Talk:Heartbeat bill

Iowa ban blocked; update image

According to the Associated Press. Thrakkx (talk) 01:03, 18 July 2023 (UTC)

Done. — kwami (talk) 02:02, 18 July 2023 (UTC)

The six weeks that isn't six weeks

I attempted to clarify the Beginning of pregnancy controversy as it relates to this type of legislation, but it was reverted.

The article previously said: "These bans make abortion illegal as early as six weeks gestational age (two or three weeks into a pregnancy), which is when proponents claim that a "fetal heartbeat" can be detected."

I changed it to read instead: "These bans make abortion illegal as early as six weeks gestational age (about four weeks after conception), which is when proponents claim that a fetal heartbeat can be detected."

I feel this is clearer and more neutral, because declaring that "six weeks gestational age" is "two or three weeks into a pregnancy" is taking a firm stand on when pregnancy begins, and there is no culturally or scientifically agreed-upon Single True™ Starting Date for Pregnancy. Six weeks' gestational is four weeks' fertilization age, and two to three weeks' end-of-implantation age, but it's not neutral to say that the end of the week-long implantation is the sole correct way to measure a pregnancy. This claim is controversial (that's why we called the relevant article the Beginning of pregnancy controversy instead of the "Beginning of pregnancy single true answer"), should not appear without either context or explanation in the second sentence of this article. WhatamIdoing (talk) 22:21, 4 August 2023 (UTC)

Thank you for that change; I agree with/support that change. It now matches the last sentence in the lead: "...since many women do not even know that they are pregnant six weeks after their last menstruation, which is four weeks post-fertilization." so this is hopefully clearer to the reader, and supported by the sources already in this article. Thanks! ---Avatar317^(talk) 22:43, 5 August 2023 (UTC)

There are different ways to count your term, but pregnancy itself is straightforward: it's implantation. That's what triggers the hormonal/physical changes, pregnancy tests and the like. Having a glass of wine at dinner before you have sex is not pregnancy, even if by GA count you're at two weeks.

Abortion is an induced miscarriage. Thus you cannot get an abortion until you cannot miscarry. If you're pregnant, you can miscarry, and of course get an abortion. If there's no implantation, there's no possibility of miscarriage, and no possibility of abortion. So we're talking about abortion being legal for about 3 weeks, from week 3 to week 6 GA -- before 3 weeks GA you can't have an abortion because you're not actually pregnant. (It's meaningless to ban abortions at conception because you cannot have an abortion at conception.)

Also, sources say these bills place the limit at 5-6 weeks GA, not necessarily 6 weeks.

In the first para, we should clarify that when we say "proponents claim that a fetal heartbeat can be detected," that is demonstrably false: there is no fetus, there is no heart, and there is no beat. It's only a marketing gimmick. That is why some of these laws do not use the phrase "fetal heartbeat". (The ones that do are forced to say, buried somewhere on page 10, that "fetus" is not a fetus, and a "heartbeat" is not a beat and does not occur in a heart.) We should report what advocates claim, but as an encyclopedia we should not give equal weight to demonstrable falsehood. — kwami (talk) 01:32, 6 August 2023 (UTC)

Kwami, there certainly exists a definition that says pregnancy begins at implantation. I've not yet seen a definition that specifies whether that's at the beginning, middle, or end of the week-long implantation process, but that's a definition that exists. I usually find it in articles explaining that emergency contraception can't technically be abortifacient because abortions end pregnancies, and pregnancies don't exist at the time of conception, so anything that ends whatever process is underway before implantation is an unnamed thing that is definitely not "an abortion".

However, it is not the only definition that exists, and nobody's going to be confused by a statement like "You two are trying to conceive, and you said you ovulated yesterday – that means you could be pregnant now, so maybe we shouldn't go out drinking tonight", and nobody except a heartless monster is going to say "Yes, I know you had a faintly positive pregnancy test last week, but that was only 9 days post-ovulation, so you were never technically pregnant and therefore you aren't really having a miscarriage. You're just having a slightly late and unexpectedly messy period, so stop crying already". Linguistic prescription lost the battle half a century ago: any widely used definition of such a common, everyday word is a valid one.

(Also, hCG [the hormone detected by pregnancy tests] is produced by the trophoblast, which develops four days after conception. The hormones produced by the trophoblast have been detectable in the lab for about 30 years at 8 days FA (PMID 7726131). Implantation starts two days after the trophoblast starts producing hCG, and even home pregnancy tests can detect this hormone before implantation is finished.)

It's the medical industry that claims women get "pregnant" two weeks before its physically possible, so there's no sense in saying that implantation is the true "medical" definition. I don't ever remember seeing a medical textbook that claimed pregnancy didn't start until implantation, but all the standard obstetrics textbooks explain that pregnancies begin two weeks before ovulation and sex. Checking a few medical dictionaries, I find these definitions for pregnant:

• Merriam–Webster's Medical Dictionary: "containing a developing embryo, fetus, or unborn offspring within the body."
• Dorland's (32nd ed.): "with child; containing developing young.  Called also gravid."
• Mosby's (9th ed.): "gravid; with child."
• Taber's (24th ed.):  "pregnant (prĕg'nănt) [L. praegnans] Having conceived; with child.  SYN:  gravid."

None of them mention implantation, and that last contradicts the implantation-based definition, since it defines conception as the start of pregnancy. The Wikipedia article for Pregnancy also provides a very general definition of pregnancy in the first sentence without mentioning implantation.

I therefore do not think that we should say that six weeks GA = two to three weeks "pregnancy", because:

• such a calculation uses the least common measurement, and
• since that uncommon definition is unexplained in the lead, it will confuse most readers.

WhatamIdoing (talk) 04:15, 6 August 2023 (UTC)

Weeks past fertilization isn't a bad way to put it. I'd say 3 to 4 weeks, though, because the tests may detect something at 5 to 6 weeks GA.

You're not going to have a "messy menstruation" (miscarriage) without implantation. It's estimated that half of all fertilized eggs are expelled with the next menses. Hard to tell because there's no sign of it happening -- they don't make the menstruation "messy".

"All the standard obstetrics textbooks explain that pregnancies begin two weeks before ovulation and sex" -- no, they don't. They use that as the count, as a conventional matter of convenience (because it's common to track when you menstruate), but I challenge you to find a single medical source that says a virgin can be pregnant today if she plans to have sex two weeks from today, but can't be pregnant tomorrow if she changes her mind. If you say "my husband and I are going to try for a child again this weekend", no doctor is going to tell you, "Well then, I think you might be pregnant!" It's only after you're pregnant that they will ask when your last menses started in order to get an estimate of when you might give birth (or how long you have the option for an abortion). — kwami (talk) 04:45, 6 August 2023 (UTC)

Please people: THIS article is NOT the place to argue whether your own knowledge, or the status quo definition of the medical establishment is valid or scientifically accurate; the argument we should be having is what SOURCES say about this (which is supposed to reduce or simplify our arguments).

The NYT puts it very succintly.

• Doctors measure the start of pregnancy from the date of a woman’s last menstrual period, which is usually about two weeks before a fetus is conceived.
• ...the sixth week of gestation, or the fourth week after conception.
• An embryo at six weeks’ gestation is only about four weeks old, because the pregnancy clock starts at the parent’s last menstrual period. Most people don’t realize they are pregnant until after they have missed a period, two weeks after conception.

So I believe that we have solid support in the sources for WhatamIdoing's revision.

Separately: kwami said In the first para, we should clarify that when we say "proponents claim that a fetal heartbeat can be detected," that is demonstrably false: there is no fetus, there is no heart,... I agree completely, that's why the second sentence reads: "when proponents claim that a "fetal heartbeat" can be detected.": note the word "claim" and notice the "fetal heartbeat" in quotes, and then the sentence which IMMEDIATELY follows explains how this is marketing spin. So this part seems fine to me. We DESCRIBE the bills and then explain how their "rationale" is marketing falsehoods.---Avatar317^(talk) 05:48, 6 August 2023 (UTC)

As I thought I saw it, that explanation was in the 2nd paragraph. Some display glitch, perhaps. So please disregard that comment.

"Doctors measure the start of pregnancy from ..." Indeed they do. But they key word is measure: They don't say you're "pregnant" in those first weeks. Some might consider fertilization to be the beginning of pregnancy, rather than implantation, but no doctor believes that menstruation is the beginning of pregnancy.

"None of them mention implantation, and that last contradicts the implantation-based definition, since it defines conception as the start of pregnancy." But conception may be implantation, so there is not necessarily a contradiction. Taking the MW med dictionary above, 'conception' is "the process of becoming pregnant involving fertilization or implantation or both."

Regardless, I think 'fertilization' (per the wording of the text) is preferable to 'conception', as it is more precise. — kwami (talk) 09:12, 6 August 2023 (UTC)

Are we all now agreed to remove the "two or three weeks into a pregnancy" language and replace it with "four weeks after fertilization"? WhatamIdoing (talk) 17:43, 6 August 2023 (UTC)

I support that change. ---Avatar317^(talk) 19:36, 6 August 2023 (UTC)

three to four weeks, I would think, since the early bans theoretically kick in at five to six weeks according to sources (even if commonly called 6-week bans). — kwami (talk) 20:37, 6 August 2023 (UTC)

Okay, I've got an embryology textbook from Cambridge University Press that says cardiac activity starts on Day 26 after fertilization. Because of the relative lifespans, that's usually three weeks plus six or seven days (i.e., exactly four weeks) after having sex. What's your source for claiming that 21 days is even theoretically possible? WhatamIdoing (talk) 20:55, 6 August 2023 (UTC)

As above, I'm going off sources saying it's 5 to 6 weeks. Did your source give the confidence interval? Is that an average, or do they claim that for all embryos it's on day 26? — kwami (talk) 21:00, 6 August 2023 (UTC)

There is no confidence interval given. It is stated as a simple fact.

What source, specifically, are you relying on here? Something in a newspaper? A quotation from an advocacy group? The article presently says "as early as six weeks", which is not what we would be writing if the sources said "5 to 6 weeks". WhatamIdoing (talk) 21:28, 6 August 2023 (UTC)

We used to say 5 to 6, with refs. I don't know what changed. — kwami (talk) 21:54, 6 August 2023 (UTC)

It doesn't matter what the article used to say, that may not have been properly sourced. I looked at sources 1-15, (used in the lead) 19,25,26,27, & 28 (used in the "Timing" section) and in addition to the three I listed above, we also have:

The Texas law bans abortion at six weeks of pregnancy, which is around four weeks after fertilization

Many of these sources involve journalists speaking with/interviewing reproductive experts (either doctors or professors/researchers), so unless you can find sources that talk about 5 weeks, we need to use what the sources we have say, which is 6 weeks. ---Avatar317^(talk) 22:42, 6 August 2023 (UTC)

I've made the change that we have agreed to. Kwami, if you can find high-quality sources that say this happens earlier, then I'm happy to change it to 3–4 weeks, but we need those sources in hand before making any such change. WhatamIdoing (talk) 14:37, 9 August 2023 (UTC)

That's fine. I saw it multiple times when this was news, but not for a while. — kwami (talk) 17:21, 9 August 2023 (UTC)

Lots of names

It's usual to put the current article title first in the first sentence. What do you think about removing some of the names (e.g., the "early abortion ban", which only permits early abortions) and having a sentence that gets straight to the point, such as:

"A heartbeat bill or six-week abortion ban is a form of abortion restriction legislation in the United States that makes abortions illegal if it has been more than two weeks after a woman's first missed period."

WhatamIdoing (talk) 01:53, 25 August 2023 (UTC)

I don't support that. For some prior discussion on the article name issue, please see: Talk:Heartbeat_bill/Archive_1#Requested_move_15_May_2022. For one, I prefer the current version because it points out that the term "heartbeat bill" is a name given by proponents.

It is somewhat difficult to decide what the proper name should be, because when these bills first started appearing around 2012 (now a decade ago), they were named "heartbeat bills" with that as a justification, and many included "fetal heartbeat" detection phrasing. So many of the sources reflect that. But since Roe was overturned, many bills have popped up withOUT that same claimed premise, solely to ban abortion as much/early as possible. As these new abortion bans get put into this article (since there is no better place to put them) this article becomes a sort of "big tent" article to hold that info also. So the content might be somewhat morphing.

I would support replacing "(about four weeks after fertilization)" in the second sentence with "(two weeks after a woman's first missed period.)". The "about four weeks after fertilization" is at the end of the lead, so it will be explained that way also there. ---Avatar317^(talk) 05:24, 25 August 2023 (UTC)

It currently says:

"A six-week abortion ban or early abortion ban, called a "heartbeat bill" or "fetal heartbeat bill" by proponents, is a form of abortion restriction legislation in the United States."

I think:

• Four alternative names is too many for the first sentence.
  • I suggest removing "early abortion ban" because Early abortion ban does not redirect here (and any such redirect would likely be contested, as it could describe other laws, too), the term is not used in the article, and it does not appear to be a significant alternative name in reliable sources.
  • I also suggest removing "fetal heartbeat bill" because the legislation isn't about the fetal stage, and it's sufficiently similar to "heartbeat bill" that it's redundant. (But if you prefer keeping fetal heartbeat bill, then let's remove "heartbeat bill" – either way, I think we only need one of these.)
• It is usual to have the current Wikipedia:Article title first in the list.
• The second half of the sentence provides very little information. There are many forms of abortion restriction legislation in the US; we should say something about which kind it is.

What do you think? WhatamIdoing (talk) 15:52, 25 August 2023 (UTC)

Heartbeat bill is an awfully common name, but the consensus among MEDRS sources seems to be that it's [inaccurate/pseudoscientific/unscientific]. Why not just say that in the first sentence? e.g. "A heartbeat bill is a form of abortion restriction in the United States based on the unscientific claim that a "fetal heartbeat" can be detected as early as four weeks after fertilization." Then bring up all the other terms in the "terminology" section? — Rhododendrites ^talk \\ 17:25, 25 August 2023 (UTC)

In the sources I've seen, these laws are commonly referred to as "six-week abortion ban"(s), and also "fetal heartbeat bill"(s), and both those terms redirect to this article. (From just one source: ...banned abortions once an ultrasound detects cardiac activity. Since that can occur as early as the sixth week, the law is commonly referred to as a six-week ban.

How about this for the first sentence:

• Six-week abortion bans, called "heartbeat bills" or "fetal heartbeat bills" by proponents, are laws in the United States which make abortion illegal as early as six weeks gestational age (two weeks after a woman's first missed period), which is when proponents falsely claim that a "fetal heartbeat" can be detected.

(I'm using plurals here to note that these laws are happening at the state level, so that readers won't think this is one law.)

The very next sentence states the medical communities' view on these laws and terms. ---Avatar317^(talk) 22:17, 25 August 2023 (UTC)

IMO that would be better than what we've got now. I might shorten it to give just the "two weeks after a woman's first missed period", which is something most people understand, instead of mentioning gestational age, which is not an intuitive date. Most adults understand that "two weeks after a first missed period" means that a woman who wants an abortion has two weeks to find out whether she's pregnant and get an abortion. I do wonder whether some of them think "six weeks gestational age" means that she has a month and a half to do this.

(Rhododendrites, if it's really the terminology bothers you, then perhaps you would like to say "...based on the unscientific claim that a "fetal heartbeat" can be detected in an embryo".) WhatamIdoing (talk) 03:35, 26 August 2023 (UTC)

The "six-week gestational age" explains why they are called six-week abortion bans. (That may be a misleading name, but that's what sources use.) If we include the "(two weeks after a woman's first missed period)" the readers will understand that a woman has two weeks to get an abortion by reading this first sentence. You are right, many people may not understand that from standard news articles. We also have that explained at the very end of the lead, ("... many women do not even know that they are pregnant six weeks after their last menstruation..." but it should also be in the first sentence. ---Avatar317^(talk) 06:40, 26 August 2023 (UTC)

Does anyone feel that it's important to name both "heartbeat bills or fetal heartbeat bills", back to back, in the first sentence? I think that one is enough. WhatamIdoing (talk) 00:17, 30 August 2023 (UTC)

Background dates

I think that this table (part of what's in Pregnancy) would help people understand why a "six week" bill is not really six weeks:

Comparison of dating systems for a typical pregnancy

Event	Gestational age (from the start of the last menstrual period)	Fertilization age	Implantation age
Menstrual period begins	Day 1 of pregnancy	Not pregnant	Not pregnant
Has sex and ovulates	2 weeks pregnant	Not pregnant	Not pregnant
Fertilization; cleavage stage begins	Day 15	Day 1	Not pregnant
Implantation of blastocyst begins	Day 20	Day 6	Day 0
Implantation finished	Day 26	Day 12	Day 6 (or Day 0)
Embryo stage begins; also, first missed period	4 weeks	2 weeks, 1 day	Day 9
Primitive heart function can be detected	5 weeks, 5 days	3 weeks, 5 days	2 weeks, 6 days
Fetal stage begins	10 weeks, 1 day	8 weeks, 1 day	7 weeks, 2 days

References

I think it would be helpful to include it in the ==Background== section. What do you think? WhatamIdoing (talk) 02:17, 14 September 2023 (UTC)

I reverted this addition earlier, (based on WP:OR in that the table's sources don't talk about these types of legislation) and I still don't understand how it would help rather than confuse the reader, since we already discuss some of this. That said, I was resistant to your desired changes in the above discussion for the first sentence of the lead, and I now feel that your pressing the issue and explaining ended up with the lead sentence being improved substantially, so I'm willing to listen here.

If this graph is included, I don't like the colorization of the "Primitive heart function" nor the text calling it that, since it is described in sources for this article as: "a group of cells which will become a heart" and "heart will only have formed enough to be able to hear a real fetal heartbeat by 17–20 weeks of gestation" - if we include the table, we should also have an entry for when a REAL fetal heartbeat is detectable.

Part of the whole issue here is that these bills aren't based on any science, they are just attempting to use the appearance of science as an excuse to reduce the legality/availability of abortion, whether it be "fetal pain" or "fetal heartbeat", so the real science here is not necessarily pertinent. ---Avatar317^(talk) 19:02, 17 September 2023 (UTC)

The sources talk directly and in detail about dating systems, which is what we need if we're going to explain how a woman can be told that she's "six weeks' pregnant" when she knows that she had sex for the first time just four weeks ago.

As for whether it's "a heartbeat": I guess that depends on how you choose to define the word. For example, is a "heartbeat" the motion of the heart, or the sound that motion makes? Is the key point when the heart begins movement, when it begins transporting blood cells, or when you can hear the sounds caused by its activity? If the latter, then what level of technology is accepted here? None at all, in which case the heartbeat isn't audible until you can press your ear up against the baby's chest after birth? An ordinary stethoscope on the outside of the mother's belly? (You'll discover that obese women's babies don't have heartbeat for several weeks after then women's do.) Any technology as long as it is acoustic? Any technology that detects enough motion in the heart that we know it's producing sound waves, even the way we're detecting that state is not, itself, acoustic?

If you can tell me which definition you want to use (whether your own personal preference or one you take from any source), I can tell you when you have a "real" heartbeat. (Real science always matters.) WhatamIdoing (talk) 08:54, 18 September 2023 (UTC)

We shouldn't go on how *I* might define the word, (sorry if I was unclear about that) but by the accepted definition from those in the field: The American College of Obstetricians and Gynecologists source says: "Until the chambers of the heart have been developed and can be detected via ultrasound (roughly 17-20 weeks of gestation), it is not accurate to characterize the embryo’s or fetus’s cardiac development as a heartbeat." ---Avatar317^(talk) 23:50, 18 September 2023 (UTC)

We can give a different date for any definition you (or anyone else) cares to use. For the ACOG statement, though, I think you might want to compare it against this source:

• "The human fetal heart is fully developed and functional by 11 weeks after conception.  Using transvaginal ultrasound, the structure and functional characteristics of the fetal heart can be observed as early as 9 weeks gestational age." [1]
• "The fetal heartbeat is detectable at four to five weeks of gestation, and by the eleventh week the cardiovascular system is fully developed in miniature." [2]
• "By around day 20 the embryo is about 1.5 millimetres in length and has a regular heartbeat, although the heart will not be fully developed until about the 10th week after conception." [3]
• "While the four-chamber view may be seen in as many 85% of 11 week fetuses, it is visualized in almost all fetuses by the 13th week of gestation.  The cardiac outflow tracts are fully developed and may be visible towards the end of the first trimester, although assessment of these structures may be more technically challenging." [4]

These are medical textbooks, from highly reputable academic publishes (Springer, Oxford University Press, Elsevier). All of them say that the heart is "fully developed" significantly before 17 weeks GA, and two of them happen to use the word heartbeat to describe early cardiac activity. I specifically looked for reputable sources that say when the heart is "fully developed" and I found none that mirrored the ACOG media guide. I didn't even find any unreliable sources making this claim (though I didn't look into obviously unreliable sources).

You've quoted a press release from the "Media Center" on ACOG's website to say that the heart isn't fully developed and can't be detected by ultrasound until almost two months later. I think both MEDRS and common sense are pretty clear about which sources we should prefer, when the options are medical textbooks from academic publishers versus a media guide directly aimed at a political situation, don't you? WhatamIdoing (talk) 03:35, 20 September 2023 (UTC)

This article is about a political set of laws, NOT the science or terminology of pregnancy.

The ONLY reason why "fetal heartbeat" matters at all, is that IF THE LAW SAYS that an abortion cannot be performed when a "fetal heartbeat can be detected" than we report on WHEN doctors/gynecologists/lawyers say that this sets the cutoff date for abortions.

Other than that, the existence/definition of "fetal heartbeat" or "infant heartbeat" or "heartbeat" is IRRELEVANT. ---Avatar317^(talk) 23:28, 20 September 2023 (UTC)

Wikipedia shouldn't misrepresent mainstream science or the terminology of pregnancy even if various politicians do.

If you want to follow the language used in the laws, then the Texas law, for example, provides a definition: '"Fetal heartbeat" means cardiac activity or the steady and repetitive rhythmic contraction of the fetal heart within the gestational sac.' That state attains from about four weeks post-fertilization.

Some of us may quibble about whether the definition in this law describes a "fetal" heart, and some sources are apparently prepared to quibble over whether an organ that is actively pumping blood cells around an organism should be called a "heart", but that doesn't change the facts on the ground. Primitive heart function begins around four weeks post-fertilization, and that law bans abortions when the embryo has "cardiac activity", not when ACOG agrees that the cardiac activity should be called a fetal heartbeat.

If you wanted to follow ACOG's advice, you might consider copyediting the article to replace as much of the "heartbeat" language in the Wikipedia article with a descriptive term like "cardiac activity". WhatamIdoing (talk) 02:41, 21 September 2023 (UTC)

Map out of date?

Rather than an out of date map, perhaps it should be removed? Valereee (talk) 22:03, 7 December 2023 (UTC)

Removal sounds good to me. This legal landscape has been changing rapidly lately, and therefore the map will always be out of date unless constantly updated, and that has not been happening at this article. ---Avatar317^(talk) 19:43, 10 December 2023 (UTC)