The data: Most later abortions are not medically necessary
Photo: Cover photo for the study “Young, Poor and Pregnant: the Psychology of Teenage Motherhood,” by developmental psychologist Judith S. Musick, 1995.
By TATIANA PROPHET
How did I find out that most late-term abortions are not medically necessary? Most of the data came from choice advocates themselves, who warn that women seeking late-term abortion face significant barriers: how far they must travel, getting the finances together, not having insurance, indecision and even disagreement with their romantic partner.
Stop for a second: Late-term abortions are extremely rare, you may have heard. And that would be correct: 1 percent to 1.3 percent of all abortion procedures are post-21-weeks gestation, according to CDC figures. The rest of the story, however, is that so many abortions are performed each year (they peaked in 1990 at 1.6 million) – that 1 percent to 1.3 percent is still a large figure: 6,000 to 20,000 well-developed fetuses aborted every year.
I easily found that late-term abortions are rare. Yes, abortions in the third trimester, while not even allowed in some states, are rare – compared with all abortions performed per year. An oft-quoted number is 1.3 percent. That comes from a CDC report in 2012. With nearly 700,000 abortions reported to the CDC in 2012, 1.3 percent of that number amounts to more than 9,000 abortions after 21 weeks gestation, according to the CDC’s Division of Reproductive Health. In 2008 the total number of abortions in the United States was 1.2 million (the abortion rate has been declining since 1990 (1.61 million), except for 2005-2006 when it rose slightly. One to 1.3 percent of the 2008 number would be 12,000 to 15,000 late-term abortions on average per year.
I still wanted more info. Could a woman get a post-21 week abortion for any reason? I found a report by the Alan Guttmacher Institute, the research arm of Planned Parenthood. (Guttmacher was the president of Planned Parenthood in the 1960s and vice president of the American Eugenics Society, renamed in 1973 the Society for Biodemography and Social Biology).
It was called “Who Seeks Abortions at or After 20 Weeks?” by Diana Greene Foster and Katrina Kimport, published in 2013. This report reveals that the majority of women who have abortions after 20 weeks gestation do so because of circumstances associated with unwanted pregnancy – not maternal health or fetal anomaly.
According to this study, the main factors slowing them down in obtaining abortion care were: not knowing they were pregnant, not knowing where to go for an abortion, difficulty getting to the abortion facility, raising money for travel costs, the cost of the procedure, difficulty securing insurance coverage, trouble deciding whether they wanted an abortion, and disagreeing with the man involved in the pregnancy on the decision to have an abortion.
And then I realized something: Life and health of the mother and fetal anomaly are not listed as the majority of reasons for late-term abortion.
The Guttmacher report reviewed interviews with hundreds of women who had the procedure at 16 clinics around the U.S., one week after the procedure. The goal of the report was to show that lack of abortion access delays the procedure for many women, who must undergo the complex and much more expensive procedure during the third trimester.
Foster and Kimport used the 1.3 percent figure from 2012 to extrapolate the average number of post-21-week abortions per year as about 15,000. To figure out how many are done for non-elective reasons (fetal anomaly or serious risk to the health of the mother), we look at how many are performed in hospitals – where almost all of them are performed.
Hospitals comprise one-third of abortion providers, and more than half of them perform fewer than 30 abortions of any kind per year. About a quarter of the hospitals that provide abortions perform less than 5 per year. We have no idea how many of those were medically necessary for the life/health of the mother or fetal anomaly. But Guttmacher states in another paper that 80 percent of hospital abortions are outpatient, indicating early abortions (not what we’re looking for). And the Guttmacher paper by Foster and Kimport states: “But data suggest that most women seeking later terminations are not doing so for reasons of fetal anomaly or life endangerment, that most late-term abortions are in fact not for fetal anomaly or the health and life of the mother.”
The Foster report also states that the hospitals with fewer than 5 abortions of any kind are likely to involve life preservation or fetal anomaly.
If we assume that the less than 5 abortions per year hospitals number 140 hospitals, that translates to 700 abortions per year for fetal anomaly or serious risk to the health of the mother, out of 9,000 to 15,000 post-20-week abortions per year across the country, for any reason.
Seven hundred is quite a small percentage of 15,000, even 9,000. Since we don’t know how many medically necessary abortions occurred in hospitals that do 30 abortions per year or less, a conservative estimate of how many abortions in hospitals are in fact medically necessary would be somewhere between 25 percent and 40 percent. I say 40 percent because the Foster report demonstrated that fetal anomaly or health of the mother is not a major reason for late-term abortions. For a non-conservative estimate, the number could be anywhere between 10 and 25 percent of all late-term abortions.
