Late-term abortion
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Late-term abortions are abortions which are performed during the late stages of pregnancy. Late-term abortion is more controversial than abortion in general because the fetus is much closer to full development and viability than in the first and second trimesters.
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Definition and Frequency
A late-term abortion usually refers to an induced abortion procedure that occurs after the 20th week of gestation. However, the term is not a medical term, and the exact point when a pregnancy become late-term is not clearly defined. Three articles published in 1998 in the same issue of the Journal of the American Medical Association could not agree on the definition. Two articles chose the 20th week of gestation to be the point where an abortion procedure would be considered late-term.<ref>Sprang ML, Neerhof MG. "Rationale for banning abortions late in pregnancy."[1] JAMA. 1998;280:744-747.
Grimes DA. "The continuing need for late abortions."[2] JAMA. 1998;280:747-750.</ref> While another article chose the third trimester, or 27th week of gestation.<ref>Gans Epner JE, Jonas HS, Seckinger DL. "Late-term abortion."[3] JAMA. 1998;280:724-729.</ref> The point at which an abortion becomes late-term is often related to the viability (ability to survive outside the uterus) of the fetus. Sometimes late-term abortions are referred to as post-viability abortions. However, viability varies greatly between pregnancies. Nearly all pregnancies are viable after the 27th week, and almost no pregnancies are viable before the 20th week. Everything in between is a "grey area".<ref>Ibid.</ref>
Because the Centers for Disease Control and Prevention's annual study on abortion statistics does not calculate the exact gestational age for abortions performed past the 20th week, there is no exact data for the number of abortions performed after viability. In the United States, 1.4% of abortions occur at 21 weeks or later<ref>Abortion Surveillance --- United States, 2002 CDC's National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health. Accessed April 14, 2006.</ref>(approximately 18,000 per year<ref name="ind_abor">Induced Abortion In the United States. Guttmacher Institute, 2005. Accessed April 2006.</ref>). In 1997, the Alan Guttmacher Institute estimated the number of abortions past 24 weeks to be 0.08% (approximately 1,032 per year).<ref>The Limitations of U.S. Statistics on Abortion. Alan Guttmacher Institute, 1997. Accessed April 14, 2006.</ref>
Usage
Reasons a woman might have a late-term abortion include:
- She was not aware she was pregnant until late in the pregnancy
- She could not obtain transportation to a clinic earlier in the pregnancy
- She could not obtain money for the abortion earlier in the pregnancy
- Her financial situation had a sudden drastic deterioration late in the pregnancy
- A fetal abnormality was diagnosed late in the pregnancy
- Continuing the pregnancy posed a risk to her life or health
There is very little data on how common each of these reasons are. In 1987, the Alan Guttmacher Institute collected questionnaires from 1,900 women who were at abortion clinics procuring abortions. Of the 1,900, 420 had been pregnant for 16 or more weeks. These 420 women were asked to choose among a menu of reasons why they had not obtained the abortions earlier in their pregnancies. Two percent (2%) said "a fetal problem was diagnosed late in pregnancy." 71% responded "did not recognize that she was pregnant or misjudged gestation," 48% said "found it hard to make arrangements," and 33% said "was afraid to tell her partner or parents." The report did not indicate that any of the 420 abortions after 16 weeks were performed because of maternal health problems.<ref name="abor_reasons">Why Do Women Have Abortions?, Family Planning Perspectives, July/August 1988.</ref>
Legal restrictions
The United States Supreme Court decisions on abortion, including Roe v. Wade, allow states to impose more restrictions on post-viability abortions than those in the earlier stages of pregnancy.
As of April 2006, 36 states had bans on late-term abortions that were not facially unconstitutional (i.e. banning all abortions) or enjoined by court order. Many of these bans are believed to be unconstitutional by pro-choice organizations. 13 states, for example, define viability as a certain number of weeks' gestation, in contrast to Supreme Court rulings that the attending physician must be allowed to determine viability in each specific case. 10 states require a second physician to approve of the reason for the abortion, a practice specifically prohibit in Court rulings. 4 states allow late-term abortions only when the woman's life is at risk; 4 states allow them only when the woman's life or physical health is at risk.
The Supreme Court has repeatedly ruled that bans must include exception for threats to the woman's life, physical health, and mental health. That leaves 16 states with what appear to be enforceable bans on late-term abortions:<ref name="state">Policies On Later-Term Abortions. Guttmacher Institute, 2006. Accessed April 2006.</ref>
- Arizona*
- Arkansas* (also allows late-term abortions in cases of rape or incest)
- California
- Connecticut
- Illinois*
- Kentucky
- Louisiana*
- Maine
- Maryland (also allows late-term abortions in cases of fetal abnormality)
- Missouri*
- Nebraska
- Oklahoma*
- Tennesee
- Washington
- Wisconsin
- Wyoming
(*) These states require a second physician to attend the abortion to care for the infant if it is accidentally born alive.
Procedures
There are three medical procedures associated with late-term abortions:
- Dilation and evacuation (D&E)
- Early induction of labor
- Intact dilation and extraction (IDX or D&X), sometimes called Partial-birth abortion
Abortions done for fetal abnormality are usually performed with induction of labor or with IDX; these procedures result in an intact body that the parents can hold and take pictures of as part of their mourning process. Elective late-term abortions are usually performed with D&E.
References
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External links
- Gina Gonzales as told to Barry Yeoman, "I Had An Abortion When I Was Six Months Pregnant," Glamour