipated minor’ means a minor who is sub3 ject to the control, authority, and supervision of his 

4 or her parents or guardians, as determined under 

5 the law of the State in which the minor resides. 

6 ‘‘(7) WOMAN.—The term ‘woman’ means a fe7 male human being whether or not she has reached 

8 the age of majority. 

9 ‘‘SEC. 3402. REQUIREMENT OF INFORMED CONSENT. 

10 ‘‘(a) REQUIREMENT OF COMPLIANCE BY PRO11 VIDERS.—Any abortion provider in or affecting interstate 

12 or foreign commerce, who knowingly performs any abor13 tion, shall comply with the requirements of this title. 

14 ‘‘(b) PERFORMANCE AND REVIEW OF

15 ULTRASOUND.— 

16 ‘‘(1) REQUIREMENT.—If an ultrasound is per17 formed on a woman by an abortion provider (or the 

18 provider’s agent) prior to having any part of an 

19 abortion performed, the abortion provider (acting di20 rectly or through the provider’s agent) shall— 

21 ‘‘(A) ensure that any agent of the provider 

22 performing the ultrasound is a qualified agent; 

23 ‘‘(B) during the performance of the 

24 ultrasound, display the ultrasound images (as 


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1 described in paragraph (2)) so that the preg2 nant woman may view the images; and 

3 ‘‘(C) provide a medical description of the 

4 ultrasound images of the unborn child’s cardiac 

5 activity, if present and viewable. 

6 ‘‘(2) QUALITY OF ULTRASOUND IMAGES.—To 

7 be displayed in accordance with paragraph (1)(B), 

8 ultrasound images shall— 

9 ‘‘(A) be of a quality consistent with stand10 ard medical practice; 

11 ‘‘(B) contain the dimensions of the unborn 

12 child; and 

13 ‘‘(C) accurately portray the presence of ex14 ternal members and internal organs, if present. 

15 ‘‘(3) VIEWING IMAGES AND LISTENING TO DE16 SCRIPTION.—This section may not be construed to 

17 be a requirement that the pregnant woman view the 

18 ultrasound images required to be displayed, or listen 

19 to the description of the images required to be given, 

20 by the provider or the provider’s agent pursuant to 

21 paragraph (1). 

22 ‘‘(c) AUDIBLE EMBRYONIC OR FETAL HEART23 BEAT.— 

24 ‘‘(1) REQUIREMENT.—Prior to a woman giving 

25 informed consent to having any part of an abortion 


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1 performed, if the pregnancy is at least 8 weeks after 

2 fertilization (10 weeks from the first day of the last 

3 menstrual period), the abortion provider (acting di4 rectly or through the provider’s employee) shall, 

5 using a hand-held Doppler fetal monitor, make the 

6 embryonic or fetal heartbeat of the unborn child au7 dible for the pregnant woman to hear. 

8 ‘‘(2) UNSUCCESSFUL ATTEMPTS AT DETECTING

9 HEARTBEAT.—An abortion provider (or the pro10 vider’s employee) shall not be in violation of para11 graph (1) if— 

12 ‘‘(A) the provider (acting directly or 

13 through the provider’s employee) has at14 tempted, consistent with standard medical prac15 tice, to make the embryonic or fetal heartbeat 

16 of the unborn child audible for the pregnant 

17 woman to hear using a hand-held Doppler fetal 

18 monitor; 

19 ‘‘(B) that attempt does not result in the 

20 heartbeat being made audible; and 

21 ‘‘(C) the provider has offered to attempt to 

22 make the heartbeat audible at a subsequent 

23 date. 

24 ‘‘(3) ABILITY TO NOT LISTEN.—Nothing in this 

25 section shall be construed to prevent the pregnant 


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1 woman from not listening to the sounds detected by 

2 the hand-held Doppler fetal monitor, pursuant to 

3 paragraph (1). 

4 ‘‘SEC. 3403. EXCEPTION FOR MEDICAL EMERGENCIES. 

5 ‘‘(a) EXCEPTION.—The provisions of section 3402 

6 shall not apply to an abortion provider in the case that 

7 the abortion is necessary to save the life of a mother whose 

8 life is endangered by a physical disorder, physical illness, 

9 or physical injury, including a life-endangering physical 

10 condition caused by or arising from the pregnancy itself. 

11 ‘‘(b) CERTIFICATION.— 

12 ‘‘(1) IN GENERAL.—Upon a determination by 

13 an abortion provider under subsection (a) that an 

14 abortion is necessary to save the life of a mother, 

15 such provider shall certify the specific medical condi16 tions that support such determination and include 

17 such certification in the medical file of the pregnant 

18 woman. The certification shall be kept by the abor19 tion provider for a period of not less than 5 years. 

20 If the female is a minor, then the certification shall 

21 be placed in the medical file of the minor and kept 

22 for at least 5 years after the minor reaches the age 

23 of majority. 

24 ‘‘(2) FALSE STATEMENTS.—An abortion pro25 vider who knowingly or recklessly falsifies a certifiVerDate Sep 11 2014 02:23 Sep 26, 2014 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H5551.IH H5551

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1 cation under paragraph (1) is deemed to have know2 ingly or recklessly failed to comply with this title for 

3 purposes of section 3404. 

4 ‘‘SEC. 3404. PENALTIES. 

5 ‘‘(a) IN GENERAL.—An abortion provider who know6 ingly or recklessly fails to comply with any provision of 

7 this title shall be subject to civil penalties in accordance 

8 with this section in an appropriate Federal court. 

9 ‘‘(b) COMMENCEMENT OF ACTION.—The Attorney 

10 General may commence a civil action under this section. 

11 ‘‘(c) FIRST OFFENSE.—Upon a finding by a court 

12 that a respondent in an action commenced under this sec13 tion has knowingly or recklessly violated a provision of this 

14 title, the court shall notify the appropriate State medical 

15 licensing authority and shall assess a civil penalty against 

16 the respondent in an amount not to exceed $100,000 for 

17 each such violation. 

18 ‘‘(d) SECOND AND SUBSEQUENT OFFENSES.—Upon 

19 a finding by a court that the respondent in an action com20 menced under this section has knowingly or recklessly vio21 lated a provision of this title, the court shall notify the 

22 appropriate State medical licensing authority and shall as23 sess a civil penalty against the respondent in an amount 

24 not to exceed $250,000 for each such violation if the re25 spondent has been found in a prior civil action to have 


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1 knowingly or recklessly committed another violation of a 

2 provision of this title. 

3 ‘‘(e) PRIVATE RIGHT OF ACTION.—A woman upon 

4 whom an abortion has been performed in violation of this 

5 title, or the parent or legal guardian of such a woman if 

6 she is an unemancipated minor, may commence a civil ac7 tion against the abortion provider for any knowing or reck8 less violation of this title for actual and punitive dam9 ages.’’. 

10 SEC. 4. PREEMPTION. 

11 Nothing in this Act or the amendments made by this 

12 Act shall be construed to preempt any provision of State 

13 law to the extent that such State law establishes, imple14 ments, or continues in effect greater disclosure require15 ments regarding abortion than those provided under this 

16 Act and the amendments made by this Act. 

17 SEC. 5. SEVERABILITY. 

18 If any provision of this Act, an amendment by this 

19 Act, or the application of such provision or amendment 

20 to any person or circumstance is held to be unconstitu21 tional, the remainder of this Act and the amendments 

22 made by this Act, and the application of the provisions 

23 of such remainder to any person or circumstance, shall 

24 not be affected thereby. 

Æ 


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