Late-term abortions is 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 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 second trimester, and generally considered to be when the woman is past 20 weeks of pregnancy. Some consider late term abortions to be after 24 weeks of pregnancy (generally around five or six months).
Late-Term Abortion Facts
Approximately 1.1 million total abortions were performed in the U.S. in 2011 (Planned Parenthood).
About 30% of women in the United States have had an abortion at some point in their lives (Guttmacher. 2008).
Approximately 23% of pregnancies were aborted in the United States in 2004 (Guttmahcer).
Approximately 66% of abortions are performed during the first eight weeks of pregnancy (Planned Parenthood).
Approximately 10% or one in ten abortions performed are later-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.
Only 1.2% of abortions are performed 20 weeks or later (about 13,200 in the U.S. in 2011) (Planned Parenthood).
Psychological or emotional damage to the woman or teen is more common and can be more intense with late-term abortion than with abortions (Coleman, Coyle, Rue. 2014).
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 approximately one-percent of abortions, or 1.2% more precisely, are performed late-term, after 20 weeks of pregnancy.
"Many physicians," states Susan Terkel in the book Abortion - Facing the Issues, "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." Sociologist Jonathan Imber concurs, documenting 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 (Imber. 1986).
An abortion is considered to be late-term between 20 or 27 weeks, depending on the medical source referred to. Late term abortion is generally considered to be the time period during pregnancy in which the fetus can likely survive if delivered.
Fewer than one out of ten women have an abortion after the first trimester
A Dilation and Evacuation D&E abortion
is usually performed in the second trimester of pregnancy, between 12 and 20 weeks (later term abortion, as opposed to late-term abortion).
Two primary methods of performing late-term abortion are:
1. Induced Labor or Medical Induction (Medical Instillation)
2. Dilation and Extraction (also referred to as partial-birth abortion)
Dilation and Evacuation - D&E Method between 12 and 20 weeks
The most common type of abortion is Dilation and Evacuation or the D&E method of abortion is by vacuum aspiration, usually in the first trimester. The Dilation and Evacuation D&E abortion is similar to vacuum aspiration. The fetus is too large to pass through the cannula after the first trimester, and therefore must be "dismembered" first, using instruments.
Performing a D & E can be stressful to professionals express who perform such abortions, while some physicians, despite supporting a woman's choice to have an abortion, will not 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) - After 21 weeks
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 LaborBetween 19 and 20 weeks
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. Use of medical induction abortions has gradually declined and are performed in less than one-percent of abortions in the U.S.
With medical induction, a chemical solution such as saline solution (salt water), urea, potassium choloride is injected into the amniotic sac in the womb; prostaglandins are inserted through the vagina; pitocin is injected intravenously. 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 later-term abortion "puts the woman under particular stress" and that labor can take as much as 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
Later term abortion experience from Susan 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.
A 2010 U.S. study published in the Journal of Pregnancy concluded that later term and late term abortions are associated with a higher rate of Post Traumatic Stress Syndrome (PTSD) in women. Some of the psychological symptoms resulting after an abortion including trouble sleeping, disturbing dreams and reliving the abortion. 67% of women having late abortion met the criteria for PTSD symptoms.
The authors conclude that women who have later term abortions (after the first trimester), "may need more active professional intervention"
"based on the increased risks identified herein." The authors recommend more research on the topic of "mental illness" and later term abortions.
20 week old fetus. Later term abortion is considered to be an abortion past the first trimester (four months and later). Late-term abortion is past 20 weeks of gestation. -- 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.
Recent U.S. Legislation Efforts on Late Term Abortion
On May 13, 2015, The House of Representatives approved a bill known as the the Pain Capable Unborn Child Protection Act banning late-term abortions from after 20-weeks of pregnancy. The vote was largely partisan, with the exception of four or five Representatives from either party. If the Senate approves the Pain Capable Unborn Child Protection Act, President Barack Obama has threatened a veto. Republicans and pro-life groups, in response, would endeavor to use a presidential veto as a campaign tool in the 2016 elections.
References for Late-Term Abortion page
1. Abortion After the First Trimester in the United States. (2014). Planned Parenthood
2. Coleman, P.K., Coyle, C.T., Rue, V.M. (2010, August 1). Late-term elective abortion and susceptibility to posttraumatic stress symptoms
. Journal of Pregnancy
3. Ertelt, S. (2015, May 13). House Passes Pro-Life Bill Banning Late-Term Abortions After 20 Weeks
4. How are late-term abortions performed?
(2004, March 8). 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).
5. Imber, J. (1986). Abortion and the Private Practice of Medicine
. Yale University Press. http://yalepress.yale.edu/book.asp?isbn=0300035543
6. ABORTION NEWS: Los Angeles Times Examines Late-Term Abortion Procedures
. (2007, May 7). Women's Health Policy Report
7. Mental Health and Abortion
. American Psychological Association
. Retrieved May 22, 2011 from http://www.apa.org/about/gr/issues/women/mental-health-and-abortion.aspx.
8. Response to the APA Task Force Report
. (2008, September). American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG)
9. Terkel, S. N. (1988). Abortion - Facing the Issues. Impact
Other Pages on Abortion
Psychological effects - Male and female grief - teen abortion - Down's Syndrome
- Moral, psychological and spiritual aspects of abortion