SIO480: Abortion Legislation Gets Embryonic Terminology and Facts All Wrong

Transcript

This transcript was generated automatically and may contain errors — the audio is the record.

0:00:16 Thomas: Hello, and welcome to Serious Inquiries Only. This is episode 480. I'm Thomas Smith, and I am so excited for today's episode. This a unique one. This really cool. So, Dr. Nathan Thompson and soon to be Dr. Rachel Feltman are on the show today. They are researchers who were inspired by opening arguments, apparently, to do some research on how well does abortion legislation throughout the country reflect medical reality? How, how medically accurate is it? I I suppose. And it won't surprise you to learn it's not super, not amazingly so. And I just think this was such a cool study to do, a really important study to doing, something that I think really should make waves. I hope people notice this because I think it should matter that when you look at abortion legislation systematically and you study it, that the results of how medically accurate it is are not good. I get that we all have such low expectations, but like, come on, that's not good, so this is super cool. I'm really excited, and it was awesome of Nathan and Rachel to come on the show and to reach out and tell us what they were doing. Why don't we just get on over to the interview, and they'll tell you more about it and themselves, but first, we have to take a quick break, and you can avoid that at patreon.com/seriouspod. Please support the show your support is so important it's the only reason we are able to do the show and I feel like it's a unique show I hope it offers something that other shows don't so if you find that valuable any amount you can contribute and if you can't we understand I'd ask you to share the show if you could or get right at a nice review all of these things are fantastic and thank you so much for doing them but if you pledge at patreon.com/seriouspod you get to avoid this ad that you're probably hearing right now so that's the best reason all All right, we'll take that ad break and then be on with Dr. Nathan Thompson and Rachel Feltman.

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0:02:19 Thomas: And I'm joined by Nathan Thompson and Rachel Feldman. How are you doing today?

0:02:23 Nathan: We're good. Thank you for having us.

0:02:23 Rachel: Good. Yeah, thank you.

0:02:24 Thomas: Oh yeah, I always forget when I have two people on an interview, I have to like very much do a turn system. Ah, start with, you know, I have point to someone, but I can't. Let's roll a die to see who goes first. No, thank you both so much for coming on. I'm really excited about this. Well, why don't we just dig into it? I'd love to know first a little bit about you and I will go ahead and randomly select Rachel first, just so there's no confusion when I ask a general question of everybody. Oh, nice. Yeah, it sounds like you did a good one. Not every master's thesis is podcast worthy. I'm going to say it. I're going to go ahead and say it, sure. Well, what do you do then if you want two seconds on what you normally do? Oh, wow. Right. Well it was Adam and Eve and then they yeah yeah

0:02:48 Rachel: I'm a fourth-year medical student at New York Institute of Technology, College of Osteopathic Medicine. And I just matched into residency at Albany Medical Center in obstetrics and gynecology. And this research that we're talking about today was actually my master's thesis project. So it's really exciting for me to be on this podcast to talk about it. Yes. Yes.

0:03:18 Nathan: Yeah, I absolutely agree. So yeah, I'm Nathan Thompson. I'm an associate professor of anatomy at NYT College of Osteopathic Medicine. And yeah, this was a really, really fun project that we worked on for this thesis. It's kind of, in many ways, very different than what I do. And it was definitely a fun kind of different thing for Rachel as well. So if you want, I mean, we can just kind of dig in and talk a little bit about the origins of it. Yeah, well, so I'm an anatomist, so I teach anatomy to first year medical students at our medical school. My research is actually in the slightly less controversial, but only slightly area of human origin. So I'm actually a biomechanist. So I am usually studying kind of the origins of walking on two legs and the interactions of muscles and bones and ligaments and other things.

0:04:05 Nathan: Yeah, exactly, and then that was it. So usually most of my research is just called Adam and Eve. Yeah.

0:04:10 Thomas: It's an easy job cushy gig yeah me too I won't tell your students that though don't don't confess that on a podcast or anything you know

0:04:14 Nathan: Well, we had an explicit conversation at the beginning of this study because I told her, I remember telling Rachel, you know, I have gotten hate mail before, so I'm not foreign to it, but you might be. So if that happens, just forward it to me. So that's kind of my wheelhouse. And, you know—and I'll preface this that, you Know, I'm kind of embryologically adjacent. You know, I'm an anatomist. Yeah, adjacent to it. And I teach a little bit of embryology, but, you you know, I knew more embryology in grad school than I do now.

0:04:45 Nathan: Well, if, yeah, I know, right? Or if my professors listen to this, they're going to be really disappointed in me.

0:04:51 Thomas: Yeah oh nice oh that's

0:04:52 Nathan: So this project started in about 2021. So I, yeah. I've been an opening arguments listener for a long time, opening arguments listener, for a lot of time since like the stormy Daniel days is basically when I got into it. And so, you know I had posted on the Reddit that the show kind of inspired this study in some ways because we look back and it was about 2021 where, where we started this and And it was around the time that the first kind of heartbeat bans were being really widely discussed. You know, Texas SB8 was a big one. And at the time, that was the biggest threat to rights and women's rights that we can think about, which seems very different these days.

0:05:25 Thomas: Awesome wait is are we on the bounty hunter one or am I is that before this Oh, okay. Because, I mean, this stuff goes back a long ways, right?

0:05:31 Nathan: Yeah, that's that's the that's The Bounty Hunter one. Yeah. Yes.

0:05:36 Thomas: In terms of trying to do it, but just not being able to. Yeah. Mm -mm. Mm -hmm. Yeah. Test what exactly when you say that? Mm. I think Rachel was just trying to turn in a paper that said, yes, and then done. Like, just saving work, you know?

0:05:38 Nathan: Yeah. And just being very explicit and unapologetic, you know, that we're not trying to find, you know, ways to make it hard, but just we're just going to straight up ban these things and create this kind of bounty hunter system. And I remember listening to the show while you guys were talking about it and thinking like, man, these are called heartbeat bands, but you don't really even have a heart at some of these time points. And it's like, someone should be able to test this. And then I remember thinking, it's not like, wait, I work at a medical school. I teach anatomy. I should beable to test it. I should test this." So yeah, so what we wanted to do is we wanted the look at how these pieces of legislation are using anatomical and embryological language. So are they using anatômical facts? Are they using anatómical language accurately? Or is it being used in a way that is maybe inaccurate or misleading? So that was the goal, right? It sounds kind of like we should be able to figure out the result of this before ever doing this.

0:06:38 Rachel: Yeah, the easy way out.

0:06:39 Thomas: Yeah, no, that's not how you scientists do it.

0:06:42 Nathan: Well, that's actually where we turned our wheels a lot at the beginning of this project is, you know, Rachel and I had met early on and we're like, man, what are we even doing? Like, how are we going to do this? Um, because both of us were new to legal stuff and legislative process. And we're looking at these pieces of legislation and just like, couldn't really figure out how to make this work. And then it, it kind of hit the back burner for a while. And dann once the decision in, in 2022, once the Dobbs versus versus Jackson Hole Women's Health decision leaked, the decision overturning Roe v. Wade leaked, we actually like both were writing, kind of crossing emails to each other saying, we should look at this again.

0:07:21 Nathan: We should do this project again. So actually, maybe if Rachel, if you want to kind of just take us through kind of how we approach the question and kind of what we found that finally kind of gave us the key in terms of how to approach this.

0:07:21 Rachel: When we first started I remember looking we didn't know what how to go about finding the laws and I remember we made a whole list of all these different states and we started researching and then we finally came across the Guttmacher legislation tracker and they have different sections and the section that we specifically looked at was the abortion ban section and so So they had all of these different pieces of legislation that had to do with abortion bans, and they divided it by state and then either House bill or Senate bill and the number. So we started looking through each of those, and we collected the pieces of legislation from January of 2016 until January of 2023. And our goal was to focus on the pieces that contained a specific legislative finding section or a legislative intent, fact, or purpose section with specific anatomical or embryological statements.

0:08:32 Rachel: And so we found 56 pieces of legislation from 23 states. And the initial number of statements we had was a lot. We had about 155 statements from each of these different pieces of legislation. We looked at only ones that passed at the end. Yeah. So we compiled the list of all the statements and we kind of went through each one. And a lot of them were very similar. The wording was a little different. Some referred to it as an unborn child or they had different language that they would use, but ultimately have the same same anatomical fact in the end. And so we narrowed down each of those statements and had more of the common statements, and we ended up with 57 anatomical

0:08:47 Thomas: Are you looking at only ones that passed, or are you looking it proposed as well? Oh, wow. Okay.

0:09:24 Rachel: Or embryological facts that we included in our survey.

0:09:27 Thomas: Now, I know some of the states or a lot of the states had trigger laws. Did any of those end up being ones you looked at? And those were the laws that like they passed before Roe v. Wade was struck down and they were ready to go as soon as Roe V. Wade were struck down, they went into effect. But I don't know when they would have been passed. Is it a bunch of whereases? Ah, okay. Yeah, they don't do those ones anymore. But once upon a time, those were great. Teeth. Sorry, that took me a second. I was like, they don't, they don't though, unless I don't. I mean, I know they grow that coat of fur at some point that then goes away. Is it like that? Yeah. It's not like these conservatives haven't had kids, right? I mean come on. That's what they're famous for.

0:09:42 Nathan: Oh, yeah. So some of them were, you know, we didn't, it's funny because we did this and we didn't pay a lot of attention to that kind of category of law that it fell under, like whether whether or not it was a heartbeat ban or if it was one of the kind of trigger law bans. Some of them definitely were in that trigger law category because we saw that language written in there. And maybe to back up a second too, like one of things that was really the key to kind of cracking this nut in terms of how we could approach this was kind of recognizing the importance of that legislative findings section. And not every state has this. And even among the states that we looked at, not every piece of legislation had it. And the way that I kind of of described this to people as, you know, it's it's that section that's supposed to explain why a state is actually doing something. Right. So, yes. Well, yeah. In some. Yes. It's usually a statement that says, you Know, the general legislature finds that. And then we got a, you know. A variably long list of statements. And I like to describe it as like, OK, you know, whereas the river is polluted, therefore we are going to clean the river. That's how you want it to work. Right? Yeah. The ones that the ones that make sense don't actually happened. So we really combed through all these legislative findings statements, and many of them were statements of court findings or other statements of legality, things that weren't really in our wheelhouse or something that wasn't really the goal of this study. But many of them did have these kind of statements of development. And that's what we wanted to look at. So you'd find statements that are saying the unborn child has teeth at 11 weeks or or pain receptors are present throughout. And yeah, well, well. Well, so that, so this is where, I mean, and this is exactly why we wanted to look at this, right. Is that, you know, anyone, certainly anyone who's, who's had a, a child born knows this, but you know most people who haven't know this too.

0:11:39 Nathan: Teeth are funny because if, if you haven't before, you should look up an x -ray or an MRI of, of teeth of a, you know, an infant and, and they're there, right? I mean the teeth actually are present quite a ways before the eruption of the tooth. But I mean, this is where we want to get out. I mean these things are complicated. And in an embryo or fetus, you have kind of primordial development of some of these structures really early. But it's nothing that anyone would ever recognize as a tooth. And, in fact, like in the case of a tooth, it's a tooth bud. And then there's this complicated stages of bell development and cap development and all these things that go on.

0:12:12 Nathan: And it's just not what anyone would call a tooth right.

0:12:12 Thomas: To be fair though, the molars is where the personhood is though. So if you,

0:12:17 Nathan: Yeah, exactly. And And some people are missing their third one and they're just soulless. I mean, we all know this. So that's that was kind of the link is, you know, really kind of recognizing that a lot of these states do try to put these anatomical statements in the legislative findings and that and now, OK, now we have something that we can coalesce, we can line them up, we can standardize the language and we can actually bring these statements forth and say, OK. People that are experts in this field, like what is the consensus about how accurate or misleading these statements are?

0:12:18 Thomas: That's where the soul is. Yeah. Now, did it matter what kind of purpose the language had? Like, I guess at first I wasn't sure, is it about how these things are going to be enforced or like, or how these laws are going to interact with the medical system? Or is it more about we're trying to figure out what the people who are passing these things seem to think about how humans work? Okay. Yeah, what

0:13:09 Nathan: It's the latter. It seems to be most of, and we tried looking for some trends just kind of anecdotally and, you know, and there's a lot of mining here still to be done, but there didn't really seem to be a link between the goal of the law and the statements being included in many cases. And sometimes there was, right? You know, some of these heartbeat ban bills wanted to ban all abortions after six weeks. And so obviously a lot OF those statements surround that kind of heart development and blood pumping and things that happen around six weeks, but that wasn't uniform. And in fact, yeah, we did have examples of states where there was one state we can talk about it. It was New Hampshire that was trying to redefine viability that happening at 24 weeks. But the only statement of anatomy they used in there was about pain development, which was at a different milestone anyways. And so, you know, there's some complicatedness here, but there's also a lot of just illogical kind of mashing together of statements too. And we can talk about some, well, funny, other than they affect a lot of people, examples of how that kind of plays out. But yeah, it was more so that these statements were like, here's things that we as legislatures recognize are important developmental milestones, and therefore we want to be able to use these to pass some kind of ban date at some area, and Therefore, we think this is justified. Now, we did have to kind of create some thresholds for what we could actually test, because, you know, when you look at a lot of these statements, a lot Of them were legal, a lot of them were things that just like, aren't testable. So we ended up creating this kind of four prongs test,

0:14:41 Thomas: Do you mean by I test? I guess I wasn't sure where you were going there. Testing the accuracy of them kind of thing. Okay. Right. Yeah. Yeah, yeah. Well, it's also dependent on like the scientific advances since then, I guess. So like the ones before that didn't quite establish that. But then starting then, it's kind of interesting.

0:14:47 Nathan: Right? So we had to we had to in kind of asking experts, okay, is this accurate? Is this misleading? It had to be a statement that people could actually evaluate, right. And so like, And I have some funny examples of ones that aren't. So, for instance, we looked at Arkansas SB 149, which was passed in 2019. And one of the statements they have is new scientific advances have demonstrated since 1973 that life begins at the moment of conception and the child in a woman's womb is a human being. And so I always thought that was a funny one because, oh yeah, before 1973, it was actually an alien. But since 1973, now we know that it's a human.

0:15:35 Thomas: Yeah but it's like it's a fact checker website where you're like, well, can't really evaluate this because it's nonsense or not even a fact claim, I Guess. Yeah But

0:15:42 Nathan: Right. Yeah. Aside from like, it's very, you know, compound statement. We can't test where life begins. Okay. We're not all priests. So what we did is we said, okay, first of all, the statement has to be, you know, some kind of, you know, anatomical or embryological fact. It has to be falsifiable. So we can't have something that just isn't provable or not provable. We only focused on statements that really referred to kind of like, well, mostly referred to specific time points in development because a lot of statements were kind of, like, the body develops lungs. It's like, Well, yeah, of course it does because we're born with lungs. And we avoided statements that required some kind of specialized, super specialized knowledge. Like there was one state that referred to some specifics about using in utero anesthesia. It's like, okay, this is a type of knowledge that is way beyond what someone with normal developmental expertise could, could evaluate.

0:16:33 Thomas: What's the purpose of that like why are they even doing that oof yeah

0:16:36 Nathan: Well, good question. I mean, I think in some cases when you compile a lot of these facts, like they're geared to be a story, right? And that Arkansas bill that I had mentioned as SB 149, when you look at all these findings in order, you know, it's a lot okay, whereas Plessy v. Ferguson was wrongly decided, whereas Whereas Dred Scott was wrongly decided, whereas you can overturn the Supreme Court when something is wrongly decided. Okay. Now, you know, it's clearly setting up the story of like, we know that the Supreme Court can change its mind. And now, whereas, and then they have all the anatomical statements, whereas an unborn child can do X, Y, Z things by a certain date. Okay, now we're setting up the story that this thing is, you Know, an autonomous being in the womb by six weeks. Now we're Setting off the threshold for abortion at six weeks, so in some cases, is they kind of read almost as a story to try to bolster their decision. And so some of these statements that are, you know, totally, in my mind, untestable, are, in MyMind, being used to kind of invoke this storyline

0:17:33 Nathan: As you go through that finding section.

0:17:33 Thomas: Well specifically the anesthesia thing you mentioned I guess I don't have all the detail on that but is there I guess my first instinct was is there a sense that anyone's trying to like bolster their their their cred a little bit by trying to do some technical talk or something or or is it all specifically toward a purpose uh in your mind

0:17:52 Nathan: Yeah, well, Rachel, do you want to cover this? Because the anesthesia ties into this other kind of category of statements that was on pain recognition, which has a really interesting tie -in to viability. But Rachel, Rachel, you can speak better to that.

0:18:06 Rachel: It was really interesting. Interesting. So a lot of the statements that we found about pain recognition and like the development of neurons in the pain system in a fetus occurs around 20 weeks. So, a lot of these viability bands use that 20 -week pain as when a fetUS becomes viable. But if you actually look at the medicine behind viability, a Lot of it has to do with the circumstances behind the pregnancy, the sex of the fetus, the gestational age of the fetus the weight. So all of these different aspects just beyond pain. And a lot of the time, like viability isn't until about 22 to 23 weeks.

0:18:50 Thomas: Yeah why would pain have anything to do with viability it feels like two different questions

0:18:53 Rachel: Right, right. And so like, as someone who wants to go into OBGYN and is going to be delivering babies, like I wouldn't say that a fetus is viable because they they have pain receptors. Like I would say that a fetus is viable if they can survive outside of the womb and we have the resources, like if the baby is preterm and we Have the resources to support them. So a lot of it is like in New York State where we are, we have a lot of resources and really good NICUs, but some other places in the country don't have as many resources. And so their level of viability might be different because they just don't have the Resources to resuscitate or help a child when they're born. So yeah, that was was interesting for me.

0:19:33 Thomas: Does seem like bad luck if you're all into this whole fetal personhood and all all this stuff, like if it depends on which hospital you happen to be in, like how viable you are, that seems like bad luck.

0:19:44 Rachel: Yeah. Yeah, it was interesting. Some of the hospitals that I did rotations in, their NICU could only handle babies as old as 25 weeks of gestation, but then you could get transferred to a hospital that has more resources, and then the NICu could handle a child that would be 22 weeks or 23 weeks.

0:20:06 Thomas: But I guess now that I think about it, I think what conservatives have tried to do is find like the world record for that and then say that's the new line for everybody, right? I suppose that tends to be how they do it. I think, right, they're like, well, they've shown it's as viable as early as such and such week, so that should be when the rule is.

0:20:23 Nathan: And I believe we even saw that in some of the legislative findings where, you know, whereas there have been children born at the age of, or at the gestational age of X, but this pain thing was an interesting phenomenon because I guess, you Know, we hadn't really thought about it, but yeah, it seems to be a very deliberate strategy to, you know, attempt to move viability from 24 to 28 week period, which is kind of the traditional traditional, viability landmark, at least 28 weeks. And it's been scooting up. But the idea now is, hey, if we can show that pain exists by 20 weeks, by 15 weeks, By 12 weeks by 10 weeks, and one of the statements we actually tested was, an unborn child may feel pain as early as five and a half weeks, you know, I think the idea is, Hey, let's keep scooting that threshold up. Therefore, pain somehow equals viability, which, you Know,

0:21:10 Thomas: Well, or is it that you're just abandoning the viability standard? Is that what it is? They're certainly now they're not worried about that anymore right or as a limiting factor maybe some of them still yeah I was gonna say yeah I want to I'm worried about like yeah putting out out uh the inaccurate information to listeners casually not

0:21:21 Nathan: So I think in some cases, you know, looking at this from the outside, it did seem to be an honest attempt to try to redefine viability. I think, in other cases, yeah, it seems like a way to just kind of like totally blow past viability altogether. I mean, especially when you're talking at, you Know, some of the statements we evaluated, actually, many of these are from the same law, which makes no sense. But in Tennessee, HB 2263, you Now, they, at various point talked about a child may feel pain as early as five and a half weeks. Uh, the neural connections for pain responses are in place by 10 weeks. Now we haven't talked about the accuracy of these and these kinds of pain statements. Sure, sure.

0:22:02 Thomas: Fine so when these are all we're all still in the bullshit phase right how

0:22:06 Nathan: Yeah. So the, that's why we, I actually wanted to jump to this because the fact that anyone was talking about anesthesia and these laws is only to do with the fact that development of pain and, and, neuronal connections to feel pain. Those were statements that we saw kind of over and over. And that pain category among our kind of expert evaluators, that was the least accurate and, you know, most misleading of the statements that we saw. So these statements about early development of pain were kind of in the range of, now we haven't really talked quite about our scale, but, you know, more inaccurate than accurate. And some of them kind of approach this completely. Yeah.

0:22:39 Thomas: Many pinocchios did you do the pinocchio scale talk about your scale

0:22:42 Nathan: So it's a 1 .4 Pinocchio. That would have been great, a graphic that has Pinocchios nose going no um yeah so so all these pain statements did pretty horribly among our among our you know evaluators one of the things that we did and that this also helped us kind of help contextualize this study we based our scale on a study by daniels at all which came out in 2016 and this this was the only other study that that we found that did something like this which was you know honestly pretty surprising to us we thought that someone must have kind of have have published on this before, but Cynthia Daniels in 2016 did something similar, but their team evaluated state -authored mandatory informed consent material. So in states that have passed laws where the hospital has to provide you material or the clinic or whatever it is has to provide your material, how accurate is the information on that material and how misleading is it? And so they had a scale that we mirror here. And actually we, both of our studies drew drew on the same kind of population of experts, which is really nice for comparison purposes. But the scale basically is a one to five. It goes from completely inaccurate to completely accurate. And then, you know, a three in the middle is essentially, you Know, equally accurate and inaccurate.

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0:24:04 Thomas: That seems abstract how does that now all of a sudden I'm like how do you even say that Oh, yeah, please. That's what it should. That should be the standard.

0:24:09 Nathan: Yeah. And we can go through some examples that kind of fall in interesting places on this list. And as we were putting these results together and writing the paper, you know what we did is we tested it against five, which has completely accurate in my mind, And, you know, right. Yes. When you're writing a law and you're riding a law that is going to affect people's health and we know it does and we know it affects people detrimentally when they can't get to the health care they need. The threshold should be completely accurate in my mind in terms of.

0:24:24 Thomas: Really, you could have done a binary, you know, like. Right. Yeah, I could imagine a either a binary or like a completely accurate, immaterially inaccurate. Like maybe there's a typo somewhere. Maybe there's something that's inconsequential and then inaccurate. Like that really seems to be like what's important here. Not to critique your scale, but but yeah, I agree that the standard for humans for writing laws that infect people's lives, you'd hope it's going to be pretty much all fives.

0:24:58 Nathan: And we talk about that. I mean, we were talking about this the other day, like when I teach, I have a lecture where part of it it covers development of the lungs, right? And I don't talk about the development in the heart in the lecture, but I need to put it on the slide because it's in the slide. So I just put heart or developing heart or something, right. And, and that's inaccurate, but I'm not talking about it. The students know that that's not the case, but yeah, exactly. If you're passing a law where people's health is going to be affected, you'd want it to be that five, that completely inaccurate and, or sorry, completely accurate and completely non -misleading. And so kind of looking at around rounded our statements, the kind of the best ones were limb and motor movement. Um, so for instance, one of the Best Statement that we encountered the most accurate, just to give you an idea of like what the best was, was a statement that's an unborn human being at eight weeks gestational age shows developing limbs. That was the best. Um... And, and it's true. I mean, I, you know, I, I didn't take the, I Didn't actually take the survey. A, I don't feel like I'm smart enough, but B, I was too involved. But, um, you look up pictures of a, of an embryo at eight eight weeks and you see little, they're called limb buds, you know, four limb bud and high limb bud, but they're there, you Know, and so that statement got a 4 .26, which in our scale is between completely accurate and more accurate than inaccurate.

0:25:46 Thomas: Okay. Yeah. Yeah, sure. Okay, sure Mm -mm.

0:26:12 Nathan: The other thing that you kind of got to, um, we always have to think about is in that statement that I read, you know, we are still using this phrase in unborn human being and different States had different ways of kind of referring to the thing that is in the womb. And at some point we kind we had this list of 100 and something statements, and many of them were just duplicates, but they all use slightly different language. So we did have to figure out a way to kind of standardize what we're calling that. But we didn't want to fix it, right? There are statements about at six weeks, the unborn child, the Unborn Human, and we didn'T want to correct it and be like the embryo, because that's not what the law says. And we didn 'T want to have to go in and make kind of meaningful changes. So what we did is, in all of our statements, we referred to it as an Unborn human being, that seems to have been what the majority of the pieces of legislation use. And compared to the opposite, it seemed to be the less kind of emotion inducing because the other options were an unborn child, which seems a little bit more immediately, a little bit more misleading than an unborne human being. So, you know, as we interpret these statements, it's hard to, you know, that limb question to me, you know, maybe if I had scored, I would have given a five, but it also still uses that language and unborn human being so we don't really, you You know, we don't know how the evaluators were kind of using this information. So it's in some ways, you know, when I look at these numbers, I look at them somewhat relative to, but, you know, some statements do pretty good and that some statements do really bad.

0:27:31 Thomas: Yeah Well, I want to make sure I was understanding it because for a second It sounded like you're saying you standardize or maybe did some sort of like when you clean up the the data before you're giving it To somebody like you were sound like you Were doing that but then it sounded like he said people might have been reacting to That language in different ways still so I wasn't sure which Okay,

0:27:50 Nathan: It's a bit of both. Yeah. So for instance, each of these laws, you know, many of these law, you're going to use the same statement over and over, but there would be slight grammatical changes. And so when I'm looking at a statement, I'm just looking through our list here. So for example, there's a state that at nine weeks gestation, eyes are present. That statement comes in a couple of different forms. You know, some use the number nine in addition to spelled out nine. Some use an apostrophe after weeks, which is just grammatically wrong. So I don't know where that came from. And so, you know, there's a certain amount of sanitizing just, yes. Yeah.

0:28:22 Thomas: You should let one grammar Nazi do a review as well, just for fun. I'll do it just for Fun. It's not important to the study. It was a little bonus for patrons.

0:28:31 Nathan: So what, yeah, for patrons, exactly. So, what we did is like, you know, of those kind of four iterations of statements, we picked one that always uses the same format. So, you Know, we pick that nine weeks and station eyes are present, we didn't use a number. That example I just said is from Arizona SB 1164. But that statement is the same statement on four different laws. There are some instances, like I said, where some states use an unborn human being and some states us unborn children. And in those cases, you You know, this was a super long long survey and instrument for the people that were taking it. So we couldn't have them kind of test six different statements that are all testing the same underlying fact. So now when we did decide in those cases, we did decide on, okay, if we need to refer to the developing thing in the womb, what are we going to call it? And we called it an unborn human being. Cause we thought that was the most,

0:29:06 Thomas: Sure. Gotcha. Sort of neutral.

0:29:18 Rachel: Neutral yeah

0:29:19 Nathan: Yeah, the most neutral, like least kind of like, yeah exactly. Right. Yeah. We want to be conservative and not, you know, prompt an emotional reaction. As soon as you read the first first word, we want to test the content. Yeah.

0:29:19 Thomas: Yeah. Because you want to test the other parts of it. Like you're not really. Yeah, OK, gotcha.

0:29:31 Thomas: Because it's not you folks evaluating. It is this like like experts that you talk about that so you found experts to evaluate the truth statements right right

0:29:38 Rachel: So we connected with um the american association for anatomy we um used their like email list of all of their members um and just sent the survey out to the anatomy experts and that's also who daniel's used in their paper that was their panel of experts as well.

0:29:57 Thomas: Yeah I'll have your badge sir and do you pepper in some real ones too like just make sure nobody gets the pattern that this is all bullshit republican bills yeah oh you didn't have any control like you know just uh from a textbook book or something to get some controls in

0:29:59 Nathan: And this is kind of our, you know, this is, I'm a member of the American Association for Anatomists. I hope I said it right. Cause I always forget if it's for anatomy or for anatomists, whatever it is. I'm member, so I should know, but it's, it's a, I know, all right, I don't want to lose my membership, but it said, you Know, it was a fairly small community. All the, you know, most of the anatomy departments kind of know where all the other ones exist. And so we relied on them. We kind of sent it to that membership. We also sent it to all the kind of anatomy departments, professors of anatomy that we knew of of that weren't on that list. Um, and basically tried to get as many people, you know, like me, although hopefully with some more embryological knowledge to evaluate these statements.

0:30:41 Nathan: Ah, that would have been a good, well, see the problem is that that's all, that's all of what they are though. No.

0:30:51 Nathan: Ooh, that would have been a good idea.

0:30:52 Rachel: Yeah, that would have been a good idea.

0:30:52 Nathan: We, no, we didn't do that. Yeah. Well, so we did have in a lot of cases, um, and what was kind of interesting is that you have a lot of kind of contrary statements through different laws, but even through the same law. So you'll actually have, you know, we talked about pain a little bit. You actually have very similar statements, but at very different dates.

0:31:12 Nathan: And it's almost like someone was compiling a list and then forgot that they had already contradicted themselves early on. So, you know, some of our statements actually, once we kind of looked at the best way to test this, and we had kind of a survey expert kind of help us devise the best Way to present some of this information, you Know, we have, You know, an unborn human being may feel pain. And then we had the time point. So as early as five and a half weeks, by eight weeks, By 10 weeks from from around 11 to 12 weeks as early, you know, so we had these almost like multiple, well, not multiple choice because each one was evaluated, but we almost had these kind of different options that were used in different bills. And you can very much see the kind of range of accuracy and misleading this, just follow this developmental trajectory too, which is really interesting.

0:31:12 Thomas: There right did you make an award for like you know best and worst most misleading terrible bill kind of

0:31:59 Nathan: Actually, this Texas HB 2263 probably takes the, I'm just looking at our giant, I am looking at seems to be on there. We found a couple of interesting things. What we talked about in terms of pain was one of the really interesting findings, both in terms of it being really inaccurate in the ways that it was discussed, but also because those specific sets of facts were the ones that are very heavily relied on in termsof trying to change the definition of viability. But one ofthe other sets that really got me that I thought was kind of interesting, both in terms of how you evaluate, but also how it changed across bills was a fact about how many, if we're going to use this phrase, unborn human being, what percentage of those survive until term, once you actually detect a heartbeat, that was one kind of set of facts that we saw over and over in these bills. And it's also interesting because it changes a lot. Lot. So for instance, one of the bills, we looked at three bills that kind of use this, this fact that over 90 % of pregnancies survive to the first trimester if cardiac activity is detected in the gestational sac.

0:32:02 Thomas: Thing yeah

0:33:16 Nathan: So basically like if you, if you have cardiac activity and we're not even calling a heartbeat at this point, if You have that 90 % Of those are supposed to survive until first trimester. So three States had that. And then it kind of ramps up. So, and then it's like the the fetal heartbeat, okay, now we're talking about heartbeat, when detected, presents an identifiable point, I'm going to skip a little language because it's not important, at which point the pre -born child in the womb has a greater than 95 % of survival to term. So now we'RE talking about, okay once you have that heartbeat, now 95 % chance that you're actually going to make it to birth. And I'll skip a couple of different like midpoints.

0:33:49 Thomas: Sure like as you get closer to birth the odds are obviously going to go up just because of math right just because the numbers like if you're saying you know there's a heartbeat at x weeks x plus 10 weeks is going to be a higher percentage just because that's how numbers work right oh okay uh -huh oh interesting

0:34:03 Nathan: Right, yeah, of course. What these statements are kind of getting at though is they're all using that same kind of time point, right? They're all using that kind of fetal heartbeat start point, whether it's referred to as cardiac activity or heartbeat. And so at first it's like, okay, you know, some states are saying 90 % chance of survival until the end of the first trimester. Now, all of a sudden, some states Are saying it's 95 % chance until being carried till term. And then this is where your award comes in, which is that that Tennessee bill, when a fetal heart beat is detected between well, okay. So now this moves forward a little bit between eight and 12 weeks. Now you get a 98 % chance of carrying that pregnancy to term. And so it's kind of like ramping up the probability of survival to term as you kind of work down these lists of statements. And we've dug into that data a little bit and that survival till term or survival till the end of the trimester is really hard data to compile. There are several big studies that look at this. And that first statement I read to you is, in my mind, 90 % of in vitro pregnancies survive to the first trimester, depending on where you're calling cardiac activity starting. That one, in mine mind, it's decent. It scored about a three on our scale, which is right in the middle. In my mind that's probably valid because depending on what your study you're looking at and the methods of the study, it could go either way. Maybe that number is 80%, maybe it's 90%, but it's in the right neighborhood. But then when when you get to some of these other statements, that's after the detection, for instance, an Ohio bill, after the detention of a fetal heartbeat, there's a 95 to 98 % certainty that the new life will develop till full term. Those kinds of statements, for example, now it's just, that does not seem to match the data.

0:35:18 Thomas: No so now they like are they retconning so like they're taking the more advanced number later and then like are THEY moving it to the very beginning and saying from that point it'll have 95 % of making it yeah yeah by the time you're done reading the legislation you you have a baby. You actually just, whoa, holy crap. No. Yeah.

0:35:58 Nathan: And that's kind of what they're seeing is like, you know, everyone's looking at the same start point. Some of them are looking at a week or two later, depending on how they're defining it. But some of These are just looking at, okay, where's the fetal heart beat. And now they're just saying, okay 90 % chance of survival of the first Now, all of a sudden, it's 95 % to term. And now, all of a sudden, it's 98 % to term. And the irony is that a lot of these are from the same pieces of legislation.

0:36:24 Nathan: Well, that's what it seems like. So it took us forever to kind of like put together these statements in a way that, you know, and really dissect all these statements in a ways that we can evaluate this because it's like, man, these laws are just contradicting themselves. But these statements, in particular, and you can see that change in accuracy, you know the first one that I said from Ohio, Ohio, the one using that 90 % number, you know, it's about a three. You know, I think based on my reading of the literature, that seems about right, because it depends on what study you're looking at. It's about equally accurate and inaccurate. And then all of a sudden, when you're saying, you Know, 95 to 98 % chance of carrying till term at detection of heartbeat, it just, it doesn't seem to jive with the data. And all of a sudden, yeah, now we're at a much lower score for accuracy and misleadingness. We did some like correlations with demographics too. Among the people reviewing this data, we also ran these correlations for, does the gender of the person reviewing this matter in terms of how accurate? Yeah, exactly. Yeah. I mean, because we wanted to look at this, right? Do men or women think that these are more or less misleading or accurate? And there were some trends. So in terms of gender, women thought that statements were generally more misleading than men. And then And ideology and political party affiliation also mattered. Now, we surveyed academics, and you don't get a lot of really conservative, highly Republican academics. So, you know, sample sizes were smaller. But for instance, political party affiliation does matter, and Democrats think that statements were less accurate and more misleading. Ideology matters, and conservatives thought that statements were more accurate than liberals. So we have a bit in the paper about kind of how that plays out, especially in terms of of how these laws are written, because most state legislatures are overwhelmingly dominated by men. So if men thinks these statements are less misleading than women, you're already going to have this kind of baseline disjunct

0:37:08 Thomas: Oh, the fact checkers or, oh, interesting. Yeah, I

0:38:14 Nathan: With how you're presenting that information than if you had like a more balanced state legislature. In fact, there's only, I believe, one state legislature that has more women than men.

0:38:23 Thomas: Wouldn't have thought there were any. Yeah huh. Oh wow.

0:38:24 Nathan: There is one, and it's not in the state that you'd expect it to be. It is Utah. I know. It happened a few years ago, and I think it's still the case. That's what I thought, too. Colorado, where I'm from, was almost 50 -50, which I was so proud about until I saw Utah.

0:38:34 Thomas: Yeah yeah yeah. Maybe a new scale and maybe some, maybe get some control statements in there like I suggested. No, but I wanted to ask what was the kind of final, I don't know, form that you were looking to put these these results in? Like, what was the question that you were trying to answer exactly? Just how inaccurate these were? Or like, in what form did you kind of distill this all in the end?

0:38:40 Nathan: And then, you know, I think putting this all together, too, it's interesting. And we have some follow -up projects we want to do really digging into a lot of the primary literature. Because, again, this is kind of, you know, what 40 experts think of this, but it's not necessarily what people that do a lot of primary research in these fields think or would rate. And that's kind of where we want To go next, although, you Know, it it's going to take a bit more time to kind of dredge into that data. Because of course, once you know something, it's a lot harder to just kind of score this on a one to five scale. Sure.

0:39:28 Nathan: Yeah. I mean, what we kind of did in the paper is we kind of grouped them by categorical part of the body, you know, so we had statements on, okay, what, you know how accurate is, you know, cardiac development versus limb development versus certain developmental milestones. And really what we were trying to do, you know, this was a kind of the initial presentation is what we're trying to do is do we overall see when you group these kinds of things, do you see these statements significantly deviate from what we want to be completely accurate or not. And, and of these statements, are some of them sufficiently completely accurate, or some of them not? And, you know, I guess it's not surprising that essentially, you know, in some of our statistical tests, almost every statement was significantly different than the expected value of five, which is completely accurate or completely non misleading. And so in some ways, you know, at the beginning, we were really hoping or at least thinking like, okay, well, maybe some of these these statements are better than others, right? And maybe there are some states or some pieces of legislation. We had this whole idea of, okay, can we then correlate which states are kind of doing this right if they're including facts of it? It turns out they're all pretty much misleading or inaccurate to some degree. And so that's kind of how we grouped it for this paper. And kind of in my mind, what I had always hoped would be the outcome of this, and we want to do a follow -up study, again, kind of really digging into some of the more specifics of these things. But what I would like to see is this information kind of being used in the legislative debate session so that when these things come up, you know, there's a resource to say, okay, well, we've already kind of evaluated this language, right? We kind of know how inaccurate it is. And so can we put pressure on legislatures to maybe use a different approach, right. And, you know, I think one can also make an argument, you you know, as fun as this project was to do in some ways, like, you know does it matter, right? I mean, does the question of abortion rights have anything to do with just a whole bunch of discrete facts about development?

0:40:11 Thomas: Sure. Yeah. Yeah, I don't, I kind of think no, sorry. I don't want to dismiss any of this really excellent work, but I sort of think they're just trying to find the justification.

0:41:30 Nathan: Right, and you know we had, Rachel presented this talk at an anatomy conference and we had a great you know another presenter in that panel who was actually a clergy member, kind of a pro -choice clergy member And that was kind of his thesis, too. So, you know, I'm stealing some of this for him. But, you know, the question of abortions rights and when should that, you know, when does that balance tip in favor of the mom versus favor of, you know, the thing that's in the womb? It is more of a question of autonomy, not just a bunch of facts about when teeth pop out or when fingernails pop out or when eyes develop. And, you know, in some ways, yes, it's it was a fun exercise to do this. But but it is, you know in some ways it is, it does highlight how much of kind of like shifting the target that is right in terms of determining, you know, should abortion be allowed? And I think it's pretty clear that we're both very much in support of that. And when should that definition of viability be?

0:42:23 Thomas: For sure. But it's still very valuable to say, hey, the people passing these bills don't know what the F they're talking about. And so do you have some numbers you can put to that? Like how much do they not know what they're F they're talking about?

0:42:36 Nathan: So overall, for all of our statements across all the states, the mean accuracy was a three, which means that it was equally inaccurate and accurate.

0:42:42 Thomas: Okay. Huh. Wait. And are these just ones they're trying to limit? So you didn't put in any like, oh, this state is trying to protect abortion rights in there or something?

0:42:52 Nathan: Well, so we followed the Guttmacher, which was great because it's a lot of, yeah. And it was only those states that were under the kind of category of abortion ban. And so that includes, you know, just full abortion bans. That also includes things like abortion banns on the basis of genetic testing or on the base of sex. So there are a couple of states that have these kind of laws of, you know—I think they're called under kind of anti -discrimination in abortion care, but many of them are wrapped up in full abortion bands anyways at this point. And so sometimes, you'd get these different pieces of legislation, but at the end of the day, the state's still trying to ban abortion at 12 weeks or six weeks, for instance. So on the whole, it was basically a three out of five. So equally accurate and inaccurate. And misleading was a bit lower. It was a 2 .5 out of 5.

0:42:54 Thomas: That's right. That's very. Okay. Right. Oh, wait, what's the difference there? I don't understand what that is.

0:43:37 Nathan: So we had these two variables. One was accuracy and one was misleadingness. And the idea there is you can have a statement that's accurate, that's technically true, but very much written to be misleading. So these statements were kind of more misleading than accurate, if that makes sense. But on the whole, accuracy was about equivocal for all of them. And misleading -less was a little bit worse than that. Does that make sense?

0:43:43 Thomas: Oh. Technically true. But yeah, yeah, yeah, yeah. Gotcha. Yeah, it does. I'm surprised it was that high, to be honest with you, but I don't know. Well, but again, I mean, maybe that's a good example of the limitations here. What the F does that have to do with anything? You know, like there's plenty of animals that have teeth that we're

0:44:04 Nathan: Oh, really? That's funny. It's funny because to me, I've spent a lot of time thinking about this now, especially when we're looking through this data. And it's funny to me because I go both ways. Sometimes I look at these things and I think, man, yeah, there was one state that I mentioned this statement about teeth development, for instance. Several states mentioned teeth development at the nine -week point, but there was one state. So let me give out a shout -out, actually, to Arkansas for HB 1439, because they actually did distinguish teeth come from things that are called teeth buds. So that was the actual only state that actually used this information on the buds for teeth are present, which to me makes it much more accurate. And in fact, the reviewers thought that, too. I don't know. Oh, because if

0:44:54 Thomas: Totally content in killing. We don't give a crap about them, you know? So it's like, yeah!

0:44:57 Nathan: You don't come out biting, you don't count as alive. I don't know.

0:45:00 Rachel: I think

0:45:00 Thomas: You don't even know what the purpose of that is. I guess they just try to build the case that, look, it's a person. It's a little baby. They try to like like build up the sympathy by making it more human -like or something?

0:45:09 Rachel: That's a lot to do with the pain also because it's like once you say that something has pain no one wants to hurt it and no one wants to be in pain yeah

0:45:17 Thomas: Once you say it has teeth, then you're like, ah, dentist, that's painful.

0:45:19 Rachel: Yeah that's like a whole thing about saying that pain is felt at 20 weeks it's a way to be like okay well if it has pain then we can't do anything.

0:45:20 Thomas: Okay. Yeah. Yeah. I mean, it certainly, it makes sense for that to be part of a calculation. Like if something feels pain versus not, like that's going to definitely affect how you're going to treat it. But the teeth, I don't, I still, I'm sorry. The teeth. What? I don't know what the teeth have to do with anything.

0:45:42 Nathan: And, and I think, I mean, I, I think this is where, I don't know, this is like playing the ball and cup game. Like if in my mind, a lot of these early milestones, if you look at them in a human and a cow and a cat and a chicken, like they're all basically look the same at this point. You know, if you put an embryo at five weeks in front of you and compare it to an embryo of a chicken and an alligator and dog, you're not going to be like, most people would not be able to tell them apart.

0:45:50 Thomas: Yeah. Mm -hmm. Yeah. Yeah. Yeah. Yeah, they do that all the time for fun to trick

0:46:09 Nathan: Yeah. And, you know, and it's, and so I, I agree that, you Know, I had a lot of fun doing this project and I think it was really enlightening, but I, it does kind of like really highlight that. I don't know what these state legislators are even digging at in terms of the arguments that we're trying to make. And I, and I it's interesting that, You know, Rachel had really been talking about this point of viability and yeah. Okay. I agree with what you're saying, St. Thomas, if you're talking about feeling pain, then yeah, you know, maybe that means for surgical procedures, you have to, you know, provide it anesthesia to the fetus. And in fact, that happens all the time, you know, in humans, but also in mice and all kinds of other research and surgeries and things. But when it comes to viability, yeah, I mean, it does come down to like, how often can something that's born at this time point survive? And what can the hospital accommodate?

0:46:09 Rachel: Right.

0:46:09 Thomas: People. Well, viability is also a really weird thing because it's supposed to be defined as it could survive outside the womb. But then it's like, well, what if we get to the point in medical science where we're just building like a mechanical womb of some kind or something and then that's how it's surviving? It's like well, that's not really the point. You know, it can't survive outside of the womb absent also a gajillion dollars worth of medical intervention, which seems important. Like I can't thrive in outer space. Space but if you send me up in a rocket with the right gear then I guess I can am I viable in outer space it's like well not really yeah yeah I want

0:47:26 Rachel: Well, that's an interesting point because there was one paper that we cited in our study and there was a quote in it that said, a meaningful discussion of neonatal viability includes not just survival, but honest and candid dialogue with the women and her family about what kind of life to expect. And so that really stood out to me because it's true like if you're just gonna have this artificial womb and but no one can care for the baby or if the life expectancy is not going to be as long it's like it's more than just can it survive outside of a womb

0:48:11 Ad: [Ad break 3 — ad music]

0:48:11 Thomas: To make sure before we run out of time um are there any good corrections you should give on these actual facts that just in case we got might have picked up a bad you know fact along the way of listening to this give any good directions on these claims like when when do we get the teeth yeah I picked that one as a joke it is such a a weird claim.

0:48:26 Nathan: Well, I I mean, so I don't, yeah, well, see, that's the thing. I don'T even know. This is what is so, in some ways, is so frustrating, both as an anatomist and someone who, you know, casually studied embryology, you know, having two kids, kids have teeth when they start biting me, you Know, so like, so, you KNOW, and yeah, yeah.

0:48:45 Thomas: I don't really understand what it's even doing here, but, but some of the other ones, I mean, yeah, I got, right. Right. Boy, I've always wondered about that. That makes sense once you say it.

0:48:48 Nathan: And sure, and maybe one to focus on is, for instance, cardiac activity, right? Because that has really centered at, or featured kind of front and center at some of these bands, is pinning that heartbeat or the detection of the heartbeat at that six weeks. And again, I say that I'm embryology adjacent, which is that I teach anatomy all the time. I teach certain things in embryology. I actually had to go really digging into my notes from when I passed my qualifier exam as a grad student to go back to, OK, what do I actually have and what I learned as like when does cardiac activity begin? If people quibble with this, if anyone listening wants to argue with this I'm going to blame my professor who I respect greatly, which is Jack Stern, that beating starts around day 28 of gestation. At that point, there is no heart yet. It's a heart tube. It is actually two heart tubes that have merged and bended a bit, so it is like a wobbly tube, but it is still a one -way tube, and you do not get like folding of that heart until a couple of weeks later, and then you still even then, like even once you have this kind of fetal heart, A, it is not done kind of forming all its internal structures until several more weeks later. And even then the blood flow is nowhere near the adult blood flow. And then in fact, the adult pattern of blood flow doesn't happen until right at birth. Because of course, you don't need blood going to the lungs when you're fetus.

0:50:07 Nathan: Yeah, yeah, yeah. No, it's really fun. What happens is that oxygenated blood that's coming from the mother actually goes up the wrong way. And it shunts through two of the chambers of the heart and it basically bypasses the lung to get to the aorta. And as soon as you're born, there's a little flap, a little valve that closes.

0:50:22 Thomas: That's insane. None of this is actually possible.

0:50:23 Nathan: And that's what then shunts blood back to the lung. Yeah, no, it's crazy. I mean, yeah. And this is kind of why we wanted to look at this. Embryology is complicated.

0:50:27 Thomas: It is crazy. Yeah. Yeah, but, well, I remember talking about that back, I don't know, a long time ago, where it's like, it's not even accurate to call it a heartbeat. Look, when you have kids, you know, I have kids it's certainly very meaningful to hear that first heartbeat. Very meaningful. As heartless as it may sound, that doesn't really, in my mind, I'm not a doctor or anything, but what is that signifying? Does that signify something? It sounds like that's a part of a biological process that humans assign a lot of meaning to that doesn'T necessarily, I guess, when I think about it, indicate some some increased amount of like humanity or personhood just because we can kind of detect these not at all formed heart thingies tubes you're talking about doing a little wobble that they do you know like it's it's I feel like so much of this is just we're putting values on stuff which is fine we put values on things but it's digging into this technical stuff that's like wait why does this matter why does it matter if you think the tube does the two heart tubes do whatever at whatever weeks, like someone explain to me what that is. You know, it sounds like that's all just unsaid.

0:51:38 Nathan: And I do think that I think there's a lot of meeting attributed to physiological function that when you take a step back is maybe less remarkable than one would want. And I mean this in terms of like, yeah I mean the developing heart has to have some cardiac activity, you know, in an embryo and then in a fetus. Because it doesn't have direct blood coming from the mother's heart. So yeah, it has to happen. Otherwise the system wouldn't work. Right. And it, and it, you know, we, we attribute a lot of value to that. I guess that maybe this is me putting my anthro hat on, but like, yeah, we attribute a Lot of value to That, but the system Wouldn't work otherwise. So there is no like alternative way for that to develop. Yeah.

0:52:16 Thomas: Well, and there's plenty of things that have a beating heart that we're happy to put in factory farms and kill the crap out of, you know, that I don't eat because I'm a vegetarian. Like we don't care about that, but they have hearts. So like, what is the, you Know, that's, I don't, a lot of that does seem like they're piggybacking on a lot of shared assumptions, but there's no, there's nowhere that says, okay, whereas having a heartbeat means you're totally a human being person. And you know, like that part, it seems to be that you still need to explain, right? Yet another crucial milestone in whether you count someone as sure. Sure.

0:52:45 Nathan: Another kind of funny example that four different pieces of legislation used were about the development of fingernails.

0:52:54 Nathan: Well, exactly. Right. But as an anatomist, I can provide some context to this. So an unborn human being's fingernails begin to form at 10 weeks gestation. That's one that we tested in four pieces of legislation. And it, you know, it did a little bit above average. It did a 3 .35 on our scale out of five. But I think that the reason that that's there and anyone who's kind of taught anatomy will know this, that's one of the kind of of emotionally inducing part for a lot of people when they first take anatomy, and especially if you're working around human cadavers and human body donors, seeing fingernails is really a bit of a trigger for a whole lot of different people. And I think it's maybe because it really is one of the areas that signifies humanity, especially because sometimes the body donors for instance might still have fingernail polish on. And it's one of those things that all of a sudden it's like, oh my gosh, this person held stuff, they touched stuff. It ascribes personhood to that person in a way that maybe looking at someone's back doesn't. Right.

0:53:27 Thomas: Oh, wow. Right. Yeah. Yeah. Sure. Yeah. Yeah. Yeah. Right.

0:53:47 Nathan: And so for the heart, I think it's these heart development stages. Like I do think it's pretty intrinsic to everyone. Why one seeking to ban abortion will want to include that. And some of these other ones, I mean, I do Think they follow along that same kind of that same line of, okay, well, fingernails are meaningful because that's your unborn human beings going to hold you. I don't, you know, I don'T know, but you know I think maybe some of These are, I DON'T don't know, maybe they're gunning for a emotional response. Right. Yes.

0:53:56 Thomas: Mm hmm. Oh, definitely all that. Like they want you to think baby. That's what it is. They want you think this is a baby because no one would kill a baby. That doesn't happen, you know, at least in medically. Like that's not what the abortionists are trying to do, as they say. So like trying to make it seem like that. But it's just so funny if you take a step back and try to look objectively at it. It's like, well, OK, it's got little arm buds or whatever you said.

0:54:35 Thomas: It's got a little it's Got teeth, but the teeth aren't. It's like, what is that? And that's nothing. That isn't anything. In fairness, I suppose on the left, people are often fond of saying it's a clump of cells or something. So maybe there's differentiation between that. Sure. Yeah, yeah. Yeah. Yeah. A crocodile even? Wow.

0:54:47 Nathan: And obviously, it's more than that, right? I mean, there's a reason that so many people spend their life studying this. It's really, the process of embryology is amazing, and having gone through it, and once you learn it, especially once you have kids, like, people have different thoughts on it. I mean in some ways, knowing it and then having a kid go go through it you know having kids in some ways made me think more it's like a clockwork process but then you know I've had these arguments with colleagues and they're like oh no it seems more magical you know and uh but it's complicated and and you know in absence of really understanding some of those complications it's easy to draw these kind of more emotional like inferences when maybe they don't need to be there because you know like I said if if you really want to have fun google six -week embryo crocodile and it'll look the same as a six -weak old human Yeah, I mean, this is kind of this, yeah, I mean, many tetrapods look basically the same at those early developmental stages. Yeah, across all of kind of tetrapoda. So yeah, oh

0:55:32 Thomas: That's insane. What's a tetrapod? Are we that? Oh, okay. Yeah. Rachel, what was your overall kind of takeaway and feeling after completing this project? What did you take away from it? Yeah.

0:55:44 Nathan: Sorry, a tetrapod is something that has four limbs. And that includes things like birds and dinosaurs, you know, that maybe, you know, whether they're walking on two limbs or not, including snakes that have lost their limbs. But at those earlier stages, yeah a lot of it just looks exactly the same.

0:56:03 Rachel: Was really interesting for me because I'm gonna be more of like the medical side of it and I do want to be an abortion provider which is one of the main reasons why I wanted to go into OBGYN. And so looking at these laws that are ultimately going to affect my patients was really interesting. And like taking a deeper look, I mean, I don't know anything about legislation, but it was interesting to see like how most of the laws are just like copy and paste of each other. And right.

0:56:32 Thomas: Yeah. Well, they often have some think tank that generates them for them, too. I don't know if you ended up tracking that down.

0:56:38 Nathan: At one point we talked about it,

0:56:40 Rachel: We did. We like I we did a little looking into it. But I mean it's interesting like how you have this like big company that just like writes these laws and then it affects millions of people and there's nothing you can do about it

0:56:51 Thomas: So you got a glimpse into what people would be yelling at you someday, probably. The absolutely insane, not factual stuff. Yeah? Wow. You learned on the streets. No, okay. Okay.

0:57:00 Rachel: Yeah yeah but it no it was interesting to do this work and now take this information and knowledge and use it in my practice in the future

0:57:12 Nathan: Another potentially fun thing too is Rachel's about about to graduate, how much exposure did you actually get as part of the medical student curriculum?

0:57:18 Rachel: Almost none. Everything I know about abortion and contraception and family planning was stuff that I sought out. Yeah, like I sought out every opportunity to learn something because I wasn't getting it in school or even in the hospitals that I was working at until the later stages, like probably my fourth year is when I really started seeing a little bit more. But yeah, my first three years of medical school, everything I learned was self-driven. Right.

0:57:47 Thomas: There's got to be such an effect of so much demagoguery on this issue. I mean, we've gotten to the point where now we're in the 1984, you know, doctors can't even mention the idea of it as an option in some places, otherwise they'll get in trouble. It's like, yeah, that's going to filter down. You know, conservatives did a very good job of making this a horrible issue all the time. Oh

0:58:07 Rachel: Well, even for medical students, just learning about contraception in general, I've heard of some hospitals that our students go to and they can't even prescribe contraception. They have to go like under the table and give a card and say like, okay, here's where you can go and get a prescription for birth control. But like, we can't prescribe it to you here.

0:58:29 Nathan: The funny thing is it's literally under the table. Like one of our collaborators on this study said that he's actually worked in a hospital where he literally had, he couldn't say it, but he would hand someone a card. And, and Rachel actually had a separate study, you know, and we're running out of time, but looking at, yeah, how well hospitals and clinics teach abortion and contraceptive care in their OBGYN rotations based on the faith or non -faith-based hospital. So like if a hospital has a faith -based association and what faith it's associated with, how well do they train students? And you can probably guess which faiths are good and which aren't at training students.

0:58:38 Thomas: My gosh. Oh, right. How's the Pastafarian Hospital? Are they good at, No, I'm just kidding.

0:59:11 Nathan: We didn't include that. Yeah. Yeah.

0:59:14 Thomas: Yeah, well, this is my pitch. I don't think I've made this pitch publicly, but my new extreme solution that you don't have to sign on for, but I do hope you do, is I think all scientists, loosely speaking, we got to find a definition, but all scientists, doctors, everybody needs to unionize and it needs to be like, because we need drastic measures, it needs to be an opt-in or opt-out of science. Like you either get the iPhone and get the vaccine or Like that's kind of, we need something like that. I just, we got to figure it out. That's my extreme solution. We can work on it. You don't have to sign off on it, but I feel like you should either get the healthcare that we've decided is scientific or not. Like, I don't feel like he gets to go out and spread doubt about how all this stuff works when you don't actually have expertise in it. Drives me nuts. Yeah. Fair, fair. Yep. Yep. Hey, you can always hop back in.

0:59:58 Nathan: It's funny because obviously as the scientist part of that, I'm like, yeah, yeah, you know, I kind of agree. But it's funny working at a med school because, yeah, as much as, you know, and maybe Rachel can speak to this, but as much as you, on the one hand, you want to believe that, on the other hand, it's like, yeah. I need to care for as many patients as possible and, you know, really, really provide people the kind of care they deserve in most people's time of emergency, right? When they need this kind of stuff, including people that very much want to have kids. Yeah, he can opt in.

1:00:20 Thomas: You come in, you come into the, to the, To the hospital. Well, shit. Looks like I made a mistake. Sake. Okay. Hop back in. Here you go. Here's your iPhone and medical care. Yeah. No, you don't. That's the whole point. We don't need them to research. We need you to research everyone needs to

1:00:29 Nathan: You got to do, you got to do a research report before you can come back in. Yeah. That's true, yeah.

1:00:36 Thomas: Stop feeling like they're the ones that should research. Well, you have people who do this for a living and not podcasters. I'm talking about real people. All right. Now I'm just talking nonsense, but no, this was a lot of fun. Seriously. Appreciate you guys for doing this and coming on. This is so fascinating. I'm looking forward to, if you end up doing any of those follow-ups, too. Definitely let me know.

1:00:57 Nathan: Yeah, no, we'll keep you posted there's a lot of cool stuff that comes out of it and it was fun it was a lot of fun we had a lot of fun doing this and definitely doing the show yeah it drives a lot of really fun and interesting conversation yeah

1:00:57 Thomas: Yeah. Right, right, right. Well, Nathan Thompson, Rachel Feltman, is there anywhere you want to point listeners to? I don't know how active on socials you are, but

1:01:17 Rachel: Thank

1:01:18 Nathan: So the the study we published in proceedings of sexual and reproductive health and if you want to post a link that'd be awesome we we made it open access so so anyone can look at at it. And then, you know, I'll plug our Instagram. So we have an NYIT Anatomy. It's NYIT Anatomy on Instagram, if you want to kind of keep up to date with the research that comes out of our department.

1:01:23 Thomas: Oh, of course. Yeah, awesome. Well thank you guys so much. This was a lot of fun.

1:01:40 Nathan: Awesome. Thank you for having us.

1:01:41 Rachel: You so much for having us.