Late termination of pregnancy, also referred to as late-term abortion,
describes the termination of
pregnancy
Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins.
Pregnancy usually occurs by sexual intercourse, but ca ...
by induced
abortion
Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of pregn ...
during a late stage of gestation.
In this context, ''late'' is not precisely defined, and different medical publications use varying
gestational age thresholds.
[ In 2015, about 1.3% of ]abortions in the United States
Abortion in the United States and its territories is a divisive issue in American politics and culture wars, with widely different abortion laws in U.S. states. Since 1976, the Republican Party (United States), Republican Party has generally ...
took place after the 21st week, and less than 1% occur after 24 weeks.
Reasons for late terminations of pregnancy include circumstances where a pregnant woman's health is at risk or when birth defect
A birth defect, also known as a congenital disorder, is an abnormal condition that is present at birth regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can ...
s, such as lethal fetal abnormalities
Fetal abnormalities are conditions that affect a fetus or embryo, are able to be diagnosed prenatally, and may be fatal or cause disease after birth. They may include aneuploidies, structural abnormalities, or neoplasms.
* Acardiac twin
* Achon ...
, have been detected.[ Later abortion is not associated with any negative physical or mental health outcomes,] and the risk of death following a surgical abortion after 20 weeks is less than that of typical full-term childbirth
Childbirth, also known as labour and delivery, is the ending of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or caesarean section. In 2019, there were about 140.11 million births globall ...
in the United States.
Late termination of pregnancy is more controversial than abortion in general. Most countries in Europe only permit abortion in later stages of pregnancy if specific circumstances are present, generally when the pregnancy represents a serious danger to the life, or to the physical or mental health of the woman, or when a serious malformation or anomaly of the fetus
A fetus or foetus (; plural fetuses, feti, foetuses, or foeti) is the unborn offspring that develops from an animal embryo. Following embryonic development the fetal stage of development takes place. In human prenatal development, fetal deve ...
is diagnosed.
Definition
A late termination of pregnancy often refers to an induced ending of pregnancy after the 20th week of gestation
Gestation is the period of development during the carrying of an embryo, and later fetus, inside viviparous animals (the embryo develops within the parent). It is typical for mammals, but also occurs for some non-mammals. Mammals during pregna ...
, i.e. after a fetal age (time since conception) of about 18 weeks. The exact point when an abortion is considered late-term, however, is not clearly defined. In three articles published in 1998 in the same issue of the ''Journal of the American Medical Association
''The Journal of the American Medical Association'' (''JAMA'') is a peer-reviewed medical journal published 48 times a year by the American Medical Association. It publishes original research, reviews, and editorials covering all aspects of bio ...
'' (JAMA), two chose the 20th week of gestation and one chose the 28th week of gestation as the point where an abortion procedure would be considered late-term. The American College of Obstetricians and Gynecologists defines a late term pregnancy as 41 weeks 0 days through 41 weeks 6 days, which differs from how the term is used in the abortion context.
In the United States, the point at which an abortion becomes late-term is often related to fetal viability
Fetal viability is the ability of a human fetus to survive outside the uterus. Medical viability is generally considered to be between 23 and 24 weeks Gestational age (obstetrics), gestational age. Viability depends upon factors such as birth weigh ...
(ability to survive outside the uterus
The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the organ in the reproductive system of most female mammals, including humans that accommodates the embryonic and fetal development of one or more embryos until birth. The uter ...
) of the fetus
A fetus or foetus (; plural fetuses, feti, foetuses, or foeti) is the unborn offspring that develops from an animal embryo. Following embryonic development the fetal stage of development takes place. In human prenatal development, fetal deve ...
. Sometimes, late-term abortions are referred to as post-viability abortions, though this is not a medical term. Anti-abortion
Anti-abortion movements, also self-styled as pro-life or abolitionist movements, are involved in the abortion debate advocating against the practice of abortion and its legality. Many anti-abortion movements began as countermovements in respons ...
activists use "late-term abortion" to refer to abortions performed after about 21 weeks of pregnancy, which is not the same usage by the medical definition obstetricians use for "late-term", which refers to about 41 or 42 weeks.
Viability
There is no sharp limit of development, age, or weight at which a fetus becomes viable.[Moore, Keith and Persaud, T]
''The Developing Human: Clinically Oriented Embryology''
p. 103 (Saunders 2003). A 2015 study found that even with active treatment, no infants born at less than 22 weeks survived, but an infant born at 21 weeks and one day in April of 2021 did survive his premature birth. At 23 weeks survival without severe impairment is less than 2%, and at 25 weeks, up to 30% might survive without severe impairment. According to studies between 2003 and 2005, 20 to 35 percent of babies born at 24 weeks of gestation survived, while 50 to 70 percent of babies born at 25 weeks, and more than 90 percent born at 26 to 27 weeks, survived. Because the chance of survival is variable based on interventions available and the weight and sex of the fetus, there is no consensus on viability. The American College of Obstetricians and Gynecologists reports that 23% of abortion providers offer abortions at 20 weeks of gestation and later, most often using a method called dilation and evacuation (D&E).
Incidence
*Australia: , South Australia is the only Australian state or territory to keep reliable abortion statistics. During 2012, 92% of abortions were performed before 14 weeks' gestation, 6% between 14 and 20 weeks, and 2% (n=96) at a later stage. Of the 96 abortions carried out beyond 20 weeks, 53 were due to actual or probable fetal abnormality.
*Canada: During the year 2019, approximately 87% of abortions occurred by 12 weeks, with 1.17% occurring after 21 weeks.
*England and Wales: In 2015, 8% of abortions occurred after 12 weeks; 0.1% occurred at or over 24 weeks.
* New Zealand: In 2003, 2.03% of induced abortions were done between weeks 16 and 19, and 0.56% were done over 20 weeks.
*Norway: In 2005, 2.28% of induced abortions were performed between 13 and 16 weeks, 1.24% of abortions between 17 and 20 weeks, and 0.20% over 21 weeks. Between February 15, 2010, and December 1, 2011, a total number of ten abortions were performed between 22 and 24 weeks. These have been declared illegal by The Norwegian Directorate of Health. Women who seek an abortion after the 12-week time limit must apply to a special medical assessment board – called an "abortion board" (Norwegian: or ) – that will determine whether or not to grant them an abortion.
*Scotland: In 2005, 6.1% of abortions were done between 14 and 17 weeks, while 1.6% were performed over 18 weeks.
*Sweden: In 2005, 5.6% of abortions were carried out between 12 and 17 weeks, and 0.8% at or greater than 18 weeks.
*Switzerland: In 2016, 10% of abortions performed after the legal term were carried out after week 21 (a total of 36 cases).[.] Of these cases 86% were carried out due to physical problems with the child or mother.[
*United States: In 2003, from data collected in those areas that sufficiently reported gestational age, it was found that 6.2% of abortions were conducted between 13 and 15 weeks, 4.2% between 16 and 20 weeks, and 1.4% at or after 21 weeks.][Strauss, L.T., Gamble, S.B., Parker, W.Y, Cook, D.A., Zane, S.B., & Hamdan, S. (November 24, 2006)]
Abortion Surveillance – United States, 2003
''Morbidity and Mortality Weekly Report, 55 (11),'' 1–32. Retrieved May 10, 2007. In 2014, the CDC reported that 1.3% of reported abortions (5,578) were performed at 21 weeks of gestation or later.
Reasons
United States
Reasons for late terminations of pregnancy include when a pregnant woman's health is at risk or when lethal fetal abnormalities have been detected.[
A study from 2013 found after excluding abortion "on grounds of fetal anomaly or life endangerment", that women seeking late abortions "fit at least one of five profiles: They were raising children alone, were depressed or using illicit substances, were in conflict with a male partner or experiencing domestic violence, had trouble deciding and then had access problems, or were young and nulliparous". They concluded that "bans on abortion after 20 weeks will disproportionately affect young women and women with limited financial resources".]
England and Wales
The NHS records the reasons given for abortions at all stages of development. In 2015, 2,877 abortions were performed at 20 weeks or above, and only 230 of these at or beyond 24 weeks gestation. Of all abortions at 20 weeks or above, 23 (0.8%) were performed to save the life of the pregnant woman, 1,801 (63%) were performed for mental or physical health reasons, and 1046 (36%) were performed because of foetal abnormalities.
Legal restrictions
As of 1998, among the 152 most populous countries, 54 either banned abortion entirely or permitted it only to save the life of the pregnant woman.[Anika Rahman, Laura Katzive and Stanley K. Henshaw]
A Global Review of Laws on Induced Abortion, 1985–1997
International Family Planning Perspectives (Volume 24, Number 2, June 1998).
On the other hand, as of 1998, 49 of the 152 most populous countries allowed abortion without restriction as to reason, but 44 of these required specific justification after a particular gestational age:
* 12 weeks (Albania
Albania ( ; sq, Shqipëri or ), or , also or . officially the Republic of Albania ( sq, Republika e Shqipërisë), is a country in Southeastern Europe. It is located on the Adriatic and Ionian Seas within the Mediterranean Sea and shares ...
, Armenia
Armenia (), , group=pron officially the Republic of Armenia,, is a landlocked country in the Armenian Highlands of Western Asia.The UNbr>classification of world regions places Armenia in Western Asia; the CIA World Factbook , , and ''Ox ...
, Azerbaijan
Azerbaijan (, ; az, Azərbaycan ), officially the Republic of Azerbaijan, , also sometimes officially called the Azerbaijan Republic is a transcontinental country located at the boundary of Eastern Europe and Western Asia. It is a part of th ...
, Belarus
Belarus,, , ; alternatively and formerly known as Byelorussia (from Russian ). officially the Republic of Belarus,; rus, Республика Беларусь, Respublika Belarus. is a landlocked country in Eastern Europe. It is bordered by R ...
, Belgium
Belgium, ; french: Belgique ; german: Belgien officially the Kingdom of Belgium, is a country in Northwestern Europe. The country is bordered by the Netherlands to the north, Germany to the east, Luxembourg to the southeast, France to th ...
, Bosnia-Herzegovina
Bosnia and Herzegovina ( sh, / , ), abbreviated BiH () or B&H, sometimes called Bosnia–Herzegovina and Pars pro toto#Geography, often known informally as Bosnia, is a country at the crossroads of Southern Europe, south and southeast Euro ...
, Bulgaria
Bulgaria (; bg, България, Bǎlgariya), officially the Republic of Bulgaria,, ) is a country in Southeast Europe. It is situated on the eastern flank of the Balkans, and is bordered by Romania to the north, Serbia and North Macedon ...
, Croatia
, image_flag = Flag of Croatia.svg
, image_coat = Coat of arms of Croatia.svg
, anthem = "Lijepa naša domovino"("Our Beautiful Homeland")
, image_map =
, map_caption =
, capit ...
, Cuba
Cuba ( , ), officially the Republic of Cuba ( es, República de Cuba, links=no ), is an island country comprising the island of Cuba, as well as Isla de la Juventud and several minor archipelagos. Cuba is located where the northern Caribbea ...
, Czech Republic
The Czech Republic, or simply Czechia, is a landlocked country in Central Europe. Historically known as Bohemia, it is bordered by Austria to the south, Germany to the west, Poland to the northeast, and Slovakia to the southeast. The ...
, Denmark
)
, song = ( en, "King Christian stood by the lofty mast")
, song_type = National and royal anthem
, image_map = EU-Denmark.svg
, map_caption =
, subdivision_type = Sovereign state
, subdivision_name = Danish Realm, Kingdom of Denmark
...
, Estonia
Estonia, formally the Republic of Estonia, is a country by the Baltic Sea in Northern Europe. It is bordered to the north by the Gulf of Finland across from Finland, to the west by the sea across from Sweden, to the south by Latvia, a ...
, Georgia, Greece
Greece,, or , romanized: ', officially the Hellenic Republic, is a country in Southeast Europe. It is situated on the southern tip of the Balkans, and is located at the crossroads of Europe, Asia, and Africa. Greece shares land borders with ...
, Kazakhstan
Kazakhstan, officially the Republic of Kazakhstan, is a transcontinental country located mainly in Central Asia and partly in Eastern Europe. It borders Russia to the north and west, China to the east, Kyrgyzstan to the southeast, Uzbeki ...
, Kyrgyzstan
Kyrgyzstan,, pronounced or the Kyrgyz Republic, is a landlocked country in Central Asia. Kyrgyzstan is bordered by Kazakhstan to the north, Uzbekistan to the west, Tajikistan to the south, and the People's Republic of China to the east. ...
, Latvia
Latvia ( or ; lv, Latvija ; ltg, Latveja; liv, Leţmō), officially the Republic of Latvia ( lv, Latvijas Republika, links=no, ltg, Latvejas Republika, links=no, liv, Leţmō Vabāmō, links=no), is a country in the Baltic region of ...
, Lithuania
Lithuania (; lt, Lietuva ), officially the Republic of Lithuania ( lt, Lietuvos Respublika, links=no ), is a country in the Baltic region of Europe. It is one of three Baltic states and lies on the eastern shore of the Baltic Sea. Lithuania ...
, Moldova
Moldova ( , ; ), officially the Republic of Moldova ( ro, Republica Moldova), is a Landlocked country, landlocked country in Eastern Europe. It is bordered by Romania to the west and Ukraine to the north, east, and south. The List of states ...
, Mongolia
Mongolia; Mongolian script: , , ; lit. "Mongol Nation" or "State of Mongolia" () is a landlocked country in East Asia, bordered by Russia to the north and China to the south. It covers an area of , with a population of just 3.3 million, ...
, Norway
Norway, officially the Kingdom of Norway, is a Nordic country in Northern Europe, the mainland territory of which comprises the western and northernmost portion of the Scandinavian Peninsula. The remote Arctic island of Jan Mayen and t ...
, Russia
Russia (, , ), or the Russian Federation, is a List of transcontinental countries, transcontinental country spanning Eastern Europe and North Asia, Northern Asia. It is the List of countries and dependencies by area, largest country in the ...
, Saudi Arabia
Saudi Arabia, officially the Kingdom of Saudi Arabia (KSA), is a country in Western Asia. It covers the bulk of the Arabian Peninsula, and has a land area of about , making it the fifth-largest country in Asia, the second-largest in the A ...
, Slovakia
Slovakia (; sk, Slovensko ), officially the Slovak Republic ( sk, Slovenská republika, links=no ), is a landlocked country in Central Europe. It is bordered by Poland to the north, Ukraine to the east, Hungary to the south, Austria to the s ...
, Slovenia
Slovenia ( ; sl, Slovenija ), officially the Republic of Slovenia (Slovene: , abbr.: ''RS''), is a country in Central Europe. It is bordered by Italy to the west, Austria to the north, Hungary to the northeast, Croatia to the southeast, an ...
, South Africa
South Africa, officially the Republic of South Africa (RSA), is the southernmost country in Africa. It is bounded to the south by of coastline that stretch along the South Atlantic and Indian Oceans; to the north by the neighbouring countri ...
, Ukraine
Ukraine ( uk, Україна, Ukraïna, ) is a country in Eastern Europe. It is the second-largest European country after Russia, which it borders to the east and northeast. Ukraine covers approximately . Prior to the ongoing Russian inv ...
, Tajikistan
Tajikistan (, ; tg, Тоҷикистон, Tojikiston; russian: Таджикистан, Tadzhikistan), officially the Republic of Tajikistan ( tg, Ҷумҳурии Тоҷикистон, Jumhurii Tojikiston), is a landlocked country in Centr ...
, Tunisia
)
, image_map = Tunisia location (orthographic projection).svg
, map_caption = Location of Tunisia in northern Africa
, image_map2 =
, capital = Tunis
, largest_city = capital
, ...
, Turkey
Turkey ( tr, Türkiye ), officially the Republic of Türkiye ( tr, Türkiye Cumhuriyeti, links=no ), is a list of transcontinental countries, transcontinental country located mainly on the Anatolia, Anatolian Peninsula in Western Asia, with ...
, Turkmenistan
Turkmenistan ( or ; tk, Türkmenistan / Түркменистан, ) is a country located in Central Asia, bordered by Kazakhstan to the northwest, Uzbekistan to the north, east and northeast, Afghanistan to the southeast, Iran to the sout ...
and Uzbekistan
Uzbekistan (, ; uz, Ozbekiston, italic=yes / , ; russian: Узбекистан), officially the Republic of Uzbekistan ( uz, Ozbekiston Respublikasi, italic=yes / ; russian: Республика Узбекистан), is a doubly landlocked cou ...
)
* 13 weeks (Italy
Italy ( it, Italia ), officially the Italian Republic, ) or the Republic of Italy, is a country in Southern Europe. It is located in the middle of the Mediterranean Sea, and its territory largely coincides with the homonymous geographical re ...
)
* 14 weeks (Argentina
Argentina (), officially the Argentine Republic ( es, link=no, República Argentina), is a country in the southern half of South America. Argentina covers an area of , making it the second-largest country in South America after Brazil, th ...
, Austria
Austria, , bar, Östareich officially the Republic of Austria, is a country in the southern part of Central Europe, lying in the Eastern Alps. It is a federation of nine states, one of which is the capital, Vienna, the most populous ...
, Cambodia
Cambodia (; also Kampuchea ; km, កម្ពុជា, UNGEGN: ), officially the Kingdom of Cambodia, is a country located in the southern portion of the Indochinese Peninsula in Southeast Asia, spanning an area of , bordered by Thailand t ...
, France
France (), officially the French Republic ( ), is a country primarily located in Western Europe. It also comprises of Overseas France, overseas regions and territories in the Americas and the Atlantic Ocean, Atlantic, Pacific Ocean, Pac ...
, Germany
Germany,, officially the Federal Republic of Germany, is a country in Central Europe. It is the second most populous country in Europe after Russia, and the most populous member state of the European Union. Germany is situated betwe ...
, Hungary
Hungary ( hu, Magyarország ) is a landlocked country in Central Europe. Spanning of the Carpathian Basin, it is bordered by Slovakia to the north, Ukraine to the northeast, Romania to the east and southeast, Serbia to the south, Croatia a ...
, Romania
Romania ( ; ro, România ) is a country located at the crossroads of Central Europe, Central, Eastern Europe, Eastern, and Southeast Europe, Southeastern Europe. It borders Bulgaria to the south, Ukraine to the north, Hungary to the west, S ...
and Spain
, image_flag = Bandera de España.svg
, image_coat = Escudo de España (mazonado).svg
, national_motto = ''Plus ultra'' (Latin)(English: "Further Beyond")
, national_anthem = (English: "Royal March")
, i ...
)
* 18 weeks (Sweden
Sweden, formally the Kingdom of Sweden,The United Nations Group of Experts on Geographical Names states that the country's formal name is the Kingdom of SwedenUNGEGN World Geographical Names, Sweden./ref> is a Nordic country located on ...
)
* 22 weeks (North Macedonia
North Macedonia, ; sq, Maqedonia e Veriut, (Macedonia before February 2019), officially the Republic of North Macedonia,, is a country in Southeast Europe. It gained independence in 1991 as one of the successor states of Socialist Feder ...
)
* 24 weeks (Singapore
Singapore (), officially the Republic of Singapore, is a sovereign island country and city-state in maritime Southeast Asia. It lies about one degree of latitude () north of the equator, off the southern tip of the Malay Peninsula, borde ...
, Netherlands
)
, anthem = ( en, "William of Nassau")
, image_map =
, map_caption =
, subdivision_type = Sovereign state
, subdivision_name = Kingdom of the Netherlands
, established_title = Before independence
, established_date = Spanish Netherl ...
)
* viability (to some extent the United States
The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territorie ...
)
* no limit (Canada
Canada is a country in North America. Its ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, covering over , making it the world's second-largest country by tot ...
, some states in the United States, China
China, officially the People's Republic of China (PRC), is a country in East Asia. It is the world's most populous country, with a population exceeding 1.4 billion, slightly ahead of India. China spans the equivalent of five time zones and ...
, and North Korea
North Korea, officially the Democratic People's Republic of Korea (DPRK), is a country in East Asia. It constitutes the northern half of the Korea, Korean Peninsula and shares borders with China and Russia to the north, at the Yalu River, Y ...
)
Dutch Criminal Code defines the "viability" of a fetus to 24 weeks, but doctors ''de facto'' limit on-request abortions to 22 weeks as a margin of error.
As of 2011 among those countries that allowed abortion without restriction as to reason, the gestational limits for such abortions on request were: 37 countries set a gestational limit of 12 weeks, 7 countries of 14 weeks, 4 did not set limits, 3 at viability, 3 at 10 weeks, one at 90 days, one at 8 weeks, one at 18 weeks, and one at 24 weeks. In addition, Abortion in Australia, and, to a certain extent, Abortion in the United States, is regulated at state/territory level, and laws vary by region.
In these countries, abortions after the general gestational age limit are allowed only under restricted circumstances, which include, depending on country, risk to the woman's life, physical or mental health, fetal malformation, cases where the pregnancy was the result of rape
Rape is a type of sexual assault usually involving sexual intercourse or other forms of sexual penetration carried out against a person without their consent. The act may be carried out by physical force, coercion, abuse of authority, or ag ...
, or poor socio-economic conditions. For instance, in Italy, abortion is allowed on request up until 90 days, after which it is allowed only if the pregnancy or childbirth pose a threat to the woman's life, a risk to physical health of the woman, a risk to mental health of the woman; if there is a risk of fetal malformation; or if the pregnancy is the result of rape or other sexual crime. Denmark provides a wider range of reasons, including social and economic ones, which can be invoked by a woman who seeks an abortion after 12 weeks.
Abortions at such stages must in general be approved by a doctor or a special committee, unlike early abortions which are performed on demand. The ease with which the doctor or the committee allows a late term abortion varies significantly by country, and is often influenced by the social and religious views prevalent in that region.
Some countries, like Canada, China (Mainland only) and Vietnam
Vietnam or Viet Nam ( vi, Việt Nam, ), officially the Socialist Republic of Vietnam,., group="n" is a country in Southeast Asia, at the eastern edge of mainland Southeast Asia, with an area of and population of 96 million, making i ...
have no legal limit on when an abortion can be performed.
United States
The United States Supreme Court
The Supreme Court of the United States (SCOTUS) is the highest court in the federal judiciary of the United States. It has ultimate appellate jurisdiction over all U.S. federal court cases, and over state court cases that involve a point o ...
decisions on abortion, including ''Roe v. Wade
''Roe v. Wade'', 410 U.S. 113 (1973),. was a landmark decision of the U.S. Supreme Court in which the Court ruled that the Constitution of the United States conferred the right to have an abortion. The decision struck down many federal and st ...
'', allow states to impose more restrictions on post-viability abortions than during the earlier stages of pregnancy.
As of December 2014, forty-two states had bans on late-term abortions that were not facially unconstitutional under ''Roe v. Wade'' or enjoined by court order.[Guttmacher Institute. (April 1, 2007)]
State Policies on Later-Term Abortions
''State Policies in Brief.'' Retrieved April 19, 2007. In addition, the Supreme Court in the case of ''Gonzales v. Carhart
''Gonzales v. Carhart'', 550 U.S. 124 (2007), was a landmark decision of the U.S. Supreme Court that upheld the Partial-Birth Abortion Ban Act of 2003. The case reached the high court after U.S. Attorney General, Alberto Gonzales, appealed a rul ...
'' ruled that Congress may ban certain late-term abortion techniques, "both previability and postviability", as it had done in banning intact dilation and extraction with the .
The Supreme Court has held that bans must include exceptions for threats to the woman's life, physical health, and mental health, but four states allow late-term abortions only when the woman's life is at risk; four allow them when the woman's life or physical health is at risk, but use a definition of health that abortion-rights organizations believe is impermissibly narrow. Note that just because a portion of a state's law is found to be unconstitutional does not mean that the entire law will be deemed unconstitutional: " validating the statute entirely is not always necessary or justified, for lower courts may be able to render narrower declaratory and injunctive relief," meaning the court could declare that only those parts of the law that are violative of the Constitution are invalid (declaratory relief), or that the court can prohibit the state from enforcing those portions of the law (injunctive relief).
Eighteen states prohibit abortion after a certain number of weeks' gestation (usually 22 weeks from the last menstrual period). The U.S. Supreme Court held in ''Webster v. Reproductive Health Services
''Webster v. Reproductive Health Services'', 492 U.S. 490 (1989), was a Supreme Court of the United States, United States Supreme Court decision on upholding a Missouri law that imposed restrictions on the use of state funds, facilities, and employ ...
'' that a statute may create "a presumption of viability" after a certain number of weeks, in which case the physician must be given an opportunity to rebut the presumption by performing tests. Because this provision is not explicitly written into these state laws, as it was in the Missouri law examined in ''Webster'', abortion-rights organizations believe that such a state law is unconstitutional, but only "to the extent that it prohibits pre-viability abortions".[NARAL Pro-Choice America. (2007).]
Delaware
" ''Who Decides? The Status of Women's Reproductive Rights in the United States.'' Retrieved April 19, 2007.
Ten states (although Florida's enforcement of such laws are under permanent injunction) require a second physician's approval before a late-term abortion can be performed. The U.S. Supreme Court struck down a requirement of "confirmation by two other physicians" (rather than one other physician) because "acquiescence by co-practitioners has no rational connection with a patient's needs and unduly infringes on the physician's right to practice". Abortion-rights organizations, such as the Guttmacher Institute
The Guttmacher Institute is a research and policy NGO that aims to improve sexual and reproductive health and rights worldwide. This research organization was started in 1968 and works to study, educate, and advance sexual and reproductive health ...
, posit that some of these state laws are unconstitutional, based on these and other Supreme Court rulings, at least to the extent that these state laws require approval of a second or third physician.
Thirteen states have laws that require a second physician to be present during late-term abortion procedures in order to treat a fetus if born alive. The Court has held that a doctor's right to practice is not infringed by requiring a second physician to be present at abortions performed after viability in order to assist in the case of a living fetus. It is not common for live infants to be born after an abortion at any stage in pregnancy.
Live birth
In 2019, a US Senate Bill entitled the "Born-Alive Abortion Survivors Protection Act" raised the issue of live birth after abortion. The bill would mandate that medical providers resuscitate neonates delivered showing signs of life during an abortion process. During the debate around this issue, US Republicans alleged that medical providers "execute" live-born babies. Existing US laws would punish execution as homicide. Furthermore, US abortion experts refute the claim that a "born-alive" fetus is a common event and reject laws that would mandate resuscitation against the wishes of the parents.
Only 1.3% of abortions occur after 21 weeks of pregnancy in the US. Although it is very uncommon, women undergoing surgical abortion after this gestational age sometimes give birth to a fetus that may survive briefly. The periviable period is considered to be between 20 and 25 weeks gestation. Long-term survival is possible after 22 weeks. However, odds of long-term survival between 22 and 23 weeks are 2–3 percent and odds of survival between 23 and 24 weeks are 20 percent. "Intact survival", which means survival of a neonate without subsequent damage to organs such as the brain or bowel is 1% at 22 weeks and 13% at 23 weeks. Survival odds increase with increasing gestational age.
If medical staff observe signs of life, they may be required to provide care: emergency medical care if the child has a good chance of survival and palliative care if not. Induced fetal demise before termination of pregnancy after 20–21 weeks gestation is recommended by some sources to avoid this and to comply with the US Partial Birth Abortion Ban. Induced fetal demise does not improve the safety of an abortion procedure and may incur risks to the health of the woman having the abortion.
Methods
There are at least four medical procedures associated with late-term abortions:
* Dilation and evacuation (D&E)
* Early labor induction
Labor induction is the process or treatment that stimulates childbirth and delivery. Inducing (starting) labor can be accomplished with pharmaceutical or non-pharmaceutical methods. In Western countries, it is estimated that one-quarter of pregnan ...
(sometimes called "induction abortion")
* Intact dilation and extraction (IDX or D&X), sometimes referred to as " ''partial-birth abortion''"
* Hysterotomy abortion
References
External links
{{DEFAULTSORT:Late-Term Abortion
Abortion debate
Human reproduction
Medical ethics