New proposed rules for Iowa doctors who perform abortions could further reduce the number of women’s health care providers in the state — already the lowest per capita in the country — according to several doctors.
“As an OB/GYN practicing in a rural area, I consider myself rare — I’m a rarity,” said Dr. Emily Bowers, an OB/GYN at Waverly Health Center in Northeast Iowa. “I think it’s very important that the board consider the impact of these rules on physicians who are in practice trying to care for patients who are in maternal health deserts and underserved areas in Iowa.”
Boevers made the comments available to the Iowa Board of Medicine on Thursday during a public hearing aimed at getting feedback on new rules he is considering for doctors in the state. No one testified Thursday in support of the written rules. The board is expected to discuss the rules and feedback at a meeting next week.
Those rules are the result of a restrictive abortion law passed by state lawmakers last year that would have banned most abortions after about six weeks of pregnancy. A judge temporarily blocked the law from taking effect shortly after it was passed, and the Iowa Supreme Court is considering the law’s constitutionality.
The proposed rules would require a doctor who intends to perform or induce an abortion to make a “good faith” attempt to detect a “fetal heartbeat” using an abdominal ultrasound before proceeding.
“This effort must be made in good faith and in accordance with standard medical practice and sound medical judgment,” the proposed rule said.
Opponents of the new law say the term “fetal heartbeat” is a misnomer when it refers to the earliest detectable heartbeat of a developing embryo. Embryos become fetuses at the end of the 10th week of pregnancy, according to the National Library of Medicine.
The rules also use the term “woman” to describe the person seeking an abortion, when in practice the person may be under 18.
“I would recommend that this board work hard with the state government to find some clarity on these clinical issues,” said Dr. Stephen Wall of Cedar Rapids. He did not say specifically which parts of the new rules needed clarification.
Wahle helps lead UnityPoint Health – St. Luke’s Hospital and said the ambiguity in the new rules could make it harder to retain and hire medical professionals.
“It does affect some of our residents who are coming from training where they will be training,” he said. “Doctors are very risk-averse.”
A doctor who does not comply with the new rules or the new law could be subject to a fine of up to $10,000 and license revocation.
Dr. Rebecca Shaw, a longtime obstetrician and gynecologist who teaches at Des Moines University, said her medical students may choose to practice in another state because of the new rules.
“Iowa already has a significant workforce problem, especially when it comes to women’s health,” she said. “I hope we don’t do something that further sets us back in time in terms of our workforce and patient care.”
The law has exceptions for pregnancies resulting from rape and incest, as well as for pregnancies that threaten the patient’s life.
The proposed rules require doctors to question their patients seeking a rape or incest exemption as part of a “good faith assessment that the woman is honest.”
“The physician … may require the woman to sign a certification form certifying that the information she has provided is true and accurate to the best of the woman’s understanding,” the proposed rules said.
Dr Bowers, an OB/GYN in Waverley, said these requirements could prevent doctors from maintaining trusting relationships with their patients.
“Treating our patients as people who need to be questioned about their traumas and treating providers as extensions of the government … will jeopardize our ability to connect with our patients and provide them with good care,” Bowers said. “It will also jeopardize our ability to recruit and retain providers in the state.”
The Board of Medicine is scheduled to meet on January 11 and 12.
