ATLANTA — A strict abortion law that could be enacted in Georgia at the start of 2020 would pose hardships on women who don't know they are pregnant by six weeks or can't see a medical provider within the legal time frame, doctors and activists say.

It also would force women to report rape or sex abuse to the police before they can get an abortion — a process women's rights activists say revictimizes them.

The state's "fetal heartbeat" abortion bill, which Republican Gov. Brian Kemp is expected to sign by May 12, bans women from getting abortions after a heartbeat is detected, or about six weeks into pregnancy.

The bill has stirred up opposition among Democratic lawmakers and abortion advocates, who claim that it attacks women's rights. The current state law allows abortions up to the 20th week of pregnancy.

As of 2014, there were 17 abortion clinics in Georgia, according to the Guttmacher Institute, a research group that supports abortion rights.

"The reality is that when we say that this is a de facto ban, it's because it happens before most women even know they are pregnant," said Staci Fox, president and CEO of Planned Parenthood Southeast Advocates. “Let’s not pretend that this is anything but an all-out ban, an all-out assault on women’s health care."

State Rep. Ed Setzler, a Republican from the Atlanta suburbs who authored the bill, said the law is about protecting the human rights of unborn children. He also insists that missed periods and home pregnancy tests should allow women to know they are pregnant by six weeks.

The American Civil Liberties Union, Planned Parenthood Southeast and the Center for Reproductive Rights have all vowed to challenge the bill in court.

Organization leaders say they are preparing to fight a case that may make its way to the Supreme Court. They believe Republican state lawmakers across the country are passing strict abortion bans in an attempt to get the landmark 1973 Roe v. Wade decision overturned.

Lawmakers in the GOP-controlled Ohio House passed a fetal heartbeat bill Wednesday. Mississippi and Kentucky have passed laws that would ban most abortions after a heartbeat is detected. Alabama lawmakers last week introduced a bill that would ban nearly all abortions in the state at any stage of the pregnancy unless the mother’s health is in jeopardy.

A Kentucky judge last month temporarily blocked the bill from being enforced. Abortion rights groups have also challenged Mississippi's law and hope to get it overturned before it's enforced on July 1.

Republican lawmakers in several other states, including Tennessee, South Carolina, Missouri, Texas, Louisiana, West Virginia and Florida are considering heartbeat bills.

Elisabeth Smith, chief counsel for state policy for the Center for Reproductive Rights, said lawsuits in Georgia will likely stop the bill from being enacted.

"We have seen a very high volume of six-week bans like the Georgia bill introduced," Smith said. "None of them have ever gone into effect. A six-week ban is absolutely unconstitutional."

The debate comes as the number of abortions performed in the United States has steadily dropped since reaching a peak of 1.6 million in 1990. The latest tally was 926,000 in 2014, according to the Guttmacher Institute.

Pregnant and unaware

Medical experts say one of the biggest concerns with the "fetal heartbeat" abortion bill is that many women don't even know they are pregnant by six weeks.

Melissa Kottke, an associate professor in the Department of Gynecology and Obstetrics at Emory University, said a missed period is typically the first sign of pregnancy. But women who have irregular menstrual cycles would not immediately know they missed a period, Kottke said.

Irregular periods are common among women in the beginning or end of their reproductive years, she said. Stress, weight loss and other health issues can also interrupt a regular cycle.

“It’s inherently false to assume that all women have the physiology that will bring them to a suspicion of pregnancy by six weeks," Kottke said. "(The bill) takes medical decisions out of the hands of patients and their providers. Having medical care directed by lawmakers is extremely dangerous."

Scheduling the procedure

Critics of the bill also argue that six weeks is too tight of a window for women with unplanned pregnancies to get an appointment with doctors and receive proper care.

A 43-year-old Atlanta woman named Jennifer, who only provided her first name for fear of attack by anti-abortion groups, said she found out she was pregnant at four weeks and knew immediately that she wanted an abortion.

However, Jennifer said she was unable to get an appointment for the procedure at a Planned Parenthood center until she was eight weeks pregnant.A Planned Parenthood spokeswoman connected USA TODAY with Jennifer.

If Kemp signs the "fetal heartbeat" bill in Georgia, women who face barriers like Jennifer will have to continue the pregnancy.

"I think this law is going to force women into parenthood that don’t want to be parents or don’t have the resources," said Jennifer, who got an abortion because she said she didn't want to be a single parent. "It’s telling a woman that I don’t trust you know what's best for you."

Democratic State Sen. Nikema Williams echoes this sentiment, saying the fetal heartbeat bill shows that lawmakers don't trust women to make a "personal and private" medical decision with their doctor.

“It’s horrifying that I could have someone else decide when and if I want to expand my family," Williams said. “To force someone to go through a pregnancy that they don’t want is not only unsafe for the woman but it’s just bad public policy."

Socioeconomic disparities

The six-week ban also puts pressure on women facing socioeconomic issues such as struggling to come up with the money for an abortion in that limited time frame, said Kwajelyn Jackson, executive director of the Feminist Women’s Health Center in Atlanta.

Abortions in the first trimester can cost up to $1,500, according to Planned Parenthood, and some health insurance plans don't cover them.

Jackson said women are also faced with finding childcare while they get the procedure, transportation to the abortion facility and taking off work. Additionally, some women have to travel hundreds of miles to get to a facility that offers abortions.

"To compact that into a very slim window is incredibly challenging," Jackson said. "We really are concerned about how legislation like this ultimately makes abortion completely inaccessible to so many people."

'Revictimization of women'

The heartbeat bill's exceptions include cases that involve rape or incest on the condition that the victim files a police report or someone files one on their behalf.

Critics say this will force women to recount being raped, which is the reason many women don't go to the police in the first place. According to the Rape, Abuse & Incest National Network, 75% of sexual assaults go unreported.

“I think it's revictimization of women,” Fox said. “We are requiring a woman to report this to an authority when she needs healthcare that is time sensitive."

If the Georgia law is enacted, abortion rights advocates fear women will resort to "back alley" or illegal abortions.

Illegal abortions are often performed in environments without minimal medical standards or performed by people lacking the appropriate medical skills. Prior to Roe v. Wade, many of these procedures had grim outcomes, including death.

"It’s definitely something to be afraid of," Jackson said. “I don’t want people's lives to be put in severe danger when we know there are completely safe alternatives that can be provided by medical professionals.”