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How Debates Over Abortion Later in Pregnancy Hurt the Women Who Need Them

Anti-abortion advocates have used what they call "late-term abortion" to distort the truth about why women may seek abortion care in the later stages of pregnancy, physicians say.

by Marie Solis
Feb 6 2019, 7:40pm

An abortion doula holds a patient's hand while she receives an abortion procedure. Photo by Carolyn Van Houten/The Washington Post via Getty Images

Dana Weinstein was about 29 weeks along when she found out the fetus she was carrying was unlikely to live for more than a few moments after delivery. She had been sitting in a doctor's office in Washington DC, looking at a side-by-side comparison of a healthy fetus' brain and the MRI of her fetus' brain. Weinstein said you didn't need to be a medical specialist to see the difference: Huge pieces of her fetus' brain were missing, which, the doctor told her, would result in the baby either to seizing to death immediately post-delivery or spending the rest of its life experiencing seizures 70 percent of the time. The doctors told her that there was no way to have caught the malformation sooner, even being so severe, as fetal brain abnormalities are often only detectable around the third trimester.

After consulting with multiple genetic counselors and doctors in hopes of a better prognosis, Weinstein asked about the possibility of terminating the pregnancy—an option she said hadn't even been offered to her.

"I kept telling my husband, 'Please don't think I'm a horrible person,'" Weinstein recalled. "Of course he didn't—but it was so frustrating that I had this stigma in my face when I was in this devastating situation."

In 2009, there were no DC doctors who would perform an abortion at Weinstein's stage in pregnancy, and the doctor Weinstein's hospital used to refer patients to—George Tiller—had been fatally shot just over a month prior by an anti-abortion extremist. Instead, Weinstein was referred to a doctor in Colorado, whose services cost her family $17,500 since her insurance wouldn't cover the procedure.

"I was so excited to expand my family," Weinstein, whose first son was two years old at the time of her abortion. "But terminating the pregnancy almost wasn't a choice: How do you say it's a choice when the ultimate end result either way is death? You're choosing how your baby dies. Being able to say goodbye the way we did was right for us."

Weinstein's experience doesn't reflect the way abortion later in pregnancy has been portrayed in national discourse lately.

In his State of the Union address Tuesday night, President Donald Trump criticized New York state legislators for passing the Reproductive Health Act, which lifted the criminal ban on abortion after 24 weeks, saying that it allowed fetuses to be "ripped from the mother's womb moments before birth."

Trump then went on to refer to recent comments from Virginia Governor Ralph Northam, who earlier this week stirred up a nationwide debate when he was asked about proper protocol in the event of a child being born after a failed attempt at an abortion. Northam had responded that "the infant would be resuscitated if that’s what the mother and the family desired," and a discussion between the mother and her physician would follow.

Northam's office told Vox that the governor was "absolutely not" talking about infanticide, and was instead referring to the tragic and extremely rare case in which a woman with a nonviable pregnancy or severe fetal abnormalities went into labor." Yet on Tuesday night, Trump said Northam had "basically stated he would execute a baby after birth."

“Tonight, we heard the president make inaccurate and deliberately misleading claims about safe, legal abortion and bills that are meant to protect women’s access if Roe v. Wade were to be overturned —something that is increasingly likely," Leana Wen, president of Planned Parenthood Federation of America, said in a statement Tuesday night. "As a physician, I know what these bills actually do is protect women’s access to abortion, a common, safe medical procedure that one in four women will have in her lifetime."

The question posed to Northam was related to a bill Virginia Delegate Kathy Tran introduced to ease restrictions on abortions that occur later in pregnancy. Though Virginia already permits third-trimester abortions, Tran's proposal would reduce the number of doctors required to sign off on later abortions from three to one. Though third-trimester abortions only make up around one percent of all abortions, according to the Center for Disease Control and Prevention, and though the women seeking them typically do so because they find themselves in circumstances similar to Weinstein's, anti-abortion advocates have continually used the procedure to create a specter of cruelty and murder around abortion.

Even the terms conservatives use to talk about abortion that occurs in the later stages of pregnancy can be a way to portray it as something morally wrong, physicians and abortion providers say.

The term "partial-birth abortion" has long been used to discuss dilation and evacuation, a common second-trimester abortion procedure. "First of all, one can’t be partially born," Jennifer Gunter, a California-based OB/GYN wrote for HuffPost in 2016. "In obstetrics, you are pregnant or you aren’t, and you are delivered or you are not."

The same goes for "late-term abortion," Anuj Khattar, an abortion provider based in Washington and a fellow at Physicians for Reproductive Health, told Broadly.

"The term 'late-term abortion' was largely created by anti-choice individuals and groups as a way to create more emotion around the process of abortion and make people feel empathy for the fetus," Khattar said. "It's not a medical term used by the medical community. Abortion is abortion no matter when it happens."

Khattar says imprecise or inflammatory language to talk about third-trimester abortions has resulted in mischaracterizations of women's experiences and barriers to access: According to Guttmacher Institute, 43 states ban abortion after a certain point in pregnancy, and 20 of them ban later abortions, with exceptions in the event that the pregnancy threatens the woman's life.

"It's important to understand that women don't get pregnant to have abortions," Khattar said. "The women who have to make this decision are pregnant because they want to be pregnant, and they've gotten to a point where they've found out devastating information about their health or their fetus' health."

Weinstein admitted that before she needed a third-trimester abortion, she had trouble understanding why anyone would seek one. Now, having gone through the experience herself, she's horrified that someone in her position could be unable to access the same care. She says she shares her story out of fear that her children—who now number three, in addition to the baby she lost—won't have the same options available if they ever find themselves facing the decision she did.

"No one just wakes up this late in a pregnancy and says, 'Oh i don’t want to have a baby today,'" Weinstein said. "As soon as you put a limit on abortion it's another cut to access. Women who choose to have abortions have their own personal stories and reasons. It's not anyone's place to judge or restrict those."