A week ago, Arizona HB 2036 passed the state Senate and headed to the House. The bill centers around the belief that a fetus feels pain at 20 weeks and thus bans abortion after 20 weeks of gestation (with an exception for the life of the mother). Much has been made of the fact that the bill specifies gestational age “as calculated from the first day of the last menstrual period of the pregnant woman.” This dates the pregnancy as up to two weeks before the actual conception, which has led some to believe that the bill actually bans abortion after 18 weeks.
This isn’t the case. Calculating gestational age from the first day of the last menstrual period is standard practice among obstetricians, even when gestational age is established via ultrasound. OB/GYN Dr. Jen Gunter offers a thorough, informed overview.
Pregnancy has ALWAYS been calculated from the 1rst day of the last menstrual period. Always, always, always. When we do an ultrasound, we still use that convention. Perhaps it seems odd to non-obstetrical folks, however, since the last day of the period can be inaccurate (do you use flow? spotting? one spot of blood?), as can date of ejaculation (what if you have sex 3 days in a row?), and date of ovulation (how would you know that?), and the fact that fertilization takes 24-48 hours, the 1rst date of the last menstrual period is the only accurate date. Every other state law uses the last menstrual period (as does every obstetrical textbook) because that is the way we calculate gestational age.
The bill specifies that “the physician is responsible for estimating the gestational age of the fetus based on ultrasound and examination and obstetric standards in keeping with established standards of care,” which, as mentioned above, incorporate the date of LMP. So HB 2036 isn’t actually limiting abortions after 18 weeks; the 20 weeks in the bill is the same 20 weeks as ever.
This doesn’t mean that HB 2036 isn’t a bad thing. It is a bad, bad thing, and we’re right to be up in arms about it. We just need to make sure we’re up in arms about the right parts of it. Focusing on gestational age draws focus from so many legitimate reasons this bill is so very bad for women.
Here’s why HB2036 is bad for women:
1. It places a restriction on a woman’s right to have an abortion, taking the decision away from a woman and her doctor and putting it into the hands of complete strangers in government. I mean, that’s the big one, really.
2. It’s based on bad science. Twenty weeks is offered as the time at which a fetus begins to feel pain, and that’s not the case. Neurological wiring simply isn’t sufficiently developed at that point. The American College of Obstetrics and Gynecologists says there is
no legitimate scientific information that supports the statement that a fetus feels pain.
3. It violates Roe v. Wade, which protects a woman’s right to choose up to the point of fetal viability.
4. It requires an ultrasound, and while it doesn’t specify whether that ultrasound be transabdominal or transvaginal, it takes that decision away from the medical professional who’s actually standing in the room with the woman.
5. It requires a 24-hour waiting period (except in case of emergency endangering a woman’s life or threatening “irreversible impairment of a major bodily function”).
6. Twenty weeks into a pregnancy is also 20 weeks left in the pregnancy. A woman who has to delay needed medical treatment–for instance, chemotherapy–for those five months could end up severely ill or dead.
7. Dr. Gunter notes that 20 weeks is pretty much the minimum for being able to diagnose many fetal abnormalities, leaving a woman frantic to find services in Arizona or forced to leave the state for an abortion.
8. The factors taken into account during the drafting of this bill, listed as “findings and purposes” under Section 9, include the risk of psychological complications after abortion. The American Psychological Association has established that this is pretty much not the case, and that most psychological complications post-abortion are more related to pre-abortion mental health than they are to the abortion itself. Doctors also are instructed to offer patients information about putting a baby up for adoption, but are not instructed to offer information about the mental health risks thereof.
9. Those findings also note the higher medical risk of abortion as pregnancy progresses, up to one death per 11,000 abortions after 21 weeks. They omit the fact that the maternal mortality rate in the U.S. is 24 maternal deaths per 100,000 live births, or 2.64 per 11,000.
10. The bill places a restriction on a woman’s right to have an abortion, taking the decision away from a woman and her doctor and putting it into the hands of complete strangers in government.
HB 2036 is infuriating enough with all the facts straight. HB 2036 isn’t bad because it makes a woman pregnant before she’s pregnant–it’s bad because of everything else.