Ultrasound Informed Consent Act

Bill Summary

H.R. 48, the “Ultrasound Informed Consent Act,” would create a new federal floor for informed consent in abortion care by amending the Public Health Service Act to add a national requirement that an obstetric ultrasound be performed and explained before a patient can give informed consent for an abortion. It applies to any abortion provider “in or affecting interstate or foreign commerce,” a standard Congress often uses to reach most clinical practice given the modern healthcare supply chain. The bill does not ban abortions; rather, it regulates the pre-procedure consent process and creates civil penalties for noncompliance.

The bill defines key terms. “Abortion” is broadly defined to include any intentional use or prescription of instruments, medicines, drugs, substances, devices, or methods to terminate the life of an “unborn child,” or to terminate a known pregnancy, except in cases to produce a live birth and preserve the child’s life, remove an ectopic pregnancy, or remove a fetus that has died as a result of miscarriage, trauma, or criminal assault. “Unborn child” is defined as a human being at any stage before birth. “Abortion provider” is anyone legally qualified to perform abortions under applicable law. “Woman” is defined as a female human being, regardless of age; the bill also defines “unemancipated minor,” although the text creates no separate parental notification rules.

Section 3402 sets the core requirement. Before a woman can provide informed consent for any part of an abortion, the provider or a supervised agent must: (1) perform an obstetric ultrasound; (2) provide a simultaneous explanation of what the ultrasound shows; (3) display the images so the woman may view them; and (4) give a “complete medical description,” including the dimensions of the embryo/fetus, whether cardiac activity is present and visible, and the presence of external members and internal organs if present and viewable. The patient is expressly allowed to avert her eyes, and neither she nor the provider is penalized if she declines to look. However, the display and description must still be offered and performed as part of consent.

The requirement applies to both surgical and medication abortion, because the definition of abortion includes the use or prescription of drugs. In practical terms, this would establish a nationwide ultrasound step before medication abortion, which in many jurisdictions can currently proceed without an ultrasound if the patient’s history and clinical judgment make it unnecessary. The bill contains a medical emergency exception limited to circumstances where an abortion is necessary to save the mother’s life. In such cases, the provider must certify in the medical file the specific medical circumstances justifying the exception. The exception does not extend to serious non-life-threatening health risks, nor does it create exemptions based on rape or incest; those circumstances are not mentioned in the informed consent requirements.

Enforcement consists of civil, not criminal, penalties. The U.S. Attorney General may bring a civil action with penalties up to $100,000 per violation in a first proceeding and $250,000 per violation in later proceedings, and must notify state medical licensing authorities when penalties are assessed. The bill also creates a private right of action for the woman on whom an abortion was performed in violation of the act, allowing her to seek actual and punitive damages; actual damages are defined as objectively verifiable money damages for all injuries. There is no third-party private enforcement. The bill includes a severability clause to preserve the remainder if any provision is struck down.

A preemption clause preserves room for state laws that are “more extensive” than this federal standard. That means states can maintain or enact stricter disclosure rules or higher penalties; permissive states could not set a lower bar than the federal requirement. Functionally, this creates a federal floor and allows a state-by-state ceiling. In states with near-total abortion bans, the law would have limited effect; in states that permit abortion or rely heavily on telehealth and medication abortion, it would add a new procedural step, likely requiring in-person ultrasound capability and associated scheduling, staffing, and cost.

Legally, the bill rests on Congress’s Commerce Clause authority and presents potential First Amendment issues because it compels physicians to speak and display images in a particular way. Federal courts have split on similar state ultrasound laws, with some upholding them as part of informed consent and others striking them down as compelled speech. Post-Dobbs, abortion regulation is largely returned to political branches, but First Amendment constraints remain. The bill’s language choices—such as “unborn child”—and its limited emergency exception reflect a pro-life framing. Practically, it would standardize a particular informed-consent ritual nationwide, increase documentation requirements, and expose providers to significant civil liability for procedural noncompliance, especially in early medication abortion and telehealth contexts.

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