Ohio is the latest state to attempt to pass a medically illiterate abortion “heartbeat” bill.

It’s bad enough that these bills exist, but the press needs to do a better job of calling them what they are. If politicians want to play doctor they should be using medical terms. If they refuse to use the correct terminology the press should correct them. People who vote for the assholes who write these shit shows know them as “heartbeat bills” not because they follow them as they groan through committee, but because that is how they read or hear about them in the news. The politicians know exactly what they are doing  as a “heartbeat” bills is a way of making a 4 mm thickening next to a yolk sac seem like it is almost ready to walk.

Fetal cardiac activity can be detected as early at six weeks from the last menstrual period. The ultrasound below shows an image at 6 weeks and 1 day.




The fetal pole is between the two markers and is a thickening at the end of the yolk sac (the yolk sac is the circular blob) and contains the earliest ultrasound evidence of cardiac activity. I know some have wondered why not use the term embryo, but as it’s the fetal pole that is being measured I think the term “fetal” is technically fine.

However, when most people think of a heartbeat they don’t think of a 4.3 mm thickening next to a blob they think of something like this…

The pro-life version of am embryo
Anti-choice “embryo”

The image above is a anti-choice version of an embryo, obviously not a faithful representation of size or appearance. If you want a real picture for comparison check out this link.

I expect nothing less than a campaign of misinformation from the misogynistic degenerates who hold office in these places. I worked in Kansas for many years and after a restrictive law passed I found myself in a three-way phone call with the hospital attorney and the politician playing doctor who tacked on the abortion rider to the bill that turned the governance of Kansas University Medical Center (KUMC) to a private authority. Yes, that’s right the State legislature in Kansas held the hospital’s financial future hostage over abortion and the Dean and the University caved. The politician who added the abortion rider to the bill was simply shocked that an abortion could actually be needed for health reasons. I mean he was gobsmacked. He believed the lie hook, line, and sinker that pregnancy never maims or kills. He was also somewhat shocked that the hospital attorney had tracked him down at night and that he had to explain what he meant by “the life of the mother being in danger” to a doctor. Dear Reader, the hospital attorney was worried we would be sued if this non-doctor didn’t think the woman was sick enough so I had to call and explain modern OB/GYN to Chance the gardener.

After some silence and muttering he said something like, Oh my, just do your doctoring of course. I am sure that even before the receiver hit the cradle the drop of truth that I had forced him to drink was rapidly diluted by the poison he’d been supping since birth and that woman and every single one like her dropped like chaff from his narrow little mind.

No one passing these laws gives a shit about the medicine or the science or the statistics. Really, they don’t. If they did these laws wouldn’t exist and there would be laws providing free long-acting reversible contraception because that’s actually what works. I really believe the assholes in Ohio who voted for the fetal pole cardiac activity bill truly believe that the more than 21,000 women in Ohio who get abortions each year are just doing so because the greedy doctors who run the abortion spa at the mall have frequent BOGOs on pleasure abortions and if these little women just had a firmer hand from the patriarchy they would see the error of their ways. As pregnant women needing abortions won’t be picketing their offices they will take the silence as tactic approval, but who has time to picket and march when it’s tic toc. Women will be panicked making calls to find an out-of-state clinic and many will be raising money. Anyway, even if you do have the cash on hand do you want your face in the paper so your rapist can see you got pregnant? Maybe you don’t want your parents to know not because your are a teen, but because you are a grown ass woman and it’s no one else’s fucking business what you do with your body?

While the press doesn’t write bills or pass laws they do pass on information or in this case subtle misinformation. Using “heartbeat” anywhere in a piece, but especially in the headline, even in quotations is not appropriate. It’s no different from allowing a neo Nazi to self identify as alt-right.

The earliest cardiac activity is seen in a fetal pole and using any other term means that you are lock step with a campaign of misinformation and it’s wrong.

The politicians who write these bills are dealing in misinformation and the press should refuse to play the game.





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  1. Pingback: My title
  2. Why isn’t anyone who thinks abortion is morally wrong the least bit vocal about the fact that pesticides (the ones you carelessly throw on your lawn, the ones killing the bees) cause miscarriage with exposure during the first two months of pregnancy and brain injury thereafter??? The law says anybody can spray it anywhere at any time, with no warning (sometimes they spray it from planes!), and it’s up to a woman to avoid exposure, whether or not she even knows she’s pregnant. As if that were possible. The Republicans won’t allow these toxic substances to be treated as such. But go on about terminating unwanted pregnancies…

  3. I’ve taken to giving an explanation along the lines of they are cardiac cells and they do what they are programmed to do…beat. We don’t view a heartbeat as the only indicator of life anymore; brain activity is a better indicator as one can have only brain stem (primitive brain) function and still have a heartbeat, yet we don’t consider them as “living.” Medical interventions like CPR, defibrillation, ventilators, and vasoactive medications have changed (blurred) the line between life and death. Abscence or presence of a heartbeat means nothing – it’s that and brain activity or lack thereof that is the determining factor.

  4. There are many reasons why individual women in real-life situations opt for an abortion: health problems, fetal anomalies, women not prepared financially and/or emotionally to rear a child, women in abusive relationships, and married couples who decide they just can’t cope with a baby (or another baby so soon after already giving birth) at that point in their lives. Read their stories on the 1 in 3 Campaign website: http://www.1in3campaign.org/

  5. So what is next? Cancer patients being required to provide funeral services for tissue removed? I can’t even imagine the effect on the plastic surgery industry. On a side note, how would teratomas be handled?

  6. I knew those photos were fake can we see a real photo of what the actual
    mass would look like?

      1. Loved the article. Since most people don’t realize what the correct info is what is needed is to put the embryo (life sized) into the hand like the faked photo. Cut the bullshit off at the knees.

  7. At what point during gestation do you suggest that the “yolk sac” or “blob” becomes a human being and cannot be ethically artificially aborted? You can obviously tell I am pro-life, but I am legitimately curious.

      1. Really? Are you under the impression that women are incorruptible in this matter? Do you really think all women (or any other individual) can always be trusted to make a totally fair and objective decision about when a fetus is human and when it isn’t?

    1. At what point does the pregnant woman stop being a human being and her body becomes fair game for another to use against her wishes?

    2. I can’t speak for Dr. Gunter, but among women’s health workers (of which I am one), it’s generally considered that a fetus becomes a separate person when it has reached a gestational age where it can survive outside its mother’s body, although some believe that NICU assistance should be factored into that GA while others don’t. Obviously, if you count NICU assistance, then the GA is much lower–26-28 weeks is a generous estimate, since most micro-premies younger than 28 weeks will not survive, or will survive only with profound disabilities. Even at 26 weeks, most surviving babies will have permanent disabilities that can range from profound neurological damage to deafness, blindness, etc. If you remove NICU assistance from the equation, then 36-37 weeks is generally considered the point at which a baby will likely survive on its own–although 36-weekers often still need medical help to keep breathing for anything from a few days to two weeks. In short, most healthcare professionals have seen from experience that there is no clear answer to your question, but we have seen enough to understand that each case is different, and that there can be no one-size-fits-all rule.

    3. At what point do you think a pregnant woman loses her civil rights and liberties? At what point is a woman not entitled to the same rights as enjoyed by males in this country, which includes bodily autonomy, medical privacy, and the right to make medical decisions concerning one’s own body and bodily contents?

      Don’t like abortion, don’t have one. I don’t know why anti-choicers cannot grasp this simple concept.

  8. Dear Doc,

    God damn, thank God for you. This heartbeat bill business is just preposterous and I thank you for saying so and doing it so well. Please post this in a million places.

    Love, a pre-Roe v. Wade survivor

  9. Thank you for your post.

    I wrote the following (satire that could someday be taken seriously) post when I read about the ridiculous bill.

    I’m going to introduce a bill that will eliminate unwanted pregnancies altogether.

    Instead of dangerously and nefariously limiting abortions to the first six weeks after conception, as proposed in Ohio’s “Heartbeat Bill,” let’s back up a bit more, before conception. Why must the burden of avoiding unwanted pregnancy and dealing with the aftermath be confined to the woman’s body only?

    I propose we give our little boys reversible vasectomies when we give them their circumcisions in the hospital. Later, when they have the urge to implant their seed into the womb of a woman, they can get her permission in writing and take that document to the doctor to have some sperm extracted for AI, or they can even have the procedure reversed once they get married. If legislators truly want to reduce unwanted pregnancies and abortions, they should be willing to shift the attention to the role played by men’s bodies, and address the true cause of this situation at its source.
    I shall nickname this bill the “Nip it in the Bud Bill.”

    Please feel free to share:

  10. You are such a vital part of the picture today and I just wish you had a gigantic audience! Thank you for all you keep trying to do to try and make people UNDERSTAND the difference between what comes from a highly educated mind, yours, and what comes from minds that are collecting, frankly, garbage!

  11. “America,

    Wake the f&€k up and stop listening to the media!!!

    If you want an understandable perspective, do the work and find the research!!! Follow people like Dr. Gunter, who will gladly give you information😎”

  12. It would have been better to show the actual size/development of 5 & 8 week fetus instead of an incorrect picture because it isn’t ‘obvious’ to anyone who isn’t an embryologist why that photo is wrong.

      1. Most excellent article, and it warms my soul to see your frank language in calling out the odious people who lie about abortion. I hope it’s widely distributed. Could you please contact the Associated Press and ask them to put an entry for “heartbeat bill” in their AP Stylebook? It might not do any good, but it’s a start to getting the press to acknowledge at least that there’s a problem with that terminology.

        But I’m with Don in that I can’t figure out what I’m seeing in the ultrasound photo. What is the hole in the middle? And is everything outside of the yolk sac the embryo? Sorry if this seems obtuse of me, but I think I’m in good company in needing more help when it comes to comprehending ultrasound pictures. Thank you.

    1. I was not at all in favor of the ‘heartbeat law’ but the 20 week law was easy to support. The reasons were well documented and valid.

      However, as a physician I am appalled that over 3000 abortions occur in the US every day! That’s fetocide of an unimaginable degree an incompatible with the Hippocratic Oath. JMO

      Terence Clark, MD

      1. There are no valid reason for an abortion ban at 20 weeks.

        DO you know who gets abortions at 20 weeks? Most are women who have fetal anomalies, some are women with ruptured membranes or infections and others are medical disenfranchised who couldn’t access care sooner. The end.

        The Hippocratic Oath tells me support the living person, i.e. the woman.

        If you have an issue with abortion the #1 cause is unplanned pregnancies so I assume that is how you spend your day, helping women get IUDs and Implanon.

      2. We will just have to disagree on the definition of a living person is. Do you think a 19 week fetus can feel pain?

      3. It is entirely possible that some fetuses will develop at an accelerated rate? Is there even a remote chance that they could sense pain? I would say yes.

        Your list of reasons for women to seek abortions was somewhat misleading.

        How ’bout:

        Birth control (contraceptive) failure. …
        Inability to support or care for a child.
        Already have a child or more
        To end an unwanted pregnancy.
        ‘Second thoughts’

        Studies also suggest that many of those wanting abortions are of lower socio-economic status and are NOT properly counseled about their options ( ie. are you sure about your finances?; is the father in agreement?; advice about the many couples anxious to adopt a child ( mother could even benefit economically)?; frank discussion of the downside of an abortion ( physically and emotionally); why don’t you sit on the decision for a short period of time. etc

        My sense is that a lot of abortion candidates, while they may receive ‘some’ advice before the procedure, don’t receive all that thorough of an evaluation. Your thoughts.

        Do you ever try to talk a patient out of an abortion?

        Do you make accommodation to those who are morally against abortions?

      4. If you are appalled about the number of abortions support the following: Comprehensive health education for all. Easy availability of a broad range of means of contraception, especially long-acting reversible means – to all. Social policies supporting women with children – from paid family leave to affordable high quality daycare for all, support for buying essentials such as diapers and nutritious food. Each one of these will reduce the number of abortions without reducing women’s rights.

      5. Come now, Mr. Clark. You’re a doctor. You should know that most embryos never make it through the reproductive process, Maybe you need to read Toby Ord, 2008, The Scourge: Moral Implications of Natural Embryo Loss: The American Journal of Bioethics, 8(7): 12–19.

        Hmmm….but you are a MALE doctor, who will never endure an unwanted or complicated pregnancy. I’d never have you as my physician with your attitude towards women.

        Click to access scourge.pdf

      6. How do you handle the fact that 1/3rd to 1/2 of all pregnancies end in natural miscarriage? Is God a mass-murderer?

      7. There is nothing in the literature that suggests a fetus at 19 wks can feel pain; conclusions trend strongly in the other direction. Because you indicated a fetus at 19 wks is a “living person,” I’m sincerely curious: If this fetus and a 28 year old person (the latter, screaming for help and dear life), were in a burning building, and you could only save one, which one would you save ?

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