What Really Happens During A ‘Late-Term’ Abortion

late term abortion
“Late-term” abortions tend to be very controversial—and confusing: Many people have read or heard horror stories about what happens when a woman aborts a fetus that’s over 20 weeks. To get a medical perspective, we talked with Dr. Anne Davis, Associate Professor of Clinical Obstetrics and Gynecology at Columbia University Medical Center and the medical director of Physicians for Reproductive Choice and Health.

What constitutes a late-term abortion?

First of all, the word “late-term” doesn’t mean anything. It doesn’t have a medical significance, and we don’t use it. What people might think is that the word “term” means a viable infant, like two minutes before the baby is about to be born. It’s more accurate to say that after 20 weeks, it’s a second-trimester abortion. The first 12 weeks is a first-trimester abortion, from 12 to 24 weeks is a second-trimester abortion, and from 24 weeks on, it’s a third-trimester abortion.

How many of these happen every year?

Only 1% of all abortions happen after 20 weeks. So if we take the 1.2 million abortions that happen in the U.S. every year, there are roughly 12,000 that happen after 20 weeks.

Why do women have abortions after 20 weeks?

Most commonly, it’s for social and economic reasons–the same reasons for earlier abortions. The majority are having abortions because they don’t have the money, or they’ve completed their families already. If you don’t have the money or insurance for an abortion, it can take you a while to save up and meanwhile the clock is ticking. Then, when you do get the money, there is a waiting period, consent, mandatory ultrasound, etc., all of which adds more time. So, by the time a woman gets through all of this, it can be later in her pregnancy.

What are some of the other reasons why someone gets an abortion after 20 weeks?

There could be fetal abnormalities, meaning an abnormal chromosome count, a genetic diagnosis, disease in the family, or a cardiac defect. Teens who didn’t realize they were pregnant and women over 40 who thought they were in menopause are often already three months along by the time they find out they’re pregnant, and some of them decide not to have the baby at that point.

What does the law state about how late an abortion can be performed?

It’s different state by state. States cannot place undue restrictions on this, but the interpretation of those restrictions has changed. The current laws that are being considered have no medical basis; they are all political. In New York, we can legally go to 24 weeks from conception or 26 weeks from last period because that’s a pretty standard definition of viability. The fetus doesn’t have lungs that can breathe until about 23 weeks. Some states won’t allow an abortion after 20 weeks because they say fetuses can feel pain, but that is complete nonsense. There is no reason to think that fetuses can feel pain until at least 26 weeks. Patients have no idea what is correct these days. It’s unfortunate that politicians have been able to throw the debate on these issues into the law.

What do you say to people who say, why not have these women carry the baby to term and then give it up for adoption?

It’s hard to counter that sort of thinking. Someone might want to do that, but if you think about the risks that women go through when they have a baby, that’s not the answer. There is the risk of everything from infection to death when giving birth. If you want to be pregnant, you take those risks because you have decided that you’re willing to do so. But once you decided that you don’t want that baby, why should you be forced to take those risks just so someone else can have your baby? There’s a lack of empathy there that people just don’t get. No one should make you do that.

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    • Poppy

      Very informative read–I definitely learned something (basic stuff that I think more people should know). Thanks for putting this out there!

    • Rapnsum

      Just curious where you get your 1% Stats from, since the President of one very large group of abortion providers himself admitted that tens of thousands of late term abortions for reasons of personal choice are performed annually.

    • Mara

      “Doctors open the cervix and remove the pregnancy.”

      That’s quite a euphemism. It doesn’t really answer the question of “What actually happens during an abortion after 20 weeks?” You don’t just gently remove a baby halfway through gestation like you’re picking a flower. It’s violent.

    • CH

      I’m pro-choice, but this article is making me re-think whether I could actually go through with this myself if I did get pregnant.

    • TF

      “There is no reason to think that fetuses can feel pain until at least 26 weeks.” – my friend recently gave birth prematurely, just before her 24 weeks stage (around 23wks & 4 days). I went to visit her baby a few days later (so still before his 25 week stage!) and witnessed the nurse trying to take blood. I can assure you – they feel pain! And he certainly wasn’t just a fetus – he was a fully formed little human being.

      • woo

        The baby may feel pain, but the foetus does not.

        Foetuses become babies. Just like seeds become plants and milk becomes cheese.

    • Benny

      This is AWFUL! This information is misleading. You do not even talk about what happens during the abortion. You’re not telling people that the baby’s body is actually dismembered in the process while it is still alive.

      What does it matter that it is only roughly 12,000 abortions per year? Have you ever seen a room full of twelve thousand babies?

      And what if that baby was you? Would you feel differently about your mother’s reproductive rights?