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). Although 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. However, research suggests that the reasons people need third-trimester abortions are not so different from why people need abortions before the third trimester.
The Two Primary Pathways
There are two pathways by which people come to need a third-trimester abortion: new information and barriers to abortion before the third trimester. These circumstances often overlap with the pathways to abortion at other gestations. The reasons include:
- They received new information—including that they were pregnant—that made the pregnancy not (or no longer) one they wanted to continue.
- They 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.
Pathway 1: New Medical Information
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 interviewee, Kara, explained regarding her experience: “Brain development happens so much in the last second trimester and early third trimester that they really could not confidently tell us more [at those earlier scans].” Simply put, she could not have known the severity of this fetal health issue earlier in pregnancy.
Pathway 2: Barriers to Earlier Access
Many individuals face significant logistical and financial hurdles. As a participant named Victoria explained, “My boyfriend was working odd jobs, and I don't have a job, and we were homeless on the street. So, I mean, we would have definitely tried, and we, you know, did try, but there was no way that we could get a couple hundred [dollars], let alone a grand, if not more.” These findings demonstrate that while third-trimester abortion may be exceptional in its cost and clinical complexity, the reasons people need care are not.
Study Design and Data
Katrina Kimport interviewed 28 cisgender women who obtained an abortion after the 24th week of pregnancy. 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 | 24 weeks to 35 weeks LMP |
| Employment Status | 8 were unemployed (including one who was homeless) |
Implications for Reproductive Healthcare
Respondent experiences illustrate the limitations of the social and legal organization of abortion care by gestation. While third-trimester abortion is relatively uncommon in the United States compared to first-trimester abortion, these findings point to the value of understanding abortion as a need throughout pregnancy. Instead of a focus on gestation or trimesters, these findings make a strong case for conceptualizing reproductive care based on individual circumstances and the inherent limits of medical knowability.