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WHY ARE SOME ABORTIONS DELAYED UNTIL LATE IN PREGNANCY?
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Terminology:
Dialog about abortion is very difficult because different groups assign
conflicting meanings to important terms:
 | We will use the term "abortion" to refer to any intentional medical
intervention which terminates a pregnancy at any stage. This is the definition
used most commonly by the public. The medical definition of the term is more
restrictive. |
| We will define the start of "pregnancy" as occurring when the the
embryo becomes implanted in the uterine wall. This the
definition used by the medical profession and by most of the public. Many
pro-lifers follow their own definition which has pregnancy beginning at
conception. |
Terminating pregnancies:
Relatively few conceptions result in the birth of a newborn baby. A
fertilized ovum has to survive many hurdles on the way to childbirth:
| Failed pregnancies: A very large percentage -- 50% is
sometimes mentioned in the medical literature -- of fertilized ova fail
to implant themselves in the uterine wall. For them, pregnancy does not
even begin. |
| Miscarriages: Approximately 25% of all pregnancies end in a
miscarriage -- sometimes called a spontaneous abortion. For whatever
reason, the pregnancy cannot continue; the fetus dies and is expelled
naturally from the woman's body. Often, this happens so early in
pregnancy that the woman is not aware that she
was pregnant. |
| Ectopic pregnancies (a.k.a. Tubal pregnancies): In
approximately one in every 4,000 pregnancies, the embryo lodges in a
location other than the endometrial lining of the uterus. In 95% of
these cases, it becomes implanted in one of the woman's fallopian tubes.
Emergency surgery is normally necessary to quickly remove the embryo in
order to prevent massive loss of blood, and almost certain death to the
woman. Unfortunately, this necessarily results in the death of the
embryo. A small percentage of
"pro-lifers" oppose all abortions, even to the extent of allowing the woman
to die during an ectopic pregnancy. However, there is a broad consensus among both pro-lifers and
pro-choicers that such an operation is morally justifiable, even though the
death of the fetus is inevitable. |
| First trimester surgical, and medically induced abortions:
Most abortions are elective procedures performed sometime during the first two
months of pregnancy when the fetus is one inch or less long. Over 90% of
abortions are done during the first trimester (i.e. the first three
months). They total about 1.2 million/year in the US -- a number that is
gradually decreasing. In almost all
cases, there is no medical reason why the pregnancy needs to be
terminated. The abortion is chosen simply because the woman does not
want to have a baby. Many women feel that a baby would interfere with her
education or career. Others feel that they are not financially or
emotionally capable of raising a child. Still
others feel that they lack adequate support from a partner, family, or
society itself to continue with the pregnancy. |
| Second trimester surgical abortions: About 140,000 second
trimester abortions are performed yearly. They represent 9% of the
total. Some are performed because the woman simply does not wish to
remain pregnant. There are many reasons for the delay until the second
trimester:
 | She may be young and in denial about her pregnancy |
| She
may have not sought an abortion in her first trimester, but has waited
until she can no longer hide her pregnancy. |
| Some fetuses are found to
have a serious genetic defect. Ultrasound examinations are normally
given at about 17 weeks gestation, when "fetal organs have developed
enough to detect such abnormalities." An amniocenteses procedure is
sometimes done at this time, particularly for women over the age of 35.
Either procedure can detect abnormalities that can cause the fetus:
 | To
die during pregnancy. |
| To be born alive but die within hours or days, perhaps in pain,
perhaps without gaining consciousness.
|
| To be born with very serious mental or physical disabilities
that will severely limit their quality of life. |
|
| Dr. Katharine O'Connell of New York's Columbia-Presbyterian Hospital
commented: "If the defect is diagnosed early, to wait the months
knowing what the inevitable outcome will be is much more upsetting and
detrimental. This is one of the worst things a woman can go through. We
want to provide her with as many options as possible." A small
percentage of couples will elect to take no action, and to continue the
pregnancy. Almost all couples, when faced with these prognoses, will
elect to terminate the pregnancy. As of 2003-NOV-6, their options are
limited to:
| Induced labor, |
| "D&E" (dilation and evacuation), and
|
| "D&X" (dilation and extraction). This is
often popularly called "Partial Birth Abortion" although that
is a vague term which lacks a definitive medical definition.
More details. |
|
President Bush has signed a bill into law which will
criminalize almost all D&X abortions. Constitutional
experts are divided over whether the law can survive a court challenge.
A number of court injunctions have been obtained to prevent the application of the law. |
| Third-trimester abortions: Medical intervention to terminate
pregnancies during the third trimester is quite rare. The Alan
Guttmacher Institute estimates that 1% of all medical terminations
of pregnancies are done at or after 21 weeks - (1994 data). It is
sometimes done when the fetus has died in the womb. Termination of the
life of a fetus is generally prohibited by medical societies'
regulations after the 20th or 21st week of gestation. Exceptions
do occur if required to save the life of the woman or avoid very
serious, disabling health consequences. e.g.:
| To save the life or health of a women experiencing a deteriorating
health problem. This problem can rapidly grow worse with every day in
late pregnancy, and can only be reversed by terminating the pregnancy. It is most often caused by diabetes or heart disease. |
| A midwifery web site quotes Dr. William F. Harrison, a diplomate of
the American Board of Obstetrics and Gynecology. 2
He wrote that "approximately 1 in 2000 fetuses
develop hydrocephalus while in the womb." About 5,000 fetuses
develop hydrocephalus each year in the U.S. This is not usually
discovered until late in the second trimester. A fetus with severe
hydrocephalus is alive, but cannot live for long; it will never
achieve consciousness. |
| In rare cases, the delivery of the fetus can go terribly wrong,
threatening the life of the woman. |
As of 2003-OCT-9, their options are limited. The main ones are:
| Hysterotomy: This involves major surgery. It is essentially
identical to a Caesarian Section. It involves significantly higher
risk to a woman than a D&X. |
| "D&X" (dilation and extraction). The third method is
often popularly called "Partial Birth Abortion" although that
is not a medical term. |
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Related essay:
Reference:
- Suzanne Batchelor, "Abortion Procedures Ban Limits Endings for Doomed
Pregnancies," Women's Enews, 2003-SEP-29, at:
http://www.now.org/
- "Information about Hydrocephalus and D&X," at: http://www.gentlebirth.org/archives/hydrceph.html
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Copyright � 2003 & 2004 by Ontario Consultants on Religious
Tolerance
Originally written: 2003-OCT-9
Latest update: 2004-MAR-8
Author: B.A. Robinson
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