Headlines today suggest that congress is attempting to ban abortion at 20 weeks.
Except they’re not. Congress might think they are enacting a 20 weeks ban. Many lay people might think they are. Many news sites might be calling it a 20 week ban. Life News might think it’s a 20 week ban. But it isn’t.
Congress is trying to ban abortion at 22 weeks.
Here is the exact wording of the “Pain-Capable Unborn Child Protection Act” related to gestational age:
Prohibits the abortion from being performed if the probable post-fertilization age of the unborn child is 20 weeks or greater…
We, meaning obstetricians, calculate gestational age from the 1st day of the last menstrual period. Embryologists, the people who study embryonic and fetal development use post fertilization age, because obviously one can’t study an embryo that has yet to be produced. For an embryologist day 1 has to be when the sperm penetrates the egg because obviously there is nothing before that.
But for doctors, the people who will have to follow this stupid legislation if it ever happens, day 1 of pregnancy is the last menstrual period. This is because historically before ovulation test kits and ultrasound no one could know for sure when they ovulated. Even if you know when you ovulate the day of fertilization will always be unknown. One the other hand the first day of your last period is an obvious event. Even when we calculate gestational age with ultrasound the convention of using the last menstrual period is built into the equation.
As we use the last menstrual period 20 weeks from fertilization is 22 weeks gestational age.
So fertilization age is for embryologists who do not look after real live patients and gestational age is for those of us who do.
A 22 week ban is of course very different from a 20 week ban. It’s still wrong, but for women planning terminations for fetal anomalies these 2 weeks would make a lot of difference. I’m not going to go into the pseudoscience of the fetal pain (at 20 weeks or 22 weeks) part of the bill, but you can read more about that here.
It’s hard to know why Congress is using such medically nonsensical terminology. Is is because they don’t know what they are doing? I can’t believe they really mean a 22 week ban as Life News, that bastion of medical falsehood and the medical textbook of the GOP, is calling it a 20 week ban. Is it as simple as being a medical dullard?
I think some of the people involved have such little understanding of medicine that they don’t understand the difference between fertilization and gestational age. Just think if they can’t even get the simple science of gestational age correct what do you think they are doing to the actual science behind fetal pain?
However, I truly believe there is something more sinister a foot. Getting “post fertilization age” into law at a Federal level would of course be the start of the slippery slope that “life” begins at conception. Once laws are on the books everything is open to interpretation. The abuse of fetal harm laws, originally meant to be used in crimes against pregnant women to criminalize premature delivery have taught us that.
Just as fetal harm laws were always a back door to criminalize abortion, so I believe that including fertilization age in federal law is a slight if hand designed to legislate that life begins at conception.
I’m pretty sure most of the GOP who vote for these bills have no idea what they are voting for, but I bet the puppet masters do.
Dr. Jen Gunter 
How does such law affect women with long or inconsistent periods? They are more likely to be later to realize they are pregnant in the first place, and then the gestational age of their pregnancy is higher than it would have been with a more typical cycle.
Here is a blog that details real life stories about women’s much wanted pregnancies they painfully elected to terminate … https://1in10blog.wordpress.com
ABOUT 1 IN 10:
According to the non-profit Guttmacher Institute, approximately 90% of abortions in the United States are performed in the first 12 weeks of pregnancy.
The 10% of pregnancy interruptions that occur after 12 weeks are sometimes due to medical complications, either with the mother’s health or with the fetus’ health. Of the less than 2% of all abortions that happen after 20 weeks, many ARE due to medical reasons. Public support for abortion steadily declines after 12 weeks, and abortions after 20 weeks are highly criticized and misunderstood.
Although our numbers might be relatively small, as we represent only 1 in 10 of all abortions, our stories are powerful and need to be told. Due to the stigma and judgment that persists around abortion (even 40 years after its legalization), many women who undergo a later termination are fearful and hesitant to share their stories, not only with society in general, but sometimes even with their own close family members and friends. But the stigma will never be lifted if we continue to allow ourselves to be ostracized and treated as shameful outcasts.
At the root of the public criticism is a genuine misunderstanding and a lack of awareness of stories like ours. People mistakenly assume that it would never happen to someone like themselves. But the reality is that it CAN happen to someone like you. Birth defects are non-discriminatory. They don’t only happen to people who are unhealthy, or have a family history of birth defects. They don’t only happen in unwanted pregnancies. They don’t only happen to women of advanced maternal age. They happen randomly and unexpectedly.
Those of us who share our stories here are neither martyrs nor monsters. Our choices were between awful and terrible. We are parents who faced an agonizing choice, sought out as much information as possible before proceeding, and then made the most loving and selfless decision possible.
Sharing our stories here will cost us nothing, but remaining silent could cost everything.
If you have a personal story you would like to have included here, please send an e-mail to support [at] ourheartbreakingchoices [dot] com.
It still confounds me why it is that everything and anything having to do with nothing about male humans makes certain male humans behave as though they know what they are talking about. As per usual, they haven’t a clue…if they wanna see what this sort of stupidity bhrings about, they can come to my town – Pomona, CA – and look, for themselves, what happens when you do not give credence to women being the ultimate choice makers when doing things in terms of our rights to our bodies…every high school in this town has a DAYCARE center…
Sad…right?
What are they saying to these young people about these things…the mere presences of those daycare centers on every high school campus here should tell the world VOLUMES about this…
It sounds like, in addition to the point you bring up, it is just going to confuse EVERYONE over when they are/aren’t allowed to terminate. Does anyone really know what post-fertilization age is, and is someone at 21 weeks GA going to end up refusing a necessary termination because she thinks she is beyond the 20 week law even though she is only 19wks post fertilization? Also, last I checked, we still can’t detect/predict the exact time of fertilization, no? Unless I’m out of date on my CE…
I love reading your write ups, I always learn something. Thanks for sharing!