20 Weeks After

* For this post on abortion procedures and laws, I will be exclusively talking about U.S.A. law and American women’s experiences. All facts & figures citations are at the conclusion of the post.

In my country, both the law and most attitudes seem to reflect the idea that an early abortion is morally superior to a late term abortion (occurring after 20 weeks’ gestation). I don’t agree with this idea at all. Women who get late term abortions are, generally speaking, women with more than enough on their plates without my judgment being heaped on as well.

I’d like to say that women who get late terminations do so exclusively for maternal health and fetal deformity. While that is true in the third trimester (after 24 weeks), it’s not true for second trimester abortions. Actually, the majority of women who terminate between 20 and 24 weeks’ gestation do so because they were denied access to abortion services earlier in their pregnancies.

Let’s talk about access for a moment. While federal court rulings ensure women have legal access to abortion services on demand in the first trimester, reality looks very different for many American women. 87% of U.S. counties have no identifiable abortion provider at all. Women who choose elective abortion and thus would prefer to acquire first trimester abortion services (as they are cheaper, safer and less invasive than later stage abortion procedures) are often mothers (61%) and very often they are poor; 42% of all abortions are chosen by women living below the federal poverty limit and an additional 27% of abortions are chosen by women living between 100-199% of the federal poverty limit.

From a study published in Contraception, Volume 74, Issue 4, the most common reason women gave for not having an abortion sooner is that it took a long time to make arrangements. “Poor women were about twice as likely to be delayed by difficulties in making arrangements.”

Don’t have a car? Have three young children who need constant supervision? Live in a county without an abortion provider? Don’t have the funds necessary to pay for an abortion? True access to abortion takes a lot more than court rulings.

How about if your state likes to add lots of hoops for pregnant women to jump through? Maybe a 72 hour waiting period, some mandatory non-licensed guilt-ridden Christian counseling, perhaps your doctor will be required to lie to you. Gee, obtaining that first trimester abortion on time should be no problem for a poor mother, right?

First trimester abortions are the safest medical procedures performed in the United States. Second trimester abortions are more complex, riskier, more expensive, and even fewer abortion providers offer this medical care. Suddenly that hard-to-access first trimester abortion is a second trimester pregnancy that will take much more time, energy, and money to terminate.

Now we’ve talked about the women who get abortions after 20 weeks simply because they could not get an abortion they had chosen earlier. It’s time to turn our attention to the other women who terminate in the second half of pregnancy.

These are women who wanted their pregnancies, whether planned or unplanned. They may have a nursery done up at home, or a baby shower planned. They have likely been sharing the good news of their pregnancy with friends and family. But disaster has struck: something has gone irrevocably wrong. Either the fetus is incompatible with life, or else doomed to a life of misery and pain and health complications, or the woman has to choose an abortion to save her own life.

When anti-abortion protesters hold up signs to try to guilt and shame women for having elective abortions, they invariably hold up imagery representing the lost pregnancies of women who mourn the children they wanted. They inflict pain on the women who didn’t have “selfish” reasons to terminate, who wanted their pregnancies, who wish more than any anti-choice activist ever could that their pregnancies had gone to term to produce a healthy baby.

Why a woman has an abortion, on a personal level, is none of your or my business. But why women have abortions overall, and what we can do to reduce barriers to family planning services to all women, those are our business. Women who lost wanted pregnancies should never be shamed or called killers, nor should they have their loss referred to as a “clump of cells” by callous activists on my side. Compassion and empathy must be key.

Women who have abortions after 20 weeks because they could not get an abortion sooner should never be shamed or called killers, nor should anyone blame them for their choice among limited choices. Again, compassion and empathy must be key. Women are human beings, they are people. They deserve to be treated as such.

We need to do more. We need to let women know about the abortion access funds like the New York Abortion Access Fund and the National Network of Abortion Funds, so they don’t have to delay getting an abortion due to financial barrier. We need to train more doctors to provide abortion services. We need to pressure our local police departments to press charges against FACE Act violators. We need to vote out anti-choice politicians who give pregnant women seeking abortions barriers to access.

We need to make sure the women in our lives know they can come to us for things like a ride to the clinic or a few hours of babysitting while they rest and recover from an abortion.

I’d like to say that women only get late term abortions when they are life-saving or due to fetal deformity, but that isn’t the case. Far too many women seeking elective abortions are denied access when an abortion would be easiest and safest for them. We need to change this. Every woman who wants or needs an abortion should be able to have one as soon as possible.

Facts & Figures Citations

National Abortion Federation
http://www.prochoice.org/about_abortion/facts/access_abortion.html

Guttmacher Institute
http://www.guttmacher.org/pubs/fb_induced_abortion.html/

Contraception, Volume 74, Issue 4
Timing of steps and reasons for delays in obtaining abortions in the United States
http://www.guttmacher.org/pubs/fb_induced_abortion.html/