Why do women decide to get third-trimester abortions?
Third-trimester abortions are defined as abortions that take place at or after 24 weeks from the last missed period (LMP). While these procedures are relatively uncommon in the United States compared to first-trimester abortion, this study examines an uncommon and understudied experience: needing a third-trimester abortion. Findings demonstrate the value of understanding abortion as a need throughout pregnancy.
Two Primary Pathways to Abortion Care
The reasons people need third-trimester abortions are not so different from why people need abortions before the third trimester. Research identifies that there are two pathways by which people come to need a third-trimester abortion: new information and barriers to abortion before the third trimester.
The New Information Pathway
The limits of medical knowability mean some information about a pregnancy is simply not available before the third trimester. For instance, clinical research shows that some serious fetal health issues are not observable until the third trimester of pregnancy. As one example, Kara (a pseudonym) learned in the third trimester of pregnancy that her fetus had a serious health issue. This information was unavailable earlier in the pregnancy because brain development happens so much in the last second trimester and early third trimester. Simply put, she could not have known the severity of this fetal health issue earlier in pregnancy.
Barriers to Abortion Access
In other cases, people tried to obtain an abortion before the third trimester but faced insurmountable barriers (including policy restrictions and stigma) that delayed them into the third trimester. These individuals received new information—including that they were pregnant—that made the pregnancy not (or no longer) one they wanted to continue. Financial challenges often play a role; for instance, Victoria (a pseudonym) explained: "My boyfriend was working odd jobs, and I don't have a job, and we were homeless on the street." Under such circumstances, there was no way that they could get a couple hundred dollars, let alone a grand, if not more.
Complexity and Logistics
Often referred to as "late-term abortions" by anti-abortion activists, third-trimester abortions are substantially more expensive, difficult to obtain, and stigmatized than first-trimester abortions. While third-trimester abortion may be exceptional in its cost, clinical complexity, logistics, and low social support, the reasons people need third-trimester abortion care are not. Instead of a focus on gestation or trimesters, these findings make a strong case for conceptualizing a need for abortion throughout pregnancy.
Study Design and Participant Data
Katrina Kimport interviewed 28 cisgender women who obtained an abortion after the 24th week of pregnancy by phone. The interviews were analyzed thematically to understand the pathways to abortion at other gestations. The following table summarizes the demographic and clinical data from the study:
| Category | Details |
|---|---|
| Number of participants | 28 cisgender women |
| Age range | 18 to 46 years old |
| Pregnancy duration at abortion | 24 weeks to 35 weeks LMP |
| Employment status | Most could meet basic needs; eight were unemployed (including one homeless) |
| Primary pathways identified | New information and insurmountable barriers |
Respondent experiences illustrate the limitations of the social and legal organization of abortion care by gestation and point to the value of understanding abortion as a need throughout pregnancy. Interviewees needed an abortion in circumstances that were similar to those of people who need abortions in the first and second trimesters.