What Actually Are Partial And Late Term Abortions?

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There has been a lot of conversation recently around abortion, which is typical during any sort of election year. This last week, however, there has been a larger focus on the issue.

"If you go with what Hillary is saying, in the ninth month, you can take the baby and rip the baby out of the womb of the mother just prior to the birth of the baby," Trump said during the final Presidential Debate.

Dr. Jennifer Gunter, an OB-GYN and proclaimed "sexpert", wrote an article in the Huffington Post stating how dangerous dramatic statements such as Trump's can be.

Partial Birth Abortions

More or less, what you need to know is that they don't exist. One cannot be 'partially' born. You are either born or you are not.

As Dr. Gunter explains in the Huffington Post, the American Congress of OB/GYNs (ACOG) has taken this term 'partial birth abortion' to imply a dilation and extraction, also known as a D & X.

This surgery can be performed at up to 36 weeks, but "procedures after 27-28 weeks are incredibly rare. Remember, only 1.3 percent of abortions happen after 20 weeks and most of these happen by 24 weeks."

The surgery involves delivering the smallest fetal part through the cervix and decompressing the cranium with suction. This is opposed to a dilation and evacuation, where there is not fetal demise.

The complication rate for a D & E or a D & X is .5-5%, compared to the complication rate for a c-section, which is 27%.

Inducing labor for a second or third trimester abortion can also be an option, but this actually has even higher complication rates. According to ACOG, "Compared with D&E, termination by induction with misoprostol is less cost-effective, is associated with a greater risk of complications, such as incomplete abortion, and may be prolonged."

"However, many women end up with inductions because their doctors aren't skilled to do a D & X," explains Dr. Gunter, "and so the legal system has foisted a less safe medical procedure on them."

As Dr. Gunter and many others have so aptly pointed out, Trump and most other pro-life supporters often ignore the well-being of the mother when it comes to the laws and regulations they are proposing when it comes to abortions.

"Anytime a woman after 20 weeks needs to be delivered. Remember: with D & X the complication rate 0.5-5 percent, and a c-section has a complication rate of 27 percent (but complication rates with c-sections rise the more premature the delivery and with maternal health problems, like infection or high blood pressure).

Consider a woman at 35 weeks and her fetus has Potter syndrome. This is typically not compatible with life (basically no kidneys or lungs). She did not want to have a termination and elects to go through with the pregnancy and deliver at term. She is now 35 weeks and her fetus is a transverse lie (meaning it's laying sideways not head down or bottom down) and so can't come out vaginally with a normal labor. The doctors can't even attempt to turn it head down with a procedure called an external cephalic version because with Potter syndrome there is no fluid and without fluid you can't turn a fetus. Her choices are a c-section or a D & X.

Consider a woman at 29 weeks and her fetus has trisomy 13. She would have terminated earlier before 23 weeks had she known, however, her doctor is very anti-choice (she was unaware of this) and so her genetic ultrasound occurred late at 21 weeks. By the time she had the amniocentesis and got the results she was 23 weeks. She met with several local OB/GYNs and non had the skill set to do a D & E at 23 weeks as none had abortion training in residency. Emotionally she does not feel she can carry the pregnancy to term. Her local options are a hysterotomy at 23 weeks, basically a very premature c-section which often damages the uterus, or wait until she delivers at term. By the time she locates a provider for a D & X and has raised the cash she is 29 weeks.

Consider a woman with mirror syndrome at 28 weeks. Her fetus has severe birth defects including a massive tumor on the lower back. This can only fit vaginally with some kind of instrumentation. The birth defects appear incompatible with life and she had previously met with a neonatal intensive care specialist at 25 weeks and the plan was no resuscitation after delivery. She is now getting sicker by the minute. Her options are a c-section or a D & X.

Consider a woman with a very wanted twin pregnancy from IVF. At 23 1/2 weeks she gets what she thought was the worst imaginable news, one of her twins has died. But then it gets worse. She develops severe preeclampia and needs to be delivered as soon as possible as her remaining wanted pregnancy is killing her. Her choice is a c-section or a D & E/D & X.

Consider a woman with ruptured membranes at 22 weeks in her first pregnancy. She has an infection and is rapidly getting sicker. She needs to be delivered as soon as possible. Drugs to induce labor have failed as an infected uterus often cannot be flogged chemically into contracting. Her option is a hysterotomy (the early, uterus-damaging c-section) with an infected uterus (her risk of a hysterectomy are high) or a D & E/D & X, which is more likely to save her uterus."

Nine-Month Abortions

What Trump is alluding to during his discussions of abortion is that doctors are taking a nearly perfect, fully grown baby and killing it a few days prior to it being born.

He is making it sound as if a mother, who has just carried around her own child for eight months, is simply deciding "eh, I've kind of lost interest in this whole kid thing. These last months were fun and all, but I guess I should probably go through this terribly mentally and physically traumatic surgery 'cause I just woke up today feeling like it".

In our current state of politics, Dr. Gunter explains that it is extremely difficult to get a late term abortion.

"There are very few providers in the country who can do a D & X over 24 weeks and most only take cash. Insurance companies don't cover late-term abortions unless there is a health of the mother situation or a serious genetic issue. The providers with the skill to do these procedures generally only take cash, that's around $15,000 at 24 weeks and by 32 weeks it's $25,000. And no that's not what the doctor is pocketing. That money goes to anesthesia, medications, the operating room time, maintaining an ultrasound machine and other equipment, building upkeep, the nurses, the office staff and THEN the doctor. How many women do anti-choice activists really believe are wandering into doctor's offices with a spare $25,000 for a spur of the moment abortion?"

An abortion is not a decision that a woman takes lightly, regardless of the financial strain it will put on her, let alone the medical trauma she will undergo.

Moral Of The Story

Full term and partial birth abortions are very rare. They are typically only performed during very difficult, medically dangerous situations wherein there is grave danger for the mother and for the child.

More importantly, abortions are not an easy choice to make. They are, however, difficult and dangerous to receive under today's current laws, not to mention the laws that Donald Trump would like to enforce.

Donald Trump is not an abortion expert. Most pro-life supporters are not abortion experts either. Regardless of what knowledge you do or do not possess when it comes to facts about abortion, Donald, unless you personally have had the devastating experience of having to give up your own child due to physical, mental, or any other form of danger, then there are so many of us who would prefer that you quit talking about the subject as if you have the right to do so.