DES MOINES, Iowa (AP) 鈥� Iowa鈥檚 medical board on Thursday approved some guidance abortion providers would need to follow if the on most after about six weeks of pregnancy is upheld by the Iowa Supreme Court.
The restrictive abortion law is as the court considers Gov. ' of the lower court鈥檚 decision that paused the crux of it, but the medical board was instructed to continue with its rulemaking process to ensure physicians would have guidance in place when the court rules.
While the board鈥檚 language outlines how physicians are to follow the law, the specifics on enforcement are more limited. The rules do not outline how the board would determine noncompliance or what the appropriate disciplinary action might be. Also missing are specific guidelines for how badly a pregnant woman鈥檚 health must decline before their life is sufficiently endangered to provide physicians protection from discipline.
The would prohibit almost all abortions once cardiac activity can be detected, which is usually around six weeks of pregnancy and before many women know they are pregnant. That would be a stark change for women in Iowa, where abortion is legal up to 20 weeks of pregnancy.
The rules instruct physicians to make 鈥渁 bona fide effort to detect a fetal heartbeat鈥� by performing a transabdominal pelvic 鈥渋n a manner consistent with standard medical practice.鈥�
Like many Republican-led , the legislation is crafted around the detection of the 鈥渇etal heartbeat,鈥� which is not easily translated to medical science. While advanced technology can detect a flutter of cardiac activity as early as six weeks gestation, medical experts clarify that the embryo at that point isn鈥檛 yet a fetus and doesn鈥檛 have a heart.
The rules approved Thursday had been revised to include terminology that doctors use, a representative from the attorney general's office explained during the meeting. It supplements the law鈥檚 definition of 鈥渦nborn child鈥� to clarify that it pertains to 鈥渁ll stages of development, including embyro and fetus.鈥�
The rules also outline the information physicians must document for a patient to be treated under the limited exceptions carved out in the law.
The documentation should be maintained in the patient鈥檚 medical records, enabling physicians to point to the information, rather than rely on memory, and thus avoid a 鈥渂attle of witnesses鈥� in the event that 鈥渟omeone gets brought before the board,鈥� the attorney general鈥檚 representative said.
The law would allow for abortion after the point in a pregnancy where cardiac activity is detected in the circumstances of rape, if reported to law enforcement or a health provider within 45 days; incest, if reported within 145 days; and fetal abnormality.
In the circumstance of fetal abnormality, the board specifies physicians should document how they determined a fetus has a fetal abnormality and why that abnormality is 鈥渋ncompatible with life."
The law also provides for an exception for 鈥渕edical emergency,鈥� which includes pregnancy complications endangering the life of the pregnant woman and cases in which 鈥渃ontinuation of the pregnancy will create a serious risk of substantial and irreversible impairment of a major bodily function of the pregnant woman.鈥�
But the board did not provide any additional guidance on just how imminent the risks must be before doctors can intervene, a across the country, especially after the Texas Supreme Court denied access to abortion.
Most Republican-led states have drastically limited abortion access since the U.S. Supreme Court overturned Roe v. Wade and handed authority on abortion law to the states. Fourteen states now have bans with limited exceptions and two states, Georgia and South Carolina, ban abortion after cardiac activity is detected.
Four states, including Iowa, have bans on hold pending court rulings.
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Associated Press reporter Geoff Mulvihill contributed to this report from Cherry Hill, New Jersey.
Hannah Fingerhut, The Associated Press
