Late termination of pregnancy

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 early second trimesters.

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 becomes 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. While another article chose the third trimester, or 27th week of gestation. 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".

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(approximately 18,000 per year). In 1997, the Alan Guttmacher Institute estimated the number of abortions past 24 weeks to be 0.08% (approximately 1,032 per year).

Reasons

See also: Reasons for abortions.

Reasons commonly given for having a late-term abortion include:

• A deteriorating financial situation
• A change in relationship with the father
• A lack of awareness of the pregnancy until its later stages
• Discovery of the pregnancy by others who persuade an abortion, for example, the parents of a minor
• Inability to have an abortion earlier in the pregnancy (possibly due to a lack of funds, lack of transportation, or a legal restriction)
• Discovery of a fetal abnormality, undetectable earlier in the pregnancy
• The pregnancy becomes a risk to the mother's 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.

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. However, 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. Ten states require a second physician to approve of the reason for the abortion, a practice specifically prohibited in Court rulings.

The Supreme Court has repeatedly ruled that bans must include exception for threats to the woman's life, physical health, and mental health, but four states allow late-term abortions only when the woman's life is at risk; four allow them when the woman's life or physical health is at risk. This analysis leaves sixteen states with what both sides agree are constitutional bans on late-term abortions:

• 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*
• Tennessee
• 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), commonly known as 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.

External links

• Gina Gonzales as told to Barry Yeoman, "I Had An Abortion When I Was Six Months Pregnant," Glamour