This morning, millions of people in Texas woke up to the nation’s most restrictive anti-abortion law. The majority-conservative Supreme Court did not respond to a last-minute emergency block motion from the American Civil Liberties Union, ensuring that Senate Bill 8 goes into effect today, September 1. The new state law outlaws abortions after six weeks from conception — before most people know they’re pregnant. There are no exemptions for rape and incest.
In a particular twist of legal cruelty, Texas state officials technically do not enforce the law. Instead, SB8 deputizes individual civilians, allowing them to sue anyone who “aids and abets” an abortion procedure after six weeks — effectively creating a vigilante network of anti-abortion crusaders.
Given that the majority of people getting abortions in Texas are past six weeks, SB8 has the de facto effect of banning all abortions. Obviously, this is a healthcare disaster for Texas — and a dangerous legal precedent for the country as a whole. Here’s what you need to know about the law, and actionable ways to help Texans in need.
Why does the abortion ban begin at six weeks?
Sponsors of the bill claimed that a fetal heartbeat can be detected at six weeks of gestation. However, this language is medically misleading, said Dr. Ted Anderson in 2019, the then-president of the American College of Obstetricians and Gynecologists. He explained to the Guardian that “What is interpreted as a heartbeat in these bills is actually electrically induced flickering of a portion of the fetal tissue that will become the heart as the embryo develops...Thus, ACOG does not use the term ‘heartbeat’ to describe these legislative bans on abortion because it is misleading language, out of step with the anatomical and clinical realities of that stage of pregnancy.”
The Supreme Court has also repeatedly affirmed that patients have a right to obtain an abortion before the fetus is viable, which the ACOG says occurs “much later in pregnancy” than six weeks.
How does the new law affect those seeking an abortion, in medical terms?
In the immediate sense, the clock is now ticking for patients needing an abortion.
At conception, an egg cell (or cells, in the case of fraternal twins) is fertilized by a sperm cell and the next menstrual cycle is missed. Now, the clock ticks backwards, because the ACOG defines the beginning of pregnancy as “measured from the [patient’s] last menstrual period (LMP).” In other words, if, hypothetically, you conceived today, and your last menstrual period was two weeks ago, you are now considered two weeks pregnant. Given that a typical menstrual cycle lasts between 21 and 40 days, according to the National Health Service, this doesn’t offer much of a time window for patients to determine if they are pregnant — especially if their menstrual cycles are irregular.
This is the first danger for Texans. Given that periods begin at LMP, irregular cycles can make it difficult for a person to suspect that they are pregnant. Menstrual cycles are notoriously irregular for a variety of reasons. According to the National Institutes of Health, medical reasons include thyroid dysfunction, use of hormonal birth control or IUDs, use of hormone therapy, diabetes, Cushing’s syndrome, endometriosis, pelvic inflammatory disease, malnutrition (either directly resulting from an eating disorder, mental disorder, substance use disorder, or abuse/neglect/housing status/income; or secondary to another medical condition, such as cancer, inflammatory bowel diseases, and autoimmune conditions), sexually-transmitted infections, polycystic ovarian syndrome, anemia, perimenopause, and the list goes on.
Some prescription medications, including steroids, antipsychotics, and antiepileptic drugs — which treat epilepsy, migraines, and bipolar disorder — can cause irregular periods. For adolescents, irregular menstrual cycles are common and may not always indicate a medical condition. Even stress or exercise can cause a skipped period, according to the Penn State College of Medicine. And Planned Parenthood notes that some otherwise healthy people never experience regular periods, or regularity fluctuates throughout their life.
As you can see, there so are so, so many reasons why a person may not think twice about their skipped period.
Let’s get back to conception, which, as stated above, is not the medically-defined beginning of pregnancy. Some immediate symptoms of pregnancy resemble — you guessed it — premenstrual syndrome, like breast tenderness, cramping, frequent urination, spotting, and bloating, making it easy for someone to assume that a period is coming, and thus, they are not pregnant. This is especially true for adolescents who aren’t as in tune with their developing bodies yet, as well as those who experience dysphoria related to getting their period.
At this point, a skipped period may prompt some people to obtain a pregnancy test. At-home and clinical pregnancy tests both detect the presence of human chorionic gonadotropin, a hormone that is released by trophoblasts — these are cells that develop around the embryo during its blastocyst stage, around 5-6 days after fertilization. Some less-accurate pregnancy tests can determine HCG in urine around 10 days after unprotected sex, but Planned Parenthood advises patients with irregular periods to take a test three weeks after unprotected sex for the most accurate results.
Between irregular menstrual cycles, the days in between conception and blastocyst HCG production, and accuracy of pregnancy tests, we’re now at about four to five weeks into a pregnancy, and by then, Texans would have very little time left to obtain an abortion to meet the six-week deadline.
How does the new law affect those seeking an abortion, in logistical terms?
Above, you can see how medical issues make it difficult for people to know if they are pregnant within 4-6 weeks. Assuming they decide to obtain an abortion, there are now a variety of logistical issues that Texans must contend with.
Most immediately, Texas law requires unmarried unemancipated minors to obtain written permission from their parents or guardians in order to get an abortion. Having to disclose to parents is scary enough, but now, minors have the added pressure of very little time. Minors can seek permission from the court to get an abortion without informing their parents, but that may take too long to meet the six-week deadline, if they get an approval in the first place, or afford the legal fees.
Patients also need to locate an abortion-providing clinic. There are only 11 Planned Parenthood locations in Texas and Whole Women’s Health operates four clinics in the state — all serving 30 million citizens in the nation’s second-most populous state.
Assuming patients can drive hours to their nearest clinic, and can afford the fees (which are not covered by Medicare or Medicaid), they must now contend with the six-week ban. If they are past six weeks, they need to travel hours to obtain abortions in other states — obviously, this is a huge time, financial, and logistical burden.
What about this private individual deputizing thing?
OK, this is where it gets even worse for Texans. In a sneaky legal maneuver, SB8 gets around Roe vs. Wade’s right to privacy by not allowing the state to enforce the ban. Instead, the new law effectively deputizes Texas citizens to enforce the law through civil court.
Anti-abortion vigilantes are now empowered to sue anyone they suspect of “aiding and abetting” abortions, including, but not limited to, abortion-providing physicians and nurses, administrative clinic staff, grassroots and large-scale abortion activist groups; even Uber/Lyft drivers, taxis, public transportation agencies, and family/friends that transport patients to receive abortions. As the New York Times explains, “Plaintiffs, who need not have any connection to the matter or show any injury from it, are entitled to $10,000 and their legal fees recovered if they win. Prevailing defendants are not entitled to legal fees.”
Patients are fearing legal reprisals from anti-abortion activist groups, abusive partners and family members, trolls, and anyone else who has a vendetta — it’s truly a terrifying state of affairs.
What can people outside of Texas do to help?
This is tough, because direct action isn’t going to change the law immediately, nor is it possible to arrange a grassroots abortion network on a Texas-sized scale overnight. Realistically, the best thing people can do is donate to Texas-based abortion funds. The funds arrange payment for transportation, medical fees, child and elder care, housing, and other costs associated with getting an abortion. Such funds will now be needed to transport patients to neighboring states, making the need for financial donations even greater.
Here are some abortion funds for Texas citizens that you can donate to today:
There are also a variety of Gofundmes and direct individual calls for money circulating all over social media — these aren’t vetted, of course, and use your own discretion if you choose to donate.