Why do women have abortions late in their pregnancies? It could be because they are often college-age, in a shaky relationship with the would-be father, and have financial problems, especially when a $650 first-trimester abortion time-lags into an $1,850 procedure, says a new study.
These and other findings about this little-studied population of women could have broad implications for abortion policy, as nine states have passed bans for most abortions after 20 weeks post-fertilization, or 22 weeks after the last menstrual period. Some of these laws have been blocked in court.
A federal law is also being promoted: The House of Representatives passed a Pain-Capable Unborn Child Protection Act in June, and a similar bill has been introduced in the Senate by Sen. Lindsey Graham, South Carolina Republican, and 40 co-sponsors.
These 20-week abortion bans are grounded in the belief that fetuses can feel pain at 20 weeks gestation, making abortion at that time brutally cruel.
“Our shared humanity demands that we end the painful dismemberment of unborn babies in the womb — babies that would receive the best care in the world if they were born at the same age,” Roland Warren, president and chief executive of Care Net, said when the House passed its bill.
“Women who consider late-term abortion often do so from a place of desperation, and, perhaps, fear,” he said Tuesday. “Yet, abortion only complicates the difficulties in her situation — and late-term abortion involves not only real suffering for the fetus but also serious risks to maternal health,” added Mr. Roland, whose organization represents pregnancy care centers that assist pregnant women to raise their babies or find adoptive parents for them.
Pro-choice groups maintain that the science about “fetal pain” is contested and even spurious. A 2005 study in the Journal of the American Medical Association, for instance, reviewed all known articles on fetal pain. “Evidence regarding the capacity for fetal pain is limited, but indicates that fetal perception of pain is unlikely before the third trimester,” concluded the study by Susan J. Lee and colleagues.
The study released Tuesday examined another under-studied group: pregnant women who seek late-term abortions.
This population is small — about 15,000 abortions, or about 1.5 percent of the annual U.S. number, are performed after 20 weeks, wrote Diana Greene Foster and Katrina Kimport, authors of the study in Guttmacher Institute’s new Perspectives on Sexual and Reproductive Health.
The researchers looked at data from 272 women who received an abortion at or after 20 weeks’ gestation and 169 women who had abortions in their first trimesters from 2008 to 2010. The women were part of the Turnaway Study, a project at the University of California at San Francisco (UCSF) that looks at the consequences of receiving or being denied a wanted abortion.
The researchers found that women in general delayed getting abortions if they are unsure they are pregnant, aren’t sure they want an abortion, and are disagreeing with the baby’s father.
Still, there were some differences in the two groups: The women seeking late-term abortions were more likely to be younger — ages 20-24 — than women who got earlier abortions, and the later-term patients waited far longer to confirm they were pregnant — they were often about 12 weeks gestation vs. five weeks gestation in the early-abortion group.
Thus, “most women in the later-abortion group were already in the second trimester by the time they had decided to have an abortion,” wrote Ms. Foster and Ms. Kimport, both of whom are professors at UCSF.
Late-abortion women were also less likely to be employed (50 percent vs. 66 percent) or have private insurance (23 percent vs. 33 percent) than early-abortion women, but were far more likely to have to drive more than three hours to get to the abortion clinic (21 percent vs. 5 percent).
Abortion costs were also a major hurdle: Average prices for study participants were $519 for a first-trimester abortion and $2,014 for a later abortion.
One woman, 28, who got an abortion at 21 weeks, told the researchers, “I couldn’t afford it.”
“They told me it was going to be $650, [but] by the time I was able to raise the $650, they had to do a different procedure, and so the price went up. The price jumped to $1,850 … and they don’t take insurance,” the Kentucky woman said.
When these findings are pieced together, “[b]ans on abortions after 20 weeks will disproportionately affect young women and women with limited financial resources,” Ms. Foster and Ms. Kimport concluded.
Pro-life leader Charmaine Yoest said Tuesday that “the known health-risks of abortion to women, especially later in pregnancy, are motivating legislators across the country to protect women and girls from a dangerous procedure.”
“In late-term abortion procedures, we are also confronted with the humanity of a living child, 5 months or more, who is poised to draw his or her first breath,” said Mrs. Yoest, president and chief executive of Americans United for Life. “Common-sense limits on abortion protect women and unborn children around the world, and should be enacted here at home,” she said.
A Gallup poll taken last December found that Americans overwhelmingly disapprove of late-term abortions: Some 64 percent of 1,000 adults said second-trimester abortions should be illegal, while 80 percent said third-trimester abortions should be outlawed.
In November, however, voters in Albuquerque, N.M., rejected a proposal that would have blocked abortions after 20 weeks from being performed in the city.
The vote targeted Southwestern Women’s Options, an clinic that performs late-term abortions, and became a national issue as major pro-choice and pro-life organizations sought to educate the public about the issue. Had the measure passed, it “would have had far-reaching national implications and set an alarming precedent,” Eleanor Smeal, president of Feminist Majority Foundation, told supporters.
Live Action, the pro-life activist group led by Lila Rose, sought to highlight the financial aspects of the procedure.
In an audio-taped conversation with an employee at the Albuquerque clinic, a Live Action woman asked about getting an abortion at 25-weeks gestation. The fee would be $8,000, the counselor said, adding that for “every week that goes by, the fee goes up by another thousand dollars.”