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story.lead_photo.caption Sally Ince/ News Tribune Sen. Andrew Koenig speaks on the topic of bill 139 Thursday January 31, 2019 in his office at the Capitol. The bill would modify provisions of law relating to abortion. Koenig is a Manchester Republican and the main sponsor of abortion legislation.

A dozen bills relating to abortions or women's rights concerning abortions have been proposed by Missouri lawmakers as of Thursday.

Many of the bills have been floated before. But this year, there's a perception there will be more movement on bills like the "fetal heartbeat bill."

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Identical bills in the House and Senate pitch a law that would require physicians to first perform a fetal heartbeat detection test before performing an abortion in most cases. Except in cases of medical emergency, the physician would then be prevented from performing the abortion if a heartbeat were detected.

Senate Bill 139, sponsored by Andrew Koenig, R-Manchester, and House Bill 126, sponsored by Nick Schroer, R-Ferguson, are both identical to previous offerings from Koenig. In addition to preventing the doctor from performing the abortion, it would require the doctor to inform the woman in writing that the abortion cannot be performed. And if four days pass before the doctor is to perform the abortion, the doctor is again required to conduct the heartbeat test.

The so-called "fetal heartbeat bill" has been introduced in more than a dozen states over the past six years.

This is the third consecutive year Koenig has sponsored the heartbeat bill.

"I haven't gotten it out of committee before. I do expect to get it out of committee this year," Koenig said. "There's more movement this year, especially with what New York has done and the governor of Virginia said."

Supporters of New York state's new abortion law say it reaffirms a woman's right to an abortion. The law moves abortion from the state's criminal code to its health code. It makes abortion legal after 24 weeks — the previous state limit — if a woman's health is at risk.

While speaking on a radio program, Virginia Gov. Ralph Northam commented on a Virginia bill that allows for third trimester abortions. Northam, a pediatric neurosurgeon, said the third trimester abortions are done in cases when the fetus has severe deformities. He said there may be fetuses that are non-viable, and if a mother delivered a baby who was non-viable, the infant would be resuscitated if the mother wished. Then, the mother and physicians would have a discussion about the options.

Northam argued government shouldn't be making decisions for the mother. The decision should be made by mothers and their health care providers. The Virginia bill is in limbo.

Those developments have people's attention in Missouri, Koenig said.

"Abortion has always been a hot issue. I think it's gaining more steam because of that," he said.

He confirmed the Missouri fetal heartbeat bills are an attempt to do away with abortions — and added he's prepared to file legislation this week that would ban abortions in Missouri and would kick in if and when Roe v. Wade is overturned.

The fetal heartbeat bill is based on the idea a fetus is a person as soon as it has a heartbeat. Fetal heartbeats may be detected beginning 5 1/2 to 6 1/2 weeks into a pregnancy using an internal ultrasound. However, it is generally not detectable using a standard ultrasound until between seven and eight weeks into a pregnancy.

Such bans are intended to challenge Roe v. Wade, the U.S. Supreme Court's 1973 decision that gave women the right to have an abortion. The court ruled in a 7-2 decision that a woman's right to privacy was guaranteed by the 14th Amendment.

It is clear that banning abortion early in pregnancy — before people even realize they're pregnant — is unconstitutional, based on Roe v. Wade, according to M'Evie Mead, director of policy and organizing at Planned Parenthood Advocates in Missouri.

"The government should not be stepping in and making important decisions about a woman's health," Mead said. "That decision should be between a woman and her healthcare provider."

Schroer, a second-term representative, said he finds bills are easier to pass from one chamber to the other if lawmakers in both are familiar with their wording. That's one reason he sponsored the heartbeat bill in the House.

But the importance of the issue is demonstrated in the number of states tackling the issue, he said. An attorney, Schroer said he's prepared for legal battles if one of the bills were to pass and be signed into law by Gov. Mike Parson.

"No matter what we do, it's going to get litigated," Schroer said. "The consensus of the states shows that it's an incredibly important issue of protecting life at all levels."

Pushed for a response about whether he would sign a fetal heartbeat bill into law during the annual Missouri Press Association dinner Thursday, Parson said he would not comment on the hypothetical question, but reaffirmed he is "pro-life."

Arkansas and North Dakota passed heartbeat bills into law in 2013. Both bans were blocked in federal courts.

More recently, Iowa Gov. Kim Reynolds signed a fetal heartbeat bill into law in 2018. The American Civil Liberties Union filed for an injunction against the law on behalf of Planned Parenthood. The injunction was granted.

On Jan. 22, an Iowa state judge struck down the law as unconstitutional, and said it didn't identify a compelling state interest in preventing most abortions after the heartbeat could be detected.

Several other abortion-related bills have been filed this session; their subjects include changing the definition of abortion and parental notification.

Missouri HB 126, like other Republican-sponsored abortion bills in the House, has been referred to the chamber's Committee on Children and Families. The lone Democratic-sponsored bill, House Bill 536, which would establish the Respect Women's Abortion Decision Act, has not been referred to committee.

HB 536, sponsored by Judy Morgan, D-Kansas City, changes the definition of "abortion" to mean any medical treatment intended to induce termination of a pregnancy except for the purpose of producing a live birth. It changes the statutory definition of "viability" to mean the point in a pregnancy when there is a reasonable likelihood that a fetus would survive outside the uterus without application of extraordinary measures. It also removes the definition of "unborn child." The bill prohibits the state from denying a woman's right — obtained through Roe v. Wade — to obtain an abortion.

A pair of the bills currently in the House are geared toward parental notification.

House Bill 431, sponsored by Rep. Tom Hurst, R-Meta, prohibits a person from knowingly taking a minor out of state to obtain an abortion without consent from the minor's parent or guardian. The bill is identical to legislation proposed each of the past two years.

Rep. Rocky Miller, R-Lake Ozark, has proposed a law that would change statutes regarding parental or guardian notification. Currently, Missouri law requires a physician who is to going to perform an abortion on a minor to get written permission from at least one parent.

Miller's bill, House Bill 127 (which is similar to Senate Bill 106), would require the consenting parent or guardian to notify any other custodial person of the upcoming procedure. Exceptions would occur if the procedure were being performed during an emergency or if the other parent or guardian had been convicted of specific crimes relating to sexual offenses, prostitution, pornography, or incidents involving the family; were listed on the sex offender registry; had been prevented from contact with the minor because of an order of protection; had their parental rights terminated; or were unreachable.

The bill is identical to one that was proposed in 2018.

"(The bill) started out as a matter of fairness — both parents should be notified," Miller said. "As we went along, we discovered it has a child abuse — child trafficking — portion that we never thought about."

Unfortunately, Miller said, a lot of parents abuse their children, some sexually. Under current law, if the abusive parent impregnates their daughter, they can get an abortion without telling the other parent.

"As a parent of a minor child, I'd want to be notified that my child was getting an abortion," Miller said. "It's a major medical operation. It is something that a parent who is in good standing should know about."

Mead said bills, such as Miller's, endanger teenagers' access to health care.

"When it comes to teens, the first thing that all of us can agree on, we want teens to be healthy and safe," she said. "The reason major medical associations oppose putting parental involvement in is that it may discourage them from seeking health care, to put them through this unnecessary hoop, and the government coming in and saying, 'We're going to force communication.' We think is a bad idea and not good policy."

Another bill, House Bill 540, requires certain health care professionals who make referrals for abortions to first conduct a "risk evaluation" for the patient.

The risk evaluation shall include any physical, psychological or situational factors which would increase the risks of the patient experiencing physical or emotional reactions to the abortion. The evaluation shall be included in the patient's medical files.

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