Steven Waldman

Steven Waldman


The Inconvenient Truths (For Both Sides) About Late Term Abortions

posted by swaldman

The murder of George Tiller has prompted many families to post first-person accounts of their own heart-wrenching decisions about abortion and child birth.
There’s a broad national consensus against late term abortions yet these stories raise the question of just how much we know about why women have them. Are these stories actually representative? What do they imply for policy?
The liberal blogger Hilzoy at the Washington Monthly published an essay by one woman who, in the eighth month of pregnancy, found out that she had conjoined twins. One of the twins had died. And the other was unlikely to survive:

“At best only one child would survive the surgery to separate them and the survivor would more than likely live a brief and painful life filled with surgery and organ transplants. We were advised that our options were to deliver into the world a child who’s life would be filled with horrible pain and suffering or fly out to Wichita Kansas and to terminate the pregnancy under the direction of Dr. George Tiller.”

Another woman discovered that one of her twins had died and that delivering the other would likely have killed her; another twice opted for a “partial birth” abortions after learning the babies had “no faces, with no way to eat or breathe,” and would die almost immediately after birth. Andrew Sullivan has published a number of stories too.
These examples startled me because they didn’t fit the stereotypes that either pro-life or pro-choice activists have offered about late-term abortions. Pro-life activists have tended to suggest that late abortions are matters of taste or convenience or, as Bill O’Reilly, put it “temporary depression.”
On the contrary, most of the stories are from women who desperately wanted their babies but were faced with horrible dilemmas of whether to give birth to a child that would suffer and then die. Some of the abortions were, in effect, mercy killings.
When I expressed surprise, one commenter chided me for my ignorance: “The pro-life movement has done a great job of spreading the lie that women are aborting their 8.5 month pregnancies because they only want to fit into a prom dress or swimsuit.”
But the pro-choice movement bears some blame, too. Whenever we have a debate about late term abortion, pro-choice activists emphasize the need to protect the life and health of the mother. While that is sometimes a factor, these heart-wrenching stories point to a completely different set of dilemmas — in which it’s not the mother’s health but the fetus/baby’s quality of life in question. These are tough questions because often times the baby can, in fact, survive, at least for a while but possibly in great pain.
Pro-lifers don’t like to discuss such cases because it’s quite easy to have sympathy for the mothers who clearly wanted the child and are choosing abortion for anything-but-casual reasons. Pro-choicers don’t like to talk about them because, despite the mitigating factors, it still involves killing a baby late in a pregnancy. Protecting a mother’s life – i.e. self defense – is a much easier case to make.
A Beliefnet member named “Connie” put it eloquently:

“The harsh truth is that is it very, very difficult to have an explicit conversation about what to do when the child you are having is not the child you wanted. And I’m not talking about sex selection.
Pro-choice people are understandably squeamish about having a forthright discussion about this. Pro-lifers, on the other hand, find it easy to say “have the baby no matter what,” when they aren’t the ones who have to suffer emotionally and financially to care for it….
We’ve gotten used to both sides of the discussion around rape, incest, life/health of the mother hard cases. The I-don’t-want-THIS-child, or I-don’t-think-my-child-should-live-the-sad-life-it-will-have discussion is carefully avoided by both sides.”

So, how many of the late term cases are mercy killings? How many relate to babies that would survive but in an impaired state (i.e. Downs Syndrome)? And how many were more casual “change of mind” cases?
Amazingly, given how controversial these abortions are, we really don’t know much about why women have them. According to the Alan Guttmacher institute, 1.1% of abortions, or 13,310 happen after 21 weeks, including roughly 1,700 after 25 weeks.
A very old 1988 Guttmacher survey, of abortions taking place after 16 weeks, listed these reasons for why an abortion was happening late in the gestational cycle:

  • 71% — Woman didn’t recognize she was pregnant or misjudged gestation
  • 48% — Woman found it hard to make arrangements for abortion
  • 33% — Woman was afraid to tell her partner or parents
  • 24% — Woman took time to decide to have an abortion
  • 8% — Woman waited for her relationship to change
  • 8% — Someone pressured woman not to have abortion
  • 6% — Something changed after woman became pregnant
  • 6% — Woman didn’t know timing is important
  • 5% — Woman didn’t know she could get an abortion
  • 2% — A fetal problem was diagnosed late in pregnancy
  • 11% — Other

The data don’t end up cleanly supporting one side or the other. Fetal illness is listed infrequently as a reason, indicating that maybe these heart-wrenching stories are not typical. And saving the life or health of the mother wasn’t mentioned at all. Points for the pro-life side.
But these data undercut some pro-life arguments, too. Some abortions happen because of problems that pro-life policies exacerbate. Pro-life groups work diligently to make it harder for women to get abortions, yet these studies show that the difficulty in making arrangements is one of the reasons that abortions happen later. (More on that in my piece, “Safe, Legal and Early.”
It’s also quite possible that if a study were done on those in the 25th week, as opposed to the 17th week, that the results would be different.
Perhaps the lesson from this renewed wave of attention to late term abortions is that we might want to understand what’s actually happening before we attack the other side.



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CluePhone

posted June 3, 2009 at 12:28 pm


uh Steve, your survey…16 weeks



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Robert

posted June 3, 2009 at 12:45 pm


And the survey isn’t relevant to Dr. Tillich, either, who only accepted patients carrying children with profound defects.
Every abortion is tragic, whether the mother recognizes this or not. But the labeling of Tillich as a wanton murderer, elsewhere on this site, is evil, too.



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Joe

posted June 3, 2009 at 1:41 pm


The link provided for the Guttmacher study says that data was collected from surveys given to women. If the women were free to respond as they choose (I think a safe assumption), I wonder if there could be any bias in the data due to the fact that certain reasons for having an abortion are less socially or personally acceptable. Just because the results are anonymous doesn’t mean that the answers are completely honest. Think of teenage drug use surveys as an comparable example.



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Tom

posted June 3, 2009 at 1:55 pm


“…who only accepted patients carrying children with profound defects.”
This is grossly false, but don’t take my word for it. Listen to all the reasons Tiller gives that don’t fall into this category for yourself (his own words):
http://www.dr-tiller.com/images/reasons.mp3



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MK

posted June 3, 2009 at 2:39 pm


Down Syndrome and Cystic Fibrosis are NOT life threatening diseases. If you can kill a 36 week old fetus because it has cystic fibrosis, then why can’t you kill a 6 week old newborn for the same reasons?
By the time a child in the womb is viable, it can be delivered alive as easily, (sometimes more easily as a late term abortion can take up to 3 days, whereas a live birth is over in a matter of hours)aborting this child.
Over 90% of children diagnosed with down syndrome in utero are aborted.
Children have been aborted for clubbed feet, cleft palate, spina bifida and other maladies that can easily be lived with.
This is about one group deciding the worth of another group…and exterminating them if they do not meet the standards of “excellence”.



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Robert

posted June 3, 2009 at 5:20 pm


“This is grossly false, but don’t take my word for it. Listen to all the reasons Tiller gives that don’t fall into this category for yourself (his own words):”
Why should I believe this mp3 is a recording of the late doctor’s voice? Why shouldn’t I believe that somebody faked it? You provide a link to an anti-abortion site put up by somebody who hides behind anonymity. Are they anonymous because they are lying? Dr. Tiller’s site was http://www.drtiller.com. The anti-abortion site you linked to is http://www.dr-tiller.com.
Dr. Tiller’s own site was taken down Sunday night, but Google maintains a cache of it. If you go through the cache, you can see that Dr. Tiller listed very clear criteria for acceptance into his clinic, and all of them were conditions from which the child does not survive. I propose to you that if bringing a child who would be stillborn to birth came at the expense of a mother’s ability to bear future children, it would be immoral not to have an abortion. These decisions are only simple for those who do not have to make them.



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Your Name

posted June 3, 2009 at 5:42 pm


“Over 90% of children diagnosed with down syndrome in utero are aborted.”
Really? Where do you get that statistic? And how did your source compute it?
“Children have been aborted for clubbed feet, cleft palate, spina bifida and other maladies that can easily be lived with.”
Easily? Really? Do you take care of such a child? Do you have these disabilities yourself?



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MK

posted June 3, 2009 at 6:08 pm


Ummmm Robert? He took it off of Tiller’s website…



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MK

posted June 3, 2009 at 6:12 pm


If current trends continue, it may eventually become “unacceptable” for parents to continue a pregnancy knowing that their baby has Down syndrome. Recent US studies have indicated that when Down syndrome is diagnosed prenatally, 84% to 91% of those babies will be killed by abortion.1,2,3,4 This trend is not isolated to the United States. In England, a 2004 study showed that 94% of babies who were diagnosed prenatally with Down syndrome were subsequently aborted.5 When all Down syndrome babies are considered – those diagnosed prenatally as well as those only diagnosed with DS after birth – studies show that 26% to 37% of these tiny lives will be ended by abortion.6
1 Forrester MB, Merz RD. 1999. Prenatal diagnosis and elective termination of Down syndrome in a racially mixed population in Hawaii, 1987-1996. Prenat Diagn 19(2):136-41.
2 Kramer RL, Jarve RK, Yaron Y, Johnson MP, Lampinen J, Kasperski SB, Evans MI. 1998. Determinants of parental decisions after the prenatal diagnosis of Down syndrome. Am J Med Genet 79:172-174.
3 Caruso TM, Westgate MN, Holmes LB. 1998. Impact of prenatal screening on the birth status of fetuses with Down syndrome at an urban hospital, 1972-1994. Genet Med 1(1): 22-8.
4 Wertz, DC. 1997. The Impact of Prenatal Diagnosis on Down Syndrome, Anencephaly and Spina Bifida. GeneSage, GeneLetter. Accessed at: http://www.genesage.com/professionals/geneletter/archives/theimpact.html
5 The National Down Syndrome Cytogenetic Register 2004 Annual Report. Accessed at: http://www.wolfson.qmul.ac.uk/ndscr
6 Siffel C, Adolfo C, Cragan J, & Alverson CJ. 2004. Prenatal Diagnosis, Pregnancy Terminations and Prevalence of Down Syndrome in Atlanta, Centers for Disease Control and Prevention, Atlanta, Georgia; Birth Defects Research (Part A) 70:565-571.
7 Grant SS. (September 30, 2000): Prenatal Genetic Screening. Online Journal of Issues in Nursing. Vol. 5, No. 3, Manuscript 3.
8 Skotko BG. 2004. Prenatally diagnosed Down syndrome: Mothers who continued their pregnancies evaluate their health care providers. Am J Obstet Gynecol 192, 670-7. [Life Issues Connector, 1/07, http://www.lifeissues.org
http://www.physiciansforlife.org/content/view/1301/26/



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MK

posted June 3, 2009 at 6:19 pm


“Children have been aborted for clubbed feet, cleft palate, spina bifida and other maladies that can easily be lived with.”
Easily? Really? Do you take care of such a child? Do you have these disabilities yourself?

Well, you’ve just proved my point. The claim in this article was that LIFE THREATENING anomalies were being given as reasons to abort late term, thus justifying the procedure.
Then you act shocked that we don’t consider cleft palates and clubbed feet so horrendous that you can’t live with them.
As for have I ever lived with these conditions? I have never been beaten with a baseball bat, but I’m pretty sure I wouldn’t like it. I have never been 5’2” but I’m guessing you can live a normal life at that height. I have never been stung by a wasp, but judging from people who have, I’m leaning towards “normal life after wasp sting”.
It’s called common sense. It’s also know as empathy. Are you telling me that people with clubbed feet and cleft palates cannot lead happy lives. That their disfigurements are so horrible that they would be better off dead?
This tells me much more about you than about them. I’ve never been you, but I’m pretty sure I wouldn’t want to be.



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Robert

posted June 3, 2009 at 6:37 pm


“Over 90% of children diagnosed with down syndrome in utero are aborted.”
Really? Where do you get that statistic? And how did your source compute it?
Ummmm Robert? He took it off of Tiller’s website…”
“He” who? This isn’t in the cache of Dr. Tiller’s webpages or anywhere else. It’s made up. And as for your next post, I’ll take the counsel of the Book of Proverbs and not argue with a fool.



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A Christian

posted June 3, 2009 at 6:52 pm


If Mary had aborted Jesus, we would not be Christians today (that is, those of us who are). Enough said.



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MK

posted June 3, 2009 at 7:40 pm


Here’s your source for the Down Syndrome statistic…
http://www.2secondsfaster.com/2008/09/palin-downs-sydrome-life/



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bifemmefatale

posted June 4, 2009 at 11:23 am


“A Christian”–Your all-powerful God couldn’t have made another Son if she had aborted Him?
I have my own issues with a “perfect, loving God” who supposedly creates conditions that cause mothers and babies to suffer such pain and heartache as leads to these difficult choices.



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bifemmefatale

posted June 4, 2009 at 11:29 am


MK–that study says 92% of fetuses *diagnosed* with Down’s prenatally are aborted, not 92% of all Down’s kids are aborted. Since many, many women in the US still do not have access to good prenatal care, and not all women with healthcare agree to amniocentesis, the actual number of Down’s fetuses aborted is a good bit lower.



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Terry Karney

posted June 4, 2009 at 2:43 pm


16 weeks is an awfully early cut off for “late-term”. It’s one-third of the way into the second trimester.
Which is to say, there is no way, from this study, to apply those numbers (even discounting the age of the study, and the changes in attitudes since) to the abortions used to fan the flames against Dr. Tiller.
A Christian: If God is so all-powerful, he knew Mary would carry to term. Or are you saying it’s possible for mere human desire to overcome a divine miracle?
(n.b., I am a pro-choice Catholic, so trying to tar me as a heathen [thouhgh I expect you don't think me a "real Christian," and I'm just fine with that], is a bit short of the mark. I just figure that God can look after His own interests, and free will isn’t all that free when the gov’t tells me how to use it)



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Terry Karney

posted June 4, 2009 at 2:48 pm


Oh, and forgot to mention that the ability to diagnose fatal disorders has gone up too, in the past 20 years, so the data are defective on that score too.
I think, all things being equal, the changes in the social landscape are so great this is useless as a tool for mapping present behaviors.



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Mairin

posted November 19, 2010 at 6:43 pm


Terry,
I must inform you: You are NOT a Catholic. Catholics believe what their Church teaches. The Church teaches that human life is inviolate and precious 100% of the time, in all cases. Anyone who dares to proclaim their Christianity must be brave and humble enough to allow God His Divine Perogative in regards to His Creation.
You may have some catholic sentiments, however, you need to reconcile yourself with God before you go calling yourself a Catholic.
It is not a roll-your-own type of Faith.
Usually when formerly “catholic” people are pro-choice, it is because they have fallen away through sin. What did you do that you shouldn’t have done? God is a forgiving God. Pushing out the guilt will only make it harder to live in peace.



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