Understanding 'Late Term Abortion': Undoing The Right-Wing Demagoguery

Image via ACLU Mich.

Late term abortions typically occur because of two general indications: lethal fetal anomalies or threats to the mother

CNN, February 6, 2019

CNN spoke with two ob-gyns to explain: Dr. Barbara Levy, vice president of health policy at the American College of Obstetricians and Gynecologists, a professional organization; and Dr. Jennifer Conti, a fellow with the advocacy group Physicians for Reproductive Health and co-host of The V Word podcast.

**CNN: What does the phrase "late-term abortion" mean to you?

Dr. Barbara Levy:** The phrase "late-term abortion" is medically inaccurate and has no clinical meaning. In science and medicine, it's essential to use language precisely. In pregnancy, to be "late term" means to be past 41 weeks gestation, or past a patient's due date. Abortions do not occur in this time period, so the phrase is contradictory.

Dr. Jennifer Conti: In obstetrics, we don't divide pregnancies into terms. "Late term" is an invention of anti-abortion extremists to confuse, mislead and increase stigma. The appropriate language is "abortions later in pregnancy."

CNN: When people speak about abortion later in pregnancy, are they referring to abortion in the third trimester or something else?

Levy: Generally, abortion later in pregnancy refers to abortion that happens at 21 weeks or later, so in the second or third trimester.

CNN: How common or uncommon are abortions at this stage of pregnancy?

Conti: According to the US Centers for Disease Control and Prevention, abortions after 21 weeks make up less than 1.3% of all abortions in the United States. This means that abortions that occur beyond 24 weeks make up less than 1% of all procedures.
**CNN: Can you explain why abortions happen later in a pregnancy?

Conti:** There are many reasons why women may need to access abortion later in pregnancy, including maternal health endangerment, diagnosis of fetal abnormalities or restrictive laws delaying earlier access to abortion care. Those exceptionally rare cases that happen after 24 weeks are often because a fetus has a condition that cannot be treated and will never be able to survive -- regardless of the gestational age or trimester.

It's this exact reason that it's nonsensical to legislate these cases: Nobody arrives at the decision to have an abortion after 24 weeks carelessly. Rather, it's the rare case of rapidly decompensating maternal heart disease or a delayed diagnosis of anencephaly, where the fetus forms without a complete brain or skull, that bring people to these decisions.

Levy: Abortions later in pregnancy typically occur because of two general indications: lethal fetal anomalies or threats to the health of the mother. Some fetal development problems or genetic anomalies do not show up or develop until later in pregnancy. Some examples might include anencephaly (described above) or limb-body wall complex, when the organs develop outside of the body cavity. With conditions like these, the fetus cannot survive out of the uterus.

Likewise, when conditions progress or appear that severely compromise a woman's health or life, abortion may be the safest, medically indicated procedure. These conditions can also reduce the possibility of fetal survival. They might include premature rupture of membranes (where the fluid surrounding the fetus is lost before labor), uterine infection, preeclampsia, placental abruption and placenta accreta. Women under these circumstances may have extensive blood loss or septic shock that can be fatal.

It's important to note, if a woman's health or life is at risk and the fetus is viable, delivery is pursued, not abortion.

In the case of either lethal fetal anomalies or complications that endanger a woman's life, it's essential that women and their physicians are able to consider the full range of appropriate treatments, whether that's abortion care, induction of labor or cesarean birth. Every pregnant woman's situation and medical condition are different, and there is no way to make a one-size-fits-all determination about the appropriate care.

No matter what, care must be compassionate and recognize that for many women, the choices they are facing are devastating and immensely complicated. ...
Read full article and interview at CNN

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