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The landscape for abortion access is shifting quickly, as state after state passes restrictive laws. Particularly affected by these new laws are women who need abortions later in their pregnancies.

Written by Susan Yanow for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.


The landscape for access to abortion is shifting quickly, as state after state passes restrictive laws. Particularly affected by these new laws are women who need abortions later in their pregnancies.

In April 2010, Nebraska became the first state in the country to pass a restriction on abortion after 20 weeks, based on an unscientific claim that fetuses feel pain after 20 weeks gestation. The Nebraska law banned abortions after 20 weeks for any reason except if the pregnant woman’s life is in danger. Prior to the passage of this law in Nebraska, there were 21 states (plus the District of Columbia) where abortion was available after 20 weeks. Although in most of these states these services were dependent on one site and one physician, nonetheless the services existed. Since April 2010, legislation limiting abortions to 20 weeks has been signed into law in Alabama, Georgia, Idaho, Indiana, Kansas, Oklahoma and North Carolina. Bills making access to later abortion more difficult were passed in Missouri and Ohio.

Arizona’s lawmakers have gone even further. Although the Roe v. Wade Supreme Court decision legalized abortion through the second trimester, generally understood as 24 to 26 weeks, Arizona has redefined biology and the right to abortion. Last week Arizona signed into law new restrictions on abortion after 18 weeks. By any calculation, 18 weeks is the middle of the second trimester, and mid-pregnancy. The trimester construction of Roe is becoming irrelevant in many states.

In Arizona, Kansas, Nebraska, North Carolina and Georgia, these new laws eliminated (or will eliminate when enacted) existing services that provide abortion care for women who needed to end a pregnancy after 20 weeks. As a result, today there are today only 16 states that provide abortion care after 20 weeks. 

Women need later abortions for a range of reasons. Studies show that many women who present at clinics after 20 weeks wanted an earlier abortion but faced financial hurdles and legal barriers, barriers which have increased as states pass law after law to restrict access early in pregnancy. Missouri, for example, is right now considering restrictions on medication abortions (which occur by or before nine weeks gestation) that would make it virtually impossible for women to obtain these, with the obvious result that women will seek later abortions, which they then will not be able to get. Other women face a diagnosis of fetal anomaly later in pregnancy, while for some women, circumstances shift and a wanted pregnancy becomes untenable when a woman’s partner leaves, her young child develops a serious illness and needs her full attention, or someone in the family loses their job and/or health insurance. For all of these women, the option to exercise their right to choose abortion is shrinking.

While it is important for all of us to champion the right to later abortion, we must be clear that it is the right to abortion at any gestational age that is under attack. When women who need abortions after 20 weeks lose access, Arizona, with its ban after 18 weeks, is a warning of what is coming next. While the majority of abortions (over 90 percent) in the U.S. are provided to women who are 12 weeks pregnant or less, our right to abortion through the second trimester is being taken away, state by state and week by week. We must come together to find new strategies to protect existing services, help women who need later abortion care get to those states where the services are still provided, and champion the right to abortion for every woman to access the abortion that she needs.

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Comment Preferences

  •  I have to disagree (0+ / 0-)

    I would have no problem with restricting abortions to 20 weeks. You can't prove a fetus feels pain, but there are many indications that they may. By 9 weeks they move, respond to light touch, startle and suck their thumbs. These are indications that pain receptors may be developed.

    Viability is almost 80% by 24 weeks. Unless the life of the mother is at risk, I don't think abortions at that stage should be legal.


    by jennybravo on Thu Apr 19, 2012 at 10:18:23 AM PDT

    •  As a relatively old mother at 41 (4+ / 0-)
      Recommended by:
      elfling, terabytes, LaraJones, BachFan

      I had my second child.  Amniocentesis did not work until the fetus was 22 weeks, and the results not  available until 24 weeks.  If there is a severe birth defect, the parental decision must be respected. I was lucky, and have a very intelligent, nice, and handsome son. If the results had come back with severe defects (not talking about diabetes or downs), I would have had a much more difficult decision.

      My sister, also an older mother, got weird results back from her amnio, abnormalities within each and every cell. She decided to risk the pregnancy, even though financially and emotionally she was not on very good ground (near divorce).  We would have supported her decision either way. My niece has, so far, turned out well.

      There is a state senator from Tennessee who insists that even if the fetus dies in utero, the mother must carry it until her body expels it (cows apparently do it, so, his "logic" goes,  can women) .   This is unsafe hogwash, and the type of legislating medical care without a medical license that I particularly hate.

      I support choice.  Andrea Bocelli was born after his mother had an emergency appendectomy when she was 4 months pregnant. Even in Catholic Italy she was offered an abortion, and warned that her child would most likely have defects as a result of antibiotics and anesthesia. She decided not to have an abortion, and he was born with defective eyesight and a beautiful singing voice.  I believe it was the choice that she was given allowed her to prepare herself for an unusual life, which she did well.

      I support choice through out the second trimester.  I think that, just as the right is currently redefining pregnancy and "life" whether it is viable or not, the right wing will work to whittle away birth control definitions as well. Not married? No birth control, slut. No barrier control .  And so on.

      I chose not to have the government make unlicensed medical decisions for me.

      "Conservatives care from conception to crowning." VetGrl " It's just a matter of time before the Republicans realize the Ten Commandments are "regulations."" TriassicSands

      by sailmaker on Thu Apr 19, 2012 at 11:21:17 AM PDT

      [ Parent ]

      •  I agree (0+ / 0-)

        that forcing women to carry a fetus who has died is ridiculous. I also believe that if a fetus has very severe birth defects which would make life after birth nearly impossible, then the mother should also have the choice.


        by jennybravo on Thu Apr 19, 2012 at 12:37:48 PM PDT

        [ Parent ]

        •  Be aware the laws in question have no such (3+ / 0-)
          Recommended by:
          sailmaker, terabytes, BachFan


          If you want to restrict access after 20 weeks, ask yourself what situation you imagine where people are better off because of the compulsory nature of the law. Few if any people accidentally or capriciously abort at that point. Doctors talk to their patients, and are in a good position to help a patient come to an appropriate medical decision.

          The problem is that such laws have no imagination. An anencephalic child may be discovered after 20 weeks. Defects where the fetus may be 'viable' but perhaps doomed to a short life of pain as well. A very young woman may not be aware before 20 weeks. The law cannot easily imagine every possible scenario and divide them into neat categories. Every case is different. The number of cases involved is small. The burden to regulate each one is great.

          Give women the support they need so that they have real choices. And then - if you were going to entrust them with raising a child - trust them to make an appropriate decision with their doctor's advice.

          Fry, don't be a hero! It's not covered by our health plan!

          by elfling on Thu Apr 19, 2012 at 01:28:59 PM PDT

          [ Parent ]

  •  The purpose of these laws (0+ / 0-)

    is to have women die. If God didn't want women to die in pregnancy or childbirth, he wouldn't have created maternal mortality, now would he?

  •  Feel pain? (1+ / 0-)
    Recommended by:

    Come on. This isn't about a fetus feeling pain. It's about changing the conversation from keeping your hands off my uterus. It's about controlling women's behaviot.

    A woman can do what the law allows, and that's get an abortion. Period. If women, particularly young women, are concerned about the loss of their freedom to chose treatment for their own bodies, they better get out there and get organized. I already did it once. It doesn't seem to have stuck and now I'm too old to picket or make phone calls or howl.

    "Even in the valley of the shadow of death, two and two do not make six." Leo Tolstoy

    by Miss Pip on Thu Apr 19, 2012 at 01:45:36 PM PDT

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