The Georgia abortion bill HB 954 has been widely promoted in the press as another “20 week” bill, but it isn’t (and this is the mistake in the bill’s wording that I was referring to in yesterday’s post). I think it wants to be a 20 week bill given it’s aimed at “fetal pain”, but if you read the exact wording it appears as if the lawmakers passed a bill that legalizes abortion (outside of life/health of mother issues) up to 22 weeks gestational age.

The Georgia lawmakers go to great lengths to describe how at 20 weeks post fertilization they think a fetus can feel pain (it can’t, BTW). In fact, the definition of a 20 week fetus in Georgia HB 954 is 20 weeks post fertilization, which is inaccurate medical terminology (and why I wrote yesterday that it was clear no doctor read the bill). At 20 weeks after fertilization a fetus is actually 22 weeks gestational age in medical terms.

This is the exact wording from the bill:

“At least by 20 weeks after fertilization” (in reference to fetal pain). This phrase appears 4 times in the 1st section.

Probable gestational age is an estimate made to assume the closest time to which the fertilization of a human ovum occurred…” also in the 1st section.

And then specifically in Code Section 31-9B-1 gestational age is defined as follows: “the postfertilization age of the unborn child at the time the abortion is planned to be performed or induced, as dated from the time of fertilization of the human ovum.”

Pregnancy Calendar from the Sprout app

Let’s be very clear. Pregnancy is dated from the 1st day of the last menstrual period (LMP) not from fertilization. Even when an ultrasound is performed, the additional 2 weeks pre-conception (if you will) are built into the dating. It’s even on a pregnancy calendar I downloaded and on every single prenatal wheel that OBs use to date pregnancies.

Think of gestational age dated from the LMP/by ultrasound as metric and correct, and think of the post fertilization age in the Georgia bill as an out of date Imperial system that has no scientific meaning (you sure won’t find it in any medical textbook).

Other states, such as Arizona, actually use the correct medical terminology of LMP/ultrasound in their laws. So, in Arizona when HB 2036 reads “Gestational age means the age of the unborn child as calculated first day of the last menstrual period of the pregnant woman,” it means what doctors everywhere call 20 weeks. As much as I disagree with the bill, at least they have their terminology correct.

According to the Guttmacher Institute, which I assume uses the correct medical terminology (i.e. 20 weeks = 20 weeks by LMP/ultrasound), as of April 1, 2012 there are 7 states with a 20 week gestational age limit: Alabama, Idaho, Indiana, Kansas, Nebraska, North Carolina, and Oklahoma. Arizona will be the 8th. Despite reports to the contrary, it is clear that Arizona is not imposing the most restrictive gestational age and given the wording in Georgia the Peach State will not be joining Arizona among the 20-week fetal elite.

Imposing gestational age limits is wrong. There are unfortunate circumstances where lethal or very severe anomalies are not detected until the 3rd trimester. I don’t think it’s anyone’s place to tell a woman who is pregnant with a baby who has no brain and a single eye like a cyclops that she has to go to term. I heard one woman in such a devastating situation say, “It was as if a little bit of me died inside every time some stranger asked when I was due to deliver.” Women don’t ever have late-term abortions out of convenience or on some kind of whim, they have them because of horrible, terrible, genetic calamities. Fortunately, with modern prenatal testing these later diagnosis are becoming rare, but they still happen.

I personally think the lawmakers in Georgia were aiming for a “real” 20 week bill, but were so deer-in-the-headlights about fetal pain! and 20 weeks! and life at fertilization!  that they forgot to do any basic research. And that’s exactly who you want writing bills, not scholarly lawmakers who have thoughtfully researched a subject and consulted the experts, but douchebags competing to pass the most misogynistic, evidence-baseless legislation in a bizarre game of one-upmanship. It’s even more concerning because lawmakers are encroaching in the practice of medicine with this misinformation.

With states like Georgia using inaccurate terminology discussions can get confusing. But it is essential to make sure we are using the accurate medical terminology so we can all compare apples with apples, because for me pro-choice is pro facts.

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  1. Absolutely spot-on correct but largely irrelevant.

    The issue before the legislature is whether a fetus deserves protection from the government against parties that seek to kill it. Whether the fetus can feel pain is irrelevant to the central argument.

    If the fetus felt pain at CONCEPTION, the issue would still be: is it okay for us to kill it? The Pro-Choice position is that the fetus does not deserve protection, the Anti-Choice position is that the fetus DOES deserve it.

  2. And that’s why this piece on Jezebel — which was based on pieces in the Atlantic (!) and RH Reality Check — made me crazy. A whole lot of pro-choice people crying foul about the Arizona bill, which at least gets this one thing right, and not about the Georgia bill, which actually IS trying to redefine medical terms.

    Thanks for setting the record straight.

  3. If fetal pain is “irrelevant,” tell that to the Georgia lawmakers who included it in the justification for the bill. You would know this if you read the bill itself, yesterday’s post, or today’s, which includes phrases like “it’s aimed at ‘fetal pain’,” and “The Georgia lawmakers go to great lengths to describe how at 20 weeks post fertilization they think a fetus can feel pain (it can’t, BTW).”

    They are saying that this pain exists, and therefore an effort is required to stop it. The pain does not exist, so their argument fails. If they have other arguments, they should use them.

    1. Pain is irrelevant because it is posterior to the issue of protection. Being handcuffed hurts (every try it?), but the fact that being handcuffed is painful is irrelevant to the law. You have to be handcuffed to be brought into custody.

      Similarly, whether being aborted hurts or not is irrelevant to the issue of whether it’s okay to kill fetuses. Georgia says it’s not okay to kill fetuses. We say it is. I suspect GA lawmakers hope to tug at heart strings, not to deal with the fundamental issue.

      1. I think we’re talking past one another somewhat. You’re certainly correct that the biggest issue here is whether we can “kill fetuses” (not the phrase I would choose, but whatever). You are also correct that the language in the law is intended to elicit an emotional response. But I will object strongly to any law that is based on invalid reasoning: their premise (fetal pain at 22 wks) is false, so their conclusion (the law is necessary) does not follow.

        Any effort answer the questions of whether society can define a point in time at which embryos/fetuses merit state protection, and if so, where that limit lies, is only undermined by inaccurate information.

      2. Again, sorry to quibble, but “society” doesn’t decide when people acquire protection by the state, legislatures do.

        I will stipulate that it appears that the GA statute is premised on the age when fetuses feel pain. With or without the section on pain, the point remains: the GA legislature extends liberty protections to fetuses. If the fetus felt no pain, it would not change the moral calculus here: after all, anesthesia could be applied before the abortion.

  4. I believe the Georgia legislature used the language it did because those same terms are present in the research supporting fetal pain. Dr. Gunter, as a physician, what are your thoughts on fetal pain and is there current research that refutes the findings of the fetal pain research?

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