"It's not only possible to miss a pregnancy at six weeks, it is very, very common," says Gillian Dean, MD, senior director of medical services at Planned Parenthood, noting that "six weeks" refers to "six weeks LMP," or after your last menstrual period. "If someone is six weeks after their last menstrual cycle and they have a 28-day menstrual cycle, that means they're only two weeks late for their period. But what if you have a much longer cycle?" says Dr. Dean.
In addition to that allegedly tell-tale late period (I'll come back to that), early symptoms of pregnancy include nausea, exhaustion, mood swings, and breast tenderness, "all of which can be attributed to just about anything else," says Mary Jane Minkin, MD, an OB/GYN. Or, none of these things could happen at all. That's the thing about pregnancies—they're so radically different for everyone who experiences one. Starting with, as mentioned, your missed period.
"Some women have erratic periods, and some women don't keep track of their periods all that closely," says Dr. Minkin. Meaning, "they won't even notice [they're late] until they've skipped a month entirely." There's also a chance, she says, that women might not take a pregnancy test because they believe they did, in fact, get their period. "About a third of all women will have some bleeding in the first trimester of pregnancy," says Dr. Minkin. "They'll say, 'Oh, I’m bleeding! It’s a period,' so they may not even think that they’ve skipped a period when they might have."
After learning you're pregnant, in places where abortions are illegal after six weeks, seeking the procedure becomes a race against the clock... or a complete impossibility, considering some abortion clinics won't perform them until shortly before the six-week mark. "Many health care providers will not initiate a medication or aspiration abortion until somebody is beyond five, six, or sometimes even more weeks of pregnancy, because they want to be sure that the patient has an intrauterine pregnancy before initiating the termination," says Dr. Dean, noting that the earliest a pregnancy will even show up on a an ultrasound is—at the absolute earliest—slightly before the five-week mark. (It's important to note that different health care providers have different criteria for when they'll perform abortion, and as medication abortion becomes more common, abortions prior to five weeks are becoming more common, if allowed by the health care provider.)
Even when pregnancy is detected six days before your period (which is the absolute earliest an at-home pregnancy test can give an accurate reading, says Dr. Minkin), getting a procedure within six weeks can still be a challenge. Many women have to travel to get an abortion—per abortion rights group Guttmacher, in 2014, 90 percent of U.S. counties had no clinics providing abortions—and some states, including Georgia, require a mandatory 24- to 48-hour waiting period between your first consultation and the abortion procedure, adding yet another element to squeeze into the tight timeline.
That is, if you can even make an appointment. "Often the people providing abortions are very, very busy, and they're serving large geographic regions because the number of abortion providers across the country are dwindling," says Dr. Dean. "So these health centers...may not be able to accommodate an appointment right away, and there could sometimes be a delay of a day or a week or even more." And, because some insurance providers won't cover abortion, coming up with the funds for a procedure could also delay a woman's appointment.
As Rep. Alexandria Ocasio-Cortez (D-N.Y.)—and many others—pointed out on Twitter in the last 24 hours, this bill seems to be nothing more than a "backdoor ban" on abortion in its entirety. And it's putting women in danger.
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