Ohio: Reproductive Care and Abortion Rights in the Buckeye State are Complicated and Uncertain

Today, our journey through the different state laws on reproductive care throughout the United States takes us through the Buckeye State. That’s Ohio, where you may or may not have the right to terminate a pregnancy, depending on when you are reading this. As of the end of September, 2022, when I am writing this, you can have an abortion in Ohio up to 21 weeks and 6 days gestational age and this will be true at least up to October 12. But this was not the case prior to September 14, because of an Ohio law that was in effect banning abortion from the point of “cardiac activity”, meaning a detectable “heartbeat” on ultrasound. This is possible as early as six weeks into pregnancy, a point when many pregnant women would not know yet that they are pregnant.

The Ohio “heartbeat law” allows no exceptions for rape or incest, which is why, during the recent summer, a ten year-old Ohio rape victim was forced to travel to obtain an abortion in neighboring Indiana. Since that time, other cases have emerged involving minor victims of rape or incest traveling out of Ohio to obtain abortion care in other states. On September 14, however, a judge in an Ohio court put a 14-day block on the state’s heartbeat law, then later extended the block an additional 14 days. This keeps abortion legal and safe in the Buckeye State until October 12. What happens next depends on the decision of the court, which, at the time of the writing of this post, is scheduled for October 7. All of this means that the right to choose is struggling in Ohio and, for the time being, depends on the courts, the judges, and the lawyers arguing the case.

All of this uncertainty in Ohio, and the inconsistencies between abortion rules among the various US states, are the result of the Supreme Court of the United States (SCOTUS) overturning the 1973 Roe v Wade decision. This happened in the context of the Dobbs versus Jackson Womens Health Organization abortion case, involving Mississippi’s Gestational Age Act. This Mississippi law would have prohibited abortion after 15 weeks gestation, although the Dobbs decision has allowed Mississippi itself to enact a law even more extreme than the Ohio ‘heartbeat’ law that now hangs in the balance, namely a prohibition against abortion at any point in pregnancy.

Now let’s talk about this idea, popular in Ohio and some other states, of making the detection of an embryonic ‘heartbeat’ into a pregnancy milestone for the sake of prohibiting abortion from that point. As we have discussed, we start counting the gestational age on the first day of bleeding of the last menstrual period, prior to pregnancy. The optimal time window for fertilization in women with the classic 28-29-day cycle is thus two weeks into the gestational age count, then implantation of an entity called a blastocyst (a kind of early embryo) into the endometrium (lining of the uterus) takes place 5-6 days after fertilization. It then takes several days before a home pregnancy test would be positive and a ‘heartbeat’ can be detectable as early as the sixth week. Consequently, many women do not learn that they are pregnant until after a ‘heartbeat’ becomes detectable on ultrasound.

As for what antiabortion activists even mean by a ‘heartbeat’, it’s not actually the presence of a heart, but simply the coordinated beating of muscle tissue around blood vessels that are in the process of fusing into what will become a fish-like heart as development advances. It does not have any significance in terms of the early embryo being a person. It’s not a person. It’s a six millimeter, brainless entity at this point. Thus, what anti-choice activists and politicians are doing in getting laws enacted, like Ohio’s ‘heartbeat’ law, is trying to get women and others emotional about the cyclic sound that the cyclic movement of blood through the embryonic pre-heart may produce at 6 weeks, when ultrasound is applied in what’s called Doppler mode. But all that Doppler detects is blood moving fast, then not so fast, then fast again. In early pregnancy, the only significance of such a heartbeat is that, if pregnancy gets to about the 9th or 10th week and there still is no heartbeat, the pregnancy is not likely to be viable, and so a spontaneous abortion (miscarriage) is expected.

Meanwhile, abortion rights in Ohio are at the center of races for various elected offices being decided this November, including one US Senate seat. So it is very, very important for you to get out and vote.

David Warmflash
Dr. David Warmflash is a science communicator and physician with a research background in astrobiology and space medicine. He has completed research fellowships at NASA Johnson Space Center, the University of Pennsylvania, and Brandeis University. Since 2002, he has been collaborating with The Planetary Society on experiments helping us to understand the effects of deep space radiation on life forms, and since 2011 has worked nearly full time in medical writing and science journalism. His focus area includes the emergence of new biotechnologies and their impact on biomedicine, public health, and society.

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