women who have had an abortion have an 81 per-
cent 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 instru-
ment, medicine, drug, or any other substance, de-
vice, 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 re-
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sult of a spontaneous abortion, accidental trau-
ma, or a criminal assault on the pregnant fe-
male or her unborn child. 
‘‘(2) ABORTION PROVIDER.—The term ‘abortion 
provider’ means any person legally qualified to per-
form an abortion under applicable Federal and State 
laws. 
‘‘(3) CERTIFIED TECHNICIAN.—The term ‘cer-
tified technician’ means— 
‘‘(A) 
a 
registered 
diagnostic 
medical 
sonographer who is certified in obstetrics and 
gynecology by the American Registry for Diag-
nostic Medical Sonography (ARDMS); or 
‘‘(B) a nurse midwife, or an advanced 
practice nurse practitioner in obstetrics, with 
certification in obstetrical ultrasonography. 
‘‘(4) 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. 
‘‘(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 sub-
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ject 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 fe-
male human being whether or not she has reached 
the age of majority. 
‘‘SEC. 3402. REQUIREMENT OF INFORMED CONSENT. 
‘‘(a) REQUIREMENT
OF
COMPLIANCE
BY
PRO-
VIDERS.—Any abortion provider in or affecting interstate 
or foreign commerce, who knowingly performs any abor-
tion, shall comply with the requirements of this title. 
‘‘(b) 
PERFORMANCE
AND
REVIEW
OF 
ULTRASOUND.— 
‘‘(1) REQUIREMENT.—Prior to a woman giving 
informed consent to having any part of an abortion 
performed, the abortion provider who is to perform 
the abortion, a certified technician, or another agent 
of the abortion provider who is competent in 
ultrasonography shall— 
‘‘(A) perform an obstetric ultrasound on 
the pregnant woman; 
‘‘(B) during the performance of the 
ultrasound, display the ultrasound images (as 
described in paragraph (2)) so that the preg-
nant woman may view the images; and 
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‘‘(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 stand-
ard medical practice; 
‘‘(B) contain the dimensions of the unborn 
child; and 
‘‘(C) accurately portray the presence of ex-
ternal members and internal organs, if present. 
‘‘(3) ABILITY TO AVERT EYES.—Nothing in this 
section shall be construed to prevent a pregnant 
woman from closing or averting her eyes from the 
ultrasound images required to be displayed, or not 
listening 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
HEART-
BEAT.— 
‘‘(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 
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menstrual period), the abortion provider who is to 
perform the abortion, a certified technician, or an-
other agent of the abortion provider shall, using a 
hand-held Doppler fetal monitor, make the embry-
onic or fetal heartbeat of the unborn child audible 
for the pregnant woman to hear. 
‘‘(2) UNSUCCESSFUL ATTEMPTS AT DETECTING 
HEARTBEAT.—An abortion provider, a certified tech-
nician, or another agent of the abortion provider 
shall not be in violation of paragraph (1) if— 
‘‘(A) the provider, certified technician, or 
agent 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 
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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 condi-
tions that support such determination and include 
such certification in the medical file of the pregnant 
woman. 
‘‘(2) FALSE
STATEMENTS.—An abortion pro-
vider who knowingly or recklessly falsifies a certifi-
cation under paragraph (1) is deemed to have know-
ingly or recklessly failed to comply with this title for 
purposes of section 3404. 
‘‘SEC. 3404. PENALTIES. 
‘‘(a) IN GENERAL.—An abortion provider who know-
ingly or recklessly fails to comply with any provision of 
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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 sec-
tion 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 com-
menced under this section has knowingly or recklessly vio-
lated a provision of this title, the court shall notify the 
appropriate State medical licensing authority and shall as-
sess a civil penalty against the respondent in an amount 
not to exceed $250,000 for each such violation if the re-
spondent 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 ac-
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tion against the abortion provider for any knowing or reck-
less violation of this title for actual and punitive dam-
ages.’’. 
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 disclosure require-
ments 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 unconstitu-
tional, 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. 
Æ 
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