Written Testimony of Danielle Pimentel, J.D. Policy Counsel, Americans United for Life In Support of Legislative Bill No. 626, “Adopt the Nebraska Heartbeat Act” Submitted to the Senate Committee on Health and Human Services February 1, 2023

Dear Chairman Hansen and Members of the Committee:

My name is Danielle Pimentel, and I serve as Policy Counsel at Americans United for Life (AUL). Established in 1971, AUL is a national law and policy nonprofit organization with a specialization in abortion, end-of-life issues, and bioethics law. AUL publishes pro-life model legislation and policy guides, tracks state bioethics legislation, and regularly testifies on pro-life legislation in Congress and the states. Our vision at AUL is to strive for a world where everyone is welcomed in life and protected in law. As Policy Counsel, I specialize in life-related legislation, constitutional law, and abortion jurisprudence.

Thank you for the opportunity to testify in support of L.B. 626 (the bill). Passage of this bill will abolish elective induced abortions after an unborn child has a detectable heartbeat, which often occurs around six weeks’ gestation. Notably, the bill provides for exceptions in cases of sexual assault and incest, ectopic pregnancies, miscarriages, and procedures done with the intent to save the life or preserve the health of the unborn child. Further, a pregnant woman subject to an abortion in violation of the bill, will not be held criminally or civilly liable. I have examined this bill, and I urge you to support it for the following reasons: 1) the bill protects the health and safety of pregnant women and preborn children, 2) the bill recognizes that women deserve better than abortion, and 3) the bill is consistent with other states that have enacted strong pro-life laws after Roe v. Wade was overturned.

This Bill Protects the Welfare of Women and Unborn Children

Nebraska has a legitimate interest in protecting the lives of women and the unborn. In Dobbs v. Jackson Women’s Health Organization, the United States Supreme Court recognized that states have an interest in the “respect for and preservation of prenatal life at all stages of development; the protection of maternal health and safety; the elimination of particularly gruesome or barbaric medical procedures; the preservation of the integrity of the medical profession; [and] the mitigation of fetal pain . . . .” Further, under our federalist system, Nebraska has the authority to create and enforce laws that improve the health and welfare of its citizens, including the youngest members of the human family.

Nebraska’s 20 Week Abortion Ban Poses Greater Risks to Women Seeking Abortions

Currently, Nebraska allows abortions up to 20 weeks’ gestation, which subjects pregnant women and their unborn children to numerous health and safety risks. Abortions carry a higher medical risk when done later in pregnancy. For example, some immediate complications that a woman may experience from an abortion include blood clots, hemorrhage, incomplete abortions, infection, and injury to the cervix and other organs. These immediate complications affect approximately 10% of women undergoing abortion, and approximately one-fifth of these complications are life-threatening. Even Planned Parenthood, the largest abortion business in the United States, agrees that abortion becomes riskier later in pregnancy, stating on its national website that, “[t]he chances of problems gets higher the later you get the abortion . . . .”

Gestational age is the strongest risk factor for abortion-related mortality, and the incidence of major complications is significantly higher after 20 weeks’ gestation. For example, compared to an abortion at 8 weeks’ gestation, the relative risk of mortality increases exponentially (by 38 percent for each additional week) at higher gestations. Specifically, the risk of death at 8 weeks is reported to be one death per one million abortions; at 16 to 20 weeks, that risk rises to 1 per every 29,000 abortions; and at 21 weeks or more, the risk of death is 1 per every 11,000 abortions.

In other words, a woman seeking an abortion at 20 weeks is 35 times more likely to die from abortion than she was in the first trimester. Shockingly, even researchers have concluded that it may not be possible to reduce the risk of death in later-term abortions because of the “inherently greater technical complexity of later abortions.” This is because in later-term abortions there is a greater degree of cervical dilation needed, the increased blood flow predisposes to hemorrhage, and the myometrium is relaxed and more subject to perforation.

Later Term Abortions Cause Fetal Pain to Preborn Children as Young As 12 Weeks’ Gestation

In addition to protecting mothers, states also have a legitimate interest in preventing fetal pain, as noted by the Supreme Court in Dobbs. There is substantial medical evidence that a preborn child can experience pain at least 20 weeks after fertilization, if not earlier. In 2019, scientists found evidence of fetal pain as early as 12 weeks’ gestation. A study from 2010 found that “the earlier infants are delivered, the stronger their response to pain” because the “neural mechanisms that inhibit pain sensations do not begin to develop until 34-36 weeks and are not complete until a significant time after birth.” As a result, preborn children display a “hyperresponsiveness” to pain. According to one group of fetal surgery experts, “The administration of anesthesia directly to the fetus is critical in open fetal surgery procedures.” It is well within the legitimate interests of the state to minimize fetal pain as much as possible and many states have acted on this legitimate interest of protecting both maternal health and the preborn child as discussed below in Section III.

The Bill’s Ultrasound Requirement Furthers the State’s Legitimate Interest in Protecting the Life of the Mother and Her Unborn Child

The bill requires that before a physician may perform an abortion, the physician shall first “[e]stimate the gestational age of the unborn child” and “[p]erform an ultrasound in accordance with standard medical procedure to determine if a fetal heartbeat is present.” Ultrasound provisions promote the woman’s physical and psychological health as well as advance the states’ important and legitimate interest in protecting life. Additionally, ultrasound requirements serve an essential and irreplaceable medical purpose in that they are the only method of diagnosing ectopic pregnancies, which, if left undiagnosed, can result in infertility or even fatal blood loss. Furthermore, an ultrasound enables the healthcare provider to more accurately date the gestational age of a child. Accurate dating of pregnancy both protects the woman by ensuring that the appropriate abortion procedure is performed and provides relevant information necessary to make an informed decision, since the risks of abortion increase as gestational age increases.

Ultimately, Nebraska’s 20-week abortion ban is insufficient to protect human life, whether that is the life of the unborn child or the mother. Enacting L.B. 626 will protect unborn children after 6 weeks gestation while also greatly reducing the risks women face when seeking an abortion. Thus, this bill is necessary to further Nebraska’s legitimate interest to protect the health and safety of its citizens in and out of the womb.

This Bill Recognizes that Women Deserve Better than Abortion

Despite the cultural narrative that abortions are necessary for women’s health and equality in America society, women are increasingly rejecting abortion, recognizing the humanity of their unborn child, and taking advantage of the resources available to help them parent or adopt. For example, the current abortion rate is nearly half of what it was at the high point in the 1980s after Roe was decided. Notably, the claim that abortions are necessary for women’s success has never been substantiated by reliable empirical evidence. Rather, even prior to the Supreme Court deciding Roe in 1973, women have been steadily gaining access and esteem within the workforce, and have continued to choose life and carry their pregnancies to term.

Over the past 50 years, pregnancy resource centers have played a central role in empowering women to choose life. In fact, Nebraska has pregnancy resource centers in 22 different locations throughout the state and a certified Pro Women’s Healthcare Center (PWHC), Sancta Familia Medical Apostolate, which is group of healthcare providers that adhere to “life-affirming standards of comprehensive health and medical services for whole women care (body, mind and spirit).” Certified PWHCs “offer multiple medical services for women, including well-woman care, maternity care, fertility education, and infertility consultation.” These pregnancy resource centers have been faithfully serving the women of Nebraska, offering free resources, counseling, and material support.

Upon the passage of this bill, numerous secular and faith-based nonprofits in Nebraska stand ready to assist women throughout their pregnancies, as they have done in the past. Women deserve better than to be subjected to the false claim that abortions are necessary for their continued success in American society, especially when women are increasingly rejecting abortion and have support from non-profit organizations such as pregnancy resource centers. Nor do women deserve to be subjected to dangerous abortion procedures that create grave risks to their physical and mental health, which this bill recognizes by enacting limits that will protect and promote maternal and fetal life.

This Bill is Consistent with Numerous States that Have Enacted Strong Pro-Life Limits After Roe v. Wade was Overturned

In Dobbs, the United States Supreme Court overturned Roe v. Wade and Planned Parenthood of Southeastern Pennsylvania v. Casey and held that “[t]he Constitution makes no reference to abortion, and no such right is implicitly protected by any constitutional provision.” Now that the Supreme Court has recognized that the federal Constitution does not protect abortion as a purported fundamental right, the abortion issue has been returned to the People and the democratic process. As a result, many states have set strong pro-life limits post-Dobbs. For example, 14 states have laws that completely abolish abortion at any gestational age, and 4 states have laws that abolish abortion at 6 weeks’ gestation. In order to protect some of its most vulnerable citizens, Nebraska should join the number of states that have implemented strong pro-life laws that are consistent with the Supreme Court’s holding in Dobbs.


In sum, this bill promotes the health and safety of pregnant mothers and their preborn children, acknowledges that women deserve better than abortions, and is consistent with other states that have enacted strong pro-life laws after Dobbs. For these reasons, I urge the Committee to support L.B. No. 626.