THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY RAPP, KULA, TURZAI, STERN, DENLINGER, CUTLER, ADOLPH, AUMENT, BAKER, BARBIN, BARRAR, BEAR, BENNINGHOFF, BLOOM, BOBACK, BOYD, BROOKS, R. BROWN, CALTAGIRONE, CAUSER, CHRISTIANA, CLYMER, COX, CREIGHTON, DAY, DiGIROLAMO, DUNBAR, ELLIS, EMRICK, EVANKOVICH, J. EVANS, EVERETT, FLECK, GABLER, GEIST, GIBBONS, GILLEN, GILLESPIE, GINGRICH, GODSHALL, GRELL, GROVE, HACKETT, HAHN, HARHART, HARKINS, HARRIS, HEFFLEY, HELM, HENNESSEY, HESS, HICKERNELL, HORNAMAN, HUTCHINSON, KAUFFMAN, KAVULICH, F. KELLER, KILLION, KNOWLES, KOTIK, KRIEGER, LAWRENCE, LONGIETTI, MAHONEY, MAJOR, MALONEY, MARSHALL, MARSICO, MASSER, METCALFE, METZGAR, MICCARELLI, MICOZZIE, MILLARD, MOUL, MURT, MUSTIO, OBERLANDER, PAYNE, PEIFER, PERRY, PICKETT, PYLE, QUIGLEY, READSHAW, REED, REESE, REICHLEY, ROAE, ROCK, SACCONE, SANTONI, SAYLOR, SCAVELLO, CULVER, SCHRODER, SIMMONS, K. SMITH, S. H. SMITH, SONNEY, STEVENSON, SWANGER, TALLMAN, TAYLOR, THOMAS, TOBASH, TOEPEL, TOOHIL, TRUITT, VEREB, VULAKOVICH AND WATSON, OCTOBER 5, 2011

AS REPORTED FROM COMMITTEE ON HEALTH, HOUSE OF REPRESENTATIVES, AS AMENDED, FEBRUARY 6, 2012   

AN ACT

Providing for ultrasound test requirements to determine

gestational ages of unborn children; establishing the right

to view ultrasound image and ultrasound video of unborn child

and the right to observe or hear the fetal heartbeat;

providing for powers and duties of the Department of Health

and for duties of physicians performing abortions; requiring

certain reports to be filed with the Department of Health;

imposing administrative sanctions and criminal penalties; and

providing for remedies.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  Short title.

This act shall be known and may be cited as the Women's

Right-to-Know Act.

Section 2.  Findings.

The General Assembly finds and declares as follows:

(1)  Many women are unaware of the state of development

of their unborn child.

(2)  An ultrasound test is a medical procedure commonly

utilized during a woman's pregnancy to determine fetal

gestational age, fetal measurements,; fetal measurements; the

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progress of fetal development; and fetal health, including

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the presence or absence of a fetal heartbeat.

(3)  The fetal heartbeat also provides useful information

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on fetal health.

(4) An ultrasound test is also commonly done prior to an

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abortion to determine gestational age and the location of the

pregnancy.

(4)  An ultrasound can provide useful information

regarding the viability of the pregnancy and the risk of

natural miscarriage or ectopic pregnancy.

(5)  The factual information provided by ultrasound

tests, including fetal heartbeat, is relevant to any decision

regarding a pregnancy and is relevant to the State's interest

in ensuring that informed consent is provided.

(5) (6)  According to the National Institutes of Health,

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among women who know they are pregnant, the miscarriage rate

is about 15-20%, with most occurring during the first seven

weeks of pregnancy.

(7)  Absent accurate ultrasound testing to determine

gestational age, confirm an intrauterine pregnancy and

establish the presence or absence of cardiac activity, an

abortion may be performed on a woman who would otherwise

miscarry naturally or whose pregnancy may be an ectopic.

(8)  Abortion is a medical procedure and, as such, it

requires the informed consent of the woman undergoing the

procedure.

(6) (9)  A woman considering an abortion has the right to

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receive complete and accurate information regarding the

development and health of her unborn child.

(7) (10)  In recognition of the importance of a woman's

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dignity in making an informed choice, the factual information

provided by an ultrasound test should be provided to a woman

as an integral part of the informed consent necessary to

undergo an abortion.

Section 3.  Definitions.

The following words and phrases when used in this act shall

have the meanings given to them in this section unless the

context clearly indicates otherwise:

"Abortion."  The use of any means to terminate the clinically

diagnosable pregnancy of a woman with knowledge that the

termination by that means will, with reasonable likelihood,

cause the death of the unborn child.

"Auscultation."  The act of listening for sounds made by

internal organs of the fetus, specifically for a fetal

heartbeat, utilizing an ultrasound transducer and fetal heart

rate monitor.

"Department."  The Department of Health of the Commonwealth.

"DVD."  A digital versatile disc.

"Digital versatile disc."  A laser-encoded plastic medium

capable of storing a large amount of digital audio, video and

computer data.

"Fetus."  An individual organism of the species homo sapiens

from fertilization until live birth.

"Gestational age."  The age of an unborn child as calculated

from the first day of the last menstrual period of the pregnant

woman.

"Health care practitioner."  An individual who is authorized

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to practice some component of the healing arts by a license,

permit, certificate or registration issued by a Commonwealth

licensing agency or board.

"Informed consent."  The informed consent provided for under

18 Pa.C.S. § 3205 (relating to informed consent).

"Medical emergency."  As defined in 18 Pa.C.S. § 3203

(relating to definitions).

"Patient."  A pregnant woman who is seeking to have an

abortion.

"Physician."  A person licensed to practice medicine in this

Commonwealth. The term includes a medical doctor and a doctor of

osteopathy.

"Pregnancy."  The female reproductive condition of having a

developing fetus in the body, which commences with

fertilization.

"Pregnant."  Being in the state of pregnancy.

"Ultrasound image."  An image produced through the use of an

ultrasound machine which is of sufficient quality to be used in

determining gestational age.

"Unborn child."  An individual organism of the species homo

sapiens from fertilization until live birth.

Section 4.  Ultrasound test requirements.

(a)  Test and waiting period.--Except as set forth in section

10, all of the following apply:

(1)  At least 24 hours before an abortion is to be

performed, an ultrasound test which produces an ultrasound

image shall be performed upon the patient by or for the

physician who is to perform the abortion or the referring

physician.

(2)  The time period under paragraph (1) may run

concurrently with the waiting period under 18 Pa.C.S. §

3205(a) (relating to informed consent).

(b)  List.--The physician who is to perform the abortion or, 

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the referring physician or a health care practitioner designated

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by the physician shall provide the patient with the list under

section 7(a)(3).

(c)  Basis of determination.--The ultrasound test shall be

used to make an accurate determination of gestational age of the

unborn child. Determination of gestational age shall be based

upon measurement of the unborn child in a manner consistent with

standard medical practice in the community in determining

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gestational age. When only the gestational sac is visible during

an ultrasound test, gestational age may be based upon

measurement of the gestational sac.

(d)  Documentation of measurements.--

(1)  A print of the ultrasound image shall be made to

document the measurements which have been taken to determine

the gestational age of the unborn child.

(2)  A copy of the print shall be maintained in the

patient's medical file at the facility where the abortion is

performed for the longer of:

(i)  seven years; or

(ii)  the extent required by applicable Federal or

State law.

(e)  Individuals who may perform test.--An ultrasound test

may only be performed by one of the following:

(1)  A physician.

(2)  An individual who meets all of the following:

(i)  Regularly conducts ultrasound tests for medical

purposes.

(ii)  Has documented evidence of satisfactory

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completion of a course, including a period of direct

supervision, in the operation of ultrasound equipment.

(iii)  Has documentary evidence of periodic

evaluation of proficiency Is a health care practitioner.

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(f)  Physician instructions.--When the physician who orders

the ultrasound test refers the patient to another facility, the

physician or a licensed health care professional practitioner to

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whom the physician has delegated responsibility shall, in a

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face-to-face consultation, do all of the following:

(1)  Personally furnish the patient with the following

materials to take to the person who will conduct that

ultrasound test:

(i)  The ultrasound direction sheet prepared under

section 7(a)(4).

(ii)  The statement to be signed by the patient after

her ultrasound test is completed.

(iii)  The statement to be signed by the person

conducting the ultrasound test.

(2)  Instruct the patient to furnish the information

under paragraph (1) to the individual who conducts the

ultrasound test.

(3)  Advise the patient that, if she wishes to move

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forward with the abortion, she will need to take her

statement and the signed statement of the individual who

performed the ultrasound test to the physician who is to

perform the abortion or the health care practitioner to whom

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that physician has delegated responsibility.

(g)  Fees.--

(1)  The amount charged for an ultrasound test must be

billed separately from the fee for an abortion.

(2)  The fee for an abortion must be fully refundable if

the abortion does not occur.

(3)  The ultrasound fee must not be different for

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patients who elect to obtain or decline an abortion.

Section 5.  Right to view ultrasound image and observe fetal

heartbeat of unborn child.

(a)  Individual performing ultrasound test.--The individual

performing the ultrasound test required under section 4 shall do

all of the following:

(1)  Conduct the ultrasound test, including fetal

heartbeat when present and detectable, in a manner which will

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enable accurate determination of the gestational age and

development of the unborn child.

(2)  Provide the patient with accurate answers to any

questions she may have during the performance of the

ultrasound. This paragraph includes the presence of external

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members extremities, internal organs, and cardiac activity

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and the expected norms for an unborn child of given size or

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gestational age.

(3)  Inform the patient of an abnormal ultrasound

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finding, including the presence of a nonviable pregnancy or

the absence of an intrauterine pregnancy, and provide

information as to the standard medical care for the treatment

of such an abnormality. In a case subject to this paragraph,

if the individual performing the ultrasound is not qualified

to provide the necessary information, the patient shall be

referred to a physician who is qualified to inform the

patient of the standard medical care for the treatment of the

abnormality within 24 hours of the ultrasound finding.

(4)  Inform the patient of her right to view the

ultrasound test in its entirety while that test is being

performed to determine gestational age.

(4) (5)  Inform the patient of her right to observe the

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fetal heartbeat and, if she exercises that right all of the

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following:

(i)  Whether a heartbeat was detected upon ultrasound

examination.

(ii)  Whether the detection or nondetection of a

heartbeat is normal for the documented gestational age.

(iii)  The patient's right to observe the fetal

heartbeat, when present and detectable.

(6)  If the patient exercises the right under paragraph

(5)(iii), make observable the live real-time heartbeat, when

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present, for the patient to observe. If the auscultation is

performed, the patient must shall also be informed of her

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right to hear the fetal heartbeat, when present, in live real

time.

(5) (7)  Position the screen so that the patient is able

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to view the ultrasound test in its entirety, with a view of

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her unborn child, while that test is being conducted to

determine gestational age. The patient is not required to

view the screen.

(6) (8)  Provide two prints to the patient, in separate

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sealed envelopes, of the ultrasound image to be used to

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accurately determine gestational age. One print shall be

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provided to the patient, and one print shall be provided to

the physician who is to perform the abortion.

(7) (9)  Sign and date a statement indicating the time of

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day when the ultrasound test was performed. The statement

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must read and which reads substantially as follows:

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I performed an ultrasound test including fetal heartbeat

on (insert name of patient) on (insert date and time) at

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(insert name of facility where ultrasound test was

performed). At that time, the gestational age was

determined to be (insert #) weeks and the heart rate was

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(not present or {insert #} beats per minute {mark one}).

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The ultrasound screen was positioned so that the patient

would be able to view the screen in its entirety while

the test was being performed. I informed her of her right

to view the ultrasound screen in its entirety while the

test was being performed (which she "accepted" or

"refused" {mark one}). I provided her with a print two

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prints of the ultrasound image that will be used to

determine gestational age. I informed her of her right to

observe or hear the fetal heartbeat because auscultation

was performed (which she "accepted" or "refused" or "no

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heartbeat was detected" {mark one}). (Print and sign name

of person performing ultrasound test and insert date of

signature and the time of day the test was performed.)

(8) (10)  Maintain a copy of the statement under

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paragraph (7) (9) in the patient's medical file at the

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facility where the abortion ultrasound is performed, and

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provide a second copy of that statement to the patient so

that she may provide it to the physician who is to perform

the abortion or the health care practitioner to whom that

physician has delegated responsibility.

(9)  Instruct (11)  If the patient wishes to continue

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with the abortion, instruct the patient to:

(i)  sign and date her statement under subsection (b)

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(1); and

(ii)  take her statement, one of the prints under

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paragraph (8) and the signed and dated statement of the

individual who performed the ultrasound test to the

physician who will perform the abortion or the health

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care practitioner to whom the physician has delegated

responsibility.

(b)  Written statement from patient.--

(1)  Except as set forth in section 10, the patient must

sign a statement which reads substantially as follows:

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I was or was not (circle one) provided with an

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opportunity to view the ultrasound test in its entirety,

while that test was being performed. I was or was not

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(circle one) given a print two prints of the ultrasound

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image. I was or was not (circle one) provided the

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opportunity to observe the fetal heartbeat, if present,

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and receive answers to any questions I had during the

ultrasound test. (Print and sign name of patient and

insert date of signature.)

(2)  The statement must be in bold print of at least ten-

point type and the paper containing such statement must only

include material which is necessary to carry out the purpose

of this subsection.

(3)  A copy of the statement, signed and dated by the

patient and with the patient's name printed on it, shall be

maintained in the patient's medical file at the facility

where the abortion is performed.

(c)  Patient obligations.--

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(1)  Except as set forth in paragraph (2), the patient

must provide to the physician who is to perform the abortion

or the health care practitioner to whom that physician has

delegated responsibility:

(i)  one of the prints under subsection (a)(8);

(ii)  the statement under subsection (a)(9) and (10);

and

(iii)  the statement under subsection (b)(1).

(2)  Paragraph (1) shall not apply to the patient if:

(i)  she determines after the ultrasound test to

continue her pregnancy;

(ii)  her pregnancy is deemed to be nonviable; or

(iii)  there is no evidence of an intrauterine

pregnancy.

Section 6.  Ultrasound video.

(a)  Scope.--This section applies if the abortion is not

performed within 14 days of the performance of the ultrasound

test under section 4.

(b)  Physician duties.--

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(1)  The physician who performs the abortion shall, in

person, do all of the following:

(i)  Inform the patient of the probable gestational

age of the unborn child at the time the abortion is

performed.

(ii)  Record the fetal heart rate and note if the

heart rate is within a normal range for the estimated

gestational age.

(iii)  Offer the patient an opportunity to view an

ultrasound video which accurately depicts an unborn child

at the stage in pregnancy when her abortion is performed.

(2)  The duties under paragraph (1) are discharged by

providing the patient with:

(i)  an opportunity to view, on site, an appropriate

ultrasound video approved by the department; or

(ii)  the DVD or viewable electronic medium under

section 7(a)(5).

(b)  Physician duties.--The physician who performs the

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abortion shall, in person, do all of the following:

(1)  Inform the patient of the gestational age of the

unborn child at the time the abortion is performed.

(2)  Record the fetal heart rate and note if the heart

rate is within a normal range for the gestational age.

(3)  Offer the patient an opportunity to view an

ultrasound video approved by the department which accurately

depicts an unborn child at the stage in pregnancy when her

abortion is performed.

(c)  Written statement.--

(1)  The patient must sign a statement which reads 

substantially as follows:

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I was or was not (circle one) informed of the probable 

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gestational age of my unborn child at the time on the day 

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the abortion was performed. I was or was not (circle one)

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provided an opportunity to view an ultrasound video

approved and provided by the Department of Health. (Print

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and sign name of pregnant woman and insert date of

signature.)

(2)  The physician who performs the abortion shall

personally provide the patient with the information required

by this section and shall sign a statement which reads

substantially as follows:

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Prior to performing an abortion on (insert name of

pregnant woman) at (insert name of facility), I

personally informed her of the probable gestational age

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of her unborn child and I provided her with an

opportunity to view an ultrasound video and observe or

hear a fetal heartbeat which accurately depicted an

unborn child at the same stage of pregnancy when the

abortion was performed and she (insert "accepted" or

"declined") this opportunity. (Print and sign name of

physician and insert date of signature.)

(d)  Documentation.--A copy of the signed and dated

statements required under subsection (c) shall be maintained in

the patient's medical file at the facility where the abortion is

performed.

Section 7.  Department.

(a)  Duties.--The department shall do all of the following to

implement this act:

(1)  Obtain from physicians information necessary to

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prepare the report Collect the reports required under section

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9.

(2)  Prepare Within 60 days of the effective date of this

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paragraph, prepare forms for statements and reports required

under this act and place the forms on a departmental Internet

website.

(3)  Prepare Within 60 days of the effective date of this

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paragraph, prepare a geographically indexed list of health

care providers, facilities and clinics that perform

ultrasounds which provide ultrasound images, including in

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compliance with this act, separately listing those that offer

ultrasound services free of charge. This paragraph requires

contact information for each provider, facility or clinic,

including telephone numbers and, if available, Internet

website addresses.

(4)  Prepare Within 60 days of the effective date of this

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paragraph, prepare an ultrasound direction sheet which sets

forth the requirements of section 5(a).

(5)  Approve Within 60 days of the effective date of this

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paragraph, approve a DVD or other viewable electronic medium

of ultrasound videos which it determines provides accurate

and clear ultrasound video images of unborn children and

audible fetal heartbeats in weekly stages, or as close to

those stages as possible, for patients to view to learn what

an unborn child's development will be like at the time of the

scheduled abortion.

(6)  Transmit a notice of approval under paragraph (5) to

the Legislative Reference Bureau for publication in the

Pennsylvania Bulletin.

(7)  Submit an annual report to the Secretary of the

Senate and the Chief Clerk of the House of Representatives by

March 31 based upon the information obtained under this act

for the preceding calendar year. The report shall be

available for public inspection and copying. The report under

this paragraph shall not contain information which discloses

the identity of a patient. The report shall include the

following information:

(i)  The gestational ages of unborn children:

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(A)  determined by ultrasound image under section

4; and

(B)  set forth in categories beginning with those

at eight weeks and proceeding forward in two-week

increments. children determined by ultrasound, for

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each abortion performed in this Commonwealth, listed

by week of gestational age at the time of the

abortion.

(ii)  The number of instances when the ultrasound

test referred to under section 4 was performed at the

facility where the abortion was performed.

(iii)  The number of instances when exemptions were

claimed under section 10(b) and (c) 10, listed separately

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by the type of exemption.

(b)  Powers.--The department may promulgate regulations to

implement this act.

Section 8.  Duties of physicians performing abortion and

abortion facilities.

(a)  Prerequisites.--Except as set forth in section 10, an

abortion may not be performed unless all of the following apply 

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conditions are met:

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(1)  The physician performing the abortion possesses 

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confirms that the patient's medical file contains a copy of:

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(i)  the print of the ultrasound image under section

5(a)(6) 5(a)(8);

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(ii)  the statement under section 5(b); and 

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statements under section 5(a)(9) and (b);

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(iii)  if applicable, the statement statements under

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section 6(c); and

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(iv)  written documentation demonstrating that all

the requirements of paragraph (3) have been met.

(2)  The physician performing the abortion, in person,

informs the patient of the probable gestational age of the

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unborn child.

(3)  The physician performing the abortion has informed

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the patient of the following:

(i)  Whether a heartbeat was detected upon ultrasound

examination, and whether this is normal for the

documented gestational age.

(ii)  If a heartbeat was detected, the number of

beats per minute that was recorded; and whether this is

normal for the documented gestational age.

(iii)  If the number of beats per minute is not

normal:

(A)  the significance of this fact with respect

to the viability of the pregnancy; and

(B)  any alternatives to abortion which are

within accepted medical standards of care.

(4)  At least 24 hours have elapsed since the time when

the ultrasound test required under section 4 was performed,

as indicated in the statement required under section 5(b) 

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5(a)(9).

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(b)  Physician statement.--If an exemption under section 10

applies, the physician who performs the abortion shall sign and

date the statement set forth below:

The exemption set forth in section 10(insert "(a)", "(b)" or

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"(c)" or "(b)") applies to the abortion that I performed upon

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(insert name of patient). I made this determination on the

basis of the following: (insert medical factors dictating

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application of exemption). (Print and sign physician's name

and insert date of signature.)

(c)  Recordkeeping.--

(1)  The physician statement required by subsection (b)

and or the print of the ultrasound test under section 4(d) or

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another method of storing the ultrasound image shall be

placed in the medical file of the patient at the facility

where the abortion is performed.

(2)  The items under paragraph (1) shall be maintained

for the longer of:

(i)  seven years; or

(ii)  the extent required by applicable Federal or

State law.

Section 9.  Reports by physicians.

(a)  Duty of physicians to file.--A physician who performs an

abortion or an agent designated by that physician shall file a

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signed report with the department. The report shall not identify

the patient by name and shall include the following information 

as applicable:

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(1)  The name of the physician who caused ordered the

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ultrasound test to be performed, the name of the person who

performed the ultrasound test and the facility where the

ultrasound test was performed.

(2)  The date and time the ultrasound test was performed.

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(3)  The name of the physician who performed the abortion

and the facility where the abortion was performed.

(4)  The date and time the abortion was performed.

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(5)  The gestational age of the unborn child as

determined by the ultrasound image required under section 4.

(6)  Whether the patient declined the opportunity to:

(i)  view the ultrasound image; or

(ii)  observe or hear the fetal heartbeat.

(7)  The basis for the medical judgment of the physician

that a medical emergency existed.

(8)  The basis for the medical judgment of the physician 

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fact that an exemption was claimed under section 10(b)

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applies.

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(9)  Whether section 6 applied to the patient and whether

she declined the opportunity to view the video.

(b)  Filing deadline.--Reports under this section shall be

filed with the department within 15 days after the end of the

month.

(c)  Confidentiality.--Reports under this section may shall 

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not contain information which discloses the identity of a

patient.

Section 10.  Exemptions.

(a)  Medical emergencies.--Sections 4, 5 and 8, 6 and 8(a) 

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shall not apply if a medical emergency exists.

(b)  Gestational age.--Sections 4, 5 and 8 shall not apply

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if, in the physician's reasonable medical opinion, the probable

gestational age of the unborn child is less than eight weeks.

(c)  Rape or incest.--Sections 4, 5 and 8, 6 and 8(a) shall

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not apply if the patient's pregnancy is the result of rape or

incest.

Section 11.  Administrative sanctions.

A physician who knowingly violates this act shall be deemed

to have engaged in unprofessional conduct and shall be subject

to appropriate disciplinary action under:

(1)  the act of October 5, 1978 (P.L.1109, No.261), known

as the Osteopathic Medical Practice Act; or

(2)  the act of December 20, 1985 (P.L.457, No.112),

known as the Medical Practice Act of 1985.

Section 12.  Criminal penalties.

(a)  Specific violations.--

(1)  A physician who knowingly violates section 4, 5, 6

or 8 and performs an abortion commits a misdemeanor of the

third degree.

(2)  An individual who knowingly violates section 4

commits a misdemeanor of the third degree.

(3)  An individual other than a patient who executes a

written statement required by this act with knowledge that

the statement is false commits a misdemeanor of the third

degree.

(b)  Disclosure of patient's identity.--

(1)  Except as set forth in paragraph (2), all of the

following apply:

(i)  A health care provider that learns of the

identity of a patient may not disclose the identity of

the patient.

(ii)  A public employee or official that learns of

the identity of a patient may not disclose the identity

of the patient.

(2)  Paragraph (1) does not apply if disclosure:

(i)  is appropriate to carry out the purposes of this

act; or

(ii)  is made with the consent of the patient.

(3)  A person that knowingly violates this subsection

commits a misdemeanor of the second degree.

Section 13.  Civil remedies.

(a)  Equity.--

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(1)  This subsection applies to any of the following that

knowingly performs an abortion in violation of this act:

(i)  A physician.

(ii)  A facility at which an abortion is performed.

(2)  Any of the following may seek an injunction against

a person specified in paragraph (1):

(i)  The woman who was a patient.

(ii)  The district attorney in the county where an

abortion was performed.

(iii)  The Attorney General.

(3)  An injunction under this section shall prevent the

person from performing further abortions.

(b)  Law.--If a physician or health care provider performs an

abortion in violation of this act, the physician or health care

provider shall be liable for actual damages as follows:

(1)  Except as set forth in paragraph (2), to the

patient.

(2)  To the parent or legal guardian of a patient who, at

the time of the abortion:

(i)  is under 18 years of age and not emancipated; or

(ii)  is incapacitated under 20 Pa.C.S. § 5512.1

(relating to determination of incapacity and appointment

of guardian).

(c)  Attorney fees.--The court shall award attorney fees as

follows:

(1)  To a successful petitioner under subsection (a)(2).

(2)  To a successful plaintiff under subsection (b).

(a)  Damages.--A health care practitioner who knowingly

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performs an abortion in violation of this act shall be liable to

the patient for:

(1)  damages caused by the violation; and

(2)  punitive damages in the amount of $5,000.

(b)  Attorney fees.--A prevailing party under subsection (a)

shall be awarded attorney fees.

(c)  Cumulative nature.--Civil liability under this section

is in addition to:

(1)  administrative sanctions under section 11; and

(2)  criminal penalties under section 12.

Section 14.  Construction.

Nothing in this act shall be deemed to do any of the

following:

(1)  Eliminate the application of the 24-hour waiting

period under 18 Pa.C.S. § 3205 (relating to informed

consent).

(2)  Limit or repeal any provision of 18 Pa.C.S. Ch. 32

(relating to abortion).

Section 48.  Severability.

The provisions of this act are severable. If any provision of

this act or its application to any person or circumstance is

held invalid, the invalidity shall not affect other provisions

or applications of this act which can be given effect without

the invalid provision or application.

Section 49.  Applicability.

The requirements of this act shall not be deemed inoperative 

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operative prior to the preparation of forms by the department

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under section 7(a)(2).

Section 50.  Effective date.

This act shall take effect as follows:

(1)  The following provisions shall take effect

immediately:

(i)  Section 7.

(ii)  Section 49.

(iii)  This section.

(2)  Section 6 shall take effect 30 days after the

publication of the notice under section 7(a)(6).

(3)  The remainder of this act shall take effect in 90

days.