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What is considered a fetal heartbeat and when can it be detected?

The legality of the Texas Heartbeat Act has been widely debated, but some people also have questions about what is medically considered a fetal heartbeat.

TEXAS, USA — The Texas abortion law that passed last year is best known as the “Texas Heartbeat Act.” The law has faced multiple legal challenges and has been widely debated, but one viewer reached out to KVUE about some of the medical terminologies in the law. 

We spoke with three doctors of varying political beliefs to get that viewer's question answered.

The law essentially bans abortions after a fetal heartbeat is detected. But although the title of the law uses the term “heartbeat,” the text of the law also uses the term “cardiac activity.”

Our viewer wanted to know: Is it correct to say a "fetal heartbeat" can be detected at six weeks?

Dr. Jennifer Villavicencio, the lead for equity transformation with the American College of Obstetricians and Gynecologists in Washington, D.C., said she believes it is more accurate to call it "cardiac activity" since the heart is not fully developed yet at six weeks.

It's the electrical impulses that will eventually begin to form the anatomy of the human heart,” Villavicencio said. “So, when we say, 'Can you detect a fetal heartbeat?,' it's complex because we can start to see the beginnings of it, but it’s not the entire anatomical heart. It's not developed at that point.”

KVUE also spoke with two other doctors, Dr. Ingrid Skop and Dr. Blake Weidaw. 

Skop is a board-certified OBGYN who has a private practice in San Antonio and is also the medical director of The Source nonprofit clinics. Weidaw is a board-certified OBGYN with the Vitae Clinic in Austin. 

Both agreed the heart is not fully formed at six weeks, but they believe the term “fetal heartbeat” is the correct wording for what is being detected by ultrasound at six weeks into pregnancy.

“The reality is, the structure is present – the heart, the blood cells are present to be pumped, and the electrical activity is present,” Skop said. “Now, the heart will get more complicated. So, at this initial point, it's more or less a tube, but it will convolute and fold so that it has four chambers, so that it has valves.”

The heart's not fully formed at six weeks,” Weidaw said. “There's still development that's happening, but there definitely is a heartbeat.”

When doctors listen to an adult heartbeat by stethoscope, they say the sound we hear is the heart's valves opening and closing. But those valves are not yet formed during the sixth week of pregnancy.

Those valves are not present until about 10 to 12 weeks of pregnancy,” Villavicencio said. “And so, you're not able to really hear those valves opening and closing until they've developed and are present. So, the heartbeat that you're hearing very early in pregnancy is actually a machine.”

The machine she is talking about is a doppler ultrasound machine, which measures sound waves that are reflected from moving objects, like flowing red blood cells.

“Some of our ultrasound machines have the ability to do doppler flow so that you can actually hear it then,” Skop said. “But the doppler through the abdomen that an obstetrician does typically is about four weeks later.”

So, in conclusion, all three doctors KVUE spoke with agreed that six weeks into pregnancy, the heart is not fully formed and is still developing, but fetal "cardiac activity" can be detected. Two doctors consider this to be called a "fetal heartbeat," while the other says it is more complicated.

Villavicencio and the American College of Obstetricians and Gynecologists have voiced her opposition to the Texas Heartbeat Act, while Skop has voiced her support of the law. Weidaw's place of work, the Vitae Clinic, is Catholic-based and does not provide or refer abortions. 

Although the viewer's question is medically-based, we wanted to make sure we heard from a variety of doctors to get the most well-rounded and medically-factual answer possible.

When it comes to the law itself, the Texas Heartbeat Act has faced multiple legal challenges since it went into effect five months ago. The U.S. Supreme Court heard arguments related to the law but didn't intervene to stop it. Right now, a court case challenging the law is waiting to be heard by the Texas Supreme Court.

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