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How to respond to a question about “late-term abortion,” a procedure that doesn’t exist

There has been so much in the news these past few weeks about abortion. The misinformation, disinformation, and lies are overwhelming.

Language always matters, but in medicine it is especially important to be precise. Imagine if we didn’t use the term appendix and instead said a small chunk of bowel on the right? In very lay terms they sound similar, but medically they are not. You do not want a very lay procedure, you want a medical procedure. When imprecise or nonsensical medical terms become law they can hurt patients as doctors don’t know what to do. I have personally had to call a Kansas state legislator at home to ask him medically what his law meant? I’ve mentioned this story a few times. The fact that it is never big news stuns me. Then again, it was just about a woman who needed an abortion to save her life. Imagine if your heart surgeon had to call a politician at home to ask what he mean by the term floppy valve so they would not be criminally prosecuted for replacing the mitral valve in this situation?

And then there is the other layer. Inaccurate terminology about abortion isn’t just malignant lay talk meant to hamper what doctors can offer, it has another purpose — to invent definitions meant to color how people view abortion and sway public opinion with lies.

Term is a pregnancy between 37 0/7 weeks and 41 weeks 6/7 weeks. It is the time period in which we generally expect the pregnancy to deliver. It is a range, as delivering on the actual due date (40 weeks) is uncommon. Between 41 0/7 weeks and 41 6/7 weeks of gestation we say a pregnancy is late-term and from 42 0/7 weeks onwards we say it is postterm. These distinctions are important as late-term and postterm pregnancies are associated with an increasing risk of perinatal mortality (which is stillbirth or death in the first week of life). We have seen the tragedy of medically unattended postterm pregnancies play out on social media with women who refuse induction of labor and “free birth” (deliver without assistance).

Looking at this language you can see how late-term being falsely applied to abortion conjures up the image of an abortion either after the due date (meaning after 40 weeks or even 41 weeks) or shortly before. And of course this does not happen. Ever. I should know, I did abortions after 24 weeks for 3-4 years in a state with no gestational age limit and no one ever asked me for such a procedure. The latest procedure I did was at 34-35 weeks for severe fetal anomalies that would not have been compatible with life after delivery. There was some other mitigating maternal medical factor that prompted the intervention. A vaginal delivery was not an option for a variety of medical reasons and so the option was termination by the vaginal route or termination by c-section. This is an important point, if we do a c-section early for a pregnancy with anomalies that are not compatible with life that should also be considered an abortion if it is done before 37 weeks.

When a patient needs an abortion we discuss trimesters of pregnancy. In general, skill sets are divided into first, second, and third trimester. A patient who needs an 18 week abortion can’t be tended to by someone with first trimester skills. Although medically we usually say weeks of gestation. This informs us of the equipment we may need, the other medical staff we may require, and of course if we have the skill set.

If I were still doing abortions and someone called me to ask for a late-term abortion I would likely hang up on them as I would believe they were a forced birth operative. Which is of course what people who use late-term are. After all, they don’t seem keen on prosecuting women who go postterm with their pregnancies and have a perinatal death. Of course I am not advocating for women to ever be prosecuted for any negative outcome in pregnancy, but if they are so worried about fetal life after 40 weeks it seems somewhat hypocritical to ignore these cases. It simply proves the point that people who use the words late-term abortion are forced birth uniquely for women who want an abortion. If they were pro-fetal life they would care about the more than 700 pregnant women murdered every year (murder of the pregnant person often results in fetal demise — the opposite of fetal life), tobacco (cause of stillbirth — which is fetal death), vaccines (the flu vaccine in pregnancy reduces maternal complications hence improving fetal outcomes — meaning it improves fetal life) and be for free, accessible maternity care, which improved perinatal outcomes (meaning more fetal lives). If fetal life is your gig there are plenty of places to work constructively to improve outcomes.

The crickets in these areas is proof that there is no concern for fetal life. It is uniquely about punishing women for abortion.

When someone asks me about late-term abortion I tell them it isn’t a word and they need to ask me what specifically they mean. If they are someone confused by what they have read they usually rephrase the question in a way that it was clear they thought late-term was 20-24 weeks (effective propaganda, eh?). If they are an anti-abortion forced birther (AAFB) they change the subject and ask a different, but equal inflammatory question. I refuse to budge until they tell me what late-term abortion means. And they never do and thus the conversation ends. I do not put words into their mouths and help them. If they are so invested in fetal life they can figure out the right words. After all, people who have been confused by their propaganda do.

Late-term should never be applied to abortion. Ever. The press need to stop repeating it. Late-term abortion is like saying vaccines cause autism. It doesn’t happen. Repeating the lies that some politician or anti-abortion forced birth activist (AAFB activist) believes is not newsworthy and most certainly does not make them true. As repetition is easily confused with accuracy every one of us, but the press especially, needs to not only abandon the use of late-term abortion, but refuse to further the conversation until the person using this false definition offers an explanation.

There is no such thing as post-term abortion. I guess when you can’t use facts to sway people, all you have is lies.

Discussion

21 thoughts on “How to respond to a question about “late-term abortion,” a procedure that doesn’t exist

  1. Thank you.

    Posted by Wendy Long Smith | February 11, 2019, 7:07 am
    • I am in correspondence with a conservative who is outraged by the mental health exception, imagining that women who are a little depressed or anxious are getting 35 week abortions. I know. But have you written anything that addresses these concerns? She was outraged about Sen. Tran until I pointed out that the VA law actually requires resuscitation attempts on a viable baby, the opposite of the claim that they kill a live-born baby. She immediately switched to the NY mental health exemption.

      Posted by Peggy | February 15, 2019, 5:51 pm
      • If a woman is emotionally mentally disturbed or under depression she should have given the right for aborting her
        child with amending the statutory requirements prevailing in different states. A disturbed woman will produce a handicapped child so in order to avoid a disturb child, it is better to abort rather to leave him/her at the mercy
        of callous society. We may not indulge in unnecessary discussion to save the life of a child.

        Posted by Shakil Ahmed | February 16, 2019, 8:11 am
  2. I suggested some antichoice troll read your blog for accurate information on abortion & he called you “radical”. I laughed and asked when did accurate science become radical? No response…

    Posted by Erin | February 11, 2019, 7:54 am
  3. A Planned Parenthood is near my work and I was seething with rage this morning after seeing 4 elderly forced birth advocates with picket signs outside.(sidenote: there’s got to be a reason most of the forced birthers I see are too old to bear children, right? It seems like womb-envy to me sometimes?) Thank you so much, doctor, for posting this today. You remind me to have hope for the future of women’s rights.

    Posted by KC | February 11, 2019, 8:01 am
  4. Thank you for always sharing your knowledge and expertise in a well-written, easy-to-comprehend way.

    Posted by sawaboof | February 11, 2019, 9:13 am
  5. Thank you for this.

    Posted by palfreyman1414 | February 11, 2019, 9:14 am
  6. Thank you so much for your blog. You help keep me informed which not only impacts my own health but keeps me aware of all the crazy that’s out there relating to women’s health. Speaking of crazy, have you heard that Gwyneth Paltrow/GOOP are getting their own Netflix series?

    Thank you for everything you do!

    Jennifer Rios

    Sent from my iPhone

    >

    Posted by Jennifer Rios | February 11, 2019, 10:29 am
  7. Bravo! I wish your blog was required reading… literally, by law. But then again some people choose to believe only what they want to, regardless of “facts”.

    Posted by fabulouslawrencesisters | February 11, 2019, 12:57 pm
  8. I appreciate her for educating her readers on different medical issues in such a nice way. Kudos to her untiring
    efforts for so long!!

    Posted by Shakil Ahmed | February 11, 2019, 9:36 pm
  9. First time reading yr blog; just found you on twitter. Sharing this in hope of clarification for anyone, even for just one person. Much appreciation for your term “anti-abortion forced birth activist (AAFB activist)”.

    Posted by plaisanter | February 11, 2019, 10:56 pm
  10. As a previous labor and delivery nurse ,after 16 weeks gestation, we would mainly induce labor with multiple days of laminaria and then use hemabate or high dose pitocin ending in a vaginal delivery. If the mothers health could handle this , of course. And their OB could do the procedure themselves and did not need to send them to a specialist.
    It was a several day process but I guess the families felt more comfortable doing it this way not thinking of it as an abortion in the usual sense of the word.

    Posted by Traci Corder | February 11, 2019, 11:02 pm
  11. I think it is the discretion of a medical doctor to decide whether to do abortion on early or late term. A specialist can
    only understand the complications involved in it. Unfortunately rape has become a common phenomena in every
    nook and cranny of the world. So abortion of an wanted child is a necessity and not a pleasure. In any such
    case no sermons from clergy are tolerable. Abortion is the only solution in this regard.

    Posted by Shakil Ahmed | February 12, 2019, 7:33 am
    • Rape has ‘become a common phenomena’?! Since when? Year One?

      Posted by Erin | February 13, 2019, 11:31 am
      • There hardly any day goes when a news about rape is not published in any newspaper anywhere in the world. Whnever we read newspapers this horrendous news is printed. It is a fact which cannot be denied. Read newspapers
        and see how much cmmon is it.

        Posted by Shakil Ahmed | February 13, 2019, 6:33 pm
  12. Thank you Dr Gunter. They anger and vitriol out there for any woman who dares to want an abortion is so intense it is exhausting. Thank you for your support and information. These people are angry at women, that is the only conclusion I can come to. It comes up very quickly in any interaction with them.

    Posted by Kathleen Margaret Schwab | February 13, 2019, 5:01 pm
  13. I think we may accept early or later stage abortion as a routine matter like other norms in our life. If a woman accidentally become pregnant with any reason and deterimend to have abortion, we may not stop her. It is better
    to have abortion of a baby rather than thow it in a deserted place. Women may be educated to use anti contraceptives regularly. Most pitiable thing is a man mostly use a woman for sexual pleasure for several months
    and when she becomes pregnant leave her. It is immporal and unethical but while penetrating his penis into her pussy forgets all about it. It is the crux of the problem in most abortion cases.

    Posted by Shakil Ahmed | February 14, 2019, 5:44 am
    • Let us not forget that men are responsible for 100% pregnancies. No ejaculate = no sperm = no pregnancy. Just one more reason why women should, under no circumstances, suffer the rhetoric of or be constrained by “forced birthers”.

      Posted by Molly Lou Mellon | February 18, 2019, 9:43 am
      • I completely agree with the remarks of Molly Mellon. Actually most of the men are main culprits in impregnating women. It is very comfortable for them to penetrate deeply into vaginas of poor women. But when they become pregnant they take no responsibility. If it is out of wedlock then it may be prohibited forcefully. There must be a
        foolproof mechanism not to insert their sperms into pussies in any way. It is upto medical doctors to think about it
        seriously how to stop their ejaculation/sperms into women’s pussies to stop unnecessary pregnancies.

        Posted by Shakil Ahmed | February 18, 2019, 10:05 am
  14. I think you should lend a hand to kindred spirit who’s getting sued for debunking quackery.
    https://www.naturopathicdiaries.com
    “Don’t let a naturopath near your vagina: “black salve” for cervical dysplasia”
    “A naturopath-midwife, homeopathy, and a dead newborn”

    Posted by Ben Sharvy | February 18, 2019, 11:00 am

Trackbacks/Pingbacks

  1. Pingback: How to respond to a question about “late-term abortion,” a procedure that doesn’t exist | Dr. Jen Gunter | Second Hand Outrage - February 18, 2019

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