Senate File 534, sponsored by Sen. Joe Bolkcom (D-Iowa City) was introduced last week in a Ways and Means subcommittee hearing. The bill was written in response to an Iowa House abortion bill aimed at keeping abortion doctor LeRoy Carhart from opening a surgical abortion clinic in Iowa.

The Iowa Senate convened at 1 p.m. today and immediately both parties went into caucus.

Senate Study Bill 1212, sponsored by Sen. Joe Bolkcom, D-Iowa City, would allow abortion doctors who want to practice late term procedures in Iowa to apply for a certificate of need before being allowed to open a clinic. Approved clinics would have to be in close proximity to hospitals that have appropriate specialists and technology to protect the lives of both the woman and fetus; such hospitals are located in Des Moines, Iowa City, Cedar Rapids and Davenport.

Previous abortion bills have been introduced during this session as an attempt to keep Dr. LeRoy Carhart from opening a late-term abortion clinic in Council Bluffs.

“Make no mistake, the bill by Joe Bolkcom does absolutely nothing to ban late term abortions in Iowa,” Senate Minority Leader Paul McKinley, R-Chariton, said Thursday morning, adding if Senate Study Bill 1212 becomes law, it will turn Iowa into “the late-term abortion Mecca of the Midwest.”

Certificate of need approval is granted by a five-person board — two of whom were appointed by Gov. Terry Branstad, and three by former Gov. Chet Culver, McKinley said. The certification of need could potentially give Carhart the loophole he needs to still open a clinic in Iowa, just not in Council Bluffs, if that board would grant approval.

“The goal of Senate Democrats, however, is specifically to prevent the abortionist Dr. Carhart from opening shop in Council Bluffs,” McKinley said.

The bill was introduced in a Senate Ways and Means Committee meeting Thursday afternoon. Though the atmosphere was cordial, questions from Sen. Roby Smith (R-Davenport) about the rules that would govern where such abortions could happen and who drafts those rules were repeatedly deflected by Bolkcom, who wanted to keep conversation on the substance of the bill.

Smith wanted to know specifically who would draft rules about what would define “close proximity” and demanded to know how Bolkcom could state there were six late-term abortions in Iowa in 2009 if he could provide no report on it. The figure is based on information from the Iowa Department of Public Health.

“I represent 60,000 people,” Smith said. “I’d appreciate it if you didn’t rush my questions. I want to represent my 60,000 people. I work for them, I don’t work for a clock.”

“These aren’t abortions that happen because there isn’t something serious that happened during the pregnancy,” Bolkcom told him, adding the bill would allow for late-term abortions for women who “were planning on a successful birth and pregnancy” but encountered medical complications.

Senate Study Bill 1212 was drafted in response to a House Republicans proposal, House File 657, which would ban abortions after 20 weeks gestation, except in certain cases of medical emergency. In abortion procedures involving multiple fetuses, doctors would have to perform the procedure in such a way that would protect the other fetuses.

However, abortion rights advocates denounced House File 657 because the legislation stipulates that life would be recognized as starting at fertilization. That single line would actually make all abortions in Iowa illegal, Ben Stone, executive director of ACLU of Iowa, said. The organization also took the stance that the bill gave no consideration to the life or health of the women seeking late-term abortions.

House File 657 was discharged out of committee last week to the Senate floor to await debate. The discharge petition was filed by Smith, according to a Senate Republican spokesman. Two Democrats, Sen. Tom Hancock, of Epworth, and Sen. Joe Seng, of Davenport, voted with Republicans to see the House File 657 discharged. Hancock told The Iowa Independent following the bill discharge that as a “pro-life Catholic,” he does not support abortion, nor does he want Carhart’s clinic in Iowa.

Sen. Bill Dotzler (D-Waterloo) said Bolkcom’s bill implements a screening process for late-term abortion clinics by mandating the doctor go through the certification of need process before being allowed to open.

Joe Bolkcom

Sen. Joe Bolkcom (D-Iowa City) said in a statement Tuesday he will introduce a new abortion bill this week aimed at prevening a Nebraska doctor from opening a family planning clinic in western Iowa that would offer late-term abortion services. Whether or not it will match Republican desires for a ban on abortion procedures after 20 weeks remains to be seen.

Bolkcom, who will run House File 657 in the Senate, said his chamber’s version of the Iowa House’s late-term abortion bill will be introduced in the Senate Ways and Means Committee this week. The day was not specified.

Last week, Bolkcom told The Iowa Independent that he wanted to thoroughly examine “the constitutionality” of House File 657 before bringing a version to the Senate floor for debate. Pro-choice advocates have said the House bill would actually ban all abortion procedures in Iowa, though proponents have said the bill aims to ban procedures after 20 weeks gestation.

That bill was discharged to the floor last week.

Bolkcom released this statement this morning:

“I share most Iowans’ goal of preventing Dr. [LeRoy] Carhart from moving his practice to Iowa. That’s why I’ll be introducing a new bill later this week in the Ways and Means Committee that will prevent him from coming to Iowa.

“What I won’t do is endanger a woman’s health and safety. As the House-passed bill is drafted right now, there’s no exception for life of the mother, rape, incest or fetus abnormalities that would prevent the baby from surviving after it’s born.

“Not every pregnancy ends the way a family hopes it will. A woman with a wanted pregnancy that goes terribly wrong must face an awful decision that none of us ever want to face. A Nebraska-style total ban will only make a difficult situation worse, and that’s no place for politicians to meddle.

“Republicans know this. Their version of the bill is a political ploy. In fact … key supporter Senator [David] Johnson said in an interview last week that ‘the bill makes it more dangerous for pregnant women with a medical emergency to have to wait until the last minute if the woman truly needs an abortion after 20 weeks.’

“What’s more, constitutional experts say the bill as drafted is blatantly unconstitutional. There’s not much point in passing an unconstitutional bill that will only embroil Iowa in an expensive court battle.

“We can all agree that there should be fewer abortions. I hope Senate Republicans will put politics aside and help me pass legislation that will prevent Dr. Carhart from coming to Iowa.”

Lawmakers could either pass or stall a bill banning abortions after 20 weeks in Iowa as early as next week. House File 5, passed by a subcommittee to the Iowa House this week, was drafted in response to the intentions of Dr. LeRoy Carhart, an abortion doctor in Nebraska, to open a clinic performing late-term abortions in Iowa. The bill would ban abortions after 20 weeks. Current state law prohibits abortion procedures after 24 weeks of pregnancy, except in cases where the mother’s health is jeopardized.

Twenty-four weeks is considered by many doctors to be the time when a fetus is typically developed enough to live outside the womb.

Other pro-life bills have been voted down this session, including House File 153 or the “Personhood Bill,” which would mandate the state to recognize life starting at conception, and consequently limiting access to birth control and services to treat complications like ectopic, or tubal, pregnancies. This caused some Republicans, who wanted to see abortions at all stages of pregnancy illegal, to give half-hearted support to the late-term abortion bill.

However, House File 5 specifically states life would be considered to start at conception, not 20 weeks, and could effectively end all abortions in Iowa, pro-choice advocates argue.

Speaker of the Iowa House Kraig Paulsen (R-Hiawatha) said House File 5 will get the support of the full Iowa House, which is held by the Republicans. As the bill was assigned to the Government Oversight Committee, it is protected from dying in the funnel. Senate Democrats, who hold the majority in that chamber, said they will consider the bill according to legislative procedure.

Democrats and Republicans will also consider a bill guiding the Iowa Utilities Board on setting the rates of a nuclear plant an energy company is thinking about building. MidAmerican Energy is exploring the construction and operation of a nuclear plant. Should it be financed by investors, the Iowa Utilities Board would have to approve the plant.

Nine senators, all Democrats, have urged the voting on Senate File 390 be delayed, in light of the nuclear plant destruction and malfunctions caused by the earthquake and tsunami in Japan last week.

However, both Democrats and Republicans indicated the issue is non-partisan, and an interest of those on both sides of the aisle.

“I think we all have concerns about this,” Senate Majority Leader Mike Gronstal (D-Council Bluffs), who is not one of the nine, said Thursday. “I commend these nine for asking tough questions. There are questions that will need to be asked as we move forward on this issue.”

Though both Republicans and Democrats agree that renewable fuel and energy need to be a legislative priority, Paulsen said the division was created over disagreement “on the right direction to go. Right now, we’re vetting (Senate File 390).”

Senate Minority Leader Paul McKinley (R-Chariton) added, “Most people who are playing politics here are playing politics with Iowa’s future. I don’t know if it’ll take rolling blackouts for people to finally do something.”

Republican leaders said the events in Japan may change the discussion on nuclear power and Senate File 390, though Republicans intend to continue advancing the legislation. The bottom line, Paulsen said, is that nuclear power is “solid, clean, reliable energy.”

Iowa has one nuclear plant, Duane Arnold Energy Plant, which is in Paulsen’s district.

A committee was expected to take up Senate File 390 for discussion yesterday afternoon, with MidAmerican Energy officials present.

That provision, contained in House File 5, would officially define life as beginning at conception, and most of the sponsors of the bill recently made that definition a separate bill. The separate bill, House File 153, never got out of committee last week, and its fate is now uncertain.

Matt Windschitl

State Rep. Matt Windschitl (R-Missouri Valley) who proposed HF 5 and is one of 28 co-sponsors of HF 153, said he found evidence for fetal pain by conducting his own research online and by consulting his family physician to learn about the stages of development of an unborn child. He said he also referred to testimony from physicians who have previously testified on the subject. Windschitl did not respond to requests for his family physician’s contact information.

But another physician, an Iowa doctor who specializes in obstetrics and gynecology, disagrees with Windschitl and the comment he attributed to his family doctor.

“I think it’s impossible to say conclusively that there is such a thing as fetal pain,” the physician said.

At the request of the physician, who offers abortion services to women who are 20 weeks pregnant, she has been granted anonymity. Several physicians who offer abortion services have been killed by people who oppose abortions in recent years. One of them was Dr. George Tiller of Wichita, Kans., who provided late-term abortions and was killed in 2009.

“It is just a safety issue for you to print that I perform those procedures,” the Iowa obstetrician-gynecologist said.

Her comments about fetal pain are supported by a 2005 study published in the Journal of American Medicine. It found that a fetus’ ability to feel pain is unlikely. The study concluded that a fetus does not have the capacity to feel pain until the 29th or 30th week of a women’s pregnancy. Evidence regarding the capacity for fetal pain is limited but indicates that fetal perception of pain is unlikely before the third trimester.

State Rep. Beth Wessel-Kroeschell (D-Ames) also questions the claims regarding a fetus’ capacity to feel pain at 20 weeks. She and state Rep. Mary Mascher (D-Iowa City) said they were unfamiliar with any concrete evidence or research that indicates a fetus can feel pain at 20 weeks.

But proponents of the bill say that even if scientists disagree on when fetuses can feel pain, they believe they should err in favor of the fetus. Windschitl pointed to studies and expert testimony that supports the notion that fetuses can feel pain as early as 20 weeks.

“Why Can’t We Love Them Both,” a book Windschitl referred to, argues that fetuses have the capacity to feel pain as early as eight weeks from fertilization. The book was published in 1997 by Jack C. Willke, a doctor, author and president of two anti-abortion organizations, the International Right to Life Federation and the Life Issues Institute.

As for the Iowa bill, Windschitl said it was important for him to propose the legislation in early January because of, “the imminent threat of LeRoy Carhart opening a practice in Council Bluffs.”

Carhart, a Nebraska physician and a former colleague of the late Dr. Tiller, has previously reported that he was one of only 12 doctors in the country who performs abortions after 20 weeks.

Late last year, Carhart announced plans to open sexual and reproductive health clinics which would offer abortion services in Iowa, Maryland and Indiana. He did so after Nebraska passed a 20-week limit law, titled Pain Capable Unborn Child Protection Act, which aimed at keeping Carhart from continuing his practice in the state. Carhart has yet to open a clinic in Iowa.

Kansas recently passed a similar bill through the state House of Representatives that would restrict abortions to 20 weeks based on the fetal pain argument that was used to justify Nebraska’s law.

Iowa law allows women to decide whether or not to have an abortion until the end of her second trimester, or approximately 26 weeks.

Windschitl said he believed this bill would ultimately, “save innocent lives from barbaric late term abortions.” Others, however, disagree.

“Women who choose to have abortions after 20 weeks are deciding to have an abortion not necessarily because it is something they want, but because it is necessary,” said the Iowa obstetrician-gynecologist.

She explained that those women typically are people who have discovered that their fetus had developed a birth defect, or women who find out that carrying on the pregnancy poses a threat to their health, not women who are looking to terminate an unwanted pregnancy.

Twenty-three percent of abortion providers offer abortions after 20 weeks. The Guttmacher Institute, an international non-profit center that does research on reproductive health and reproductive rights, said that in the United States, 22 percent of all pregnancies end in abortion and 1.5 percent of these abortions occur after 20 weeks. The institute is named after the late Alan Guttmacher, a long-time president of the Planned Parenthood Federation of America.

The bill would protect a woman’s right to have an abortion after 20 weeks in cases of medical emergencies, but women who find out their fetus have some sort of abnormality would not have this same protection.

Women who discover that their fetus has a birth defect do so through an amniocentesis test, a prenatal diagnosis of fetal abnormalities, according to Harvard Health Publications. This test is typically administered between the 15th and 20th weeks of pregnancy in order to determine a fetus’ health before birth.

Possible birth defects found during an amniocentesis include Down syndrome, muscular diseases that may worsen over time, lung diseases and even diseases in which the brain and spinal cord do not develop correctly.

Wessel-Kroeschell said in situations where an amniocentesis test shows birth defects, the women may have approximately two weeks to decide if they want to continue testing or terminate the pregnancy.

“I think we’re rushing her into a decision that she’s not ready to make,” she said.

The bill also says that life begins at conception. Windschitl said that it was important for him to include the clause in the bill because of his own personal feelings and pro-life stance.

Several women’s health advocates, including members from The Center for Reproductive Rights and Planned Parenthood of the Heartland, strongly oppose a possible 20-week limit on abortions and do not want the idea that “life begins at conception” written into law.

Both advocacy groups, Wessel-Kroeschell, Mascher and others have concerns over the possible legal ramifications of the bill.

The 1973 landmark Supreme Court case Roe v. Wade never addressed whether or not life begins at conception. The Supreme Court ruled that a woman had the right to have an abortion up to viability, or the point in her pregnancy in which the fetus could independently survive outside of the womb, as determined by a doctor. Most research suggests that a fetus has over a 50 percent chance for survival outside of the womb beginning at 24 weeks.

“People have different reasons, religious, personal, moral reasoning for deciding when life begins. It should never be up to legislators to decide,” Jordan Goldberg, the state advocacy counsel for the Center for Reproductive Rights, said.

Rebecca Zietlow, an adjunct law professor at the University of Iowa, questioned the constitutionality of the bill, because it attempts to establish a legal definition for a religious issue – when life begins.

“Freedom of religion issues bring up First Amendment concerns,” said Zietlow.

A separate bill, HF153, takes this issue one step further. HF153 declares that life is protected from the moment of conception. The bill was approved by an Iowa House subcommittee on February 14th.

Zietlow said HF5 may be unconstitutional under Planned Parenthood v. Casey. In 1992, the Supreme Court’s decision in Casey determined that, prior to viability, individual states could not place an undue burden on a woman’s right to have an abortion. Because fetuses are not viable at 20 weeks, Zietlow argued that the bill, if passed, would pose the undue burden that the 1992 decision prohibits.

“Sometimes legislators enact laws like this to be challenged so that they can appeal to the Supreme Court and use it as a vehicle to overturn Roe v. Wade,” said Zietlow.

Regardless, Windshitl believes that if the bill was challenged and sent to court, it would hold up constitutionally. He remains passionate about the legislation and continues to advocate for its passage as well as for his pro-life stance.

“If I could, I’d stop the illegal precedent set by Roe v. Wade,” Windschitl said. “It’s a personal feeling of mine.”

Layla Pena is sophomore at the University of Iowa majoring in journalism and international studies. She wrote this story for IowaWatch.org, a nonprofit website run by The Iowa Center for Public Affairs Journalism, as part of a national collaboration with the Center for Public Integrity.

Here’s how the pregnant reader learned that her fetus had a likely fatal brain deformity, just one day after the time limit beyond which most doctors will no longer perform an abortion:

Our appointment began jovially. The perinatologist and nurse joked about names, and at one point, the doctor called the baby a “little rascal.” As the ultrasound continued, the room grew quiet. The perinatologist scanned the baby’s head again and again. He finally announced, in a solemn voice, “I’m seeing some things in the baby’s brain that concern me.” Time stopped, and everything in the universe shifted. Holding my partner’s hand, I struggled to listen despite the thick blanket of grief that settled over the room.

The doctor continued, “The baby has holoprosencephaly. It’s a brain malformation in which the forebrain fails to divide. Most of these babies die before term. Those that are born have severe disabilities.” He finally took a deep sigh and started to deliver the especially delicate part: “I don’t know what your beliefs are but some people would terminate a pregnancy of this nature. Since you are 22 weeks along, you would have to go to Wichita for the procedure.” Everyone in the room knew this was shorthand for, “You would have to see George Tiller, the infamous late-term abortion doctor. No one else will help you at this point.” Numb, I asked to know the baby’s gender. He placed the ultrasound wand back on my stomach and read the grainy image: “It’s a girl.” We walked out of the clinic with blank stares and wept in the car.

Read the rest of the excerpt here.