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Demonstrators protest a Texas law that effectively bans nearly all abortions. Sergio Flores for the Washington Post via Getty Images
  • The new law, which took effect on Sept. 1 in Texas, bans abortion at 6 weeks when a fetal heartbeat can be detected.
  • The bill makes no exceptions for pregnancies that resulted from rape or incest.
  • The Supreme Court is hearing another case in Mississippi on the state’s 15-week abortion ban.

A Texas law banning abortion at 6 weeks, which is before most people even realize they’re pregnant or have missed a period, officially took effect on Wednesday, Sept. 1, months after Texas Gov. Greg Abbott signed it last May.

Until September 2021, Texas permitted abortions up to 20 weeks. After 20 weeks pregnant people could get an abortion only if they had a life-threatening medical condition or the fetus had a severe abnormality.

The U.S. Supreme Court did not rule on the constitutionality of the law before it took effect.

On Wednesday in a 5 to 4 decision, the court voted against blocking the implementation of the law before legal challenges could be heard in court. This vote does not decide if the law is constitutional or not, just that it can be implemented before the full case is heard in court.

This is not the only reproductive rights case being heard by the Supreme Court. The court is also hearing an abortion case in Mississippi — Dobbs v. Jackson Women’s Health Organization — regarding the state’s law that bans abortions after 15 weeks.

Depending on the decision, the court will either reaffirm or overturn Roe v. Wade, the 1973 decision that protects the constitutional right to have an abortion.

If Roe v. Wade were to be overturned, more states may sign restrictive and extreme laws blocking access to abortions. Just in 2021 at least 90 state laws have been passed that restrict access to abortion, according to the Guttmacher Institute, a research and policy organization committed to advancing sexual and reproductive health and rights.

The new law in Texas bans abortion at 6 weeks when a fetal “heartbeat” can be detected. The bill makes no exceptions for pregnancies that resulted from rape or incest.

At 6 weeks, many people do not realize they are pregnant. Pregnancy is counted from a person’s last menstrual cycle. That means once a person misses their first period they may be considered 4 weeks pregnant whether or not conception actually occurred 4 weeks prior.

The law also categorizes abortion after 6 weeks as a civil violation, not a criminal ban, which essentially allows people to sue anyone who may have helped people get an abortion, such as abortion providers or abortion care advocates.

The threat of a lawsuit could push some abortion providers to shut down.

This bill “means that patients only have about 2 weeks from their missed period to recognize and confirm the pregnancy, decide they want an abortion, find a clinic, arrange time off from work or school and childcare, if needed, as well as organize transportation since many people live far from the nearest clinic in Texas,” said Dr. Daniel Grossman, a professor in the department of obstetrics, gynecology, and reproductive sciences at the University of California, San Francisco.

Under current Texas laws people would need to visit a clinic 24 hours before their abortion for an ultrasound and state-mandated counseling.

They’d also need to secure enough money to cover the abortion since abortion care is not covered by insurance in Texas, according to Grossman.

The law makes abortion care extremely difficult, if not impossible, to access.

“Because most people do not realize they are pregnant at that point, it functions as a de facto ban on all abortion,” said Jill Adams, JD, the executive director of the reproductive justice organization If/When/How.

Abortion care advocates are preparing to challenge the law so the courts can rule on its constitutionality.

“We are endeavoring every day to halt the criminalization of self-managed abortion so that all people can self-determine their reproductive lives free from the threat of criminalization,” Adams told Healthline.

The Supreme Court is currently hearing another case based in Mississippi — Dobbs v. Jackson Women’s Health Organization — that could potentially weaken Roe v. Wade.

A federal district court and the 5th U.S. Circuit Court of Appeals both found the law unconstitutional since Roe v. Wade protects the constitutional right to an abortion up to the point in pregnancy when a fetus would be viable outside the body, which is around 24 weeks.

According to Adams, the 15-week abortion ban in Mississippi further limits access to abortion care in a state where it’s already very difficult to get an abortion.

“This case presents the frightening opportunity for the high court, now comprised of a majority of vehement abortion opponents, to reverse Roe v. Wade,” Adams said.

If the Mississippi law holds up in court, it would effectively overturn Roe v. Wade.

“If that were to happen, it could open the door for extreme laws like this one in Texas to stand up in court,” Grossman said.

States have never been able to pass a law banning abortion before fetus viability.

Dobbs v. Jackson Women’s Health Organization is the first abortion case that will be reviewed by the Supreme Court’s 6–3 conservative majority.

If Roe v. Wade were to be overturned, or if the restrictive laws in Texas and Mississippi hold up, people will find ways to end their pregnancies at home. In a 1976 report from the Centers for Disease Control and Prevention (CDC), the number of illegal abortions in the United States estimated prior to the decision of Roe v. Wade was 130,000 in 1972.

At least 39 deaths were also reported in 1972 underscoring how abortions without medical oversight could be dangerous.

According to a 2017 report from the Guttmacher Institute, nonhospital facilities saw a rise in people who had tried to self-induce an abortion without medical oversight. In 2012, 12 percent of these facilities saw one or more patients for a missed or failed abortion due to self-induction. By 2018, it was 18 percent, with these patients more likely to be located in the South.

“Throughout the world, resourceful and determined people have always found ways to end pregnancies, and they will do that here,” Adams said.

Others will be forced to continue their pregnancy, which has higher health risks than abortion, noted Grossman.

“Patients forced to carry an unwanted pregnancy to term also face higher socioeconomic risks compared to those who obtain a wanted abortion,” Grossman said.

People may also turn to self-managed abortions, which means there is no medical oversight of the abortion. Today these self-managed abortions are likely to be accomplished with FDA-approved medications, according to the Guttmacher Institute.

Unlike more invasive abortions that occurred prior to Roe vs. Wade, according to Adams, these self-managed abortions have the potential to be safe and effective with the right information, resources, methods, and reliable backup care.

Self-managed abortions can, however, come with legal risks.

“People throughout the country, including in Texas, have been arrested, prosecuted, and incarcerated for ending their own pregnancies outside the formal medical system or for helping another person do so,” Adams said.

Anyone who has been criminalized or is interested in the legal rights and risks of abortion care and self-managed abortion can get free advice from the Repro Legal Helpline by calling 844-868-2812.

Texas Gov. Greg Abbott signed in May a law that bans abortion at 6 weeks, which is before most people even realize they are pregnant or have missed a period. The law officially went into effect on Sept. 1.

Abortion advocates may have a hard time challenging the law because of the way it is written.

The Supreme Court is hearing another case in Mississippi on the state’s 15-week abortion ban. The ruling will either overturn or reaffirm Roe v. Wade, which protects the constitutional right to abortion before fetus viability outside the body.