by Bailey Shoemaker Richards
Bailey Shoemaker Richards is a writer, feminist activist, and market research analyst. She holds a BA in creative writing from Ohio University.
Ohio is latest on the list of states where anti-choice legislation is being proposed, and House Bill 200 is an impossibly restrictive bill. HB 200, introduced as part of an omnibus anti-abortion bill, was brought by Representative Ron Hood and is backed by 34 Republicans. HB 200 restricts access to abortion in multiple ways, relying on the same tactics that anti-choice activists use everywhere to chip away at access to reproductive health services and the right to bodily autonomy.
What has not been widely reported as yet, in addition to the fact that this bill infringes on Ninth Amendment rights, is that HB 200 is another so-called “Heartbeat Bill.” Buried in the bill, proposed HB 200 §2317.56 (A)(3) is an amendment that says a “viable pregnancy” is one in which “cardiac activity is present,” making abortion illegal beyond that point. Compare this to current §2901.01 (B)(1)(a)(ii): a “person” is an “unborn human who is viable.” According to §2901.01 (B)(1)(c)(i), an “unborn human” is “an individual organism of the species Homo sapiens from fertilization until live birth” and “Viability,” according to §2901.01 (B)(2)(c)(ii), is “the stage of development of a human fetus at which there is a realistic possibility of maintaining and nourishing of a life outside the womb with or without temporary life-sustaining support.”
HB 200 attempts to essentially redefine the meaning of viability in this clause, altering it to the point at which there is a heartbeat and effectively altering current §2919.151 (B) to make ending a “viable” fetus a felony. Fetal heartbeats can be detected very early in a pregnancy, when many people are unaware they are even pregnant. In effect, HB 200 will make abortion illegal for the vast majority of individuals who would seek one.
Despite the fact that full-color 360 ultrasounds are not medically necessary, the bill requires that doctors perform an ultrasound on patients seeking an abortion, which must be paid for out-of-pocket. This mandates transvaginal ultrasounds for patients who are less than 12 weeks pregnant, as the bill requires a full view of the embryo and external ultrasounds cannot get a complete image. The ultrasound requirement has a number of adverse effects on people seeking abortion care.
Transvaginal ultrasounds may add further trauma to the experience of patients seeking an abortion following a sexual assault, compounding the psychological and physical pain of the experience. These ultrasounds will also increase the cost of an already expensive procedure, potentially making abortion care unattainable for low-income patients. The Guttmacher Institute (At What Cost? Payment for Abortion Care by U.S. Women, 2013) reports that the majority of individuals pay out-of-pocket for abortions already, with additional costs coming from travel, childcare (60% of U.S. patients seeking an abortion already have at least 1 child), and lost wages.
Additionally, as with many of the provisions in HB 200, it places the government in the doctor’s office and forces ideological concerns to take precedence over the health of individual people.
HB 200 requires that doctors provide a mandatory description of ultrasound images and a heartbeat, if one is present. As with the full-color 360 ultrasound, there is no medical necessity for this action. It is designed only to induce feelings of guilt or shame in a patient seeking an abortion. The social stigma associated with abortion, in addition to the lack of medical necessity of this description, is intended to shame individuals into keeping a pregnancy they do not want or cannot carry to term.
The bill extends the waiting period for an abortion from 24 to 48 hours and removes the exception for medical necessity in favor of medical emergencies. While the exception for medical emergencies remains, it has been redefined under section 2317.56 (A)(1) to apply only to patients who will die without the abortion. Despite that exception, this extension will result in the deaths of patients seeking abortion, without question. Whether they develop further medical complications as the result of the delay, or are forced to seek out unlawful abortions under unsafe conditions, the 48-hour waiting period will cost people their lives.
In addition, a 48-hour waiting period will make abortion inaccessible for many individuals. Abortion procedures frequently require absence from work; for low-income patients, taking 2 days off of work to travel for a costly medical procedure is an unaffordable expense, and can in some cases cost them their jobs. The waiting period requires individuals to miss work for an initial appointment, wait 48 hours, and return for a procedure – an impossible cost for many people. The waiting period will disproportionately affect low-income patients and people of color who need access to abortion services as a result.
HB 200 requires doctors to tell their patients that the fetus can feel pain, despite the fact that this claim is unsupported by medical evidence. The medical community remains divided on whether fetuses feel pain and if so, at what point in the pregnancy. Pain is a subjective matter for those who are cognizant of pain in and of itself. As it is used in this statutory proposition, pain is something that is used to deter individuals from seeking abortion. It is little more than a play on words, and an obfuscation tactic to elicit a specific emotional reaction. Forcing doctors to provide controversial and unsupported information to patients is purely an ideological act, and is designed to cause feelings of guilt in those seeking abortion care.
The bill forces doctors to tell patients that there is a link between abortion and breast cancer, despite the fact that the medical community has established that no such link exists.Multiple studies have shown that abortion is unrelated to breast cancer, including:
- A Danish study of over 1.5 million women that showed no link
- A 2007 Harvard study of over 100,000 women that showed no link
- A 2008 California Teachers Study of over 100,000 women that showed no link
- The U.S. Cancer Institute’s expert analysis by over 100 of the world’s leading researchers on pregnancy and breast cancer that showed no link between abortion and breast cancer, but demonstrated a link between live birth and a slightly elevated risk of breast cancer
- The American Congress of Obstetricians and Gynecologists, in both 2003 and 2009, showed that earlier studies touting a link between abortion and breast cancer were methodologically flawed, and that no link exists between them
Forcing doctors to provide medically unsound information to their patients is a breach of doctor-patient trust, and intended solely to frighten individuals into carrying an unwanted pregnancy to term. It also presents an ethical violation for doctors, who are required to provide inaccurate medical information to patients.
HB 200 requires doctors or facilities to provide a “written statement divulging gross income” from the prior year, including the percentage related to abortion services. This action has no medical relevance whatsoever for patients or doctors. Information on individual or facility incomes is not provided for routine examinations or other medical procedures, and the motivation for including this requirement is wholly ideological. It is designed to make abortion seem like a for-profit activity, rather than a legal medical procedure.
HB 200 punishes doctors who do not comply with these restrictions with a first-degree felony and a fine of up to $1 million, a much higher penalty than most felonies incur. These punishments are intended to force doctors out of the practice of providing abortions based on the fear of felony charges and absurd fines. This reduces the number of doctors that patients will be able to seek out for reproductive health services, increasing the cost of abortion and making it more likely that they will find illegal practitioners, exposing them to health risks.
The implementation of a stringent code of requirements and restrictions on the seeker of an abortion cannot be said to be anything other than a constructive blockade to Ninth Amendment rights. It is clear that the Republican-dominated Ohio Legislature is only appeasing a highly religious demographic, based on the language in the proposed Bill. The exaggerated breadth of the legal ramifications and retribution extracted from doctors is reflected in the extreme nature of HB 200’s proposed §2317.56(I). The punishment and felonious context in which this Heartbeat Bill is placed is in a similar context to that of the War on Drugs: intrinsically and exclusively political, ineffective and inefficient, and counterproductive.
We do not stand poised to raise the flag against a sociological problem. Rather, we stand poised to dominate and control the uterus of the masses of those who deserve nothing less than the freedom to choose what they should do with their own bodies. The decision reflected here, to determine when a pregnancy is viable, is a theological one – at best – and only ideology could drive one to feel that they have the power to determine when a life begins and a pregnant person’s freedom ends.
To contact your Ohio legislator and let them know your feelings on HB 200, visit The Ohio House of Representatives.
[Editor’s note: more people than just cis women need and want access to abortion care.]
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