A Dangerous Limit

Last week the U.S. House passed a bill prohibiting most abortions after 20 weeks, with only narrow exceptions for women with life-threatening conditions and for rape survivors. No exceptions are included for cases when the woman’s health is at risk or in cases of severe fetal anomalies.

Aside from being unconstitutional, legislation that disregards the thousands of variables that can arise in any given pregnancy ignores a central concern of reproductive health:

Every pregnancy is different.

When a woman finds out she is pregnant, her universe explodes with questions and unknowns: How far along am I? What will this mean for my family? My health? My job?

Can I afford this? Do I want this? Is the fetus healthy? 

“There has never been—and never can be—a one-size-fits-all answer to navigating such variables,” says Angela Hooton, vice president of the U.S. Policy and Advocacy Program at the Center for Reproductive Rights. “Blanket legislation like this 20-week ban intrudes on the importance of these questions as well as on a woman’s constitutionally protected right.” 

While the overwhelming majority of abortions take place before 20 weeks, there are a number of situations and circumstances that demand more time to become clear.

“The women we serve for abortion care past 20 weeks present with a myriad of complex situations,” says Texas reproductive health provider, Amy Hagstrom Miller, CEO of Whole Woman’s Health.  “Some women don’t find out they are pregnant until much later than others. Some women need time to save money to end their pregnancy. Some women’s life circumstances change drastically during the course of their pregnancies. No matter the reason, women need access to safe, compassionate care.” 

Hagstrom Miller adds, “We also see women who face logistical challenges such as arranging child care and getting adequate time off work to both negotiate the web of state-imposed abortion restrictions—such as two-trip waiting period requirements and limited clinic access—and make time for a healthy recovery. When anti-choice legislation shuttered more than half of Texas’s clinics last fall, we saw women forced to wait up to four weeks just to get an appointment.”

Other women, like Whitney, are confronted with the news of a difficult diagnosis. Whitney, who lives in North Carolina—where a 20-week ban is currently in place—learned at a routine ultrasound that her fetus had a condition that would make it incompatible with life. It was four days before the state’s legal cut-off. She and her husband were unnecessarily rushed into the decision about what to do, and eventually had to travel out of state to get the care they needed.

“There are more considerations than you can imagine when it comes to a pregnancy,” says Hooton. “No politician under the sun could anticipate every single one, and that is why abortion bans are both unnecessary and dangerous. These complex and personal decisions must be left to each individual woman and her trusted health care provider.”

The conversation surrounding abortion limits and the definition of “viability”—as laid out by several landmark U.S. Supreme Court cases—intensified last week following the publication of a study citing that in certain cases, groundbreaking medical interventions have allowed for infants born as early as 22 weeks gestation to survive outside the womb.    

“These are remarkable advancements,” notes Hooton. “They underscore just how unique and individual the meaning of viability is for each patient. This is exactly why it is essential that the full range of reproductive health services must be accessible to everyone who needs them without the intervention of politicians.”