Ohio’s six-week abortion ban became law last week, just hours after the U.S. Supreme Court overturned Roe v. Wade and punted control of the procedure to states.
Republican lawmakers passed legislation in 2019 that prohibits abortions after about six weeks into a pregnancy. Advocates for abortion access sued over the measure, known as the heartbeat bill, and a federal judge put the law on hold while the fate of Roe was determined.
The court lifted the injunction in that case late Friday at the request of Attorney General Dave Yost, allowing the law to take effect.
Here’s what you need to know about the six-week ban.
When is abortion legal in Ohio?
Abortions are permitted until cardiac activity is detected, which usually occurs at about six weeks gestation. Physicians mark the start of a pregnancy by the first day of the person’s last menstrual period, so many people don’t know they’re pregnant before six weeks unless they have a regular cycle.
Are there any exceptions?
Abortions beyond this threshold are legal if the provider determines it’s a medical emergency and necessary to prevent the pregnant person’s death or “serious risk of the substantial and irreversible impairment of a major bodily function.” There are no exceptions for cases of rape and incest or fatal fetal anomalies.
What constitutes a medical emergency is not clear and left to “the physician’s reasonable medical judgment.”
“We are even now still working out the details and trying to figure out processes, as are many places across the state,” said Dr. David Hackney, a maternal fetal medicine specialist and chair of the Ohio chapter of the American College of Obstetricians and Gynecologists.
State statute does define a “serious risk” as conditions including pre-eclampsia, inevitable abortion and premature rupture of the membranes. Those conditions may also include, but are not limited to, diabetes and multiple sclerosis.
The law explicitly says mental health conditions do not qualify as a “serious risk” that warrants terminating a pregnancy.
Is there a heartbeat at six weeks?
Ohio’s law specifically references a fetal heartbeat, but experts say that phrase is misleading.
What people actually hear around six weeks of pregnancy are electric impulses captured by the ultrasound machine and translated into the sound of a heartbeat, said Dr. Nisha Verma, an obstetrician-gynecologist and fellow with the American College of Obstetricians and Gynecologists.
A heartbeat is the sound of cardiac valves opening and closing, but the embryo does not have cardiac valves at this stage. The heart is not fully developed, either.
“Scientifically, this is not a particularly important part of fetal cardiac development, even though it may be an important moment for my patients who are connecting with their pregnancies,” Verma said. “This arbitrary moment in the development of a pregnancy absolutely should not be the basis of restrictive legislation.”
Can I be prosecuted for having an abortion?
Pregnant people can’t be criminally charged for having an abortion after cardiac activity is detected, nor are they liable in civil cases.
Doctors who provide an illegal abortion face a fifth-degree felony. The State Medical Board can also pursue disciplinary action against doctors who don’t maintain the required medical records for abortion procedures. The board can fine them up to $20,000 for each violation.
Can I get an abortion out of state?
Yes. Ohio law does not prevent people from crossing state lines to get an abortion.
Senate President Matt Huffman said last week that he doesn’t anticipate the state trying to restrict that in the future.
“We’re not going to be able to prevent that,” Huffman said. “People go to Colorado to smoke marijuana recreationally.”
What if I lose my pregnancy?
Anyone who experiences a spontaneous pregnancy loss can and should seek medical care, said Dr. Amy Burkett, an OB-GYN hospitalist in northeast Ohio. If cardiac activity is present, Burkett said providers would need to fill out the paperwork required for abortions.
“If their health is at risk, we will take care of them, and if we need to refer them, we will make those appropriate referrals,” Burkett said.
How does this affect ectopic pregnancies?
An ectopic pregnancy occurs when a fertilized egg implants and grows somewhere outside the uterus, usually in a fallopian tube. The egg will not survive when this occurs, and it can be life-threatening to the pregnant person.
Because of that, ectopic pregnancies are exempt from Ohio’s six-week ban.
“If you’ve gotten far enough in the pregnancy that you see an ectopic with a heartbeat, that’s an emergency surgery,” said Dr. Catherine Romanos, a family physician based in Columbus.
Is contraception still legal? What about IVF?
Contraception is still legal in Ohio. Nothing in the six-week ban bars access to birth control and emergency contraception such as Plan B.
In vitro fertilization can also proceed under this law, said Dr. Thomas Burwinkel, a fertility specialist in Cincinnati.
But IVF providers are concerned that House Bill 598 – the state’s proposed total ban – could put them out of business. The bill specifies that the life of an unborn child begins at fertilization, which Burwinkel said could make doctors liable if an accident occurs or a couple requests that their embryos be discarded.
USA TODAY Network Ohio Bureau reporter Anna Staver contributed.
Haley BeMiller is a reporter for the USA TODAY Network Ohio Bureau, which serves the Columbus Dispatch, Cincinnati Enquirer, Akron Beacon Journal and 18 other affiliated news organizations across Ohio.
