The anti-choice movement has taken a sadistic turn in Georgia, where a new abortion ban, called HB 481, has just been signed by Governor Brian Kemp. Signed into law this Tuesday and due to take effect in 2020, the bill effectively bans abortion outright, declares fetuses to be persons with full legal rights and protections, and imposes prison sentences for women found guilty of aborting or attempting to abort their pregnancies.

The bill is misleadingly termed a “heartbeat” bill, and it bans abortions at any stage of pregnancy after the detection of “embryonic or fetal cardiac activity”. But “heartbeat” is a bit is a bit of a misnomer, since the cardiac activity that is first detected in an embryo is not a heartbeat by any stretch of the imagination; what is first observed is the pulsing of cells that are specializing and will eventually become a heart. At this point in the pregnancy, the fetus has no brain and no face.

This cellular movement can first be detected at a phase of pregnancy referred to as six weeks of gestation. But this, too, is a misleading phrase. Gestational age is measured not from insemination, but from the beginning of the patient’s last menstrual period. So the bill bans all abortions at four weeks after conception, or roughly two weeks after the woman’s first missed period.

This stage of pregnancy is often past before the patient even knows that she is pregnant. This is the idea: to make the logistical, legal and monetary burdens to access an abortion so heavy that most women will not be able to get one. All this is justified by a moralizing, misogynistic and medically arbitrary logic based on a fantasy that wants to equate the movement of cells with personhood. Based on this logic, women who abort their pregnancies – and, probably, some women who have accidental miscarriages – will be treated as murderers under the law, subject to imprisonment and even capital punishment. Those who leave the state for an abortion, or who help others leave the state for an abortion, can be charged with conspiracy to commit murder and sentenced to up to 10 years in prison.

It is tempting to imagine that the law would not be enforced this way, that prosecutors and juries would not enforce a law that forces women to give birth and threatens to kill them if they refuse. But prosecutors have proved themselves zealous in prosecuting women in states where abortion is already de facto illegal. It would be a mistake to underestimate their capacity for cruelty.

“Heartbeat” bills are nothing new. They have been signed into law in six states – Iowa, Kentucky, Mississippi, North Dakota, Ohio and now Georgia – just since the beginning of this year. In the past, heartbeat bills were put forth by state legislatures as deliberate legal provocations: they were designed to provoke lawsuits from women’s and civil rights groups that could go to federal court and chip away at the edges of Roe v Wade. They were expensive, experimental, taxpayer-funded misadventures in misogynist litigating that were designed to provoke a lot of controversy, rally the anti-choice movement and eventually get struck down – which most of them were. It’s not certain, but it’s highly likely, that HB 481 will be blocked or delayed by a federal court before it goes into effect on 1 January 2020. For now, it’s still legal to get an abortion in Georgia.

Quick guide What is Roe v Wade? Show Hide Norma McCorvey, pictured, was the real name of the woman known as “Jane Roe” in the landmark 1973 US supreme court case Roe v Wade, which established the right of American women to have abortions. McCorvey became the plaintiff in 1970 after she met with two lawyers looking for a test case to challenge the abortion ban in Texas, where it was a crime unless a woman's life was at risk. Similar statutes were in place in nearly every other state at the time. At the time, McCorvey was pregnant, unmarried, unemployed and unable to obtain an abortion legally or otherwise. The case went to the supreme court, which handed down the watershed ruling that a woman's right to make her own medical decisions, including the choice to have an abortion, is protected under the 14th amendment. McCorvey never had an abortion. Her case, which proceeded largely without her involvement, took too long to resolve, and she gave birth to a child that she placed for adoption. Several years after the ruling, she publicly revealed her identity and became involved in the pro-abortion rights movement. But after a conversion to Christianity, she became an anti-abortion rights activist. Before she died in 2017, McCorvey had said it was her wish to see Roe v Wade overturned in her lifetime. Photograph: Manuel Balce Ceneta/AP

But we are not living under the same legal regime that we were a year ago. The new slew of six-week abortion bans is a direct result of the appointment of the multiply accused sexual assault perpetrator Brett Kavanaugh to the supreme court, where anti-choice conservatives now hold a five-four majority and can dismantle or strike down Roe v Wade at any time.

Before, these bills were passed by lawmakers who knew they would be struck down, but who wanted to test the limits of Roe, to see how stringent and outlandish a state could make its abortion restrictions and still have those restrictions deemed legal. Now, they are designed to eliminate Roe altogether, and to throw the question of abortion legality back to individual states – many of which will immediately ban it. When Justice Anthony Kennedy (now retired) was on the supreme court, these states had little chance of having outright abortion bans like HB 481 upheld. Now, with Kavanaugh on the court, the door is wide open for misogynist laws to make legal, clinic-based abortion access a thing of the past in large swaths of the United States.

To some extent, this has already happened. Since the landmark 1992 ruling Planned Parenthood v Casey, the supreme court has held that states may not impose an “undue burden” on abortion access before fetal viability, roughly 24 weeks gestation. But states have been generous to anti-choice interests in interpreting what burdens on abortion access are undue. They have been able to impose long waiting periods, arbitrary and expensive facility standards for clinics, mandatory ultrasounds, including vaginal ultrasounds, for patients, and mandates that abortion providers read false and misleading statements saying that fetuses can feel pain (which they cannot) and that abortion increases a woman’s risk of cancer (which it does not) or that women who have had abortions exhibit severe psychological ramifications (they do not). They have been able to ban state Medicaid plans from covering abortion and they have been able to keep insurance companies from covering abortion. They have been able to make it too logistically hard, too time-consuming, and far, far too expensive for many women to get an abortion in a medical clinic.

This does not mean, however, that abortions are not happening. Instead, self-induced, self-managed abortions are on the rise again in the United States. Before Roe, self-induced abortions were risky, violent and dangerous: women would attempt to pierce their cervixes with knitting needles or coat hangers, and they would puncture organs and suffer infection, hemorrhage and sepsis. Women would drink bleach and poison themselves.

Now, self-managed abortions are largely safe and effective, because the face of self-managed abortion has changed. Self-induced abortion no longer looks like a coat hanger; it looks like a pill. Misoprostol, a drug that can be used to treat ulcers but also empties the uterus, is prescribed by abortion clinics as the second of two abortion drugs, along with Mifepristone, which is used first to loosen the lining of the uterus. Mifepristone is hard to find on the black market, because it is subject to tight regulations. But Misoprostol can easily be found on the internet, and it can end a pregnancy on its own; it’s overwhelmingly effective during the first 10 weeks of pregnancy, especially for women with an average BMI. The effect of the medication looks identical to an accidental miscarriage; if the patient doesn’t tell anyone she induced, then no one needs to know.

However, under the new law, it’s at least possible that Georgia authorities could start treating every miscarriage as a potential homicide. Women who are able to self-induce at home with black market Misopristol might be relatively more safe than their grandmothers who had to use coat hangers and knitting needles. But that doesn’t mean that the cops won’t start asking questions.