Is Late-Term Abortion Ever Justified?

Steve Hammond, Sr., MD, FACOG and Emily LaBonte, FNP-BC

In our new book, The Christian and Abortion: A Nonnegotiable Stance (Credo House Publishers), we seek to provide medically-sound and crystal-clear answers to some of the most important questions surrounding this highly controversial topic.

So, is late-term abortion ever justified?

What is the definition of late-term abortion?

“Late-term abortion,” in the context of this article, refers to the purposeful destruction of a baby in the late second or third trimester. Obstetricians sometimes refer to any pregnancy loss as “abortion,” such as “spontaneous abortion,” but we are using the term here to refer to the primary objective being the willful destruction of a baby in the womb.

The issue of viability is still debated.

Many proponents of abortion object to the designation “late-term” since it does not define the gestational parameters of the procedure. The most accepted view of the gestational age at which an abortion qualifies as “late-term” is when the fetus would be viable outside the womb.

This is not easily determined and is itself arbitrary since medical advances have made it possible for some babies born as early as 21 to 22 weeks to survive; who knows where that line may be drawn with medical advances in the future.

Most available statistics for late-term abortions include babies between 21 weeks and term.

How often are late-term abortions occuring?

Roughly 1.3% of all abortions fall into this category. That sounds like a small percent but remember that 1.3% of a large number is still a large number. The actual number may actually be higher due to the fact that some states do not report such abortion statistics to the CDC.

What's legal?

Roe vs. Wade made abortion legal in the United States, but gave the states the right to restrict abortion after the first trimester. At this time more than a third of the States ban abortion, some with medical caveats, after 22 weeks. Eight states and the District of Columbia allow abortions up to term.

What are the reasons?

Abortion proponents give many reasons for patients choosing to abort late in pregnancy. The most common, they cite, are maternal health complications and severe fetal malformations. A noted published peer-reviewed paper suggests, however, that these indications are actually uncommon, and that reasons for late-term abortions are very similar to those done in early pregnancy such as family dysfunction, pressure by a partner, financial difficulties, young maternal age, and not ready to have a baby.

The former procedure has been banned.

Late-term abortions pose a more difficult and potentially more dangerous challenge to the abortionist. Since the Supreme Court upheld the “partial-birth abortion ban” in 2003, the preferred way to perform a late-term abortion is called a D&X procedure.

The partial birth abortion technique allowed the baby to be delivered feet first leaving the largest part of the baby, his or her head, inside the womb. A sharp suction device called a trocar would then be inserted through the base of the skull and the brain would then be suctioned out. This allowed the baby to be born intact, albeit without the brain and the skull, collapsed, to allow delivery.

What is the current procedure?

While the partial birth abortion technique may sound gruesome, a D&X abortion may be more so.

The baby is extracted by pulling off the legs and arms and removing the baby piece by piece. The head, too large to remove intact, is crushed and removed with forceps. It is riskier because as the pregnancy progresses, the long bones and spine are very sharp and, when extracted, can lacerate the uterus sometimes causing massive bleeding.

Also, in later gestation, the uterus is larger and softer and the risk of perforation is much greater. This could risk injury to internal organs and cause massive bleeding.

What is the risk to the mother of a late-term abortion by this D&X abortion method?

Sadly, it has a higher morbidity and maternal mortality rate than a normal delivery. That is why, if time allows, many abortionists prefer to remove the baby intact. First, they “euthanize” the baby by injecting a lethal drug into the baby’s heart, killing it, and then inducing labor, delivering a stillborn.

This takes more time because the natural process of induction of labor can take a day or more.

There are objections on both sides.

With this background, we now come to the question: “Is late-term abortion ever justified?” Let’s look at some of the objections raised in the debate on both sides.

First, the largest abortion provider in the US, Planned Parenthood, objects to the use of the phrase “late-term abortion” because, they say, it conjures up the picture of a baby being killed late in pregnancy.

Though they don’t want us to think about a baby being aborted just before it is due, isn’t that what the law in some of the States above allow?

Second, they go on to give the real reason they don’t want us to have a discussion about late-term abortion. It would be a “slippery slope,” they say, that would put women at great risk who are in serious physical or mental danger if they don’t abort their babies.

Third, they know that if they give in on drawing the line on late-term abortions that the line will ultimately shift to earlier gestational ages, a conversation they don’t want to have.

Fourth, their claim that a medical condition in pregnancy might “require” an abortion is simply not true—not true in any instance.

Let me make this emphatic: There is no indication to kill a baby before delivering him or her to improve maternal outcome.

Hard cases and complications are real, but they don't justify abortion.

I have had experience with many complicated pregnancies in my decades as an Obstetrician. Some of these require a baby to be delivered before 40 weeks (full term). On rare occasions, sadly, the baby must be delivered extremely prematurely.

Severe preeclampsia, placental abruption, and placenta previa are probably the most common situations that force us to deliver early or even very early. These are medical conditions that require delivery for the safety of the mother, and are not (nor have ever been) controversial.

No one would advocate trying to prolong a pregnancy that would put the mother’s life in danger.

While the timing of delivery in these cases can be one of the most difficult decisions that an Obstetrician ever makes, there comes a point at which the baby must be delivered regardless of the gestational age.

This sometimes happens even when we know that the baby may not survive, but this is not an abortion. It is a required medical intervention; no restriction on late-term abortion would stay the hand of an Obstetrician in these circumstances.

So, is late-term abortion ever justified?

Abortion proponents purposefully confuse the argument for late-term abortion with the occasional medical necessity for early delivery. In no case, however, does the intentional destruction of the baby, before delivery, improve the chances of maternal recovery.

Is late-term abortion ever justified? Never.

cover of book The Christian Abortion A NonNegotiable StanceSteve Hammond, MD, FACOG, has been practicing Obstetrics and Gynecology in Jackson, Tennessee, for decades. He is board-certified by the American Board of Obstetricians and Gynecologists, is a Fellow of the American College of Obstetricians and Gynecologists, serves as Medical Director of Clinical Research at The Jackson Clinic, and has served as the Principal Investigator for scores of clinical trials. 

Emily LaBonte, FNP-BC, is a board-certified nurse practitioner working for a large healthcare company in Las Vegas, Nevada. There she serves as a lead on the committee in charge of mentoring new providers hired into the company. LaBonte also is a member of the American Association of Pro-life Obstetricians and Gynecologists. LaBonte is the co-author, with Steve Hammond, MD, FACOG, of the landmark new book, The Christian and Abortion: A Nonnegotiable Stance (Credo House Publishers).

Photo Credit: ©GettyImages/Natali Mis