With ‘Heartbeat’ Law, Texas Instates Near-Total Ban on Abortion

New abortion restrictions began in Texas on Wednesday, banning the procedure as early as week six of pregnancy. The law, which was originally signed by Gov. Greg Abbott in May, sharply curtails access to abortion in the country’s second-most populous state.

Hours after the law went into effect, the United States Supreme Court declined a request to block the measure until it could undergo further legal review. Legal challenges are underway, but the decision alarmed pro-choice advocates — and, some argue, it may signal the slow demise of the court’s landmark precedent in Roe v. Wade. “The Supreme Court has abandoned the constitutional right to abortion,” Slate legal analyst Mark Joseph Stern wrote on Thursday.

Another piece of legislation, which is still awaiting a signature from Gov. Abbott, would restrict access to medication abortion in the state after seven weeks of pregnancy, and bar mailing abortion pills in Texas.

In an attempt to fend off legal challenges, the Texas law that went into effect this week does not call for state enforcement. Instead, it gives private citizens the ability to sue anyone who provides or assists with an abortion. The legislation is part of a raft of bills that aim to restrict abortion after the detection of a so-called fetal heartbeat, which the Texas bill defines “as cardiac activity or the steady and repetitive rhythmic contraction of the fetal heart within the gestational sac.” (Medically speaking, an embryo is not considered a fetus at six weeks of pregnancy.)

That cardiac activity is detectable by a transvaginal ultrasound during the first trimester, and physicians and websites for prospective parents routinely refer to it as a heartbeat. Many medical experts, however, argue that such terminology is a misleading characterization of what is, in effect, electrical activity in a group of cells that have not yet formed a heart. “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,” Ted Anderson, then-president of the American College of Obstetricians and Gynecologists, or ACOG, told The Guardian in 2019. This week, ACOG was among the organizations decrying the Texas bill as a restriction on essential health care services for women.

But other recent developments may make abortions more accessible even for people living in increasingly restrictive states. While most abortions in the U.S. require at least one visit to a clinic, some providers have recently explored remote medication abortion services, taking advantage of a temporary change to federal policy early in the Covid-19 pandemic. Under this model, people seeking an abortion can undergo a digital screening and receive pills in the mail. As Rebecca Grant reported for Undark earlier this year, a growing body of research suggests that such telemedicine abortion services can often offer a safe — if not always legal — alternative to in-person care, at least early in a pregnancy.

Right now, federal regulations limit telehealth abortion services, and pending Texas legislation would add further legal barriers. Those obstacles have not stopped some providers from sending the pills by mail. Already, the advocacy organization Plan C, which helps connect people with remote abortion services, has begun advertising in Texas cities.

Also in the News:

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• Results are in from the most extensive scientific study to date on the effectiveness of mask-wearing in curtailing the spread of Covid-19. And experts say the data leave little doubt: Masks work. The new study, which is still undergoing peer review, is notable because it was a randomized controlled trial, considered the gold standard for studying health interventions, and because it was enormous, tracking more than 340,000 participants in rural Bangladesh. (An earlier, much smaller randomized controlled trial conducted in Denmark last year yielded inconclusive results.) In the Bangladesh study, researchers partnered with local officials and leaders to distribute masks and encourage mask wearing in hundreds of Bangladeshi villages. They then compared health outcomes in those villages with outcomes in villages that hadn’t received the interventions. In places where the masking measures were deployed, the rate of mask-wearing jumped by nearly 29 percentage points, and the prevalence of Covid-19 — inferred from blood tests and reported symptoms — fell by more than 9 percent. The effect would likely have been even stronger, the researchers say, with more widespread masking. Speaking to The Washington Post, Brown University professor and emergency medicine physician Megan L. Ranney, who was not involved with the research, called it an incredibly challenging study to pull off. “Anti-mask people keep saying, ‘Where’s the randomized controlled trial?’” said Ranney. “Well, here you go.” (The Washington Post)

• The recent Taliban takeover of Afghanistan has alarmed many scientists there, who worry about their futures and the futures of their institutions. The last time the Taliban took power, in 1996, the group enforced strict laws that suppressed freedom of expression and women’s rights. After the U.S. and other countries overthrew the regime in 2001, though, universities began to flourish. According to Nature, since 2004, with aid from the World Bank and other organizations, millions of dollars poured into universities for research and staffing, and several public and private universities were established. Thousands of women began enrolling in universities, many studying science. Now, it’s unclear whether academic programs will continue to operate under the Taliban. Academics and scholars, especially women and members of some marginalized ethnic groups, fear persecution for being at odds with the Taliban ideology. These scholars are also worried that, without funding and academic freedoms, educated people will flee the country and undo the progress of the last 20 years. “We spent all our money, energy, and time in Afghanistan to build a brighter future for ourselves and our children,” said Musa Joya, an Afghan medical physicist who lectures in Kabul and also holds an academic posting at Tehran University of Medical Science in Iran. “But,” he told Nature, “with this kind of withdrawal, they destroyed all our lives, all our hopes and ambitions.” (Nature)

• And finally: On Tuesday, Johnson & Johnson announced that its experimental HIV vaccine had failed to adequately protect against infection. The company developed the vaccine using the same technology behind its effective Covid-19 jab. But, according to the results of a study conducted in southern Africa, the HIV shot did not work as well. The study, known as Imbokodo, included 2,600 participants, all of them women. It launched in 2017 with funding from the Bill and Melinda Gates Foundation and the National Institutes of Health. As of last year, all participants had gotten their shot of the vaccine or a placebo. The study found that the vaccine was only 25.2 percent effective at preventing infection — falling short of the 50 percent target. Other vaccine makers, though, are turning their attention to HIV and the condition it causes, AIDS, which still kills hundreds of thousands of people each year. The biotechnology company Moderna is set to begin human trials on HIV vaccines developed using its heralded mRNA technology; those trials could begin as soon as this month. (STAT News)