Late-Term Abortions

Disclaimer: Throughout this article, we will be using the term “women” to refer to individuals who are pregnant. We understand that sex and gender are two different things, and just because a person is biologically a female does not necessarily mean they identify as a women. However, for the sake of simplicity and consistency, we use that term. If you would like to learn more about gender identity, visit our article Sexual Orientation and Gender Identity.

“Late termination of pregnancy” or “late term abortion” refer to abortions performed during an advanced stage of pregnancy. Although abortion is generally a controversial practice, abortions performed later in the pregnancy are particularly controversial because the fetus is closer to being able to survive outside the uterus. A 2013 Gallup poll showed that many people who thought abortion in general should be legal still debated whether or not late term abortions should be acceptable.1 Late-term abortions are generally rare in the United States. A 2012 report by the National Center for Chronic Disease Prevention and Health Promotion found that 91.4 % of abortions in the US were performed during or before the eighth week of gestation. Contrarily, only 1.3% were performed during or after the twenty first week of gestation.2

Defining a Late–Term Abortion

The exact point when a pregnancy becomes late-term is not clearly defined. A late-term abortion often refers to an induced abortion procedure that occurs after the twentieth week of gestation or during the third trimester of pregnancy which begins after 26 weeks. An induced abortion is defined as the termination of a pregnancy through either a medical procedure or medication taken.3 

Often, “variability” is the strongest factor that doctors consider when determining if a pregnancy should be deemed late-term. Viability refers to a fetus’ ability to survive outside the uterus. Usually, an abortion that is performed after the fetus is able to survive outside of the uterus is considered late-term. However, viability can vary greatly among pregnancies; as such, there is no particular week at which all pregnancies become viable. No pregnancy is viable before the twenty-first week and almost all pregnancies are considered viable after the twenty-seventh week. 4

The Process

The most common technique for abortions after 14 to 15 weeks of pregnancy is “dilation and evacuation.” This process is similar to the surgical abortion illustrated in the image above but requires a larger cervical opening. The dilation and evacuation process usually takes about 10 to 30 minutes to complete.5 The other technique for late-term abortion is “induction.” In this procedure, a needle is passed through the abdomen and into the uterus to deliver contraction-inducing medication.5 The medicine induces labor and aids in the expulsion of the fetus. Abortion-related complications tend to be the least common during the first trimester. However, studies show that complications from the dilation and evacuation method are still considerably low when the procedure is performed during the second trimester.

Possible Complications

While complications from late term abortions are rare, some risks do exist.  According to the American Pregnancy Association, the most common complications of the dilation and evacuation method include nausea, cramping, and bleeding. These complications should go away after a few weeks.6 In a 2015 study, researchers examined 4,520 women receiving second term abortions in California hospitals through the dilation and evacuation process. They found that they were only two predictors of complications. The first was the gestation week: the further along the pregnancy, the higher the likelihood for complications. The second was whether or not the women had previously had children; giving birth through both vaginal delivery and caesarian seemed to increase the risk of experiencing complications. Of the 4,520 women, minor complications occurred in about 8 % of the women while major complications occurred in only 1.8 % of the patients. Minor complications consisted of clinical hemorrhage, cervical laceration, and uterine atony. Major complications, which were defined by the patient needing further hospitalization, were very rare.7

Why Women Get Late-Term Abortions

There are many reasons why a woman might consider having a late-term abortion. In a 2013 US study, researchers investigated reasons women gave for seeking out a late-term abortion. Fifty-five percent of the women in the study reported seeking a late-term abortion because they had trouble deciding whether to have an abortion. Twenty-two percent reported financial barriers that caused them to not seek an abortion earlier and 21 % reported that they had only recently discovered that they were pregnant. Other reasons included transportation problems, being uninformed about how to get an abortion and social pressures to continue with pregnancy.  Of the women surveyed who were under 18 years old, 26.9 % delayed seeking out an abortion due to the fear of telling their parents they were pregnant.8Outside of the United States, the cost of an abortion and the difficulty of accessing a proper medical center are common reasons that women report for getting a late term-abortion.9

A woman may also undergo a late-term abortion because of an undiagnosed medical condition. If a woman finds that her baby has fatal or serious health problems, she may want to terminate the pregnancy. Also, if a woman fears that her health is in danger because of issues such as diabetes or heart problems, she may want to terminate the pregnancy to save her own life.10

Are Late-Term Abortions Legal?

The legality of abortions that occur later in the pregnancy vary from country to country and from state to state. For example, in the United States, most states ban abortions after the age of viability unless the mother’s health or life is in danger. This time period differs between states: it most commonly ranges from 20 weeks to 24 weeks post fertilization.11 As of 2016, thirteen states including Alabama, Arkansas, Indiana, Kansas, Louisiana, Mississippi, Nebraska, North Dakota, Oklahoma, South Carolina, Texas, West Virginia, and Wisconsin have laws banning abortion after 20 or 22 weeks unless the mother’s life is in danger. The South Carolina bill cites that at 20 weeks into gestation the fetus is capable of feeling pain, although most scientific research suggests that a fetus becomes capable of feeling pain towards the beginning of the third trimester (which starts 28 weeks into gestation).12 Many states have other laws involving abortions, such as requiring the written consent of parents or guardians for persons under 18 or requiring that abortion clinics meet the most stringent of requirements. Currently, many states are seeing the repeal of laws demanding abortion clinics meet these stringent requirements with the Supreme Court’s ruling in Whole Woman's Health v. Hellerstedt which found these laws to be unconstitutional.13

Internationally, the laws differ between countries.  For example, within Latin America  and the Caribbean alone seven countries have a ban on all abortions. In India abortion after 20 weeks is only permitted if the mother’s health is in danger.14

For information on clinics near your area and the services they offer follow this link to a nationwide database.

In conclusion, late term abortions are very rare and according to most statistics considerably rare. For more information on abortions please feel free to explore our other articles on the topic:

References

  1. Gallup, Inc. "Abortion." Gallup.com. N.p., 26 May 2016. Web. 11 Oct. 2016.
  2. Pazol, Karen, Andreea A. Creanga, and Denise J. Jamieson. "Abortion Surveillance — United States, 2012." Center For Disease Control and Pervention. N.p., 27 Nov. 2015. Web. 11 Oct. 2016.
  3. "Induced Abortions." Induced Abortion. The American Congress Of Obstetricians And Gynecologists, May 2015. Web. 03 Nov. 2016.
  4. "Fetal Viability (definition)." Reference. MD. N.p., n.d. Web. 03 Nov. 2016.
  5. LeVay, Simon, Janice I. Baldwin, and John D. Baldwin. Discovering Human Sexuality. 2nd ed. Sunderland, MA: Sinauer Associates, 2012. Print.
  6. “Abortion Procedures.” American Pregnancy Association. September 3, 2016 Web. 27 October 2016.
  7. Lederle, Lauren, et al. "Obesity As A Risk Factor For Complications After Second-Trimester Abortion By Dilation And Evacuation." Obstetrics & Gynecology 126.3 (2015): 585-592. Academic Search Complete. Web. 27 Oct. 2016.
  8. Janiak, Elizabeth, et al. "Abortion Barriers And Perceptions Of Gestational Age Among Women Seeking Abortion Care In The Latter Half Of The Second Trimester." Contraception 89.4 (2014): 322-327. Academic Search Complete. Web. 10 Oct. 2016.
  9. Zavier, A.J. Francis, Shireen Jejeebhoy, and Shveta Kalyanwala. "Factors Associated With Second Trimester Abortion In Rural Maharashtra And Rajasthan, India." Global Public Health 7.8 (2012): 897-908. Academic Search Complete. Web. 11 Oct. 2016.
  10. Painter, Kim. "Doctors Say Abortions Do Sometimes save Women's Lives." USA Today. N.p., 22 Oct. 2012. Web. 11 Oct. 2016.
  11. State Policies on Later Abortions." Guttmacher Institute. N.p., 03 Oct. 2016. Web. 11 Oct. 2016.
  12. Grinberg, Emanuella. “S.C. Gov. Nikki Haley signs law banning abortion at 20 weeks” CNN Politics. 26 May, 2016 Web.
  13. SCOTUSBlog. "Whole Woman's Health v. Hellerstedt." SCOTUSblog RSS. N.p., n.d. Web. 03 Nov. 2016.
  14. Stillman M et al., Abortion in India: A Literature Review, New York: Guttmacher Institute, 2014.

Last updated on 3 November 2016.

 

 

 

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