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Texas ’new strict abortion law has been described as a ban on abortions starting at six weeks of pregnancy.
It is a characterization that politicians have clung to, with Governor Greg Abbott using it to defend why the law does not exempt victims of rape or incest.
“Obviously, it provides at least six weeks for a person to be able to have an abortion,” she said Tuesday, arguing that it does not force victims to carry out the pregnancy.
But in reality, the time to have an abortion is much shorter, even if someone realizes she is pregnant right away. And in Texas, more than 80% of abortions happened after six weeks.
Measurement of the duration of pregnancy
The new law does not actually provide a specific time period for someone to have an abortion, but it does stipulate that it cannot occur once cardiac activity is detected. This happens around the sixth week of pregnancy.
But if a strict six-week ban is established, the nuance is not taken into account in the circumstances many people face when it comes to pregnancy, according to medical professionals and major medical organizations.
On the one hand, medically, the duration of pregnancy is not normally measured from the date of conception. Instead, according to the new law, “pregnancy is calculated from the first day of a woman’s last menstrual period.” This statement aligns with the typical way doctors initially work to determine gestational age, according to the American College of Obstetricians and Gynecologists.
But this traditional method assumes that a person has regular periods that usually occur every 28 days or four weeks. Many women have more irregular periods.
And ovulation, or when an ovary releases an egg, usually occurs about two weeks after the end of a woman’s last menstrual period.
“So the day you actually ovulate, send the egg, and have chances of conception, by convention we say you’re two weeks pregnant right now,” said Dr. Rachel Breedlove, who practices obstetrics and gynecology at St. St. David Medical Center David’s South. “So I think it’s really confusing for non-doctors to understand how you could be two weeks pregnant? But we’re dating it from the last period, not the date of conception.”
About two weeks after conception and four weeks after her last period, someone could get pregnant after losing the start of her new period. However, unless someone intends to become pregnant or closely monitor their period, they are unlikely to know that they are pregnant at this marked time.
For people with irregular periods, the unpredictability of their cycle can make it even more difficult to determine gestational age or detect if the period is late.
“Most of us don’t have clock cycles,” Breedlove said. “So what do most people do? They wait five to seven days, so many people don’t even test until a week after this missed period. “
What is the true period of time that someone has to abort according to the law?
At most, a person would have about two weeks to determine whether or not they want to end the pregnancy by law. However, medical professionals have said the likely time period is even shorter.
“I think it’s more likely to happen in about a week, and it will even be an ideal situation,” Breedlove said.
There are a handful of reasons why the completion window may condense. For example, if a person chooses to take a pregnancy test about a week after missing a period, which is not uncommon, this will shorten the window. In addition, in light of the new law being implemented, some abortion providers in the state have stopped performing abortions at the risk of facing legal action, which means that some people may have to fight for an out-of-state abortion.
Under previous Texas law, an ultrasound must be performed 24 hours before a person receives an abortion, condensing an already limited period of time and forcing a person to make two visits. During the ultrasound, the doctor should describe the sonogram images to the person and also check for the presence of cardiac activity. Some interpretations of the new law suggest that another ultrasound should be done at the second visit to confirm that cardiac activity has not developed.
“So this further compresses that timeline because now you have to make two visits,” said Dr. John Thoppil, president of the Texas Association of Obstetricians and Gynecologists. “… Since the enactment of this law, there have been cases where someone came in and over the next 24 hours cardiac activity progressed and they were unable to continue.”
When can an ultrasound pregnancy be detected?
Typically, the earliest pregnancy can be detected in the uterus by ultrasound is around the five-week gestation period, Breedlove said.
Doctors usually do not do an ultrasound so soon, unless it is a high-risk pregnancy.
ACOG recommends receiving an ultrasound during the first trimester of a person, which is approximately the first 13 weeks of pregnancy, as the most accurate method for determining gestational age. Breedlove said that, based on the patients he sees, most are introduced to ultrasound in about eight weeks. Some people may also wait even longer and receive their first ultrasound during the second trimester, or with about 18 to 20 weeks of pregnancy, according to the March of Dimes, a nonprofit that focuses on health outcomes. of mothers and babies.
Under the new law, abortion is not allowed when a “fetal heartbeat” or “cardiac activity” of an embryo is detected. The law states that “cardiac activity begins at a biologically identifiable time, usually when the fetal heart is formed in the gestational sac,” a fluid-filled structure that surrounds an embryo during the first weeks of development.
Experts have said, however, that the nickname politicians have used in the bill is misleading, saying it is not a proper medical descriptor. Although cardiac tissue begins to develop during the first weeks of pregnancy, an embryo does not have a fully developed heart at six weeks of gestation, when cardiac activity is usually first detected by ultrasound.
“You can’t see anything structural that looks like a four-chambered choir, but you can see a flicker [of it]”,” Breedlove said.
What development does an embryo have at six weeks of gestation?
According to some doctors, after six to eight weeks of gestation, an embryo measures about an inch.
“It almost looks like a tadpole, in terms of what the embryo looks like right now,” Thoppil said. “So you see something at the center of that flicker of movement, and it’s that cardiac activity.”
Although cardiac activity can be detected around six weeks of gestation, Breedlove said it is easier to hear the actual heartbeats around eight weeks of gestation.
“We basically put a Doppler detector where we see the heartbeat flash and then we can turn on the speaker and then you can hear the blood moving, so this is the beat that most people are able to hear. and that they are usually more than eight. weekly mark, ”he said.
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