Florida’s 6-week abortion ban: When do women learn they’re pregnant?

Once a destination for women seeking an abortion, Florida now has one of the strictest abortion laws in the nation after Gov. Ron DeSantis signed a bill that bans most procedures after six weeks of pregnancy.

A coalition of abortion providers is already challenging a state law passed last year that banned abortion after 15 weeks and made no exceptions for cases of incest or victims of rape or human trafficking. That case will likely now focus on the constitutionality of Florida’s new law.

The state’s six-week ban does include exemptions for rape and incest up to 15 weeks. But it has been described as effectively a blanket ban by abortion rights advocates, who say it leaves too small a window for women to find out they’re pregnant and to schedule an abortion.

Medical studies and surveys have repeatedly shown that pregnancy awareness — when a woman discovers she’s expecting — typically occurs between five and seven weeks. That suggests that a significant number of people will not be able to get an abortion by the time they discover they are pregnant. Studies also found that poor women and minorities, who data show seek abortions at a higher rate than their peers, are more likely to be among those who miss the legal window to abort.

Here’s a look at what that might mean for those seeking an abortion.

When do women typically find out they’re expecting?

Limited studies on pregnancy awareness have been published. Many researchers have gone public in their call for more money for research they say is critical to ensure those expecting get important prenatal health care as early as possible. The introduction of six-week abortion bans has heightened those calls.

On average, pregnancy awareness occurs at 5.5 weeks, according to a 2018 study of more than 17,000 people using data from the National Survey of Family Growth.

A study from the University of California San Francisco found that 1 in 3 women don’t know they are expecting until they are past six weeks into their pregnancy. And 1 in 7 don’t find out until their seventh week. It also showed that because of lack of access to health care, Black and Hispanic women are more likely than their white peers to be further along before they realize they’re expecting.

The Turnaway Study, also conducted by the University of California, San Francisco, surveyed 1,000 women who went to abortion clinics in 21 states. Of those seeking abortions after the first trimester, or 13 weeks, most had not known they were pregnant for more than eight weeks. More than 1 in 5 recognized pregnancy after 20 weeks. The study found that awareness was delayed either because of a lack of symptoms or because it coincided with other health issues.

“There’s going to be a significant number of persons who aren’t going to know that they’re pregnant until after six weeks,” said Richard Leach, professor and chair of the Department of Obstetrics, Gynecology and Reproductive Biology at Michigan State University.

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What can affect whether someone knows they’re pregnant?

Missing a period has been the telltale sign women have relied on for centuries. But that isn’t always reliable.

Up to a quarter of women experience irregular menstrual cycles, according to National Institutes of Health, making it difficult or impossible for them to rely on it to detect a pregnancy.

Teenagers or people living with strict parents may put off getting a pregnancy test.

Other outside factors such as stress, workload, poverty, homelessness and domestic violence can also lead people to miss or ignore pregnancy symptoms, said Gretchen Ely, professor of social work at the University of Tennessee Knoxville.

“People have a lot going on, especially existing parents,” she said. “Not being housed adequately, having difficulty finding stable employment — those things will take precedence over whether or not you’re worried you might be pregnant.”

There are also cases where a person has few or no symptoms and is unaware they are expecting until very late into the pregnancy. Known as cryptic, or stealth pregnancy, studies show about 1 in 475 pregnancies go unnoticed until about 20 weeks gestation, according to the Mayo Clinic. About 1 in 2,500 pregnancies go undetected until delivery.

How is the age of a fetus determined?

States that provide data to the Centers for Disease Control and Prevention on the number of abortions and gestational age of the fetus do not do so in a uniform manner.

Some states use estimates from clinicians based on measurements of the fetus taken during ultrasounds. Others calculate the age from the first day of a woman’s last menstrual cycle. Florida switched to that method in 2022. Combined with the state’s new restrictions, it means a smaller window for legal abortions since conception typically occurs about 14 days after the start of the last period.

How many abortions occur within the new 6-week time frame?

Just under 75,000 abortions were performed in Florida in 2020, according to the most recent data available through the Centers for Disease and Control’s abortion surveillance program. Those numbers include 1,170 abortions for Alabama residents; 1,452 for Georgia residents; and 408 for those from Mississippi.

The fetus’ age at the time of abortions was calculated using clinician’s estimates. The data shows that almost 56,000 abortions occurred by the sixth week of pregnancy. But the figure is considered an outlier by some experts including the Guttmacher Institute because of how the gestational age was calculated.

Data supplied by the Florida Agency for Health Care Administration shows there were close to 80,000 abortions in Florida in 2021. More than 45,500, or about 57%, occurred after the sixth week calculated from the last menstrual cycle.

Staff writer Romy Ellenbogen contributed to this report.