Arizona is advancing the front line of the war on women. Every week, or so it seems, there are increasingly dystopian bills floated around the state House and Senate. Senate Bill 1359, which hopes to protect doctors from wrongful birth suits, the narrowly defeated no-sex-please-we’re-from-Arizona bill, which would allow employers to ask if their employees getting contraception are using it for “medical” or “sexual” reasons, and finally, as Mother Jones is reporting, House BIll 2036 which would be an anti-abortion bill to out-do everyone. Except, Mother Jones has a very important fact wrong (click here for the link to the Mother Jones Article).
The Mother Jones article claims the bill would impose the most restrictive gestational age limit, but Mother Jones is wrong because the proposed Arizona limit in the bill is 20 weeks, currently the gestational age limit in six states. (The current Arizona law allows abortion up to viability). Bill 2036 spells out how gestational age is calculated, from the last menstrual period, and that is apparently where Mother Jones got confused. See the excerpt below:
Not to go all middle-school health on you, but that’s not exactly the same as the actual date the egg and the sperm hooked up. Figuring out that exact point one became pregnant can be tricky. Most women ovulate about 14 or 15 days after their period starts, and women can usually get pregnant from sexual intercourse that occured [sic] anywhere between five days before ovulation and a day after it. Arizona’s law would start the clock at a woman’s last period—which means, in practice, that the law prohibits abortion later than 18 weeks after a woman actually becomes pregnant.
No, it doesn’t mean that the law prohibits abortion at 18 weeks. It means 20 weeks. 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.
There are many things wrong with the bill and to focus on an erroneous gestational age detracts from the real issues. The 20 week bills being introduced around the country are a response to the erroneous claims that a fetus feels pain at 20 weeks. Basing legislation on anything but facts is wrong.
In addition, 20 weeks is overly restrictive as many fetal anomalies are not diagnosed correctly until around the 20 week mark, leaving a mad scramble to get services in state or worse, have to pay to fly out of state. It happens more than you think.).
The bill also mandates an ultrasound, not a transvaginal probe (although mandating any ultrasound is wrong). It should be a medical decision. Mandating that a doctor ask if the patient wants see the image is also in the bill, but I disagree with the reporter on why that is an issue. The bill only says the doctor has to offer, and studies tell us that the majority of women want to see the image when asked. My issue with that part of the bill is simply the intrusion of the state into the practice of medicine.
And finally, at the end of the bill this statement appears:
The legislature finds that abortion can cause serious both short-term and long-term physical and psychological complications for women…
Which is wrong. The complication rate with an abortion is lower than with a pregnancy that goes to term and there is no credible evidence based medicine that supports any psychological harm from a legal, safe abortion (worthy of a post in itself at a later date).
So there are many reason to take issue with House Bill 2036 from Arizona, but an 18 week gestational age limit is not one of them. Let’s make sure we focus on the facts.