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June 11, 2019

Shifting Perspectives on Abortion Laws Through Respectful Dialogue

I visited my hometown last week in Western NY. Surprisingly, my chiropractor and I had the most interesting and inspiring conversation this morning. She expressed how frustrated she was with the “crazy NY State laws” that were being passed. Realizing that she could probably break my neck as she adjusted it, I gently inquired which ones specifically she was referring to… Well the “full-term abortion one where they partially deliver the baby and then decide to kill it.” My first thought was that no doctor delivers healthy full term babies and then decides to kill them if the parents don’t want them. That’s murder.

But, after taking a deep breath I quietly mentioned that this isn’t a thing. She seemed surprised, but inquisitive and we proceeded to have a calm conversation that “late-term abortion” is a complete misnomer. Ironically, it does not mean nearly born, but rather applies to pre-viable children < 24 weeks of gestational age that could not survive outside of their mother’s uterus. Full-term is 38–40 weeks of gestation and a lot of growth and development occurs every week enabling the unborn fetus to survive outside of a mother’s womb.

[Ok this might sound hypocritical, since as a neonatologist I take care of neonates that are born at 23–24 weeks gestational age… This is true. However, there is a significant risk for death or long-term severe medical and cognitive complications when neonates are born this premature. In many hospitals around the US, parents are given a decision around the thresholds of viability (typically 23–24 weeks gestational age) or a little over ½ way through pregnancy, whether or not to continue intensive care options for their children or let them pass peacefully in their arms. This is a highly personal and gut-wrenching decision for families with typically highly desired pregnancies.]

But, back to the conversation. She asked how they perform “late term” abortions and under what circumstances and then gave me the platform to clear up misconceptions and respectfully provide a few facts. In 2013, only 1.3% of all abortions occurred at 21 weeks gestational age or later. And these near-viability (rather than “late term”) abortions are typically performed for exceptional reasons — the child is found to not have a brain (anencephaly) or other definitively lethal conditions, not simply due to patient preference.

The facts…

New York State’s Reproductive Health Act effective January 2019 made the following changes:

  1. Abortions need to occur before the end of the 24th week of gestation
  2. If later than 24 weeks, the mother’s life must be in danger to perform an abortion [In practice, if these fetuses (> 24 weeks) are premature, but healthy they are delivered, resuscitated and cared for in the neonatal intensive care unit, not aborted.]
  3. There is an absence of fetal viability (i.e. lethal condition of the fetus)
  4. Licensed providers other than physicians can legally perform abortions
  5. Abortions were removed from the penal code, effectively conveying that an abortion is a medical procedure, not a crime. [2]

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Sources:

  1. https://www.guttmacher.org/fact-sheet/induced-abortion-united-states
  2. https://www.democratandchronicle.com/story/news/politics/albany/2019/02/01/abortion-law-ny-what-reproductive-health-act-does-and-doesnt-do/2743142002/