The Beat Beat Beat is Not a Heart
Dear Texas, That's Not How it F**king Works
Last week, Texas’s draconian abortion law dominated national news (as much as anything could while one coast was on fire, the other under water, and states were running out of ICU beds because people would rather fight for their freedom from masks and vaccines than protect the lives of their neighbors). The law bans abortion after a “fetal heartbeat” is detected and deputizes private citizens to sue each other for aiding and abetting someone who gets an abortion later than that.
I don’t usually write about abortion laws in part because so many states have spent so many years trying to chip away at Roe v. Wade that it’s hard to follow the latest. Mostly, though, it’s because I have really smart friends and colleagues who have been doing this for years and know more than me about the legal arguments and political implications. Here’s a quick reading list:
For those who want to better understand the impact of the Texas law on the ground, I recommend reading Amy Littlefield’s piece in the Nation.
For those who want to better understand the Supreme Court’s role in this and how we are actually as screwed as we thought we would be on the night RBG died, I recommend reading Jessica Mason Pieklo’s article in Rewire News Group.
For those who want to better understand the private citizen brigade, I recommend reading Iman Gandi’s piece in Rewire News Group. (Jess and Imani also have a podcast called Boom Lawyered that you should check out.)
For those of who want to keep up on all proposed state laws, I recommend subscribing to Rachel Perrone’s daily (yes daily) newsletter, Bomboniera, which grabs the important headlines for you.
And, for those of you who want to know how we will survive in a country without guaranteed abortion rights, I recommend Robin Marty’s Post Roe Handbook.
For my part, I’m going to focus on the concept of the fetal heartbeat because surprise, surprise, that’s not how it f**king works and offer a note on rhetoric and semantics to those of who want to support abortion access but might unintentionally be undermining the cause with the arguments we use.
(Before I start those rants, however, I have to wish a Happy Wednesday Birthday to a certain purple-haired 11-year-old.)
Embryos Don’t Have Hearts or Heartbeats
Texas is far from the first state to try to ban abortions as soon as a “fetal heartbeat” can be detected. This has been a strategy of the anti-choice crowd for at least a decade and part of their rhetoric for even longer. There’s been a giant sign across from a church near my parents’ house that says “abortion stops a beating heart” for as long as I can remember. It’s works as a talking point because it evokes the image of a full-grown baby in the womb and it works as a legal strategy for essentially ending all abortions because it happens so early in pregnancy.
Our technology has gotten so sophisticated that at about six weeks into pregnancy, a sonogram can detect electrical activity in cells that will at some point in the future (if the fetus continues to develop on track) become the heart. Doctors often call this a heartbeat as shorthand, especially with patients who are anxious to be pregnant, because it’s one sign that a pregnancy is progressing. But calling it a “fetal heartbeat” is a misnomer at best.
It isn’t a fetus yet. Remember, pregnancies are essentially back-dated. If you go to the doctor having missed a period or peed on a stick, you will be asked to recall the date your last period started (the day a month or so ago that you started to bleed). This is, by definition, before ovulation, before copulation, before fertilization, and before implantation but it’s counted as day one of the pregnancy. The six to eight weeks that follow are considered the embryonic development stage. (But the word embryo doesn’t evoke the same emotional response as unborn baby or fetus—after all, we create embryos in labs and store them in freezers.)
The embryo does not have a heart yet. Dr. Nisha Verma, an OB-GYN who works with the American College of Obstetricians and Gynecologists (ACOG), explained it this way to NPR: “When I use a stethoscope to listen to an [adult] patient's heart, the sound that I'm hearing is caused by the opening and closing of the cardiac valves. At six weeks of gestation, those valves don't exist. The flickering that we're seeing on the ultrasound that early in the development of the pregnancy is actually electrical activity, and the sound that you 'hear' is actually manufactured by the ultrasound machine.”
At this point, what we are talking about is a cluster of cells that are just starting to distinguish themselves. And, most people will not yet know they are pregnant. Pregnancy symptoms like nausea and breast pain usually start a little later and there won’t have been enough time for people—especially those with irregular cycles—to realize that they’d missed a period. In truth, the people who are most likely to know they are pregnant at this point are those who are actively trying to conceive by carefully tracking their menstrual cycles.
It’s also important to know that seeing cardiac activity on a sonogram does not guarantee that the embryo will develop normally or that pregnancy can go to term. Early pregnancy loss is common—it’s estimated that 10 to 15% of pregnancies end in miscarriages. Some people may find out they’ve had or are having a miscarriage because they start bleeding, some may be told by a doctor that there is no longer a “heartbeat,” and others may be told that their cervix has dilated and they will miscarry soon, despite the fact that a “heartbeat” can still be detected. This last situation, called an inevitable abortion, may pose a problem under strict laws like this one in Texas because the patient may require medical care that resembles an abortion.
Heartbeat bans may have implications later in pregnancy as well. A 2012 case in Ireland helped advocates reform that country’s law. Dr. Savita Halappanavar, a dentist, was in her second trimester when she went to the hospital with back pain. At 17 weeks, she was, in fact, carrying a fetus and it did have a heart and an actual heartbeat. Nonetheless doctors told her she was having a miscarriage and would need an abortion to remove the non-viable fetus from her uterus.
Irish law, however, meant that the hospital could not do that kind of procedure if a heartbeat was detected. Dr. Halappanavar had to wait six days for the fetus’s heartbeat to stop and during that time she developed an infection. She had the procedure but died the next day. Ireland’s National Health Service investigated and concluded that the infection killed her not the restrictions or confusion about the law. Many people disagreed. In 2018, voters in Ireland overwhelmingly chose to repeal the constitutional amendment that served as a near-total ban on abortion.
Our country, on the other hand, seems to be going steadily backwards.
How We Talk About Abortion Matters
The discussion of fetal heartbeats should also remind us how important it is not to let the other side set the language of the debate as we are now forced to start conversations with lengthy explainers like the one above. They did the same thing with “partial birth abortion” which made us fight against images of the gradually dismembered fetus. Heck, even letting them get away with calling themselves pro-life is a problem given how often the very same people vote against help for parents and their already born children.
We also lose ground when we are apologetic about abortion. Bill Clinton coined the phrase that abortions should be “safe, legal, and rare” in an effort to appeal to those who were uncomfortable with abortion but didn’t want it outlawed. It may have been politically expedient but ultimately not helpful.
It reminds me of arguments I used to have during the height of the abstinence-only debate when a colleague insisted on saying things like: “abstinence is best for teens, but the majority of teens do have sex and they need to learn how to protect themselves.” That may appeal to parents who get uncomfortable with the idea of their teenager being a sexual being, but it does not accurately represent the position of sex educators. I, for one, am not convinced that abstinence is best for all teens.
By starting with “sure this shouldn’t happen, but it does, so we have to deal with it,” we cede the moral high ground and weaken our own arguments. In the case of abortion this undermines the idea that abortion is not about an “unborn baby” but about bodily autonomy and the right to make one’s own decisions.
Unfortunately, one of the “pro-choice” posts I’ve seen most often this week falls into this same trap. The post, which is meant to be cut and pasted, starts with:
I’m not pro-abortion.
I’m not “pro-murdering babies.”
I'm pro-Becky who found out at her 20-week anatomy scan that the infant she had been so excited to bring into this world had developed without life-sustaining organs.
I'm pro-Susan who was sexually assaulted on her way home from work, only to come to the horrific realization that her assailant planted his seed in her when she got a positive pregnancy test result a month later.
I'm pro-little Cathy who had her innocence ripped away from her by someone she should have been able to trust and her 11 year-old body isn't mature enough to bear the consequence of that betrayal.
I'm pro-Melissa who's working two jobs just to make ends meet and has to choose between bringing another child into poverty or feeding the children she already has because her spouse walked out on her.
It tells more stories and ends with:
You don't get to pick and choose which scenarios should be accepted.
It's not about which stories you don't agree with.
It's about fighting for the women in the stories that you do agree with and the CHOICE that was made.
Women's rights are meant to protect ALL women, regardless of their situation!
I love the intent and completely agree that we don’t get to choose whose abortion is okay and whose is not. Yet, by starting with “I’m not pro-abortion” and going on to tell stories of rape and poverty and heartbreak, it prompts us to do just that.
There’s an exercise I do in my college course each semester called The Last Abortion (which was written years ago by another fabulous colleague). Students are told that Roe v. Wade expires at midnight and there is only one slot for abortion left. They are then given 10 stories and asked to decide which of these pregnant people gets that appointment. My students struggle and inevitably ask if they can grant the wish of termination to more than one person on the list. I stay firm. In the end one of two stories—either the young rape victim or the mother with cancer who can’t get chemo—get the slot. No one ever chooses the person who just doesn’t want to be pregnant right now.
Most of my students already believe in a person’s right to choose. The point of this exercise is to help them realize that even on the pro-choice side of this issue, we often look for a reason why a person needs an abortion and shy away from appearing accepting of “abortions on demand” (another phrase we let them insert into our vernacular).
How we talk about abortion as supporters matter. We have to stop being apologetic, accepting their opening premise, and ceding the moral high ground.