I, for one, am growing a little tired of hearing about “the evils” of late-term abortions, aren’t you? I decided to compile a little bit of data stating why late-term abortions are legitimate medical procedures that do serve their own purposes and, in my opinion, should be granted fewer restrictions. Yes, I remain pro-choice throughout the entire pregnancy. Here is why.
Some background/relevant information:"Statistics from 1995, the most recent available, confirm the consistent finding that the overwhelming majority of abortions take place in the first trimester; almost 99% occur within the first 20 weeks of gestation (see table). Since abortions after that point are relatively infrequent, and state reporting requirements vary so widely, it is extremely difficult to assess exactly how many of the 1% of all abortions that are performed after 20 weeks actually occur after viability. (Current medical thinking places viability at 23-24 weeks at the earliest but more commonly at the beginning of the third trimester, or 26 weeks.) The only recent national breakdowns on abortions after 20 weeks are from 1992; according to AGI, some 320-600, or under 4/100ths of 1% of all abortions, are performed in the third trimester."Alan Guttmacher Institute
"Once pregnancy is suspected, most women who want an abortion act fairly quickly and are able to obtain an abortion in the first trimester.
However, Dr. Finer and his colleagues report that two groups of women —adolescents and poor women—have greater difficulty obtaining an early abortion, but for very different reasons: Teens are hampered by a lack of knowledge about the symptoms of pregnancy, while poor women’s financial constraints are often an obstacle to timely receipt of services.
For adolescents, the time between their last period and suspecting they are pregnant is significantly longer than for adult women. The authors assert that a lack of knowledge about the basic aspects and specific signs of pregnancy impedes teens’ ability to recognize a pregnancy, and suggest that increased instruction on such topics in sexuality education programs would help overcome these problems.
Poor women take significantly longer than other women from the time they first try to obtain an abortion to when they actually have the procedure, most frequently because they need to raise money for the procedure. In some cases, women make and cancel multiple appointments before they are able to get the necessary funds, or they wait days or even weeks until they can get Medicaid coverage (which is only broadly available in 17 states). The authors suggest that these findings indicate the importance of financial support for low-income women when they seek abortion."Alan Guttmacher InstituteThe sources above, while not particularly pertinent, do show that women are not merely acting flippantly and waiting out of sheer laziness. (Though, I must say, if they were simply opting to have a much riskier late-term abortion on a whim, I must confess that I would not entrust such a person with the life of another.)
So, why shouldn’t a woman simply opt for an early Caesarian-Section? Obviously, the risks are only minimally different, right?
Risk factors for a Caesarean-Section:"A few women have one or more of these complications after a c-section:
• Increased bleeding, which may require a blood transfusion
• Infection in the incision, in the uterus, or in other nearby organs
• Reactions to medications, including the drugs used for anesthesia
• Injuries to the bladder or bowel
• Blood clots in the legs, pelvic organs or lungs
A very small number of women who have c-sections die. Death is rare, but it is more likely with cesarean than with vaginal delivery.
If a woman who has had a cesarean section becomes pregnant again, she is at increased risk of:
• Placenta previa: The placenta implants very low in the uterus. It covers all or part of the internal opening of the cervix (the birth canal).
• Placenta accreta: The placenta implants too deeply and too firmly into the uterine wall.
Both of these conditions can lead to severe bleeding during labor and delivery, endangering mother and baby. The risk increases with the number of pregnancies."
Furthermore: "A woman who has a c-section usually takes longer to recover than a woman who has had a vaginal birth. Women can expect to stay 3 to 4 days in the hospital after a c-section. Full recovery usually takes 4 to 6 weeks. Usually, the hospital stay for vaginal birth is 2 days, with full recovery taking less time than a cesarean. C-section may be more expensive than a vaginal birth."((Note: This should not be misconstrued as an argument against the Caesarean-Section procedure in general – I do believe that it should remain as an available alternative to vaginal birth.))
March of DimesRisk factors for a Late-Term Abortion:What are the side effects and risks of dilation & evacuation?
"The common side effects for most women include nausea, bleeding and cramping which may occur for two weeks following the procedure. Although rare, the following are additional risks related to dilation and evacuation: damage to uterine lining or cervix, perforation of the uterus, infection, and blood clots."What are the side effects of induction abortion?
"The side effects are similar to dilation and evacuation, although in rare cases it is possible for the mother’s blood stream to be accidentally injected with saline or other medications. Excessive bleeding and cramping may also be experienced."What are the side effects and risks related to dilation and extraction?
"The side effects are the same as dilation and evacuation. However, there is an increase chance for additional emotional problems because of further fetal development"American PregnancySummary/Analysis of comparison between a Caesarian and Late-term abortions:Looking at the information above, it is clear that a Caesarean possesses all of the risks associated with Late-Term Abortions (perforations, infections, clotting, etcetera) and then some (placenta previa and placenta accretia, for example).
The costs of a late-term abortion is fairly significant (
$3,000); however, in proportion to the cost of childbirth (
$3,000-$41,766), it is fairly reasonable, especially when one takes into consideration that raising a child typically costs about
$165,630.
Furthermore, it is not reasonable to force a woman to undergo further violations against her right to bodily integrity/autonomy/domain, especially when there is an easier, less-risky, avenue currently available – though, as noted earlier, not highly practiced.
More basic information:"In [America] and Europe, one in 4,000 women die during childbirth."HarvardBy comparison:
"The risk of death associated with abortion increases with the length of pregnancy, from one death for every one million abortions at or before eight weeks to one per 29,000 at 16–20 weeks—and one per 11,000 at 21 or more weeks."Alan Guttmacher InstituteInduced pregnancies:I have mentioned earlier that vaginal births carry fewer risks than Caesarians. Perhaps, then, it would not be unreasonable to ask the woman in question to simply induce early vaginal labor, right?
"Inducing labor is not like turning on a faucet. If the body isn't ready, an induction may fail and, after hours or days of trying, a woman may end up having a cesarean delivery (or C-section). This appears to be more likely if the cervix is not yet ripe.
If rupturing the amniotic sac doesn't work, your doctor may need to induce labor a different way. Why? Because there's a risk of infection to both you and your baby if the membranes are ruptured for a long time before the baby is born.
When prostaglandin and/or oxytocin are used, there is a risk of abnormal contractions developing. In that case, the doctor may remove the vaginal insert and turn the oxytocin dose down. While it is rare, there is an increase in the risk of developing a tear in the uterus (uterine rupture) when these medications are used. Some other complications associated with oxytocin use are low blood pressure and low blood sodium (which can cause problems such as seizures)."Nemours FoundationAside from the risks posed by induced labor practices, complications will occur in roughly
one in three childbirths."Possible Complications
* Bleeding
* Uterine infection
* Urinary tract infection
* Perineal tears, including tears through the rectum
* Complications requiring forceps, vacuum extraction, or cesarean section
* Blood clots
* Mastitis (breast infection)
* Postpartum depression"NYU Medical CenterSummary/Analysis of a comparison between late-term abortions and induced labor:Once again, it is not reasonable to expect women to undergo induced childbirth in order to give birth to a fetus that she no longer desires to carry -- this is especially true when you consider that a great number (I apologize for not having an exact statistic) of induced labors will result in a Caesarian in the end. The risks, when weighed against one another, stack in favor of elective late-term abortions.
Risks to the fetus:I may come across as cold and callous when I push for the rights of women to obtain late-term abortions; however, I can assure you that I do care about the fetus as well -- early induced labors and premature deliveries can result in a great number of complications.
"In 2004, more than one-half million babies in the United States (about 12.5 percent) were born prematurely (less than 37 weeks of pregnancy) – the highest number reported since comparable national data have been available, according to the Centers for Disease Control and Prevention (CDC). Last year, costs associated with premature births in the United States totaled approximately $26.2 billion, or $51,600 per infant, according to a report released July 13 by an independent panel convened by the Institute of Medicine of the National Academies.
Breathing problems at birth are common among babies born very prematurely and at very low birthweight (under 3 pounds). Because their lungs are not fully developed, premature infants are likely to have trouble breathing continuously or on their own, a condition known as respiratory failure. Oxygen and, in many cases, use of a mechanical breathing machine, or ventilator, is used to help them breathe and to protect other organs such as the brain, heart, liver, and kidneys from damage while the lungs have a chance to mature.
However, high levels of extra oxygen or prolonged use of ventilators can damage the lungs and interrupt normal development, leading to a chronic lung disease known as bronchopulmonary dysplasia (BPD). Very small babies (those born weighing less than 1250 grams, or about 3 pounds) are at high risk for BPD even if they do not require a ventilator. BPD is associated with increased risk of ongoing lung problems such as pulmonary hypertension (high blood pressure in the arteries that supply blood to the lungs), sensitivities to secondhand smoke, asthma, and respiratory infections; neurodevelopmental problems such as cerebral palsy; learning disabilities; impaired growth; and cardiovascular problems. In the United States, more than 10,000 babies develop BPD each year."National Institute of HealthThat, of course, presumes that we are speaking of fetii that have already passed the point of viability.
"# A fetus is viable when it reaches an "anatomical threshold" when critical organs, such as the lungs and kidneys, can sustain independent life. Until the air sacs are mature enough to permit gases to pass into and out of the bloodstream, which is extremely unlikely until at least 23 weeks gestation (from last menstrual period), a fetus cannot be sustained even with a respirator, which can force air into the lungs but cannot pass gas from the lungs into the bloodstream.(4)
# While medical advances have increased the survival of infants born between 24 and 28 weeks of gestation, the point of viability has moved little over the past decade; at the earliest, it remains at approximately 24 weeks, where it was when the Supreme Court decided Roe -- a fact acknowledged by the court in its recent decision in PLANNED PARENTHOOD OF SOUTHEASTERN PENNSYLVANIA V. CASEY.(5) A study of infant survival by researchers at Case Western Reserve University Medical School found that the rate of survival for infants born before 25 weeks gestation has not improved appreciably in recent years.(6)
# According to a brief submitted to the Supreme Court in WEBSTER V. REPRODUCTIVE HEALTH SERVICES(7) by more than 150 distinguished scientists and physicians, 'There are no medical developments anticipated in the foreseeable future that would bring about adequate fetal lung function prior to 23 or 24 weeks of gestation.'"Planned Parenthood
Fetal viability and late-term abortions:I would like to point out, at this point, that late-term abortions are those occuring after 20 weeks of gestation -- the point of viability does not occur until roughly 23-24 weeks of gestation. That is nearly a month's worth of time where the fetus is not capable of being delivered.
What good would it do to tell a pregnant woman twenty weeks along that she must wait, at the very bare minimum, three more weeks before she is allowed to remove the fetus from her body. Furthermore, as I have shown above, removing the fetus early still poses more of a threat to the woman's bodily integrity/autonomy/domain than any method of late-term abortion.
Also, bear in mind that delivering the fetus at this particular point in time is not only expensive (
$51,600), but also poses a great deal of danger to the fetus in question. Are you really so willing to put both parties through such trauma?
Conclusion/Wrap up:I am a staunch proponent of granting women the rights to late-term abortions if they should desire to obtain one at this point.
I would not push women to simply wait this long because (A) late-term abortions are much more invasive and expensive than early-term abortions and (B) I am personally squicked out (a little, anyway) by late-term abortions after viability has been achieved (though, I still support abortions after this point).
All in all, I believe that it is necessary to push our government for looser regulations on these procedures and, hopefully, an eventual ban on any such restrictions tied to time alone (while the fetus is still in the womb, not after).
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