Women in the US could die because of the heartbeat abortion bill
A controversial bill (HB 481) that makes abortion illegal after a fetal ‘heartbeat’ can be detected has recently been passed in the US state of Georgia. The new reproductive law is one of the most restrictive in all of the US, with sixteen states in the process of passing it or having already made it law in their jurisdictions.
It is a blatant and grave attack on women’s health and rights, placing women at a higher risk of mortality and persecution.
A ‘fetal heartbeat’ can often be detected at only six weeks, before many women even know they are pregnant or realise they’ve missed a period. The Alabama senate is also due to vote on a different piece of abortion legislation next week that would make abortion a criminal act, even in the case of sexual assault.
Officially known as the Living Infants Fairness and Equality Act, the new Georgia state law redefines an unborn fetus as a person with human rights, as well as an “independent object of state protection”, separate to that of the mother. Beneath Georgia state law, any person who has “unlawfully” caused the death of another human being is liable for murder.
“This is actually medical malpractice and it will result in patients being misinformed because the law has decided to tell healthcare professionals how to do their job”
The bill will also reshape the state tax code, establishing a fetus as a dependent minor from the point of conception, allowing pregnant women to claim tax credits on this basis. It will come into effect from January 2020.
Across the pond, women in Northern Ireland (NIR) are already living beneath similar laws, which have been named by Amnesty International as the harshest in Europe. And their impact on women’s lives has been severe.
It’s currently illegal to get an abortion at any stage of pregnancy in NIR, unless the life of the mother is threatened in a medical capacity, like certain death or a history of psychotic episodes after giving birth. The procedure is not even permissable in the case of sexual assault or incest.
“Only 12 women have apparently met this criteria in the last year,” says Emma Cambell of Northern Ireland’s Alliance for Choice. “Yet, more than 1000 women in NIR needed access to abortion services in the last year, too. The bar is incrediby high for a legal abortion to be carried out on medical grounds.”
Travelling to England for an abortion is a costly and often traumatic experience, with some women enduring pain and heavy bleeding while on a boat or plane. For women from deprived areas or those unable to take time off work, this journey is not even an option. Ironically, NIR has no state provisions for childcare.
Though HB 481 will apply to all women who are able to get pregnant in the states that have approved it, it could similarly impact those from lower-income backgrounds. Women who have the means to relocate may do so, pricing out others from seeking care elsewhere. However, emergencies can happen at any time, and to anyone within affected states who can reproduce.
In NIR, staff are legally obliged to report women who have undergone abortions to the police. This has resulted in prosecutions and deterred women from seeking aftercare in emergency situations
Legislating people’s rights to care invariably impacts the quality and availability of that care. Many healthcare providers worry HB 481 will limit their ability to act in emergencies, potentially endangering women’s lives.
Washington-based OB GYN Dr Sara Imershein says the new bill flies in the face of currently active laws by redefining what fetus viability — the ability of the fetus to survive outside the uterus — means.
Before the introduction of HB 481, the Roe vs Wade ruling established something called the ‘trimester framework’, whereby a termination is permitted as long as the fetus cannot survive outside the womb. Once a fetus is able to survive outside the womb, the state can step in to prevent abortion and approaches to this differ by state.
“This bill is dangerous, women will be harmed because of it,” Dr Imershein says. “It doesn’t follow the established framework, and some parts of the bill are completely unenforceable. How exactly will they decide who is eligible for dependent minor tax credits? Will women have to start submitting their medical records to the state to prove a pregnancy? Do you lose the tax benefit if you miscarry?”
Medical professionals may also face criminal prosecution of up to 99 years in prison if intervention to address a medical issue with a mother impacts the fetus negatively.
Medically, what US lawmakers are defining as a ‘fetal heartbeat’ is actually just the ‘practice motion’ of developing tissues that couldn’t keep the fetus functioning outside of the womb at six weeks
“Facilities will ultimately be prevented from carrying out the procedures that are necessary,” says Dr Imershein. “This is the only law that actively deincentivises medical professionals from doing their job and carrying out best practice.
“It will create situations where medically, the best option is to intervene, but because of the law, patients will be told that it’s ‘ok’ to wait because fetal life must be preserved by law, when often, where the mother is concerned, it absolutely won’t be ok to wait.
“This is actually medical malpractice and it will result in patients being misinformed because the law has decided to tell healthcare professionals how to do their job.”
In NIR, staff are legally obliged to report women who have undergone abortions to the police. This has resulted in prosecutions and deterred women from seeking aftercare in emergency situations.
“The introduction of the abortion pill has caused a decline in fatally unsafe abortion cases in NIR, because women do access them online illegally” says Emma. “But if a woman seeks care for unusually heavy bleeding after this treatment, she could face prosecution.
“There is an ongoing case involving a mother who is being prosecuted for accessing the abortion pill online for her teenage daughter who was in an abusive relationship.”
Some states are already introducing backstops to limit the impact of a possible overturn of the Roe vs Wade ruling
While abortion pills are considered to be safe, medical supervision and continuity of care is still essential.
What’s more, the pro-life language around HB 481 is scientifically misleading.
Medically, what US lawmakers are defining as a ‘fetal heartbeat’ is actually just the ‘practice motion’ of developing tissues that couldn’t keep the fetus functioning outside of the womb at six weeks, explains Dr Imershein.
“At six weeks, a fetus is a parasite by definition” she says. “In situations like ectopic pregnancy, the new legislation makes treatment options less clear, and women are put at great risk because of this uncertainty. In emergency situations, there’s no room for apprehension, but this bill creates that.”
The ‘six weeks’ clause is a backhanded attempt by lawmakers to appear as though they are offering women some leeway in seeking appropriate care. Women aren’t even likely to be aware of a pregnancy at six weeks: they may only miss one period and show no visible signs. Even where a woman may be aware she is pregnant, she is forced to bear the significant emotional burden of making a snap decision about her health and seeking care.
“There is a religious minority in the US, Northern Ireland, and globally that have immense lobbying power when it comes to reproductive health rights”
With US lawmakers in different states coming down vehemently on either side of this issue, discussions about abortion access on a national level are likely to eventually appear before the US Supreme Court. Some states are already introducing backstops to limit the impact of a possible overturn of the Roe vs Wade ruling.
“There is a religious minority in the US, Northern Ireland, and globally that have immense lobbying power when it comes to reproductive health rights,” says Emma. “Men’s reproductive rights are not targeted in the same way by laws, and there is absolutely no ‘burden’ placed on them.
“This makes it abundantly clear that this is not about preserving life but actually just about policing women’s bodies and restricting our rights.”
Emma points out that the state of reproductive rights in NIR is greatly influenced by the political climate in the US, claiming that as a result, NIR is now “circling in on itself”.
Despite religious and moral beliefs, all women may find themselves in a position where they need an abortion. “Even the protestors outside the clinics access abortion services as and when they need it, because they always think their situation is different and somehow ‘acceptable’,” says Dr Imershein.
Abortion is healthcare, and should be available for every woman should she choose.
The featured image is of the Statue of Liberty, containing clusters of short squiggles strategically placed over her face, torch, and behind her crown, symbolising an erosion of liberty and human rights