Doctors' organization: calling abortion bans 'fetal heartbeat bills' is misleading

American College of Obstetricians and Gynecologists says term does not ‘reflect medical accuracy or clinical understanding’

America’s largest professional organization for doctors specializing in women’s health has come out against the term “fetal heartbeat bill” to describe abortion bans recently enacted by US states.

The president of the American College of Obstetricians and Gynecologists called the bills “arbitrary” bans not reflective of fetal development or science.

“Arbitrary gestational age bans on abortion at six weeks that use the term ‘heartbeat’ to define the gestational development being targeted do not reflect medical accuracy or clinical understanding,” said Dr Ted Anderson, president of ACOG. The organization represents 58,000 physicians across the US.

“Pregnancy and fetal development are a continuum. 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,” Anderson said.

“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,” Anderson said. The ACOG president called on politicians to base policy on “science and evidence”.

In addition, the Guardian has updated its style guide more accurately to reflect abortion bans spreading across the United States.

Instead of using “fetal heartbeat bills”, as the laws are often called by anti-abortion campaigners, the Guardian will make “six-week abortion ban” the preferred term for the laws, unless quoting someone, in order to better reflect the practical effect of the laws.

State abortion bans have been enacted from Ohio to Kentucky, in a new and severe strategy from rightwing groups pushing to make abortion illegal. The bans, dubbed “heartbeat” bills by supporters, have the practical effect of banning abortion before most women know they are pregnant.

Abortion is legal in all 50 states despite the bans. Anti-abortion campaigners hope the court battles will prompt the US supreme court to reconsider the 1973 landmark decision Roe v Wade, which legalized abortion. The laws are all expected to be challenged in court, and are highly unlikely ever to go into effect.

While states have long sought to heavily regulate abortion, outright bans on the procedure were once rare. Nevertheless, abortion care has not always remained accessible. Highly restrictive state regulations have driven many clinics out of business. There are six states that each have only one abortion clinic. In Missouri, the state’s last remaining abortion clinic is fighting the state health authorities in order to stay open.

Obstetrician and gynecologist Dr Sarah Horvath said that accurately describing the bans is important, to avoid confusion among patients and providers alike.

“I don’t think the coverage tends to line up with medical reality,” said Horvath. “No one seems to know what is allowed – and what isn’t – even when it’s medically appropriate,” she said.

Several state bans allow for criminal penalties for doctors performing abortions, including a 99-year penalty in Alabama. Physicians said the bans, if they ever went into effect, will have life-threatening consequences for women.

“There’s this noble ideal you all have,” she said about reporters, but added, “But one is a viewpoint, and one is science and medicine.”

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The steep drop in teen pregnancies and abortions in Colorado since 2009 is mainly due to one thing: free, low-cost access to IUDs.

Intrauterine devices — tiny, T-shaped pieces of plastic placed in the uterus — are the main reason Colorado’s teen birth rate fell 54 percent and the teen abortion rate declined 64 percent in the last eight years, state health officials said Thursday.

The astounding numbers, capturing the eight-year period since IUDs became an affordable option for low-income health clinics, were released along with a study estimating the state avoided paying nearly $70 million for labor and delivery, well-baby check-ups, food stamps and child-care assistance because of fewer births to teen moms.

“This is one of the biggest public-health home runs that I’ve seen in my 35-year public-health career,” said Dr. John Douglas, executive director of the Tri-County Health Department, which has six clinics in Douglas, Arapahoe and Adams counties. “The work that’s happened is really striking.”

Thanks to a grant from billionaire Warren Buffett’s family, Colorado spent $28 million during eight years supplying IUDs to 75 public health clinics throughout the state, several based inside high schools. From 2009 to 2016, the program provided 43,713 contraceptive implants to women, plus trained medical staff on how to insert the devices.

“Because of that, everything changed,” said Jody Camp, who oversees the state health department’s family planning program. “People started hearing about it, saying ‘Wait, I can get one of those (IUDs) that my girlfriends with insurance have?’ It caught on like wildfire in a really important way.”

Before 2009, clinics typically couldn’t afford to spend up to $350 per patient who wanted an IUD, instead offering lower-cost options including the patch, monthly contraception shots or birth-control pills, which cost a clinic as little as $1 per pack. Some clinics, including in Tri-County, had an IUD wait list.

Pills, patches and rings often aren’t reliable birth control for teens and young women, Camp said. IUDs, though, can prevent pregnancy for three, five or even 10 years, depending on the type.

“That can change the trajectory of your life,” she said.

Colorado’s “teen fertility rate,” measured in births per 1,000 by teens aged 15-19, has dropped considerably faster than the national rate, also in decline. From 2009 to 2014, the U.S. rate decreased from 37.9 to 24.2 births. In Colorado, the rate dipped from 37.5 to 19.4.

The program was a “game-changer” for Tri-County’s clinics, said Lauren Mitchell, the department’s family planning nurse coordinator. The health department partnered with a campaign called “Before Play” to advertise, and teens walked in asking for long-term, reversible contraceptives.

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