By Randall K. O’Bannon, Ph.D., NRL Director of Education & Research
It is hard to tell exactly when or where the first statement was made, but shortly after pro-lifers introduced the first “Heartbeat Bill” in 2011, pro-abortion activists began complaining that the law, if passed, would ban abortions as early as the sixth week of pregnancy, they at a time before “many” or even “most” women even know that they are pregnant.
The intended implication clearly is that such a law is really effectively a ban on abortion, as many, if not most women won’t realize they are pregnant until after the six week deadline has passed. The law’s allowance of abortions prior to that time is meaningless, they infer, if a woman never really has an authentic opportunity to exercise that “right,” “choice,” or provision within that time frame.
But is this really so early that many of these women don’t even realize they are pregnant? Is it really that difficult to figure out? What do the statistics show about women having abortions at six weeks or less?
Abortions do drop once a heartbeat bill is in place, but plenty of women still have abortions before six weeks of pregnancy, clearly indicating they do, in fact, know that they are pregnant. Those who forego abortions may be doing so because the information that their baby has a heartbeat at six weeks may change their minds and intentions.
A myth pushed by the press and abortion advocates
Like many of the abortion lobby’s claims, this is accepted as a truism and is constantly repeated in the media.
The Advocacy Team of the Center for American Progress, in an article titled, “The Latest Extreme Anti-Abortion Trend,” Jan 31, 2013, “Now Republicans are starting off 2013 with another major anti-abortion push in the states. This time the push is around so-called ‘fetal heartbeat’ bills — bills that attempt to ban abortion as soon as a fetal heartbeat can be detected. This means abortion could be banned after just six weeks, which is before many women even know they are pregnant.”
In December of 15, 2016, Jessica Goldstein wrote in Think Progress that Ohio Governor John Kasich had line item vetoed a law which “would have banned an abortion after six weeks, before most women even know they are pregnant.”
The phrase reflects the official position of the Guttmacher Institute, the research arm of the pro-abortion movement, which declared as recently as January 1, 2019 that there had been “A Surge in Bans on Abortion as Early as Six Weeks, Before Most People Know They Are Pregnant.”
CNN helpfully offered an article “Reasons a woman may not know she’s pregnant at six weeks” in May 9, 2019, and the New York Times gave the myth its official blessing in a piece by Roni Caryn Rabin titled “Answers to Questions About the Texas Abortion Law,” published September 1, 2021. The Times piece included the helpful subhead, “The law prohibits abortions before many women even know they’re pregnant, and it will be hard to challenge in the courts.”
Data show high numbers of abortion at six weeks
If many, or even most women didn’t realize they were pregnant until six weeks after their last menstrual period (LMP), there would be few abortions performed at this stage. But that is not what statistics show.
The U.S. Centers for Disease Control, the federal agency responsible for collecting and publishing national abortion data, regularly reports on the number of abortions by gestational age. In its most recent report for abortions performed in 2019, 42.9% of abortions in the country were performed at six weeks gestation or less.
Though several states considered and passed such legislation between 2011 and 2022, because of legislative processes and court challenges, the first Heartbeat Law to take effect was in Texas, which began to be enforced in September of 2021. This means that the CDC gestational data reflects practice before any of these laws took effect.
The point is that, even without the clock ticking and the earliest (and cheapest) chemical and surgical abortions still widely available for several more weeks, nearly 43% of women not only knew they were pregnant but got abortions at six weeks or less. Many of the additional 36.4% who the CDC says got abortions between seven and nine weeks of gestation surely knew they were pregnant by six weeks and simply took the time to collect funds or schedule the abortion at a time convenient to them.
Data published by the state of Texas subsequent to the Heartbeat Law’s taking effect back up this contention. After recording 5,706 abortions in August of 2021, Texas showed only 2,251 abortions for the following month, September. Even if August was a bigger month, owing to women rushing to beat the deadline, the months prior to that, when abortions averaged about 5,000, show that even with the six month ban in effect, about 45% of women were still able to obtain abortions in Texas.
Statistics for the following months show the number of abortions ticking up a bit more, with December 2021 reaching 2,699, or about 54% of what they had been in May-July, 2021 before the law took effect.
Texas statistics for that year do not currently have a separate category for abortions at six weeks or less, but do show that all but 14 of the abortions it counted after September 2021 were performed by the eighth week, the lowest gestational window the state records.
If these statistics are accurate, “most” women clearly knew they were pregnant and were still able to get abortions within the six week window.
Put another way, if most women did not know they were pregnant, the number of abortions performed in that state would necessarily have fallen considerably more once the law took effect.
Planned Parenthood says drugstore pregnancy tests are at least 99% accurate at 5-6 weeks
While there are still the odd, occasional stories of women who go through an entire pregnancy and never realize they are pregnant until giving birth, there is really little reason in this modern age for any woman not to be able to determine whether or not she is pregnant.
As Planned Parenthood points out on its website, “The pregnancy tests you get at the drugstore work 99 out of 100 times” and are “just as accurate as a urine test that you’d get at a doctor’s office” (www.plannedparenthood.org/learn/pregnancy/pregnancy-tests, accessed 11/3/22).
The group tells women they can take a pregnancy test “anytime after your period is late,” but adds that though some may work as early as 10 days after unprotected sex or a few days before a missed period, “your best bet for accurate results is to take a pregnancy test 3 weeks after sex.”
Given that ovulation tends to occur in the middle of a woman’s normal 28 day cycle and is an essential precursor to conception, pregnancy testing at the three week mark after unprotected intercourse practically means 5-6 weeks LMP, meaning she can know her status well within the legal limit.
Irregular periods and other objections
Pregnancy can be reliably detected at six weeks or less even if a woman has irregular periods or otherwise thinks she has reason to doubt pregnancy. If she has had unprotected intercourse, even if she has been using some form of birth control, pregnancy is possible and it can usually be reliably detected three weeks later using a standard drugstore pregnancy test.
Some women do have irregular periods and may not know how to check for signs of ovulation and enhanced fertility. But unless they totally fail to understand the connection between intercourse and pregnancy and have special difficulty dating or tracking their sexual encounters, they still should be able to know when a test can reliably rule in or rule out pregnancy, before the six-week deadline occurs.
A woman on birth control may believe that she is incapable of conceiving, but no method on the market can advertise itself as 100% effective.[1] The new law may not prevent such a woman from having an abortion, but it may encourage her, if she intends to have sex, and would consider aborting that baby, to check for pregnancy three weeks after the encounter, even if she was using birth control.
Testing earlier than she might have planned won’t change the test result one way or the other, but it could alter her options.
If she has experienced spotting, she may think that is a sign she is not pregnant. But if she is well informed about sex and pregnancy, she will realize that spotting may occur when the baby implants in the uterine wall. Once again, the best thing to do is not to simply hope or assume but to take a pregnancy test as soon as three weeks after that original intercourse.
Claims that many women will still not know they are pregnant run counter to assertions by abortion advocates that women do indeed know and are ready to manage chemical abortions on their own. April Lockley, a self-identified “abortion provider” defending “self-managed abortion” performed with pills ordered online, confidently declares “Most people know their own bodies—they know when they had a period, they know when they’re pregnant, they know when they’re no longer pregnant, and they know if they’re experiencing something that might need in-person medical care.”[2]
If a substantial number of women do not know and do not understand how their bodies work and lack the knowledge, maturity, and responsibility to manage their own pregnancies, then abortion advocates should not only stop pushing “self-managed abortions” and stop petitioning the government to allow abortion pills to ordered online and sent by mail without limitations, but should also drop any opposition to informed consent and parental involvement laws, which they sometimes portray as intrusive or unnecessary.
The law is saving some lives
While the Texas “Heartbeat Law” may have been one of the reasons for some women traveling to other states for abortion or even ordering abortion pills to be shipped to their homes, it is clear, even from the limited data available, that it has saved some babies lives.
The Texas statistics cited earlier showed more than 11,000 fewer abortions, in the four months following the law’s implementation, or about 2,750 fewer a month, and the four months that preceded it, the monthly numbers dropping more than half.
According to the New York Times, the Texas Policy Evaluation Project, an abortion supporting public policy group, surveyed clinics in surrounding states and found out that a number of women (logistically and financially aided by Texas abortion groups), traveled to neighboring states to have abortions. They estimated that an average of 1,400 women visited one of seven neighboring states and got abortions there, displacing a significant part of the drop Texas.
Aid Access, a Dutch-based group selling Indian abortion pills online and delivering them by mail to American women, claimed that it as many as 1,100 Texas women a month ordered abortion pills. While this, taken together with the women having abortions out of state, would appear to account for a lot of the drop, it would not account for all of it.
Abigail Aiken, part of the Texas Policy Evaluation Project which tracked the out of state abortions, admitted to the New York Times that the law was at least “semi-effective” but noted it would not stop all abortions. Though higher numbers of prevented abortions would certainly be welcome, even the saving of a few hundred or even thousands of lives would give pro-lifers reason for celebration
Ultimately, the Times granted that while “The data shows the limitations of laws restricting abortion,” that same data “also shows how restrictions erect significant obstacles, which will cause some women to carry unwanted pregnancies to term,” which means babies will be born and not aborted.
The scope is broader, spread over the entire country, and covers laws ranging from outright bans to laws prohibiting abortions once an unborn child can be shown to be capable of experiencing pain (against states which encourage and even fund abortion). But a recent national study by the Society of Family Planning found a net 10,570 fewer abortions in just the first full two months (July and August of 2022) following the Supreme Court’s Dobbs decision.
This again, is the net drop. The states with bans of some sort actually saw declines of 15,910 for those two months; this was offset by those states where abortion was fully legal or legislatures took steps to protect the abortion industry.
Even so, the net effect of these new abortion limits appears to have been the saving of thousands of unborn lives.
The unborn child at four weeks (or six weeks gestation)
Though the fall of Roe seems to have prompted the abortion industry’s revival of the ludicrous “blob of tissue” falsehood, arguing that what is lost in abortion is nothing more than a “clump of cells,” modern embryology shows that even at its earliest stages, the human embryo is a marvel to behold.
Though starting as just a single celled zygote, within a matter of just a couple of weeks there have countless numbers of cell divisions and the cells have already begun forming specialized structures and organs. By the third to fourth week, the child’s body has already begun to take form, with the appearance of the head, the brain, the back, the spinal cord, and yes, the heart and circulatory system. Lungs and the gastrointestinal tract begin to form. The first signs of limbs appear.
Before the child’s fourth week of life is over (when doctors would date her pregnancy at six weeks, measuring from the day of the mother’s last menstrual period), the child’s heart is beating steadily at about 113 beats a minute.
This is clearly no mere mass of undifferentiated cells.
The abortion industry’s acknowledgment these Heartbeat Laws take effect at six weeks gestation is an admission that there is a scientific consensus on at least this basic embryological fact.
For many people, the presence of a beating heart is irrefutable evidence of living humanity, and a clear reason for the state to extend its legal protection to unborn child by at least this stage.
This is the basis for the Heartbeat Laws that have been passed in many states.
Women’s awareness of these basic fetal facts, perhaps in part facilitated by the law, may be the reason that some of these women choose to forego abortion and carry their children to term, especially if and when they find out about help and assistance that may be available to them if they allow their child to be born.
Summary: Women can and do know they are pregnant at six weeks gestation
Assertions that most women do not know they are pregnant at six weeks after their last menstrual period are not supported by the evidence. Whether the error stems from reliance on outdated medical information from before the era of modern home pregnancy tests or intentional obfuscation is unknown. But the evidence clearly shows that a large percentage of women know they are pregnant by the sixth week and are able to schedule and have their abortions within that time frame.
In the modern day, women can easily, cheaply obtain reliable tests that indicate pregnancy as early as three weeks after unprotected intercourse, early enough to meet the six week abortion deadline.[3] The data show that many women clearly do.
The data also show that, once the law passed, many women seem to have chosen to carry their pregnancies to term. This could be due to missing the deadline, but just as well might be because the law helped them realize the humanity of their unborn child, that the child they were carrying was no mere “blob of cells,” but a living human being with a beating heart. And once they knew this, and had the time to access community help and services available to women in their situation, they charted a different course.
Which is precisely what these laws were designed to do.