Recently, I was doing an ultrasound on a pregnant patient. This was so early in her pregnancy that the only thing present was the gestational sac, which usually appears around five weeks after the first day of the last menstrual period.
Still, the patient asked me, “Is there a heartbeat?”
My response: “There’s not even an embryo to have a heartbeat.”
Then I gave her an analogy I often use. People are familiar with chicken eggs and know that, with the eggs they eat, there is a yolk but no chick forming yet. We humans start out that way, too.
But the patient’s question about the heartbeat touches on a topic that abortion opponents use to further their goals of outlawing all or nearly all abortions. In recent years, many states have passed heartbeat bills that ban abortions if a heartbeat can be detected, which these bills usually set at six weeks into the pregnancy. Many women aren’t even aware they are pregnant at that point.
Heartbeat bills aren’t that new. The first one was passed in North Dakota in 2013, but was later struck down as unconstitutional under Roe v. Wade, which protected the right to an abortion. Even with that defeat, state legislatures kept trying, and judges kept blocking their efforts. That changed in 2022 when the U.S. Supreme Court struck down Roe v. Wade. Soon, a number of states, using that heartbeat timetable as a guide, passed laws banning abortions after a woman has been pregnant for six weeks.
Unfortunately, heartbeat bills get a lot wrong about biology and about pregnancy. Let’s examine a few myths surrounding them.
Myth No. 1: Life Begins When the Heart Starts Beating
Those who support heartbeat bills argue that, since we consider that a life ends when the heart stops beating, we should also assume that life begins when the heart begins to beat.
The question of when life begins is difficult to pinpoint because “life” as a biological process is inherently different from what theologians mean by “life.”
But here is something we do know: According to the NIH, “embryo loss is approximately 10-40% before implantation, and total loss from fertilisation to birth is 40-60%.” It is the process of implantation that establishes a pregnancy. After implantation, 15 to 20 percent of pregnancies will end naturally in miscarriage, which is known in medical terms as spontaneous abortion.
Giving personhood to a cell or a set of cells, most of which will be destroyed in normal biological processes, feels arbitrary, even absurd.
Myth No. 2: The Heart is Beating at Six Weeks
Heartbeat bills, and the laws that came about after Roe v. Wade was overturned, hinge on the idea that the embryo’s heart begins to beat six weeks into the woman’s pregnancy. But is that the case?
Not really, at least not in the way most people think of a beating heart.
Six weeks is still the embryonic stage of the pregnancy, and although a flutter can be detected, the heart is still developing at that point and is simply a cluster of cells. It isn’t until the end of the eighth week that the heart and other organs start to take shape. Finally, at the end of the 10th week, the heart is fully developed.
So, even though people may refer to a heartbeat at six weeks, the heart still has a few weeks to go before it has truly formed into what people think of when they visualize a heart.
Myth No. 3: Exceptions Protect the Life of the Pregnant Person
At times, problems arise during a pregnancy, and an abortion is necessary to protect the health and life of the pregnant person. That situation becomes problematic with much of the legislation that’s been passed in the last few years.
Proponents of these bills tell us not to worry. They say that exceptions are typically added to allow an abortion if it’s needed to save the pregnant person’s life.
That may be technically true, but it isn’t always the case in practice.
Often, it’s unclear when those exceptions apply, and most healthcare professionals aren’t willing to risk their licenses or go to jail because of the complicated nature of what “life of the mother” means.
We’ve seen this already with professionals refusing to perform abortions until a truly dire emergency exists—sometimes too late.
We see providers moving out of states where “life of mother” exceptions exist, thus putting care out of reach of people who will need emergency care. We see clinics in states with these bans closing in record numbers, further limiting access to care. Even the doctors who stay may not be much help.
There has to be the opportunity to gain the skill set and expertise to safely perform those unique, special abortions that legal exceptions are written for. Healthcare professionals won’t have the skills to perform abortions later in pregnancy if they’re so severely restricted. They won’t be able to train the next generation of doctors. It takes training and experience to take care of those very particular, specific cases. The way healthcare providers learn to treat people is to actually have people to treat.
As soon as there is any restriction, it becomes too risky for the practitioner and soon, the skills are atrophied. Allowing for “reasonable” restrictions means when people need help, it won’t be there. Any restriction is a recipe for unnecessary harm.
Saving Lives
I have seen firsthand the danger pregnant people face when serious problems arise in a pregnancy.
Let me give you an example that happened more than 15 years ago. As you read this scenario, imagine if the medical personnel involved had been worried that their decisions could result in them losing their licenses or being arrested.
I was called to a hospital to save the life of a mother of two who was 22 weeks pregnant. She was in the cardiac intensive care unit with a damaged and failing heart, the result of an infection called endocarditis. That generally is not lethal to someone who is not pregnant, but in her case, the pregnancy was straining her heart.
We told her she was dying but that we could perform an abortion, save her life, and she could return home to her children, who needed her. Initially, because of her religious beliefs, she declined.
Over the next few days, her health worsened. Finally, she changed her mind, and after the abortion, her health began to improve immediately.
Two days later, this dying woman went home to her family. This is what is at stake. This is what is on my mind when restrictive laws are passed. We need to support people at their most vulnerable. We need to do better.
