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Hey Rubio an OB/GYN says there’s no such thing as a “due date” abortion

As per usual when GOP candidates get together they beat their chests and howl about who is more anti-abortion. The loudest at the most recent debate was Marco Rubio. Why do people pester him about abortion and the fact that he thinks raped women should be forced to carry their pregnancies to term, when the democrats are the real extremists?

 

Hillary Clinton, according to Rubio,  “believes there should be no such thing as an illegal abortion — even on the due date of that unborn child”

Hillary Clinton has explained her position on abortion pretty well. Leave it up to women and their doctors. As Rubio is neither a woman nor a doctor he can’t fathom how that might actually work, so all he can do is fabricate an extremist view of choice that is, of course, as based in reality as unicorns because there is no such thing as a “due date abortion.”  I’m an OB/GYN and I know more about this than he does.

 

Let’s be clear, late-term abortions are rare

The CDC tracks abortions so we we know exactly how many women are having procedures legally and at what gestational age. In 2012, the last year for which we have complete statistics, 91.4% of abortions were performed by 13 weeks’ gestation, 7.2% were performed between 14–20 weeks’ gestation, and 1.3%  at ≥21 weeks’ gestation.

So only 1.3% of women have abortions at or after 21 weeks.

Why do a small minority of women have later-term abortions?

  1. Cost. The time it takes to raise the funds to pay for the procedure and travel is a known cause of delays. The later the procedure, the more expensive and so there is a cycle of increasing cost and delay. In fact, of women having abortions 58% said they would have wanted to have them sooner and 60% quote the time it took to raise money as the cause of their delay.
  2. Not recognizing they were pregnant until later. I have cared for women who did not realize they were pregnant until their due date. In fact, almost every OB/GYN has delivered a few women in the emergency department who had been able to ignore the signs of her pregnancy until it just couldn’t be ignored any longer. So yes, some  women don’t realize (or accept) they are pregnant until 18 weeks and so they account for some later procedures.
  3. Not knowing where to find a provider.
  4. Not knowing how to get to a provider. As clinics close this will become more of an issue. Not everyone who needs an abortion has a car or can ask someone who does for a ride, especially if the round trip is 100 miles. And you have to drive it twice because of mandatory waiting periods.
  5. Birth defect not identified until later.
  6. Health of mother. Between 20 and 23 weeks 6 days this would almost always be an intrauterine infection (chorioamnionitis) as the treatment is delivery. Over 24 weeks when it comes to physical health of the mother at this point we just deliver prematurely. If a woman is seriously ill and 24 + weeks the fastest way to get the baby out is almost always a c-section (though sometimes an induction of labor is an acceptable option). I can think of no physical health scenario where an abortion (dilation and evacuation) would be recommended as the procedure of choice for a seriously ill woman over induction of labor or a c-section. As Rubio is playing doctor maybe he can explain it to me. I know of only one post 24 week abortion in my 25 year career in OB/GYN and it was for mental health of the mother – a 12-year-old girl who was raped by her 17 year-old brother and the pregnancy wasn’t identified until 27 weeks. It took a couple of more weeks to arrange the procedure as she had to leave the state. Tragic outliers should not be the basis for laws.  Rape is rarely mentioned in studies on later-term abortions in the United States, so that’s why I haven’t listed it separately above. However, as costs rise and the number of clinics drop we may sadly see arise in later term abortions for this indication.

 

What is the main indication for late term abortions?  

Fetal anomalies.

In one study of later abortions (average gestational age of 22 weeks) 79.2% of procedures were for birth defects/chromosomal abnormalities and 20.8% were elective abortion.

The birth defects that lead to abortion are almost always lethal or very severe. Conditions like holoprosencephaly or anencephaly or multiple anomalies that are deemed not compatible with life.  Women don’t have abortions because of cleft lips.

I am 100% confident that Rubio has never had to hold the hand of a woman who has just been told her baby has no brain, or has a single eye like a cyclops, or has Trisomy 13. When faced with the diagnosis of a fetal condition that has either a very high probability of death or severe irreversible cognitive development there are many paths to consider. First doctors discuss the option of not intervening medically at birth and then they discuss the option of termination (hopefully in a completely non judgmental way). Some women decide to carry the pregnancy to fruition. Some women want a c-section to increase the chances their baby will be born alive so they can hold him or her as they die. Some want the pregnancy to end as soon as possible. Some want to make arrangements for their children at home to visit family of friends and then arrange their termination. Gestational age limits make giving women this small convenience harder and harder.

 

What about the few women who are 22-23 weeks without fetal anomalies and not for maternal health? This is 0.27% of abortions in the United States.  Women are almost always in this delayed situation because of reasons already discussed – money, travel, medically disenfranchised, didn’t understand the abortion laws, or sometimes it is severe drug abuse and they aren’t sober enough to access the system until they are in the second trimester. If these women could have accessed abortion sooner they almost all would have.

RubioIf I were Hillary Clinton this is what’s I’d say to Rubio…

Let’s be clear there is no “due date abortion.” This is some made up non existent procedure. Is that how you like to ground your policies, in fiction? Later abortions have been well-studied and it is pretty clear from your rhetoric that you haven’t availed yourself of that knowledge or don’t care. Or it doesn’t suit your fundraising.

There are a small group of women at or beyond 21 weeks who have abortions and the vast majority are for severe fetal anomalies. Have you ever spoken with one of those women Marco, because before you stick your foot any further into you mouth you really should understand the despair of having strangers ask about your due date when you know your baby will die at birth. The few women who have late abortions for other reasons are in this situation precisely because of the laws that your party has enacted. Laws that raise the cost and limit the availability of abortion and contraception. Talk about hypocrisy.

 

Also, there is also no such thing as a partial birth abortion.

If you want to play junior gynecologist you should have gone to medical school.

 

 

 

 

 

 

Discussion

39 thoughts on “Hey Rubio an OB/GYN says there’s no such thing as a “due date” abortion

  1. Thank you for this!!

    Sent from my iPhone, so please blame the machine if the content displeases you.

    >

    Posted by dfelsenfeld | February 8, 2016, 2:08 pm
  2. Here here! Thank you Dr. Jen. The GOPs mindless, thoughtless rhetoric on this subject is appalling. I wish politicians had the nerve to present actual facts when talking about abortion.

    Posted by Mimi | February 8, 2016, 2:14 pm
  3. Rubio and those like him intentionally don’t become informed because facts would not support their agenda.

    Posted by RevW | February 8, 2016, 2:25 pm
  4. On the health of the mother bit I have heard that a prompt abortion (method unspecified) is the recommended course of action for a Lassa fever infection in the third trimester. Fetal mortality is basically 100% anyway, there’s little value in trying to save it but it makes a tremendous difference in her odds to empty the uterus. Since is a hemorrhagic fever they are going to want to keep the bleeding to a minimum.

    Hopefully we never have to face Lassa fever in the US.

    Posted by Loren Pechtel | February 8, 2016, 4:10 pm
  5. Dr. Jen, you are a super hero! Keep up the great work with your blog and never let stupidity of politicians slip through the cracks.

    Posted by William Stueve | February 9, 2016, 8:50 pm
  6. I love your posts. Thank you for your voice. It’s so desperately needed these days

    Posted by Andersays | February 9, 2016, 9:30 pm
  7. Rubio is a tool and a fool and he’s on the way out.

    Posted by Jim Christian | February 10, 2016, 7:43 am
  8. Maybe he simply should have gone to ANY school that taught critical thought instead of kissing religious right rectums?

    Posted by syrbal-labrys | February 10, 2016, 3:26 pm
  9. “Some want to make arrangements for their children at home to visit family of friends and then arrange their termination. ”

    Women are also terminating their pre-existing children. How awful.

    Posted by Michael | February 11, 2016, 8:57 pm
    • She is referring to women who have just found out that their desired fetus has a lethal anomaly. That means the baby won’t make it. If the patient doesn’t choose termination, she will carry that pregnancy for 5 more months knowing there is no chance of survival. If you have not ever been in that situation, and I hope you haven’t, don’t judge. It IS awful beyond imagination. Look up anencephaly.

      Posted by Suzanne Dixon | February 12, 2016, 3:19 am
    • This comment can only indicate one of two things: a monstrous indifference to the suffering of a woman carrying a fetus that cannot survive, or a total failure of reading comprehension.

      Posted by madder | February 12, 2016, 6:43 am
  10. So a lot could be said in response to this post as it’s about abortion obviously. However, there is one thing that stuck out to me when you mentioned the 12 year old having an abortions- AT 27 weeks. 27 weeks. For mental health reasons. Now I do not know if this girl was suicidal or if she was literally going insane all of a sudden at this stage of her pregnancy or if her family and everyone was so repulsed by the image of her being pregnant by the brother that they immediately decided for an abortion but I do have a similar story.

    Now as someone whose sister was raped and had a late term abortion as a child, i was a witness to the situation. Yes, she technically did agree to it although, can I say it was ACTUALLY her choice or that she knew the gravity of what she was concenting to? No, I can’t. although it felt like the least damaging thing to do in the moment the abortion literally, in her own words, raped her– again. As well as her “mental health” which was of course, the killing of the baby was supposed to protect. Well it didn’t work that smoothly after all, and after several suicide attempts and years of drug use she has gotten better. she now even considers herself “pro-life”, as she can never forget the ” baby she got but didn’t get”. Sometimes little girls, when they have babies in their tummies feel pain DUE to the fact that they were killed inside of them.

    Posted by Brian | March 6, 2016, 8:39 pm
    • You are blaming your sister’s problems on the abortion when there are actually three candidates here:

      1) You.
      2) The rape.
      3) The abortion.

      When you convince someone who has had an abortion to be pro-life you’re asking for major mental problems.

      My wife is from China. She’s talked to plenty of women who have had abortions, even a fair number pressured into it. Mental problems from such abortions? None, because they don’t have a pro-life community telling the women they are murderers. (Note that the situation might have changed somewhat in the years she has been here instead of there.)

      Posted by Loren Pechtel | March 7, 2016, 1:42 pm
      • No, no one convinced her to be anti-abortion but her. She’s an agent. She’s made up her mind on the issue.(And I love how I am #1 on your list of causes…just a little reminder to me how disconnected you are from the actual situation ).

        And as far as the mental health problems go- yea the rape AND abortion itself did her in well (And she’s seen more than a couple Psychiatrists and Psychologists, just for the record). In terms of the abortion It wasn’t the anti-abortion protestors that weren’t out that day. Wasn’t our atheistic family– that told her this was the best thing. Wasn’t her surrounding herself with people who are not exactly moral influences. Wasn’t her cutting herself off from the outside world. It was the fetus dying inside her (its was scolded to death by saline). It killed her.

        In fact It’s not an entertainable idea that the abortion didn’t cause her harm- so I won’t spend anytime entertaining it. And to be honest if you heard my sister speak, you would not dare question how much pain the abortion caused her. I will NOT say to her ” Hey, there was NOTHING wrong with what happened during that procedure , it’s just society. This is just an illusion really! “, for reasons you would know…IF you knew my sister. The pain is there its real and raw.

        (And yea, im MORE than well aware that not all women react or feel the same way about their abortions (My grandmother who was born in russia in 1910, had 8 abortions by the time she was in her late 20s, and she told us this when we were kids- with a tone of pride– and a relatively expressionless face. So…)

        Now, I honestly don’t know if i consider myself to be “pro choice” or “pro life”, and the reasons for this are very deep. But what i do know is that this is a horribly horribly heartbreaking and complicated issue (hence our talk including children being raped and babies with one eye).

        Now im not going to be posting again , but thank you Dr. Gunter for bringing up some of the complexities and raw realities that abortion can present. I personally beleive when/if we decide to confirm abortions in these horrific situations we should feel a very deep pain for the loss of the little one in the womb, and love mom with our deepest love.It’s sad certain things have to exist.The abortion issue has the potential to bring out a darkness that many people don’t know is real. was just trying to tell my sister’s story, so I hope it can be appreciated by someone.

        Posted by Brian | March 9, 2016, 11:12 pm
    • Well that was a trash fire full of dumb.

      Posted by William Stueve | March 7, 2016, 4:39 pm
  11. This article is highly incorrect. First, statistics can be made to lie. And this article tries to hide the truth with misleading statistics. The article says only 1/3% of women have abortions at or past 21 weeks (which is 5 months y’all), as if this were a small thing. But there are 1.5 million–million!–abortions in this nation each year. So 1.3% of that is 19,500 abortions after 21 weeks. That’s 19,500 human beings whose lives are taken in their mothers’ wombs after 5 months.

    Those little ones have fully formed little bodies, hearts that beat, and everything. And contrary to certain lies being told in the MSM and by pro-abortion people, they do feel pain. But even if they don’t, killing them is wrong. How would you like it if someone ripped you to pieces when you were in your mother’s womb? Case closed. And the fact is also that the law still allows abortion up to the very moment of delivery. That’s why we had the huge debate and a law passed (though vetoed) about partial-birth abortion, which do exist, and that is a late term abortion where the “doctor” leaves just the baby’s head inside the woman and stabs the child in the neck to kill it. If the baby were all the way out, we would call that infanticide. But it’s murder either way, of an innocent human being. And there are about 2,000, if I remember right of those partial-birth abortions every year according to the abortionist’s own numbers, and the abortionists finally admitted that it was because they were necessary to save a mother’s life. And I read an article with my own two eyes where a late-term abortionist said sometimes they were in fact done even for things as trivial as cleft palate. So to try to make it sound like “there’s nothing to see here, and pro-lifers are crazy and exaggerate” is garbage.

    It is time for us all to repent of these wretched practices which kill the innocent and damage women and men, too, emotionally, morally, socially…and then we can heal and get on with REALLY helping and loving all, born and preborn.

    Posted by Nonna | March 10, 2016, 1:40 pm
    • Actually, there is nothing incorrect in this post. At all.

      However, your reply is filled with anti choice/forced birth fallacies.

      Posted by Dr. Jen Gunter | April 2, 2016, 7:03 am
    • Who does third-trimester abortions because the woman doesn’t want to be pregnant? Nobody!

      Thus your argument is wrong. What is confusing you is that fetal-defect abortions are classed as “elective”. How doctors label things and how we see their labels sometimes differ. To a doctor, “elective” simply means it doesn’t have to be done *right now*.

      And if it’s murder why do the vast majority of so-called “pro-life” people accept abortion in case of rape or incest? The method of conception has no relevance to whether it’s a person or not.

      Posted by Loren Pechtel | April 2, 2016, 8:14 am
  12. PS, big type In my comment above I meant to say that the abortionists finally admitted that partial-birth abortions were NOT done because they were necessary to save a mother’s life. (That was the big lie used to destroy bans on the brutal procedures)

    Posted by Nonna | March 10, 2016, 1:49 pm
    • Do you know what the banning of intact D&X (dilation and extraction) procedures actually did, Juana? It stopped women being able to hold their much wanted, much loved babies.

      It stopped them from making little hand and footprints, or taking a photograph, for the memory box that would hold the cherished mementoes of a live that was never lived. IDX let them have that, it let them hold their baby, who was sadly incompatible with life, for the first time, which was also the last time.

      So brava for you, Juana, bravissima! Now grieving parents can’t have that choice, they can’t hold their babies and say a devastated “Goodbye” to them. You must be so proud.

      Posted by boostick | April 23, 2016, 1:06 pm
  13. I notice that my comment exposing the errors in this article was not posted. An error, or was it deliberate censorship because the truth is not welcome? (Though I did make one error – I implied partial-birth abortion was still legal, whereas it is now illegal, praise God.)

    Posted by Juana Oner | March 11, 2016, 11:21 am
  14. Dr. thank you for this article. Can you clarify one of your statistics? You mention that “1.3% of women have abortions at or after 21 weeks.” Do you actually mean 1.3% of ALL women who are pregnant, or just 1.3% of those that have abortions are performed at or after 21 weeks?

    Posted by Angela O'Brien | October 25, 2016, 2:17 pm

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