What does ‘Heartbeat Bill’ mean for pregnant rape victims, cancer patients?

Kina Johnson, left, and Natajah Williams, Client Support Coordinators, at the YWCA Rape Crisis Center in downtown Dayton. MARSHALL GORBY\STAFF

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Kina Johnson, left, and Natajah Williams, Client Support Coordinators, at the YWCA Rape Crisis Center in downtown Dayton. MARSHALL GORBY\STAFF

A week after Ohio’s “Heartbeat Bill” banning most abortions in the state after about six weeks suddenly became law following the fall of Roe v. Wade, Ohioans are grappling with the ramifications for women who are rape victims or have health issues or pregnancy complications.

The law contains an exception allowing abortions to save the life of the pregnant woman, but a representative with Women’s Med Center in Kettering — one of the few remaining abortion providers in Ohio — said the center’s attorneys find the law “extraordinarily poorly written and confusing.”

A patient with melanoma had to get an abortion before receiving treatment, for example, but “the intricacies of her particular medical condition are not addressed in the law thus creating a significant gray area,” the representative said.

Women’s Med Center sent her to a Women’s Med Center facility in Indianapolis to get an abortion.

Ohio’s Heartbeat Bill says someone who performs an abortion after detection of a fetal heartbeat can be found guilty of a fifth degree felony and face discipline and fines from the State Medical Board of Ohio.

“The prohibition does not apply to a physician who performs a medical procedure designed or intended, in that physician’s reasonable medical judgment, to prevent the death or a serious risk of the substantial and irreversible impairment of a major bodily function of the pregnant woman,” according to a legislative analysis of the bill.

This includes conditions like pre-eclampsia, inevitable abortion and premature rupture of membranes, as well as possibly diabetes and multiple sclerosis, the analysis says. It does not include conditions related to the woman’s mental health.

The law spells out steps a doctor must take to declare in writing that the abortion is necessary.

Mike Gonidakis, president of Ohio Right to Life who sits on the state medical board, said this allows women to receive an abortion if it’s necessary for life-saving treatment.

“If they believe this is needed to do to save this woman’s life then do it,” he said. “But you have to put it in writing and explain it to the Ohio Department of Health.”

Law ‘vaguely worded’

But the law isn’t clear-cut, according to Jessie Hill, law professor at Case Western Reserve University specializing and reproductive rights in Ohio and lead attorney on a lawsuit against the Heartbeat Bill that was filed this week before it was ruled against by the Ohio Supreme Court.

Hill said the language of the law makes it uncertain if a woman could get an abortion because she was diagnosed with cancer that isn’t terminal — but could be if care is delayed — or if she has an illness that affects her health but doesn’t complicate the pregnancy.

“This law is very vaguely worded and very poorly written and creating a lot of distress for people trying to figure out what it means and having to operate under it now,” Hill said.

Hill said the ban only applies to intrauterine pregnancies, so ectopic pregnancies could still be ended. And miscarriages could still be aborted if needed.

Hill also said the law doesn’t include exemptions for fatal fetal anomalies where the child is unlikely to survive after delivery.

Gonidakis said the law can’t contemplate every “hypothetical,” but physicians should follow standards of care to preserve the life of the mother and child.

“There have been many instances where a mother is told their baby won’t survive and does survive,” he said. “The law as drafted and signed by the governor prevents abortions once the fetal heartbeat is detected.”

No rape, incest exception

The law also includes no exemption for victims of rape or incest. This is concerning for Amy Dudley, director of the YWCA Dayton Center for Survivors of Sexual Violence.

“It is cruel and unusual punishment and no female should have to carry a pregnancy by force to birth unless they made the choice to,” she said.

Dudley said the YWCA offers counseling to survivors of sexual violence, many of whom are trying to find a return to normalcy after the trauma of rape.

“They’re seeking to be whole again and being pregnant from a rape is not being whole,” she said.

Heartbeat Bill proponents say the six-week window gives rape survivors time to address this.

“You don’t know you were raped for two months?” said U.S. Rep. Warren Davidson, R-Troy, recently when asked about this in a CNN interview. “I think it’s incorporated in to deal with that. That is a compromise. People believe that life begins at conception.”

Dudley said emergency contraceptive offered to rape victims loses effectiveness for women over a certain weight. And trauma interrupts menstrual cycles, impacts rational thinking and often prevents women from reporting or coming to terms with what happened for some time.

In cases of incest or a young victim the girl may not have access to medical care or know what is going on until the pregnancy presents itself well past six weeks, she said.

Dudley said some survivors opt to have the baby but end up fighting in the court system against the perpetrator who has custody rights he may use to extend control over the woman.

“We have a legal system that is not protecting (survivors),” she said.

$1B to help children, mothers

Many abortion opponents say they don’t believe a rape should result in the death of an unborn child, even though they agree that it is a heinous crime.

“We believe all life is sacred and all life should be preserved and protected … from conception until natural death,” said Gonidakis. “At Ohio Right to Life we’ve never believed an abortion is an ethical thing to do except to save a mother’s life, period.”

Asked how the state will support women unable to access abortion — especially those who were victims of rape — a spokesman for Ohio Gov. Mike DeWine pointed to the governor’s statements the evening the Supreme Court released its order overturning Roe v. Wade.

DeWine touted his “Bold Beginning” initiative, investing more than $1 billion into prenatal care, parenting classes, mentoring, education, and nutrition assistance for pregnant women and their families. DeWine said he directed Ohio’s health and human service agencies to seek innovative ways to ensure vulnerable mothers are identified and receive help.

“In the weeks ahead, I will be working with the General Assembly and our local communities to improve the quality of pre- and post-natal care, to increase the frequency of maternal depression screenings, and to expand mental health resources for women who experience miscarriages,” he said.

He said they will also increase awareness of adoption and seek to expand healthcare coverage to mothers and children.

While abortion rights advocates lament the new law, and medical providers work to understand its implications, abortion foes are celebrating reports of abortions being cancelled.

“The Heartbeat Law is potentially saving dozens of children from being killed by abortion each day, and we must work to keep it that way,” said Mark Harrington president of the anti-abortion group Created Equal. “Ohio is on the path to completely ban abortion and protect every human life, despite the efforts of abortion advocates.”

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