Late Term Abortion is not baby killing, obliteration, manslaughter, homicide, or slaying. It is the preservation of the mother’s existence or well-being. It is essentially any technique used for aborting a pregnancy after twenty-four weeks (in some definitions after 20 weeks) from the woman’s last menstrual period. Laminaria (sterile seaweed) are passed through the vagina into the cervix to remain over night which causes it to become soft and open to reduce the chance of complications. Laminaria are inserted one to three days prior to the actual abortion procedure. The fetal heart is stopped by way of one of several operative procedures utilizing fetal intracardiac injection of potassium chloride, digoxin, hypertonic saline, urea, or air. The subsequent day, provided the cervix is sufficiently dilated labor is initiated. If the cervix is assessed and found not to be dilated adequately, the decision may be made to introduce additional Laminaria overnight to attain acceptable dilation. Rupture of the amniotic membranes (fluid surrounding the fetus) is fulfilled along with providing medications to initiate labor.
Stopping the fetal heart beat prior to initiating labor is similar in technique to performing certain intrauterine fetal medical procedures (i.e. supraventricular tachycardia [fast heart rate] where digoxin or other medications are given to the fetus IM (buttocks, thigh, or deltoid) to slow down the fetal heart rate, blood transfusion into the fetal intra-abdominal cavity for Rh sensitization or other reasons that cause destruction of fetal blood cells, Periumbilical Blood Sampling (PUBS), which is used to draw blood from the umbilical vessel, or inject blood or other medications essential to treat certain fetal disease states, or for fetal blood transfusions. When performing PUBS, anesthetics can be given to stop fetal mobilization in order to avoid the fetus from shearing or dislodging the spinal needle from the fetal umbilical cord while undergoing a procedure. Never has there been a discussion of concern of not performing these intrauterine procedures because of fetal pain. Yet it is now a reason to stop performing late term abortions. This is a ploy by some to stop all late term abortions which are lifesaving procedures for women who need them. It is stated in the legislative fetal pain bill by abortion opponents that anesthetic medications are used at 20 weeks during fetal surgery. These same medications can be injected into the intra-amnionic cavity, the fetus intramuscularly, or intravenously as described during the PUBS procedure where the anesthetics are injected into the fetal umbilical cord prior to performing any intrauterine procedure. Thus the issue of fetal pain becomes moot regarding late term abortions.
Late Term Abortions are performed after viability if the pregnancy is a threat to the woman’s life or health or the fetus has a genetic defect or a significant fetal anomaly.
The circumstances by which the fetus may be viable, and an ill mother whose life is in danger raises the question of why it is necessary to perform an abortion to end the pregnancy. Mother’s who are subject to delivery at 23.5 to 25 weeks experience a higher incidence of morbidity or mortality due to surgery, but the child that is born extremely premature, has a higher chance of death and or long term morbidity which may include cerebral palsy, developmental delay, mild to severe mental retardation, vision or hearing problems and failure to thrive among other complications. After talking to the mother regarding the risks and benefits of early delivery or abortion, the decision should remain between the woman and her Physician.
Severe fetal anomalies or genetic defects are reasons for considering a late term abortion. There are many fetal abnormalities that go undetected until late in gestation. With improvements in fetal testing and modern day sophisticated ultrasound study along with MRI analysis, prenatal diagnoses have improved. Pediatric Neurologists, Geneticists, Pediatric Surgeons, and Perinatiologists extensively evaluate the risks and complications that may occur if the woman continues the pregnancy. This information is then given to the patient and her family so that they may make the decision whether to continue the pregnancy or undergo a termination.
There should be no issue in terminating a pregnancy when the fetus has genetic defects, or severe fetal anomalies that are incompatible with life or it is a threat to the mother’s life or health. Maternal morbidity and mortality is dramatically less with termination of pregnancy than with delivery of a full term infant. The emotional and psychological health of the mother may occur when she knows she is carrying a pregnancy when the fetus is going to die in utero or succumb shortly after birth. She is subject to stress, anxiety, and unnecessary heartache. If the mother and family choose to continue the pregnancy, and it is known the pregnancy will increase the mother’s chance of serious complications including her death, then her wishes must be carried out. Hospitals are set up for support and comfort of the family in this circumstance. If the mother chooses to have a late term abortion performed, in the vast majority of cases, she will not be able to have it performed in a hospital and she must seek services through a medical office or other out-patient facility.
