waiver form contained in the Unborn Child Pain 
Awareness Decision Form. 
‘‘(d) UNBORN CHILD PAIN AWARENESS DECISION 
FORM.—Not later than 30 days after the date of enact-
ment of this title, the Secretary shall develop an Unborn 
Child Pain Awareness Decision Form. To be valid, such 
form shall— 
‘‘(1) with respect to the pregnant woman— 
‘‘(A) contain a statement that affirms that 
the woman has received or been offered all of 
the information required in subsection (b); 
‘‘(B) affirm that the woman has read the 
following statement: ‘You are considering hav-
ing an abortion of an unborn child who will 
have developed, at the time of the abortion, ap-
proximately ll weeks after fertilization. 
There is a significant body of evidence that un-
born children at 20 weeks after fertilization 
have the physical structures necessary to expe-
rience pain. There is substantial evidence that 
at least by this point, unborn children draw 
away from surgical instruments in a manner 
which in an infant or an adult would be inter-
preted as a response to pain. There is substan-
tial evidence that the process of being killed in 
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an abortion will cause the unborn child pain, 
even though you receive a pain-reducing drug or 
drugs. Under the Federal Unborn Child Pain 
Awareness Act of 2006, you have a right to 
know that there is evidence that the process of 
being killed in an abortion will cause your un-
born child pain. You may request that anes-
thesia or other pain-reducing drug or drugs are 
administered directly to the pain-capable un-
born child if you so desire. The purpose of ad-
ministering such drug or drugs would be to re-
duce or eliminate the capacity of the unborn 
child to experience pain during the abortion 
procedure. In some cases, there may be some 
additional risk to you associated with admin-
istering such a drug.’; 
‘‘(C) require the woman to explicitly either 
request or refuse the administration of pain-re-
ducing drugs to the unborn child; and 
‘‘(D) be signed by a pregnant woman prior 
to the performance of an abortion involving a 
pain-capable unborn child; and 
‘‘(2) with respect to the abortion provider— 
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‘‘(A) contain a statement that the provider 
has provided the woman with all of the informa-
tion required under subsection (b); 
‘‘(B) if applicable, contain a certification 
by the provider that an exception described in 
section 2903 applies and the detailed reasons 
for such certification; and 
‘‘(C) be signed by the provider prior to the 
performance of the abortion procedure. 
‘‘(e) MAINTENANCE OF RECORDS.—The Secretary 
shall promulgate regulations relating to the period of time 
during which copies of forms under subsection (d) shall 
be maintained by abortion providers. 
‘‘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 so as to necessitate the immediate 
termination of her pregnancy to avert her death, or 
for which a delay would create a serious risk of sub-
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stantial and irreversible impairment of a major bod-
ily function. The term ‘medical emergency’ shall not 
include emotional, psychological or mental disorders 
or conditions. 
‘‘(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 
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