The Republican-dominated U.S. House voted 242 to 184 Wednesday to pass a bill that would ban abortion after 20 weeks nationwide, with no exceptions for a woman’s health or fetal anomalies, and with rape and incest exceptions that advocates call callous and cruel.

“This bill is a danger to women’s lives and well-being, an affront to their dignity, and a threat to the rights and liberties all Americans hold dear,” Nancy Northup, president of the Center for Reproductive Rights, said in a statement after the bill’s passage.

While supporters said the bill is necessary because 20-week-old fetuses can feel pain, medical experts disagree. Critics charged that the bill is unconstitutional and intended to help end legal abortion in America by challenging Roe v. Wade.

“It’s the beginning of the end of abortion—at 20 weeks, at 17 weeks, at 12 weeks, at one week, at conception,” Rep. Steve Cohen (D-TN) said on the House floor. “This is an anti-abortion bill. It’s not about fetal pain, it’s not about 20 weeks.”

This isn’t the first time the House has passed a 20-week abortion ban, but Sen. Mitch McConnell (R-KY) has promised the unprecedented step of taking the bill up in the Senate.

President Obama has threatened to veto the bill. White House Press Secretary Josh Earnest called the bill “disgraceful” at a press conference Wednesday, and said that the president “strongly opposes” it.

An earlier version of the 20-week ban was pulled from the House floor in January after objections from some Republicans that it was too burdensome to rape victims who needed later abortion care. The new version is no better, advocates say—it forces rape victims to wait 48 hours and see two different providers before having an abortion.

The bill passed after an impassioned floor debate, during which female representatives testified both to their own and others’ experiences with complicated pregnancies. They said that only about 1 percent of abortions take place after 20 weeks, usually in difficult and personal circumstances that are impossible to legislate around.

Rep. Jackie Speier (D-CA) talked about her own two abortions, and how it felt to have to “carry around a dead fetus for two days” while waiting for her medically necessary abortion procedure.

“Women who go through these experiences go through them with so much pain and anguish,” Speier said.

Rep. Louise Slaughter (D-NY) called the bill “disgustingly cruel” and read aloud the stories of real women whose struggles with medical and financial hardship brought them to the difficult and expensive decision to have a later abortion.

Some women had fetuses with no chance of survival or medical conditions like lupus that made the pregnancy too dangerous to continue. Another had to borrow money from friends because she was already living in a homeless shelter with two children, couldn’t care for another, and was further along than she realized.

One woman was desperate enough to ask her rapist to help fund the abortion.

“If you haven’t talked to any of these women, you don’t know what they have been through,” Slaughter said.

Anti-choice Republicans on the House floor like Rep. Cathy McMorris Rodgers (R-WA) repeatedly urged their colleagues to pass the 20-week ban because it would protect “unborn babies” who can “feel pain and survive outside the womb.” They invoked a recent study finding that a small minority of premature infants survived after just 22 weeks in the womb.

Medical professionals point out that only 5 percent of the infants in that study who were born at 22 weeks’ gestational age survived, and many had health complications. Further, doctors don’t agree that these dismal outcomes are any reason to redefine fetal viability—the point before which a woman has a guaranteed right to an abortion.

“In no way, shape, or form is a 20-week-old fetus viable,” Dr. Hal Lawrence, who has practiced as an OB-GYN for nearly 30 years and is the CEO of the American Congress of Obstetricians and Gynecologists, told reporters on a press call Wednesday.

“There is no medical milestone associated with 20 weeks,” Lawrence said. “The 20-week mark is simply not notable from a fetal development standpoint.”

Anti-choice advocates and legislators are notorious for writing abortion bans with medically inaccurate language about gestational age, and Congress’ “20-week ban” could potentially include fetuses of up to 22 weeks’ gestational age. But even at 22 weeks, Lawrence said, “we’re not dealing with fetuses that are going to be viable.”

He added that it’s “outrageous” the bill has no exceptions for fetal anomalies, since they are a major reason women need later procedures.

“I became a doctor to care for women, and so I take issue with cold-hearted legislation intended to interfere with my patients,” Lawrence said.

Christie Brooks, a stay-at-home mom in Virginia, told reporters on the call about her experience with a later abortion.

Brooks, at her routine 20-week ultrasound, learned that her fetus had a serious condition in which the stomach, intestines, and liver migrate into the chest cavity, push the heart out of position, and prevent the lungs from developing. Survival would have been uncertain at best, even with major surgery immediately after birth.

“Because there was no 20-week ban in place at the time, I was given the time and space to research my options,” Brooks said. “I wasn’t coerced or influenced in either direction by my doctors.”

She had an abortion just shy of 22 weeks, and said it was the best decision for her and her family.

Not all women are so lucky, Brooks said. She moderates an online forum for women who have had abortions for medical reasons. Many are abandoned by their doctors forced to scramble to find another provider, often out of state and at great cost.

“A federal 20-week ban would have a devastating effect on so many families like mine and the many women I’ve come across while sharing my story,” Brooks said.

Ironically, she added, a 20-week ban could have the opposite effect its sponsors hope for. Faced with a pressing deadline imposed by the GOP legislation, some might hurry to abort before it’s too late.

“It could actually rush some families into a decision before they have the time to properly research and make an informed decision,” she said.