Iowans would need to see a doctor in person to receive abortion medications under a bill awaiting Gov. Kim Reynolds’ signature.
Iowa’s legislation comes as Republicans nationally seek to place restrictions on abortion medication.
On May 1, a federal appeals court issued a ruling barring people from getting the abortion pill mifepristone through the mail. The ruling is likely to be appealed to the U.S. Supreme Court.
House lawmakers voted 58-29 on May 1 to pass House File 2788. The Senate followed on May 3 with an 30-11 vote, sending the bill to Reynolds for her signature.
The bill says doctors could only dispense abortion medications such as mifepristone and misoprostol in person after performing an exam on the patient, which would include screening the patient for abuse or coercion.
Republicans have described the legislation as being intended to stop “black market” abortion pills, which they say patients can use to circumvent Iowa’s current law, which bans most abortions after about six weeks of pregnancy.
“The heartbeat law is the law of Iowa,” said Rep. Jon Dunwell, R-Newton. “And every day that out-of-state mail order operations dispense abortion drugs to Iowans with no exam, no doctor and no oversight, the heartbeat law this chamber passed is being eroded.”
Rep. Megan Srinivas, D-Des Moines, who is a doctor, said anyone prescribing medicine to an Iowa resident is already required to be licensed in Iowa.
“This bill doesn’t do anything to address the problem of black-market abortions because those are already illegal,” she said. “All this does is take away options for people in rural Iowa who have no other ability to get care.”
Republicans say the legislation is the first time doctors will be required to screen women seeking abortions for signs of coercion or abuse.
Rep. Devon Wood, R-New Market, said there are times when women seeking abortions are victims of domestic abuse and are “being silenced by her abusers.”
“By requiring in person screenings we are giving these women a lifeline,” she said. “We are providing a private, clinical sanctuary where an expert can look them in the eye and ask, ‘Are you safe?’ That opportunity for intervention is lost the moment that we remove this process to a computer screen, a phone or a mailbox.”
Democrats pointed to Iowa’s ranking as one of the worst states in the country for OB-GYN access per capita and the fact that health centers and birthing units have closed around the state over the years. They argued women will struggle to find appointments if they are required to do so in person.
“One-third of our counties have no access to OB-GYN care. None,” Srinivas said. “They rely on telehealth.”
Senators consider abortion restrictions after overnight marathon
The bill was one of the final pieces of legislation to pass the Iowa Senate in 2026, with Republican leaders waiting to hold subcommittee and committee meetings on the bill until well into the afternoon on Sunday, May 3, after lawmakers worked more than 30 hours straight in an overnight push to adjourn.
Kyrstin Delagardelle, public affairs director for Planned Parenthood Advocates of Iowa, called the bill “unnecessary government overreach.”
“Health care decisions, including abortion, should be rooted in medicine and science,” she said. “Not determined by the agenda of anti-abortion politicians and special interests.”
Tom Chapman, executive director of the Iowa Catholic Conference, said the group opposes abortion and believes it is reasonable for the state to place restrictions on the procedure.
“The purpose of this bill as we see it is not to get between a physician and the woman,” he said. “It’s exactly the opposite, to bring them together. Abortion drugs are widely available through unregulated websites, and that’s what we’re trying to get to in this bill.”
Sen. Janet Petersen, D-Des Moines, thanked the members of the public who waited overnight to share their thoughts on the bill.
“I know this is unusual, having to potentially stay the night at the Statehouse to make your voices heard, so thank you for being here today,” she said.
Iowa doctors could face licensing discipline, out of state groups could be sued
Anyone who dispenses an abortion medication in violation of the bill’s requirements could be sued for damages.
However, licensed Iowa medical providers who violate the legislation would only be subject to licensing discipline.
The provision is intended to allow lawsuits against out-of-state medical providers or organizations who may provide abortion medication virtually, although several states have “shield laws” that prevent providers being sued in other states.
The bill changes Iowa law to specify that miscarriages and treatment of an ectopic pregnancy do not qualify as abortions under the law.
Stephen Gruber-Miller covers the Iowa Statehouse and politics for the Register. He can be reached by email at sgrubermil@registermedia.com or by phone at 515-284-8169. Follow him on X at @sgrubermiller.
This article originally appeared on Des Moines Register: Iowans must see doctor to get abortion medication under passed bill
Reporting by Stephen Gruber-Miller, Des Moines Register / Des Moines Register
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