Missouri 2025 Regular Session

Missouri Senate Bill SB241 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1
2	2	EXPLANATION-Matter enclosed in bold-faced brackets [thus] in this bill is not enacted
3	3	and is intended to be omitted in the law.
4	4	FIRST REGULAR SESSION
5	5	SENATE BILL NO. 241
6	6	103RD GENERAL ASSEMBLY
7	7	INTRODUCED BY SENATOR WEBBER.
8	8	1316S.01I KRISTINA MARTIN, Secretary
9	9	AN ACT
10	10	To repeal sections 188.015, 188.017, 188.026, 188.027, 188.038, 188.052, 188.056, 188.057,
11	11	188.058, 188.080, and 188.375, RSMo, and to enact in lieu thereof four new sections
12	12	relating to abortion, with an emergency clause.
13	13
14	14	Be it enacted by the General Assembly of the State of Missouri, as follows:
15	15	Section A. Sections 188.015, 188.017, 188.026, 188.027, 1
16	16	188.038, 188.052, 188.056, 188.057, 188.058, 188.080, and 2
17	17	188.375, RSMo, are repealed and four new sections enacted in 3
18	18	lieu thereof, to be known as sections 188.015, 188.027, 188.052, 4
19	19	and 188.080, to read as follows:5
20	20	188.015. As used in this chapter, the followin g terms 1
21	21	mean: 2
22	22	(1) "Abortion": 3
23	23	(a) The act of using or prescribing any instrument, 4
24	24	device, medicine, drug, or any other means or substance with 5
25	25	the intent to destroy the life of an embryo or fetus in his 6
26	26	or her mother's womb; or 7
27	27	(b) The intentional termination of the pregnancy of a 8
28	28	mother by using or prescribing any instrument, device, 9
29	29	medicine, drug, or other means or substance with an 10
30	30	intention other than to increase the probability of a live 11
31	31	birth or to remove a dead unborn child ; 12
32	32	(2) "Abortion facility", a clinic, physician's office, 13
33	33	or any other place or facility in which abortions are 14
34	34	performed or induced other than a hospital; 15 SB 241 2
35	35	(3) "Affiliate", a person who or entity that enters 16
36	36	into, with an abortion facility, a legal relationship 17
37	37	created or governed by at least one written instrument, 18
38	38	including a certificate of formation, a franchise agreement, 19
39	39	standards of affiliation, bylaws, or a license, that 20
40	40	demonstrates: 21
41	41	(a) Common ownership, management, or contr ol between 22
42	42	the parties to the relationship; 23
43	43	(b) A franchise granted by the person or entity to the 24
44	44	affiliate; or 25
45	45	(c) The granting or extension of a license or other 26
46	46	agreement authorizing the affiliate to use the other 27
47	47	person's or entity's b rand name, trademark, service mark, or 28
48	48	other registered identification mark; 29
49	49	(4) "Conception", the fertilization of the ovum of a 30
50	50	female by a sperm of a male; 31
51	51	(5) "Department", the department of health and senior 32
52	52	services; 33
53	53	(6) ["Down Syndrome", the same meaning as defined in 34
54	54	section 191.923; 35
55	55	(7)] "Gestational age", length of pregnancy as 36
56	56	measured from the first day of the woman's last menstrual 37
57	57	period; 38
58	58	[(8)] (7) "Medical emergency", a condition which, 39
59	59	based on reasonable medical judgment, so complicates the 40
60	60	medical condition of a pregnant woman as to necessitate the 41
61	61	immediate abortion of her pregnancy to avert the death of 42
62	62	the pregnant woman or for which a delay will create a 43
63	63	serious risk of substantial and irreversib le physical 44
64	64	impairment of a major bodily function of the pregnant woman; 45 SB 241 3
65	65	[(9)] (8) "Physician", any person licensed to practice 46
66	66	medicine in this state by the state board of registration 47
67	67	for the healing arts; 48
68	68	[(10)] (9) "Reasonable medical ju dgment", a medical 49
69	69	judgment that would be made by a reasonably prudent 50
70	70	physician, knowledgeable about the case and the treatment 51
71	71	possibilities with respect to the medical conditions 52
72	72	involved; 53
73	73	[(11)] (10) "Unborn child", the offspring of human 54
74	74	beings from the moment of conception until birth and at 55
75	75	every stage of its biological development, including the 56
76	76	human conceptus, zygote, morula, blastocyst, embryo, and 57
77	77	fetus; 58
78	78	[(12)] (11) "Viability" or "viable", that stage of 59
79	79	fetal development wh en the life of the unborn child may be 60
80	80	continued indefinitely outside the womb by natural or 61
81	81	artificial life-supportive systems; 62
82	82	[(13)] (12) "Viable pregnancy" or "viable intrauterine 63
83	83	pregnancy", in the first trimester of pregnancy, an 64
84	84	intrauterine pregnancy that can potentially result in a 65
85	85	liveborn baby. 66
86	86	188.027. 1. Except in cases of medical emergency, no 1
87	87	abortion shall be performed or induced on a woman without 2
88	88	her voluntary and informed consent, given freely and without 3
89	89	coercion. Consent to an abortion is voluntary and informed 4
90	90	and given freely and without coercion if, and only if, at 5
91	91	least seventy-two hours prior to the abortion: 6
92	92	(1) The physician who is to perform or induce the 7
93	93	abortion, a qualified professi onal, or the referring 8
94	94	physician has informed the woman orally, reduced to writing, 9
95	95	and in person, of the following: 10 SB 241 4
96	96	(a) The name of the physician who will perform or 11
97	97	induce the abortion; 12
98	98	(b) Medically accurate information that a reasonable 13
99	99	patient would consider material to the decision of whether 14
100	100	or not to undergo the abortion, including: 15
101	101	a. A description of the proposed abortion method; 16
102	102	b. The immediate and long -term medical risks to the 17
103	103	woman associated with the proposed ab ortion method 18
104	104	including, but not limited to, infection, hemorrhage, 19
105	105	cervical tear or uterine perforation, harm to subsequent 20
106	106	pregnancies or the ability to carry a subsequent child to 21
107	107	term, and possible adverse psychological effects associated 22
108	108	with the abortion; and 23
109	109	c. The immediate and long -term medical risks to the 24
110	110	woman, in light of the anesthesia and medication that is to 25
111	111	be administered, the unborn child's gestational age, and the 26
112	112	woman's medical history and medical condition; 27
113	113	(c) Alternatives to the abortion which shall include 28
114	114	making the woman aware that information and materials shall 29
115	115	be provided to her detailing such alternatives to the 30
116	116	abortion; 31
117	117	(d) A statement that the physician performing or 32
118	118	inducing the abortion is a vailable for any questions 33
119	119	concerning the abortion, together with the telephone number 34
120	120	that the physician may be later reached to answer any 35
121	121	questions that the woman may have; 36
122	122	(e) [The location of the hospital that offers 37
123	123	obstetrical or gynecolog ical care located within thirty 38
124	124	miles of the location where the abortion is performed or 39
125	125	induced and at which the physician performing or inducing 40
126	126	the abortion has clinical privileges and where the woman may 41 SB 241 5
127	127	receive follow-up care by the physician if c omplications 42
128	128	arise; 43
129	129	(f)] The gestational age of the unborn child at the 44
130	130	time the abortion is to be performed or induced; and 45
131	131	[(g)] (f) The anatomical and physiological 46
132	132	characteristics of the unborn child at the time the abortion 47
133	133	is to be performed or induced; 48
134	134	(2) The physician who is to perform or induce the 49
135	135	abortion or a qualified professional has presented the 50
136	136	woman, in person, printed materials provided by the 51
137	137	department, which describe the probable anatomical and 52
138	138	physiological characteristics of the unborn child at two - 53
139	139	week gestational increments from conception to full term, 54
140	140	including color photographs or images of the developing 55
141	141	unborn child at two-week gestational increments. Such 56
142	142	descriptions shall include information a bout brain and heart 57
143	143	functions, the presence of external members and internal 58
144	144	organs during the applicable stages of development and 59
145	145	information on when the unborn child is viable. The printed 60
146	146	materials shall prominently display the following 61
147	147	statement: "The life of each human being begins at 62
148	148	conception. Abortion will terminate the life of a separate, 63
149	149	unique, living human being."; 64
150	150	(3) The physician who is to perform or induce the 65
151	151	abortion, a qualified professional, or the referring 66
152	152	physician has presented the woman, in person, printed 67
153	153	materials provided by the department, which describe the 68
154	154	various surgical and drug -induced methods of abortion 69
155	155	relevant to the stage of pregnancy, as well as the immediate 70
156	156	and long-term medical risks commo nly associated with each 71
157	157	abortion method including, but not limited to, infection, 72
158	158	hemorrhage, cervical tear or uterine perforation, harm to 73 SB 241 6
159	159	subsequent pregnancies or the ability to carry a subsequent 74
160	160	child to term, and the possible adverse psychologic al 75
161	161	effects associated with an abortion; 76
162	162	(4) The physician who is to perform or induce the 77
163	163	abortion or a qualified professional shall provide the woman 78
164	164	with the opportunity to view at least seventy -two hours 79
165	165	prior to the abortion an active ultraso und of the unborn 80
166	166	child and hear the heartbeat of the unborn child if the 81
167	167	heartbeat is audible. The woman shall be provided with a 82
168	168	geographically indexed list maintained by the department of 83
169	169	health care providers, facilities, and clinics that perform 84
170	170	ultrasounds, including those that offer ultrasound services 85
171	171	free of charge. Such materials shall provide contact 86
172	172	information for each provider, facility, or clinic including 87
173	173	telephone numbers and, if available, website addresses. 88
174	174	Should the woman decide to obtain an ultrasound from a 89
175	175	provider, facility, or clinic other than the abortion 90
176	176	facility, the woman shall be offered a reasonable time to 91
177	177	obtain the ultrasound examination before the date and time 92
178	178	set for performing or inducing an abortion. The person 93
179	179	conducting the ultrasound shall ensure that the active 94
180	180	ultrasound image is of a quality consistent with standard 95
181	181	medical practice in the community, contains the dimensions 96
182	182	of the unborn child, and accurately portrays the presence of 97
183	183	external members and internal organs, if present or 98
184	184	viewable, of the unborn child. The auscultation of fetal 99
185	185	heart tone must also be of a quality consistent with 100
186	186	standard medical practice in the community. If the woman 101
187	187	chooses to view the ultrasound or hear the heartbeat or both 102
188	188	at the abortion facility, the viewing or hearing or both 103
189	189	shall be provided to her at the abortion facility at least 104 SB 241 7
190	190	seventy-two hours prior to the abortion being performed or 105
191	191	induced; 106
192	192	(5) The printed materials provided by t he department 107
193	193	shall include information on the possibility of an abortion 108
194	194	causing pain in the unborn child. This information shall 109
195	195	include, but need not be limited to, the following: 110
196	196	(a) Unborn children as early as eight weeks 111
197	197	gestational age start to show spontaneous movements and 112
198	198	unborn children at this stage in pregnancy show reflex 113
199	199	responses to touch; 114
200	200	(b) In the unborn child, the area around his or her 115
201	201	mouth and lips is the first part of the unborn child's body 116
202	202	to respond to touch a nd by fourteen weeks gestational age 117
203	203	most of the unborn child's body is responsive to touch; 118
204	204	(c) Pain receptors on the unborn child's skin develop 119
205	205	around his or her mouth at around seven to eight weeks 120
206	206	gestational age, around the palms of his or h er hands at ten 121
207	207	to ten and a half weeks, on the abdominal wall at fifteen 122
208	208	weeks, and over all of his or her body at sixteen weeks 123
209	209	gestational age; 124
210	210	(d) Beginning at sixteen weeks gestational age and 125
211	211	later, it is possible for pain to be transmitted from 126
212	212	receptors to the cortex of the unborn child's brain, where 127
213	213	thinking and perceiving occur; 128
214	214	(e) When a physician performs a life -saving surgery, 129
215	215	he or she provides anesthesia to unborn children as young as 130
216	216	sixteen weeks gestational age in ord er to alleviate the 131
217	217	unborn child's pain; and 132
218	218	(f) A description of the actual steps in the abortion 133
219	219	procedure to be performed or induced and at which steps the 134
220	220	abortion procedure could be painful to the unborn child; 135 SB 241 8
221	221	(6) The physician who is to perform or induce the 136
222	222	abortion or a qualified professional has presented the 137
223	223	woman, in person, printed materials provided by the 138
224	224	department explaining to the woman alternatives to abortion 139
225	225	she may wish to consider. Such materials shall: 140
226	226	(a) Identify on a geographical basis public and 141
227	227	private agencies available to assist a woman in carrying her 142
228	228	unborn child to term, and to assist her in caring for her 143
229	229	dependent child or placing her child for adoption, including 144
230	230	agencies commonly known and g enerally referred to as 145
231	231	pregnancy resource centers, crisis pregnancy centers, 146
232	232	maternity homes, and adoption agencies. Such materials 147
233	233	shall provide a comprehensive list by geographical area of 148
234	234	the agencies, a description of the services they offer, and 149
235	235	the telephone numbers and addresses of the agencies; 150
236	236	provided that such materials shall not include any programs, 151
237	237	services, organizations, or affiliates of organizations that 152
238	238	perform or induce, or assist in the performing or inducing 153
239	239	of, abortions or that refer for abortions; 154
240	240	(b) Explain the Missouri alternatives to abortion 155
241	241	services program under section 188.325, and any other 156
242	242	programs and services available to pregnant women and 157
243	243	mothers of newborn children offered by public or private 158
244	244	agencies which assist a woman in carrying her unborn child 159
245	245	to term and assist her in caring for her dependent child or 160
246	246	placing her child for adoption, including but not limited to 161
247	247	prenatal care; maternal health care; newborn or infant care; 162
248	248	mental health services; professional counseling services; 163
249	249	housing programs; utility assistance; transportation 164
250	250	services; food, clothing, and supplies related to pregnancy; 165
251	251	parenting skills; educational programs; job training and 166 SB 241 9
252	252	placement services; drug and alcohol t esting and treatment; 167
253	253	and adoption assistance; 168
254	254	(c) Identify the state website for the Missouri 169
255	255	alternatives to abortion services program under section 170
256	256	188.325, and any toll -free number established by the state 171
257	257	operated in conjunction with the pro gram; 172
258	258	(d) Prominently display the statement: "There are 173
259	259	public and private agencies willing and able to help you 174
260	260	carry your child to term, and to assist you and your child 175
261	261	after your child is born, whether you choose to keep your 176
262	262	child or place him or her for adoption. The state of 177
263	263	Missouri encourages you to contact those agencies before 178
264	264	making a final decision about abortion. State law requires 179
265	265	that your physician or a qualified professional give you the 180
266	266	opportunity to call agencies like t hese before you undergo 181
267	267	an abortion."; 182
268	268	(7) The physician who is to perform or induce the 183
269	269	abortion or a qualified professional has presented the 184
270	270	woman, in person, printed materials provided by the 185
271	271	department explaining that the father of the unbor n child is 186
272	272	liable to assist in the support of the child, even in 187
273	273	instances where he has offered to pay for the abortion. 188
274	274	Such materials shall include information on the legal duties 189
275	275	and support obligations of the father of a child, including, 190
276	276	but not limited to, child support payments, and the fact 191
277	277	that paternity may be established by the father's name on a 192
278	278	birth certificate or statement of paternity, or by court 193
279	279	action. Such printed materials shall also state that more 194
280	280	information concerning pat ernity establishment and child 195
281	281	support services and enforcement may be obtained by calling 196
282	282	the family support division within the Missouri department 197
283	283	of social services; and 198 SB 241 10
284	284	(8) The physician who is to perform or induce the 199
285	285	abortion or a qualifie d professional shall inform the woman 200
286	286	that she is free to withhold or withdraw her consent to the 201
287	287	abortion at any time without affecting her right to future 202
288	288	care or treatment and without the loss of any state or 203
289	289	federally funded benefits to which she m ight otherwise be 204
290	290	entitled. 205
291	291	2. All information required to be provided to a woman 206
292	292	considering abortion by subsection 1 of this section shall 207
293	293	be presented to the woman individually, in the physical 208
294	294	presence of the woman and in a private room, to p rotect her 209
295	295	privacy, to maintain the confidentiality of her decision, to 210
296	296	ensure that the information focuses on her individual 211
297	297	circumstances, to ensure she has an adequate opportunity to 212
298	298	ask questions, and to ensure that she is not a victim of 213
299	299	coerced abortion. Should a woman be unable to read 214
300	300	materials provided to her, they shall be read to her. 215
301	301	Should a woman need an interpreter to understand the 216
302	302	information presented in the written materials, an 217
303	303	interpreter shall be provided to her. Should a woman ask 218
304	304	questions concerning any of the information or materials, 219
305	305	answers shall be provided in a language she can understand. 220
306	306	3. No abortion shall be performed or induced unless 221
307	307	and until the woman upon whom the abortion is to be 222
308	308	performed or induced certifies in writing on a checklist 223
309	309	form provided by the department that she has been presented 224
310	310	all the information required in subsection 1 of this 225
311	311	section, that she has been provided the opportunity to view 226
312	312	an active ultrasound image of the unb orn child and hear the 227
313	313	heartbeat of the unborn child if it is audible, and that she 228
314	314	further certifies that she gives her voluntary and informed 229 SB 241 11
315	315	consent, freely and without coercion, to the abortion 230
316	316	procedure. 231
317	317	4. No physician shall perform or indu ce an abortion 232
318	318	unless and until the physician has obtained from the woman 233
319	319	her voluntary and informed consent given freely and without 234
320	320	coercion. If the physician has reason to believe that the 235
321	321	woman is being coerced into having an abortion, the 236
322	322	physician or qualified professional shall inform the woman 237
323	323	that services are available for her and shall provide her 238
324	324	with private access to a telephone and information about 239
325	325	such services, including but not limited to the following: 240
326	326	(1) Rape crisis centers, as defined in section 455.003; 241
327	327	(2) Shelters for victims of domestic violence, as 242
328	328	defined in section 455.200; and 243
329	329	(3) Orders of protection, pursuant to chapter 455. 244
330	330	5. The physician who is to perform or induce the 245
331	331	abortion shall, at least seventy-two hours prior to such 246
332	332	procedure, inform the woman orally and in person of: 247
333	333	(1) The immediate and long -term medical risks to the 248
334	334	woman associated with the proposed abortion method 249
335	335	including, but not limited to, infection, hemorrhag e, 250
336	336	cervical tear or uterine perforation, harm to subsequent 251
337	337	pregnancies or the ability to carry a subsequent child to 252
338	338	term, and possible adverse psychological effects associated 253
339	339	with the abortion; and 254
340	340	(2) The immediate and long -term medical risks to the 255
341	341	woman, in light of the anesthesia and medication that is to 256
342	342	be administered, the unborn child's gestational age, and the 257
343	343	woman's medical history and medical conditions. 258
344	344	6. No physician shall perform or induce an abortion 259
345	345	unless and until the physician has received and signed a 260
346	346	copy of the form prescribed in subsection 3 of this 261 SB 241 12
347	347	section. The physician shall retain a copy of the form in 262
348	348	the patient's medical record. 263
349	349	7. In the event of a medical emergency, the physician 264
350	350	who performed or induced the abortion shall clearly certify 265
351	351	in writing the nature and circumstances of the medical 266
352	352	emergency. This certification shall be signed by the 267
353	353	physician who performed or induced the abortion, and shall 268
354	354	be maintained under section 188.060 . 269
355	355	8. No person or entity shall require, obtain, or 270
356	356	accept payment for an abortion from or on behalf of a 271
357	357	patient until at least seventy -two hours have passed since 272
358	358	the time that the information required by subsection 1 of 273
359	359	this section has been pr ovided to the patient. Nothing in 274
360	360	this subsection shall prohibit a person or entity from 275
361	361	notifying the patient that payment for the abortion will be 276
362	362	required after the seventy -two-hour period has expired if 277
363	363	she voluntarily chooses to have the abortion . 278
364	364	9. The term "qualified professional" as used in this 279
365	365	section shall refer to a physician, physician assistant, 280
366	366	registered nurse, licensed practical nurse, psychologist, 281
367	367	licensed professional counselor, or licensed social worker, 282
368	368	licensed or registered under chapter 334, 335, or 337, 283
369	369	acting under the supervision of the physician performing or 284
370	370	inducing the abortion, and acting within the course and 285
371	371	scope of his or her authority provided by law. The 286
372	372	provisions of this section shall not be const rued to in any 287
373	373	way expand the authority otherwise provided by law relating 288
374	374	to the licensure, registration, or scope of practice of any 289
375	375	such qualified professional. 290
376	376	10. By November 30, 2010, the department shall produce 291
377	377	the written materials and f orms described in this section. 292
378	378	Any written materials produced shall be printed in a 293 SB 241 13
379	379	typeface large enough to be clearly legible. All 294
380	380	information shall be presented in an objective, unbiased 295
381	381	manner designed to convey only accurate scientific and 296
382	382	medical information. The department shall furnish the 297
383	383	written materials and forms at no cost and in sufficient 298
384	384	quantity to any person who performs or induces abortions, or 299
385	385	to any hospital or facility that provides abortions. The 300
386	386	department shall make al l information required by subsection 301
387	387	1 of this section available to the public through its 302
388	388	department website. The department shall maintain a toll - 303
389	389	free, twenty-four-hour hotline telephone number where a 304
390	390	caller can obtain information on a regional bas is concerning 305
391	391	the agencies and services described in subsection 1 of this 306
392	392	section. No identifying information regarding persons who 307
393	393	use the website shall be collected or maintained. The 308
394	394	department shall monitor the website on a regular basis to 309
395	395	prevent tampering and correct any operational deficiencies. 310
396	396	11. In order to preserve the compelling interest of 311
397	397	the state to ensure that the choice to consent to an 312
398	398	abortion is voluntary and informed, and given freely and 313
399	399	without coercion, the departm ent shall use the procedures 314
400	400	for adoption of emergency rules under section 536.025 in 315
401	401	order to promulgate all necessary rules, forms, and other 316
402	402	necessary material to implement this section by November 30, 317
403	403	2010. 318
404	404	12. If the provisions in subsection s 1 and 8 of this 319
405	405	section requiring a seventy -two-hour waiting period for an 320
406	406	abortion are ever temporarily or permanently restrained or 321
407	407	enjoined by judicial order, then the waiting period for an 322
408	408	abortion shall be twenty -four hours; provided, however, t hat 323
409	409	if such temporary or permanent restraining order or 324
410	410	injunction is stayed or dissolved, or otherwise ceases to 325 SB 241 14
411	411	have effect, the waiting period for an abortion shall be 326
412	412	seventy-two hours. 327
413	413	188.052. 1. An individual abortion report for each 1
414	414	abortion performed or induced upon a woman shall be 2
415	415	completed by the physician who performed or induced the 3
416	416	abortion. [Abortion reports shall include, but not be 4
417	417	limited to, a certification that the physician does not have 5
418	418	any knowledge that the woman sought the abortion solely 6
419	419	because of a prenatal diagnosis, test, or screening 7
420	420	indicating Down Syndrome or the potential of Down Syndrome 8
421	421	in the unborn child and a certification that the physician 9
422	422	does not have any knowledge that the woman sought the 10
423	423	abortion solely because of the sex or race of the unborn 11
424	424	child.] 12
425	425	2. An individual complication report for any post - 13
426	426	abortion care performed upon a woman shall be completed by 14
427	427	the physician providing such post -abortion care. This 15
428	428	report shall include: 16
429	429	(1) The date of the abortion; 17
430	430	(2) The name and address of the abortion facility or 18
431	431	hospital where the abortion was performed or induced; 19
432	432	(3) The nature of the abortion complication diagnosed 20
433	433	or treated. 21
434	434	3. All abortion reports shall be signed by the 22
435	435	attending physician who performed or induced the abortion 23
436	436	and submitted to the department within forty -five days from 24
437	437	the date of the abortion. All complication reports shall be 25
438	438	signed by the physician providing th e post-abortion care and 26
439	439	submitted to the department within forty -five days from the 27
440	440	date of the post-abortion care. 28
441	441	4. A copy of the abortion report shall be made a part 29
442	442	of the medical record of the patient of the abortion 30 SB 241 15
443	443	facility or hospital i n which the abortion was performed or 31
444	444	induced. 32
445	445	5. The department shall be responsible for collecting 33
446	446	all abortion reports and complication reports and collating 34
447	447	and evaluating all data gathered therefrom and shall 35
448	448	annually publish a statistical r eport based on such data 36
449	449	from abortions performed or induced in the previous calendar 37
450	450	year. 38
451	451	188.080. Any person who is not a physician who 1
452	452	performs or induces or attempts to perform or induce an 2
453	453	abortion on another is guilty of a cl ass B felony, and, upon 3
454	454	conviction, shall be punished as provided by law. [Any 4
455	455	physician performing or inducing an abortion who does not 5
456	456	have clinical privileges at a hospital which offers 6
457	457	obstetrical or gynecological care located within thirty 7
458	458	miles of the location at which the abortion is performed or 8
459	459	induced shall be guilty of a class A misdemeanor, and, upon 9
460	460	conviction shall be punished as provided by law. ] 10
461	461	[188.017. 1. This section shall be known 1
462	462	and may be cited as the "R ight to Life of the 2
463	463	Unborn Child Act". 3
464	464	2. Notwithstanding any other provision of 4
465	465	law to the contrary, no abortion shall be 5
466	466	performed or induced upon a woman, except in 6
467	467	cases of medical emergency. Any person who 7
468	468	knowingly performs or induces an abortion of an 8
469	469	unborn child in violation of this subsection 9
470	470	shall be guilty of a class B felony, as well as 10
471	471	subject to suspension or revocation of his or 11
472	472	her professional license by his or her 12
473	473	professional licensing board. A woman upon whom 13
474	474	an abortion is performed or induced in violation 14
475	475	of this subsection shall not be prosecuted for a 15
476	476	conspiracy to violate the provisions of this 16
477	477	subsection. 17
478	478	3. It shall be an affirmative defense for 18
479	479	any person alleged to have violated the 19 SB 241 16
480	480	provisions of subsection 2 of this section that 20
481	481	the person performed or induced an abortion 21
482	482	because of a medical emergency. The defendant 22
483	483	shall have the burden of persuasion that the 23
484	484	defense is more probably true than not. 24
485	485	4. The enactment of this section shall 25
486	486	only become effective upon notification to the 26
487	487	revisor of statutes by an opinion by the 27
488	488	attorney general of Missouri, a proclamation by 28
489	489	the governor of Missouri, or the adoption of a 29
490	490	concurrent resolution by the Missouri general 30
491	491	assembly that: 31
492	492	(1) The United States Supreme Court has 32
493	493	overruled, in whole or in part, Roe v. Wade, 410 33
494	494	U.S. 113 (1973), restoring or granting to the 34
495	495	state of Missouri the authority to regulate 35
496	496	abortion to the extent set forth in this 36
497	497	section, and that as a result, it is reasonably 37
498	498	probable that this section would be upheld by 38
499	499	the court as constitutional; 39
500	500	(2) An amendment to the Constitution of 40
501	501	the United States has been adopted that has the 41
502	502	effect of restoring or granting to the state of 42
503	503	Missouri the authority to regulate abortion to 43
504	504	the extent set forth in this section; or 44
505	505	(3) The United States Congress has enacted 45
506	506	a law that has the effect of restoring or 46
507	507	granting to the state of Missouri the authority 47
508	508	to regulate abortion to the extent set fo rth in 48
509	509	this section.] 49
510	510	[188.026. 1. This section and sections 1
511	511	188.056, 188.057, and 188.058 shall be known and 2
512	512	may be cited as the "Missouri Stands for the 3
513	513	Unborn Act". 4
514	514	2. In Roe v. Wade, 410 U.S. 113 (1973), 5
515	515	certain information about the development of the 6
516	516	unborn child, human pregnancy, and the effects 7
517	517	of abortion was either not part of the record or 8
518	518	was not available at the time. Since 1973, 9
519	519	advances in medical and scientific technology 10
520	520	have greatly expanded our knowle dge of prenatal 11
521	521	life and the effects of abortion on women. The 12
522	522	general assembly of this state finds: 13 SB 241 17
523	523	(1) At conception, a new genetically 14
524	524	distinct human being is formed; 15
525	525	(2) The fact that the life of an 16
526	526	individual human being begins at con ception has 17
527	527	long been recognized in Missouri law: "[T]he 18
528	528	child is, in truth, alive from the moment of 19
529	529	conception". State v. Emerich, 13 Mo. App. 492, 20
530	530	495 (1883), affirmed, 87 Mo. 110 (1885). Under 21
531	531	section 1.205, the general assembly has 22
532	532	recognized that the life of each human being 23
533	533	begins at conception and that unborn children 24
534	534	have protectable interests in life, health, and 25
535	535	well-being; 26
536	536	(3) The first prohibition of abortion in 27
537	537	Missouri was enacted in 1825. Since then, the 28
538	538	repeal and reenactment of prohibitions of 29
539	539	abortion have made distinctions with respect to 30
540	540	penalties for performing or inducing abortion on 31
541	541	the basis of "quickening"; however, the unborn 32
542	542	child was still protected from conception onward; 33
543	543	(4) In ruling that Missouri 's prohibition 34
544	544	on abortion was constitutional in 1972, the 35
545	545	Missouri supreme court accepted as a stipulation 36
546	546	of the parties that "'[i]nfant Doe, Intervenor 37
547	547	Defendant in this case, and all other unborn 38
548	548	children have all the qualities and attributes 39
549	549	of adult human persons differing only in age or 40
550	550	maturity. Medically, human life is a continuum 41
551	551	from conception to death.'" Rodgers v. Danforth, 42
552	552	486 S.W.2d 258, 259 (1972); 43
553	553	(5) In Webster v. Reproductive Health 44
554	554	Services, 492 U.S. 490 (1989), the Sup reme 45
555	555	Court, while considering the "preamble" that set 46
556	556	forth "findings" in section 1.205, stated: "We 47
557	557	think the extent to which the preamble's 48
558	558	language might be used to interpret other state 49
559	559	statutes or regulations is something that only 50
560	560	the courts of Missouri can definitively decide. 51
561	561	State law has offered protections to unborn 52
562	562	children in tort and probate law". Id. at 506. 53
563	563	Since Webster, Missouri courts have construed 54
564	564	section 1.205 and have consistently found that 55
565	565	an unborn child is a person f or purposes of 56
566	566	Missouri's homicide and assault laws when the 57 SB 241 18
567	567	unborn child's mother was killed or assaulted by 58
568	568	another person. Section 1.205 has even been 59
569	569	found applicable to the manslaughter of an 60
570	570	unborn child who was eight weeks gestational age 61
571	571	or earlier. State v. Harrison, 390 S.W.3d 927 62
572	572	(Mo. Ct. App. 2013); 63
573	573	(6) In medicine, a special emphasis is 64
574	574	placed on the heartbeat. The heartbeat is a 65
575	575	discernible sign of life at every stage of human 66
576	576	existence. During the fifth week of gestational 67
577	577	age, an unborn child's heart begins to beat and 68
578	578	blood flow begins during the sixth week; 69
579	579	(7) Depending on the ultrasound equipment 70
580	580	being used, the unborn child's heartbeat can be 71
581	581	visually detected as early as six to eight weeks 72
582	582	gestational age. By about twelve weeks 73
583	583	gestational age, the unborn child's heartbeat 74
584	584	can consistently be made audible through the use 75
585	585	of a handheld Doppler fetal heart rate device; 76
586	586	(8) Confirmation of a pregnancy can be 77
587	587	indicated through the detection of the un born 78
588	588	child's heartbeat, while the absence of a 79
589	589	heartbeat can be an indicator of the death of 80
590	590	the unborn child if the child has reached the 81
591	591	point of development when a heartbeat should be 82
592	592	detectable; 83
593	593	(9) Heart rate monitoring during pregnancy 84
594	594	and labor is utilized to measure the heart rate 85
595	595	and rhythm of the unborn child, at an average 86
596	596	rate between one hundred ten and one hundred 87
597	597	sixty beats per minute, and helps determine the 88
598	598	health of the unborn child; 89
599	599	(10) The Supreme Court in Roe dis cussed 90
600	600	"the difficult question of when life begins" and 91
601	601	wrote: "[p]hysicians and their scientific 92
602	602	colleagues have regarded [quickening] with less 93
603	603	interest and have tended to focus either upon 94
604	604	conception, upon live birth, or upon the interim 95
605	605	point at which the fetus becomes 'viable', that 96
606	606	is, potentially able to live outside the 97
607	607	mother's womb, albeit with artificial aid". 98
608	608	Roe, 410 U.S. at 160. Today, however, 99
609	609	physicians' and scientists' interests on life in 100
610	610	the womb also focus on other markers o f 101 SB 241 19
611	611	development in the unborn child, including, but 102
612	612	not limited to, presence of a heartbeat, brain 103
613	613	development, a viable pregnancy or viable 104
614	614	intrauterine pregnancy during the first 105
615	615	trimester of pregnancy, and the ability to 106
616	616	experience pain; 107
617	617	(11) In Planned Parenthood of Central 108
618	618	Missouri v. Danforth, 428 U.S. 52 (1976), the 109
619	619	Supreme Court noted that "we recognized in Roe 110
620	620	that viability was a matter of medical judgment, 111
621	621	skill, and technical ability, and we preserved 112
622	622	the flexibility of the term". Id. at 64. Due to 113
623	623	advances in medical technology and diagnoses, 114
624	624	present-day physicians and scientists now 115
625	625	describe the viability of an unborn child in an 116
626	626	additional manner, by determining whether there 117
627	627	is a viable pregnancy or viable intrauterine 118
628	628	pregnancy during the first trimester of 119
629	629	pregnancy; 120
630	630	(12) While the overall risk of miscarriage 121
631	631	after clinical recognition of pregnancy is 122
632	632	twelve to fifteen percent, the incidence 123
633	633	decreases significantly if cardiac activity in 124
634	634	the unborn child has been confirmed. The 125
635	635	detection of a heartbeat in an unborn child is a 126
636	636	reliable indicator of a viable pregnancy and 127
637	637	that the unborn child will likely survive to 128
638	638	birth, especially if presenting for a prenatal 129
639	639	visit at eight weeks gestational age or late r. 130
640	640	For asymptomatic women attending a first 131
641	641	prenatal visit between six and eleven weeks 132
642	642	gestational age where a heartbeat was confirmed 133
643	643	through an ultrasound, the subsequent risk of 134
644	644	miscarriage is one and six -tenths percent. 135
645	645	Although the risk is hi gher at six weeks 136
646	646	gestational age at nine and four -tenths percent, 137
647	647	it declines rapidly to one and five -tenths 138
648	648	percent at eight weeks gestational age, and less 139
649	649	than one percent at nine weeks gestational age 140
650	650	or later; 141
651	651	(13) The presence of a heartb eat in an 142
652	652	unborn child represents a more definable point 143
653	653	of ascertaining survivability than the ambiguous 144
654	654	concept of viability that has been adopted by 145 SB 241 20
655	655	the Supreme Court, especially since if a 146
656	656	heartbeat is detected at eight weeks gestational 147
657	657	age or later in a normal pregnancy, there is 148
658	658	likely to be a viable pregnancy and there is a 149
659	659	high probability that the unborn child will 150
660	660	survive to birth; 151
661	661	(14) The placenta begins developing during 152
662	662	the early first trimester of pregnancy and 153
663	663	performs a respiratory function by making oxygen 154
664	664	supply to and carbon dioxide removal from the 155
665	665	unborn child possible later in the first 156
666	666	trimester and throughout the second and third 157
667	667	trimesters of pregnancy; 158
668	668	(15) By the fifth week of gestation, the 159
669	669	development of the brain of the unborn child is 160
670	670	underway. Brain waves have been measured and 161
671	671	recorded as early as the eighth week of 162
672	672	gestational age in children who were removed 163
673	673	during an ectopic pregnancy or hysterectomy. 164
674	674	Fetal magnetic resonance imaging (MR I) of an 165
675	675	unborn child's brain is used during the second 166
676	676	and third trimesters of pregnancy and brain 167
677	677	activity has been observed using MRI; 168
678	678	(16) Missouri law identifies the presence 169
679	679	of circulation, respiration, and brain function 170
680	680	as indicia of life under section 194.005, as the 171
681	681	presence of circulation, respiration, and brain 172
682	682	function indicates that such person is not 173
683	683	legally dead, but is legally alive; 174
684	684	(17) Unborn children at eight weeks 175
685	685	gestational age show spontaneous movements, such 176
686	686	as a twitching of the trunk and developing 177
687	687	limbs. It has been reported that unborn 178
688	688	children at this stage show reflex responses to 179
689	689	touch. The perioral area is the first part of 180
690	690	the unborn child's body to respond to touch at 181
691	691	about eight weeks gestatio nal age and by 182
692	692	fourteen weeks gestational age most of the 183
693	693	unborn child's body is responsive to touch; 184
694	694	(18) Peripheral cutaneous sensory 185
695	695	receptors, the receptors that feel pain, develop 186
696	696	early in the unborn child. They appear in the 187
697	697	perioral cutaneous area at around seven to eight 188
698	698	weeks gestational age, in the palmar regions at 189 SB 241 21
699	699	ten to ten and a half weeks gestational age, the 190
700	700	abdominal wall at fifteen weeks gestational age, 191
701	701	and over all of the unborn child's body at 192
702	702	sixteen weeks gestational age; 193
703	703	(19) Substance P, a peptide that functions 194
704	704	as a neurotransmitter, especially in the 195
705	705	transmission of pain, is present in the dorsal 196
706	706	horn of the spinal cord of the unborn child at 197
707	707	eight to ten weeks gestational age. 198
708	708	Enkephalins, peptides tha t play a role in 199
709	709	neurotransmission and pain modulation, are 200
710	710	present in the dorsal horn at twelve to fourteen 201
711	711	weeks gestational age; 202
712	712	(20) When intrauterine needling is 203
713	713	performed on an unborn child at sixteen weeks 204
714	714	gestational age or later, the re action to this 205
715	715	invasive stimulus is blood flow redistribution 206
716	716	to the brain. Increased blood flow to the brain 207
717	717	is the same type of stress response seen in a 208
718	718	born child and an adult; 209
719	719	(21) By sixteen weeks gestational age, 210
720	720	pain transmission from a peripheral receptor to 211
721	721	the cortex is possible in the unborn child; 212
722	722	(22) Physicians provide anesthesia during 213
723	723	in utero treatment of unborn children as early 214
724	724	as sixteen weeks gestational age for certain 215
725	725	procedures, including those to correct fetal 216
726	726	urinary tract obstruction. Anesthesia is 217
727	727	administered by ultrasound -guided injection into 218
728	728	the arm or leg of the unborn child; 219
729	729	(23) A leading textbook on prenatal 220
730	730	development of the human brain states, "It may 221
731	731	be concluded that, although nocipe rception (the 222
732	732	actual perception of pain) awaits the appearance 223
733	733	of consciousness, nociception (the experience of 224
734	734	pain) is present some time before birth. In the 225
735	735	absence of disproof, it is merely prudent to 226
736	736	assume that pain can be experienced even earl y 227
737	737	in prenatal life (Dr. J. Wisser, Zürich): the 228
738	738	fetus should be given the benefit of the 229
739	739	doubt". Ronan O'Rahilly & Fabiola Müller. The 230
740	740	Embryonic Human Brain: An Atlas of 231
741	741	Developmental Stages (3d ed. 2005); 232 SB 241 22
742	742	(24) By fourteen or fifteen weeks 233
743	743	gestational age or later, the predominant 234
744	744	abortion method in Missouri is dilation and 235
745	745	evacuation (D&E). The D&E abortion method 236
746	746	includes the dismemberment, disarticulation, and 237
747	747	exsanguination of the unborn child, causing the 238
748	748	unborn child's death; 239
749	749	(25) The Supreme Court acknowledged in 240
750	750	Gonzales v. Carhart, 550 U.S. 124, 160 (2007), 241
751	751	that "the standard D&E is in some respects as 242
752	752	brutal, if not more, than the intact D&E" 243
753	753	partial birth abortion method banned by Congress 244
754	754	and upheld as facially con stitutional by the 245
755	755	Supreme Court, even though the federal ban was 246
756	756	applicable both before and after viability and 247
757	757	had no exception for the health of the mother; 248
758	758	(26) Missouri's ban on the partial birth 249
759	759	abortion method, section 565.300, is in effec t 250
760	760	because of Gonzales v. Carhart and the Supreme 251
761	761	Court's subsequent decision in Nixon v. 252
762	762	Reproductive Health Services of Planned 253
763	763	Parenthood of the St. Louis Region, Inc., 550 254
764	764	U.S. 901 (2007), to vacate and remand to the 255
765	765	appellate court the prior inva lidation of 256
766	766	section 565.300. Since section 565.300, like 257
767	767	Congress' ban on partial birth abortion, is 258
768	768	applicable both before and after viability, 259
769	769	there is ample precedent for the general 260
770	770	assembly to constitutionally prohibit the brutal 261
771	771	D&E abortion method at fourteen weeks 262
772	772	gestational age or later, even before the unborn 263
773	773	child is viable, with a medical emergency 264
774	774	exception; 265
775	775	(27) In Roper v. Simmons, 543 U.S. 551 266
776	776	(2005), the Supreme Court determined that 267
777	777	"evolving standards of decency" dictat ed that a 268
778	778	Missouri statute allowing the death penalty for 269
779	779	a conviction of murder in the first degree for a 270
780	780	person under eighteen years of age when the 271
781	781	crime was committed was unconstitutional under 272
782	782	the Eighth and Fourteenth Amendments to the 273
783	783	United States Constitution because it violated 274
784	784	the prohibition against "cruel and unusual 275
785	785	punishments"; 276 SB 241 23
786	786	(28) In Bucklew v. Precythe, 139 S. Ct. 277
787	787	1112, 1123 (2019), the Supreme Court noted that 278
788	788	"'[d]isgusting' practices" like disemboweling 279
789	789	and quartering "readily qualified as 'cruel and 280
790	790	unusual', as a reader at the time of the Eighth 281
791	791	Amendment's adoption would have understood those 282
792	792	words"; 283
793	793	(29) Evolving standards of decency dictate 284
794	794	that Missouri should prohibit the brutal and 285
795	795	painful D&E abortion method at fourteen weeks 286
796	796	gestational age or later, with a medical 287
797	797	emergency exception, because if a comparable 288
798	798	method of killing was used on: 289
799	799	(a) A person convicted of murder in the 290
800	800	first degree, it would be cruel and unusual 291
801	801	punishment; or 292
802	802	(b) An animal, it would be unlawful under 293
803	803	state law because it would not be a humane 294
804	804	method, humane euthanasia, or humane killing of 295
805	805	certain animals under chapters 273 and 578; 296
806	806	(30) In Roper, the Supreme Court also 297
807	807	found that "[i]t is proper that we acknowledge 298
808	808	the overwhelming weight of international opinion 299
809	809	against the juvenile death penalty.... The 300
810	810	opinion of the world community, while not 301
811	811	controlling our outcome, does provide respected 302
812	812	and significant confirmation for our own 303
813	813	conclusions". Roper, 543 U.S. at 578. In its 304
814	814	opinion, the Supreme Court was instructed by 305
815	815	"international covenants prohibiting the 306
816	816	juvenile death penalty", such as the 307
817	817	International Covenant on Civil and Political 308
818	818	Rights, 999 U.N.T.S. 171. Id. at 577; 309
819	819	(31) The opinion of the world community, 310
820	820	reflected in the laws of the United Nation's 193 - 311
821	821	member states and six other entities, is that in 312
822	822	most countries, most abortions are prohibited 313
823	823	after twelve weeks gestational age or later; 314
824	824	(32) The opinion of the world community is 315
825	825	also shared by most Americans, who believe that 316
826	826	most abortions in the second and third 317
827	827	trimesters of pregnancy should be illegal, based 318
828	828	on polling that has remained consistent since 319
829	829	1996; 320 SB 241 24
830	830	(33) Abortion procedures pe rformed later 321
831	831	in pregnancy have a higher medical risk for 322
832	832	women. Compared to an abortion at eight weeks 323
833	833	gestational age or earlier, the relative risk 324
834	834	increases exponentially at later gestational 325
835	835	ages. The relative risk of death for a pregnant 326
836	836	woman who had an abortion performed or induced 327
837	837	upon her at: 328
838	838	(a) Eleven to twelve weeks gestational age 329
839	839	is between three and four times higher than an 330
840	840	abortion at eight weeks gestational age or 331
841	841	earlier; 332
842	842	(b) Thirteen to fifteen weeks gestational 333
843	843	age is almost fifteen times higher than an 334
844	844	abortion at eight weeks gestational age or 335
845	845	earlier; 336
846	846	(c) Sixteen to twenty weeks gestational 337
847	847	age is almost thirty times higher than an 338
848	848	abortion at eight weeks gestational age or 339
849	849	earlier; and 340
850	850	(d) Twenty-one weeks gestational age or 341
851	851	later is more than seventy -five times higher 342
852	852	than an abortion at eight weeks gestational age 343
853	853	or earlier; 344
854	854	(34) In addition to the short -term risks 345
855	855	of an abortion, studies have found that the long - 346
856	856	term physical and psychological consequences of 347
857	857	abortion for women include, but are not limited 348
858	858	to, an increased risk of preterm birth, low 349
859	859	birthweight babies, and placenta previa in 350
860	860	subsequent pregnancies, as well as serious 351
861	861	behavioral health issues. These risks increase 352
862	862	as abortions are performed or induced at later 353
863	863	gestational ages. These consequences of an 354
864	864	abortion have a detrimental effect not only on 355
865	865	women, their children, and their families, but 356
866	866	also on an already burdened health care system, 357
867	867	taxpayers, and the workforce; 358
868	868	(35) A large percentage of women who have 359
869	869	an abortion performed or induced upon them in 360
870	870	Missouri each year are at less than eight weeks 361
871	871	gestational age, a large majority are at less 362
872	872	than fourteen weeks gestational age, a large r 363
873	873	majority are at less than eighteen weeks 364 SB 241 25
874	874	gestational age, and an even larger majority are 365
875	875	at less than twenty weeks gestational age. A 366
876	876	prohibition on performing or inducing an 367
877	877	abortion at eight weeks gestational age or 368
878	878	later, with a medical emerge ncy exception, does 369
879	879	not amount to a substantial obstacle to a large 370
880	880	fraction of women for whom the prohibition is 371
881	881	relevant, which is pregnant women in Missouri 372
882	882	who are seeking an abortion while not 373
883	883	experiencing a medical emergency. The burden 374
884	884	that a prohibition on performing or inducing an 375
885	885	abortion at eight, fourteen, eighteen, or twenty 376
886	886	weeks gestational age or later, with a medical 377
887	887	emergency exception, might impose on abortion 378
888	888	access, is outweighed by the benefits conferred 379
889	889	upon the following: 380
890	890	(a) Women more advanced in pregnancy who 381
891	891	are at greater risk of harm from abortion; 382
892	892	(b) Unborn children at later stages of 383
893	893	development; 384
894	894	(c) The medical profession, by preserving 385
895	895	its integrity and fulfilling its commitment to 386
896	896	do no harm; and 387
897	897	(d) Society, by fostering respect for 388
898	898	human life, born and unborn, at all stages of 389
899	899	development, and by lessening societal tolerance 390
900	900	of violence against innocent human life; 391
901	901	(36) In Webster, the Supreme Court noted, 392
902	902	in upholding a Missouri statute, "that there may 393
903	903	be a 4-week error in estimating gestational 394
904	904	age". Webster, 492 U.S. at 516. Thus, an 395
905	905	unborn child thought to be eight weeks 396
906	906	gestational age might in fact be twelve weeks 397
907	907	gestational age, when an abortion poses a 398
908	908	greater risk to the woman and the unborn child 399
909	909	is considerably more developed. An unborn child 400
910	910	at fourteen weeks gestational age might be 401
911	911	eighteen weeks gestational age and an unborn 402
912	912	child at eighteen weeks gestational age might be 403
913	913	twenty-two weeks gestational age, when an 404
914	914	abortion poses a greater risk to the woman, the 405
915	915	unborn child is considerably more developed, the 406
916	916	abortion method likely to be employed is more 407
917	917	brutal, and the risk of pain experienced by the 408 SB 241 26
918	918	unborn child is greater. An unborn child at 409
919	919	twenty weeks gestational age might be twenty - 410
920	920	four weeks gestational age, when an abortion 411
921	921	poses a greater risk to the woman, the unborn 412
922	922	child is considerably more developed, the 413
923	923	abortion method likely to be employed is more 414
924	924	brutal, the risk of pain experienced by the 415
925	925	unborn child is greater, and the unborn child 416
926	926	may be viable. 417
927	927	3. The state of Missouri is bound by 418
928	928	Article VI, Clause 2 of the Constitution of the 419
929	929	United States that "all treaties made, or which 420
930	930	shall be made, under the au thority of the United 421
931	931	States, shall be the supreme law of the land". 422
932	932	One such treaty is the International Covenant on 423
933	933	Civil and Political Rights, entered into force 424
934	934	on March 23, 1976, and adopted by the United 425
935	935	States on September 8, 1992. In ratifying the 426
936	936	Covenant, the United States declared that while 427
937	937	the provisions of Articles 1 through 27 of the 428
938	938	Covenant are not self -executing, the United 429
939	939	States' understanding is that state governments 430
940	940	share responsibility with the federal government 431
941	941	in implementing the Covenant. 432
942	942	4. Article 6, Paragraph 1, U.N.T.S. at 433
943	943	174, of the International Covenant on Civil and 434
944	944	Political Rights states, "Every human being has 435
945	945	the inherent right to life. This right shall be 436
946	946	protected by law. No one shall be arbi trarily 437
947	947	deprived of his life". The state of Missouri 438
948	948	takes seriously its obligation to comply with 439
949	949	the Covenant and to implement this paragraph as 440
950	950	it relates to the inherent right to life of 441
951	951	unborn human beings, protecting the rights of 442
952	952	unborn human beings by law, and ensuring that 443
953	953	such unborn human beings are not arbitrarily 444
954	954	deprived of life. The state of Missouri hereby 445
955	955	implements Article 6, Paragraph 1 of the 446
956	956	Covenant by the regulation of abortion in this 447
957	957	state. 448
958	958	5. The state of Missour i has interests 449
959	959	that include, but are not limited to: 450 SB 241 27
960	960	(1) Protecting unborn children throughout 451
961	961	pregnancy and preserving and promoting their 452
962	962	lives from conception to birth; 453
963	963	(2) Encouraging childbirth over abortion; 454
964	964	(3) Ensuring respect for all human life 455
965	965	from conception to natural death; 456
966	966	(4) Safeguarding an unborn child from the 457
967	967	serious harm of pain by an abortion method that 458
968	968	would cause the unborn child to experience pain 459
969	969	while she or he is being killed; 460
970	970	(5) Preserving the integrity of the 461
971	971	medical profession and regulating and 462
972	972	restricting practices that might cause the 463
973	973	medical profession or society as a whole to 464
974	974	become insensitive, even disdainful, to life. 465
975	975	This includes regulating and restricting 466
976	976	abortion methods that are not only brutal and 467
977	977	painful, but if allowed to continue, will 468
978	978	further coarsen society to the humanity of not 469
979	979	only unborn children, but all vulnerable and 470
980	980	innocent human life, making it increasingly 471
981	981	difficult to protect such life; 472
982	982	(6) Ending the incongruities in state law 473
983	983	by permitting some unborn children to be killed 474
984	984	by abortion, while requiring that unborn 475
985	985	children be protected in nonabortion 476
986	986	circumstances through, including, but not 477
987	987	limited to, homicide, assault, self -defense, and 478
988	988	defense of another statutes; laws guaranteeing 479
989	989	prenatal health care, emergency care, and 480
990	990	testing; state-sponsored health insurance for 481
991	991	unborn children; the prohibition of restraints 482
992	992	in correctional institutions to protect pregnant 483
993	993	offenders and their unborn children; and 484
994	994	protecting the interests of unborn children by 485
995	995	the appointment of conservators, guardians, and 486
996	996	representatives; 487
997	997	(7) Reducing the risks of harm to pregnant 488
998	998	women who obtain abortions later in pregnancy; 489
999	999	and 490
1000	1000	(8) Avoiding burdens on the health care 491
1001	1001	system, taxpayers, and the workforce because of 492
1002	1002	increased preterm births, low birthweight 493
1003	1003	babies, compromised pregnancies, extended 494 SB 241 28
1004	1004	postpartum recoveries, and behavioral health 495
1005	1005	problems caused by the long -term effects of 496
1006	1006	abortions performed or induced later in the 497
1007	1007	pregnancy.] 498
1008	1008	[188.038. 1. The general assembly of this 1
1009	1009	state finds that: 2
1010	1010	(1) Removing vestiges of any past bias or 3
1011	1011	discrimination against pregnant women, their 4
1012	1012	partners, and their family members, including 5
1013	1013	their unborn children, is an important task for 6
1014	1014	those in the legal, medical, social services, 7
1015	1015	and human services professions; 8
1016	1016	(2) Ending any current bias or 9
1017	1017	discrimination against pregnant women, their 10
1018	1018	partners, and their family members, including 11
1019	1019	their unborn children, is a legitimate purpose 12
1020	1020	of government in order to guarantee that those 13
1021	1021	who "are endowed by their Creator with certain 14
1022	1022	unalienable Rights" can enjoy "Life, Liberty and 15
1023	1023	the pursuit of Happiness"; 16
1024	1024	(3) The historical relationship of bias or 17
1025	1025	discrimination by some family planning programs 18
1026	1026	and policies towards poor and minority 19
1027	1027	populations, including, but not limited to, the 20
1028	1028	nonconsensual sterilization of mentally ill, 21
1029	1029	poor, minority, and immigr ant women and other 22
1030	1030	coercive family planning programs and policies, 23
1031	1031	must be rejected; 24
1032	1032	(4) Among Missouri residents, the rate of 25
1033	1033	black or African-American women who undergo 26
1034	1034	abortions is significantly higher, about three 27
1035	1035	and one-half times higher, than the rate of 28
1036	1036	white women who undergo abortions. Among 29
1037	1037	Missouri residents, the rate of black or African - 30
1038	1038	American women who undergo repeat abortions is 31
1039	1039	significantly higher, about one and one -half 32
1040	1040	times higher, than the rate of white women who 33
1041	1041	undergo repeat abortions; 34
1042	1042	(5) Performing or inducing an abortion 35
1043	1043	because of the sex of the unborn child is 36
1044	1044	repugnant to the values of equality of females 37
1045	1045	and males and the same opportunities for girls 38 SB 241 29
1046	1046	and boys, and furthers a false mindset of femal e 39
1047	1047	inferiority; 40
1048	1048	(6) Government has a legitimate interest 41
1049	1049	in preventing the abortion of unborn children 42
1050	1050	with Down Syndrome because it is a form of bias 43
1051	1051	or disability discrimination and victimizes the 44
1052	1052	disabled unborn child at his or her most 45
1053	1053	vulnerable stage. Eliminating unborn children 46
1054	1054	with Down Syndrome raises grave concerns for the 47
1055	1055	lives of those who do live with disabilities. 48
1056	1056	It sends a message of dwindling support for 49
1057	1057	their unique challenges, fosters a false sense 50
1058	1058	that disability is som ething that could have 51
1059	1059	been avoidable, and is likely to increase the 52
1060	1060	stigma associated with disability. 53
1061	1061	2. No person shall perform or induce an 54
1062	1062	abortion on a woman if the person knows that the 55
1063	1063	woman is seeking the abortion solely because of 56
1064	1064	a prenatal diagnosis, test, or screening 57
1065	1065	indicating Down Syndrome or the potential of 58
1066	1066	Down Syndrome in an unborn child. 59
1067	1067	3. No person shall perform or induce an 60
1068	1068	abortion on a woman if the person knows that the 61
1069	1069	woman is seeking the abortion solely beca use of 62
1070	1070	the sex or race of the unborn child. 63
1071	1071	4. Any physician or other person who 64
1072	1072	performs or induces or attempts to perform or 65
1073	1073	induce an abortion prohibited by this section 66
1074	1074	shall be subject to all applicable civil 67
1075	1075	penalties under this chapter in cluding, but not 68
1076	1076	limited to, sections 188.065 and 188.085. ] 69
1077	1077	[188.056. 1. Notwithstanding any other 1
1078	1078	provision of law to the contrary, no abortion 2
1079	1079	shall be performed or induced upon a woman at 3
1080	1080	eight weeks gestational age or later, ex cept in 4
1081	1081	cases of medical emergency. Any person who 5
1082	1082	knowingly performs or induces an abortion of an 6
1083	1083	unborn child in violation of this subsection 7
1084	1084	shall be guilty of a class B felony, as well as 8
1085	1085	subject to suspension or revocation of his or 9
1086	1086	her professional license by his or her 10
1087	1087	professional licensing board. A woman upon whom 11
1088	1088	an abortion is performed or induced in violation 12 SB 241 30
1089	1089	of this subsection shall not be prosecuted for a 13
1090	1090	conspiracy to violate the provisions of this 14
1091	1091	section. 15
1092	1092	2. It shall be an affirmative defense for 16
1093	1093	any person alleged to have violated the 17
1094	1094	provisions of subsection 1 of this section that 18
1095	1095	the person performed or induced an abortion 19
1096	1096	because of a medical emergency. The defendant 20
1097	1097	shall have the burden of persuasion that the 21
1098	1098	defense is more probably true than not. 22
1099	1099	3. Prosecution under this section shall 23
1100	1100	bar prosecution under section 188.057, 188.058, 24
1101	1101	or 188.375 if prosecution under such sections 25
1102	1102	would violate the provisions of Amendment V to 26
1103	1103	the Constitution of the U nited States or Article 27
1104	1104	I, Section 19 of the Constitution of Missouri. 28
1105	1105	4. If any one or more provisions, 29
1106	1106	subsections, sentences, clauses, phrases, or 30
1107	1107	words of this section or the application thereof 31
1108	1108	to any person, circumstance, or period of 32
1109	1109	gestational age is found to be unenforceable, 33
1110	1110	unconstitutional, or invalid by a court of 34
1111	1111	competent jurisdiction, the same is hereby 35
1112	1112	declared to be severable and the balance of the 36
1113	1113	section shall remain effective notwithstanding 37
1114	1114	such unenforceability, uncon stitutionality, or 38
1115	1115	invalidity. The general assembly hereby 39
1116	1116	declares that it would have passed this section, 40
1117	1117	and each provision, subsection, sentence, 41
1118	1118	clause, phrase, or word thereof, irrespective of 42
1119	1119	the fact that any one or more provisions, 43
1120	1120	subsections, sentences, clauses, phrases, or 44
1121	1121	words of the section, or the application of the 45
1122	1122	section to any person, circumstance, or period 46
1123	1123	of gestational age, would be declared 47
1124	1124	unenforceable, unconstitutional, or invalid. ] 48
1125	1125	[188.057. 1. Notwithstanding any other 1
1126	1126	provision of law to the contrary, no abortion 2
1127	1127	shall be performed or induced upon a woman at 3
1128	1128	fourteen weeks gestational age or later, except 4
1129	1129	in cases of medical emergency. Any person who 5
1130	1130	knowingly performs or induces an abortio n of an 6
1131	1131	unborn child in violation of this subsection 7 SB 241 31
1132	1132	shall be guilty of a class B felony, as well as 8
1133	1133	subject to suspension or revocation of his or 9
1134	1134	her professional license by his or her 10
1135	1135	professional licensing board. A woman upon whom 11
1136	1136	an abortion is performed or induced in violation 12
1137	1137	of this subsection shall not be prosecuted for a 13
1138	1138	conspiracy to violate the provisions of this 14
1139	1139	section. 15
1140	1140	2. It shall be an affirmative defense for 16
1141	1141	any person alleged to have violated the 17
1142	1142	provisions of subsection 1 of this section that 18
1143	1143	the person performed or induced an abortion 19
1144	1144	because of a medical emergency. The defendant 20
1145	1145	shall have the burden of persuasion that the 21
1146	1146	defense is more probably true than not. 22
1147	1147	3. Prosecution under this section shall 23
1148	1148	bar prosecution under section 188.056, 188.058, 24
1149	1149	or 188.375 if prosecution under such sections 25
1150	1150	would violate the provisions of Amendment V to 26
1151	1151	the Constitution of the United States or Article 27
1152	1152	I, Section 19 of the Constitution of Missouri. 28
1153	1153	4. If any one or more provisions, 29
1154	1154	subsections, sentences, clauses, phrases, or 30
1155	1155	words of this section or the application thereof 31
1156	1156	to any person, circumstance, or period of 32
1157	1157	gestational age is found to be unenforceable, 33
1158	1158	unconstitutional, or invalid by a court of 34
1159	1159	competent jurisdiction, the same is hereby 35
1160	1160	declared to be severable and the balance of the 36
1161	1161	section shall remain effective notwithstanding 37
1162	1162	such unenforceability, unconstitutionality, or 38
1163	1163	invalidity. The general assembly hereby 39
1164	1164	declares that it would have pass ed this section, 40
1165	1165	and each provision, subsection, sentence, 41
1166	1166	clause, phrase, or word thereof, irrespective of 42
1167	1167	the fact that any one or more provisions, 43
1168	1168	subsections, sentences, clauses, phrases, or 44
1169	1169	words of the section, or the application of the 45
1170	1170	section to any person, circumstance, or period 46
1171	1171	of gestational age, would be declared 47
1172	1172	unenforceable, unconstitutional, or invalid. ] 48
1173	1173	[188.058. 1. Notwithstanding any other 1
1174	1174	provision of law to the contrary, no abortion 2 SB 241 32
1175	1175	shall be performed or induced upon a woman at 3
1176	1176	eighteen weeks gestational age or later, except 4
1177	1177	in cases of medical emergency. Any person who 5
1178	1178	knowingly performs or induces an abortion of an 6
1179	1179	unborn child in violation of this subsection 7
1180	1180	shall be guilty of a class B felony, as well as 8
1181	1181	subject to suspension or revocation of his or 9
1182	1182	her professional license by his or her 10
1183	1183	professional licensing board. A woman upon whom 11
1184	1184	an abortion is performed or induced in violation 12
1185	1185	of this section shall not be prosecuted for a 13
1186	1186	conspiracy to violate the provisions of this 14
1187	1187	section. 15
1188	1188	2. It shall be an affirmative defense for 16
1189	1189	any person alleged to have violated the 17
1190	1190	provisions of subsection 1 of this section that 18
1191	1191	the person performed or induced an abortion 19
1192	1192	because of a medical emergenc y. The defendant 20
1193	1193	shall have the burden of persuasion that the 21
1194	1194	defense is more probably true than not. 22
1195	1195	3. Prosecution under this section shall 23
1196	1196	bar prosecution under section 188.056, 188.057, 24
1197	1197	or 188.375 if prosecution under such sections 25
1198	1198	would violate the provisions of Amendment V to 26
1199	1199	the Constitution of the United States or Article 27
1200	1200	I, Section 19 of the Constitution of Missouri. 28
1201	1201	4. If any one or more provisions, 29
1202	1202	subsections, sentences, clauses, phrases, or 30
1203	1203	words of this section or the app lication thereof 31
1204	1204	to any person, circumstance, or period of 32
1205	1205	gestational age is found to be unenforceable, 33
1206	1206	unconstitutional, or invalid by a court of 34
1207	1207	competent jurisdiction, the same is hereby 35
1208	1208	declared to be severable and the balance of the 36
1209	1209	section shall remain effective notwithstanding 37
1210	1210	such unenforceability, unconstitutionality, or 38
1211	1211	invalidity. The general assembly hereby 39
1212	1212	declares that it would have passed this section, 40
1213	1213	and each provision, subsection, sentence, 41
1214	1214	clause, phrase, or word thereof, irr espective of 42
1215	1215	the fact that any one or more provisions, 43
1216	1216	subsections, sentences, clauses, phrases, or 44
1217	1217	words of the section, or the application of the 45
1218	1218	section to any person, circumstance, or period 46 SB 241 33
1219	1219	of gestational age, would be declared 47
1220	1220	unenforceable, unconstitutional, or invalid. ] 48
1221	1221	[188.375. 1. This section shall be known 1
1222	1222	and may be cited as the "Late -Term Pain-Capable 2
1223	1223	Unborn Child Protection Act". 3
1224	1224	2. As used in this section, the phrase 4
1225	1225	"late-term pain-capable unborn child" s hall mean 5
1226	1226	an unborn child at twenty weeks gestational age 6
1227	1227	or later. 7
1228	1228	3. Notwithstanding any other provision of 8
1229	1229	law to the contrary, no abortion shall be 9
1230	1230	performed or induced upon a woman carrying a 10
1231	1231	late-term pain-capable unborn child, except in 11
1232	1232	cases of medical emergency. Any person who 12
1233	1233	knowingly performs or induces an abortion of a 13
1234	1234	late-term pain-capable unborn child in violation 14
1235	1235	of this subsection shall be guilty of a class B 15
1236	1236	felony, as well as subject to suspension or 16
1237	1237	revocation of his or her professional license by 17
1238	1238	his or her professional licensing board. A 18
1239	1239	woman upon whom an abortion is performed or 19
1240	1240	induced in violation of this subsection shall 20
1241	1241	not be prosecuted for a conspiracy to violate 21
1242	1242	the provisions of this subsection. 22
1243	1243	4. It shall be an affirmative defense for 23
1244	1244	any person alleged to have violated the 24
1245	1245	provisions of subsection 3 of this section that 25
1246	1246	the person performed or induced an abortion 26
1247	1247	because of a medical emergency. The defendant 27
1248	1248	shall have the burden of persu asion that the 28
1249	1249	defense is more probably true than not. 29
1250	1250	5. Prosecution under subsection 3 of this 30
1251	1251	section shall bar prosecution under section 31
1252	1252	188.056, 188.057, or 188.058 if prosecution 32
1253	1253	under such sections would violate the provisions 33
1254	1254	of Amendment V to the Constitution of the United 34
1255	1255	States or Article I, Section 19 of the 35
1256	1256	Constitution of Missouri. 36
1257	1257	6. When in cases of medical emergency a 37
1258	1258	physician performs or induces an abortion upon a 38
1259	1259	woman in her third trimester carrying a late - 39
1260	1260	term pain-capable unborn child, the physician 40
1261	1261	shall utilize the available method or technique 41 SB 241 34
1262	1262	of abortion most likely to preserve the life or 42
1263	1263	health of the unborn child. In cases where the 43
1264	1264	method or technique of abortion most likely to 44
1265	1265	preserve the life or h ealth of the unborn child 45
1266	1266	would present a greater risk to the life or 46
1267	1267	health of the woman than another legally 47
1268	1268	permitted and available method or technique, the 48
1269	1269	physician may utilize such other method or 49
1270	1270	technique. In all cases where the physician 50
1271	1271	performs or induces an abortion upon a woman 51
1272	1272	during her third trimester carrying a late -term 52
1273	1273	pain-capable unborn child, the physician shall 53
1274	1274	certify in writing the available method or 54
1275	1275	techniques considered and the reasons for 55
1276	1276	choosing the method or techn ique employed. 56
1277	1277	7. When in cases of medical emergency a 57
1278	1278	physician performs or induces an abortion upon a 58
1279	1279	woman during her third trimester carrying a late - 59
1280	1280	term pain-capable unborn child, there shall be 60
1281	1281	in attendance a physician other than the 61
1282	1282	physician performing or inducing the abortion 62
1283	1283	who shall take control of and provide immediate 63
1284	1284	medical care for a child born as a result of the 64
1285	1285	abortion. 65
1286	1286	8. Any physician who knowingly violates 66
1287	1287	any of the provisions of subsection 6 or 7 of 67
1288	1288	this section shall be guilty of a class D 68
1289	1289	felony, as well as subject to suspension or 69
1290	1290	revocation of his or her professional license by 70
1291	1291	his or her professional licensing board. A 71
1292	1292	woman upon whom an abortion is performed or 72
1293	1293	induced in violation of subsection 6 o r 7 of 73
1294	1294	this section shall not be prosecuted for a 74
1295	1295	conspiracy to violate the provisions of those 75
1296	1296	subsections. 76
1297	1297	9. If any one or more provisions, 77
1298	1298	subsections, sentences, clauses, phrases, or 78
1299	1299	words of this section or the application thereof 79
1300	1300	to any person, circumstance, or period of 80
1301	1301	gestational age is found to be unenforceable, 81
1302	1302	unconstitutional, or invalid by a court of 82
1303	1303	competent jurisdiction, the same is hereby 83
1304	1304	declared to be severable and the balance of the 84
1305	1305	section shall remain effective notwi thstanding 85 SB 241 35
1306	1306	such unenforceability, unconstitutionality, or 86
1307	1307	invalidity. The general assembly hereby 87
1308	1308	declares that it would have passed this section, 88
1309	1309	and each provision, subsection, sentence, 89
1310	1310	clause, phrase, or word thereof, irrespective of 90
1311	1311	the fact that any one or more provisions, 91
1312	1312	subsections, sentences, clauses, phrases, or 92
1313	1313	words of the section, or the application of the 93
1314	1314	section to any person, circumstance, or period 94
1315	1315	of gestational age, would be declared 95
1316	1316	unenforceable, unconstitutional, or invali d.] 96
1317	1317	Section B. Because of the need to protect the health 1
1318	1318	and safety of Missouri women, section A of this act is 2
1319	1319	deemed necessary for the immediate preservation of the 3
1320	1320	public health, welfare, peace, and safety, and is hereby 4
1321	1321	declared to be an emergency act within the meaning of the 5
1322	1322	constitution, and section A of this act shall be in full 6
1323	1323	force and effect upon its passage and approval. 7
1324	1324	