While abortion continues to be a politically contentious and divisive issue, later abortion is marginalized even among those who otherwise support abortion rights. Women who need later abortions are younger and more economically vulnerable than those who seek first-trimester abortion care, yet polling indicates public support for later abortion is significantly lower than for earlier abortion. Legal restrictions, higher costs, and fewer providers mean that women who need later abortions must overcome many obstacles to access care. At later gestations, access to high-quality abortion services becomes more contested, restricted, and inaccessible.
The Later Abortion Initiative (LAI), a project of Ibis Reproductive Health, will change the conversation around later abortion and the women who need this service. LAI particularly focuses on the increased stigma, challenges, and barriers for women who need abortions after 18 weeks.
Here are some fact sheets from the Later Abortion Initiative of Ibis Reproductive Health:
Summary: Based on the best available scientific evidence, a human fetus does not have the functional capacity to experience pain until after the beginning of the third trimester of pregnancy, and it is unlikely that pain can be experienced until birth. Requirements to offer fetal anesthesia, which provide no benefit to the fetus or the pregnant person, increase the risk of complications and delay access to care.
Laws requiring individuals seeking later abortion to be informed of the potential existence of fetal pain should be modified to be consistent with scientific evidence, and any discussion of fetal capacity to experience pain should also include a discussion of the fetus’ sensation during the birth process and post-birth medical interventions and not focus exclusively on ending a pregnancy.
Summary: Both in the law and in medical science, viability is not defined as occurring at a specific gestational age in pregnancy. A recent study of survival of extremely premature infants found that even with active intervention, no infants born at less than 22 weeks of gestation survived. At 23 weeks, survival without severe impairment is less than 2%; at 25 weeks, up to 30% may survive without severe impairment.
Summary: It is not always possible for a person to get an abortion as soon as they would like to. Many things can stand in their way of early abortion care, including not knowing about and/or having access to services; personal, financial, and other circumstances; and structural and legal issues like state bans on insurance coverage.
Reasons why an individual may need an abortion after the first trimester include delays in finding out they are pregnant, needing time to decide what to do about an unintended pregnancy, difficulties accessing care due to trouble finding or traveling to a provider, and needing the time to raise money to pay for the procedure or make travel arrangements to a provider in a distant location.
These factors often cause a chain reaction in which delay leads to increased barriers, because as the pregnancy progresses, the costs of the abortion procedure increase while the availability of services decreases. Additionally, some individuals seek abortions in the second trimester or later after developing a serious health problem or learning about a genetic or health condition in the developing fetus, as many of these conditions cannot be accurately diagnosed until later in pregnancy. Abortions performed due to maternal and/or fetal indicators are a small percentage of the abortions done later in pregnancy
As patient advocates, we understand the role that stigma and shame play in restricting access to safe and legal abortion, especially later in pregnancy. This stigma is rooted in misconceptions about who seeks an abortion and why. Real stories are silenced by shame and rhetoric fills the void.
Our projects aim to put patients back into the conversation around later abortion. We disrupt traditional storytelling by filtering stories and facts through a creative lens. Our engagements move beyond brief impressions so connection to the cause may be unequivocal, comprehensive and ultimately, long lasting.