On September 1, 2021, a ‘heartbeat bill’ – a pro-life law that bans abortions after 6 weeks of pregnancy will go into effect in Texas, the second-most populous state in the United States with a population of approximately 30 million. For the 15 million women residing in Texas, this means that they can only get an abortion before fetal heartbeat can be detected at 6 weeks, even if the pregnancy occurred as a result of rape or incest.
Furthermore, Texas will allow any citizen to bring a lawsuit against anyone who aids a woman in getting an unauthorised abortion – the suing citizen need not even be connected to the woman or those helping her to be able to sue.
This bill has drawn the ire of several attorneys and pro-choice supporters – numerous notable attorneys have denounced this law as unconstitutional and a prominent organisation Planned Parenthood has filed a lawsuit against Lubbock, a city in Texas. President and CEO of Whole Woman’s Health, Amy Hagstron Miller has also called this bill ‘hostile’ and said that permitting citizens to sue abortion providers intentionally causes tension, fear and intimidation surrounding abortions.
What is a heartbeat bill?
This strict American anti-abortion law is colloquially known as a ‘heartbeat bill’ as it criminalises abortion once the fetal heartbeat can be detected. So far, it has been passed in eight states – Alabama, Georgia, Kentucky, Louisiana, Mississippi, Missouri, Ohio and Texas, most of which lie in the conservative Christian Bible Belt in the Southern U.S.. This extreme law is a controversial one, for many reasons.
Numerous other states, mostly Republican, have also proposed similar laws, though they have been either struck down or temporarily blocked by the court for being unconstitutional – such a law goes against the landmark 1973 U.S. Supreme Court case that determined a woman has the fundamental right to choose to have an abortion.
This precedent sets out abortion laws in accordance with the three trimesters of pregnancy, each lasting about three months. In the first trimester, governments are forbidden from outlawing abortions. However, at the end of the second trimester, once the baby is able to survive outside the womb, abortions can be prohibited unless the mother’s life or health is at stake. Heartbeat bills go against this precedent, as the bill generally bans abortions when the pregnancy is not even halfway through the first trimester.
Why is the Heartbeat Bill controversial?
Knowledge of pregnancy
At 6 weeks of pregnancy, a woman may not even know about her pregnancy – to her, it simply appears as if her menses is two weeks late.
Although a late menstruation can be a telltale sign that one may be pregnant, menstrual cycles are commonly delayed for several other reasons, be it stress, chronic disease, thyroid issues, or even weight. External factors may also mess up one’s cycle, such as taking a morning-after pill, or going on or off birth control. Besides, some women generally have irregular menstrual cycles. According to the American Academy of Family Physicians, between 9 to14 percent of women experience irregular periods.
For any of the above women, once they find out about their pregnancy, the 6 weeks have already passed, and it is too late for her to get an abortion, forcing them to carry on with their pregnancy.
According to the American Pregnancy Association, at 5.5 to 6.5 weeks, a fetal heartbeat may be detected via a vaginal ultrasound. However, if no heartbeat is detected, mothers are told not to worry, instead to wait 3 to 7 more days before doing another ultrasound. While waiting to do another ultrasound, the deadline to get the abortion before 6 weeks would have passed before they have even obtained confirmation of their pregnancy.
Mother and baby’s health
The main, and sometimes only exception to the anti-abortion law is if the mother’s life or health is at stake.
However, the bill may put the mother (and baby) at risk anyway – if the fetus has any anomalies, they cannot be detected until later in the pregnancy, likely increasing infant and maternal mortality rates. Additionally, unintended births are more likely to result in negative physical and mental health outcomes for children as compared to intended births. Women who are unintentionally pregnant and forced to carry the baby to term are more likely to delay prenatal care, which ideally commences as soon as the mother finds out she is pregnant. In turn, this may lead to higher incidences of maternity-related health problems.
Women who are desperate for abortions may also seek unsafe back-alley abortions carried out by unlicensed practitioners or seek ‘home remedies’ to induce an abortion that can debilitateher health, resulting in an increased maternal mortality rate.
Megan Donovan, senior policy manager at the Guttmacher Institute, a reproductive health research organisation, has said that states with legislation that protect a woman’s right, such as California and Nevada, to abortions have the lowest rates of infant mortality in the U.S. This is a stark contrast to maternal mortality rates in five heartbeat bill states – Louisiana, Georgia, Alabama, Missouri and Texas, which are among the 10 states with the highest maternal mortality rates. This statistic is even more shocking, when taking into account a recent report published by The Commonwealth Fund which shows that the U.S. currently has the highest maternal mortality rate among developed countries, with 17 maternal deaths for every 100,000 live births in the US – implementing heartbeat bills will only increase the numbers.
Inbred children are also more likely than not to have serious birth defects. According to a Czechoslovakian study, 42% of children born as a product of incestuous relations were born with severe birth defects or died early, and another 11% were mildly mentally impaired. Incestuous children are at high risk of health issues such as congenital anomalies, hearing and vision impairment, developmental delay, blood disorders, epilepsy and unexplained deaths.
Lawsuits and jail for those who help
The American Congress of Obstetricians and Gynecologists (ACOG) has also decried heartbeat bills for compromising their ob-gyns’ ability to make ethical and professional decisions in the best interest of their patients. In 2017, Thomas Gellhaus, MD, president of ACOG, wrote, “under the bill, when a patient’s health is threatened by pregnancy, the physician will be forced to wait to terminate the pregnancy until the patient’s condition so deteriorates that her life is in jeopardy. As a result, physicians who follow the law may risk negligence claims from the patients. And, physicians who act in the best interests of their patients by providing medically necessary care will face criminal sanctions. This places physicians in an impossible position between the law and providing evidence-based, individualized, and medically necessary care to their patients.”
In addition to risking negligence claims, anyone in Texas who aids a woman in getting an unauthorised abortion in any way can be sued by a citizen – they do not have to be connected to the person who had the abortion or any of the abortion providers to be able to bring a lawsuit. This opens up medical professionals, family members, and even rape crisis counselors to lawsuits, where those who sued would be awarded 5-figure sums if they won.
In Alabama, performing an unauthorised abortion is considered a Class A felony – the most serious category of crimes in Alabama – along with grave crimes such as premeditated murder, kidnapping, rape, domestic violence, burglary and arson. The minimum prison sentence for Class A felonies is 10 years and can go up to 99 years or even life. Alabama doctors who merely attempt to perform an abortion could also go to prison may be charged with a Class C felony,which carries a sentence ranging from 1 to 10 years.
Cases of rape or incest
Of all the states with heartbeat bills in force, Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Missouri and Ohio make no exception for pregnancies that resulted from rape or incest. In such cases where a woman conceived in a traumatic experience, she may suffer from post-traumatic stress disorder and find it difficult to make a decision so soon after the incident.
In Texas, the 91 sponsors of the bill – 90 Republicans and 1 Democrat – clapped and cheered as Texan Governor Greg Abbott signed the law. After the signing, Abbott declared, “Our creators endowed us with the right to live, and yet, millions of children lose their right to life every year because of abortion. In Texas, we work to save those lives.”
Meanwhile, in Ohio, an 11-year-old girl was impregnated when a 26-year-old man raped her frequently. And if Ohio’s restrictive new laws had already kicked in, the child would have been forced to carry the baby to term unless it posed great risk to her health or life.
According to the Ohio-based organisation Faith2Action, which wrote the model legislation that heartbeat bills are based on, “No other law allows for the killing of an innocent child for the crime of his or her father. None of us chose the manner in which we are conceived; it does not change our humanity.”
Harper’s Bazaar writer Jennifer Wright has even compared these abortion bans to torture, stating that ‘forcing women to carry their rapists’ baby to term has traditionally been used as a weapon of war, and is considered a violation of human rights. For example, in 2014, Islamic terrorist group Boko Haram kidnapped hundreds of schoolgirls, raping them with the aim of impregnating them to create a new generation of Boko Haram fighters.
Abortion laws in other states and countries
Abortion laws in New York
On January 22, 2019, New York enacted the Reproductive Health Act (RHA), which legalised abortions up to 24 weeks of gestation, and allowed it after 24 weeks if the woman’s healthcare provider determined that it threatened the women’s health or the foetus is not viable. The RHA also made abortions more accessible, by permitting qualified advanced practice clinicians and licensed midwives to provide abortion services.
Abortion laws in California
In October 2015, The California Legislature passed the Reproductive FACT (Freedom, Accountability, Comprehensive Care, and Transparency) Act. Under this act, California not only legalises abortions, but also covers the cost of ‘medically necessary’ abortions for eligible, low-income women. Other than doctors, the state also allows qualified health professionals such as assistants, nurses and nurse midwives to perform first-trimester aspiration abortions, and to prescribe drugs for medical abortions.
Abortion laws in Malaysia
Abortion in Malaysia is illegal, as per Section 315 of the Penal Code. It states that anyone who does any action with the intention of preventing the birth of the child or causing the death of the child after its birth will be punished with imprisonment of up to 10 years, a fine, or both. However, an exception is made where the pregnancy is risky to the mother’s life, physical health or mental well-being.
In a report written by ARROW for Change, an organisation championing women’s sexual and reproductive rights, it shows how abortions are not easily accessible for a number of reasons – social stigma, cost and poor awareness. Public hospitals are reluctant to perform abortions even after valid reasons are presented, even turning away women pregnant as a result of rape. Due to this, those who can afford it turn to private hospitals that provide expensive abortions costing up to RM 2,000.
Many in Malaysia also hold the misconception that abortion is totally illegal, be it healthcare professionals, women or the media. Moreover, many government doctors and nurses have unsympathetic and judgemental attitudes towards abortions. When 120 of them were surveyed and asked what they thought women who were pregnant due to rape should do, 38% of them responded that they should continue the pregnancy and either look after the baby themselves or give it up for adoption, rather than consider having an abortion.
Abortion laws in Singapore
Singapore’s Termination of Pregnancy Act passed in 1974 declares that all citizens, residents and their spouses are permitted to undergo abortions up till 24 weeks. Before an abortion, the woman must attend counselling – 48 hours after that, they can undergo the abortion. Post-abortion counselling is also provided. To perform an abortion, only the pregnant woman’s consent is needed, even if the woman is a minor – any person found guilty of coercing a woman into terminating her pregnancy against her will faces a prison term of up to three years, a fine, or both.
For all the above, exceptions are made for those facing medical emergencies. To protect the privacy of the pregnant woman, information surrounding the abortion may not be shared without her consent.
Written by: Natalie
Edited by: Jamie