In the aftermath of Dr. George Tiller’s assassination—out of the sorrow, anger, and fear—comes a much-needed conversation about the realities of late-term abortions. Over the past several days, Dr. Tiller’s death has provided a chance to speak openly about the work he did, to learn the facts about late-term abortions and—even more importantly—hear the stories behind those statistics.
Jodi Jacobson points out on RH Reality Check that much of the media coverage of Dr. Tiller’s murder has highlighted the fact that he was “one of the very few doctors who perform late-term abortions, without providing any context as to why he did so and under what circumstances.”
Indeed, the terms “late-term abortion,” or “later term abortion” (plus, of course, the politically motivated and medically inaccurate “partial-birth abortion”) are often batted around with little to no discussion about what they actually are, who needs them, and why they do. It’s not surprising then that even some in the pro-choice community are uninformed about the realities.
Late-term abortions are extremely rare. According to the Guttmacher Institute, 1.1% of all abortions performed in the U.S. every year occur after 21 weeks. Thirty seven states currently restrict access to abortion in the third trimester, except when necessary to preserve the woman’s life or health. Dr. Tiller was one of the only providers who would perform abortions past 24 weeks in order to save women’s lives or preserve their health, including their future fertility.
Contrary to right-wing myth, women who have late-term abortions do not choose them for the sake of convenience, out of laziness, or after an impulsive change of heart. In 2006, the National Institute submitted an amicus brief in the case Gonzales v. Carhart, which challenged the federal ban on so-called partial-birth abortion. The amicus brief provided the Court with first-hand accounts from individual women who obtained second-trimester abortions in order to show the real-life impact of the Federal Abortion Ban on women’s lives. As these stories show, the primary reason for second trimester abortion is the discovery of a complication that threatens the life or health of the fetus, the woman, or both. On Salon’s Broadsheet, Kate Harding writes:
[The cases Dr. Tiller took] included women diagnosed with cancer who needed abortions to qualify for chemotherapy, women who learned late in their pregnancies that their wanted babies had fatal illnesses, and rape victims so young they didn’t realize they were pregnant for months.
Tragically, women in these desperate situations also face the added difficulty of finding a doctor who will perform a late-term abortion. At the vigil held for Dr. Tiller in New York City’s Union Square on Monday night, fellow abortion provider Dr. Laura MacIssac spoke eloquently about how thankful she and her colleagues were that they could send many of their most heartbreaking cases to Dr. Tiller.
Conventional wisdom holds that when it comes to abortion the earlier the better, yet late-term abortions are often the ones that are absolutely necessary to preserve a woman’s health or life. Michelle Goldberg writes on The American Prospect:
Late-term abortion is often spoken of as the most morally dubious aspect of the abortion debate. Many people who are nominally pro-choice, particularly politicians, are quick to condemn it, to treat the work that Tiller did as repugnant even if it’s legal.
Ironically, though, many of the procedures Tiller did were as far away from the much-reviled concept of “abortion on demand” as one could get. Unwanted pregnancy can, to some extent, be prevented. A pregnancy that goes horribly wrong cannot.
To me, it is the stories of women who have found themselves in need of an abortion late in their pregnancies that provide the most harrowing illustration of why abortion must be safe, legal, and available As Erin Kate Ryan of the National Network of Abortion Funds writes on RH Reality Check, in the high-stakes world of late-term abortions “our own biases about which abortions are necessary, justifiable, or merciful” are rendered irrelevant:
When faced with real families and real stories and the dazzling complexity of women’s lives, the one-dimensional slogans and false righteousness of the extreme anti-choice movement are revealed again as flimsy and hollow distractions that disregard women’s realities and dignity.
These difficult and complex realities serve as a reminder that the only moral rule when it comes to abortion is the one Dr. Tiller lived by and had printed up on buttons: “Trust women.”
By Maya Dusenbery