The governor of Georgia signed into law one of the strictest abortion bans in the country. The sponsor of an anti-abortion bill in Ohio made headlines by falsely claiming that it’s possible to transplant an ectopic pregnancy into the uterus. And the Alabama state Senate erupted in shouting after Republicans removed exceptions for rape and incest from an anti-abortion bill. All these developments happened just this week, a new level of activity in a year that has already seen a raft of abortion restrictions pass — and some states move to shore up abortion access in response. Anti-abortion groups and legislators have been backing more aggressive restrictions since President Trump’s election, but their efforts have ramped up in 2019. Four “heartbeat” bills, like Georgia’s, that would ban abortion as early as six weeks, have passed this year alone, and total bans on abortion are under consideration in Alabama and elsewhere. Meanwhile, supporters of this kind of legislation have stated openly that their goal is to challenge Roe v. Wade. “The gloves are off” among abortion opponents, Kristin Ford, the national communications director for NARAL Pro-Choice America, told Vox. “They feel like they have the wind at their backs and they don’t have to dance around their true intentions anymore.” Abortion rights supporters have backed legislation of their own, including efforts in New York and Virginia to lift some abortion restrictions. These efforts, too, have generated debate as state abortion laws become an increasingly visible part of the national conversation. The Georgia ban, like others of its kind, will likely be challenged in court. But the fact that it was signed in the same week that nationwide controversy broke out on restrictions in at least two other states is a reminder that the abortion debate has reached a place that’s unprecedented in recent memory, with multiple states poised to outlaw the procedure as the federal protections enshrined in Roe hang in the balance. State legislatures around the country are introducing stricter and stricter anti-abortion laws During his presidential campaign, Trump promised to appoint Supreme Court justices who would overturn Roe v. Wade. So after he took office, abortion opponents in state legislatures began passing increasingly restrictive abortion laws, attempting to ban the procedure at 15 weeks or even earlier. They were responding to the prospect of a friendly Supreme Court, as well as Trump’s appointments of anti-abortion judges to lower federal courts. After Justice Brett Kavanaugh, widely seen as a potential deciding vote to overturn Roe, was confirmed in October 2018, restrictions began to proliferate even more. “State legislators around the country are taking signals from Trump being in the White House and Kavanaugh being on the court,” Rachel Sussman, the national director of state policy and advocacy at Planned Parenthood Act, told Vox in April. The result has been a growing number of bills around the country that would ban abortion in almost all cases, subjecting doctors and, potentially, women themselves to criminal prosecution. Some of these bills go further than ever before (at least in recent memory) in restricting abortion, while others may be based on inaccurate medical information. They’ve generated not just intense debate but also some confusion as residents and even advocacy groups try to figure out what the bills would actually do. Here’s a breakdown of the abortion restrictions that have captured the most attention in recent days: Georgia’s “heartbeat” law With Gov. Brian Kemp’s signature on Tuesday, Georgia became the fourth state this year to pass a “heartbeat” bill, which bans abortion as soon as a fetal heartbeat can be detected. This can be as early as six weeks’ gestation, before many women know they are pregnant. The bill contains exceptions for medical emergencies, as well as for rape and incest, but someone who wanted to obtain an abortion after rape would have to file a police report. The Georgia law became the focus of nationwide attention prior to its passage, when celebrities including actress and #MeToo advocate Alyssa Milano spoke out against it. Several TV and film production companies have responded to the ban by announcing they will cease operations in Georgia, which had become a popular site for filming due to its tax incentives, according to NBC News. The law also gained added attention on Tuesday when Mark Joseph Stern of Slate reported that it could lead to criminal prosecutions for women who perform their own abortions using drugs, who miscarry, or even who travel out of state to have abortions. But reproductive rights groups aren’t sure if the law would in fact be used in this way. “It seems to be a stretch to what’s actually in the law and I’m really confused as to whether or not this would be possible,” Elizabeth Nash, the senior state issues manager at the Guttmacher Institute, told Vox. Though some anti-abortion lawmakers, notably in Texas, have recently called for criminal prosecution of women seeking abortion, most anti-abortion groups have historically been against the idea. For example, the anti-abortion group Americans United for Life opposes “the use of the criminal law to punish women for any acts during pregnancy toward their unborn child,” Clarke Forsythe, senior counsel for the group, told Vox. He called the notion that the Georgia bill could be used to prosecute women “ludicrous,” arguing that “there’s a long tradition in Georgia law that women can’t be prosecuted for abortion.” Meanwhile, some abortion rights advocates say the bill is concerning enough regardless of whether women can be charged under it. “We know that doctors could face serious jail time; we know that women would have to have this police report if they were claiming an exception,” Ford said. “There’s a lot to be really concerned about on the face of the bill.” Ohio’s ban on insurance coverage for abortion A bill recently introduced in Ohio in April would ban most private insurance coverage of abortion. It gained added attention this week when Jo Ingles of the Ohio radio station WOSU reported on an unusual provision: The bill allows insurance companies to cover “a procedure for an ectopic pregnancy that is intended to reimplant the fertilized ovum into the pregnant woman’s uterus.” An ectopic pregnancy occurs when a fertilized egg implants in the fallopian tube rather than in the uterus. Such pregnancies are almost never viable, and the only reliable treatment is an abortion, as Kayla Epstein reports at the Washington Post. It is not possible to remove the egg from the fallopian tube and reimplant it into the uterus. If left untreated, an ectopic pregnancy can be fatal. It is not clear why the bill’s sponsor, Republican state Rep. John Becker, chose to include a provision in the bill for coverage of a procedure that, as Epstein points out, does not exist. Becker has not responded to Vox’s request for comment. But the provision may speak to a larger issue with the bill. Because it bans coverage for “drugs or devices used to prevent the implantation of a fertilized ovum,” reproductive rights groups say it could eliminate coverage for some forms of contraception, like birth control pills or IUDs. Becker told WOSU that his bill was not intended to target birth control. “When you get into the contraception and abortifacients, that’s clearly not my area of expertise,” he said, before speculating that “if it were true that what we typically know as the pill would be classified as an abortifacient, then I would imagine the drug manufacturers would reformulate it so it’s no longer an abortifacient and is strictly a contraceptive.” As New York Times editorial board member Lauren Kelley noted earlier this week, the Ohio bill isn’t the first anti-abortion measure to stand on shaky medical ground. Eric Johnston, an attorney who helped draft the Alabama bill, told AL.com in March that “a man and woman can have sex and you can take her straight into a clinic and determine an egg and sperm came together.” In fact, as Kelley has written, the most sensitive pregnancy tests cannot detect anything until about a week after fertilization.<doc-sep>The anti-choice movement has taken a sadistic turn in Georgia, where a new abortion ban, called HB 481, has just been signed by Governor Brian Kemp. Signed into law this Tuesday and due to take effect in 2020, the bill effectively bans abortion outright, declares fetuses to be persons with full legal rights and protections, and imposes prison sentences for women found guilty of aborting or attempting to abort their pregnancies. The bill is misleadingly termed a “heartbeat” bill, and it bans abortions at any stage of pregnancy after the detection of “embryonic or fetal cardiac activity”. But “heartbeat” is a bit is a bit of a misnomer, since the cardiac activity that is first detected in an embryo is not a heartbeat by any stretch of the imagination; what is first observed is the pulsing of cells that are specializing and will eventually become a heart. At this point in the pregnancy, the fetus has no brain and no face. This cellular movement can first be detected at a phase of pregnancy referred to as six weeks of gestation. But this, too, is a misleading phrase. Gestational age is measured not from insemination, but from the beginning of the patient’s last menstrual period. So the bill bans all abortions at four weeks after conception, or roughly two weeks after the woman’s first missed period. This stage of pregnancy is often past before the patient even knows that she is pregnant. This is the idea: to make the logistical, legal and monetary burdens to access an abortion so heavy that most women will not be able to get one. All this is justified by a moralizing, misogynistic and medically arbitrary logic based on a fantasy that wants to equate the movement of cells with personhood. Based on this logic, women who abort their pregnancies – and, probably, some women who have accidental miscarriages – will be treated as murderers under the law, subject to imprisonment and even capital punishment. Those who leave the state for an abortion, or who help others leave the state for an abortion, can be charged with conspiracy to commit murder and sentenced to up to 10 years in prison. It is tempting to imagine that the law would not be enforced this way, that prosecutors and juries would not enforce a law that forces women to give birth and threatens to kill them if they refuse. But prosecutors have proved themselves zealous in prosecuting women in states where abortion is already de facto illegal. It would be a mistake to underestimate their capacity for cruelty. “Heartbeat” bills are nothing new. They have been signed into law in six states – Iowa, Kentucky, Mississippi, North Dakota, Ohio and now Georgia – just since the beginning of this year. In the past, heartbeat bills were put forth by state legislatures as deliberate legal provocations: they were designed to provoke lawsuits from women’s and civil rights groups that could go to federal court and chip away at the edges of Roe v Wade. They were expensive, experimental, taxpayer-funded misadventures in misogynist litigating that were designed to provoke a lot of controversy, rally the anti-choice movement and eventually get struck down – which most of them were. It’s not certain, but it’s highly likely, that HB 481 will be blocked or delayed by a federal court before it goes into effect on 1 January 2020. For now, it’s still legal to get an abortion in Georgia. Quick Guide What is Roe v Wade? Show Norma McCorvey, pictured, was the real name of the woman known as “Jane Roe” in the landmark 1973 US supreme court case Roe v Wade, which established the right of American women to have abortions. McCorvey became the plaintiff in 1970 after she met with two lawyers looking for a test case to challenge the abortion ban in Texas, where it was a crime unless a woman's life was at risk. Similar statutes were in place in nearly every other state at the time. At the time, McCorvey was pregnant, unmarried, unemployed and unable to obtain an abortion legally or otherwise. The case went to the supreme court, which handed down the watershed ruling that a woman's right to make her own medical decisions, including the choice to have an abortion, is protected under the 14th amendment. McCorvey never had an abortion. Her case, which proceeded largely without her involvement, took too long to resolve, and she gave birth to a child that she placed for adoption. Several years after the ruling, she publicly revealed her identity and became involved in the pro-abortion rights movement. But after a conversion to Christianity, she became an anti-abortion rights activist. Before she died in 2017, McCorvey had said it was her wish to see Roe v Wade overturned in her lifetime. Photograph: Manuel Balce Ceneta/AP Was this helpful? Thank you for your feedback. But we are not living under the same legal regime that we were a year ago. The new slew of six-week abortion bans is a direct result of the appointment of the multiply accused sexual assault perpetrator Brett Kavanaugh to the supreme court, where anti-choice conservatives now hold a five-four majority and can dismantle or strike down Roe v Wade at any time. Before, these bills were passed by lawmakers who knew they would be struck down, but who wanted to test the limits of Roe, to see how stringent and outlandish a state could make its abortion restrictions and still have those restrictions deemed legal. Now, they are designed to eliminate Roe altogether, and to throw the question of abortion legality back to individual states – many of which will immediately ban it. When Justice Anthony Kennedy (now retired) was on the supreme court, these states had little chance of having outright abortion bans like HB 481 upheld. Now, with Kavanaugh on the court, the door is wide open for misogynist laws to make legal, clinic-based abortion access a thing of the past in large swaths of the United States. To some extent, this has already happened. Since the landmark 1992 ruling Planned Parenthood v Casey, the supreme court has held that states may not impose an “undue burden” on abortion access before fetal viability, roughly 24 weeks gestation. But states have been generous to anti-choice interests in interpreting what burdens on abortion access are undue. They have been able to impose long waiting periods, arbitrary and expensive facility standards for clinics, mandatory ultrasounds, including vaginal ultrasounds, for patients, and mandates that abortion providers read false and misleading statements saying that fetuses can feel pain (which they cannot) and that abortion increases a woman’s risk of cancer (which it does not) or that women who have had abortions exhibit severe psychological ramifications (they do not). They have been able to ban state Medicaid plans from covering abortion and they have been able to keep insurance companies from covering abortion. They have been able to make it too logistically hard, too time-consuming, and far, far too expensive for many women to get an abortion in a medical clinic. This does not mean, however, that abortions are not happening. Instead, self-induced, self-managed abortions are on the rise again in the United States. Before Roe, self-induced abortions were risky, violent and dangerous: women would attempt to pierce their cervixes with knitting needles or coat hangers, and they would puncture organs and suffer infection, hemorrhage and sepsis. Women would drink bleach and poison themselves. Now, self-managed abortions are largely safe and effective, because the face of self-managed abortion has changed. Self-induced abortion no longer looks like a coat hanger; it looks like a pill. Misoprostol, a drug that can be used to treat ulcers but also empties the uterus, is prescribed by abortion clinics as the second of two abortion drugs, along with Mifepristone, which is used first to loosen the lining of the uterus. Mifepristone is hard to find on the black market, because it is subject to tight regulations.<doc-sep>ATLANTA (AP) — Georgia’s Republican Gov. Brian Kemp signed legislation on Tuesday banning abortions once a fetal heartbeat can be detected. That can be as early as six weeks, before many women know they’re pregnant. Kemp said he was signing the bill “to ensure that all Georgians have the opportunity to live, grow, learn and prosper in our great state.” The signing caps weeks of tension and protests at the state Capitol in Atlanta, and marks the beginning of what could be a lengthy and costly legal battle over the law’s constitutionality. The legal showdown is exactly what supporters are looking for. Anti-abortion activists and lawmakers across the country , energized by the new conservative majority on the U.S. Supreme Court that includes President Donald Trump appointees Neil Gorsuch and Brett Kavanaugh, are pushing abortion bans in an attack on the high court’s 1973 Roe v. Wade ruling, which legalized abortion nationwide until a fetus is developed enough to live outside a woman’s uterus. ACLU of Georgia legal director Sean Young said the group would challenge Georgia’s new abortion restriction in court. “Under 50 years of Supreme Court precedent, this abortion ban is clearly unconstitutional,” Young said in a recent interview. “Every federal court that has heard a challenge to a similar ban has ruled that it’s unconstitutional.” Under current law, women in Georgia can seek an abortion during the first 20 weeks of a pregnancy. If it’s not blocked in court, the new ban would take effect Jan. 1, 2020. HB 481 makes exceptions in the case of rape and incest — if the woman files a police report first — and to save the life of the mother. It also would allow for abortions when a fetus is determined not to be viable because of serious medical issues. The bill also deals with alimony, child support and even income tax deductions for fetuses, declaring that “the full value of a child begins at the point when a detectable human heartbeat exists.” Republican Rep. Ed Setzler, the bill’s author, said in an interview after the bill passed the state House that it’s a “common sense” measure that seeks to “balance the difficult circumstances women find themselves in with the basic right to life of a child.” But Democratic Sen. Jen Jordan disagreed that the legislation was balanced. “There’s nothing balanced about it, it’s an all-out abortion ban,” Jordan said in a recent interview. Jordan said she is especially worried the new law will push obstetricians away from practicing in Georgia, worsening health care outcomes for women in a state that already has one of the worst maternal mortality rates in the country. “It’s about the unintended consequences,” Jordan said. “They’re making policy choices that are going to end up causing women to die, and they’re preventable deaths.” In the first few months of 2019, “heartbeat abortion” bans have been signed into law in four states: Mississippi, Kentucky, Ohio, and now Georgia. Lawmakers in a number of other states including Tennessee, Missouri, South Carolina, Florida, Texas, Louisiana and West Virginia are considering similar proposals. A bill that recently passed the Alabama House would outlaw abortions at any stage of pregnancy, with a few narrow exceptions. Kentucky’s law was immediately challenged by the ACLU after it was signed in March, and a federal judge temporarily blocked it. According to the Guttmacher Institute, a research group that supports abortion rights, about 33,000 abortions were provided in Georgia in 2014.<doc-sep>
If a new Mississippi law survives a court challenge, it will be nearly impossible for most pregnant women to get an abortion there. Or, potentially, in neighboring Louisiana. Or Alabama. Or Georgia. The Louisiana legislature is halfway toward passing a law — like the ones enacted in Mississippi and Georgia — that will ban abortions after a fetal heartbeat is detected, about six weeks into a pregnancy and before many women know they’re pregnant. Alabama is on the cusp of approving an even more restrictive bill. State governments are on a course to virtually eliminate abortion access in large chunks of the Deep South and Midwest. Ohio and Kentucky also have passed heartbeat laws; Missouri’s Republican-controlled legislature is considering one. State governments are on a course to virtually eliminate abortion access in large chunks of the Deep South and Midwest. Their hope is that a more conservative U.S. Supreme Court will approve, spelling the end of the constitutional right to abortion. “For pro-life folks, these are huge victories,” said Sue Liebel, state director for the Susan B. Anthony List, an anti-abortion advocacy group. “And I think they’re indicative of the momentum and excitement and the hope that’s happening with changes in the Supreme Court and having such a pro-life president.” For abortion rights supporters, meanwhile, the trend is ominous. Said Diane Derzis, owner of Mississippi’s sole abortion clinic, the Jackson Women’s Health Organization: “I think it’s certainly more dire than it ever has been. They smell blood and that’s why they’re doing this.” Already, Mississippi mandates a 24-hour wait between an in-person consultation. That means women must make at least two trips to her clinic, often traveling long distances. Other states have passed similar, incremental laws restricting abortion in recent years, and aside from Mississippi, five states have just one clinic — Kentucky, Missouri, North and South Dakota, and West Virginia. But the latest efforts to bar the procedure represent the largest assault on abortion rights in decades. Lawmakers sponsoring the bans have made it clear their goal is to spark court challenges in hopes of ultimately overturning the 1973 Roe v. Wade decision legalizing abortion. Those challenges have begun. Derzis’ attorneys are scheduled to go before a judge on May 21, seeking to prevent Mississippi’s heartbeat law from taking effect July 1. A judge in Kentucky blocked enforcement of that state’s heartbeat ban after the American Civil Liberties Union filed suit on behalf of the clinic in Louisville. Similar legal action is expected before bans can take effect in Ohio and Georgia, where Republican Gov. Brian Kemp signed the latest heartbeat bill into law Tuesday. Kemp said he welcomed the fight, vowing: “We will not back down.” Georgia’s ban doesn’t take effect until Jan. 1. But the impact was immediate. An abortion clinic operated by The Women’s Centers in Atlanta began receiving anxious calls from patients soon after Kemp signed the law. Many callers had plans to travel from outside the state for abortions. Georgia’s heartbeat ban would have a wider impact because the state has 17 abortion clinics — more than the combined total in the other four Southern states that have passed or are considering bans. “On a typical day we will see people from North Carolina, Tennessee, Alabama, South Carolina — all over the region,” said Dr. Lisa Haddad, the Atlanta clinic’s medical director. “And my thought is we’re not going to see those people coming here because they assume it’s already illegal in Georgia.” Dr. Ernest Marshall, co-founder of Kentucky’s last remaining abortion clinic in Louisville, said in an email that banning abortions before most women know they’re pregnant would “have a disproportionate impact on poor women and communities of color throughout the South.” Advocates for abortion rights expect judges to halt enforcement of any new bans while lawsuits work their way through the courts. That could take years. “These laws are blatantly unconstitutional,” said Elisabeth Smith, chief counsel for state policy and advocacy for the Center for Reproductive Rights, which also has filed suit over Mississippi’s ban. “But if they were allowed to go into force, they would have devastating consequences for the residents of all of these states.” If heartbeat bans are upheld, many women who are poor and have limited means to travel would have few options other than to try to terminate their own pregnancies, Haddad said, possibly using abortion drugs purchased online.