Levy: Abortions later in pregnancy typically occur because of two general indications: lethal fetal anomalies or threats to the health of the mother. Some fetal development problems or genetic anomalies do not show up or develop until later in pregnancy. Some examples might include anencephaly (described above) or limb-body wall complex, when the organs develop outside of the body cavity. With conditions like these, the fetus cannot survive out of the uterus.
Likewise, when conditions progress or appear that severely compromise a woman’s health or life, abortion may be the safest, medically indicated procedure. These conditions can also reduce the possibility of fetal survival. They might include premature rupture of membranes (where the fluid surrounding the fetus is lost before labor), uterine infection, preeclampsia, placental abruption and placenta accreta. Women under these circumstances may have extensive blood loss or septic shock that can be fatal.
It’s important to note, if a woman’s health or life is at risk and the fetus is viable, delivery is pursued, not abortion.
In the case of either lethal fetal anomalies or complications that endanger a woman’s life, it’s essential that women and their physicians are able to consider the full range of appropriate treatments, whether that’s abortion care, induction of labor or cesarean birth. Every pregnant woman’s situation and medical condition are different, and there is no way to make a one-size-fits-all determination about the appropriate care.
Levy: Abortion later in pregnancy is a very complex decision and, often, a very emotional one. We know that women who make the decision to have an abortion do so in a considered, deliberate fashion. This is especially true for women who have abortions later in pregnancy who are often facing devastating fetal diagnoses or life-threatening conditions that may introduce a multitude of clinical considerations into their decision-making.
Moreover, the ob-gyns who provide later in pregnancy abortion care have very specific training both in the technical procedure, as well as ethical decision-making in complex clinical circumstances.
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If a person needs to end their pregnancy after 24 weeks, there are a limited number of places in the country where they can do that, and the approval process for that procedure is scrupulous.
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For women who need abortion care in the third trimester, there are very few places across the country where this care is accessible, and it is very rarely covered by insurance. Typically, these procedures would cost in the thousands of dollars. Moreover, many women would have to travel by plane to reach these providers, so in addition to the cost of the care, they are incurring the cost of travel and lodging.