Ohio lawmakers recently passed the so-called "Heartbeat Bill," which bans abortions in the state from the moment a fetal heartbeat can be detected. In most pregnancies, this typically occurs when you're six weeks pregnant. But with some pregnancies, first signs of a heartbeat can happen as early as the fourth or fifth week.
Pregnancy—and the time measurements surrounding it—can get incredibly confusing, so we asked experts to break it down for us. Here, an explainer of what exactly it means to be "six weeks pregnant."
Monica Simons, M.D., ob/gyn at Every Woman Wellness, tells that doctors measure pregnancies in terms of weeks since a mother's last period. Simons and other doctors tell their patients that normal pregnancies last 40 weeks—that's 10 months, instead of nine. "You're not actually pregnant for 10 months," she says. "But we're counting from your last period."
So for many women, six weeks pregnant could really just mean two weeks after they missed their period. That's not a long time—especially considering that many women with a regular menstrual cycle don't even realize they're pregnant until after they've missed their period, according to Juana Cuevas, M.D., ob/gyn at Every Woman Wellness. "Women are usually about five or six weeks pregnant when they realize," Cuevas says. But women whose menstrual cycles are less regular may not realize until much later.
Simons says that at six weeks, your body will have undergone very little change. You may feel bloated or nauseated, and you may start experiencing morning sickness. This is because your hormones are changing. Once a pregnancy has gotten to five or six weeks, your ovarian tissue produces a hormone called progesterone. The hormone supports the pregnancy, but you likely won't start showing until the second trimester, Simons says.
The first four weeks of pregnancy are filled with things like conception, fertilization (when the sperm and egg unite), and implantation (when a ball of cells, known as a blastocyst, burrow into the uterine wall). By week five, the embryonic period—when the fetus' brain, spinal cord, and heart start developing—is only beginning. At week six, the fetus is only the size of a pomegranate seed. During this week, the neural tube across the fetus' back closes, and the heart should begin pumping blood.
That's thanks to something called implantation bleeding, which many people can mistake for a period. Think of the timeline again: Day one is the first day of your period. Around 14 days (two weeks) later, your body releases the egg. Sometime in the next few days the egg becomes fertilized, and then a few days after that it implants into the side of the uterus. Some people will have implantation bleeding at that time, which happens sometime in the late third or early fourth week—and can be mistaken for period, even though it isn't the same thing. So it's possible for a person not to even realize that they're pregnant until their second missed period.
Prenatal testing for anomalies isn't available until 10 weeks into a pregnancy, Cuevas says. These abnormalities can include untreatable lifelong conditions, like microcephaly, or conditions that will kill the baby shortly after birth, like anencephaly.
Six weeks is very early into pregnancy—so early that some women don't even know they're pregnant yet. Considering Ohio legislation requires women to attend two separate appointments in order to get an abortion—and enforces a 24-hour waiting period between the counseling appointment and the actual procedure—the so-called Heartbeat Bill could extremely restrict a person's access to abortion. People in Ohio seeking abortion would be given a very small window to obtain them, and those who don't realize they're pregnant until after the six-week mark would be given no window at all. "Women's health should not be a political football," NARAL Pro-Choice Ohio Executive Director Kellie Copeland previously said. "Once a woman makes a decision to have an abortion, she should be able to access quality health care in her community."