Is there a "fetal heartbeat" at six weeks pregnant? This is what the experts say

By Kaitlin SullivanNBC

As states become increasingly bold in restricting access to abortion, many have drawn the line around six weeks of pregnancy, a time when, under some laws, the fetal heartbeat can be detected.

But, according to experts, the term "fetal heartbeat" is misleading and medically inaccurate.

"Although the heart begins to develop at around six weeks, at that point the heart as we know it does not yet exist," said Ian Fraser Golding, a pediatric and fetal cardiologist at Rady Children's Hospital San Diego.

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Instead, at six weeks, the embryo will develop a tube that generates sporadic electrical impulses that eventually coordinate into rhythmic pulses, he said.

(Six weeks of pregnancy is closer to four weeks of actual development, because pregnancy is measured from the first day of a woman's last period, before she is actually pregnant.)

That's far from a fully formed heart, with four chambers and valves that pump blood throughout the body.

The correct medical term for what is seen at this point is "cardiac activity," said Sarah Prager, a professor of obstetrics and gynecology at the University of Washington Medicine.

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"It's not until around 10 weeks gestation that there's an actual structure that has four tubes and it connects to the lungs and the main vascular system like a heart," he said.

Around 10 weeks of pregnancy, the embryo becomes a fetus.

And it remains a fetus until birth.

But defining a heartbeat is tricky even after 10 weeks, said Nisha Verma, an OB/GYN speaking on behalf of the American Association of Obstetricians and Gynecologists, because the heart continues to develop throughout pregnancy.

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Around 17 to 20 weeks, after all four chambers of the heart have developed and can be detected on an ultrasound, is when the term heartbeat is accurate, she says.

Although what exists at six weeks is not a beating heart, pregnant women hear something during ultrasounds early in pregnancy.

"Medically speaking, when I put a stethoscope against a patient's heart, that 'lub dub' sound is made by opening and closing the heart valve. But at six weeks, those valves are gone," Verma said.

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In fact, the sound pregnant women hear during ultrasounds at six weeks is entirely made by the ultrasound machine, Verma said.

"It's an electrical pulse that translates into the sound that we hear from the ultrasound machine."

Also, the electrical pulse of the embryo can almost always be detected only by transvaginal ultrasound, and does not yet show up on an ultrasound of the mother's abdomen.

But that's where the way doctors talk to patients comes into play, Verma said.

While he wouldn't consider any six-week embryo to have a heartbeat, he said doctors use language that patients can connect with, which often isn't medical language, and the use of that language plays a big role in how doctors communicate with patients.

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For example, two doctors talking to each other would use the term "myocardial infarction," while a doctor talking to a patient would use the term "heart attack."

"I think it's okay for people with a wanted pregnancy to come to the six-week appointment and see that flicker and feel connected to it like a heartbeat," Verma said.

"There is no problem with using the term 'heartbeat' by itself. The problem is using that incorrect term to regulate the practice of medicine and imposing these artificial deadlines to regulate abortion. At the end of the day, an abortion is a decision that should be taken between the patient and her health care provider," says the specialist.

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Prager said the language and technology used during pregnancy, including in the doctor's office, were designed for people who want to continue their pregnancies.

"If you're involved in pregnancy, you want to anthropomorphize that pregnancy as soon as possible, and for people, that translates to a heartbeat," Prager said.