Georgia Gov. Brian Kemp signs legislation banning abortions once a fetal heartbeat can be detected, which can be as early as six weeks, before many women know they’re pregnant. (Bob Andres/Atlanta Journal-Constitution via AP)

I was trying to schedule a sonogram last year when my understanding of a basic scientific principle was totally upended. The nurse, attempting to discern how pregnant I might be, turned out to be utterly uninterested in the date of conception. She only wanted to know the date of my last period. That, she explained, is how pregnancy is calculated. Which meant that as far as the medical community was concerned, I was technically five weeks along, even though there was no way I could physically be more than three. Those two previous weeks, I guess I was . . . pre-pregnant? Pregnant-in-waiting? Truly, this was stunning news.

So last week, when John Becker, a lawmaker from Ohio, casually suggested that an ectopic pregnancy could be “removed from the fallopian tube and reinserted in the uterus” (nope: tragically, that procedure doesn’t exist), and when prominent pundit Ben Shapiro confidently conflated the concept of “six weeks of pregnancy” with “a six-week-old embryo” (two different things, actually), and when Georgia Gov. Brian Kemp signed a bill requiring that abortions may only take place in a time frame before many women even realize they’re pregnant — when all of those things occurred, my frustration approached a cosmic level. Not toward those lawmakers, but toward the squeamish cloak of secrecy and ignorance that shrouds all things ovarian.

Georgia signs ‘heartbeat bill’ into law, banning most abortions
Georgia Gov. Brian Kemp (R) signed a bill outlawing abortion if a doctor can detect a fetal heartbeat – one of the nation’s most restrictive abortion laws. (Reuters)

We are collectively terrible at talking about reproduction. Especially when it comes to pregnant bodies. We’ve got to do better.

When the Georgia abortion bill was signed into law, I heard some armchair OB/GYNs claim that a woman could easily meet this six-week deadline by simply taking a pregnancy test really, really early — like, immediately after sexual intercourse! — to find out whether she had an unwanted pregnancy to terminate.

Dispiritingly, these advice-givers did not seem to know that fertilized eggs take several days to implant in the uterus. And that pregnancy tests are not highly accurate until a period has been missed. And that, even assuming one has a textbook 28-day menstruation cycle — many are longer or far less predictable — a period won’t be missed until at least 15 or 16 days after conception.

Harry and Meghan, the Duke and Duchess of Sussex, debuted their newborn son this week, and I saw royal-watchers sharing the family photo, innocently wondering why Meghan still looked “fat.” Clearly, they’d never learned that the female body doesn’t bounce back like a rubber ball; it can take weeks or months or never for midsections to return to their previous size.

Some of the pontificators in these instances were male, but far from all of them. These aren’t the infractions of individual men. This is centuries’ worth of an attitude that, though conception might be a biological miracle, it’s also a gross one, filled with pudge and sludge that — la la la la la! — decent people are allowed to run screaming from. Plenty of folks are willing to treat fetuses as precious citizens, but seem to regard the bodies that nurture them as embarrassing slums. At a party, I once saw a new father proudly call his new kid a “princess” and his wife a “champ,” but then showily cover his ears when the wife mentioned the word “placenta.” As if the placenta wasn’t precisely what had allowed Princess to thrive.

And everyone at the party laughed! As if this willful ignorance was acceptable! Because it is, in fact, acceptable: We have accepted it.

Stories like this used to seem amusing. I have snickered over BuzzFeed listicles with titles such as “24 Ridiculous Things People Have Actually Believed About Periods.” I once snorted at my desk while skimming a complaint from a gentleman annoyed that menstruating women felt the need to waste money on sanitary products. Why didn’t they just learn to “hold it,” he suggested, the way men kept themselves from urinating?

But I’m beginning to realize that this kind of ignorance isn’t something to be laughed off. Because if we’re going to make laws around biology — about whether tampons should be taxed, or whether abortions should happen by six or eight or 14 weeks — we need to understand that biology. Because whether you’re an abortion rights advocate or antiabortion, you should be able to understand and defend the complexity of your position.

There’s another reason that has nothing to do with the law: If you don’t understand how female bodies work, you might end up believing some really harmful things about women.

If you think that menstruating women need sanitary products only because they’re unwilling to “hold in” their periods, then you might end up believing they’re just lazier than men.

If you view postpartum women as “fat,” then you might be inclined to see women as slightly less disciplined. If you don’t know what a placenta does, you might start to think your wife’s body is just gross.

If you think a woman should know she’s pregnant within days — as opposed to the weeks that biology generally dictates — then you might assume that not knowing within days is a sign that she’s scatterbrained and irresponsible. You might decide she’s unable to manage her own health.

We desperately, desperately need to do better at talking honestly and openly about reproduction. About missed periods, and heartbeats, and fetal-growth charts, and menstruation cycles, and fertilization timelines, and all of it.

Because if defending your position requires relying on falsehoods, then perhaps you should be questioning whether it’s defensible at all.


You have surely heard by now that Georgia passed an extremely strict “heartbeat bill,” set to go into effect on the first of January, that would treat women who get abortions like criminals. It’s been suggested that this bill will also put mothers who miscarry in danger of prosecution. I have things to say about the bill, but I want to get back  to them at a later time. First I need to address something that’s happening in my own state, Ohio.

I have learned that Ohio legislators are considering a billthat is in some ways even more draconian than the one passed in Georgia. This bill would ban all insurance coverage for anything that lawmakers consider an abortion– and I use the phrase “anything that lawmakers consider an abortion” deliberately, because the bill isn’t being written by doctors but legislators, and the legislators seem to have some fanciful ideas about what constitutes an abortion.

This bill is sponsored by republican John Becker, who no doubt thinks of himself as pro-life. It includes legislation on what to do with an ectopic pregnancy, where the baby implants in the fallopian tubes instead of the womb. Ectopic pregnancies are always fatal to the embryo and, if not treated quickly, are fatal to the mother as well. She will eventually rupture and bleed out. Treatments for an ectopic pregnancy involve removing the embryo from the fallopian tube and leaving it intact, or removing the tube itself with the embryo still inside. Both result in the the death of the embryo, who is going to die no matter what, but removing the tube is 100% accepted by Catholic bioethics as necessary and not an abortion. That may not matter to non-Catholics in my audience, but I’m a Catholic who studied bioethics at Franciscan University at the graduate level, and we discussed ectopic pregnancies specifically in my classes, so it matters to me. Even by the strictest standards, treating an ectopic pregnancy is not abortion. It’s something else entirely. No one who is pro-life should hesitate to accept that treatment.

Becker doesn’t seem to realize this. He has a fanciful idea about a treatment that’s right out of science fiction: “Part of that treatment would be removing that embryo from the fallopian tube and reinserting it in the uterus so that is defined as not an abortion under this bill.”

Actually, no, Mr. Becker, that would not be part of the treatment. And I know that it’s not part of the treatment, because it’s not physically possible to save an ectopic pregnancy by just scraping the baby off the lining of the fallopian tube and stuffing it  in the womb. Unborn babies are not cuttings from a hydrangea bush. They don’t take root when transplanted. I wish they did. For the sake of my dear friends who have suffered the loss of a baby and the trauma of an ectopic pregnancy, I wish with all my heart that you could save a tiny embryo by scooping her out of the tube and sticking her in the uterus where she belongs, but you can’t.

And saying that you can is a slap in the face to any woman who’s suffered such a horror.

My dear friends who have suffered ectopic pregnancies didn’t get abortions. They got treatment for their ectopic pregnancy, they lost their babies, they went home mourning and traumatized and also recovering from a dangerous medical emergency that could have killed them. I am relieved and grateful that they’re alive. I am terrified that this law would ban insurance coverage for their condition except in the case of a fictional “procedure for an ectopic pregnancy, that is intended to reimplant the fertilized ovum into the pregnant woman’s uterus.” you can tell no doctor ever came within a mile of this legislation, not only because that procedure doesn’t exist, but because a “fertilized ovum” is an earlier stage of pregnancy; by the time you’re removing a fallopian tube to save a woman, it’s much further along. But that’s the exact wording of the bill as it stands today.

The bill also includes coverage of “a procedure, in an emergency situation, that is medically necessary to save the pregnant woman’s life.” Only in an emergency situation. In practice, in the case of an ectopic pregnancy, this could easily mean that insurance would cover you if your fallopian tube had already ruptured and you managed to make it to the hospital in extreme pain and internal bleeding before you died. But if the ectopic pregnancy was diagnosed before then– apparently Ohio legislators expect the doctor to scrape the baby out of the tube, killing him or her instantly, and then stuff the dead baby into the mother’s uterus. This would be as likely to result in a healthy baby as the doctor cutting the mother’s nose off and throwing that in the uterus too. This bill is not pro-life, it’s pro-sepsis.

It’s not even that; it’s gibberish.

It’s a man with no medical expertise crafting legislation for a body part that will never impact him personally because he doesn’t have one.

If this bill is somehow signed into law as it is, women are going to die. They are not going to bravely sacrifice their lives to save their babies, which would be bad enough; they’re going to bleed to death with a tiny dead baby rotting inside of them, because an ignorant male legislator wanted to look extra pro-life for his constituents.

He’s not being pro-life. He’s not even being rational. He’s attempting to legislate something about which he is completely ignorant.

And everyone, pro-life and pro-choice, should be outraged.


On Thursday the Alabama Senate adjourned after an abortion bill debate descended into chaos. Lt. Gov. Will Ainsworth gaveled a voice vote through before Democrats could ask for a roll call vote. (Mike Cason/

I’ve seen Alabama lawmakers try some stupid things, but never anything so cowardly.

On Thursday, lawmakers were set to vote to force victims of rape and incest to have their rapists’ babies — only some of them didn’t want their names attached to the bill.

Instead, Lt. Gov. Will Ainsworth tried to push the near-total abortion ban through without a roll call vote on amendments that would have created exceptions for rape and incest.


The bill didn’t pass. It was carried over after Democrats and some Republicans raised hell. There will likely be a do-over next week.

But you need to see this, Alabama. Because the whole country is going to see this. And you need to let these folks know whether they speak for you. And once the vote is taken, you have a right to know where your lawmakers stood.

Here’s how it went down.

Last week, the Alabama House passed what would be the strictest abortion ban in the country. The bill, sponsored by state Rep. Terri Collins, R-Decatur, would make abortions in all instances, except when the mother’s life is in danger, a felony.

That bill did not include the exceptions that have been boilerplate in these things before — for pregnancies that result from rape or incest.

Collins argued that those exceptions had to be left out because the bill is designed to challenge Roe v. Wade. It’s not an incremental chipping-away at the landmark Supreme Court decision, but a direct assault.

That bill passed the Alabama House. As cruel as the bill might be to rape victims, at least the lawmakers in the lower house put their names on it. At least they owned their votes.

But not in the Alabama Senate.

On Wednesday, the bill moved through the Alabama Senate Judiciary Committee, but not before Sen. Tom Whatley, R-Auburn, introduced amendments to it including exceptions for rape and incest. It was a small victory.

And a short-lived one.

Before Democrats could get a word in at the podium, the bill’s Senate sponsor, Sen. Clyde Chambliss, R-Prattville, motioned to table the amendments. Lt. Gov. Will Ainsworth upheld the motion before anyone could demand a roll call vote.

In short, they intended to ram this thing through without anyone else having to put their names on it.

State Sen. Bobby Singleton, D-Greensboro, erupted in anger. Chambliss muttered and sputtered while Singleton shouted over him. Ainsworth tried to gavel Singleton down. Some Republicans, including Sen. Cam Ward, R-Alabaster, and Senate Pro Tem Del Marsh, R-Anniston, stood behind the Democrats and seemed to take their side. State Senator Vivian Figures, D-Mobile, appealed to her colleagues for fairness.

“I know this bill is going to pass,” Figures said. “You are going to get your way. But at least treat us fairly and do it the right way. That’s all that I ask. That’s all that my Democratic colleagues ask. That’s all that women in this state ask, both Democratic and Republican women.”

Ultimately, Marsh moved that the Senate hold over the bill until the call of the chair and adjourn. He encouraged his colleagues to take the weekend to cool off and speak with their constituents.

That’s a lot of procedural back-and-forth, but here’s what it means.

It means that when some poor young girl, inevitably, has to have her dirty uncle’s baby, the Alabama lawmakers who vote for this thing don’t want their names attached to it.

It means all the talk about personal responsibility is just talk.

It means owning choices is something for women in Alabama (even when they never had a choice) but not for Alabama lawmakers.

It means they’re scared.

It means they are cowards.

It means they are hypocrites.

And it means the newly elected lieutenant governor was not just going to let them get away with it. He tried to help. (Ainsworth insisted to me later that the voice vote wasn’t rushed and that it was fair. I’m embedding video of it here so you can watch and decide for yourself.)

Figures argued that today’s chaos was over fairness, but it’s about more than that. This is about accountability and character — and those who’d walk away from all those things.

If you’re going to do this, lawmakers, don’t hide. Don’t cheat. And don’t lie.

Take responsibility for it.

If you’re going to bring this bill into the world, let everybody know who the father was.

[Correction: A previous version of this column said it was state Sen. Bobby Singleton who introduced amendments in committee. In fact, it was state Sen. Tom Whatley, and the column has been corrected.]


Anti-abortion advocates have asked the U.S. Supreme Court to step in on a restriction requiring patients to obtain an ultrasound 18 hours before getting an abortion.

The U.S. Supreme Court on Friday will consider a request by attorneys from the State of Indiana to uphold a Pence-era law that requires patient to undergo an ultrasound at least 18 hours prior to obtaining an abortion.

The U.S. Supreme Court on Friday will consider a request by attorneys from the State of Indiana to uphold a Pence-era law that requires patients to undergo an ultrasound at least 18 hours before obtaining an abortion.

Indiana lawmakers in 2016 passed HB 1337, an omnibus abortion bill that amended numerous provisions of existing abortion regulations, including the state’s mandatory ultrasound requirement. Before that, patients in Indiana were required to have an ultrasound before receiving abortion care, but they could schedule and have it on the same day as their abortion. As a result of HB 1337’s 18-hour delay, patients would have to make two trips to a clinic to have an abortion. Reproductive rights advocates sued, arguing the law unduly burdened abortion rights.

In April 2017, U.S. District Judge Tanya Walton Pratt blocked the measure, ruling it “creates significant financial and other burdens” on providers and patients. The Seventh Circuit Court of Appeals agreed, affirming Pratt’s decision last summer. Attorneys for the State of Indiana in February asked the Roberts Court to step in and hear the case.

The Supreme Court is already considering two other provisions of HB 1337 in a different case, which I previewed here. One requires certain procedures for the disposal of fetal remains while the other bans abortions based on the sex, race, or disability of the fetus. And just like in that case, there’s no good reason for the Court to get involved at this time in the question of Indiana’s mandatory delayed ultrasound. As attorneys for Planned Parenthood of Indiana and Kentucky note, there is no circuit-split for similar cases—one of the traditional reasons for the Supreme Court to agree to hear a case.

But attorneys for the State of Indiana insist this case is a good candidate for Supreme Court review because it will allow the Roberts Court opportunity to clarify whether the substantial burden test from Whole Woman’s Health v. Hellerstedt applies to abortion restrictions passed in the name of “protecting fetal health.”

The test states that courts must weigh the extent to which the laws in question actually serve the stated government interest—in Indiana’s case, the interest in “fetal health”—against the burden they impose. So while Indiana’s petition may not be a traditional candidate for Supreme Court review, it serves other purposes: It reminds the Court of a brewing fight the justices will eventually have to resolve, and it starts suggesting the framework for them to do so.

Whole Woman’s Health v. Hellerstedt was an important win for abortion rights advocates not just because it struck as unconstitutional restrictions that had significantly reduced clinic access, but because the decision outlines an accountability standard for lawmakers. If a law is to restrict abortion access, the decision says, there must be some data—some verifiable evidence—that the restriction furthers the state’s interest.

Anti-choice lawmakers do not like this accountability standard. It’s blocked some of their most successful anti-choice measures—ones they unsuccessfully claimed were designed to promote patient health and safety. Their goal now is to prevent the Whole Woman’s Health standard from applying to those restrictions supposedly passed in the name of advancing potential fetal life. And to further that goal, they argue that instead of creating clarity, the decision in Whole Woman’s Health v. Hellerstedt created confusion in abortion rights jurisprudence.

“The Seventh Circuit’s decision in this case illustrates why the balancing test of Hellerstedt does not make sense in the context of statutes designed to protect fetal life,” Indiana’s petition states. “The Court held that the Ultrasound Law violates the Constitution because the significant burdens imposed on women’s access to abortion, amounting to an additional cost of $219 to $247, outweigh the ‘very small’ impact of the law on persuading women to choose life.”

“Even assuming this data accurately predicts the impact of the ultrasound law on Indiana women, the panel’s conclusion necessarily raises the question: what number of fetal lives must be saved before the benefit of the statute outweighs its burdens?” the petition continues.

The question is, of course, designed to bait the Court’s conservatives into restricting Whole Woman’s Health‘s reach.

“What if … only one woman is persuaded by the ultrasound to carry her pregnancy to term? What dollar amount in burdens is her unborn child’s life worth? Surely the Constitution does not require this type of utilitarian calculus,” the petition continues.

The state’s framing of the “dollar amount in burdens” is especially telling because it ignores the additional burdens on the pregnant person the lower courts considered—including the emotional burdens an extra barrier to care creates. Those burdens, from the State of Indiana’s perspective, should not factor into the Court’s analysis.

The State of Indiana is arguing that the data to support the idea of advancing potential fetal life is impossible to quantify, unlike data regarding patient safety. It’s an attempt to create a distinction between types of restrictions as a way to try and undercut the legislative accountability the Whole Woman’s Healthstandard demands. But Whole Woman’s Health made clear that the same undue burden standard first articulated in Planned Parenthood v. Casey applies to both categories of restrictions. Anti-abortion advocates are playing loose with the language of the decision to suggest a conflict when one does not exist, and they are hoping in this petition they can get the Court’s conservatives to play along.

The Court could decide as early as Monday whether to hear the case.


The anti-choice movement used to pretend it cared about women. Now it doesn’t have to.

Credit: Saul Loeb/Getty Images

his week, Georgia became the sixth state to ban abortions after six weeks — so early in pregnancy that many women don’t even realize they’ve missed a period, let alone that they’re pregnant. Laws like these effectively ban all abortions — and that, of course, is the whole point.

Republicans want to ensure that women are forced to carry pregnancies no matter how far along they are, and these so-called heartbeat bills do double duty: They prevent women from legally being able to obtain an abortion, and were written with the hope that they’d be challenged all the way to the Supreme Court to help overturn Roe v. Wade.

But the danger of this law is not just that it will prevent women from getting abortions, but that women who do would be subject to life in prison or the death penalty. Imagine a future where women who have miscarried are interrogated by the police over whether they took an abortion pill. Where mothers of stillborn babies are arrested because they refused to have a C-section. This is the unsaid reality of criminalizing abortion.

Up until recently, the anti-abortion movement would have taken great pains to pretend that women wouldn’t be punished under such a law. That the GOP no longer has the need for such niceties should scare every single one of us.

The truth is that the anti-abortion movement — emboldened by Donald Trump — has made a disturbing return to its extremist roots.

Up until recently, mainstream anti-choicers tried to distance themselves from their most radical proponents. They understood that videos of men screaming “murderer” at women as they walked out of clinics were not a good look, and as such, tried to soften their image. Instead of attacking women, they claimed women “deserved better” than abortion, and created organizations with feminist-sounding names.

Anti-choicers always believed women should be forced into motherhood. But before now, the country and culture necessitated that they shroud their most extreme views.

Those who once fought so hard to seem “woman-friendly” have seemingly given up on their public image problem — embracing the most radical rhetoric. It was less than two weeks ago, for example, that the president of the United States claimed that after a child is born, “they take care of the baby, they wrap the baby beautifully… and then the doctor and the mother determine whether or not they will execute the baby.” No Republicans or anti-abortion leaders stepped up to correct him. It was also just last month that, for the first time in Texas’s history, the state heard public testimony in support of a bill that would punish women who had abortions with the death penalty. And last year, conservatives rallied around a writer who said that women who end their pregnancies should be executed by hanging.

This is not to say that the anti-choice movement has changed in some fundamental way — anti-choicers always believed women should be forced into motherhood, and they always knew that the consequences of such beliefs would put women in jail or worse. But before now, the country and culture necessitated that they shroud their most extreme views.

It does not bode well for the women of America that this is no longer the case.

How long will it be before anti-choicers brag about the prison sentences women who have abortions will get? This not an imaginary future — women have already been prosecuted for ending their pregnancies, and doctors who perform abortions have already been attacked and killed. These laws are just more proof that the anti-choice movement is not afraid to double down on its most extreme and callous beliefs. Beliefs that will put women’s lives and freedom in danger.

The danger of post-Roe America is already here.



A new bill would ban most private insurance coverage for abortions. But opponents say it would also ban effective methods of birth control.

One fifth of the representatives in the House have signed on to a bill sponsored by Republican John Becker that would prohibit most insurance companies from offering coverage for abortion services.

“The intent is to save lives and reduce the cost of employers and employees health care insurance,” Becker says.

The bill would ban nontherapeutic abortions that include “drugs or devices used to prevent the implantation of a fertilized ovum.”

And Becker says the bill also speaks to coverage of ectopic or tubal pregnancies where the fertilized egg attaches outside of the womb.

“Part of that treatment would be removing that embryo from the fallopian tube and reinserting it in the uterus so that is defined as not an abortion under this bill,” Becker explains.

“That doesn’t exist in the realm of treatment for ectopic pregnancy. You can’t just re-implant. It’s not a medical thing,” says Jaime Miracle, deputy director of NARAL Pro-Choice Ohio.

She says, under this bill, women would have to wait until their very lives were in danger to get an abortion in the case of an ectopic pregnancy.

“This bill will have grave impacts on Ohio’s infant and maternal mortality rate,” Miracle says.

And she says that’s not all. She says it will ban insurance from covering popular methods of birth control.

“Birth control pills, IUD’s and other methods of birth control like that – the bill states that any birth control that could act to stop a fertilized egg from implanting in the uterus is considered an abortion under this bill,” Miracle says.

Becker insists his bill does not target birth control.

“When you get into the contraception and abortifacients, that’s clearly not my area of expertise but I suppose, if it were true that what we typically known as the pill would be classified as an abortifacient, then I would imagine the drug manufacturers would reformulate it so it’s no longer an abortifacient and is strictly a contraceptive,” Becker says.

This bill just had its first hearing in committee. If it goes further, supporters, opponents and medical professionals will testify for or against it.

Less than a month ago, Ohio lawmakers passed and Gov. Mike DeWine signed a law that bans abortion as early as six weeks into a pregnancy – at the point a fetal heartbeat can be detected. If this legislation goes through as written, it would go even further.



Anti-abortion activists participate in the March for Life, an annual event to mark the anniversary of Roe v. Wade, outside the U.S. Supreme Court in Washington, D.C., on Jan. 18.
Saul Loeb/AFP/Getty Images

On Tuesday, Georgia Republican Gov. Brian Kemp signed a “fetal heartbeat” bill that seeks to outlaw abortion after about six weeks. The measure, HB 481, is the most extreme abortion ban in the country—not just because it would impose severe limitations on women’s reproductive rights, but also because it would subject women who get illegal abortions to life imprisonment and the death penalty.

The primary purpose of HB 481 is to prohibit doctors from terminating any pregnancy after they can detect “embryonic or fetal cardiac activity,” which typically occurs at six weeks’ gestation. But the bill does far more than that. In one sweeping provision, it declares that “unborn children are a class of living, distinct person” that deserves “full legal recognition.” Thus, Georgia law must “recognize unborn children as natural persons”—not just for the purposes of abortion, but as a legal rule.

This radical revision of Georgia law is quite deliberate: The bill confirms that fetuses “shall be included in population based determinations” from now on, because they are legally humans, and residents of the state. But it is not clear whether the bill’s drafters contemplated the more dramatic consequences of granting legal personhood to fetuses. For instance, as Georgia appellate attorney Andrew Fleischman has pointed out, the moment this bill takes effect on Jan. 1, 2020, the state will be illegally holding thousands of citizens in jail without bond. That’s because, under HB 481, pregnant inmates’ fetuses have independent rights—including the right to due process. Can a juvenile attorney represent an inmate’s fetus and demand its release? If not, why? It is an egregious due process violation to punish one human for the crimes of another. If an inmate’s fetus is a human, how can Georgia lawfully detain it for a crime it did not commit?

But the most startling effect of HB 481 may be its criminalization of women who seek out unlawful abortions or terminate their own pregnancies. An earlier Georgia law imposing criminal penalties for illegal abortions does not apply to women who self-terminate; the new measure, by contrast, conspicuously lacks such a limitation. It can, and would, be used to prosecute women. Misoprostol, a drug that treats stomach ulcers but also induces abortions, is extremely easy to obtain on the internet, and American women routinely use it to self-terminate. It is highly effective in the first 10 weeks of pregnancy. Anti-abortion advocates generally insist that they do not want to punish women who undergo abortions. But HB 481 does exactly that. Once it takes effect, a woman who self-terminates will have, as a matter of law, killed a human—thereby committing murder. The penalty for that crime in Georgia is life imprisonment or capital punishment.

HB 481 would also have consequences for women who get abortions from doctors or miscarry. A woman who seeks out an illegal abortion from a health care provider would be a party to murder, subject to life in prison. And a woman who miscarries because of her own conduct—say, using drugs while pregnant—would be liable for second-degree murder, punishable by 10 to 30 years’ imprisonment. Prosecutors may interrogate women who miscarry to determine whether they can be held responsible; if they find evidence of culpability, they may charge, detain, and try these women for the death of their fetuses.

Even women who seek lawful abortions out of state may not escape punishment. If a Georgia resident plans to travel elsewhere to obtain an abortion, she may be charged with conspiracy to commit murder, punishable by 10 years’ imprisonment. An individual who helps a woman plan her trip to get an out-of-state abortion, or transports her to the clinic, may also be charged with conspiracy. These individuals, after all, are “conspiring” to end of the life of a “person” with “full legal recognition” under Georgia law.

It is entirely possible that Georgia prosecutors armed with this new statute will bring charges against women who terminate their pregnancies illegally. In 2015, a Georgia prosecutor chargedKenlissia Jones with murder after she self-terminated; he only dropped the charges after concluding that “criminal prosecution of a pregnant woman for her own actions against her unborn child does not seem permitted.” Starting in 2020, however, Georgia law will permit precisely this kind of prosecution. There is no reason to doubt that history will repeat itself, and more prosecutors will charge women who undergo abortions with murder.

For now, Supreme Court precedent protecting women’s reproductive rights should bar such prosecutions—and indeed, require the invalidation of HB 481. But the court’s conservative majority may be on the verge of dismantling Roe v. Wade. If that happens, Georgia and otherconservative states will be free to outlaw abortion, and to imprison women who self-terminate. HB 481 is further proof that once Roe is gone, it won’t just be abortion providers who risk legal jeopardy: Women will be punished, too.