“Late-Term Abortion” is Not a Medical Term, and Other Abortion Facts
As part of reproductive healthcare, abortion is on a spectrum of health services available to women and people. As determined by the Supreme Court in 1973, abortion, as with other decisions for reproductive and general healthcare, is protected under the constitutional right to privacy.
Conversations around abortion, particularly from anti-abortion camps, have attempted to isolate it from other reproductive health services, but healthcare providers have warned that doing so can have dangerous implications. Ohio abortion provider Dr. Z, whose real name has been withheld*, says the “number of situations that could arise [for a pregnant person] are infinite, as numerous as the number of patients that become pregnant and start to think about their options. The last thing you need when you’re making that decision is some sort of hamstring, or some kind of legal wall or barrier.”
New fervor has risen around the legality and morality of abortion, seemingly in response to New York Governor Andrew Cuomo’s decision to codify Roe v Wade in New York State law, guaranteeing the ability to seek a safe and legal abortion up until 24 weeks, and after if the health or life of the mother is threatened, or the fetus is determined not to be viable.
Within the same month, abortion rights advocates were holding their breaths, waiting for a decision from the Supreme Court on a Louisiana law that would have required physicians providing abortions to have admitting privileges at a nearby hospital. While risking the closure of the state’s three remaining clinics, the Court’s decision on the law could also have broader implications for clinics nationwide. It was struck down, 5-4, with Chief Justice John G. Roberts Jr. joining the majority.
Here in Ohio, the Senate will hold a committee hearing on the six week abortion ban on Wednesday, Feb. 13, the third time to be introduced in the state in as many years. Though no liberal on the issue, former governor John Kasich previously vetoed the bill twice. Governor Mike DeWine, a vocal opponent of abortion rights, has said he would sign a six week ban.
As abortion advocates celebrate a win and brace for losses, misinformation has spread about abortion, from the very terms used to describe abortions throughout pregnancy, to how they’re funded, to the kind of people that seek them. CU has spoken with Dr. Z and consulted with credible research organizations including the American College of Obstetricians and Gynecologists (ACOG) to introduce some facts to the conversation.
1 in 4 women will seek an abortion in their lifetime
One in 20 will seek an abortion by age 20, one in five by age 30, and one in four by age 45.
Abortions are verifiably safe procedures
Abortions are 14 times safer than childbirth.
An in-clinic abortion takes roughly five minutes, not including recovery from sedation should the patient choose it. Without sedation, a patient can obtain an abortion and drive back home or return to work that same day.
Prior to 10 weeks gestation, patients have the option of either an in-clinic procedure or pills, one dose of mifepristone to take at the clinic, followed by misoprostol taken at home 24 to 48 hours later.
The vast majority of abortions take place before 13 weeks gestation
According to the CDC, 91 percent of abortions take place 13 weeks or prior into a person’s pregnancy; 7.6 percent between 14-20 weeks; and 1.3 percent after 20 weeks.
At 13 weeks, the fetus is roughly the size of a lime.
A fetal heartbeat does not develop at a fixed point
The six week distinction is an estimate; a heartbeat can be detected anywhere between one and eight weeks.
Fetal viability occurs between 26-28 weeks
Fetuses do not feel pain until late in the third trimester (week 27-end of pregnancy)
Pain is an emotional and psychological experience that requires conscious recognition of harmful stimuli. Evidence has shown that the neural circuitry necessary to distinguish touch from painful touch does not develop until well into the third trimester.
The terms “late term abortion” and “partial birth abortion” are not medical terms
The terms “late term abortion” and “partial birth abortion” were coined by the National Right to Life Committee (NRLC) to politicize the dilation and extraction (D&X) procedure, used in 0.2 percent of abortions, largely prior to the point of fetal viability.
D&X, developed by Ohio abortion provider Martin Haskell, involves pulling the fetus bottom first with the head still inside the birth canal, and puncturing and compressing the head so that it can be pulled through the birth canal without damaging the woman’s cervix and endangering her future ability to have children.
The circumstances surrounding the use of D&X, and surrounding abortions sought after 20 weeks, are so varied and rare that the statistics for them are not available.
“I think the reason that people are having trouble getting their heads around this, and even the reason I have trouble explaining it, is because when you get to that point, the scenario is so unimaginably horrific for the patient that we can’t even imagine,” says Dr. Z. “Those are cases that developed really horrible anomalies, or have grave health implications for the woman, and so we have a hard time talking about hypotheticals because the actual cases are so complex, you can’t make them up.
Federal dollars (and in Ohio, state dollars) do not fund abortions
Like any healthcare provider, Planned Parenthood receives federal funding via Medicaid reimbursements. A patient can obtain a Pap smear, STI test or birth control from the clinic, Planned Parenthood then submits a claim to Medicaid for the care provided, and Medicaid reimburses Planned Parenthood. State Medicaid sends the bill to the federal government, which reimburses the state for part of the costs.
Abortions are not covered by Medicaid and are not required to be covered by private insurances. Patients pay for abortions out of pocket.
Mental and emotional impacts of abortion are unique to each patient
Women and people who seek an abortion are at no higher risk of PTSD than those who go through with their pregnancy.
As Dr. Z puts it, “for some patients, it is a really difficult and complicated decision. For some patients, it’s an easy decision, but it’s still really sad. And for some patients, it’s just a very straightforward decision.”
*Dr. Z, like many abortion providers, faces verbal attacks from clinic protesters as she enters and leaves her place of work. Unlike her colleagues, Dr. Z has never been harassed at home, though protesters have threatened to follow her home.
“I’ve learned things that you’re supposed to do to make sure you’re not followed home, and the kind of maneuvers to do to see if you are being followed home. I know where the police stations are between work and home, so I could go somewhere safe if I needed to,” she says. “It’s kind of like a constant thing in the back of my mind.”