Yes, a “heartbeat” abortion ban is really a full abortion ban

The state of Ohio is currently voting on a ban that would ban abortion from the point in which a “heartbeat” can be detected. South Carolina pre-filed a ban, too. Even Missouri is in on the action, planning to ban abortion when a heartbeat can be found on a “heartbeat detection device” – whatever it is they mean by that.

These far-right politicians claim that a heartbeat should be used as the new point of viability to rule when abortion should no longer be legal. But as any reputable medical practitioner would tell you, a heartbeat in utero doesn’t mean the pregnancy is necessarily viable – and it definitely doesn’t equal “life.”

That “heartbeat” that antis will tell you starts as early as “21 days post conception!” is really just cardiac electrical impulses. The heart itself is only just beginning to form at six week after your last period (or four weeks after fertilization), and doesn’t develop all four chambers until at least the 8th week. New research suggests that heart development now continues on until the 20th week of pregnancy. To tie “viability” to this first point of impulses isn’t any different than saying abortion should be banned at the point which a fetus develops ears, or bendable elbows. Early cardiac activity is just one minuscule component of an entire plethora of extensive and ongoing embryonic development, all of which at that point is occurring in a form that is no larger than a grain of rice.

Meanwhile, even once this so-called “heartbeat” is found, there is no guarantee that the pregnancy is a viable one. An estimated 10 to 30% of pregnancies are found to be nonviable even after cardiac activity has been detected on an ultrasound, making it clear that the “heartbeat =viability” talking point is nothing but the fantasy of the anti-abortion movement.

The gynoticians introducing these bills pretend that they aren’t actually proposing total abortion bans – after all, they argue, you can still get an abortion prior to a detectable “heartbeat.” But in practice, that’s nearly impossible to do. Most clinics won’t even perform an abortion before there are signs of an intrauterine pregnancy (a fetal pole, or at least a yolk sac) – and that already doesn’t occur until nearly 20 days post conception as it is.

In my own clinic, a patient who wants an abortion would need to contact me the moment that they have a positive pregnancy test, and that patient would need to be seen within the next day or two from that phone call. We would need to confirm that pregnancy with either a blood or urine test or both, and if using a blood test would need to quantify how much pregnancy hormone (HGC) is in the blood to make a best guess about if that pregnancy is healthy, ectopic, or even a miscarriage or blighted ovum (a fertilized egg that doesn’t develop into an embryo). Because it would be too early to see much at all on even a vaginal ultrasound (possibly a gestational sac, but little more) we would perform a termination (either with medication or aspiration) but would then need have the patient return a week later to ensure that the abortion was successful, there was no ectopic pregnancy, and that the pregnancy did not continue.

Getting an abortion at all would be a fraught procedure where time is of the essence. The only people who would even be able to manage the process would be those who are utterly certain of their cycles to the point where they would be immediately aware that their periods were late. Those who have longer or irregular cycles will probably miss that window all together.

If “heartbeat ban” proponents succeed, the only way to obtain a legal abortion would be to take a test every day starting a week after sex, just to be completely positive you aren’t pregnant and be able to get into an abortion clinic immediately if you ever get a positive result. Is that really how Republicans expect women to live?

“Heartbeat” may be a politically hot word for abortion opponents, but medically it means nothing – at least, not when it comes to an embryo. The heartbeats that really matter are the hearts of the people who come into clinics every day looking to end pregnancy they are unable or unwilling to continue. These patients feel and think and have rich full lives that conservative politicians only too eager to cast aside in order to ensure that every fertilized egg is carried to term.

When will their heartbeats matter?


Author: drgoodrick

Dr. Gabrielle Goodrick is the owner and medical director of Camelback Family Planning, one of only four private abortion clinics left in Arizona. She also serves on the board of NARAL Pro-Choice Arizona.

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