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.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Heartbeat Informed Consent Act''.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (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 fertilization 
        (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 pregnancies end 
        in spontaneous miscarriage after detection of cardiac activity. 
        A fetal heartbeat is therefore 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 woman's unborn 
        child, when a heartbeat has been detected, is an important 
        component of full informed consent.
            (8) Ensuring full informed consent for an abortion is 
        imperative, because of the profound physical and psychological 
        risks of an abortion. As the Supreme Court has observed, 
        ``[t]he medical, emotional, 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 abortion 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 sustained,'' and ``[s]evere depression and loss of 
        esteem can follow . . . The State has an interest in ensuring 
        so grave a choice is well informed. It is self-evident that a 
        mother who comes to regret her choice 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 opportunity 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 consequences, that her decision 
        was not fully informed. If the information the State requires 
        to be made available to the woman is truthful and not 
        misleading, 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 account 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 percent 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 instrument, medicine, drug, or any 
        other substance, device, 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 result of a 
                spontaneous abortion, accidental trauma, or a criminal 
                assault on the pregnant female or her unborn child.
            ``(2) Abortion provider.--The term `abortion provider' 
        means any person legally qualified to perform an abortion under 
        applicable Federal and State laws.
            ``(3) Certified technician.--The term `certified 
        technician' means--
                    ``(A) a registered diagnostic medical sonographer 
                who is certified in obstetrics and gynecology by the 
                American Registry for Diagnostic 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 subject 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 female human being 
        whether or not she has reached the age of majority.

``SEC. 3402. REQUIREMENT OF INFORMED CONSENT.

    ``(a) Requirement of Compliance by Providers.--Any abortion 
provider in or affecting interstate or foreign commerce, who knowingly 
performs any abortion, 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 pregnant 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 standard 
                medical practice;
                    ``(B) contain the dimensions of the unborn child; 
                and
                    ``(C) accurately portray the presence of external 
                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 Heartbeat.--
            ``(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 menstrual period), the abortion 
        provider who is to perform the abortion, a certified 
        technician, or another agent of the abortion provider shall, 
        using a hand-held Doppler fetal monitor, make the embryonic 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 technician, 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 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 conditions that support such determination and 
        include such certification in the medical file of the pregnant 
        woman.
            ``(2) False statements.--An abortion provider who knowingly 
        or recklessly falsifies a certification under paragraph (1) is 
        deemed to have knowingly or recklessly failed to comply with 
        this title for purposes of section 3404.

``SEC. 3404. PENALTIES.

    ``(a) In General.--An abortion provider who knowingly 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 section 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 commenced under this section 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 $250,000 for each such violation if the respondent 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 action against the abortion provider for any knowing or 
reckless violation of this title for actual and punitive damages.''.

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, implements, or continues in effect greater 
disclosure requirements 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 unconstitutional, 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.

Summary: Heartbeat Informed Consent Act - Amends the Public Health Service Act to require abortion providers to perform an obstetric ultrasound on the pregnant woman, display the ultrasound images so that the she may view them, and provide a medical description of the ultrasound images of the unborn child's cardiac activity, if present and viewable. Requires the ultrasound to be performed before the woman gives informed consent for an abortion.

Requires an abortion provider to make the embryonic or fetal heartbeat audible for the pregnant woman to hear prior to the woman giving informed consent to an abortion if the pregnancy is at least eight weeks after fertilization.

Exempts an abortion provider if 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. Requires a certification in such cases.

Subjects an abortion provider who knowingly or recklessly fails to comply with this Act to civil penalties and notification of the appropriate state medical licensing authority. Gives standing to file a civil action for violations of this Act to the Attorney General or a woman upon whom an abortion has been performed in violation of this Act or the parent or legal guardian of such a woman if she is an unemancipated minor.