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 fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce 
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 Representa-
tives 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: 
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(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 fer-
tilization (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 preg-
nancies end in spontaneous miscarriage after detec-
tion of cardiac activity. A fetal heartbeat is therefore 
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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 wom-
an’s unborn child, when a heartbeat has been de-
tected, is an important component of full informed 
consent. 
(8) Ensuring full informed consent for an abor-
tion is imperative, because of the profound physical 
and psychological risks of an abortion. As the Su-
preme Court has observed, ‘‘[t]he medical, emo-
tional, 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 abor-
tion 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 sus-
tained,’’ and ‘‘[s]evere depression and loss of esteem 
can follow . . . The State has an interest in ensur-
ing so grave a choice is well informed. It is self-evi-
dent that a mother who comes to regret her choice 
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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 op-
portunity 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 con-
sequences, that her decision was not fully informed. 
If the information the State requires to be made 
available to the woman is truthful and not mis-
leading, 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 ac-
count 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 per-
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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-
sult of a spontaneous abortion, accidental trau-
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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) 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 Diag-
nostic 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 pro-
vider 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. 
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‘‘(6) 
UNEMANCIPATED
MINOR.—The 
term 
‘unemancipated minor’ means a minor who is sub-
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.—If an ultrasound is per-
formed 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 di-
rectly 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 
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described in paragraph (2)) so that the preg-
nant 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 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) VIEWING IMAGES AND LISTENING TO DE-
SCRIPTION.—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
HEART-
BEAT.— 
‘‘(1) REQUIREMENT.—Prior to a woman giving 
informed consent to having any part of an abortion 
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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 di-
rectly or through the provider’s employee) shall, 
using a hand-held Doppler fetal monitor, make the 
embryonic or fetal heartbeat of the unborn child au-
dible for the pregnant woman to hear. 
‘‘(2) UNSUCCESSFUL ATTEMPTS AT DETECTING 
HEARTBEAT.—An abortion provider (or the pro-
vider’s employee) shall not be in violation of para-
graph (1) if— 
‘‘(A) the provider (acting directly or 
through the provider’s employee) has at-
tempted, consistent with standard medical prac-
tice, 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 
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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 condi-
tions that support such determination and include 
such certification in the medical file of the pregnant 
woman. The certification shall be kept by the abor-
tion 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 pro-
vider who knowingly or recklessly falsifies a certifi-
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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 
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 
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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-
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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