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Setting the record straight on late-term abortion

During the third and final presidential debate on October 19, between Republican nominee Donald Trump and Democratic nominee Hillary Clinton, the conversation quickly turned to a subject that is divisive and controversial for many Americans: abortion. More specifically, the topic of late-term abortions. Considering both candidates got the facts on this very sensitive topic wrong, I thought clarifying a few key points might be helpful.

When discussing this topic, Trump said the following: “In the ninth month you can take the baby and rip the baby out of the womb of the mother just prior to the birth of the baby … you can take the baby and rip the baby out of the womb in the ninth month, on the final day.”

Whew. Thankfully, that’s not true … at all. Let me try and help you make sense of this (dramatic) declaration.

First, what is a late-term abortion? This term is used to describe an abortion that generally occurs after the 20th week of pregnancy. Other definitions state that a late-term abortion is passed the point when a fetus would be viable, or survive if born at this time. This is at approximately 24 weeks of gestation.

Based on Trump’s strong statements, he makes it seem that these procedures are happening in great numbers in the United States, but thankfully the opposite is true. In fact, 98.7 percent of all abortions are before the 21st week of pregnancy. That means only 1.3 percent of all abortions fall in this late-term category.

More importantly, the reality that Trump is presenting — that these abortions are happening “on the final day” of pregnancy — is ridiculous and not true at all. As Dr. Aaron Caughey, a maternal-fetal medicine specialist is quoted in the New York Times as saying, “It is, of course, such an absurd thing to say … I’m unaware of anyone that’s terminating a pregnancy a few days prior to delivery of a normal pregnancy.”

This is the truth. Obstetricians are not “ripping babies” out of uteruses one day prior to a woman’s due date. And women aren’t waiting until this time to get an abortion because they woke up one morning thinking they actually weren’t down with having a baby.

Hillary Clinton also messed up one fact when she spoke of abortion, but it was much less of a splash than Trump’s untruths. She stated that late-term abortions may happen because of the risk to a mother’s health. This usually isn’t the case — it is more often because of birth defects that weren’t diagnosed until the usual routine anatomy ultrasound, which is done around the 20th week of pregnancy. It’s a minor point, but one worth mentioning (most of the medical issues affecting a woman’s health happen later in pregnancy, and the baby can usually be safely delivered to protect her health, rather than needing an abortion).

So, what is the truth? Well, I think the first point is clear: politicians are not doctors, and as a society we should be sure we get our medical facts from people trained to understand and explain them accurately. Second, this is what is true of late-term abortions, in about the easiest-to-digest, least sensational way I can describe them:

  • They are rare, as was previously stated, accounting for only 1.3 percent of all abortions.
  • They are usually done because the fetus has anomalies or developmental issues that are incompatible with life.
  • These anomalies are often not diagnosed until 20 weeks or beyond, hence the late timing of the terminations.
  • If they are for elective reasons (that is, the woman’s choice and not because of another medical issue), this is only 0.3 percent of all abortions — an extremely small amount of the overall picture of abortion in America. And the most common reason that they happen this late is that the woman had trouble getting the funds to pay for the abortion or had difficulty accessing an abortion sooner (a common reality for many women who live in states where abortion providers are scarce, and this is becoming more normal as states continue to pass more restrictive abortion laws).
  • They are almost always done via a surgical procedure called a dilation and evacuation or an induction of labor (more on those procedures here).
  • A woman carrying a baby with a developmental problem that will cause it to eventually die may initially choose to wait until she gives birth naturally, only to change her mind as her due date nears. This may be due to a number of reasons; one might be that she just can’t bear explaining to well-meaning strangers that her baby won’t survive. She may choose at this point to induce labor. This is not an abortion, and if this is what Trump is referring to as “ninth month abortions,” he is wrong.

The most important fact is that this is never an easy choice for a woman or family to make. It often becomes what defines that woman for the rest of her life, and the complication that keeps her from being able to feel complete joy for a long time afterward, and for some women, ever. I can’t do these women justice by explaining what it means to make this sad choice, so I will instead refer you to this mother’s story to understand what she went through. And how much it hurts to have to hear politicians hurl misinformed insults at the women who live this reality every day.

Comments

    1. Thank you for your comment Christon. As you stated, each circumstance is different and each mother’s decision unique. Long thoughtful discussion between woman and physicians help each understand the other. Doctors can help women by informing them of all their options as well as the likelihood of a safe outcome for both woman and fetus. The goal is taking our best scientific knowledge and offering it as information so that a woman can feel informed about what is happening to her body and empowered to guide her own care.

      Reply
  1. I understand that the baby is not literally ripped from the womb. Could you please explain what does happen to the baby during the procedure?

    Reply
    1. For a later term abortion (and remember, that definition isn’t a set gestational age), a termination of pregnancy can be done either by an induction of labor or a surgical procedure. The surgical procedure most commonly done is a D&E where the cervix is dilated (through medicine or mechanical dilators – this can take up to a few days) and then the fetus is taken apart and removed surgically from the uterus. The “partial birth abortion” that many anti-choice proponents speak of is sort of a blurry term that actually doesn’t have a true definition. I know that sounds strange, but you can read more about that here if you want: http://www.huffingtonpost.com/entry/term-and-partial-birth-abortions-the-mythical-arch-nemeses-of-the-anti-choice-movement_us_580d4427e4b02444efa3f33a

      Reply

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