This week, the governor of Georgia signed one of the most restrictive abortion laws in the country. It effectively outlaws the procedure after six weeks of pregnancy. Republican governors in three other states — Mississippi, Kentucky and Ohio — have signed similar laws this year, marking a new and more severe tactic by the anti-abortion movement.
The current constitutional standard under the Supreme Court’s Roe v. Wade decision is that abortion is legal up until the point when the fetus could survive outside a woman’s womb — usually about 24 weeks into the pregnancy.
What would these laws do?
These so-called “heartbeat” laws ban abortion after the point when a fetal heartbeat can be detected. This often occurs as early as six weeks into a pregnancy, when an ultrasound may be able to detect the pulsing of what will become the fetus’s heart.
These laws therefore move the ban on abortion in those states more than four months earlier than the current constitutional standard.
Doctors measure the start of pregnancy from the date of a woman’s last menstrual period, which is usually about two weeks before a fetus is conceived. (That timing is used because it’s generally impossible to know the exact moment of conception.) So these new laws would essentially prohibit abortion when an embryo is four weeks into development.
That — usually just two weeks after a missed period — is before many women realize they are pregnant.
The Georgia law makes exceptions, allowing later terminations of pregnancies resulting from rape or incest, something not included in every version of these laws. Most of the laws allow abortion if the woman’s life or health is seriously threatened.
What does the science and medicine say?
According to the American College of Obstetricians and Gynecologists, an embryo is not considered a fetus until eight weeks after fertilization, which is about 10 weeks into a pregnancy.
At six weeks into a pregnancy, the tissues that will become the heart are beginning to develop and a pulsing can be detected that is faster than the heartbeat of the expectant mother.
Several medical experts, including those opposed to the new abortion restrictions, say that it isn’t medically correct to call that pulsing a heartbeat. Rather, they say, it is the vibration or “embryonic cardiac activity” of the fetal pole, a tubelike structure that will become the heart.
At six weeks into a pregnancy, the embryo has not developed a brain, spinal cord or organs that would enable survival outside the womb.
Some medical experts worry that Georgia’s law could cause harm to women who have nonviable pregnancies that aren’t identified by the six-week mark. They cite the example of an ectopic pregnancy, in which the embryo is developing outside the uterus and will never develop into a viable fetus. An ectopic pregnancy may not be detectable at six weeks, and as it progresses, it can cause severe bleeding in the woman.
Some reproductive health experts say the law would prevent the standard medical practice of terminating an ectopic pregnancy early to prevent harm to the woman. They are concerned that the law would force a doctor to allow a nonviable pregnancy to proceed until it is actually causing dire harm to a woman’s health.
Pam Belluck is a health and science writer. She was one of seven Times staffers awarded the 2015 Pulitzer Prize for International Reporting for coverage of the Ebola epidemic. She is the author of “Island Practice,” about a colorful and contrarian doctor on Nantucket. @PamBelluck
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