ministering such anesthesia or analgesic, if 
any, and the costs associated therewith. 
‘‘(iii) 
ADMINISTRATION
OF
ANES-
THESIA.—If the abortion provider is not 
qualified or willing to administer the anes-
thesia or other pain-reducing drug in re-
sponse to the request of a pregnant women 
after making the statement required under 
clause (i), the provider shall— 
‘‘(I) arrange for a qualified spe-
cialist to administer such anesthesia 
or drug; or 
‘‘(II) 
advise 
the 
pregnant 
woman— 
‘‘(aa) where she may obtain 
such anesthesia or other pain re-
ducing drugs for the unborn child 
in the course of an abortion; or 
‘‘(bb) that the abortion pro-
vider is unable to perform the 
abortion if the woman elects to 
receive anesthesia or other pain- 
reducing drug for her unborn 
child.
‘‘(iv) RULE
OF
CONSTRUCTION.— 
Nothing in this section may be construed 
to impede an abortion provider or the 
abortion provider’s agent from offering 
their own evaluation on the capacity of the 
unborn child to experience pain, the advis-
ability 
of 
administering 
pain-reducing 
drugs to the unborn child, or any other 
matter, as long as such provider or agent 
provides the required information, obtains 
the woman’s signature on the decision 
form, and otherwise complies with the af-
firmative requirements of the law. 
‘‘(B) UNBORN
CHILD
PAIN
AWARENESS 
BROCHURE.—An abortion provider to whom 
paragraph (1) applies shall provide the preg-
nant woman with the Unborn Child Pain 
Awareness Brochure (referred to in this section 
as the ‘Brochure’) to be developed by the De-
partment of Health and Human Services under 
subsection (c) or with the information described 
in subsection (c)(2) relating to accessing such 
Brochure. 
‘‘(C) UNBORN
CHILD
PAIN
AWARENESS 
DECISION
FORM.—An abortion provider to
which paragraph (1) applies shall provide the 
pregnant woman with the Unborn Child Pain 
Awareness Decision Form (provided for under 
subsection (c)) and obtain the appropriate sig-
nature of the woman on such form. 
‘‘(c) UNBORN
CHILD
PAIN
AWARENESS
BRO-
CHURE.— 
‘‘(1) DEVELOPMENT.—Not later than 90 days 
after the date of enactment of this title, the Sec-
retary shall develop an Unborn Child Pain Aware-
ness Brochure. Such Brochure shall be written in 
English and Spanish and shall contain the same in-
formation as required under the statement under 
subsection (b)(2)(A)(i), including greater detail on 
her option of having a pain-reducing drug or drugs 
administered to the unborn child to reduce the expe-
rience of pain by the unborn child during the abor-
tion. Such information shall be written in an objec-
tive and nonjudgmental manner and be printed in a 
typeface large enough to be clearly legible. The Bro-
chure shall be made available by the Secretary at no 
cost to any abortion provider. 
‘‘(2) INTERNET INFORMATION.—The Brochure 
under this section shall be available on the Internet 
website of the Department of Health and Human
Services at a minimum resolution of 70 DPI (dots 
per inch). All pictures appearing on the website shall 
be a minimum of 200x300 pixels. All letters on the 
website shall be a minimum of 12 point font. All 
such information and pictures shall be accessible 
with an industry standard browser, requiring no ad-
ditional plug-ins. 
‘‘(3) PRESENTATION OF BROCHURE.—An abor-
tion provider or his or her agent must offer to pro-
vide a pregnant woman with the Brochure, developed 
under paragraph (1), before any part of an abortion 
of a pain-capable child begins— 
‘‘(A) through an in-person visit by the 
pregnant woman; 
‘‘(B) through an e-mail attachment, from 
the abortion provider or his or her agent; or 
‘‘(C) through a request to have such Bro-
chure mailed, by certified mail, to the woman at 
least 72 hours before any part of the abortion 
begins. 
‘‘(4) WAIVER.—After the abortion provider or 
his or her agent offers to provide a pregnant woman 
the Brochure, a pregnant woman may waive receipt 
of the Brochure under this subsection by signing the
waiver form contained in the Unborn Child Pain 
Awareness Decision Form. 
‘‘(5) UNBORN CHILD PAIN AWARENESS DECI-
SION FORM.—Not later than 30 days after the date 
of enactment of this title, the Secretary shall develop 
an Unborn Child Pain Awareness Decision Form. 
To be valid, such Form shall— 
‘‘(A) 
with 
respect 
to 
the 
pregnant 
woman— 
‘‘(i) contain a statement that affirms 
that the woman has received or been of-
fered all of the information required in 
subsection (b); 
‘‘(ii) require the woman to explicitly 
either request or refuse the administration 
of pain-reducing drugs to the unborn child; 
‘‘(iii) be signed by a pregnant woman 
prior to the performance of an abortion in-
volving a pain-capable unborn child; and 
‘‘(B) with respect to the abortion pro-
vider— 
‘‘(i) contain a statement that the pro-
vider has provided the woman with all of 
the information required under subsection 
(b);
‘‘(ii) if applicable, contain a certifi-
cation by the provider that an exception 
described in section 2903 applies and the 
detailed reasons for such certification; and 
‘‘(iii) be signed by the provider prior 
to the performance of the abortion proce-
dure. 
‘‘(6) MAINTENANCE
OF
RECORDS.—The Sec-
retary shall promulgate regulations relating to the 
period of time during which copies of Forms under 
paragraph (5) shall be maintained by abortion pro-
viders. 
‘‘SEC. 2903. EXCEPTION FOR MEDICAL EMERGENCIES. 
‘‘(a) IN GENERAL.—The provisions of section 2902 
shall not apply to an abortion provider in the case of a 
medical emergency. 
‘‘(b) MEDICAL EMERGENCY DEFINED.— 
‘‘(1) IN GENERAL.—In subsection (a), the term 
‘medical emergency’ means a condition which, in the 
reasonable medical judgment of the abortion pro-
vider, so complicates the medical condition of the 
pregnant woman that a delay in commencing an 
abortion procedure would impose a serious risk of 
causing grave and irreversible physical health dam-
age entailing substantial impairment of a major bod-
ily function. 
‘‘(2) REASONABLE
MEDICAL
JUDGMENT.—In 
paragraph (1), the term ‘reasonable medical judg-
ment’ means a medical judgment that would be 
made by a reasonably prudent physician, knowledge-
able about the case and the treatment possibilities 
with respect to the medical conditions involved. 
‘‘(c) CERTIFICATION.— 
‘‘(1) IN GENERAL.—Upon a determination by 
an abortion provider under subsection (a) that a 
medical emergency exists with respect to a pregnant 
woman, such provider shall certify the specific med-
ical conditions that constitute the emergency. 
‘‘(2) FALSE
STATEMENTS.—An abortion pro-
vider who willfully falsifies a certification under 
paragraph (1) shall be subject to all the penalties 
provided for under section 2904 for failure to com-
ply with this title. 
‘‘SEC. 2904. PENALTIES FOR FAILURE TO COMPLY. 
‘‘(a) IN GENERAL.—An abortion provider who will-
fully fails to comply with the provisions 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, the Deputy Attorney General, the Associate At-
torney General, or any Assistant Attorney General or 
United States Attorney who has been specifically des-
ignated by the Attorney General may commence a civil ac-
tion under this section. 
‘‘(c) CERTIFICATION REQUIREMENTS.—At the time 
of the commencement of an action under this section, the 
Attorney General, the Deputy Attorney General, the Asso-
ciate Attorney General, or any Assistant Attorney General 
or United States Attorney who has been specifically des-
ignated by the Attorney General to commence a civil ac-
tion under this section, shall certify to the court involved 
that, at least 30 calendar days prior to the filing of such 
action, the Attorney General, the Deputy Attorney Gen-
eral, the Associate Attorney General, or any Assistant At-
torney General or United States Attorney involved— 
‘‘(1) has provided notice of the alleged violation 
of this section, in writing, to the Governor or Chief 
Executive Officer and Attorney General or Chief 
Legal Officer of the State or political subdivision in-
volved, as well as to the State medical licensing 
board or other appropriate State agency; and
‘‘(2) believes that such an action by the United 
States is in the public interest and necessary to se-
cure substantial justice. 
‘‘(d) FIRST OFFENSE.—Upon a finding by a court 
that a respondent in an action commenced under this sec-
tion has knowingly violated a provision of this title, the 
court shall notify the appropriate State medical licensing 
authority in order to effect the suspension of the respond-
ent’s medical license in accordance with the regulations 
and procedures promulgated under section 2905, or shall 
assess a civil penalty against the respondent in an amount 
not to exceed $100,000, or both. 
‘‘(e) SECOND OFFENSE.—Upon a finding by a court 
that the respondent in an action commenced under this 
section has knowingly violated a provision of this title and 
the respondent has been found to have knowingly violated 
a provision of this title on a prior occasion, the court shall 
notify the appropriate State medical licensing authority in 
order to effect the revocation of the respondent’s medical 
license in accordance with the regulations and procedures 
promulgated under section 2905, or shall assess a civil 
penalty against the respondent in an amount not to exceed 
$250,000, or both. 
‘‘(f) HEARING.—With respect to an action under this 
section, the appropriate State medical licensing authority
shall be given notification of and an opportunity to be 
heard at a hearing to determine the penalty to be imposed 
under this section. 
‘‘(g) PRIVATE
RIGHT
OF
ACTION.—A pregnant 
woman upon whom an abortion has been performed in vio-
lation of this title, or the parent or legal guardian of such 
a woman if she is an unemancipated minor, may com-
mence a civil action against the abortion provider for any 
knowing or reckless violation of this title for actual and 
punitive damages. 
‘‘SEC. 2905. REGULATIONS. 
‘‘A State, and the medical licensing authority of the 
State, shall promulgate regulations and procedures for the 
revocation or suspension of the medical license of an abor-
tion provider upon a finding by a court under section 2904 
that the provider has violated a provision of this title. A 
State that fails to implement such procedures shall be sub-
ject to loss of funding under title XIX of the Social Secu-
rity Act (42 U.S.C. 1396 et seq.).’’. 
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, imple-
ments, or continues in effect greater protections for un-