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Ellen R. Shaffer

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Top 10 Problems With a 20-Week Abortion Ban

Posted: 07/31/2013 6:15 pm

The same Congress that failed to popularize rape, can't stop themselves from attacking immigrants, and votes to shut down government funds for food stamps and cut Medicare while shoveling subsidies to agribusiness and drug companies -- they have a new plan to divide and conquer: the 20-week abortion ban. What could be wrong with that? Plenty!

It aggravates obstacles to critical health care services while it stigmatizes and criminalizes the small number of women who need late-term abortions, erodes the legal right to abortions for everyone, and sets policy based on myths and bad math instead of trusting science -- and trusting women. It's an opportunity for women and men across the social spectrum to get the scoop and short-circuit this latest devious scheme.

1. Only 1.3 percent of abortions occur after 20 weeks. The two main reasons for late-term abortions are lack of access to better, earlier care and biology. A 20-week abortion ban would make both problems worse by criminalizing them.

2. The ban would hurt the most vulnerable in our society. Women who had abortions after the first trimester in 2008 were more likely to be black, and/or to be young, less educated and living in poverty. They were also more likely to have experienced violence at the hands of the man who got them pregnant and to have dealt with at least three serious life events in the last year. The ban won't help. What would: better access to the full range of health care services, including contraception and timely abortion, as well as safe communities and a vibrant economy.

3. The other group more likely to have a later abortion are older, higher income women and those paying with health insurance. Pregnancy is riskier for women over 35. Amniocentesis, the test for fetal anomalies, is not done until 15-18 weeks, and ultrasounds for congenital malformations are done at weeks 18-20. Women from Rep. Jackie Speier to the general public public have spoken up about the medical needs for late-term abortions. After getting the results, women need time to find a provider (see point 4 below), and often to arrange for money, transportation, and child care.

4. Abortion is already stigmatized. Late abortion is worse. My experience after a conclusively negative amniocentesis in my early 40s was a case in point. Though abortion was still covered by my federal employee health plan and I lived in a major metropolitan area with plenty of medical facilities, the environment for performing a second-trimester abortion was already so poisoned that we found only two doctors in the area who would do it. One had previously lost his license. The doctor we chose punished me by refusing to provide anesthesia as mild as Valium, on the pretext that I was not his regular patient. I was sad about that abortion, but I never felt badly about my decision. I'll remain bitter 'til I die about how I was treated.

5. Bad math. It's hard to know when a pregnancy really starts. That's why it's best left to a physician to assess when a fetus is viable. Here are the metrics:

Doctors generally calculate a pregnancy as beginning two weeks after the first day of a woman's last menstrual cycle. (Women stop getting their periods once they are pregnant.)

The proposed ban would start the count differently, from the date of fertilization.

But, surprise! Women's periods and fertility cycles vary! The time between periods can be different from month to month. Ovulation can occur soon after, or even during, the bleeding phase of a woman's menstrual cycle. Sperm can survive for up to a week to connect with an egg. (This is why couples who rely on timing fertility cycles as a form of birth control are often called "parents.")

6. Math challenge: If you believe a pregnancy lasts nine months: A month typically has 4.33 weeks, so a nine-month pregnancy would last about 39 weeks. If you believe a pregnancy lasts 36 weeks: 36 / 4.33 = 8.33 months. So which date/standard should the law adopt?

7. A fetus inside the womb does not feel pain before 26 weeks according to the American College of Obstetricians and Gynecologists (ACOG) and is not a person. This is one misleading premise for proposing a 20-week ban.

8. States can presemtly ban abortions after a fetus is determined to be "viable," that is, able to survive outside of the womb. Viability is generally considered at 27 weeks; with medical advances, survival is possible but unlikely at 24 weeks, though probably with significantly compromised health. Viability of the fetus is increasingly challenged as a standard for limiting women's rights to abortion.

9. We don't need more restrictions on abortion. We have enough. Many states already limit abortions by the numbers of weeks of pregnancy, relying on a rigid construct based on specific weeks of gestation or trimester.

10. The Supreme Court's Roe v Wade decision in 1973 also guaranteed the constitutional right to an abortion to save the mother's life, a right also recently recognized in Ireland. This proposal contains exceptions for women whose lives are in danger as well as some rape and incest victims who can prove that they reported their assaults to criminal authorities, but it contains no exceptions for severe fetal anomalies or situations in which the woman's health is threatened by her pregnancy.

Want to stick up for yourself and your community? Join with the Trust Women/Silver Ribbon Campaign to pledge that you Trust Women to figure out what kind of health care they need, and don't need an ignorant assembly of bullies telling you how to manage your body or your family.

 

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