On September 1, 2021, the Supreme Court decided not to block a Texas bill that effectively bans abortions after the 6-week mark. The new law is highly contested by public health experts and many organizations dedicated to safeguarding female health. How can this ban affect well-being and access to healthcare in the long term?
Share on PinterestAn activist, who declined to be named, speaks outside the Supreme Court in protest against the new Texas abortion law, in Washington, D.C., on September 2, 2021. Image credit: Drew Angerer/Getty Images
In Texas, as of September 1, a controversial abortion bill that Governor Greg Abbott signed into law in May has become effective, following the Supreme Court’s decision not to block it.
The new law, also known as Senate Bill 8 (SB8), effectively bans abortions after 6 weeks of pregnancy. This is calculated as starting from the date of a person’s last menstrual cycle, when, the bill alleges, the “fetal heartbeat” is most often detectable.
Since the Supreme Court announced its decision, the new law has come under strong public scrutiny, with many experts and public figures pointing out that what legally counts as “6 weeks of pregnancy” is too soon for most people to even realize that they are pregnant.
Most other states that allow abortions have set the cut-off point at 20 or 24 weeks of pregnancy, when most fetuses are considered viable — that is, likely to survive.
The fetal heartbeat allegedly detectable in the early weeks of pregnancy, according to SB8, “has become a key medical predictor that an unborn child will reach live birth.” Yet many experts contest the idea that a heartbeat is possible in a fetus at this stage.
Moreover, SB8 has dire implications for access to healthcare and the rights of women and other people assigned female at birth.
To find out more about the long-term effects of SB8 on healthcare and health equity, Medical News Today has heard from the national reproductive healthcare nonprofit organization Planned Parenthood and The Afiya Center (TAC), a nonprofit organization for reproductive justice founded and directed by Black womxn, which is headquartered in North Texas.
Controversies about medical accuracy
The first point of contention regarding the medical accuracy of SB8 concerns the fetal heartbeat and just how early it is detectable.
The text of the bill states that “cardiac activity begins at a biologically identifiable moment in time, normally when the fetal heart is formed in the gestational sac” and implies that this occurs around the sixth week of pregnancy.
SB8 mandates that “A physician may not knowingly perform or induce an abortion on a pregnant woman if the physician detected a fetal heartbeat for the unborn child […] or failed to perform a test to detect a fetal heartbeat.”
But while activity akin to a heartbeat may be detectable at around 5 weeks, health experts explain that this is not technically a heartbeat — since, at that point, the embryo does not have a fully developed heart.
“Embryo” is the medical term used during the first 8 weeks of pregnancy. This activity may be more accurately described as “embryonic cardiac activity,” as it refers to electrical impulses fired between cells that will help regulate the heartbeat once the heart is fully formed.
Are people even aware of pregnancy at 6 weeks?
Many public figures have insisted that the 6-week cutoff point may prevent abortion access because many people may not be aware that they are pregnant within this time frame.
This may be due to the fact that some people naturally have irregular periods. Some data indicate that as many as 9–14% of women have irregular periods throughout their menstruating lives.
Women or people assigned female at birth may also have irregular periods due to conditions such as polycystic ovary syndrome or hyperthyroidism.
Other factors that may cause this irregularity include stress, perimenopause, changes to hormonal levels, and birth control medication.
Each of these factors can keep a person from recognizing a missed period as a sign of pregnancy.
Other concerns
There are also concerns about the way that the Texas abortion law facilitates a system in which community members are actively encouraged to report and sue anyone suspected of breaking this law.
This includes people suspected of seeking an abortion after 6 weeks, any organization or individual who helps someone seeking an abortion after 6 weeks, and any medical professional suspected of providing abortions after the cut-off point.
“Unlike bans in other states that are enforced by state officials, SB8 includes a provision that allows individual citizens — including antiabortion protesters who have no connection to the patient — to sue anyone they believe provided or assisted a patient with an abortion that violates this law. It can be used to target abortion providers, abortion-rights activists, and a patient’s friends and family,” Planned Parenthood explained to MNT, adding that it “will continue to fight this [law] in the courts.”
How SB8 affects access to healthcare
Many health experts and women’s rights activists argue that the new abortion law will have a serious negative impact on menstruating people’s access to time-sensitive healthcare.
MNT heard from doulas Helen Zimba, Qiana Arnold, and D’andra Willis, members of Southern Roots Doula Services, TAC’s doula collective. It also heard from TAC’s Support Your Sistah Fund Coordinator Zuleka Edwards. The group explained:
“Abortions later in pregnancy typically cost more than procedures performed at earlier gestational ages. Therefore, delays in obtaining care are likely to create dire obstacles in obtaining any care at all for those with limited financial resources. When pregnant people don’t have access to abortion care and, instead, are forced to carry a pregnancy to term, their long-term physical, emotional, and mental health suffers. In addition, their families and communities are impacted.”
Planned Parenthood informed us that it is already hearing alarming reports from Texas-based patients and healthcare providers.
“Patients are scared, patients are confused, and Planned Parenthood health centers are getting flooded with calls from people trying to figure out what they can do and where they can turn for care. All three Planned Parenthood affiliates in Texas are experiencing higher call volumes than normal.”
“One [healthcare] provider in Houston usually would see around 30 patients seeking [an] abortion each day — now, because of this law, [it] saw only six. And half of them were already past the 6-week limit. This included one woman who didn’t realize she was, in fact, 7 weeks along, not 6,” the organization reported, speaking to concerns that many are unaware of their pregnancies until after the 6-week mark.
The ‘invisible’ impact of the abortion law
The TAC-affiliated contributors emphasized that a lack of access to abortions may have unseen effects on women’s well-being by forcing many into unemployment or preventing them from leaving situations in which they experience domestic abuse:
“Women denied an abortion have an increased likelihood of being unemployed and having a household income almost four times the federal poverty level. They report an increased likelihood that they don’t have enough money to pay for necessities like food, housing, and transportation, and are more likely to remain in contact with a violent partner, putting themselves and their children at increased risk for harm.”
“Texas will experience more womxn accessing government-funded services due to homelessness, abandonment, emotional and physical abuse, unplanned visits to emergency rooms, child protective services involvements, [and] loss of jobs, among other barriers, with the passing of SB8,” they explained, when asked about unseen long-term effects of the abortion law.
The TAC contributors also highlighted that the Texas abortion law will only deepen healthcare disparities and have a serious impact on Black women, who already face significant inequities.
“The socioeconomic status that SB8 targets in Black folx are those with income inequalities, who are on Medicaid, which doesn’t cover abortions, which leads to poor healthcare later. Ultimately, there [will] be an increase of the high maternal mortality and morbidity of Black women in Texas,” they projected.
How SB8 deepens health disparities
“[A] law like SB8 will further criminalize Black folk,” the TAC respondents warned, adding that as many as “85–90% of womxn that get abortions are already at or past 6 weeks gestation.”
Like Planned Parenthood, the group expressed concern that many will be unaware of their pregnancies by the 6-week cutoff point for abortions.
And even for those who learn of their pregnancies early, at 3–4 weeks, this would leave only 2 weeks to locate a clinic, make an appointment, “which could take over a week or more,” and if necessary apply for additional funding, the TAC group said, suggesting that the timeline would be unfeasible for most.
They added that people with undocumented status and people with HIV — who already face discrimination and often find it difficult to access healthcare — will encounter even more hurdles because of SB8:
“With all of this, those womxn who miss the 6-week deadline now face bigger obstacles. If there was an issue with coming up with the money to cover the procedure cost, it’s going to be even more of a challenge to figure out travel and lodging cost, just to get out of the state.
A big, unfortunate disparity is for our undocumented birthing folx or those who live with HIV. There is already a disadvantage due to economic status, undocumented status, [the fact that they are] uninsured and now can’t afford to seek [a] healthier and proper procedure [means] that [the circumstances will] likely result in death.”
The hard road ahead
The TAC-affiliated contributors were very clear on their stance concerning SB8. This law, they warned, will have dire consequences for all women and other people who can give birth, particularly those who are Black, in the state.
“There are innumerable challenges and issues that Black womxn face as a whole. Being a Black womxn in Texas, we are considered to be a preexisting condition,” they told MNT.
“This law further pushes the agenda of rich white men controlling everything, including women’s bodies. […] To be clear, abortions are not elective procedures. This ban ignores the fact that abortion care is, in fact, medically necessary, time-sensitive, and essential.”
“Everyone should have the freedom and power to control their own body, decisions, and lives,” Planned Parenthood said, urging anyone who may need abortion care to visit abortionfinder.org for resources.
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