On a Friday in June 2022 the nurse practitioner warned my husband, Brad, and me that it might be too soon to hear our baby’s heartbeat. “If we don’t hear anything,” she said, “I don’t want you to worry.” For the next few minutes, as she finicked with the Doppler and cocked her head this way and that, I worried. But just when it seemed she was about to give up, she walked to the other side of the exam table, pressed against my abdomen once more, and found it: a fast, squishy thump, twice the rate of my heartbeat.
“Oh” was the only word I managed to speak.
On the following Friday, I began my eleventh week of pregnancy and the Supreme Court ended federal protections for abortion. In my state, Ohio, this led to the enactment of Senate Bill 23, the Human Rights and Heartbeat Protection Act, which had been signed into law and subsequently blocked by a federal court in 2019, and which prohibited abortion after detection of what the legislation called a “fetal heartbeat,” around six weeks of pregnancy.
Medical professionals opposed to Ohio’s bill—and others like it—noted that the “fetal heartbeat” referenced in the legislation was neither “fetal” nor a “heartbeat.” The ACOG Guide to Language and Abortion on the American College of Obstetricians and Gynecologists website explains that an embryo does not become a fetus until after eight weeks of pregnancy. The guide includes heartbeat on its list of terms to avoid and offers this reasoning: “It is clinically inaccurate to use the word ‘heartbeat’ to describe the sound that can be heard on ultrasound in very early pregnancy. In fact, there are no chambers of the heart developed at the early stage in pregnancy that these bills are used to target, so there is no recognizable ‘heartbeat.’”
In other words, when most people think of a heartbeat, they imagine the sound of the rhythmic closing of valves in a four-chambered heart—a sound that can be heard with a stethoscope. But these valves and chambers are not developed enough to be heard via stethoscope until between weeks eighteen and twenty of pregnancy. At six weeks, the valves do not yet exist, though there is what medical professionals call “embryonic cardiac activity.” Cells beginning to thrum together. A flickering detectable only by transvaginal ultrasound. At six weeks, there is the hope of a heart.
“There’s no issue with using the term ‘heartbeat’ on its own,” said Dr. Nisha Verma of the ACOG in an interview with NBC News. “The issue is using that incorrect term to regulate the practice of medicine and impose these artificial time frames to regulate abortion.”
For the purposes of Ohio’s legislation, Senate Bill 23 collapsed all stages of development into two words: “‘Fetal heartbeat’ means cardiac activity or the steady and repetitive rhythmic contraction of the fetal heart within the gestational sac . . . ‘Fetus’ means the human offspring developing during pregnancy from the moment of conception and includes the embryonic stage of development.” The bill provided exceptions to the abortion ban only in cases where continuing the pregnancy risked the life of the mother or “the substantial and irreversible impairment of a major bodily function.” It provided no exceptions for rape or incest. It made it illegal for a person to have an abortion starting in a time frame when they might not even know they were pregnant.
I learned I was pregnant on the fourth day of my fifth week. Throughout the morning I composed typo-laden emails and struggled to recall the vocabulary of my profession. Precedent. Contingency. Ex officio. At lunch, my stomach flipped at the sight of a ham sandwich. Upon leaving the office at five o’clock and walking to the parking garage, I discovered I’d lost the ability to climb a flight of stairs without gasping. I drove straight to the store to buy a box of pregnancy tests, and after, back in my car, I had a startling thought: I’m pregnant, my baby is a girl, and her name is Georgina.
Immediately, my Scully brain kicked in to remind me that I knew no such things. I might not be pregnant at all; I could just be coming down with something, maybe COVID. If I were pregnant, it’d be weeks before a doctor would know the sex. And as to Georgina, that was a name I’d never considered and wasn’t sure I liked. I must’ve heard it somewhere recently, I thought—a conversation in the checkout line, or on the show I’d fallen asleep to the night before. But at home an hour later, three tests confirmed my first prediction: I was, in fact, pregnant.
At my first ultrasound scan—twelve days after the Doppler and five days after Ohio’s abortion ban took effect—the nurse practitioner explained that the images showed several “alarming abnormalities.” Possible explanations ranged from “nothing” to conditions that caused severe intellectual disabilities, fatal heart defects, and organs growing outside of a baby’s body. I asked for a genetic screening on the spot. The result arrived a few days later, over Independence Day weekend: positive for Turner Syndrome, or Monosomy X, a genetic disorder in which a female is missing an X chromosome. At a follow-up appointment with Maternal-Fetal Medicine a few days after that, a specialist reminded Brad and me that a genetic screening is, by definition, not a diagnosis but that in light of the accompanying ultrasound images, she was confident in our screening’s conclusion. And so, our baby was, indeed, a girl, and there was a 98 to 99 percent chance—to stretch the meaning of the word—that she would not survive the pregnancy.
As to her name, my third prediction was slightly off. The week before we lost her, I told Brad about my experience on the way home from buying the pregnancy tests. “I don’t know what I believe about God or the universe,” he said, “but I don’t think you ignore a sign like that.” He began saying her name with another “a” added in, and so, our daughter became Georgiana.
. . .
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Karen Maner is a nonfiction writer, a semi-casual gamer, and a proud Daytonian. Her essays have appeared in The Best American Nonrequired Reading, Colorado Review, Ninth Letter, The Rumpus, and Sonora Review and on the notable essays list in The Best American Essays.
