Well Being

What Really Happens During A ‘Late-Term’ Abortion

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late term abortion
“Late-term” abortions tend to be very controversial—and confusing: Many people have read or heard horror stories about what happens when a woman aborts a fetus that's over 20 weeks. To get a medical perspective, we talked with Dr. Anne Davis, Associate Professor of Clinical Obstetrics and Gynecology at Columbia University Medical Center and the medical director of Physicians for Reproductive Choice and Health.

What constitutes a late-term abortion?

First of all, the word “late-term” doesn’t mean anything. It doesn’t have a medical significance, and we don't use it. What people might think is that the word “term” means a viable infant, like two minutes before the baby is about to be born. It's more accurate to say that after 20 weeks, it's a second-trimester abortion. The first 12 weeks is a first-trimester abortion, from 12 to 24 weeks is a second-trimester abortion, and from 24 weeks on, it's a third-trimester abortion.

How many of these happen every year?

Only 1% of all abortions happen after 20 weeks. So if we take the 1.2 million abortions that happen in the U.S. every year, there are roughly 12,000 that happen after 20 weeks.

Why do women have abortions after 20 weeks?

Most commonly, it's for social and economic reasons–the same reasons for earlier abortions. The majority are having abortions because they don’t have the money, or they’ve completed their families already. If you don’t have the money or insurance for an abortion, it can take you a while to save up and meanwhile the clock is ticking. Then, when you do get the money, there is a waiting period, consent, mandatory ultrasound, etc., all of which adds more time. So, by the time a woman gets through all of this, it can be later in her pregnancy.

What are some of the other reasons why someone gets an abortion after 20 weeks?

There could be fetal abnormalities, meaning an abnormal chromosome count, a genetic diagnosis, disease in the family, or a cardiac defect. Teens who didn't realize they were pregnant and women over 40 who thought they were in menopause are often already three months along by the time they find out they're pregnant, and some of them decide not to have the baby at that point.

What does the law state about how late an abortion can be performed?

It’s different state by state. States cannot place undue restrictions on this, but the interpretation of those restrictions has changed. The current laws that are being considered have no medical basis; they are all political. In New York, we can legally go to 24 weeks from conception or 26 weeks from last period because that’s a pretty standard definition of viability. The fetus doesn’t have lungs that can breathe until about 23 weeks. Some states won’t allow an abortion after 20 weeks because they say fetuses can feel pain, but that is complete nonsense. There is no reason to think that fetuses can feel pain until at least 26 weeks. Patients have no idea what is correct these days. It’s unfortunate that politicians have been able to throw the debate on these issues into the law.

What do you say to people who say, why not have these women carry the baby to term and then give it up for adoption?

It’s hard to counter that sort of thinking. Someone might want to do that, but if you think about the risks that women go through when they have a baby, that's not the answer. There is the risk of everything from infection to death when giving birth. If you want to be pregnant, you take those risks because you have decided that you’re willing to do so. But once you decided that you don’t want that baby, why should you be forced to take those risks just so someone else can have your baby? There’s a lack of empathy there that people just don’t get. No one should make you do that.

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