Heartbeat bill
A six-week abortion ban, also called a "fetal heartbeat bill" by proponents, is a law in the United States which makes abortion illegal as early as six weeks gestational age, which is when proponents claim that a "fetal heartbeat" can be detected. Many medical and reproductive health experts, including the American Medical Association and the American College of Obstetricians and Gynecologists, say that the reference to a fetal heartbeat is medically inaccurate and misleading. They note that a conceptus is not considered a fetus until eight weeks after fertilization, and that at four weeks after fertilization the embryo only has a simple tubelike structure that will later develop into a heart. Some medical professionals advise that a "true fetal heartbeat" cannot be detected until around 17 to 20 weeks of gestation when the chambers of the heart have become sufficiently developed.
Janet Porter, an anti-abortion activist from Ohio, is considered to be the person that first authored this type of legislation. Efforts to introduce her model law succeeded in passing through political branches of government in about a dozen states but in most cases the courts struck down or blocked similar legislation; however, the Texas Heartbeat Act and analogues subsequently adopted in other states succeeded due to a unique enforcement mechanism that makes challenging the law extremely difficult, and which was upheld by the Supreme Court. In some states, the heartbeat bills' effect has been minimized by more stringent total abortion bans that were announced following the decision in Dobbs v. Jackson Women's Health Organization; in other states, such as Ohio, South Carolina and Tennessee, judges lifted the injunctions against the previously passed laws.
Porter's anti-abortion group argues that a heartbeat "is the universally recognized indicator of life." Reproductive rights advocates, on the other hand, say that these bans are de facto complete abortion bans, since many women do not even know that they are pregnant six weeks after their last menstruation, which is on average four weeks post-fertilization and three weeks post-implantation.
Background
The heartbeat bills are based on model legislation created by Faith2Action, a conservative Christian ministry from Ohio advocating for abortion restrictions. Its founder and leader, Janet Porter, said that she was frustrated by what she saw was slow progress in banning pregnancy termination around the United States. The activist thus authored the Ohio House Bill 493 in 2011, and arranged for heart-shaped balloons and fetuses' "testimony" in the legislature, but the bill failed to get out of the Senate because the lawmakers feared the bill was unconstitutional. Her efforts were not considered mainstream at the time, and the Ohio Right to Life, an anti-abortion group which previously employed Porter, opposed such legislation. While that proposal failed, a flurry of copycat legislation was proposed in several other states, which has not abated since then.In 2013, North Dakota became the first state to pass legislation banning abortions after six weeks. In 2015, the law was ruled unconstitutional under the precedent set by the U.S. Supreme Court decision Roe v. Wade. Eleven states have proposed bills for six-week abortion bans since 2018; since 2019, such bills have passed including bills in Ohio, Georgia, Louisiana, Missouri, Alabama, Kentucky, South Carolina, and Texas, most of which lie either partly or entirely in the Bible Belt. Utah and Arkansas voted to limit the procedure to the middle of the second trimester. As of June 2021, except for the Texas bill, none of the laws were in effect due to court intervention. The Guttmacher Institute writes that "state policymakers are testing the limits of what the new U.S. Supreme Court majority might allow and laying the groundwork for a day when federal constitutional protections for abortion are weakened or eliminated entirely." Texas has taken a novel approach in their wording of the legislation; rather than have the government enforce the law, private citizens are to be allowed to sue the provider or anyone that helps the woman to get an abortion. The Texas Tribune writes that "supporters of the bill hope this novel provision will trip up legal challenges to the legislation, as without state officials enforcing the ban, there will be nobody for pro-women's rights groups to sue."
Timing
Because the start of pregnancy is measured from the date of a woman's last menstruation, six weeks into a pregnancy equals four weeks of embryonic development, and only two weeks after a woman's first missed period, when many women are unaware that they are pregnant. Most women who have an abortion do so after six weeks' gestation. Reproductive rights advocates contend that because of these and other reasons, the "fetal heartbeat" bills are de facto bans on abortion.Terminology
While some of these laws ban abortions after six weeks of pregnancy and are called "fetal heartbeat" laws by their proponents who claim that a fetal heartbeat can be detected at six weeks, doctors have said that the term "fetal heartbeat" at that stage is false and intentionally misleading. A conceptus is not called a fetus until after ten weeks of pregnancy. Additionally, since at six weeks the embryo has no heart – only a group of cells which will become a heart – calling it a heartbeat is also misleading. The heart will only have formed enough to be able to hear a real fetal heartbeat by 17–20 weeks of gestation.Jennifer Keats, an OB-GYN at University of California, San Francisco, stated that the embryo's cardiovascular system at six weeks is "very immature". Keats described the cardiac activity as "a group of cells with electrical activity. That's what the heartbeat is at that stage of gestation... We are in no way talking about any kind of cardiovascular system."
Ted Anderson, formerly president of the American College of Obstetricians and Gynecologists, said that "ACOG does not use the term 'heartbeat' to describe these legislative bans on abortion because it is misleading language, out of step with the anatomical and clinical realities of that stage of pregnancy." and "Pregnancy and fetal development are a continuum; What's interpreted as a heartbeat in these bills is actually electrically induced flickering of a portion of fetal tissue that will become the heart as the embryo develops."
Controversy exists surrounding six-week abortion bans in part because there is debate on the point at which an embryo heartbeat can be detected. In 2013, when the Wyoming House of Representatives considered a "heartbeat bill", Norine Kasperik said that "she heard different answers to when a heartbeat is detectable", and in her view "there seemed to be variation by medical equipment used". Mary Throne asked: "Is this abortion illegal at 22 days with a highly invasive ultrasound or is it illegal at 9 weeks when we hear a heartbeat with a stethoscope?" Other critics of the bills have claimed that they ignore that not all embryos' heartbeats become detectable at the same time, even when measured using the same methods.
The Center for Reproductive Rights has stated that there is some inconsistency with regard to these laws; specifically, the Arkansas law requires providers to use an abdominal ultrasound to attempt to detect a fetal heartbeat, while the North Dakota law allows the use of any available technology, including a transvaginal probe, which makes it possible to detect a fetal heartbeat earlier than an abdominal ultrasound can. With specific regard to the North Dakota law, detecting an embryo's heartbeat at six weeks into a pregnancy requires the use of a transvaginal ultrasound, which some members of the abortion-rights movement say is unnecessarily invasive.
Controversy
Pregnancy from rape
In the United States, it is estimated that there are 25–32thousand pregnancies from rape per year in adult women, although the number may be considerably higher, since many women do not report rape. Many victims receive little to no aftercare, and most experience various forms of post-traumatic stress disorder. A third of these pregnancies are not discovered until the second trimester. Any delay in detection reduces women's options, especially outside major urban centers. However, this is complicated by the fact that, when they are called on to decide whether to have an abortion, many women are still physically and mentally recovering from being raped.Most women do not report sexual assault, and often it is hard to bring an assault case to trial. Teenage girls are especially unlikely to report assault, even though 74% of women who had intercourse before age 14 and 60% of those who had sex before age 15 report having had a forced sexual experience. One study conducted in the 1970s that looked at California data found that "on average, only 413 men were arrested annually for statutory rape in California, even though 50,000 pregnancies occurred among underage women in 1976 alone".
Alabama's "heartbeat bill", passed in 2019, makes abortions illegal even in cases of rape and incest. Furthermore, it requires that judges terminate the parental rights of a man convicted of first-degree rape or certain other sex crimes, leaving a loophole that allows rapists to seek custody of a child conceived as the result of their assault. However, because the law requires a conviction, activists say that since most sexual assaults are never reported, much less produce a finding of guilt in court, many victims are left vulnerable. Activists fear that a victim could find herself in a situation where she would be forced to bear a child of rape and then be forced to co-parent the child with her rapist.
Responding to criticism of the Texas "heartbeat bill", which also does not exempt from its provisions women and girls who have been raped, Governor Greg Abbott asserts that the Act will not force a woman who has been raped to carry a pregnancy to term because the state will "work tirelessly to make sure that we eliminate all rapists from the streets of Texas by aggressively going out and arresting them and prosecuting them and getting them off the streets."