Iowa medical providers could no longer require women to obtain permission from their spouses in order to receive a hysterectomy under a bill that House Republicans are trying to advance for a second time this year.
House lawmakers backing the bill say that some doctors in Iowa are still using the requirement, which appears to be uncommon. However, they declined to identify any doctors that do.
While their proposal passed the House unanimously in March, it has stalled in the Senate, where lawmakers said they want to look into the issue more. House members are now seeking to keep the proposal alive by amending a separate bill to include the requirement.
A hysterectomy is an operation to remove the uterus. It can be done for several reasons, including cancer or other growths, called fibroids.
The idea for the bill came from Rep. Eddie Andrews, R-Johnston, who said multiple women have contacted him with stories about their experiences. Ahead of the session, he said, a woman had called him and told him her medical provider had asked her to obtain consent from her husband before they would perform a hysterectomy meant to help with a medical condition she had.
“I literally stood there with my mouth open for probably a long time,” Andrews said.
At the beginning of the session, he said, a second woman called him with a personal story of how medical staff had been attempting to reach her husband while preparing her for her hysterectomy procedure. They had eventually reached him, put him on speakerphone and obtained his consent, the woman had said.
The stories motivated Andrews to work on a bill to outlaw such a requirement. The requirement is not in Iowa law, he said, but some providers still use it.
“Especially for the case where you’ve got an abusive relationship or an estranged spouse — come on. In 2021? I could not believe it,” he said.
His bill, House File 684, would have specified that health care professionals cannot require a woman to obtain consent from another person, including their spouse. According to the bill, any woman who is 18 years or older, or younger and married, would have the legal capacity to consent to the procedure.
Bill dies in funnel, then gains new life
The House passed the bill unanimously in early March. But it then failed to make it out of the Senate Human Resources Committee, where lawmakers have said they want more information about where the practice is occurring, as well as whether a solution could instead come through an internal policy at a hospital or clinic.
“I’m really searching to find where or who or what went on with that issue,” Sen. Jeff Edler, the State Center Republican who chairs the Senate Human Resources Committee, said Wednesday.
Sen. Annette Sweeney, R-Alden, the Senate manager of the bill, also indicated she hadn’t heard enough from either side. She said she planned to do more research after the session ends.
“There’s some other things that we have to discover with that particular bill,” she said.
The legislation fell victim to Friday’s second “funnel” deadline, meaning the original bill is dead for the year.
In an effort to resurrect the proposal, Rep. Ann Meyer, R-Fort Dodge, has re-introduced the legislation as an amendment to another bill, Senate File 529, which would ban assisted reproduction fraud. That means the proposal remains alive for now.
If the House adopts the amendment and approves the bill, the Senate would also need to approve the amended version of the bill. Meyer, who chairs the House Senate Resources Committee, said she believes giving the Senate more time to consider it, and allowing them to vote on it from the Senate floor as part of another bill, could help it pass this year.
“This is a couple sentences to put in code just to give women a little protection,” Meyer said. “I don’t have a problem with, again, giving women the freedom to control their own body.”
Medical groups: Issue not common practice, but extent remains unclear
The extent of the issue in Iowa remains unclear. Andrews declined to name which providers require a spouse’s consent, but he said he couldn’t believe the requirement still exists at all.
Meyer said she’s heard from physicians that this is an issue occurring not on the hospital-wide level but with individual providers.
Rep. Timi Brown-Powers, the Waterloo Democrat who sat on the House’s subcommittee hearing for the bill, said she’s not fully clear where it’s occurring, but medical groups have informed her that it appears to not be a requirement at medical facilities in the state.
“We believe it was just a physician’s opinion, that they wanted the woman to get a signature from her spouse,” she said.
Brown-Powers, who works as a therapist with MercyOne, said many couples will typically have a conversation about the procedure regardless, but she believes doctors shouldn’t be requiring consent.
“The fact that this was something that, unfortunately, women were still having to jump through those hoops to get done was really kind of mind-boggling to me,” she said.
Dennis Tibben, director of external affairs for the Iowa Medical Society, said he is not aware of any clinics that currently have that policy, and any instance is likely isolated. But he said the groups supports the idea that patients should be able to make their own medical decisions.
“Something like this is not common practice, but if there is a problem, we want to address it,” he said.
According to the National Women’s Health Network, a women’s health advocacy group, no state by law requires a spouse’s consent for the procedure, but some private providers, particularly some with religious affiliations, may have the practice in place.
The original bill had the support of a handful of medical groups, including the Iowa Medical Society, Iowa Nurse Practitioners Society, Iowa Chapter of the National Association of Pediatric Nurse Practitioners, Iowa Mental Health Planning Council and Iowa Independent Physician Group. No group was registered against.