Reproductive Wars

04.30.13

The Firestorm Over Late-Term Abortions

An exposé of a Bronx, New York, clinic purports to show ghoulish late-term abortion practices. Michelle Goldberg investigates how the videos are misleading—and why some women feel the need to seek out the procedure in the first place.

Last summer, when I was 20 weeks pregnant with my son, I went for a 3-D ultrasound that would tell me if he had any serious physical abnormalities. In the days leading up to it, I was seized with anxiety that something would go wrong, and it was the deepest sort of relief to see each healthy part of him in turn—fingers and toes, heartbeat and brain, liver and stomach. I could even see, sort of, what his face would look like. At that stage, a fetus appears quite human. Not that I referred to him as a fetus. I am very pro-choice, but I already spoke of him as my baby.

Once a fetus has gestated to five or six months, most people, whatever their politics, can see its inherent human value. And so, after suffering a serious political setback in the 2012 election, the anti-abortion movement has been smart to refocus attention where it’s strongest, on the very small percentage of abortions that take place late in pregnancy. These are the cases where instinctive revulsion easily overshadows concerns about women in crisis.

First came the campaign to increase attention to the ghoulish Kermit Gosnell trial by accusing the media of covering it up. Now comes the follow-up—a series of video exposés of late-term abortion providers by the anti-abortion group Live Action that purport to show, as the Live Action website says, that “Gosnell is not alone.” In fact, the videos do nothing of the sort, revealing no illegality or disregard for patient safety. But that doesn’t really matter. Any time the details of late-term abortion procedures are pushed into the spotlight absent any context about the reasons women have them, it’s a victory for the anti-abortion movement.

Not long ago, the anti-abortion movement was in danger of looking like a millstone around the neck of the GOP. In the months before the election, we saw fights over personhood for embryos and abortions for rape victims. On both issues, most people’s moral intuition conflicts with the movement’s rigid ideology. Republican extremism on abortion cost the party at least one winnable Senate seat, and left Mitt Romney running away from the movement during the general election, where he ran ads designed to make him look pro-choice.

Late-term abortion, by contrast, is an issue where the anti-abortion movement can garner widespread popular support. “What I think people are looking for when they hear both sides talk about abortion is the sense of, do people feel any sense of limits or boundaries?” says Frances Kissling, president of the Center for Health, Ethics and Social Policy and a longtime abortion rights activist. “For those who are opposed to abortion, are they opposed to all abortions, all the time? At five days of pregnancy, no matter what the reason is? Because most people are mixed on the subject, they tend to reject thinking that is at the extreme end of yes or no. I think the same thing happens when those of us who are pro-choice are put in the position of stretching our limits.”

Late abortion is horrible. We should acknowledge that before we discuss why it happens and why it's sometimes needed.”

Certainly, the videos by Live Action appear to show abortion provision at its most extreme. In secret recordings made at clinics in the Bronx and in Washington, D.C., women nearing their third trimester pose as abortion seekers and repeatedly ask clinic workers what will happen if their abortions failed and their babies are born alive. In the Bronx, New York, a clinic intake worker tells the undercover activist that, if the fetus is moving or breathing after the procedure, it would be put into a jar of “solution” that would make it stop. In Washington, D.C., a doctor tells another woman that if her fetus survived the attempt at abortion, he would let it expire. “Legally, we would be obligated to help it to survive,” he says, but adds, “it’s all in how vigorously you do things to help a fetus survive at this point.”

The way all this is presented is somewhat deceptive. Live Action posts both short, edited versions of its videos as well as unabridged recordings. In the full recordings, we see that in the Bronx, the woman also meets with an abortion counselor, who contradicts what the less-qualified intake worker says. The doctor, she says, “cannot do a termination once it’s outside of the body. He has to resuscitate it and he has to send it to the hospital.” Then the counselor urges the woman to rethink her decision: “Are you sure this is what you’re comfortable doing? Are you sure you want to do a termination?” She asks whether the person’s problems that made her want to end her pregnancy can be rectified, and suggests she talk it over with a friend. In other words, she’s sensitive and responsible.

But pointing this out is unlikely to blunt the visceral impact of the videos, because ultimately, what they reveal is something we all already know—late abortion is horrible. We should acknowledge that before we discuss why it happens, and why it’s sometimes needed.

Women do not have late abortions cavalierly. The vast majority of abortions—98.5 percent, according to the Guttmacher Institute—are done before 20 weeks. There’s not very much research about the 1.5 percent of abortions that happen after 20 weeks, but a significant number are done when a wanted pregnancy goes horribly awry. If my 20-week ultrasound had revealed a baby without prospects for a tolerable life, I would have joined the sad sorority of women for whom a late abortion is hardly a choice at all. You can read their stories on websites like A Heartbreaking Choice.

Then there are those who are simply desperate, often because of the lack of access to decent reproductive health care. Diana Greene Foster, associate professor of obstetrics and gynecology and the University of California, San Francisco, co-authored a forthcoming paper looking at more than 200 women who had abortions after 20 weeks for nonmedical reasons. According to Foster, two thirds of them were delayed while they tried to raise money to pay for a termination. Twelve percent were teenagers, some of whom went months without realizing they were pregnant. These are people who were failed by our health system. “Public financing and private insurance coverage would make abortions happen faster,” says Foster. “We’re moving in exactly the wrong direction from that.”

We would be far better off with a system like that in France, where abortion is limited after 12 weeks but freely available and fully subsidized before then. Late-term abortion can be truly problematic. That doesn’t mean that the anti-abortion movement is the solution.