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What We Are Debating When We Debate Late-Term Abortions

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You know what the debate over late-term abortions would benefit from? Some data. Which Dana McCourt provides:

Let’s look at the late-term abortions. Only 1.1% are after more than 21 weeks. 21 weeks is about two weeks shy of the lower-end of viability. 21 weeks is still in the second trimester. We can safely assume that the number of abortions in the third trimester is even smaller, especially because abortion after 24 weeks is generally not permitted by law except in cases of danger to the health of the mother and the fetus.

Let’s have some more context. One commonly-cited reason for abortion past the first trimester is the presence of fetal abnormalities, including Down syndrome and other fetal abnormalities. These are usually detected on an ultrasound and confirmed via amniocentesis. Amniocentesis is somewhat risky, so it’s usually performed only if there’s a reason to suspect an abnormality. And the usual time to find an abnormality would be during the second trimester ultrasound, usually around 18-20 weeks, sometimes a bit earlier. It seems reasonable to conclude that many of the abortions performed post 21-weeks are due to the discovery of some sort of anomaly. Moreover, medicine can’t catch these abnormalities significantly sooner than they are discovered.[...]

At 1.2 million abortions per year, 1.1% is about 13,200 abortions. I mention this because late-term abortion looms much larger as a reason to oppose abortion than it should given its rarity. It’s also important to note that past 24 weeks, the laws do not permit abortion that isn’t tied to reasons of life and health (fetal or maternal). People primarily worried about late-term abortion need to understand what it is that they’re worried about, understand that what they’re worried about is already heavily regulated, and then need to make the case from there, based on the cases that actually occur.

(Hat tip: Andrew Sullivan)

By Ezra Klein  |  June 5, 2009; 9:01 AM ET
 
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Comments

It's always nice to have more data but don't fool yourself that this will influence the debate. People who oppose abortion do so not because it's an inconvenient medical procedure but because they believe it is murder. Under what circumstances would you consider murder? How rare would it have to be?

This debate has stayed where it has for 20 years because the two sides comes from fundamentally divergent views on what the process is, and so they aren't really talking to each other. If you want to convince pro-life people that abortion should be legal, then you have to convince them that it isn't murder. Nothing else will have any effect.

Posted by: gilroy0 | June 5, 2009 10:08 AM | Report abuse

WHAT WE ARE DEBATING WHEN WE DEBATE SECOND-TERM (AND EVEN FIRST-TERM) ABORTION

Many abortion providers wont do post 10 week abortions for fear of killing (murdering: in their conception) 14 week old fetuses because of the normal 2 week error range.

I have always thought that when artificial wombs become technically possible 14 week gestation babies will be considered legal persons just on our emotional reaction to their large size. (I hope most of us can leave born/unborn behind as relevant to right/wrong in this discussion.)

What status to give fetuses near 14 weeks -- possible human life? Possible human life is where Roe took off and flew from reality. Possible human life would seem -- ipso facto -- to represent a compelling state interest: Roe's supposed requirement for legislatively overriding fundamental constitutional privacy.

Roe was perfectly logical until it got to possible human life which it had to evade to get to where it wanted to go -- with the words: "We do not agree that Texas, just by ADOPTING ONE THEORY OF LIFE, may override the rights of the pregnant woman that are at stake.

What ever happened to Roe's compelling interest test? Simple enough: possible human life (pre-14 week gestation) passes the test, ipso facto.

Posted by: DenisDrew | June 5, 2009 10:28 AM | Report abuse

Ezra, thank you as always for approaching the abortion debate responsibly. I can certainly blanch at the thought of 13,200 malformed or mother-endangering fetuses being aborted each year. But I also blanch at the thought of 13,200 malformed or mother-endangering fetuses being forced to term. Ultimately, I cannot presume the right to force others to terminate if they wish to endure the harrowing risks of birth, nor can I presume the right to force others to attempt birth under such circumstances.

Posted by: tomveiltomveil | June 5, 2009 11:10 AM | Report abuse

Prenatal tests for Down's Syndrome are available in the 1st trimester. While I would defend a woman's right to have a late term abortion because of the fetus having Down's Syndrome, I am disappointed that this is a commonly cited reason for women having late term abortions. If women had the tests earlier, there would be less late term abortions for pro-lifers to be venomous about. When it comes to the abortion debate, I think staying as far away from the viability point as possible is the best way to combat would-be ethical quandaries from the right. But I am also assuming here that women want to avoid late term abortions--which I do think is true based on what I have read recently from the accounts told by Dr Tiller's patients who recalled their late term abortions as very traumatic. And I know that it is incredibly idealistic, but, it seems to me, that achieving better prenatal care for every woman in this country in order to allow them the option to get the earliest prenatal tests and procedures should be our first goal.

Posted by: chebella7604 | June 5, 2009 11:15 AM | Report abuse

chebella, I agree that better prenatal care should be a goal for all sorts of reasons. However, the only truly diagnostic test is amniocentesis. Amniocentesis is never done in the first trimester. What you may be referring to as tests that can predict for down syndrome are imaging tests that may (possibly) reveal fetal states that are potentially predictive of down syndrome. These anomalies, however, can also appear with normal fetuses. Accordingly, they are never used as a basis for concluding that a fetus has down syndrome -- they are only used as a basis for advising further diagnostic testing,, which then occurs in the second trimester at the earliest.

Posted by: nolo93 | June 5, 2009 11:32 AM | Report abuse

Won't a pro-lifer just respond that you are morally corrupt for not caring about the murders of THIRTEEN THOUSAND CHILDREN despite their deformities? This won't even begin to satisfy a critic; instead, they'll just see that it illustrates your profound moral depravity.

The implicit argument here falls right into their hands - "See, pro-choicers really don't care about the sanctity of human life; after all, they actually cite as an argument on behalf of permitting partial birth-abortion that mothers are only killing disabled children anyway!"

Posted by: Selfreferencing | June 5, 2009 12:18 PM | Report abuse

Ezra,

It's not a good idea to argue that because late term abortions are not common, that it's somehow not worth arguing over.

Mass murder at schools is also rare, but because it, too, is as grisly business, it's worth discussing and ultimately preventing.

Posted by: ElViajero1 | June 5, 2009 12:18 PM | Report abuse

nolo93, I believe you are correct that aminiocentesis is the best and other earlier tests might not be conclusive, but some people opt to abort if there is only a chance simply for the sake of an earlier termination. Anyhow, a better test is on the way http://www.reuters.com/article/healthNews/idUSTRE4957RF20081006 and http://clinicaltrials.gov/ct2/show/NCT00877292

Posted by: chebella7604 | June 5, 2009 12:59 PM | Report abuse

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