Abortions After The First Trimester
Who Not When: A people-centered resource for understanding abortions later in pregnancy.
What’s important to know about later abortions:
“Later Abortion” is not a bright line. For a person seeking an abortion, it is when the gestation of their pregnancy becomes a factor in being able to access care.
Abortion is safe at any point in pregnancy.
Later Abortions are expensive, costing between $2,500 and $20,000, or more.
Health Insurance plans rarely cover abortions later in pregnancy.
Many people are not able to access a desired abortion.
Who gets Later Abortions and Why?
Rhetoric vs Lived Experiences: Why do people seek abortions later in pregnancy?
People seek abortions later in pregnancy for the same reasons they do earlier in pregnancy, but many are not able to access care as soon as they would like. According to researchers at ANSIRH, “Not having enough money to care for a child or another child is the most common reason for seeking an abortion.”
Katrina Kimport, a researcher at UCSF, identified two common pathways through which people find themselves seeking abortions later in pregnancy :
New information that changes the course of the pregnancy :
Click the image to listen to this podcast episode of Repros Fight Back.
Pregnancy was discovered after the 1st trimester
Poor fetal diagnosis
Newly discovered threat to the health or life of the patient
Sudden life event or significant change in circumstances
Barriers to obtaining care as early as desired :
Abortion restrictions and burdensome regulations
Difficulty paying for an abortion earlier
Interaction with Crisis Pregnancy Center (CPC)
Childcare struggles
Conflicts with family and/or partner about the pregnancy
Difficulty finding or traveling to an abortion provider
Plenty of people fit into both categories. They may get information later in their pregnancy and then have difficulty accessing abortion care.
A persistent misconception is that most later abortions involve a poor fetal diagnosis, but there is no data to support this. Stories featuring a poor fetal diagnosis in a “wanted” pregnancy are overrepresented in media coverage and advocacy around later abortion. This contributes to increased stigma for the many patients who do not terminate for a poor fetal diagnosis.
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.
Who Needs Abortion Later in Pregnancy, and Why?
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.
Abortion AMA: What Is A "Late-Term" Abortion?
Here is a great article that explains it all. "The important thing to remember is that abortions later in pregnancy are not [happening because] people waltz in off the street and say, 'I’m done being pregnant, I want an abortion," Dr. D. says.
@EmilyOnLife