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When is a heartbeat not a heartbeat?Abortion debate resurrected on Guam

By Mar-Vic Cagurangan

The abortion debate never ends, often tapping emotions, religion and pragmatism rather than science. When does life actually begin? Is a blob of blood the beginning of life? This is a question that even medical experts can’t answer categorically.

Some U.S doctors say advanced technology can detect that first flutter as early as six weeks, but maintain that an embryo isn’t yet a fetus until it develops a heart in the 11th week of pregnancy. Pro-lifers, however, insist that life begins at conception and is not defined by numerical considerations.

The question about “the beginning of life” is the anchor of most abortion laws. Guam’s own statutes have undergone countless amendments, never failing to trigger animosity. It doesn’t matter that abortion has not been accessible on Guam in the past five years since the retirement of the only doctor who provided the pregnancy-termination service.

Each time, it is debated as if it’s a fresh concept. Every proposed amendment finds its way to election debates. But for most Guam politicians, the abortion issue is too hot to handle and too politically risky to take a clear stand on.

“Do you support abortion?” Recognizing that either a “yes” or a “no” answer is political suicide, most candidates running for office would either duck or reply with an elaborate defense, insisting it can’t be answered by simply marking a box.

While it creates a distinct ideological divide in the U.S. mainland’s political landscape, abortion blurs party lines on Guam. The island has a history of legislative conservatism that can be traced back to 1990, when senators passed a very restrictive law that banned all abortions—without even an exception for rape, incest or a fetal deformity —defying the 1973 jurisprudence on Roe v Wade. The Guam Society of Obstetricians & Gynecologists and Guam Nursing Association sought judicial intervention that culminated in a U.S. Supreme Court decision that “guaranteed all women the right to an abortion through the sixth month of pregnancy.”


The abortion debate has once again been resurrected. Democratic Sen. Telena Cruz Nelson, a congressional candidate, last month introduced a bill that would ban abortions after five and six-and-a-half weeks of pregnancy.

“The Guam Heartbeat Act of 2022 was created for one reason–and one reason only,” Nelson said. “It is a bill to protect—to protect—our most vulnerable and give every single human with a heartbeat the fighting chance to live a life, to be able to breathe, to live freely and experience the opportunity to be on this Earth, like all of us here today.”

Modeled after stateside anti-abortion laws, the Guam Heartbeat Act of 2022 prohibits doctors from performing abortions after a fetal heartbeat is detected. It provides exceptions for medical emergencies “where a pregnant woman would lose her life or her health would be severely impaired.”

Bill 291-36 authorizes private citizens the right to file a civil lawsuit, with a minimum of $10,000, against anyone who performs or induces an abortion after a heartbeat has been detected.

The pro-choice women are adamant about their leave-my-body alone stance.

“Women have the right to confidential, affordable and unrestricted access to the full range of reproductive health care options available in 2022, including the option to terminate a pregnancy,” said Jayne Flores, director of the Bureau of Women’s Affairs.


“A woman has the right to decide what is best for her own health, and that includes the right to control what happens within her own body. It is a decision that she should make, in consultation with whomever she trusts and deems important to make it with her,” she added.

The church, naturally, won’t stay on the sidelines. “Unborn children have no way of defending themselves. We must be the ones to protect them against all danger,” Archbishop Michael Byrnes said during a gathering outside the Dulce Nombre de Maria Cathedral-Basilica in Hagatña. “We are the big brothers and sisters of unborn children. Here and across the globe, we are our brothers’ and sisters’ keepers.”

Just when the debate started heating up on Guam, the Fifth Circuit Court of Appeals rejected a central lawsuit filed by abortionists against the Texas Heartbeat Act. The appeals court dismissed the lawsuit that had attempted to overturn the pro-life heartbeat law that bars nearly "50 percent of abortions each day in Texas." Essentially shunning Roe v Wade, the three-judge panel tossed the Heartbeat Act (SB 8) back to the Texas Supreme Court with orders to dismiss all challenges.

“This decision is a major national and local victory for pro-life advocates who have literally waited 50 years to bring an end to the murder of innocent children,” said Peter Sgro, a pro-life attorney. “This case has significant positive impacts to the recently introduced Guam Heartbeat Act of 2022 and further supports the legality of the act.”

The Guam Heartbeat Act of 2022 was modeled after the Texas Heartbeat Act, which is scheduled for a public hearing this month.

Sgro said the section in Nelson’s bill that authorizes civil action by private citizens “leaves that authority in the hands of the people where it rightfully belongs.”

Sgro said the appeals court’s decision on the Texas lawsuit “is yet another string of court victories in favor of saving the lives of the unborn.”

The Ninth Circuit Court’s decision is headed to the U.S conservative-dominated U.S. Supreme Court. Legal analysts predict that throughout the U.S., abortion access could soon depend on a patchwork of state laws given the likelihood of the Supreme Court eventually overturning Roe v Wade.

There are now 23 states including Arizona, Florida, Idaho, Kentucky, Oklahoma and Wyoming, that have laws clamping down on abortion access.

On Guam, Flores said the Heartbeat Act is a moot proposal. “We do not currently have any doctors on Guam who perform abortions, or any doctors on Guam who provide medically induced abortions, that BWA is aware of,” she said.

In July 2018, Guam lost its only doctor who provided pregnancy termination services at the Women’s Clinic in Tamuning. Dr. William Freeman left Guam after his retirement. The doctor who took over the clinic refused to perform abortions, creating an untenable situation for Guam women who wish to end their pregnancies. This means that the closest U.S. abortion clinic is now in Hawaiʻi, an eight-hour and $1,000 flight away.

There are no records of abortions being performed on Guam since Freeman’s retirement. Which doesn’t mean no woman on Guam has had an abortion. Tele-abortion is one option for those who cannot afford the travel cost. Again, the legislature attempted to block women’s access to this medicated-assisted tele-abortion practice by adding layers of requirements that restrict the medical process.

In September last year, Chief Federal Judge Frances Tydingco-Gatewood ruled that seeking an abortion with remote guidance from off-shore physicians must be permitted on Guam.

The court issued a preliminary injunction on Guam laws requiring that abortions be “performed” in a clinic or hospital, and after completing government-mandated counseling "in person."

Ruling in favor of two Hawai’i doctors, Drs. Shandhini Raidoo and Bliss Kaneshiro, who sued Guam, Tydingco-Gatewood pointed out that the government failed to support its argument about the "superiority" of in-person communication, other than invoking “common sense.”

Unlike the traditional abortion procedures performed in clinics by a doctor, medication abortion can be self-administered by the patient herself. Raidoo and Kaneshiro said they were willing to remotely supply abortion pills.

"The undisputed evidence before the court all points to the fact that live, face-to-face video conferencing is comparable to, and may even have some benefits over, in-person communication," the court said.

In a predominantly Catholic community, however, court decisions won’t put an end to the abortion debate.

“I gave provisional support of the bill in a letter last week, with the understanding that we would review the final version. We have done so and now welcome this powerful pro-life legislation,” Byrnes said.

The Republican Party is the church’s ally. “Another false narrative that is always part of this argument is that proponents for this type of legislation don’t address social issues, such as, but not limited to, foster care, adoption, homelessness, and sexual assault,” the Republican Party of Guam said in a statement. “These are issues that require a moral responsibility which should be addressed by all parties, always, regardless of their position on abortion. We don’t need to fix the world to justify a person’s existence, and equally important is that we can’t only start addressing these social issues when pro-life measures are introduced.”

But as far as Flores is concerned, the proposed Heartbeat Act is nothing but “a pro-vote bill, not a pro-life bill.”


“Being ‘pro-life’ is addressing the nearly 2,000 children in our foster care system. The sponsors of ‘The Guam Heartbeat Act’ should focus their ‘pro-life’ efforts on improving, expanding, or establishing social programs to make raising children easier and more affordable.”

Following the introduction of Nelson’s Heartbeat bill, Vice Speaker Tina Rose M

uña Barnes proposed Bill 293-36, titled “the Pregnancy Support Act of 2022,” which would allow a court to award child support payments while the child is still in the womb and retroactively up to the sixth week of gestational age.

The bill would require expectant fathers to share the costs of pregnancy expenses. If paternity is disputed, child support payments and shared costs of pregnancy expenses would be paid retroactively once paternity is established.

“The health of the mother is essential to a successful pregnancy and the birth of a healthy baby. By ensuring fathers take responsibility for the life they helped create, the Pregnancy Support Act of 2022 helps expectant mothers throughout pregnancy,” Muña Barnes said.

“If we as a community decide that a woman must carry a baby to term, we need to have their back. That means ensuring that men step up and pay their fair share.”

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