Late-term abortions are a subject of political, moral, ethical and religious controversy. Opposition to the practice of late-term abortion has gone so far as to spark hatreds resulting in murders of abortion-performing doctors. Questions to consider involving late-term abortion include:
Why do women have a late-term abortion?
What are the specific procedures involved with late-term abortion?
What are the risks involved with late-term abortion and how serious are they?
Beyond the debate involved with the right-to-life movement, how does having a late-term abortion affect emotions of women or teens?
Understanding what late-term abortion is, how it is performed, what the medical risks are, and how having a late-term abortion might affect a woman psychologically are vital questions, then, for any woman or teen considering a late-term abortion.
Late-term Abortion Definition
: A late-term abortion is an abortion that is performed after the first trimester, and generally considered to be when the woman is between 14 to 24 weeks pregnant, (approximately three to six months).
Late-Term Abortion Facts
About 30-percent of women in the United States have an abortion (Guttmacher. 2008).
Approximately 23% of pregnancies were aborted in the United States in 2004 (Guttmahcer).
Approximately 10% or one in ten abortions performed are late-term, after the first trimester (Terkel).
Risk of the mother's death for abortions between 16 and 20 weeks is one in 29,000.
Risk of death at 21 weeks and beyond is one in 11,000.
Psychological or emotional damage to the woman or teen is more common and can be more intense with late-term abortion than with abortions.
Susan Neiburg Terkel offers a comprehensive look at various aspects of abortion, ethical, personal, political, and other angles. Issues surrounding late term abortion are considered and the following presents a synopsis of the ideas in Terkel’s account, in addition to other references as noted.
Approximately 10-percent of women have an abortion after the first three months of pregnancy, what most consider to be later term, that is four months or later. Only one-percent of abortions are performed after 20 weeks.
"Many physicians," she states, "are reluctant to perform abortions after the twentieth week because of the fear that they might end up performing an abortion on a viable fetus." An abortion is considered to be late-term between 20 or 27 weeks, depending on the medical source referred to.
Fewer than one out of ten women have an abortion after the first trimester
Sociologist Jonathan Imber documents the fact that many physicians are hesitant to conduct abortions past the first trimester because the fetus is markedly similar to the babies that they also deliver.
Three primary methods of performing late-term abortion are:
1. Dilation and Evacuation
2. Induced Labor or Medical Induction (Medical Instillation)
3. Dilation and Extraction (also referred to as partial-birth abortion)
Dilation and Evacuation - D&E Method of Late Term Abortion
There are two methods of late term abortion that Terkel considers. The first referred to is Dilation and Evacuation or the D&E method.
Terkel documents that between the thirteenth and fifteenth week of pregnancy, the dilation and evacuation, or D&E method of abortion, which is similar to vacuum aspiration; vacuum aspiration is the abortion method most frequently performed. The fetus is too large to pass through the cannula after the first trimester, and therefore must be "dismembered" first, using instruments.
This process can be so stressful that many professionals express ambivalence towards performing such abortions, while others, despite supporting a woman's choice to have an abortion, refuse to perform this procedure.
Dilation and Evacuation can be performed on an outpatient basis and takes approximately a half-hour to perform. It is usually performed in the second trimester.
(Intact) Dilation and Extraction Method of Late-term Abortion - D&X
(also referred to as "partial-birth" abortion)
The dilation and extraction method of late-term abortion is a focal point of legislation efforts by anti-abortion advocates.
The Los Angeles Times Health News accurately describes the Dilation and Extraction method as follows:
Intact dilation and extraction involves removing the fetus feet-first except for the head. Physicians then use suction to collapse the head, usually after injecting the fetus with a drug to kill it before beginning the procedure.
Sometimes, an abortion that begins as a Dilation and Evacuation (D&E) runs in to complications and a Dilation and Extraction (D&X) is then performed.
Medical Induction or Instillation
- Induced Labor
A second method of abortion performed after the sixteenth week of pregnancy, usually at 19 to 20 weeks, is referred to as "medical induction" or "instillation". This method that employs drugs to force an early labor (induced labor) and can only be performed at the sixteenth week of pregnancy or later because the ambiotic sac which surrounds the fetus is too small to accurately locate.
With medical induction, a chemical solution such as saline solution or prostaglandin is injected into a woman’s womb, "instilled". This causes the woman to go into premature labor. She then expels the fetus and placenta. With the medical induction or instillation method, labor can be prolonged, lasting hours or even days. It can be painful and also emotionally draining.
Dr. Katharine O'Connell from New York's Columbia-Presbyterian Hospital is a member of the pro-choice group of Physicians for Reproductive Choice and Health. She explains that this method of late-term abortion "puts the woman under particular stress" and that labor can take two to three days.
Many women having an abortion in the fourth or fifth month of pregnancy have experienced the feeling of the fetus moving in the womb or have seen sonograms to that effect. This can be one reason that abortion, as performed during later terms, can be emotionally or psychologically distressing for a woman.
Possible Physical and Psychological Effects of Late-Term Abortion
Late term abortion experience from Terkel’s book, Abortion – Facing the Issues
"I was given a saline abortion at four months, and I never once was told of the pain involved during the injection of the saline solution into my womb. Neither was I told of the pain involved in labor, nor even that my body would go into labor to reject the struggling, dying baby that was being burned alive in my uterus. Over four hours after the injection, I gave birth to my dead son. I know he was my son because I asked the nurse what it was as she removed the bedpan, and she said, 'It's a boy'".
The American Psychological Association's study of the mental health effects of abortion for women in the United States concluded that teenagers and women who are pressured to have an abortion, women who have more than one abortion, and for those who have late-term abortions are at a higher risk for mental health disorders than those who do not abort.
20 week old fetus. Late term abortion is considered to be an abortion past the first trimester (four months and later) -- Illustration: Melchior Meijer
Medical Induction Method - When the Fetus is Born Alive
Though not common, the possibility of the fetus being born alive when the medical induction method is employed is real, and there is no guarantee that the fetus will be born dead. When the fetus is born alive, doctors are under obligation to try to save the life of the fetus, as babies can survive through this ordeal, performed as it is late in the pregnancy.
Some of the ethical considerations that have been raised by the pro-life movement concerning late-term abortion in general is that there is not a moral distinction between a fetus that dies during an abortion and infanticide. For those in favor of abortion, the possibility of giving birth to a live fetus during the abortion procedure dissuades some from having a late-term abortion.
Majority of this page is based on information from the book: Abortion - Facing the Issues, by Susan Neiburg Terkel (1988).
Review of Abortion - Facing the Issues, by Susan Terkel, from School Library Journal for middle-school and high school educators
A comprehensive analysis of the issues personal, political, legal, and medical surrounding one of our most controversial individual and national dilemmas. Inevitably concluding with no resolution, Terkel includes extended information on how abortions are performed, the abortion "industry," numerous anecdotal illustrations for both sides of the question, and some profound and far-reaching ethical discussions. Abundant and sometimes surprising statistics buttress an already fact-filled analysis.
Although Carol Emmens' The Abortion Controversy (Messner, 1987) includes some additional information on the issue's international status, it [Emmens' book] is by comparison better suited for a less sophisticated readership, late middle graders through high school.
Terkel's examination of the persona and national ethics of the problem, broader consideration of medical and physiological data, and relentless pursuit of the ambivalent sides to the issue make it an excellent choice for high-school and even adult collections; it is recommended over Emmens' book, but not necessarily in addition to it. Catherine VanSonnenberg, LaJolla Country Day School, Calif.
Copyright 1989 Reed Business Information, Inc.
References for Late-Term Abortion page
1. Abortion - Facing the Issues, by Susan Neiburg Terkel, (1988). Impact
2. How are late-term abortions performed?
(March 8, 2004). Religious Tolerance.org.
(The Religious Tolerance accurate summation of late-term abortion is neither pro-life nor pro-choice, but factually presents how late-term abortions are practiced).
3. Los Angeles Times Examines Late-Term Abortion Procedures
. (May 9, 2007).
4. Mental Health and Abortion
American Psychological Association. Retrieved May 22, 2011.
5. AAPLOG Response to the APA Task Force Report
, (September 2008). American Association of Pro-Life Obstetricians and Gynecologists.
Other Pages on Abortion
Psychological effects - Male and female grief - teen abortion - Down's Syndrome
- Moral, psychological and spiritual aspects of abortion