Why do people get late term abortions?

Great Debates
61

Most people simply don’t get late-term abortions. “Few reported abortions occurred after 15 weeks’ gestation: 4.0% at 16–20 weeks and 1.4% at >21 weeks.” (from the CDC) In addition, abortions have declined overall since their high in 1991. Fewer women are obtaining abortions, and when they do get one they are doing it earlier in the pregnancy than they did in the past; many terminate a pregnancy at less than 8 weeks.

There is some confusion as to what constitutes late-term. Apparently, Pro-Choice people apply it to third trimester abortions, while Right-to-Life people apply it to the second trimester. Sometimes people are talking past each other simply because they don’t understand the others’ terms correctly. The latter position makes little medical sense – as other posters have pointed out – if for no other reason than that amniocentesis results are often unobtainable until relatively late in the pregnancy.

In my opinion, the current Roe v. Wade guidelines of viability are actually very good guidelines because any baby born before 24 weeks, who actually survives, still has a significant chance to have severe developmental problems, especially in neurological development. And that’s even at the best hospitals. One in four odds of neurological impairment, even with the best medical care available, are not really encouraging. Any halfway reasonable Pro-Choice statement I’ve ever seen does not advocate terminating a pregnancy past the point of viability unless there is a medical reason to do so. Those who do advocate it are in the “Out There” category that almost no one wants to associate themselves with.

I admittedly didn’t spend much time searching for a refutation for Shodan’s cite, but there don’t seem to be many places besides anti-abortion sites that break down the reasons for obtaining an abortion so finely. Most report only aggregates that probably cannot and should not be broken down simply by dividing out the whole percentage by the percentage of late-term abortions.

I did find a site that discusses the issue, and gives recommendations for reducing late-term abortions. They very strongly support the position that third trimester abortions are done only out of necessity. “Also, remember that the number and reasons for “late term” as applied to third trimester, post-viable abortions, makes it very clear that those abortions occur only to protect the health and life of the woman. Period.”
(from Life and Liberty for Women)

In their recommendations, they point out that parent notification laws actually increase the number of abortions that are performed later in a pregnancy among teens. This is supported in a recent article in Forbes, which cites a study in the New England Journal of Medicine. Girls who were pretty close to majority often chose to wait until they could get an abortion without having to notify a parent.

The whole late-term abortion issue is really a non-issue. The vast majority of abortions are performed well before the point of viability. Focusing on abortions that make up 1% or less of all the procedures is nothing more than rhetorical and political misdirection.

On a related note: I found an article in the Boston Globe where the reporter had a similar experience to Shagnasty’s wife’s. Her fetus had severe neurological abnormalities that were not detected until her 18th week.

62

Well, I can tell about late abortions in the UK, where the legislation is the 1967 Abortion Act.

As it stands at the moment, a woman can have a termination for any reason up to 24 weeks (i.e. a 1st or 2nd trimester abortion, before viability). However a termination can be carried out at any point if the mother’s life or health are gravely threatened, or if the child would be born with severe abnormalities. If a termination must be carried out as a medical emergency only one doctor needs to authorise it. More info here.

Therefore, ALL third trimester terminations of pregnancy in the UK are performed on medical grounds- either for the health of the mother or a foetal abnormality.

People for get the timings of tests for foetal abnormalities, 10-14 weeks for CVS and 14-18 weeks for amniocentesis and 20-28 weeks for a detailed Ultrasound scan (with probably at least a week after the test before receiving results and arranging a termination). Meaning anyone terminating a pregnancy because of Downs, Edwards, Cri-du-chat or another severe abnormality would almost certainly have to have a 2nd (and possibly third) trimester termination.
The cruellest thing, IMO, about Irish abortion law as it stand (i.e. only life or health of the mother exceptions) is that although Irish hospitals will perform amnio, CVS, testing for rubella and detailed abnormality ultrasound scans, so that the majority of abnormal foetuses are detected, if a woman wishes to terminate such a pregnancy she must travel to the UK and have it done privately.

The last thing IMO a woman who has made the difficult choice to terminate a wanted pregnancy because of foetal abnormality needs is to have to book flights, hotels and to travel to a strange city, with a strange medical team providing her care, and to have to pay a large amount of money for that choice.

In the UK almost any termination over about 13 weeks is medical, rarely surical and never partial birth. That means that usually drugs are taken to interrupt placental functioning and terminate the pregnancy and 24-48 hours later labour is induced to deliver the foetus. It is not pleasant, but it is safe, and means that the woman has the opportunity to see and hold the baby if she wishes (some find it helpful).

I find it unbelievable that no-one in a Catholic hospital was trained in D and C- it’s not a difficult prodecure, the technique doesn’t require much training and is commonly used when products of conception are retained after a miscarriage, for “missed” miscarriages and for simple endometrial sampling in non-pregnant women. The maternity hospitals in Dublin (where, as I said, an abortion is a once or twice annual occurrence) D and C for retained products of conception is a twice or thrice daily occurrence. It is not rare, there is no ethical problem with it (the foetus has already died, it is not a termination) and it is a medically necessary procedure to prevent the woman suffering infection or haemorrhage, so it is negligent to refuse to perform it. In fact in the past any woman presenting to hospital with a miscarriage was given a D and C (sometimes known as a “curette”), whether she needed it or not.

63

There is one, sadly quite common, reason for early 2nd trimester terminations- more and more women are running their contraceptive pills together, so that they only have 3 or 4 periods a year.

Side-effects from the pill include nausea, vomiting, weight gain, abdominal bloating, mood swings and breast swelling and tenderness- all the symptoms of early pregnancy. If you’re running your pills together and for some reason manage to get pregnant during the first week or the first packet, you will probably not know until you miss your expected period at the end of your third packet or fourth packet- 9 or 12 weeks later.

By then you’ll already be 10-13 weeks pregnant, and making the decision to terminate, finding the money and arranging the appointments and time off work could take another 2-3 weeks- bingo 12-15 week, 2nd trimester termination. I personally don’t think such a woman shuld be prevented from having a termination when the delay to second trimester is through no fault of her own.

I know one patient in that situation who made the decision to terminate when she found out that the same antibiotics that had caused her pill to fail and to get her pregnant, were also strongly teratogenic and that the foetus was already obviously abnormal on the 12 week scan. Poor woman, to be told you’re 3 months pregnant and that the foetus is badly abnormal and oh, BTW if you want a termination you’ll have to go to the UK and organise it yourself, all in one day… I wouldn’t wish that on anyone.