Here’s the thing: Many women don’t even know they’re pregnant at 6 weeks

The news of Texas’ abortion ban being implemented this week put abortion restrictions back in the national spotlight. Senate Bill 8, known as SB8, is now believed to be the strictest abortion ban in the U.S. and prohibits abortions after a heartbeat is detected, which typically occurs around 6 weeks gestation.

There’s a huge issue with that timing: Many women don’t even know they’re pregnant at 6 weeks.

To clarify just how early six weeks in pregnancy actually is, think of it this way: It’s just six short weeks—a month and a half—from the end of your last menstrual cycle. Because of the way gestational age is calculated, pregnant women are considered 4 weeks pregnant by the time they miss their period—often the first sign of pregnancy.

The Texas law’s emphasis on this timing means that if women living in Texas want an abortion, they’d have to do so extremely early in pregnancy—before many women are even aware they’re pregnant—just two weeks after a missed period.

While many other extreme abortion bans (sometimes called “heartbeat bills”, a misnomer) have been passed, this is the first to actually be implemented, effectively barring Texans’ right to an abortion under the landmark Roe v. Wade case of 1973.

The near-total ban on abortions does not allow for any exceptions to be made for rape or incest, and also takes an unprecedented legal approach in that it enables private citizens to sue providers offering abortion care or anyone else who enables a person access to an abortion (even ride-share drivers), which could bring a lawsuit upwards of $10,000.

Abortions are an essential part of women’s healthcare, according to the American College of Obstetricians and Gynecologists

According to the American College of Obstetricians and Gynecologists (ACOG), abortion is healthcare. The implications of this bill may be life-changing—or even life-threatening—to those seeking abortions.

“Where abortion is illegal or highly restricted, women resort to unsafe means to end unwanted pregnancies, including self-inflicted abdominal and bodily trauma, ingestion of dangerous chemicals, self-medication with a variety of drugs, and reliance on unqualified abortion providers. Today, approximately 21 million women around the world obtain unsafe, illegal abortions each year, and complications from these unsafe procedures account for approximately 13% of all maternal deaths, nearly 50,000 annually,” share the members of ACOG in a press statement.

Banning abortion access is dangerous—and with ICU bed capacity increasingly scarce in Texas thanks to a surge in the COVID-19 pandemic, many healthcare providers are worried that if women are forced to take pregnancy termination into their own hands, the consequences could be dire.

Six weeks pregnant is early enough to be missed

The calculations can be tricky, unless you closely monitor your menstrual cycle. Because the first day of your last period is technically day 1 of your pregnancy, if you have a 28-day cycle (often used as an average, but not standard by any means), you’re already 4 weeks pregnant.

“It is extremely possible and very common for people to get to the six-week mark and not know they are pregnant,” Dr. Jennifer Villavicencio, lead for equity transformation at the American College of Obstetricians and Gynecologists, tells The New York Times.

Unless you’re actively trying to conceive, you may not realize you’re pregnant within that two-week window after your missed period.

“To illustrate how insane a six-week abortion ban is: I did IVF and still did not know I was pregnant until 4.5 weeks,” tweeted writer Lucy Huber in a series of viral tweets this week. “That’s LITERALLY as early as you can possibly know and that’s when you are PAYING someone to put an embryo in your body on a specific day and keep track of it.”

Now, under the Texas law, a woman has actually less than two weeks to learn that she’s pregnant, confirm the pregnancy with a test and make a decision on whether to have an abortion—plus also scheduling and undergoing the procedure. Most obstetricians and midwives typically won’t even see a patient for a new pregnancy before 8 weeks.

“While it is called a ‘six-week’ abortion ban, in reality the Texas law is a near-total ban on abortion,” state experts from Guttmacher Institute in a press release. “Patients would have to contend with many logistical, legal and financial hurdles in the small window of time they might have between realizing and confirming they are pregnant and then scheduling and obtaining their abortion—all while navigating myriad other abortion restrictions.”

It’s also important to recognize that the ban may disproportionately affect marginalized communities, including those living in poverty, those in rural areas, people of color and LGBTQ individuals, who traditionally have reduced access to healthcare.

Cycle irregularity and other factors may also play a role

The potential to recognize you’re pregnant at six weeks also strongly depends on whether you’re tracking your cycle: paying attention to not only when your last cycle started, but also noticing when you’re ovulating and last had sexual intercourse. If they’re not trying to get pregnant, many women may not be tracking these inputs.

It’s a complicated metric that can become even more complicated if you have an irregular cycle. If your period or ovulation phase is often late or off-schedule—which could be caused by chronic stress, illness, travel, a medical condition such as polycystic ovary syndrome or another factor, like a previous chemical pregnancy—it makes cycle tracking even harder to stay on top of.

Ultimately, unless you’re tracking your cycle—which you may only be doing if you’re trying to conceive—it’s very difficult to determine the exact timing of a pregnancy.

“But obviously, this is the point, right?” tweeted Huber. “A 6-week abortion ban is a total abortion ban, because pretty much the only people who could reasonably get an abortion are people who very much want to be pregnant.”